POS Equity Proposals
Draft Proposals for ABX 2 1 Funding
Please see below for the proposals that are being considered for submission to the Department of Developmental Services (DDS). Your comments are welcome. Please send your comments to email@example.com and include “POS Equity Proposals – Comments” in the subject line.
Proposals must be submitted to DDS by September 8th. Thank you.
Overview of Proposals specific to SG/PRC
Based on the information gathered through the 13 community meetings held in February and March, 2016, there were three central themes that emerged in terms of addressing POS disparity and promoting equity: Information, Training, and Outreach. The proposals presented below are organized into those three main groups.
The central strategy for the majority of the proposals is to empower families who support clients living at home to advocate for appropriate and effective regional center services paid by Purchase of Services (POS) funds by providing accessible information (meaning provided in the family language), training and education (made available in-person and on-line).
Information (including, providing information in preferred languages)
Hire two Community Outreach Specialists, one who speaks Spanish and one who speaks at least one Asian language. Both will be dedicated to implementing the proposals to reduce POS disparity, which includes identifying and supporting Parent Support Groups, creating a communication bridge with families associated with our regional center, providing training and information to families to help families understand the services available and to help them access those services. They will also do outreach to the community at large to those who are not yet being served by the regional center, through health plans, schools, churches and other local organizations, as mentioned below.
COST: One position is supported by the ABX 2 1 funding being provided by DDS to each regional center for one cultural specialist. The second position would cost $70,000 per year, including benefits and employer taxes and other expenses.
PUBLIC COMMENT/INPUT: Family member stated that she would like to have SG/PRC also hire a Chinese Outreach Specialist in addition to the two. This specialist needs to speak Mandarin and Cantonese and be proficient in reading and writing Traditional and Simplified Chinese. Another family member wanted to know how soon they could access the outreach specialist and when the community outreach specialist can start providing training on the regional center and the IPP process.
Provide bi-lingual pay differential to SG/PRC staff to encourage hiring more bi-lingual service coordinators and to retain service coordinators at the regional center. Reimburse SG/PRC staff overtime for reviewing and fine-tuning translated material, when that is not a part of their typical work responsibilities, to assure that correct regional center terminology is used and that families understand the terms used.
COST: $165,000 for bi-lingual pay only is the estimated cost per year, based on the number of bilingual staff currently employed at SG/PRC who would be eligible for bilingual pay differential.
An additional $2,000 is needed to cover the overtime costs to pay bi-lingual staff for translations that are above and beyond their regular job duties, such as to “vet” the translations of materials done outside SG/PRC by professional translation services. Total =$167,000
PUBLIC COMMENT/INPUT: Families agreed that it was important that they can communicate directly with their Service Coordinator (SC) in their primary language. In addition to understanding regional center services, they depend on their SC to translate material that comes in the mail from other agencies regarding services for their child. Also having materials written in their languages – besides the IPP – regarding regional center services, training opportunities, etc. is vital to the families.
Develop an introductory curriculum for families who have just recently received a diagnosis for their child that covers the diagnoses of cerebral palsy, epilepsy, intellectual disabilities, with specialty information about Down Syndrome. Provide this curriculum in the translations used for SG/PRC clients and their families. This project includes development of in-person and on-line formats for the presentation of information, as well as the translation of these materials..
COST: $121,000 for project. This project has statewide significance and application, as the content is not specific to the SG/PRC service area. The curriculum development and translation potentially may take more than one year to complete.
PUBLIC COMMENT/INPUT: There was general agreement that families needed to have this information about their child’s diagnosis in their primary language.
Fund a Community Engagement App that will allow SG/PRC to connect with families through their cell phones. This application can be made available in multiple languages so that alerts can be sent out to subscribers, and families can be referred back to the SG/PRC website for more detailed information, in their preferred language. During our meeting with families during the spring 2016, families told us that they wanted SG/PRC to connect with them through their smart phones – not to expect them to have a desktop computer. They wanted access to information from the regional center through text messages.
COST: $10,000 per year. Unlimited number of subscribers and unlimited number of messages can be delivered each year, at no cost to recipient of test. Once funded, this app can be advertised by SG/PRC as available and its services can be used immediately.
PUBLIC COMMENT/INPUT: One forum participant in particular really liked this idea. She said that her Spanish-speaking group has an app through which they text each other every day and stay connected. It was through this app that they were able to get the word out about the public forum.
Provide verbal and written translation to the Learning Modules on introduction to behavior modification called ADEPT that is being used by parents who are unable to attend the mandatory behavior modification training in person before one-on-one ABA can be provided. Add the voice over translations in Mandarin, Cantonese, Korean and Vietnamese for this training module. Provide closed captioning in Spanish, Simplified Chinese, Traditional Chinese, Korean and Vietnamese. (The learning modules already provide spoken Spanish but closed captioning is needed for the Spanish language version to be consistent).
This project has statewide significance and application, as these modules can be used statewide to meet the requirements for families to complete the basic behavior modification training prior to receiving individualized behavior management services.
COST: Being estimated. Approximately $50,000. The closed captioning and voice over translations should be completed within six months.
Provide culturally sensitive practices training to SG/PRC staff and Board Members. Material to be incorporated into a series of “just in time” learning modules that can be made available to staff in the years to come. The proposed trainer is well-known and respected for her training on developing respectful working relationships within a diverse, multicultural environment.
