BILL NUMBER: SB 555 AMENDED
BILL TEXT
AMENDED IN SENATE APRIL 1, 2013
INTRODUCED BY Senator Correa
( Principal coauthor: Senator
Padilla )
FEBRUARY 22, 2013
An act to amend Section 95020 of the Government Code, and to
amend Sections 4512, 4641, 4642, 4643, 4646, 4646.5, 4648, and 4685
of the Welfare and Institutions Code, relating to
developmental services.
LEGISLATIVE COUNSEL'S DIGEST
SB 555, as amended, Correa. Developmental services: regional
centers: individual program plans and individual
individualized family service plans.
Under existing law, the Lanterman Developmental Disabilities
Services Act, the State Department of Developmental Services is
authorized to contract with regional centers to provide services and
supports to individuals with developmental disabilities. The services
and supports to be provided to a regional center consumer are
contained in an individual program plan (IPP) or individual
individualized family service plan (IFSP),
developed in accordance with prescribed requirements. Existing law
states that it is the intent of the Legislature to ensure that the
individual program plan and provision of services and supports by the
regional center system is centered on the individual and the family
of the individual with developmental disabilities and takes into
account the needs and preferences of the individual and the family,
as specified.
This bill would state the intent of the Legislature to enact
legislation that would require an IPP or IFSP to consider the needs
of the consumer, and his or her family, in order to provide services
and supports in a culturally and linguistically appropriate manner.
This bill would require those provisions to be implemented in a
manner that meets the cultural preferences, values, lifestyle, and
native language of the consumer and the consumer's family, and
require the IPP or IFSP, and the services and supports provided under
the IPP or IFSP, to be designed to meet the cultural preferences,
values, and lifestyle of the consumer and the consumer's family, and
provided in their native language, as defined.
Under existing law, regional centers are required to conduct
casefinding activities, including notification of the availability of
services in English and other languages that are appropriate to the
service area.
This bill would require the department and the regional centers to
ensure that consumers and their families receive culturally and
linguistically competent information, including written documents,
about the IPP and the IFSP, and related processes and procedures, as
prescribed. This bill would require each regional center to make this
information available to the public, and require the department and
the regional centers to make this information available on the
department's and regional center's Internet Web sites.
Under existing law, a person believed to have a developmental
disability or to have a high risk of parenting a developmentally
disabled infant is eligible for initial intake and assessment in the
regional centers, as specified.
This bill would require all communication with the consumer and
his or her family pursuant to those provisions to be in their native
language.
This bill would make other conforming changes.
Vote: majority. Appropriation: no. Fiscal committee: no
yes . State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. The Legislature finds and declares the
following:
(a) California's diverse language and ethnic communities account
for about 60 percent of its population. The number of people in the
United States who do not speak English as their native language has
grown 140 percent over the past three decades. In California, about
40 percent of Californians speak a language other than English at
home, and the number of individuals whose first language is not
English is rapidly growing.
(b) Health disparities can result in significant health, social,
and economic consequences. Culturally and linguistically competent
health care services can assist in achieving health equity. Health
literacy plays a central role in promoting quality of life, health
development, and health behaviors across all groups and life stages.
(c) To address any disparities in the regional center system, it
is the intent of the Legislature that the State Department of
Developmental Services and regional centers ensure that all consumers
and their families receive culturally and linguistically competent
information, including written documents, about the individual
program plan and individualized family service plan processes and
procedures. It is also the intent of the Legislature that each
regional center make available culturally and linguistically
competent information to individuals living in its geographic
catchment area about regional center services, processes, and
procedures.
SEC. 2. Section 95020 of the Government
Code is amended to read:
95020. (a) An eligible infant or toddler shall have an
individualized family service plan. The individualized family service
plan shall be used in place of an individualized education program
required pursuant to Sections 4646 and 4646.5 of the Welfare and
Institutions Code, the individualized program plan required pursuant
to Section 56340 of the Education Code, or any other applicable
service plan.
