BILL NUMBER: SB 82 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY JUNE 16, 2015
INTRODUCED BY Committee on Budget and Fiscal Review
JANUARY 9, 2015
An act relating to the Budget Act of 2015.
to add Section 14670.36 to the Government Code, to amend Sections
1267 .75 and 1531.15 of the Health and Safety Code, to
amend Sections 4418.25, 4474.1, 4519.5, 4629, 4646.5, 4648, 4681.6,
4684.81, 4685.8, 4691.6, 4691.9, and 7505, of, to add Section 4474.11
to, and to repeal and add Section 7502.5 of, the Welfare and
Institutions Code, relating to developmental services, and making an
appropriation therefor, to take effect immediately, bill related to
the budget.
LEGISLATIVE COUNSEL'S DIGEST
SB 82, as amended, Committee on Budget and Fiscal Review.
Budget Act of 2015. Developmental Services.
(1) Existing law authorizes the Director of General Services, with
the consent of the State Department of Developmental Services, to
lease up to 60 acres located within the grounds of Fairview
Developmental Center for a period of up to 55 years, for the purpose
of developing affordable housing for the employees of, and
transitional housing for patient-clients of, Fairview Developmental
Center.
This bill would additionally authorize the Director of General
Services, with the consent of the Director of Developmental Services,
to lease up to 20 acres located within the grounds of Fairview
Developmental Center for a period of up to 55 years, at a price that
will permit the development of affordable housing for people with
developmental disabilities. The bill would require the proceeds of
this housing project and the housing project described above to be
deposited in the Department of Developmental Services Trust Fund,
which the bill would create. The bill would require that money in the
fund be used, upon appropriation by the Legislature, to provide
housing and transitional services for people with developmental
disabilities, and would require that any funds not needed to support
individuals with developmental disabilities be transferred to the
General Fund.
(2) Under existing law, the State Department of Public Health
licenses and regulates various types of health facilities, including
specified facilities for people with developmental disabilities.
Under existing law, the State Department of Social Services licenses
community care facilities, including adult residential facilities or
group homes that serve persons with developmental disabilities.
Existing law authorizes a licensee of certain facilities to utilize
secured perimeters, as defined. Existing law requires a person's
individual program planning team to meet annually and determine that
placement in a facility with secured perimeters is appropriate. These
facilities are required to serve no more than 15 residents and be
eligible for, and serve clients eligible for, federal Medicaid
funding.
This bill would remove the requirement that facilities with
secured perimeters be eligible for, and serve clients eligible for,
Medicaid funding. The bill would also limit the facilities to serving
no more than 6 residents, except as specified. This bill would
require the individual program planning team to meet every 90 days
after admission of an individual to a facility with secured
perimeters to determine the appropriateness of the placement. This
bill would prohibit the state from authorizing more than a combined
total of 150 beds statewide in facilities with secured perimeters.
(3) Existing law vests in the State Department of Developmental
Services jurisdiction over state hospitals, referred to as
developmental centers, for the provision of residential care to
individuals with developmental disabilities. Existing law requires
the department, when closing a developmental center, to comply with
procedural requirements that include the submission of a detailed
plan to the Legislature. Existing law specifies required information
to be included in a plan, including the fiscal impact of the closure,
the impact on residents and their families, and anticipated
alternative placements for residents.
This bill would require the department to submit to the
Legislature, on or before October 1, 2015, a plan or plans to close
one or more developmental centers, as specified. The bill would
provide that implementation of that plan would be contingent upon
legislative approval of the plan as part of the legislative budget
process during the 2016-17 Regular Session of the Legislature. The
bill would require the department, following approval of a closure
plan, to provide quarterly briefings to specified legislative staff
on progress related to the plan, as specified.
Existing law limits the total number of developmental center
residents in the secure treatment facility at Porterville
Developmental Center to 230, including residents receiving services
in the Porterville Developmental Center transition treatment program.
Existing law prohibits the admission of a person to a developmental
center except under certain circumstances, including when the person
is a juvenile committed by a court to the secure treatment program at
Porterville Developmental Center.
This bill would instead authorize an individual to be admitted to
the secure treatment facility at Porterville Developmental Center
only when specified conditions are satisfied, including, among
others, that the individual is at least 18 years of age. The bill
would also provide that an individual may be admitted to the
transitional treatment facility at Porterville Developmental Center
when specified conditions are satisfied, and would prohibit the
placement of an individual in the transitional treatment program for
longer than necessary to procure a less restrictive placement. The
bill would require the department to report to the Legislature on or
before March 1, 2016, regarding transitional program residents who
are placed in the program for more than one year.
This bill would declare the intent of the Legislature that General
Fund savings derived from the closure of developmental centers
benefit persons with developmental disabilities living in the
community. The bill would require the department to display annually
in its budget estimates specified information related to the
downsizing or closure of developmental centers, as specified.
(4) Under existing law, the Lanterman Developmental Disabilities
Services Act, the department is responsible for providing various
services and supports to persons with developmental disabilities, and
for ensuring the appropriateness and quality of those services and
supports. Existing law authorizes the department to contract with
regional centers to provide these services and supports. Existing law
requires a regional center to develop an individual program plan for
a person who, following intake and assessment, is found to be
eligible for regional center services. Existing law specifies
requirements related to the process of developing an individual
program plan. Existing law requires a regional center to complete a
plan within 60 days of the completion of the assessment.
This bill would require a regional center to offer, and upon
request provide, a written copy of the individual program plan to the
consumer of services or other specified individuals in a threshold
language, as defined, within 45 days of the request.
Existing law requires the department and regional centers to
annually collaborate to compile specified data relating to purchase
of service authorization, utilization, and expenditure by each
regional center. Existing law requires each regional center to
annually report to the department regarding the regional center's
implementation of these requirements.
This bill would require the department and regional centers to
include in that data the number of instances when a written copy of
an individual program plan is provided at the request of the consumer
or other specified individuals in a language other than a threshold
language, as defined, and that written copy was provided more than 60
days after the request. The bill would require the department to
consult with stakeholders to achieve specified objectives related to
reducing disparities and promoting equity in connection with
providing the services and supports described above, and to report
progress on those objectives to the Legislature during the 2016-17
annual legislative budget subcommittee hearing process.
Existing law also requires the department to establish a statewide
specialized resource service to reduce reliance on out-of-state
placements, developmental centers, and mental health facilities for
which federal funding is not available. Existing law requires the
department to also annually provide to the fiscal and appropriate
policy committees of the Legislature information on efforts to serve
those consumers, as specified.
This bill would require the department and each institution for
mental disease that has admitted a regional center consumer to report
annually to the contractor for regional center clients' rights
advocacy services, information related to those consumers served. The
bill would also expand the information the department is required to
report to the policy committees and the contractor, as specified.
Existing law requires that contracts entered into with regional
centers include annual performance objectives, including annual
performance objectives that are specific, measurable, and designed
to, among other things, develop services and supports identified as
necessary to meet identified needs.
This bill would include measuring progress in reducing disparities
and improving equity in purchase of service expenditures in those
annual performance objectives.
(5) Existing law prohibits a regional center from purchasing new
residential services from, or placing a consumer in, institutions for
mental disease, regardless of the availability of federal funding.
Existing law provides that the prohibition does not apply to
emergencies, as determined by the regional center, and as otherwise
specified. Under those circumstances, existing law requires the
regional center to complete a comprehensive assessment, as specified.
This bill would require an institution for mental disease that
receives placement of a regional center consumer from another entity
to inform the regional center of the placement, as specified. After
notice is provided to the regional center, the bill would require the
regional center to complete an assessment.
(6) Existing law sets forth the department's and the regional
center's authority to establish provider rates. Existing law
prohibits certain provider rate increases, but authorizes increases
to those rates as necessary to adjust employee wages to meet the
state minimum wage law.
Existing law generally provides that employees who, on or after
July 1, 2015, work in California for 30 or more days within a year
are entitled to a specified number of paid sick days.
This bill would authorize adjustment in prescribed provider rates
commencing July 1, 2015, if the adjustment is necessary to implement
the requirement that employees be provided paid sick days.
(7) Existing law requires the department to establish a pilot
program, until January 1, 2020, for the operation of up to 6 enhanced
behavioral supports homes for adults and children with developmental
disabilities who need intensive services and supports due to
challenging behaviors that cannot be managed in a community setting
without the availability of enhanced behavioral services and
supports.
This bill would delete the restriction on the number of enhanced
behavioral supports homes that the department may approve as part of
the pilot project.
(8) Existing law requires the department, contingent upon approval
of federal funding, to establish and implement a state
Self-Determination Program, as defined, that would be available in
every regional center catchment area to provide participants and
their families, within an individual budget, increased flexibility
and choice, and greater control over decisions, resources, and needed
and desired services and supports to implement their IPP, in
accordance with prescribed requirements. The statewide program would
be phased in over 3 years, serving up to 2,500 regional center
consumers during the phase-in period, and thereafter, available on a
voluntary basis to all eligible regional center consumers. Existing
law requires the department to annually provide specified information
to the appropriate policy and fiscal committees of the Legislature,
including the number and characteristics of participants, by regional
center.
This bill would authorize the Department of Finance to approve, as
specified, an increase to the number of consumers served by the
Self-Determination Program before the end of the 3-year phase-in
period. The bill would specify that following the phase-in period,
the regional center consumers that the program is made available to
would include residents in developmental centers who are moving to
the community, and would require that the annual information provided
by the department to the appropriate policy and fiscal committees of
the Legislature include the number of participants who entered the
program upon movement from a developmental center.
(9) Existing law establishes the In-Home Supportive Services
(IHSS) program, administered by the State Department of Social
Services and counties, under which qualified aged, blind, and
disabled persons are provided with services in order to permit them
to remain in their own homes and avoid institutionalization. Existing
federal law, the Fair Labor Standards Act (FLSA), and regulations
promulgated under the FLSA, generally require that an employee
covered by the act receive overtime pay for hours worked in excess of
40 hours in a workweek at a rate not less than 11/2 times the
employee's regular rate of pay, unless specifically exempted.
The bill would require the department, when federal FLSA
regulations regarding payment of overtime compensation are
implemented in the state, to consult with specified entities to
evaluate the impact of those regulations on consumers and providers
of supported living services, in-home respite services, and personal
assistants to persons with developmental disabilities. The bill would
require the department to report on the progress of that evaluation
and specified resulting actions or recommendations to the Legislature
during the 2016-17 legislative budget subcommittee hearing process.
(10) This bill would appropriate $61,554,000 from the General Fund
to the department to fund expenditures for services provided by
regional centers, as specified. The bill would provide that those
funds shall be available for encumbrance and expenditure until June
30, 2016.
(11) This bill would declare that it is to take effect immediately
as a bill providing for appropriations related to the Budget Bill.
This bill would express the intent of the Legislature to enact
statutory changes relating to the Budget Act of 2015.
Vote: majority. Appropriation: no yes
. Fiscal committee: no yes .
State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 14670.36 is added to the
Government Code , immediately following Section
14670.35 , to read:
14670.36. (a) Notwithstanding any other law, the Director of
General Services, with the consent of the Director of Developmental
Services, may, in the best interests of the state, let to any person
or entity real property not exceeding 20 acres located within the
grounds of the Fairview Developmental Center for a period not to
exceed 55 years, at a price that will permit the development of
affordable housing for people with developmental disabilities.
(b) Notwithstanding any other law, the lease authorized by this
section may be assignable subject to approval by the Director of
General Services, with the consent of the Director of Developmental
Services. The lease shall do all of the following:
(1) Provide housing for individuals who qualify based upon
criteria established by the Department of Developmental Services. A
minimum of 20 percent of the housing units developed shall be
available and affordable to individuals with developmental
disabilities served by a regional center pursuant to the Lanterman
Developmental Disabilities Services Act (Chapter 1 (commencing with
Section 4500) of Division 4.5 of the Welfare and Institutions Code).
When filling vacancies, priority for housing shall be given to
individuals transitioning from a developmental center or at risk for
admission to a developmental center.
(2) Allow for lease revenues or other proceeds received by the
state under the leases for projects authorized by this section and
Section 14670.35, to be utilized by the Department of Developmental
Services to support individuals with developmental disabilities,
including subsidizing rents for those individuals.
(3) Include provisions authorizing the Department of Developmental
Services, or its designee, to provide management oversight and
administration over the housing for individuals with developmental
disabilities and the general operations of the project sufficient to
assure the purposes of the lease are being carried out and to protect
the financial interests of the state.
(c) The Department of Developmental Services may share in
proceeds, if any, generated from the overall operation of the project
developed pursuant to this section. All proceeds received from the
project authorized by this section and the project authorized by
Section 14670.35, in accordance with the terms of the lease, shall be
deposited in the Department of Developmental Services Trust Fund,
which is hereby created in the State Treasury. Moneys in the
Department of Developmental Services Trust Fund shall be used, upon
appropriation by the Legislature, for the purpose of providing
housing and transitional services for people with developmental
disabilities. Any funds not needed to support individuals with
developmental disabilities shall be transferred to the General Fund
upon the order of the Director of Finance.
(d) The Director of General Services, with the consent of the
Director of Developmental Services, may enter into a lease pursuant
to this section at less than market value, provided that the cost of
administering the lease is recovered.
(e) The project and lease, including off-site improvements
directly related to the housing project authorized by this section,
shall not be deemed a "public works contract" as defined by Section
1101 of the Public Contract Code. However, construction projects
contemplated by the lease authorized by this section shall be
considered "public works," as defined by paragraph (1) of subdivision
(a) of Section 1720 of the Labor Code, for the purpose of prevailing
wage requirements.
SEC. 2. Section 1267.75 of the Health
and Safety Code is amended to read:
1267.75. (a) A licensee of an intermediate care
facility/developmentally disabled habilitative, as defined in
subdivision (e) of Section 1250, or of an intermediate care
facility/developmentally disabled, as defined in subdivision (g) of
Section 1250, for no more than 15 residents, that is
eligible for and serving clients eligible for federal Medicaid
funding may, with the approval of the State Department of Public
Health and contingent upon continued eligibility for federal Medicaid
funding, six residents, except for the larger
facilities provided for in paragraph (1) of subdivision (k), may
install and utilize delayed egress devices of the time delay
type in combination with secured perimeters in accordance with the
provisions of this section.
(b) For purposes of this section, the following definitions shall
apply:
(1) "Delayed egress device" means a device that precludes the use
of exits for a predetermined period of time. These devices shall not
delay any resident's departure from the facility for longer than 30
seconds.
(2) "Secured perimeters" means fences that meet the requirements
prescribed by this section.
(c) Only individuals meeting all of the following conditions may
be admitted to or reside in a facility described in subdivision (a)
utilizing delayed egress devices of the time delay type in
combination with secured perimeters:
(1) The person shall have a developmental disability as defined in
Section 4512 of the Welfare and Institutions Code.
(2) The person shall be receiving services and case management
from a regional center under the Lanterman Developmental Disabilities
Services Act (Division 4.5 (commencing with Section 4500) of the
Welfare and Institutions Code).
(3) (A) The person shall be 14 years of age or older.
