BILL ANALYSIS                                                                                                                                                                                                    �






                                  SENATE HUMAN
                               SERVICES COMMITTEE
                          Senator Leland Y. Yee, Chair


          BILL NO:       SB 137                                       
          S
          AUTHOR:        Emmerson                                     
          B
          VERSION:       January 28, 2013
          HEARING DATE:  April 9, 2013                                
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          FISCAL:        Yes                                          
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          CONSULTANT:  Mareva Brown                                  

                                        

                                     SUBJECT
                                         
                    Developmental services: regional centers

                                         
                                    SUMMARY  

          This bill requires that specified information about vendor  
          rates and payments to nonprofit housing corporations be  
          posted on each Regional Center's website, alongside other  
          existing information.

                                     ABSTRACT  

          Existing law:
           
             1)   Establishes the Lanterman Developmental  
               Disabilities Services Act, which states that  
               California is responsible for providing an array of  
               services and supports sufficient to meet the needs and  
               choices of each person with developmental  
               disabilities, regardless of age or degree of  
               disability, and at each stage of life and to support  
               their integration into the mainstream life of the  
               community. (WIC 4500, et seq.)

                                                         Continued---



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             2)   Establishes a system of 21 nonprofit regional  
               centers to identify and coordinate services for  
               eligible individuals with developmental disabilities  
               who live in California. (WIC 4620 et seq.)

             3)   Requires each regional center to enter into a  
               contractual agreement with the state Department of  
               Developmental Services (DDS) to provide appropriate  
               services to eligible individuals and sets forth  
               specific performance objectives. (WIC 4629)

             4)   Requires each regional center, as a condition of  
               satisfying its contract with DDS, to adopt, maintain  
               and post on its website, a board-approved policy  
               regarding transparency and access to public  
               information. The policy shall provide for timely  
               public access to contract information, service  
               provider rates, documentation related to establishment  
               of negotiated rates, audits, and other information, as  
               specified. (WIC 4629.5)

             5)   Requires each regional center to post on its  
               website:

                  a.        Regional center annual independent  
                    audits.
                  b.        Biannual fiscal audits conducted by the  
                    department.
                  c.        Regional center annual reports, as  
                    specified.
                  d.        Contract awards, including the  
                    organization or entity awarded the contract, and  
                    the amount and purpose of the award.
                  e.        Purchase of service policies.
                  f.        The names, types of service, and contact  
                    information of all vendors, except consumers or  
                    family members of consumers.
                  g.        Board meeting agendas and approved  
                    minutes of open meetings of the board and all  
                    committees of the board.
                  h.        Bylaws of the regional center governing  
                    board.
                  i.        The annual performance contract and  
                    year-end performance contract entered into with  
                    the department pursuant to this division.




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                  j.        The biannual Home and Community-based  
                    Services Waiver program review conducted by the  
                    department and the State Department of Health  
                    Care Services.
                  aa.       The board-approved transparency and  
                    public information policy.
                  bb.       The board-approved conflict-of-interest  
                    policy.
                  cc.       Reports required pursuant to Section  
                    4639.5, which require a regional center to post  
                    its salary schedule and administrative  
                    expenditures, as specified. (WIC 4629.5)

           This bill:
           
             1)   Adds to the required information to be posted on  
               each regional center's website: 

                  a.        The actual rates paid to each vendor,  
                    updated annually, except vendors who are  
                    consumers, or family members of consumers.

                  b.        Any regional center purchase of services  
                    from, or operations funds provided to, a  
                    nonprofit housing organization outside the  
                    request for proposals process.

             2)   Clarifies that a vendor's business telephone number  
               must be provided on the website.

                                  FISCAL IMPACT  

          This bill has not been analyzed by a fiscal committee.

                                         


                           BACKGROUND AND DISCUSSION  
          
           Purpose of the bill
           
          This is the third attempt in three years to add specific  
          data to existing vendor information that regional centers  
          are required to post on their websites. The first attempt  
          was vetoed by the Governor; the second was held last year  




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          in Assembly Appropriations. The author states that this  
          bill adds necessary information that would provide  
          transparency of actual vendor rates, which is not available  
          in the required public postings. 

          The requirement that regional centers post vendor rates,  
          enacted in 2011, followed an audit that highlighted some  
          improprieties in regional center contracting practices.  
          Because regional centers are nonprofit agencies that  
          contract with DDS to provide services, the public and  
          Legislature are not afforded the same level of transparency  
          in business that is required of state agencies. Despite the  
          required posting of vendor rates, which vary widely, the  
          author states that persistent questions about the range of  
          specific vendor rates require additional legislation to  
          ensure transparency. 

          "Several important data points were excluded from the  
          measure that would allow the taxpayer and the Legislature  
          to better understand how the regional centers are using  
          their public funds," the author states. 

