BILL ANALYSIS Ó
AB 1112
Page 1
Date of Hearing: April 16, 2013
ASSEMBLY COMMITTEE ON HUMAN SERVICES
Mark Stone, Chair
AB 1112 (Ammiano) - As Introduced: February 22, 2013
SUBJECT : Developmental services: habilitation
SUMMARY : Requires rates and fees for supported employment
services for people with developmental disabilities to be
consistent with rates and fees set by the Department of
Rehabilitation (DOR).
Specifically, this bill :
1) Deletes hourly supported employment services job
coaching rates for individuals and groups and instead makes
them consistent with the Department of Rehabilitation rate
structure policy.
2) Deletes provisions establishing a service structure for
consumers and fee structure for interim providers to be
used when a regional center consumer has been put on a
waitlist for services by the Department of Rehabilitation,
and instead requires fees for those services to be
consistent with the applicable service fees established by
DOR.
EXISTING LAW
1)Establishes the Lanterman Developmental Disabilities Services
Act (Lanterman Act), under which the Department of
Developmental Services (DDS) is authorized to contract with
private non-profit regional centers to provide case management
services and arrange for, or purchase, services that meet the
needs of individuals with developmental disabilities, as
defined.
2)Grants all individuals with developmental disabilities, among
all other rights and responsibilities established for any
individual by the United States Constitution and laws and the
California Constitution and laws, the right to treatment and
habilitation services and supports in the least restrictive
environment.
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3)Requires the development of an Individual Program Plan (IPP)
for each regional center consumer, which specifies services to
be provided to the consumer, based on his or her
individualized needs determination and preferences, and
defines that planning process as the vehicle to ensure that
services and supports are customized to meet the needs of
consumers who are served by regional centers.
4)Requires that the planning processes to create an IPP include:
a) A statement of the individual's goals and objectives, a
schedule of the type and nature of services to be provided
and other information and considerations, as specified;
b) Review and modification, as necessary, by the regional
center's planning team no less frequently than every three
years; and
c) Statewide training and review of the IPP plan creation,
as specified.
1)States the Legislature's intent that habilitation services for
adults with developmental disabilities be planned and provided
in a manner that enables persons with developmental
disabilities to approximate the pattern of everyday living
available to nondisabled people of the same age.
2)Defines "habilitation services" as community-based services
purchased or provided for adults with developmental
disabilities, including services provided under the Work
Activity Program and the Supported Employment Program, to
prepare and maintain them at their highest level of vocational
functioning, or to prepare them for referral to vocational
rehabilitation services.
3)Requires a regional center to authorize appropriate
habilitation services for a consumer while he or she awaits
service authorization from the Department of Rehabilitation if
the regional center has referred that consumer to the
Department of Rehabilitation for vocational rehabilitation
services, and the consumer is put on a waiting list.
4)Establishes the following rates and fees to be paid to interim
providers of rehabilitation services that are authorized by
the regional center for the period during which a consumer is
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on a waiting list for vocational services from the Department
of Rehabilitation:
a) A rate of thirty dollars and eighty-two cents ($30.82)
per hour for supported employment services provided to
consumers receiving individualized or group services;
b) A three-hundred-sixty-dollar ($360) fee to be paid to a
program provider upon intake of a consumer into a supported
employment program;
c) A seven-hundred-twenty-dollar ($720) fee to be paid upon
placement of a consumer in an integrated job, as specified;
and
d) A seven-hundred-twenty-dollar ($720) fee to be paid
after a 90-day retention of a consumer in a job, as
specified.
FISCAL EFFECT : Unknown
Background
The Lanterman Developmental Disabilities Services Act (Welfare &
Institutions Code § 4500 et seq.) guides the provision of
services and supports for Californians with developmental
disabilities. Each individual under the Act, typically referred
to as a "consumer," is legally entitled to treatment and
habilitation services and supports in the least restrictive
environment. Lanterman Act services are designed to enable all
consumers to live more independent and productive lives in the
community.
