Assembly Budget Subcommittee No. 2 on Human Services

We're gonna talk about implementation.

We will call the Assembly Bill Jits subcommittee two on human services to order. Right when we thought we were done, they sucked us all back in. And so we are here to address some substantive and complex proposals as well as feedback, questions, and concerns about those proposals. These proposals came to the legislature at the May revision when there was very limited time for thoughtful discussion and consideration. These proposals are largely policy based, and the magnitude of possible impacts is large and system altering.

So we want to give them the space and time needed to fully understand the intention of the proposals and to hear candid, comprehensive reactions. So we will carefully consider what we hear today, and we will go back to members of the legislature and leadership, and we'll make sure that as we continue to engage with stakeholders as well, we will then discuss next steps, that might be taken, at this end of the legislative session.

As always, we always try to make sure that we lead, with one thing that is important, and that is how do we keep people stable. And we have to make sure that any changes that we make will also help in that stability and the long term stability of our systems, the long term stability of the populations in which, we are serving. So there will be no votes taken in today's hearing.

And as always, we will do public comment at the end. Two minute public comment. Two minute public comment each. You have you may not clap once you try to go over two minutes, though. So I implore you to practice now.

Alright? If you have more than three pages, I you are not getting done in two minutes. So make sure that you are practicing now, and we'll make sure that we hear everyone who wishes to be heard. So at this time, we'll just start off with our first panel. And our first issue is the equitable access to intake and services.

Are we going in the, order of the agenda? And so that means we will lead off, with the LAO.

Good afternoon, Chair Jackson, Karina Hendren, LAO. The subcommittee has asked our office to provide background information to introduce this item. We first wanna note that the proposal has two parts. The first part titled standardizing intake eligibility assessment processes relates to a regional center's determination of whether a person is eligible for Lanterman Act services. The second part of the proposal titled modern modernizing strengths and need evaluation relates to the identification of a person's strengths and needs after they are determined to be eligible for Lanterman Act services.

We'll next provide more details about each part of the proposal. Part one, standardizing intake eligibility assessment processes would affect the process that regional centers use to determine whether an individual has a developmental disability that is considered to be a substantial disability qualifying for services under the Lanterman Act. Today's agenda includes more details on how statute defines the terms developmental disability and substantial disability. The Lanterman Act establishes that any person believed to have a developmental disability is eligible for intake services in a regional center.

Statute does not go into detail on the exact way that regional centers should assess whether a person meets the definition of a substantial developmental disability.

Statute also specifies timelines in which regional centers must complete their eligibility determinations. According to DDS compliance standards data, regional centers met these timelines in about seventy percent of cases in fiscal year twenty twenty four-twenty five. Data has shown disparities in spending per person on developmental services when disaggregated by race and ethnicity. In response to this finding, the legislature adopted SB 138 in 2023.

SB 138 is budget related legislation that establishes legislative intent to provide more statewide uniformity and consistency and promote equity in the administrative practices and services of regional centers.

As part of SB 138, the legislature directed DDS to establish a standardized intake process. The proposal before the legislature today is intended to make progress towards this requirement and, by extension, to reduce disparities. DDS has stated that the first part of the proposal addresses inconsistencies across regional centers' eligibility processes. Specifically, the department notes that regional centers differ when diagnosing substantially disabling developmental disabilities.

The department has stated that its proposal is needed for achieving equity and consistency in individuals' experiences with the regional center eligibility assessment process.

Now moving on to part two of the proposal, modernizing strengths and needs evaluation. This would affect the process that regional centers use to assess their clients' strengths and needs to help inform the individual program plan or IPP process. The IPP is an agreement between the regional center and the individual served, identifying the services that will help the individual reach their goals. The Lanterman Act establishes that each client's IPP must be developed through a process of individualized needs determination.

The legislature's codified intent is that the IPP is centered on the individual and their family and considers the needs and preferences of the individual.

Statute also states that regional centers must gather information and conduct assessments as part of the planning process. The client development evaluation report or CDER is one type of assessment tool that regional centers can use to help inform the IPP. According to DDS, an updated CDER is required at least once every three years, and the CDER should also be updated whenever there is a significant change in a person's physical or mental capabilities.

Regional centers can also use the CEDAR as a tool to help determine whether an individual services might qualify to receive federal matching funds through Medicaid. SB 138 does not specifically direct DDS to address regional centers needs evaluation processes.

Nonetheless, DDS stated that this part of the proposal would also help improve consistency and equity across the state. The department has noted that the use of the cedar varies across regional centers. DDS stated that the second part of the proposal is meant to establish a consistent, equitable, and evidence based way for the developmental services system to understand each person's unique strengths and needs regardless of where they live.

For both parts of the proposal, existing law establishes the legislature's intent and goals broadly, but it does not specify details of the implementation process. The choice before the legislature now is whether to authorize the department to prepare a proposal for legislative approval that would set more detailed parameters for implementation.

And next, the department will provide more details on the proposal.

DDS.

Thank you, Mister Chair. Pete Cervinka, director of the Department of Developmental Services. I have some opening remarks and my my team will expand on those with more detail. Simply put, individuals and families deserve better. The two of the three proposals before you today directly address critical problems that have been identified in our meetings with community groups, in private meetings, and through the development of California's master plan for developmental services.

I wanna note there are two numbers on page one of your agenda, not three, but we treat the merging of the community placement program and the community resource development program as a separate third. Just

Okay.

I say that on the record to avoid confusion. I wanna provide a philosophical frame for all three of those proposals, why they're before you today, and some context. It feels necessary given that the rhetoric that we've heard about them so far is rather vastly disappointing at both the human and individual level. Problem number 1, everyone agrees that where you live should not determine whether you are eligible for Lanterman Act services. Where you live should not determine which services you can access.

A lack of any objective evaluation of acuity or magnitude of needs should not leave uncertainty in how much each sir of each service you should receive. I can talk a lot about whole person views, being person centered, being data informed, consistent definitions. You get it. Our two part proposal would use the existing definitions of developmental disability and substantial disability recommend to the legislature a proposed consistent operational solution to the front door problem.

It also would recommend to the legislature a proposed consistent statewide needs evaluation of strengths and needs, not just needs, across multiple domains in a tool that is valid and reliable to be used with Fidelity after evaluator certification.

I think it's worth calling out that the best part of this 2 part proposal is that nothing can be implemented without legislative approval. So, essentially, this first proposal is the equivalent of a very important multi year study bill. It's presented to you and the legislature because people deserve better. Problem number 2. Individuals have a right to live in the least restrictive and appropriate environment.

This is the core result of the Supreme Court's Olmstead decision many years ago. That decision led to California's closure of developmental centers over the past two decades. Our last remaining developmental center, Porterville Developmental Center, has a different purpose than the others did, and people should not be staying there for years. We have 14 people at Porterville Developmental Center who have been there longer than ten years, And every single one of those 14 people were civilly committed from day one.

At our Canyon Springs facility, we have more long stayers, one of whom's been there for nineteen years.

This is unacceptable, both for those individuals and it's just morally wrong, period. Setting reasonable time limits on their residency in those locations creates pressure for our programs to do better, to develop appropriate community placements that do not currently exist, provides time to do so, and also time to adjust later depending on how things go. And relative to May revision, now also includes a right of return if things don't work out in the community, because those individuals at these places also deserve better.

What I called problem number 3 is a little bit odd that it's an August discussion. This last proposal simply is an administrative proposal to collapse two programs into one.

The CPP program, the community placement program existed to develop community homes as an alternative for people exiting developmental centers. That mission ended with the closure of those developmental centers. The community resource development program exists to develop provide community provider capacity in response to locally identified needs for services, placements, and innovative solutions. It's always been prioritized for, but not limited to, resources for individuals with complex needs. Very similar purposes, so I have two programs.

We're asking to run one program instead of 2 with one set of requirements, one set of due dates for proposals, and one oversight and transparency mechanism. Does it sound like this combined proposal or even keeping those programs separate would help solve problem number 2, the time limits at at our other facilities? Yes, it would. But even if we decided not to help those individuals at all with the problems that I identified first, we'd still wanna do this proposal.

In conclusion, the community has asked for years for equal treatment at the front door and for fair access to services.

Where people live should not matter. People should live in the community, not in state run facilities. I have yet to meet someone who disagrees with that statement. No one disagrees either when government is described as a bureaucracy. Combining two programs into one is at least progress toward less bureaucracy.

These proposals will not eliminate eligibility for thousands of people. They will not change anybody's services. Page 12 of the agenda, and as alluded to by the LAO in its opening remarks, contains, purchase of service expenditure trends. Nothing in these proposals affects purchase of services.

What they do do is ensure that people have fair access through the front door and that the IPP teams, the individual program planning teams at which the person is the center, are still the teams making decisions about what services should be provided and how much.

Additionally, the only option to modernizing how we assess needs is not updating a 50 year old tool. It may be something worth considering. We've learned a lot from it. People should ask why it's not used by very many people at all. It's analogous to the you know, if you want a new ride, you don't just look to which models you can upgrade.

Sometimes it's worth looking at all the new cars on the lot too. Assertions about these proposals that they would do those things as a disservice and a disrespect to the individuals and families dealing with these problems every day. Whatever the fears and concerns are about this proposal, they can be addressed in the language. We've already shown significant flexibility here and prohibited any implementation at all without eventual legislative approval. The administration is seeking partners in making the system better.

We wanna work with people who bring solutions to these long standing problems. We are grateful to the many people in organizations who have reached out and sought some understanding. They've offered concrete improvements, many of which have been amended into our proposal since the May revision. These improvements include notice to legal advocates, explicitly enhanced public input. They've added significant detail to new legislative reporting requirements.

And as I've said a couple times now, prohibited implementation of either component of the first proposal without prior legislative approval. We know the legislature believes in equitable access at the front door. We know they believe that the legislature believes in providing services appropriate to individual person centered needs and believes in maximizing the information available to IPP planning teams that actually decide the services and how much should be provided. We know the legislature believes that individuals should live in the community.

We know the legislature wants to minimize bureaucracy and to improve everything we do through public input.

So today, very simply, we are asking the legislature to prove those things again by approving all three of these proposals after engaging with the administration and after public input, much of which you will hear today, to make these proposals even better. Thank you for hearing me out because people deserve better.

Anyone else from DDS speaking on issue number 1?

Yep. Two of us.

She know what I'm good at.

Alright. You may begin.

I need everyone to settle down, please. Alright. You may begin.

Okay. Hello. Good afternoon, Doctor. Jackson. Michi Gates, chief deputy director at the Department of Developmental Services.

Thank you for listening to us today. Go over a brief summary of the proposal again, even though LAO did a very good job with that. But just because there has been some confusion, again, there are two parts to this proposal. The first creates one way for regional centers to assess applicants for eligibility. It does not change the current definitions in law of development, developmental and substantial disability.

The second part is separate from that intake assessment process and focuses on how improving, how to improve regional centers, method for evaluating the needs of people once they are being served by the regional center after they have been found eligible. Both proposals, as has been stated many times, require robust community input and the approval of the legislature. So we would only be coming with proposals that would require that approval.

The proposal would make it easier for people who are applying to regional centers to understand how eligibility decisions secondly, it would provide a meaningful meaningful way to evaluate strengths and needs of people who are in the regional center system. This evaluation would strengthen how well people's needs are met and achievement of desired outcomes by providing information to planning teams about a person's needs.

It does not in any way replace the planning team or the person centered process. People need to be able to understand how the system works and feel empowered to fully participate in decision making as intended under the Lanterman Act. People need a system that supports them to achieve their desired outcomes. And they need data that can improve the system over time. These proposals do not create risk for people with developmental disabilities as any changes would require robust community input, partnership, and legislative approval.

The proposals are designed to improve supports and services to people who are applying to and being supported by regional centers. They create meaningful and transparent processes for important decisions about eligibility and the supports and services a person receives. With respect to intake and substantial disability, today every regional center determines substantial disability differently. This proposal does not change the definition of substantial disability. It proposes to create a valid, reliable, and consistent way to assess it.

The proposed needs evaluation would not be used to determine substantial disability. These are two entirely different processes. Regarding current work on standardizing the intake process under SB 138, the department has been meeting with many stakeholders to identify what is working, what isn't, and how to make those things better. As a result, the department believes that simply addressing the steps in the process will not improve the experience when a major concern is how eligibility is assessed.

Standardizing only the process does not address the core issue of not understanding how an eligibility decision was made.

In closing, again, the department is open to ideas about how to further strengthen the consultation and legislative review processes in the trailer bill language. Thank you.

Good afternoon, doctor Jackson. Christine Bagley, Department of Developmental Services. I'm gonna specifically tailor my testimony today around the cedar and the strengths and needs evaluation. So I just wanna lift up first and foremost that we're really committed to transparent and best practice research process that's aligned with both the Lanterman Act and Medicaid HCBS with the core purpose of this needs evaluation, helping IPP teams identify the supports and services that a person needs in their daily life.

This proposal, right, is is is only allowing us to move through a research and discovery process with the community, listening to the community, and coming back to the legislature for your review, consideration, and approval.