(b) For an infant or toddler who has been evaluated for the first
time, a meeting to share the results of the evaluation, to determine
eligibility and, for children who are eligible, to develop the
initial individualized family service plan shall be conducted within
45 calendar days of receipt of the written referral. Evaluation
results and determination of eligibility may be shared in a meeting
with the family prior to the individualized family service plan.
Written parent consent to evaluate and assess shall be obtained
within the 45-day timeline. A regional center, local educational
agency, or the designee of one of those entities shall initiate and
conduct this meeting. Families shall be afforded the opportunity to
participate in all decisions regarding eligibility and services.
During intake and assessment, but no later than the IFSP
individualized family service plan meeting, the
parents, legal guardian, or conservator shall provide copies of any
health benefit cards under which the consumer is eligible to receive
health benefits, including, but not limited to, private health
insurance, a health care service plan, Medi-Cal, Medicare, and
TRICARE. If the individual, or, where appropriate, the parents, legal
guardians, or conservators, have no such benefits, the regional
center shall not use that fact to negatively impact the services that
the individual may or may not receive from the regional center.
(c) Parents shall be fully informed of their rights, including the
right to invite another person, including a family member or an
advocate or peer parent, or any or all of them, to accompany them to
any or all individualized family service plan meetings. With parental
consent, a referral shall be made to the local family resource
center or network.
(d) The individualized family service plan shall be in writing and
shall address all of the following:
(1) A statement of the infant's or toddler's present levels of
physical development including vision, hearing, and health status,
cognitive development, communication development, social and
emotional development, and adaptive developments.
(2) With the concurrence of the family, a statement of the family'
s concerns, priorities, and resources related to meeting the special
developmental needs of the eligible infant or toddler.
(3) A statement of the major outcomes expected to be achieved for
the infant or toddler and family where services for the family are
related to meeting the special developmental needs of the eligible
infant or toddler.
(4) The criteria, procedures, and timelines used to determine the
degree to which progress toward achieving the outcomes is being made
and whether modifications or revisions are necessary.
(5) (A) A statement of the specific early intervention services
necessary to meet the unique needs of the infant or toddler as
identified in paragraph (3), including, but not limited to, the
frequency, intensity, location, duration, and method of delivering
the services, and ways of providing services in natural generic
environments, including group training for parents on behavioral
intervention techniques in lieu of some or all of the in-home parent
training component of the behavior intervention services, and
purchase of neighborhood preschool services and needed qualified
personnel in lieu of infant development programs.
(B) Effective July 1, 2009, at the time of development, review, or
modification of an infant's or toddler's individualized family
service plan, the regional center shall consider both of the
following:
(i) The use of group training for parents on behavior intervention
techniques, in lieu of some or all of the in-home parent training
component of the behavior intervention services.
(ii) The purchase of neighborhood preschool services and needed
qualified personnel, in lieu of infant development programs.
(6) A statement of the agency responsible for providing the
identified services.
(7) The name of the service coordinator who shall be responsible
for facilitating implementation of the plan and coordinating with
other agencies and persons.
(8) The steps to be taken to ensure transition of the infant or
toddler upon reaching three years of age to other appropriate
services. These may include, as appropriate, special education or
other services offered in natural environments.
(9) The projected dates for the initiation of services in
paragraph (5) and the anticipated duration of those services.
(e) Each service identified on the individualized family service
plan shall be designated as one of three types:
(1) An early intervention service, as defined in subsection (4) of
Section 1432 of Title 20 of the United States Code, and applicable
regulations, that is provided or purchased through the regional
center, local educational agency, or other participating agency. The
State Department of Health Care Services, State Department of Social
Services, and State Department of Alcohol and Drug Programs shall
provide services in accordance with state and federal law and
applicable regulations, and up to the level of funding as
appropriated by the Legislature. Early intervention services
identified on an individualized family service plan that exceed the
funding, statutory, and regulatory requirements of these departments
shall be provided or purchased by regional centers or local
educational agencies under subdivisions (b) and (c) of Section 95014.
The State Department of Health Care Services, State Department of
Social Services, and State Department of Alcohol and Drug Programs
shall not be required to provide early intervention services over
their existing funding, statutory, and regulatory requirements.