           Regional Centers

           Regional Centers are part of a system of care overseen by  
          the Department of Developmental Services (DDS). With a  
          proposed budget of $4.3 billion for community-based  
          services in 2013-2014, DDS is responsible for coordinating  
          care and providing services for more than 250,000 people  
          with developmental disabilities who receive services and  
          supports to live in their communities, as well as  
          approximately 1,560 people who resided in developmental  
          centers as of March 6, 2013. 

          California's 21 regional centers are non-profit  
          organizations that provide local services and supports to  
          individuals through contracts with DDS. Regional centers  
          provide diagnosis and assessment of eligibility and help  
          plan, access, coordinate and monitor the services and  
          supports that are needed because of a developmental  
          disability. Services for consumers are determined through  
          an individual program plan.

          In order to receive funding from a regional center, service  
          providers first must be vendored by a regional center.  




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          "Vendorization" is the term used to describe the entire  
          approval process involved in preparing to provide services  
          to regional center consumers. While this process often  
          involves obtaining licenses or approvals from other State  
          and local agencies prior to becoming a vendor, the main  
          point of contact is the local regional center. 
          
           California Bureau of State Audits 
           
          In August 2010, the Bureau of State Auditors (BSA) released  
          a report examining the Regional Center system. Entitled, "A  
          More Uniform and Transparent Procurement and Rate-Setting  
          Process Would Improve the Cost-Effectiveness of Regional  
          Centers," the report noted concerns with the lack of DDS  
          oversight in vendor selection and rate setting.

               Regional centers set rates using different  
               methodologies, often do not keep documentation  
               demonstrating how rates were set, and in certain  
               instances gave the appearance of favoritism or fiscal  
               irresponsibility.

          The BSA examined 61 rates at six regional centers  
          statewide. In 26 of those samples, auditors could not  
          determine how the rates were set, and only 18 were  
          established using a detailed cost statement from the  
          vendor, which auditors cited as a best practice.  
          Additionally, five rates at four regional centers appeared  
          to violate a rate freeze required by law, and in two of  
          those instances the regional center approved rates almost  
          twice as high as the statewide median rate for the same  
          service. 

          Auditors recommended a number of reforms intended to  
          clarify and make transparent the vendor selection and  
          rate-setting process. 

           Committee hearing
           
          On Nov. 4, 2010, the Senate and Assembly Human Services  
          Committees held a joint oversight hearing, "Oversight of  
          California's Regional Centers: Ensuring integrity,  
          Transparency, and Best Practices in a Challenging Fiscal  
          Environment." The hearing and audit came on the heels of  
          three years of significant budget reductions, including  




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          $100 million from the regional center system in 2009 and  
          $234 million, enacted in 2010. The reductions were based on  
          a series of stakeholder meetings that the legislature  
          required DDS to conduct, which explored ways to trim the  
          systems inefficiencies in order to reduce direct  
          elimination of services.

          The 2010 oversight hearing focused on ways to increase  
          efficiency and cost-effectiveness within the system while  
          achieving the underlying purpose and keeping the promise of  
          the Lanterman Act including: 

                 Whether regional center rate-setting and provider  
               selection practices were sufficiently transparent to  
               ensure accountability in their use of public funds.

                 Whether the right balance has been struck between  
               allowing flexibility in the operation of regional  
               centers and establishing statewide standards and  
               guidelines for regional center fiscal practices and  
               the IPP process.

                 Whether there is adequate communication - including  
               training and information sharing - between DDS and  
               regional centers, among regional centers, and between  
               regional center management and employees - about  
               efficient, cost-effective practices in rate-setting,  
               provider selection, resource development, and other  
               issues.

           Related legislation
           
          AB 1554 (Jeffries, Silva, 2012) contained identical  
          language to SB 137. It died in the Assembly Appropriations  
          Committee.

          AB 862 (Silva, Jeffries, 2011) contained identical language  
          to SB 137. It was vetoed by the Governor.

          SB 74 (Committee on Budget and Fiscal Review, Chapter 9,  
          Statues of 2011) required that DDS contracts include  
          provisions requiring each regional center to adopt,  
          maintain, and post on its Internet Web site a transparency  
          and public information policy containing prescribed  
          components, among other requirements.




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          Arguments in support

          "The intent and motivation of SB 137 to require the  
          Regional Centers to disclose information to the public is  
          simple: the Regional Center system is funded with  
          California taxpayer's monies; therefore, they should be  
          obligated to share information with the public, if  
          requested," writes Boyd Bradshaw, president of  
          ResCoalition, and the sponsor of the bill.
           
          Comments
           
          Should the bill move from this committee, the author may  
          want to consider better defining "actual rates," to  
          identify the scope of information being sought. This  
          language could be considered an overly broad requirement,  
          when the author may be satisfied with regional centers  
          providing categories of rates. 

                                    POSITIONS  

          Support:       ResCoalition (sponsor)

          Oppose:   None received






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