SAN DIEGO REGIONAL CENTER DEMOGRAPHIC INFORMATION February 25, 2016

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1 DEMOGRAPHIC INFORMATION February 25, 2016 TABLE OF CONTENTS Section Page General Demographic Information 1 SDRC Demographic Information 1 Community Living Services 2 Adult Day Services 4 Other Services 4 Glossary of Resource Terms 5 General Client Statistics SDRC Vendor Category Statistics New Vendor Statistics Community Living Situation Statistics Licensed Residential Resources and Vacancy Rates Deflection Team Statistics State Developmental Center Client Statistics Adult Day Services Statistics Regional Center Funded Adult Day Services Statistics Transition Age Adult Day Services Needs Statistics Appendix I Appendix II Appendix III Appendix IV Appendix V Appendix VI Appendix VII Appendix VIII Appendix IX Appendix X

2 DEMOGRAPHIC INFORMATION February 25, 2016 INTRODUCTION This report contains population demographics and client and service provider statistics for the San Diego Regional Center (SDRC). SDRC provides services to persons who meet the state definition of developmental disabilities or, if younger than the age of three, have a developmental delay, or an established risk of a condition causing a developmental delay, or at high risk for a developmental disability, and who reside in San Diego or Imperial counties. DEMOGRAPHIC INFORMATION San Diego County is the most southwestern county in the state and covers 4,261 square miles. The population of San Diego County as of January 1, 2015, was estimated to be 3,227,496. It is the second largest county in California after Los Angeles County. It encompasses 18 separate municipalities. San Diego is the ninth largest city in the United States. Imperial County is the most southeastern county in the state and covers 4,597 square miles. The population of Imperial County as of January 1, 2015 was approximately 183,429. It is primarily a rural, agricultural area and is sparsely populated when contrasted with San Diego County. Approximately 80% of the population in Imperial County is Latino. In December 2015 the estimated unemployment rate in Imperial County was 19.6%, compared with the California state estimated unemployment rate for December 2015 of 5.8%. SDRC DEMOGRAPHIC INFORMATION San Diego Regional Center is the second largest of the 21 California regional centers, serving 24,377 clients as of January 4, The population eligible for SDRC services has increased by approximately 1,374 clients in calendar year SDRC has a main office located in the city of San Diego, and four satellite offices. Three of the satellite offices are located in San Diego County, in the northern, eastern, and southern geographic portions of the county. Each of these satellite offices serves 18% to 23% of SDRC s clients. The fourth satellite office is located in Imperial County, and serves 8% of SDRC s clients. Seventy percent (70%) of the clients served by SDRC who are older than the age of three years have a diagnosis of intellectual disability, seventeen percent (17%) have a diagnosis of epilepsy, sixteen percent (16%) have a diagnosis of cerebral palsy, and thirty-three percent (33%) have a diagnosis of autism (a client may have more than one diagnosis). 1

3 DEMOGRAPHIC INFORMATION February 25, 2016 The percentage of SDRC clients with a diagnosis of autism has increased dramatically over the past 20 years, from 7% of the clients in 1995 to 33% of the clients in Sixty-six percent (66%) of SDRC clients in the three years to thirteen years age group have a diagnosis of autism, while only seventeen percent (17%) of SDRC clients in the 18 years to 55 years age group have a diagnosis of autism. Thirteen percent (13%) of clients older than the age of 22 have a mental health diagnosis in addition to a developmental disability (Appendix I). Fifty percent (50%) of the clients served by SDRC are children, and fifty percent (50%) are adults. Twelve percent (12%) of the clients served by SDRC are three years of age or younger, and are receiving early intervention services. English is the primary language spoken by seventy-five percent (75%) of SDRC s clients, twenty percent (20%) of SDRC s clients speak Spanish as their primary language, and less than one percent (1%) speak Vietnamese, Tagalog, or Arabic. Two percent (2%) of SDRC s clients speak a variety of other languages. SDRC employs service coordinators who are bilingual in English and other languages. SDRC has more than 4,050 vendored services. This includes a number of large agencies that often provide a number of vendored services, as each service vendorization is for a specific type of service, provided at a specific location. This also includes more than 1,850 family members of clients who are vendored to obtain respite, nursing, day care, transportation, or supported living services (Appendix IIa). Sixty SDRC vendors are located in Imperial County, including one family member of a client (Appendix IIb). In January through December 2015, a total of 294 new services and individuals were vendored in San Diego County (Appendix IIIa). These new services include 50 specialists, five Adult Day programs, three Tailored Day Service Options, two Independent Living Services Agencies, one Supported Living Service Agency, five Day Care/Out-of-Home Respite programs, six In-Home Respite Agencies, 148 family member vendors, and 16 other services. Sixteen additional licensed residential homes with a total of 87 additional beds were vendored in COMMUNITY LIVING SERVICES As of January 2016, a total of 19,220 clients were residing with family members, 1,813 clients were residing in their own homes, 347 clients were residing in foster homes, 2,811 clients were residing in residential facilities, and 66 clients were residing in state developmental centers (Appendix IV). More than 97% of the clients younger than the age of 18 live with family members. There has been a decrease in each of the past twenty years in the percentage of SDRC clients living in licensed residential facilities, and an increase in the percentage of SDRC clients living with family members and living in their own homes. 2

