Amended in Senate June 12, 2014

California Legislature—2013–14 Regular Session

Assembly Bill No. 1461

Introduced by Committee on Budget (Skinner (Chair), Bloom, Campos, Chesbro, Dababneh, Daly, Dickinson, Gordon, Jones-Sawyer, Mullin, Muratsuchi, Nazarian, Rodriguez, Stone, Ting, and Weber)

January 9, 2014

begin delete An act relating to the Budget Act of 2014. end delete begin insert An act to amend Section 854.1 of, and to amend, repeal, and add Section 95014 of, the Government Code, to amend Sections 1502 and 1524 of, to add Article 9.7 (commencing with Section 1567.80) to Chapter 3 of Division 2 of, and to add and repeal Article 9.5 (commencing with Section 1567.61) of Chapter 3 of Division 2 of, the Health and Safety Code, and to amend Sections 4418.25, 4418.7, 4474.2, 4474.3, 4514, 4519.6, 4648, 4659.1, 4681.6, 4691.6, 4691.9, 6504.5, and 6509 of, to amend, repeal, and add Section 7505 of, to add Section 4436 to, to add Article 8 (commencing with Section 4698) to Chapter 6 of Division 4.5 of, and to add and repeal Article 3.6 (commencing with Section 4684.80) of Chapter 6 of Division 4.5 of, the Welfare and Institutions Code, relating to developmental services, and making an appropriation therefor, to take effect immediately, bill related to the budget. end insert

LEGISLATIVE COUNSEL’S DIGEST

AB 1461, as amended, Committee on Budget. begin delete Budget Act of 2014. end delete begin insert Developmental services. end insert

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(1) Existing law, the California Community Care Facilities Act, provides for the licensing and regulation of community care facilities, as defined, by the State Department of Social Services. A violation of the act is a misdemeanor.

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This bill would license as a community care facility an enhanced behavioral supports home, which is a facility certified by the State Department of Developmental Services and licensed by the State Department of Social Services as an adult residential facility or a group home, with a maximum of 4 clients, that provides 24-hour nonmedical care to individuals with developmental disabilities who require enhanced behavioral supports, staffing, and supervision in a homelike setting, and that is eligible for federal Medicaid funding. The bill would require the State Department of Developmental Services to establish a pilot program, until January 1, 2020, for the operation of up to 6 enhanced behavioral supports homes, as specified, each fiscal year in which the pilot program is in effect and to the extent funding is available. The bill would require an enhanced behavioral supports home to be certified by the State Department of Developmental Services, and its plan of operation approved by both the State Department of Developmental Services and the State Department of Social Services prior to being licensed as a community care facility.

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This bill would also include within the definition of a community care facility a community crisis home. The bill would define a community crisis home as a facility that has a maximum of 8 clients, conforms to certain federal regulations, is eligible for federal Medicaid home and community-based services funding, is certified by the State Department of Developmental Services, and is licensed by the State Department of Social Services as an adult residential facility. A community crisis home would provide 24-hour nonmedical care to individuals with developmental disabilities receiving regional center service, in need of crisis intervention services, and who would otherwise be at risk of admission to the acute crisis center at Fairview Developmental Center or Sonoma Developmental Center, an out-of-state placement, a general acute hospital, an acute psychiatric hospital, or an institution for mental disease.

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This bill would require the State Department of Developmental Services, using community placement plan funds, to establish a community-based residential option consisting of community crisis homes, as specified. The bill would authorize the State Department of Developmental Services to issue a certificate of program approval to a qualified community crisis home. The bill would also require a community crisis home to have been issued a certificate of program approval by the State Department of Developmental Services, and its plan of operation to have been approved by both the State Department of Developmental Services and the State Department of Social Services, prior to licensure by the State Department of Social Services as a community care facility. The bill would prohibit either the certificate or the license from being issued until the publication of emergency regulations by the State Department of Developmental Services, as provided.

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By expanding the definition of a community care facility, this bill would change the definition of an existing crime, creating a state-mandated local program.

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(2) Existing law establishes the State Department of Developmental Services and sets forth its powers and duties, including, but not limited to, the administration of state developmental centers and the administration and oversight of community programs providing services to consumers with developmental disabilities and their families.

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This bill would require the department to evaluate enhanced behavioral supports homes, community crisis homes, and the acute crisis centers at the Fairview Developmental Center and the Sonoma Developmental Center, and to provide the evaluations to the budget committees and appropriate policy committees of the Legislature, as specified. The bill would require the evaluation for each facility to include specified information, including, but not limited to, comparative summary information regarding the characteristics of the persons served and their immediate past residential settings.

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(3) Existing law specifies procedures for the commitment of persons with developmental disabilities to the department for purposes of placement and treatment, including, among others, that a written report be submitted to the court containing a specified evaluation of the person alleged to have a developmental disability. Existing law requires that treatment, services, and supports be provided in natural community settings to the maximum extent possible, and authorizes the department to contract with regional centers to provide services and supports to individuals with developmental disabilities.

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Under existing law, those services and supports are contained in an individual program plan, developed in accordance with prescribed requirements. Existing law also requires the department to establish a statewide specialized resource service to reduce reliance on out-of-state placements and developmental centers and mental health facilities for which federal funding is not available. Existing law requires regional centers to complete, and update annually as part of the individual program planning process for as long as the consumer resides in the developmental center, a comprehensive assessment of specified consumers residing in a developmental centers, and requires that this assessment be provided to the individual program planning team in order to assist the planning team in determining the least restrictive environment for the consumer. Under existing law, the regional center is required to also provide, to the extent appropriate, relevant information from the statewide specialized resource service to the individual program planning team. Existing law requires that the clients’ rights advocate for the regional center be notified of each individual program plan meeting that includes discussion of the results of the assessment, and authorizes the advocate to participate in the meeting unless the consumer objects on his or her own behalf.

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This bill would additionally require the regional center to provide the comprehensive assessment, or updated assessment, and relevant information from the statewide specialized resource service to the clients’ rights advocate for the regional center and the superior court with jurisdiction over the consumer’s placement at the developmental center, including the consumer’s attorney of record and other parties known to the regional center, as specified. The bill would require the comprehensive assessment, or updated assessment, to be provided to the court as part of the report described above in specified circumstances. The bill would also require the regional center to provide a copy of the most recent comprehensive assessment or updated assessment to notify the clients’ rights advocate of the time, date, and location of each individual program plan meeting that includes discussion of the results of the comprehensive assessment and updates to that assessment as soon as practicable following the completion of the comprehensive assessment or update and not less than 30 calendar days prior to the meeting.

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(4) Existing law requires the confidentiality of all information and records obtained in the course of providing intake, assessment, and services pursuant to specified provisions of existing law to persons with developmental disabilities and authorizes disclosure in certain cases, including to the courts and designated parties as part of a regional center report or assessment in compliance with specified statutory or regulatory requirements.

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This bill would authorize a regional center to, when a comprehensive assessment has been conducted or updated pursuant to specified provisions of existing law, provide the assessment to the regional center clients’ rights advocate.

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(5) Existing law requires a regional center to immediately notify the appropriate regional resource development project, the consumer, and the consumer’s parents, legal guardian, or conservator if the regional center determines, or is informed by the consumer’s parents, legal guardian, conservator, or authorized representative that the community placement of a consumer is at risk of failing, and that admittance to a state developmental center is a likelihood, or the regional center is notified by a court of a potential admission to a developmental center.

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This bill would additionally require the regional center to notify the clients’ rights advocate for the regional center in the circumstances described above.

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(6) Existing law generally prohibits a regional center from purchasing new residential services from institutions for mental disease, including in emergencies when a regional center cannot locate alternate services to meet the consumer’s needs. Existing law requires a regional center, as soon as possible within 30 days of admission due to an emergency, to complete an assessment and convene an individual program plan meeting immediately following the assessment, to determine the services and supports needed for stabilization and to develop a plan to transition the consumer from the facility to the community. Existing law requires the clients’ rights advocate to be notified of each admission and individual program planning meeting pursuant these provisions and authorizes the clients’ rights advocate to participate in all individual program planning meetings unless the consumer objects on his or her own behalf.

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This bill would require the notification to the clients’ rights advocate described above to be provided as soon as practicable, but not less than 7 calendar days prior to the meeting, and require the notification to include the date, time and location of the meeting.

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(7) 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. The act requires these services to be provided pursuant to the existing regional center system under the Lanterman Developmental Disabilities Service Act, and further requires the regional centers to comply with that act and its implementing regulations, as specified.

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This bill would, beginning January 1, 2015, revise the definition of an eligible infant or toddler for purposes of eligibility for services.

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(8) Existing law authorizes a regional center to pay any applicable copayment or coinsurance for a service or support required by a consumer’s individual program plan if the service is paid for by the health care service plan or health insurance policy of the consumer or his or her parent, guardian, or caregiver and, among other conditions, the family or the consumer, as applicable, has an annual gross income that does not exceed 400% of the federal poverty level. Existing law prohibits a regional center from paying health care service plan or health insurance policy deductibles.

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This bill would delete that prohibition against payment of deductibles and would authorize a regional center to pay any applicable deductible for a service or support required by a consumer’s individual program plan if the support or service is paid for by the health care service plan or health insurance policy of the consumer or his or her parent, guardian, or caregiver, and other specified conditions are satisfied.

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(9) Existing law requires the department and regional centers to annually collaborate to determine the most appropriate methods to collect and compile meaningful data in a uniform manner, as specified, related to the payment of copayments and coinsurance by each regional center.

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This bill would also require the department and regional centers to include in that collaboration the most appropriate methods to collect and compile meaningful data in a uniform manner related to the payment of deductibles by each regional center.

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(10) Existing law prohibits the admission of a person to a developmental center except under certain circumstances, including when the person is experiencing an acute crisis and is committed by a court to the Fairview Developmental Center.

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This bill, commencing January 1, 2015, would additionally authorize the admission of a person to the acute crisis center at Sonoma Developmental Center upon commitment by a court due to an acute crisis. The bill would require the acute crisis center at the Fairview Developmental Center and the acute crisis center at the Sonoma Developmental Center to each consist of a unit that is distinct from other residential units in the developmental center and to each serve no more than 5 residents. The bill would authorize crisis center residents to participate in day, work, and recreation programs, and other developmental center facility activities, outside of the acute crisis unit, when the individual program plan identifies it is appropriate and consistent with the individual’s treatment plan. The bill would further require the acute crisis centers to assist the consumer with transitioning back to his or her residence, as specified.

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(11) Existing law details a process for the transition of an individual from a developmental center to a community living arrangement, including a requirement that the department provide followup services to help ensure a smooth transition to the community. Under existing law, whenever the State Department of Developmental Services proposes the closure of a developmental center, the department is required to submit a detailed plan to the Legislature by a specified date that includes a description of the services that will no longer be provided by the center and potential job opportunities for developmental center employees and other efforts made to mitigate the effect of the closure on employees. Existing law authorizes the department to operate a facility, provide employees to assist in the operation of a facility, or provide other necessary services if the department determines that the activity will assist in meeting the goal of the orderly closures of specified developmental centers and requires the department to annually prepare a report on the use of the department’s employees in this regard. Existing law makes specified public contracting conflict-of-interest provisions inapplicable to those employees.

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This bill would expand those provisions to authorize the department to operate a facility, provide employees to assist in the operation of a facility, or provide other necessary services and supports if the department determines that the activity will assist in meeting the goal of successfully transitioning developmental center residents to community living or deflecting the admission of individuals with developmental disabilities to a developmental center, an institution for mental disease, an out-of-state placement, a general acute care hospital, or an acute psychiatric hospital. The bill would require the department to annually prepare a report on the use of the department’s employees in this regard, and would exempt those employees from specified public contracting conflict-of-interest provisions. The bill would also require the report to include specified recommendations.

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(12) Existing law sets forth the rules relating to the liability of governmental agencies for tort injury caused by the action or omission of its officers or employees, including the operation of mental institutions or medical facilities. Existing law defines a mental institution or medical facility for purposes of those provisions to include a facility where a public employee provides services relating to the closure of specified developmental centers.

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This bill would expand the definition of a “mental institution” or “medical facility” for purposes of those provisions to include a facility where a public employee provides services and supports to individuals transitioning from a developmental center to the community or to individuals at risk of admission to a developmental center, an institution for mental disease, an out-of-state placement, a general acute care hospital, or an acute psychiatric hospital.

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(13) Existing law requires the department to enter into contracts with private nonprofit corporations to operate regional centers that provide community services and support for consumers and their families, including, but not limited to, residential placement. Existing law sets forth the department’s and the regional center’s authority to negotiate provider rates, and sets forth certain limitations. Existing law authorizes prescribed provider rate increases and prohibits others.

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Existing law, commencing July 1, 2014, increases the state minimum wage to no less than $9 per hour.

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This bill would, notwithstanding existing law, authorize adjustment in prescribed provider rates commencing July 1, 2014, as necessary to adjust employee wages to meet the new state minimum wage law.

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The bill would, commencing January 1, 2015, require an increase of the in-home respite service agency rate schedule and the rates for personal assistance and supported living services by 5.82%, subject to funding being specifically appropriated for these purposes, as specified.

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(14) The Budget Act of 2011 appropriated $2,289,463,000 to the State Department of Developmental Services for regional centers, payable from the General Fund.

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This bill would, notwithstanding any other law, provide that this appropriation is available for liquidation of encumbrances through June 30, 2015. The bill would also reappropriate the unencumbered balance of $13,048,000 of that appropriation for the purposes provided for in the appropriation and make that amount available for encumbrance or expenditure until June 30, 2015, and for liquidation through June 30, 2017.

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(15)The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

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This bill would provide that no reimbursement is required by this act for a specified reason.

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(16) This bill would declare that it is to take effect immediately as a bill providing for appropriations related to the Budget Bill.

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This bill would express the intent of the Legislature to enact statutory changes relating to the Budget Act of 2014.

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Vote: majority. Appropriation:  begin delete no end delete begin insert yes end insert . Fiscal committee:  begin delete no end delete begin insert yes end insert . State-mandated local program:  begin delete no end delete begin insert yes end insert .

The people of the State of California do enact as follows:

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begin insert SECTION 1. end insert   

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begin insert Section 854.1 of the end insert begin insert Government Code end insert begin insert is amended
to read: end insert

854.1.  

(a) It is the intent of the Legislature to ensure continuity
of care for begin delete clients of Agnews Developmental Center end delete begin insert individuals
with developmental disabilities transitioning from a developmental
center to the community end insert and begin delete Lanterman Developmental Center. end delete
begin insert to prevent the unnecessary institutionalization and hospitalization
of these individuals. end insert

(b) In the effort to achieve these goals, it is the intent of the
Legislature to seek and implement recommendations that include
all of the following services to retain begin delete Agnews and Lanterman end delete
begin insert developmental center end insert staff as employees:

(1) Crisis management teams that provide behavioral, medical,
and dental treatment, training, and technical assistance.

(2) Specialized services, including adaptive equipment design
and fabrication, and medical, dental, psychological, and assessment
services.

(3) Staff support in community homes to assist individuals with
behavioral or psychiatric needs.

(c) As used in this chapter, the terms “mental institution” or
“medical facility” also include a developmental services facility.
For the purposes of this chapter “developmental services facility”
means any facility or place where a public employee provides
begin insert services and supports to individuals transitioning from a end insert
developmental begin delete services relating end delete begin insert center end insert to the begin delete closure end delete begin insert community
or to individuals with developmental disabilities at risk end insert of begin delete Agnews
Developmental Center end delete begin insert admission to a developmental center, an
institution for mental disease, an out-of-state placement, a general
acute care hospital, end insert or begin delete Lanterman Developmental Center. end delete begin insert an acute
psychiatric hospital. end insert

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begin insert SEC. 2. end insert   

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begin insert Section 95014 of the end insert begin insert Government Code end insert begin insert is amended to
read: end insert

95014.  

(a) The term “eligible infant or toddler” for the
purposes of this title means infants and toddlers from birth through
two years of age, for whom a need for early intervention services,
as specified in the federal Individuals with Disabilities Education
Act (20 U.S.C. Sec. 1431 et seq.) and applicable regulations, is
documented by means of assessment and evaluation as required
in Sections 95016 and 95018 and who meet one of the following
criteria:

(1) Infants and toddlers with a developmental delay in one or
more of the following five areas: cognitive development; physical
and motor development, including vision and hearing;
communication development; social or emotional development;
or adaptive development. Developmentally delayed infants and
toddlers are those who are determined to have a significant
difference between the expected level of development for their
age and their current level of functioning. This determination shall
be made by qualified personnel who are recognized by, or part of,
a multidisciplinary team, including the parents. A significant
difference is defined as a 33-percent delay in one developmental
area before 24 months of age, or, at 24 months of age or older,
either a delay of 50 percent in one developmental area or a
33-percent delay in two or more developmental areas. The age for
use in determination of eligibility for the Early Intervention
Program shall be the age of the infant or toddler on the date of the
initial referral to the Early Intervention Program.

(2) Infants and toddlers with established risk conditions, who
are infants and toddlers with conditions of known etiology or
conditions with established harmful developmental consequences.
The conditions shall be diagnosed by a qualified personnel
recognized by, or part of, a multidisciplinary team, including the
parents. The condition shall be certified as having a high
probability of leading to developmental delay if the delay is not
evident at the time of diagnosis.

(b) Regional centers and local educational agencies shall be
responsible for ensuring that eligible infants and toddlers are served
as follows:

(1) The State Department of Developmental Services and
regional centers shall be responsible for the provision of
appropriate early intervention services that are required for
California’s participation in Part C of the federal Individuals with
Disabilities Education Act (20 U.S.C. Sec. 1431 et seq.) for all
infants eligible under Section 95014, except for those infants with
solely a visual, hearing, or severe orthopedic impairment, or any
combination of those impairments, who meet the criteria in
Sections 56026 and 56026.5 of the Education Code, and in Section
3030(a), (b), (d), or (e) of, and Section 3031 of, Title 5 of the
California Code of Regulations.

(2) The State Department of Education and local educational
agencies shall be responsible for the provision of appropriate early
intervention services in accordance with Part C of the federal
Individuals with Disabilities Education Act (20 U.S.C. Sec. 1431
et seq.) for infants with solely a visual, hearing, or severe
orthopedic impairment, or any combination of those impairments,
who meet the criteria in Sections 56026 and 56026.5 of the
Education Code, and in Section 3030(a), (b), (d), or (e) of, and
Section 3031 of, Title 5 of the California Code of Regulations,
and who are not eligible for services under the Lanterman
Developmental Disabilities Services Act (Division 4.5
(commencing with Section 4500) of the Welfare and Institutions
Code).