(B) Notwithstanding subparagraph (A), a child who is at least 10
years of age and less than 14 years of age may be placed in a
licensed facility described in subdivision (a) using delayed egress
devices of the time delay type in combination with secured perimeters
only if both of the following occur:
(i) A comprehensive assessment is conducted and an individual
program plan meeting is convened to determine the services and
supports needed for the child to receive services in a less
restrictive, unlocked residential setting in California, and the
regional center requests assistance from the State Department of
Developmental Services' statewide specialized resource service to
identify options to serve the child in a less restrictive, unlocked
residential setting in California.
(ii) The regional center requests placement of the child in a
facility described in subdivision (a) using delayed egress devices of
the time delay type in combination with secured perimeters on the
basis that the placement is necessary to prevent out-of-state
placement or placement in a more restrictive, locked residential
setting such as a developmental center, institution for mental
disease, or psychiatric facility, and the State Department of
Developmental Services approves the request.
(4) (A) An interdisciplinary team, through
the individual program plan (IPP) process pursuant to Section 4646.5
of the Welfare and Institutions Code, shall have determined that the
person lacks hazard awareness or impulse control and, for his or her
safety and security, requires the level of supervision afforded by a
facility equipped with delayed egress devices of the time delay type
in combination with secured perimeters and that, but for this
placement, the person would be at risk of admission to, or would have
no option but to remain in, a more restrictive placement. The
individual program planning team shall determine the
continued appropriateness of the placement at least annually.
convene every 90 days after admission to determine and
document the continued appropriateness of the current placement and
progress in implementing the transition plan.
(B) The clients' rights advocate for the regional center shall be
notified of the proposed admission and the individual program plan
meeting and may participate in the individual program plan meeting,
unless the consumer objects on his or her own behalf.
(d) The licensee shall be subject to all applicable fire and
building codes, regulations, and standards, and shall receive
approval by the county or city fire department, the local fire
prevention district, or the State Fire Marshal for the installed
devices and secured perimeters.
(e) The licensee shall provide staff training regarding the use
and operation of the delayed egress devices of the time delay type
and secured perimeters, protection of residents' personal rights,
lack of hazard awareness and impulse control behavior, and emergency
evacuation procedures.
(f) The licensee shall revise its facility plan of operation.
These revisions shall first be approved by the State Department of
Developmental Services. The plan of operation shall not be approved
by the State Department of Public Health unless the licensee provides
certification that the plan was approved by the State Department of
Developmental Services. The plan shall include, but not be limited
to, all of the following:
(1) A description of how the facility is to be equipped with
secured perimeters that are consistent with regulations adopted by
the State Fire Marshal pursuant to Section 13143.6.
(2) A description of how the facility will provide training for
staff.
(3) A description of how the facility will ensure the protection
of the residents' personal rights consistent with Sections 4502,
4503, and 4504 of the Welfare and Institutions Code, and any
applicable personal rights provided in Title 22 of the California
Code of Regulations.
(4) A description of how the facility will manage residents' lack
of hazard awareness and impulse control behavior.
behavior, which shall emphasize positive behavioral supports and
techniques that are alternatives to physical, chemical, or
mechanical restraints, or seclusion.
(5) A description of the facility's emergency evacuation
procedures.
(6) A description of how the facility will comply with applicable
health and safety standards.
(g) Delayed egress devices of the time delay type in combination
with secured perimeters shall not substitute for adequate staff.
(h) Emergency fire and earthquake drills shall be conducted on
each shift in accordance with existing licensing requirements, and
shall include all facility staff providing resident care and
supervision on each shift.
(i) Interior and exterior space shall be available on the facility
premises to permit clients to move freely and safely.
(j) For the purposes of using secured perimeters, the licensee
shall not be required to obtain a waiver or exception to a regulation
that would otherwise prohibit the locking of a perimeter fence or
gate.
(k) Except as provided in subdivision (k) of Section 4684.81 of
the Welfare and Institutions Code, the state shall not authorize or
fund more than a combined total of 150 beds statewide in facilities
with secured perimeters under this section and under Section 1531.15.
The department shall notify the appropriate fiscal and policy
committees of the Legislature through the January and May budget
estimates prior to authorizing an increase above a combined total of
100 beds statewide in facilities with secured perimeters under this
section and under Section 1531.15.
(1) A minimum of 50 beds shall be available within programs
designed for individuals who are designated incompetent to stand
trial pursuant to Section 1370.1 of the Penal Code. These beds shall
be within facilities that are exclusively used to provide care for
individuals who are placed and participating in forensic competency
training pursuant to Section 1370.1 of the Penal Code, except as
provided in paragraph (2). No more than half of these facilities may
have more than six beds and no facility may have more than 15 beds.
(2) When, in the joint determination of the regional center and
the facility administrator, an individual would be most appropriately
served in a specific program, regardless of whether the facility
meets the criteria established in paragraph (1), individuals who are
not similarly designated may be placed in the same facility. That
placement may occur only when the individual's planning team
determines that the placement and the facility plan of operation meet
the individual's needs and that placement is not incompatible with
the needs and safety of other facility residents.
(k)
(l) This section shall become operative only upon the
filing of emergency regulations by the State Department of
Developmental Services. These regulations shall be developed with
stakeholders, including the State Department of Public Health,
consumer advocates, and regional centers. The regulations shall
establish program standards for homes that include delayed egress
devices of the time delay type in combination with secured
perimeters, including requirements and timelines for the completion
and updating of a comprehensive assessment of the consumer's needs,
including the identification through the individual program plan
process of the services and supports needed to transition the
consumer to a less restrictive living arrangement, and a timeline for
identifying or developing those services and supports. The
regulations shall establish a statewide limit on the total number of
beds in homes with delayed egress devices of the time delay type in
combination with secured perimeters. The adoption of these
regulations shall be deemed to be an emergency and necessary for the
immediate preservation of the public peace, health and safety, or
general welfare.
(l)
(m) This section shall not apply to developmental
centers and state-operated community facilities.
SEC. 3. Section 1531.15 of the Health
and Safety Code is amended to read:
1531.15. (a) A licensee of an adult residential facility or group
home for no more than 15 residents, that is eligible for
and serving clients eligible for federal Medicaid funding and
six residents, except for the larger facilities
provided for in paragraph (1) of subdivision (k), that is
utilizing delayed egress devices pursuant to Section 1531.1, may
install and utilize secured perimeters in accordance with the
provisions of this section.
(b) As used in this section, "secured perimeters" means fences
that meet the requirements prescribed by this section.
(c) Only individuals meeting all of the following conditions may
be admitted to or reside in a facility described in subdivision (a)
utilizing secured perimeters:
(1) The person shall have a developmental disability as defined in
Section 4512 of the Welfare and Institutions Code.
(2) The person shall be receiving services and case management
from a regional center under the Lanterman Developmental Disabilities
Services Act (Division 4.5 (commencing with Section 4500) of the
Welfare and Institutions Code).
(3) (A) The person shall be 14 years of age or older, except as
specified in subparagraph (B).
(B) Notwithstanding subparagraph (A), a child who is at least 10
years of age and less than 14 years of age may be placed in a
licensed group home described in subdivision (a) using secured
perimeters only if both of the following occur:
(i) A comprehensive assessment is conducted and an individual
program plan meeting is convened to determine the services and
supports needed for the child to receive services in a less
restrictive, unlocked residential setting in California, and the
regional center requests assistance from the State Department of
Developmental Services' statewide specialized resource service to
identify options to serve the child in a less restrictive, unlocked
residential setting in California.
(ii) The regional center requests placement of the child in a
licensed group home described in subdivision (a) using secured
perimeters on the basis that the placement is necessary to prevent
out-of-state placement or placement in a more restrictive, locked
residential setting such as a developmental center, institution
for mental disease or psychiatric facility, and the State
Department of Developmental Services approves the request.
(4) The person is not a foster child under the jurisdiction of the
juvenile court pursuant to Section 300, 450, 601, or 602 of the
Welfare and Institutions Code.
(5) (A) An interdisciplinary team, through
the individual program plan (IPP) process pursuant to Section 4646.5
of the Welfare and Institutions Code, shall have determined the
person lacks hazard awareness or impulse control and, for his or her
safety and security, requires the level of supervision afforded by a
facility equipped with secured perimeters, and, but for this
placement, the person would be at risk of admission to, or would have
no option but to remain in, a more restrictive placement. The
individual program planning team shall determine the
continued appropriateness of the placement at least annually.
convene every 90 days after admission to determine and
document the continued appropriateness of the current placement and
progress in implementing the transition plan.
(B) The clients' rights advocate for the regional center shall be
notified of the proposed admission and the individual program plan
meeting and may participate in the individual program plan meeting
unless the consumer objects on his or her own behalf.
(d) The licensee shall be subject to all applicable fire and
building codes, regulations, and standards, and shall receive
approval by the county or city fire department, the local fire
prevention district, or the State Fire Marshal for the installed
secured perimeters.
(e) The licensee shall provide staff training regarding the use
and operation of the secured perimeters, protection of residents'
personal rights, lack of hazard awareness and impulse control
behavior, and emergency evacuation procedures.
(f) The licensee shall revise its facility plan of operation.
These revisions shall first be approved by the State Department of
Developmental Services. The plan of operation shall not be approved
by the State Department of Social Services unless the licensee
provides certification that the plan was approved by the State
Department of Developmental Services. The plan shall include, but not
be limited to, all of the following:
(1) A description of how the facility is to be equipped with
secured perimeters that are consistent with regulations adopted by
the State Fire Marshal pursuant to Section 13143.6.
(2) A description of how the facility will provide training for
staff.
(3) A description of how the facility will ensure the protection
of the residents' personal rights consistent with Sections 4502,
4503, and 4504 of the Welfare and Institutions Code, and any
applicable personal rights provided in Title 22 of the California
Code of Regulations.
(4) A description of how the facility will manage residents' lack
of hazard awareness and impulse control behavior.
behavior, which shall emphasize positive behavioral supports and
techniques that are alternatives to physical, chemical, or
mechanical restraints, or seclusion.
(5) A description of the facility's emergency evacuation
procedures.
(6) A description of how the facility will comply with applicable
health and safety standards.
(g) Secured perimeters shall not substitute for adequate staff.
(h) Emergency fire and earthquake drills shall be conducted on
each shift in accordance with existing licensing requirements, and
shall include all facility staff providing resident care and
supervision on each shift.
(i) Interior and exterior space shall be available on the facility
premises to permit clients to move freely and safely.
(j) For the purpose of using secured perimeters, the licensee
shall not be required to obtain a waiver or exception to a regulation
that would otherwise prohibit the locking of a perimeter fence or
gate.
(k) Except as provided in subdivision (k) of Section 4684.81 of
the Welfare and Institutions Code, the state shall not authorize or
fund more than a combined total of 150 beds statewide in facilities
with secured perimeters under this section and under Section 1267.75.
The department shall notify the appropriate fiscal and policy
committees of the Legislature through the January and May budget
estimates prior to authorizing an increase above a combined total of
100 beds statewide in facilities with secured perimeters under this
section and under Section 1267.75.
(1) A minimum of 50 beds shall be available within programs
designed for individuals who are designated incompetent to stand
trial pursuant to Section 1370.1 of the Penal Code. These beds shall
be within facilities that are exclusively used to provide care for
individuals who are placed and participating in forensic competency
training pursuant to Section 1370.1 of the Penal Code, except as
provided in paragraph (2). No more than half of these facilities may
have more than six beds and no facility may have more than 15 beds.
(2) When, in the joint determination of the regional center and
the facility administrator, an individual would be most appropriately
served in a specific program, regardless of whether the facility
meets the criteria established in paragraph (1), individuals who are
not similarly designated may be placed in the same facility. That
placement may occur only when the individual's planning team
determines that the placement and the facility plan of operation meet
the individual's needs and that placement is not incompatible with
the needs and safety of other facility residents.
(k)
(l) This section shall become operative only upon the
publication in Title 17 of the California Code of Regulations of
emergency regulations filed by the State Department of Developmental
Services. These regulations shall be developed with stakeholders,
including the State Department of Social Services, consumer
advocates, and regional centers. The regulations shall establish
program standards for homes that include secured perimeters,
including requirements and timelines for the completion and updating
of a comprehensive assessment of each consumer's needs, including the
identification through the individual program plan process of the
services and supports needed to transition the consumer to a less
restrictive living arrangement, and a timeline for identifying or
developing those services and supports. The regulations shall
establish a statewide limit on the total number of beds in homes with
secured perimeters. The adoption of these regulations shall be
deemed to be an emergency and necessary for the immediate
preservation of the public peace, health and safety, or general
welfare.
SEC. 4. Section 4418.25 of the Welfare
and Institutions Code is amended to read:
4418.25. (a) The department shall establish policies and
procedures for the development of an annual community placement plan
by regional centers. The community placement plan shall be based upon
an individual program plan process as referred to in subdivision (a)
of Section 4418.3 and shall be linked to the development of the
annual State Budget. The department's policies shall address
statewide priorities, plan requirements, and the statutory roles of
regional centers, developmental centers, and regional resource
development projects in the process of assessing consumers for
community living and in the development of community resources.
(b) (1) To reduce reliance on developmental centers and mental
health facilities, including institutions for mental disease as
described in Part 5 (commencing with Section 5900) of Division 5, for
which federal funding is not available, and out-of-state placements,
the department shall establish a statewide specialized resource
service that does all of the following:
(A) Tracks the availability of specialty residential beds and
services.
(B) Tracks the availability of specialty clinical services.
(C) Coordinates the need for specialty services and supports in
conjunction with regional centers.
(D) Identifies, subject to federal reimbursement, developmental
center services and supports that can be made available to consumers
residing in the community, when no other community resource has been
identified.
(2) By September 1, 2012, regional centers shall provide the
department with information about all specialty resources developed
with the use of community placement plan funds and shall make these
resources available to other regional centers.
(3) When allocating funding for community placement plans,
priority shall be given to the development of needed statewide
specialty services and supports, including regional community crisis
homes.
(4) If approved by the director, funding may be allocated to
facilities that meet the criteria of Sections 1267.75 and 1531.15 of
the Health and Safety Code.
(5) The department shall not provide community placement plan
funds to develop programs that are ineligible for federal funding
participation unless approved by the director.
(c) (1) The community placement plan shall provide for dedicated
funding for comprehensive assessments of developmental center
residents, for identified costs of moving individuals from
developmental centers to the community, and for deflection of
individuals from developmental center admission. The plans shall,
where appropriate, include
budget requests for regional center operations, assessments,
resource development, and ongoing placement costs. These budget
requests are intended to provide supplemental funding to regional
centers. The plan is not intended to limit the department's or
regional centers' responsibility to otherwise conduct assessments and
individualized program planning, and to provide needed services and
supports in the least restrictive, most integrated setting in accord
with the Lanterman Developmental Disabilities Services Act (Division
4.5 (commencing with Section 4500)).
(2) (A) Regional centers shall complete a comprehensive assessment
of any consumer residing in a developmental center on July 1, 2012,
who meets both of the following criteria:
(i) The consumer is not committed pursuant to Section 1370.1 of
the Penal Code.
