Valley services for developmentally disabled struggle to survive: ‘We’re on our knees’

Don Hobson likes to talk, and he readily admits it when his boss good-naturedly tells him his productivity would improve if he spent less time socializing.

At The Arc Fresno/Madera Counties Production Center in east-central Fresno, Hobson makes friends almost as fast as he fills plastic bags with caps and screws for windows – his latest job at the center, which employs people with developmental disabilities.

Hobson, 48, has epilepsy and a mild case of cerebral palsy. He’s worked at The Arc for 25 years. Co-workers turn to him for assistance, and he likes to help.

The Arc supplies him with more than a job and income, Hobson says. “It gives me a feeling like I’m part of a group or community.”

Nearly 290,000 Californians have developmental disabilities and rely on nonprofit organizations for assistance, including help with housing, jobs and home care to live as independently as possible. But providers of these services say they have not had substantial rate increases from the state in more than a decade and are struggling to stay open.

“We’re on our knees and there is absolutely no support for what we’re doing,” said Lori Ramirez, executive director of The Arc/Fresno Madera Counties. The Arc provides several programs for people with developmental disabilities and serves more than 750 people with intellectual and developmental disabilities. The organization, which began providing services 63 years ago, remains fiscally sound, Ramirez said. “But if we don’t see some change in funding, we’re going to worry about closing programs.”

California’s developmental services system is “on the brink of collapse,” according to a February report by the Association of Regional Center Agencies. California’s 21 regional centers, created under the 1977 Lanterman Developmental Disabilities Services Act, contract with providers for services for their clients. Fresno’s center serves about 17,600 children and adults. (The Inland Regional Center, the scene of mass murder in San Bernardino earlier this month, is the largest in the state.)

According to the association’s report, California’s rates for services fall below other large states, and the difference is made worse by the high cost of living and of doing business in California.

Providers are asking the state for a 10 percent increase, a raise they say is only a stop-gap. Funding for developmental services is among the topics the California Legislature is debating in a special health session called by Gov. Jerry Brown. The state could have a $7.9 billion reserve that providers say could be tapped, but funding for developmental disabilities is only one of the topics on the table. The state could lose $1.1 billion in federal funds for Medi-Cal if it cannot resolve an issue with the federal government over a Managed Care Organization tax. So far, no recommendation for funding developmental services has come out of the special session. Legislators will meet again after the first of the year.

The California Department of Developmental Services has heard complaints about rates from providers throughout the state, said John Doyle, chief deputy director. But the department has to work within the direction it gets from the Legislature, he said.

Diana Dooley, secretary of the state’s Health and Human Services Agency, has convened a task force to look at issues affecting developmental services, Doyle said. The rate structure for paying providers is complicated, however, he said. A consultant could be needed to assist the task force. “It’s the kind of thing where you need a certain type of financial expertise,” he said.

Providers in the Valley say something has to give to preserve services for the most vulnerable.

Six providers for the Central Valley Regional Center have gone out of business in the past two years, said Heather Flores, executive director. Hardest hit have been providers of six-bed homes for people who have cerebral palsy, epilepsy, autism and who use ventilators, she said.

Flores said costs continue to increase for providers for insurance and workers’ compensation; an increase in the minimum wage also has affected their bottom line.

Ramirez said it means staff are going without raises this year, and they deserve to be rewarded for their dedication, she said.

Salary, though, is not what keeps Marcella Bracamonte on her job at The Arc’s production center in Fresno. She’s worked for the center for 10 years and earns $12.30 an hour.

When she was hired, she thought she’d stay a year, but Bracamonte, 39, found the job overseeing and training workers at the center too gratifying to leave. “It fulfills their lives and fulfills my life,” she said. “When I see a big smile on their faces, I know they’re feeling good.”

Hobson was glad to oblige, smiling broadly when Bracamonte and program manager Brian Trukki stopped by his workbench to chat recently.

Bantering with Trukki about his work habits, Hobson said he “likes being around friends” at the center. “But I know I have to be socializing at the appropriate times.”

Without the job at the production center, Hobson said: “I’d be sitting around home, twiddling my thumbs.”

Providers said a passion for helping people with disabilities keeps them in the developmental services business.

Doug Middleton volunteered for the Special Olympics as a high school student. After completing a bachelor’s degree in psychology, he went to work for Vocation Plus Services, a Fresno business that prepares people with developmental disabilities for employment. In 2015, he bought the 30-year-old business from the retiring owner; Vocation Plus Connections, Inc., now serves about 194 people a day.

“I just couldn’t see myself leaving. I loved it too much,” Middleton said of his decision to keep the business going. But he’s had to take a financial hit along with his staff, he said. “We’re all making do with what we have to ensure the consumers are still receiving services.”

Many of the developmental services providers in the Valley are nonprofit organizations, and they’ve turned more to fundraising and grant writing to keep going. “Fresno is a generous community or we wouldn’t be here,” said Jeffrey Snyder, executive director of UCP of Central California. “We couldn’t survive on the frozen rates in the state.”

UCP operates a Center for Arts and Technology that offers vocational and artistic training to adults with disabilities. Local supporters helped UCP upgrade the laboratory last year. Snyder said he’s grateful for the community’s contributions, but “I’m saying the basic money to run the place is not coming from a responsive state Legislature.”

And developmental service providers need to be able to expand services to meet consumer needs without having to fundraise, the providers said.

The Arc wants to expand a supportive living program, where individuals are taught how to live independently. “Families are being affected by us not being able to expand our services and do more,” Ramirez said.

“We’re having to say ‘no,’ and we’re not used to saying, ‘no.’ ”

This story was originally published December 10, 2015 at 4:23 PM with the headline "Valley services for developmentally disabled struggle to survive: ‘We’re on our knees’."