(2) Another service, other than those specified in paragraph (1),
which the eligible infant or toddler or his or her family may receive
from other state programs, subject to the eligibility standards of
those programs.
(3) A referral to a nonrequired service that may be provided to an
eligible infant or toddler or his or her family. Nonrequired
services are those services that are not defined as early
intervention services or do not relate to meeting the special
developmental needs of an eligible infant or toddler related to the
disability, but that may be helpful to the family. The granting or
denial of nonrequired services by a public or private agency is not
subject to appeal under this title. Notwithstanding any other
provision of law or regulation to the contrary, effective July 1,
2009, with the exception of durable medical equipment, regional
centers shall not purchase nonrequired services, but may refer a
family to a nonrequired service that may be available to an eligible
infant or toddler or his or her family.
(f) An annual review, and other periodic reviews, of the
individualized family service plan for an infant or toddler and the
infant's or toddler's family shall be conducted to determine the
degree of progress that is being made in achieving the outcomes
specified in the plan and whether modification or revision of the
outcomes or services is necessary. The frequency, participants,
purpose, and required processes for annual and periodic reviews shall
be consistent with the statutes and regulations under Part C of the
federal Individuals with Disabilities Education Act (20 U.S.C. Sec.
1431 et seq.) and this title, and shall be specified in regulations
adopted pursuant to Section 95028. At the time of the review, the
parents, legal guardian, or conservator shall provide copies of any
health benefit cards under which the consumer is eligible to receive
health benefits, including, but not limited to, private health
insurance, a health care service plan, Medi-Cal, Medicare, and
TRICARE. If the parents, legal guardian, or conservator have no such
benefit cards, the regional center shall not use that fact to
negatively impact the services that the individual may or may not
receive from the regional center.
(g) Individualized family service plans and the provision of
services and supports shall be designed to meet the cultural
preferences, values, and lifestyle of the infant or toddler and his
or her family, and shall be provided in their native language. A copy
of the individualized family service plan shall be provided in their
native language.
SEC. 3. Section 4512 of the Welfare and
Institutions Code is amended to read:
4512. As used in this division:
(a) "Developmental disability" means a disability that originates
before an individual attains age 18 years, continues, or can be
expected to continue, indefinitely, and constitutes a substantial
disability for that individual. As defined by the Director of
Developmental Services, in consultation with the Superintendent of
Public Instruction, this term shall include mental retardation,
cerebral palsy, epilepsy, and autism. This term shall also include
disabling conditions found to be closely related to mental
retardation or to require treatment similar to that required for
individuals with mental retardation, but shall not include other
handicapping conditions that are solely physical in nature.
(b) "Services and supports for persons with developmental
disabilities" means specialized services and supports or special
adaptations of generic services and supports directed toward the
alleviation of a developmental disability or toward the social,
personal, physical, or economic habilitation or rehabilitation of an
individual with a developmental disability, or toward the achievement
and maintenance of independent, productive, normal lives. The
determination of which services and supports are necessary for each
consumer shall be made through the individual program plan process.
The determination shall be made on the basis of the needs and
preferences of the consumer or, when appropriate, the consumer's
family, and shall include consideration of a range of service options
proposed by individual program plan participants, the effectiveness
of each option in meeting the goals stated in the individual program
plan, and the cost-effectiveness of each option. Services and
supports listed in the individual program plan may include, but are
not limited to, diagnosis, evaluation, treatment, personal care, day
care, domiciliary care, special living arrangements, physical,
occupational, and speech therapy, training, education, supported and
sheltered employment, mental health services, recreation, counseling
of the individual with a developmental disability and of his or her
family, protective and other social and sociolegal services,
information and referral services, follow-along services, adaptive
equipment and supplies, advocacy assistance, including self-advocacy
training, facilitation and peer advocates, assessment, assistance in
locating a home, child care, behavior training and behavior
modification programs, camping, community integration services,
community support, daily living skills training, emergency and crisis
intervention, facilitating circles of support, habilitation,
homemaker services, infant stimulation programs, paid roommates, paid
neighbors, respite, short-term out-of-home care, social skills
training, specialized medical and dental care, supported living
arrangements, technical and financial assistance, travel training,
training for parents of children with developmental disabilities,
training for parents with developmental disabilities, vouchers, and
transportation services necessary to ensure delivery of services to
persons with developmental disabilities. Nothing in this subdivision
is intended to expand or authorize a new or different service or
support for any consumer unless that service or support is contained
in his or her individual program plan.