(ii) The consumer has not had such an assessment in the prior two
years.
(B) The assessment shall include input from the regional center,
the consumer, and, when appropriate, the consumer's family, legal
guardian, conservator, or authorized representative, and shall
identify the types of community-based services and supports available
to the consumer that would enable the consumer to move to a
community setting. Necessary services and supports not currently
available in the community setting shall be considered for
development pursuant to community placement planning and funding.
(C) Regional centers shall specify in the annual community
placement plan how they will complete the required assessment and the
timeframe for completing the assessment for each consumer. Initial
assessments pursuant to this paragraph for individuals residing in a
developmental center on July 1, 2012, shall be completed by December
31, 2015, unless a regional center demonstrates to the department
that an extension of time is necessary and the department grants such
an extension.
(D) The assessment completed in the prior two years, or the
assessment completed pursuant to the requirements of this section,
including any updates pursuant to subparagraph (E), shall be provided
to both of the following:
(i) The individual program planning team and clients' rights
advocate for the regional center in order to assist the planning team
in determining the least restrictive environment for the consumer.
(ii) The superior court with jurisdiction over the consumer's
placement at the developmental center, including the consumer's
attorney of record and other parties known to the regional center.
For judicial proceedings pursuant to Article 2 (commencing with
Section 6500) of Chapter 2 of Part 2 of Division 6, the comprehensive
assessment shall be included in the regional center's written report
required by Section 6504.5. For all other proceedings, the regional
center shall provide the comprehensive assessment to the court and
parties to the case at least 14 days in advance of any regularly
scheduled judicial review. This clause shall not apply to consumers
committed pursuant to Section 1370.1 of the Penal Code.
(E) The assessments described in subparagraph (D) shall be updated
annually as part of the individual program planning process for as
long as the consumer resides in the developmental center. To the
extent appropriate, the regional center shall also provide relevant
information from the statewide specialized resource service. The
regional center shall notify the clients' rights advocate for the
regional center of the time, date, and location of each individual
program plan meeting that includes discussion of the results of the
comprehensive assessment and updates to that assessment. The regional
center shall provide this notice as soon as practicable following
the completion of the comprehensive assessment or update and not less
than 30 calendar days prior to the meeting. The clients' rights
advocate may participate in the meeting unless the consumer objects
on his or her own behalf.
(d) The department shall review, negotiate, and approve regional
center community placement plans for feasibility and reasonableness,
including recognition of each regional centers' current developmental
center population and their corresponding placement level, as well
as each regional centers' need to develop new and innovative service
models. The department shall hold regional centers accountable for
the development and implementation of their approved plans. The
regional centers shall report, as required by the department, on the
outcomes of their plans. The department shall make aggregate
performance data for each regional center available, upon request, as
well as data on admissions to, and placements from, each
developmental center.
(e) Funds allocated by the department to a regional center for a
community placement plan developed under this section shall be
controlled through the regional center contract to ensure that the
funds are expended for the purposes allocated. Funds allocated for
community placement plans that are not used for that purpose may be
transferred to Item 4300-003-0001 for expenditure in the state
developmental centers if their population exceeds the budgeted level.
Any unspent funds shall revert to the General Fund.
(f) Commencing May 1, 2013, and then on April 1, 2014, and on
April 1 annually thereafter, the department shall provide to the
fiscal and appropriate policy committees of the Legislature
Legislature, and to the contractor for regional center
clients' rights advocacy services under Section 4433,
information on efforts to serve consumers with challenging service
needs, including, but not limited to, all of the following:
(1) For each regional center, the number of consumers admitted to
each developmental center, including the legal basis for the
admissions.
(2) For each regional center, the number of consumers described in
paragraph (2) of subdivision (a) of Section 7505 who were admitted
to Fairview Developmental Center by court order pursuant to Article 2
(commencing with Section 6500) of Chapter 2 of Part 2 of Division 6,
and the number and lengths of stay of consumers, including those who
have transitioned back to a community living arrangement.
(3) Outcome data related to the assessment process set forth in
Section 4418.7, including the number of consumers who received
assessments pursuant to Section 4418.7 and the outcomes of the
assessments. Each regional center, commencing March 1, 2013, and then
on February 1, 2014, and on February 1 annually thereafter, shall
provide the department with information on alternative community
services and supports provided to those consumers who were able to
remain in the community following the assessments, and the unmet
service needs that resulted in any consumers being admitted to
Fairview Developmental Center.
(4) Progress in the development of needed statewide specialty
services and supports, including regional community crisis options,
as provided in paragraph (3) of subdivision (b). Each regional center
shall provide the department with a report containing the
information described in this paragraph commencing March 1, 2013, and
then on February 1, 2014, and on February 1 annually thereafter.
(5) Progress in reducing reliance on mental health facilities
ineligible for federal Medicaid funding, and out-of-state
placements. placements, including information on the
utilization of those facilities, which shall include, by regional
center, all of the following:
(A) The total number and age range of consumers placed in those
facilities.
(B) The number of admissions.
(C) The reasons for admissions by category, including, but not
limited to, incompetent-to-stand-trial (IST) commitment, Section 6500
commitment, crisis stabilization, and lack of appropriate community
placement.
(D) The lengths of stay of consumers.
(E) The type of facility.
(6) Information on the utilization of facilities serving consumers
with challenging service needs that utilize delayed egress devices
and secured perimeters, pursuant to Section 1267.75 or 1531.15 of the
Health and Safety Code, including the number of admissions, reasons
for admissions, and lengths of stay of consumers, including those who
have transitioned to less restrictive living arrangements.
(7) If applicable, any recommendations regarding additional rate
exceptions or modifications beyond those allowed for under existing
law that the department identifies as necessary to meet the needs of
consumers with challenging service needs.
(g) Each regional center, commencing March 1, 2013, and then on
February 1, 2014, and on February 1 annually thereafter, shall
provide information to the department regarding the facilities
described in paragraph (6) of subdivision (f), including, but not
limited to, the number of admissions, reasons for admissions, and
lengths of stay of consumers, including those who have transitioned
to less restrictive living arrangements.
(h) Each institution for mental disease that has admitted a
regional center consumer in the preceding year shall report on
February 1, 2016, and on February 1 annually thereafter, to the
contractor for regional center clients' rights advocacy services
under Section 4433, all of the following:
(A) The total number and age of consumers placed in that facility.
(B) The number of admissions.
(C) The reasons for admissions by category.
(D) The lengths of stay of consumers.
(E) The funding source.
SEC. 5. Section 4474.1 of the Welfare
and Institutions Code is amended to read:
4474.1. (a) Whenever the State Department of Developmental
Services proposes the closure of a state developmental center, the
department shall be required to submit a detailed plan to the
Legislature not later than April 1 immediately prior to the fiscal
year in which the plan is to be implemented, and as a part of the
Governor's proposed budget. A plan submitted to the Legislature
pursuant to this section, including any modifications made pursuant
to subdivision (b), shall not be implemented without the approval of
the Legislature.
(b) A plan submitted on or before April 1 immediately prior to the
fiscal year in which the plan is to be implemented may be
subsequently modified during the legislative review process.
(c) Prior to submission of the plan to the Legislature, the
department shall solicit input from the State Council on
Developmental Disabilities, the Association of Regional Center
Agencies, the protection and advocacy agency specified in Section
4901, the local regional center, consumers living in the
developmental center, parents, family members, guardians, and
conservators of persons living in the developmental centers or their
representative organizations, persons with developmental disabilities
living in the community, developmental center employees and employee
organizations, community care providers, the affected city and
county governments, and business and civic organizations, as may be
recommended by local state Senate and Assembly representatives.
(d) Prior to the submission of the plan to the Legislature, the
department shall confer with the county in which the developmental
center is located, the regional centers served by the developmental
center, and other state departments using similar occupational
classifications, to develop a program for the placement of staff of
the developmental center planned for closure in other developmental
centers, as positions become vacant, or in similar positions in
programs operated by, or through contract with, the county, regional
centers, or other state departments.
departments, including, but not limited to, the community state staff
program, use of state staff for mobile health and crisis teams in
the community, and use of state staff in new state
-operated models that may be developed as a component of the closure
plan.
(e) Prior to the submission of the plan to the Legislature, the
department shall confer with the county in which the development
center is located, and shall consider recommendations for the use of
the developmental center property.
(e)
(f) Prior to the submission of the plan to the
Legislature, the department shall hold at least one public hearing in
the community in which the developmental center is located, with
public comment from that hearing summarized in the plan.
(f)
(g) The plan submitted to the Legislature pursuant to
this section shall include all of the following:
(1) A description of the land and buildings affected.
at the developmental center.
(2) A description of existing lease arrangements at the
developmental center.
(3) A description of resident characteristics, including, but not
limited to, age, gender, ethnicity, family involvement, years of
developmental center residency, developmental disability, and other
factors that will determine service and support needs.
(4) A description of stakeholder input provided pursuant to
subdivisions (c), (d), and (e), including a description of local
issues, concerns, and recommendations regarding the proposed closure,
and alternative uses of the developmental center property.
(3)
(5) The impact on residents and their families.
(6) A description of the unique and specialized services provided
by the developmental center, including, but not limited to, crisis
facilities, health and dental clinics, and adaptive technology
services.
(7) A description of the assessment process and community
placement decision process that will ensure necessary services and
supports are in place prior to a resident transitioning into the
community.
(4)
(8) Anticipated alternative placements for residents.
(9) A description of how the department will transition the client
rights advocacy contract provided at the developmental center
pursuant to Section 4433 to the community.
(10) A description of how the well-being of the residents will be
monitored during and following their transition into the community.
(5)
(11) The impact on regional center services.
(6)
(12) Where services will be obtained that, upon closure
of the developmental center, will no longer be provided by that
facility.
(7)
(13) Potential A description of
the potential job opportunities for developmental center
employees employees, activities the
department will undertake to support employees through the closure
process, and other efforts made to mitigate the effect of the
closure on employees.
(8)
(14) The fiscal impact of the closure.
(9)
(15) The timeframe in which closure will be
accomplished.
SEC. 6. Section 4474.11 is added to the
Welfare and Institutions Code , immediately
following Section 4474.1 , to read:
4474.11. (a) Notwithstanding any other law, on or before October
1, 2015, the Department of Developmental Services shall submit to the
Legislature a plan or plans to close one or more developmental
centers. The plan or plans shall meet the requirements of
subdivisions (c) to (g), inclusive of Section 4474.1, and shall be
posted on the department's Internet Web site. The department may
develop community resources and otherwise engage in activities for
transitioning developmental center residents into the community, and
utilize funds allocated for that purpose as part of the annual Budget
Act that is enacted at the 2015-16 Regular Session of the
Legislature. Implementation of a plan following the 2015-16 fiscal
year is contingent upon legislative approval of the plan as part of
the legislative budget process during the 2016-17 Regular Session of
the Legislature.
(b) A plan submitted to the Legislature pursuant to this section
may subsequently be modified during the legislative review process.
Modifications may include changes based on stakeholder and
county-designated advisory group comments, as well as recommendations
made by the county in which the developmental center is located.
SEC. 7. Section 4519.5 of the Welfare
and Institutions Code is amended to read:
4519.5. (a) The department and the regional centers shall
annually collaborate to compile data in a uniform manner relating to
purchase of service authorization, utilization, and expenditure by
each regional center with respect to all of the following:
(1) The age of consumer, categorized by the following:
(A) Birth to age two, inclusive.
(B) Three to 21, inclusive.
(C) Twenty-two and older.
(2) Race or ethnicity of the consumer.
(3) Primary language spoken by the consumer, and other related
details, as feasible.
(4) Disability detail, in accordance with the categories
established by subdivision (a) of Section 4512, and, if applicable, a
category specifying that the disability is unknown.
(5) Residence type, subcategorized by age, race or ethnicity, and
primary language.
(6) Number of instances when the written copy of the individual
program plan was provided at the request of the consumer and, when
appropriate, his or her parents, legal guardian or conservator, or
authorized representative, in a language other than a threshold
language, as defined by paragraph (3) of subdivision (a) of Section
1810.410 of Title 9 of the California Code of Regulations, if that
written copy was provided more than 60 days after the request.
(b) The data reported pursuant to subdivision (a) shall also
include the number and percentage of individuals, categorized by age,
race or ethnicity, and disability, and by residence type, as set
forth in paragraph (5) of subdivision (a), who have been determined
to be eligible for regional center services but are not receiving
purchase of service funds.
(c) By March 31, 2013, each regional center shall post the data
described in this section that is specific to the regional center on
its Internet Web site. Commencing on December 31, 2013, each regional
center shall annually post this data by December 31. Each regional
center shall maintain all previous years' data on its Internet Web
site.
(d) By March 31, 2013, the department shall post the information
described in this section on a statewide basis on its Internet Web
site. Commencing December 31, 2013, the department shall annually
post this information by December 31. The department shall maintain
all previous years' data on its Internet Web site. The department
shall also post notice of any regional center stakeholder meetings on
its Internet Web site.
(e) Within three months of compiling the data with the department,
and annually thereafter, each regional center shall meet with
stakeholders in one or more public meetings regarding the data. The
meeting or meetings shall be held separately from any meetings held
pursuant to Section 4660. The regional center shall provide
participants of these meetings with the data and any associated
information, and shall conduct a discussion of the data and the
associated information in a manner that is culturally and
linguistically appropriate for that community, including providing
alternative communication services, as required by Sections 11135 to
11139.7, inclusive, of the Government Code and implementing
regulations. Regional centers shall inform the department of the
scheduling of those public meetings 30 days prior to the meeting.
Notice of the meetings shall also be posted on the regional center's
Internet Web site 30 days prior to the meeting and shall be sent to
individual stakeholders and groups representing underserved
communities in a timely manner. Each regional center shall, in
holding the meetings required by this subdivision, consider the
language needs of the community and shall schedule the meetings at
times and locations designed to result in a high turnout by the
public and underserved communities.
(f) (1) Each regional center shall annually report to the
department regarding its implementation of the requirements of this
section. The report shall include, but shall not be limited to, all
of the following:
(A) Actions the regional center took to improve public attendance
and participation at stakeholder meetings, including, but not limited
to, attendance and participation by underserved communities.
(B) Copies of minutes from the meeting and attendee comments.
(C) Whether the data described in this section indicates a need to
reduce disparities in the purchase of services among consumers in
the regional center's catchment area. If the data does indicate that
need, the regional center's recommendations and plan to promote
equity, and reduce disparities, in the purchase of services.
(2) Each regional center and the department shall annually post
the reports required by paragraph (1) on its Internet Web site by
August 31.
(g) (1) The department shall consult with stakeholders, including
consumers and families that reflect the ethnic and language diversity
of regional center consumers, regional centers, advocates,
providers, the protection and advocacy agency described in Section
4901, and those entities designated as University Centers for
Excellence in Developmental Disabilities Education, Research, and
Service pursuant to Section 15061 of Title 42 of the United States
Code, to achieve the following objectives:
(A) Review the data compiled pursuant to subdivision (a).
