Understanding California's Regional Centers: From Yesterday To Today And Tomorrow Amy Westling, Executive Director Association of Regional Center Agencies

Today We’ll Cover The history of developmental services in California; What the service system looks like today; and, Issues on the horizon that may shape services in the future.

In the Beginning

The Early Days California began opening state-run institutions for individuals with disabilities in the mid to late 1800’s. By the 1960’s California had over 13,000 individuals with developmental disabilities in institutional care, with thousands more on waiting lists for admission.

Things Begin to Change Eunice Shriver Kennedy drew national attention to the issue of individuals with disabilities. In a 1963 speech, President John F. Kennedy noted that in caring for individuals with disabilities, “we have to offer something more than crowded custodial care in our state institutions.”

Families Take the Lead in California Three parents and a reporter for the Orange County Register visited Fairview State Hospital in the early 1960’s. This led to hearings and investigations. A group of parents organized and demanded other options.

Building Momentum A 1965 report summed up the issue as, “The heart of the problem is that most families who are unable to care for their [intellectually disabled] child at home have no choice other than to place the child in a state hospital.”

A Potential Solution In 1966 the first two regional centers were opened, one in Los Angeles and the other in San Francisco. The goal was to provide an alternative to institutional care to meet each person’s unique needs. In 1968 a study found these to have been a success.

Statewide Expansion Assemblyman Frank D. Lanterman introduced AB225 in 1969 to expand regional centers statewide. The system was a public-private partnership that created services that reflected the needs of each community to fill in the gaps in existing services and supports. In 1978, the 21st regional center opened.

Important Developments In 1973 Assemblyman Lanterman wrote legislation to expand regional center services to individuals with cerebral palsy, epilepsy, autism, and other conditions closely related to intellectual disability. In 1983 California begins to receive federal funding for the regional center system.

Important Developments Continued In 1985 the California Supreme Court ruled that the Lanterman Act “defines a basic right and a corresponding basic obligation . . . [T]he right which it grants to the developmentally disabled person is to be provided with services that enable him to live a more independent and productive life in the community; the obligation which it imposes on the state is to provide such services.”

Important Developments Continued A 1993 out-of-court settlement required more than 2,000 residents from the state-run developmental centers to be placed into the community over a five-year period. Since that time, Stockton, Camarillo, Agnews, and Lanterman Developmental Centers have closed, with plans underway for the closure of Sonoma, Fairview, and a portion of Porterville Developmental Center.

Where We are Today

California’s Regional Centers Now 21 regional centers now support more than 300,000 individuals with developmental disabilities. Each regional center is an independent non-profit overseen by a volunteer Board of Directors Approximately half of individuals are adults and half are children.

Three Major Goals Help infants and toddlers to catch up to same age peers; Help children to remain in the family home; and, Help adults to be as independent as possible.

Exploring Individual Needs The planning process for each individual includes: Determining hopes and dreams; Setting goals; Exploring available resources; Purchasing services to meet remaining needs; and, Monitoring progress.

Person-Centered Planning “The person-centered service plan must reflect the services and supports that are important for the individual…as well as what is important to the individual...”

Paying for It All Total community-based budget: $6.4 billion (FY 2016-17) Total federal reimbursement: $2.6 billion Federal share: 41%

Trends Impacting the System Higher autism rates; Individuals living longer than their aging family members can support them; Individuals with multiple diagnoses; Increasing diversity within the state; and, Increased focus on individualized services.

The System of Tomorrow

What is Community? “Community” used to mean just not institutional. Then, “community” was a standard only applied to where people lived. There were rules about what it meant to be “homelike.” Now, “community” means services must be integrated in and support full access to the greater community.

What is Work? Work means more than just a paycheck. There have been changes at the state and federal level to work expectations in the last few years.

Ongoing Developmental Center Closures New models of care to support people with complex medical and behavioral support needs; and, Enhancing safety net services.

Self-Determination Program Designed to give individuals and their families more choice, responsibility, and control; Person-centered thinking and planning as central; and, Pending federal approval.

Other Challenges The cost of business in California; Housing costs; and, Old funding models.

Federal Uncertainty Affordable Care Act; Medicaid funding; Tax reform efforts; and, Policy changes.

Supporting Diverse Communities Language access; Cultural norms; Service restrictions; and, Community partnerships.

For Further Questions Association of Regional Center Agencies www.arcanet.org (916) 446-7961