(c) Notwithstanding subdivisions (a) and (b), for any organization
or agency receiving federal financial participation under the
federal Developmental Disabilities Assistance and Bill of Rights Act
of 2000, as amended, "developmental disability" and "services for
persons with developmental disabilities" mean the terms as defined in
the federal act to the extent required by federal law.
(d) "Consumer" means a person who has a disability that meets the
definition of developmental disability set forth in subdivision (a).
(e) "Natural supports" means personal associations and
relationships typically developed in the community that enhance the
quality and security of life for people, including, but not limited
to, family relationships, friendships reflecting the diversity of the
neighborhood and the community, associations with fellow students or
employees in regular classrooms and workplaces, and associations
developed through participation in clubs, organizations, and other
civic activities.
(f) "Circle of support" means a committed group of community
members, who may include family members, meeting regularly with an
individual with developmental disabilities in order to share
experiences, promote autonomy and community involvement, and assist
the individual in establishing and maintaining natural supports. A
circle of support generally includes a plurality of members who
neither provide nor receive services or supports for persons with
developmental disabilities and who do not receive payment for
participation in the circle of support.
(g) "Facilitation" means the use of modified or adapted materials,
special instructions, equipment, or personal assistance by an
individual, such as assistance with communications, that will enable
a consumer to understand and participate to the maximum extent
possible in the decisions and choices that effect his or her life.
(h) "Family support services" means services and supports that are
provided to a child with developmental disabilities or his or her
family and that contribute to the ability of the family to reside
together.
(i) "Voucher" means any authorized alternative form of service
delivery in which the consumer or family member is provided with a
payment, coupon, chit, or other form of authorization that enables
the consumer or family member to choose his or her own service
provider.
(j) "Planning team" means the individual with developmental
disabilities, the parents or legally appointed guardian of a minor
consumer or the legally appointed conservator of an adult consumer,
the authorized representative, including those appointed pursuant to
subdivision (d) of Section 4548 and subdivision (e) of Section 4705,
one or more regional center representatives, including the designated
regional center service coordinator pursuant to subdivision (b) of
Section 4640.7, any individual, including a service provider, invited
by the consumer, the parents or legally appointed guardian of a
minor consumer or the legally appointed conservator of an adult
consumer, or the authorized representative, including those appointed
pursuant to subdivision (d) of Section 4548 and subdivision (e) of
Section 4705, and including a minor's, dependent's, or ward's
court-appointed developmental services decisionmaker appointed
pursuant to Section 319, 361, or 726.
(k) "Stakeholder organizations" means statewide organizations
representing the interests of consumers, family members, service
providers, and statewide advocacy organizations.
(l) "Substantial disability" means the existence of significant
functional limitations in three or more of the following areas of
major life activity, as determined by a regional center, and as
appropriate to the age of the person:
(1) Self-care.
(2) Receptive and expressive language.
(3) Learning.
(4) Mobility.
(5) Self-direction.
(6) Capacity for independent living.
(7) Economic self-sufficiency.
Any reassessment of substantial disability for purposes of
continuing eligibility shall utilize the same criteria under which
the individual was originally made eligible.
(m) "Native language" means the language normally used by the
individual and, when appropriate, his or her parent, legal guardian
or conservator, or authorized representative.
SEC. 4. Section 4641 of the Welfare and
Institutions Code is amended to read:
4641. (a) All regional centers shall
conduct casefinding activities, including notification of
availability of service in English and such other languages as may be
appropriate to the service area, outreach services in areas with a
high incidence of developmental disabilities, and identification of
persons who may need service.