(B) Identify barriers to equitable access to services and supports
among consumers and develop recommendations to help reduce
disparities in purchase of service expenditures.
(C) Encourage the development and expansion of culturally
appropriate services, service delivery, and service coordination.
(D) Identify best practices to reduce disparity and promote
equity.
(2) The department shall report the status of its efforts to
satisfy the requirements of paragraph (1) during the 2016-17
legislative budget subcommittee hearing process.
SEC. 8. Section 4629 of the Welfare and
Institutions Code is amended to read:
4629. (a) The state shall enter into five-year contracts with
regional centers, subject to the annual appropriation of funds by the
Legislature.
(b) The contracts shall include a provision requiring each
regional center to render services in accordance with applicable
provision of state laws and regulations.
(c) (1) The contracts shall include annual performance objectives
that shall do both of the following:
(A) Be specific, measurable, and designed to do all of the
following:
(i) Assist consumers to achieve life quality outcomes.
(ii) Achieve meaningful progress above the current baselines.
(iii) Develop services and supports identified as necessary to
meet identified needs, including culturally and linguistically
appropriate services and supports.
(iv) Measure progress in reducing disparities and improving equity
in purchase of service expenditures.
(B) Be developed through a public process as described in the
department's guidelines that includes, but is not limited to, all of
the following:
(i) Providing information, in an understandable form, to the
community about regional center services and supports, including
budget information and baseline data on services and supports and
regional center operations.
(ii) Conducting a public meeting where participants can provide
input on performance objectives and using focus groups or surveys to
collect information from the community.
(iii) Circulating a draft of the performance objectives to the
community for input prior to presentation at a regional center board
meeting where additional public input will be taken and considered
before adoption of the objectives.
(2) In addition to the performance objectives developed pursuant
to this section, the department may specify in the performance
contract additional areas of service and support that require
development or enhancement by the regional center. In determining
those areas, the department shall consider public comments from
individuals and organizations within the regional center catchment
area, the distribution of services and supports within the regional
center catchment area, and review how the availability of services
and supports in the regional area catchment area compares with other
regional center catchment areas.
(d) Each contract with a regional center shall specify steps to be
taken to ensure contract compliance, including, but not limited to,
all of the following:
(1) Incentives that encourage regional centers to meet or exceed
performance standards.
(2) Levels of probationary status for regional centers that do not
meet, or are at risk of not meeting, performance standards. The
department shall require that corrective action be taken by any
regional center which is placed on probation. Corrective action may
include, but is not limited to, mandated consultation with designated
representatives of the Association of Regional Center Agencies or a
management team designated by the department, or both. The department
shall establish the specific timeline for the implementation of
corrective action and monitor its implementation. When a regional
center is placed on probation, the department shall provide the state
council and the clients' rights advocacy contractor identified in
Section 4433 with a copy of the correction plan, timeline, and any
other action taken by the department relating to the probationary
status of the regional center.
(e) In order to evaluate the regional center's compliance with its
contract performance objectives and legal obligations related to
those objectives, the department shall do both of the following:
(1) Annually assess each regional center's achievement of its
previous year's objectives and make the assessment, including
baseline data and performance objectives of the individual regional
centers, available to the
public. The department may make a special commendation of the
regional centers that have best engaged the community in the
development of contract performance objectives and have made the most
meaningful progress in meeting or exceeding contract performance
objectives.
(2) Monitor the activities of the regional center to ensure
compliance with the provisions of its contracts, including, but not
limited to, reviewing all of the following:
(A) The regional center's public process for compliance with the
procedures set forth in paragraph (2) of subdivision (c).
(B) Each regional center's performance objectives for compliance
with the criteria set forth in paragraphs (1) and (2) of subdivision
(c).
(C) Any public comments on regional center performance objectives
sent to the department or to the regional centers, and soliciting
public input on the public process and final performance standards.
(f) The renewal of each contract shall be contingent upon
compliance with the contract including, but not limited to, the
performance objectives, as determined through the department's
evaluation.
SEC. 9. Section 4646.5 of the Welfare
and Institutions Code is amended to read:
4646.5. (a) The planning process for the individual program plan
described in Section 4646 shall include all of the following:
(1) Gathering information and conducting assessments to determine
the life goals, capabilities and strengths, preferences, barriers,
and concerns or problems of the person with developmental
disabilities. For children with developmental disabilities, this
process should include a review of the strengths, preferences, and
needs of the child and the family unit as a whole. Assessments shall
be conducted by qualified individuals and performed in natural
environments whenever possible. Information shall be taken from the
consumer, his or her parents and other family members, his or her
friends, advocates, authorized representative, if applicable,
providers of services and supports, and other agencies. The
assessment process shall reflect awareness of, and sensitivity to,
the lifestyle and cultural background of the consumer and the family.
(2) A statement of goals, based on the needs, preferences, and
life choices of the individual with developmental disabilities, and a
statement of specific, time-limited objectives for implementing the
person's goals and addressing his or her needs. These objectives
shall be stated in terms that allow measurement of progress or
monitoring of service delivery. These goals and objectives should
maximize opportunities for the consumer to develop relationships, be
part of community life in the areas of community participation,
housing, work, school, and leisure, increase control over his or her
life, acquire increasingly positive roles in community life, and
develop competencies to help accomplish these goals.
(3) When developing individual program plans for children,
regional centers shall be guided by the principles, process, and
services and support parameters set forth in Section 4685.
(4) When developing an individual program plan for a transition
age youth or working age adult, the planning team shall consider the
Employment First Policy described in Chapter 14 (commencing with
Section 4868).
(5) A schedule of the type and amount of services and supports to
be purchased by the regional center or obtained from generic agencies
or other resources in order to achieve the individual program plan
goals and objectives, and identification of the provider or providers
of service responsible for attaining each objective, including, but
not limited to, vendors, contracted providers, generic service
agencies, and natural supports. The individual program plan shall
specify the approximate scheduled start date for services and
supports and shall contain timelines for actions necessary to begin
services and supports, including generic services. In addition
to the requirements of subdivision (h) of Section 4646, each regional
center shall offer, and upon request provide, a written copy of the
individual program plan to the consumer, and, when appropriate, his
or her parents, legal guardian or conservator, or authorized
representative within 45 days of their request in a threshold
language, as defined by paragraph (3) of subdivision (a) of Section
1810.410 of Title 9 of the California Code of Regulations.
(6) When agreed to by the consumer, the parents, legally appointed
guardian, or authorized representative of a minor consumer, or the
legally appointed conservator of an adult consumer or the authorized
representative, including those appointed pursuant to subdivision (a)
of Section 4541, subdivision (b) of Section 4701.6, and subdivision
(e) of Section 4705, a review of the general health status of the
adult or child, including medical, dental, and mental health needs,
shall be conducted. This review shall include a discussion of current
medications, any observed side effects, and the date of the last
review of the medication. Service providers shall cooperate with the
planning team to provide any information necessary to complete the
health status review. If any concerns are noted during the review,
referrals shall be made to regional center clinicians or to the
consumer's physician, as appropriate. Documentation of health status
and referrals shall be made in the consumer's record by the service
coordinator.
(7) (A) The development of a transportation access plan for a
consumer when all of the following conditions are met:
(i) The regional center is purchasing private, specialized
transportation services or services from a residential, day, or other
provider, excluding vouchered service providers, to transport the
consumer to and from day or work services.
(ii) The planning team has determined that a consumer's community
integration and participation could be safe and enhanced through the
use of public transportation services.
(iii) The planning team has determined that generic transportation
services are available and accessible.
(B) To maximize independence and community integration and
participation, the transportation access plan shall identify the
services and supports necessary to assist the consumer in accessing
public transportation and shall comply with Section 4648.35. These
services and supports may include, but are not limited to, mobility
training services and the use of transportation aides. Regional
centers are encouraged to coordinate with local public transportation
agencies.
(8) A schedule of regular periodic review and reevaluation to
ascertain that planned services have been provided, that objectives
have been fulfilled within the times specified, and that consumers
and families are satisfied with the individual program plan and its
implementation.
(b) For all active cases, individual program plans shall be
reviewed and modified by the planning team, through the process
described in Section 4646, as necessary, in response to the person's
achievement or changing needs, and no less often than once every
three years. If the consumer or, where appropriate, the consumer's
parents, legal guardian, authorized representative, or conservator
requests an individual program plan review, the individual program
shall be reviewed within 30 days after the request is submitted.
(c) (1) The department, with the participation of representatives
of a statewide consumer organization, the Association of Regional
Center Agencies, an organized labor organization representing service
coordination staff, and the state council shall prepare training
material and a standard format and instructions for the preparation
of individual program plans, which embody an approach centered on the
person and family.
(2) Each regional center shall use the training materials and
format prepared by the department pursuant to paragraph (1).
(3) The department shall biennially review a random sample of
individual program plans at each regional center to ensure that these
plans are being developed and modified in compliance with Section
4646 and this section.
SEC. 10. Section 4648 of the Welfare
and Institutions Code is amended to read:
4648. In order to achieve the stated objectives of a consumer's
individual program plan, the regional center shall conduct
activities, including, but not limited to, all of the following:
(a) Securing needed services and supports.
(1) It is the intent of the Legislature that services and supports
assist individuals with developmental disabilities in achieving the
greatest self-sufficiency possible and in exercising personal
choices. The regional center shall secure services and supports that
meet the needs of the consumer, as determined in the consumer's
individual program plan, and within the context of the individual
program plan, the planning team shall give highest preference to
those services and supports which would allow minors with
developmental disabilities to live with their families, adult persons
with developmental disabilities to live as independently as possible
in the community, and that allow all consumers to interact with
persons without disabilities in positive, meaningful ways.
(2) In implementing individual program plans, regional centers,
through the planning team, shall first consider services and supports
in natural community, home, work, and recreational settings.
Services and supports shall be flexible and individually tailored to
the consumer and, where appropriate, his or her family.
(3) A regional center may, pursuant to vendorization or a
contract, purchase services or supports for a consumer from any
individual or agency that the regional center and consumer or, when
appropriate, his or her parents, legal guardian, or conservator, or
authorized representatives, determines will best accomplish all or
any part of that consumer's program plan.
(A) Vendorization or contracting is the process for
identification, selection, and utilization of service vendors or
contractors, based on the qualifications and other requirements
necessary in order to provide the service.
(B) A regional center may reimburse an individual or agency for
services or supports provided to a regional center consumer if the
individual or agency has a rate of payment for vendored or contracted
services established by the department, pursuant to this division,
and is providing services pursuant to an emergency vendorization or
has completed the vendorization procedures or has entered into a
contract with the regional center and continues to comply with the
vendorization or contracting requirements. The director shall adopt
regulations governing the vendorization process to be utilized by the
department, regional centers, vendors, and the individual or agency
requesting vendorization.
(C) Regulations shall include, but not be limited to: the vendor
application process, and the basis for accepting or denying an
application; the qualification and requirements for each category of
services that may be provided to a regional center consumer through a
vendor; requirements for emergency vendorization; procedures for
termination of vendorization; the procedure for an individual or an
agency to appeal any vendorization decision made by the department or
regional center.
(D) A regional center may vendorize a licensed facility for
exclusive services to persons with developmental disabilities at a
capacity equal to or less than the facility's licensed capacity. A
facility already licensed on January 1, 1999, shall continue to be
vendorized at their full licensed capacity until the facility agrees
to vendorization at a reduced capacity.
(E) Effective July 1, 2009, notwithstanding any other law or
regulation, a regional center shall not newly vendor a State
Department of Social Services licensed 24-hour residential care
facility with a licensed capacity of 16 or more beds, unless the
facility qualifies for receipt of federal funds under the Medicaid
Program.
(4) Notwithstanding subparagraph (B) of paragraph (3), a regional
center may contract or issue a voucher for services and supports
provided to a consumer or family at a cost not to exceed the maximum
rate of payment for that service or support established by the
department. If a rate has not been established by the department, the
regional center may, for an interim period, contract for a specified
service or support with, and establish a rate of payment for, any
provider of the service or support necessary to implement a consumer'
s individual program plan. Contracts may be negotiated for a period
of up to three years, with annual review and subject to the
availability of funds.
(5) In order to ensure the maximum flexibility and availability of
appropriate services and supports for persons with developmental
disabilities, the department shall establish and maintain an
equitable system of payment to providers of services and supports
identified as necessary to the implementation of a consumers'
individual program plan. The system of payment shall include a
provision for a rate to ensure that the provider can meet the special
needs of consumers and provide quality services and supports in the
least restrictive setting as required by law.
(6) The regional center and the consumer, or when appropriate, his
or her parents, legal guardian, conservator, or authorized
representative, including those appointed pursuant to subdivision (a)
of Section 4541, subdivision (b) of Section 4701.6, or subdivision
(e) of Section 4705, shall, pursuant to the individual program plan,
consider all of the following when selecting a provider of consumer
services and supports:
(A) A provider's ability to deliver quality services or supports
that can accomplish all or part of the consumer's individual program
plan.
(B) A provider's success in achieving the objectives set forth in
the individual program plan.
(C) Where appropriate, the existence of licensing, accreditation,
or professional certification.
(D) The cost of providing services or supports of comparable
quality by different providers, if available, shall be reviewed, and
the least costly available provider of comparable service, including
the cost of transportation, who is able to accomplish all or part of
the consumer's individual program plan, consistent with the
particular needs of the consumer and family as identified in the
individual program plan, shall be selected. In determining the least
costly provider, the availability of federal financial participation
shall be considered. The consumer shall not be required to use the
least costly provider if it will result in the consumer moving from
an existing provider of services or supports to more restrictive or
less integrated services or supports.
(E) The consumer's choice of providers, or, when appropriate, the
consumer's parent's, legal guardian's, authorized representative's,
or conservator's choice of providers.
(7) No service or support provided by any agency or individual
shall be continued unless the consumer or, when appropriate, his or
her parents, legal guardian, or conservator, or authorized
representative, including those appointed pursuant to subdivision (a)
of Section 4541, subdivision (b) of Section 4701.6, or subdivision
(e) of Section 4705, is satisfied and the regional center and the
consumer or, when appropriate, the person's parents or legal guardian
or conservator agree that planned services and supports have been
provided, and reasonable progress toward objectives have been made.
(8) Regional center funds shall not be used to supplant the budget
of any agency that has a legal responsibility to serve all members
of the general public and is receiving public funds for providing
those services.
(9) (A) A regional center may, directly or through an agency
acting on behalf of the center, provide placement in, purchase of, or
follow-along services to persons with developmental disabilities in,
appropriate community living arrangements, including, but not
limited to, support service for consumers in homes they own or lease,
foster family placements, health care facilities, and licensed
community care facilities. In considering appropriate placement
alternatives for children with developmental disabilities, approval
by the child's parent or guardian shall be obtained before placement
is made.
(B) Effective July 1, 2012, notwithstanding any other law or
regulation, a regional center shall not purchase residential services
from a State Department of Social Services licensed 24-hour
residential care facility with a licensed capacity of 16 or more
beds. This prohibition on regional center purchase of residential
services shall not apply to any of the following:
(i) A residential facility with a licensed capacity of 16 or more
beds that has been approved to participate in the department's Home
and Community Based Services Waiver or another existing waiver
program or certified to participate in the Medi-Cal program.
