BILL NUMBER: AB 1427	AMENDED
	BILL TEXT

	AMENDED IN ASSEMBLY  MARCH 29, 2007

INTRODUCED BY   Assembly Member Krekorian

                        FEBRUARY 23, 2007

   An act  to add Section 4695.3 to the Welfare and Institutions
Code,  relating to developmental services.


	LEGISLATIVE COUNSEL'S DIGEST


   AB 1427, as amended, Krekorian. Developmental services: 
workforce development   tra   ining  pilot
program.
   Existing law, the Lanterman Developmental Disabilities Services
Act, grants persons with developmental disabilities the right to
receive treatment and services to meet their needs, regardless of age
or degree of handicap, at each stage of life. Existing law requires
that the state pay for these services through contracts with various
private nonprofit corporations for the operation of regional centers
for the developmentally disabled, and requires regional centers to
develop an Individual Program Plan (IPP) for each consumer that sets
forth the treatment and services to be provided for the consumer.

   This bill would declare the intent of the Legislature to
subsequently amend this bill to include provisions that would
establish a pilot program to promote development of a more stable and
highly skilled direct-care workforce to provide services for persons
with developmental disabilities that contains prescribed components.
 
   This bill would require the department, commencing January 1,
2008, to establish a developmental services training pilot program
using the Quality Improvement Fund, which would be established by the
bill, to incentivize, reimburse, and assess the use of recognized
training resources for direct support workers in consumer-directed
services. The bill would require the department to, by January 2008,
enter into a contract with the University of California, or other
contractor, to assess the pilot program and report to the Legislature
by April 1, 2010. 
   Vote: majority. Appropriation: no. Fiscal committee:  no
  yes  . State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

   SECTION 1.    The Legislature finds and declares all
of the following:  
   (a) Over the years, new methods of service delivery are introduced
to better respond to the needs and the choices of people with
developmental disabilities. As community services thus evolve, new
training opportunities should be made available that are designed for
the values and methods of these new services.  
   (b) Many community services for people with developmental
disabilities have in the past often been provided by workers who have
little formal training in the skills necessary to serve that
population. There have been few workforce standards or career options
to help train and retain competent and committed people. Though the
state has previously established training standards for community
care facilities, it has not done so for the most consumer-directed
services, including, but not limited to, independent and supported
living, supported employment, and similar services. These are the
services in which workers must perform a broad array of tasks in a
variety of settings with minimal onsite supervision. Demand for the
more consumer-directed services is growing, causing utilization to
move away from more traditional services; yet the necessary level of
training infrastructure and investment have not been in place for
this growing part of the service system. Thus provider agencies for
these services have been left with a disproportionate burden of
workforce development without state support or guidance.  
   (c) For a training program to improve the quality and availability
of consumer-directed services, it must do all of the following:
 
   (1) Be based on curriculum developed for those types of services.
 
   (2) Include consumer, family, and worker oversight of planning and
implementation.  
   (3) Reward completion of training milestones with compensation
increases or promotional opportunities.  
   (4) Train consumers and family members, as appropriate, in
advocacy and interacting with paid and natural supports.  
   (d) The College of Direct Support is a national standard and an
example of a values-based training curriculum for consumer-directed
services.  
   (e) It is the intent of the Legislature to establish a pilot
project establishing a Quality Improvement Fund to incentivize,
reimburse, and assess the use of state-of-the-art training resources
for direct support workers in consumer-directed services. The pilot
should include an independent assessment of training outcomes to
inform future decisions on the use of this funding and development of
a training model. Therefore, participation should be limited to a
specified geographical area, specific service types, and agencies
that maintain data systems adequate to evaluate training outcomes.

