The Regional Centers serve people who can't live in the community, even with support. In general, they serve people with developmental disabilities who also have:
Many of the people in the RCs would otherwise be in prison.
Colorado has 3 regional centers. They're in:
The Regional Centers offer two kinds of services:
All three of the centers have state-operated group homes. Grand Junction and Wheat Ridge also have institutional ICF/MR facilities.
The Department measures capacity, the number of people it can serve in Regional Services, in "beds." For licensing purposes, the beds in Regional Centers fall into different categories:
Over the past few years, the level of services required for people at the centers has gone up. That's forcing the Departent to adjust its staffing ratio (the number of staff per patient) to the more severe patients.
No one knows for sure why we suddenly have so many people with severe problems. It spiked in the Spring of 2007 and has stayed high ever since. It may just be a statistical anomaly.
They're concentrated at the Regional Centers partially because it's hard to keep them in the community and partially because of changes in policy:
Regardless of the reasons, the Regional Centers have a larger number of people who need intensive services. Normal staffing is 3-to-1; three patients per employee. Some high-need patients require 1-to-1 supervision 24 hours a day, 7 days a week.
One-to-one staffing for one patient requires 5.4 full time employees; that's 3 people per 24-hour day over 7 days, plus reserve staff to cover sick/vacation days.
The Regional Centers are trying to adjust their staffing ratios to match the new needs. They're doing it in three ways:
This year the Department is asking for 43 new employees. Over five years, it intends to reduce the number of patients in the Regional Centers from 403 to 307.
Increasing the staffing level at the Regional Centers by reducing the number of patients they accept means turning away people. That leads to an obvious question: what's happening to people who would otherwise be in the regional centers?
Prison is one obvious alternative. The ARC of Colorado says at least a dozen people are behind bars because they can't get into a regional center. People with behavioral problems often break the law, repeatedly. Without proper care, they wind up in a cycle of increasingly-long stints in jail or prison. It's an uncomfortable fact the putting high-need disabled people in prison is cheaper than caring for them in a regional center.
Others will wind up in hospitals. The ARC says it knows about two such cases already. That's not a good situation for the people with disabilities, and it puts unnecessary pressure on the health care system.
DHS says to get the right staffing ratio while keeping the same number of beds available would take 200 new employees. That would cost -- ballpark -- about $7 million.
The Governor is recommending that we spend $6 million this year to reduce the DD wait list. We could put some, or all, of that money into staffing the regional centers. It's a tough choice. Spending themoney on community services adds services to hundreds of people; spending it on regional centers would help far fewer.
- a history of sex offenses
- severe behavioral or psychological issues
- severe medical problems
Many of the people in the RCs would otherwise be in prison.
The Regional Centers
Colorado has 3 regional centers. They're in:
The Regional Centers offer two kinds of services:
- Institutional services called Intermediate Care Facilities for the Mentally Retarded (ICFs/MR)
- state-operated group homes that serve 4-6 people
All three of the centers have state-operated group homes. Grand Junction and Wheat Ridge also have institutional ICF/MR facilities.
High-needs Patients
The Department measures capacity, the number of people it can serve in Regional Services, in "beds." For licensing purposes, the beds in Regional Centers fall into different categories:
- Home- and Community-Based Medicaid waiver (HCBS-DD) (295 of these beds)
- Intermediate Care Facility for the Mentally Retarded (ICF/MR) (108 beds)
Over the past few years, the level of services required for people at the centers has gone up. That's forcing the Departent to adjust its staffing ratio (the number of staff per patient) to the more severe patients.
No one knows for sure why we suddenly have so many people with severe problems. It spiked in the Spring of 2007 and has stayed high ever since. It may just be a statistical anomaly.
They're concentrated at the Regional Centers partially because it's hard to keep them in the community and partially because of changes in policy:
- Since April 2003, the regional centers have used the following admissions criteria:
- extremely high needs requiring very specialized professional medical support services
- extremely high needs due to challenging behaviors
- pose significant community safety risks to others and require a secure setting
- Since April of 2008 the Regional Centers have required CCBs to remove someone from a center in order to send a new person in, which means the CCBs have been swapping lower-need patients for higher-need patients.
Regardless of the reasons, the Regional Centers have a larger number of people who need intensive services. Normal staffing is 3-to-1; three patients per employee. Some high-need patients require 1-to-1 supervision 24 hours a day, 7 days a week.
One-to-one staffing for one patient requires 5.4 full time employees; that's 3 people per 24-hour day over 7 days, plus reserve staff to cover sick/vacation days.
Adjusting the Staffing Ratio
The Regional Centers are trying to adjust their staffing ratios to match the new needs. They're doing it in three ways:
- increasing the number of staff
- reducing the number of patients
- converting existing beds to ICF/MR and building new ICF/MR facilities
This year the Department is asking for 43 new employees. Over five years, it intends to reduce the number of patients in the Regional Centers from 403 to 307.
Opposition to the Plan
The ARC of Colorado says effects of the Department's plan are "intolerable.Increasing the staffing level at the Regional Centers by reducing the number of patients they accept means turning away people. That leads to an obvious question: what's happening to people who would otherwise be in the regional centers?
Prison is one obvious alternative. The ARC of Colorado says at least a dozen people are behind bars because they can't get into a regional center. People with behavioral problems often break the law, repeatedly. Without proper care, they wind up in a cycle of increasingly-long stints in jail or prison. It's an uncomfortable fact the putting high-need disabled people in prison is cheaper than caring for them in a regional center.
Others will wind up in hospitals. The ARC says it knows about two such cases already. That's not a good situation for the people with disabilities, and it puts unnecessary pressure on the health care system.
DHS says to get the right staffing ratio while keeping the same number of beds available would take 200 new employees. That would cost -- ballpark -- about $7 million.
The Governor is recommending that we spend $6 million this year to reduce the DD wait list. We could put some, or all, of that money into staffing the regional centers. It's a tough choice. Spending themoney on community services adds services to hundreds of people; spending it on regional centers would help far fewer.
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