Senate Budget and Fiscal Review Subcommittee No. 3 on Health and Human Services

The budget hearing will begin in 30 seconds. Good morning. Budget Subcommitee 3 will now come to order. This hearing is taking place in room 1200. This hearing should take no more than two hours. I want to welcome everyone that is here. We will have six Department items up for discussion.

We will solicit public comment after completion of the presentation items within the agenda, at which time the public may comment with any of the previous items. We will start with issue number one, the Department of Developmental Services budget overview. Good morning and the Department may begin when you're ready.

It just turned red. Thank you. Good morning, Madam Chair. Members, thanks for the opportunity to be here today. My name is Pete Cervinka. I'm the Director at the Department. I want to take a second and just say thank you to the staff because pages three through five cover the overview for the Department.

Really well, well very pleased to lead a dedicated team of people in partnership with Regional Centers and service providers to support the needs of half a million Californians. Our budget for next year as proposed in the Jan.10 Governor's Budget is just about $19 billion.

That's an increase of 3.2 billion over the current fiscal year and is comprised largely of a request of for 2.6 billion to cover an anticipated estimated caseload of 40,000 people, which is really tremendous for our system and the needs of those individuals and families as well as an additional almost 410 million to full year annualize.

The cost of service provider rate reform, which in California was implemented fully after a multi year investment as of January 1, efforts to fully implement that, as I said, that was the effective date of it efforts continue to implement it through the end of the calendar year this year.

So two really remarkable benefits to the people of California from those investments. Most other things are comparatively small. In our budget proposal we have roughly 150 million going to Fund largely service coordinators at Regional Centers to coordinate the additional services for the anticipated caseload increase. And we only have two small budget proposals, budget change proposals before you.

One deals with implementation of the Public Records Act which is legislation enacted by this body last year and becomes effective for Regional Centers on January 1st of 2026. And the other is to convert two existing limited term positions to permanent status for implementation of federal requirement that we call EVV electronic visit verification.

So both of those are mandated proposals and the costs of both are consistent with either experience on the positions or in the public Record act consistent with the experience of our own department's compliance. Having said that, I will note for you that as part of the upcoming May revision.

We intend to relook at our BCP for AB 1147, which is the Public Records Act measure. We think there may be a little bit of room to scale that back. We wrote that within 10 days of the bill's enactment, and obviously some thought has occurred since then.

And I think it's safe to say that the Department itself doesn't need 10 positions. And Regional Centers have been thinking through their approach as well. So there will be an adjustment to that proposal, but I don't know exactly where we're going to land on that.

But just for full clarity and expectation setting, we are definitely in uncertain times. I don't think I need to tell this Committee that we are watching very carefully what happens at the federal level and watching with great consternation some of the proposals. We know what's ahead for Congress and its deliberations.

What's not clear is how it impacts our Department ultimately. What we do know is that federal Medicaid funding provides $6.5 billion for our Department as proposed next year. That's roughly 37% of the total funding for Developmental Services in California. I don't say that number to suggest all of it is at risk. Quite the contrary.

I think there are a lot of federal mandates that currently exist that require that. But to provide some context for the potential magnitude as we look at what might happen both with state revenues but also at the federal level, there are some priorities that we have in mind as we think about what's coming.

And I will tell you, we don't contingency plan for every single possible scenario. So we're really focused on principles at the Department and in concert with our agency about what's important. The Lanterman act, entitlement to services after other sources of services have been exhausted is a key feature for California and how we serve people.

And we intend to protect that entitlement at all costs. The second there are a number of things that we want to do in our system where we just don't have the foundational infrastructure. None of you would do your daily business on a computer that's 45 years old, but that's what we do day in and day out.

And so updating the technology we use both for case management and fiscal control is a crucial priority and rather fundamental to everything that we do. And then I don't think I need to convince this Committee either that services to children when they are youngest are most effective.

And so protecting services to the youngest among us is going to be a priority as we look for what comes. There are obviously many things that I could talk about but haven't, but I'm happy to stop there and answer any questions.

Thank you, LAO.

Karina Hendren, LAO, we wanted to start by noting that the LAO published an analysis of DDS's budget on March 5. The analysis covers some of the oversight issues that are addressed in today's agenda as well as the Master Plan for Developmental Services, which is issue number two today.

And today's hearing agenda includes some excerpts from our analysis and the full text is available on our website. For this issue, we wanted to talk about two oversight topics that we covered in our analysis.

The first is the quality incentive component of rate reform implementation and then the second is the Lois IT Project, which Director Cervinka alluded to.

We'll start our comments on the Quality Incentive Program as noted in the agenda, providers Must enroll in DDS's new provider directory in order to earn the quality incentive component of their rate model through the end of the 25-26 fiscal year.

The creation of the provider directory is an important first step in providing a more comprehensive view of the state's network of service providers, and the Department has previously stated that it intends to build out the provider directories functions over time.

Once the Department connects the information in the provider directory to Regional Center service areas, the Department could identify potential gaps in service availability throughout the state.

We think this would be valuable information for the Legislature to have in order to prioritize efforts to improve access to services and we therefore recommend that the Legislature ask the Department about its long term plans to build out the provider directory with the capability to identify areas of the state that might lack access to certain types of services.

Continuing on with rate reform implementation and the Quality Incentive program, we also want to note that chapter legislation establishes the Legislature's long term interest in using the quality incentive program to improve consumer outcomes and the quality of SCORE services.

To ensure that the quality incentive program is implemented according to legislative intent, we recommend that the Subcommitee ask the Administration to address the following four questions regarding the development of future quality measures beyond the provider directory. So beyond 25-264 questions. Some of them are kind of long, so bear with me please.

First question as noted in the agenda, DDS has offered one time incentive payments since 2023 for specified outcome measures. So a follow up question is how will the data collected from these one time quality incentive payments inform the ongoing quality incentive payments that will be put in place as of 2026?

The second question concerns individual level outcome measures so the quality incentive component component of service provider rates must include individual level outcome measures by the start of the 26-27 fiscal year as currently established in statute. So our question would be what data are necessary to measure these individual level outcomes, and how would the Department collect this data?

The third question concerns equity in quality metrics. So when a quality metric is established, providers have a financial incentive to maximize their chance of satisfying that metric in order to earn their full rate. One potential unintended consequence could be that providers focus their efforts on individuals that are already closer to meeting the established metric.

So one example could be that if the established quality metric for employment services is the percent of individuals that keep a job for six months, providers would have a financial incentive to focus on individuals that are most likely to maintain their jobs.

These individuals would likely be those with relatively lower support needs and who might already have employment experience. Conversely, providers would have a financial disincentive potentially to focus on individuals who need the most training and support to maintain their jobs. And just again, this is all hypothetical.

But just as an example, this type of incentive structure could unintentionally contribute to inequities in service provision between individuals that have varying degrees of support needs. And so the key question, therefore, is how to avoid these unintended consequences in the quality incentive process program.

So our question would be how would the Department ensure that quality metrics do not incentivize providers to prioritize relatively easier to serve consumers with relatively fewer support needs at the expense of individuals with more significant support needs?

And then our fourth and final question is that under existing statute, providers that do not satisfy the established quality metrics will not earn 100% of the rates. Aside from reducing payments. We would want to know what steps the Department or Regional Centers would take to assist providers that fail to fully satisfy the quality metrics.

For example, would these providers have the option to access technical assistance to help improve their performance moving forward? And last thing so moving on from the quality incentive program, Just a Few Notes on the Lois IT Project So Lois is intended to integrate Regional Center's case management and financial systems.

IT was a project that began in 2021 and has evolved notably since that time. Most recently, the Department stated that it plans to gather new stakeholder feedback this year in addition to the feedback that has already been collected in earlier stages of project planning.

As with any major IT project, it will be important for the Legislature to exercise its oversight authority to ensure that the project can be completed on time and within budget. To do this, the Legislature must be equipped with up to date information about the project.

We therefore recommend that the Legislature direct the Department to provide IT planning documents that reflect the latest stakeholder feedback that's going to be collected this year in 2025.

This will allow the Legislature to understand how this latest round of stakeholder feedback and any resulting goals or desires for the IT project might differ from what's previously been documented in the program's existing IT documents. Thank you.

Thank you. Any comments from Department of Finance?

Omar Sanchez, Department of Finance. Nothing further to add.

Thank you. Any questions? Senator Menjivar?

Thank you, Madam Chair. Director. One of the first questions proposed in Alio was actually one of the questions I had wanted to see if you could share a little bit more information on the plan for the 2026 Quality Incentive Programs and if some of the things that were brought up here are being taken into consideration for that development.

Easy part, the second part, yes. On the first part, it's a little bit of a longer answer on the development process. Infrastructure or the lack of it is part of the problem. I think the explicit question was how are the one time incentives informing the future development?

And the key to being able to measure improvement is of course, knowing where you are today and starting.

So if I take for example the prevention and wellness measure that we have, it's looking at certain facility types, in this case adult residential facilities for people with special health care needs, Irf, push ins, there's a reason we have an acronym and looking at the percentage of the people that they serve who regularly receive preventive health screenings.

So we're talking about mammograms, colonoscopies, regular dental visits are three of the things that are part of that measure, for example. And so in that case, rewarding their reporting of that information helps us set a baseline for what's happening out there.

That baseline will also help us establish targets that we expect is that 80%, if everybody's already at 90%, you're not going to set an improvement target at 80. Right. So those kinds of things help us inform what happens.

Have all providers signed up in the portal.

So signing up in the portal is a different conversation. Right now people qualify for the quality incentive portion of their 100% rate model. That is the 10% of the 9010. Only this year and through the end of the hold harmless period by validating their information inside the provider directory, we continue to make progress on that.

We have about 65% of provider's information fully validated. There's going to be a big push. We've made some announcements in the last couple of weeks, giving people roughly another month and a half at this point to get their information validated. And at some point, we're going to need a stick to get people into that provider directory.

That stick is not punitive, but it's essentially the equivalent of blocking your login to the billing system until you call the help desk and get it sorted.

So we're still going to be taking bills from people, but their ability to submit claims to us or more specifically to Regional Centers is going to be blocked in order to get them into the provider directory.

Okay, maybe I need clarification. So going onto there is not where you pull the data to help you establish the incentive program.

So the world as it exists Today, we have 21 Regional Centers, and they each have an independent database that tracks the vendors that they've approved to provide services at that Regional Center.

The statewide provider directory is the state's first ever attempt to consolidate and deduplicate all of that information, as well as make sure that all of that information is up to date.

So we are looking at state and federal tax ID numbers, corporate ownership structures, dedicated contact people at those organizations with accurate addresses and phone numbers and those kinds of basic information. As the LAO indicated, there are plans to build out the functionality within the directory.

We will be tying service codes at some point to those providers so that we're able to look at where we have what we would call service deserts or a lack of services and things like that.

We may be looking at asking them to identify linguistic characteristics of their workforce so we can identify gaps in workforce development that can be addressed by additional mechanisms and those kinds of things. But it's the first ever statewide directory of those things.

And I think it would be fair to say that everybody involved in that effort, including Regional Centers and providers, is surprised at how difficult something so simple actually is turning out to be.

Would the Legislature, or at least this Subcommitee, have the opportunity to look at the incentive program before its official rollout?

Yes. The statute requires that measures get publicly posted and available. We have a work group meeting next in July, for the next year. We have a little bit of time in terms of the measures because of what I said earlier about provider directory being good through the end of budget year to the end of the hold harmless.

So we have focus groups going. We have a full work group going. Focus groups are specific to each measure. The full work group looks at the whole package. There is public transparency. Those meetings are open to the public, and there is required communication with the Legislature on that.

