Self Determination Program
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As previously reported, DDS must receive approval of a federal Waiver application before California can begin to implement the Self Determination Program. We have been informed that the Center for Medicare and Medicaid Services (CMS) continues to have approximately 30 remaining questions for the Department of Developmental Services (DDS). They are hopeful that in these ongoing discussions, they will be able to resolve any remaining questions from CMS, and then submit what they hope will be a final and successful Waiver application in early 2017 (perhaps in February).
We have been informed that the federal Centers for Medicare and Medicaid Services (CMS) has provided additional questions to DDS regarding their application for a Self Determination Program waiver, which they are working to address.
Therefore the application was not submitted as planned by the end of August. Once all of CMS’ questions have been addressed, the waiver application will be posted on the DDS website for public comment and officially resubmitted to CMS for consideration.
Although last reported that they would resubmit the application to CMS in March, DDS now reports they plan to resubmit by the end of August, (after posting for public comment).
Summary and Update Provided to the Legislature March 2016
"On December 31, 2014, DDS submitted an HCBS Waiver application to CMS seeking federal funding for the Self-Determination Program (SDP). Under the authority of Senate Bill (SB) 468 (Chapter 683, Statutes of 2013) and upon CMS approval, DDS will implement the SDP, allowing regional center consumers and their families more freedom, control and responsibility in choosing services and supports to help them meet objectives in their individual program plans. Under the provisions of SB 468, participation will be limited to 2,500 individuals for the first three years of implementation.
After the Waiver application was originally submitted in December 2014, CMS indicated that it must be withdrawn since DDS had not met public participation policies (specifically posting the application prior to submitting). Additionally, CMS was concerned that the application did not adequately address how the program complied with the new regulations concerning HCBS settings. Subsequently, after working with CMS, the application was revised and resubmitted in September 2015. In a letter dated December 11, 2015, CMS asked for more information regarding information in the application. This is part of the typical review process when applications are submitted to CMS.
In general, some themes in CMS’ questions relate to:
How the settings (where services are provided) comply with the HCBS requirements.
Oversight of providers since regional center vendorization is not required (except for Financial Management Services providers.)
Clarification of service definitions
Clarification of measurements DDS will use to report back to CMS regarding how the self-determination program is meeting federal assurances.
In addition to working through the questions from CMS, in conjunction with the self-determination workgroup DDS is finalizing training materials that will be used for training of regional centers, as required by statute. The Department expects to begin the training in the next few months with participation from workgroup members. Other current activities of the workgroup include identifying suggested qualifications and other requirements for Financial Management Services providers.
While DDS has made a great deal of progress towards implementation, there is notable frustration from Advocates that the program has not moved further along. DDS states that the process for obtaining federal approval typically does not occur quickly under ordinary circumstances, and positions that since self-determination is a new program in California (from CMS’ perspective), these are not ordinary circumstances."
DDS Update December 21, 2015
- As noted in previous updates, the Department submitted the Home and Community-Based Services Waiver application for the Self-Determination Program to the Centers for Medicare and Medicaid Services (CMS) in September of this year. As part of its standard waiver review and approval process, CMS sent a letter to the State asking questions about, and requesting more information on, specific sections in the Self-Determination Program Waiver Application. Following the normal process, the Department will work through the Department of Health Care Services to provide written responses to answer CMS' questions and secure approval of the waiver. Questions about this process can be submitted to the Department via email at firstname.lastname@example.org.
DDS Update October, 2015
- The Self-Determination Program Waiver Application was formally resubmitted to the Centers for Medicare and Medicaid Services on September 29, 2015. DDS is awaiting further questions or direction from CMS.
DDS Update August 7, 2015
- "At the request of the federal government, new language was added to the Self-Determination Program (SDP) Waiver application describing how homes and settings where SDP participants will reside and receive services meet the requirements of the federal home and community-based settings rules that became effective in March 2014. As a result of this change, the Department is required to repost the Waiver application for at least 30 days. The Waiver application will be formally resubmitted to the Centers for Medicare and Medicaid Services shortly after the public comment period, which ends on September 7, 2015. Comments or requests to review a hardcopy of the application can be submitted via email at email@example.com, by phone at (916) 653-7710, or in writing to the Department, Attention Community Services Division, 1600 Ninth Street, Room 320, MS 3-8, Sacramento, CA 95814.
