OVERVIEW OF THE DEVELOPMENTAL DISABILITIES SERVICES SYSTEM

The developmental disabilities service system in California was created by the state Legislature through the Lanterman Developmental Disabilities Services Act (Lanterman Act). This Act establishes the structure and principles of California's developmental disabilities services system. It also defines the roles and responsibilities of the Department of Developmental Services (the Department), the regional centers, and other involved agencies.

Approximately 98,000 persons with developmental disabilities are clients of the service system. The term "developmental disability" is defined in the Lanterman Act as a substantial handicap, originating before the age of 18, due to mental retardation, cerebral palsy, epilepsy, autism or other handicapping condition requiring treatment similar to that for mental retardation.

The Department administers the service system through contracts with 21 private, non-profit regional centers and through the direct operation of seven state developmental centers (formerly known as state hospitals). Located throughout the state, the regional centers serve as the single point of entry into the system, including admissions to the developmental centers. (See Appendix F for the locations of regional centers and developmental centers.)

PURPOSE OF THE LONG-RANGE PLAN 1990-1995

The Department has prepared the Long--Range Plan 1990-1995 (LRP 90-95) to guide and encourage a positive, coordinated response to service needs for persons with developmental disabilities over the next five years. The LRP 90-95 describes significant issues facing the developmental disabilities service system in California and proposes goals and objectives to address and resolve those issues.

The Department offers the LRP 90-95 as a tool for directing the service system toward excellence. We hope that this document will serve as a focal point for communication, planning, and coordination throughout the service system, and as a primary statement of the Department's dedication to improving the lives of the persons it serves in accordance with the Lanterman Act.

This plan, like its predecessors, is not mandated by any law, regulation, or other requirement. The Department initiated this series of long range plans voluntarily, in recognition of the importance of long-range planning for moving the service system toward desired goals. It is the result of a careful process undertaken to identify the most important issues in the developmental disabilities service system and to decide the best ways to resolve those issues. It will serve as a blueprint for action and as a guide for change in the years ahead.

The LRP 90-95 is an extension and refinement of the previous plan, the Long-Range Plan 1988-93. This plan continues the direction and goals of the LRP 88-93. Many objectives from the prior plan have been modified significantly. Objectives were added or reformulated to build upon previous accomplishments, to reflect new ways of dealing with barriers that hindered those accomplishments, or to more closely reflect changing emphases in goal areas. The previous two goals for prevention and early intervention have been merged. A chart summarizing the correspondence between the LRP 88-93 and the LRP 90-95 is included as Appendix B.

The implementation of the plan will occur through the normal budgetary, legislative, and administrative processes. Objectives that require new resources or authorizations will be submitted for formal approval in the form of budget change proposals, legislation, or both. Completion of plan objectives will depend upon the Department's success in acquiring these approvals. Budgetary constraints or legislative disapproval will require postponement or modification of objectives.

The Department's emphasis in Goal 1 is to provide an array of community residential services that is flexible enough to meet the needs of a diverse regional center population. Goal 1 emphasizes ways of ensuring that adequate numbers and types of out-of-home care will be available when they are needed.

Objectives under this goal seek to strengthen and expand community residential resources in a variety of ways. These include implementing the final phases of the Alternative Residential Model, continuing to provide community living options for clients who reside in the state developmental centers, increasing the number of clients who can live independently in their own home, developing foster family placements for children, developing alternative community-based residential programs, marketing the availability of various financing opportunities to attract potential providers, developing housing on land at the state developmental centers, and providing technical assistance to handle disruptions in the community residential system in a coordinated approach statewide.

Ensuring the quality of out-of-home care has been a major Departmental initiative for the last several years. Two principles underlie the Department's approach to quality assurance: (1) emphasize training and technical assistance to providers and staff, and (2) work cooperatively with providers, regional centers, and SDCs to refine and improve service delivery. Accomplishments have included creating statewide quality assurance standards for community care facilities in the Alternative Residential Model (ARM), developing a residential service provider training curriculum offered in community colleges, and obtaining ACDD accreditation for the state developmental centers.

@e seven objectives in Goal 2 also reflect these two underlying principles. Four objectives focus on service quality in community residential care, and three objectives are concerned with the state developmental centers. The four community-based objectives are to evaluate the ARM quality assurance (OA) process in terms of facility compliance and regional center implementation procedures; study the comparative effectiveness of accreditation processes and ARM OA in community residential facilities; evaluate the impact of ARM regulations on clients' quality of life; and complete a revised community college training curriculum for service providers. The SDC objectives are to retain ACDD accreditation of all SDCS, and to develop and implement new SDC staffing standards and guidelines to reflect the needs of the 1990s.

