BILL NUMBER: AB 104 CHAPTERED
BILL TEXT
CHAPTER 37
FILED WITH SECRETARY OF STATE JUNE 30, 2011
APPROVED BY GOVERNOR JUNE 30, 2011
PASSED THE SENATE JUNE 10, 2011
PASSED THE ASSEMBLY JUNE 15, 2011
AMENDED IN SENATE JUNE 8, 2011
AMENDED IN SENATE MARCH 14, 2011
INTRODUCED BY Committee on Budget (Blumenfield (Chair), Alejo,
Allen, Brownley, Buchanan, Butler, Cedillo, Chesbro, Dickinson,
Feuer, Gordon, Huffman, Mitchell, Monning, and Swanson)
JANUARY 10, 2011
An act to amend Section 95020 of, and to add Section 95020.5 to,
the Government Code, to amend Sections 709, 712, 4643, 4646.4,
4646.5, 4646.55, 4648.35, 4688.1, 4688.2, 4689, and 7502.5 of, to
amend and repeal Section 4435 of, to add Sections 4435.1, 4641.5,
4648.55, 4681.7, 4686.3, 4686.31, 4688.21, and 4690.6 to, and to add
and repeal Section 4785 of, the Welfare and Institutions Code, and to
amend Section 10 of Chapter 13 of the Third Extraordinary Session of
the Statutes of 2009, relating to developmental services, making an
appropriation therefor, to take effect immediately, bill related to
the budget.
LEGISLATIVE COUNSEL'S DIGEST
AB 104, Committee on Budget. Developmental services.
(1) The Lanterman Developmental Disabilities Services Act
authorizes the State Department of Developmental Services to contract
with regional centers to provide services and supports to
individuals with developmental disabilities. The services and
supports to be provided to a regional center consumer are contained
in an individual program plan (IPP), developed in accordance with
prescribed requirements.
This bill would require the planning process for the development
of an IPP to include the development of a transportation access plan,
as specified, when certain conditions are met.
This bill would specify the process by which a consumer who is 18
to 22 years of age, inclusive, is provided with day, vocational
education, work services, independent living, or mobility and related
transportation services.
(2) Existing law, in counties that agree to be subject to these
provisions pursuant to a resolution adopted by the board of
supervisors, provides that when it appears to the court, or upon
request of the prosecutor or counsel, that a minor who is alleged to
come within the jurisdiction of the juvenile court as a person who is
or may be found to be a ward of the juvenile court may have a
serious mental disorder, is seriously emotionally disturbed, or has a
developmental disability, the court may order that the minor be
referred for evaluation by a licensed mental health professional.
Existing law also authorizes, during the pendency of any juvenile
proceeding, the minor's counsel or the court to express a doubt as to
the minor's competency. Existing law requires proceedings to be
suspended if the court finds substantial evidence raises a doubt as
to the minor's competency. Existing law requires the court to appoint
an expert, as specified, to evaluate whether the minor suffers from
a mental disorder, developmental disability or developmental
immaturity, or other condition and, if so, whether the condition
impairs the minor's competency. Existing law requires that, if the
minor is found to be incompetent by a preponderance of the evidence,
all proceedings remain suspended to determine whether there is a
substantial probability that the minor will attain competency in the
foreseeable future or the court no longer retains jurisdiction.
This bill would eliminate the requirement that the court appoint
an expert, as specified, to evaluate whether the minor suffers from a
developmental disability, and instead provide that, if the minor is
suspected of being developmentally disabled, the court is required to
appoint the director of a regional center for developmentally
disabled individuals to evaluate the minor, as prescribed, and would
make related changes.
(3) Existing law, the California Early Intervention Services Act,
provides a statewide system of coordinated, comprehensive,
family-centered, multidisciplinary, and interagency programs that are
responsible for providing appropriate early intervention services
and support to all eligible infants and toddlers, as defined, and
their families, and requires an eligible infant or toddler receiving
services under the act to have an individualized family service plan
(IFSP). Existing law requires direct early intervention services to
eligible infants and toddlers and their families to be provided
pursuant to the existing regional center system under the Lanterman
Developmental Disabilities Services Act and the existing local
education agency system, as specified.
This bill would require, at specified times, the consumer of
regional center services through either an IPP or IFSP, or the
consumer's parent, guardian, or conservator to provide copies of any
health benefit cards under which the consumer is eligible to receive
health benefits. The bill would prohibit a regional center from using
the lack of these benefits to negatively impact the decision as to
which services and supports the consumer receives.
(4) Existing law authorizes a regional center, pursuant to
vendorization or a contract, to purchase services or supports for a
consumer from any individual or agency that the regional center and
consumer or, where appropriate, his or her parents, legal guardian,
or conservator, or authorized representative, determines will best
accomplish all or any part of that consumer's IPP.
This bill would require, on and after July 1, 2012, with specified
exceptions, all providers of early intervention services purchased
through a regional center and all vendors and contracted providers of
services or supports for a consumer purchased through a regional
center to submit all billings through the regional center e-billing
system Internet Web application provided by the department. The bill
would also require, effective July 1, 2011, regional centers to begin
transitioning vendors and contracted providers into the regional
center e-billing system.
This bill, beginning July 1, 2011, would require any vendor who
provides specified services to submit prescribed verification to the
regional center for services provided to consumers who are under 18
years of age and residing in the family home, and would make related
changes. This bill would also require the department to adopt
regulations to address the use of paraprofessionals, as specified.
(5) Existing law requires the department to establish a prevention
program for at-risk babies, as defined, to provide intake,
assessment, case management, and referrals to agencies.
This bill would phase out this program by June 30, 2011, and would
repeal the current provisions as of January 1, 2013. The bill would,
effective July 1, 2011, require the department to contract with an
organization representing one or more family resource centers, as
defined, to provide outreach, information, and referral services for
at-risk babies. The bill would also require regional centers to refer
at-risk babies to the family resource centers.
(6) Existing law requires vendors of specified services to provide
alternative senior program and alternative customized program
components, as specified.
This bill would prohibit a regional center from referring
consumers to these programs after July 1, 2011. The bill would
authorize a consumer to choose a tailored day service or vouchered
community-based training service in lieu of other specified programs.
(7) Existing law requires the Director of Developmental Services
to establish, maintain, and revise, as necessary, an equitable
process for setting rates of payment for nonresidential services
purchased by regional centers.
This bill would require specified programs with a daily rate to
bill regional centers for services provided to consumers in terms of
half days and full days, as defined.
(8) Under existing law, Medi-Cal benefits include intermediate
care facility services for persons with developmental disabilities.
Existing law requires certain types of licensed intermediate care
facilities for persons with developmental disabilities (ICF-DDs), as
specified, to be responsible for providing day treatment and
transportation services that are selected and authorized through an
IPP, as specified, for each beneficiary receiving those services who
resides in that licensed ICF-DD.
Existing law authorizes the department to make a supplemental
payment to an enrolled Medi-Cal provider that is a licensed ICF-DD
for day treatment and transportation services provided to Medi-Cal
beneficiaries residing in the ICF-DDs, and requires the department to
amend the regional center contracts for the 2007-08 fiscal year to
extend the contract liquidation period until June 30, 2011.
This bill would instead require the department to amend the
regional center contracts for the 2007-08 and 2008-09 fiscal years,
to extend the contract liquidation period to December 31, 2011, as
specified.
(9) Existing law requires the department to adopt regulations that
specify rates for community care facilities serving persons with
developmental disabilities on the basis of a cost model designed by
the department that ensures that aggregate facility payments support
the provision of services to each person in accordance with his or
her IPP and applicable program requirements.
This bill would, commencing July 1, 2011, authorize a regional
center to enter into a signed written agreement with a residential
service provider for a consumer's needs to be provided at a lower
level of payment than the facility's designated Alternative
Residential Model (ARM) service level without adjusting the approved
service level.
(10) Existing law requires the department and regional centers to
ensure that supported living arrangements for adults with
developmental disabilities are made available, as specified.
This bill would revise the provisions relating to supported living
arrangements by, among other things, providing for the sharing of
tasks, as specified, for consumers who share a household with other
adults receiving supported living services. The bill would also
require an independent assessment for certain consumers in a
supported living arrangement who either are receiving, or initially
entering, supported living, who have supported living service costs,
or who have an initial recommendation for service costs, that exceeds
125% of the annual statewide average cost of supported living
services, as published by the department commencing June 30, 2011.
The bill would specify the duties of the department and the regional
centers in connection with the reassessment process. This bill would
require the regional center, if implementation of the task-sharing or
reassessment requirements set forth in the bill would result in a
determination of a reduction in services, to inform the consumer of
the reason for that determination, and provide the consumer with
written notice of specified fair hearing rights.
(11) Existing law establishes the Family Cost Participation
Program to collect fees, as prescribed, from families with a child
who receives services through the regional center system.