I just wanna underscore again. I mean, I think there's been, again, acknowledging a lot of confusion. You know, this this both components of this proposal, you know, are not going to replace the IPP process in any way. This needs strengths and needs evaluation is really to give teams information to help them make decisions. You know, right now, people are having different experiences.

We want every person in California served in the developmental service system to have the same experience, an equitable experience. Right now, every person is asked different questions depending on which regional center you're served by, depending on the experience and training of your service coordinator. This proposal makes sure that everyone in California has the same and equal foundation to build their planning process off of.

Additionally, the state has blind spots that are significant, which means we can't make changes that are informed to our system that are based on people's needs. So we can't confidently today tell you how many people have a mental health condition, how many people need access to a speech and language therapist, or how many people need crisis service services until it's too late.

What we we know what we spend, but this is our opportunity to move beyond using purchase of service as a proxy for needs, and move into a future where we can understand what people's unique needs are, whether those needs are met or unmet, and what services we need more of, and where to direct those services in terms of local communities. In terms of the community engagement, I wanna be clear.

The department has not hired any contractors, entered into any contracts, or have any preconceived notions or assumptions or favor to any specific tool across the state. We are open. We are curious.

We want to use this study period to learn alongside our community to really see what's best for California. Community voices are gonna be central to this this process, and I just, you know, wanna start with the first step is even engaging our community and how they want to be engaged. It will be central to every step of this process. There was a lot of questions regarding the CEDAR, which is our current, needs evaluation. Can it be fixed?

Can we look at inter incremental processes to address that? We will be doing a baseline analysis of the cedar, but I wanna I wanna be clear. The cedar the cedar deficits are pretty significant. There's too many, and they're pretty big. It doesn't work well.

It was developed almost half a century ago, and it gives different results depending on who uses it. So some questions are confusing. They're outdated, even disrespectful and hurtful. They also some of the questions don't explain what they mean. If we make changes to the cedar, you touch one thing in that tool, right, we will have to go through an entire end to end revalidation and norming process.

It would no longer be the CEDAR after we addressed the substantial changes that this tool currently, you know, contains. So some examples of that is there is no way to track or understand people's changes in their needs across their lifespan. Also, things like mild to moderate to severe. Those are undefined. Right?

There's no operational definitions. We can't we don't know what those mean. So one service coordinator could think that a need is mild while another might define that as moderate. So those are scoring issues in terms of the the the foundation of the tool. So it also uses outdated medical terms that aren't aligned with twenty first century medical definitions.

There's been years of revisions, and you'll probably hear a little bit about that today. But some of those revisions have actually muddied the data because it's duplicating it's asking the same question in different areas. So, you know, in closing, I would just say, you know, we want to work with the community to adopt something that is modern, focused on strengths, you know, that is attuned to twenty first century needs, like cyber safety, social media, transportation, cultural identity.

And we look forward to working with the community to develop a proposal to put before the legislature. I appreciate your time.

Thank you.

Thank you. Now we have Harrington? Yes. Alright. You may begin.

Good afternoon. I'm Charlene Harrington. I'm a professor emerita at the University of California, San Francisco, and I have conducted research studies of the DDS program using the cedar assessment data. My DDS research studies show that individual needs are related to serve service allocation, use and expenditures. This is expected, of course, because if someone has more complex needs, they would need, more services.

But taking needs into account, we found that inequities in service allocation use and expenditures are of very wide for non white racial and ethnic groups. DDS also reports inequities for racial and ethnic groups. But because DDS does not consider individual needs in their reports, the actual inequities are likely to be even greater than reported. The regional centers vary widely in the level of their client needs, and yet the regional center budget allocations are based on previous historic budgets rather than client needs.

Inequities occur when in allocations are not adequate or appropriate to meet the needs of the of in individuals.

The regional centers are required to use the cedar, which is a comprehensive standardized instrument that identifies needs for services and supports and has been tested for reliability and validity. The cedar instrument, as you say, is is an old instrument, and it certainly needs to be updated on a regular basis to ensure that it uses current terms and testing, that it takes cultural differences into account, and that it includes sufficient in information on both skills and unmet needs in order to make appropriate allocation decisions.

Replacing the cedar would be expensive and time consuming. Either updating or replacing the cedar assessment will not necessarily improve equity in services and supports. If, first, the assessments are not completed of when major changes occur, and secondly, if the regional centers don't use the data in their developing individual program plans.

And third, if DDS does not use the data for planning and resource development purposes. So in summary, DDS should use assessment data for allocating regional center budgets and resources based on client needs of also developing detailed IPP allocation guidelines, providing additional staff education and training, and improving the oversight of regional center decision making processes and practices. Thank you.

Next up.

Good afternoon. My name is Vivian Hahn. I am a senior policy attorney at Disability Rights California and the sibling of a regional center client. Thank you for the opportunity to speak. First, my remarks today will focus on the service needs assessment piece of this proposal.

With regard to the language related to determining eligibility, while we agree with the department that those processes need to be standardized across the state, we believe that this can and should be done outside of this trailer bill. The topic that remains goes to the heart of everything we do in this system. What services do people need? How do we figure that out? What steps should we be taking to make those determinations?

A lot of confusion has come up regarding this proposal. But for the moment, I wanna focus on where we seem to largely have agreement. At a high level, I think we all agree that the way our system has historically determined service needs is not sustainable. That going forward, we need to find a different and better way to do this. That Californians with IDD deserve so much more from their case management and IPP process.

And that regional centers currently do not have and perhaps have never been given the resources or capacity that they need to do it right and do it better. I think there's agreement that whatever the new way is, we are going to need to do a lot more homework and have many more discussions before we even think about pulling the trigger on anything.

In other words, the more I've talked with all sides, the more convinced I am that actually we're not quite as far apart on the policy as it might seem. Each of us has a vital piece of the puzzle. We just need to figure out how the pieces fit together, and we need much, much better communication about what this proposal is actually trying to accomplish.

For example, thank you today for talking about acuity, magnitude of needs. Many of these things, it's the first time I have heard it that explicitly and specifically from the department. It wasn't stated specifically in your previous written materials, and I think things like that make a big difference. So thank you.

I also wanna thank the administration for recognizing how urgently we need to find better ways of figuring this out, for making this a priority, bringing a sense of urgency, and being willing to commit real resources to making change happen.

Thank you to this subcommittee for slowing down this process and taking the time to make sure we have clarity and a shared understanding of what we're actually trying to do here and why. Thank you to my fellow advocates and good friends for reminding us that even if you have the best and shiniest assessment tool ever, if the people it's meant to serve don't understand it and don't trust it, it's not gonna work.

As tough as this process has been, the clarification that I hope comes out of it will lead to much better policy for us all. DRC is absolutely committed to rolling up our sleeves and working in collaboration with everyone here to find a way through. Thank you.

Thank you. I'm I'm just going to ask miss Hahn and doctor Harrington if you can give your seats up to Mister Gomez and Mister Siampa Kiampa. Come on up. Mister Gomez, come on up. And we'll start off with Mister Gomez.

Yes. Good afternoon, Chair Jackson and members of the committee. My name is Fernando Gomez. I'm the cofounder and of the Integrated Community Collaborative as well as the vice president of Disability Voices United. That's both organizations that are led by people with disabilities and their families.

I'm also the father of two sons who rely on the California's developmental services system. So here today, it's not only my voice that I wanna share with you, but those of in the community, in the audience today across California. We're here to respectfully ask you to not just slow the proposal down, but actually stop it and evaluate it.

The creation of a new statewide assessment is one of the most significant policy changes our system has considered in decades, yet our community has not had adequate time to understand its long term implications to ensure California gets it right. DDS has listed has listened to stakeholders' feedback, and we appreciate the changes they've already made.

However, there's one fundamental question that remains unanswered. What problem is this new assessment intended to solve that cannot already be addressed today? Well, if the goal is equity, then the burden should be on DDS to demonstrate with evidence that this proposal will improve equity without creating new disparities or unintended consequences. We are particularly concerned about standardizing the definition of substantial disability. DDS has assured us that no one will lose eligibility, and we sincerely hope that that is true.

But the current law already allows eligibility Dem determinations to change. And if California adopts a narrow definition, future decisions can result in fewer people qualifying for for or retaining services. That risk deserves careful scrutiny before moving forward. We also question investing $11,500,000 in a brand new assessment when California already has a cedar. System whose consequences remain unknown?

We should also learn from other states. Oregon implemented a similar assessment process using the same consulting firm that's not working with DDS. And Disability Rights Oregon documented concerns regarding reduced services and decreased liability reliability. So California should learn from those experiences, not necessarily repeat them. But most importantly, a standardized assessment must never become a shortcut, a ceiling, or a substitute for the individualized programming plan.

The IPP is the heart of the Latterman Act because it recognizes that every person is unique. We're not a score. We're not an algorithm, or we're not a checklist. The disability community is not afraid of improvement. What we are afraid of is unintended consequences.

So I respectfully ask this committee to require DDS to demonstrate why this proposal is necessary, proof that it will not weaken the rights or reduce services, and ensure that every safeguard is written to the law, not left to future promises. And as I close, I have one question. Or one comment to say is that the Laderman Act promises individualized services, not standardized lives. Please give California it's time to get this right. Thank you.

Alright. Alright, audience. That's strike one. Relax. We gotta get through all this, so we're gonna be here for a very long time.

And y'all are last for public comment, by the way. So you remember that next time you wanna clap. Alright? Next up.

Thank you, doctor Jackson, member of the committee and staff. Thank you for the opportunity to speak today. My name is Eric Ciampa, and I'm with UCP of Sacramento in Northern California. We're a provider of in home respite, transportation, camp, and social recreation services, and independent living. I'm just one of many advocates dedicated to reforming our service system.

I've been asked to provide my perspective on the proposal and the some of the origin explains from the origin of the stakeholder concerns and define what may meaningful stakeholder engagement would look like. First, I'd like to clarify where I think we have agreement. Community believes in building better assessments. Recent clarifications from the department have been appreciated. Thank you.

There's much to agree on. One important question being asked is whether our system is adequately prepared to take on this important work. I think that concern is understandable. The proposal arrived at a time when federal officials are questioning HCS eligibility and spending, making unsubstantiated allegations and disputing the role of paid family caregivers. It's a time in California where there's a time when California continues to project rising expenditures and possible reduction in federal reimbursements.

Although the feared budget cuts never appeared, that anxiety remained. Additionally, our system has engaged in similar projects recently, such as a standardized respite assessment and the new transportation rate models. Unfortunately, these initiatives fell short of stakeholders' hopes and expectations. Those experience taught us that building trusted assessments is difficult work. It's complicated.

So where do we go from here? I have three ideas. First, let's recognize what's at stake. Many have already spoken to this. Assessments are part of the gateway into this system.

They help orient new families on how the system works, what to expect, and what's our values. As a resp provider, I often sit with these new families as they enter our system, and I can tell you how invaluable it is to have a positive introductory experience and how harmful the negative one is. We must ensure that the on ramp into the system is built right. Second, let us draft a strong group blueprint for stakeholder engagement. We need clarity on what stakeholder engagement looks like.

Sometimes, it means providing feedback after key decisions have been made. I define stakeholder engagement as meaningful codesign if of the process and the tool from start to finish. It includes making consultants and data available to the community and developing the work in transparent phases with oversight. Third, let us build a tool that remains valuable to everyone. Build it so families understand it and find it useful.

Design it to stay relevant for planning team and service coordinators or service providers. Share it so the data is available to the community to improve experience, equity, and outcomes. And finally, I'll close with this. Fundamentally, I believe that advocates are less concerned about the proposal's technical details and more about building a better design and intake process. Together, I believe we can build better tools that enhance human decision making and equity.

And as advocates, I hope to receive that invitation from our department partners of the department partners of the department to join them as valued beneficiaries and cocreators. Thank you.

Thank you very much. So I'll ask you two to allow two others to come up from our regional center folks. Please come on up.

Thank you very much. So I'll ask you two to allow two others to come up from our regional center folks. Please come on up.

And Orange County, you may begin first.

Good afternoon, doctor Jackson, committee members, staff. Thank you for the opportunity to to be before the committee today. My name is Larry Landauer. I'm the executive director of the Regional Center of Orange County. I'm also a social worker.

Started out as a social worker. Worked my way up and going on eighteen years as the executive director. I think what the committee is probably wondering, why do we have to just drop the cedar? Get that great new product, put it in front of us, stakeholders, parents, everybody, let's we'll jump at it. Why not?

Why are we saying we're gonna cut something off before we even know? That that's my concern because of my almost 800 staff, the almost 10,000 service coordinators, all the clinical staff. The cedar is working. It is it is working. So that's the first question I just after hearing everything, let me get back on track.

I'm gonna run out of time here. In addition to my comments, I've submitted some details of everything that you're hearing in the CDER manual. All the regional centers are using the ARCA, very well laid out, document that we all have been using. All regional centers agree, met their medical staff on the that document is a value document then updated what 2023 or so. Very powerful.

You heard from the department and others about the cedar and its impacts on the community. I was invited here to share a bit about the Regional Center of Orange County. So you're gonna hear about our CoC and how we use the cedar. At our COC, we work to maximize the cedar to its fur fullest potential, as a tool that guides us in identifying services and supports for almost nine 29,000 individuals that we're serving. At its inception, the CEDAR was designed to be person centered.

