Report 2021-120 Recommendation 8 Responses

Report 2021-120: In-Home Respite Services: The Department of Developmental Services Has Not Adequately Reduced Barriers to Some Families' Use of In-Home Respite Services (Release Date: August 2022)

Recommendation #8 To: Developmental Services, Department of

DDS should review the policies of all 21 regional centers by October 2022 to ensure that they do not contain provisions imposing overall limits on the amount of in-home respite service hours authorized for families to receive each quarter and require revisions as necessary.

Annual Follow-Up Agency Response From August 2024

DDS continues to disagree with the CSA, as statute (WIC 4620.3) does allow regional centers to have policies indicate a limit on the amount of in-home respite service hours provided there is a timely process for the regional center to allow exceptions to authorize additional hours when needed to meet an individual's needs. It should also be noted that prior to the implementation of the statute (WIC 4686.5) that placed caps on respite hours (this statute was approved in response to a budget crisis), statute did not speak to caps. As part of the implementation of trailer bill language SB138 (2023-2024), and WIC 4435.1(c), DDS will work with regional centers on establishing standardized processes for the provision of respite services including making any modifications to regional center purchase of service policies.

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

DDS indicates that it believes that statute allows it , so long as the policies include exceptions processes. As we stated in our audit report, we disagree with DDS's practice of approving policies that specify a limit on the amount of in-home respite hours as long as there is an exceptions process to authorize additional hours. Although we acknowledge that case law and statute require review and consideration of each individual's needs and circumstances, we state that, because the Legislature removed hourly caps, policies that reference limits on respite hours are inconsistent with the intent of the Legislature and risk creating the impression among consumers, families, and regional center staff that an hourly cap is still in place. Moreover, such policies create additional barriers to families accessing respite services by imposing an hour limit and requiring a family to seek an exception. Thus, we stand by our conclusion that an exceptions process is not sufficient to comply with the Legislature's intent in repealing the hourly cap.

As DDS indicates, recent changes to statute require DDS to work with regional centers on establishing standardized processes for the provision of respite services. As part of this process to standardize the provision of respite services and modify policies, we believe DDS should follow our recommendation to ensure that policies do not contain limits on respite hours.

1-Year Agency Response

DDS has completed the actions described in the Department's response to audit report.

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

DDS recently informed us that it maintains its original response to our finding and believes that the policies that impose a limit are consistent with the statute and case law, so long as the policies include exceptions processes. As we stated in our audit report, we disagree with DDS's practice of approving policies that specify a limit on the amount of in-home respite hours as long as there is an exceptions process to authorize additional hours. Although we acknowledge that case law and statute require review and consideration of each individual's needs and circumstances, we state that, because the Legislature removed hourly caps, policies that reference limits on respite hours are inconsistent with the intent of the Legislature and risk creating the impression among consumers, families, and regional center staff that an hourly cap is still in place. Moreover, such policies create additional barriers to families accessing respite services by imposing an hour limit and requiring a family to seek an exception. Thus, we stand by our conclusion that an exceptions process is not sufficient to comply with the Legislature's intent in repealing the hourly cap.

6-Month Agency Response

DDS has completed the actions agreed to in the Department's response to audit report.

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

DDS recently informed us that it maintains its original response to our finding and believes that the policies that impose a limit are consistent with the statute and case law, so long as the policies include exceptions processes. As we stated in our audit report, we disagree with DDS's practice of approving policies that specify a limit on the amount of in-home respite hours as long as there is an exceptions process to authorize additional hours. Although we acknowledge that case law and statute require review and consideration of each individual's needs and circumstances, we state that, because the Legislature removed hourly caps, policies that reference limits on respite hours are inconsistent with the intent of the Legislature and risk creating the impression among consumers, families, and regional center staff that an hourly cap is still in place. Moreover, such policies create additional barriers to families accessing respite services by imposing an hour limit and requiring a family to seek an exception. Thus, we stand by our conclusion that an exceptions process is not sufficient to comply with the Legislature's intent in repealing the hourly cap.

60-Day Agency Response

DDS reviewed the respite policies of the 21 regional centers, and has identified that 11 of those policies impose either quarterly or monthly limits on the number of authorized service hours. Each of these 11 policies also provides allowable exception language, as described in our initial response to the audit report.

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

As we stated in our audit report, we disagree with DDS's practice of approving policies that specify a limit on the amount of in-home respite hours as long as there is an exceptions process to authorize additional hours. Although we acknowledge that case law and statute require review and consideration of each individual's needs and circumstances, we state that, because the Legislature removed hourly caps, policies that reference limits on respite hours are inconsistent with the intent of the Legislature and risk creating the impression among consumers, families, and regional center staff that an hourly cap is still in place. Moreover, such policies create additional barriers to families accessing respite services by imposing an hour limit and requiring a family to seek an exception. Thus, we stand by our conclusion that an exceptions process is not sufficient to comply with the Legislature's intent in repealing the hourly cap.

All Recommendations in 2021-120

Agency responses received are posted verbatim.