Current System Funding Sources
From the perspective of the consumer and many providers the sources of funding for services are relatively straightforward. The two major funding sources are the regional center (funded by the Department of Developmental Services) and the Department of Rehabilitation. From a system perspective, The funding becomes exceptionally complex, due to the variety of sources the State of California has to receive funds. Based on the Lanterman Act the state is primarily responsible for all services and supports through the general fund (State Tax Revenue). However, over time the Federal Government has become a major player in the funding of the services for individuals with developmental disabilities.
Developmental Centers (DDS is the responsible State Department) - These state run institutions are funded 50% from the Federal Government and 50% from the State General Funds. They currently serve around 3,500 consumers with development disabilities.
DDS is the responsible State Department (which uses local non-profit organizations called Regional Centers to implement the State Responsibility).
Regional Center Operations - This is primarily funded through the State Generals Funds, although each Regional Center also receives some Federal Funds for targeted Case Management.
Regional Purchase of Service - This has been funded primarily through State General Funds, however an increasing emphasis has been placed on the use of Federal Funds (through the Federal Medical Waiver program). California currently has approximately 45,000 consumers of the 180,000 in the community receiving funds from the Federal Government. The waiver requires the State to pay 100% of the cost and then the State is reimbursed for 50% of those cost from Federal Funds.
ICF/MR Residential Model - These are homes that serve individuals with significant medical and other needs. This program is run under the Department of Health Services, although the consumers are also Regional Center consumers. The funding is similar to the Federal Medicaid Waiver in that the Federal Government pays for 50% of the costs.
The Department of Rehabilitation - The Department of Rehabilitation has two distinct programs. The first is Vocational Rehabilitation (VR). This program provides services to individuals needing help achieving vocational goals, who have some type of disability (this is not a developmental disability only service). The source of funding for these services is a Federal Government Block Grant that is given to every state based on the population of the state. the State is required to match the Block Grant at a rate of 22%. So for every dollar that the state spends $0.22 comes from the General Fund match and $0.78 comes from the Federal Government. Vocational Rehabilitation is used for individuals with developmental disabilities primarily to help them achieve their highest level of employment in the community (VR's most successful outcome is a competitive Job, without any long-term supports, followed by Individual Placements, with follow along supports, Group Placements, and Sheltered Employment).
The second component is Habilitation Services (HAB). This program is for individuals with developmental disabilities. It provides long-term employment support to individuals who have been placed in individual, group and/or sheltered employment settings. This program is primarily funded by State General Fund Dollars, however, as individuals served in this program are also consumers of the Regional Center they may be identified and receive Federal Funding under the Medicaid Waiver Program. Currently, The Department of Rehabilitation serves approximately 20,000 consumers with developmental disabilities under one of these services.
Other State Funded Services and Supports - Individuals with developmental disabilities are often recipients of SSI support, receive their Health Care as Medical Patients and receive IHSS support in their living arrangements.