The terminology needs to be updated. There's no question, because it says client oriented, but it should be per more that's basically person centered. Track people throughout the system. It it tracks longevity, provides measures of change and independence and living settings, provides measures of change in person's productive productivity and work settings is applicable to all service settings. All any service that you're getting, the cedar is able to, gives get some scoring, basically, Be applicable to all types and levels of developmental disabilities.

Not just autism, but all all categories. Our our fifth our five categories. The CEDAR is primarily a management tool. For management purposes, the CEDAR data is used for determining the number of persons with developmental disabilities. You do have some very solid data of why, somebody is eligible.

You that data, is, is very sound data that comes out of after somebody's declared eligible and that CEDAR cedar booklet is done. At least in Orange County, that is a doctor, psychologist, nurses. And what what else does it do? Budgetary purposes. We're able to pull up when we're looking at somebody, other similarities in from the cedar scores, and what are some of the other services that individual is getting.

We can see hundreds of, in some cases, if it's the more of the mild. And then even the more complex cases, there might be 14 or 15 cases. And it really helps with the, what what are the, the budget and what services are available. It establishes a priority of services according to the unmet needs of identified during assessment of the the individual.

So you're gonna start wrapping up? You're not gonna be able to finish all those pages?

There's there's more here than that.

I know. I see. So you can Let me close out in the most important part that hasn't already been said.

Yes. Let me get to the closing, basically. Medicaid waiver, all the regional centers are using this and it's billions of dollars. It is billions. The assess needs area is something that not only in Orange County, but all the ... centers.

It really helps to pull that in. That is been a very useful tool. And, lastly or it's, definitely the tried and true instrument for for Orange County. While we eagerly anticipate the the new capacity of capabilities of the life outcomes improvement system, Lois promises to deliver in the future, we believe the cedar can continue to coexist and be utilized during the lowest development. Introduction of this system would be make planning and information gathering much easier and interactive with parents and individuals served.

Again, we we're doing the cedar in person. We can bring it up on screen. We can bring it up on Zoom. It is interactive. Parents don't realize it's a cedar because we're going through questions to try to get to understand the individual better because parents will often say, oh, he he he trusts himself.

He takes care of his own hygiene. But when you get into the questions, you start seeing there is some assessed needs areas. Okay. And in closing, we believe the cedar is effectively working as it was intended. And while it has has been updated several times, it is current on the DSM five.

It is current on the ICD 10. Could use some additional revisions, especially the the language, person centered thinking language. And California's unique developmental services system, this is this is built for California. There's this is this has been built and modified and updated to the unique system that California is. We welcome the continuation of this conversation with the legislature, DDS, and the community as, together, we will work continue to continue improving the accuracy, efficiency, consistency, equity, and timeliness of the service system that delivery system.

Thank you. Thank you. Miss Wesley. Westling.

Good afternoon. Thank you for the opportunity to be here, doctor Jackson, and for the comprehensive work on this issue from your staff. My name is Amy Westling. I'm the executive director of the Association of Regional Center Agencies working to support all 21 of California's regional centers. I think it's important to take a step back and think about the Lanterman Act and the intention that was built into it.

Individuals basically have unique needs related to their eligible condition. Those needs change with time, and our services are designed to meet them where they are. The function of our system is to understand their needs and work in partnership with them and their families, to secure appropriate services and supports. And I think that's the greater context for the conversation we're having today. Over the years, I've worn a lot of different hats in this system.

I've been on both the advocacy side as well as the regional center side. And I think it goes without saying that our job, all of us, no matter what seat we occupy at this table in this room or in the greater system, our job is to use comp a comprehensive understanding of individuals' needs and their strengths to work alongside them to help them create the life they envision for themselves. That's that's what this is all about.

We owe it to those we serve to provide clarity about our decision making. The clearer and more transparent we are about the factors that do and those do that do not impact eligibility and other service decisions, the better for everyone.

Clear processes that we can point to build trust in fair processes. Basically, without having clarity about how decisions are arrived at, we leave room for people to misinterpret or misjudge our intentions and the thought process behind decisions. Systematically documented strengths and needs don't undermine, but rather are the foundation of a strong individualized planning process. Today, the cedar is used in a variety of ways ranging from a simple administrative activity in some places that is disconnected from individual planning to, as Mr.

Landauer said right before me, a jumping off point for service considerations based on those with similar, profiles of needs.

As miss Bagley stated, on a broader systems level, good information about needs, including those needs we struggle to meet, drive our understanding of the services we need more of and the gaps that exist today. Quality data fuels more strategic development and innovation. And today, we lack the data sensitivity to, really inform a lot of those decisions. More sensitive information about individual and overall strengths and needs could would support this work.

As Mister Landauer said, while operating quietly in the background, reliable data about the support needs of those we serve that is accurately reflected in their individual plans, which are then tied to regional centers purchases, generates billions of federal dollars to make possible our entitlement.

And it's the only entitlement in the nation, and it's possible only because of the federal dollars we draw down. In short, we all have the same responsibility to our joint community, reliable individual and systematic information about the strengths and needs of those served by regional centers is of unquestionable value. What lies ahead are decisions about how we all best get there together. Thank you.

Thank you. Department of Finance.

... Department of Finance. Nothing further to add

So this is because we have a very large panel. We're gonna do it this way. I'm gonna ask that we, please hit that button that we usually use for public comment. I'm gonna ask a few questions, and then any panelists who are in on the back in the audience, please use the mic right there if you would like to participate in that question.

Okay? Number 1, let me just say this. We were asked by leadership to spend more time on this issue. And I I think it was appropriate because ensuring that we uphold the fidelity of fair process is also important.

And for those that really don't understand the concept of fair process, and all it basically says is is that it's important for people to feel that the process that was used was fair to everybody so that no matter what the outcome of the of the process is, they trust the outcome because the process was fair.

Everyone following me? And so that's what we are committed to doing to making sure. And to be quite honest, the Assembly does not believe any proposal given to us in the May revise is a fair process. And so we wanna make sure that this is done correctly, because if the end users and the clients themselves do not believe that it was a fair process, they are going to not believe or trust or accept the outcome of whatever ends up being after the assessment tool is used. Okay? So first, I wanna say that. Number 2 is let's first deal with Cedar. Cedar was originally created fifty years ago. Is that correct?

Correct.

Okay. When was the last time Cedar updated?

2015.

It's important to note no update was comprehensive. They were minor changes and sometimes just the parts of it just so that we're clear.

So comprehensively, cedar has not been updated and research based and validated. Okay? This is what's important, and I need everyone to follow me here, is that when you the only acceptable tool to use is one that is research based validated. Nobody cannot can just add things to it and change it and say, yes, this feels good. Okay?

Everyone's following me here. So that means that if the entire tool has not been validated for fifty years, that is not a good tool. There's a whole lot of language that has changed. There's a whole lot of philosophies that has changed over time. There's a whole lot of research that has been conducted over the last fifty years.

So we need to make sure that we are using a tool that will make sure, that number 1, it is validated appropriately. And number 2, it is updated based upon today's most recent research and published literature. Okay? Now the next question that leads us to to this is how many possible other tools are available to us to look into that would help us deal with this issue? Because number 1, the fact that it hasn't been updated in fifty years is a problem, and shame on us.

Okay? Number 2 I I see you. And then number 2 is what alternatives are available to us that the community can then look at and engage in, and the end users can give feedback and as well, including feedback from clients and everyone involved. Do we know how many other tools that may be available to us? And if so, how many?

So just at a high level, I would just state that every state uses a tool, and every state uses a a variation of a combination of some set tools that are kinda more widely used and some tools that are homegrown like the CEDAR. There's some tool states that have developed their own. So I think what I would lift up is there are a variety even across the the the whole world, quite frankly. There's different tools used on Australia and The UK. And so I think, you know, that's the opportunity here.

Like, we don't have the answer. We want to engage in a full landscape analysis. We can make that available. I I think that's part of the study we'd like to conduct, again, in partnership with the community to to really evaluate because, you know, I think we can't yeah. There's a lot of options.

Okay. Comment, and then we'll come over

yes. At the thirty year mark, roughly 2007, we got rid of the, what was called the, Franklin factor in developmental level. They were very valuable scores for a long time, but those were replaced. They are now obsolete, and they were replaced with practical independence, personal and social skills, challenging behaviors, personal well-being, and integration and inclusion, all very important topics now that come out of the scoring. That was a great improvement.

So those those 20 questions really made a big difference as part of that. And back in In 2004, 2005, and that product coming out in 2007. So that was a and that those still apply today. Very important.

Okay. Yes, sir.

So trust the outcome because the process was fair. It's a great statement. When we as a community hear the word tool, it sends shivers down our spine. Now tools usually are good. They they help their they they they empower and they get outcomes.

But what we've experienced in using the an example as a respite tool several years back that was implemented, and it was it was supposed to be a beneficial a a a resource to help our community ended up being something that was really a a restriction. It took away services. The way it was implemented was very unbiased, if you will.

And so as we look at what options we have and we look and we're talking about things as tools, the red flag that was raised with the assessment tool tool as it was originally called was the fact that we will experience what we saw with the respite tool. Even though there are technically, there is no respite tool from DDS perspectives, there is a respite tool that is used by every single one of the 21 regional centers.

Hold hold hold hold on. I'm gonna keep in control of this baby. Alright, relax. Relax. Everybody breathe. Thank you for that. Let me go to the next one right behind you.

Thank you, doc doctor Jackson. And while I don't know the exact number of all the different possible assessments I can tell you what the to build on what miss Bagley was saying, the most widely used assessment tools in the Didi space in the country include, first, the supports intensity scale or SIS, which was specifically designed and normed for people with IDD. It this is the single most used tool.

It was designed to move away from a deficit based model and to focus instead on the frequency, duration, and type of support a person needs. Right?

And it covers more quality of life domains than older, more clinical models have focused on. The second is something called the interRAI. The interRAI, in I n t e r r a Aye, is designed to measure long term care needs across many different populations, including aging, physical disabilities, and mental health. This cross sector functionality appeals or typically appeals to state health and human services agencies where it's interoperability across sectors. There's something also called the ICAP, the inventory for client and agency planning.

It used to be much more used, but more recently, states have been moving away from the ICAP towards more more progressive, more strengths based tools. And as miss Bagley said, homegrown tools are one option of which the CDER is one. Oregon and Colorado are probably the most notable states right now who've chosen to develop their own proprietary assessment tools instead of adopting an existing off the shelf.

Right.

So so, basically We this information is out there, and I I believe that the department can tell you more.

No. I appreciate this. So it seems to me, and I'll I'll get I'll get you there, is that, number 1, we have a number of options. We can look at the various tools that are out there. We can do we might need to do our a new homegrown tool possibly is another option.

And or a mixture of them, but a properly validated once we understand what that mixture is. Am I am I correct in that?

That's correct. There could be combinations of different types of tools. I think, again, this is, I think, we're really open to listening and learning alongside the community, but, you know, maybe an off the shelf doesn't work for us. But I I I think that's where our study needs to, you know, we need to learn and and explore what will work for California and in California and our community. So lots of options that we can Right.

And does this mean that we intend to do away with the IPP?

Look for. Yeah.

Okay. That's what I need people to hear.

No. Not at all.

And and one last thing

That is unwavering.

That's what hold hold. I run this show.

If I may. Nope. That'll be helpful.

This is what's important because I understand how important the IPP is. And this so I need everyone to hear that. This in no way are we considering a replacement of IPP. We're only talking about CEDAR, which is already done in conjunction with the IPP. Am I correct in that?

I might have gotten the language wrong. But

You're correct. In practice, it should be done together. Correct? It would not replace the IPP. And I wanna I wanna underscore one more point.

It also is not going to determine services. The decision is with the team. The IPP makes the decisions about the service. But the evaluation should be what helps teams ask the right questions to make informed decisions in their planning process. And I just would thank you for the time to underscore that piece.

Absolutely. Now one more thing I just need for my understanding, and that is and what we have to understand is Fidelity matters. It actually doesn't matter what tool we're using

If it's not valid.

If it's not done with Fidelity. And in order to make sure that your level of service is not dependent on your location, the only way to do that is to ensure that the tools and evaluations that are used are done with Fidelity no matter who is doing it. And that they're properly trained to do so. So I am not concerned about one regional center doing it. What I'm concerned about is all the regional centers are not doing it correctly and with its proper Fidelity.

And it seems like that is something everyone knows and accepts. So we've gotta fix that problem as well. Okay? Regional sender, you have some comments, and then we'll come back there, and then we'll get to the director.

Yes. So just wanted to follow-up on the comment that Mister Gomez made related to a standardized respite tool that's used across the regional centers. At this time, that is not the case. The last time that there was a tool that regional centers worked on and implemented, consistently amongst themselves was about 2008. And for those of you that have been around our system for a long time, you know that that was the year that there were respite caps put in place on individuals.

And so regional centers got together and said, how can we within the cap that is now statutory, It was ninety hours per quarter. How can we build a consistent assessment tool? Those respite caps have since been lifted. Those tools are not used across that is. No.

Uh-uh.Hold on.

Is not used across the regional center system as was presented at 21 regional centers today. I just wanted to make that clear that there was a policy basis in statute that drove that action. And so it was, done at that time for that reason.

