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Regional Center Caseload Growth Analysis
The following report is a review of caseload data completed by professors from California State University, Sacramento (CSUS), under contract to the Department of Developmental Services (DDS). This review was performed to provide additional insight as to what the caseload trends imply for future services by providing status breakdowns by diagnosis, residence, age, and regional center.
Data for this analysis is largely from two DDS sources: the Client Master File and the Client Development Evaluation Report (CDER). The data is provided for December 31st of each year. While the integrity of the CDER data for the 2003 and 2004 years is good, there were problems with the reporting of information in prior years. It is difficult, therefore, to have a high confidence level in what the trends mean. In addition, the data that is provided addresses caseload alone and does not address utilization and, therefore, expenditure trends. Additional research is being performed to correlate the caseload information to costs.
The analysis conducted by CSUS focused on those individuals entering and leaving the system. That data is summarized on page two of the analysis. Most of the intake and attrition in caseload is due to clients in "status 1" who reach age three and are not found eligible for developmentally disabled services, but also includes deaths and clients leaving the system for other reasons. Because "status 2" individuals are those that will continue to be served in the system, this analysis is focused on them.
The data suggests that since 2002 caseload growth has slowed. It is not clear why this occurred. However, in July of 2002, cost containment practices that included a change from 60 to 120 days for intake and assessment, non-community placement plan startup suspensions, suspension of the Supplemental Security Income/State Supplementary Payment pass-through and a $52 million unallocated reduction were initiated that could have influenced the caseload. In July of 2003 there was a clarification in eligibility criteria to make it consistent with federal practice that requires evidence of substantial impairment in three domains before determining a person eligible for regional center services. An unknown is how the State's fiscal climate could have influenced intake. Additional research is required to confirm whether one, two or any of these factors are affecting caseload growth. The data also reveal that with the exception of autism, growth in all other categories of developmental disabilities has significantly declined.
There is aggregate data about caseload by regional center; however, it is difficult to identify any important facts without further data analysis. This was not possible to do in the time available. Similarly, breakdowns by age group would be more useful if they included information about diagnosis, but time was a constraint. However, it is important to note that cost-containment is age based and the growth in the younger population implies greater future year costs. Other information that DDS has developed shows that most of the consumers with autism fall under the age of nineteen.