4 DEMOGRAPHIC INFORMATION February 25, 2016 Appendix V summarizes the number of SDRC residential resources of various types and vacancy rates for each type of residential service. The more specialized homes maintain lower vacancy rates and there are generally very few vacancies in licensed residential facilities which provide behavior management services for children. Vacancy rates for health licensed facilities remain very low. When no residential resources are identified for a client through the standard process, the person is referred to the SDRC Deflection Review Team for review and a determination of whether a statewide search for an appropriate resource is warranted. Deflection Review Team statistics from January 2015 through December 2015 are summarized in Appendix VI. A total of 22 client referrals were reviewed during this 12-month time period. Sixteen(73%) of the clients referred were either identified by their service coordinator as having a mental health diagnosis, or were prescribed psychotropic medications, in addition to having a developmental disability. Eight (36%) clients referred to the Deflection Review Team have a diagnosis of autism, with 50% of clients younger than the age of 18 having a diagnosis of autism. Sixteen (73%) of the clients identified for deflection are younger than the age of 30. As of July 1, 2012, a person may only be admitted to a State Developmental Center (SDC) when the person is in acute crisis and there is a transition plan to return that person to the community within six months. Eleven (50%) of the clients referred to the Deflection Review Team were deflected from an SDC Placement by the use of a highly specialized residential facility. Sixtytwo of SDRC s clients currently live in an SDC. Statistics of these clients are summarized in Appendix VII. In contrast to the clients identified for deflection, 76% of these clients are older than the age of 30, and 48% of these clients are older than the age of 50. Appropriate community placements have been identified for fourteen of these clients. SDRC currently has 1,813 clients who live in their own homes (i.e. their own apartments or houses rather than in the houses of family members). Ninety-nine percent (1,804) of these clients use independent or supported living services to support them in their residence (Appendix IV). Two hundred and forty-nine clients receive support through Supported Living Services agencies and 1,461 receive services through Independent Living agencies. There are currently 49 Independent Living Services vendors, and 24 agencies that provide Supported Living Services. Increased rental costs in San Diego County, combined with very low vacancy rates have made it very difficult for SDRC clients to locate affordable housing. Clients who wish to utilize the Section 8 rental assistance program, a federally funded program, are almost always placed on a waiting list, and often wait for this assistance for more than ten years. SDRC contracts with two different non-profit corporations to assist clients with accessing affordable housing. One of these non-profit housing corporations is working with local affordable housing developers to increase the availability of affordable housing options for people with developmental disabilities. SDRC also contracts with a non-profit agency to assist clients who are interested in pursuing home ownership. 3

