A message from our Executive Director
TO: Dr. Gisele Ragusa, Board President & Board of Directors, San Gabriel / Pomona Valleys Developmental Services, Inc.
FROM: Anthony Hill, M.A. J.D. Esq., Executive Director
RE: Executive Director’s Report
SG/PRC Critical Business Functions
The SG/PRC office remains open to the public on an appointment only basis. We are pleased to report that all critical functions including Intake/Eligibility, Fiscal, Clinical, Human Resources, Quality Assurance and Information Technology are at optimal levels.
SG/PRC is an essential business, according to “Essential Workforce Coronavirus Covid-19 Response”, under Healthcare/Public Health Sector as a business that supports social workers serving individuals with developmental disabilities.
In response to the anticipated surge in COVID-19 transmission, we have increased our remote workforce to 95%. We have reviewed our internal practices and are now in our “abundance of caution” monitoring phase, in that if work related tasks can be performed remotely, regardless of the tasks with the exception of intake and eligibility, supervisors are instructed to advise their direct reports to work from home and only come to the office when necessary to pick-up work-related documents. Additionally, we have temporarily suspended our policy allowing Service Coordinators to visit the office at least one day weekly for at least two weeks following the Thanksgiving Holiday, as a risk mitigation strategy to slow the spread of COVID-19 through employee contacts. All visitors to the SG/PRC office and staff are required to pass a contactless, scanner temperature check and face masks monitoring station upon entry into the building. There are no reported transmissions of COVID-19 within the SG/PRC office.
SG/PRC retains the distinction of being the only regional center in California that offers full scope intake and eligibility services throughout the COVID-19 Health Pandemic. The following reflects our data ending October 31, 2020.
Early Intervention/Intake
- 159 New Referrals
- 105 Reviews
- 100 children found eligible
Lanterman/Intake
- 36 New Referrals
- 16 Reactivations
- 47 Eligible (Including EI transitions)
As many of you are aware, Los Angeles County is experiencing a surge of COVID-19 transmissions. Recently, Los Angeles County has implemented “Targeted Temporary Safer at Home Health Officer Order” effective November 30, 2020 through December 20, 2020 (please see Attachment A). In short, this Order mandates that individuals stay at home with exceptions to travel to and from essential businesses to work or to provide work at an essential business or engage in an essential activity.
During the past reporting period, there has been a 28% percent increase in total COVID-19 cases in Los Angeles County. Hospitalizations have increased, and the overall positivity rate was 12 percent as of December 1, 2020 (see publichealth.lacounty.gov).
With regard to SG/PRC’s efforts that support our community, we are conducting check-in programs, securing and delivering PPE, conducting weekly Zoom meetings with our Service Providers and Community, and daily we are performing COVID-19 risk mitigation tasks through a multidisciplinary approach including our Nurse Advocates, Quality Assurance Staff, Leadership staff, DDS representatives and Public Health officials. The following table illustrates SG/PRC’s PPE distribution efforts throughout the COVID-19 Pandemic.
Face masks (N95 & surgical masks): 1,250,400
Gowns: 182,000
Hand sanitizer bottles: 40,176
Gloves: 668,000
Face shields: 48,384
Total number of PPE units distributed: 2,188,960
During the past two weeks, SG/PRC’s COVID-19 cases have increased 7.4 percent or alternatively stated at 20 additional new cases (please see Attachment B). There are at least 10 residential hotspots. A residential hotspot is operationally defined as a licensed setting with at least (1) positive COVID-19 testing outcome for any individual served within that setting (please see Attachment C). Also, as part of our risk mitigation strategy, we are tracking licensed settings, where only staff working in that residential or a day program setting have tested COVID-19 positive. As a result of the surge our resources including licensed residential settings, and registry staffing are nearly full or have limited remaining capacity. We are currently exploring options with partnering regional centers to expand our surge capacity.
