DDS Releases New Draft of Parental "Share of Cost" Plan Requiring Families to Pay Portion of Regional Center Community-Based Services

SACRAMENTO -  The Department of Developmental Services released this morning a new draft of an implementation plan to require parents of children with developmental disabilities between the ages of 3-17, to pay some portion of their regional center funded community-based services.   The controversial plan, as previously reported, now attempts to mitigate several of the major concerns raised by families, with some advocates praising the Department of Developmental Services for being "responsive", though withholding final judgment on the new proposal.  The plan requires approval from both houses of the legislature and the Governor.

The new draft proposal is still likely to be opposed by other advocates as a "trojan horse" that they claim will eventually result in forcing families to pay a greater portion of costs than what is currently proposed. The Department of Developmental Services however has said it believes the new proposal protects families while also implementing ways to help contain costs so that "core services" needed by people with developmental disabilities can be maintained.

The new plan, would be implemented locally by the regional centers, and would cover families whose incomes were at or above 400% of the federal poverty level (about $70,000 for family of four) on a sliding scale. The plan would also only cover certain specific services used by the family:  respite, day care and camping.  All other services funded through the regional centers are not included in the the current family share of cost plan.  The new plan does not call for any "enrollment fee" for regional center services.

Cost Savings And New Regional Center Operations Positions
The Department of Developmental Services projects only modest savings in the first year of the plan, assuming it is approved as drafted, of $570,000 in the 2004-2005 budget year, though growing to $3.1 million 2005-06 and $3.5 million in later years.
The Department reported that an increase in funding for regional center operations would be needed to implement the new plan:
* 2004-2005 budget year: $570,000 and 11 positions needed to perform assessments needed at the regional centers, beginning January 2005.
* 2005-2006 budget year: $912,000 and 18 positions needed to continue initial assessments and begin re-determination process for those families phased in the year before
* 2006-2007 budget year: $770,000 and 15 positions (approximately) needed for on-going functions

Who Is Directly Impacted By Current Family Share of Cost Proposal
* Families at or above 400% of the federal poverty level (though the actual financial impact varies on a sliding scale), with children between the ages of 3-17 years (and who are not on Medi-Cal).  The Department of Developmental Services estimates that 48,000 persons with developmental disabilities fall within that age group who receive regional center services - and of that, about 26,000 children are covered by Medi-Cal and would be exempted from the family payment requirement.  The remaining 22,000 children would - at least initially - fall under the requirements of the plan (many of those would end up being exempted due to the family income requirements).
* Community-based organizations who provide respite, day care or camping services for children with developmental disabilities
* Direct care staff who are employed directly by the family as their respite workers

Family Income Level Targeted
* The current plan would apply to families whose annual gross income is 400% or more of the federal poverty level (about $70,000 for family of four), as adjusted by family size - and would be on a sliding scale basis from 5% at 400% of the federal poverty level to 80% participation at 1300% of the federal poverty level and higher.
* The assessment to determine who would be required to pay, would be adjusted to recognize a family with two or more children in the home, receiving one more more of the "targeted services" - by off-setting the cost for the second child by 50%, the third child by 75% and making no assessments against the services for any additional children after that.
* A similar off-set would be made for families with children in 24-hour, out of home placement who also pay a parental fee to the State.
* The Department of Developmental Services would develop "simplified" assessment tools to be used by the regional centers in determining what families would be required to pay - and at what level.
* The Department would also establish audit tools to ensure compliance, including procedures on collecting family financial information, computing the contribution of families,

