The California Department of Developmental Services (
Welcome to DDS (
As of 1965, 13,500 people in California with mental retardation lived in four overcrowded state hospitals. That year, the state took its first steps toward dealing with the concerns expressed mostly through the California Association for the Retarded by passing legislation establishing two pilot regional centers for people with mental retardation. They served 559 clients.
Governor Edmund G. “Pat” Brown signed the bill, authored by Republican state Senator Frank D. Lanterman, who was the key figure behind much of the state’s mental health care legislation. The regional centers were established in San Francisco and Los Angeles under a contract with the Department of Public Health.
Four years later, the Lanterman Mental Retardation Services Act expanded the network and by 1972 there were seven regional centers in operation across the state.
Legislation in 1976 expanded the clientele to include people with cerebral palsy, epilepsy, autism and other neurological handicapping conditions closely related to mental retardation. Estimates were that 5% of the California population had a significant developmental disability. Creation of the full complement of 21 regional centers was fulfilled that year. Nine state hospitals continued to serve a reduced population of approximately 10,100 people with developmental disabilities.
In 1978, California moved the administration of developmental service programs from the huge Department of Health to the newly-created Department of Developmental Services. By 1979, regional centers were serving 50,000 clients, and the state hospital population had fallen to 9,000. The next year, the department transferred all responsibility for placement, case management and monitoring of clients in residential placement to the regional centers.
The California Supreme Court ruled in the 1981 case In re Hop that any adult with developmental disabilities already placed in a state hospital was entitled to a judicial review to determine if they should remain hospitalized.
State budget deficits in the early ‘80s resulted in reduced funding and services at the regional centers. But a landmark ruling by the state Supreme Court in 1985 (Association for Retarded Citizens v. California Department of Developmental Services, et al) found that the Lanterman Act had established a right to services for the developmentally disabled that allowed independent living, and that therefore it had an obligation to provide such services as an entitlement. The 21 regional centers were empowered to provide the services and given wide latitude, within their budget, but not the power to deny services. The
By 1989, regional centers were serving 92,000 clients and the population at state hospitals (now called developmental centers) had been reduced to 6,700.
The department established the Office of Consumer Affairs in 1992, led by Michael Long, the first person with a developmental disability appointed to such a high post by a governor.
By the end of fiscal year 2010-11, the developmental center population was 1,979 and dropping.
Despite judicial imperatives and legislative directives, California’s undulating economic fortunes over the next two decades led to unfunded mandates and overwhelmed regional centers, and engendered never-ending struggles for services that play out in the courts, the Legislature and the lives of the developmentally disabled and their families.
History of Regional Centers/Lanterman Act (Alta California Regional Center)
History of the Developmental Disabilities Service Delivery System in California (Association of Regional Center Agencies) (pdf)
The Ever-Widening Circle of Inclusion (The Minnesota Governor’s Council on Developmental Disabilities) (pdf)
Association for Retarded Citizens v. Department of Developmental Services (Justia US Law)
In re Hop, 29 Cal.3d 82 (Robert Crown Law Library)
As of 2011,
Regional Centers
The department contracts with 21 independently operated non-profit regional centers, each serving a specific geographic location. They provide services for the developmentally disabled, people at high risk of giving birth to a child with a developmental disability and infants with a high risk of becoming developmentally disabled.
The centers provide diagnosis and eligibility assessment at no cost, and then offer a range of programs based on test results. The programs, often operated by other public and private social services, include counseling, lifelong individualized planning and service coordination, genetic counseling, family support, early intervention services for at-risk individuals and their families, and planning, placement and monitoring for 24-hour out-of-home care.
The centers provide information and contacts concerning affordable housing, a key factor in the developmentally disabled residing in their local communities. Other programs that facilitate living arrangements include Independent Living, In-Home Supportive Services and Respite In-Home Services.
The centers help clients find employment through a work services program and operate a Supported Employment service for severely disabled individuals who need specialized assistance in the field.
Developmental Centers
In addition to the privately operated regional centers,
Activities at the centers incorporate all aspects of daily living including residential services through skill training, specialized medical and dental health-care, physical, occupational and speech therapies, and language development. Leisure and recreational opportunities are also part of the daily regimen, and those under the age of 22 attend school at the facility or in the community. Adults participate in a vocational programs at the center and / or locally.