Parents’ Place /SG/PRC Technology Lending Library
The Parents’ Place technology lending library in collaboration with SG/PRC is the first lending library created within the entire regional center system of care. SG/PRC allocated 250 iPads to Parents’ place and secured $24,000 from a resulting trust. We are thrilled to announce that individuals served are now receiving remote telehealth services that were not accessible due to economic barriers or the lack of technology.
This technology lending library is only available for individuals served through SG/PRC. Please contact your SG/PRC Service Coordinator, if you need to access the Parents’ Place Technology Lending Library.
SG/PRC Budget 19/20
Our Operation Budget (OPS) projects within our FY 19/20 Budget allocation at year-end. On November 30, 2020 we were notified by the Department of Developmental Services (DDS) that SG/PRC will receive $149,130 in OPS allocation for COVID-19 OPS expenses and subsequent claims. SG/PRC anticipates an OPS deficit in its CPP Budget due to the funding allocation applied by DDS that does not allow for claims that incorporate staff raises or annual increases in the costs for their benefits. Our POS budget shows a year-end balance of $3,257,957.
SG/PRC Budget 20/21
Our OPS allocation is $31,674,844 with current month expenditures ending October 19, 2020 representing $2,578,655 and year to date is $7,555,748 representing a deficit of $279,487. However, SG/PRC and all regional centers within the B1 were only allocated 50% of their CPP Operations Budget relying on prior year as the base. SG/PRC anticipates receiving the remaining CPP allocation in subsequent allocations throughout current year.
Our POS allocation within the B1 is $271,307,068 with year-to-date expenditures at $59,075,664 projecting at a deficit of $5,379,969 including COVID-19 expenses. We are tracking COVID-19 POS cost monthly. We are anticipating full funding in subsequent allocations as current year moves forward.
SG/PRC applied for CARES ACT (Provider Relief Funding) and received $138,953, representing 2% of the ICF/DD-SPA revenue from FY18-19. SG/PRC has modified its claim representing the full amount reported by DDS, nearly $27 million, less grant dollars received. These funds are for operations cost related to COVID-19 expenses and specific cost centers in accordance with issued guidelines.
Caseload Ratios
On September 16, 2020, SG/PRC received a letter from DDS regarding SG/PRC’s compliance with the caseload ratio requirements as expressed in Welfare & Institutions Code Section 4640 (c). SG/PRC outperformed the statewide caseload average in (5) of the (7) categories measured. SG/PRC as required by law conducted a public meeting on November 25. 2020, and incorporated input from the public within its corrective action plan. SG/PRC submitted its plan of correction to DDS and is currently awaiting a reply. Contingent upon DDS approval of SG/PRC’s plan of action, afterward, SG/PRC’s plan will be implemented and referenced within my Director’s report (please see Attachment D).
Department of Developmental Center Updates
Survey
DDS is currently conducting a survey tailored for self-advocates and family members for the purpose of gathering information and feedback regarding the impact of COVID-19 on service delivery. Please participate in the survey.
Feedback from individuals served and their family members is essential because it helps us understand what is working well and gives us insight on what is not working well within the regional center system of care in response to the COVID-19 Pandemic. This survey is located at www.SGPRC.org and at www.DDS.CA.Gov. The survey is available in threshold languages.
Participant Directed Services (PDS)
On November 5, 2020, DDS conducted a Zoom training tailored for individuals served and their families regarding Participant Directed Services. This service model is bridge between traditional services and the Self-Determination service delivery model. On March 30, 2020, DDS issued a directive expanding Participant Directive Services to include personal assistance, independent living services, and supported employment services. Participant Directive Services that remain available prior to this new directive includes respite, day care, non-medical transportation, nursing, and community-based training services. If individuals served or their family members are interested in receiving services through the Participant Service Delivery model, they should contact their Service Coordinator.
