Publication Date

Spring 2024

Degree Type

Master's Project

Degree Name

Master of Public Administration (MPA)

Department

Urban and Regional Planning

First Advisor

James Brent

Keywords

California Regional Center System, The Lanterman Act, Case Management, Heath Equity, Racial Disparities

Abstract

This project adds to knowledge of case management assumptions, resources, and inputs for California’s Regional Center system by surveying members of the Service Access and Equity working group, formed by the Department of Developmental Services (DDS). It recommends development of a logic model to evaluate case management activities because their intended societal impacts are difficult to directly measure. Additionally, it adds to the debate on health equity and racial disparities in Medicaid long-term services and supports (LTSS). In 1969, passage of the Lanterman Developmental Disabilities Services Act (The Lanterman Act) led to the first and still only entitlement to community-based services that is granted to people with developmental and intellectual disabilities (I/DD) by a state. Twenty-one private, nonprofit Regional Centers have exclusive rights to provide case management and to purchase community- based services for eligible consumers within their catchment area. By contracting with DDS, Regional Centers receive reimbursement for case management operations, pass-through rates to purchase community-based services, and administer various grants, projects, and funds.

This project contributes to understanding whether and how knowledge gaps in Regional Center case management affect expenditures of home- and community-based services (HCBS). In addition, Vogel et al. (2019) lay out systemic LTSS and demographic challenges in California: a higher percentage of people require services and have autism; a growing unpaid caregiver and adult consumer population aging-in-place at home; a struggle with rising labor costs to recruit and retain qualified personnel, high cost of housing for community living, and non-compliance with Medicaid HCBS regulation that may restrict federal funding. Surveying working group members’ knowledge of case management in home- and community-based services improves understanding of the disparities in service access for racial and non-English speaking consumers.

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