Vivian?

Thank you. On the note of, the IPP and and whether it would be replaced, and I am grateful that it would not that it would not be replaced. There are other types of tools to consider, more qualitative tools, because a more quantitative tool like the SIS and the other ones I talked about, those can give you some information. They can tell you love the levels of impairment. They can talk to you about the amount.

They can quantify, right, the amount of support you might need, say, to feed yourself or bathe yourself. What those types of tools are not good at is helping a service coordinator understand what is most important to and most meaningful to a person. What gives you a sense of purpose? What gives you a sense of community? Right?

What fills you with belonging? Right? That that quality of life stuff. But there are more qualitative tools out there that are were designed to do that. Are they good tools?

Are they tools that are appropriate for us? Are they tools that community can trust? I don't know. But there are tools out there that other states have been using for some time and that have been tested and trialed on many people. So there is the kind of research base that you're talking about.

So I would, what I would ask the administration is, would the administration be open to also looking at those types of tools to elicit some of that information and and to see what we can learn.

Okay. Thank you, director. And then we'll come back down here.

Five quick things, and maybe six. I appreciate the recognition that we must do something here, and I echo what we've heard from a few folks that there's a lot to agree on here as well. I agree with the statement you made that Fidelity matters. I'd like to offer a friendly amendment. However, I think the tool itself does matter.

It also has to be valid and reliable, meaning that when you use it with different people who are identical, you get identical results from it.

So I I I do think the tool matters. I would call out and answer to I just wanna reiterate what you said. Nothing here changes the IPP. We are proposing to inform the IPP. And I will remind the community too.

We standardized the entire IPP template statewide in January 2025. We are not about to throw it in the garbage. Just wanna be really clear about that. And I also one of the panelists today with us, Eric Chiampa, talked a lot about cocreation. That's exactly what we want.

We do not have a preconceived notion about this. You heard my colleague, Christine Bagley, talk about this. Everybody needs to have buy into the things that we do. This is something we are really trying hard to do across the board. Last thing, it's number 7.

I apologize. I will also share for those that don't receive our newsletters. We are required to implement a standardized respite assessment tool across the state. We announced last week that we are pausing that effort completely because it's vastly more complex and cannot be done in solely in isolation one service at a time for a wide variety of reasons. So we're coming back to the community to share the second draft of the tool, the data that resulted from it, and why we're pausing that now.

It's tough. It's complicated. That was one service. We know that this is complicated, and we know we need to do this together so that everybody understands what we're doing. Thanks for indulging all of those points.

Absolutely.

Thank you once again. This conversation is very personal to me. What's been discussed is something that not only our community, but my family and I have have experienced. My son is sitting right here. And what he has experienced through the system and what my other son who's not here because he can't be because the system failed him.

And when we try to do the course correct, what the system gave us was we're sorry. Twelve years of no services, no supports because a tool, an assessment that was not right, not correctly conducted to come back and said, we're sorry. And, Amy, the beauty of having such a large community present in these hearings is to hear on real time their responses to what your comments were in a sense about their experience with but the respite tool.

I think it's important to hear from them to to and to see firsthand what a tool, when not properly used, when implemented in a wrong way, will have the the the results that what you're gonna hear today. That's what my fear is, and that's why I take it so personal.

How many more people are gonna experience what my family experienced in an assessment that is so rigid and so structured that it's limited will not accommodate the need of those individuals who need it, who would years later, somebody receives a, I'm sorry. We cannot afford that.

Thank you.

Thank you. Absolutely.

Eric Champ with UCP. The respite tool has come up. That was part of my comments. And in in my comments, I mentioned that we learned from trying to go through the respite tool, which is a respite provider providing those services and being part of that stakeholder process, how difficult assessments are. And we appreciate the the recent announcement of the suspension.

I would just highlight communication is mostly nonverbal. So while we agree largely on the principles that are stated here today, we are not really sure what lessons have been learned about the respite assessment tool. Are we following similar guidelines or new guidelines? And as a hot pot and topic in this community and as a service provider and as a stakeholder offering feedback, it's it's led for some questions.

So I do think in the future, some of these things could be better handled and with with more clarity and more more determination.

Because you mentioned this, this is really about building trust first and then a good tool. Second, that's validated agree with all those concerns. And that's something that because of the circumstances, especially at the federal level, which is not the fault of the department, that it raises anxieties.

And so folks want tools that enable that empower human decision makers, but don't determine eligibility or don't determine a score in with AI and the the state of technology, everybody wants more tools, but nobody wants those tools to tell you how you live your life. And so the just reinforcing that.

And as I see folks nodding their head, I'm assuming there's agreement on that. But we just don't know where we stand on those issues, and I think that's some of the concerns today.

Thanks. So what we're what we want to do is this. Because also, I think what how this language within the trailer bill is written is also important so that there is not miscommunication or misunderstanding of what we're trying to do as well, which is why it's gonna be important for us to really pay attention to language. So and the people understand what the process or framework of what the process would look like moving forward so that people know possibly to what to expect.

And so I think that's what the challenge is that we're gonna have to work through.

Hopefully, we can get there. And, you know, we will be engaged as much as we need to to ensure that we are able to get there. And then also, it won't be and also making sure that we have proper feedback from those from advocates as well. Doctor, did you have any comments you wanted to make on this item? Lucky me.

Yeah. Yeah. You're the lucky 1. So so I I I think that, number 1, I think this was a very great discussion. Concerns have been heard.

Also, I hope that everyone in the room also has some clarification as well on what we're trying to achieve. And most importantly, I need everyone to hear that it is our intention to have a fair process. Okay? This decision is a start of a fair process. It is not the end.

Right? So at the end of the day, there's no decision to make yet until proper discussions, input, and research has been done to ensure that we are making the best decision possible that will ensure that individualized, timely, and effective services are given to the client. At the end of the day, that's what we want. And the only way to do that is to make sure also because it's also important that the legislature and the administration believes in the process as well.

Because at the end of the day, it's also gonna determine what type of budgetary allocations are gonna be necessary to ensure that people are getting the services that they need.

Services that they need at the individualized in a individualized way. Okay? And the last thing I will say and then, of course, we we never leave this room until we hear from the people on the ground and people most affected. So you will have I hope you've been practicing your two minutes, by the way, so that we can make sure that everyone is involved in the process. Okay?

Any other questions or comments from the panel?

Thank you, Mister Chair.

Okay. Thank you all very much. We'll go on to issue number 2. And after issue number 2, we will have public comment.

Alright. It seems like everyone is properly seated. Obviously [counting]. Who else does not have a seat that's supposed to be on? Okay.

So we're gonna go in the order of the agenda. Okay? So one, two, three, four. The first five on the agenda should be the one sitting here right now. Okay?

Alright. We didn't play hot potato. Right? We're good. Okay.

Alright. So issue number two, which is really two issues into one. Understand that. I get it. Alright.

So now let's go with Miss Bagley. I think you're you're kicking us off.

Sounds good.

Let's do it. Alright.

So I'm gonna open specific yeah. Is that fine? Okay. Perfect. Wonderful.

Appreciate the opportunity. I'm gonna specifically focus my testimony today on the state operated transitional and rehabilitative services proposal, and then I'll hand it to Angela Munoz to speak to the CPP CRDP proposal. This policy establishes clear timelines, 24 months specifically for to transition individuals that are living at Canyon Springs and individuals that are living at Porterville Developmental Center under a 6,500 commitment into community based settings consistent with the Lanterman Act.

The absence of time limits, has led the developmental service system to rely on Canyon Springs and Porterville as long term residential placements rather than prioritizing transitional and community based options. As a result, individuals have remained there for extended amounts of time, long beyond what's necessary for rehabilitation.

On average, Canyon Springs stays are about four years, and Porterville is five and a half with some exceeding stays of over two decades. We wanna thank our community partners for their input and feedback as it has guided this proposal.

In response to the feedback we've received, this proposal includes twelve month provisional placement into the community with the right to return to both Canyon Springs and Porterville should something go wrong, a built in 60 day extension to the 24 month limit when specific criteria is met, clear timelines and transition plan notifications to counsel to really enhance communication and collaboration across partners.

And in the development of an initial implementation plan that we would develop with our community partners, quarterly legislative briefing, updates, written updates that would be posted publicly to really provide updates on the progress of the implementation.

I wanna, just highlight, right? There there's concerns around the balancing of public safety and, you know, the rights of individuals. You know, it's important that we look at individuals as a whole person and not just focus on the event that brought them through the front door.

The Lanterman Act requires us to support people in ways that are safe for them and safe for the community. We have gone the a lot of the people in these settings have gone through years of medical, behavioral, and therapeutic programming, and their needs have changed over time. So it's not fair or accurate to assume that those individuals haven't made improvements or stabilized just because of the stigma of their previous charge.

We've also demonstrated as a department, and I would say as a system, regional centers, as a community, that we can do this. We do transition people from Porterville and Canyon Springs.

That takes place every day. And I would just note in terms of the right of return that's exercised over the past ten years, only 11 people have exercised the right of return to Canyon Springs. And Porterville only 14 people over ten years. That lets us know that the infrastructure, the oversight, the technical assistance, the capacity we've built and continue to build is responsive and keeping the individuals we're supporting safe and stable in the community and the community safe at the same time.

You know, as I disclosed, my last point would just say, you know, we're committed to working with all partners to make sure that we develop safe and successful transitions and capacity.

We've done this work before. Right? We've closed, we've moved thousands of people with complicated needs into the community when we've closed developmental centers. This proposal and the time limits will help us do this more consistently with a sense of prioritization, a sense of urgency while honoring the Lanterman Act, and most importantly, the individual rights of the individuals living at Porterville and Canyon Springs. Thank you so much.

Good afternoon. Thank you. My name is Angela Munoz with the Department of Developmental Services. Thank you, Doctor Jackson and members, for giving this opportunity to speak on the department's Community Placement Plan and Community Resource Development Plan merge proposal.

This proposal combines the community placement plan and the community resource development plan into one unified program. The community placement plan historically was created to develop residential supports and services for individuals that were transitioning from the developmental centers to the community.

With the closures of the developmental centers behind us, that original purpose of the community placement plan has been completed. The community resource development plan develops community resources to support services and needs for those individuals in the community while also prioritizing the development of resources for individuals residing in restrictive settings and with complex or with complex needs.

The community placement plan has always served this purpose. Essentially, instead of maintaining two separate programs, we are proposing one program with one name with one set of requirements that serves the same purpose. Thank you.

Thank you. Good afternoon, Doctor Chair Jackson and members. Aaron Carruthers, Executive Director of the State Council on Developmental Disabilities. In '19 since 1999, the State Council has had a unique role inside Porterville and Canyon Springs. We do independent on-site rights advocacy.

We also do volunteer advocacy services that follow former residents into the community for up to two years. So we're the only ones who see people from when they enter the developmental center through transition and beyond. So that gives us a really direct line of sight to whether these proposals would lead to good outcomes for individuals in the community.

We believe they will. To assess community safety, the State Council team did chart reviews of 585 individuals who have left developmental centers since 2015. Only eleven have returned on new charges, so that creates a recidivism rate of 1.9%.

Let's compare this to CDCR's recidivism rate of 39.5%. People who leave developmental centers with right supports don't come back. But what we see is the system's readiness to provide those supports has been uneven. We've seen an individual wait over seventeen years for a single appropriate provider.

We currently have someone with complex medical and behavioral needs who's waited more than a year for placement. We've seen a transition delayed two years by staffing shortages, and that delay itself triggered anxiety and behavioral crisis is for that individual. The pattern's consistent. The problem's not individual readiness. It's system delay.

That's exactly why a firm deadline is needed. It creates urgency. It creates accountability. And do we think the state will be ready by the proposed deadlines? Yes. State teams inside developmental centers have been preparing for the shift for 20 years.

Really, since the large scale closures of developmental centers began because the hardest part of that change has already happened, which is shifting the staff culture from believing people come and stay to knowing people come and go. All that's needed now is a deadline, to get those right supports in place, and we saw this with the closure of the developmental centers. When there's a deadline, the services are found, and needs are met.

We took an the language you have in front of you is it is good language. But in all fairness, in service to the committee, we took another critical candid look at this language to see if there are ways to strengthen it for both individual well-being and community safety.

So the State Council and Disability Rights California offer the following for the committee's consideration. One is to improve mental health supports. So identify mental health services and supports as part of the planning. Also, specify that CRDP funds are eligible for new mental health programs.

Next, strengthen oversight. Ensure DDS has aggregated data for each center to carry out its oversight authority. And last, improve backstops. Make it explicit that health and safety waivers can be used if needed to authorize service and supports. With these changes, the state can meet these deadlines responsibly, protecting both the people transitioning and the communities they return to. Thank you.

Doctor Jackson, members, good afternoon. Will Miner with Disability Rights California. The proposals in front of us reflect a long standing principle in our state. Disabled people should get the same opportunities as everybody else to live a life in their community. This promise runs through our Lanterman Act, and it also lies at the heart of the Supreme Court's Olmstead decision.

And at a time when the Federal Government is attempting to sharply limit homestead's reach, the administration's commitment to these principles is as important as ever. I also wanna briefly talk about the conditions that some of our clients experience in these facilities as context to underscore our support of this proposal.

