Report 2021-107 Recommendation 7 Responses

Report 2021-107: Department of Developmental Services: It Has Not Ensured That Regional Centers Have the Necessary Resources to Effectively Serve Californians With Intellectual and Developmental Disabilities (Release Date: June 2022)

Recommendation #7 To: Developmental Services, Department of

By January 2023, evaluate its processes for monitoring regional centers' performance of quality and biennial reviews to ensure that its processes are sufficient for identifying regional centers' noncompliance.

Annual Follow-Up Agency Response From June 2026

DDS developed a protocol for monitoring regional center (RC) compliance with the HCBS Settings Rule by creating an additional review tool (provided) to be used by DDS to monitor vendor compliance during the semi-annual review process beginning July 2026. The tool will be used with a sample size determined by DDS for each specialized home type. After review, the RC will receive a copy of the tool and is expected to support the vendor to create a remediation plan, if needed. Because this tool reviews vendor compliance with the HCBS Settings Rule and findings are shared with the RC, it also serves as a means for DDS to assess RC monitoring of vendor compliance with the HCBS Settings Rule.

In FY 2023-24, during semi-annual reviews DDS completed informal verifications for HCBS compliance with new and revised Program Designs for specialized home vendors. HCBS compliance was formally added to the Program Design checklist in 2025.

In July 2023, DDS developed and began using the provided Vendor File Monitoring Protocol and Rating Sheet to monitor RC compliance with the provided November 2, 2022 directive. A RC sample report of findings is provided (FNRC Vendor Monitoring Final Report). During its reviews, DDS provided technical assistance and training to each RC based on their compliance with this requirement. After one biennial cycle of this protocol, DDS found RCs were 96% compliant with this statutory requirement.

In July 2025, DDS updated its oversight process. DDS now verifies that RCs have written procedures for reviewing vendor files biennially and that reviews have been conducted. To monitor ongoing compliance, DDS obtains each RC's written procedure and reviews a sample of vendor file monitoring reviews. This allows for oversight of RC compliance with the biennial vendor file requirement without continued direct review of vendor files, which is the RC's responsibility. Since this update to DDS' monitoring, no RC has received a finding for noncompliance.

California State Auditor's Assessment of Annual Follow-Up Status: Fully Implemented

Annual Follow-Up Agency Response From March 2025

DDS evaluated its processes for monitoring regional centers' performance of quality and biennial reviews to ensure that the processes are sufficient for identifying regional centers' noncompliance. The one-pager previously provided to CSA details regional centers' statutorily required reviews and monitoring of Specialized Residential Facilities which DDS verifies as having occurred during its semi-annual reviews at each of the homes. Any noncompliance by the regional center is noted in DDS' report and the regional center is required to take corrective actions to remediate its noncompliance and improve its oversight of Specialized Residential Facilities. DDS previously provided CSA with documentation relevant to these reviews.

In evaluating our oversight of regional centers' completion of biennial vendor file reviews, DDS determined we did not have a process or mechanism for monitoring regional centers' compliance. DDS subsequently revised its protocol for monitoring regional centers' compliance with the Home and Community based Services (HCBS) Waiver by incorporating a review of regional centers' compliance with biennial vendor file reviews. DDS previously provided CSA with its revised HCBS monitoring protocol which reflects this additional component.

DDS believes it has fully complied with CSA's recommendation.

California State Auditor's Assessment of Annual Follow-Up Status: Pending

The department did not provide documentation to substantiate its claims.

Annual Follow-Up Agency Response From June 2024

DDS has evaluated the process for monitoring regional center performance of quality assurance reviews for specialized facilities - ARFPSHN, EBSH, and CCH. This data is reviewed on a regular and ongoing basis to ensure compliance.

California State Auditor's Assessment of Annual Follow-Up Status: Pending

The documentation that Developmental Services provided did not demonstrate that it has sufficient processes for monitoring regional centers' performance of quality and biennial reviews to identify regional centers' noncompliance. Until it provides such documentation, we will continue to report this recommendation as not fully implemented.

1-Year Agency Response

DDS has evaluated the process for monitoring regional center performance of quality assurance reviews for specialized facilities - ARFPSHN, EBSH, and CCH.

DDS has developed an additional component to the biennial HCBS Monitoring Review, effective July 1, 2023, that will include monitoring regional centers' compliance with vendor file reviews. DDS will hold a training for regional centers on June 28, 2023, regarding Title 17 requirements.

California State Auditor's Assessment of 1-Year Status: Pending

6-Month Agency Response

DDS has evaluated the process for monitoring regional center performance of quality assurance reviews for specialized facilities - ARFPSHN, EBSH, and CCH.

California State Auditor's Assessment of 6-Month Status: Pending

60-Day Agency Response

DDS is reviewing its current practices related to oversight of regional center quality assurance monitoring and biennial review of vendor files to determine sufficiency of current practices and areas of improvement.

California State Auditor's Assessment of 60-Day Status: Pending

All Recommendations in 2021-107

Agency responses received are posted verbatim.