This bill would, effective July 1, 2011, and until June 30, 2013,
establish a family program fee, as specified, for families with an
adjusted gross family income, as defined, at or above 400% of the
federal poverty level and who have a child meeting prescribed
requirements, including receiving specified services from a regional
center.
(12) Existing law establishes specified state hospitals for the
developmentally disabled, including, but not limited to, Porterville
Developmental Center, and prohibits the total number of developmental
center residents in the secure treatment facility at Porterville
Developmental Center from exceeding 297.
This bill would prohibit the total number of developmental center
residents in the secure treatment facility at Porterville
Developmental Center from exceeding 230, would prohibit the
department from admitting any persons into the secure treatment
facility until the population is less than 230 persons, and would
prohibit the department from admitting more than 104 people who are
ineligible to participate in programs certified for federal financial
participation into the secure treatment facility.
(13) Existing law requires regional centers to reduce payments for
specified services and supports by 3% from February 1, 2009, to June
30, 2010, inclusive, and by 4.25% from July 1, 2010, to June 30,
2012, inclusive, unless the regional center demonstrates that a
nonreduced payment is necessary to protect the health and safety of
the individual for whom the services and supports are proposed to be
purchased, and the State Department of Developmental Services has
granted prior written approval. Existing law excepts from this rate
reduction services with usual and customary rates, pursuant to a
specified regulation.
This bill would exclude payment for designated services with usual
and customary rates from the exception to the above-described rate
reduction, thereby making rates for the designated services subject
to that reduction.
This bill would also require the department to reimburse the
Office of Statewide Audits and Evaluations to conduct a review and
analysis of the budget methodology, including relevant data,
formulas, and cost assumptions, used in determining the department's
annual budget.
(14) This bill would appropriate $1,000 from the General Fund to
the department for departmental support.
(15) This bill would declare that it is to take effect immediately
as a bill providing for appropriations related to the Budget Bill.
Appropriation: yes.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 95020 of the Government Code is amended to
read:
95020. (a) An eligible infant or toddler shall have an
individualized family service plan. The individualized family service
plan shall be used in place of an individualized education program
required pursuant to Sections 4646 and 4646.5 of the Welfare and
Institutions Code, the individualized program plan required pursuant
to Section 56340 of the Education Code, or any other applicable
service plan.
(b) For an infant or toddler who has been evaluated for the first
time, a meeting to share the results of the evaluation, to determine
eligibility and, for children who are eligible, to develop the
initial individualized family service plan shall be conducted within
45 calendar days of receipt of the written referral. Evaluation
results and determination of eligibility may be shared in a meeting
with the family prior to the individualized family service plan.
Written parent consent to evaluate and assess shall be obtained
within the 45-day timeline. A regional center, local educational
agency, or the designee of one of those entities shall initiate and
conduct this meeting. Families shall be afforded the opportunity to
participate in all decisions regarding eligibility and services.
During intake and assessment, but no later than the IFSP meeting, the
parents, legal guardian, or conservator shall provide copies of any
health benefit cards under which the consumer is eligible to receive
health benefits, including, but not limited to, private health
insurance, a health care service plan, Medi-Cal, Medicare, and
TRICARE. If the individual, or, where appropriate, the parents, legal
guardians, or conservators, have no such benefits, the regional
center shall not use that fact to negatively impact the services that
the individual may or may not receive from the regional center.
(c) Parents shall be fully informed of their rights, including the
right to invite another person, including a family member or an
advocate or peer parent, or any or all of them, to accompany them to
any or all individualized family service plan meetings. With parental
consent, a referral shall be made to the local family resource
center or network.
(d) The individualized family service plan shall be in writing and
shall address all of the following:
(1) A statement of the infant's or toddler's present levels of
physical development including vision, hearing, and health status,
cognitive development, communication development, social and
emotional development, and adaptive developments.
(2) With the concurrence of the family, a statement of the family'
s concerns, priorities, and resources related to meeting the special
developmental needs of the eligible infant or toddler.
(3) A statement of the major outcomes expected to be achieved for
the infant or toddler and family where services for the family are
related to meeting the special developmental needs of the eligible
infant or toddler.
(4) The criteria, procedures, and timelines used to determine the
degree to which progress toward achieving the outcomes is being made
and whether modifications or revisions are necessary.
(5) (A) A statement of the specific early intervention services
necessary to meet the unique needs of the infant or toddler as
identified in paragraph (3), including, but not limited to, the
frequency, intensity, location, duration, and method of delivering
the services, and ways of providing services in natural generic
environments, including group training for parents on behavioral
intervention techniques in lieu of some or all of the in-home parent
training component of the behavior intervention services, and
purchase of neighborhood preschool services and needed qualified
personnel in lieu of infant development programs.
(B) Effective July 1, 2009, at the time of development, review, or
modification of an infant's or toddler's individualized family
service plan, the regional center shall consider both of the
following:
(i) The use of group training for parents on behavior intervention
techniques, in lieu of some or all of the in-home parent training
component of the behavior intervention services.
(ii) The purchase of neighborhood preschool services and needed
qualified personnel, in lieu of infant development programs.
(6) A statement of the agency responsible for providing the
identified services.
(7) The name of the service coordinator who shall be responsible
for facilitating implementation of the plan and coordinating with
other agencies and persons.
(8) The steps to be taken to ensure transition of the infant or
toddler upon reaching three years of age to other appropriate
services. These may include, as appropriate, special education or
other services offered in natural environments.
(9) The projected dates for the initiation of services in
paragraph (5) and the anticipated duration of those services.
(e) Each service identified on the individualized family service
plan shall be designated as one of three types:
(1) An early intervention service, as defined in subsection (4) of
Section 1432 of Title 20 of the United States Code, and applicable
regulations, that is provided or purchased through the regional
center, local educational agency, or other participating agency. The
State Department of Health Care Services, State Department of Social
Services, State Department of Mental Health, and State Department of
Alcohol and Drug Programs shall provide services in accordance with
state and federal law and applicable regulations, and up to the level
of funding as appropriated by the Legislature. Early intervention
services identified on an individualized family service plan that
exceed the funding, statutory, and regulatory requirements of these
departments shall be provided or purchased by regional centers or
local educational agencies under subdivisions (b) and (c) of Section
95014. The State Department of Health Care Services, State Department
of Social Services, State Department of Mental Health, and State
Department of Alcohol and Drug Programs shall not be required to
provide early intervention services over their existing funding,
statutory, and regulatory requirements.
(2) Another service, other than those specified in paragraph (1),
which the eligible infant or toddler or his or her family may receive
from other state programs, subject to the eligibility standards of
those programs.
(3) A referral to a nonrequired service that may be provided to an
eligible infant or toddler or his or her family. Nonrequired
services are those services that are not defined as early
intervention services or do not relate to meeting the special
developmental needs of an eligible infant or toddler related to the
disability, but that may be helpful to the family. The granting or
denial of nonrequired services by a public or private agency is not
subject to appeal under this title. Notwithstanding any other
provision of law or regulation to the contrary, effective July 1,
2009, with the exception of durable medical equipment, regional
centers shall not purchase nonrequired services, but may refer a
family to a nonrequired service that may be available to an eligible
infant or toddler or his or her family.
(f) An annual review, and other periodic reviews, of the
individualized family service plan for an infant or toddler and the
infant's or toddler's family shall be conducted to determine the
degree of progress that is being made in achieving the outcomes
specified in the plan and whether modification or revision of the
outcomes or services is necessary. The frequency, participants,
purpose, and required processes for annual and periodic reviews shall
be consistent with the statutes and regulations under Part C of the
federal Individuals with Disabilities Education Act (20 U.S.C. Sec.
1431 et seq.) and this title, and shall be specified in regulations
adopted pursuant to Section 95028. At the time of the review, the
parents, legal guardian, or conservator shall provide copies of any
health benefit cards under which the consumer is eligible to receive
health benefits, including, but not limited to, private health
insurance, a health care service plan, Medi-Cal, Medicare, and
TRICARE. If the parents, legal guardian, or conservator have no such
benefit cards, the regional center shall not use that fact to
negatively impact the services that the individual may or may not
receive from the regional center.
SEC. 2. Section 95020.5 is added to the Government Code, to read:
95020.5. (a) Effective July 1, 2011, regional centers shall begin
transitioning providers of early intervention services purchased
through a regional center to electronic billing. All providers of
early intervention services provided or purchased through a regional
center shall submit all billings electronically for services provided
on or after July 1, 2012, with the exception of the following:
(1) A provider whose services are paid for by vouchers, as that
term is defined in subdivision (i) of Section 4512 of the Welfare and
Institutions Code.
(2) A provider who demonstrates that submitting billings
electronically for services presents a substantial financial
hardship.
(b) For purposes of this section, "electronic billing" is defined
as the Regional Center e-Billing System web application provided by
the State Department of Developmental Services.
SEC. 3. Section 709 of the Welfare and Institutions Code is
amended to read:
709. (a) During the pendency of any juvenile proceeding, the
minor's counsel or the court may express a doubt as to the minor's
competency. A minor is incompetent to proceed if he or she lacks
sufficient present ability to consult with counsel and assist in
preparing his or her defense with a reasonable degree of rational
understanding, or lacks a rational as well as factual understanding,
of the nature of the charges or proceedings against him or her. If
the court finds substantial evidence raises a doubt as to the minor's
competency, the proceedings shall be suspended.
(b) Upon suspension of proceedings, the court shall order that the
question of the minor's competence be determined at a hearing. The
court shall appoint an expert to evaluate whether the minor suffers
from a mental disorder, developmental immaturity, or other condition
and, if so, whether the condition or conditions impair the minor's
competency. The expert shall have expertise in child and adolescent
development, and training in the forensic evaluation of juveniles,
and shall be familiar with competency standards and accepted criteria
used in evaluating competence. If the minor is suspected of being
developmentally disabled, the court shall appoint the director of a
regional center for developmentally disabled individuals described in
Chapter 5 (commencing with Section 4620) of Division 4.5, or his or
her designee, to evaluate the minor. The director of the regional
center, or his or her designee, shall determine whether the minor has
a developmental disability as defined in subdivision (a) of Section
4512, and shall provide the court with a written report informing the
court of its determination. The Judicial Council shall develop and
adopt rules for the implementation of these requirements.
(c) If the minor is found to be incompetent by a preponderance of
the evidence, all proceedings shall remain suspended for a period of
time that is no longer than reasonably necessary to determine whether
there is a substantial probability that the minor will attain
competency in the foreseeable future, or the court no longer retains
jurisdiction. During this time, the court may:
(1) Make orders that it deems appropriate for services that may
assist the minor in attaining competency, consistent with the
Lanterman Developmental Disabilities Services Act (Division 4.5
(commencing with Section 4500)).
(2) Rule on motions that do not require the participation of the
minor in the preparation of the motions. These motions include, but
are not limited to:
(A) Motions to dismiss.
(B) Motions by the defense regarding a change in the placement of
the minor.
(C) Detention hearings.
(D) Demurrers.
(d) If the minor is found to be competent, the court may proceed
commensurate with the court's jurisdiction.
(e) This section applies to a minor who is alleged to come within
the jurisdiction of the court pursuant to Section 601 or 602.
SEC. 4. Section 712 of the Welfare and Institutions Code is
amended to read:
712. (a) The evaluation ordered by the court under Section 711
shall be made, in accordance with the provisions of Section 741 and
Division 4.5 (commencing with Section 4500), by either of the
following, as applicable:
(1) For minors suspected to be developmentally disabled, by the
director of a regional center or his or her designee, pursuant to
subdivision (b) of Section 709.
(2) For all other minors, by an appropriate and licensed mental
health professional who meets one or more of the following criteria:
(A) The person is licensed to practice medicine in the State of
California and is trained and actively engaged in the practice of
psychiatry.
(B) The person is licensed as a psychologist under Chapter 6.6
(commencing with Section 2900) of Division 2 of the Business and
Professions Code.
(b) The evaluator selected by the court shall personally examine
the minor, conduct appropriate psychological or mental health
screening, assessment, or testing, according to a uniform protocol
developed by the county mental health department, and prepare and
submit to the court a written report indicating his or her findings
and recommendations to guide the court in determining whether the
minor has a serious mental disorder or is seriously emotionally
disturbed, as described in Section 5600.3. If the minor is detained,
the examination shall occur within three court days of the court's
order of referral for evaluation, and the evaluator's report shall be
submitted to the court not later than five court days after the
evaluator has personally examined the minor, unless the submission
date is extended by the court for good cause shown.
(c) Based on the written report by the evaluator or the regional
center, the court shall determine whether the minor has a serious
mental disorder or is seriously emotionally disturbed, as described
in Section 5600.3, or has a developmental disability, as defined in
Section 4512. If the court determines that the minor has a serious
mental disorder, is seriously emotionally disturbed, or has a
developmental disability, the case shall proceed as described in
Section 713. If the court determines that the minor does not have a
serious mental disorder, is not seriously emotionally disturbed, or
does not have a developmental disability, the matter shall proceed
without the application of Section 713 and in accordance with all
other applicable provisions of law.
(d) This section shall not be construed to interfere with the
legal authority of the juvenile court or of any other public or
private agency or individual to refer a minor for mental health
evaluation or treatment as provided in Section 370, 635.1, 704, 741,
5150, 5694.7, 5699.2, 5867.5, or 6551 of this code, or in Section
4011.6 of the Penal Code.
SEC. 5. Section 4435 of the Welfare and Institutions Code is
amended to read:
4435. (a) The department shall establish a prevention program for
at-risk babies. For purposes of this section, "at-risk baby" means a
child under 36 months of age who is otherwise not eligible for the
California Early Intervention Program pursuant to Title 14
(commencing with Section 95000) of the Government Code or services
provided under the Lanterman Developmental Disabilities Services Act
(Division 4.5 (commencing with Section 4500)) and whose genetic,
medical, developmental, or environmental history is predictive of a
substantially greater risk for developmental disability than that for
the general population, the presence of which is diagnosed by
qualified clinicians.
(b) This program shall provide intake, assessment, case
management, and referral to generic agencies. For purposes of this
section, "generic agency" means any agency that has a legal
responsibility to serve the general public and that is receiving
public funds for providing these services.
(c) The department shall allocate to each regional center, subject
to appropriation, specific funding for this program. A regional
center's total expenditures for purchasing or providing services
under the prevention program shall not exceed the funding allocated
in its contract for this purpose.
(d) Babies identified as being at-risk who are in the prevention
program as of June 30, 2011, shall continue in the prevention program
until the child reaches 36 months of age, the regional center has
determined the child is eligible for services under the California
Early Intervention Program pursuant to Title 14 (commencing with
Section 95000) of the Government Code or the Lanterman Developmental
Disabilities Services Act (Division 4.5 (commencing with Section
4500)), or June 30, 2012, whichever date is earlier.
(e) Effective July 1, 2011, a regional center shall not refer any
at-risk babies to the prevention program described in this section.
(f) This section shall become inoperative on July 1, 2012, and, as
of January 1, 2013, is repealed, unless a later enacted statute,
that becomes operative on or before January 1, 2013, deletes or
extends the dates on which it becomes inoperative and is repealed.
SEC. 6. Section 4435.1 is added to the Welfare and Institutions
Code, to read:
4435.1. (a) Effective July 1, 2011, the department shall
establish a program for at-risk babies. For purposes of this section,
"at-risk baby" means a child under 36 months of age who is otherwise
not eligible for the California Early Intervention Program pursuant
to Title 14 (commencing with Section 95000) of the Government Code or
services provided under the Lanterman Developmental Disabilities
Services Act (Division 4.5 (commencing with Section 4500)) and whose
genetic, medical, developmental, or environmental history is
predictive of a substantially greater risk for developmental
disability than that for the general population, the presence of
which is diagnosed by qualified clinicians.
(b) Effective July 1, 2011, when a regional center intake and
assessment determination is that a baby is an at-risk baby as defined
in subdivision (a), the regional center shall, with parental
consent, refer the baby and family to the family resource center set
forth in subdivision (c) for outreach, information, and referral
services.
(c) Effective July 1, 2011, the department shall contract with an
organization representing one or more family resource centers which
receive federal funds from Subchapter III of the Individuals with
Disabilities Education Act (20 U.S.C. Sec. 1431, et seq.) to provide
outreach, information, and referral services to generic agencies for
children under 36 months of age who are otherwise not eligible for
the California Early Intervention Program pursuant to Title 14
(commencing with Section 95000) of the Government Code or services
provided under the Lanterman Developmental Disabilities Services Act
(Division 4.5 (commencing with Section 4500)). The organization with
which the department contracts shall be an organization that supports
families of young children with intellectual or developmental
disabilities, and those at risk of intellectual or developmental
disabilities by ensuring the continuance, expansion, promotion, and
quality of local family support services, including coordination,
outreach, and referral. Any contracts entered into pursuant to this
section shall be exempt from state contracting and procurement
requirements set forth in the Government and Public Contract Codes
and shall take effect immediately to protect the health and safety of
the children receiving the services.
(d) The contract described in subdivision (c) shall do both of the
following:
(1) Ensure the expeditious delivery of outreach, information, and
referral services to at-risk babies.
(2) Require the organization to establish a process with the
applicable regional center or centers for referral of the at-risk
baby to the regional center when the family resource center suspects
that the child may be eligible for services pursuant to the
California Early Intervention Program or the Lanterman Developmental
Disabilities Services Act.
SEC. 7. Section 4641.5 is added to the Welfare and Institutions
Code, to read:
4641.5. (a) Effective July 1, 2011, regional centers shall begin
transitioning all vendors of all regional center services to
electronic billing for services purchased through a regional center.
All vendors and contracted providers shall submit all billings
electronically for services provided on or after July 1, 2012, with
the exception of the following:
(1) A vendor or provider whose services are paid for by vouchers,
as that term is defined in subdivision (i) of Section 4512 of the
Welfare and Institutions Code.
(2) A vendor or provider who demonstrates that submitting billings
electronically for services presents a substantial financial
hardship for the provider.
(b) For purposes of this section, "electronic billing" is defined
as the Regional Center e-Billing System Web application provided by
the department.
SEC. 8. Section 4643 of the Welfare and Institutions Code is
amended to read:
4643. (a) If assessment is needed, the assessment shall be
performed within 120 days following initial intake. Assessment shall
be performed as soon as possible and in no event more than 60 days
following initial intake where any delay would expose the client to
unnecessary risk to his or her health and safety or to significant
further delay in mental or physical development, or the client would
be at imminent risk of placement in a more restrictive environment.
Assessment may include collection and review of available historical
diagnostic data, provision or procurement of necessary tests and
evaluations, and summarization of developmental levels and service
needs and is conditional upon receipt of the release of information
specified in subdivision (b).
(b) In determining if an individual meets the definition of
developmental disability contained in subdivision (a) of Section
4512, the regional center may consider evaluations and tests,
including, but not limited to, intelligence tests, adaptive
functioning tests, neurological and neuropsychological tests,
diagnostic tests performed by a physician, psychiatric tests, and
other tests or evaluations that have been performed by, and are
available from, other sources.
(c) At the time of assessment, the individual, or, where
appropriate, the parents, legal guardian, or conservator, shall
provide copies of any health benefit cards under which the consumer
is eligible to receive health benefits, including, but not limited
to, private health insurance, a health care service plan, Medi-Cal,
Medicare, and TRICARE. If the individual, or where appropriate, the
parents, legal guardians, or conservators, have no such benefits, the
regional center shall not use that fact to negatively impact the
services that the individual may or may not receive from the regional
center.
SEC. 9. Section 4646.4 of the Welfare and Institutions Code is
amended to read:
4646.4. (a) Regional centers shall ensure, at the time of
development, scheduled review, or modification of a consumer's
individual program plan developed pursuant to Sections 4646 and
4646.5, or of an individualized family service plan pursuant to
Section 95020 of the Government Code, the establishment of an
internal process. This internal process shall ensure adherence with
federal and state law and regulation, and when purchasing services
and supports, shall ensure all of the following:
(1) Conformance with the regional center's purchase of service
policies, as approved by the department pursuant to subdivision (d)
of Section 4434.
(2) Utilization of generic services and supports when appropriate.
(3) Utilization of other services and sources of funding as
contained in Section 4659.
(4) Consideration of the family's responsibility for providing
similar services and supports for a minor child without disabilities
in identifying the consumer's service and support needs as provided
in the least restrictive and most appropriate setting. In this
determination, regional centers shall take into account the consumer'
s need for extraordinary care, services, supports and supervision,
and the need for timely access to this care.
(b) At the time of development, scheduled review, or modification
of a consumer's individual program plan developed pursuant to
Sections 4646 and 4646.5, or of an individualized family service plan
pursuant to Section 95020 of the Government Code, the consumer, or,
where appropriate, the parents, legal guardian, or conservator, shall
provide copies of their health benefit cards under which the
consumer is eligible to receive health benefits, including, but not
limited to, private health insurance, a health care service plan,
Medi-Cal, Medicare, and TRICARE. If the individual, or, where
appropriate, the parents, legal guardians, or conservators, have no
such benefits, the regional center shall not use that fact to
negatively impact the services that the individual may or may not
receive from the regional center.
(c) Final decisions regarding the consumer's individual program
plan shall be made pursuant to Section 4646.
(d) Final decisions regarding the individual family support plan
shall be made pursuant to Section 95020 of the Government Code.
(e) By no later than April 1, 2009, the department shall provide
the fiscal and policy committees of the Legislature with a written
update regarding the implementation of this section.
SEC. 10. 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,
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) 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.
(5) When agreed to by the consumer, the parents or legally
appointed guardian of a minor consumer, or the legally appointed
conservator of an adult consumer or the authorized representative,
including those appointed pursuant to subdivision (d) of Section 4548
and subdivision (e) of Section 4705, a review of the general health
status of the adult or child including a 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 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.
(6) (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.
(7) 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, 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 Organization of Area Boards shall
prepare training material and a standard format and instructions for
the preparation of individual program plans, which embodies 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 assure that these
plans are being developed and modified in compliance with Section
4646 and this section.
SEC. 11. Section 4646.55 of the Welfare and Institutions Code is
amended to read:
4646.55. (a) Notwithstanding any other provision of law or
regulation to the contrary, and to the extent federal financial
participation is available, effective July 1, 2007, the State
Department of Developmental Services is hereby authorized to make
supplemental payment to an enrolled Medi-Cal provider that is a
licensed intermediate care facility/developmentally
disabled-habilitative, licensed intermediate care
facility/developmentally disabled-nursing, or licensed intermediate
care facility/developmentally disabled, for day treatment and
transportation services provided pursuant to Sections 4646 and
4646.5, applicable regulations, and Section 14132.925, to Medi-Cal
beneficiaries residing in a licensed intermediate care
facility/developmentally disabled-habilitative, licensed intermediate
care facility/developmentally disabled-nursing, or licensed
intermediate care facility/developmentally disabled. These payments
shall be considered supplemental payments to the enrolled Medi-Cal
provider and shall be comprised of the full costs of reimbursing
regional centers for making disbursements to day treatment and
transportation service providers, plus a coordination fee which will
include an administrative fee and reimbursement for the increased
costs associated with the quality assurance fee paid accordingly and
without a separate State Department of Developmental Services
contract.
(b) Notwithstanding any other provision of law and to the extent
federal financial participation is available, and in furtherance of
this section and Section 14132.925, the State Department of
Developmental Services shall amend the regional center contracts for
the 2007-08 and 2008-09 fiscal years to extend the contract
liquidation period until December 31, 2011. The contract amendments
and budget adjustments shall be exempt from the provisions of Article
1 (commencing with Section 4620).
SEC. 12. Section 4648.35 of the Welfare and Institutions Code is
amended to read:
4648.35. At the time of development, review, or modification of a
consumer's individual program plan (IPP) or individualized family
service plan (IFSP), all of the following shall apply to a regional
center:
(a) A regional center shall not fund private specialized
transportation services for an adult consumer who can safely access
and utilize public transportation, when that transportation is
available.
(b) A regional center shall fund the least expensive
transportation modality that meets the consumer's needs, as set forth
in the consumer's IPP or IFSP.
(c) A regional center shall fund transportation, when required,
from the consumer's residence to the lowest-cost vendor that provides
the service that meets the consumer's needs, as set forth in the
consumer's IPP or IFSP. For purposes of this subdivision, the cost of
a vendor shall be determined by combining the vendor's program costs
and the costs to transport a consumer from the consumer's residence
to the vendor.
(d) A regional center shall fund transportation services for a
minor child living in the family residence, only if the family of the
child provides sufficient written documentation to the regional
center to demonstrate that it is unable to provide transportation for
the child.
SEC. 13. Section 4648.55 is added to the Welfare and Institutions
Code, to read:
4648.55. (a) A regional center shall not purchase day program,
vocational education, work services, independent living program, or
mobility training and related transportation services for a consumer
who is 18 to 22 years of age, inclusive, if that consumer is eligible
for special education and related education services and has not
received a diploma or certificate of completion, unless the
individual program plan (IPP) planning team determines that the
consumer's needs cannot be met in the educational system or grants an
exemption pursuant to subdivision (d). If the planning team
determines that generic services can meet the consumer's day,
vocational education, work services, independent living, or mobility
training and related transportation needs, the regional center shall
assist the consumer in accessing those services. To ensure that
consumers receive appropriate educational services and an effective
transition from services provided by educational agencies to services
provided by regional centers, the regional center service
coordinator, at the request of the consumer or, where appropriate,
the consumer's parent, legal guardian, or conservator, may attend the
individualized education program (IEP) planning team meeting.
(b) For consumers who are 18 to 22 years of age, inclusive, who
have left the public school system, and who are receiving regional
center purchased services identified in subdivision (a) on or before
the effective date of this section, a determination shall be made
through the IPP as to whether the return to the educational system
can be achieved while meeting the consumer's needs. If the planning
team determines that the consumer's needs cannot be met in the
educational system, the regional center may continue to purchase the
services identified in subdivision (a). If the planning team
determines that generic services can meet the consumer's day,
vocational education, work services, independent living, or mobility
training and related transportation needs, the regional center shall
assist the consumer in accessing those services.
(c) For consumers who are 18 to 22 years of age, inclusive, who
have left school prior to enactment of this section, but who are not
receiving any of the regional center purchased services identified in
subdivision (a), the regional center shall use generic education
services to meet the consumer's day, vocational education, work
services, independent living, or mobility training and related
transportation needs if those needs are subsequently identified in
the IPP unless the consumer is eligible for an exemption as set forth
in subdivision (d). If the planning team determines that generic
services can meet the consumer's day, vocational education, work
services, independent living, or mobility training and related
transportation needs, the regional center shall assist the consumer
in accessing those services.