There is chronic use of physical and mechanical restraints at Porterville and Canyon Springs. And at Porterville, where a mechanical restraint can mean strapping somebody to a bed for an average of 90 minutes, that's not okay. This is an average.

It's not a maximum. And while we acknowledge that restraint can sometimes be used in emergency circumstances, they are not therapeutic for our clients. They do not help prepare them for the community. They're traumatic for them. We have clients that would tell us, I wish I would rather be in jail than at Porterville.

So we support these proposals. But at the same time, right? our support doesn't mean we believe that transitions can just happen without safeguards. And we know that poorly plans or unsupported transitions that can also cause harm. So that's why we have consistently insisted on individualized assessments, thoughtful transition planning, appropriate community resources, and a meaningful safety net if things go wrong.

So to that end, I wanna acknowledge what Miss Bagley talked about. The proposals, they've improved significantly since May. They now require an implementation plan. You know, DDS show your work. Right? They require legislative updates.

They prioritize resource development for this population. And Miss Bagley talked about the one year right of return, that safety net, the what if it doesn't work out for this person? What do we do then? People can go back. We do think that there are a few modest but important changes that would make the proposal stronger.

We support the targeted changes that state council discussed that would strengthen transition planning and resource developments. We also support some of the changes I believe miss Regular will describe to that will strengthen the role of public defenders to participate in people's transition planning meetings. And we know we know that resource development requires, investments.

But let's talk about the status quo. It costs roughly $1,000,000 per person, per year for a person to remain at Porterville. Canyon Springs isn't that far behind. This isn't cost effective, and it's not unharmful either. We believe these proposals offer a responsible path forward. We support them. We urge the committee to do the same.

Thank you.

Thank you. Good afternoon, Chair and members. My name is Stephanie Regular, and I'm here on behalf of the California Public Defenders Association. First, I'd like to thank the committee, the Department of Developmental Services, and Disability Rights for working with CPDA over the past several weeks. We appreciate the amendments that have been made, and we support DDS proposals.

Specifically, we support reducing the overreliance on locked institutions like Porterville and Canyon Springs because too often they have become the destination rather than the step toward returning to the community. These facilities are typically hundreds of miles away from the person's home and importantly their families. These facilities usually are not the least restrictive settings, and they disproportionately house people of color.

Our state has made significant progress in diversion, community based treatment, and civil court options for people with serious mental illness, but we have paid less attention to people with developmental disabilities in criminal systems. Many of these clients are first identified as having a developmental disability in criminal courts instead of through the systems that could have prevented them from ending up in prisons, jails, and institutions like Porterville in the first place.

Most have never received services they should have received through their regional centers before ending up in a place like Porterville. I've represented clients charged with very serious offenses where it seemed impossible that they could ever succeed in the community. But once they finally received the right treatment, behavioral supports, housing, and specialized services, they didn't just stop cycling through the criminal system.

They actually built stable lives. This is just one of the reasons why we support DDS's proposal.

We also appreciate the amendments requiring increased notice to the court and counsel, written discharge plans, and quarterly reports on community based infrastructure and implementation. These changes are key to making sure that people are not transitioned from Porterville or Canyon Springs before they're ready and that community supports are in place when they are.

I would also encourage DDS to think beyond conservatorships as it looks towards reform.

Individuals committed under penal code section 1371 are often placed in these high security facilities even when they are charged with nonviolent felonies and misdemeanors. And as California moves away from institutional care, I hope DDS will also consider whether these individuals could receive treatment and support in less restrictive community settings much earlier.

It would certainly help with the transition if they're placed on a 6,500 thereafter. Finally, as Mister Miner alluded to, there is one remaining amendment we ask this committee to adopt. We ask that attorneys of record receive notice of and an opportunity to participate in individual program plan or IPP meetings. Public defenders bring a perspective that no one else at the table has. We know our clients.

We understand the court orders governing their commitments, and we often know what legal or practical barriers could affect a successful transition. Including defense counsel in IPP meetings will help identify those issues early and make these transitions smoother for everyone involved. Thank you.

And just for reference, for any of anyone testifying, if you have recommendations, please make sure we get it to the committee so that we have the proper time to reflect on them as well. I'm gonna ask our three advocates to give room for our next three, which is Napa District Attorney, STEP, and Regional Center. And we'll start with the, Napa County District Attorney's Office.

Thank you. Good afternoon, Chair Doctor Jackson, and members of the committee. Thank you for having me and encouraging a candid discussion today. My name is Taryn Hunter, and I'm honored to serve as Chief Deputy District Attorney of the Napa County District Attorney's Office and represent the California District Attorney's Association. For a little added context, I'm also the mother of former regional center patients.

But as a prosecutor who's handled these cases, the real life and practical concern I wanna share with the committee is that limiting the stay for all patients to 24 months in Porterville or Canyon Springs may not adequately protect the public. I certainly appreciate the sediment and laws which value treating and housing those with disabilities in the least restrictive setting when appropriate.

But placing what appears to be an arbitrary 24 month limit across the board does not acknowledge the unfortunate truth that some of these offenders and patients will continue to threaten public safety after the arbitrary 24 months. Based on the latest numbers provided, overcrowding does not appear to be an issue at Porterville or Canyon Springs. Both facilities have the capacity to treat their patients and more.

Current residents at Canyon Springs, as we heard, have an average stay of 4 years ranging from 8 days to 19 years, making just the average stay double the proposed cap of two years. Porterville, similarly appears to be flushed with available beds with residents averaging a five and a half year stay up to twenty six years. The average stay being more than double the new time limit proposed. Yes.

Some individuals may remain in restrictive settings for extended periods, but the real world actuality that I hope that the Chair and the committee do not forget is that some of these offenders require this kind of supervision.

Sadly, 24 months may not make, say a disabled child molester an appropriate candidate for lease into the community. That's just one example I pulled from my own county. No matter how extreme the level of violence, how poor treatment is going, or what complex needs or other mental health or behavioral issues a patient faces, under the proposed policy change, an offender must be moved into another community setting far below the current average stay.

That's a big change and one that does not appear to be justified by the data. I wanna remind the committee that there is already a process for extended stays.

These commitments under Welfare Institution Code 6500 are reviewed annually by the court. That is a legal requirement. And this review mandates an assessment and recommendation from the treatment providers. As a District Attorney, I don't decide who stays. I don't decide who's ready for release.

That's not up to me. Each case is individually analyzed by an expert, and placement is only extended when necessary. And as we can see from the numbers, the majority of patients are under recommendations for stays far exceeding two years. One of the purposes of 6500 is protect public safety, and that requires what I, a case by case analysis.

Moreover, we know that many of the people served do not have a qualifying develop not only have qualifying development, but also as I mentioned, a range of complex needs.

The patients who have been there for 5, 10, 25 five years, who are they? Why did an expert recommend they remain committed? Are they continuing to display violence even in that restrictive setting? I encourage the committee to review these specific cases, look into the real reasons that these longer term offenders have these extended stays and read the court reports recommending that they do not leave.

In closing, if I can better understand the tangible issues that need to be solved, I would be happy to be included in any ongoing discussion and could help identify case examples or applicable data for the community or sorry, for the committee and the community.

However, based on what has been presented thus far, I urge the committee to reject the relevant proposed changes and allow the current flexibility for a range of stays at these facilities, some being much less than two years. But I think to disregard the reasons that some of these folks are there for significantly longer would be shortsighted.

Thank you again for your time, your consideration, and for welcoming a discussion that also includes public safety. Thank you.

Absolutely. STEP?

Good afternoon. My name is Jay Culvert, and I'm the CEO for Strategies to Empower Think People. Thank you for the opportunity to speak today. I'm not an expert on Trailer bill language or legislative processes. I'm an expert on people and services.

You're the lucky one.

Sorry?

You're the lucky one.

I agree. Every day, I have the honor of working alongside individuals with intellectual and developmental disabilities, including many who have transitioned from the state's most restrictive institutions. California made an extraordinary commitment to ensuring people with developmental disabilities have the opportunity to live in their community.

That commitment started with the Lanterman Act and continues due to the closure of the developmental centers. But our work is not finished simply because we closed a single facility. Our responsibility is fulfilled only when every person has the opportunity to live in this in the with the right supports in their community.

We also need to acknowledge the difficult reality that many of these individuals who remain at Porterville are among the most behaviorally complex people in the state. On paper, the records describe crimes such as arson, robbery, assaults, drug offenses, and sexual offenses. What those records often don't tell us is there's traumas behind those offenses.

Often these individuals were manipulated and exploited by gangs used as drug couriers and victimized through abuse and sex trafficking themselves.

They have intellectual and development of disabilities, and many effectively spent decades behind bars. Had they been born nor typical, they would have completed their sentences long ago. Too often, we start conversations based in fear. Fear is understandable, but fear itself should not drive public policy. Instead, I wanna introduce you to two real people.

This is Jerome. Jerome transitioned out of Porterville's institution and built a successful life, worked part time as a landscaper, and married the love of his life. Their marriage was officiated by then Senator Holly Mitchell. I also want to introduce you to Carl. Carl is a statewide advocate.

He helps develop the state the master plan for developmental services. He advocates for supported decision making. He leads a local marching band, enjoys socializing, seeing his sister in playing darts. They are not case files. They are real people.

We have decades of experience transitioning folks out of these locked facilities. We've learned a lot of things on the way. Success requires that we invest in experienced providers. We create thoughtful transition plans. We provide specialized housing with modifications as needed but most importantly, that we have a responsive safety net.

When a first person's, first placement is not successful, they may need to return to a more secure setting before trying again. This should not be viewed as failure but rather as part of the process. It is actual responsible treatment planning. Those decisions must be made quickly by the treatment team and supported by the department to protect both the individual and the community from which their long term success depends.

Finally, this is not only the right thing to do, it's morally think right thing to do. It's fiscally responsible. California currently spends over $1,000,000 with for each person in these locked facilities.

For many individuals, comprehensive community based services provide better or out equal outcomes with something no institution can offer. An opportunity to build a meaningful life like Carl and Jerome. I apologize for my stuttering.

Good afternoon. Again, Amy Westling from ARCA. Today, I'm gonna on this topic, talk from my personal experience transitioning individuals from state operated facilities to a variety of community settings, including residential support models developed with a particular individual explicitly in mind. Here's a few things I've learned along the way.

First, we have an obligation to the individual to provide them a better life post transition than they had in the institution. Change, even positive, is hard in real time. But in time, the person's day to day life has to improve. We can't just move them for the sake of moving them.

Second, the development of needed resources, particularly those that require the acquisition of property, it takes a long time to do it right. From the approval of the plan to the time the facility is ready to open takes two years. Conceptualizing and defining new service models takes even longer. In the Agnews developmental center closure, we figured out we needed models to support those with, medical frailties, and so we set up our cushions.

In other DC closures, we set up enhanced behavioral support homes and community crisis homes. The population that we probably have the greatest difficulty supporting today are those whose needs arise primarily from their, psychiatric conditions, which overlay their developmental disability.

So if we are to develop new models and we then have to develop the homes to support these individuals, the 2029 timeline for the current residents of Canyon Springs to exit is challenging to meet.

Third, transitions, particularly for those who have been in the same setting for a long time, need to be planned and executed individually, and we have to be responsive to their needs and comfort levels.

Fourth, as my colleague said a moment ago, sometimes despite the most careful planning, things don't work out the way we anticipate, and someone might need to return in order to give the team time to recalibrate and rethink steps, before moving ahead.

Transitions are nonlinear, and that comes with the territory when supporting people in general and specifically those with complex service needs. And while it's important to think back to developmental center closures, this is a little bit different for a couple of reasons. Number 1, before the Coffelt settlement, which led to the round of developmental center closures, about 4% to 5% percent of individuals served by regional centers lived in developmental centers.

And they weren't necessarily the most complex population because many of them had lived there before regional centers were ever envisioned. So we had models in many cases that could meet their needs. Today, less than one tenth of 1% of individuals live in state operated services, and they are by definition, the most complex people that we are serving today because of their legal complexities and their clinical presentation.

Second, the developmental center closures involved a static population. We knew we were starting with this group of people, and we could plan from there. This proposal was a little bit different in that we need to invest in not only the resources to meet the needs of the population today, but it needs to be an ongoing investment to ensure adequate capacity because we will continue to see people who need to transition. It's not a static population.

In closing, no one wants to see people linger in state operated facilities. It's not in anyone's best interest, but policy decisions must support their successful return to the community. And that will hinge on adequate capacity, careful transitions, and meeting timelines in and of itself is not the goal, but rather is the indicator that we have the right systems and supports in place to meet the needs of an increasingly wide range of individuals.

Thank you.

Thank you very much. LAO

Karina Hendren, LAO. No comments.

Department of Finance.

[Inaudible] Department of Finance. Nothing further to add.

So let's just, there's a lot to unpack here, but I kinda wanna first make sure that we understand the reason why this will slow down. And that is we too had questions whether the community was ready for wherever community they go to, that they have a right to go to, is ready for them because we don't wanna be in a situation where they become in a worse place than they were before. Right?