The term "developmental disability" means a disability that
originates before an individual attains 18 years of age, is
expected to continue indefinitely, and constitutes a substantial
disability for that individual. It includes intellectual
disabilities, cerebral palsy, epilepsy, and autism spectrum
disorders (ASD). Other developmental disabilities are those
disabling conditions similar to an intellectual disability that
require care and management similar to that required by
individuals with intellectual disabilities. This does not
include conditions that are solely psychiatric or physical in
nature, and the conditions must occur before age 18, result in a
substantial disability, be likely to continue indefinitely, and
involve brain damage or dysfunction. Examples of conditions
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might include intracranial neoplasms, degenerative brain disease
or brain damage associated with accidents.
Direct responsibility for implementation of the Lanterman Act
service system is shared by the Department of Developmental
Services and 21 regional centers, which are private nonprofit
entities, established pursuant to the Lanterman Act, that
contract with DDS to carry out many of the state's
responsibilities under the Act. The principal roles of regional
centers include intake and assessment, individualized program
plan development, case management, and securing services through
generic agencies or purchasing services provided by vendors.
Regional centers also share primary responsibility with local
education agencies for provision of early intervention services
under the California Early Intervention Services Act. Regional
centers serve over 250,000 consumers who receive services such
as residential placements, supported living services, respite
care, transportation, day treatment programs, work support
programs, and various social and therapeutic programs.
Approximately 1,600 consumers reside at one of California's four
Developmental Centers-and one state-operated, specialized
community facility-which provide 24-hour habilitation and
medical and social treatment services. Over 125,000 regional
center consumers are of working age.
Services provided to people with developmental disabilities are
determined through an individual planning process. Under this
process, planning teams-which include, among others, the
consumer, his or her legally authorized representative, and one
or more regional center representatives-jointly prepare an
Individual Program Plan (IPP) based on the consumer's needs and
choices. The Lanterman Act requires that the IPP promote
community integration and maximize opportunities for each
consumer to develop relationships, be part of community life,
increase control over his or her life, and acquire increasingly
positive roles in the community. The IPP must give the highest
preference to those services and supports that allow minors to
live with their families and adults to live as independently as
possible in the community.
Employment Services
Regional centers contract with employment services programs and
providers to address the employment needs of individuals with
developmental disabilities. Consumers are placed in jobs
according to their individual skills, needs and choices, and
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they are provided support services on an individual or group
basis. In addition to meeting the employment needs of the
consumer, work programs can also greatly increase opportunities
for community integration for consumers.
Work Activity Programs (WAPs) are employment services programs
in a sheltered work environment for consumers who have acquired
basic vocational and independent living skills. All WAP work is
paid at a daily per capita rate based on productivity.
Alternatively, Supported Employment Programs (SEPs) are
community-based rehabilitation programs that focus on helping
consumers obtain, retain or maintain employment in integrated
settings. SEPs often involve job coaches that provide
on-the-job services and training and direct pay from employers
to consumers.
Department of Rehabilitation
If it is determined that supported employment services would
best meet the employment needs of a consumer, a regional center
will refer the consumer to the Department of Rehabilitation
(DOR) for time-limited employment services in an integrated
employment setting. If a regional center consumer needs
long-term support to continue in their place of employment, the
responsibility for providing a job coach and maintaining
supportive services shifts back to DDS. DOR provides and pays
for three tiers of employment-related services, with set
corresponding rates, for individuals with developmental
disabilities, which include: 1) intake to determine employment
needs and develop a plan of action; 2) placement in a particular
job; and 3) retention for 90-days in a particular job. Within
the DOR service and rate structure, individuals who have
disabilities but are not diagnosed with developmental
disabilities receive an additional "Employment Preparation"
service.
COMMENTS :
According to the author, this bill would provide job seekers
with intellectual/developmental disabilities equal access to
employment opportunities and the full array of supports funded
by DOR. Additionally, the author intends to address the absence
of "Employment Preparation" services for individuals with
developmental disabilities within DOR's uniform fee structure,
which puts a group of people who have a documented unemployment
rate of over 80% at a disadvantage.
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Rather than adding in an Employment Preparation service and fee
to WIC §4860, which this bill amends, the language instead
strikes statutorily set rates and fees and replaces them with a
requirement that the rates/fees established be consistent with
the rate structure policy set by DOR. The author contends that
the structure set in WIC §4860 restricts opportunities for
individuals with disabilities, and that there could be
opportunities for greater funding levels for supported
employment service providers and access to additional services
if the structure and rates/fees are directly linked to DOR.