5 DEMOGRAPHIC INFORMATION February 25, 2016 ADULT DAY SERVICES SDRC has 7,766 clients who participate in adult day services (Appendix VIII). SDRC funds adult day services for 5,838 clients. The Department of Rehabilitation funds services for 197 clients. Eighteen percent (1,411) of the SDRC clients who participate in adult day services go to a public school program, community college, or other publically and privately funded educational programs. Approximately 428 clients will turn 22 years old in 2016 who will consequently need regional center funded adult day services. Appendix XI provides estimates, based on recent trends, on the types and locations of the adult day services that will be needed by these clients. Currently there are 192 SDRC vendored adult day programs. Providing services for most of the clients graduating from public school programs in 2015 should be within the capacity of current adult day service resources; however, licensed (site-based) programs in the central area of San Diego County are near capacity. OTHER SERVICES As of January 4, 2016, SDRC funded respite services for 7,251 clients, which is 38% of the clients who are living with a parent or relative. Most clients authorized for respite services use an In-Home Respite Agency or utilize the Respite Registry Services (Appendix IV). SDRC has one In-Home Respite Agency that acts as employer of record for the respite workers. SDRC funds licensed nursing respite care for 397 clients. SDRC has substantially increased the number of individually vendored Registered and Licensed Vocational Nurses. The current total of 234vendored nurses and 20 Home Health Agencies is sufficient to meet the respite needs of SDRC clients. 4

6 GLOSSARY OF RESOURCE TERMS Adult Developmental Center (ADC): A day program that serves adults who are in the process of acquiring self-help skills, need sustained support and direction in developing the ability to interact with others, need support to make their needs known, and need support to respond to instructions. ADC programs focus on the development and maintenance of the functional skills required for self-advocacy, community integration, employment and self-care. Activity Center (AC): A day program that serves adults who generally have acquired most basic self-care skills, have some ability to interact with others, and are able to make their needs known and respond to instructions. AC programs focus on the development and maintenance of the functional skills required for self-advocacy, community integration, and employment. Behavior Management Program: A day program that serves adults with severe behavior challenges and/or a mental health diagnosis who have not been accepted into any other adult day program because of their behaviors. Behavior Management programs work towards understanding the function of the behavior and assisting clients with communicating their needs effectively so that transition to another program can take place. Client Development Evaluation Report (CDER): The CDER is an assessment instrument containing diagnostic and developmental information. Completion of the CDER for clients older than the age of three years is required by DDS. Community Placement Plan (CPP): The plan developed by the regional center to return clients placed in state developmental centers to the local community, and to deflect clients who might otherwise be placed in a state developmental center so that they can remain in the local community. Foster Family Agency: A non-profit organization which is community care licensed to recruit, train, certify, and support foster families who provide specialized care to 1-2 children in their own homes. Infant Development Program: A training and activity program for infants and their families designed to encourage the development and adjustment of the infants in the community and their homes, and to prepare the infants for entrance into the classes of local schools. Intermediate Care Facility/Developmentally Disabled (ICF/DD) A health care licensed residential facility that offers special programming in sensory motor skills, self-help skills, behavior management, and close monitoring of medical needs. These facilities are larger, more institutional, more restrictive, and more structured than other levels of care available in the community. 5

7 Intermediate Care Facility/Developmentally Disabled-Habilitative (ICF/DD-H): A health care licensed residential facility which provides personal care, habilitation and supported health services to 15 or fewer (usually 6) individuals with developmental disabilities who have intermittent recurring needs for nursing services but have been certified by a physician as not requiring availability of continuous skilled nursing care. Intermediate Care Facility/Developmentally Disabled-Nursing (ICF/DD-N): A health care licensed residential facility which provides personal care, habilitation, and nursing staff for 15 or fewer individuals with developmental disabilities who are medically fragile. Level 2 Home: A community care licensed residential facility with a staffing level of one staff for up to six residents. These homes offer training, supervision, activities and intervention as needed during the normal activities of the day. Level 3 Home: A community care licensed residential facility that serves individuals who need extensive assistance with behavior challenges, self-help skills, and/or who are non-ambulatory. The home provides structured programming, including planned instruction and activities with an average staff to client ratio of 1:3. Level 4 Home: A community care licensed residential facility that specializes in behavior management. Objectives and plans are developed to diminish challenging behaviors. High staff/client ratios and a licensed behavioral consultant are provided. Respite: Temporary or intermittent care and supervision which can be provided in the family home or a licensed facility that relieves family members from the constantly demanding responsibility of caring for a client. San Diego Information System (SANDIS): SANDIS is a software data base for client information used by the San Diego Regional Center. Skilled Nursing Facility (SNF): A health care licensed facility which offers skilled nursing and supportive care. A SNF- Distinct Part is a SNF that has a contract with, and is in close proximity to an acute care hospital. State Developmental Center: A large institution owned and operated by the State of California. As of July 1, 2012, a person may be admitted to a State Developmental Center only when the person is in acute crisis. Any person admitted to a State Developmental Center must be transitioned back to the community within six months of admission. 6