Individuals are admitted to the centers under court orders, either civilly or through the criminal courts. Those admitted via the criminal justice system reside at Porterville, which operates the Secure Treatment Program.
Early Developmental Services
The California Early Intervention Services Act initiated a program for infants or toddlers who have a developmental delay or disability or a condition with a high probability of resulting in delayed development. The 1993 act established the department’s Early Developmental Services program, which targets “at-risk” infants and toddlers up to 36 months old. Regional centers located in each county determine eligibility for services, along with school districts, under two programs: Early Start and Prevention Resource & Referral Services.
Early Start
The Early Start program is for children who have cognitive, communication, social or emotional, adaptive, or physical and motor development including vision and hearing problems. Children can be referred to the program by parents, doctors, neighbors, family members, foster parents or day care providers. After the referral, a service coordinator helps the parents negotiate the process to determine eligibility. Once a need is established, the state provides ongoing care and assistance in numerous areas, including assistive technology, family training, counseling, home visits, nursing and nutrition services, vision and speech care, psychological services and physical therapy. The services are provided through regional centers or local education agencies. Costs for evaluation and coordination of services are covered by
Prevention Resource & Referral Services
The department operates a program for children who are at risk for developmental disabilities, but who would otherwise be ineligible for services through the Early Start Program. The Prevention Resource & Referral Services offer families information, resources and referrals to outside agencies or groups that may provide additional support or other help.
Foster Grandparent and Senior Companion Programs
Nine of
The bulk (86%) of the department’s $4.6 billion budget in 2011-12 was allocated to community services, in support of myriad programs. These monies are disbursed to counties and municipalities or independent non-profits who own and/or operate the centers, as well as to the vendors who provide services to those facilities. Vendors, who must meet the requirements and standards specified in the state’s regulations, operate under a categorized rate structure which details allowable fees within a range of services. Many of the services must meet additional requirements under Medi-Cal and are subject to the limitations of the federal government’s Medicare program.
The department’s Developmental Centers receive about 14% of the department’s funding.
A little over half of the department’s budget (54%) is paid for out of the state General Fund. Most of the rest (45%) come from “reimbursements” and much of that is from federal Medicare and Medi-Cal programs.
Budget cuts have taken a heavy toll on the department in recent years. The 2011-12 budget indicated a 6.7% overall cut in funds—with slightly higher cuts coming from Washington—including loss of federal stimulus dollars.
2011-12 Department of Developmental Services Budget Highlights (
3-Year Budget (pdf)
State Sued Over Funding
The Lanterman Act, which provides the foundation for services provided by the Department of Developmental Services, guarantees a level of essential services and support to live in mainstream society that has been recognized by the state Supreme Court.
In September 2011, advocates for the developmentally disabled sued the state over claims it had underfunded services. The Arc California and United Cerebral Palsy (
California froze provider reimbursement rates in 2003 and them reduced them 3% in 2009. The reduction was subsequently increased to 4.25%.
The Department of Developmental Services issued a press release that blamed the economy for the cuts. “Given the size of the budget shortfall, difficult decisions are needed,” it said. Dave Carucci, executive director of
Tony Anderson, executive director of The Arc of California, said the cuts were devastating. “The whole system is just collapsing.” Anderson said the cuts reduce access to services because fewer providers can afford to care for developmentally developed residents. He said his group considered a lawsuit in the past but held off because it hoped funding levels would be restored to previous levels. “In our view it's just gotten worse and there's no other alternative for us.”
The lawsuits continue the public debate over funding for the disabled and other services, which played out earlier this year in the ongoing budget battle. Earlier in 2011, the Senate Budget Committee voted in a rare display of unanimity to reduce the amount of the governor’s proposed General Fund cuts to the department from $750 million to $476.2 million. Democratic Senator Mark Leno, chairman of the committee, said that
Lanterman Act Backgrounder (Regional Center of Orange County) (pdf)
Calif. Sued Over Cuts for Developmentally Disabled (by Associated Press)
Disability Advocates File Lawsuit Against State (by R.J. Ignelzi, San Diego Union-Tribune)
California Budget Hit With 3 Lawsuits (by Wyatt Buchanan and Marisa Lagos, San Francisco Chronicle)
Advocates for Disabled to Sue California Over Budget Cuts (by Kevin Yamamura, Sacramento Bee)
Largest Regional Center Put on Probation
The Inland Regional Center was put on probation by the Department of Developmental Services in January 2011 after being accused of illegally using state money to develop housing, violating the center’s contract with the state and circumventing a statutory freeze on rates paid to care providers.