And we make this topic a key feature of our quarterly meetings with legislative staff.

You mentioned hold harmless. When do we anticipate decreasing this number of providers on the hold harmless list?

So hold harmless ends by current statute at the end of the day on June 30, 2020. It's the last day of budget year.

And are we going to see a scenario with these individuals who are going to be below getting paid below the rate reform? Because they were.

Yeah. So let me clarify just a little bit about this. We have basically, for any given service, there's a bell curve of where the rates were. The rate study in 2019 created rate models that we're implementing that define the factors used to establish a rate.

So within rate reform, now we know what the rate is supposed to be. But because there's a bell curve, some providers already have rates that exceed the maximum of the rate study and those are the providers held in the hold harmless.

So when hold harmless ends, those providers have the certainty that they will fall back to the rates. And in the rate model, they will not fall below the rate model rate.

So they were originally, before they were originally higher than the rate model.

Those are the people in hold harmless.

And once hold harmless ends, they're going to get a decrease to match everyone.

Yes. The goal of the rate study was to bring rates statewide in alignment and make them consistent.

Is it going to impact those providers? How is it going to impact those providers?

I would like to think that they are making plans accordingly. The rate models have been published already and they're well aware that some of their peers are operating successfully according to the rate model rate. So there's obviously individual variation. Nobody has told us they plan to go out of business when that happens.

Okay, thank you for that. Moving into DSP workforce initiatives, this is another obviously really great incentive initiative to help even address. Even with the rate reform, we recognize this is still not enough. We get that. I mean, people can easily leave. We're still seeing a bottleneck dealing with the workforce at different providers. But these are great incentives.

So I'm wondering what is the barriers that still exist to have a full implementation of DSP University or the bilingual pay differentials that don't exist in all the regions centers?

Yeah. So bilingual pay differential I believe is currently live and has been for a while in four Regional Centers in California. The plan to take it statewide I think revolves largely around the timing that we can feasibly implement the number of things that we have currently on the table. And it's an important investment. Even though it's only, I think $4.5 million. Not B, M. DSP University.

Sorry, let's go back. I feel like the response is a little too technical. I don't think I really am satisfied with that response. What is really in the. Okay. If you can help me understand why we can't spread this to the other Regional Centers.

We want to do that. We are very cognizant that there are quite a few things that need to be done in the immediate short term term by Regional Centers and their staff. And we also know that providers have been really heavily engaged in adjusting their program designs to align to the new rate models.

So everybody is doing a tremendous amount of work and we're cognizant that we don't want to add more stuff to it. We are hoping that to be more specific to your question, that sometime in the August, September timeframe we will make the program available statewide.

Okay, thank you. University

On DSP University the primary roadblock there is twofold. One, it's making sure that we have curriculum that's appropriate. We have multiple domains in which curriculum is being developed. There are several partnerships with that as well as analysis of some nationally available curriculum.

And the second piece is being able to track who's taken what courses and who they were code for. So we are working closely with Sacramento State University to build out what we call a learning management system, or what you and I would call the tracking system for people to log in, take those courses and record course completion.

Do we still anticipate a summer 2025 rollout?

Late summer, yes.

How long would these programs last?

Yeah. Both are subject to appropriation by the Legislature. I'm hoping, given the level of effort on both, that when they're implemented they would be ongoing. We did have a time limited program that provided stipends to direct support professionals last year. It closed in August of 24.

We had 80,000 direct support professionals complete over 200,000 courses in that program. But that was not renewed. That was a one time effort. Neither of these that I was discussing are one time in nature as presently planned.

Okay, thank you. And next topic is on implementation of SB138. Particularly is the standardization of the intake forms. I recognize retirement of Director and the master plan wasn't an idea or wasn't in place yet when we were doing this. So there's just a combination compounds of things.

So I recognize that if you could just share an update on the progress there.

Yeah, I will acknowledge that progress is not as fast on this one as we wanted it to be. I would also say that given the variance in practice around California, there isn't necessarily even agreement on where intakes starts, which has been part of it.

And two, there is process change that can happen in terms of how business is done. But there's also a question about what, if any, automation we want to do to support that process and get to that point. And anything like that needs to be done in consideration of the lowest project.

So there are, I think we are attacking the intake process in kind of chunks rather than as a whole and seeing what we can implement first, second and third.

There's still a lot of community engagement that needs to happen on that and we recognize that how people come into our system and their first impressions, as well as the consistency and time clocks standards that we have and the impact it has on equity and access is really important.

So we are taking the time we need to do this right and want to have fully inclusive conversations. I don't have an estimated completion date.

Because it sounds like we can't even get a definition of intake.

Getting a definition is hard.

So it seems like we're really behind on this.

Well, I would say that that doesn't stand in the way of good forward progress. I'm just saying that's one of the things that we are struggling with is when exactly it starts.

Okay, my last question is going back to the rate increases. The whole goal was to increase the wages. Right. Are we verifying that the actual rate reform is going to workers provide?

Yeah. So it's part of our audit protocol to this point. We haven't identified any violations.

Great. How often does it happen? Do we audit? How often.

We touch in the neighborhood of 70 to 80 providers every single year in varying levels of detail.

Thank you so much.

Yep. Thanks for the questions.

Thank you. Senator Menjivar, thank you so much for presenting on this panel. We will now move to the second issue, master plan for Developmental Services. We'll ask for Sasha Bittner, Oscar Mercado, Amy Wessling and Will Liner. Hopefully I got all of your names correct to come and join at the desk here.

Seeing that this is a very large panel we'll be requesting and having everyone stick to less than 2 minutes, no more than 2 minutes for your presentation.

And we will start with the Director.

Thank you again. I'll go ahead as people are getting settled. Appreciate the opportunity to present on this. I want to take a moment and say thank you to the many thousands of people who contributed to the master plan for Developmental Services over the course of the last year.

You heard me in earlier remarks say that knowing where we are today is really important. And I think we have a sense of where we are today. The critical part in moving forward is, of course, knowing what people want for their future. And that's really what the master plan did for us.

In a series of monthly meetings of the full Committee, as well as its five work groups over the course of the last year, as well as over 45 separate community engagement efforts, we now have a document with 167 recommendations covering a wide gamut of things that go far beyond what our Department provides, but touch on housing, transportation, education and other topics as well.

So knowing where people want to go is absolutely critical in terms of steps forward with the master plan.

The Department is publicly committed to meeting with the full Committee twice a year to talk about implementation, what's happening on the different measures, and just as importantly, to hear from the Committee what other people are doing on those master plan recommendations as well.

Those conversations, in addition to holding us all mutually accountable for progress on the things we can make progress on, will also inform an annual report to the Legislature in March of every year, starting in March of 2026. There's a lot there.

I'm sure you will hear more from my colleagues here, so I'll stop my remarks there with an emphasis on the appreciation to everybody for the time and effort that was no small task and a lot of time was put into it. We're really grateful.

I guess the only other thing I would add, it's currently available in English and Spanish with four other languages currently in the translation process. And all of that's going to be publicly available and for anybody that felt either concerned with a recommendation or that their recommendation didn't make it in.

Comments from Committee Members are being accepted through May 14, and their comments call them dissenting opinions for clarity, but they may be supporting opinions as well. Also will be put online next to the master plan for public consideration and transparency. Thank you.

Thank you, Director. We will now go to Sasha Bittner.

I've been honored to serve as co Director of the workgroup.

I've been honored to serve as co Chair of the workforce workgroup

For the stakeholder Committee.

For the stakeholder Committee.

And I'm proud of the plan we created.

And I'm proud of the plan we created. My work group was very respectful and receptive regarding perspectives of all Members and made sure every voice was heard and valued as we developed our recommendations.

Overall, that was also true of the larger Committee as developmentally disabled advocates, family advocates and professionals joined together in this collaborative effort with additional input from community voices. At the same time, I was disappointed when several disabled Members reported pressure from a very small number of family advocates to support opinions they did not share.

I very much respect the critical advocacy these family members provide for their own children and and for others unable to effectively self advocate. But disabled Committee Members are not in that position and can speak for themselves. Most of us are quite used to being patronized, but expect better from allies.

Fortunately, the facilitators work closely with self advocates to ensure our own authentic perspectives would be expressed and included as we develop the master plan. To me, this experience highlights the pressing need for more people with IDD to be in leadership positions in the DDS system and elsewhere.

And that is one of our recommendations that I would like to see prioritized. Also, in light of the Los Angeles fires and the high likelihood of other such disasters, implementing our recommendations regarding emergency preparedness is essential.

Finally, with threatened attacks on our services by the by the Federal Administration,

it is critically important

it is critically important

to prioritize

to prioritize

our recommendation to fulfill the promise of the Lanterman Act

To fullfill the promise of the Lanterman Act,

by fully maintaining

by fully maintaining

the services that allow us to live and thrive in our community.

That allow us to live and thrive in our communities.

Thank you so much for having me.

Thank you so much for having me.

Thank you so much for being here. Oscar Mercado.

Thank you.

Thank you for giving me the opportunity to speak. I'm Oscar Mercado, Self Advocate with the Integrated Community Collaborative and also had the honor and privileged to be one of the co chairs for the Master Plan on Developmental Services.

Over the course of a year, I had the amazing privilege and responsibility to serve in one of those work groups. We engaged in meaningful consecutive dialogue, developed ideas, and those ideas developed into potential recommendations. And everybody gave input and they all resulted in 170 recommendations in total for the entire master plan process.

All of these ready for implementation. But today I do share a deep concern regarding the implementation phase. We've heard from the Department that they are going to hold two meetings per year to give us a quick checkup on how that implementation process is going to be. In my opinion, I don't believe that's enough time.

We need to have a more consecutive, more collaborative group effort and steering Committee to ensure that the recommendations of the Master Plan are being pushed ahead, are being fulfilled as intended by the people who authored them, and as well ensuring that the entire Master Plan process is not just another bureaucratic document that sits on top of a shelf collecting dust over the years.

We've worked very hard, all Committee Members, self advocates, members of the community, siblings, parents, everybody has worked extremely hard on the development of these recommendations. It would not be fair if all that hard work were to go to waste because of bureaucracy and the Master Plan not reaching its full potential.

I urge this legislative body and everybody here present that we work together and we continue working together and ensure that the Master Plan is not another empty promise. Thank you.

Thank you so much. We will now hear from Amy Westling.

Good morning. Amy Westling, Executive Director of the Association of Regional Center Agencies and really appreciate the opportunity to be here today to share my perspective on the Master Plan, its progress, the process and ideas for where we put our energy next.

First, want to echo my colleagues who expressed that it was an incredible honor to serve on the Committee and the greatest thing that came out of it, as

Ms. Bittner alluded to, was a recognition and a reminder to us all of the power of self advocacy and that we need to prioritize hearing their voices and allowing them to lead us in this system. That is really the future of this system.

For the sake of time, I will just rattle off a few other places where I think we need to put our time and energy first, because obviously we can't focus on 170 recommendations all at the same time.

So first, setting clear goals and for the system as Director Cervinka referenced, we need to know what it is that we are seeking to achieve and how we measure that success. And then we need to build our funding structures around those goals so that we know when we've achieved things and when we need to do better.

We heard from our community that accessing services across systems is important and that we need to find ways within the professionals in our system and across other systems to make it easier to access services that people need. We heard a lot.

And to Senator Menjivar's point that echoes SB 138 about the need for greater consistency within our service system. But we also heard equally loudly the need to understand that we can't put people into boxes and that we need to ensure that there is still flexibility at the individual level for them.