Alternative Non-residential Services
On August 31, 2020, DDS issued a directive defining Alternative Non-residential Services, including covered activities, certification procedures, and the methodology to compute service rates. On October 28, 2020, DDS issued further guidance with a requirement that claims must be supported through alternative or traditional service delivery. The goal is to encourage reengagement of services while also creating a monthly Alternative Non-residential Service rate. DDS is working with Burns & Associates (Consulting entity) and various stakeholder groups to create the new monthly rate model. Implementation is scheduled to occur effective January 1, 2021.
Holiday Gatherings
On November 25, 2020, DDS issued guidance regarding “Holiday Gatherings.” Guidance recommended incorporates risk mitigation strategies to help slow the spread of COVID-19. It encourages everyone to explore alternative and virtual options to connect with family members and others, to avoid travel, to wear face masks, and to engage handwashing for at least 20 seconds (please see Attachment E).
Association of Regional Center Agencies (ARCA) Updates
The Association of Regional Center Agencies (ARCA) represents the 21 non-profit regional centers that advocate on behalf of and coordinate services for California’s over 350,000 people with developmental disabilities. The Association functions as a leader and advocate in promoting the continuing entitlement of individuals with developmental disabilities to achieve their full potential and highest level of self- sufficiency. The Association participates in the development of public legislative policy that impact individuals with developmental disabilities and their families.
Bills with Operational Impact 2020
AB 2257- clarifies the business or employee/employer relationship that traditionally existed with independent contractors. Simply put, the California Supreme Court “Borello” test is applicable that is aligned with the “right of control” test used by the Internal Revenue Service.
The “Borello” test is controlling legal authority, if the contractor establishes their rate of pay, and remains free from control of the contracting entity, and is engaging in that work independently and publicly. AB-5 was a concern for regional centers and many business entities that rely on independent contractors. Specifically, for regional centers, AB-5 created pressure on regional centers to develop new unsustainable cost centers in Operations Budget not included in the core staffing formula, frustrating regional center’s compliance with meeting caseload ratio requirements, and existing statutory obligations (please see Attachment F).
Bills that Impact Public Health Policy
AB 1544 (Gipson) gives Counties the discretion to develop a “triage” program. If such program is developed, the County may allow paramedics to take individuals to a sobering facility or mental health facility instead of an emergency room. ARCA strongly opposed this bill, because an individual served that might present with a behavioral crisis, in fact, might have an underlying health related crisis that might go both undetected, and untreated. ARCA is currently developing strategies that will inform Counties Officials with the goal to shape local public policy should a County decide to develop a “triage” program (see Attachment G).
SB 1159 (Stern) provides worker compensation protections for workers during the period of March 19, 2020 through January 1, 2023 for a special class of employees that will be eligible for disability/worker’s compensation if they contract coronavirus within the above-mentioned time frame. There is a rebuttal presumption. Specific rules are applicable with strict timeline requirements (see Attachment H).
ARCA COVID-19 Vaccine Statement
On November 29, 2020, ARCA submitted a Vaccine Prioritization Statement to inform public policymakers on their need to prioritize Californians with developmental disabilities, their families and service providers when developing guidelines regarding the distribution of FDA and CDC approved COVID-19 vaccines (see Attachment I). As many of us are aware, Operation Warp Speed, has been effective in developing promising vaccines with high efficacy rates in preventing the infection, transmission and spread of COVID-19. On November 23, 2020 the California Department of Public Health announced membership in the Community Vaccine Advisory Committee including 64 entities. Disability Rights of California, and the State Council on Developmental Disabilities are members the broad coalition that will guide statewide public policy (see Attachment J).
In closing, we are so very thankful for the efforts and unyielding commitment of our staff, Board of Directors, Service Providers, ARCA, DDS, and Community Partners throughout 2020 with serving the SG/PRC community of individuals with developmental disabilities that we deeply cherish. We have remained united throughout. We have been very successful in managing the spread of COVID-19 through our soul force, kindness, love and countless actions demonstrating goodwill and support for each other. Our mission of serving others is… the purpose that gives us fuel to do even more for each other. SG/PRC Community have a wonderful, peaceful and restful holiday season! Stay safe and remain well!