A message from our Executive Director
TO: Sheila James, 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
Mental Health Awareness Month
San Gabriel/Pomona Regional Center (SG/PRC) welcomes May 2022, as mental health awareness month. We have lived through two years of the pandemic. We are surrounded by crosswinds of social injustice. A conflict is enduring because of mere unwillingness to talk and create space to listen and collaborate to find opportunities. We are within a sea of economic uncertainty every day. We encourage mothers who need supplemental nutritional resources for their children to hold on to faith. We know that our life’s purpose is to serve others and to be there for others. We must take care of ourselves as our foundation to serve others. We encourage everyone to carve out time in your day or during your week to engage in those things that you enjoy, that unplugs you from the stress and conditions around us. Where you can simply get lost in either reading a book, taking a walk, listening to your favorite music, dancing or watching your favorite movie and speaking the lines before they arrive. Let’s support each other through kindness, words of appreciation, and just having fun and making others smile.
SG/PRC’s Critical Business Functions
SG/PRC’s critical business functions remain unchanged from the prior month. SG/PRC is the only regional center in the state that kept its business office open throughout the pandemic and has delivered full scope in-person intake, eligibility, early intervention, dentistry, and other clinical assessments and services. Every business day we see children and their parents or guardians spending time with us, waiting in our temporary lobby, and thereafter receiving diagnostic counselling, assessments, and intake services. Many of the children that visit with us, leave us a special gift. Their painted handprint on our community tree. Demonstrating that we are a strong, resilient, and united community.
All staff and visitors are required to pass a touchless temperature screening device, wear facemasks, and practice social distancing. All staff are required to participate in the SG/PRC COVID-19 testing clinic held every week, Monday through Thursday, receiving the rapid BinaxNow Antigen test and PCR test consecutively. Also, all staff are required to disclose their vaccination status when engaged in business activities, upon entering homes of individuals served, residential facilities, skilled nursing facilities, supported living arrangements, day programs, schools, jails, and homeless shelters through relying on our electronic confirmation system, verified through our Human Resource team. Service Coordinators, Nurses, and Quality Assurance Staff are conducting in-person visits and are required to wear facemask, practice physical distancing, and follow practices detailed within the SG/PRC COVID-19 Contingency Operations Plan.
We are Setting a New Forward Looking Standard
We are committed to making our intake and eligibility process and practices more applicant and family friendly. Our first step is to abandon our use of the terms intake and eligibility to describe the process of admissions and assessments as the bridge to receive either Early Intervention or Lanterman Act Services. Moving forward our team and our process is Admissions and Assessments. “Words matter” is what many parents, advocates and several Service Providers have told me when we announced this change during our weekly Zoom meetings over the course of the past two weeks. They applauded this change through the Zoom chat feature and flooded their screens with the heart reaction feature.
You likely ask yourself why this change was made? We reviewed the dictionary definition of intake, and we found the following:
- an amount of food, air, or another substance taken into the body.
- “your daily intake of calories”
- a location or structure through which something is taken in, e.g., water into a channel or pipe from a river, fuel or air into an engine or machine, commodities into a place, etc.
- “cut rectangular holes for the air intake”
SG/PRC’s services and supports for applicants for services do not fit any of the above definitions. Indeed, our process is admissions and assessments. We intend to examine our current Admissions and Assessments practices to encourage discovery of other opportunities to better support applicants for services and their families.
Admissions/Assessment Data Third Quarter
Early Intervention
- 1870 New Referrals
- 1719 Eligibility Reviews
- 1629 Children Found Eligible
- 60 Reactivations
- 10 Transfer in
Lanterman/Provisional/Transfers
- 402 New Referrals
- 485 Eligibility Reviews
- 315 Found Eligible
- 613 Exiting EI (Eligibility Reviews)
- 299 Eligible (/EI transitions)
- 59 Provisional Eligible
- 140 Reactivations
- 56 Transfer in
(See Attachment A). Charts labeled Attachment A were created before our applicant friendly change.