8 Appendix I GENERAL CLIENT STATISTICS (based on CDER data of 1/4/16) Persons Served by San Diego Regional Center Intake Case Management Genetics Total Total Number , ,377 Diagram 1 Client Caseload Growth Number of Clients Intake Case Management Persons Served by Each Area Office San Diego (Main Office) Santee (East County Office) Carlsbad (North County Office) National City (Southbay Office) Imperial (Imperial County Office) 7858 (33%) 4157 (18%) 5368 (23%) 4422 (19%) 1908 (8%)

9 Appendix I GENERAL CLIENT STATISTICS (based on CDER data of 1/4/16) Age > > (change based on CDER data of 1/5/15) Diagram 2 Client Age Groups Older than 55 Years 6.63% Younger than Age % 22 to 55 Years Old 35.00% 3 to 18 Years old 37.57% 18 to 22 Years Old 8.50% Primary Language English Spanish Vietnamese Tagalog Arabic All Other 18,328 (75%) (20%) 193 (0.8%) 133 (0.6%) 133 (0.6%) 550 (2.3%)

10 Appendix I GENERAL CLIENT STASTICS (based on CDER data of 1/4/16) Intellectual Disability (ID) Qualifying Diagnosis of Clients age 3 and older (each person may have more than one diagnosis) Epilepsy (EP) Cerebral Palsy (CP) Autism (AU) Other 14,257 (70%) 3,525 (17%) 3,296 (16%) 6,663 (33%) 1,636(8%) Diagram 3 SDRC Clients Types of Developmental Disabilities CP Only 3.37% ID/CP 6.56% EP Only 1.96% EP/CP 1.22% Other Only 0.31% ID/EP/AU 1.04% ID/CP/AU 0.24% ID/AU/CP/EP 0.24% ID/CP/EP 6.95% ID Only 41.72% ID/EP 8.24% ID/AU 12.98% AU Only 22.92% Ages Psychiatric Diagnosis Additional Client Diagnostic/Service Needs G-Tube Feeding Injections (weekly or more often) Tracheostomy Care Under (3.3%) 142 (1.3%) 29 (0.3%) 21 (0.2%) 22 and over 1282 (12.8%) 187 (1.9%) 193 (1.9%) 25 (0.2%)

11 Percentage with Diagnosis Percentage with Diagnosis Appendix I GENERAL CLIENT STASTICS (based on CDER data of 1/5/15) Diagram 4 Changes in Client Diagnoses Intellectual Disability Cerebral Palsy Epilepsy Autism Jan-96 Jan-01 Jan-06 Jan-11 Jan-16 Diagram 5 Current Client Diagnoses by Age Groups Intellectual Disability Cerebral Palsy Epilepsy Autism Children (3 to 13) Adolescents (13 to 18) Adults (18 to 55) Seniors (Over 55)