And when we first saw the language, we cannot see that there was a comprehensive plan from the time they exit. First, from the time they're assessed, from the time they exit, and the supports that will be waiting for them.

And it shouldn't be where, hopefully, they can scrounge together something for them. We wanted to make sure that along with this proposal, we're also allocating the resources to those communities, right? to be ready for them.

Number 2 though, is equally as important, and that is there is no doubt that there will be some of the population in which no matter what less restrictive format you put them in, they may still be a danger to those in the community.

Not even at the fault of their own, by the way. Just depending on the complexity in which they of the issues or obstacles that they may be dealing with.

And how are we accounting for that scenario? That too was not a part. And if it was a part, we didn't have enough time to find it. Okay? So I think those are two things that I think are going to be and we also know a cookie cutter method is never gonna work for any human beings.

Right? So an arbitrary timeline, I think also is an issue. Now a goal in which we need to do, but we also wanna make sure that we are not just saying, Oh, we're about to miss this timeline. Let's just let them go. Right?

Do we? Is it possible? Yes. It is possible. Why?

Because we're human. And humans are messy. I know I'm messy. Alright? At least that's what everyone tells me.

Anyway, so I think the first question is, number 1.

I think the problem is not everyone, the legislature as a whole is not comfortable with that. Okay? And because of the population we're dealing with, we do owe the public a more comprehensive and transparent plan to ensure that we thought of the different scenarios that may happen. So first, what are your thoughts about community supports, making sure that we're setting up the client and the community for success?

Your thoughts? And by the way, I have no answer for that.

Well, thank you for the question. I appreciate it, and I I wanna I mean, I think we share that reflection. I mean, we intentionally set the timeline out by five years. So we do have time to engage in a thoughtful implementation process and development process. We do have an existing development pipeline with CPP and CRDP.

And I would also name that 50% about 58 57, 58% of the individuals currently at Porterville under 6,500. And I I do wanna make the distinction, right, between the 13 seventies and the 65. Because

And even that, I have no clue what she was just saying to me.

No. It's okay. So, the 1370s, that's a penal code commitment where people come in the front door to Porterville because they've been found incompetent. They come for restoration.

After two years, it's determined fork in the road. Are you competent? Yes? Then it's a local determination on whether that person faces their charges or not, and they would go through that process. Or no, not competent, unrestorable, and then they would become, they'd either be planned to discharge back home with family, back into the community, or they can become civilly committed to a 6500, danger to self or others.

And so we're really talking about that population where they kind of get stuck there with a lot of kind of stigma. And that in those individuals have not been committed I mean, convicted, right, of any sort of they've been charged, but there has been no conviction. And so then they get stuck. So, I would just say, I mean, they go two years at the 1370. Two years at the 6500 is what we're proposing.

The 1370 penal code, that is what it is. We're not proposing to touch that in any way. But then we're our proposal addresses two years at the 6500, but it would also be another two years at Canyon Spring.

So we there would be, potentially, that's six years in, right, a locked facility, which gives us a continuum and six years to actually develop the resources tailored to that person while we also engage in the bigger systemic development, which we do currently have that development pipeline. And I don't know if you wanna speak to the CPP.

Yeah. I just wanted to add on the development pieces and, like, capacity and what are we ready for, right, in the community. That happens right now. That happens, it's currently happening. It happens every year. Regional centers every year are required and responsible for proposing projects.

Right? Homes, whether it's homes for folks at Porterville, Canyon Springs, institutions for mental diseases, restrictive settings, right, that are otherwise not in the community. We have a pipeline of those homes that are currently being built, and that is then supportive, you know, push in one way that we're giving the regional centers that you've had a person there for nineteen years who, over year after year, has been, you know, reporting that they are they're stable. They're ready to go.

Like, where is their next transition from this lock setting?

And so it's, like, plan for that because as Amy Westling said, development takes time. It doesn't happen overnight.

Right? So why can't we do that right now? Someone's in there. Let's let's just take this scenario. Someone's in there for sixteen years.

They themselves are saying, Hello? Why am I still here? What, right now, is preventing them from taking at least the next step down?

I think it's, yeah, I think it's that kind of thought process of they've been there, they've been safe, and they kinda get stuck. So, it's like, no, you need to...

But who makes the decision? Why are they stuck? That's what I'm trying to understand.

So, as referenced earlier, there is an annual commitment process that, so the physicians certify that somebody remains a danger to themselves or others, and then that is brought before the courts, and they recertify that 6500. So that's an annual process and, I think, what we are...

So if they've been evaluated

Right. But I...

Hold on, let me just finish. And it's totally fine if I'm wrong by the way, I'm just digging.

I'm trying to see where I'm gonna find. Okay? So if they have gone through the evaluation process and they're deemed that there's still a risk to themselves or the public Why is that a problem?

So, I would just lift up that there is the certification of dangerous to self or others, but there's also the IDT team or the interdisciplinary team, and then the court. So, you have multiple systems that are putting pressures in the decision-making process around, right, that on that individual. So you have potentially teams, people in the IDT team that are saying they're not ready.

And then you might have somebody else who says they are ready.

And then it goes to the judge to make the final decision. And then the judge has determined, in that case, that they should still remain there. Why is that a problem? That's I mean, I'm just trying to, because, unless you're saying the process is unfair or unjust.

I think that's where we're at. We feel that there are stigmas that drive a lot of the decision making, and I think as Jay referenced earlier, fear around decision making. And, right, there are multiple people that are representing the positions and decision making for that individual. And so sometimes those positions are competing.

Correct, which is the responsibility then of the judge. So, that's okay, we'll go here, and I'm not trying to jam anyone, I'm trying to figure this out because, and that's why it's so complex, which is why we're here, by the way.

And so we're gonna spend as much time as we need to on this because we need to get this right.

So having, the beginning of my career was working with kids that were in corrections. And, so institutions for people with intellectual and developmental disabilities are very similar. Right? The people who are seeing what you did wrong and how you did wrong and documenting those things or the individuals are doing service, they're not, if there's nobody outside making decisions or evaluations on what's going on. One of the questions I asked is why are they being restrained? There's no information currently coming out that says anything about...

Well that's a whole different subject than what we're talking about.

So that's what they're using to tell the judge they're not safe to come out. They're not safe to come out. They've been in this many...

That they need to stay.

That's been one of the reasons why you're saying the judge has determined that they are not...

Got it.

We also, I was concerned about the length of time too. It takes us six months to get somebody ready to transition out of an institution. Thirty-eight people, we've transitioned out of the institutions, 38 people who have done well and we have not had to have one person go back because we made good plans on how to get those individuals out. They also are humans just like you or I.

If they went to a traditional jail, they wouldn't have a judge telling them that they can continue to stay there for another thirty years. They, at some point, would be told that they can be released regardless of what they did in most cases right? You did some vandalism? Okay.

You destroyed some property. Okay. That's not a thirty-year sentence. It is a thirty year sentence there. And that's just unconscionable that we would say that's okay.

These timelines are to help go, we're not okay with this anymore. You're not gonna treat the people with developmental intellectual disabilities differently than you would treat a neurotypical person. They don't have to be held to a higher standard and institutionalized and incarcerated for an untold number of years just because we don't understand them and we're fearful of them.

So, for me, it's a simple saying of we need to set those timelines so that we push people to make good decisions about how do we support those people. Because I'll tell you for me, if most of the people that I see coming out when I read the news, that are neurotypical that are coming out.

I was like, man, I wish that person was coming out with 24/7 staffing. Man, I wish that person was coming out with some way of knowing where they are and what they're doing. They're coming out to more structure than any neurotypical prisoner that's coming out of jail. And we continue to say not good enough. We need to keep them incarcerated. That has to be fair.

I understand part of the unjust part of it in terms of, if they were, if they did not have these intellectual developmental disabilities, and they were going through the traditional criminal justice system, that they wouldn't be treated the same way they're being treated now. Right? I understand that argument. What I'm trying to get at, and a part of the reason why I'm always hesitant is that, a part of it is that it's the judge piece that they have made a distinction and they've heard all the evidence. They've heard the evaluations even when they are, the evidence or the opinions are a conflict with each other, that is still the judge's determination. Starting to sound like the Judiciary Committee. So I understand, I'm just trying to wrestle with these two. Before I come here to DDS, though, I wanna make sure we get those on the back.

So let's hear what you have to say.

Yeah. Thank you, Doctor Jackson. So, one point about...

Oh, yeah. We will we will.

Yep. Thank you. I wanna make one point about readiness. So based on our experience in the clients we serve, what we see happen is that for years, people say, you're dangerous. You're not ready.

You're dangerous. You're not ready. These are the recommendations that go before the court. Right? And then all of a sudden, community capacity comes online, and it's like, wow, there's a place for you.

Oh, this person's not dangerous anymore. Right? This person can live some somewhere else. So I wanna make it seem like a chicken and egg thing, but the fact that there's been a finding of dangerous doesn't necessarily mean the person is dangerous. Where we see time and time happen again is that there's not a place that's identified for them to go.

Their record gets stacked with finding after finding of dangerousness and stigma year after year, which actually then makes it harder to place them. But then something comes online based on individualized assessment that meets their support needs, all the things that Jake talked about, and then they leave.

So, I just wanna put a critical eye to kind of the judicial findings year after year that somebody is dangerous and needs to stay at Porterville and to suggest maybe we shouldn't read so much into them because, again, it's about the capacity in the community, which in the real world drives a lot of these decisions and not, you know, the finding of dangerousness. And I wanna make one more quick point on timelines.

For the Porterville movers, for the people currently at Porterville, when these changes go into effect in 2031, I think, it's 2035 when the kind of deadline arrives.

We need to think about, wow, do we have a placement for this person? So we're not talking about two years here. Right? We're not even talking about 2031. We're talking about 2035.

That is a long runway for the department to do their gap analysis to show their work, to demonstrate what resources we need to develop for these folks. So I wanna put that...

I think my problem is, is that whenever the state has a deadline, they're gonna wait till the very last minute to be able to do it in some cases. And the people who are asking us to make the decision now will may not even be there during that time as well. And so, you know, I don't know what your guys' plans are, but I'm not trying to speak for you or anything, but I'm just saying.

But I also think though, now I understand what you mean about not holding that record over them, which makes a predestined outcome. I understand that part.

But the public still needs to understand that we are still seriously taking that into, that we can't ignore that either because the community also has to understand that we are being very thoughtful in this process as well. Miss Westling, did you have something in regards to?

I think, I just wanted to reply to and kind of build off of what Mister Liner said. When I was doing this work directly, he's absolutely right that, you know, when presented with an option of either we have nothing for this person or they return to a secure facility and it's somebody with fairly complex needs, the court tends to default to returning them to the secure facility.

So the you know, because part of the conversation is around, do we have a place for this person to go? Do we have a plan to mitigate the risk? And that was sort of the point I was trying to raise in terms of, you know, making sure that not just for those individuals at Porterville, but also for those at Canyon, that we have the array of services that we need.

And we've used other opportunities, the closure of developmental centers to build up those service models for people with medical frailties, for people with complex behavioral challenges, which actually have prevented future people from going into locked facilities in the first place.

So I think the point is, you know, part of this is looking at what are we still missing in that continuum, and do we have the opportunity to fill in additional gaps, not only for the people who are currently at Canyon or currently at Porterville, but, you know, who, may find themselves in situations that would have landed them at one of those facilities in the future?

And if we would have if we folk if we also focus on building those community supports now Yes. There could be people in the facilities now that could be let out now without even waiting for that deadline. Am I correct?

Yes.

Okay. So that's why I think we're also equally focused on, not just the timeline or the deadline for those who, are in these facilities, but we're equally focused on the community supports that are necessary as well. And we would like a proposal that includes both of them at the same time as opposed to just the, either way, community supports now or later, nothing happened.

Some of these folks, and it could actually prevent others from actually going into these higher levels simply because those supports don't exist at the community level. Am I wrong in that?

I mean, that's happening...

And it's okay if I'm wrong.

No. That happening now. I mean, people are transitioning now from Canyon Springs, from Porterville, into homes that have been planned the last two, three years with supports, with crisis services, with mental health supports, with wrap teams that's already been in development. And already, you know, we've got probably three or four individuals, I think, within the next six months from either Canyon Springs or Porterville that have been planned for and are ready to then transition into their homes. So, there is a current pipeline now and then what will need to come, obviously, is that array, our safety net continuum, which we have been building since 2017, which includes a variety of different models and things that we are still working on with our community, with our regional center partners.

And what else do we need in order to have this robust safety net, which includes our complex needs residential program that was, you know, approved and enacted in 2023 with our last safety net plan that was a step down or an option too when our Canyon Springs sister Desert Star program closed. That was the concern then. What happens when we no longer have this acute crisis? What are we going to build?

So that is now in development being built and will be yet another option potentially for some of these individuals that would be needing some, you know, higher level of care or restrictive setting that would be necessary.

Miss Hunter, do you have

I do.

See, right now this is the wild wild west, and you're not being aggressive enough. And so I need you to give me a nod. I need you to give me a side eye. I need you to do something to let me know that you got something to say.

Chair Jackson, you might be one of the first people who have ever said that

I have been told by many a judge I do not have a good poker face, and I can see that one of your committee members has so kindly picked up on that. But all joking aside, I do appreciate you giving me some time to speak. And I think a lot of things that are being discussed are great. Having these other options, having more support in the community, fantastic.