(ii) A residential facility service provider that has a written
agreement and specific plan prior to July 1, 2012, with the vendoring
regional center to downsize the existing facility by transitioning
its residential services to living arrangements of 15 beds or less or
restructure the large facility to meet federal Medicaid eligibility
requirements on or before June 30, 2013.
(iii) A residential facility licensed as a mental health
rehabilitation center by the State Department of Mental Health or
successor agency under any of the following circumstances:
(I) The facility is eligible for Medicaid reimbursement.
(II) The facility has a department-approved plan in place by June
30, 2013, to transition to a program structure eligible for federal
Medicaid funding, and this transition will be completed by June 30,
2014. The department may grant an extension for the date by which the
transition will be completed if the facility demonstrates that it
has made significant progress toward transition, and states with
specificity the timeframe by which the transition will be completed
and the specified steps that will be taken to accomplish the
transition. A regional center may pay for the costs of care and
treatment of a consumer residing in the facility on June 30, 2012,
until June 30, 2013, inclusive, and, if the facility has a
department-approved plan in place by June 30, 2013, may continue to
pay the costs under this subparagraph until June 30, 2014, or until
the end of any period during which the department has granted an
extension.
(III) There is an emergency circumstance in which the regional
center determines that it cannot locate alternate federally eligible
services to meet the consumer's needs. Under such an emergency
circumstance, an assessment shall be completed by the regional center
as soon as possible and within 30 days of admission. An individual
program plan meeting shall be convened immediately following the
assessment to determine the services and supports needed for
stabilization and to develop a plan to transition the consumer from
the facility into the community. If transition is not expected within
90 days of admission, an individual program plan meeting shall be
held to discuss the status of transition and to determine if the
consumer is still in need of placement in the facility. Commencing
October 1, 2012, this determination shall be made after also
considering resource options identified by the statewide specialized
resource service. If it is determined that emergency services
continue to be necessary, the regional center shall submit an updated
transition plan that can cover a period of up to 90 days. In no
event shall placements under these emergency circumstances exceed 180
days.
(C) (i) Effective July 1, 2012, notwithstanding any other law or
regulation, a regional center shall not purchase new residential
services from, or place a consumer in, institutions for mental
disease, as described in Part 5 (commencing with Section 5900) of
Division 5, for which federal Medicaid funding is not available.
Effective July 1, 2013, this prohibition applies regardless of the
availability of federal funding.
(ii) The prohibition described in clause (i) shall not apply to
emergencies, as determined by the regional center, when a regional
center cannot locate alternate services to meet the consumer's needs.
As soon as possible within 30 days of admission due to an emergency,
an assessment shall be completed by the regional center. An
individual program plan meeting shall be convened immediately
following the assessment, to determine the services and supports
needed for stabilization and to develop a plan to transition the
consumer from the facility to the community. If transition is not
expected within 90 days of admission, an emergency program plan
meeting shall be held to discuss the status of the transition and to
determine if the consumer is still in need of placement in the
facility. If emergency services continue to be necessary, the
regional center shall submit an updated transition plan to the
department for an extension of up to 90 days. Placement shall not
exceed 180 days.
(iii) To the extent feasible, prior to any admission, the regional
center shall consider resource options identified by the statewide
specialized resource service established pursuant to subdivision (b)
of Section 4418.25.
(iv) The clients' rights advocate shall be notified of each
admission and individual program planning meeting pursuant to this
subparagraph and may participate in all individual program planning
meetings unless the consumer objects on his or her own behalf. For
purposes of this clause, notification to the clients' rights advocate
shall include a copy of the most recent comprehensive assessment or
updated assessment and the time, date, and location of the meeting,
and shall be provided as soon as practicable, but not less than seven
calendar days prior to the meeting.
(v) If a consumer is placed in an institution for mental disease
by another entity, the institution for mental disease shall inform
the regional center of the placement within five days of the date the
consumer is admitted. If an individual's records indicate that he or
she is a regional center consumer, the institution for mental
disease shall make every effort to contact the local regional center
or department to determine which regional center to provide notice.
As soon as possible within 30 days of admission to an institution for
mental disease due to an emergency pursuant to clause (ii), or
within 30 days of notification of admission to an institution for
mental disease by an entity other than a regional center, an
assessment shall be completed by the regional center.
(v)
(vi) Regional centers shall complete a comprehensive
assessment of any consumer residing in an institution for mental
disease as of July 1, 2012, for which federal Medicaid funding is not
available, and for any consumer residing in an institution for
mental disease as of July 1, 2013, without regard to federal funding.
The comprehensive assessment shall be completed prior to the
consumer's next scheduled individual program plan meeting and shall
include identification of the services and supports needed and the
timeline for identifying or developing those services needed to
transition the consumer back to the community. Effective October 1,
2012, the regional center shall also consider resource options
identified by the statewide specialized resource service. For each
individual program plan meeting convened pursuant to this
subparagraph, the clients' rights advocate for the regional center
shall be notified of the meeting and may participate in the meeting
unless the consumer objects on his or her own behalf. For purposes of
this clause, notification to the clients' rights advocate shall
include the time, date, and location of the meeting, and shall be
provided as soon as practicable, but not less than seven calendar
days prior to the meeting.
(D) A person with developmental disabilities placed by the
regional center in a community living arrangement shall have the
rights specified in this division. These rights shall be brought to
the person's attention by any means necessary to reasonably
communicate these rights to each resident, provided that, at a
minimum, the Director of Developmental Services prepare, provide, and
require to be clearly posted in all residential facilities and day
programs a poster using simplified language and pictures that is
designed to be more understandable by persons with intellectual
disabilities and that the rights information shall also be available
through the regional center to each residential facility and day
program in alternative formats, including, but not limited to, other
languages, braille, and audiotapes, when necessary to meet the
communication needs of consumers.
(E) Consumers are eligible to receive supplemental services
including, but not limited to, additional staffing, pursuant to the
process described in subdivision (d) of Section 4646. Necessary
additional staffing that is not specifically included in the rates
paid to the service provider may be purchased by the regional center
if the additional staff are in excess of the amount required by
regulation and the individual's planning team determines the
additional services are consistent with the provisions of the
individual program plan. Additional staff should be periodically
reviewed by the planning team for consistency with the individual
program plan objectives in order to determine if continued use of the
additional staff is necessary and appropriate and if the service is
producing outcomes consistent with the individual program plan.
Regional centers shall monitor programs to ensure that the additional
staff is being provided and utilized appropriately.
(10) Emergency and crisis intervention services including, but not
limited to, mental health services and behavior modification
services, may be provided, as needed, to maintain persons with
developmental disabilities in the living arrangement of their own
choice. Crisis services shall first be provided without disrupting a
person's living arrangement. If crisis intervention services are
unsuccessful, emergency housing shall be available in the person's
home community. If dislocation cannot be avoided, every effort shall
be made to return the person to his or her living arrangement of
choice, with all necessary supports, as soon as
possible.
(11) Among other service and support options, planning teams shall
consider the use of paid roommates or neighbors, personal
assistance, technical and financial assistance, and all other service
and support options which would result in greater self-sufficiency
for the consumer and cost-effectiveness to the state.
(12) When facilitation as specified in an individual program plan
requires the services of an individual, the facilitator shall be of
the consumer's choosing.
(13) The community support may be provided to assist individuals
with developmental disabilities to fully participate in community and
civic life, including, but not limited to, programs, services, work
opportunities, business, and activities available to persons without
disabilities. This facilitation shall include, but not be limited to,
any of the following:
(A) Outreach and education to programs and services within the
community.
(B) Direct support to individuals that would enable them to more
fully participate in their community.
(C) Developing unpaid natural supports when possible.
(14) When feasible and recommended by the individual program
planning team, for purposes of facilitating better and cost-effective
services for consumers or family members, technology, including
telecommunication technology, may be used in conjunction with other
services and supports. Technology in lieu of a consumer's in-person
appearances at judicial proceedings or administrative due process
hearings may be used only if the consumer or, when appropriate, the
consumer's parent, legal guardian, conservator, or authorized
representative, gives informed consent. Technology may be used in
lieu of, or in conjunction with, in-person training for providers, as
appropriate.
(15) Other services and supports may be provided as set forth in
Sections 4685, 4686, 4687, 4688, and 4689, when necessary.
(16) Notwithstanding any other law or regulation, effective July
1, 2009, regional centers shall not purchase experimental treatments,
therapeutic services, or devices that have not been clinically
determined or scientifically proven to be effective or safe or for
which risks and complications are unknown. Experimental treatments or
therapeutic services include experimental medical or nutritional
therapy when the use of the product for that purpose is not a general
physician practice. For regional center consumers receiving these
services as part of their individual program plan (IPP) or
individualized family service plan (IFSP) on July 1, 2009, this
prohibition shall apply on August 1, 2009.
(b) (1) Advocacy for, and protection of, the civil, legal, and
service rights of persons with developmental disabilities as
established in this division.
(2) Whenever the advocacy efforts of a regional center to secure
or protect the civil, legal, or service rights of any of its
consumers prove ineffective, the regional center or the person with
developmental disabilities or his or her parents, legal guardian, or
other representative may request advocacy assistance from the state
council.
(c) The regional center may assist consumers and families
directly, or through a provider, in identifying and building circles
of support within the community.
(d) In order to increase the quality of community services and
protect consumers, the regional center shall, when appropriate, take
either of the following actions:
(1) Identify services and supports that are ineffective or of poor
quality and provide or secure consultation, training, or technical
assistance services for any agency or individual provider to assist
that agency or individual provider in upgrading the quality of
services or supports.
(2) Identify providers of services or supports that may not be in
compliance with local, state, and federal statutes and regulations
and notify the appropriate licensing or regulatory authority to
investigate the possible noncompliance.
(e) When necessary to expand the availability of needed services
of good quality, a regional center may take actions that include, but
are not limited to, the following:
(1) Soliciting an individual or agency by requests for proposals
or other means, to provide needed services or supports not presently
available.
(2) Requesting funds from the Program Development Fund, pursuant
to Section 4677, or community placement plan funds designated from
that fund, to reimburse the startup costs needed to initiate a new
program of services and supports.
(3) Using creative and innovative service delivery models,
including, but not limited to, natural supports.
(f) Except in emergency situations, a regional center shall not
provide direct treatment and therapeutic services, but shall utilize
appropriate public and private community agencies and service
providers to obtain those services for its consumers.
(g) When there are identified gaps in the system of services and
supports or when there are identified consumers for whom no provider
will provide services and supports contained in his or her individual
program plan, the department may provide the services and supports
directly.
(h) At least annually, regional centers shall provide the
consumer, his or her parents, legal guardian, conservator, or
authorized representative a statement of services and supports the
regional center purchased for the purpose of ensuring that they are
delivered. The statement shall include the type, unit, month, and
cost of services and supports purchased.
SEC. 11. Section 4681.6 of the Welfare
and Institutions Code is amended to read:
4681.6. (a) Notwithstanding any other law or regulation,
commencing July 1, 2008:
(1) A regional center shall not pay an existing residential
service provider, for services where rates are determined through a
negotiation between the regional center and the provider, a rate
higher than the rate in effect on June 30, 2008, unless the increase
is required by a contract between the regional center and the vendor
that is in effect on June 30, 2008, or the regional center
demonstrates that the approval is necessary to protect the consumer's
health or safety and the department has granted prior written
authorization.
(2) A regional center shall not negotiate a rate with a new
residential service provider, for services where rates are determined
through a negotiation between the regional center and the provider,
that is higher than the regional center's median rate for the same
service code and unit of service, or the statewide median rate for
the same service code and unit of service, whichever is lower. The
unit of service designation shall conform with an existing regional
center designation or, if none exists, a designation used to
calculate the statewide median rate for the same service. The
regional center shall annually certify to the department its median
rate for each negotiated rate service code, by designated unit of
service. This certification shall be subject to verification through
the department's biennial fiscal audit of the regional center.
(b) Notwithstanding subdivision (a), commencing July 1, 2014,
regional centers may negotiate a rate adjustment with residential
service providers regarding rates that are otherwise restricted
pursuant to subdivision (a), if the adjustment is necessary in order
to pay employees no less than the minimum wage as established by
Section 1182.12 of the Labor Code, as amended by Chapter 351 of the
Statutes of 2013, and only for the purpose of adjusting payroll costs
associated with the minimum wage increase. The rate adjustment shall
be specific to the unit of service designation that is affected by
the increased minimum wage, shall be specific to payroll costs
associated with any increase necessary to adjust employee pay only to
the extent necessary to bring pay into compliance with the increased
state minimum wage, and shall not be used as a general wage
enhancement for employees paid above the minimum wage. Regional
centers shall maintain documentation on the process to determine, and
the rationale for granting, any rate adjustment associated with the
minimum wage increase.
(c) Notwithstanding subdivision (a), commencing July 1, 2015,
regional centers may negotiate a rate adjustment with residential
service providers regarding rates that are otherwise restricted
pursuant to subdivision (a), if the adjustment is necessary to
implement Article 1.5 (commencing with Section 245) of Chapter 1 of
Part 1 of Division 2 of the Labor Code, as added by Chapter 317 of
the Statutes of 2014. The rate adjustment may be applied only if a
minimum of 24 hours or three days of paid sick leave per year was not
a benefit provided to employees as of June 30, 2015, and shall be
specific to payroll costs associated with any increase necessary to
compensate an employee up to a maximum of 24 hours or three days of
paid sick leave in each year of employment.
(c)
(d) For purposes of this section, "residential service
provider" includes Adult Residential Facilities for Persons with
Special Health Care Needs, as described in Section 4684.50.
(d)
(e) This section shall not apply to those services for
which rates are determined by the State Department of Health Care
Services, or the State Department of Developmental Services, or are
usual and customary.
SEC. 12. Section 4684.81 of the Welfare
and Institutions Code is amended to read:
4684.81. (a) The department shall implement a pilot project using
community placement plan funds, as appropriated in the State
Department of Developmental Services' annual budget, to test the
effectiveness of providing enhanced behavioral supports in homelike
community settings. The enhanced behavioral supports homes shall be
for purposes of providing intensive behavioral services and supports
to adults and children with developmental disabilities who need
intensive services and supports due to challenging behaviors that
cannot be managed in a community setting without the availability of
enhanced behavioral services and supports, and who are at risk of
institutionalization or out-of-state placement, or are transitioning
to the community from a developmental center, other state-operated
residential facility, institution for mental disease, or out-of-state
placement.
(b) An enhanced behavioral supports home may only be established
in an adult residential facility or a group home approved through a
regional center community placement plan pursuant to Section 4418.25.
(c) No more than six enhanced Enhanced
behavioral supports homes may be approved by the State
Department of Developmental Services each fiscal year in which the
pilot program is in effect and to the extent funding is available for
this purpose, each for no more than four individuals with
developmental disabilities. The homes shall be located throughout the
state, as determined by the State Department of Developmental
Services, based on regional center requests.
