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Why the Lanterman Coalition 10% Initiative is Important

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I’m sure you have heard all the talk, seen all the social media posts asking for a 10% increase and to Keep the Promise!   We’ve heard the system is in crisis and we are about to lose our entitlement.  But what does that really mean and why are we in a crisis now?  Haven’t we always been in a crisis?  Hasn’t the Lanterman Act been historically underfunded?  If there is a budget surplus, doesn’t that mean that there won’t be any more cuts and we can sustain?  This is a crisis that has been building for years and to really understand where we are at now, it is important to look at the history of the Lanterman Act.

 

lantermanAfter much pressure from a group of parents to bring services for people with developmental disabilities out of the institutions and into the community, Assembly Bill 691 authored by Assemblymen Jerome Waldie and Frank D. Lanterman was signed in 1965 establishing two pilot regional centers serving people with mental retardation.  These two regional centers served 559 clients.  In 1969, the Lanterman Mental Retardation Act is signed by Governor Reagan expanding the regional center system throughout the State of California.  A few years later in 1972, the regional center services were expanded to include other developmental disabilities.  In addition to persons with mental retardation, the centers are now mandated to serve people with cerebral palsy, epilepsy, autism and other neurological handicapping conditions closely related to mental retardation.  The last regional center was also established with 21 regional centers throughout the state, serving 33,833 clients.

By the end of the 1980’s, the regional centers are serving 92,000 clients and the state hospital system population has been reduced to 6,700.  Serious budget deficits cause the Department of Developmental Services to reduce funding for regional centers, forcing some regional centers to implement cost- saving strategies such as waiting lists and categorical cuts in services.  However in a landmark court case, the California Supreme Court rules that the Lanterman Act “defines a basic right and a corresponding basic obligation….. services are to be determined through the individual program planning process and provided as an entitlement.” This is the first time that the Lanterman Act is referred to as an entitlement and is important to understanding the problems we face today. The Court prohibited the use of cost-saving strategies such as waiting lists, and other strategies that were proposed by the defendant regional centers.  The Court further ruled that if regional center budgets are not sufficient, DDS must inform the state legislature which must in turn either increase funding or statutorily change the entitlement.

In the early 1990’s, the national recession hits California and the state budget deficit is more than $15 billion.  All state budgets are subject to “unallocated reductions” in their budgets.  Regional Centers’ total unallocated reduction is more than $31 million.  During this time California begins the implementation of the California Early Intervention Services Act requiring statewide services for eligible infants and toddlers from birth to 36 months, further adding to the Regional Center services and caseload.   The mid 1990’s bring even more budget reductions to regional centers totaling more than $113 million.   In 1999 an increase in $207 million (17.7 percent) for community services is approved however the previous cuts imposed on regional centers were never restored.  Regional centers are overwhelmed with unfunded mandates, rising expectations of consumers and their families, and an inability to retain an adequate number of employees.

In 1999, a report by the Bureau of State Audits concludes that the budget and allocation process used by the Department of Developmental Services to fund regional centers does not ensure that clients throughout the state have equal access to needed services.  The report concludes that the success of the regional center system has been undermined by insufficient state funding and budget cuts.  In additional an outside agency called Citygate Associates is commissioned to conduct a legislatively mandated study of the budgeting methodology for funding regional centers.  A conclusion of the report is that the regional center system is dramatically underfunded for what they are legislatively and contractually required to do.  No action is ever taken.

In a November 2000 survey of regional centers finds that virtually all centers cite their inability to hire and retain an adequate number of service coordinators and other key positions as their chief problem.

In 2006, the California Legislature approves a long-awaited across the board increase in rates to selected service providers.  While supported employment programs receive a 24% increase, most programs only receive a 3% increase.  This provides some acknowledgement of the chronic underfunding of the community service system. However in 2008, Supported employment programs were decreased by 10% and that funding has never been reinstated despite increased costs of wages, benefits and insurance.

Currently regional centers serve over 210,000 people at an annual cost of $3.2 billion.  Fewer than 3,000 people still reside in the five state developmental centers.  We have a system that has the potential to be the best in the nation at providing for our population with disabilities; however we spend less to support this population than most other states in nation.  California can no longer assure the federal government that sufficient services and support are available to ensure the health and safety of Californians with developmental disabilities, putting our federal funds at risk.

Funding levels for California’s community based developmental service system have fallen dramatically in the last two decades, with over $1 billion in cuts during the five years of the Great Recession.  This has left our system seriously underfunded.  The average investment nationally is more than double California’s expenditures.  Also as part of our entitlement, California does not artificially limit the system’s enrollment through waiting lists, so a greater percentage of its disabled population receives developmental services than in most other states.

Since the beginning of 2011, the State has lost 435 homes that were available for adults with disabilities through forced closures due to lack of funds.  Also more than 57 day and work programs have closed their doors and 15 supported living programs have stopped providing this service.

The Lanterman Act promised individuals with developmental disabilities and their families a more personalized alternative to large, state-run institutions and a system that would promote independence and community integration.  However due to systematic underfunding and the lack of any commitment from the California Legislature to solve this issue, this promise has not been kept.  The federal government has laid out similar expectations for developmental services nationwide.  All states must ensure that by March 2019, they provide services and support planning that will offer ready access to the broader community.  Services provided in segregated settings will no longer be eligible for federal reimbursement.  There is also a renewed emphasis on making work opportunities available for adults with developmental disabilities.  While these system changes are very positive, they cannot be sustained without adequate resources.

The Lanterman Coalition approach to rebuilding California’s community-based service system is as follows:

1.        Provide community service providers and regional centers with a one-time 10% increase in funding to help stop the further decline of the system.

2.       Work to reform funding for service rates and regional center operations to ensure that funding levels are adequate and sustainable.

3.       Add a provision for annual 5% funding increases to the system until the funding reform strategies can be implemented.

As you can see, the State of California has not kept its promise to people with developmental disabilities.  It is important for everyone to educate the legislators on these issues.  The history has been lost in the system and we have not had a Frank Lanterman in the legislature to champion for the rights of people with disabilities in a long time.  I hope this helps you understand better the crisis we are facing and do your part to make your voice heard.

Sources:

http://www.rcocdd.com/wp-content/uploads/pdf/aboutrcoc/40thHistoryBrochure-r2.pdf

On the Brink of Collapse – report from Association of Regional Centers (ARCA)