We need to look at how we ensure that service coordinators, whom are that critical relationship between the Regional Center and the individual served. We need to make sure that they have the time and space to do what it is they are there to do and reduce the administrative burden on them.

And lastly, we need to focus on ensuring that we have an adequate workforce as we have discussed earlier this morning. Thank you for the opportunity to speak.

Thank you. We will now go to Will Leiner.

Good morning and thank you for the opportunity to speak today. My name is Will Leiner. I am with Disability Rights California. I was also a Member of the Master Plan Steering Committee and I'm also a sibling. I have a brother who is served by our system.

I'm going to start quickly by just zooming out to something that I think is bigger than the master plan, zooming back in to talk about how it relates and I'm going to connect a couple of dots all in two minutes. Our disability system, it's under threat. It's under threat. We are facing drastic cuts to Medicaid.

We are seeing a potential dismantling of civil rights laws to protect disabled people. We are seeing proposals to take federal funding away from disability advocacy organizations like my own. You'll also be hearing from State Council later today. Our community is under threat. I don't have a crystal ball.

None of us know where we'll be a year from now. But that doesn't mean that we can't prepare, we can't plan for the worst. So how does that connect to the master plan? I would just urge everybody not to lock us into a specific list of priorities to move forward immediately.

I would urge coming up with a clear framework. We need a clear framework to decide, to use values based decisions to decide what recommendations to move forward, like in what order. But most importantly, how we engage the community in those conversations too.

I fully support Mr. Mercado's suggestion to have a Master Plan Steering Committee for the implementation phase. You know, respectfully, twice annual meetings to talk about progress. It doesn't feel like enough. It doesn't feel like it's enough to meet this moment. It's how we created the Master Plan. It's how we can implement it too.

But I do want to lift up one recommendation that I think sits at the intersection of the Master Plan. The emerging threats our system is facing and SB 138. And that's our system's broken relationship with generic resources.

If federal funding cuts happen, people are going to look to Regional Centers in our system as the payer of last resort, as the gap filling system.

So we have to figure out how to define generic resources, what they are, and we really have to figure out how to streamline the complicated kind of web of burden that we put people through to prove that a resource isn't available or it's not accessible to them. We have to figure that out.

If many of these generic resources are maybe cut right, the cracks we talk about in our system, they're going to become chasms if we don't fix this problem soon. I think that's my two minutes and I'll stop there and happy to answer questions.

Thank you so much. Any input from LAO?

Karina Hendren LAO we want to note that the recommendations in the Master Plan were developed by the community following a process established in statute. Some of these recommendations call for significant policy changes that would represent fundamental changes to the Developmental Services system if implemented.

All of the recommendations provide valuable information about opportunities to improve the experience of the individuals and families receiving services. To ensure that the community's feedback is effectively translated into actionable plans, there needs to be some type of roadmap for next steps. We have several recommendations for what is needed next from the Administration.

First, as has been noted, the state likely does not have the capacity to enact all 167 recommendations in the Master Plan. We therefore think that it would be helpful for the California Health and Human Services Agency as well as DDS to outline the administration's long term vision in light of the Master Plan's recommendation.

We acknowledge that the Administration has stated that it does not plan to prioritize the specific recommendations presented in the Master Plan, but nonetheless, the Legislature could benefit from more information about the administration's high level priorities moving forward, and this sense of direction will be particularly important in planning for the next few years given projected budget deficits through the 28-29 fiscal year.

Additionally, the Administration previously informed Master Plan Work Group Members that they should focus on the "what" of the recommendations contents and that the state would then develop the "how" for enacting those recommendations. The Administration should therefore start to fill in these sort of how details.

For example, the Administration could start to identify recommendations that overlap with state efforts already underway or with the activities of existing DDS work groups. It could also start to identify recommendations that might be constrained by existing laws and regulations. This added context will provide the beginnings of an implementation structure that the plan currently does not have.

The Legislature needs this kind of technical expertise from the Administration in order to make informed budget and policy choices moving forward.

The Legislature now has an opportunity to help establish next steps and the LAO would be happy to assist the subcommitee in developing trailer Bill language, if that's of interest, which could include requirements for fleshing out the annual reports that will be submitted to the legislature.

And this will help ensure that the master plan implementation process reflects legislative priorities. Thank you.

Thank you. Any comments from Department of Finance?

Mark Sanchez, Department of Finance we would like to note that any recommendation that originates from the master plan would need to follow the normal budget process.

Thank you. All right. I want to thank all of those who are on the panel. We will now turn to questions. Senator Menjivar.

Maybe the Director, Department of Finance question. What was our, what was our intent here? Because I've been very critical. We've had the Master Plan on Aging, and I keep saying that the number one priority there was housing.

Yet once again this year, we're cutting funding for a program that helps seniors on adult protective services put them in housing. So I'm just wondering why we keep doing these practices if we're not going to put money behind it? What is the intent?

Pete from the Department, again, I'll take that one. Actually, unlike the Master Plan for Aging, although the Administration ran the process for the development of the Master Plan for Developmental Services, it was not driven by the Administration in terms of a firm commitment to implement the recommendations.

It's been a very long time in our system since we had a comprehensive look at what people want for the future of the services and the system and cross system interactions. And so the major benefit from my personal perspective is that we now know what people want.

We are then charged with looking at the environment we operate in, the resources that are available to do those things, and seeing what's feasible and possible to implement and what it takes to get those things done. As LAO mentioned, I've personally said in multiple forums, I am not going to prioritize services for autism people over employment.

Both are important. And I think we can walk, chew gum and act like a symphony all at the same time. So there are things that can be done. I also, I think, want to respond to the comment about just two meetings a year to check on implementation. There is a boatload of work happening. All right.

So Master Plan recommendations don't just cover the topics that I talked about. They talk about the use of plain language, the access for information, the consistent statewide experience. A bunch of stuff underway today already speaks to those. We have a language access plan. We have over 150 vital documents being translated and made available to the public.

We are issuing a newsletter to the public. Plain language is increasingly a focus. We've gotten a lot of kudos from the Master Plan itself for being written and really accessible language. So there's a boatload of things that we're doing. Standardizing the intake process. We have a standard, sorry, IPP individual program plan process across the state.

Now we have standard information about the services Regional Centers offer. There's a lot already being done that addresses Master Plan recommendations. I'm no longer sure I've answered your question. All to say we're doing what we can within the resources that are available to us. Knowing where people want to go is really helpful. Knowing where we can go.

And on that there's a note of caution. And I'll associate that myself with the doom cloud to my right about the things that we're facing as challenges to the system.

Yeah, I can appreciate that. But I guess I would say we've been having meetings and panels on this topic for years. At least in my time here now, three years. It's hard for me to accept that now we know what people want. I mean, we've been having these conversations for a long time.

So I don't want to look at a book and say, now we know what they want. We've been hearing what they've been wanting for years now. So for a book to just put it in print. There's a lot of work that went into it.

There's a lot of work into it. So where I started with two meetings a year to look at implementation and update status, I would say a couple things. One, it's not just the Administration and the Department that should be implementing things in the Master Plan where it's possible. Right.

We have sister departments at Education, at Healthcare Services, at Aging and Housing areas that all have a role to play in the implementation. You're right. We know what people want. Right. That's why we have bills every year. That's why we ended up with SB 138 a couple years ago. We know people want more consistent standard information.

We know they want to know what Regional Centers offer. They want to know what Regional Centers offer in terms of support in accessing generics. Like it's not news to us from the Master Plan that cross system coordination is a problem that would benefit from attention. And there are topics going on all of these things.

We have employment focus groups. We have the provider directory that will give us insight into service access and availability. There are lots of things underway. LOIS. You and I may do mobile banking, we may do mobile health care. We don't call Our Doctor and leave a voicemail and hope they call us back.

Like, can we get some modern technology into how we serve people? We have a LOIS project in the planning phase. There's lots of work going on to address what we know people want.

And there are lots of focus groups that are now going to be informed by the most recent understanding of what people want, as evidenced in the Master Plan. But I'm not going to sit here and tell you the Administration is firmly committed to implementing 167 recommendations. Simply not possible.

Right, of course, 100%.

And I know you know that. Yeah.

And I think it's a good plan to do themes. Right. Pillars of what we're going to approach first. Because you're right, some of the things are already being addressed. Can we check those off? I don't think I'd be naive to say we're going to do all these in the next five years. It's going to take some time.

I recognize that. But I do agree with the advocates to say while, yes, you're working on other things. Two meetings specific to the follow up of this plan that the Administration touted as a great success I think is not enough.

I do think there has to be an increase of meetings because while Director, you're sharing that this wasn't completely led by the Administration. The Governor and the secretary when this came out said, look what we're doing. So by default, I would say this is, you know, this is something that the Administration in HHS said.

We're putting our hats on this and we're excited. So for us to. We need a step, a second step forward. Sorry. We need the second step to implement and I don't think two meetings is going to get that. I have a question for everyone. You know, one of the account or anyone, anyone can answer.

I'm sorry, one of the recommendations is more accountability for Regional Centers and providers. And I'm wondering because some of the recommendations are specific and some of the recommendations are a little bit more vague. I'm wondering the intent of what comes after if a recommendation is vague, how to implement that?

How do we get to the accountability of Regional Centers and providers.

Within our group about the implementation.

I know we wrestled within our work group about the implementation part,

But we I would say frankly,

But I would say frankly,

we didn't really have time.

We didn't really have time.

to thoroughly, you know, investigated it.

to fully investigate,

We only had a year of meetings.

We only had a year of meetings.

And so two meetings each Month, basically.

Two meetings each month, basically.

With a particular work group and the old Committee.

With a particular work group and a committee.

And the whole Committee. And if I feel like if we wanted to talk about implementation, we simply needed more time.

I feel like if we wanted to talk about implementation, we simply needed more time.

And I think some groups may have tried to,

And I think that some groups may have tried to.

To think about it more.

To think about it more.

But I'm someone who's very cautious,

I'm someone who's very cautious

and I had kind of.

And so I, as a layman, I wouldn't know when to implementation would entail.

And so I as a layman wouldn't know what implementation would really entail.

I have some ideas, but I wouldn't know.

I have some ideas, but I wouldn't really know.

And so yes, I think the Department should be accountable.

And I think the Department should be accountable. and all of that.

And all of that, but we didn't have time.

But we just didn't have time

for implementation.

For implementation.

Right, yeah, that makes sense. Obviously, full year for that. But I'm reminded of a book I got in grad school when I was about to graduate. It said, you have an idea now what? Right. So we have all these great ideas, but now what?

Now obviously I think the creation of ideas takes a shorter time than the actual implementation of ideas. So if we had two meetings per month for the creation of the ideas, I think obviously we're not going to match that. But the two for a year. I'll leave it at that.

I'm wondering and Oscar, you talked a little bit about it, but can I hear more about how would you like or how would the advocates like to be involved in moving forward with these? Because you're going to see legislators, we're going to look at this book and then we're going to come up with bills ourselves.

Like, oh, I think this is from the master plan, this is a recommendation. Or how would you like to be involved in that?

Thank you. And it's a very important question because that's the question that as members of the community, people who are served by the system have. We want to be included. We want to progress in a system that includes the entire person as a whole. And self advocates are certainly at the forefront of that. I would like to.

That's where I would say in this steering Committee, I'd like to see self advocates at the forefront with their circles of support, whether it's the community, the parents, siblings, people who support them, people who help elevate their voice.

And I think to the Master Plan's credit, when they had the self advocate groups and they had facilitators, I think they did a wonderful job at supporting the self advocates. It helped everybody, including myself, with doing our work in the Master Plan process.