The penalty followed an investigation by the Sacramento Bee of the center and its nonprofit affiliate, the California Housing Foundation. The center, which serves 22,000 clients in Riverside and San Bernardino counties, is the largest regional center in the state.
The center had committed to paying the foundation $450,000 to develop 15 bungalows in the city of Moreno Valley, but didn’t build any. The newspaper also reported that the center spent $2.9 million in 2006 to develop four houses for its clients. Just after completion, the property was assessed at $1.8 million and four years later at less than $1 million. The Bee investigation alleged that the center paid above market rates for construction and issued no-bid contracts.
The center attempted to get off probation in May, but was rebuffed by the department.
Probation Notice (
State Seeks More Changes at Inland Center for Developmentally Disabled (by Jim Miller, Riverside Press-Enterprise)
Southern California Center Serving Disabled Put on Probation (by Jack Chang, Sacramento Bee)
California Housing for Developmentally Disabled Has High Cost (by Jack Chang, Sacramento Bee)
Wanted: More Oversight for Service Centers (Sacramento Bee editorial)
California Regional Centers Spend Without Public Scrutiny (by Jack Change, Sacramento Bee)
Closing Lanterman Developmental Center
In 1965, 13,500 developmentally disabled people were housed in state hospitals. Forty-five years later that number was under 2,000 and many of the facilities, now called developmental centers, were closed.
In January 2010, the Department of Developmental Services announced that the 82-year-old Lanterman Developmental Center where 398 people with severe autism, cerebral palsy and other lifelong disabilities lived would be shutting its doors within two years.
Although the Lanterman buildings were in a state of disrepair and its population greatly reduced from its peak of 3,000 in the ‘60s, not everyone was happy to hear it was going to close. “It's devastating for us,” said Ann Grivich, whose brother-in-law Bobby Grivich, 61, has lived at Lanterman since 1969. He has the mental capacity of an 18-month-old, she said. “People like Bobby are actually more confined in the community. At least [at Lanterman] he can wander the grounds safely,” Grivich said.
The state closed two other developmental centers in 2009: Agnews in San Jose and Sierra Vista in Yuba City.
The Legislature approved the closure plan in October 2010 and added subsequent amendments to its plan to facilitate an orderly transition. And therein lays the greatest concern. “Key to successful implementation of the Plan is development of housing and community resources,” according to a May 2011
“In this fiscal climate, I think it's going to be very hard to figure out what people need,” said Terry DeBell, who spoke for a group representing families of Lanterman residents.
While the state grapples with a bad economy and large fiscal deficits, social programs are finding their budgets cut and programs reduced.
Parents Coordinating Council at Lanterman Developmental Center (Contact: The Newsletter for Parents and Friends) (pdf)
News: Lanterman Developmental Center Closure (
State Plans to Close Pomona Center for Disabled (by Jack Dolan, Los Angeles Times)
A Rocky Transfer to Group Homes
The movement away from institutionalizing developmentally disabled people in California began in earnest in the ‘70s with passage of the Lanterman Act and creation of 21 regional centers to coordinate the mainstreaming process. It was not a smooth transition away from state hospitals to local care and in 1997 the controversy exploded.
In May of that year, Democratic California Senator Diane Feinstein demanded that the Department of Developmental Services stop transferring people from hospitals to group homes until quality of care and client monitoring improved in the homes. Allegations were surfacing that people were being coerced into making the transition, although state law forbid that. The department denied the charges and pointed a finger at the regional centers.
“Our responsibility is to work through the 21 regional centers,” said
The regional centers were defensive yet admitted there were problems. “Sometimes, we have to meet our clients' needs with homes we have questions about,” said Kathy Munn, executive director of the Regional Center of the East Bay.