However, DOR bases its uniform fee structure for individuals
with developmental disabilities -including correlating
services-on WIC §4860. Essentially, removing dollar amounts in
this section and linking rates and fees back to DOR would result
in a cycle in which no rates would exist for supported
employment services provided to regional center consumers,
whether they are provided through DOR or a regional center.
SUGGESTED AMENDMENTS
In order to meet the author's goals of offering job seekers with
developmental disabilities the same options as other individuals
who receive supported employment services through DOR, and
allowing for potential increases in hourly rates, staff
recommends the following amendments, which include restoring the
rates and fees in current statute:
4860. (a) (1) The hourly rate for supported employment services
provided to consumers receiving individualized services shall be
thirty dollars and eighty-two cents ($30.82) consistent with the
Department of Rehabilitation rate structure policy .
(2) Job coach hours spent in travel to consumer worksites may be
reimbursable for individualized services only when the job coach
travels from the vendor's headquarters to the consumer's
worksite or from one consumer's worksite to another, and only
when the travel is one way.
(b) The hourly rate for group services shall be thirty dollars
and eighty-two cents ($30.82) consistent with the Department of
Rehabilitation rate structure policy , regardless of the number
of consumers served in the group. Consumers in a group shall be
scheduled to start and end work at the same time, unless an
exception that takes into consideration the consumer's
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compensated work schedule is approved in advance by the regional
center. The department, in consultation with stakeholders,
shall adopt regulations to define the appropriate grounds for
granting these exceptions. When the number of consumers in a
supported employment placement group drops to fewer than the
minimum required in subdivision (r) of Section 4851, the
regional center may terminate funding for the group services in
that group, unless, within 90 days, the program provider adds
one or more regional centers, or Department of
Rehabilitation-funded supported employment consumers to the
group.
(c) Job coaching hours for group services shall be allocated on
a prorated basis between a regional center and the Department of
Rehabilitation when regional center and Department of
Rehabilitation consumers are served in the same group.
(d) When Section 4855 applies, fees for services provided
through the regional center shall be consistent with the fee for
that service established by the Department of Rehabilitation.
(d)When Section 4855 applies, fees shall be authorized for the
following:
(1)A three-hundred-sixty-dollar ($360) fee shall be paid to the
program provider upon intake of a consumer into a supported
employment program. No fee shall be paid if that consumer
completed a supported employment intake process with that same
supported employment program within the previous 12 months.
(2) A seven hundred dollar ($700) fee shall be paid to the
program provider for employment preparation services provided
to a consumer prior to placement in an integrated job. No fee
shall be paid if that consumer completed an employment
preparation process with the same supported employment program
within the previous 12 months.
(3)A seven-hundred-twenty-dollar ($720) fee shall be paid upon
placement of a consumer in an integrated job, except that no fee
shall be paid if that consumer is placed with another consumer
or consumers assigned to the same job coach during the same
hours of employment.
(4)A seven-hundred-twenty-dollar ($720) fee shall be paid after
a 90-day retention of a consumer in a job, except that no fee
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shall be paid if that consumer has been placed with another
consumer or consumers, assigned to the same job coach during the
same hours of employment.
(e)Notwithstanding paragraph (4) of subdivision (a) of Section
4648, the regional center shall pay the supported employment
program rates established by this section, or rates established
by the Department of Rehabilitation, whichever are greater.
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RELATED LEGISLATION
AB 954 (Maienschein) restores the hourly job coach rate and
employment service fees that are paid for by regional centers to
2006 levels, which were decreased by 10% in 2008-09. *It should
be noted that the provisions of AB 954 (Maienschein) and AB 1112
(Ammiano) are in direct conflict, as currently drafted.
AB 1041 (Chesbro) establishes Employment First Policy
requirements related to the inclusion of integrated employment
opportunities and services in a regional center consumer's
individual program plan (IPP).
SB 577 (Pavley) requires DDS to establish a pilot program for
young adults with ASD to help them find pathways to financial
independence through work.
REGISTERED SUPPORT / OPPOSITION :
Support
Toolworks Inc.
Opposition
None on file
Analysis Prepared by : Myesha Jackson / HUM. S. / (916)
319-2089