How This Plan Would Impact Families
The Department of Developmental Services outlined several scenarios on how the plan would work - though this has not been verified either by advocates or others:
* Example 1:  A family of 4 persons (including parents, and two children ages 3-17) one child with developmental disabilities residing in the home, is authorized in their child's individual program plan (IPP)  for 60 hours every three months for "vouchered" respite services.  The family's annual gross income is $73,600 which is 400% above the federal poverty line.
What the family would pay:  this family would be obligated to pay for 5% of those 60 hours (or 3 hours every three months). The regional center would be required to fund the other 57 hours per quarter.  Using current hourly rates budgeted for vouchered respite ($8.57), the family would be required to pay $25.71 every three months for that service - or $8.57 a month.
* Example 2:  Same family size and composition as in example 1, with same income level, but is authorized for 72 hours of  vouchered respite services every three months, even though the family indicates it needs 90 hours per quarter.  The regional center determines that limiting the authorized hours at 72 would not be harmful to the health and safety of the child.
What the family would pay:  The family would be required to pay for 5% of the 72 authorized hours or four hours every three months of the vouchered respite services, or $34.28 per quarter. The regional center would fund the other 68 hours.
* Example 3: Same family size and composition as in example 1, with same income level, but is authorized for 90 hours per quarter for vouchered respite services.
What the family would pay:  The family would be required to pay 5% of the 90 authorized hours or 5 hours every three months (amounting to $42.85 per quarter).  The regional center would be required to pay the remaining 85 hours per quarter.
* Example 4: A family of five (parents, with three minor children), one child with developmental disabilities residing in the home, is authorized for 72 hours per quarter for vouchered respite services.  The family's annual gross income is $280,000 which is 1300% over the federal poverty level.
What the family would pay: The family would be required to pay for 80% of the 72 hours (or 58 hours and amounting to $497.06 per quarter).  The regional center would be required to fund the remaining 14 hours per quarter.

Accessing the Full Report on The Web
The fulll report can be found at the Department if Developmental Services'  website at:  http://www.dds.cahwnet.gov/0405proposals/Proposals_Home.cfm
or at the Caliufornia Disability Community Action Network (CDCAN) website at www.cdcan.org

Background
* Last year, January 2003, former Governor Davis initially proposed a plan for parental co-payments that would have required families at or above 200% of the federal poverty level (about $36,000 for a family of four)  to pay 100% of their regional center funded services up to $5,000.  There was no sliding scale or other mitigating factors, and the plan was fiercely opposed by families and other advocates in hearings last year that drew thousands of people last April.
* As a compromise, the Assembly later approved the general concept of a parental co-payment or share of cost plan, to take effect July 1, 2005, that would require parents with a child with developmental disabilities between the ages of 3-17 years, and with incomes at or above 200% of the federal poverty level (about $36,000 for a family of four) to pay some portion of their regional center funded services.  The Senate later agreed to the plan, which also required the Department of Developmental Services to submit to the Legislature on April 1 this year, a draft implementation proposal, with specifics details.  The Legislature reserved the right to modify, reject or accept the plan.
* The Department of Developmental Services held one statewide community meeting to hear input and comments on the proposed concept, on December 2.  They also heard additional public comment in a California Disability Community Action Network Townhall Telemeeting, held on December 12.  In additional the Department of Developmental Services received many written comments from advocates and families.
* The Department of Developmental Services released an initial draft plan in early March, though without the specific income level requirements - and specifics on what services would be impacted.  The draft plan was met with initial opposition from many advocates.  A final draft plan to the Legislature was due on April 1 - but was delayed until April 9 due to the time needed for review within the Schwarzenegger Administration.

NEXT STEPS
* A special panel of the Assembly Budget Committee is scheduled to meet April 15, Thursday morning upon adjournment of the Assembly floor session, to continue its look at the broad oversight issues relating to regional center funded services - including the parental/family share of cost plan and its implications in savings for the state.  Other issues will be reviewed at that special meeting, which is not a hearing - and follows up on an earlier meeting held on March 11.  The meeting will also review the current draft of proposed statewide limits on regional center  funding for community-based services and supports, regional center operations, and regional center director salaries.  In addition, the Department of Developmental Services is required to report back on specific questions raised at the March 11th meeting - including specifics on costs savings and cost shifting of several of the proposed reductions.
* Budget hearings on developmental services - including the parental/family share of cost plan are scheduled for April 19th (Monday afternoon at 1:30 PM) by the Senate Budget Subcommittee and April 26th (Monday afternoon at 4:00 PM) by the Assembly Budget Subcommittee.

URGENT - CONTRIBUTIONS NEEDED TO CONTINUE EFFORT
As  of 4/8/04, many many, thanks again,  to the friends, people with disabilities and their families, community organizations and others who have sent in generous and needed contributions and donations.  As mentioned before, individual thank you letters are now being sent out (due to workload have been delayed!). However, until grant funding is finalized, contributions from people and organizations is still very urgently needed to keep the advocacy efforts going for the next several months. Please make check or money order  to:  California Disability Community Action Network  (or abbreviate CDCAN). CDCAN is not yet a non-profit organization (work on this will have this happen in within the next few months) Send contributions to: California Disability Community Action Network,  1225 8th Street Suite #480, Sacramento, CA  95814.  A method to contribute by credit card (through Paypal) is NOW set up on our website, at www.cdcan.org.