(c) For infants and toddlers and their families who are eligible
to receive services from both a regional center and a local
educational agency, the regional center shall be the agency
responsible for providing or purchasing appropriate early
intervention services that are beyond the mandated responsibilities
of local educational agencies and that are required for California’s
participation in Part C of the federal Individuals with Disabilities
Education Act (20 U.S.C. Sec. 1431 et seq.). The local educational
agency shall provide special education services up to its funded
program capacity as established annually by the State Department
of Education in consultation with the State Department of
Developmental Services and the Department of Finance.

(d) No agency or multidisciplinary team, including any agency
listed in Section 95012, shall presume or determine eligibility,
including eligibility for medical services, for any other agency.
However, regional centers and local educational agencies shall
coordinate intake, evaluation, assessment, and individualized
family service plans for infants and toddlers and their families who
are served by an agency.

(e) Upon termination of the program pursuant to Section 95003,
the State Department of Developmental Services shall be
responsible for the payment of services pursuant to this title.

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(f) This section shall remain in effect only until January 1, 2015,
and as of that date is repealed, unless a later enacted statute, that
is enacted before January 1, 2015, deletes or extends that date.

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begin insert SEC. 3. end insert   

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begin insert Section 95014 is added to the end insert begin insert Government Code end insert begin insert , to
read: end insert

begin insert

begin insert 95014. end insert   

(a) The term “eligible infant or toddler” for the
purposes of this title means infants and toddlers from birth through
two years of age, for whom a need for early intervention services,
as specified in the federal Individuals with Disabilities Education
Act (20 U.S.C. Sec. 1431 et seq.) and applicable regulations, is
documented by means of assessment and evaluation as required
in Sections 95016 and 95018 and who meet one of the following
criteria:

(1) Infants and toddlers with a developmental delay in one or
more of the following five areas: cognitive development; physical
and motor development, including vision and hearing;
communication development; social or emotional development;
or adaptive development. Developmentally delayed infants and
toddlers are those who are determined to have a significant
difference between the expected level of development for their age
and their current level of functioning. This determination shall be
made by qualified personnel who are recognized by, or part of, a
multidisciplinary team, including the parents. A significant
difference is defined as a 33-percent delay in one or more
developmental areas.

(2) Infants and toddlers with established risk conditions, who
are infants and toddlers with conditions of known etiology or
conditions with established harmful developmental consequences.
The conditions shall be diagnosed by a qualified personnel
recognized by, or part of, a multidisciplinary team, including the
parents. The condition shall be certified as having a high
probability of leading to developmental delay if the delay is not
evident at the time of diagnosis.

(3) Infants and toddlers who are at high risk of having
substantial developmental disability due to a combination of
biomedical risk factors, the presence of which are diagnosed by
qualified personnel recognized by, or part of, a multidisciplinary
team, including the parents.

(b) Regional centers and local educational agencies shall be
responsible for ensuring that eligible infants and toddlers are
served as follows:

(1) The State Department of Developmental Services and
regional centers shall be responsible for the provision of
appropriate early intervention services that are required for
California’s participation in Part C of the federal Individuals with
Disabilities Education Act (20 U.S.C. Sec. 1431 et seq.) for all
infants eligible under Section 95014, except for those infants with
solely a visual, hearing, or severe orthopedic impairment, or any
combination of those impairments, who meet the criteria in Sections
56026 and 56026.5 of the Education Code, and in Section 3030(a),
(b), (d), or (e) of, and Section 3031 of, Title 5 of the California
Code of Regulations.

(2) The State Department of Education and local educational
agencies shall be responsible for the provision of appropriate early
intervention services in accordance with Part C of the federal
Individuals with Disabilities Education Act (20 U.S.C. Sec. 1431
et seq.) for infants with solely a visual, hearing, or severe
orthopedic impairment, or any combination of those impairments,
who meet the criteria in Sections 56026 and 56026.5 of the
Education Code, and in Section 3030(a), (b), (d), or (e) of, and
Section 3031 of, Title 5 of the California Code of Regulations, and
who are not eligible for services under the Lanterman
Developmental Disabilities Services Act (Division 4.5 (commencing
with Section 4500) of the Welfare and Institutions Code).

(c) For infants and toddlers and their families who are eligible
to receive services from both a regional center and a local
educational agency, the regional center shall be the agency
responsible for providing or purchasing appropriate early
intervention services that are beyond the mandated responsibilities
of local educational agencies and that are required for California’s
participation in Part C of the federal Individuals with Disabilities
Education Act (20 U.S.C. Sec. 1431 et seq.). The local educational
agency shall provide special education services up to its funded
program capacity as established annually by the State Department
of Education in consultation with the State Department of
Developmental Services and the Department of Finance.

(d) No agency or multidisciplinary team, including any agency
listed in Section 95012, shall presume or determine eligibility,
including eligibility for medical services, for any other agency.
However, regional centers and local educational agencies shall
coordinate intake, evaluation, assessment, and individualized
family service plans for infants and toddlers and their families
who are served by an agency.

(e) Upon termination of the program pursuant to Section 95003,
the State Department of Developmental Services shall be
responsible for the payment of services pursuant to this title.

(f) This section shall become operative on January 1, 2015.

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begin insert SEC. 4. end insert   

end insert

begin insert Section 1502 of the end insert begin insert Health and Safety Code end insert begin insert is amended
to read: end insert

1502.  

As used in this chapter:

(a) “Community care facility” means any facility, place, or
building that is maintained and operated to provide nonmedical
residential care, day treatment, adult day care, or foster family
agency services for children, adults, or children and adults,
including, but not limited to, the physically handicapped, mentally
impaired, incompetent persons, and abused or neglected children,
and includes the following:

(1) “Residential facility” means any family home, group care
facility, or similar facility determined by the director, for 24-hour
nonmedical care of persons in need of personal services,
supervision, or assistance essential for sustaining the activities of
daily living or for the protection of the individual.

(2) “Adult day program” means any community-based facility
or program that provides care to persons 18 years of age or older
in need of personal services, supervision, or assistance essential
for sustaining the activities of daily living or for the protection of
these individuals on less than a 24-hour basis.

(3) “Therapeutic day services facility” means any facility that
provides nonmedical care, counseling, educational or vocational
support, or social rehabilitation services on less than a 24-hour
basis to persons under 18 years of age who would otherwise be
placed in foster care or who are returning to families from foster
care. Program standards for these facilities shall be developed by
the department, pursuant to Section 1530, in consultation with
therapeutic day services and foster care providers.

(4) “Foster family agency” means any organization engaged in
the recruiting, certifying, and training of, and providing
professional support to, foster parents, or in finding homes or other
places for placement of children for temporary or permanent care
who require that level of care as an alternative to a group home.
Private foster family agencies shall be organized and operated on
a nonprofit basis.

(5) “Foster family home” means any residential facility
providing 24-hour care for six or fewer foster children that is
owned, leased, or rented and is the residence of the foster parent
or parents, including their family, in whose care the foster children
have been placed. The placement may be by a public or private
child placement agency or by a court order, or by voluntary
placement by a parent, parents, or guardian. It also means a foster
family home described in Section 1505.2.

(6) “Small family home” means any residential facility, in the
licensee’s family residence, that provides 24-hour care for six or
fewer foster children who have mental disorders or developmental
or physical disabilities and who require special care and supervision
as a result of their disabilities. A small family home may accept
children with special health care needs, pursuant to subdivision
(a) of Section 17710 of the Welfare and Institutions Code. In
addition to placing children with special health care needs, the
department may approve placement of children without special
health care needs, up to the licensed capacity.

(7) “Social rehabilitation facility” means any residential facility
that provides social rehabilitation services for no longer than 18
months in a group setting to adults recovering from mental illness
who temporarily need assistance, guidance, or counseling. Program
components shall be subject to program standards pursuant to
Article 1 (commencing with Section 5670) of Chapter 2.5 of Part
2 of Division 5 of the Welfare and Institutions Code.

(8) “Community treatment facility” means any residential
facility that provides mental health treatment services to children
in a group setting and that has the capacity to provide secure
containment. Program components shall be subject to program
standards developed and enforced by the State Department of
Health Care Services pursuant to Section 4094 of the Welfare and
Institutions Code.

Nothing in this section shall be construed to prohibit or
discourage placement of persons who have mental or physical
disabilities into any category of community care facility that meets
the needs of the individual placed, if the placement is consistent
with the licensing regulations of the department.

(9) “Full-service adoption agency” means any licensed entity
engaged in the business of providing adoption services, that does
all of the following:

(A) Assumes care, custody, and control of a child through
relinquishment of the child to the agency or involuntary termination
of parental rights to the child.

(B) Assesses the birth parents, prospective adoptive parents, or
child.

(C) Places children for adoption.

(D) Supervises adoptive placements.

Private full-service adoption agencies shall be organized and
operated on a nonprofit basis. As a condition of licensure to provide
intercountry adoption services, a full-service adoption agency shall
be accredited and in good standing according to Part 96 of Title
22 of the Code of Federal Regulations, or supervised by an
accredited primary provider, or acting as an exempted provider,
in compliance with Subpart F (commencing with Section 96.29)
of Part 96 of Title 22 of the Code of Federal Regulations.

(10) “Noncustodial adoption agency” means any licensed entity
engaged in the business of providing adoption services, that does
all of the following:

(A) Assesses the prospective adoptive parents.

(B) Cooperatively matches children freed for adoption, who are
under the care, custody, and control of a licensed adoption agency,
for adoption, with assessed and approved adoptive applicants.

(C) Cooperatively supervises adoptive placements with a
full-service adoptive agency, but does not disrupt a placement or
remove a child from a placement.

Private noncustodial adoption agencies shall be organized and
operated on a nonprofit basis. As a condition of licensure to provide
intercountry adoption services, a noncustodial adoption agency
shall be accredited and in good standing according to Part 96 of
Title 22 of the Code of Federal Regulations, or supervised by an
accredited primary provider, or acting as an exempted provider,
in compliance with Subpart F (commencing with Section 96.29)
of Part 96 of Title 22 of the Code of Federal Regulations.

(11) “Transitional shelter care facility” means any group care
facility that provides for 24-hour nonmedical care of persons in
need of personal services, supervision, or assistance essential for
sustaining the activities of daily living or for the protection of the
individual. Program components shall be subject to program
standards developed by the State Department of Social Services
pursuant to Section 1502.3.

(12) “Transitional housing placement provider” means an
organization licensed by the department pursuant to Section
1559.110 and Section 16522.1 of the Welfare and Institutions Code
to provide transitional housing to foster children at least 16 years
of age and not more than 18 years of age, and nonminor
dependents, as defined in subdivision (v) of Section 11400 of the
Welfare and Institutions Code, to promote their transition to
adulthood. A transitional housing placement provider shall be
privately operated and organized on a nonprofit basis.

(13) “Group home” means a residential facility that provides
24-hour care and supervision to children, delivered at least in part
by staff employed by the licensee in a structured environment. The
care and supervision provided by a group home shall be
nonmedical, except as otherwise permitted by law.

(14) “Runaway and homeless youth shelter” means a group
home licensed by the department to operate a program pursuant
to Section 1502.35 to provide voluntary, short-term, shelter and
personal services to runaway youth or homeless youth, as defined
in paragraph (2) of subdivision (a) of Section 1502.35.

begin insert

(15) “Enhanced behavioral supports home” means a facility
certified by the State Department of Developmental Services
pursuant to Article 3.6 (commencing with Section 4684.80) of
Chapter 6 of Division 4.5 of the Welfare and Institutions Code,
and licensed by the State Department of Social Services as an adult
residential facility or a group home that provides 24-hour
nonmedical care to individuals with developmental disabilities
who require enhanced behavioral supports, staffing, and
supervision in a homelike setting. An enhanced behavioral supports
home shall have a maximum capacity of four consumers, shall
conform to Section 441.530(a)(1) of Title 42 of the Code of Federal
Regulations, and shall be eligible for federal Medicaid home-and
community-based services funding.

end insert begin insert

(16) “Community crisis home” means a facility certified by the
State Department of Developmental Services pursuant to Article
8 (commencing with Section 4698) of Chapter 6 of Division 4.5 of
the Welfare and Institutions Code, and licensed by the State
Department of Social Services pursuant to Article 9.7 (commencing
with Section 1567.80), as an adult residential facility, providing
24-hour nonmedical care to individuals with developmental
disabilities receiving regional center service, in need of crisis
intervention services, and who would otherwise be at risk of
admission to the acute crisis center at Fairview Developmental
Center, Sonoma Developmental Center, an acute general hospital,
acute psychiatric hospital, an institution for mental disease, as
described in Part 5 (commencing with Section 5900) of Division
5 of the Welfare and Institutions Code, or an out-of-state
placement. A community crisis home shall have a maximum
capacity of eight consumers, as defined in subdivision (a) of Section
1567.80, shall conform to Section 441.530(a)(1) of Title 42 of the
Code of Federal Regulations, and shall be eligible for federal
Medicaid home and community-based services funding.

end insert

(b) “Department” or “state department” means the State
Department of Social Services.

(c) “Director” means the Director of Social Services.

begin insert

begin insert SEC. 5. end insert   

end insert

begin insert Section 1524 of the end insert begin insert Health and Safety Code end insert begin insert is amended
to read: end insert

1524.  

A license shall be forfeited by operation of law when
one of the following occurs:

(a) The licensee sells or otherwise transfers the facility or facility
property, except when change of ownership applies to transferring
of stock when the facility is owned by a corporation, and when
the transfer of stock does not constitute a majority change of
ownership.

(b) The licensee surrenders the license to the department.

(c) (1) The licensee moves a facility from one location to
another. The department shall develop regulations to ensure that
the facilities are not charged a full licensing fee and do not have
to complete the entire application process when applying for a
license for the new location.

(2) This subdivision shall not apply to a licensed foster family
home, a home certified by a licensed foster family agency, or a
home approved pursuant to Sections 309, 361.4, and 361.45 of the
Welfare and Institutions Code. When a foster family home licensee,
certified home parent, or a person approved to care for children
pursuant to Sections 309, 361.4, and 361.45 of the Welfare and
Institutions Code moves to a new location, the existing license,
certification, or approval may be transferred to the new location.
All caregivers to whom this paragraph applies shall be required to
meet all applicable licensing laws and regulations at the new
location.

(d) The licensee is convicted of an offense specified in Section
220, 243.4, or 264.1, or paragraph (1) of Section 273a, Section
273d, 288, or 289 of the Penal Code, or is convicted of another
crime specified in subdivision (c) of Section 667.5 of the Penal
Code.

(e) The licensee dies. If an adult relative notifies the department
of his or her desire to continue operation of the facility and submits
an application, the department shall expedite the application. The
department shall promulgate regulations for expediting applications
submitted pursuant to this subdivision.

(f) The licensee abandons the facility.

(g) When the certification issued by the State Department of
Developmental Services to a licensee of an Adult Residential
Facility for Persons with Special Health Care Needs, licensed
pursuant to Article 9 (commencing with Section 1567.50), is
rescinded.

begin insert

(h) When the certification issued by the State Department of
Developmental Services to a licensee of an enhanced behavioral
supports home, licensed pursuant to Article 9.5 (commencing with
Section 1567.61), is rescinded.

end insert begin insert

(i) When the certificate of program approval issued by the State
Department of Developmental Services, pursuant to Article 8
(commencing with Section 4698) of Chapter 6 of Division 4.5 of
the Welfare and Institutions Code, to a licensee of a community
crisis home, licensed pursuant to Article 9.7 (commencing with
Section 1567.80), is rescinded.

end insert

begin insert

begin insert SEC. 6. end insert   

end insert

begin insert Article 9.5 (commencing with Section 1567.61) is added
to Chapter 3 of Division 2 of the end insert begin insert Health and Safety Code end insert begin insert , to read: end insert

begin insert

 

Article begin insert 9.5. end insert   Enhanced Behavioral Supports Homes

 

begin insert 1567.61. end insert   

As used in this article the following terms apply:

(a) “Consumer” or “client” means an individual who has been
determined by a regional center to meet the eligibility criteria of
Section 4512 of the Welfare and Institutions Code and applicable
regulations and for whom the regional center has accepted
responsibility.

(b) “Individual behavior supports plan” means the plan that
identifies and documents the behavior and intensive support and
service needs of a consumer and details the strategies to be
employed and services to be provided to address those needs, and
includes the entity responsible for providing those services and
timelines for when each identified individual behavior support will
commence.

(c) “Individual behavior supports team” means those individuals
who develop, monitor, and revise the individual behavior supports
plan for consumers residing in an enhanced behavioral supports
home, pursuant to subdivision (d) of Section 4684.80 of the Welfare
and Institutions Code.

begin insert 1567.62. end insert   

(a) Each enhanced behavioral supports home shall
be licensed as an adult residential facility or a group home and
certified by the State Department of Developmental Services.

(b) A certificate of program approval issued by the State
Department of Developmental Services shall be a condition of
licensure for the enhanced behavioral supports home by the State
Department of Social Services.

(c) An enhanced behavioral supports home shall not be licensed
by the State Department of Social Services until the certificate of
program approval, granted by the State Department of
Developmental Services, has been received.

(d) Placements of dual agency clients into enhanced behavioral
supports homes that are licensed as group homes shall be subject
to the limitations on the duration of the placement set forth in
Sections 319.2 and 319.3 of, and subparagraph (A) of paragraph
(8) and subparagraph (A) of paragraph (9) of subdivision (e) of
Section 361.2 of, the Welfare and Institutions Code.

(e) For the purpose of this article, dual agency clients are foster
children in temporary custody of the child welfare agency under
Section 319 of the Welfare and Institutions Code or under the
jurisdiction of the juvenile court pursuant to Section 300, 450,
601, or 602 of the Welfare and Institutions Code who are also
either a consumer of regional center services, or who are receiving
services under the California Early Intervention Services Act (Title
14 (the age of commencing with Section 45000) of the Government
Code) but who are under three years of age and have not yet been
determined to have a developmental disability.

(f) The State Department of Social Services shall not be
responsible for any of the following:

(1) Developing and approving a consumer’s individual behavior
supports plan in conjunction with the consumer’s individual
behavior supports team.