(d) Each enhanced behavioral supports home shall be licensed as an
adult residential facility or a group home pursuant to the
California Community Care Facilities Act (Chapter 3 (commencing with
Section 1500) of Division 2 of the Health and Safety Code) and
certified by the State Department of Developmental Services, shall
exceed the minimum requirements for a Residential Facility Service
Level 4-i pursuant to Sections 56004 and 56013 of Title 17 of the
California Code of Regulations, and shall meet all applicable
statutory and regulatory requirements applicable to a facility
licensed as an adult residential facility or a group home for
facility licensing, seclusion, and restraint, including Division 1.5
(commencing with Section 1180) of the Health and Safety Code, and the
use of behavior modification interventions, subject to any
additional requirements applicable to enhanced behavioral supports
homes established by statute or by regulation promulgated pursuant to
this article and Article 9.5 (commencing with Section 1567.61) of
Chapter 3 of Division 2 of the Health and Safety Code.
(e) A regional center shall not place a consumer in an enhanced
behavioral supports home unless the program is certified by the State
Department of Developmental Services and the facility is licensed by
the State Department of Social Services.
(f) The State Department of Developmental Services shall be
responsible for granting the certificate of program approval for an
enhanced behavioral supports home.
(g) The State Department of Developmental Services may, pursuant
to Section 4684.85, decertify any enhanced behavioral supports home
that does not comply with program requirements. Upon decertification
of an enhanced behavioral supports home, the State Department of
Developmental Services shall report the decertification to the State
Department of Social Services. The State Department of Social
Services shall revoke the license of the enhanced behavioral supports
home that has been decertified pursuant to Section 1550 of the
Health and Safety Code.
(h) If the State Department of Developmental Services determines
that urgent action is necessary to protect a consumer residing in an
enhanced behavioral supports home from physical or mental abuse,
abandonment, or any other substantial threat to the consumer's health
and safety, the State Department of Developmental Services may
request that the regional center or centers remove the consumer from
the enhanced behavioral supports home or direct the regional center
or centers to obtain alternative or additional services for the
consumers within 24 hours of that determination. When possible, an
individual program plan (IPP) meeting shall be convened to determine
the appropriate action pursuant to this section. In any case, an IPP
meeting shall be convened within 30 days following an action pursuant
to this section.
(i) Enhanced behavioral supports homes shall have a facility
program plan approved by the State Department of Developmental
Services.
(1) The facility program plan approved by the State Department of
Developmental Services shall be submitted to the State Department of
Social Services for inclusion in the facility plan of operation.
(2) The vendoring regional center and each consumer's regional
center shall have joint responsibility for monitoring and evaluating
the services provided in the enhanced behavioral supports home.
Monitoring shall include at least quarterly, or more frequently if
specified in the consumer's individual program plan, face-to-face,
onsite case management visits with each consumer by his or her
regional center and at least quarterly quality assurance visits by
the vendoring regional center. The State Department of Developmental
Services shall monitor and ensure the regional centers' compliance
with their monitoring responsibilities.
(j) The State Department of Developmental Services shall establish
by regulation a rate methodology for enhanced behavioral supports
homes that includes a fixed facility component for residential
services and an individualized services and supports component based
on each consumer's needs as determined through the individual program
plan process, which may include assistance with transitioning to a
less restrictive community residential setting.
(k) (1) The established facility rate for a full month of service,
as defined in regulations adopted pursuant to this article, shall be
paid based on the licensed capacity of the facility once the
facility reaches maximum capacity, despite the temporary absence of
one or more consumers from the facility or subsequent temporary
vacancies created by consumers moving from the facility. Prior to the
facility reaching licensed capacity, the facility rate shall be
prorated based on the number of consumers residing in the facility.
When a consumer is temporarily absent from the facility, including
when a consumer is in need for inpatient care in a health facility,
as defined in subdivision (a), (b), or (c) of Section 1250 of the
Health and Safety Code, the regional center may, based on consumer
need, continue to fund individual services, in addition to paying the
facility rate. Individual consumer services funded by the regional
center during a consumer's absence from the facility shall be
approved by the regional center director and shall only be approved
in 14-day increments. The regional center shall maintain
documentation of the need for these services and the regional center
director's approval.
(2) An enhanced behavioral supports home using delayed egress
devices, in compliance with Section 1531.1 of the Health and Safety
Code, may utilize secured perimeters, in compliance with Section
1531.15 of the Health and Safety Code and applicable regulations. No
more than two enhanced behavioral supports homes using delayed egress
devices in combination with secured perimeters may be certified by
the State Department of Developmental Services during the first year
of the pilot program, one in northern California and one in southern
California, and no more than one additional home using delayed egress
devices in combination with a secured perimeter may be certified by
the State Department of Developmental Services in each subsequent
year of the pilot program. No more than six enhanced behavioral
supports homes that use delayed egress devices in combination with a
secured perimeter shall be certified during the pilot program.
Enhanced behavioral supports homes shall not be counted for purposes
of the statewide limit established in regulations on the total number
of beds permitted in homes with delayed egress devices in
combination with secured perimeters pursuant to subdivision (k) of
Section 1531.15 of the Health and Safety Code. The department shall
make reasonable efforts to include enhanced behavioral supports homes
within the statewide limit.
SEC. 13. Section 4685.8 of the Welfare
and Institutions Code is amended to read:
4685.8. (a) The department shall implement a statewide
Self-Determination Program. The Self-Determination Program shall be
available in every regional center catchment area to provide
participants and their families, within an individual budget,
increased flexibility and choice, and greater control over decisions,
resources, and needed and desired services and supports to implement
their IPP. The statewide Self-Determination Program shall be phased
in over three years, and during this phase-in period, shall serve up
to 2,500 regional center consumers, inclusive of the remaining
participants in the self-determination pilot projects authorized
pursuant to Section 13 of Chapter 1043 of the Statutes of 1998, as
amended, and Article 4 (commencing with Section 4669.2) of Chapter 5.
Following the phase-in period, the program shall be available on a
voluntary basis to all regional center consumers
consumers, including residents in developmental centers who are
moving to the community, who are eligible for the
Self-Determination Program. The program shall be available to
individuals who reflect the disability, ethnic, and geographic
diversity of the state. The Department of Finance may approve,
upon a request from the department and no sooner than 30 days
following notification to the Joint Legislative Budget Committee, an
increase to the number of consumers served by the Self-Determination
Program before the end of the three-year phase-in period.
(b) The department department, in
establishing the statewide program program,
shall do both of the following:
(1) For the first three years of the Self-Determination Program,
determine, as part of the contracting process described in Sections
4620 and 4629, the number of participants each regional center shall
serve in its Self-Determination Program. To ensure that the program
is available on an equitable basis to participants in all regional
center catchment areas, the number of Self-Determination Program
participants in each regional center shall be based on the relative
percentage of total consumers served by the regional centers minus
any remaining participants in the self-determination pilot projects
authorized pursuant to Section 13 of Chapter 1043 of the Statutes of
1998, as amended, and Article 4 (commencing with Section 4669.2) of
Chapter 5 or another equitable basis.
(2) Ensure all of the following:
(A) Oversight of expenditure of self-determined funds and the
achievement of participant outcomes over time.
(B) Increased participant control over which services and supports
best meet his or her needs and the IPP objectives. A participant's
unique support system may include the purchase of existing service
offerings from service providers or local businesses, hiring his or
her own support workers, or negotiating unique service arrangements
with local community resources.
(C) Comprehensive person-centered planning, including an
individual budget and services that are outcome based.
(D) Consumer and family training to ensure understanding of the
principles of self-determination, the planning process, and the
management of budgets, services, and staff.
(E) Choice of independent facilitators who can assist with the
person-centered planning process and choice of financial management
services providers vendored by regional centers who can assist with
payments and provide employee-related services.
(F) Innovation that will more effectively allow participants to
achieve their goals.
(c) For purposes of this section, the following definitions apply:
(1) "Financial management services" means services or functions
that assist the participant to manage and direct the distribution of
funds contained in the individual budget, and ensure that the
participant has the financial resources to implement his or her IPP
throughout the year. These may include bill paying services and
activities that facilitate the employment of service and support
workers by the participant, including, but not limited to, fiscal
accounting, tax withholding, compliance with relevant state and
federal employment laws, assisting the participant in verifying
provider qualifications, including criminal background checks, and
expenditure reports. The financial management services provider shall
meet the requirements of Sections 58884, 58886, and 58887 of Title
17 of the California Code of Regulations and other specific
qualifications established by the department. The costs of financial
management services shall be paid by the participant out of his or
her individual budget, except for the cost of obtaining the criminal
background check specified in subdivision (w).
(2) "Independent facilitator" means a person, selected and
directed by the participant, who is not otherwise providing services
to the participant pursuant to his or her IPP and is not employed by
a person providing services to the participant. The independent
facilitator may assist the participant in making informed decisions
about the individual budget, and in locating, accessing, and
coordinating services and supports consistent with the participant's
IPP. He or she is available to assist in identifying immediate and
long-term needs, developing options to meet those needs, leading,
participating, or advocating on behalf of the participant in the
person-centered planning process and development of the IPP, and
obtaining identified services and supports. The cost of the
independent facilitator, if any, shall be paid by the participant out
of his or her individual budget. An independent facilitator shall
receive training in the principles of self-determination, the
person-centered planning process, and the other responsibilities
described in this paragraph at his or her own cost.
(3) "Individual budget" means the amount of regional center
purchase of service funding available to the participant for the
purchase of services and supports necessary to implement the IPP. The
individual budget shall be determined using a fair, equitable, and
transparent methodology.
(4) "IPP" means individual program plan, as described in Section
4646.
(5) "Participant" means an individual, and when appropriate, his
or her parents, legal guardian or conservator, or authorized
representative, who has been deemed eligible for, and has voluntarily
agreed to participate in, the Self-Determination Program.
(6) "Self-determination" means a voluntary delivery system
consisting of a defined and comprehensive mix of services and
supports, selected and directed by a participant through
person-centered planning, in order to meet the objectives in his or
her IPP. Self-determination services and supports are designed to
assist the participant to achieve personally defined outcomes in
community settings that promote inclusion. The Self-Determination
Program shall only fund services and supports provided pursuant to
this division that the federal Centers for Medicare and Medicaid
Services determines are eligible for federal financial participation.
(d) Participation in the Self-Determination Program is fully
voluntary. A participant may choose to participate in, and may choose
to leave, the Self-Determination Program at any time. A regional
center shall not require or prohibit participation in the
Self-Determination Program as a condition of eligibility for, or the
delivery of, services and supports otherwise available under this
division. Participation in the Self-Determination Program shall be
available to any regional center consumer who meets the following
eligibility requirements:
(1) The participant has a developmental disability, as defined in
Section 4512, and is receiving services pursuant to this division.
(2) The consumer does not live in a licensed long-term health care
facility, as defined in paragraph (44) of subdivision (a) of Section
54302 of Title 17 of the California Code of Regulations. An
individual, and when appropriate his or her parent, legal guardian or
conservator, or authorized representative, who is not eligible to
participate in the Self-Determination Program pursuant to this
paragraph may request that the regional center provide
person-centered planning services in order to make arrangements for
transition to the Self-Determination Program, provided that he or she
is reasonably expected to transition to the community within 90
days. In that case, the regional center shall initiate
person-centered planning services within 60 days of that request.
(3) The participant
agrees to all of the following terms and conditions:
(A) The participant shall receive an orientation to the
Self-Determination Program prior to enrollment, which includes the
principles of self-determination, the role of the independent
facilitator and the financial management services provider,
person-centered planning, and development of a budget.
(B) The participant shall utilize the services and supports
available within the Self-Determination Program only when generic
services and supports are not available.
(C) The participant shall only purchase services and supports
necessary to implement his or her IPP and shall comply with any and
all other terms and conditions for participation in the
Self-Determination Program described in this section.
(D) The participant shall manage Self-Determination Program
services and supports within his or her individual budget.
(E) The participant shall utilize the services of a financial
management services provider of his or her own choosing and who is
vendored by a regional center.
(F) The participant may utilize the services of an independent
facilitator of his or her own choosing for the purpose of providing
services and functions as described in paragraph (2) of subdivision
(c). If the participant elects not to use an independent facilitator,
he or she may use his or her regional center service coordinator to
provide the services and functions described in paragraph (2) of
subdivision (c).
(e) A participant who is not Medi-Cal eligible may participate in
the Self-Determination Program and receive self-determination
services and supports if all other program eligibility requirements
are met and the services and supports are otherwise eligible for
federal financial participation.
(f) An individual receiving services and supports under a
self-determination pilot project authorized pursuant to Section 13 of
Chapter 1043 of the Statutes of 1998, as amended, or pursuant to
Article 4 (commencing with Section 4669.2) of Chapter 5, may elect to
continue to receive self-determination services and supports
pursuant to this section or the regional center shall provide for the
participant's transition from the self-determination pilot program
to other services and supports. This transition shall include the
development of a new IPP that reflects the services and supports
necessary to meet the individual's needs. The regional center shall
ensure that there is no gap in services and supports during the
transition period.
(g) The additional federal financial participation funds generated
by the former participants of the self-determination pilot projects
authorized pursuant to Section 13 of Chapter 1043 of the Statutes of
1998, as amended, or pursuant to Article 4 (commencing with Section
4669.2) of Chapter 5, shall be used as follows:
(1) First, to offset the cost to the department for the criminal
background check conducted pursuant to subdivision (w),
(w) and other administrative costs incurred by
the department in implementing the Self-Determination Program.
(2) With the remaining funds, to offset the costs to the regional
centers in implementing the Self-Determination Program, including,
but not limited to, operations costs for caseload ratio enhancement,
training for regional center staff, costs associated with the
participant's initial person-centered planning meeting, the
development of the participant's initial individual budget, and the
costs associated with training consumers and family members.
(h) If at any time during participation in the Self-Determination
Program a regional center determines that a participant is no longer
eligible to continue in, or a participant voluntarily chooses to
exit, the Self-Determination Program, the regional center shall
provide for the participant's transition from the Self-Determination
Program to other services and supports. This transition shall include
the development of a new IPP that reflects the services and supports
necessary to meet the individual's needs. The regional center shall
ensure that there is no gap in services and supports during the
transition period.
(i) An individual determined to be ineligible for or who
voluntarily exits the Self-Determination Program shall be permitted
to return to the Self-Determination Program upon meeting all
applicable eligibility criteria and upon approval of the participant'
s planning team, as described in subdivision (j) of Section 4512. An
individual who has voluntarily exited the Self-Determination Program
shall not return to the program for at least 12 months. During the
first three years of the program, the individual's right to return to
the program is conditioned on his or her regional center not having
reached the participant cap imposed by paragraph (1) of subdivision
(b).
(j) An individual who participates in the Self-Determination
Program may elect to continue to receive self-determination services
and supports if he or she transfers to another regional center
catchment area, provided that he or she remains eligible for the
Self-Determination Program pursuant to subdivision (d). The balance
of the participant's individual budget shall be reallocated to the
regional center to which he or she transfers.
