HRC will post updates on on this page that we receive about the Self Determination Program, and the state's (Department of Developmental Services) application for approval of federal funding for implementation.
June 29, 2018
The application for federal funding of the Self Determination Program Waiver has been approved.
Updated estimated timeline for implementation–
The Department of Developmental Services, in collaboration with the self-determination advisory workgroup and other stakeholders, has been working on the major components necessary to implement the Self-Determination Program (SDP). Outlined below are some of the major components requiring completion prior to the SDP becoming operational. The list below is not exhaustive but includes the key components and steps under active development.
The Department will post updates on the progress of each component.
Federal Funding Approval
Status: Completed. The application for federal funding, or Waiver, was approved by the Centers for Medicare and Medicaid Services on June 6, 2018.
Individual Budgets - Target for completion: August 15, 2018
Task: Finalizing guidance information on how the individual budget amount is calculated, and the process for adjusting the budget when needed.
Financial Management Services (FMS) - Target for completion: August 31, 2018.
Task: Finalizing FMS vendorization requirements and rates.
Independent Facilitators - Target for completion: August 31, 2018.
Task: Defining the role(s) an independent facilitator may play and how this may be different if a participant chooses to select their service coordinator to fulfill the functions of an independent facilitator.
Participant Selection - Target for completion: October 1, 2018
Task: Selection of the initial SDP participants. It's important to note that only those individuals who have participated in an informational meeting and whose names have been received by the Department by September 17, 2018 at 5:00 PM will be considered for selection (by the Department) of the initial 2,500 participants in the SDP. Individuals whose names are received after September 17, 2018 will be considered for subsequent selections of SDP participants. Subsequent participant selections will occur if some of the initial 2,500 participants choose not to enroll or they enroll, then decide not to continue in the SDP. Timing for future selections will be established at a later date. Information for those who are interested on how they can be considered for participation in the SDP can be found at www.dds.ca.gov/SDP/sdpEnrollment.cfm.
§ Home and Community-Based "Settings" Requirements - Target for completion: October 31, 2018.
Task: Finalizing training materials on the federal requirements, how they apply to services in the SDP and the assessment process for ensuring all services, or "settings", meet the requirements. Due to federal regulations effective in March 2014, everywhere someone receives services (e.g. the "setting" where the service is provided,) must promote, and not prevent, community participation and inclusion. The target date projects time needed to provide training to those who will be involved in the assessment process.
§ Orientation Materials - Target for completion: October 31, 2018.
Task: Finalize all orientation materials. The orientation materials will form the basis of the information participants need to support them in the SDP. In addition to the components above, the orientation will include information on what services are available in the SDP and tools to help participants choose qualified service providers. Training for those providing these orientations will also be necessary prior to participant orientations.
For more information on the Self Determination Program, including a description of the program, fact sheets, orientation sessions, and advisory committee meetings, click here.
June 2018: Waiver Application Approved
Letter from Department of Developmental Services
The Department is very pleased to announce that the application for federal funding, or Waiver, for the Self-Determination Program was approved by the Centers for Medicare and Medicaid Services (CMS). This news represents an essential step toward providing people who receive regional center services and their families an alternative way to coordinate their services, with more freedom and control over how the services are provided and the individuals who support them. We would like to express sincere appreciation for the assistance and guidance from the Department’s self-determination advisory workgroup and other stakeholders, which has been instrumental in gaining CMS’ approval of the Waiver. We also thank and recognize the work and technical assistance received from many representatives of CMS and California’s Department of Health Care Services.
In October 2013, Governor Edmund G. Brown signed Senate Bill 468, authored by Senators Bill Emmerson and Jim Beall and co-authored by Assembly Members Holly Mitchell and Wesley Chesbro, into law. This law, championed by remarkable and determined self-advocates, family members and advocacy organizations, established a statewide Self-Determination Program that adheres to the following principles to ensure those who participate have:
· Freedom - to exercise the same rights as all citizens; to establish, with freely chosen supporters, 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 ability 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 system that they rely on.
Self-determination in California began almost twenty years ago as a small pilot project in limited areas of the state, with the intention of eventually expanding the program statewide. The time from the start of the pilot project, to Governor Brown’s signing of the law in October 2013, to now has only heightened the desire to implement self-determination broadly in California.
While approval of the Waiver represents the key step towards implementation of the Self-Determination Program, the Department and the self-determination advisory workgroup must continue to focus on finalizing program components for implementation. Providing information and support, in particular training and orientation materials, needed to assist those who are selected and choose to participate is central to implementation and is in the final stages of completion. We remain committed to implementing this important program and look forward to the continued collaboration, not only with the Department’s advisory workgroup, but also the local volunteer advisory committees and the Statewide Self-Determination Advisory Committee. The Department will publish a timeline with key dates for implementation by June 18, 2018. Updates will be posted on the Department’s dedicated website page for Self-Determination at: https://www.dds.ca.gov/SDP/. If you would like to be notified of future updates about Self-Determination, please send an email to firstname.lastname@example.org. Information for those who are interested on how they can be considered for participation in the Self-Determination Program can be found at https://www.dds.ca.gov/SDP/sdpEnrollment.cfm
Please join me in celebrating the approval of the Self-Determination Program Waiver and thanking the Department’s self-determination advisory workgroup for their dedication and countless hours of work to make it happen.
NANCY BARGMANN, Director
Department of Developmental Services
"The Department is pleased to announce that on March 13, 2018, the Home and Community-Based Services Waiver application seeking federal funding for the Self-Determination Program was formally re-submitted to the federal Centers for Medicare and Medicaid Services (CMS).
CMS has 90 days to either approve the application, deny the application or request additional information. Because of all the work that's been done with CMS to prepare for this formal re-submission, we are very hopeful the application will be approved.
We are very appreciative of the significant efforts of the Department's Self-Determination advisory group and other stakeholders that have been instrumental in assisting the Department in completing the Waiver application. We look forward to this continued partnership to complete the other steps necessary to implement the program.
The Department will continue to post updates as we progress toward implementation.
A copy of the Waiver application is available at this link: http://www.dds.ca.gov/SDP/SDPUpdates.cfm.
Questions about this update can be submitted to the Department via email at email@example.com.
The Department and its Stakeholder Workgroup report confidence in their progress towards approval of California's application. they expect to submit their application by the end of January, and we may see movement forward in a few months.
The Department of Developmental Services will hold trainings on the Self-Determination Program (SDP) at five locations throughout the state in September 2017 and October 2017.
The training is designed as a train-the-trainer meeting, and will be specific to learning how to conduct a SDP Informational Meeting. The SDP Informational Meeting is required before an individual can be added to the candidate list from which the Department will randomly select the first 2,500 SDP participants. This training is open to regional centers, local consumer or family-run organizations, and community-based organizations interested in voluntarily conducting SDP Informational Meetings in their region. A community-based organization is a public or private organization of demonstrated effectiveness that is representative of a community, or significant segments of a community, and provides educational or related services to individuals in the community.
For more information about these trainings, please see the letter sent to community-based organizations dated August 18, 2017, along with the attached flyer. Questions about these trainings can be submitted to the Department via email at firstname.lastname@example.org.
As part of its standard waiver review and approval process, Centers for Medicare and Medicaid Services (CMS) sent a letter to the State asking questions about, and requesting more information on, specific sections in the Self-Determination Program Waiver Application. The Department of Developmental Services, through the Department of Health Care Services, continues to have discussions with CMS to resolve their remaining questions. They hope to provide written responses to answer CMS' questions and secure approval of the waiver in the near future.
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 email@example.com.
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 firstname.lastname@example.org, 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.