In terms of the implementation, I also agree with what Sascha said and I'm a layperson, I don't know too much about systems or laws, but I can say that, you know, this, obviously this is going to involve a lot of work and a lot of time.

And when we talk about implementation, we're not saying just do it without a plan. You know, we're saying let's take a couple steps back. Let's break it down, you know, to how it will impact people with IDD.

Is it going to have a high impact or is it just going to be something mediocre or is it not going to have an impact at all? Then we would look at the timing. If you know, is it going to be one to two years, three to five years or 10 years? Right. That would be another consideration.

And also degree of difficulty. And then you'd look at cost. I think when I'm hearing these conversations, there's a lot of emphasis on the cost, which, you know, in this system, in this society, obviously we need to look at that.

But I wouldn't want to put that as a first priority when considering making changes or pushing recommendations for the implementation phase. I'd like to see the priority being how it's going to impact people with lived experience who are receiving services in the system.

Thank you. And for anyone I know, we were just talking about the standardization for the intake and difficulty to find a definition of where does intake start. I'm wondering if that conversation was had in the work group? And I know one of the recommendations is the defining of the generic services and all that.

So just wondering if you saw barriers even with defining generic services as we're seeing barriers with the intake definition or anyone can answer. I'm not just.

I'll comment for myself. In the work group process, it was a barrier when it came to definitions. Certainly, you know, again, coming from a layman perspective, when we got into the nitty gritty of the system itself and definitions, certainly it became very difficult.

And that's where the facilitators would come in and that's where plain language would come in.

It wasn't just the timing, but also the time needed to kind of decrypt and interpret what the language was because there was a lot of legalistic and systematic language involved and to speaking for myself, and I'm pretty sure many of the Committee Members could advocate to this.

It was very difficult to understand and follow up with what was being said.

I have two quick points to make to follow up on what Oscar said on the standardization, when we're talking about intake and assessment timelines is just the tip of the iceberg around what's not standard across our system.

At Disability Rights California, we get calls where we see Regional Centers have a completely different understanding of what autism is and how to find like how to find it eligible, completely different understanding of fifth category and what diagnoses counts or what gets rolled out. So standardization for intake and assessment, it's a huge project.

I understand we're talking about just the right timelines right now in this context, but it's a much bigger progress of that and can go much deeper into where the practices are that diverge across Regional Centers.

The other really quick points I want to make about accountability and like the steering Committee and other meetings, I think the word that people are looking for is partnership, right? We've heard like people will talk about the "what", but the administration will focus on the "how".

And obviously it's an administration's prerogative about like how to move things forward. But sometimes just, let's just say in life we see like someone says, good idea, I'm going to run with it, I'm going to implement it.

And then the person that had the idea to begin was like, that's not what I had in mind about how it's going to affect me. And so it's in the implementation phase, the how, having those same partnerships, having feedback loops like, is this working? Are we on the right track? That's, I think, what people are looking for.

And in that way it's okay not to have the substantive technical expertise on everything, right? It's that partnership between people that's the mark that, you know, when I uplift Oscar's idea about steering committee, what I'm thinking about in my head as well.

Amy, I know you wanted to share something, but I want to add another question so you can to you specifically in your response as you see these recommendations, what is needed for Regional Centers to absorb some of these that are specific to them, like, what do you need for Regional Centers to be successful?

So I think the. That's a really good question in terms of what we need in order to make these things happen.

And I think some of it is tied to one of the comments I made a bit earlier about once we have, to your point a few minutes ago, we've had some clarity about what it is people are seeking for a long time.

I think the value of this process was allowing us to explore it in greater depth and really understand when we say standardizing intake, what does that mean? When we say standardizing vendorization, what does that mean? And then the next piece of this is really, then what data and metrics are going to tell us when we're successful.

But also understanding that Regional Centers, just like everyone in the social services arena, are operating with limited budgets in terms of what's possible.

So if we're going to expect the system to be more responsive, which is something we all want, we all want it to be a system of partnership and responsiveness, then what are some of those pieces that we can peel away and maybe find technological solutions for.

Or maybe there are some processes that are underway today that have outlived their usefulness.

So I think taking that look at ensuring that our expectations for the system then match the funding structures that are in place, and that's a huge piece of it because without doing that, you can't ask the system to do more with the same amount, but you can ask it to differently.

And I think that's really fundamental to this process, is we're taking a step back and asking the system to do differently. And we anticipate doing that, of course, in collaboration with the department. But one of the other key things is we need is partnership with our community to do that.

Thank you.

Well, thank you so much, Senator Menjivar, for those questions. Really want to thank everyone on the panel for coming and giving us an overview. I know this is just the beginning because the report was just released last month.

I think that it will be incumbent on all of us to continue to have these conversations and the dialogues and these oversight hearings with joint policy and budget so that we can really ensure that we are doing the right things at the right times with the resources that we have. So I want to thank everyone.

And with that, we will move to issue number three, Public Records Act, AB 1147.

Madam Chair, Members, I'm going to be real short on this one. I think I actually covered most of it in my opening remarks. We wrote a proposal based on the enacted law. The approach has been thought through. We're providing legal support and advice to Regional Centers as they think through compliance.

We are probably not building out an IT system at the department to support its implementation as originally envisioned. It's an important transparency measure that Legislature enacted. The Governor signed last year becomes effective January 1st. And we are doing everything we can to support Regional Centers and be important prepared for implementation of the requirement.

I will just make the side note. In the current environment, across everything writ large, privacy is really important. So I just want to say on the record to you, but also for people listening, there are many legal protections in place for their own private personal information. And we fully intend to comply with those laws and requirements.

Meaning you have access to your own information, but you don't get to know things about everybody else around you in a way that's identifiable. I think all of us would support that. But I want to say it on the record that those protections are in place.

Thank you. Anything from the LAO? Anything from DOF? Any questions? Very good. We will now move to issue number four, Rate Reform Employment Services.

I will try to be similarly brief on this one. There are two things that this language attempts to do. This is a Trailer Bill proposal aligned with the implementation of rate reform. One, In addition to establishing appropriate rates for services, one of the goals of rate reform was to simplify the service code structure.

There are provisions in statute now that require use of a particular service code for employment to only include bills from nonprofit organizations supporting people with employment. And by definition then that forces us to use a .055 misc services code for for profit providers of that. So we are trying to eliminate the restriction.

We are interested in maximizing employment less care about who does it as long as they're doing it well. So there's a statutory amendment to allow both for profit and nonprofit providers to use the service code. And then we are also cleaning up one place in statute that specifies the actual rate to be provided.

We publish all of the rate models and those are the rate models that should be used. So we're instead referring people to the rate model section of our website as opposed to specifying the rate dollar figure in the statute. So that's what this language is intended to accomplish.

Thank you. Any comments from LAO? DOF? Not seeing any questions here. Thank you so much. We will now move to the State Council on Developmental Disabilities.

Thank you Madam Chair Members.

Thank you.

And thank you, Senators. Aaron Carruthers with the State Council on Developmental Disabilities. I'm joined today with Chief Deputy Director Rihana Ahmad. The State Council exists in federal and state authority to be a disruptor in the system, to make systems more accountable, more agile to the people they're there to serve.

And we're largely federally funded and can do it in a number of different ways.

If you think about the State Council, you look at the state org chart of different departments, the State Council, we're not under any other department or agency and we can move sort of like a free radical among those different departments, finding where there are barriers or problems that keep people with developmental disabilities from living fully integrated lives in the community.

And in doing that, we can focus really on any issue. It could be regional centers just like the department was just here. It could be interactions with law enforcement, emergency responses to disasters, could be housing, special education. So we have authority and flexibility in our federal funding to get involved in really any issue.

And one of those issues that we've been involved in is the issue of rights and what happens when someone's rights are taken away through conservatorship. And are there other options for people who need different tools? And in doing that, we focused on a project called supported decision-making.

And the Legislature, through a one-time appropriation, gave $5 million in the 2022 budget act for that purpose. We have a BCP in front of you to ask for for reappropriation of the remaining dollars. We have most of it out in grants out in contracts.

Just need a bit more time to make sure that we carry out and execute those agreements. I'll pause for any questions on that issue.

Thank you. No questions. You can continue.

Thank you very much, Madam Chair. The other issue is that we are federally funded for large part.

And last Thursday on April 17, we learned of a leaked document from the President's Office of Management and Budget that would give details and specific numbers to the reorganization that had already been announced by the US Secretary of Health and Human Services. In this proposal, it proposed zeroing out all federal dollars for DD councils across the country.

That would eliminate our federal funding. It would also zero out funding for many programs that serve people with disabilities, developmental disabilities, aging Californians. It really is another continuation of the assault, this multi-front assault on people with disabilities and aging Californians that are coming from the federal administration. Now, it's a plan.

It's not an official proposal by the President, but it strongly points to their thinking. We're waiting to see what the President proposes. Whatever the President proposes, then Congress needs to act on it. So we're waiting to see how this process plays out for these dollars which are proposed for the next federal fiscal year 2026.

A little bit more urgently is our current year funding. The federal government hasn't issued us a notice of award for the remainder of the federal fiscal year. So the federal government was set to shut down March 14th.

They passed a continuing resolution keeping the federal government open from March 14th through the rest of the federal fiscal year September 30th. And our funds, our dollars for our federal dollars have not been released. We cannot access them. So we're waiting to see how this plays out. And we're making contingencies because the two together, a proposal to zero out our funding overall and no releasing of the current funding may mean we get no more federal dollars.

So we're making contingency plans if that's the case. We are also continuing to work in our independent capacity in Washington, D.C. for a better outcome. So we'll keep the Budget Committee apprised of developments. Thank you.

Thank you. Any comments from LAO, DOF?

Two questions. Can you share what percentage we depend on the federal government for this? And then the second, are those dollars flexible or are they specific to certain services within the department?

I can speak directly to my dollars and our dollars are-- We have a federal part of our budget that is entirely federally funded. It has the authority. It funds the council with our governor appointee council members. We have the authority to be independent, work in anything that impacts people's lives. It is very, very flexible.

We have some other funding that are contracts with the Department of Developmental Services for reimbursement contracts on specific tasks. It's separate. So everything I'm talking about regarding this advocacy, supporting people with developmental disabilities to be their best advocates.

Right now we're leaning very, very into the space of protecting Medicaid, making sure that people are able to tell their story. They know what's going on, they know what Congress's plan is and they know what they can do about it and inviting them to be part of meaningful solutions.

So with our federal dollars, we're leaning very much in that space. So that's an example of how flexible it actually is.

Department of Finance? Department of Finance. Because we still haven't gotten for this fiscal year our federal portion of it, at what point do we do we need a-- I mean, are we going to see a May Revise, incorporating general fund to offset or at what point do we need to worry about this current year?

Chris Odneal, Department of Finance. I think that's difficult to say. I think as we've, as the administration has shared in other Committee hearings, we're continuing to monitor, you know, challenges at the federal level, particularly in the release of federal funds.

So I think the exact timing on that, Senator, is a little challenging, but it's something that we're continuing to monitor and we're in communication with our different departments and entities as well.

Okay. But the council has been able to function this fiscal year without?

We still have cash flow to keep functioning, even though we only receive funding through March 14th. And I agree in support with Department of Finance's position that we're in close communication. And in my head, I know when I need to send a flare over to them like, okay, need your help.

Okay, thank you.

Thank you for those questions. And so I guess it is concerning that you haven't received the funds that were already promised or supposedly allocated for this year. And so if that does not happen, then what will happen? Do we have any idea?