SG/PRC COVID-19 Data
Los Angeles County COVID-19 positivity rate 7-day average reported as of my last report was 1.01%, and now the positivity rate is 2.64% as of May 19, 2022, according to Los Angeles County Department of Public Health. Internally we have an electronic communication system “Covidexposure”, and we have noticed a steady increase in COVID-19 positive testing outcomes with all individuals served living in several residential settings, regardless of their vaccination status. Also, President Biden has expressed a reasonable concern regarding a surge of cases occurring in the upcoming fall months, encouraged from Dr. Fauci relying on scientific models. As a proactive response, we are securing COVID-19 surge staffing registries. Also, we are developing COVID-19 surge residential living options. We will be prepared to protect the health and safety of individuals served and their families, while we remain optimistic a surge will not happen as projected.
COVID-19 Vaccine Data
SG/PRC’s vaccine data collection efforts have always remained at the top of the list of regional centers according to DDS Data at www.dds.ca.gov under COVID-19 data. May 13, 2022 is the most current update.
SG/PRC’s COVID-19 Testing Clinic
The SG/PRC COVID-19 testing clinic is open Monday, Tuesday, Wednesday, and Thursday for individuals served and their families, Service Provider staff and their families, and SG/PRC staff and their families, and general members of the community.
The clinic is held at the SG/PRC business office from 9 a.m. to 11:30 a.m. We are now offering both BinaxNow Covid-19 Antigen test, a rapid test, and the gold standard PCR test to anyone that participates in our clinic. We had a change in our laboratory partner. The California Department of Public Health has extended its testing incentive for another 6 weeks. Any time a person test at our clinic they will receive a $20 gift card and at their choice, they will receive (2) COVID-19 home test at a retail value of $18 dollars. We are so very proud of our clinic, and the SG/PRC staff and nurse through Aveanna Health, that offer a great testing experience for everyone that visits our clinic. We imagined having a clinic and we made it happen. I simply enjoy visiting our clinic everyday to admire the abundance of goodwill and the unity within our community that is demonstrated.
Personal Protective Equipment
SG/PRC has sufficient supplies of Personal Protective Equipment (PPE) for our Service Providers and individuals served and their families.
SG/PRC has partnered with Parents’ Place to distribute PPE. You can reach Parents’ Place at (626) 919-1091. Jaimie Anabalon, Quality Assurance Manager coordinates PPE distributions for Service Providers and can be reached at PPE@sgprc.org.
Sirens of Silence/Emergency Response Outreach Event
San Gabriel/Pomona Regional Center, in partnership with the Los Angeles County Fire Department, held its first Sirens of Silence event on April 30, 2022. Over 250 people participated. The SG/PRC parking lot was filled with police vehicles, fire trucks, police and fire dogs, booths with community partners, individuals served, and their families. There was music, great food (taco plates) and some attendees created their own dance floor and danced. We were overjoyed to see many smiling faces, and simply coming together under an umbrella of unity.
Community Outreach/Compliance Report
The SG/PRC Community Outreach/Compliance Director, Salvador Gonzalez has issued a report dated May 4, 2022, that includes SG/PRC’s community outreach activities that occurred during prior months covering the Foster Grandparent and Senior Companions Programs, Cultural Specialists, Board Certified Behavioral Analyst, Educational Specialist, Fair Hearings Specialist, Deaf and Hard of Hearing Specialist, and Equity Partnerships (See Attachment B).
After-Hours Response Team
Every regional center is required to have an emergency response system that ensures that a regional center staff member will respond within 2 hours to an individual served or individual acting on the behalf of the individual served 24 hours a day, and 365 days per year.
SG/PRC has an After-Hours Response Team (AHRT) of (10) staff that serve on a rotational schedule. The team is supported, at their need and discretion, through consultation with the SG/PRC Executive Management Team. The SG/PRC AHRT was recently redesigned through a project management team. The team has two lead staff, Scott Kelly ~ Residential Service Manager, and Joan Williams ~ Nurse Advocate Manager, that supports the team. The team holds diverse expertise and are highly qualified and trained to meet the emergency needs of individuals served (See Attachment C).
SG/PRC Caseload Ratio Plan of Correction
As expected, none of the 21 regional centers met caseload ratio thresholds in all areas measured. Funding to close the caseload ratio gap is trailing the problem and will be available effective July 1, 2022, in the amount of $87.5 million dollars. However, the caseload ratio gap has grown and is now estimated at 1077 Service Coordinator positions. A larger number than the amount of Service Coordinators needed when the Trailer Bill funding was enacted into law.