   SEC. 2.    Section 4695.3 is added to the  
Welfare and Institutions Code   , to read:  
   4695.3.  (a) Notwithstanding any other provision of law or
regulation, the department shall establish, commencing January 1,
2008, a developmental services training pilot program to incentivize,
reimburse, and assess the use of recognized training resources for
direct support workers in consumer-directed services.
   (b) There is hereby established the Quality Improvement Fund in
the State Treasury, to be used by the department upon appropriation
by the Legislature, for implementation of this section. The
department shall allocate moneys in the fund to regional centers
participating in the pilot program.
   (c) Moneys in the fund shall be distributed by the department
between participating regional centers based on the number of clients
served. Moneys expended from the fund shall be limited to one
million five hundred thousand dollars ($1,500,000) for the 2008-09
fiscal year and three million dollars ($3,000,000) for each of the
2009-10 and 2010-11 fiscal years.
   (d) The following six regional centers may participate in the
pilot program: North Bay, East Bay, Golden Gate, San Andreas, Kern,
and Lanterman. In the event one or more of these regional centers
decline to participate, the department may select one or more other
regional centers willing to participate, for a total of six.
   (e) Vendor agencies shall qualify for the pilot program by meeting
the base qualifications set forth in subdivision (i).
   (f) Participating regional centers shall distribute rate
augmentations set forth in subdivision (j) to qualifying agencies to
fund costs of training implementation and administration and
compensation enhancements to reward and retain trained, qualified
workers.
   (g) Regional center reimbursement rates for services and supports
provided within the pilot catchment areas shall be increased as set
forth in subdivision (j) for any of the following services: supported
living, independent living, supported employment, in-home respite,
and day services, if the services meet the criteria for community
integration specified in paragraph (1) of subdivision (a) of Section
4691.8.
   (h) The department shall establish the Quality Improvement Review
Board consisting of one representative from, and appointed by, each
of the following organizations:
   (1) Protection and Advocacy Inc.
   (2) The State Employment Training Panel.
   (3) The State Workforce Investment Board.
   (i) In order to receive funding from the Quality Improvement Fund,
an agency providing training shall be certified by the department to
meet the criteria set forth in this subdivision. The Quality
Improvement Review Board, established in subdivision (h), shall
evaluate all training agency applications for funding and shall
approve the department's certification of the training program. The
certification criteria shall include, but shall not be limited to,
all of the following:
   (1) The program shall utilize a training curriculum authorized by
the department for the purpose of this pilot program.
   (2) The program shall maintain one or more formal advisory
committees for consumer, family, and worker oversight on the planning
and implementation of training program meeting the requirements of
this section.
   (3) The program shall maintain a training plan that does all of
the following:
   (A) Maps skill gaps for workers to be trained.
   (B) Integrates training curriculum with on-the-job training and
mentoring by trained supervisors.
   (C) Links compensation improvements and promotion opportunities to
completion of training milestones.
   (D) Trains consumers and family members, as appropriate, on
interaction with paid and natural supports.
   (4) The program shall maintain data on wages, turnover,
new-worker-retention rate, and completion of training.
   (5) The program shall maintain an agreement with an independent
evaluator, pursuant to subdivision (m), to provide access to agency
records, staff, and clients as needed for purposes of the evaluation.