Chris Odneal, Department of Finance again. I think, again, it's just there's a lot of-- there's a lot of question marks out there with how things are, you know, happening at the federal level and what we're monitoring here.

I think broadly we can say, and this has been shared in other settings as well as from our leadership as well, that, you know, as we're continuing to monitor, that should federal funding not materialize to a great degree, like, that's not something that we're able to necessarily backfill across the board.

And that's just we wanted to-- you know, that's something we've shared previously and I need to reiterate. So broadly we can speak to that. I think when it comes to specific departments, you know, we're just continuing to monitor and have those conversations and just it's information that we appreciate.

Yeah, no, I know it's an extremely tough budget year for us as a state.

And so when you are talking about some of the contingency plans, excuse me, that you all have been discussing or planning for, have you thought about that fact that we as a state may not be able to backfill any or most of what would be coming from the federal government.

Yes, Madam Chair, have thought about that. And my purpose in raising these issues are really just to put a flag to say this is-- here we are, it's where we are today. We can kind of see the horizon there. In reality, there can be different outcomes. We're going to keep working for the best outcome, but I'm here in front of you, Senator, to say this also could be another outcome.

Thank you. Thank you all so much for coming to present and letting us know about that issue at the federal government level. We will now move to our next item, the Department of Rehabilitation.

Good afternoon Chair, Members of the Committee. Kim Rutledge, Director of the Department of Rehabilitation. I'm going to start out by providing a brief budget and caseload overview of the department.

The Governor's budget includes $570.6 million in total funds, which is 83.6 million in general fund for DOR in fiscal year 25-26, which is a net decrease of 786,000 over the updated FY 24-25 budget. As of March 2025, DOR had 161,101 participants in the vocational rehabilitation program, which represents a 15% increase from last year.

Out of those participants, 55,482 are receiving DOR student services, which represents a 7% increase from last year. To briefly go over the reductions, the department is implementing the CS 412 and 405 reduction in alignment with the administration's directive to protect core services and minimize impacts on consumers.

As such, for the position reductions, we will be eliminating 66.5 positions, generating a savings of 11.4 million, which is 2.4 million general fund and 9 million federal funds for us. And on the operational efficiency side, we are going to have a reduction of 649,000 in our general fund operating expenses.

And any other questions on the reduction overview, I defer to my colleagues from Finance and can take any questions on our budget overview.

Thank you so much. Any comment from LAO, DOF? Okay.

All right. Moving on to we have three programs that are one-time funded programs that are expiring this year. I'll cover brief updates on each of those, the first one being our Traumatic Brain Injury Program.

We were able to expand this program with $5 million as a part of the Home and Community-Based Services one-time funding. So we were able to expand this program from 6 to 12 traumatic brain injury sites throughout the state. And we were able to serve unserved and underserved areas in 33 counties statewide.

The services to consumers in those expanded areas will continue using existing sources the department has. From April-- Hold on. From April 2022 when the money was received through September 2024, the program sites provided 80,433 core services to over 4,000 traumatic brain injury survivors, family members and stakeholders in 41 counties.

The expansion resulted in doubling the number of individuals served. The HCBS funding was successfully utilized to stand up new program sites in communities where there were gaps in services. And our goal is to be able to continue serving all of those populations with our current funds.

I'm going to move on now to the Community Living Fund. That was also funded through one-time HCBS funds. In November 2024, seven months prior to the program's end date, the goal to serve 1,360 consumers was met. As of January 2025, the department has served 1,413 individuals with institutional transition and diversion services.

Of those that were served, 1,236 individuals received diversion services, preventing them from going into an institutional setting, While an additional 177 individuals received services to transition from an institution to an independent living in their own community. With this one-time funding, it will end in June 2025.

But our goal is to ensure that individuals who still want to either transition or diverted from having to go into a facility, receive the supports they need through alternative funding and other community resources.

I'll finally briefly touch on our Integrated Employment and Recovery Program, which also ends in June 2025. That was funded through funds from the opioid settlement. This program provided employment and career services to nearly 3,000 individuals in treatment facilities, of which 550 went on to receive the full scope of vocational rehabilitation services.

The program also trained professionals working in these facilities on the efficacy of including employment services during substance use treatment. And we were also able to train DOR staff on how to better serve this population. We're currently partnering with San Diego State University to publish a program evaluation by the end of 2025 of this program.

And with that, I am open to questions.

Thank you. Anything from LAO, DOF? Senator Menjivar.

Maybe Department of Finance, since the Employment and Recovery Program was funded by the Settlement Fund and we continue to get money, can we continue to fund this program?

Kayla Knott, Department of Finance. There are no plans at this time.

Was it-- Director, is it a successful program?

It has been successful, yes.

Okay. I mean, it's not general fund money. I'm just wondering.

We can-- Well, we can note the interest, Senator, and take it back.

Okay. And then, Director, on the Community Living Fund, you said alternatives to connect them to community resources. Is there a-- What's the word I'm looking for? Not supplement. Is there something that exists that can do the services that the Community Living Fund was doing?

There are a number of existing services through both the Independent Living Centers that DOR oversees as well as some of the programs the Department of Aging oversees that does provide some of these transition and diversion services already.

Okay, thank you so much.

Thank you. Thank you so much for the presentation. We will now move to the next issue item from the Department of Aging. And we will begin with issue number one that a California Department of Aging budget overview. Thank you.

Great. Good afternoon, Madam Chair, Members. Mark Beckley, I'm the Chief Deputy for the California Department of Aging and I'm joined here today by Andy Sachs who is our Assistant Deputy Director for Administration. I'll begin with the budget overview. So in fiscal year 25-26, CDA primarily returns to a baseline funding level, totaling from $404 million.

Of the 404 million, CDA's overall budget in fiscal year 25-26 is 165 million general fund and 208 million in federal funding. 80% of the overall budget is dedicated to local assistance funding. Our largest program is nutrition programs, both home-delivered and congregate and that constitutes 56% of our budget.

And the remaining funding is allocated to a variety of other programs that support older adults caregivers such as our Long Term Care Ombudsman, information assistance, legal services, caregiving, transportation, health insurance, counseling and aging and disability resource connections.

In terms of other funding sources that we've received over the past several years, per the 2024 Budget Act, $365 million in federal home and community based services funding was awarded to CDA to make available for encumbrance and expenditure and liquidation through December 31, 2024.

Local partners have expended 91% of the funding across all of their local programs. The funding that the locals were unable to spend was transferred to the Department of Social Services as outlined in a March 10, 2025 JLBC notification.

Regarding the American Rescue Plan or ARPA funds that we received, the AAAs continue to spend down the final year of the ARPA funds. CDA was allocated $138 million in ARPA funding and the funding expires September 30, 2025. The ARPA funds are separate and distinct from the HCBS spending plan funds that have already expired.

Finally, the AAA has also continued to spend down an investment of $186 million general fund for the Older Californians Act modernization that was included in the 2022 budget. The purpose of these funds was to stabilize nutrition and other services programs that were supported by Covid era funds such as HCBS and ARPA to avoid any service cliffs and discontinuing services for folks receiving these services.

The nutrition component of the funds are available until March 2027 and the supportive services funds are available until March of next year. To the other question regarding the efficiencies.

So in terms of efficiencies to state operations in the current year, we really focused our reductions on state operations functions, such as lease savings, travel equipment and unused lease funding. Our goal was really to minimize the impact to local programs and to critical state operations, and we think that we've done that.

We also eliminated three programs that were related to training regulations and a program position whose functions were able to be absorbed by other program team members. So that is a summary of our state operations reductions and I'll pause to see if you have any questions on this item.

No. Anything from LAO, DOF?

Okay, so the next question is to provide an update on the $4 million in CDPH licensing and certification funds that were provided to our Long Term Care Ombudsman program in the 2024 Budget Act. So this funding was released to the AAAs in August of 2024. The AAAs engaged with CDA and their local ombudsman contractors.

And some AAA's actually provide ombudsman programs directly as well. And so we allocated the funding and then they worked with their contractors to determine how those funds would be spent. Happy to announce that all the funding has been encumbered and is currently in use by the local ombudsman programs.

They've expended roughly about 40% of the total allocated funds.

The funds are available for expenditure until June 2026 and the sites have used the funds to start hiring either part time staff in order to expedite the completion of investigations and to do additional facility visits, purchase new equipment for field use and purchase new vehicles for better access to facilities.

And I'll take a pause to see if there's any questions on this item. Yes, Senator.

Do you have any additional data on the changes that this investment created? I know you briefly mentioned examples, but--

Yeah, I mean we could get more details, certainly. Like I say, what we're hearing from the field is that a lot of it is being spent on staff and it is important because, you know, they promptly respond to investigations.

What the additional staffing allows them to do is to complete those investigations quicker with additional staffing. And then of course to complete additional facility visits, there are federal requirements around the number of facilities that need to be visited every year, at least percentage of facilities.

So this gets them closer to that, but we can certainly provide additional details. Okay, the next item is a summary of our budget change proposals. So I'll start with our Health Insurance Counseling and Advocacy Program proposal or HICAP. This proposal is a proposal that you've seen before.

This is a proposal to provide additional funding to our local HICAP providers so that they can hire a full-time volunteer coordinator position. This position really is critical because staffing for the high cap agencies have declined by 20% over the past five years. We especially saw during COVID a large decline in volunteer staffing.

And so what these positions do is they attempt to recruit additional staff and then train new volunteers. And at the same time that we've seen this reduction, we've also seen an overall increase in the Medicare population by 8.1%. So there's definitely a need in a band and these volunteers are helping to bridge that gap.

There are also three limited term positions for CDA to oversee data training and fiscal for the HICAP providers. I'd also like to briefly provide an update on our HICAP modernization plan. We mentioned this plan in last year's budget hearing. This is a plan to really address system needs in the HICAP system.

The key needs that have been identified is in the area of staffing. Like I say, they've lost a lot of staff over the past five years. So one of the elements of the plan will address staffing and how to address the staffing needs. A second key need is in the area of training.

As Medicare advantage plans get more complicated and as we're seeing a greater increase in Medi-Cal and Medicare beneficiaries or dual beneficiaries, there's very complex issues that need to be addressed there. So they're looking for additional training with those clients. And then additional marketing and outreach and public awareness of the program, like the AAA's.

We also say that our HICAP providers are the best kept secret in California. We actually reached less than 1% of Medicare eligible beneficiaries for our counseling services. So the plan will also address that. We expect to have that plan released within the next few months.

Okay, I will move on to our next and final BCP, the Multipurpose Senior Services case management system. So we're requesting resources to implement a new holistic case management and billing software system for our MSSP providers. This system really is essential to implement at this point.

Last year, the CMS released a final rule that required MSSP as well as other health care providers to implement what's called the Access Rule. What the Access Rule does is it has additional reporting requirements for incident management, grievance and population access to a variety of different health program services. The rule actually took effect January 1, 2025.

DHCS has received an extension until 2027 to come into compliance. And so by implementing the system that would allow our providers to come into compliance. Currently there are a variety of different systems, a lot of legacy systems that really can't do the reporting that's being required of them.

Also note a couple of other benefits of having a consolidated system. It would facilitate at the CDA level, our ability to approve enrollments and then also to create pathways for standardized data exchange with managed care plans so that we can better facilitate care coordination and eliminate duplication of services between MSSP and those plans.

So that's an update on our case management system BCP, and I believe I addressed the items in the agenda. So happy to answer any questions you may have.

Thank you. Any input from LAO, DOF? All right, not seeing any further questions. Thank you so much for your presentation. We will now move to the Department of Community Services and Development.

And you may begin.