(2) (A) Oversight of any services that may be provided by a
licensed health professional or licensed mental health professional
to a consumer.

(B) Services provided by a licensed health or licensed mental
health professional means services that may only be provided
under the authority of the licensed health service provider’s or
licensed mental health service provider’s professional license.

(g) Subdivision (f) shall not limit the State Department of Social
Services’ ability to enforce Chapter 3 (commencing with Section
1500), and applicable regulations.

begin insert 1567.63. end insert   

The license applicant shall submit a facility program
plan to the State Department of Developmental Services for
approval and submit the approved plan to the State Department
of Social Services as part of the facility plan of operation. The
plan of operation shall be approved by the State Department of
Social Services prior to licensure.

begin insert 1567.64. end insert   

The State Department of Social Services shall adopt
regulations to address, at a minimum, staffing structure, staff
qualifications, and training. Training requirements shall include
a minimum of 16 hours of emergency intervention training.
“Emergency intervention training” means the techniques the
licensee will use to prevent injury to, and maintain safety for,
consumers who are a danger to themselves or others and shall
emphasize positive behavioral supports and techniques that are
alternatives to physical restraints.

begin insert 1567.65. end insert   

If the State Department of Social Services determines
that urgent action is necessary to protect a consumer residing in
an enhanced behavioral supports home from physical or mental
abuse, abandonment, or any other substantial threat to their health
and safety, the State Department of Social Services shall notify
the State Department of Developmental Services. The State
Department of Developmental Services may request that the
regional center or centers take action within 24 hours, which may
include, as appropriate, the removal of a consumer from the
enhanced behavioral supports home or obtaining alternative or
additional services. When possible, an individual program plan
(IPP) meeting shall be convened to determine the appropriate
action pursuant to this section. In any case, an IPP meeting shall
be convened within 30 days following an action pursuant to this
section.

begin insert 1567.66. end insert   

An enhanced behavioral supports home employing
secured perimeters shall comply with Section 1531.15 and
applicable regulations.

begin insert 1567.67. end insert   

(a) The State Department of Social Services shall
revoke the enhanced behavioral supports home’s facility license
if the State Department of Developmental Services has decertified
an enhanced behavioral supports home program certification
pursuant to Article 3.6 (commencing with Section 4684.80) of
Chapter 6 of Division 4.5 of the Welfare and Institutions Code.

(b) The State Department of Developmental Services and
regional centers shall, for purposes of assisting in licensing,
provide the State Department of Social Services with all available
documentation and evidentiary support that was submitted to the
State Department of Developmental Services in connection with
certification by an applicant for licensure under this article.

begin insert 1567.68. end insert   

(a) A license shall not be issued pursuant to this
article before emergency regulations for this article filed by the
State Department of Developmental Services have been published.

(b) Emergency regulations to implement this article may be
adopted by the director of the State Department of Social Services
in accordance with the Administrative Procedure Act (Chapter
3.5 (commencing with Section 11340) of Part 1 of Division 3 of
Title 2 of the Government Code). These regulations shall be
developed in consultation with system stakeholders. The initial
adoption of the emergency regulations and one readoption of the
initial regulations shall be deemed to be an emergency and
necessary for the immediate preservation of the public peace,
health, safety, or general welfare. Initial emergency regulations
and the first readoption of those emergency regulations shall be
exempt from review by the Office of Administrative Law. The
emergency regulations authorized by this section shall be submitted
to the Office of Administrative Law for filing with the Secretary
of State and shall remain in effect for no more than 180 days.

(c) The adoption, initial amendment, repeal, or readoption of
a regulation authorized by this section is deemed to be an
emergency and necessary for the immediate preservation of the
public peace, health, safety, or general welfare for purposes of
Sections 11346.1 and 11349.6 of the Government Code, and the
State Department of Social Services 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. The emergency regulations may be readopted and
remain in effect until approval of the certificate of compliance.

begin insert 1567.69. end insert   

Nothing in this article shall interfere with the
authority of the State Department of Social Services to temporarily
suspend or revoke the license of an enhanced behavioral supports
home pursuant to Section 1550 of the Health and Safety Code.

begin insert 1567.70. end insert   

This article shall remain in effect only until January
1, 2020, and as of that date is repealed, unless a later enacted
statute, that is enacted before January 1, 2020, deletes or extends
that date.

end insert

begin insert

begin insert SEC. 7. end insert   

end insert

begin insert Article 9.7 (commencing with Section 1567.80) is added
to Chapter 3 of Division 2 of the end insert begin insert Health and Safety Code end insert begin insert , to read: end insert

begin insert

 

Article begin insert 9.7. end insert   Community Crisis Home Licensure

 

begin insert 1567.80. end insert   

For the purposes of this article, the following
definitions apply:

(a) “Consumer” or “client” means an individual who has been
determined by a regional center to meet the eligibility criteria of
Section 4512 of the Welfare and Institutions Code and applicable
regulations, and for whom the regional center has accepted
responsibility.

(b) “Individual behavior support plan” means the plan that
identifies and documents the behavioral and intensive support and
service needs of a consumer and details the strategies to be
employed, and services to be provided, to address those needs,
and includes the entity responsible for providing those services
and timelines for when each identified individual behavioral
support will commence.

begin insert 1567.81. end insert   

(a) (1) Each community crisis home shall be licensed
as an adult residential facility, pursuant to this article, and certified
by the State Department of Developmental Services, pursuant to
Article 8 (commencing with Section 4698) of Chapter 6 of Division
4.5 of the Welfare and Institutions Code.

(2) Notwithstanding whether a community crisis home is licensed
for more than six consumers, subdivisions (a) and (b) of Section
1524.5 shall apply.

(b) A certificate of program approval issued by the State
Department of Developmental Services, pursuant to Article 8
(commencing with Section 4698) of Chapter 6 of Division 4.5 of
the Welfare and Institutions Code, shall be a condition of licensure
for the community crisis home by the State Department of Social
Services.

(c) A community crisis home shall not be licensed by the State
Department of Social Services until the certificate of program
approval, issued by the State Department of Developmental
Services, has been received.

(d) The State Department of Social Services shall not be
responsible for any of the following:

(1) Developing and approving a consumer’s individual behavior
support plan in conjunction with the consumer’s individual
behavior support team.

(2) Oversight of any services that may be provided by a licensed
health or licensed mental health professional to a consumer.
“Services provided by a licensed health or licensed mental health
professional” means services that may only be provided under the
authority of the licensed health or licensed mental health service
provider’s professional license.

(e) Subdivision (d) does not limit the State Department of Social
Services’ ability to enforce this chapter and applicable regulations.

begin insert 1567.82. end insert   

The State Department of Social Services’ regulations
shall address at least both of the following:

(a) Staffing structure, staff qualifications, and training.

(b) Training requirements shall include a minimum of 16 hours
of emergency intervention training. “Emergency intervention
training” shall include the techniques the licensee will use to
prevent injury and maintain safety regarding consumers who are
a danger to self or others and shall emphasize positive behavioral
supports and techniques that are alternatives to physical restraints.

begin insert 1567.83. end insert   

(a) When the State Department of Social Services
determines that urgent action is necessary to protect consumers
residing in a community crisis home from physical or mental abuse,
abandonment, or any other substantial threat to their health and
safety, the State Department of Social Services shall notify the
State Department of Developmental Services. The State Department
of Developmental Services may request that the regional center
or centers take action within 24 hours, which may include, as
appropriate, the removal of a consumer from the community crisis
home or obtaining alternative or additional services. When
possible, an individual program plan (IPP) meeting shall be
convened to determine the appropriate action pursuant to this
section. In any case, an IPP meeting shall be convened within 30
days following an action pursuant to this section.

(b) Nothing in this article shall interfere with the authority of
the State Department of Social Services to temporarily suspend
or revoke the license of a community crisis home pursuant to
Section 1550.

begin insert 1567.84. end insert   

The licensee shall submit the facility program plan
approved by the State Department of Developmental Services,
pursuant to Section 4698 of the Welfare and Institutions Code, to
the State Department of Social Services as part of the facility plan
of operation. The plan of operation shall be approved by the State
Department of Social Services prior to licensure.

begin insert 1567.85. end insert   

If applicable, a community crisis home shall be in
compliance with Section 1531.15 and the applicable regulations.

begin insert 1567.86. end insert   

(a) The State Department of Social Services shall
revoke the community crisis home’s facility license if the State
Department of Developmental Services has rescinded a community
crisis home’s certificate of program approval.

(b) The State Department of Developmental Services and
regional centers shall provide the State Department of Social
Services all available documentation and evidentiary support
necessary for the licensing and administration of community crisis
homes and enforcement of this article and the applicable
regulations.

begin insert 1567.87. end insert   

(a) A license shall not be issued pursuant to this
article until the publication in Title 17 of the California Code of
Regulations of emergency regulations filed by the State Department
of Developmental Services pursuant to Section 4698.1 of the
Welfare and Institutions Code.

(b) Emergency regulations to implement this article may be
adopted by the Director of Social Services in accordance with the
Administrative Procedure Act (Chapter 3.5 (commencing with
Section 11340) of Part 1 of Division 3 of Title 2 of the Government
Code). These emergency regulations shall be developed in
consultation with system stakeholders. The initial adoption of the
emergency regulations and one readoption of the initial regulations
shall be deemed to be an emergency and necessary for the
immediate preservation of the public peace, health and safety, or
general welfare. Initial emergency regulations and the first
readoption of those emergency regulations shall be exempt from
review by the Office of Administrative Law. The emergency
regulations authorized by this section shall be submitted to the
Office of Administrative Law for filing with the Secretary of State
and shall remain in effect for no more than 180 days.

(c) The adoption, amendment, repeal, or readoption of a
regulation authorized by this section is deemed to be an emergency
and 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 State
Department of Social Services 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. The emergency regulations may be readopted and
remain in effect until approval of the certificate of compliance.

end insert

begin insert

begin insert SEC. 8. end insert   

end insert

begin insert Section 4418.25 of the end insert begin insert Welfare and Institutions Code end insert
begin insert is amended to read: end insert

4418.25.  

(a) The department shall establish policies and
procedures for the development of an annual community placement
plan by regional centers. The community placement plan shall be
based upon an individual program plan process as referred to in
subdivision (a) of Section 4418.3 and shall be linked to the
development of the annual state budget. The department’s policies
shall address statewide priorities, plan requirements, and the
statutory roles of regional centers, developmental centers, and
regional resource development projects in the process of assessing
consumers for community living and in the development of
community resources.

(b) (1) To reduce reliance on developmental centers and mental
health facilities, including institutions for mental disease as
described in Part 5 (commencing with Section 5900) of Division
5, for which federal funding is not available, and out-of-state
placements, the department shall establish a statewide specialized
resource service that does all of the following:

(A) Tracks the availability of specialty residential beds and
services.

(B) Tracks the availability of specialty clinical services.

(C) Coordinates the need for specialty services and supports in
conjunction with regional centers.

(D) Identifies, subject to federal reimbursement, developmental
center services and supports that can be made available to
consumers residing in the community, when no other community
resource has been identified.

(2) By September 1, 2012, regional centers shall provide the
department with information about all specialty resources
developed with the use of community placement plan funds and
shall make these resources available to other regional centers.

(3) When allocating funding for community placement plans,
priority shall be given to the development of needed statewide
specialty services and supports, including regional community
crisis homes.

(4) If approved by the director, funding may be allocated to
facilities that meet the criteria of Sections 1267.75 and 1531.15
of the Health and Safety Code.

(5) The department shall not provide community placement
plan funds to develop programs that are ineligible for federal
funding participation unless approved by the director.

(c) (1) The community placement plan shall provide for
dedicated funding for comprehensive assessments of developmental
center residents, for identified costs of moving individuals from
developmental centers to the community, and for deflection of
individuals from developmental center admission. The plans shall,
where appropriate, include budget requests for regional center
operations, assessments, resource development, and ongoing
placement costs. These budget requests are intended to provide
supplemental funding to regional centers. The plan is not intended
to limit the department’s or regional centers’ responsibility to
otherwise conduct assessments and individualized program
planning, and to provide needed services and supports in the least
restrictive, most integrated setting in accord with the Lanterman
Developmental Disabilities Services Act (Division 4.5
(commencing with Section 4500)).

(2) (A) Regional centers shall complete a comprehensive
assessment of any consumer residing in a developmental center
on July 1, 2012, who meets both of the following criteria:

(i) The consumer is not committed pursuant to Section 1370.1
of the Penal Code.

(ii) The consumer has not had such an assessment in the prior
two years.

(B) The assessment shall include input from the regional center,
the consumer, and, when appropriate, the consumer’s family, legal
guardian, conservator, or authorized representative, and shall
identify the types of community-based services and supports
available to the consumer that would enable the consumer to move
to a community setting. Necessary services and supports not
currently available in the community setting shall be considered
for development pursuant to community placement planning and
funding.

(C) Regional centers shall specify in the annual community
placement plan how they will complete the required assessment
and the timeframe for completing the assessment for each
consumer. Initial assessments pursuant to this paragraph for
individuals residing in a developmental center on July 1, 2012,
shall be completed by December 31, 2015, unless a regional center
demonstrates to the department that an extension of time is
necessary and the department grants such an extension.

begin insert

(D) The assessment completed in the prior two years, or the
assessment completed pursuant to the requirements of this section,
including any updates pursuant to subparagraph (E), shall be
provided to both of the following:

end insert begin insert

(i) The individual program planning team and clients’ rights
advocate for the regional center in order to assist the planning
team in determining the least restrictive environment for the
consumer.

end insert begin insert

(ii) The superior court with jurisdiction over the consumer’s
placement at the developmental center, including the consumer’s
attorney of record and other parties known to the regional center.
For judicial proceedings pursuant to Article 2 (commencing with
Section 6500) of Chapter 2 of Part 2 of Division 6, the
comprehensive assessment shall be included in the regional
center’s written report required by Section 6504.5. For all other
proceedings, the regional center shall provide the comprehensive
assessment to the court and parties to the case at least 14 days in
advance of any regularly scheduled judicial review. This clause
shall not apply to consumers committed pursuant to Section 1370.1
of the Penal Code.

end insert begin delete

(D)

end delete

begin insert (E) end insert  The begin delete assessment completed end delete begin insert assessments described end insert in begin delete the
prior two years, or the assessment completed pursuant to the
requirements of this section end delete begin insert subparagraph (D) end insert shall be begin delete provided
to the individual program planning team in order to assist the
planning team in determining the least restrictive environment for
the consumer. These assessments shall be end delete updated annually as part
of the individual program planning process for as long as the
consumer resides in the developmental center. To the extent
appropriate, the regional center shall also provide relevant
information from the statewide specialized resource service. begin delete For end delete
begin insert The regional center shall notify the clients’ rights advocate for the
regional center of the time, date, and location of end insert each individual
program plan meeting that includes discussion of the results of the
begin delete assessment, the clients’ rights advocate for the end delete begin insert comprehensive
assessment and updates to that assessment. The end insert regional center
shall begin delete be notified end delete begin insert provide this notice as soon as practicable
following the completion end insert of the begin delete meeting end delete begin insert comprehensive assessment
or update end insert and begin insert not less than 30 calendar days prior to the meeting.
The clients’ rights advocate end insert may participate in the meeting unless
the consumer objects on his or her own behalf.

(d) The department shall review, negotiate, and approve regional
center community placement plans for feasibility and
reasonableness, including recognition of each regional centers’
current developmental center population and their corresponding
placement level, as well as each regional centers’ need to develop
new and innovative service models. The department shall hold
regional centers accountable for the development and
implementation of their approved plans. The regional centers shall
report, as required by the department, on the outcomes of their
plans. The department shall make aggregate performance data for
each regional center available, upon request, as well as data on
admissions to, and placements from, each developmental center.

(e) Funds allocated by the department to a regional center for
a community placement plan developed under this section shall
be controlled through the regional center contract to ensure that
the funds are expended for the purposes allocated. Funds allocated
for community placement plans that are not used for that purpose
may be transferred to Item 4300-003-0001 for expenditure in the
state developmental centers if their population exceeds the
budgeted level. Any unspent funds shall revert to the General Fund.

(f) Commencing May 1, 2013, and then on April 1, 2014, and
on April 1 annually thereafter, the department shall provide to the
fiscal and appropriate policy committees of the Legislature
information on efforts to serve consumers with challenging service
needs, including, but not limited to, all of the following:

(1) For each regional center, the number of consumers admitted
to each developmental center, including the legal basis for the
admissions.

(2) For each regional center, the number of consumers described
in paragraph (2) of subdivision (a) of Section 7505 who were
admitted to Fairview Developmental Center by court order pursuant
to Article 2 (commencing with Section 6500) of Chapter 2 of Part
2 of Division 6, and the number and lengths of stay of consumers,
including those who have transitioned back to a community living
arrangement.

(3) Outcome data related to the assessment process set forth in
Section 4418.7, including the number of consumers who received
assessments pursuant to Section 4418.7 and the outcomes of the
assessments. Each regional center, commencing March 1, 2013,
and then on February 1, 2014, and on February 1 annually
thereafter, shall provide the department with information on
alternative community services and supports provided to those
consumers who were able to remain in the community following
the assessments, and the unmet service needs that resulted in any
consumers being admitted to Fairview Developmental Center.

(4) Progress in the development of needed statewide specialty
services and supports, including regional community crisis options,
as provided in paragraph (3) of subdivision (b). Each regional
center shall provide the department with a report containing the
information described in this paragraph commencing March 1,
2013, and then on February 1, 2014, and on February 1 annually
thereafter.

(5) Progress in reducing reliance on mental health facilities
ineligible for federal Medicaid funding, and out-of-state
placements.

(6) Information on the utilization of facilities serving consumers
with challenging service needs that utilize delayed egress devices
and secured perimeters, pursuant to Section 1267.75 or 1531.15
of the Health and Safety Code, including the number of admissions,
reasons for admissions, and lengths of stay of consumers, including
those who have transitioned to less restrictive living arrangements.

(7) If applicable, any recommendations regarding additional
rate exceptions or modifications beyond those allowed for under
existing law that the department identifies as necessary to meet
the needs of consumers with challenging service needs.

(g) Each regional center, commencing March 1, 2013, and then
on February 1, 2014, and on February 1 annually thereafter, shall
provide information to the department regarding the facilities
described in paragraph (6) of subdivision (f), including, but not
limited to, the number of admissions, reasons for admissions, and
lengths of stay of consumers, including those who have transitioned
to less restrictive living arrangements.

begin insert

begin insert SEC. 9. end insert   

end insert

begin insert Section 4418.7 of the end insert begin insert Welfare and Institutions Code end insert
begin insert is amended to read: end insert

4418.7.  