The plan developed by SG/PRC and its sister regional centers to optimize operations savings locally will never close the $87.5 million dollar funding shortfall. Regrettably, the caseload ratio gap will always remain because it is caused by the outdated Core Staffing Formula (CSF) that set the Service Coordinator salary at $34,000 annually. The CSF was developed nearly 40 years ago and is anchored to underlying fiscal assumptions that existed at that time and are no longer reasonable or sustainable. Also, during fiscal years 2010-2011 and to 2012-2013 SG/PRC’s operations budget was substantially reduced to mitigate the impact of the Great Recession.
Astoundingly, 13 years have come and gone since the recession, and California has a surplus of $97.5 billion dollars. None of those dollars have been allocated to address the need to fix the CSF at $21 million current year with modest investments moving forward. We believe California can do better. Service Coordinators, specialized services staff, clinical staff, resource development staff, quality assurance and fiscal teams are the heart of service delivery and is the bridge that supports people with developmental disabilities to be fully included in all aspects of community live. The equitable promise of the Lanterman Act.
We resoundingly affirm that the nearly 15,000 individuals served, and their families deserve and are entitled to community-based services that are competently delivered and encourages self-sufficiency. A fundamental right agreed to by Californians during 1969. You will find in (Attachment D) the SG/PRC Caseload Ratio Plan of Correction letter, with public input, a budget request from Assemblymember Devon Mathis to fix the CSF and letters I sent to all key lawmakers to fix the outdated CSF. We are pleased to report that Assemblymember Blanca Rubio is a co-sponsor and is advocating to have the CSF fixed. The time to do so is now.
Social Recreation Services Survey
Beginning March 9, 2022, ending April 15, 2022, SG/PRC conducted a social recreation services survey to gather information from individuals served and their families to gain insight regarding their preferred social recreational activities. SG/PRC will rely on survey outcomes to guide its resource development plan (See Attachment E).
SG/PRC’s Budget Expenditures FY 21/22
SG/PRC’s Operations allocation is $36,282,148 with projected expenditures of $35,536,351. An OPS allocation reserve is projected. SG/PRC’s POS allocation is $318,032,645, with year-to-date expenditures $198,607,537 aggregating expenditures projected and late billings reflecting $104,379,6787. A POS reserve is projected.
Department of Developmental Services (DDS)
Service Provider Audits
On April 18, 2022, DDS, in accordance with contract language, issued a letter advising that SG/PRC is required to complete (12) Service Provider audits. Within the (12) audits, at minimum, SG/PRC is required to conduct 4 billing audits, 2 cost verification or staffing audits, and 1 audit for programs that serve children under the age of 3. All regional centers are required to conduct audits of Service Providers every year. These audits are performed by internal fiscal staff with accounting and audit expertise (See Attachment F).
Liaison for Children Transitioning to Preschool or Kindergarten
On April 21, 2022, SG/PRC was informed that it has received one-time funding for 12 months to pilot school transition supports for children transitioning from Part C to Part B services as a recommendation of the California Kids Workgroup and subsequent legislative report. The letter offers specific details on the scope of duties that are required (See Attachment G).
Funding to Support Compliance with the Final Rule (HCBS)
On April 21, 2022, DDS allocated $284,109 for every regional center to support Service Providers with adjusting their service delivery philosophy and designs to align with the final regulations issued through the federal centers for Medicare and Medicaid Services for Home and Community Based Services. The final rule furthers full access to the benefits of community living for individuals served through regional center purchase of service funding. Services purchased through regional centers are matched at 50% percent federal funding or called federal financial participation (FFP). SG/PRC is required to work with its Vendor Advisory Committee to prioritize the use of the above-mentioned allocation.
DDS has identified priorities broadly. SG/PRC and its Vendor Advisory Committee are required to submit their plan to DDS before August 30, 2022 (See Attachment H).
Enhanced Service Coordination Guidelines
On April 26, 2022, DDS issued service coordination guidelines for individuals served through regional centers that have no or low Purchase of Services (POS). The dollar threshold is no greater than $2000.00. SG/PRC received funding for (5) Enhanced Service Coordinator positions. SG/PRC has filled all (5) positions. These Service Coordinators have caseload ratios of 1 to 40. There is specific entrance and exit criteria for individuals served to remain on these caseloads (See Attachment I).
