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TMI Headed to the Capitol to Advocate for a Greatly Needed 8% Rate Increase

TMI Executive Director Rachel Harris and Associate Executive Director Jessie Campbell with fellow advocates and representatives at the Capitol

(TMI Executive Director Rachel Harris and Associate Executive Director Jessie Campbell with fellow advocates and representatives at the Capitol)

Toward Maximum Independence (TMI) Executive Director Rachel Harris, along with TMI's Associate Executive Director Jessie Campbell and Director of Community Living Services Angela Newmeyer visited our State Capitol last week to push for a greatly needed 8% rate increase for services for children and adults with intellectual and developmental disabilities (I/DD). They had the opportunity to meet with legislators and representatives to have their voices heard on the importance of a rate increase, the challenges in hiring and paying staff and the need for immediate action.

California's I/DD service system as a whole, which serves more than 350,000 people, has been and will continue to be impacted by the incremental raises of the state minimum wage to $15/hour. The service rates are too low to cover the wage increases. Without change, our system is in jeopardy.

RIGHT NOW, There are waiting lists for services:

• People are processed into Regional Centers, but can’t get the services they need. • 45% of provider organizations in a recent survey said they are turning away clients or putting them on waiting lists.

RIGHT NOW, Programs are closing:

• The Governor’s budget adjustment for the current year reduces spending estimates for day, employment, transportation, respite, and residential services by $79 million even though the population being served grew by 5%. • 49% of providers in a recent survey have reduced capacity or closed programs due to deficits in funding.

RIGHT NOW, The quality of services is wavering:

• Staff qualifications have been reduced by 67% of providers to maintain sufficient staff. • Staff turnover among providers exceeds 40% and goes as high as 60%, so clients too often have new staff learning about their needs. • Staff training is the first thing cut in a budget crisis and now only addresses state requirements. • Staff are stretched thin because 53% have to work another job to make ends meet.

RIGHT NOW, Inadequate rates are forcing providers to pay poverty wages.

• 20% of direct support professionals (DSPs) receive public food assistance. • 36% of DSPs are on Medi-Cal. • 42% of DSPs have children on Medi-Cal.


• When adjusted for inflation, the Department of Developmental Services (DDS) per capita expenditure declined between 2006-7 and the 2019-20 budget by 4.6%, while the minimum wage has risen 78%. • Rates for services in the Lanterman System are too low, so providers can’t afford to raise wages. This was partially addressed by ABX2-1, which was a wage and benefit pass through. Unfortunately, the impact was significantly limited by the nearly immediate passage of SB 3, which incrementally raises the state minimum wage to $15/hour. • The DDS response to minimum wage hikes is inadequate and hurts people with I/DD. The DDS increases ignore the higher minimum wage rates in major cities and counties, so providers in high cost areas get no assistance with minimum wage increases. The DDS increases also ignore wage compression, so an increasing number of experienced, more qualified staff find themselves at or near minimum wage, with greater incentive to find work in another industry.

• Rent, insurance, gas, vehicles, and many other costs providers must pay continue to rise and haven’t been adequately addressed for more than 20 years.

THE SOLUTION People with I/DD need an 8% across-the-board rate increase in the 2019-20 budget to stabilize the system until the recommendations from a DDS rate study can be implemented.

• The 8% increase matches the increase in the Consumer Price Index since we last received funding in 2016 via ABX2-1. • The 8% rate increase equates to $290 million General Fund dollars, which will yield an additional $200 million in federal matching funds. • We expect the rate study to call for funding increases greater than $1 billion, a sum that’s easier to address in stages. • The rate study will call for systemic reforms and modernization that require time for policy consideration and implementation. The service system can’t wait to be saved.

THE OUTCOME With an 8% rate increase, we expect to see a significant reduction in key indicators of the crisis – the stability needed until the Rate Study is implemented.

• Providers believe they should be able to reduce the length of their waiting lists by 50%. • We estimate that the rate of program closures could decline by 50%. • We expect that Purchase of Service spending on day, employment, transportation, respite, and residential services could increase by 12%.

Thankfully, TMI remains strong in both its quality of services and staff, however, we recognize change must happen or even the most stable providers will not survive. We will continue to be advocates for not only our wonderful clients and their needs, but also for our amazing employees. Our Direct Support Professionals are the backbone of our organization and invaluable to the service system. The work they do is beyond measure and they should be compensated fairly.

Rachel Harris with Assemblywoman Dr. Shirley Weber, advocates and representatives

(Rachel Harris with Assemblywoman Dr. Shirley Weber, advocates and representatives)

We are cautiously optimistic about the future of our system, but know for certain our clients deserve every opportunity to live full, meaningful and independent lives. We will do everything in our power to ensure we have exemplary employees to help them to do just that!

(Contributing statistics and data courtesy of California Disability Services Association.)


Toward Maximum Independence (TMI) has been transforming the lives of children and adults with intellectual and developmental disabilities since 1981 and the deaf and hard of hearing since 2000. Like all of us, our clients are born with hopes, dreams and the drive to contribute to society. TMI strives to help our clients to realize their hopes and dreams by providing Employment Solutions, Community Living Services and Family Support Services throughout San Diego, Riverside and Imperial Counties.

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