One of the Department's guiding principles is that children with developmental disabilities should be given the opportunity to remain in their parental homes until at least age 18, as is true of the majority of non-disabled persons. While the proportion of children residing with their families has increased over the years, the Department continues to be concerned that the system of family support services may not be adequate for keeping as many children as possible in their family homes. Because of these concerns, the Department initiated two major studies of family support services in 1987-88. The results of these studies were published in late 1989 and early 1990. One study, conducted by the University of California at Riverside, examined family support services from the perspective of the families themselves and was based upon the reports of approximately 2600 families across the state. The second study, conducted by the Department, examined family support services from the perspective of more than 225 regional center staff and board members.

Together, these studies provide a wealth of data on both the strengths and the weaknesses of systems that currently exist to support families who keep their children with disabilities at home. Material from these studies and other forums were used in developing the six objectives in Goal 3. The following actions will be pursued to enhance family support services: establishing an advisory committee to evaluate the recommendations from the family support studies and recommend actions to the department; secure foundation and other funding support for demonstrations of innovative approaches to family support; examine the regional centers' core staffing formula, with particular reference to the caseloads and responsibilities of regional center case managers; pilot-test the feasibility and cost of family-centered approaches to family support services; promote additional types and amounts of medical and dental care through a variety of activities; and compile or create informational and training materials for families of children with disabilities, and disseminate these materials for statewide use.

The objectives under this goal continue the Department's focus on the community integration of persons with developmental disabilities. For individuals of school age, the emphasis is on enlisting the support of client advocates in calling for the school system to implement the full range of its responsibilities in Public Law 94-142, Part B of the Education for the Handicapped Act. For young adults, the Department will encourage day program operators to adopt curricula which emphasize community integration and vocational placement. For state developmental centers, the Department will continue the expansion of day programs which utilize off-unit and off-campus resources in preparing clients for community integration. And for older people, the Department will study the availability and accessibility of generic services, and identify any significant gaps in the array of services. The Department itself will further the aim of community integration by publishing a policy on non-residential services in conjunction with a report assessing the status of community integration services in California. It will also evaluate the utility of the self-evaluation system that is included in the new day program regulations.

This goal reflects the Department's commitment to developing solutions to complex 5ystem problems. All of the objectives under this goal require the examination and evaluation of the Department's current methods of operation; the assessment of whether these approaches are effective and efficient; and the creation of new methods when needed. Each objective under this goal will require a major commitment of energy and creativity on the part of many people if an impact is to be made on the broad-based and complex issues each objective addresses.

Objectives under this goal include establishing an advisory group to explore avenues for improving services to clients who are members of racial or ethnic minority groups; maximizing the use of federal funding; monitoring state developmental center (SDCS) populations and beginning to consolidate populations on single-purpose campuses; establishing an advisory group to make recommendations about ways of meeting future needs for SDC services; consolidating community resource development and client placement activity into one planning process; developing a training program in new program development and needs assessment; developing better ways of using data for planning; proposing statutory language to the Legislature to establish a preferred method of establishing residential rates; assessing public information programs; and encouraging research to improve the prevention, care, and treatment of developmental disabilities.

Both the human and the fiscal costs of preventable developmental disabilities to the citizens of California can be reduced below their current levels. Prevention and early intervention for persons with developmental disabilities therefore remain top priorities of the Department and the Health and Welfare Agency.

Goal 6 recognizes that prevention and early intervention resources currently exist throughout the service system, and focuses on the need to coordinate these resources, both inside and outside the Department. The regional center prevention programs serve as key axes for the transfer of information and service at the local level. These programs have made significant progress in educating the primary infant care professionals who advise parents about the choices and possibilities facing them and their infants. Regional centers offer genetic screening services to families in the community, and all new clients are screened for risk factors that contribute to preventable handicaps. The Department is conducting public information campaigns on topics that include drowning prevention, bicycle safety, prenatal care, and alcohol and drug abuse. The Department also monitors prevention activities and maintains a statewide prevention plan that is periodically updated to reflect current needs and the latest technology.

The Department has taken a central role in the area of early intervention, serving as the lead agency for the administration of federal funds appropriated through Part H of Public Law 99-457, Amendments to the federal Education of the Handicapped Act. During the last planning period, the Department selected 26 organizations across the state to coordinate local early intervention service planning efforts, and established a statewide technical assistance network. A complex research agenda was completed by the Department in order to determine California's early intervention service and outreach needs. A comprehensive cost evaluation study was also conducted to identify the fiscal impacts of fully implementing federal early intervention requirements.

This Long-Range Plan includes seven objectives that build upon these earlier efforts in the area of prevention and early intervention. These objectives ensure the continuation and improvement of outreach, genetic screening services, and public and professional information activities; the revision of the statewide prevention plan; the development and implementation of an automated information reporting system uniquely designed for monitoring prevention activities and trends; provision of technical and financial assistance to local agencies for the improved coordination of early intervention services; maintenance of a statewide early intervention technical assistance network; provision of information and analysis to the Legislature on alternatives to participation in Part H of the federal Education of the Handicapped Act Amendments that would improve on the state's early intervention system; and completion of the research necessary to determine the fiscal and programmatic impact of fully implementing the federal early intervention requirements of the statewide system.