DDS’ FY 2022 May Revise Summary
DDS published its Fiscal Year 2022, May Revise. There are no budget cuts. The highlights include a reduction in projected growth of the number of individuals served through regional centers at approximately 15,043 reflecting the population size of a medium size regional center per capita such as SG/PRC. Currently 371,388 individuals are served with a projected increase to 400,485 during Fiscal Year 2022-23. A hefty rate of growth statewide. Reflecting, nearly 29,000 individuals served. Approximately, twice the number of individuals served through a regional center the size of SG/PRC.
Major policy items impacting regional centers are as follows:
- $1.86 million General Fund one-time funding including $500 dollar stipends for Direct Support Professionals and a tuition reimbursement program for regional center staff that pursue an advance degree in the field of Human Services.
- Financial Management Services (FMS) is proposed to be funded outside of the Self- Determination participant’s budget.
- The criteria for the determination of a developmental delay will be lowered from 33% to 25%, consider children with fetal alcohol syndrome, and separate criteria for expressive and receptive language delays.
- The Half-Day billing policy will be eliminated.
- The introduction of a pilot program relying on remote and electronic technology to further greater independence for individuals served living independently.
- A temporary suspension of Family Fee programs.
- Retaining a 10 percent increase for Intermediate Care Facilities rates.
Major DDS policy items include the following:
- $4.4 million dollars Trailer Funding (TF) and $3.7 million General Fund (GF) supporting the creation of the Division of Community Assistance and Resolutions including 20: Fulltime positions.
- $2.5 million (TF) and $2.0 million (GF), 19: Fulltime positions to enhance data collection.
- $1.7 million dollars (TF), $1.6 million dollars (GF), 5: Fulltime positions to replace clinical software.
- Resources to support e-Signature/e-Forms $436,000 (TF) and $409,00 (GF).
Regrettably, the May Revise bypasses the Direct Support Professional workforce crisis and urgent need to accelerate the implementation of the rate reform. Also missing is the dire need to modernize the Core Staffing Formula (CSF) that underfunds regional centers operations, sustaining the growing caseload ratio gap and its perpetual erosive effects against sustainability of the regional center workforce. The SG/PRC community remains hopeful that budget policies and priorities will shift before the final Fiscal Year 2022-23 budget compromise melding reasonable and timely actions to protect the stability of Service Providers’ and Regional Centers’ workforces (See Attachment J).
Quality Incentive Program
A feature of its Quality Incentive Program, DDS is collecting data from Service Providers that employ Direct Support Professionals or Direct Service Providers (DSP) for future budget and public policy initiatives. The data collection window closes on June 30, 2022. We encourage that all Service Providers vendored with SG/PRC participate. Agencies must submit a response to every question within the survey to qualify for a one-time $8,000 incentive payment (See Attachment K).
Association of Regional Center Agencies (ARCA) Updates
The Association of Regional Center Agencies (ARCA) represents the twenty-one non-profit regional centers that advocate on behalf of and coordinates services for California’s over 380,000 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.
ARCA Response to Department of Developmental Services FY 2022-23 May Revise
On May 16, 2022, ARCA issued a written response to Senator Susan Talamantes Eggman Chair, Senate Budget Subcommittee #3 on Health and Human Services and Assemblymember Joaquin Arambula, Chair, Assembly Committee on Budget, Subcommittee # 1 Health and Human Services regarding the DDS FY 2022-23 May revise.
ARCA is supportive of the proposed one-time investments intended to support the Service Provider and Regional Center workforces. However, these proposals do not address the need to offset underlying factors driving the shortages of workers related to the Core Staffing Formula and the rate implementation scheduling.
ARCA is supportive of investments connected to equity, disaster preparedness, adjustments in the Half-Day billing practices, Financial Management Services funding for Self-Determination Program participants, sustaining rate increases for Intermediate Care Facilities, and expanding early intervention services. However, ARCA states early intervention rate models need adjustments to increase capacity (See Attachment L).
ARCA Supports – AB 2645
ARCA supports Assembly Bill 2645 – Freddie Rodriguez, refining emergency response planning, and the development of resilience centers to save lives during emergencies; including fires, earthquakes, and floods as examples (See Attachment M).
May 2022 – Executive Director’s Report (PDF)
May 2022 – Attachments (PDF)