More than 420,000 Californians with intellectual and developmental disabilities (IDD) live in California; they are our neighbors, classmates, coworkers, family, and friends. However, their support structure has been grossly underfunded for more than two decades. Direct Support Professionals (DSPs) are quitting the field or working multiple jobs due to low wages, and, because of this, essential programs are closing throughout the state. There is now a critical shortage of accessible and affordable housing for adults with disabilities, and individuals are forced to live with inadequate support or with no support at all.
Californians with disabilities aren’t being supported to find jobs or participate in the community because there aren’t enough DSPs in the workforce. As a result, many parents and family members are forced to quit their jobs. Regional Centers can’t hire enough service coordinators to help find additional services for the individuals they serve and their families. In addition, the reimbursement rates that fund our industry are in desperate need of updates to ensure outcomes are aligned with incentives. This year’s California Regional Centers (21 combined) had approximately $1.6 Billion in unspent “Purchase of Service”. These are funds that could have been used to support Californians with IDD. This is the backdrop for California’s IDD community as the 2024 state legislative season begins. In early January, Governor Gavin Newsom released his 2024-25 proposed state budget.
As we navigate the landscape of challenges in our industry, I wanted to take a moment to provide you with my perspective on Governor Newsom’s January Budget Proposal for 2024-2025. I want all of our stakeholders to understand its potential impact on Home of Guiding Hands (HGH), as well as our organization’s involvement in crucial advocacy efforts.
Overview of Governor Newsom’s January Budget Proposal:
Governor Newsom’s recent budget announcement, amidst a projected $68 billion shortfall, has raised concerns about the potential impact on Home of Guiding Hands, the individuals and families we support, and our community.
The Governor’s proposed fiscal and policy changes that impact our industry are:
Fiscal / Budget:
- Service Provider Rate Reform: The proposal aims to return to the original timeline of July 1, 2025, for the full implementation of service provider rate reform. This is coupled with a focus on improving outcomes and service quality through the Quality Incentive Program.
- Preschool Inclusion Grants: There is a proposed delay of $10 million General Fund annually from the Preschool Inclusion Grant program until 2026-27.
- Developmental Services Master Plan: Over the next year, the Department of Developmental Services (DDS) will develop a Master Plan for Developmental Services. This plan aims to create a more quality-driven and consumer-friendly experience for individuals and families receiving developmental services. A workgroup of key stakeholders will be convened to inform the development of the plan, with a specific focus on a program management system to collect and analyze data. This group will emphasize on quality, equity, and outcomes, while improving regional center accountability.
CEO’s Perspective on the Budget Proposal:
The delay in the implementation of the Service Provider Rate Reform until July 1, 2025, instead of the initially planned date of July 1, 2024, carries significant implications, particularly for the IDD population. This delay has far-reaching consequences, with potential adverse effects on organizations like Home of Guiding Hands. The impact is particularly troubling financially, considering the challenges in retaining, attracting, and compensating competitive wages for quality staff, a struggle not unique to this sector but resonating across various industries.
Organizations providing services to this vulnerable population are already grappling with the complexities of ensuring a skilled and dedicated workforce. Postponing the rate increases further exacerbates the existing challenges these service providers face. One of the critical issues at the forefront is the difficulty in retaining qualified personnel, let alone attracting new talent, due to financial constraints.
The delay in rate reform directly affects the financial stability of service providers, impeding their ability to offer competitive wages. As with any business, attracting and retaining skilled staff is essential for maintaining a high standard of service. For organizations supporting the IDD population this is paramount, as the quality of care and support provided greatly depends on the proficiency and commitment of the staff.
Home of Guiding Hands, along with other similar entities, finds itself in a precarious position. The postponement of rate increases disrupts the anticipated financial planning and projections, making it challenging to allocate resources effectively. The ripple effect extends beyond the immediate financial impact on service providers; it directly impacts the individuals and families relying on these services.
Last year, regional centers collectively held approximately $1.6 billion in unspent Purchase of Service funds, and a significant contributing factor to this surplus was the shortage of staff among vendor partners. This surplus reflects not an abundance of resources, but rather an inability to fully utilize allocated funds due to staffing challenges. The delayed rate reform exacerbates this issue, creating a bottleneck where allocated funds cannot be optimally utilized for the benefit of the IDD population.
In essence, the postponement of the Service Provider Rate Reform undermines the ability of organizations like Home of Guiding Hands to address critical staffing needs, hindering their capacity to provide quality care and support to individuals with IDD. As a result, the delay not only impacts the financial health of service providers, but also jeopardizes the well-being of those dependent on these essential services. It is crucial for policymakers and stakeholders to recognize the urgency of addressing these challenges. These individuals need to work towards ensuring the timely implementation of reforms to safeguard the interests of the IDD population and the organizations dedicated to their care.
These changes are not just numbers on a page, but they have real-life implications for the individuals and families we support. They could mean the difference between having access to quality services or being left behind. They could mean the difference between realizing one’s full potential or being held back by systemic barriers. They could mean the difference between hope or despair.
Advocacy Efforts and Involvement in the Lanterman Coalition and CDSA:
As a member of the Lanterman Coalition, I am proud to be part of a community that represents tens of thousands of stakeholders in California’s intellectual and developmental disabilities (IDD) community. We are united by a common goal: to ensure a viable and sustainable IDD support system that is inclusive, equitable, and just.
The three strategies proposed by the Lanterman Coalition regarding this budget freeze are not just a set of recommendations, but a call to action:
- Regional Center Capacity.Update and keep current regional center staff funding to bring California into compliance with federal commitments on caseload ratios.
- Workforce Capacity. Honor the commitment to fully implement the rate models on July 1, 2024. Update the rate models to 2024 costs (including consideration of new state wage floors for competing industries) prior to implementation. Standardize an annual adjustment so that individuals continue to have access to the direct care staff on whom they depend.
- Align Rate Structure with Desired Outcomes. Rate reform is underway and there are areas that need refinement to avoid unintended, potentially harmful repercussions to people with IDD. Solutions include: 1) Maintaining current billing units instead of transitioning to hourly units; 2) Developing sustainable transportation rates; 3) Incentivizing competitive individual employment; 4) Expanding affordable housing options; and 5) Including innovative services, maintaining appropriate staff credentials, and fairly measuring outcomes.
I am deeply moved by the dedication and commitment of the California Disability Services Association (CDSA) to support and empower people with intellectual and developmental disabilities and their families. As a member of the CDSA Board, I share their vision of a world where every Californian, regardless of their abilities or disabilities, has access to quality services and support.
Californians with disabilities and their families are relying on the State to keep its commitment to investing in their services, while still living with the long-term effects of chronic underfunding. This is not just a matter of numbers, but a matter of human dignity and compassion. Even in this budget reality, the state can continue to improve outcomes and individual experiences by removing barriers to service availability. We can make the most of every dollar already allocated by making funding fully accessible and sustainable with current expenses, while minimizing administrative demands that drive unnecessary costs.
It is crucial to note that this budget proposal is the beginning of a lengthy process involving discussions, negotiations with legislators, and significant opportunities for community input. Home of Guiding Hands will actively participate in these discussions, representing not only our organization, but the entire system that supports over 420,000 individuals in California.
Martin Luther King Jr. said, “Life’s most persistent and urgent question is, ‘What are you doing for others?'” If you would like to assist in advocacy action, you can find your California state legislator and start the conversation with their office about why this delay would be devastating for the individuals we serve. Your voice matters, and your proactive engagement can make a substantial impact on the decisions that will shape the future of those we support. Let’s work together to ensure the well-being and progress of our community.
Yours in service,