(k) The IPP team shall utilize the person-centered planning
process to develop the IPP for a participant. The IPP shall detail
the goals and objectives of the participant that are to be met
through the purchase of participant-selected services and supports.
The IPP team shall determine the individual budget to ensure the
budget assists the participant to achieve the outcomes set forth in
his or her IPP and ensures his or her health and safety. The
completed individual budget shall be attached to the IPP.
(l) The participant shall implement his or her IPP, including
choosing and purchasing the services and supports allowable under
this section necessary to implement the plan. A participant is exempt
from the cost control restrictions regarding the purchases of
services and supports pursuant to Sections 4648.5 and 4686.5. A
regional center shall not prohibit the purchase of any service or
support that is otherwise allowable under this section.
(m) A participant shall have all the rights established in
Sections 4646 to 4646.6, inclusive, and Chapter 7 (commencing with
Section 4700).
(n) (1) Except as provided in paragraph (4), the IPP team shall
determine the initial and any revised individual budget for the
participant using the following methodology:
(A) (i) Except as specified in clause (ii), for a participant who
is a current consumer of the regional center, his or her individual
budget shall be the total amount of the most recently available 12
months of purchase of service expenditures for the participant.
(ii) An adjustment may be made to the amount specified in clause
(i) if both of the following occur:
(I) The IPP team determines that an adjustment to this amount is
necessary due to a change in the participant's circumstances, needs,
or resources that would result in an increase or decrease in purchase
of service expenditures, or the IPP team identifies prior needs or
resources that were unaddressed in the IPP, which would have resulted
in an increase or decrease in purchase of service expenditures.
(II) The regional center certifies on the individual budget
document that regional center expenditures for the individual budget,
including any adjustment, would have occurred regardless of the
individual's participation in the Self-Determination Program.
(iii) For purposes of clauses (i) and (ii), the amount of the
individual budget shall not be increased to cover the cost of the
independent facilitator or the financial management services.
(B) For a participant who is either newly eligible for regional
center services or who does not have 12 months of purchase service
expenditures, his or her individual budget shall be calculated as
follows:
(i) The IPP team shall identify the services and supports needed
by the participant and available resources, as required by Section
4646.
(ii) The regional center shall calculate the cost of providing the
services and supports to be purchased by the regional center by
using the average cost paid by the regional center for each service
or support unless the regional center determines that the consumer
has a unique need that requires a higher or lower cost. The regional
center shall certify on the individual budget document that this
amount would have been expended using regional center purchase of
service funds regardless of the individual's participation in the
Self-Determination Program.
(iii) For purposes of clauses (i) and (ii), the amount of the
individual budget shall not be increased to cover the cost of the
independent facilitator or the financial management services.
(2) The amount of the individual budget shall be available to the
participant each year for the purchase of program services and
supports. An individual budget shall be calculated no more than once
in a 12-month period, unless revised to reflect a change in
circumstances, needs, or resources of the participant using the
process specified in clause (ii) of subparagraph (A) of paragraph
(1).
(3) The individual budget shall be assigned to uniform budget
categories developed by the department in consultation with
stakeholders and distributed according to the timing of the
anticipated expenditures in the IPP and in a manner that ensures that
the participant has the financial resources to implement his or her
IPP throughout the year.
(4) The department, in consultation with stakeholders, may develop
alternative methodologies for individual budgets that are computed
in a fair, transparent, and equitable manner and are based on
consumer characteristics and needs, and that include a method for
adjusting individual budgets to address a participant's change in
circumstances or needs.
(o) Annually, participants may transfer up to 10 percent of the
funds originally distributed to any budget category set forth in
paragraph (3) of subdivision (n) to another budget category or
categories. Transfers in excess of 10 percent of the original amount
allocated to any budget category may be made upon the approval of the
regional center or the participant's IPP team.
(p) Consistent with the implementation date of the IPP, the IPP
team shall annually ascertain from the participant whether there are
any circumstances or needs that require a change to the annual
individual budget. Based on that review, the IPP team shall calculate
a new individual budget consistent with the methodology identified
in subdivision (n).
(q) (1) On or before December 31, 2014, the department shall apply
for federal Medicaid funding for the Self-Determination Program by
doing one or more of the following:
(A) Applying for a state plan amendment.
(B) Applying for an amendment to a current home- and
community-based waiver for individuals with developmental
disabilities.
(C) Applying for a new waiver.
(D) Seeking to maximize federal financial participation through
other means.
(2) To the extent feasible, the state plan amendment, waiver, or
other federal request described in paragraph (1) shall incorporate
the eligibility requirements, benefits, and operational requirements
set forth in this section. Except for the provisions of subdivisions
(k), (m), (p), and this subdivision, the department may modify
eligibility requirements, benefits, and operational requirements as
needed to secure approval of federal funding.
(3) Contingent upon approval of federal funding, the
Self-Determination Program shall be established.
(r) (1) The department, as it determines necessary, may adopt
regulations to implement the procedures set forth in this section.
Any regulations shall be adopted in accordance with the requirements
of Chapter 3.5 (commencing with Section 11340) of Part 1 of Division
3 of Title 2 of the Government Code.
(2) Notwithstanding paragraph (1) and Chapter 3.5 (commencing with
Section 11340) of Part 1 of Division 3 of Title 2 of the Government
Code, and only to the extent that all necessary federal approvals are
obtained, the department, without taking any further regulatory
action, shall implement, interpret, or make specific this section by
means of program directives or similar instructions until the time
regulations are adopted. It is the intent of the Legislature that the
department be allowed this temporary authority as necessary to
implement program changes only until completion of the regulatory
process.
(s) The department, in consultation with stakeholders, shall
develop informational materials about the Self-Determination Program.
The department shall ensure that regional centers are trained in the
principles of self-determination, the mechanics of the
Self-Determination Program, and the rights of consumers and families
as candidates for, and participants in, the Self-Determination
Program.
(t) Each regional center shall be responsible for implementing the
Self-Determination Program as a term of its contract under Section
4629. As part of implementing the program, the regional center shall
do both of the following:
(1) Contract with local consumer or family-run organizations to
conduct outreach through local meetings or forums to consumers and
their families to provide information about the Self-Determination
Program and to help ensure that the program is available to a diverse
group of participants, with special outreach to underserved
communities.
(2) Collaborate with the local consumer or family-run
organizations identified in paragraph (1) to jointly conduct training
about the Self-Determination Program.
(u) The financial management services provider shall provide the
participant and the regional center service coordinator with a
monthly individual budget statement that describes the amount of
funds allocated by budget category, the amount spent in the previous
30-day period, and the amount of funding that remains available under
the participant's individual budget.
(v) Only the financial management services provider is required to
apply for vendorization in accordance with Subchapter 2 (commencing
with Section 54300) of Chapter 3 of Division 2 of Title 17 of the
California Code of Regulations, Regulations
for the Self-Determination Program. All other service and
support providers shall not be on the federal debarment list and
shall have applicable state licenses, certifications, or other state
required documentation, including documentation of any other
qualifications required by the department, but are exempt from the
vendorization requirements set forth in Title 17 of the California
Code of Regulations when serving participants in the
Self-Determination Program.
(w) To protect the health and safety of participants in the
Self-Determination Program, the department shall require a criminal
background check in accordance with all of the following:
(1) The department shall issue a program directive that identifies
nonvendored providers of services and supports who shall obtain a
criminal background check pursuant to this subdivision. At a minimum,
these staff shall include both of the following:
(A) Individuals who provide direct personal care services to a
participant.
(B) Other nonvendored providers of services and supports for whom
a criminal background check is requested by a participant or the
participant's financial management service.
(2) Subject to the procedures and requirements of this
subdivision, the department shall administer criminal background
checks consistent with the department's authority and the process
described in Sections 4689.2 to 4689.6, inclusive.
(3) The department shall electronically submit to the Department
of Justice fingerprint images and related information required by the
Department of Justice of nonvendored providers of services and
supports, as specified in paragraph (1), for purposes of obtaining
information as to the existence and content of a record of state or
federal convictions and state or federal arrests and also information
as to the existence and content of a record of state or federal
arrests for which the Department of Justice establishes that the
person is free on bail or on his or her recognizance pending trial or
appeal.
(4) When received, the Department of Justice shall forward to the
Federal Bureau of Investigation requests for federal summary criminal
history information received pursuant to this section. The
Department of Justice shall review the information returned from the
Federal Bureau of Investigation and compile and disseminate a
response to the department.
(5) The Department of Justice shall provide a state or federal
response to the department pursuant to paragraph (1) of subdivision
(p) of Section 11105 of the Penal Code.
(6) The department shall request from the Department of Justice
subsequent notification service, as provided pursuant to Section
11105.2 of the Penal Code, for persons described in paragraph (1).
(7) The Department of Justice shall charge a fee sufficient to
cover the cost of processing the request described in this
subdivision.
(8) The fingerprints of any provider of services and supports who
is required to obtain a criminal background check shall be submitted
to the Department of Justice prior to employment. The costs of the
fingerprints and the financial management service's administrative
cost authorized by the department shall be paid by the services and
supports provider or his or her employing agency. Any administrative
costs incurred by the department pursuant to this subdivision shall
be offset by the funds specified in subdivision (g).
(9) If the criminal record information report shows a criminal
history, the department shall take the steps specified in Section
4689.2. The department may prohibit a provider of services and
supports from becoming employed, or continuing to be employed, based
on the criminal background check, as authorized in Section 4689.6.
The provider of services and supports who has been denied employment
shall have the rights set forth in Section 4689.6.
(10) The department may utilize a current department-issued
criminal record clearance to enable a provider to serve more than one
participant, as long as the criminal record clearance has been
processed through the department and no subsequent arrest
notifications have been received relative to the cleared applicant.
(11) Consistent with subdivision (h) of Section 4689.2, the
participant or financial management service that denies or terminates
employment based on written notification from the department shall
not incur civil liability or unemployment insurance liability.
(x) To ensure the effective implementation of the
Self-Determination Program and facilitate the sharing of best
practices and training materials commencing with the implementation
of the Self-Determination Program, local and statewide advisory
committees shall be established as follows:
(1) Each regional center shall establish a local volunteer
advisory committee to provide oversight of the Self-Determination
Program. The regional center and the State Council on Developmental
Disabilities shall each appoint one-half of the membership of the
committee. The committee shall consist of the regional center clients'
rights advocate, consumers, family members, and other advocates, and
community leaders. A majority of the committee shall be consumers
and their family members. The committee shall reflect the
multicultural diversity and geographic profile of the catchment area.
The committee shall review the development and ongoing progress of
the Self-Determination Program, including whether the program
advances the principles of self-determination and is operating
consistent with the requirements of this section, and may make
ongoing recommendations for improvement to the regional center and
the department.
(2) The State Council on Developmental Disabilities shall form a
volunteer committee, to be known as the Statewide Self-Determination
Advisory Committee, comprised of the chairs of the 21 local advisory
committees or their designees. The council shall convene the
Statewide Self-Determination Advisory Committee twice annually, or
more frequently in the sole discretion of the council. The Statewide
Self-Determination Advisory Committee shall meet by teleconference or
other means established by the council,
council to identify self-determination best practices,
effective consumer and family training materials, implementation
concerns, systemic issues, ways to enhance the program, and
recommendations regarding the most effective method for participants
to learn of individuals who are available to provide services and
supports. The council shall synthesize information received from the
Statewide Self-Determination Advisory Committee, local advisory
committees, and other sources, shall share the
information with consumers, families, regional centers, and the
department, and shall make recommendations, as
appropriate, to increase the program's effectiveness in furthering
the principles of self-determination.
(y) Commencing January 10, 2017, the department shall annually
provide the following information to the appropriate policy and
fiscal committees of the Legislature:
(1) Number and characteristics of participants, by regional
center. center, including the number of
participants who entered the program upon movement from a
developmental center.
(2) Types and amount of services and supports purchased under the
Self-Determination Program, by regional center.
(3) Range and average of individual budgets, by regional center,
including adjustments to the budget to address the adjustments
permitted in clause (ii) of subparagraph (A) of paragraph (1) of
subdivision (n).
(4) The number and outcome of appeals concerning individual
budgets, by regional center.
(5) The number and outcome of fair hearing appeals, by regional
center.
(6) The number of participants who voluntarily withdraw from the
Self-Determination Program and a summary of the reasons why, by
regional center.
(7) The number of participants who are subsequently determined to
no longer be eligible for the Self-Determination Program and a
summary of the reasons why, by regional center.
(z) (1) The State Council on Developmental Disabilities, in
collaboration with the protection and advocacy agency identified in
Section 4900 and the federally funded University Centers for
Excellence in Developmental Disabilities Education, Research, and
Service, may work with regional centers to survey participants
regarding participant satisfaction under the Self-Determination
Program and, when data is available, the traditional service delivery
system, including the proportion of participants who report that
their choices and decisions are respected and supported and who
report that they are able to recruit and hire qualified service
providers, and to identify barriers to participation and
recommendations for improvement.
(2) The council, in collaboration with the protection and advocacy
agency identified in Section 4900 and the federally funded
University Centers for Excellence in Developmental Disabilities
Education, Research, and Service, shall issue a report to the
Legislature, in compliance with Section 9795 of the Government Code,
no later than three years following the approval of the federal
funding on the status of the Self-Determination Program authorized by
this section, and provide recommendations to enhance the
effectiveness of the program. This review shall include the program's
effectiveness in furthering the principles of self-determination,
including all of the following:
(A) Freedom, which includes the ability of adults with
developmental disabilities to exercise the same rights as all
citizens to establish, with freely chosen supporters, family and
friends, where they want to live, with whom they want to live, how
their time will be occupied, and who supports them; and for families
to have the freedom to receive unbiased assistance of their own
choosing when developing a plan and to select all personnel and
supports to further the life goals of a minor child.
(B) Authority, which includes the ability of a person with a
disability, or family, to control a certain sum of dollars in order
to purchase services and supports of their choosing.
(C) Support, which includes the ability to arrange resources and
personnel, both formal and informal, that will assist a person with a
disability to live a life in his or her community that is rich in
community participation and contributions.
(D) Responsibility, which includes the ability of participants to
take responsibility for decisions in their own lives and to be
accountable for the use of public dollars, and to accept a valued
role in their community through, for example, competitive employment,
organizational affiliations, spiritual development, and general
caring of others in their community.
(E) Confirmation, which includes confirmation of the critical role
of participants and their families in making decisions in their own
lives and designing and operating the system that they rely on.
SEC. 14. Section 4691.6 of the Welfare
and Institutions Code is amended to read:
4691.6. (a) Notwithstanding any other law or regulation,
commencing July 1, 2006, the community-based day program, work
activity program, and in-home respite service agency rate schedules
authorized by the department and in operation June 30, 2006, shall be
increased by 3 percent, subject to funds specifically appropriated
for this increase in the Budget Act of 2006. The increase shall be
applied as a percentage, and the percentage shall be the same for all
providers. Any subsequent increase shall be governed by subdivisions
(b), (c), (d), (e), (f), (g), and (h), (i),
and (j), and Section 4691.9.