(a)  begin insert (1) end insert begin insert   end insert If the regional center determines, or is
informed by the consumer’s parents, legal guardian, conservator,
or authorized representative that the community placement of a
consumer is at risk of failing, and that admittance to a state
developmental center is a likelihood, or the regional center is
notified by a court of a potential admission to a developmental
center consistent with Section 7505, the regional center shall
immediately notify the appropriate regional resource development
project, the consumer, begin delete and end delete the consumer’s parents, legal guardian,
or begin delete conservator. end delete begin insert conservator, and the regional center clients’ rights
advocate. end insert

begin insert

(2) For purposes of this section, notification to the clients’ rights
advocate for the consumer’s regional center shall include a copy
of the most recent comprehensive assessment or updated
assessment, and the time, date, and location of an individual
program plan meeting held pursuant to subdivision (b). The
regional center shall provide this notice as soon as practicable
but not less than 7 calendar days prior to the meeting.

end insert

(b) In these cases, the regional resource development project
shall immediately arrange for an assessment of the situation,
including, visiting the consumer, if appropriate, determining
barriers to successful integration, and recommending the most
appropriate means necessary to assist the consumer to remain in
the community. The regional center shall request assistance from
the statewide specialized resource service pursuant to Section
4418.25 as necessary in order to determine the most appropriate
means necessary to assist the consumer to remain in the community
and shall provide the information obtained from the statewide
specialized resource service to the regional resource developmental
project. If, based on the assessment, the regional resource
development project determines that additional or different services
and supports are necessary, the department shall ensure that the
regional center provides those services and supports on an
emergency basis. An individual program plan meeting, including
the regional resource development project’s representative, shall
be convened as soon as possible to review the emergency services
and supports and determine the consumer’s ongoing needs for
services and supports. The regional resource development project
shall follow up with the regional center as to the success of the
recommended interventions until the consumer’s living
arrangement is stable.

(c) (1) If the regional resource development project determines,
based on the assessment conducted pursuant to subdivision (b),
that the consumer referred to the regional resource development
project by the court cannot be safely served in the developmental
center, the department shall notify the court in writing.

(2) (A) If the regional resource development project, in
consultation with the regional center, the consumer, and the
consumer’s parents, legal guardian, or conservator, when
appropriate, determines that admittance to a state developmental
center is necessary due to an acute crisis, as defined in paragraph
(1) of subdivision (d), the regional center shall immediately pursue
the obtainment of a court order for short-term admission and crisis
stabilization.

(B) (i) The regional resource development project, in
consultation with the regional center, the consumer, and, when
appropriate, the consumer’s parents, legal guardian, conservator,
or authorized representative, shall not make a determination that
admittance to a state developmental center is necessary due to an
acute crisis as defined in paragraph (1) of subdivision (d) unless
the determination includes a regional center report detailing all
considered community-based services and begin delete supports end delete begin insert supports,
including a community crisis home certified pursuant to Article 8
(commencing with Section 4698) of Chapter 6 of Division 4.5, end insert and
an explanation of why those options could not meet the consumer’s
needs at the time of such a determination.

(ii) For purposes of complying with clause (i), the regional
center shall not be required to consider out-of-state placements or
mental health facilities, including institutions for mental disease,
as described in Part 5 (commencing with Section 5900) of Division
5, that are ineligible for federal Medicaid funding.

(d) (1) For purposes of this section, an “acute crisis” means a
situation in which the consumer meets the criteria of Section 6500
and, as a result of the consumer’s behavior, all of the following
are met:

(A) There is imminent risk for substantial harm to self or others.

(B) The service and support needs of the consumer cannot be
met in the community, including with supplemental services as
set forth in subparagraph (E) of paragraph (9) of subdivision (a)
of Section 4648 and emergency and crisis intervention services as
set forth in paragraph (10) of subdivision (a) of Section 4648.

(C) Due to serious and potentially life-threatening conditions,
the consumer requires a more restrictive environment for crisis
stabilization.

(2) For purposes of paragraph (1), out-of-state placements or
mental health facilities and other facilities, including institutions
for mental disease, as described in Part 5 (commencing with
Section 5900) of Division 5, for which federal Medicaid funding
is not available, shall not be deemed to be supplemental services
or emergency and crisis intervention services.

(e) When an admission occurs due to an acute crisis, all of the
following shall apply:

(1) As soon as possible following admission to a developmental
center, a comprehensive assessment shall be completed by the
regional center in coordination with the developmental center. The
comprehensive assessment shall include the identification of the
services and supports needed for crisis stabilization and the timeline
for identifying or developing the services and supports needed to
transition the consumer back to the community. The regional center
shall immediately submit a copy of the comprehensive assessment
to the committing court. Immediately following the assessment,
and not later than 30 days following admission, the regional center
and the developmental center shall jointly convene an individual
program plan meeting to determine the services and supports
needed for crisis stabilization and to develop a plan to transition
the consumer into community living pursuant to Section 4418.3.
The clients’ rights advocate for the regional center shall be notified
of the admission and the individual program plan meeting and may
participate in the individual program plan meeting unless the
consumer objects on his or her own behalf.

(2) If transition is not expected within 90 days of admission, an
individual program plan meeting shall be held to discuss the status
of transition and to determine if the consumer is still in need of
crisis stabilization. If crisis services continue to be necessary, the
regional center shall submit to the department an updated transition
plan and a request for an extension of stay at the developmental
center of up to 90 days.

(3) (A) A consumer shall reside in the developmental center
no longer than six months before being placed into a community
living arrangement pursuant to Section 4418.3, unless, prior to the
end of the six months, all of the following have occurred:

(i) The regional center has conducted an additional
comprehensive assessment based on information provided by the
regional center, and the department determines that the consumer
continues to be in an acute crisis.

(ii) The individual program planning team has developed a plan
that identifies the specific services and supports necessary to
transition the consumer into the community, and the plan includes
a timeline to obtain or develop those services and supports.

(iii) The committing court has reviewed and, if appropriate,
extended the commitment.

(B) The clients’ rights advocate for the regional center shall be
notified of the proposed extension pursuant to clause (iii) of
subparagraph (A) and the individual program plan meeting to
consider the extension, and may participate in the individual
program plan meeting unless the consumer objects on his or her
own behalf.

(C) (i) In no event shall a consumer’s placement at the
developmental center exceed one year unless both of the following
occur:

(I) The regional center demonstrates significant progress toward
implementing the plan specified in clause (ii) of subparagraph (A)
identifying the specific services and supports necessary to transition
the consumer into the community.

(II) Extraordinary circumstances exist beyond the regional
center’s control that have prevented the regional center from
obtaining those services and supports within the timeline based
on the plan.

(ii) If both of the circumstances described in subclauses (I) and
(II) exist, the regional center may request, and the committing
court may grant, an additional extension of the commitment, not
to exceed 30 days.

(D) Consumers placed in the community after admission to a
developmental center pursuant to this section shall be considered
to have moved from a developmental center for purposes of Section
4640.6.

(f) The department shall collect data on the outcomes of efforts
to assist at-risk consumers to remain in the community. The
department shall make aggregate data on the implementation of
the requirements of this section available, upon request.

(g)  begin insert (1) end insert begin insert   end insert Notwithstanding any other law or regulation,
commencing July 1, 2012, begin insert and until December 31, 2014, end insert Fairview
Developmental Center shall be the only developmental center
authorized to admit a consumer pursuant to a court order for an
acute crisis as described in this section.

begin insert

(2) Commencing January 1, 2015, admissions to a
developmental center pursuant to a court order for an acute crisis
as described in this section shall be limited to the acute crisis
center at the Fairview Developmental Center and the acute crisis
center at the Sonoma Developmental Center.

end insert begin insert

(h) The acute crisis center at the Fairview Developmental Center
and the acute crisis center at the Sonoma Developmental Center
shall each consist of one unit that is distinct from other residential
units at the developmental center and shall each serve no more
than five consumers. Crisis center residents may participate in
day, work, and recreation programs, and other developmental
center facility activities, outside of the acute crisis unit, when the
individual program plan identifies it is appropriate and consistent
with the individual’s treatment plan. The acute crisis centers shall
assist the consumer with transitioning back to his or her prior
residence, or an alternative community-based residential setting,
within the timeframe described in this section.

end insert

begin insert

begin insert SEC. 10. end insert   

end insert

begin insert Section 4436 is added to the end insert begin insert Welfare and Institutions
Code end insert begin insert , to read: end insert

begin insert

begin insert 4436. end insert   

(a) In order to provide the information necessary to
assess the impact of implementing the recommendations of the
report submitted by the California Health and Human Services
Agency, pursuant to Section 14 of Chapter 25 of the Statutes of
2013, the State Department of Developmental Services shall
evaluate enhanced behavioral supports homes, established
pursuant to Article 3.6 (commencing with Section 4684.80) of
Chapter 6 of Division 4.5, community crisis homes, established
pursuant to Article 8 (commencing with Section 4698) of Chapter
6 of Division 4.5, and the acute crisis centers at the Fairview
Developmental Center and the Sonoma Developmental Center, as
described in subdivision (h) of Section 4418.7.

(b) The evaluation for enhanced behavioral supports homes
and community crisis homes shall include information, by regional
center catchment area, regarding the number of homes approved,
the number of homes opened, the number of beds, the number of
placements in a home from outside the regional center catchment
area, comparative summary information regarding the
characteristics of the persons served in these homes, immediate
past residential settings, vacancy rates, and the established fixed
facility rates and individual rates.

(c) The evaluation for community crisis homes and the acute
crisis centers at the Fairview Developmental Center and the
Sonoma Developmental Center shall include comparative
information regarding characteristics of the persons served,
immediate past residential settings, staffing requirements, the
average monthly occupancy, the average length of time to secure
placement into the home or center, the average length of stay, the
regional center of origin for placements, the number of placements
from outside the regional center of origin, the number of
individuals with multiple stays, the number of residents whose
discharge was delayed due to the unavailability of a residential
placement, and the per capita and total cost for each home or
center.

(d) The evaluation for enhanced behavioral supports homes
shall also include the number of beds in the homes utilizing delayed
egress devices in combination with secured perimeters, the extent
to which the statewide limit established in regulation on the total
number of beds permitted in homes with delayed egress devices
in combination with secured perimeters is exceeded, the number
of residents requiring out-of-home crisis intervention services, the
nature of the services provided, and the ability of residents to
return to the same home after temporary placement in another
facility.

(e) (1) Notwithstanding Section 10231.5 of the Government
Code, the department shall provide the evaluations of enhanced
behavioral supports homes and community crisis homes to the
budget committees and appropriate policy committees of the
Legislature annually, commencing on January 10 of the year after
the first enhanced behavioral supports home or community crisis
home is opened and services have commenced.

(2) Notwithstanding Section 10231.5 of the Government Code,
the department shall provide the evaluations for the acute crisis
centers at the following facilities to the budget committees and
appropriate policy committees of the Legislature annually:

(A) The Fairview Developmental Center, commencing on
January 10, 2015.

(B) The Sonoma Developmental Center, commencing on January
10, 2016.

end insert

begin insert

begin insert SEC. 11. end insert   

end insert

begin insert Section 4474.2 of the end insert begin insert Welfare and Institutions Code end insert
begin insert is amended to read: end insert

4474.2.  

(a) Notwithstanding any begin delete law to end delete begin insert other law, end insert the begin delete contrary,
the end delete department may operate any facility, provide its employees to
assist in the operation of any facility, or provide other necessary
services and supports if, in the discretion of the department, it
determines that the activity will assist in meeting the goal of
begin insert successfully transitioning developmental center residents to
community living or deflecting end insert the begin delete orderly closures end delete begin insert admission end insert of
begin delete Agnews Developmental Center and Lanterman Developmental
Center. end delete begin insert individuals with developmental disabilities to a
developmental center, an institution for mental disease, an
out-of-state placement, a general acute care hospital, or an acute
psychiatric hospital. end insert The department may contract with any entity
for the use of the department’s employees to provide services begin insert and
supports end insert in furtherance of begin delete the orderly closures of Agnews
Developmental Center and Lanterman Developmental Center. end delete begin insert this
goal. end insert

(b) The department shall prepare a report on the use of the
department’s employees in providing services in the community
begin insert pursuant end insert to begin delete assist in the orderly closures of Agnews Developmental
Center and Lanterman Developmental Center. end delete begin insert this section. end insert The
report shall include data on the number and classification of state
employees working in the community program. The report shall
begin insert include recommendations on whether the program should end insert be
begin insert continued or ways in which the program may be improved.
Notwithstanding Section 10231.5 of the Government Code, the
report shall be end insert submitted with the Governor’s proposed budget
for the begin delete 2012-13 end delete begin insert 2015-16 end insert fiscal year to the fiscal committees of
both houses of the Legislature and annually thereafter.

begin insert

begin insert SEC. 12. end insert   

end insert

begin insert Section 4474.3 of the end insert begin insert Welfare and Institutions Code end insert
begin insert is amended to read: end insert

4474.3.  

The provisions of Section 10411 of the Public Contract
Code shall not apply to any person begin delete who, in connection with the
closures of Agnews Developmental Center or Lanterman
Developmental Center, provides developmental services. end delete begin insert who
provides developmental services and supports to individuals
transitioning from a developmental center to community living or
to individuals with developmental disabilities at risk of admission
to a developmental center, an institution for mental disease, an
out-of-state placement, a general acute care hospital, or an acute
psychiatric hospital, pursuant to Section 4474.2. end insert

begin insert

begin insert SEC. 13. end insert   

end insert

begin insert Section 4514 of the end insert begin insert Welfare and Institutions Code end insert begin insert is
amended to read: end insert

4514.  

All information and records obtained in the course of
providing intake, assessment, and services under Division 4.1
(commencing with Section 4400), Division 4.5 (commencing with
Section 4500), Division 6 (commencing with Section 6000), or
Division 7 (commencing with Section 7100) to persons with
developmental disabilities shall be confidential. Information and
records obtained in the course of providing similar services to
either voluntary or involuntary recipients prior to 1969 shall also
be confidential. Information and records shall be disclosed only
in any of the following cases:

(a) In communications between qualified professional persons,
whether employed by a regional center or state developmental
center, or not, in the provision of intake, assessment, and services
or appropriate referrals. The consent of the person with a
developmental disability, or his or her guardian or conservator,
shall be obtained before information or records may be disclosed
by regional center or state developmental center personnel to a
professional not employed by the regional center or state
developmental center, or a program not vendored by a regional
center or state developmental center.

(b) When the person with a developmental disability, who has
the capacity to give informed consent, designates individuals to
whom information or records may be released, except that begin delete nothing
in end delete this chapter shall begin insert not end insert be construed to compel a physician and
surgeon, psychologist, social worker, marriage and family therapist,
professional clinical counselor, nurse, attorney, or other
professional to reveal information that has been given to him or
her in confidence by a family member of the person unless a valid
release has been executed by that family member.

(c) To the extent necessary for a claim, or for a claim or
application to be made on behalf of a person with a developmental
disability for aid, insurance, government benefit, or medical
assistance to which he or she may be entitled.

(d) If the person with a developmental disability is a minor,
dependent ward, or conservatee, and his or her parent, guardian,
conservator, limited conservator with access to confidential records,
or authorized representative, designates, in writing, persons to
whom records or information may be disclosed, except that begin delete nothing
in end delete this chapter shall begin insert not end insert be construed to compel a physician and
surgeon, psychologist, social worker, marriage and family therapist,
professional clinical counselor, nurse, attorney, or other
professional to reveal information that has been given to him or
her in confidence by a family member of the person unless a valid
release has been executed by that family member.

(e) For research, begin delete provided that end delete begin insert if end insert the Director of Developmental
Services designates by regulation rules for the conduct of research
and requires the research to be first reviewed by the appropriate
institutional review board or boards. These rules shall include, but
need not be limited to, the requirement that all researchers shall
sign an oath of confidentiality as follows:

 

	“
	Date

 

As a condition of doing research concerning persons with
developmental disabilities who have received services from ____
(fill in the facility, agency or person), I, ____, agree to obtain the
prior informed consent of persons who have received services to
the maximum degree possible as determined by the appropriate
institutional review board or boards for protection of human
subjects reviewing my research, or the person’s parent, guardian,
or conservator, and I further agree not to divulge any information
obtained in the course of the research to unauthorized persons, and
not to publish or otherwise make public any information regarding
persons who have received services so those persons who received
services are identifiable.

I recognize that the unauthorized release of confidential
information may make me subject to a civil action under provisions
of the Welfare and Institutions Code.

 

	”
	Signed

 

(f) To the courts, as necessary to the administration of justice.

(g) To governmental law enforcement agencies as needed for
the protection of federal and state elective constitutional officers
and their families.

(h) To the Senate Committee on Rules or the Assembly
Committee on Rules for the purposes of legislative investigation
authorized by the committee.

(i) To the courts and designated parties as part of a regional
center report or assessment in compliance with a statutory or
regulatory requirement, including, but not limited to, Section
1827.5 of the Probate Code, Sections 1001.22 and 1370.1 of the
Penal Code, and Section 6502 of the Welfare and Institutions Code.

(j) To the attorney for the person with a developmental disability
in any and all proceedings upon presentation of a release of
information signed by the person, except that when the person
lacks the capacity to give informed consent, the regional center or
state developmental center director or designee, upon satisfying
himself or herself of the identity of the attorney, and of the fact
that the attorney represents the person, shall release all information
and records relating to the person except that begin delete nothing in end delete this article
shall begin insert not end insert be construed to compel a physician and surgeon,
psychologist, social worker, marriage and family therapist,
professional clinical counselor, nurse, attorney, or other
professional to reveal information that has been given to him or
her in confidence by a family member of the person unless a valid
release has been executed by that family member.

(k) Upon written consent by a person with a developmental
disability previously or presently receiving services from a regional
center or state developmental center, the director of the regional
center or state developmental center, or his or her designee, may
release any information, except information that has been given
in confidence by members of the family of the person with
developmental disabilities, requested by a probation officer charged
with the evaluation of the person after his or her conviction of a
crime if the regional center or state developmental center director
or designee determines that the information is relevant to the
evaluation. The consent shall only be operative until sentence is
passed on the crime of which the person was convicted. The
confidential information released pursuant to this subdivision shall
be transmitted to the court separately from the probation report
and shall not be placed in the probation report. The confidential
information shall remain confidential except for purposes of
sentencing. After sentencing, the confidential information shall be
sealed.

