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Sunday, April 3, 2011

Regional Center Reform

At The California Progress Report, attorney Raphael Metzger writes:

Last week the California Senate Committee on Human Services held a hearing on the Lanterman Act and the future of services for the disabled. Among those present were representatives from the leadership of some of the nonprofit organizations mis-conceptualized as “regional centers created by the Lanterman Act” to serve the disabled. The fact is that the Lanterman Act did not create any of the organizations we today call “regional centers”.

Regional centers are privately run nonprofit corporations created and existing pursuant to California law governing non-profit corporations. What Lanterman did do was to create a function called “regional center” and require that DDS work through private sector contractors to implement this function. Similarly, although they are not labeled as such, the individuals, nonprofit organizations, and for-profit businesses “vendorized” through regional centers to provide services to the disabled are, fundamentally, sub-contractors.

He proposes a number of reforms, including:

Implementation of the regional center function should be competitively procured by DDS. Competition helps to drive performance and fuels innovation. It is part of what makes the private sector effective, and by failing to compete these contracts the purpose of turning to the private sector is lost.

Eliminate the lack of transparency in regional center operations. Either the entities acting as regional centers need to be deemed quasi-governmental in nature so that they are subject to the California Public Records Act, or DDS should include clauses in its contracts with regional center implementing agencies requiring disclosure of internal documents as if they were subject to the Public Records Act.

DDS should incorporate advocacy clauses into its contracts with regional center implementing partners. DDS should specifically acknowledge in their contracts for regional center services that organizations awarded the contract are expected to advocate for the disabled and will not be penalized for being an advocate. Fealty to the intent and purposes of the Lanterman Act means that regional centers must be willing to advocate for consumers against school districts, insurance companies, vendors, and even DDS itself.

Focus on quality control by develop metrics to evaluate institutional performance. Best practices committees are an ineffective means of controlling quality and do far more harm than good to consumers. DDS’s focus should be on developing metrics with public input and quality control through data collection, publication of raw data for use by researchers, and thorough, macro level evaluation of contractor performance.