COST: $5,800 for five (5) in-person training sessions across three days. Training tentatively scheduled for March 2017.
Develop an in-person, parent/family education, community–based model to help train parents in “Learning to Navigate the Regional Center System” and to train a cadre of parent mentors to assist other families. This “navigation the system” training would include components like learning how to prepare for the IPP meeting, how to participate and contribute to the outcome of the IPP entitlement document. Other components would include understanding expectations and roles of the vendors/providers, as well as the regional center’s expectations of the parent.
The Mentors training be similar to and mirror the principles of the Promotora model. A part of this would include developing a strengths-based approach, helping the family to build on the skills they have already learned so that they can acquire new skills needed to help their child achieve yearly goals. This may include helping families meet basic needs, like using food banks and Medi-Cal benefits that may need to be met before the families can address their child’s developmental needs.
COST: for both components for one year is $142,500. Funding for two years at $285,000.
PUBLIC COMMENT/INPUT: Family member stated that service coordinators do not have the time to give them information, or may not know the information that families need to know. Also, family member stated that families need to know what to do when they have been approved for a service, but the service provider authorized does not speak the family’s language. Families also communicated that they are not sure what to do when they find out about abuse or neglect caused by a service worker, especially for clients over the age of 22 years. Families wanted to know how soon they could access this type of training and support.
Families also indicated that they felt that they could really use the support of a peer mentor. There was discussion about how the role of the mentor would be different from the service coordinator or the community outreach specialist.
Fund training for SG/PRC staff member to learn to develop on-line training modules customized for families. SG/PRC currently utilizes a statewide Learning Management System (LMS) but the modules are primarily for staff training. This same system can be set up to provide needed training and information to parents. Parents told us that they needed short-session training accessible on-demand from their own homes. The modules developed would have statewide significance as they could be used by all regional centers utilizing LMS.
COST: $1500 for training and travel to training site within California. Can implement modifying and increasing number of parent-focused learning modules immediately after training. May take six months or more to find a training course with opening located within California.
Support the development of a Vietnamese Outreach Specialist as part of the local Family Resource Center, to connect with the growing Vietnamese community in Pomona and El Monte and to help establish a parent/family support group.
COST: $20,000 per year for salary and benefits. Can begin within a couple of months of funding approval, allowing for recruitment.
Support the increased cost for the Mandarin-Speaking Outreach Specialist, who is an employee of the local Family Resource Center, to work an additional day per week to outreach to the Chinese community in the SG/PRC service area.
COST: $6,600 per year for salary and benefits. Increased hours can be implemented immediately following funding approval.
NOTE: It is understood that funds are going to be made available from DDS for one person per regional center to be hired as a cultural competency specialist to address POS disparity. But due to the diversity of our community and the extent of the underserved within our service area, the need for two staff members is evident. Census data shows that SG/PRC is currently underserving by more than least 10% the number of Asian people with disabilities who are living in our area. The cost for this position is already included under the Information section.
There are additional issues that SG/PRC cannot correct, that need to be addressed by the State or through the Department:
greater wages/rates of reimbursement for attracting and retaining bi-lingual direct care staff and professional staff, such as occupational therapists and behavioral analysts;
funds to develop services needed by our community members who were not former residents of developmental centers;
more scientific analyses of the POS data to identify root causes for disparity issues.
However, SG/PRC is submitting a couple of proposals that may help alleviate some of these issues, if only on a temporary basis.
Incentives for Service Providers
SG/PRC was informed by parents that some of the disparity in utilization was due to the lack of staff who could speak the language of the family. There were interruptions in services when one bi-lingual direct care staff would separate from the provider’s agency and many months went by before another bi-lingual worker would be hired and assigned to the family. Therefore, SG/PRC proposes to provide incentives to service providers serving SG/PRC clients for hiring and retaining up to three bilingual direct service providers or therapists for a minimum of 90 days after January 1, 2017 through June 15, 2017. Providers would be eligible for a $500.00 stipend/incentive for each staff member hired (and retained) who was proficient in the following languages: American Sign Language (ASL), Spanish, Korean, Mandarin, Cantonese and Vietnamese. The service categories eligible for the incentive would be Agency Respite, ILS, SLS, Infant Development, Occupational Therapy, Physical Therapy, Speech Therapy, and Applied Behavior Analysis.
COST: $60,000, based on three new staff per agency and approximately five agencies per category. Incentive funding to be available from January 2017 through end of May 2017.
PUBLIC INPUT/COMMENTS: Families would like to have seen that regional center could have paid providers more money so that more bi-lingual staff could be hired, but the incentives were seen as something that might help. Families indicated that there were problems with not having enough options of service providers who had direct support workers who spoke their family language.
Fund Service Utilization Research
SG/PRC is in support of the ARCA proposal to fund a study to better understanding POS utilization patterns in different communities. Funding for this study would not only review existing data but would also include individual interviews, focus groups, and surveys to determine whether specific barriers to accessing needed services exist and to develop suggestions for how best to correct them going forward. The research project would seek to better understand whether these variances are a result of differences in care-seeking behavior due to differing cultural beliefs and preferences, personal or family choice or that these variances are due to inequities prevalent in the developmental disabilities service system based on lack of culturally competent services, linguistic barriers, socioeconomic or other factors that may limit access to services and negatively impact utilization of services.
COST: $50,000 would be SG/PRC share in the cost for this study.
General Comments from Public Forum: