BILL ANALYSIS Ó
Senate Appropriations Committee Fiscal Summary
Senator Kevin de León, Chair
SB 468 (Emmerson) - Developmental services: statewide
Self-Determination Program.
Amended: April 15, 2013 Policy Vote: Human Services 6-0
Urgency: No Mandate: No
Hearing Date: May 23, 2013 Consultant: Brendan McCarthy
SUSPENSE FILE. AS PROPOSED TO BE AMENDED.
Bill Summary: SB 468 would require the Department of
Developmental Disabilities to establish a Self-Determination
Program, which would allow regional center consumers to use an
individual budget to purchase services and supports at the
consumer's direction.
Fiscal Impact (as approved on May 23, 2013):
One-time costs likely in the hundreds of thousands for the
Department of Developmental Disabilities to establish
program requirements and apply for federal approval to draw
down federal matching funds (General Fund).
Ongoing administrative costs by the regional centers of
about $2.4 million per year (General Fund). Because the bill
requires the program to be cost-neutral, eventually these
administrative costs will be offset by reduced
administrative costs or proportional reductions in
participating consumers' individual budgets.
One-time administrative costs by the regional centers in
the low millions (General Fund). There are likely to be
increased administrative costs to the regional centers at
first, but as consumers shift to using self-directed budget,
regional center administrative costs are likely to decline.
Because the bill requires the program to be implemented in
a manner that is cost-neutral to the state, the overall
demand for services and supports under the program is not
expected to increase.
Potential ongoing state savings of about $2.8 million per
year from additional federal funding for current services
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(General Fund). See below.
Background: The Department of Developmental Services is
responsible for coordinating services and supports for about
250,000 people with developmental disabilities. The vast
majority of these people are served by 21 regional centers,
which are non-profit entities that contract with the state. The
regional centers, in turn, contract with vendors to provide
direct services to the developmentally disabled.
Under current practice, regional center staff (in consultation
with consumers and their families) will develop an Individual
Program Plan for each consumer. The Individual Program Plan lays
out the services and supports that the consumer is entitled to,
based on his or her individual needs. The regional centers then
work with outside vendors to arrange for the provision of those
services and supports. (Vendors who have been approved by a
regional center to provide services are referred to as
"vendorized".)
SB 1038 (Thompson, Statutes of 1998) established a pilot
self-determination project within the regional center system.
Under this pilot project, about 200 regional center consumers
from five regional centers were allocated a personal budget and
allowed to personally direct how funds in the budget would be
spent (in accordance with the Individual Program Plan). Although
that pilot program was not statutorily required to be budget
neutral, the Department found that between 1998 and 2002 the
pilot was budget-neutral overall. While the pilot project has
not been expanded, participants have been allowed to continue to
participate and about 140 consumers still do so.
In recent years, the state has negotiated a Home and
Community-Based Services for the Developmentally Disabled Waiver
(the "Waiver") which allows the Department to receive federal
matching funds for services provided to regional center
consumers. The purpose of this Waiver is to use state and
federal funds to allow consumers to remain in the community,
rather than being institutionalized.
The current Wavier does not allow self-directed services to
receive federal matching funds. Thus expenditures by
participants in the existing pilot project are not eligible for
federal matching funds.
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Proposed Law: SB 468 would require the Department of
Developmental Disabilities to establish a Self-Determination
Program, which would allow regional center consumers use an
individual budget to purchase services and supports at the
consumer's direction.
Specific provisions of the bill would:
Authorize participants to use an individual budget to
purchase services;
Require the program to be phased in over three years with
up to 2,500 participants;
After three years, expand the program to any willing
consumer;
Require the program to be cost-neutral to the state in the
aggregate;
Require the program to only pay for services and supports
eligible for federal cost-sharing;
Require participants to use the services of a vendorized
financial services provider;
Require participants in the prior pilot program be included
in the new program;
Exempt participants from limitations on services imposed by
the state in recent years (costs for those services would
still have to be within the consumer's budget);
Require the Department to develop a methodology for
developing individual budgets;
Require the Department to apply to the federal government
to authorize federal funding for services provided under the
program;
Make the program contingent on federal funding;
Allow services provided at the consumer's direction to come
from non-vendorized providers (except for financial
management services);
Require reporting on the program by the Department and the
State Council on Developmental Disabilities.
Related Legislation: AB 1244 (Chesbro, 2011) would have created
a program similar to this bill. That bill was held in the Senate
Human Services Committee.
Staff Comments: As was noted above, since the development of the
initial pilot program, the state has received federal approval
to draw down federal matching funds for many services provided
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to regional center consumers. Services provided to participants
in the pilot project are not eligible for federal matching
funds, because the current Waiver does not allow for
self-directed services. The sponsors of the bill and the
Department have indicated that the federal government has
authorized federal matching funds for self-directed services in
other states and that the state may be able to receive federal
approval to do so under this bill.
Because the state is already receiving federal funding for many
services provided to regional center consumers, the bill is not
likely to result in new federal funding for most consumers who
are likely to participate in the program established by this
bill. However, because the state is not receiving federal
matching funds for services provided to participants in the
existing pilot project, the bill may result in additional
federal funding, as those consumers would be automatically
included in the program authorized under this bill. The
Department has indicated that the potential savings to the state
from additional federal funding would be about $2.8 million per
year.
Committee amendments: would delay the deadline for application
for a federal waiver.