But your honor, not your honor. Chair Jackson, your honor to me in this setting. I think you hit the nail on the head, you know, when you asked about isn't there a process? There is an annual review for some of these folks. Under the current law, you will continue to see individuals when appropriate to be released.

And I've learned a lot today to learn about all of these programming and advocates in the community that can help these folks. That's fantastic, and you'll keep seeing that. But I'm talking about the individuals, and I'm not talking about stigma. I'm talking about common sense.

The individuals who every year, or on some years right? Some people might have this finding once and not again, but are having a determination by experts, by treatment providers that they are dangerous and a court agreeing with that and being released. Porterville, to my knowledge, is the only secure facility of this kind. And by putting this twenty-four month arbitrary time, what I think is an arbitrary time limit, unless I'm misunderstanding, it is going to, I think it's going to put...

There might be some unintended, there might be some unintended consequence. Yeah.

I don't think in unintended consequences. That's why I'm here today telling you what's gonna happen is, some of these individuals, not low level, vandals, or petty theft cases, those are not the folks we're talking about because they wouldn't be there under this law in the first place. It's the violent offenders. It's the murderers. It's the kidnappers. It's the child molesters who are found to be dangerous, who then, after twenty four-months, would be released.

And I I'm not saying that to scare anyone. I'm saying that just to be practical. And I know I'm only talking about a subset of folks. And, you know, I actually agree with a lot of what miss Regular from the Public Defender's Association said. We might be different advocates, but there are there are parts and aspects of this law that I understand her position.

I understand why the committee might make some changes. I'm just urging the this group, the legislatures here and everybody to be very thoughtful about why is it that we need this twenty-four month cap. That's not an overcrowding issue. I understand it costs money as everything does. But when the average stay is already longer than this, that's a lot of folks that have not been assessed.

Last comment, I believe miss Bagley and Mister I'm gonna pronounce it wrong, Carruthers might have mentioned, was the data about folks who have been released, how it's been going well for some of those folks. That's great. But those aren't the folks that had a finding of dangerousness. Right? Those are the folks that did not have a analysis, did not have a report saying from the actual treatment providers, these folks are dangerous.

Do not release them. It went well for those folks, and that's fantastic. I'm talking about the other individuals who are not meeting the standards under the report that I discussed.

I understand.

Thank you.

Thank you, Mister Chair. And thank you, Miss Hunter, for acknowledging the statistics that I have cited did not, apply. It's actually why I raised, to speak to clarify or hopefully bring some simplicity out of the complexity that's been blurred around. Miss Hunter acknowledged your comments only apply to a subset. This policy, this proposal is not talking about that subset.

So you get to Porterville. You get to development centers either through the welfare and institutions code, 6500 civil commitment, or you get there through the penal code, 1370.1. This proposal only applies to who came into the door through WIC, through 6500, through civil commitments. Those who came in through the penal code, they have their own set of rules. This proposal doesn't speak to that, doesn't touch that.

That's an important detangling for this committee. The other piece is I don't know that twenty-four months is arbitrary. The reality is if we look at the rules as applies, if you come in through the penal code, it's twenty-four months. It's two years or the greater of your maximum committed offense.

So what it's doing is it's taking that same standard for if you came into the development center through the penal code, let's at least apply it to you within if you came in through civil commitments.

Somebody who's not being committed of a crime. My statistics to you, the hand count that my team did, the 585 individuals over ten years, was specifically who this proposal applies to. You came in through a civil commitment, you left. Out of those 585 people, that's where we saw 11 return under 1370.1. So, looking who actually committed a charge and were convicted.

So detangling that, I think, is pretty important. The other piece that we see is again, we see people from the day they leave all the way through and into the community, is that people are pretty much, if you come in through a civil commitment, you're largely stabilized within the two years. So the two years has a functional purpose, a human purpose. It also has a legal parallel, within the penal code. So thank you.

Thank you.

So I just want to make sure that the Chair, the Committee is aware, there already is a safety valve in place for individuals who are not ready for community placement who are either at Porterville or who haven't made it to Porterville yet on a 6500 commitment in that 7301, well, for an institution's code. So I actually have two clients who were placed at the Department of State Hospitals who, were deemed too unstable to be at Porterville Developmental Center.

They are on 6500s, and they are at the Department of State Hospitals. So there already is a safety valve in place.

And then also, you know, to this idea of, you know, we're going to be letting murderers and child molesters out. I'm wondering if Napa County has any 6500s at Porterville right now. I've represented individuals, as I said, charged with a number of offenses, and not a single one of my clients who were committed to Porterville on the 1370.1 commitment, as incompetent to stand trial, were returned to Porterville on the 6500.

Instead, all of those clients all of those clients were placed in other facilities either usually, like, level four, secure perimeter, delayed egress. They were not returned to Porterville.

Yeah. I think we're just trying to get to the problem we're trying to solve. How do we avoid any unintended consequences?

And what I'm telling you...

As we do the policy is the preference of this Committee and, quite frankly, the leadership of this House to ensure that we are also authorizing the proper supports that should come with the policy, Right? So that we can make sure that everybody is being set up for success. I think that's what we're really trying to make sure that we do. How do we make sure that we're totally set up for success?

And, as you know, and the reason why we're slowing this down this way is because there are decisions that this committee has made, three years ago, that I have totally forgotten about. And I don't know when I'll even remember to bring up the issue again. And that's just, I ain't that old, but I'm human. And because we know how this place works with an issue like this, that's why we usually even build in certain check-in.timelines, certain, you know, times in which we have to come back and reauthorize things. It's just so that we can make sure that we account for the human experience.

See what I'm saying?

Yeah.

And so, and sometimes it is and literally, this is what the case is, It's the fear of the unknown. And how do we work through this? Because I do understand and what I'm hearing is that the process that's currently happened, even though the last decision is being made by the judge, that there is still something unjust about the process and how we have set up the process. Right?

And I'm willing to entertain that. I'm just trying to figure out, well, then what is the fix in a way? And I understand what the beginning of the fix is, what seems to be the timeline to force people to make decisions. I'm just trying to make sure that we are taking all of these things into account, and we are backing it up not with a promise, but some resources or whatever you deem is gonna be necessary to make sure that everyone's being successful.

That's kinda where I'm trying to go here. But is there anything else you wanted to add?

If I may.

That's fine and then we'll go to the director right behind you.

Thank you

very much.

I'm not sure if you see him, but he's behind you. Okay.

Yes. So first of all, with regards to the unfairness of the process, so if I can just give you an example, and this is related to, because I don't have any 6500s at Porterville. But, for example, at the Department of State Hospitals, there are clients who are deemed too dangerous, very similar standard, either on a Murphy, which is, like, the equivalent for mental illness is a 6500, who are still at the Department of State hospital who are literally in a sniff bed and cannot move.

And so I just want to make sure that the Chair recognizes that just the fact that somebody is still at Porterville doesn't necessarily mean that that person is still dangerous. It may have meant that it has moved through the process and everybody is, for some whatever whatever reason, has agreed that the person stays, but it doesn't necessarily mean that that person is dangerous.

And then as to...

And that's what I'm trying to get at though. I'm gonna let you finish, but I don't wanna gloss over that. Is that, if there's other issues why there's people who are staying there and it's not because they're dangerous, why are they still there? And how do we make sure that that doesn't happen in the future? And I think it's more than just a timeline.

It seems like there's something wrong there where there's nowhere for them to go. Or can you tell me why they are still, that they are there, but they are not in a danger to anyone?

I think that there are probably, failures at a number, a number of steps. So one is that Porterville is making the recommendation that they shouldn't be making. Second, what the Chairs brought up, there isn't a placement for them to go, perhaps because of their medical needs. I don't know if it's in a county where there is no public defender, there are probably varying levels where many of the checks have failed.

I plan on going to Porterville, by the way, because this issue has piqued my interest. And I think we have to make sure that we're having a comprehensive approach to this.

Go ahead. To the final point, and then I will sit down. As for the resources, so we the public defenders had the same concerns as the district attorneys, and we wrote a letter of concern because we wanted to make sure that our clients were not just dumped on the street at the end of two years with no placements to go to. And that is the reason why we, and we appreciate the Department of Developmental Services meeting with us, working with us, adding language to make sure that there were actually checks that they need to check-in with the legislature to actually make sure that they are building the infrastructure that is required to make this work. And while I was also worried about the timeline, interestingly, our state can step up when it is pushed to step up. So the Department of State Hospitals for years was well, if they've...

No I understand. And that's the thing. How can we, what's gonna be that impetus to, what's that catalyst of change. Right?

It is the, I believe it's the timeline. When there is a deadline, the state has proven that it can step up to meet those deadlines, and we've seen it with the Department of State Hospitals.

I mean, that's why I pay my bills. Absolutely. If I didn't have that deadline I ain't paying nothing.

Regular? Ms. Regular, can you make sure that you share a letter you were talking about? Okay. Just make sure you share that with us, okay? Director.

Thank you, Mr. Chair and members. This is an important point, and I wanna reiterate a couple things that my staff have said that I think are important here. We transition people into and out of Porterville today. We do the same thing at Canyon Springs today.

We have a pot of money. That's the CPP and CRDP that we find a mouthful to spell out. Those pots of money develop the community resources for those people to move out in our community. There are people in our facilities that we can do better for, and we need to do that, and it starts with--and I didn't pay her to make the transition for me--but it starts with an expectation, and the expectation is the date. You have a deadline when people should be gone. There's a right of return to come back if it doesn't work out. There are years before these deadlines actually hit. We are happy to report progress in the development of capacity in the community to do this.

We share the DA's concern about public safety. There's a reason that people are judged whether they're able to be released into the community with the appropriate support. So I appreciate the comments that he made. We support our population into the community better than neurotypical people coming out of the prison. We need those things to be in place. We need more behavioral model-- mental health model programs in California. We need time to build them. These deadlines don't take effect tomorrow. They don't take effect July 1. They don't take effect January 1 this year.

We built time for us to develop the models. It also gives us time to adjust if we're not making the progress that we think we should. But the expectation of a deadline is critical to drive forward progress. It puts pressure on the provider community to step up and offer programs that can support these people, it puts pressure on regional centers to support those providers and prepare those supports to be available for people, and quite frankly, it puts pressure on my own department to do better programming.

Yes. We go to a judge who makes the final decision. Why are the people coming to the judge year after year with their problems unresolved? We need that pressure too ourselves to do better by the people that we serve. The checks and balances are there. People get a comprehensive assessment. There is no timeline today that says you're out in 60 days or two years or five years. There's none of that today. We release people when the resources are in place and the person is ready for that and the supports are in place.

We have the funding to do that. So I-- apologies. There's some repetition there of what's already been said. We can do this. We need a date. We can move the date if we need to. It's the setting of the expectation that's really important. Thank you.

Thank you for that.

Mr. Chair, you asked, why do people get stuck? And people get stuck because the system does not have the drive and a deadline and the motivation to put everything in place so they become unstuck. So I think maybe I just repeated what the director said or maybe I just repeated what the chair said, which is I pay my bills because of the deadline. The deadline is what-- I'm saying it for me now, too.

Yeah. Yeah, don't be repeating my stuff.

I'm not talking about your bills. I don't know about any of your bills.

I don't know if I got myself in trouble or not. So don't be--

I'm talking about my bills right now. So the deadline is what causes systems to act. We appreciate and give credit to the administration for stepping forward and saying, here's how it will happen. Put the pressure on us. They're creating burdens for themselves for this proposal. One of your questions was-- you ask, why the timeline? I don't know. From the State Council's point of view, we think things are ready, like, shorten it up. If you wanna be really revolutionary, be really disruptive, bring in the timeline. That's not gonna happen.

But you also asked, department, would you please bring-- we would like to see both the plan for the services and the plan for this timeline at the same time. I actually think the Legislature and the committee in its own wisdom did that by bringing these two trailer bills together and hearing them together, which is how the State Council analyzed them. This, together with that, what type of outcome will it get. We saw the administration improve in those services. With a few pieces of recommendation, we think it'll button down every single thing that's there, and per your request, we had already provided the committee inline edits to accomplish that. So thank you.

Okay. Thank you. Any additional questions or comments at this time?

Can I just make-- I just wanna make--

--one clarification around the 6500. There's a placement recommendation that accompanies that. So we actually do have individuals. For example, we have three homes that are Porterville Developmental Center step-down homes. They're community homes. They're beautiful. They're nicer than my house. They're gorgeous. It's delayed egress, secure perimeter, and that 6500 then follows that individual to the community placement, putting kind of a framework for supervision and continued court involvement.

Absolutely.

So, again, I lift up, right-- there's the clinical determinations, which can be challenged and rejected by the various parties involved in that case, and at the same time, I think, just underscoring that the placement determination, right, that's made in relationship to that 6500 can be remanded to Porterville, but it can be also remanded to the community for supports.

And I just-- so I just wanted to underscore that point that there is that kind of framework that can follow in support, and the only answer for 6500 doesn't have to be just Porterville or just Canyon Springs. So I just wanted to underscore that.

Thank you. Any additional questions or comments? Doctor, are you good?

No.