(l) Between persons who are trained and qualified to serve on
“multidisciplinary personnel” teams pursuant to subdivision (d)
of Section 18951. The information and records sought to be
disclosed shall be relevant to the prevention, identification,
management, or treatment of an abused child and his or her parents
pursuant to Chapter 11 (commencing with Section 18950) of Part
6 of Division 9.

(m) When a person with a developmental disability dies from
any cause, natural or otherwise, while hospitalized in a state
developmental center, the State Department of Developmental
Services, the physician and surgeon in charge of the client, or the
professional in charge of the facility or his or her designee, shall
release information and records to the coroner. The State
Department of Developmental Services, the physician and surgeon
in charge of the client, or the professional in charge of the facility
or his or her designee, shall not release any notes, summaries,
transcripts, tapes, or records of conversations between the resident
and health professional personnel of the hospital relating to the
personal life of the resident that is not related to the diagnosis and
treatment of the resident’s physical condition. Any information
released to the coroner pursuant to this section shall remain
confidential and shall be sealed and shall not be made part of the
public record.

(n) To authorized licensing personnel who are employed by, or
who are authorized representatives of, the State Department of
Public Health, and who are licensed or registered health
professionals, and to authorized legal staff or special investigators
who are peace officers who are employed by, or who are authorized
representatives of, the State Department of Social Services, as
necessary to the performance of their duties to inspect, license,
and investigate health facilities and community care facilities, and
to ensure that the standards of care and services provided in these
facilities are adequate and appropriate and to ascertain compliance
with the rules and regulations to which the facility is subject. The
confidential information shall remain confidential except for
purposes of inspection, licensing, or investigation pursuant to
Chapter 2 (commencing with Section 1250) and Chapter 3
(commencing with Section 1500) of Division 2 of the Health and
Safety Code, or a criminal, civil, or administrative proceeding in
relation thereto. The confidential information may be used by the
State Department of Public Health or the State Department of
Social Services in a criminal, civil, or administrative proceeding.
The confidential information shall be available only to the judge
or hearing officer and to the parties to the case. Names begin delete which end delete begin insert that end insert
are confidential shall be listed in attachments separate to the general
pleadings. The confidential information shall be sealed after the
conclusion of the criminal, civil, or administrative hearings, and
shall not subsequently be released except in accordance with this
subdivision. If the confidential information does not result in a
criminal, civil, or administrative proceeding, it shall be sealed after
the State Department of Public Health or the State Department of
Social Services decides that no further action will be taken in the
matter of suspected licensing violations. Except as otherwise
provided in this subdivision, confidential information in the
possession of the State Department of Public Health or the State
Department of Social Services shall not contain the name of the
person with a developmental disability.

(o) To any board begin delete which end delete begin insert that end insert licenses and certifies professionals
in the fields of mental health and developmental disabilities
pursuant to state law, when the Director of Developmental Services
has reasonable cause to believe that there has occurred a violation
of any provision of law subject to the jurisdiction of a board and
the records are relevant to the violation. The information shall be
sealed after a decision is reached in the matter of the suspected
violation, and shall not subsequently be released except in
accordance with this subdivision. Confidential information in the
possession of the board shall not contain the name of the person
with a developmental disability.

(p)  begin insert (1) end insert begin insert   end insert To governmental law enforcement agencies by the
director of a regional center or state developmental center, or his
or her designee, when (1) the person with a developmental
disability has been reported lost or missing or (2) there is probable
cause to believe that a person with a developmental disability has
committed, or has been the victim of, murder, manslaughter,
mayhem, aggravated mayhem, kidnapping, robbery, carjacking,
assault with the intent to commit a felony, arson, extortion, rape,
forcible sodomy, forcible oral copulation, assault or battery, or
unlawful possession of a weapon, as provided in any provision
listed in Section 16590 of the Penal Code.

begin insert (2) end insert begin insert   end insert This subdivision shall be limited solely to information
directly relating to the factual circumstances of the commission
of the enumerated offenses and shall not include any information
relating to the mental state of the patient or the circumstances of
his or her treatment unless relevant to the crime involved.

begin insert (3) end insert begin insert   end insert This subdivision shall not be construed as an exception to,
or in any other way affecting, the provisions of Article 7
(commencing with Section 1010) of Chapter 4 of Division 8 of
the Evidence Code, or Chapter 11 (commencing with Section
15600) and Chapter 13 (commencing with Section 15750) of Part
3 of Division 9.

(q) To the Division of Juvenile Facilities and Department of
Corrections and Rehabilitation or any component thereof, as
necessary to the administration of justice.

(r) To an agency mandated to investigate a report of abuse filed
pursuant to either Section 11164 of the Penal Code or Section
15630 of the Welfare and Institutions Code for the purposes of
either a mandated or voluntary report or when those agencies
request information in the course of conducting their investigation.

(s) When a person with developmental disabilities, or the parent,
guardian, or conservator of a person with developmental disabilities
who lacks capacity to consent, fails to grant or deny a request by
a regional center or state developmental center to release
information or records relating to the person with developmental
disabilities within a reasonable period of time, the director of the
regional or developmental center, or his or her designee, may
release information or records on behalf of that person provided
both of the following conditions are met:

(1) Release of the information or records is deemed necessary
to protect the person’s health, safety, or welfare.

(2) The person, or the person’s parent, guardian, or conservator,
has been advised annually in writing of the policy of the regional
center or state developmental center for release of confidential
client information or records when the person with developmental
disabilities, or the person’s parent, guardian, or conservator, fails
to respond to a request for release of the information or records
within a reasonable period of time. A statement of policy contained
in the client’s individual program plan shall be deemed to comply
with the notice requirement of this paragraph.

(t) (1) When an employee is served with a notice of adverse
action, as defined in Section 19570 of the Government Code, the
following information and records may be released:

(A) All information and records that the appointing authority
relied upon in issuing the notice of adverse action.

(B) All other information and records that are relevant to the
adverse action, or that would constitute relevant evidence as
defined in Section 210 of the Evidence Code.

(C) The information described in subparagraphs (A) and (B)
may be released only if both of the following conditions are met:

(i) The appointing authority has provided written notice to the
consumer and the consumer’s legal representative or, if the
consumer has no legal representative or if the legal representative
is a state agency, to the clients’ rights advocate, and the consumer,
the consumer’s legal representative, or the clients’ rights advocate
has not objected in writing to the appointing authority within five
business days of receipt of the notice, or the appointing authority,
upon review of the objection has determined that the circumstances
on which the adverse action is based are egregious or threaten the
health, safety, or life of the consumer or other consumers and
without the information the adverse action could not be taken.

(ii) The appointing authority, the person against whom the
adverse action has been taken, and the person’s representative, if
any, have entered into a stipulation that does all of the following:

(I) Prohibits the parties from disclosing or using the information
or records for any purpose other than the proceedings for which
the information or records were requested or provided.

(II) Requires the employee and the employee’s legal
representative to return to the appointing authority all records
provided to them under this subdivision, including, but not limited
to, all records and documents or copies thereof that are no longer
in the possession of the employee or the employee’s legal
representative because they were from any source containing
confidential information protected by this section, and all copies
of those records and documents, within 10 days of the date that
the adverse action becomes final except for the actual records and
documents submitted to the administrative tribunal as a component
of an appeal from the adverse action.

(III) Requires the parties to submit the stipulation to the
administrative tribunal with jurisdiction over the adverse action
at the earliest possible opportunity.

(2) For the purposes of this subdivision, the State Personnel
Board may, prior to any appeal from adverse action being filed
with it, issue a protective order, upon application by the appointing
authority, for the limited purpose of prohibiting the parties from
disclosing or using information or records for any purpose other
than the proceeding for which the information or records were
requested or provided, and to require the employee or the
employee’s legal representative to return to the appointing authority
all records provided to them under this subdivision, including, but
not limited to, all records and documents from any source
containing confidential information protected by this section, and
all copies of those records and documents, within 10 days of the
date that the adverse action becomes final, except for the actual
records and documents that are no longer in the possession of the
employee or the employee’s legal representatives because they
were submitted to the administrative tribunal as a component of
an appeal from the adverse action.

(3) Individual identifiers, including, but not limited to, names,
social security numbers, and hospital numbers, that are not
necessary for the prosecution or defense of the adverse action,
shall not be disclosed.

(4) All records, documents, or other materials containing
confidential information protected by this section that have been
submitted or otherwise disclosed to the administrative agency or
other person as a component of an appeal from an adverse action
shall, upon proper motion by the appointing authority to the
administrative tribunal, be placed under administrative seal and
shall not, thereafter, be subject to disclosure to any person or entity
except upon the issuance of an order of a court of competent
jurisdiction.

(5) For purposes of this subdivision, an adverse action becomes
final when the employee fails to answer within the time specified
in Section 19575 of the Government Code, or, after filing an
answer, withdraws the appeal, or, upon exhaustion of the
administrative appeal or of the judicial review remedies as
otherwise provided by law.

(u) To the person appointed as the developmental services
decisionmaker for a minor, dependent, or ward pursuant to Section
319, 361, or 726.

(v) To a protection and advocacy agency established pursuant
to Section 4901, to the extent that the information is incorporated
within any of the following:

(1) An unredacted facility evaluation report form or an
unredacted complaint investigation report form of the State
Department of Social Services. This information shall remain
confidential and subject to the confidentiality requirements of
subdivision (f) of Section 4903.

(2) An unredacted citation report, unredacted licensing report,
unredacted survey report, unredacted plan of correction, or
unredacted statement of deficiency of the State Department of
Public Health, prepared by authorized licensing personnel or
authorized representatives described in subdivision (n). This
information shall remain confidential and subject to the
confidentiality requirements of subdivision (f) of Section 4903.

begin insert

(w) When a comprehensive assessment is conducted or updated
pursuant to Section 4418.25, 4418.7, or 4648, a regional center
is authorized to provide the assessment to the regional center
clients’ rights advocate, who provides service pursuant to Section
4433.

end insert

begin insert

begin insert SEC. 14. end insert   

end insert

begin insert Section 4519.6 of the end insert begin insert Welfare and Institutions Code end insert
begin insert is amended to read: end insert

4519.6.  

The department and the regional centers shall annually
collaborate to determine the most appropriate methods to collect
and compile meaningful data in a uniform manner, as specified in
Section 4519.5, related to the payment of begin delete copayments end delete begin insert copayments,
coinsurance, end insert and begin delete coinsurance end delete begin insert deductibles end insert by each regional center.

begin insert

begin insert SEC. 15. end insert   

end insert

begin insert Section 4648 of the end insert begin insert Welfare and Institutions Code end insert begin insert is
amended to read: end insert

4648.  

In order to achieve the stated objectives of a consumer’s
individual program plan, the regional center shall conduct activities,
including, but not limited to, all of the following:

(a) Securing needed services and supports.

(1) It is the intent of the Legislature that services and supports
assist individuals with developmental disabilities in achieving the
greatest self-sufficiency possible and in exercising personal
choices. The regional center shall secure services and supports
that meet the needs of the consumer, as determined in the
consumer’s individual program plan, and within the context of the
individual program plan, the planning team shall give highest
preference to those services and supports which would allow
minors with developmental disabilities to live with their families,
adult persons with developmental disabilities to live as
independently as possible in the community, and that allow all
consumers to interact with persons without disabilities in positive,
meaningful ways.

(2) In implementing individual program plans, regional centers,
through the planning team, shall first consider services and supports
in natural community, home, work, and recreational settings.
Services and supports shall be flexible and individually tailored
to the consumer and, where appropriate, his or her family.

(3) A regional center may, pursuant to vendorization or a
contract, purchase services or supports for a consumer from any
individual or agency which the regional center and consumer or,
where appropriate, his or her parents, legal guardian, or
conservator, or authorized representatives, determines will best
accomplish all or any part of that consumer’s program plan.

(A) Vendorization or contracting is the process for identification,
selection, and utilization of service vendors or contractors, based
on the qualifications and other requirements necessary in order to
provide the service.

(B) A regional center may reimburse an individual or agency
for services or supports provided to a regional center consumer if
the individual or agency has a rate of payment for vendored or
contracted services established by the department, pursuant to this
division, and is providing services pursuant to an emergency
vendorization or has completed the vendorization procedures or
has entered into a contract with the regional center and continues
to comply with the vendorization or contracting requirements. The
director shall adopt regulations governing the vendorization process
to be utilized by the department, regional centers, vendors and the
individual or agency requesting vendorization.

(C) Regulations shall include, but not be limited to: the vendor
application process, and the basis for accepting or denying an
application; the qualification and requirements for each category
of services that may be provided to a regional center consumer
through a vendor; requirements for emergency vendorization;
procedures for termination of vendorization; the procedure for an
individual or an agency to appeal any vendorization decision made
by the department or regional center.

(D) A regional center may vendorize a licensed facility for
exclusive services to persons with developmental disabilities at a
capacity equal to or less than the facility’s licensed capacity. A
facility already licensed on January 1, 1999, shall continue to be
vendorized at their full licensed capacity until the facility agrees
to vendorization at a reduced capacity.

(E) Effective July 1, 2009, notwithstanding any other provision
of law or regulation to the contrary, a regional center shall not
newly vendor a State Department of Social Services licensed
24-hour residential care facility with a licensed capacity of 16 or
more beds, unless the facility qualifies for receipt of federal funds
under the Medicaid Program.

(4) Notwithstanding subparagraph (B) of paragraph (3), a
regional center may contract or issue a voucher for services and
supports provided to a consumer or family at a cost not to exceed
the maximum rate of payment for that service or support
established by the department. If a rate has not been established
by the department, the regional center may, for an interim period,
contract for a specified service or support with, and establish a
rate of payment for, any provider of the service or support
necessary to implement a consumer’s individual program plan.
Contracts may be negotiated for a period of up to three years, with
annual review and subject to the availability of funds.

(5) In order to ensure the maximum flexibility and availability
of appropriate services and supports for persons with
developmental disabilities, the department shall establish and
maintain an equitable system of payment to providers of services
and supports identified as necessary to the implementation of a
consumers’ individual program plan. The system of payment shall
include provision for a rate to ensure that the provider can meet
the special needs of consumers and provide quality services and
supports in the least restrictive setting as required by law.

(6) The regional center and the consumer, or where appropriate,
his or her parents, legal guardian, conservator, or authorized
representative, including those appointed pursuant to subdivision
(d) of Section 4548, subdivision (b) of Section 4701.6, or
subdivision (e) of Section 4705, shall, pursuant to the individual
program plan, consider all of the following when selecting a
provider of consumer services and supports:

(A) A provider’s ability to deliver quality services or supports
which can accomplish all or part of the consumer’s individual
program plan.

(B) A provider’s success in achieving the objectives set forth
in the individual program plan.

(C) Where appropriate, the existence of licensing, accreditation,
or professional certification.

(D) The cost of providing services or supports of comparable
quality by different providers, if available, shall be reviewed, and
the least costly available provider of comparable service, including
the cost of transportation, who is able to accomplish all or part of
the consumer’s individual program plan, consistent with the
particular needs of the consumer and family as identified in the
individual program plan, shall be selected. In determining the least
costly provider, the availability of federal financial participation
shall be considered. The consumer shall not be required to use the
least costly provider if it will result in the consumer moving from
an existing provider of services or supports to more restrictive or
less integrated services or supports.

(E) The consumer’s choice of providers, or, where appropriate,
the consumer’s parent’s, legal guardian’s, authorized
representative’s, or conservator’s choice of providers.

(7) No service or support provided by any agency or individual
shall be continued unless the consumer or, where appropriate, his
or her parents, legal guardian, or conservator, or authorized
representative, including those appointed pursuant to subdivision
(d) of Section 4548, subdivision (b) of Section 4701.6, or
subdivision (e) of Section 4705, is satisfied and the regional center
and the consumer or, when appropriate, the person’s parents or
legal guardian or conservator agree that planned services and
supports have been provided, and reasonable progress toward
objectives have been made.

(8) Regional center funds shall not be used to supplant the
budget of any agency that has a legal responsibility to serve all
members of the general public and is receiving public funds for
providing those services.

(9) (A) A regional center may, directly or through an agency
acting on behalf of the center, provide placement in, purchase of,
or follow-along services to persons with developmental disabilities
in, appropriate community living arrangements, including, but not
limited to, support service for consumers in homes they own or
lease, foster family placements, health care facilities, and licensed
community care facilities. In considering appropriate placement
alternatives for children with developmental disabilities, approval
by the child’s parent or guardian shall be obtained before placement
is made.

(B) Effective July 1, 2012, notwithstanding any other law or
regulation to the contrary, a regional center shall not purchase
residential services from a State Department of Social Services
licensed 24-hour residential care facility with a licensed capacity
of 16 or more beds. This prohibition on regional center purchase
of residential services shall not apply to any of the following:

(i) A residential facility with a licensed capacity of 16 or more
beds that has been approved to participate in the department’s
Home and Community Based Services Waiver or another existing
waiver program or certified to participate in the Medi-Cal program.

(ii) A residential facility service provider that has a written
agreement and specific plan prior to July 1, 2012, with the
vendoring regional center to downsize the existing facility by
transitioning its residential services to living arrangements of 15
beds or less or restructure the large facility to meet federal
Medicaid eligibility requirements on or before June 30, 2013.

(iii) A residential facility licensed as a mental health
rehabilitation center by the State Department of Mental Health or
successor agency under any of the following circumstances:

(I) The facility is eligible for Medicaid reimbursement.

(II) The facility has a department-approved plan in place by
June 30, 2013, to transition to a program structure eligible for
federal Medicaid funding, and this transition will be completed by
June 30, 2014. The department may grant an extension for the date
by which the transition will be completed if the facility
demonstrates that it has made significant progress toward transition,
and states with specificity the timeframe by which the transition
will be completed and the specified steps that will be taken to
accomplish the transition. A regional center may pay for the costs
of care and treatment of a consumer residing in the facility on June
30, 2012, until June 30, 2013, inclusive, and, if the facility has a
department-approved plan in place by June 30, 2013, may continue
to pay the costs under this subparagraph until June 30, 2014, or
until the end of any period during which the department has granted
an extension.

(III) There is an emergency circumstance in which the regional
center determines that it cannot locate alternate federally eligible
services to meet the consumer’s needs. Under such an emergency
circumstance, an assessment shall be completed by the regional
center as soon as possible and within 30 days of admission. An
individual program plan meeting shall be convened immediately
following the assessment to determine the services and supports
needed for stabilization and to develop a plan to transition the
consumer from the facility into the community. If transition is not
expected within 90 days of admission, an individual program plan
meeting shall be held to discuss the status of transition and to
determine if the consumer is still in need of placement in the
facility. Commencing October 1, 2012, this determination shall
be made after also considering resource options identified by the
statewide specialized resource service. If it is determined that
emergency services continue to be necessary, the regional center
shall submit an updated transition plan that can cover a period of
up to 90 days. In no event shall placements under these emergency
circumstances exceed 180 days.

(C) (i) Effective July 1, 2012, notwithstanding any other law
or regulation to the contrary, a regional center shall not purchase
new residential services from, or place a consumer in, institutions
for mental disease, as described in Part 5 (commencing with
Section 5900) of Division 5, for which federal Medicaid funding
is not available. Effective July 1, 2013, this prohibition applies
regardless of the availability of federal funding.

(ii) The prohibition described in clause (i) shall not apply to
emergencies, as determined by the regional center, when a regional
center cannot locate alternate services to meet the consumer’s
needs. As soon as possible within 30 days of admission due to an
emergency, an assessment shall be completed by the regional
center. An individual program plan meeting shall be convened
immediately following the assessment, to determine the services
and supports needed for stabilization and to develop a plan to
transition the consumer from the facility to the community. If
transition is not expected within 90 days of admission, an
emergency program plan meeting shall be held to discuss the status
of the transition and to determine if the consumer is still in need
of placement in the facility. If emergency services continue to be
necessary, the regional center shall submit an updated transition
plan to the department for an extension of up to 90 days. Placement
shall not exceed 180 days.

(iii) To the extent feasible, prior to any admission, the regional
center shall consider resource options identified by the statewide
specialized resource service established pursuant to subdivision
(b) of Section 4418.25.

(iv) The clients’ rights advocate shall be notified of each
admission and individual program planning meeting pursuant to
this subparagraph and may participate in all individual program
planning meetings unless the consumer objects on his or her own
behalf. begin insert For purposes of this clause, notification to the clients’
rights advocate shall include a copy of the most recent
comprehensive assessment or updated assessment and the time,
date, and location of the meeting, and shall be provided as soon
as practicable, but not less than 7 calendar days prior to the
meeting. end insert

(v) Regional centers shall complete a comprehensive assessment
of any consumer residing in an institution for mental disease as of
July 1, 2012, for which federal Medicaid funding is not available,
and for any consumer residing in an institution for mental disease
as of July 1, 2013, without regard to federal funding. The
comprehensive assessment shall be completed prior to the
consumer’s next scheduled individual program plan meeting and
shall include identification of the services and supports needed
and the timeline for identifying or developing those services needed
to transition the consumer back to the community. Effective
October 1, 2012, the regional center shall also consider resource
options identified by the statewide specialized resource service.
For each individual program plan meeting convened pursuant to
this subparagraph, the clients’ rights advocate for the regional
center shall be notified of the meeting and may participate in the
meeting unless the consumer objects on his or her own behalf. begin insert For
purposes of this clause, notification to the clients’ rights advocate
shall include the time, date, and location of the meeting, and shall
be provided as soon as practicable, but not less than 7 calendar
days prior to the meeting. end insert

(D) Each person with developmental disabilities placed by the
regional center in a community living arrangement shall have the
rights specified in this division. These rights shall be brought to
the person’s attention by any means necessary to reasonably
communicate these rights to each resident, provided that, at a
minimum, the Director of Developmental Services prepare,
provide, and require to be clearly posted in all residential facilities
and day programs a poster using simplified language and pictures
that is designed to be more understandable by persons with
cognitive disabilities and that the rights information shall also be
available through the regional center to each residential facility
and day program in alternative formats, including, but not limited
to, other languages, braille, and audio tapes, when necessary to
meet the communication needs of consumers.

(E) Consumers are eligible to receive supplemental services
including, but not limited to, additional staffing, pursuant to the
process described in subdivision (d) of Section 4646. Necessary
additional staffing that is not specifically included in the rates paid
to the service provider may be purchased by the regional center if
the additional staff are in excess of the amount required by
regulation and the individual’s planning team determines the
additional services are consistent with the provisions of the
individual program plan. Additional staff should be periodically
reviewed by the planning team for consistency with the individual
program plan objectives in order to determine if continued use of
the additional staff is necessary and appropriate and if the service
is producing outcomes consistent with the individual program plan.
Regional centers shall monitor programs to ensure that the
additional staff is being provided and utilized appropriately.

(10) Emergency and crisis intervention services including, but
not limited to, mental health services and behavior modification
services, may be provided, as needed, to maintain persons with
developmental disabilities in the living arrangement of their own
choice. Crisis services shall first be provided without disrupting a
person’s living arrangement. If crisis intervention services are
unsuccessful, emergency housing shall be available in the person’s
home community. If dislocation cannot be avoided, every effort
shall be made to return the person to his or her living arrangement
of choice, with all necessary supports, as soon as possible.

(11) Among other service and support options, planning teams
shall consider the use of paid roommates or neighbors, personal
assistance, technical and financial assistance, and all other service
and support options which would result in greater self-sufficiency
for the consumer and cost-effectiveness to the state.

(12) When facilitation as specified in an individual program
plan requires the services of an individual, the facilitator shall be
of the consumer’s choosing.

(13) The community support may be provided to assist
individuals with developmental disabilities to fully participate in
community and civic life, including, but not limited to, programs,
services, work opportunities, business, and activities available to
persons without disabilities. This facilitation shall include, but not
be limited to, any of the following:

(A) Outreach and education to programs and services within
the community.

(B) Direct support to individuals which would enable them to
more fully participate in their community.

(C) Developing unpaid natural supports when possible.

(14) When feasible and recommended by the individual program
planning team, for purposes of facilitating better and cost-effective
services for consumers or family members, technology, including
telecommunication technology, may be used in conjunction with
other services and supports. Technology in lieu of a consumer’s
in-person appearances at judicial proceedings or administrative
due process hearings may be used only if the consumer or, when
appropriate, the consumer’s parent, legal guardian, conservator,
or authorized representative, gives informed consent. Technology
may be used in lieu of, or in conjunction with, in-person training
for providers, as appropriate.

(15) Other services and supports may be provided as set forth
in Sections 4685, 4686, 4687, 4688, and 4689, when necessary.

(16) Notwithstanding any other provision of law or regulation
to the contrary, effective July 1, 2009, regional centers shall not
purchase experimental treatments, therapeutic services, or devices
that have not been clinically determined or scientifically proven
to be effective or safe or for which risks and complications are
unknown. Experimental treatments or therapeutic services include
experimental medical or nutritional therapy when the use of the
product for that purpose is not a general physician practice. For
regional center consumers receiving these services as part of their
individual program plan (IPP) or individualized family service
plan (IFSP) on July 1, 2009, this prohibition shall apply on August
1, 2009.

(b) (1) Advocacy for, and protection of, the civil, legal, and
service rights of persons with developmental disabilities as
established in this division.

(2) Whenever the advocacy efforts of a regional center to secure
or protect the civil, legal, or service rights of any of its consumers
prove ineffective, the regional center or the person with
developmental disabilities or his or her parents, legal guardian, or
other representative may request the area board to initiate action
under the provisions defining area board advocacy functions
established in this division.

(c) The regional center may assist consumers and families
directly, or through a provider, in identifying and building circles
of support within the community.

(d) In order to increase the quality of community services and
protect consumers, the regional center shall, when appropriate,
take either of the following actions:

(1) Identify services and supports that are ineffective or of poor
quality and provide or secure consultation, training, or technical
assistance services for any agency or individual provider to assist
that agency or individual provider in upgrading the quality of
services or supports.

(2) Identify providers of services or supports that may not be
in compliance with local, state, and federal statutes and regulations
and notify the appropriate licensing or regulatory authority, or
request the area board to investigate the possible noncompliance.

(e) When necessary to expand the availability of needed services
of good quality, a regional center may take actions that include,
but are not limited to, the following:

(1) Soliciting an individual or agency by requests for proposals
or other means, to provide needed services or supports not presently
available.

(2) Requesting funds from the Program Development Fund,
pursuant to Section 4677, or community placement plan funds
designated from that fund, to reimburse the startup costs needed
to initiate a new program of services and supports.

(3) Using creative and innovative service delivery models,
including, but not limited to, natural supports.

(f) Except in emergency situations, a regional center shall not
provide direct treatment and therapeutic services, but shall utilize
appropriate public and private community agencies and service
providers to obtain those services for its consumers.

(g) Where there are identified gaps in the system of services
and supports or where there are identified consumers for whom
no provider will provide services and supports contained in his or
her individual program plan, the department may provide the
services and supports directly.

(h) At least annually, regional centers shall provide the
consumer, his or her parents, legal guardian, conservator, or
authorized representative a statement of services and supports the
regional center purchased for the purpose of ensuring that they are
delivered. The statement shall include the type, unit, month, and
cost of services and supports purchased.

begin insert

begin insert SEC. 16. end insert   

end insert

begin insert Section 4659.1 of the end insert begin insert Welfare and Institutions Code end insert
begin insert is amended to read: end insert

4659.1.  

(a) If a service or support provided pursuant to a
consumer’s individual program plan under this division or
individualized family service plan pursuant to the California Early
Intervention Services Act (Title 14 (commencing with Section
95000) of the Government Code) is paid for, in whole or in part,
by the health care service plan or health insurance policy of the
consumer’s parent, guardian, or caregiver, the regional center may,
when necessary to ensure that the consumer receives the service
or support, pay any applicable begin delete copayment end delete begin insert copayment, coinsurance, end insert
or begin delete coinsurance end delete begin insert deductible end insert associated with the service or support
for which the parent, guardian, or caregiver is responsible if all of
the following conditions are met:

(1) The consumer is covered by his or her parent’s, guardian’s,
or caregiver’s health care service plan or health insurance policy.

(2) The family has an annual gross income that does not exceed
400 percent of the federal poverty level.

(3) There is no other third party having liability for the cost of
the service or support, as provided in subdivision (a) of Section
4659 and Article 2.6 (commencing with Section 4659.10).

(b) If a service or support provided to a consumer 18 years of
age or older, pursuant to his or her individual program plan, is paid
for in whole or in part by the consumer’s health care service plan
or health insurance policy, the regional center may, when necessary
to ensure that the consumer receives the service or support, pay
any applicable begin delete copayment end delete begin insert copayment, coinsurance, end insert or begin delete coinsurance end delete
begin insert deductible end insert associated with the service or support for which the
consumer is responsible if both of the following conditions are
met:

(1) The consumer has an annual gross income that does not
exceed 400 percent of the federal poverty level.

(2) There is no other third party having liability for the cost of
the service or support, as provided in subdivision (a) of Section
4659 and Article 2.6 (commencing with Section 4659.10).

(c) Notwithstanding paragraph (2) of subdivision (a) or
paragraph (1) of subdivision (b), a regional center may pay a
begin delete copayment end delete begin insert copayment, coinsurance, end insert or begin delete coinsurance end delete begin insert deductible end insert
associated with the health care service plan or health insurance
policy for a service or support provided pursuant to a consumer’s
individual program plan or individualized family service plan if
the family’s or consumer’s income exceeds 400 percent of the
federal poverty level, the service or support is necessary to
successfully maintain the child at home or the adult consumer in
the least-restrictive setting, and the parents or consumer
demonstrate one or more of the following:

(1) The existence of an extraordinary event that impacts the
ability of the parent, guardian, or caregiver to meet the care and
supervision needs of the child or impacts the ability of the parent,
guardian, or caregiver, or adult consumer with a health care service
plan or health insurance policy, to pay the begin delete copayment end delete begin insert copayment,
coinsurance, end insert or begin delete coinsurance. end delete begin insert deductible. end insert

(2) The existence of catastrophic loss that temporarily limits
the ability to pay of the parent, guardian, or caregiver, or adult
consumer with a health care service plan or health insurance policy
and creates a direct economic impact on the family or adult
consumer. For purposes of this paragraph, catastrophic loss may
include, but is not limited to, natural disasters and accidents
involving major injuries to an immediate family member.

(3) Significant unreimbursed medical costs associated with the
care of the consumer or another child who is also a regional center
consumer.

(d) The parent, guardian, or caregiver of a consumer or an adult
consumer with a health care service plan or health insurance policy
shall self-certify the family’s gross annual income to the regional
center by providing copies of W-2 Wage Earners Statements,
payroll stubs, a copy of the prior year’s state income tax return,
or other documents and proof of other income.

(e) The parent, guardian, or caregiver of a consumer or an adult
consumer with a health care service plan or health insurance policy
is responsible for notifying the regional center when a change in
income occurs that would result in a change in eligibility for
coverage of the health care service plan or health insurance policy
begin delete copayments end delete begin insert copayments, coinsurance, end insert or begin delete coinsurance. end delete begin insert deductibles. end insert

(f) Documentation submitted pursuant to this section shall be
considered records obtained in the course of providing intake,
assessment, and services and shall be confidential pursuant to
Section 4514.

begin delete end delete begin delete

(g) Regional centers shall not pay health care service plan or
health insurance policy deductibles.

end delete begin delete end delete begin delete

(h)

end delete

begin insert (g) end insert  This section shall not be implemented in a manner that is
inconsistent with the requirements of Part C of the federal
Individuals with Disabilities Education Act (20 U.S.C. Sec. 1431
et seq.).

begin insert

begin insert SEC. 17. end insert   

end insert

begin insert Section 4681.6 of the end insert begin insert Welfare and Institutions Code end insert
begin insert is amended to read: end insert

4681.6.  

begin insert (a) end insert begin insert   end insert Notwithstanding any other begin delete provision of end delete law or
regulation, commencing July 1, 2008:

begin delete

(a)

end delete

begin insert (1) end insert   begin delete No end delete begin insert A end insert regional center begin delete may end delete begin insert shall not end insert pay an existing
residential service provider, for services where rates are determined
through a negotiation between the regional center and the provider,
a rate higher than the rate in effect on June 30, 2008, unless the
increase is required by a contract between the regional center and
the vendor that is in effect on June 30, 2008, or the regional center
demonstrates that the approval is necessary to protect the
consumer’s health or safety and the department has granted prior
written authorization.

begin delete

(b)

end delete

begin insert (2) end insert   begin delete No end delete begin insert A end insert regional center begin delete may end delete begin insert shall not end insert negotiate a rate with a
new residential service provider, for services where rates are
determined through a negotiation between the regional center and
the provider, that is higher than the regional center’s median rate
for the same service code and unit of service, or the statewide
median rate for the same service code and unit of service,
whichever is lower. The unit of service designation begin delete must end delete begin insert shall end insert
conform with an existing regional center designation or, if none
exists, a designation used to calculate the statewide median rate
for the same service. The regional center shall annually certify to
the department its median rate for each negotiated rate service
code, by designated unit of service. This certification begin delete will end delete begin insert shall end insert be
subject to verification through the department’s biennial fiscal
audit of the regional center.

begin insert

(b) Notwithstanding subdivision (a), commencing July 1, 2014,
regional centers may negotiate a rate adjustment with residential
service providers regarding rates that are otherwise restricted
pursuant to subdivision (a), if the adjustment is necessary in order
to pay employees no less than the minimum wage as established
by Section 1182.12 of the Labor Code, as amended by Chapter
351 of the Statutes of 2013, and only for the purpose of adjusting
payroll costs associated with the minimum wage increase. The
rate adjustment shall be specific to the unit of service designation
that is affected by the increased minimum wage, shall be specific
to payroll costs associated with any increase necessary to adjust
employee pay only to the extent necessary to bring pay into
compliance with the increased state minimum wage, and shall not
be used as a general wage enhancement for employees paid above
the minimum wage. Regional centers shall maintain documentation
on the process to determine, and the rationale for granting, any
rate adjustment associated with the minimum wage increase.

end insert

(c) For purposes of this section, “residential service provider”
includes Adult Residential Facilities for Persons with Special
Health Care Needs, as described in Section 4684.50.

(d) This section shall not apply to those services for which rates
are determined by the State Department of Health Care Services,
or the State Department of Developmental Services, or are usual
and customary.

begin insert

begin insert SEC. 18. end insert   

end insert

begin insert Article 3.6 (commencing with Section 4684.80) is
added to Chapter 6 of Division 4.5 of the end insert begin insert Welfare and Institutions
Code end insert begin insert , to read: end insert

begin insert

 

Article begin insert 3.6. end insert   Enhanced Behavioral Supports Homes

 

begin insert 4684.80. end insert   

(a) “Enhanced behavioral supports home” means a
facility certified by the State Department of Developmental Services
and licensed by the State Department of Social Services pursuant
to Section 1567.62 of the Health and Safety Code as an adult
residential facility or a group home that provides 24-hour
nonmedical care to individuals with developmental disabilities
who require enhanced behavioral supports, staffing, and
supervision in a homelike setting. An enhanced behavioral supports
home shall have a maximum capacity of four consumers, shall
conform to Section 441.530(a)(1) of Title 42 of the Code of Federal
Regulations, and shall be eligible for federal Medicaid home- and
community-based services funding.

(b) “Enhanced behavioral services and supports” means
additional staffing supervision, facility characteristics, or other
services and supports to address a consumer’s challenging
behaviors, which are beyond what is typically available in other
community facilities licensed as an adult residential facility or a
group home to serve individuals in a community setting rather
than an institution.

(c) “Individual behavior supports plan” means the plan that
identifies and documents the behavior and intensive support and
service needs of a consumer and details the strategies to be
employed and services to be provided to address those needs, and
includes the entity responsible for providing those services and
timelines for when each identified individual behavior support will
commence.

(d) “Individual behavior supports team” means those
individuals who develop, monitor, and revise the individual
behavior supports plan for consumers residing in an enhanced
behavioral supports home. The team shall, at a minimum, be
composed of all of the following individuals:

(1) Regional center service coordinator and other regional
center representatives, as necessary.

(2) Consumer and, where appropriate, his or her conservator
or authorized representative.

(3) Service provider’s board-certified behavior analyst or
qualified behavior modification professional.

(4) Enhanced behavioral supports home administrator.

(5) Regional center clients’ rights advocate, unless the consumer
objects on his or her own behalf to participation by the clients’
rights advocate.