   (6) The program shall be vendored and provide services in one or
more of the pilot regional center catchment areas.
   (j) Subject to the availability of funds, the department shall
award each of the following rate augmentations to an eligible agency
for services specified in subdivision (g) when the agency achieves
each of the following benchmarks:
   (1) An agency that meets all the requirements of subdivision (i)
shall receive a 1 percent rate augmentation for qualifying services.
This base funding augmentation shall be used exclusively for the
purchase of a qualified training program, administrative costs
associated with the program, and payment for training time for the
program.
   (2) The department shall award an additional 5 percent rate
augmentation for qualified services to agencies that meet all of the
following qualifications:
   (A) The agency maintains base eligibility as set forth in
subdivision (i).
   (B) Thirty percent of the agency's direct support workers within a
qualified service code shall have completed at least 200 hours of a
qualifying training program as set forth in subdivision (i).
   (C) Direct support workers qualified in subparagraph (B) shall
have completed their training under the supervision of agency
personnel who have themselves completed a qualifying training program
for supervisors.
   (D) The agency shall have provided qualified training to at least
30 percent of consumers, or family members of consumers, within the
service qualified in subparagraph (B). This training shall address,
at a minimum, advocacy, rights, and the relationship of paid and
natural supports for individuals served in the qualified service.
   (E) The agency shall agree to use a minimum of 65 percent of the
rate augmentation exclusively to enhance benefits and improve the
wages of direct support staff completing the qualifying training
program within the service qualified in subparagraph (B).
   (3) The department shall award an additional 10 percent rate
augmentation for qualified services to agencies that meet all of the
following qualifications:
   (A) The agency maintains base eligibility as set forth in
subdivision (i).
   (B) Fifty percent of the agency's direct support workers within a
qualified service code shall have completed at least 200 hours of a
qualifying training program as set forth in subdivision (i).
   (C) Direct support workers qualified in subparagraph (B) shall
have completed their training under the supervision of agency
personnel who have themselves completed a qualifying training program
for supervisors.
   (D) The agency shall have provided qualified training to at least
60 percent of consumers, or family members of consumers, within the
service qualified in subparagraph (B). This training shall address,
at a minimum, advocacy, rights, and the relationship of paid and
natural supports for individuals served in the qualified service.
   (E) The agency shall agree to use a minimum of 65 percent of the
rate augmentation exclusively to enhance benefits and improve the
wages of direct support staff completing the qualifying training
program within the service qualified in subparagraph (B).
   (k) Rate augmentations awarded pursuant to subdivision (j) shall
become the permanent rate of the eligible agency and shall be funded
from the regional center base allocation in subsequent years, except
as set forth in subdivision (l).
   (l) (1) The department shall prospectively rescind any rate
augmentation awarded pursuant to paragraph (1) of subdivision (j) for
agencies that fail throughout the second or subsequent years to
maintain at least 15 percent of the direct support workforce trained
pursuant to criteria set forth in paragraph (2) of subdivision (j).
   (2) The department shall prospectively rescind any rate
augmentation awarded pursuant to subdivision (j) for agencies that
fail throughout the second or subsequent years to maintain the
qualifying criteria specified in that subdivision.
   (m) (1) The department shall, by January 2008, contract with the
University of California or other qualified postsecondary institution
to assess the effect of the training pilot. The contract shall be
approved by the Quality Improvement Review Board, in consultation
with the department. The contractor shall periodically review its
assessment standards to ensure that data gathering is adequate and
consistent across participating agencies. The contractor shall submit
a report to the department and to the Legislature by April 1, 2010.
This subdivision shall apply to the University of California only if
consented to by resolution of the Regents of the University of
California.
   (2) The impact of the pilot program shall be measured by analyzing
quantitative measures of recruitment and retention for each
participating agency before and during participation in the pilot.
   (3) Participating agencies shall maintain data that establishes a
baseline and tracks ongoing data on wages, benefits, retention rates,
vacancy rates, and costs of turnover for their direct support and
supervisory staff. The data shall be collected through an information
data system that shall automatically track human resources data on
all individual direct support workers. The participating agencies
shall agree to permit the contractor access to the information,
redacted to protect consumer confidentiality, as necessary for the
contractor to assess the program.
   (4) The contractor shall measure the effect of program
participation on measures of workforce stability, including, but not
limited to, turnover and vacancy rates. The evaluation shall compare
participating agencies to a control group of nonparticipating
agencies. The evaluation shall also analyze differences among
participating agencies, and their causes.  
  SECTION 1.    It is the intent of the Legislature
to subsequently amend this act to include provisions that would
establish a pilot program to promote the development of a more stable
and highly skilled direct-care workforce to provide services for
persons with developmental disabilities, with all of the following
components:
   (a) The pilot program would promote best practices, cost-efficient
recruitment, training, and retention of direct-care workers and
other human resource services to multiple provider agencies that
provide consumer services, including, but not limited to,
consumer-directed services to persons with developmental
disabilities.
   (b) For the purposes of this section, "consumer-directed services"
include, but are not limited to, services and supports for persons
with developmental disabilities that enhance community inclusion and
consumer self-direction, including, but not limited to, supported
living services, independent living services, integrated day
services, supported employment, respite services, family supports,
self-directed services pursuant to Section 4685.7 of the Welfare and
Institutions Code, and similar services.
   (c) The purpose of the pilot project would be to demonstrate the
feasibility and effectiveness of activities to strengthen the direct
support workforce through a multiemployer initiative in which
economies of scale are achieved, in order to increase the quality and
accessibility of services for consumers.
   (d) The pilot program would include an independent evaluation of
the program to be completed by December 31, 2012.