Report 2021-107
June 28, 2022

Department of Developmental Services
It Has Not Ensured That Regional Centers Have the Necessary Resources to Effectively Serve Californians With Intellectual and Developmental Disabilities

June 28, 2022

The Governor of California
President pro Tempore of the Senate
Speaker of the Assembly
State Capitol
Sacramento, California 95814

Dear Governor and Legislative Leaders:

Through a statewide network of 21 regional centers, California's Department of Developmental Services (DDS) oversees the coordination and delivery of services for more than 380,000 individuals with developmental and intellectual disabilities, whom state law refers to as consumers. Our audit of three of these regional centers, which collectively serve more than 65,000 consumers, found that they have neither sufficient staff nor funding. As a result, service coordinators at the regional centers are responsible for assisting more consumers than the maximum set in state law, which limits the total amount of time that service coordinators can spend to assist their consumers. One of the causes we found for the insufficient staffing is that state funding for salaries has generally remained frozen since 1991, so regional centers hire fewer staff members at higher‑than‑funded salaries.

Furthermore, DDS has not ensured that regional centers properly monitor vendors. As a result, DDS and regional centers cannot be assured of the quality of services that the regional centers' vendors deliver to consumers. DDS has also not provided regional centers with the data systems or processes necessary to track and measure whether consumers have convenient access to services. Finally, DDS has not ensured that regional centers promptly resolve consumers' complaints regarding their rights.

Although DDS has been aware of many of these issues, it has not always taken timely and adequate actions to address them. As a result, it cannot be certain that regional centers are effectively serving Californians with intellectual and developmental disabilities.

Respectfully submitted,

Acting California State Auditor

ARCA Association of Regional Center Agencies
CERMS Consumer Electronic Records Management System
CPI Consumer Price Index
DDS Department of Developmental Services
IPP individual program plan
SANDIS San Diego Information System


Audit Highlights . . .

Our audit of DDS and three regional centers highlighted the following:

  • » For years, most of the State's 21 regional centers have exceeded their service coordinators' maximum caseload ratios.
    •     DDS has not adequately addressed funding issues that make it difficult for regional centers to meet caseload ratios.
  • » DDS has not ensured that regional centers monitor vendors, and neither DDS nor the regional centers monitor whether consumers experience difficulties in accessing services.
  • » DDS has not provided adequate oversight of regional centers' processes for resolving consumer rights violations.
    •     Two of the three regional centers we reviewed did not consistently inform consumers about the process for filing complaints, and all three frequently took too long to investigate complaints.
  • » DDS should ensure that regional centers make timely decisions on applicants' eligibility for services.

Results in Brief

The Department of Developmental Services (DDS) is responsible for overseeing a network of 21 regional centers throughout the State that coordinate services and supports for Californians with intellectual and developmental disabilities, whom state law refers to as consumers. The regional centers assess the consumers' needs, then coordinate the services they require to live independent, productive, and satisfying lives. To procure these services, the regional centers contract with service providers (vendors). DDS is responsible for monitoring regional centers' compliance with all applicable requirements in state law to ensure that consumers receive quality care and can achieve their desired goals.

Despite the importance of the work performed by the regional centers, DDS has not ensured that the regional centers receive adequate funding for critical staff positions. Specifically, service coordinators who work at the regional centers are responsible for working with consumers and their families to coordinate services and address concerns. Because a high caseload can negatively affect a service coordinator's ability to assist consumers, state law requires that regional centers maintain certain service coordinator‑to‑consumer ratios. However, none of the 21 regional centers are currently meeting all of these required caseload ratios. In fact, many of the regional centers have been out of compliance with the required caseload ratios for years. This lack of adequate staffing may have contributed to a significant percentage of consumers claiming in a recent DDS survey that they were not consistently able to contact their service coordinators in a timely manner.

The three regional centers we reviewed—Alta California Regional Center (Alta California), North Bay Regional Center (North Bay), and North Los Angeles County Regional Center (North L.A.)—explained that inadequate funding for salaries is the primary reason they are unable to meet the caseload ratios. DDS uses a core staffing formula to determine the budget for all regional center positions. However, in response to budget cuts, the State froze the salaries for service coordinators in fiscal year 1991–92 and since that time, DDS has largely not adjusted the salaries. If service coordinator salaries had kept pace with the Consumer Price Index, we estimate they would have been more than twice their currently funded level of $34,000. Although DDS is aware of this problem, it did not take steps to address it until recently, and the steps it has taken to date do not represent long-term solutions.

Further, DDS has not ensured that regional centers monitor vendors as state law requires. Proper monitoring of vendors is critical to ensuring the quality of the services that they provide and the well‑being of the consumers who are in their care. However, one of the regional centers we reviewed—Alta California—could not demonstrate that it consistently conducted required on-site visits of vendors that offer residential services. These reviews—referred to as quality assurance visits (quality reviews)—focus on the quality of care consumers receive and their safety, among other things. In addition, none of the three regional centers have consistently performed required biennial reviews of all vendor files to ensure that the vendors continue to meet all the necessary qualifications for providing services. We find the lapses in biennial vendor file monitoring especially concerning because we identified a similar problem in a 2016 audit and recommended then that DDS require the regional centers to address the issue. However, DDS has yet to take adequate action to ensure that regional centers perform these reviews.

Moreover, DDS and regional centers do not monitor whether consumers have convenient access to services. Generally recognized best practices provide that state agencies should develop processes to track and monitor customer service metrics, such as wait times for appointments, timeliness of referrals, and the distance that individuals must travel to access services, especially in rural areas. However, neither DDS nor the regional centers collect the information needed to monitor these metrics. Although DDS is developing a new data system for tracking consumer information statewide, it has not considered capturing data that would allow regional centers to assess convenience of access. Further, DDS stated that it does not expect to implement the new system until July 2025. As it develops its new system, DDS should ensure that the system can track key convenience metrics. Until it does so, it will not be able to ensure that consumers can quickly and easily receive the services they need.

Finally, DDS has also not ensured that regional centers promptly resolve consumers' complaints regarding their rights and adequately inform them about the complaint process. All three regional centers we reviewed often failed to complete investigations within the required 20-workday time frame. In fact, one regional center we reviewed—North L.A.—averaged around 50 working days to complete the complaint investigations we reviewed. Although DDS is aware that many regional centers are not consistently completing their investigations in a timely manner, it has not taken steps to systematically address this shortcoming. In addition, DDS's monitoring is insufficient to ensure that regional centers are notifying consumers of their right to file a complaint. Our review found that North Bay and North L.A. did not always provide complaint information to consumers as state law requires.

Agency Comments

DDS generally agreed with our recommendations and indicated that it will take action to implement them. However, it disagreed with our recommendation that it annually review and update as necessary the core staffing formula to ensure adequacy of regional center staff's salaries.