Good afternoon, Madam. Excuse me. Good afternoon, Madam Chair and members. I am Jason Wimbley, Director of the Department of Community Services and Development. CSD works with community based organizations dedicated to helping vulnerable Californians achieve and maintain economic security, pay their home energy bills, and meet their home energy needs.

Today, as evidenced by the excellent budget overview contained in the agenda, CSD is largely a federally funded department. Today I'm here to present the department's two budget proposals and provide an update on CSD's federal funding.

So, summary of our proposals so I'll start with the first one which is our Prop 4 expenditure plan that's tied to our Low-Income Weatherization Program Farm Worker Housing Component. Proposition 4 was approved by voters November 2024 and authorized $10 billion in general obligation bonds to protect communities and nature from the impacts of climate change.

Many of the investments called for in the climate bond can be delivered through existing programs. In keeping with this, CSD schedule to receive $10 million for the farm worker housing component. The Low-Income Weatherization Program reduces households energy costs and greenhouse gas emissions by funding energy efficiency upgrades and rooftop solar systems at no cost to low income households. With a focus on multi-family and farm worker housing.

The farm worker housing component has been in operation since 2017 and targets services to vulnerable farm worker households across 18 counties with the highest farm worker populations. The services of these programs offers the offerings of the programs lessens the financial burden that these households face for managing their home financial burdens or energy financial burdens improves health and safety all the while of reducing energy consumption at the dwelling site and greenhouse gas emissions.

The funding will be used to extend the farmworker services in the program that's in current operation. I'll pause there to field any questions. The second proposal is focused on the department's compliance with AB 1163. CSD is requesting an augmentation of general fund to implement statewide data collection system changes to meet the requirements of Assembly Bill 1163 which requires a collection of voluntary self identification information pertaining to sexual orientation and other demographic data. CSD works with 60 CSD sub grantees that collect data at the local level through third party data collection system.

In order to meet this requirement of to meet the statutory requirements, CSD and sub grantee intake systems will require modification to collect the required data. The 2024 State Budget Act appropriated 943,000 to CSD to assist compliance with the statutory requirement.

However, after further analysis it was determined that additional changes are needed and that the cost for the system modifications would be closer to $2 million. So the request is for an augmentation for the difference. So I'll pause there. Okay. So to question two, describing the status of CSD's federal funds.

Given the move to eliminate the LIHEAP division and the Office of Community Services under the Federal Administration, I will start with that programs to acknowledge that program staff were recently laid off in the Federal Division of Energy Assistance, which oversees the Low-Income Home Energy Assistance Program and is under the Office of Community Services.

As of today, we are not experiencing any impacts to light to our ability to access funds and provide benefits to low-income households as a result of these job cuts. And our priority remains on maintaining the effective Administration of LIHEAP funds awarded to CSD and ensuring that California is continuing to receive uninterrupted access to essential LIHEAP services.

This remains the case for all of our federal programs which continue to receive funding to operate and provide vital services to low-income Californians. As of today, California has received approximately $215 million in federal funding for the 2025 LIHEAP grant and $33.8 million in funding for the 2025 Community Services Block Grant.

These funds were appropriated by Congress under continuing resolutions last year. 2025 LIHEAP funding received thus far for LIHEAP is approximately 90% of the appropriation for 2024 and 2025 CSBG funding is approximately 50% of what we received last year.

Congress passed a continuing resolution in March 2025 that funds the Federal Government through the rest of the federal fiscal year. CSD is currently awaiting details from our federal partners on the final awards for those two core grants and additional grant awards that may be forthcoming to California. And that completes my update.

Thank you. Anything from LAO?

Thank you, Madam Chair. Ginny Bello with the Legislative Analyst Office. Just a note that we've reviewed the BCPs and we have no concerns to raise at this time and that we will also continue to monitor any federal changes.

Thank you. Department of Finance? All right, not seeing any questions. Thank you so much. Oh, I'm sorry.

I looked over there just for further clarification on the Prop 4 funding. LIWP.

Yes.

Previous general fund funding.

Yes. So that program has been funded with greenhouse gas reduction funds as well as general funds in the past.

Okay. And then we're no longer doing that to utilize Prop 4 money.

So the current program, the current iteration of the program is scheduled to run through May of 2026 and then the $10 million will be used, if approved, we'll use those dollars to initiate another program cycle. So that will require us to do procurement, stakeholder engagement, contracting, and then the program will continue to operate with the Prop 4 funding.

Okay. I know that some of my colleagues have been a little concerned regarding utilizing Prop 4 for not utilizing Prop 4 for new programs and not to offset in current programs. Since that was. So I just want to clarify, since that's what voters wanted, like investment in new programs and not to offset what we currently have. So I just wanted to clarify. That's what we were doing.

Yeah. Senator, Christopher Odneal with the Department of Finance. I think just two clarifications too on the general fund and previous greenhouse gas reduction funds. Those are one time augmentation. So to your question about like, are we not funding these anymore with those fund sources? Those were all one time augmentations and similar to what's proposed through Prop 4. And I believe in the, in the text of Prop 4, on the actual ballot initiative, $10 million was specifically cited for this program.

Thank you so much.

Thank you.

All right. Thank you so much for your presentation. We will now move to Department of Child Support Services. You may begin.

Kristen Donadee, Director for the Department of Child Support Services, joined by Nan Chen, Chief Financial Officer. Thank you for the opportunity to speak about our budget today. The Department of Child Support Services collects annually approximately $2.5 billion and the bulk of that is sent through to our families that we serve.

The first question we were asked to address was an overview of our proposed budget for 25-26 and how we are implementing the operations and vacancies reductions. Our proposed budget for this year is $1.2 billion, which is $373 million in state general fund and $830 million other funds, which is generally federal funds.

We have two thirds matching funds from our federal partners. For our adjustments, we have routine adjustments such as an increase for employee compensation, a decrease for retirement and a small increase for federal funds for our statewide cost allocation plan. For our local adjustment, we have a 3.4 million increase in federal funds from our federal performance incentives.

That's based on an increase from our prior year actuals, a small decrease for mandatory fees that we have to pay to the Federal Government as well as a $1.18 million increase for a newly awarded Section 1115 demonstration grant. In terms of the reductions, we are focused on our mission critical operations.

We do have 40 positions with the detail to come in terms of those vacant positions in which we're eliminated. Pause. Any questions? Thank you. For the first year of implementation of our pass through for formerly assisted families, we have updated our estimate of the cost for that program and that's a reduction.

We're estimating that to be a total of 118 million that will be passed through to families, which is a reduction of approximately 47 million. So as we implemented, we did identify there were two different populations where there will be direct recoupment that we had been unable to estimate the size of those populations prior to implementation of that project.

So the reduction of 47 million from the pass through does result in an increase of recoupment to the general fund of $25 million and those two populations. The first is a state funded aid code that nevertheless relies on the maintenance of effort categorization from the Department of Social Services so they are considered currently assisted still.

And the second is for individuals who pre deceased the parent who's paying that support. And under the statute that means we are unable to deliver those funds to that person and so they are directly recouped. Questions? All right.

In terms of additional savings, we were able to allocate about or expend, excuse me, about 92% or 95% for last year. I think we're on track about the same. We're able to have a few redirections already where we've reallocated six points to other LCSAs to do their day to day work, 6.3 million for our tech refresh needs, and 2.2 million for special depreciation.

The two year budget agreement for the reduction has caused our LCSAs, or local child support agencies, to hold some positions vacant over this two year period to plan for increases in salary costs that they expect to see and are seeing already over this time period. So we don't expect that savings to be long term. Thank you.

Thank you. Anything from LAO? Department of Finance? All right, not seeing any questions. Want to thank you so much for your presentation. We will now move to the public comment portion for today. If you want to speak, please come to the mic. You will have one minute to speak. Thank you.

Good afternoon members of the committee. I want to thank you for your leadership and dedication to aging and disability issues. They intersect on a number of levels. I'm Christina Mills, the Executive Director of the California Association of Area Agencies on Aging.

We strongly support the $15 million budget request to expand California's aging and disability resource connection connections, the ADRC network. This funding has the potential to double the reach of ADRCs helping serve over 300,000 Californians annually. Older adults, people with disabilities, and caregivers alike.

At a time when programs are being restructuring and policy is uncertain, ADRCs are the stable, trusted network that people can count on. Whether it's a change in Medi-Cal, IHSS, or caregiving support, ADRCs are the frontline navigators helping people find answers and access to services. Thank you for investing in the future of aging and older adults care and coordination in California.

Thank you.

Thank you, Madam Chair and members. My name is Ted Jackson. I'm the Director of Public Policy and Community Engagement at the Marin Center for Independent Living. We are in strong support of the $15 million increase for ADRCs. My organization partners with our local AAA to be the ADRC in Marin County known as One Door.

It has been instrumental in bringing older adults and people with disabilities together. This expanded funding would support building out a statewide no wrong door system, supporting new and existing ADRCs in communities where access has long been limited, especially rural regions of the state.

The ADRC budget is small and we've had to be efficient in providing navigation support for older adult and disabled populations. Earlier we heard about the Community Living Fund. My center is the highest level provider of the Community Living Fund in the state. And we were able to backfill some of these transition diversions coming in through the ADRC. But we can't do that anymore because that program is gone. So we desperately need more funding into the ADRC program.

Thank you.

Thank you.

Good afternoon. My name is Dan Okenfuss, Public Policy Manager for the California Foundation for Independent Living Centers and here to proudly support our ADRC budget request. This modest increase is a smart investment. For every dollar we put into ADRCs, we prevent higher costs later.

So very dynamic modeling of more for less, reducing ER visits, avoiding institutionalization and easing pressure on our dear family caregivers. The return on investment is more than 3 to 1. That's much better than my 401k right now.

In times of uncertainty when federal or state programs shift, ADRCs are the consistent low resource, local resource that people can turn to. They don't just connect people to services, they help them adapt to change. California can't afford to lose the stability in this program. Let's expand these programs by moving forward with our modest budget request. Thank you.

Thank you.

Good afternoon, Madam Chair, members. Carl London, here on behalf of the Alliance Supporting People with IDD. Wanted to talk about the Department of Developmental Services really quickly. First on the discussion of the provider directory and the QIP incentive, just want you to be aware that a high percentage of providers have struggled with trying to complete that directory process, it isn't easy.

Many have multiple programs under different names and registrations and if they're at risk for losing 10% of the race simply because they can't get through the process that the department's running, that ought to be a concern for everybody.

These are rates that we all agreed need to get to the providers to be able to help them hire employees and run quality programs. There shouldn't be a barrier on that. Second thing I'd say is just an answer to your question earlier, Senator Menjivar.

The cost of business for these programs are mostly employees and we run under a strict 85 15 rule. Financially we have to give 85% of the money to the employees. But keep in mind please that the administrative costs of doing business are also rising dramatically as well and those have to be addressed as part of the rates.

Last thing I'd say really quickly is that programs are at real risk for failure. Any limitation on what's happening through the rate changes that affect those programs will cause programs to go out of business. And I'm hearing that every single day. Thank you very much.

Good afternoon. Rebecca Gonzales with the Truth and Justice in Child Support Coalition and the Western Center on Law and Poverty. On child support, there is broad support to keep moving toward full pass through for currently assisted families.

The harms caused by TANF recovery policy undermines our state's goal to end child poverty and negatively impacts parent child relationships, co-parenting, employment opportunities, and housing stability. After DCSS reports back to the Legislature in January 2026, we urge the Legislature and Administration to include full child support pass through in the 26-27 budget.

We would also like the Legislature to consider trailer bill language that ensures all all government collected child support collected and formally assisted cases is paid to or benefits families and children with respect to parents who could not be located.

The Legislature should evaluate whether the one year time period for former recipients of aid is sufficient with respect to parents who are deceased. We suggest that the money be passed on to the new guardian or to the child themselves that they are of age or return the money to the low income non-custodial child support support pain parent.

Okay, thank you.

Thank you.

Hi Madam Speaker, I am Christopher Bennett. I am a board member of board directors with regional centers and DDS and our our communities are being affected due to the fundings and we would like to ask our communities are gathering in sowing how we receive our supports and services with regional centers and we represent regional science from each city.

My question is after reviewing the materials that you were talking about from earlier. What kind of future what kind of future are we going to receive supports and services in the near future and how we go about it and how we go about it within our communities for us to keep thriving for every day.

Thank you.

Peter Hansell, Volunteer Advocate for AARP California. AARP supports two stakeholder proposals that are part of today's agenda. AARP supports the California Association of Long Term Care Ombudsman's request for non general fund augmentation to support the Long Term Care Ombudsman's programs.

As you've heard, older and dependent adults in long term care facilities must have consistent access to these services to ensure they're receiving the highest quality of care and experience the best quality of life. Our second support is for the augmentation of $15 million to support the emerging and existing program functions of the Aging and Disability Centers that has been spoken about.

These are Central to the 10 year master plan for Aging and its much developed efforts to create a no wrong door system for Californians to access services regardless of income, condition, or location. These centers have been funded at the same level for several years despite the expansion of this program and therefore we urge the committee support of this important request.

Thank you.

Madam Chair and members. Alex Torres with Brownstein on behalf of the Special Olympics of Northern and Southern California, here to voice our strong support for the proposed investment. $68 million in state funding 34 million for the Special Olympics Northern California 34 million for the Special Olympics Southern California.

These funds will be used over a five year period to help expand operations statewide and increase services for individuals with intellectual and developmental disabilities. This investment is especially critical due to ongoing challenges, as you've heard with the regional center caseloads and insufficient funding for background. In the 2022-2023 budget cycle, Special Olympics received 30 million in state funding.

That was for over three years. This investment allowed significant expansion of programs and services. We're very thankful for Senator Ashby's leadership in the Senate and Assemblymember Nguyen's leadership in the Assembly. Look forward to the continued conversations on this and urge your support of that investment. Thank you so much.

Thank you.

Madam Chair and members of the vommittee. I'm David Solo, President and CEO for Special Olympics Northern California and I want to give an update on the return on investment from the prior funding that was just alluded to for Special Olympics California.

In the area of health and safety we we conduct over 6400 preventive health screens in optometry, dentistry, podiatry, nutrition, and audiology. Our mental health initiative Strong Minds is making significant strides. Young adults in Special Olympics programs are 49% less likely to be diagnosed with depression than their non participating peers.

Approximately 50,000 people with IDD have taken part in health and fitness activities, leading to a 15% reduction in diabetes rates among adults with IDD compared to those who don't participate. Equity and Inclusion Our Unified Champion Schools has reached over 1100 schools and 340,000 students in the state.

Increased inclusion and confidence for students with and without IDD decreased bullying and teasing, reduced use of offensive language and improvements in test scores, attendance, and gpa. Thank you.

Good afternoon, Madam Chair and members. Kevin Lee from Special Olympics Northern California. With the minute that I have, I just want to highlight a few data points for your consideration. According to the latest NCI survey, 70% of California adults with IDD report not participating in any regular physical activity or exercise.

Our Wisconsin Chapter worked with researchers from the University of Wisconsin, Madison and they examined Medicaid services usage and healthcare costs from 2007 to 2017. This research was published in the Journal of Policy and Practices in Intellectual Disabilities and found that our athletes had significantly lower health care and pharmacy claims as well as lower health care costs compared to non athletes with a mean difference of over $80,000 after adjusting for ethnicity, race, and age.

While Special Olympics California provides programs at no cost, we do not qualify for reimbursement through the Department of Developmental Services, Regional Centers or adult day programs. Despite this, we fill a critical service gap for individuals supported by these systems. This is why your support is critical and we ask for your help.

Thank you.

Thank you, Madam Chair, Senator, and staff for your work coordinating this hearing and your leadership on these important issues. Andrew Mendoza on behalf of the Alzheimer's Association. We're in strong support of the budget request from the California Long Term Care Ombudsman Association to utilize special fund reserves for Long Term Care Ombudsman Program mandates.

These programs are a critical resource for the more than 700,000 individuals living with dementia, their families and caregivers. They assist with establishing and implementing quality measures that protect and enhance the lives of individuals living with dementia, regardless of their care setting, which is a priority for the Alzheimer's Disease Association. Thank you.

Thank you.

Good afternoon. My name is Karen Jones. I'm an Ombudsman. I've been an Ombudsman for 26 years and I run the program in San Luis Obispo County. I'm also on the Board of Directors for the California Association of Local Long-Term Care Ombudsman and I'm here in strong support of our budget proposal.

We are also targeted by the Health and Human Services federal proposal and it is very concerning. These funds are going to be used to provide direct services. There's no profiteering with these funds and they also do not affect general funds. So they go to making sure people in care facilities have quality of life and quality of care. And thank you for your consideration.

Thank you.

Good afternoon. Susannah Meyer, Executive Director for Empowered Aging. We are the ombudsman for three Bay Area counties. Recently two of our ombudsman conducted a routine visit to a six bed facility and found the front door unlocked and open.

The facility residents, primarily bed bound and impacted by dementia and Alzheimer's, had been left unattended as there was no staff present. They'd not received any meals or water for the day, nor their required medications. Our team contacted emergency and licensing officials and stayed with the residents until their safety was secured.

The state funding we are desperately asking for is available outside of the general fund. We. We were already seeking this support to meet the critically growing need. With developments at the federal level and risking funding cuts, we are even more in crisis. This is literally life and death and we are asking for your help. Thank you so much for listening.

Thank you.

Hi. Crista Barnett Nelson, Senior Advocacy Services. Also the Board Chair for Cal COA, California Long Term Care Ombudism Association. We represent Sonoma County. I thought I'd tell you a story about representative. Recently we had a gentleman call one of our ombudsman who to state that within two hours he was about to be evicted to homelessness.

This was an unlawful eviction. When she went over to the facility there were five people that were being moved to homelessness. There was no lawful reason she was able to rescue them and they still live in there. This is the importance of what the ombudsman do. We save people. Critical services that we provide. Thank you so much.

Thank you.

Hello and thank you. My name is Ginger Perini and I am with the Long Term Care Ombudsman program in Los Angeles. Our county is the home of one third of the state's skilled nursing facilities. During a recent facility closure where over 60 residents were being relocated, the ombudsman program provided resources and support to older adults who are coping with the trauma of learning that they were being relocated from the home they thought they would be spending their final days.

California cannot compromise its promise to ensure quality long term care for older Californians and the Long Term Care Ombudsman Program is a vital part of ensuring this quality of care. Please fund the Long Term Care Ombudsman Program adequately. Our older Californians depend on it.

Thank you.

Hi, my name is Rachel Tate. I am a social worker and the Vice President of Ombudsman Services for Wise and Healthy Aging. We house the Los Angeles City and County programs as well as the San Bernardino program.

The State of California borrowed from accounts outside of the general fund that have a stated purpose of funding things like the Ombudsman Program. The program now faces the additional threat of federal cuts. Protections for long term care residents should not be sacrificed during these challenging times.

During a recent visit to a facility in our county, an individual shared with the Ombudsman that he was being physically abused by the facility staff. The Ombudsman was able to assist him with resources including relocating to a safe environment.

The non general fund asked to support the Long Term Care Ombudsman Program is critical to ensure that we are keeping our promise to older Californians living in long Term care facilities that they are still a valuable part of our communities and deserve to be protected. Thank you.

Hello, my name is Eden Rosales. I am the Acting State Long Term Care Ombudsman representing the California Long Term Care Ombudsman Program and we support the Ombudsman funding request.

As you have heard, Ombudsman are the people going into facilities daily and directly improving the lives and care of all residents through their work of complaint resolution, information sharing education and maintaining a presence in care homes. During the past fiscal year, the ombudsman program received approximately 35,000 complaints made by or on behalf of residents.

Almost a third of those complaints included an allegation of abuse. Additionally, ombudsman provided over 100,000 instances of exchanging information with residents, their loved ones and facility staff. However, There are over 300,000 long term care beds in California.

With the increased complexity of complaints received, coupled with our severe drop in volunteer numbers because of several factors including the pandemic, it is imperative that there's adequate funding to support the rebuilding of our volunteer base and increasing our paid staff to ensure those volunteers have the support and supervision they need. Thank you for hearing us today and thank you for your consideration of the Ombudsman funding request.

Thank you.

Madam Chair and members, Tiffany Whiten with SEIU California. As a member of the Master Plan, definitely appreciate all the thought and the efforts that went into it. Look forward to exploring opportunities and ways to implement the recommendations related to service coordinators.

And DSPs also want to express our continued support for DSP University, think it's a great program and should be implemented within the whole system and then related to child support in support of the complete pass through. Thank you.

Thank you.

Good afternoon Chair and members. George Cruz on behalf of the California Behavioral Health Association. First we'd like to express our strong support for the master plan for development services and the broader investments that make this vision real. We urge the committee to fund and support these recommendations so they don't become another roadmap without a destination.

Second, we want to voice our support for investing in direct supporting direct support professional workforce. These workers are at the front line of care and they support daily living, dignity and community connections. And yet they're underpaid and overstretched.

Initiatives like DSP University and bilingual pay differentials are critical to ensuring that people with IDD have consistent culturally responsive support. Lastly, we support continued investments in PAVE initiative. PAVE is a model rooted in dignity and choice and it reflects the kind of person centered care that people need across the state. Thank you so much.

Thank you.

Madam Chair and Senator, I'm Doug Pascover here with Imagine Supported Living Services in Aptos, California. Here in appreciation for the rate reform which has allowed us to hire trainers, compensate and keep caregivers better than ever before with consequences, positive consequences for the outcomes of those we serve. Thank you.

Thank you.

Hello, I'm Jacquie Foss. I'm the Board President for the California Community Living Network. And I'm also a somewhat retired policy person. So I get to say whatever I want whenever I want because I'm not a CEO. One is Senator Menjivar, thank you for talking about DSPU. He such a critical component.

If we want to talk about sustainability of our workforce, we need to be able to professionalize that workforce. And also that I want to talk about that. The agency that I'm the founder of is a pilot for bilingual pay. Bilingual pay for the deaf staff. What that has led to is increased retention and recruitment.

People being respected for having a second language is really critically important. So I think that's also a piece of the workforce initiatives. And the other one is please take a look at the technology initiative. I think that could be really powerful in the State of California. When we bring technology into the home of a person with a disability and they're not so dependent on a workforce, they have more autonomy and Independence.

And then I would say on the Master Plan 167 initiatives a lot, it'd be really nice to see them categorize short term, long term midterm plans so that we don't get lost in being overwhelmed with 167 initiatives and their master plan doesn't gain dust on a shelf. So thank you so much for your time.

Good afternoon. My name is Jay Kolvoord. I'm the CEO for Strategies to Empower People. I represent multiple people with IDD and most of the group that you saw earlier here today that were deaf. Their current day program services are at risk if there's not a change to the rate reform. All of the people that we support in those programs are working and being paid above minimum wage to work.

And so if there's not a change in the language of that, they will lose their support and we will have to look at something different for those folks who have worked for over 20 years and their staff who are also our deaf and signing really quickly also I was a member of the Master Plan, felt very grateful to be a member of that.