And everyone pointed a finger at Sacramento, including its own politicians. “Before people are transferred from institutions to the community, there ought to be guaranteed programs in place—health care, follow-up and enough caseworkers to keep track of these people,” said state Senator John Burton, a Democrat from San Francisco. “If the state had done its homework, there wouldn't be these horror stories.”
Department Director Dennis Amundson was criticized by Feinstein for not heeding a UC Riverside study that concluded mortality rates in community homes were much higher in the developmental centers (formerly called state hospitals). She blasted the director for calling the higher mortality rates “miniscule.” Feinstein said many group home employees were undertrained, poorly paid and ill-equipped to care for people who may require constant supervision.
Amundson defended his department. “I believe this is the finest program of its kind in the country. In a system this size you can find problems. They've decided to focus on the problems rather than all the good things that have happened.”
He resigned before the year was out.
Chief of Disabled Programs Resigns (Sacramento Bee)
Troubled Group Homes Stay Open (by Reynolds Holding, San Francisco Chronicle)
Sen. Feinstein Urges Wilson to Stop Community Placements and Create an Independent
Team to Analyze the DD System (Outreach magazine)
Fiscal Reform in Vendor Oversight
The department’s oversight of its regional centers came under criticism by the state auditor in a recent report. “We found that under Developmental Services’ limited monitoring” wrote State Auditor Elaine M. Howle, “regional centers have established vendor payment rates that have the appearance of fiscal irresponsibility.”
The December 2010 report took issue with the rates set at the local level for vendor services, noting that the Lanterman Act mandated that costs be negotiated at reasonable and fair rates. The audit, however, concluded that “Developmental Services’ monitoring activities have provided only limited assurance that the payment rates established in this way are reasonable.” The report went on to say that the regional centers “frequently have not supported established rates with an appropriate level of analysis.” Moreover, the auditor found, “At times, regional centers have established payment rates under circumstances that had the appearance of vendor favoritism or fiscal irresponsibility, or that did not comply with recent legislation intended to control the costs of purchased services.”
The office had found similar irregularities in fiscal years 2006-07, which were corrected. Howle went on to recommend that, “If Developmental Services believes it needs statutory or regulatory changes to implement this recommendation, it should seek these changes” from the Legislature and governor.
Recommendations for Legislative Consideration from Audits During 2009 and 2010 (State Auditor) (pdf)
Significant Overtime Costs
In February 2009, the auditor’s office issued a report titled “The California State Auditor Has Designated the State Budget as a High Risk Area.” The report concluded that the state’s budget was at risk because of the fiscal crisis and a history of ongoing deficits, in part due to employee overtime costs. A March 2011 audit further found “significant overtime costs” incurred at the DDS developmental centers. The department was examined, along with five others, and the audit comprehensively studied three—Fire, Mental Health, and Developmental Services—because each had numerous individuals earning more than $150,000 in overtime pay.
The overtime pay accounted for 50% of the employee’s total earnings during the five-year period reviewed. The auditor centered its probe on two classifications of jobs—registered nurses at Napa State Hospital (under the Department of Mental Health) and psychiatric technician assistants at Sonoma Developmental Center (employed by
The audit determined that, “One reason for the significant amounts of overtime at Napa and Developmental Services’ Sonoma Developmental Center (Sonoma) is fluctuations in staffing ratios caused by the need to provide certain patients or consumers with one-on-one care.” Payroll records examined in the audit showed that psychiatric technicians at Sonoma worked significant overtime—averaging 36 hours per week—to fulfill internal staff needs, despite the fact that the vacancy rates for the jobs were low.
Additionally, collective bargaining agreements in place at the time of the audit allowed leave time to be calculated as time worked in computing overtime. As a result, one employee at Sonoma was paid for 167 hours of overtime in a month, in spite of having taken 160 hours of leave. Since that time, state law has been changed to prevent leave time being factored into overtime pay, although future collective bargaining agreements could well nullify that measure.
Recommendations Not Fully Implemented After One Year (State Auditor) (pdf)
Implementation of State Auditor’s Recommendations (State Auditor) (pdf)
A More Uniform and Transparent Procurement and Rate-Setting Process Would Improve the Cost-Effectiveness of Regional Centers (State Auditor) (pdf)
Are Regional Centers Doing the Job?
