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The Self-Determination Program & the Traditional System: Part 1

California’s Self-Determination Program (SDP), which is currently in its pilot phase, will be available to all regional center clients this coming June. Given that many individuals and families have struggled with understanding the workings of the traditional service provision itself, confusion abounds on what this new system will offer. To learn more about the traditional system, the new program, and what makes them different, I met Will Sanford, NeuroNav partner. Will has spent the last seven years helping with the roll out of the Self-Determination Program and, as a result, has a wealth of knowledge on these topics. Because there’s so much valuable information to share, we will have two articles; part 2 will be published in the next edition of the NeuroNav newsletter.

Our conversation began with an explanation of the Department of Developmental Services traditional system of services. Will said that, for the last 50 years or so, the regional center has managed the intake of new clients and quality control for services clients received. Once a client underwent the intake process, a Service Coordinator created an Individual Program Plan (IPP) for the client. This plan identified services and supports available to the client based on their age and needs. Once the client has an IPP, they receive referrals for service providers who have been approved (or “vendorized”) by the regional center. Approved service providers all follow the same fee structure for associated services. Within the traditional system, clients can only use those service providers who are regional center approved vendors. Will says this created almost a closed or segregated system.

Under the Self-Determination Program, the client is no longer limited to the regional center approved vendors and can instead use any service agencies or individuals of their choosing.

The only regional center vendor in SDP is the Financial Management Service (FMS). This is the third party that handles all of the money and payments for the services and providers that the client uses. The Federal Government doesn’t allow the state or regional center to give funds for services directly to the client; participants must use an FMS to pay for all services in SDP.

The regional center will continue to be a key player in the Self-Determination Program as they are responsible for developing the client’s budget. A client’s budget is the amount of funding available to purchase services, activities, and items needed to implement their plan. The budget is based on the amount the regional center spent for that client’s services during the past 12 months and based on any unmet needs. For instance, if you live in a group home, go to a day program, and use transportation, those traditional services would be given a dollar cost by the regional center, which would be turned into a spending dollar amount for the individual to create their own system.

Will emphasized that SDP is about control, about responsibility, and understanding you have the right to make your own decisions about what you want to do. All this allows for that flexibility in how you spend your budget. SDP offers the ability to pay slightly higher for preferred services which can help some people find the services they need. The hardest part right now is helping people understand that they can make different choices.

What has not changed between the old and new system is that clients are still expected to make use of generic services first. For instance, for clients under age 22, the regional center will not pay to replace the K12 system. In the adult world, it’s expectant that clients first use generic services like In Home Support Services (IHSS), Department of Rehabilitation, or medical insurance before seeking regional center funding.

Will expanded further on the idea of how generic services come into play with concrete examples. He said one way to think of it is that regional center funds can not be used to supplement or replace the generic support, unless that generic support has denied service or the person's eligibility to access that service. So, in the case of IHSS, if someone needs 24/7 support to live independently, they would be required to access the maximum support available to them from IHSS before the regional center provides support. For example, if someone gets 8 hours of IHSS support a day, then the regional center budget could fund the other 16 hours a day. That support could come in a number of forms, such as Adult Day programs for 6 hours a day 5 days a week, additional support when the individual is between Day services and IHSS, etc.

A major shift in SDP is about what people want. For instance, the traditional adult day programs have not kept up with the fact that more people have been in integrated settings at the school level itself. In the traditional system, a client might have a support that was close to but not exactly what they needed. The client had to accept that because there was no other option.

Under the new system, day programs will look like what people want them to be, created and based on the Person Centered Plan. You can say, “No, that’s not what I want, and here are some of the things I’m really interested in.” So, SDP really allows you to create that scenario.

You could go back to the day program and contract to do just that cool art class on Tuesdays but you don’t have to attend all 5 days. You could choose how your day is planned whether it’s community college, an adult school class, a recreation activity, a job, or a social activity that’s important to you.

As you can see, there are many differences between the traditional system and the new Self-Determination Program. In the next piece, we’ll continue our exploration of these two systems. Look for Part 2 of our conversation in next months’ newsletter.

In addition to his work on the SDP, Will Sanford also consults for NeuroNav. Together they have partnered on projects with three Regional Centers to help increase and build capacity of Independent Facilitators in the Bay Area. Will’s alma mater is Stanford, he has an MBA from Berkeley, and has been in the Developmental Disabilities (DD) and Intellectual Disabilities (ID) space for the last 40 years. Will’s interest in entering the field was fueled, in part, due to time spent with an aunt with DD while he was growing up. Given his extensive experience in this space, Will sees himself as a mentor and a resource for the next generation of leaders like NeuroNav and others. Will offers his knowledge and experience to help the rising leaders understand where we’ve been and where we’re going so that they can better support people to do greater things in the coming years.

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