Okay. Go for it.

No. It was just a couple of things. I know that we have continued to talk about the timelines, but it was a couple of questions that were inside the packet that I just feel that we haven't actually hit on. So I'm just wondering if you can kinda clarify a little bit more for me. Wanted to question Number Three about DDS and the state operated facilities, regional centers, public safety professionals, and clients' rights advocacy.

Are they ready and able to provide the supports and services necessary to safely and also effectively transition movers but at the same time provide staffing? 'Cause we haven't talked about the staffing for and also maintain access for non-forensic individuals who specialize in complex case placements. I haven't heard anything to that because we took a real deep dive into another direction. So if you don't mind-- someone from the panel doesn't mind speaking to that, I'd appreciate it.

Yeah. So, happy to start and pass off to anybody else. So, this is two different potentially clinical milieus, right? Transition planning is individual on each person's needs and their kind of clinical needs and therapeutic needs. So it is not likely, right, for-- I'm gonna use a hypothetical. It is not appropriate for us to take, say, a individual who happens to be, you know, on the spectrum and potentially, you know, kind of more vulnerable and maybe, like, clinically compatible-- like, clinical compatibility wouldn't then, say, let's bring in somebody with a history, like a 290 registrant, right, with somebody who's that vulnerable.

So there's, like, matching and clinical kind of milieu that has to be considered, and that is the IPP process. That's the transition process that takes place while people are at Porterville or Canyon Springs. And so it's-- we understand the question, but we develop for both, right--individuals not involved in forensic capacity and those that are forensically involved.

And so it's-- we don't see it as an either/or. We see it as we are-- there's a continuous development process. And in terms of staffing specifically, to your question, you know, the department has engaged in a variety of initiatives around supporting and expanding our direct support professionals and really, you know-- it's really at the provider level. At the same time, the department hasn't, you know, tried to create pathways to support direct professional workforce.

And I would just add--and appreciate the question--that I think one of the things that regional centers are wrestling with is, is there a model that we don't yet have? And does the proposal specific to Canyon give us a long enough runway to develop the model, build the standards around it, and then develop the facilities that will implement the model?

Our experience tells us that when we did the medical model, when we did the behavioral model, it took us longer than that timeline appears to include for the current residents of Canyon. And so that's really the outstanding question for us. When we look at people who have not been well served by our existing services, one of the common themes is that their predominant issues many times arise from their psychiatric disorder that they have in conjunction with their intellectual or developmental disability.

And our behavioral support models aren't necessarily the right fit for that. So our question isn't really a philosophical one. It's more about, is there enough runway there in that first timeline that will come up for the Canyon movers? And that's really the concern that we have related to that question.

If-- and if I could, you know, we have been working with the state for the last couple years on enhanced supported living. So enhanced supported living services is individuals in the community that are not in group homes or facilities.

We have been doing that for years, and we've been working for the last two years really developing that model so it can be across the state, and I think it's a really option for people because often you can't take somebody who has really complex behaviors and put them in the same home as somebody else who has complex behaviors and expect for there not to be problems. So it's an opportunity for us to really focus on that individual and get them stabilized and doing well in the community. That's already in progress, and I don't think it's talked about enough as an opportunity that we are looking to expand across the state.

So just listening in-- and Amie, when you were talking about just the process itself, that's taken me to one of the questions towards the end of it about the administration being amenable to formalizing the Transition Preparedness Plan because it sounds like you're now getting into that as well, so the preparedness plan and accountability report and creating an annual date for this to be submitted should the state operated facilities' proposals move forward. So can someone talk a little bit further about that? Because it sounds like that's where that connection was going was into that plan.

Yes. The language that-- the current proposal does include an implementation plan that we would develop in partnership. You know, we wanna expand our community engagement, right? It's important that we are engaging a variety of perspectives, you know? I think it's been lifted up, right? We might not have the right model. Like, do we need to diversify? And so we want to engage through that implementation plan.

Yes. We do develop right now, right? It's a pipeline. There's so much effort, regional centers that goes into that, but we are wanting to ensure, right, as a department, as a system that we're collaborative, that we are, like, reaching across new and different aisles that we haven't necessarily historically done. We cannot do this alone. I want to be super clear, right? So we would, yes, develop that.

That is reflected in the proposal. The current language reflected in the proposal also has ongoing updates through the ledge briefings in writing that then would be posted publicly. So if-- you know, again, if there's language in the proposal that needs to be strengthened around that, we're open and, you know, wanna be collaborative if there needs to be changes. But, yes, it is reflected in the current. Yep.

Thank you. I want to thank everyone. Great discussion. I'm glad we got the viewpoints of everyone who's involved. I'm glad we included our criminal justice partners as well to making sure their voices are being heard, and so we will take all this information, and we will figure out what our path-- our next steps are going to be. So thank you very much for this panel, and we will just start going into public comment at this time. Thank you all very, very much.

Love you, Stacy. Everyone thinks we're going to go robot rogue so we can make this very smooth.

Oh, they have a plan. I hope you-- I hope you practiced your two minutes. So what we're gonna do, I'm gonna need everyone to keep it quiet. Follow the directions of the sergeants, please. The sergeants will let you know when to come up, when to stand up, and to come and stand in line.

All right. Name and affiliation, and you have two minutes.

I'm Jo, and what did you say? Okay.

Just a minute. They just wanna make sure that they can hear you, okay?

Okay. This thing on?

All right. Just get a little close to it.

Is it like this?

You're good. Go ahead.

Good afternoon. My name is Jovani Romero. I'm 18 years old, and I'm here as a self-advocate and as someone who depends on regional center services. Because my evaluations were done properly, I received early intervention services that changed my life, but getting those services has not been easy.

My mother often has to drive up to an hour so I can access the support I need. I'm about to start college, and we've had to make more than 10 trips to complete everything required. Thanks to these services, I've been able to keep moving forward, but I worry about what could happen if these supports become harder to access. I respectfully ask you to oppose the proposed changes to the DDS evaluation tool and cost-effectiveness rules. These changes could hurt people like me who rely on these services to live with dignity and reach our full potential. Thank you for your time and consideration.

Thank you. Next, name and affiliation, please.

Good afternoon, everyone. My name is Mariana Guerrero, and I'm an advocate, a sibling, and a provider for individuals with developmental disabilities. I respectfully urge you to oppose any assessment tool that has not been thoroughly researched, validated, and proven accurately reflect lifelong support needs of individuals with developmental disabilities. Based on my experience, tools like this can create fear and anxiety.

Individuals begin to worry that they must prove that they are disabled enough to keep the services that allow them to live independently, work, attend college, and participate in their communities. No one should have to live that fear. As an advocate, I have seen lives transformed because of the regional center services. As a sibling, I know these supports give families hope and stability. As a provider, I have seen firsthand that progress is possible because the right services are placed, not because they are no longer needed. Please do not allow any approving assessment tool to determine someone's future.

Decisions that affect people's life must be based on sound research, transparency, and the voices of the disability community. Protect the services that protect our community. Thank you, and I also have some letters from 20 families that actually feel the same.

You can leave it with the sergeants, please. Thank you very much. Next, name and affiliation, please.

Yes. Good afternoon. My name is--sorry. My name is Maribel Ahumada. I am affiliated to the ICC. I'm a co-founder, proudly to say that we work with many families across the 21 regional centers. But I'm-- more importantly, I'm also a mother of triplets and one with--

Oh, boy.

Yes. And one with multiple medical and intellectual disabilities. Then to the services that he had through the years, even though he was rejected out of the regional center or kicked out of the regional center at the age of three and bring back to the regional center, thanks to one of the amazing neuropsychologist who was in shock while he was on the regional center, he lost many years of therapy.

He's 21 now. He can barely speak, but thanks to therapy, he's thriving. Also, thanks to self-determination. And I can tell you that I'm afraid, because even though he has hydrocephalus, cerebral palsy, autism, intellectual disability, <unintelligible>, and short-term memory, I'm afraid that because he's thriving now, thanks to self-determination program and the therapy that he has received through the years, I'm afraid that if this tool is put in place, he might be-- you know, look under the loop because he's doing better. I just want to tell Mr. Cervinka that tends to the services, our kiddos are thriving.

And know that it doesn't mean because they're thriving, and this tool is gonna determine that they are no longer qualified; they're gonna regress and lose all the gains that they have through the years. So I am strongly speaking not just on behalf of my son, but on behalf of the community. On behalf of the families, caregivers, and community members supporting Fernando Gomez, we strongly reject the current standardization of digital tools and questionnaires.

This rigid format failed to accommodate language, culture, or logistic analysis, penalizing vulnerable individuals and creating significant barriers to care. We request an end to using automated formulas to predetermine eligibility or reduce services hours as caregiving requires a human process that digital formulas cannot manage. Thank you for your urgent attention to this important matter.

Thank you.

Thank you.

Next, name and affiliation, please.

Hi. Good afternoon, Dr. Jackson and honorable committee. My name is Elizabeth Gomez. I'm the co-founder and director of the Integrated Community Collaborative, and a lot of us have come here today to tell you-- my husband, Fernando Gomez, did mention that we have two boys. One is here, my son with Down syndrome.

That's your husband?

There's my husband.

Oh, okay. I see what's going on here.

And we have two-- we were blessed with two beautiful boys, and he has Down syndrome. My other son has autism, and he was in the early intervention program. At three years old, it was decided that he was functional and that he was not gonna need any services. Against my sixth sense, I navigated elementary school, middle school as best as we could, but my son was the one suffering. I did not know how much he was suffering, and at middle school, he stopped going, exactly during COVID, actually.

He stopped attending school. He has not come back, not one day back to school, and my fear is, that like him, there's so many more. The word functional on paper removes many clients from the regional center, and like my son, miss out on a lot of years. I still remember when he used to smile. He doesn't anymore. And so I urge you to please-- and I've said this to DDS. A lot of our members of the community who have autism may look okay, but they're dealing with a lot of things inside--

Yeah.

--and they're not functional in jobs or to live a normal life. So like my son, I ask that you please look into these evaluation tools. Another thing that I wanna tell you, the respite tools do exist in all 21 regional centers, maybe not by a standardized tool that DDS is proposing, but every regional center has a tool.

And most of our families, Latino families and all families walk away with 12 hours of services of respite, and that's all they get based on those boxes that says if you walk, if you breathe, if you talk, you don't-- you get zero points. You have to be, you know, really extreme, and you have to vilify your child in order to get services. So this is the reason why we are so afraid of what's being proposed here today.

I understand.

So thank you. Thank you.

Yeah. Absolutely. Thank you.

And you wanted to just say something?

My dad-- in the doctor-- Fernando Gomez.

He supports his dad's testimony, he says.

All right. Thank you.

Good afternoon. My name is Rubi Saldana. I am ICC co-founder and mother of three clients served by the system. Thank you for the opportunity to hear, and I'm agreeing with Fernando Gomez and Elizabeth Gomez. And I have something in writing, Mr.-- Dr. Jackson, but I'm not gonna read. I'm just gonna speak from my heart. I have three children, two of them with autism. They were assessed, and they were-- like, the diagnosis came late.

And all that I had was-- I'm sorry. One of them, you know him. He was next to you. And he is a wrestler today, but he depend a lot in services, but because he walks, because he looks okay, he will be without services just as Diego Gomez because I was pushing a lot for him. Like, damn, there is a lot of kids. I went in three hearings trying to defend three kids in three different regional centers, and guess what? It was the same system. The same-- I found that it was the same specialist behind those cases.

It was the same doctor, the same specialist, saying the same thing, and it was the same kind of a pattern. They-- trying to loop people in disadvantaged by ethnic, economic, or a language. Because those people who are more vulnerable look like they were targeting it. So I'm-- I have fear for my kids, but more because of them. I can defend myself, and I will with all of my heart and all that I have. But what about them? Just please. I urge you to defend us and think about those kids that are in the shadows and our people. Like, people are suffering right now. Thank you very much.

Thank you. Name and affiliation, please.

Hi. My name is Marisol Gomez. I am here on behalf of my son who is a client of the regional center. For families like mine, regional center services are essential. My son's opportunities, independence, and quality of life depend on the supports he receives.

I also want to express my support for Fernando Gomez's comments. Families deserve answers about why this assessment is being pushed forward so quickly. DDS should focus on completing and evaluating the work already underway before implementing another major assessment system. If the respite assessment tool was paused because it was not ready, how can many families have confidence that this much larger assessment will be done correctly?

I am deeply concerned that this assessment could create more barriers to services, affect eligibility, or weaken individualized person-centered planning process. The regional center system was built on the principle that services should be based on the unique needs of each individual. The truth is we do not need more tools. We do not need another assessment that tries to fit people into categories. What we need is a commitment to providing services based on each person's individual needs, strengths, goals, and circumstances. No standardized tool can replace the voice of the individual, their family, and the person-centered planning process.

As a parent, I have experienced unmet needs, service denials, and barriers to assessing support for my son. Families should not have to have fear that another assessment will create even more obstacles. I urge DDS to slow down, listen to families and self-advocates, and ensure that any decisions protect individualized services and supports the lives of people with-- developmental disabilities are too important to be reduced to a score or a checklist.

Thank you.

Absolutely.

Thank you so much. Hey, I remember you.