(6) Others deemed necessary by the consumer, or his or her
conservator or authorized representative, for developing a
comprehensive and effective individual behavior supports plan.

begin insert 4684.81. end insert   

(a) The department shall implement a pilot project
using community placement plan funds, as appropriated in the
State Department of Developmental Services’ annual budget, to
test the effectiveness of providing enhanced behavioral supports
in homelike community settings. The enhanced behavioral supports
homes shall be for purposes of providing intensive behavioral
services and supports to adults and children with developmental
disabilities who need intensive services and supports due to
challenging behaviors that cannot be managed in a community
setting without the availability of enhanced behavioral services
and supports, and who are at risk of institutionalization or
out-of-state placement, or are transitioning to the community from
a developmental center, other state-operated residential facility,
institution for mental disease, or out-of-state placement.

(b) An enhanced behavioral supports home may only be
established in an adult residential facility or a group home
approved through a regional center community placement plan
pursuant to Section 4418.25.

(c) No more than six enhanced behavioral supports homes may
be approved by the State Department of Developmental Services
each fiscal year in which the pilot program is in effect and to the
extent funding is available for this purpose, each for no more than
four individuals with developmental disabilities. The homes shall
be located throughout the state, as determined by the State
Department of Developmental Services, based on regional center
requests.

(d) Each enhanced behavioral supports home shall be licensed
as an adult residential facility or a group home pursuant to the
California Community Care Facilities Act (Chapter 3 (commencing
with Section 1500) of Division 2 of the Health and Safety Code)
and certified by the State Department of Developmental Services,
shall exceed the minimum requirements for a Residential Facility
Service Level 4-i pursuant to Sections 56004 and 56013 of Title
17 of the California Code of Regulations, and shall meet all
applicable statutory and regulatory requirements applicable to a
facility licensed as an adult residential facility or a group home
for facility licensing, seclusion, and restraint, including Division
1.5 (commencing with Section 1180) of the Health and Safety Code,
and the use of behavior modification interventions, subject to any
additional requirements applicable to enhanced behavioral
supports homes established by statute or by regulation promulgated
pursuant to this article and Article 9.5 (commencing with Section
1567.61) of Chapter 3 of Division 2 of the Health and Safety Code.

(e) A regional center shall not place a consumer in an enhanced
behavioral supports home unless the program is certified by the
State Department of Developmental Services and the facility is
licensed by the State Department of Social Services.

(f) The State Department of Developmental Services shall be
responsible for granting the certificate of program approval for
an enhanced behavioral supports home.

(g) The State Department of Developmental Services may,
pursuant to Section 4684.85, decertify any enhanced behavioral
supports home that does not comply with program requirements.
Upon decertification of an enhanced behavioral supports home,
the State Department of Developmental Services shall report the
decertification to the State Department of Social Services. The
State Department of Social Services shall revoke the license of the
enhanced behavioral supports home that has been decertified
pursuant to Section 1550 of the Health and Safety Code.

(h) If the State Department of Developmental Services
determines that urgent action is necessary to protect a consumer
residing in an enhanced behavioral supports home from physical
or mental abuse, abandonment, or any other substantial threat to
the consumer’s health and safety, the State Department of
Developmental Services may request that the regional center or
centers remove the consumer from the enhanced behavioral
supports home or direct the regional center or centers to obtain
alternative or additional services for the consumers within 24
hours of that determination. When possible, an individual program
plan (IPP) meeting shall be convened to determine the appropriate
action pursuant to this section. In any case, an IPP meeting shall
be convened within 30 days following an action pursuant to this
section.

(i) Enhanced behavioral supports homes shall have a facility
program plan approved by the State Department of Developmental
Services.

(1) The facility program plan approved by the State Department
of Developmental Services shall be submitted to the State
Department of Social Services for inclusion in the facility plan of
operation.

(2) The vendoring regional center and each consumer’s regional
center shall have joint responsibility for monitoring and evaluating
the services provided in the enhanced behavioral supports home.
Monitoring shall include at least quarterly, or more frequently if
specified in the consumer’s individual program plan, face-to-face,
onsite case management visits with each consumer by his or her
regional center and at least quarterly quality assurance visits by
the vendoring regional center. The State Department of
Developmental Services shall monitor and ensure the regional
centers’ compliance with their monitoring responsibilities.

(j) The State Department of Developmental Services shall
establish by regulation a rate methodology for enhanced behavioral
supports homes that includes a fixed facility component for
residential services and an individualized services and supports
component based on each consumer’s needs as determined through
the individual program plan process, which may include assistance
with transitioning to a less restrictive community residential
setting.

(k) (1) The established facility rate for a full month of service,
as defined in regulations adopted pursuant to this article, shall be
paid based on the licensed capacity of the facility once the facility
reaches maximum capacity, despite the temporary absence of one
or more consumers from the facility or subsequent temporary
vacancies created by consumers moving from the facility. Prior
to the facility reaching licensed capacity, the facility rate shall be
prorated based on the number of consumers residing in the facility.

When a consumer is temporarily absent from the facility,
including when a consumer is in need for inpatient care in a health
facility, as defined in subdivision (a), (b), or (c) of Section 1250
of the Health and Safety Code, the regional center may, based on
consumer need, continue to fund individual services, in addition
to paying the facility rate. Individual consumer services funded
by the regional center during a consumer’s absence from the
facility shall be approved by the regional center director and shall
only be approved in 14-day increments. The regional center shall
maintain documentation of the need for these services and the
regional center director’s approval.

(2) An enhanced behavioral supports home using delayed egress
devices, in compliance with Section 1531.1 of the Health and Safety
Code, may utilize secured perimeters, in compliance with Section
1531.15 of the Health and Safety Code and applicable regulations.
No more than two enhanced behavioral supports homes using
delayed egress devices in combination with secured perimeters
may be certified by the State Department of Developmental
Services during the first year of the pilot program, one in northern
California and one in southern California, and no more than one
additional home using delayed egress devices in combination with
a secured perimeter may be certified by the State Department of
Developmental Services in each subsequent year of the pilot
program. No more than six enhanced behavioral supports homes
that use delayed egress devices in combination with a secured
perimeter shall be certified during the pilot program. Enhanced
behavioral supports homes shall not be counted for purposes of
the statewide limit established in regulations on the total number
of beds permitted in homes with delayed egress devices in
combination with secured perimeters pursuant to subdivision (k)
of Section 1531.15 of the Health and Safety Code. The department
shall make reasonable efforts to include enhanced behavioral
supports homes within the statewide limit.

begin insert 4684.82. end insert   

The vendoring regional center shall, before placing
any consumer into an enhanced behavioral supports home, ensure
that the home has a license issued by the State Department of
Social Services for not more than four individuals with
developmental disabilities, is certified by the State Department of
Developmental Services, and has a contract with the regional
center that meets the contracting requirements established by the
State Department of Developmental Services through regulations
promulgated pursuant to this article. Under no circumstances shall
the contract extend beyond the stated termination date, which shall
not be longer than January 1, 2020.

begin insert 4684.83. end insert   

The enhanced behavioral supports home provider
shall be responsible for coordinating the development and updating
of each consumer’s individual behavior supports plan with the
consumer’s individual behavior supports team. The initial
individual behavior supports plan shall be developed within one
week of the consumer’s admission to the enhanced behavioral
supports home.

begin insert 4684.84. end insert   

(a) The regional center shall have responsibility for
monitoring and evaluating the implementation of the consumer’s
individual behavior supports plan objectives.

(b) A regional center qualified behavior modification
professional shall visit, with or without notice, the consumer, in
person, at least monthly in the enhanced behavioral supports home,
or more frequently if specified in the consumer’s individual
behavior supports plan. At least four of these visits, annually, shall
be unannounced.

(c) The State Department of Developmental Services shall
monitor and ensure the regional centers’ compliance with the
requirements of this article. The monitoring shall include onsite
visits to all the enhanced behavioral supports homes at least every
six months for the duration of the pilot project.

(d) The State Department of Developmental Services shall
conduct a review of the pilot project in consultation with
stakeholders. The review shall be completed and the results of the
review shall be shared in writing with the State Department of
Social Services no later than September 1, 2018.

begin insert 4684.85. end insert   

(a) In addition to any other contract termination
provisions, a regional center may terminate its contract with an
enhanced behavioral supports home when the regional center
determines that the home is unable to maintain substantial
compliance with state laws, regulations, or its contract with the
regional center, or the home demonstrates an inability to ensure
the health and safety of the consumers.

(b) The enhanced behavioral supports home may appeal a
regional center’s decision to terminate its contract by sending to
the executive director of the contracting regional center a detailed
statement containing the reasons and facts demonstrating why the
termination is inappropriate. The appeal shall be received by the
regional center within 10 working days from the date of the letter
terminating the contract. The executive director shall respond with
his or her decision within 10 working days of the date of receipt
of the appeal from the enhanced behavioral supports home. The
executive director shall submit his or her decision to the State
Department of Developmental Services and the State Department
of Social Services on the same date that it is signed. The decision
of the executive director shall be the final administrative decision.

(c) The Director of Developmental Services may rescind an
enhanced behavioral supports home program certification when,
in his or her sole discretion, an enhanced behavioral supports
home does not maintain substantial compliance with an applicable
statute, regulation, or ordinance, or cannot ensure the health and
safety of the consumers. The decision of the Director of
Developmental Services shall be the final administrative decision.
The Director of Developmental Services shall transmit his or her
decision whether to rescind an enhanced behavioral supports home
program certification to the State Department of Social Services
and the regional center with his or her recommendation as to
whether to revoke the enhanced behavioral supports home’s
residential care facility license, for which the State Department
of Social Services shall revoke the license of the enhanced
behavioral supports home pursuant to Section 1550 of the Health
and Safety Code.

(d) The State Department of Developmental Services and
regional centers shall, for purposes of assisting in licensing,
provide the State Department of Social Services with all available
documentation and evidentiary support that was submitted to the
State Department of Developmental Services in connection with
certification by an applicant for licensure under this article.

begin insert 4684.86. end insert   

(a) A certification for an enhanced behavioral
supports home shall not be issued before emergency regulations
filed by the State Department of Developmental Services pursuant
to this article have been published. These regulations shall be
developed in consultation with stakeholders, including the State
Department of Social Services, consumer advocates, and regional
centers. The regulations shall address at least the following:

(1) Program standards, including program design requirements,
staffing structure, staff qualifications, and training. Training
requirements shall include:

(A) A minimum of 16 hours of emergency intervention training,
which shall include the techniques the licensee will use to prevent
injury and maintain safety regarding consumers who are a danger
to self or others and shall emphasize positive behavioral supports
and techniques that are alternatives to physical restraints.

(B) Additional training for direct care staff to address the
specialized needs of the consumers, including training in
emergency interventions.

(2) Requirements and timelines for the development and
updating of consumers’ individual behavior supports plans.

(3) Admission and continued stay requirements.

(4) Requirements for ensuring that appropriate services and
supports are provided at the time of admission to meet the
consumer’s immediate needs pending development of the
consumer’s individual behavior supports plan.

(5) The rate methodology.

(6) Consumer rights and protections.

(b) The adoption, initial amendment, repeal, or readoption of
a regulation authorized by this section is deemed to be an
emergency and necessary for the immediate preservation of the
public peace, health, 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.
These regulations shall be developed in consultation with system
stakeholders. 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.
The emergency regulations may be readopted and remain in effect
until approval of the certificate of compliance.

begin insert 4684.87. end insert   

This article shall remain in effect only until January
1, 2020, and as of that date is repealed, unless a later enacted
statute, that is enacted before January 1, 2020, deletes or extends
that date.

end insert

begin insert

begin insert SEC. 19. end insert   

end insert

begin insert Section 4691.6 of the end insert begin insert Welfare and Institutions Code end insert
begin insert is amended to read: end insert

4691.6.  

(a) Notwithstanding any other begin delete provision of end delete law or
regulation, commencing July 1, 2006, the community-based day
program, work activity program, and in-home respite service
agency rate schedules authorized by the department and in
operation June 30, 2006, shall be increased by 3 percent, subject
to funds specifically appropriated for this increase in the Budget
Act of 2006. The increase shall be applied as a percentage, and
the percentage shall be the same for all providers. Any subsequent
increase shall be governed by subdivisions (b), (c), (d), begin insert (e), (f),
(g), end insert and begin delete (e) end delete begin insert (h), end insert and Section 4691.9.

(b) Notwithstanding any other begin delete provision of end delete law or regulation,
the department begin delete may end delete begin insert shall end insert not establish any permanent payment
rate for a community-based day program or in-home respite service
agency provider that has a temporary payment rate in effect on
June 30, 2008, if the permanent payment rate would be greater
than the temporary payment rate in effect on or after June 30, 2008,
unless the regional center demonstrates to the department that the
permanent payment rate is necessary to protect the consumers’
health or safety.

(c) Notwithstanding any other begin delete provision of end delete law or regulation,
neither the department nor any regional center begin delete may end delete begin insert shall end insert approve
any program design modification or revendorization for a
community-based day program or in-home respite service agency
provider that would result in an increase in the rate to be paid to
the vendor from the rate that is in effect on or after June 30, 2008,
unless the regional center demonstrates that the program design
modification or revendorization is necessary to protect the
consumers’ health or safety and the department has granted prior
written authorization.

(d) Notwithstanding any other begin delete provision of end delete law or regulation,
the department begin delete may end delete begin insert shall end insert not approve an anticipated rate
adjustment for a community-based day program or in-home respite
service agency provider that would result in an increase in the rate
to be paid to the vendor from the rate that is in effect on or after
June 30, 2008, unless the regional center demonstrates that the
anticipated rate adjustment is necessary to protect the consumers’
health or safety.

(e) Notwithstanding any other begin delete provision of end delete law or regulation,
begin insert except as set forth in subdivision (f), end insert the department begin delete may end delete begin insert shall end insert not
approve any rate adjustment for a work activity program that would
result in an increase in the rate to be paid to the vendor from the
rate that is in effect on or after June 30, 2008, unless the regional
center demonstrates that the rate adjustment is necessary to protect
the consumers’ health and safety and the department has granted
prior written authorization.

begin insert

(f) Notwithstanding any other law or regulation, commencing
July 1, 2014, the department may approve rate adjustments for a
work activity program that demonstrates to the department that
the rate adjustment is necessary in order to pay employees who,
prior to July 1, 2014, were being compensated at a wage that is
less than the minimum wage established on and after July 1, 2014,
by Section 1182.12 of the Labor Code, as amended by Chapter
351 of the Statutes of 2013. The rate adjustment pursuant to this
subdivision shall be specific to payroll costs associated with any
increase necessary to adjust employee pay only to the extent
necessary to bring pay into compliance with the increased state
minimum wage, and shall not constitute a general wage
enhancement for employees paid above the increased minimum
wage.

end insert begin insert

(g) Notwithstanding any other law or regulation, commencing
July 1, 2014, community-based day program and in-home respite
services agency providers with temporary payment rates set by
the department may seek unanticipated rate adjustments from the
department due to the impacts of the increased minimum wage as
established by Section 1182.12 of the Labor Code, as amended by
Chapter 351 of the Statutes of 2013. The rate adjustment shall be
specific to payroll costs associated with any increase necessary
to adjust employee pay only to the extent necessary to bring pay
into compliance with the increased state minimum wage, and shall
not constitute a general wage enhancement for employees paid
above the increased minimum wage.

end insert begin insert

(h) Notwithstanding any other law or regulation, commencing
January 1, 2015, the in-home respite service agency rate schedule
authorized by the department and in operation December 31, 2014,
shall be increased by 5.82 percent, subject to funds specifically
appropriated for this increase for costs due to changes in federal
regulations implementing the federal Fair Labor Standards Act
of 1938 (29 U.S.C. Sec. 201 et seq.). The increase shall be applied
as a percentage, and the percentage shall be the same for all
applicable providers.

end insert

begin insert

begin insert SEC. 20. end insert   

end insert

begin insert Section 4691.9 of the end insert begin insert Welfare and Institutions Code end insert
begin insert is amended to read: end insert

4691.9.  

begin insert (a) end insert begin insert   end insert Notwithstanding any other begin delete provision of end delete law or
regulation, commencing July 1, 2008:

begin delete

(a)

end delete

begin insert (1) end insert   begin delete No end delete begin insert A end insert regional center shall begin insert not end insert pay an existing service
provider, for services where rates are determined through a
negotiation between the regional center and the provider, a rate
higher than the rate in effect on June 30, 2008, unless the increase
is required by a contract between the regional center and the vendor
that is in effect on June 30, 2008, or the regional center
demonstrates that the approval is necessary to protect the
consumer’s health or safety and the department has granted prior
written authorization.

begin delete

(b)

end delete

begin insert (2) end insert   begin delete No end delete begin insert A end insert regional center begin delete may end delete begin insert shall not end insert negotiate a rate with a
new service provider, for services where rates are determined
through a negotiation between the regional center and the provider,
that is higher than the regional center’s median rate for the same
service code and unit of service, or the statewide median rate for
the same service code and unit of service, whichever is lower. The
unit of service designation begin delete must end delete begin insert shall end insert conform with an existing
regional center designation or, if none exists, a designation used
to calculate the statewide median rate for the same service. The
regional center shall annually certify to the State Department of
Developmental Services its median rate for each negotiated rate
service code, by designated unit of service. This certification begin delete will end delete
begin insert shall end insert be subject to verification through the department’s biennial
fiscal audit of the regional center.

begin insert

(b) Notwithstanding subdivision (a), commencing July 1, 2014,
regional centers may negotiate a rate adjustment with providers
regarding rates if the adjustment is necessary in order to pay
employees no less than the minimum wage as established by Section
1182.12 of the Labor Code, as amended by Chapter 351 of the
Statutes of 2013, and only for the purpose of adjusting payroll
costs associated with the minimum wage increase. The rate
adjustment shall be specific to the unit of service designation that
is affected by the increased minimum wage, shall be specific to
payroll costs associated with any increase necessary to adjust
employee pay only to the extent necessary to bring pay into
compliance with the increased state minimum wage, and shall not
be used as a general wage enhancement for employees paid above
the increased minimum wage. Regional centers shall maintain
documentation on the process to determine, and the rationale for
granting, any rate adjustment associated with the minimum wage
increase.

end insert begin insert

(c) Notwithstanding any other law or regulation, commencing
January 1, 2015, rates for personal assistance and supported living
services in effect on December 31, 2014, shall be increased by
5.82 percent, subject to funds specifically appropriated for this
increase for costs due to changes in federal regulations
implementing the federal Fair Labor Standards Act of 1938 (29
U.S.C. Sec. 201 et seq.). The increase shall be applied as a
percentage, and the percentage shall be the same for all applicable
providers. As used in this subdivision, both of the following
definitions shall apply:

end insert begin insert

(1) “Personal assistance” is limited only to those services
provided by vendors classified by the regional center as personal
assistance providers, pursuant to the miscellaneous services
provisions contained in Title 17 of the California Code of
Regulations.

end insert begin insert

(2) “Supported living services” are limited only to those services
defined as supported living services in Title 17 of the California
Code of Regulations.

end insert begin delete

(c)

end delete

begin insert (d) end insert  This section shall not apply to those services for which rates
are determined by the State Department of Health Care Services,
or the State Department of Developmental Services, or are usual
and customary.

begin insert

begin insert SEC. 21. end insert   

end insert

begin insert Article 8 (commencing with Section 4698) is added
to Chapter 6 of Division 4.5 of the end insert begin insert Welfare and Institutions Code end insert begin insert ,
to read: end insert

begin insert

 

Article begin insert 8. end insert   Community Crisis Home Certification

 

begin insert 4698. end insert   

(a) (1) “Community crisis home” means a facility
certified by the State Department of Developmental Services
pursuant to this article, and licensed by the State Department of
Social Services pursuant to Article 9.7 (commencing with Section
1567.80) of Chapter 3 of Division 2 of the Health and Safety Code,
as an adult residential facility, providing 24-hour nonmedical care
to individuals with developmental disabilities receiving regional
center services and in need of crisis intervention services who
would otherwise be at risk of admission to the acute crisis center
at Fairview Developmental Center or Sonoma Developmental
Center, an out-of-state placement, a general acute hospital, an
acute psychiatric hospital, or an institution for mental disease, as
described in Part 5 (commencing with Section 5900) of Division
5. A community crisis home shall have a maximum capacity of
eight consumers.

