CAIC
ANNOUNCES
Report by Dr.
David Braddock on
California's
Financial Commitment to
Developmental
Disabilities Services
CAIC is pleased
to announce the completion of the analysis by Dr. David Braddock and
Richard Hemp which compares California's financial commitment to people
with developmental disabilities to that of other states.
The research
team brings unparalleled credibility to this analysis. Dr. Braddock is a
Professor in Psychiatry at the University of Colorado School of Medicine,
Director of the State of the States in Developmental Disabilities Project,
and a past President of the American Association on Mental Retardation.
Richard Hemp is a senior researcher on the State of the States project in
the Department of Psychiatry, Colorado School of Medicine. The biennial
State of the States publication is the standard reference for state budget
trends and comparisons, as well as progress in key areas such as
utilization of federal matching funds and the transition from institutions
to community living. The project's data base has been developed and
refined over the last twenty years with the cooperation of specialists
within the departments of MR/DD services in the various states.
This project was funded
through a grant from the Center for Disability Studies and Community
Inclusion, USC University Affiliated Program (UAP), Grant #90DD0540 from
the Administration on Developmental Disabilities.
Click here to view the full report
Reason for the Study
The
developmental services budget is one of three major California health and
human services programs that have caught the attention of budget writers
because of their rapid growth. One example of the state's response to our
growing budget is the recent proposal (now withdrawn) to suspend the
Lanterman Act and roll back services to children and families. Other
examples include proposals for a $100M budget cut to be achieved at least
in part by Statewide Purchase of Service Standards and a copay for parents
of minor children receiving regional center services.
Administration representatives have explained that the
state cannot afford continued growth in developmental services, yet the
Community Imperative Strategy Group has released a budget trends analysis
showing that the developmental services budget must increase substantially
over time if it is to meet consumer need.
Has our entitlement to services led to "unrestrained" or "unreasonable"
growth? A comparison of California budget trends to that of other states
may help us respond to such concerns.
CAIC Summary of
Results
Please read
below for a brief summary by CAIC intended to give a flavor of the
results. For a more detailed examination of the subject, please
check the full report. The report is
intentionally fairly short, so it is accessible for people who want to
learn more.
The Braddock Report compares
California to other states in five ways with respect to the provision of
services for people with developmental disabilities:
1.
Growth in spending for developmental services.
Over the last two decades,
California has ranked about average among the states in its rate
of spending growth for services for people with developmental
disabilities. From
1977 to 2002, our state's total DD spending increased an average of 5.8%
per year, compared to the national average of 5.2%. We ranked 29th in
growth rate out of the 50 states and District of Columbia.
2.
"Fiscal Effort" for developmental disabilities spending.
The "fiscal effort" ranking
compares states based on the proportion of the state's wealth (personal
income) dedicated to developmental services. As such it is a measure of
political commitment to people with developmental disabilities.
California has consistently
ranked below the U.S. average for fiscal effort in each of the last 25
years. For 2002,
the State of the States comparison ranks California only 39th out of the
50 states and District of Columbia.
From 1998-2002 California's
rapid DD budget growth helped California get closer to the national norm
for fiscal effort, but its ranking did not improve compared to other
states: Although California ranked 37th in 1997, we fell behind two more
states over the next five years to rank only 39th. Evidently other states
with a similarly poor record of fiscal commitment took the opportunity of
the good national economy to expand services to people with developmental
disabilities.
State to state comparisons are
difficult, because states can support people with developmental
disabilities through different budgets (e.g., county funds, departments of
DD/MR, departments of rehabilitation, state/federal programs, etc.). The
State of the States data base has spent 20 years refining the data and the
comparisons they make. But one program not typically included in the
fiscal effort calculations for the states are personal attendant services
such as California's IHSS program. Since California has a relatively
generous IHSS program, this was a possible bias in the data which would
unfairly hurt California's rankings. The Braddock report found that
adding personal attendant support (IHSS) expenditures into California's
fiscal effort calculation (and not adding it for other states) would still
leave our state well below the national norm in fiscal effort.
3.
Capturing federal matching funds.
California Captures HCBS Waiver
funding for DD services at a rate significantly below that of the average
state. Per capita Waiver spending in California (federal-state Waiver
spending per citizen of the general population) was only $24 IN 2002,
compared to the US average of $45 per capita. The state ranked 41st
nationally.
Whereas, California ranks very
low in waiver spending, we rank very high in the amount of total DD
spending that has not been matched by federal dollars. Twenty-six percent
of California's total DD budget (including programs outside of DDS, such
as SSI, DR, and ICFs) is unmatched, compared to a national average of
14%. In 2001, California ranked fifth in the nation in the percentage of
unmatched service dollars.
4.
Out-of-home residential services.
The entitlement provision of
the Lanterman Act has not lead to a greater use of residential services
than the nation as a whole.
California ranks slightly below the national average for utilizing
out-of-home residential supports. In California, 153 people per 100,000
of general population use residential services, while the national average
is 160. California ranked 33rd among the states.
5.
Factors influencing growth in the DD budget.
The demand for community based
services for people with developmental disabilities has increased
substantially over the past two decades, both in California and
nationally. Most of the growing demand in
California is being influenced by: 1)
youth aging out of special education programs; 2) the increased longevity
of persons with developmental disabilities; 3) the impact of the growing
number of aging caregivers; and 4) relocation of residents with DD from
public and private institutions to community settings.