12 Appendix IIa VENDORS* by category of vendorization 1/4/16 *includes vendors not currently being used Education Day Programs Resources Medical Services Developmental Spec. 1 Sup. Employ. Ind. 16 Physicians 79 Teacher 12 Sup. Employ. - Group 15 Dentists 69 Ind. or Family Train. 57 Work Activity Prog. 13 Psychiatrists 8 Tutor Services 1 Activity Centers 15 R.N.s 49 ADCs 98 LVNs 185 Psychology Resources B. Mod. Programs 29 Hospitals 19 Clinical Psychologists 60 Community Pharmacies 30 B. Mod. Consultants 22 Integration Training 6 Dietary Services 10 Behavior Analyst 43 Socialization Train. 5 Med. Equipment 25 Counseling Services 3 Adult Day Health 18 Audiology 7 Family Services Comm. Act. Support 2 Speech 13 Respite Voucher 51 Community Living Lab/Radiology 16 Nursing Voucher 4 Licensed Facilities 569 Orthoptic Service 8 Day Care Voucher 123 Ind. Living Agencies 49 PT/OT 212 Early Start Voucher 51 Sup. Living Agencies 24 Home Health Agency 20 Day Care Facility 38 Parent Coord. SL 4 Other Med. Service 19 Camps 18 Adult Fam. Home Ag. 3 Other Services In-Home Res. Agency 41 Personal Assist. Serv. 4 Translators/Interpret. 11 Out-of-Home Respite 12 Transportation Mobile Crisis Team 4 Parent Coordinated Trans. Voucher 1618 Legal Services 13 Personal Assistance 1 Trans. Company 19 Sports Club 2 Homemaker Program 2 T-Add. Component 20 Housing Service 2 Infant Dev. Programs 59 Public Transit Co. 10 Retail Stores 4 Infant Dev. Specialist 10 Mobility Training 4 Interdisciplin. Assess. 9 Fiscal Management 2 Vehicle Modification 1 Lifeline Emergency 1 Total Vendors 4051 Total Vouchers 1847 Total Vendors w/o Vouchers 2204

13 Appendix IIb VENDORS Located* in Imperial County by category of vendorization 1/4/16 * This list only includes vendors whose office address is in Imperial County. There are some agencies and individuals who provide services in Imperial County with a home office address in San Diego County Respite/Family Services Community Living Services Early Start Voucher 1 Licensed Facilities 8 In-Home Respite Agency 1 Independent Living Agencies 4 Out-of-Home Respite 1 Supported Living Agencies 1 Day Care Facility 1 Homemaker Program 1 Day Programs Supported Employment Ind. 2 Clinical Services Supported Employment - Group 2 Physicians 1 Work Activity Program 1 Dentist 3 Activity Centers 1 Registered Nurse 1 Adult Development Center (1:4) 1 Teacher 1 Adult Development Centers (1:3) 2 Dietary Services 3 Behavior Management Program 2 Pharmacy 2 Socialization Training 2 Audiology 1 Adult Day Health Center 2 Orthoptic Service 1 Medical Equipment 1 Transportation Resources Physical Therapy 2 Public Transit Company 4 Hospital 1 Transportation-Add. Component 2 Home Health Agency 1 Behavior Analyst 1 Speech Therapist 1 Occupational Therapist 1 Total Vendors 60 Total Vendors w/o Vouchers 59

14 Appendix IIIa NEW VENDORS by category of vendorization January through December 2015 Specialists Other Services 2 - Dentists 3 Individual/Family Training Services 11 Behavior Analysts 2 Interdisciplinary Assessments 1 Audiology 2 Durable Medical Equipment Provider 1 Teacher 4 Home Health Agencies 5 - Registered Nurses 1 Interpreter 20 - Licensed Vocational Nurses 3 - Pharmacy 1 Behavior Management Consultant 1 Transportation Company 7 - Clinical Psychologists Total: 16 Other New Services 2 Physicians Total: 50 New Specialists Licensed Residential Facilities Level 3 homes for Adults 5 homes/25 beds Level 4 homes for Adults 7 homes/42 beds ICF/DD-H - 1 home/6 beds ICF/DD-N - 1 home/6 beds Specialized Res. for Adults 2 homes/8 beds Total: 16 New Homes/87 beds Programs 1- Adult Development Center 1 Activity Center 1 Community Integration Training Program 3 Tailored Day Service Option 6 - In-Home Respite Agencies 5 - Day Care/Out-of-Home Respite Programs 1 Supported Living Agency 2 - Independent Living Agencies 30 Early Start Specialized Therapeutic Programs 12 Infant Development Programs Total: 62 New Programs Parent Directed Services (Vouchers) 125- Transportation/Family Member 23- Day Care/Family Member Total: 148 New Family Member Vendors