(2) “Consumer” or “client” means an individual who has been
determined by a regional center to meet the eligibility criteria of
Section 4512 and applicable regulations and for whom the regional
center has accepted responsibility.

(b) (1) The State Department of Developmental Services, using
Community Placement Plan funds, shall establish a
community-based residential option consisting of community crisis
homes for adults with developmental disabilities receiving regional
center services who require crisis intervention services and who
would otherwise be at risk of admission to the acute crisis center
at Fairview Developmental Center or Sonoma Developmental
Center, an out-of-state placement, a general acute hospital, an
acute psychiatric hospital, or an institution for mental disease, as
described in Part 5 (commencing with Section 5900) of Division
5.

(2) The State Department of Developmental Services may issue
a certificate of program approval to a community crisis home
qualified pursuant to this article.

(c) A community crisis home shall not be licensed by the State
Department of Social Services until the certificate of program
approval, issued pursuant to this article by the State Department
of Developmental Services, has been received.

(1) A community crisis home shall be certified only if approved
through a regional center community placement plan pursuant to
Section 4418.25. Each home shall conform to Section 441.530(a)(1)
of Title 42 of the Code of Federal Regulations, and shall be eligible
for federal Medicaid home and community-based services funding.

(2) A consumer shall not be placed in a community crisis home
unless the program is certified by the State Department of
Developmental Services, pursuant to this article, and the facility
is licensed by the State Department of Social Services, pursuant
to Article 9.7 (commencing with Section 1567.80) of Chapter 3 of
Division 2 of the Health and Safety Code.

(3) A certificate of program approval, issued pursuant to this
article by the State Department of Developmental Services, shall
be a condition of licensure for the community crisis home by the
State Department of Social Services, pursuant to Article 9.7
(commencing with Section 1567.80) of Chapter 3 of Division 2 of
the Health and Safety Code.

(4) Community crisis homes shall exceed the minimum
requirements for a Residential Facility Service Level 4-i pursuant
to Sections 56004 and 56013 of Title 17 of the California Code of
regulations, and shall meet all applicable statutory and regulatory
requirements for facility licensing, the use of behavior modification
interventions, and seclusion and restraint, including Division 1.5
(commencing with Section 1180) of the Health and Safety Code,
and that are applicable to facilities licensed as adult residential
facilities.

(d) Community crisis homes shall have a facility program plan
approved by the State Department of Developmental Services. The
facility program plan approved by the State Department of
Developmental Services shall be submitted to the State Department
of Social Services for inclusion in the facility plan of operation,
pursuant to Section 1567.84 of the Health and Safety Code.

(e) The local regional center and each consumer’s regional
center shall have joint responsibility for monitoring and evaluating
the provision of services in the community crisis home. Monitoring
shall include at least monthly face-to-face, onsite case management
visits with each consumer by his or her regional center and at least
quarterly quality assurance visits by the vendoring regional center.
The State Department of Developmental Services shall monitor
and ensure the regional centers’ compliance with their monitoring
responsibilities.

(f) A consumer’s regional center shall also notify the clients’
rights advocate of each community crisis home admission. Unless
the consumer objects on his or her own behalf, the clients’ rights
advocate may participate in developing the plan to transition the
consumer to his or her prior residence or an alternative
community-based residential setting with needed services and
supports.

(g) The State Department of Developmental Services shall
establish by regulation a rate methodology for community crisis
homes that includes a fixed facility component for residential
services and an individualized services and supports component
based on each consumer’s needs as determined through the
individual program plan process, which may include assistance
with returning to the consumer’s prior living arrangement or
transitioning to an alternative community residential setting.

(h) If the State Department of Developmental Services
determines that urgent action is necessary to protect a consumer
residing in a community crisis home from physical or mental abuse,
abandonment, or any other substantial threat to the consumer’s
health and safety, the State Department of Developmental Services
may request that the regional center or centers remove the
consumer from the community crisis home or direct the regional
center or centers to obtain alternative or additional services for
the consumer within 24 hours of that determination. When possible,
an individual program plan (IPP) meeting shall be convened to
determine the appropriate action pursuant to this section. In any
case, an IPP meeting shall be convened within 30 days following
an action pursuant to this section.

(i) The Director of Developmental Services shall rescind a
community crisis home’s certificate of program approval when,
in his or her sole discretion, a community crisis home does not
maintain substantial compliance with an applicable statute,
regulation, or ordinance, or cannot ensure the health and safety
of consumers. The decision of the Director of Developmental
Services shall be the final administrative decision. The Director
of Developmental Services shall transmit his or her decision
rescinding a community crisis home’s certificate of program
approval to the State Department of Social Services and the
regional center with his or her recommendation as to whether to
revoke the community crisis home license, and the State
Department of Social Services shall revoke the license of the
community crisis home pursuant to Section 1550 of the Health and
Safety Code.

(j) The State Department of Developmental Services and
regional centers shall provide the State Department of Social
Services all available documentation and evidentiary support
necessary for the licensing and administration of community crisis
homes and enforcement of Chapter 3 (commencing with Section
1500) of Division 2 of the Health and Safety Code, and the
applicable regulations.

begin insert 4698.1. end insert   

(a) A certificate of program approval shall not be
issued pursuant to this article until the publication in Title 17 of
the California Code of Regulations of emergency regulations filed
by the State Department of Developmental Services. These
regulations shall be developed in consultation with stakeholders,
including the State Department of Social Services, consumer
advocates, and regional centers. The regulations shall address at
least all of the following:

(1) Program standards, including program design requirements,
staffing structure, staff qualifications, and training. Training
requirements shall include all of the following:

(A) A minimum of 16 hours of emergency intervention training,
which shall include the techniques the facility will use to prevent
injury and maintain safety regarding consumers who are a danger
to self or others and shall emphasize positive behavioral supports
and techniques that are alternatives to physical restraint.

(B) Additional training for direct care staff to address the
specialized needs of the consumers, including training in
emergency interventions.

(2) Requirements and timelines for the development and
updating of each consumer’s individual program plan, including
time-limited objectives and a plan to transition the consumer to
his or her prior residence or an alternative community-based
residential setting with needed services and supports. In developing
these regulations, the department shall place a high priority on
transitioning the consumer to his or her prior residence, when that
is the preferred objective in the consumer’s individual program
plan.

(3) Procedures and requirements for identifying and providing
supplemental and ancillary staffing and supports, including
therapeutic, behavioral, and clinical services and supports, based
on individual consumer need.

(4) The rate methodology.

(5) Consumer rights and protections.

(b) The adoption, amendment, repeal, or readoption of a
regulation authorized by this section is deemed to be an emergency
and 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 State
Department of Developmental Services is hereby exempted from
the requirement that it describe specific facts showing the need
for immediate action. These emergency regulations shall be
developed in consultation with system stakeholders. 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. The emergency
regulations may be readopted and remain in effect until approval
of the certificate of compliance.

end insert

begin insert

begin insert SEC. 22. end insert   

end insert

begin insert Section 6504.5 of the end insert begin insert Welfare and Institutions Code end insert
begin insert is amended to read: end insert

6504.5.  

begin insert (a) end insert begin insert   end insert Wherever a petition is filed pursuant to this article,
the court shall appoint the director of a regional center for the
developmentally disabled established under Division 4.5
(commencing with Section 4500), or the designee of the director,
to examine the person alleged to have a developmental disability.

begin insert (b) end insert begin insert   end insert Within 15 judicial days after his or her appointment, the
regional center director or designee shall submit to the court in
writing a report containing his or her evaluation of the person
alleged to have a developmental disability. If the person is an
individual described in paragraph (2) of subdivision (a) of Section
7505, the report shall include the results of the assessment
conducted pursuant to subdivision (b) of Section 4418.7. The report
shall contain a recommendation of a facility or facilities in which
the alleged developmentally disabled person may be placed. begin insert The
report shall include any comprehensive assessment, or updated
assessment, conducted by the regional center pursuant to
paragraph (2) of subdivision (c) of Section 4418.25. end insert

begin insert (c) end insert begin insert   end insert The report shall include a description of the least restrictive
residential placement necessary to achieve the purposes of
treatment. In determining the least restrictive residential placement,
consideration shall be given to public safety. If placement into or
out of a developmental center is recommended, the regional center
director or designee simultaneously shall submit the report to the
executive director of the developmental center or his or her
designee. The executive director of the developmental center or
his or her designee may, within 15 days of receiving the regional
center report, submit to the court a written report evaluating the
ability of the developmental center to achieve the purposes of
treatment for this person and whether the developmental center
placement can adequately provide the security measures or systems
required to protect the public health and safety from the potential
dangers posed by the person’s known behaviors.

begin insert (d) end insert begin insert   end insert The reports prepared by the regional center director and
developmental center director, if applicable, shall also address
suitable interim placements for the person as provided for in
Section 6506.

begin insert

begin insert SEC. 23. end insert   

end insert

begin insert Section 6509 of the end insert begin insert Welfare and Institutions Code end insert begin insert is
amended to read: end insert

6509.  

(a)   If the court finds that the person has a
developmental disability, and is a danger to himself, herself, or to
others, the court may make an order that the person be committed
to the State Department of Developmental Services for suitable
treatment and habilitation services. Suitable treatment and
habilitation services is defined as the least restrictive residential
placement necessary to achieve the purposes of treatment. Care
and treatment of a person committed to the State Department of
Developmental Services may include placement in any of the
following:

(1) Any licensed community care facility, as defined in Section
1504, or any health facility, as defined in Section 1250, other than
a developmental center or state-operated facility.

(2)  begin insert The acute crisis center at end insert Fairview Developmental begin delete Center end delete
begin insert Center, end insert if the person meets the criteria for admission pursuant to
paragraph (2) of subdivision (a) of Section 7505.

begin insert

(3) On or after January 1, 2015, the acute crisis center at
Sonoma Developmental Center, if the person meets the criteria
for admission pursuant to paragraph (3) of subdivision (a) of
Section 7505.

end insert begin delete

(3)

end delete

begin insert (4) end insert  The secure treatment program at Porterville Developmental
begin delete Center end delete begin insert Center, end insert if the person meets the criteria for admission
pursuant to paragraph (3) of subdivision (a) of Section 7505.

begin delete

(4)

end delete

begin insert (5) end insert  Any other appropriate placement permitted by law.

(b) (1) The court shall hold a hearing as to the available
placement alternatives and consider the reports of the regional
center director or designee and the developmental center director
or designee submitted pursuant to Section 6504.5. After hearing
all the evidence, the court shall order that the person be committed
to that placement that the court finds to be the most appropriate
and least restrictive alternative. If the court finds that release of
the person can be made subject to conditions that the court deems
proper and adequate for the protection and safety of others and the
welfare of the person, the person shall be released subject to those
conditions.

(2) The court, however, may commit a person with a
developmental disability who is not a resident of this state under
Section 4460 for the purpose of transportation of the person to the
state of his or her legal residence pursuant to Section 4461. The
State Department of Developmental Services shall receive the
person committed to it and shall place the person in the placement
ordered by the court.

(c) If the person has at any time been found mentally
incompetent pursuant to Chapter 6 (commencing with Section
1367) of Title 10 of Part 2 of the Penal Code arising out of a
complaint charging a felony offense specified in Section 290 of
the Penal Code, the court shall order the State Department of
Developmental Services to give notice of that finding to the
designated placement facility and the appropriate law enforcement
agency or agencies having local jurisdiction at the site of the
placement facility.

(d) If the begin insert State end insert Department of Developmental Services decides
that a change in placement is necessary, it shall begin delete notify end delete begin insert notify, end insert in
begin delete writing end delete begin insert writing, end insert the court of commitment, the district attorney, begin delete and end delete
the attorney of record for the begin delete person end delete begin insert person, end insert and the regional center
of its decision at least 15 days in advance of the proposed change
in placement. The court may hold a hearing and (1) approve or
disapprove of the change, or (2) take no action in which case the
change shall be deemed approved. At the request of the district
attorney or of the attorney for the person, a hearing shall be held.

begin insert

begin insert SEC. 24. end insert   

end insert

begin insert Section 7505 of the end insert begin insert Welfare and Institutions Code end insert begin insert is
amended to read: end insert

7505.  

(a) Notwithstanding any other begin delete provision of end delete law,
commencing July 1, 2012, the State Department of Developmental
Services shall not admit anyone to a developmental center unless
the person has been determined eligible for services under Division
4.5 (commencing with Section 4500) and the person is:

(1) Committed by a court to Porterville Developmental Center,
secure treatment program, pursuant to Section 1370.1 of the Penal
Code.

(2) Committed by a court to Fairview Developmental Center
pursuant to Article 2 (commencing with Section 6500) of Chapter
2 of Part 2 of Division 6 due to an acute crisis, pursuant to Section
4418.7.

(3) Committed by a court to Porterville Developmental Center,
secure treatment program, pursuant to Article 2 (commencing with
Section 6500) of Chapter 2 of Part 2 of Division 6 as a result of
involvement with the criminal justice system, and the court has
determined the person is mentally incompetent to stand trial.

(4) A person described in Section 4508.

(5) A juvenile committed to Porterville Developmental Center,
secure treatment program, pursuant to Section 709.

(b) Under no circumstances shall the State Department of
Developmental Services admit a person to a developmental center
after July 1, 2012, as a result of a criminal conviction or begin delete where end delete
begin insert when end insert the person is competent to stand trial for the criminal offense
and the admission is ordered in lieu of trial.

begin insert

(c) This section shall remain in effect only until January 1, 2015,
and as of that date is repealed, unless a later enacted statute, that
is enacted before January 1, 2015, deletes or extends that date.

end insert

begin insert

begin insert SEC. 25. end insert   

end insert

begin insert Section 7505 is added to the end insert begin insert Welfare and Institutions
Code end insert begin insert , to read: end insert

begin insert

begin insert 7505. end insert   

(a) Notwithstanding any other law, the State Department
of Developmental Services shall not admit anyone to a
developmental center unless the person has been determined
eligible for services under Division 4.5 (commencing with Section
4500) and the person is:

(1) Committed by a court to Porterville Developmental Center,
secure treatment program, pursuant to Section 1370.1 of the Penal
Code.

(2) Committed by a court to the acute crisis center at Fairview
Developmental Center, or the acute crisis center at Sonoma
Developmental Center, pursuant to Article 2 (commencing with
Section 6500) of Chapter 2 of Part 2 of Division 6 due to an acute
crisis, pursuant to Section 4418.7.

(3) Committed by a court to Porterville Developmental Center,
secure treatment program, pursuant to Article 2 (commencing with
Section 6500) of Chapter 2 of Part 2 of Division 6 as a result of
involvement with the criminal justice system, and the court has
determined the person is mentally incompetent to stand trial.

(4) A person described in Section 4508.

(5) A juvenile committed to Porterville Developmental Center,
secure treatment program, pursuant to Section 709.

(b) Under no circumstances shall the State Department of
Developmental Services admit a person to a developmental center
after July 1, 2012, as a result of a criminal conviction or when the
person is competent to stand trial for the criminal offense and the
admission is ordered in lieu of trial.

(c) This section shall become operative on January 1, 2015.

end insert

begin insert

begin insert SEC. 26. end insert   

end insert begin insert

Notwithstanding any other law, Item 4300-101-0001
of Section 2.00 of the Budget Act of 2011 (Chapter 33 of the
Statutes of 2011) is available for liquidation of encumbrances
through June 30, 2015. The unencumbered balance of thirteen
million forty-eight thousand dollars ($13,048,000) of the amount
appropriated by Item 4300-101-0001 of Section 2.00 of the Budget
Act of 2011 (Chapter 33 of the Statutes of 2011) is reappropriated
for the purposes provided for in the appropriation and is available
for encumbrance or expenditure until June 30, 2015, and for
liquidation through June 30, 2017.

end insert

begin insert

begin insert SEC. 27. end insert   

end insert begin insert

No reimbursement is required by this act pursuant
to Section 6 of Article XIII B of the California Constitution because
the only costs that may be incurred by a local agency or school
district will be incurred because this act creates a new crime or
infraction, eliminates a crime or infraction, or changes the penalty
for a crime or infraction, within the meaning of Section 17556 of
the Government Code, or changes the definition of a crime within
the meaning of Section 6 of Article XIII B of the California
Constitution.

end insert

begin insert

begin insert SEC. 28. end insert   

end insert begin insert

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.

end insert

begin delete

SECTION 1.  

It is the intent of the Legislature to enact statutory
changes relating to the Budget Act of 2014.

end delete