(b) Notwithstanding any other law or regulation, the department
shall not establish any permanent payment rate for a community-based
day program or in-home respite service agency provider that has a
temporary payment rate in effect on June 30, 2008, if the permanent
payment rate would be greater than the temporary payment rate in
effect on or after June 30, 2008, unless the regional center
demonstrates to the department that the permanent payment rate is
necessary to protect the consumers' health or safety.
(c) Notwithstanding any other law or regulation, neither the
department nor any regional center shall approve any program design
modification or revendorization for
a community-based day program or in-home respite
service agency provider that would result in an increase in the rate
to be paid to the vendor from the rate that is in effect on or after
June 30, 2008, unless the regional center demonstrates that the
program design modification or revendorization is necessary to
protect the consumers' health or safety and the department has
granted prior written authorization.
(d) Notwithstanding any other law or regulation, the department
shall not approve an anticipated rate adjustment for a
community-based day program or in-home respite service agency
provider that would result in an increase in the rate to be paid to
the vendor from the rate that is in effect on or after June 30, 2008,
unless the regional center demonstrates that the anticipated rate
adjustment is necessary to protect the consumers' health or safety.
(e) Notwithstanding any other law or regulation, except as set
forth in subdivision (f), subdivisions (f)
and (i), the department shall not approve any rate adjustment
for a work activity program that would result in an increase in the
rate to be paid to the vendor from the rate that is in effect on or
after June 30, 2008, unless the regional center demonstrates that the
rate adjustment is necessary to protect the consumers' health and
safety and the department has granted prior written authorization.
(f) Notwithstanding any other law or regulation, commencing July
1, 2014, the department may approve rate adjustments for a work
activity program that demonstrates to the department that the rate
adjustment is necessary in order to pay employees who, prior to July
1, 2014, were being compensated at a wage that is less than the
minimum wage established on and after July 1, 2014, by Section
1182.12 of the Labor Code, as amended by Chapter 351 of the Statutes
of 2013. The rate adjustment pursuant to this subdivision shall be
specific to payroll costs associated with any increase necessary to
adjust employee pay only to the extent necessary to bring pay into
compliance with the increased state minimum wage, and shall not
constitute a general wage enhancement for employees paid above the
increased minimum wage.
(g) Notwithstanding any other law or regulation, commencing July
1, 2014, community-based day program and in-home respite services
agency providers with temporary payment rates set by the department
may seek unanticipated rate adjustments from the department due to
the impacts of the increased minimum wage as established by Section
1182.12 of the Labor Code, as amended by Chapter 351 of the Statutes
of 2013. The rate adjustment shall be specific to payroll costs
associated with any increase necessary to adjust employee pay only to
the extent necessary to bring pay into compliance with the increased
state minimum wage, and shall not constitute a general wage
enhancement for employees paid above the increased minimum wage.
(h) Notwithstanding any other law or regulation, commencing
January 1, 2015, the in-home respite service agency rate schedule
authorized by the department and in operation December 31, 2014,
shall be increased by 5.82 percent, subject to funds specifically
appropriated for this increase for costs due to changes in federal
regulations implementing the federal Fair Labor Standards Act of 1938
(29 U.S.C. Sec. 201 et seq.). The increase shall be applied as a
percentage, and the percentage shall be the same for all applicable
providers.
(i) Notwithstanding any other law or regulation, commencing July
1, 2015, the department may approve rate adjustments for a work
activity program that demonstrates to the department that the rate
adjustment is necessary to implement Article 1.5 (commencing with
Section 245) of Chapter 1 of Part 1 of Division 2 of the Labor Code,
as added by Chapter 317 of the Statutes of 2014. The rate adjustment
may be applied only if a minimum of 24 hours or three days of paid
sick leave per year was not a benefit provided to employees as of
June 30, 2015, and shall be specific to payroll costs associated with
any increase necessary to compensate an employee up to a maximum of
24 hours or three days of paid sick leave in each year of employment.
(j) Notwithstanding any other law or regulation, commencing July
1, 2015, community-based day program and in-home respite services
agency providers with temporary payment rates set by the department
may seek unanticipated rate adjustments from the department if the
adjustment is necessary to implement Article 1.5 (commencing with
Section 245) of Chapter 1 of Part 1 of Division 2 of the Labor Code,
as added by Chapter 317 of the Statutes of 2014. The rate adjustment
may be applied only if a minimum of 24 hours or three days of paid
sick leave per year was not a benefit provided to employees as of
June 30, 2015, and shall be specific to payroll costs associated with
any increase necessary to compensate an employee up to a maximum of
24 hours or three days of paid sick leave in each year of employment.
SEC. 15. Section 4691.9 of the Welfare
and Institutions Code is amended to read:
4691.9. (a) Notwithstanding any other law or regulation,
commencing July 1, 2008:
(1) A regional center shall not pay an existing service provider,
for services where rates are determined through a negotiation between
the regional center and the provider, a rate higher than the rate in
effect on June 30, 2008, unless the increase is required by a
contract between the regional center and the vendor that is in effect
on June 30, 2008, or the regional center demonstrates that the
approval is necessary to protect the consumer's health or safety and
the department has granted prior written authorization.
(2) A regional center shall not negotiate a rate with a new
service provider, for services where rates are determined through a
negotiation between the regional center and the provider, that is
higher than the regional center's median rate for the same service
code and unit of service, or the statewide median rate for the same
service code and unit of service, whichever is lower. The unit of
service designation shall conform with an existing regional center
designation or, if none exists, a designation used to calculate the
statewide median rate for the same service. The regional center shall
annually certify to the State Department of Developmental Services
its median rate for each negotiated rate service code, by designated
unit of service. This certification shall be subject to verification
through the department's biennial fiscal audit of the regional
center.
(b) Notwithstanding subdivision (a), commencing July 1, 2014,
regional centers may negotiate a rate adjustment with providers
regarding rates if the adjustment is necessary in order to pay
employees no less than the minimum wage as established by Section
1182.12 of the Labor Code, as amended by Chapter 351 of the Statutes
of 2013, and only for the purpose of adjusting payroll costs
associated with the minimum wage increase. The rate adjustment shall
be specific to the unit of service designation that is affected by
the increased minimum wage, shall be specific to payroll costs
associated with any increase necessary to adjust employee pay only to
the extent necessary to bring pay into compliance with the increased
state minimum wage, and shall not be used as a general wage
enhancement for employees paid above the increased minimum wage.
Regional centers shall maintain documentation on the process to
determine, and the rationale for granting, any rate adjustment
associated with the minimum wage increase.
(c) Notwithstanding any other law or regulation, commencing
January 1, 2015, rates for personal assistance and supported living
services in effect on December 31, 2014, shall be increased by 5.82
percent, subject to funds specifically appropriated for this increase
for costs due to changes in federal regulations implementing the
federal Fair Labor Standards Act of 1938 (29 U.S.C. Sec. 201 et
seq.). The increase shall be applied as a percentage, and the
percentage shall be the same for all applicable providers. As used in
this subdivision, both of the following definitions shall apply:
(1) "Personal assistance" is limited only to those services
provided by vendors classified by the regional center as personal
assistance providers, pursuant to the miscellaneous services
provisions contained in Title 17 of the California Code of
Regulations.
(2) "Supported living services" are limited only to those services
defined as supported living services in Title 17 of the California
Code of Regulations.
(d) Notwithstanding subdivision (a), commencing July 1, 2015,
regional centers may negotiate a rate adjustment with existing
service providers for services for which rates are determined through
negotiation between the regional center and the provider, if the
adjustment is necessary to implement Article 1.5 (commencing with
Section 245) of Chapter 1 of Part 1 of Division 2 of the Labor Code,
as added by Chapter 317 of the Statutes of 2014. The rate adjustment
may be applied only if a minimum of 24 hours or three days of paid
sick leave per year was not a benefit provided to employees as of
June 30, 2015, and shall be specific to payroll costs associated with
any increase necessary to compensate an employee up to a maximum of
24 hours or three days of paid sick leave in each year of employment.
(d)
(e) This section shall not apply to those services for
which rates are determined by the State Department of Health Care
Services, or the State Department of Developmental Services, or are
usual and customary.
SEC. 16. Section 7502.5 of the Welfare
and Institutions Code is repealed.
7502.5. (a) The total number of developmental center residents in
the secure treatment facility at Porterville Developmental Center,
including those residents receiving services in the Porterville
Developmental Center transition treatment program, shall not exceed
230.
(b) As of the effective date of this subdivision, the State
Department of Developmental Services shall not admit any persons into
the secure treatment facility at Porterville Developmental Center
unless the population of the secure treatment facility is less than
230 persons, including 60 residents receiving services in the
transition treatment program.
SEC. 17. Section 7502.5 is added to the
Welfare and Institutions Code , to read:
7502.5. (a) An individual may be admitted to the secure treatment
facility at Porterville Developmental Center, as provided in
paragraphs (1) and (3) of subdivision (a) of Section 7505, only when
all of the following conditions are satisfied:
(1) The unit to which the individual will be admitted is approved
for occupancy and licensed.
(2) The population of the secure treatment facility is no more
than 211 persons.
(3) The individual is at least 18 years of age.
(b) An individual may be admitted to the transitional treatment
program at Porterville Developmental Center when all of the following
conditions are satisfied:
(1) The individual was admitted to Porterville Developmental
Center pursuant to paragraphs (1) and (3) of subdivision (a) of
Section 7505.
(2) The individual remains eligible for commitment pursuant to
paragraph (3) of subdivision (a) of Section 7505.
(3) The unit to which the individual will be admitted is approved
for occupancy and licensed.
(4) The population of the transitional treatment program is no
more than 60 persons.
(c) As soon as possible, but no later than 30 days following
admission to the transitional treatment program, the regional center,
in coordination with the developmental center, shall do both of the
following:
(1) Complete a comprehensive assessment that shall include the
identification of services and supports needed to transition the
individual to the community.
(2) Jointly convene an individual program plan meeting to discuss
the comprehensive assessment and develop a plan to transition the
individual to the community pursuant to Section 4418.3. The clients'
rights advocate for the regional center shall be notified of the
individual program plan meeting and may participate in the meeting
unless the consumer objects on his or her own behalf.
(d) An individual described in this section shall not be placed in
the transitional treatment program for longer than necessary to
procure a less restrictive placement. Each year, pursuant to Section
4418.25, an individual in the transitional treatment program at
Porterville Developmental Center shall receive an updated
comprehensive assessment that shall include all of the following:
(1) The reason or reasons for placement in the program for longer
than one year.
(2) A description of the issue or issues preventing community
placement.
(3) The estimated timeframe for placement in the community and the
plan for that placement.
(e) On or before March 1, 2016, the department shall provide the
following information to the appropriate policy and fiscal committees
of the Legislature:
(1) For each regional center, the number of transitional program
residents who are placed in the program for more than one year.
(2) A description of reasons for placement in the program beyond
one year.
(3) The steps undertaken to resolve the issue or issues
prohibiting community placement.
(4) The additional steps necessary before community placement can
be made.
SEC. 18. Section 7505 of the Welfare
and Institutions Code is amended to read:
7505. (a) Notwithstanding any other law, the State Department of
Developmental Services shall not admit anyone to a developmental
center unless the person has been determined eligible for services
under Division 4.5 (commencing with Section 4500) and the person is
any of the following :
(1) Committed An adult committed
by a court to Porterville Developmental Center, secure
treatment program, pursuant to Section 1370.1 of the Penal Code.
(2) Committed by a court to the acute crisis center at Fairview
Developmental Center, or the acute crisis center at Sonoma
Developmental Center, pursuant to Article 2 (commencing with Section
6500) of Chapter 2 of Part 2 of Division 6 due to an acute crisis,
pursuant to Section 4418.7.
(3) Committed An adult committed
by a court to Porterville Developmental Center, secure
treatment program, pursuant to Article 2 (commencing with Section
6500) of Chapter 2 of Part 2 of Division 6 as a result of involvement
with the criminal justice system, and the court has determined the
person is mentally incompetent to stand trial.
(4) A person described in Section 4508.
(5) A juvenile committed to Porterville Developmental Center,
secure treatment program, pursuant to Section 709.
(b) Under no circumstances shall the State Department of
Developmental Services admit a person to a developmental center after
July 1, 2012, as a result of a criminal conviction or when the
person is competent to stand trial for the criminal offense and the
admission is ordered in lieu of trial.
(c) This section shall become operative on January 1, 2015.
SEC. 19. Following the approval of a closure plan
submitted pursuant to Section 4474.11 of the Welfare and Institutions
Code, and continuing until one year after the last developmental
center consumer has transitioned into the community, the State
Department of Developmental Services shall provide quarterly
briefings on progress related to the plan's milestones and timelines
to legislative staff, including staff to fiscal and policy
committees, and staff for legislators who represent the area in which
the developmental center is located.
SEC. 20. (a) It is the intent of the Legislature
that General Fund savings derived from the closure of state
developmental centers benefit persons with developmental disabilities
living in the community.
(b) The State Department of Developmental Services shall display
annually in its January and May budget estimate documents, for any
year in which it is applicable, all of the following:
(1) All General Fund savings or gains reasonably associated with
the downsizing or closure of a developmental center.
(2) All community development funds reasonably associated with the
downsizing or closure of a developmental center, including the costs
associated with the development and provision of services and
supports for persons moving from a developmental center or at risk of
institutionalization.
SEC. 21. (a) Upon the implementation, pursuant to
Section 12300.4 of the Welfare and Institutions Code, of federal
regulations regarding payment of overtime compensation adopted
pursuant to the federal Fair Labor Standards Act of 1938 (29 U.S.C.
Sec. 201 et seq.), the State Department of Developmental Services
shall consult with the Association of Regional Center Agencies,
legislative staff, consumers, providers, and advocacy organizations
to evaluate the impact of those regulations on consumers and
providers of supported living services, in-home respite services, and
personal assistants to persons with developmental disabilities.
(b) The State Department of Developmental Services shall report on
the progress of the following to the Legislature during the 2016-17
legislative budget subcommittee hearing process:
(1) Results of the initial evaluation performed pursuant to
subdivision (a).
(2) Steps taken to minimize a negative impact on consumers and
providers.
(3) Recommendations to address future negative impacts on
consumers and providers.
SEC. 22. The amount of sixty-one million five
hundred fifty-four thousand dollars ($61,554,000) is hereby
appropriated from the General Fund to the State Department of
Developmental Services to fund expenditures pursuant to Schedule (1)
10.10.010-Operations and Schedule (2) 10.10.020-Purchase of Services
as provided for in Item 4300-101-0001 of Section 2.00 of the Budget
Act of 2011 (Chapter 33 of the Statutes of 2011) and the Budget Act
of 2012 (Chapters 21 and 29 of the Statutes of 2012). These funds
shall be available for encumbrance and expenditure until June 30,
2016.
SEC. 23. This act is a bill providing for
appropriations related to the Budget Bill within the meaning of
subdivision (e) of Section 12 of Article IV of the California
Constitution, has been identified as related to the budget in the
Budget Bill, and shall take effect immediately.
SECTION 1. It is the intent of the Legislature
to enact statutory changes relating to the Budget Act of 2015.