6: How Budgets are Made

Pre-Enrollment Transition Supports

The initial SDP budget is created during the pre-enrollment transition period, and it is based on current needs and current authorizations. To ensure the budget reflects all current needs, consider adjusting the IPP before beginning the transition process. This will make the budget process significantly easier.

Traditional services and the Lanterman Act

Understanding what services are available in the traditional regional center system is key to success in the Self Determination Program. The only way to add to a budget is to identify services and supports that would be provided to a participant in the traditional system. Once those services and supports are identified, the Self Determination Program allows participants to allocate the funds to services they choose themselves to meet the person-centered goals. This is the beauty of SDP: the creativity and innovation to meet needs in “out of the box” ways.

Some services in the traditional system for individuals under 18 are:

• Respite, in-home or out-of-home
• Personal Assistance
• Social Recreation, Camp, and Creative arts
• Socialization Training Program
• Healthy Relationships and Preventing Sexual Abuse (under Individual and Family Training 102, according to the SCDD regional center look up tool)
• Daycare Services: This is for costs above daycare needs for children without disabilities of the same age.

In adulthood, services shift dramatically to include all aspects of life with a developmental disability. Some services added in adulthood include:

• Independent Living Skills (ILS)
• Supported Living Skills (SLS)
• Employment Supports
• Day Programs
• Tailored Day programs
• Money Management

Remember, there is no need to request the exact service or use the traditional service codes. Independent facilitators, participants, and families can describe the challenge and the goal to the service coordinator. Then the service coordinator can think about how that challenge would be addressed in the traditional service delivery model. Different regional centers use service codes in varied ways.

Some people participate in day programs, while others are eligible for more intensive supports to meet their needs. The services an individual needs are the foundation of their budget.

Just like in the traditional system, generic resources are used first in the Self Determination Program. If a participant is trying to use SDP to get around using private insurance or school-based services, this will not work. If a participant’s private insurance or Medi-Cal covers a service, this funding source will be used instead of the Self Determination Program.

Person-Centered Plans: Revealing Needs

A wonderful person-centered plan will also help the independent facilitator and service coordinator identify services and supports that are available in the traditional system.

When participants or independent facilitators describe goals and challenges to service coordinators, this provides all parties a chance to work together to brainstorm possible solutions using the traditional service delivery system’s available and allowable resources. The person-centered plan can describe the life, the goals, and the challenges a person wants to address, and the service coordinator can suggest solutions based on the traditional system.

When independent facilitators decide what the services should be, before discussions with service coordinators, they might miss additional services, ideas, or even better supports and services from the traditional model.

If the independent facilitator has developed expertise and understanding of a specific regional center, and the predetermined request works for the people they serve, it can be effective and direct. Yet, it might miss the opportunity to build rapport and demonstrate respect for the expertise service coordinators can potentially offer SDP participants.

Current needs

In the regional center system, current needs are the parts of life that people with developmental disabilities need support for and are eligible to receive services.

Sometimes, people struggle to get access to the services they need.

Common reasons for not receiving these services include a lack of providers, inadequate program design, services are not provided in a way that works for the person served, or the service is never offered at all, even when the individual served is eligible for it.

In a person-centered plan, there could be additional needs that are not met, but it is possible that these needs do not connect to services provided in the traditional system. These person-centered needs can lead to goals that connect to a developmental disability, but they will not increase a Self Determination Program budget.

Changes in circumstances

There are many events that can change life. These life-changing events impact what we need in our daily lives. We have changes in circumstances when we move to a new community, get a new job, graduate from high school, enter a new life stage, or lose someone close to us. In each of these circumstances, the change can impact our mental health, our daily living situation, and more.

When there is a change in the lives of a person in SDP, the person-centered plan needs to be updated and this can be shared with the regional center to see how to meet this new need.

Why rules about budgets matter

The Self Determination Program relies on Medicaid funding. This means there are rules from the Centers for Medicaid and Medicare Services (CMS) that determine how funds can be used. Independent facilitators should know what “allowable” expenses are. Allowable expenses are simply the acceptable ways to use federal funds. There is a huge CMS Regulations text with over 400 pages of regulations. Sometimes these rules conflict with each other. However, the important part for independent facilitators to understand is that when we use federal funds for services, we have to follow the rules attached to the money.