(d) An exemption to the provisions of this section may be granted
on an individual basis in extraordinary circumstances to permit
purchase of a service identified in subdivision (a). An exemption
shall be granted through the IPP process and shall be based on a
determination that the generic service is not appropriate to meet the
consumer's need. The consumer shall be informed of the exemption and
the process for obtaining an exemption.
(e) A school district may contract with regional center vendors to
meet the needs of consumers pursuant to this section.
SEC. 14. Section 4681.7 is added to the Welfare and Institutions
Code, to read:
4681.7. (a) Effective July 1, 2011, in order to maintain a
consumer's preferred living arrangement and adjust the residential
services and supports in accordance with changing service needs
identified in the individual program plan (IPP), a regional center
may enter into a signed written agreement with a residential service
provider for a consumer's supervision, training, and support needs to
be provided at a lower level of payment than the facility's
designated Alternative Residential Model (ARM) service level. The
regional center signed written agreement with the provider shall
ensure all of the following:
(1) Services provided to other facility residents comply with the
applicable service requirements for the facility's approved service
level pursuant to Section 4681.1 and Title 17 of the California Code
of Regulations.
(2) Protection of the health and safety of each facility resident.
(3) Identification of the revised services and supports to be
provided to the consumer within the ARM rate structure as part of the
establishment or revision of an IPP.
(4) Identification of the rate.
(b) If the service needs of a consumer referred to in subdivision
(a) change such that the consumer requires a higher level of
supervision, training, and support, the regional center shall adjust
the consumer's service level and rate to meet the consumer's changing
needs.
(c) A regional center is authorized to enter into a signed written
agreement with a residential service provider for a consumer's
needed services at a lower level of payment and staffing without
adjusting the facility's approved service level. A signed written
agreement for a lower level of payment and staffing may only be
entered into when a regional center, a consumer, and the facility
agree that the facility can safely provide the service and supports
needed by the consumer, as identified in the IPP, at the lower level
of payment.
(d) Any negotiated lower level of payment pursuant to this section
shall be consistent with the payment options within the ARM rate
structure and with associated ARM service level requirements.
SEC. 15. Section 4686.3 is added to the Welfare and Institutions
Code, to read:
4686.3. The department shall adopt emergency regulations to
address the use of paraprofessionals in group practice provider
behavioral intervention services and establish a rate. The
regulations shall also establish a rate and the educational or
experiential qualifications and professional supervision requirements
necessary for the paraprofessional to provide behavioral
intervention services. The adoption, amendment, repeal, or readoption
of a regulation authorized by this section is deemed to be necessary
for the immediate preservation of the public peace, health and
safety, or general welfare, for purposes of Sections 11346.1 and
11349.6 of the Government Code, and the department is hereby exempted
from the requirement that it describe specific facts showing the
need for immediate action. A certificate of compliance for these
implementing regulations shall be filed within 24 months following
the adoption of the first emergency regulations filed pursuant to
this section.
SEC. 16. Section 4686.31 is added to the Welfare and Institutions
Code, to read:
4686.31. (a) Effective July 1, 2011, notwithstanding any other
law or regulation to the contrary, any vendor who provides services
as specified in paragraph (4) shall submit verification to the
regional center for services provided to consumers who are under 18
years of age and residing in the family home as follows:
(1) The department shall develop and post a standard form for
vendors to complete and provide to the family for signature. The form
shall include, but not be limited to, the name and title of the
vendor, the vendor identification number, the name of the consumer,
the unique client identifier, the location of the service, the date
and start and end times of the service, and a description of the
service provided. The form shall also include instructions for the
parents or legally appointed guardians to contact the regional center
service coordinator immediately if they are unable to sign the form.
(2) The vendor shall provide the parents or legally appointed
guardians of a minor consumer with the department form to sign. The
form shall be signed and dated by the parents or legally appointed
guardians of a minor consumer and be submitted to the vendor
providing services within 30 days of the month in which the services
were provided.
(3) The vendor shall submit the completed forms to the regional
center together with the vendor's invoices for the services provided.
(4) If the parents or legally appointed guardians of a minor
consumer do not submit a form to the vendor, the vendor shall notify
the regional center.
(5) This subdivision shall only apply to the following types of
services: Behavior Analyst, Associate Behavior Analyst, Behavior
Management Assistant, Behavior Technician (Paraprofessional),
Behavior Management Consultant, Counseling Services, Tutor, Crisis
Team-Evaluation and Behavioral Intervention, Tutor Services-Group,
Client/Parent Support Behavior Intervention Training, and
Parent-Coordinated Home Based Behavior Intervention Program for
Autistic Children.
(b) The failure of the parents or legally appointed guardians of a
minor consumer to submit a verification of services to the vendor
shall not be a basis for terminating or changing behavioral services
to the minor consumer. Any changes to behavioral services shall be
made by the consumer's planning team pursuant to Section 4512.
SEC. 17. Section 4688.1 of the Welfare and Institutions Code is
amended to read:
4688.1. (a) Notwithstanding any other provision of law or
regulation to the contrary, vendors of behavior management, activity
center, and adult development center day programs, social recreation
programs, socialization training programs, community integration
training programs, community activities support programs, creative
art programs, and work activity programs shall offer an alternative
senior program component focused on the needs of individuals with
developmental disabilities who are over 50 years of age, at a rate
not to exceed the lesser of thirty-five dollars ($35) per day or the
vendor's existing daily rate.
(1) The alternative senior program component shall be provided at
a ratio of no more than eight consumers to one staff member.
(2) Consistent with the intent of the Lanterman Developmental
Disabilities Services Act, the alternative senior program component
shall be offered within the provider's existing vendored capacity as
reflected in its program design or licensed capacity.
(b) Effective July 1, 2009, at the time of development, review, or
modification of an eligible consumer's individual program plan,
regional centers, as appropriate, shall provide information about and
offer an alternative senior program. The alternative senior program
shall be offered to eligible consumers who want to transition to a
program component focused on the needs and interests of seniors.
(c) Effective July 1, 2011, a regional center shall not refer any
additional consumers to alternative senior programs.
SEC. 18. Section 4688.2 of the Welfare and Institutions Code is
amended to read:
4688.2. (a) Notwithstanding any other provision of law or
regulation to the contrary, vendors of behavior management, activity
center, and adult development center adult day programs, community
integration training programs, and community activities support
services programs shall offer an alternative customized program
component with an appropriate staffing component to meet
individualized consumer needs.
(1) The alternative customized program component shall be offered
within the provider's existing vendored capacity, as reflected in its
program design or licensed capacity.
(2) The regional center shall fund customized programs based on
the vendor's existing rate and only fund those hours provided.
(b) Effective July 1, 2009, at the time of development, review, or
modification of a consumer's individual program plan, regional
centers, as appropriate, shall provide information about and make
available the customized program option.
(1) The alternative customized program component shall be offered
to individuals with developmental disabilities who want a program
focused on their individualized needs and interests to develop or
maintain employment or volunteer activities in lieu of their current
program.
(2) Total hours of service for this alternative customized program
shall range between 20 and 80 hours per month, per person, depending
on the support needs of the individual.
(c) Effective July 1, 2011, a regional center shall not refer any
additional consumers to alternative customized programs.
SEC. 19. Section 4688.21 is added to the Welfare and Institutions
Code, to read:
4688.21. (a) The Legislature places a high priority on
opportunities for adults with developmental disabilities to choose
and customize day services to meet their individualized needs; have
opportunities to further the development or maintenance of employment
and volunteer activities; direct their services; pursue
postsecondary education; and increase their ability to lead
integrated and inclusive lives. To further these goals, a consumer
may choose a tailored day service or vouchered community-based
training service, in lieu of any other regional center vendored day
program, look-alike day program, supported employment program, or
work activity program.
(b) (1) A tailored day service shall do both of the following:
(A) Include an individualized service design, as determined
through the individual program plan (IPP) and approved by the
regional center, that maximizes the consumer's individualized choices
and needs. This service design may include, but may not be limited
to, the following:
(i) Fewer days or hours than in the program's approved day
program, look-alike day program, supported employment program, or
work activity program design.
(ii) Flexibility in the duration and intensity of services to meet
the consumer's individualized needs.
(B) Encourage opportunities to further the development or
maintenance of employment, volunteer activities, or pursuit of
postsecondary education; maximize consumer direction of the service;
and increase the consumer's ability to lead an integrated and
inclusive life.
(2) The type and amount of tailored day service shall be
determined through the IPP process, pursuant to Section 4646. The IPP
shall contain, but not be limited to, the following:
(A) A detailed description of the consumer's individualized
choices and needs and how these choices and needs will be met.