What is the Self Determination Program?
In October of 2013, Governor Edmund G. Brown Jr. signed into law the Self-Determination Program, which will provide regional center clients and their families with a new option. .As authorized in Welfare and Institutions Code, Section 4685.8, "the Self-Determination Program (SDP) is a voluntary delivery system consisting of a mix of services and supports, selected and directed by a participant through person-centered planning, in order to meet the objectives in his or her Individual Program Plan (IPP). Self-determination services and supports are designed to assist the participant to achieve personally defined outcomes in community settings that promote inclusion," and allow participants to have more control in developing service plans and selecting service providers.
The Priniciples of Self Determination include:
- Freedom to exercise the same rights as all citizens; to establish, with freely chosen supports, family and friends, where they want to live, with whom they want to live, how their time will be occupied, and who supports them;
- Authority to control a budget in order to purchase services and supports of their choosing;
- Support, including the ability to arrange resources and personnel, which will allow flexibility to live in the community of their choice;
- Responsibility, which includes the opportunity to take responsibility for making decisions in their own lives and accept a valued role in their community, and
- Confirmation, in making decisions in their own lives by designing and operating the service that they rely on.
When Will It Become Available?
The law requires that before this proram can be made available, the Department of Developmental Services submit an application for federal funding, and that this application be approved for funding by the federal government. Because the application process by DDS to the federal government is still in beginning stages, and because this process for review and approval may take some time, we do not yet have an estimated date when this program will be implemented.
The program will be implemented gradually. Upon approval of the Waiver application (federal funding), the SDP will be implemented for up to 2,500 participants in the state, to be phased in during the first three years. During the phase in period, the Department of Developmental Services will identify a limited number of clients/families from each regional center that may be enrolled in the Self Determination Program. After this three year phase-in period, the program will be available to all clients.
The Harbor Regional Center Self Determination Program Community Advisory Committee providesinput and oversight for the future implementation of the SDP. Agendas for the SDP CAC will include review of legislation; updates on the status of the Department of Developmental Services' federal Waiver application,and on the work of Statewide Advisory Group including materials (video, training & implementation guidelines) as they are made available. Meetings take place on the second Wednesday of every month at 6:00 pm at Torrance in Conference Room A4. Meetings are open to the public.
As reported here earlier, the SDP must be approved for federal funding before it will be implemented. A similar program has been piloted at a few regional centers. Informational meetings will be scheduled for interested persons upon approval of the program, and announced on this webpage and in the HRC ENews.
Members of the Community Advisory Committee include:
Ray Ceragioli, Parent, Fairview, Rancho Palos Verdes
Linda Cha-Rapp, Parent, Lomita
Rosalinda Garcia, Parent/Provider, Redondo Beach
David Gauthier, Client, Torrance
Miriam Kang, Parent, Long Beach
Carola Maranon, Parent, Norwalk
Deaka McClain, Client, Long Beach
Mariano Sanz, Parent, Long Beach
Marsha Johnson, Clients Rights Advocate, DRC
Frequently Asked Questions about Self Determination Program
The Department of Developmental Services provides answers, and periodic updateson their webpage for Frequently Asked Questions.
Where can you obtain the latest information?
- You may refer to the Self Determination Program information page on the Department of Developmental Services website
- Sign up for email updates by sending an email to firstname.lastname@example.org and ask to be included on the update notification list.
- If after reading the general information and Frequently Asked Questions on this page and the DDS webpage, you still have questions, you may submit those questions to email@example.com.
- HRC will b provide more information to our clients and families on this website as it becomes available.
- You may sign up to receive email updates regarding local planning by sending an email to firstname.lastname@example.org with your name, client's name if different, email address, and note that you wish to be added to the Self Determination Program information email list.