15 Appendix IIIb DEVELOPMENT OF NEW OR ENHANCED PROGRAM SERVICES January 2011 through December 2015 Community Integration Program for Adults designed to serve clients who need intensive staffing in Adult Day Services - 3 Sites Tailored Day Services for Adults - 16 Programs Behavior Support Module for Adult Day Health Center Substance Use Disorder (SUD) Treatment services including recovery coaching that assist clients with accessing community SUD treatment and recovery services Specialized Mental Health Counseling and Support Programs - 2 Programs Cross Systems Support & Treatment Team for individuals with complex/high profile forensic needs Specialized Residential Facilities with intensive levels of staffing, licensed professional interdisciplinary consultation, and a variety of other services - 15 four bed homes for adults - 4 four bed homes for adolescents - 1 four bed home for elderly Wraparound program developed in collaboration with San Diego Mental Health Services for adolescents with a developmental disability and a mental health diagnosis Non-Profit Housing Organization which purchases and renovates residential homes to be used as Specialized Residential Facilities. These homes are deed restricted to be maintained and used solely for the benefit of SDRC clients in perpetuity. - 3 homes purchased and renovated before 1/1/16 Specialized Competency Training provided by vendors who are also contractors with San Diego Behavioral Health Services

16 Appendix IV COMMUNITY LIVING SITUATION STATISTICS (based on SANDIS data of 1/4/16) Community Living Situation Under 18 Years Old Over 18 Years Old Totals Total on 1/4/16 Change from 1/5/15 Total on 1/4/16 Change from 1/5/15 Total on 1/4/16 Change from 1/5/15 Parent or Relative Independent/Supported Living Foster Home/Family Home Agency Community Care Facility ICF/DD-H Health Facility Developmental Center Other Total INDEPENDENT AND SUPPORTED LIVING SERVICE AUTHORIZATIONS as of 1/4/16 Service Number of Clients Change from 1/5/15 Supported Living Services Independent Living Services TOTAL RESPITE SERVICE AUTHORIZATIONS as of 1/4/16 Service Type Number of Clients Change from 1/5/15 In-Home Respite Agency 5483 (76%) +479 Respite Registry 1003 (14%) +8 Respite Service Family Member (Voucher) 3(0%) +1 Nursing Respite 397 (5%) -24 Out-of-Home Respite (Day/Evening) 247(3%) +34 Out-of-Home Respite (Overnight) 118(2%) -25 TOTAL

17 Appendix IV COMMUNITY LIVING SITUATION STATISTICS (based on SANDIS data of 1/4/16) Diagram 6 Client Living Situations Children (under age 18) Health Facility 0.11% Community Care Facility 0.59% Foster Home 2.00% Parent or Relative 97.30% Diagram 7 Client Living Situations Adults (Age 18 and older) ICF/DD-H 3.85% Developmental Center 0.55% Parent or Relative 60.63% Independent or Supported Living 15.15% Community Care Facility 16.40% Health Facility 2.93% Adult Family Home 0.84%

18 Appendix IV COMMUNITY LIVING SITUATION STATISTICS (based on SANDIS data of 1/4/16) Diagram 8 Changes in Client Living Situations Children (Under 18) Health Facility Jan-16 Foster Home Community Care Facility Jan-11 Jan-06 Jan-01 Jan-96 Parent or Relative Percentage of Clients in Living Situation Diagram 9 Changes in Client Living Situations Adults (18 and older) Parent or Relative Independent and Supported Living Community Care Facility Health Facility Jan-16 Jan-11 Jan-06 Jan-02 Jan-96 Developmental Center Percentage of Clients in Living Situation

19 Appendix V RESIDENTIAL RESOURCES & VACANCY RATES January 4, 2016 Level 2O Level 2S Homes Beds Vac. Homes Beds Vac. Adults Children Totals Level 3 O Level 3 S Level 4 Homes Beds Vac. Homes Beds Vac. Homes Beds Vac. Adults Children Children-Spec. Needs N/A Totals Community Care Licensed Homes - Totals Homes Beds Vacancies/% Non-amb. Beds Homes with > 6 beds Level /13% 84 9 Level /13% Level /7% CPP TOTAL /11% Health Care Licensed Homes - Totals Homes Beds Vacancies/% Non-amb. Beds Homes with > 6 beds ICF/DD-H /2% ICF/DD-N /2% 78 0 ICF/DD SNF-Distinct Part /9% 59 1 TOTAL /2% TOTALS - ALL RESIDENTIAL Homes Beds Vacancies/% /8%