(B) The type and amount of services and staffing needed to meet
the consumer's individualized choices and needs, and unique health
and safety and other needs.
(3) The staffing requirements set forth in Section 55756 of Title
17 of the California Code of Regulations and subdivision (r) of
Section 4851 shall not apply to a tailored day service.
(4) For currently vendored programs wishing to offer a tailored
day service option, the regional center shall vendor a tailored day
service option upon negotiating a rate and maximum units of service
design that includes, but is not limited to, the following:
(i) A daily or hourly rate and maximum units of service design
that does not exceed the equivalent cost of four days per week of the
vendor's current rate, if the vendor has a daily day program rate.
(ii) A rate and maximum units of service design that does not
exceed the equivalent cost of four-fifths of the hours of the vendor'
s current rate, if the vendor has an hourly rate.
(5) The regional center shall ensure that the vendor is capable of
complying with, and will comply with, the consumer's IPP, individual
choice, and health and safety needs.
(6) For new programs wishing to offer a tailored day service
option, the regional center shall vendor a tailored day service
option upon negotiating a rate and maximum units of service design.
The rate paid to the new vendor shall not exceed four-fifths of the
temporary payment rate or the median rate, whichever is applicable.
(7) Effective July 1, 2011, and prior to the time of development,
review, or modification of a consumer's IPP, regional centers shall
provide information about tailored day service to eligible adult
consumers. A consumer may request information about tailored day
services from the regional center at any time and may request an IPP
meeting to secure those services.
(c) (1) A vouchered community-based training service is defined as
a consumer-directed service that assists the consumer in the
development of skills required for community integrated employment or
participation in volunteer activities, or both, and the assistance
necessary for the consumer to secure employment or volunteer
positions or pursue secondary education.
(2) Implementation of vouchered community-based training service
is contingent upon the approval of the federal Centers for Medicare
and Medicaid Services.
(3) Vouchered community-based training service shall be provided
in natural environments in the community, separate from the consumer'
s residence.
(4) A consumer, parent, or conservator vendored as a vouchered
community-based training service shall utilize the services of a
financial management services (FMS) entity. The regional center shall
provide information about available financial management services
and shall assist the consumer in selecting a FMS vendor to act as
coemployer.
(5) A parent or conservator shall not be the direct support worker
employed by the vouchered community-based training service vendor.
(6) If the direct support worker is required to transport the
consumer, the vouchered community-based training service vendor shall
verify that the direct support worker can transport the consumer
safely and has a valid California driver's license and proof of
insurance.
(7) The rate for vouchered community-based training service shall
not exceed thirteen dollars and forty-seven cents ($13.47) per hour.
The rate includes employer-related taxes and all transportation
needed to implement the service, except as described in paragraph
(8). The rate does not include
the cost of the FMS.
(8) A consumer vendored as a vouchered community-based training
service shall also be eligible for a regional center-funded bus pass,
if appropriate and needed.
(9) Vouchered community-based training service shall be limited to
a maximum of 150 hours per quarter. The services to be provided and
the service hours shall be documented in the consumer's IPP.
(10) A direct support worker of vouchered community-based training
service shall be an adult who possesses the skill, training, and
experience necessary to provide services in accordance with the IPP.
(11) Effective July 1, 2011, and prior to the time of development,
review, or modification of a consumer's IPP, regional centers shall
provide information about vouchered community-based training service
to eligible adult consumers. A consumer may request information about
vouchered community-based training service from the regional center
at any time and may request an IPP meeting to secure those services.
(12) The type and amount of vouchered community-based training
service shall be determined through the IPP process pursuant to
Section 4646. The IPP shall contain, but not be limited to, the
following:
(A) A detailed description of the consumer's individualized
choices and needs and how these choices and needs will be met.
(B) The type and amount of services and staffing needed to meet
the consumer's individualized choices and unique health and safety
and other needs.
(d) The department may adopt emergency regulations for tailored
day service or vouchered community-based training service. The
adoption, amendment, repeal, or readoption of a regulation authorized
by this subdivision is deemed to be necessary for the immediate
preservation of the public peace, health and safety, or general
welfare, for purposes of Sections 11346.1 and 11349.6 of the
Government Code, and the department is hereby exempted from the
requirement that it describe specific facts showing the need for
immediate action. A certificate of compliance for these implementing
regulations shall be filed within 24 months following the adoption of
the first emergency regulations filed pursuant to this subdivision.
SEC. 20. Section 4689 of the Welfare and Institutions Code is
amended to read:
4689. Consistent with state and federal law, the Legislature
places a high priority on providing opportunities for adults with
developmental disabilities, regardless of the degree of disability,
to live in homes that they own or lease with support available as
often and for as long as it is needed, when that is the preferred
objective in the individual program plan. In order to provide
opportunities for adults to live in their own homes, the following
procedures shall be adopted:
(a) The department and regional centers shall ensure that
supported living arrangements adhere to the following principles:
(1) Consumers shall be supported in living arrangements which are
typical of those in which persons without disabilities reside.
(2) The services or supports that a consumer receives shall change
as his or her needs change without the consumer having to move
elsewhere.
(3) The consumer's preference shall guide decisions concerning
where and with whom he or she lives.
(4) Consumers shall have control over the environment within their
own home.
(5) The purpose of furnishing services and supports to a consumer
shall be to assist that individual to exercise choice in his or her
life while building critical and durable relationships with other
individuals.
(6) The services or supports shall be flexible and tailored to a
consumer's needs and preferences.
(7) Services and supports are most effective when furnished where
a person lives and within the context of his or her day-to-day
activities.
(8) Consumers shall not be excluded from supported living
arrangements based solely on the nature and severity of their
disabilities.
(b) Regional centers may contract with agencies or individuals to
assist consumers in securing their own homes and to provide consumers
with the supports needed to live in their own homes.
(c) The range of supported living services and supports available
include, but are not limited to, assessment of consumer needs;
assistance in finding, modifying and maintaining a home; facilitating
circles of support to encourage the development of unpaid and
natural supports in the community; advocacy and self-advocacy
facilitation; development of employment goals; social, behavioral,
and daily living skills training and support; development and
provision of 24-hour emergency response systems; securing and
maintaining adaptive equipment and supplies; recruiting, training,
and hiring individuals to provide personal care and other assistance,
including in-home supportive services workers, paid neighbors, and
paid roommates; providing respite and emergency relief for personal
care attendants; and facilitating community participation. Assessment
of consumer needs may begin before 18 years of age to enable the
consumer to move to his or her own home when he or she reaches 18
years of age.
(d) Regional centers shall provide information and education to
consumers and their families about supported living principles and
services.
(e) Regional centers shall monitor and ensure the quality of
services and supports provided to individuals living in homes that
they own or lease. Monitoring shall take into account all of the
following:
(1) Adherence to the principles set forth in this section.
(2) Whether the services and supports outlined in the consumer's
individual program plan are congruent with the choices and needs of
the individual.
(3) Whether services and supports described in the consumer's
individual program plan are being delivered.
(4) Whether services and supports are having the desired effects.
(5) Whether the consumer is satisfied with the services and
supports.
(f) The planning team, established pursuant to subdivision (j) of
Section 4512, for a consumer receiving supported living services
shall confirm that all appropriate and available sources of natural
and generic supports have been utilized to the fullest extent
possible for that consumer.
(g) Regional centers shall utilize the same supported living
provider for consumers who reside in the same domicile, provided that
each individual consumer's particular needs can still be met
pursuant to his or her individual program plans.
(h) Rent, mortgage, and lease payments of a supported living home
and household expenses shall be the responsibility of the consumer
and any roommate who resides with the consumer.
(i) A regional center shall not make rent, mortgage, or lease
payments on a supported living home, or pay for household expenses of
consumers receiving supported living services, except under the
following circumstances:
(1) If all of the following conditions are met, a regional center
may make rent, mortgage, or lease payments as follows:
(A) The regional center executive director verifies in writing
that making the rent, mortgage, or lease payments or paying for
household expenses is required to meet the specific care needs unique
to the individual consumer as set forth in an addendum to the
consumer's individual program plan, and is required when a consumer's
demonstrated medical, behavioral, or psychiatric condition presents
a health and safety risk to himself or herself, or another.
(B) During the time period that a regional center is making rent,
mortgage, or lease payments, or paying for household expenses, the
supported living services vendor shall assist the consumer in
accessing all sources of generic and natural supports consistent with
the needs of the consumer.
(C) The regional center shall not make rent, mortgage, or lease
payments on a supported living home or pay for household expenses for
more than six months, unless the regional center finds that it is
necessary to meet the individual consumer's particular needs pursuant
to the consumer's individual program plan. The regional center shall
review a finding of necessity on a quarterly basis and the regional
center executive director shall annually verify in an addendum to the
consumer's individual program plan that the requirements set forth
in subparagraph (A) continue to be met.