I will echo what was said earlier by all the self advocates. Was it enough time to be able to focus on things that we need to do to really transition the Master Plan into a living document? Families are needing it, people with IDD are needing it, Vendors are needing it. We need to focus on what actual changes need to happen and not just let it die.

Thank you.

Good afternoon. Mark Melanson, Chief Executive Officer of the California Community Living Network. We're so pleased to report that the work on the PAVE project, Person Centered Advocacy, Vision and Education is progressing with the selection of the first pilot regional center. This is the on the ground pre pilot implementation that will happen this summer early fall.

The DDS PAVE team members and DDS leadership have been great partners to support the project to get it where it is today. We look forward to keeping the community updated as we work as our work continues on development of individual level quality outcomes measures. My second comment is regard to the Master Plan on Developmental Services.

I was also on the Stakeholder Committee in a work group. What we have now is a list of 167 recommendations. It's what we do next. That's the plan. The plan should 1 focus on what's already being worked on 2 what can be done that will result in the most beneficial impact and three can be done in the shortest amount of time. CCLN looks forward to working together moving forward. Thank you.

Hello, my name is Eric Ciampa. I'm with United Cerebral Palsy here in Sacramento. Just four quick points I'd like to emphasize regarding the discussion regarding Master Plan and system reform first. The comments around the QIP I think are very important. We need continued oversight around QIP. Please heed the LAO's comments around unintended consequences.

So that's something that's particularly important with the implementation of rate reform, the transportation rates and really the system is broken and that needs to be continued to be addressed. So that's something that is a big priority for us and our advocates. Master Plan we talked a lot about intake. Intake is great. We're fully supportive of that.

The next step is initiating services. We need to make sure that families have a great introduction to the first services in the Regional Center, which is often early start, early intervention respite services. So we've got the respite standardized respite assessment that's coming up. We see huge opportunities there if we could do that right?

So we're in favor of that. And then lastly, just please remember those workforce initiatives, DSPU, pave the technology projects. We need those to synthesize the system. So thank you for your support and stay involved.

Hello, my name is Alex Mountford. I'm the President of the California Respite Association. I was also a member of the Master Plan. So I'll quickly just highlight that I agree with everything that's been said about that. I did want to follow up on Eric's comments about the Universal Respite Assessment SB 138.

We believe that that is an important assessment too, that that is going to do a lot to improve and help standardize and unify the system. We do have some slight concerns about that due to the short timeline and limited public comment too.

We believe that's important that for that to actually address equity and ensure that those services are being properly prescribed, that there is an appropriate amount of time for people to review, understand the tool and then make public comment. Thank you so much.

Thank you. I am going to ask for our comments to be a little bit more focused.

Thank you, Madam Chair. My name is Michael Smitsky and I am the Executive Director of the Child Support Directors Association of California. In regard to the DCSS presentation from earlier, I'd like to briefly address the savings for LCSAs and underscore the critical importance of maintaining full funding levels for LCSA support agencies.

It's essential to understand that existing budgeting processes inherently requires LCSAs to generate savings in the current year simply to meet the next year's obligations. The current methodology does not fully fund unavoidable cost increases like COLAs and other personnel and county related costs compelling LCSAs to consistently under underspend to sustain operations year over year.

Additionally, it's critical to emphasize that imposed cuts have outsized impacts. As a 4D program, the recent $6 million state general fund reduction effectively resulted in $18 million total cut due to lost federal matching funds. We urge this committee to prioritize restoring funding to LCSAs and reaffirm its commitment to workload reforms already set in motion. Thank you.

Thank you.

Good afternoon. Excuse me. Good afternoon, Madam Chair. I'm Barry Jardini of the California Disability Services Association. We represent providers throughout the state. Just a quick comment today specifically around rate model implementation. I really appreciated the focus on the quality incentive program.

Obviously it's critically important that as we face some difficult times ahead, we really stay focused on making sure that providers have access to the full 100% of their rate. Just a reminder that the 90 10 structure does not mean that providers don't need 100% of that rate.

So as we look forward, making sure everyone can access the full rate that was promised in rate model implementation. Also wanted to comment on Senator Menjivar's question earlier about the hold harmless provision. And as we see those that sunset go away, would it impact providers? Absolutely, yes. We worry about access to services and the impact on workforce who rely on wages that are built on existing structures. Thank you very much.

Good afternoon, Madam Chair. My name is Jordan Lindsey. I'm Executive Director of the ARC of California and the ARC United Cerebral Palsy California Collaboration and also speaking on behalf of the Lanterman Coalition. Last year we were talking about $1 billion delay. Glad we aren't doing that this year.

We do have the overhanging threat of Medicaid cuts that are being discussed in Congress. With that in mind, the coalition across the state has put together a small incremental proposals for this year that we think are budget neutral in this coming fiscal year. And that has been submitted to committee and we look forward to discussions talking about those including hold harmless and other items that have been discussed today. Thanks very much.

Hello. My name is Esteban Mercado. I'm a special athlete leader and health engineer from Stanislaus. I'm here on behalf of Special Olympics California. Special Olympics is important to me because, yes, I have participated in Special Olympics programs beyond sports, including healthy athletes, athlete leadership, and school initiatives.

These programs have been live training, providing athletes with essential health services, leadership opportunities, and educational resources to help them to fulfill their full potential. Through athlete leadership, individuals are empowered to use their voices to take charge of their futures and inspire others to embrace inclusivity.

The Healthy Athlete Program ensured that IDD athletes receive the care and support they need to stay strong, healthy, and ready to shine in all aspects of life. These initiatives prove that Special Olympics is more than just a competition. It's a movement that builds confidence and promotes dignity and creates a world where everyone belongs. Please consider our funding request that will help Special Olympics impact thousands of people in California. Thank you for your time and for listening to me today. Thank you.

Hello. My name is Tommy Holleman. I am a Special Olympic athlete leader from Sacramento County, and I'm here on behalf of talking with Special Olympics. Special Olympics is important to me because they included me when no one else would. I was cut from my high school's basketball team and then I was devastated because I thought I could do better. And I wanted to play with team with my high school, but they just thought I was too short for the team.

So I saw my brother playing Special Olympics and I saw how happy he was and I was eligible to join and so I did. And it was the best decision I honestly have ever made. I'm competing in a lot of sports now. I'm playing basketball, soccer, floor hockey, many. And please consider our funding for Special Olympics, and it will impact thousands of people in California. And thank you for listening to me and thank you for your time.

Thank you.

Hello. I'm Riley Casler. I'm from Lake County Special Olympics with Northern California. I'm an athlete leader and a health messenger and a global ambassador. I hope you will continue our funding and respect all and what we have done for people with disabilities. And we hope that you can continue to fund our program and do everything possible to keep this program running. I'm looking forward to doing my sports and continuing to play. Thanks. Thank you for your time.

Thank you.

Hello. I'm Hannah Stoner. I am a. I am a Special Olympics athlete leader from Stockton, California here on behalf of Special Olympics California. Special Olympics is important to me. It makes me feel included and lets me enter other opportunities. I love sports. Thank you so much.

Good afternoon. Hello. My name is Jake Lafrance. I am a Special Olympics athlete leader from Calaveras County here on behalf of Special Olympics California. Special Olympics is important to me because through Special Olympics I have been able to make been able to make new friends and create a whole new family and support system.

All while getting to do what I love, which is to participate and play sports. I love swimming. Because of Special Olympics, I become more confident and outgoing and that I can overcome any obstacle that comes my way. Please consider our funding request that will help Special Olympics impact thousands of people in California. I would like to thank you for your time and for listening listening to me today. Thank you.

Thank you.

Hello. My name is Jason Guillaume, and I'm a Special Olympics athlete leader from Sacramento County. I'm here for behalf of the Special Olympics California. And the Special Olympics is important to me because I competing against sports and I participated in every way. So I played soccer, softball, basketball, floor hockey, bowling, and much more.

And my goal is I have to win the medals and earning my friends and I really participated with my family too. Please consider our funding request that will help Special Olympics impact thousands of people in California. And thank you for your time for your listening to me today.

Thank you.

Hello. My name is Lillian. I am an athlete leader and health messenger from Contra Costa County here on behalf of Special Olympics California. I am a Special Olympics athlete that plays on two different teams. I swim for the East Bay Sea Serpents in Contra Costa County. I also play soccer for Team Oakland in Alameda County. Special Olympics is important to me because it has helped me be able to meet new people and make new friends. It has also helped me to be more confident in myself and to learn that I can overcome any obstacle I face within life.

Special Olympics is so beneficial to people with special needs because it creates a community and gives us a place where we can be ourselves and the opportunity to learn and create long lasting healthy habits. Please consider our funding request. The funding will help Special Olympics impact thousands of people in California. Thank you for your time today and for listening to me today.

Thank you, Madam Chairman and Committee Members. My name is Rebecca and I'm Lillian's mom. I just wanted to say Special Olympics is a really incredible program because it's with you from the very beginning until the end of Lillian's life. She never ages out and as a parent, that's something that I worry about constantly.

The second thing is it's really here to help support her growth and health, as well as all the other athletes. So now, in addition to playing soccer and swimming, she walks and bikes every day. Because of Fit 5, the health and nutrition program, she eats great, healthy, fresh foods and she makes them for us. And lastly, because of the confidence she's had in being a leader in this community and meeting others like these folks that have just spoken, she's had the confidence to live her dreams.

And her dream is to create a food company, which she'll be launching later this year, to employ special needs adults to make food for Special Olympics athletes at Special Olympics events. And it's incredible. She could barely speak, and now she's going to run her own company. That's the impact.

Madam Chair and Members, my name is Melissa Kelley and I work for Special Olympics Northern California. You've heard some impactful statistics from my colleagues today, and you've heard some impactful stories directly from some of my Special Olympics athlete friends. So I'm here in front of you just to say, please consider our funding proposal. It is very important, critically important. Thank you.

Good afternoon, Madam Chairman. My name is Matt Cohen. I represent Special Olympics Northern California in support of funding. You've heard from all our athletes and some of my colleagues. We are looking to continue to expand. We're currently only reaching about 7% within the IDD population within California and only about 5% in our schools with our Special Education department. These funds go a long way to expand our programs, and our overall goal is special in every county in California. So please, I beg you to take a look at our request.

Thank you.

My name is Dora Contreras, and I'm grandmother to a 32 year old young man with an intellectual disability. I wholeheartedly support self advocate Oscar Mercado's testimonial today. Especially as he mentioned the need for an oversight committee for the implementation of the Master Plan.

Recommendations that consist of leaders of community based organizations, self advocates, consumers and families of Regional Centers, and DDS representatives. Who better to inform you whether the recommendations of the Master Plan are being implemented than families and consumers directly affected by the recommendations? Thank you.

Thank you.

[Translated] Hi. Thank you for being here. My name is Blanca Mercado. Mother of a young adult with autism. Excuse me for speaking in Spanish. Thank you for the opportunity. First of all, I completely agree and support the recommendation that monitoring committees should be created to immediately implement the recommendations collected in the Master Plan and that there should be more community participation since they are the ones who really have the life experience and would be of great support.

[Translated] Second, in response to the question of how to make the work of the Regional Centers more effective, I dare to suggest that more collaboration be allowed from ICC type organizations that more closely support and facilitate the work of the social coordinators in order to more quickly and effectively follow up on the cases of clients or participants. Thank you very much.

All right. I want to thank everyone so much for coming out to this hearing. I want to give a special thank you to all of those from the Special Olympics who sat through the whole hearing so that they could give their testimony in the end. This Budget Committee hearing is now adjourned.