20 Appendix V RESIDENTIAL RESOURCES & VACANCY RATES January 4, 2016 Diagram 10 Residential Homes-Licensed Beds ICF/DD-H 16.4% ICF/DD 1.8% ICF/DD-N 3.6% SNF-Distinct Part 1.9% CPP Home 5.2% Level % Level % Level % Diagram 11 Residential Homes-Vacancies Health Licensed Facilities 6% CPP 0% Level 2 36% Level 4 14% Level 3 44%

21 Appendix VI REFERRALS TO DEFLECTION TEAM January December 2015 Level of Intellectual Disability None/Border. Mild Moderate Severe Profound Total 5(23%) 11(50%) 5(23%) Age and Gender Total Male (73%) Female (27%) Mental Health Diagnosis Other Background Factors Autism-Under 18 4(45%) 16(73%) Autism-Over 18 4(31%) Residence on 12/31/15 Residence at the time of referral Family Level 4 SDC Crisis Center CPP Home ICF- DD/H Fred Finch Youth Center Psych. Hosp. Total Family (32%) Level (36%) ICF-DD/H CPP Home 2 2 Psych. Hospital Total (50%)

22 Appendix VII Clients living in State Developmental Centers 1/4/16 Age and Gender Total Male (74%) Female (26%) Qualifying Diagnosis (each person may have more than one diagnosis) Intellectual Disability (ID) Epilepsy (EP) Cerebral Palsy (CP) Autism (AU) 60 (97%) 4 (6%) 13 (21%) 7 (11%) Level of Intellectual Disability None/Border. Mild Moderate Severe Profound Total 2 27(44%) (30%) 62 Legal Commitment to State Developmental Center HOP (Gravely Disabled) 29(47%) 6500 (Danger to Self or Others) 31(50%) (Penal Code Competency Training) 2 Other Important Information Family Opposed to Community Placement 11(18%) Specific Community Placement has been identified for the Client Needs an Adult Residential Facility for People with Special Healthcare Needs (ARF-PSHN) 14(23%) 16(26%)

23 Appendix VIII ADULT DAY SERVICES STATISTICS (based on SANDIS data of 1/4/16) Type of Program/Activity Number of Clients Competitively Employed (without funded supports) 211 Department of Rehabilitation Funded Services 254 Other Publicly and Privately Funded Programs 263 Educational Programs (Community College, Public School, Adult Education, etc.) 1411 No Day Services 2953 Regional Center Funded Services 5838 Diagram 12 Adult Client-Day Program/Activity Competitely Employed 1.9% No Day Services 27.0% Department of Rehabilitation Funded Services 2.3% Educational Program 12.9% Other Programs 2.4% Regional Center Funded Services 53.4%

24 Appendix IX REGIONAL CENTER FUNDED ADULT DAY SERVICES STATISTICS (based on SANDIS data of 1/4/16) REGIONAL CENTER FUNDED DAY SERVICE Supported Employment- Individual Placement Supported Employment- Group Placement Staff: Client Ratio Number of Clients Change from 1/5/15 1: : Work Activity Program 1: Activity Center 1: : : Adult Development Center 1: : Behavior Management Program 1: Tailored Day Services 1:1 618 N/A Diagram 13 Clients in SDRC Funded Adult Day Services Work Activity Program 8.8% Supported Employment-Group Placement 10.6% Tailored Day Services 9.0% Activity Center (1:8) 2.5% Activity Center (1:7) 0.5% Activity Center (1:6) 4.5% Adult Development Center (1:4) 15.7% Supported Employment- Individual Placement 6.8% Behavior Management Program (1:3) 10.7% Adult Development Center (1:3) 31.0%

25 Appendix X Clients turning 22 years old in 2016 by Geographic Area and Estimated Adult Day Service needs Geographic Area Central San Diego # needing Activity Center # needing ADC # needing Behavior Manage. # needing Hab. Services Total North County Southbay East County Imperial County Total Licensed Program Capacities compared to Authorizations (1/4/16) by Type of Program and Location Central East County North County Southbay Imperial County Cap. Auth. Cap. Auth. Cap. Auth. Cap. Auth. Cap. Auth. AC ADC Behavior Manage Seniors