(2) A regional center that has been contributing to rent,
mortgage, or lease payments or paying for household expenses prior to
July 1, 2009, shall at the time of development, review, or
modification of a consumer's individual program plan determine if the
conditions in paragraph (1) are met. If the planning team determines
that these contributions are no longer appropriate under this
section, a reasonable time for transition, not to exceed six months,
shall be permitted.
(j) All paid roommates and live-in support staff in supported
living arrangements in which regional centers have made rent,
mortgage, or lease payments, or have paid for household expenses
pursuant to subdivision (i) shall pay their share of the rent,
mortgage, or lease payments or household expenses for the supported
living home, subject to the requirements of Industrial Welfare
Commission Order No. 15-2001 and the Housing Choice Voucher Program,
as set forth in Section 1437f of Title 42 of the United States Code.
(k) Regional centers shall ensure that the supported living
services vendors' administrative costs are necessary and reasonable,
given the particular services that they are providing and the number
of consumers to whom the vendor provides services. Administrative
costs shall be limited to allowable costs for community-based day
programs, as defined in Section 57434 of Title 17 of the California
Code of Regulations, or its successor.
(l) Regional centers shall ensure that the most cost-effective of
the rate methodologies is utilized to determine the negotiated rate
for vendors of supported living services, consistent with Section
4689.8 and Title 17 of the California Code of Regulations.
(m) For purposes of this section, "household expenses" means
general living expenses and includes, but is not limited to,
utilities paid and food consumed within the home.
(n) A supported living services provider shall provide assistance
to a consumer who is a Medi-Cal beneficiary in applying for in-home
supportive services, as set forth in Section 12300, within five days
of the consumer moving into a supported living services arrangement.
(o) For consumers receiving supported living services who share a
household with one or more adults receiving supported living
services, efficiencies in the provision of service may be achieved if
some tasks can be shared, meaning the tasks can be provided at the
same time while still ensuring that each person's individual needs
are met. These tasks shall only be shared to the extent they are
permitted under the Labor Code and related regulations, including,
but not limited to, Industrial Welfare Commission Minimum Wage Order
No. 15. The planning team, as defined in subdivision (j) of Section
4512, at the time of development, review, or modification of a
consumer's individual program plan (IPP), for housemates currently in
a supported living arrangement or planning to move together into a
supported living arrangement, or for consumers who live with a
housemate not receiving supported living services who is responsible
for the task, shall consider, with input from the service provider,
whether any tasks, such as meal preparation and cleanup, menu
planning, laundry, shopping, general household tasks, or errands can
appropriately be shared. If tasks can be appropriately shared, the
regional center shall purchase the prorated share of the activity.
Upon a determination of a reduction in services pursuant to this
section, the regional center shall inform the consumer of the reason
for the determination, and shall provide a written notice of fair
hearing rights pursuant to Section 4701.
(p) To ensure that consumers in supported living arrangements
receive the appropriate amount and type of supports, an independent
assessment shall be required for consumers currently receiving, or
initially entering, supported living who have supported living
services costs, or have an initial recommendation for service costs,
that exceed 125 percent of the annual statewide average cost of
supported living services, as published by the department commencing
June 30, 2011. Notwithstanding any other provision of law, commencing
July 1, 2011, regional centers shall identify consumers currently
receiving supported living services, pursuant to this section, whose
annual supported living service costs exceed 125 percent of the
annual statewide average cost of supported living services. The
regional center shall also identify consumers who have an initial
recommendation for supported living service costs that exceed 125
percent of the annual statewide average cost of supported living
services. For those consumers identified pursuant to this
subdivision, the regional center shall arrange for an independent
assessment to be completed prior to the next scheduled IPP for
consumers currently in a supported living arrangement and within 30
days of identification of consumers with an initial recommendation
for services. The independent assessment shall be completed by an
impartial entity or individual other than the supported living
services agency providing, or planning to provide, the service and
shall be used during IPP meetings to assist the team to determine
whether the services provided or recommended are necessary and
sufficient and that the most cost-effective methods of service are
utilized. Decisions about supported living shall be made by the IPP
team. The independent assessment process shall adhere to all of the
following:
(1) Supported living service providers shall conduct comprehensive
assessments for the purpose of getting to know the consumer they
will be supporting and developing a support plan congruent with the
choices and needs of the individual and consistent with the
principles of supported living set forth in this section and in
Subchapter 19 (commencing with Section 58600) of Chapter 3 of
Division 2 of Title 17 of the California Code of Regulations. The
independent assessment required by this paragraph is not intended to
take the place of or repeat the service provider's comprehensive
assessment. The purpose of the independent assessment is to provide
an additional look at whether the supported living services being
provided, or being proposed for a person initially entering supported
living, are necessary, sufficient, or cost-effective to meet the
person's choices and needs, as determined by the comprehensive
assessment and the planning team. The independent needs assessment
may include, but is not limited to, use of natural and generic
support, technology that provides support otherwise necessary through
direct staffing hours, shared housing, support alternatives,
learning methods, lifting and transferring, bathroom, grooming,
meals, communication, transportation, mobility, emergency procedures,
medication management, household responsibilities, personal needs,
interpersonal relationships, and behavioral, medical, and overnight
supports.
(2) A consumer shall not be excluded from supported living
services based on an independent assessment.
(3) The entity or individual conducting independent assessments
shall not be an employee of a regional center or the consumer's
service provider. Current supported living providers may conduct
independent assessments for consumers being supported, or about to be
supported, by other providers. However a provider who conducts an
independent assessment may not provide direct services to a consumer
it has assessed for a period of one year. Each regional center shall
publicly identify the entities and individuals it will use to conduct
independent assessments. Regional centers shall ensure there are
sufficient independent assessors so that assessments can be provided
when required without undue delay.
(4) Initial entry into supported living shall not be delayed for
more than 30 days following the determination to request an
independent assessment due to the need for an independent assessment
pursuant to this section. If the independent assessment cannot be
conducted within that time period, the individual may move into
supported living with the amount of supports recommended by the
service provider's comprehensive assessment and an additional IPP to
consider the results of the independent assessment shall be conducted
when that assessment becomes available, if necessary. For
individuals currently in a supported living arrangement, supports
shall continue at the same level while the independent assessment is
being conducted.
(5) Independent assessors shall meet all of the following
qualifications:
(A) Have a demonstrated understanding of the foundation of
supported living as a service that assists an individual to live in
his or her own home with supports as needed to be part of their
community and of the principles and operational requirements of
supported living set forth in this section and in Subchapter 19
(commencing with Section 58600) of Chapter 3 of Division 2 of Title
17 of the California Code of Regulations.
(B) Have a demonstrated understanding of the IPP process and the
legal rights of people with developmental disabilities in California.
(C) Have experience with the provision of supported living
services in California.
(6) The department shall establish a rate of payment for an
independent assessment.
(7) The planning team, as defined in subdivision (j) of Section
4512, shall consider the independent assessment along with the
provider's assessment, if available, and any other relevant
information in determining whether there should be any adjustment to
the amount or type of supports currently being received by
individuals in supported living arrangement or recommended for
individuals initially entering supported living arrangement. Any
decisions to reduce supports shall not be applied retroactively.
(8) A consumer shall be reassessed as described in this
subdivision every three years in conjunction with the consumer's IPP
review to determine whether all services are necessary and sufficient
and to ensure that the most cost-effective methods of service are
being utilized.
(9) Individuals who are moving to a supported living arrangement
or have moved to a supported living arrangement from a developmental
center or state-operated community facility shall not be required to
have an additional assessment during the first 12 months following
placement.
(10) Upon a determination of a reduction in services pursuant to
this section, the regional center shall inform the consumer of the
reason for the determination, and shall provide a written notice of
fair hearing rights pursuant to Section 4701.
(11) Nothing in this section precludes the completion of an
independent assessment for other purposes.
SEC. 21. Section 4690.6 is added to the Welfare and Institutions
Code, to read:
4690.6. (a) Activity centers, adult development centers, behavior
management programs, and other look-alike day programs with a daily
rate shall bill regional centers for services provided to consumers
in terms of half days of service and full days of service.
(b) For purposes of this section, the following definitions apply:
(1) "Full day of service" means a day in which the consumer's
attendance is at least 65 percent of the declared and approved
program day.
(2) "Half day of service" means any day in which the consumer's
attendance does not meet the criteria for billing for a full day of
service.
(c) A regional center may change the length of the declared and
approved program day for a specific consumer in order to meet the
needs of that consumer, upon the recommendation of the individual
program planning team. The regional center shall set forth in the
individual program plan the length of the consumer's program day and
the reasons for the change in the length of the declared and approved
program day.
(d) The definitions set forth in this section shall not apply to
vendors of tailored day program service.
SEC. 22. Section 4785 is added to the Welfare and Institutions
Code, to read:
4785. (a) (1) Effective July 1, 2011, a regional center shall
assess an annual family program fee, as described in subdivision (b),
from parents whose adjusted gross family income is at or above 400
percent of the federal poverty level based upon family size and who
have a child to whom all of the following apply:
(A) The child has a developmental disability or is eligible for
services under the California Early Intervention Services Act (Title
14 (commencing with Section 95000) of the Government Code).