When the Lanterman Act was passed in 1969, it envisioned a joint venture between government and the community in search of a more humane way to help the neediest members of our society. Rather than lock people up in large institutions, government would provide funds and guidance to regional centers that, in turn, would work with communities to provide solutions at a local level.
Has it worked?
Yes. It’s a Success Despite Its Flaws
California is the only state in the nation with a legally established entitlement for developmentally disabled services. It has successfully transitioned away from locking up people in large institutions where they were all too often abused by their keepers, ignored by society and given up as lost causes.
Regional centers allow families, friends and caring professionals to join in the process of teaching living skills, providing employment and critical services and, most importantly, giving hope to those once considered hopeless.
It has been a long and tortuous journey, fraught with peril and marked by regular setbacks. But today, the archaic state hospitals have withered and died and been replaced by a decentralized, community-based system for which we are all the better. No one denies there are problems, but many of those problems can be traced to a lack of funding in difficult economic times.
Those who work with the developmentally disabled need to be better trained and educated. Development of facilities needs to be better planned and monitored. The relationship between the Department of Developmental Services and the 21 regional centers needs to be more transparent and better defined. Families, friends and caring professionals need to be given a greater role in the process. And the Legislature must refine the laws that govern it all and find a way to properly fund the effort.
But has it worked? Instead of 13,500 hapless souls locked away in aging hospitals, more than 90,000 people are interacting with their communities, learning new skills, being educated and living their lives in the real world.
The Ever-Widening Circle of Inclusion (The Minnesota Governor’s Council on Developmental Disabilities) (pdf)
Realm of Possibilities (Far Northern Regional Center) (pdf)
Advocating on Behalf of Californians with Developmental Disabilities and the Statewide Regional Center System (Association of Regional Center Agencies)
How Frank D. Lanterman Changed My Life (by Rebecca Liu, California Historian) (pdf)
I Get to Live My Life (
No. It Is Not Fulfilling It's Promise
Critics of the regional centers aren’t pining for a return to the bad old days when we hid society’s neediest members in large institutions, out of our sight and consciousness. But regional centers aren’t fulfilling the promise that the Lanterman Act made in 1969 and it’s not necessarily all about a lack of cash.
Raphael Metzger, a lawyer with expertise in nonprofit organization management, argues that there is a systemic problem with the regional centers themselves. Lanterman could have simply directed the Department of Developmental Services to set up its own elaborate bureaucracy to provide services and support, Metzger argues. But instead it chose to empower regional centers to perform that function, hopefully capitalizing on the creativity, innovation, advocacy and business efficiencies of community-based, private-sector organizations.
But that isn’t what it ended up with. The regional center contractors who work with
Because they are a quasi-government agency, and not an advocacy group, they are immune from the public accountability mechanisms fundamental to a democracy. Because they operate in the dark, they are prone to corruption and waste, all to the detriment of the disabled. Forty years of no-bid contracts and cozy relationships has created an impenetrable buffer-zone between regional centers, the
Genuine community-based nonprofit organizations don’t act this way. Instead of being mission-driven and results-oriented, it is process-oriented and conformist with a hierarchical organization.
It operates like a bloated, inefficient government bureaucracy, Metzker says. And that is not success.
The Hijacking of the Lanterman Act for the Developmentally Disabled (by Raphael Metzger, California Progress Report)
Challenges to Sustaining California’s Developmental Disability Services System (by Daphna Gans, Anna C. Davis, Christina M. Kinane, and Gerald F. Kominski,
Billions in Social-Service Spending Remain in the Dark (by Christina Jewitt, California Watch)
In Praise of the Monkey (Developmental Disability System Reform blog)
Dale Sorbello, 2005-2006 (interim)
Cliff Allenby, 1997-2005
Dennis G. Amundson, 1991-1997. Amudson resigned amid a high-profile controversy over serious problems in the community care program for Californians with developmental disabilities. Allegations were made that disabled people in state hospitals were being coerced to move to community-based facilities ill-prepared to accept them.
Gary D. Macomber, 1983-1991
David Loberg, 1978-1983
- Table of Contents
- Overview
- History
- What it Does
- Where Does the Money Go
- Controversies
- Suggested Reforms
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