(B) The child is less than 18 years of age.
(C) The child lives with his or her parent.
(D) The child or family receives services beyond eligibility
determination, needs assessment, and service coordination.
(E) The child does not receive services through the Medi-Cal
program.
(2) An annual family program fee shall not be assessed or
collected pursuant to this section if the child receives only
respite, day care, or camping services from the regional center, and
a cost for participation is assessed to the parents under the Family
Cost Participation Program.
(3) The annual family program fee shall be initially assessed by a
regional center at the time of the development, scheduled review, or
modification of the individual program plan (IPP) pursuant to
Sections 4646 and 4646.5, or the individualized family services plan
(IFSP) pursuant to Section 95020 of the Government Code, but no later
than June 30, 2012, and annually thereafter.
(4) Application of this section to children zero through two years
of age, inclusive, shall be contingent upon necessary approval by
the United States Department of Education.
(b) (1) The annual family program fee for parents described in
paragraph (1) of subdivision (a) shall be two hundred dollars ($200)
per family, regardless of the number of children in the family with
developmental disabilities or who are eligible for services under the
California Early Intervention Services Act.
(2) Notwithstanding paragraph (1), parents described in paragraph
(1) of subdivision (a) who demonstrate to the regional center that
their adjusted gross family income is less than 800 percent of the
federal poverty level shall be required to pay an annual family
program fee of one hundred fifty dollars ($150) per family,
regardless of the number of children in the family with developmental
disabilities or who are eligible for services under the California
Early Intervention Services Act.
(c) At the time of intake or at the time of development, scheduled
review, or modification of a consumer's IPP or IFSP, but no later
than June 30, 2012, the regional center shall provide to parents
described in paragraph (1) of subdivision (a) a form and an envelope
for the mailing of the annual family program fee to the department.
The form, which shall include the name of the children in the family
currently being served by a regional center and their unique client
identifiers, shall be sent, with the family's annual program fee, to
the department.
(d) The department shall notify each regional center at least
quarterly of the annual family program fees collected.
(e) The regional center shall, within 30 days after notification
from the department pursuant to subdivision (d), provide a written
notification to the parents from whom the department has not received
the annual family program fees. Regional centers shall notify the
department if a family receiving notification pursuant to this
section has failed to pay its annual family program fees based on the
subsequent notice pursuant to subdivision (d). For these families,
the department shall pursue collection pursuant to the Accounts
Receivable Management Act (Chapter 4.3 (commencing with Section
16580) of Part 2 of Division 4 of Title 2 of the Government Code).
(f) A regional center may grant an exemption to the assessment of
an annual family program fee if the parents demonstrate any of the
following:
(1) That the exemption is necessary to maintain the child in the
family home.
(2) The existence of an extraordinary event that impacts the
parents' ability to pay the fee or the parents' ability to meet the
care and supervision needs of the child.
(3) The existence of a catastrophic loss that temporarily limits
the ability of the parents to pay and creates a direct economic
impact on the family. For purposes of this paragraph, catastrophic
loss may include, but is not limited to, natural disasters, accidents
involving, or major injuries to, an immediate family member, and
extraordinary medical expenses.
(g) Services shall not be delayed or denied for a consumer or
child based upon the lack of payment of the annual family program
fee.
(h) For purposes of this section, "parents" means the parents,
whether natural, adoptive, or both, of a child with developmental
disabilities under 18 years of age.
(i) Parents described in paragraph (1) of subdivision (a) shall be
jointly and severally responsible for the annual family program fee,
unless a court order directs otherwise.
(j) (1) "Total adjusted gross family income" means income
acquired, earned, or received by parents as payment for labor or
services, support, gift, or inheritance, or parents' return on
investments. It also includes the community property interest of a
parent in the gross adjusted income of a stepparent.
(2) The total adjusted gross family income shall be determined by
adding the gross income of both parents, regardless of whether they
are divorced or legally separated, unless a court order directs
otherwise, or unless the custodial parent certifies in writing that
income information from the noncustodial parent cannot be obtained
from the noncustodial parent and in this circumstance only the income
of the custodial parent shall be used to determine the annual family
program fee.
(k) This section shall become inoperative on June 30, 2013, and as
of January 1, 2014, is repealed, unless a later enacted statute,
that becomes operative on or before June 30, 2013, deletes or extends
the dates on which it becomes inoperative and is repealed.
SEC. 23. Section 7502.5 of the Welfare and Institutions Code is
amended to read:
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
until the population of the secure treatment facility is less than
230 persons.
(c) To maximize federal financial participation, the State
Department of Developmental Services shall not admit any more than
104 people who are ineligible to participate in programs certified
for federal financial participation into the secure treatment
facility at Porterville Developmental Center.
SEC. 24. Section 10 of Chapter 13 of the Third Extraordinary
Session of the Statutes of 2009, as amended by Section 16 of Chapter
9 of the Statutes of 2011, is amended to read:
Sec. 10. (a) Notwithstanding any other provision of law, in order
to implement changes in the level of funding for regional center
purchase of services, regional centers shall reduce payments for
services and supports provided pursuant to Title 14 (commencing with
Section 95000) of the Government Code and Division 4.1 (commencing
with Section 4400) and Division 4.5 (commencing with Section 4500) of
the Welfare and Institutions Code. From February 1, 2009, to June
30, 2010, inclusive, regional centers shall reduce all payments for
these services and supports paid from purchase of services funds for
services delivered on or after February 1, 2009, by 3 percent, and
from July 1, 2010, to June 30, 2012, inclusive, by 4.25 percent,
unless the regional center demonstrates that a nonreduced payment is
necessary to protect the health and safety of the individual for whom
the services and supports are proposed to be purchased, and the
State Department of Developmental Services has granted prior written
approval.
(b) Regional centers shall not reduce payments pursuant to
subdivision (a) for the following:
(1) Supported employment services with rates set by Section 4860
of the Welfare and Institutions Code.
(2) Services with "usual and customary" rates established pursuant
to Section 57210 of Title 17 of the California Code of Regulations,
except as provided in subdivision (c).
(3) Payments to offset reductions in Supplemental Security
Income/State Supplementary Payment (SSI/SSP) benefits for consumers
receiving supported and independent living services.
(c) The exemption provided for in paragraph (2) of subdivision (b)
shall not apply to payments for any of the following services:
(1) Crisis and behavioral services provided by a nationally
certified or state-licensed professional, consistent with the
professional's scope of practice, as set forth in the Business and
Professions Code.
(2) Services of group practices providing behavioral intervention.
(3) Parent-coordinator home-based behavioral intervention for
children with autism.
(4) Individual or family training.
(5) Registered nurse services.
(6) Therapy services, including physical, speech, occupational,
recreational, and music therapy.
(7) Audiology services.
(8) Independent living specialist services.
(9) Translator and interpreter services.
(10) Mobility training, socialization training, or community
integration training services.
(11) Community activities support, program support, or parenting
support services.
(12) Personal assistance services.
(13) Tutoring services.
(14) Creative arts services.
(15) Early start specialized therapeutic services.
(d) Notwithstanding any other provision of law, in order to
implement changes in the level of funding appropriated for regional
centers, the department shall amend regional center contracts to
adjust regional center budgets accordingly for the 2008-09 fiscal
year through the 2011-12 fiscal year. The contract amendments and
budget adjustments shall be exempt from the provisions of Article 1
(commencing with Section 4620) of Chapter 5 of Division 4.5 of the
Welfare and Institutions Code.
SEC. 25. Due to a change in the availability of federal funding
that addresses California's ability to capture additional federal
financial participation for day treatment and transportation services
provided to a Medi-Cal beneficiary residing in a licensed
intermediate care facility, as specified in Sections 4646.55 and
14132.925 of the Welfare and Institutions Code, funds appropriated in
the following budget items shall be available for liquidation until
December 31, 2011:
(a) Item 4300-101-0001 of the Budget Act of 2007 (Chapters 171 and
172, Statutes of 2007), as previously reappropriated by Chapter 268
of the Statutes of 2008.
(b) Item 4300-101-0001 of the Budget Act of 2008 (Chapters 268 and
269, Statutes of 2008).
SEC. 26. The State Department of Developmental Services (DDS)
shall reimburse the Office of Statewide Audits and Evaluations (OSAE)
within the Department of Finance to conduct a review and analysis of
the budget methodology, including relevant data, formulas, and cost
assumptions, used in determining the annual state budget for the
developmental centers. The DDS shall provide information to the OSAE
as necessary for it to complete its analysis and provide
recommendations. It is the Legislature's intent for the DDS to notify
the OSAE and to proceed with this analysis during the fall of 2011.
SEC. 27. The sum of one thousand dollars ($1,000) is hereby
appropriated from the General Fund to the State Department of
Developmental Services for departmental support.
SEC. 28. 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.