(b) The department and the regional centers shall ensure that
consumers and their families receive culturally and linguistically
competent information, including written documents, about the
individual program plan required by Section 4646, and the
individualized family service plan required by Section 95020 of the
Government Code, and related processes and procedures. Each regional
center shall make available to the public information about regional
center services, processes, and procedures. The department and the
regional centers shall fulfill these obligations in a manner that
meets the standards set forth in Sections 7295.2 and 7296.2 of the
Government Code, and ensure that its materials are written in plain,
straightforward language and in an easily readable style. The
materials provided by the department and the regional centers shall
also be available on the department's and the regional centers'
Internet Web sites.
SEC. 5. Section 4642 of the
Welfare and Institutions Code is amended to read:
4642. (a) (1) Any
person believed to have a developmental disability, and any person
believed to have a high risk of parenting a developmentally disabled
infant shall be eligible for initial intake and assessment services
in the regional centers. In addition, any infant having a high risk
of becoming developmentally disabled may be eligible for initial
intake and assessment services in the regional centers. For purposes
of this section, "high-risk infant" means a child less than 36 months
of age whose genetic, medical, or environmental history is
predictive of a substantially greater risk for developmental
disability than that for the general population. The department, in
consultation with the State Department of Public Health
Services , shall develop specific risk and service
criteria for the high-risk infant program on or before July 1, 1983.
These criteria may be modified in subsequent years based on analysis
of actual clinical experience.
Initial
(2) Initial intake shall be
performed within 15 working days following request for assistance.
Initial intake shall include, but need not be limited to, information
and advice about the nature and availability of services provided by
the regional center and by other agencies in the community,
including guardianship, conservatorship, income maintenance, mental
health, housing, education, work activity and vocational training,
medical, dental, recreational, and other services or programs that
may be useful to persons with developmental disabilities or their
families. Intake shall also include a decision to provide assessment.
(b) All communication with the consumer and his or her family
pursuant to this section shall be in their native language.
SEC. 6. Section 4643 of the Welfare and
Institutions Code is amended to read:
4643. (a) If assessment is needed, the assessment shall be
performed within 120 days following initial intake. Assessment shall
be performed as soon as possible and in no event more than 60 days
following initial intake where any delay would expose the client to
unnecessary risk to his or her health and safety or to significant
further delay in mental or physical development, or the client would
be at imminent risk of placement in a more restrictive environment.
Assessment may include collection and review of available historical
diagnostic data, provision or procurement of necessary tests and
evaluations, and summarization of developmental levels and service
needs and is conditional upon receipt of the release of information
specified in subdivision (b).
(b) In determining if an individual meets the definition of
developmental disability contained in subdivision (a) of Section
4512, the regional center may consider evaluations and tests,
including, but not limited to, intelligence tests, adaptive
functioning tests, neurological and neuropsychological tests,
diagnostic tests performed by a physician, psychiatric tests, and
other tests or evaluations that have been performed by, and are
available from, other sources.
(c) At the time of assessment, the individual, or, where
appropriate, the parents, legal guardian, or conservator, shall
provide copies of any health benefit cards under which the consumer
is eligible to receive health benefits, including, but not limited
to, private health insurance, a health care service plan, Medi-Cal,
Medicare, and TRICARE. If the individual, or where appropriate, the
parents, legal guardians, or conservators, have no such benefits, the
regional center shall not use that fact to negatively impact the
services that the individual may or may not receive from the regional
center.
(d) All communication with the consumer and his or her family
pursuant to this section shall be in their native language.
SEC. 7. Section 4646 of the Welfare and
Institutions Code is amended to read:
4646. (a) It is the intent of the Legislature to ensure that the
individual program plan and provision of services and supports by the
regional center system is centered on the individual and the family
of the individual with developmental disabilities and takes into
account the needs and preferences of the individual and the family,
where appropriate, as well as promoting community integration,
independent, productive, and normal lives, and stable and healthy
environments. It is the further intent of the Legislature to ensure
that the provision of services to consumers and their families be
effective in meeting the goals stated in the individual program plan,
reflect the preferences and choices of the consumer, and reflect the
cost-effective use of public resources.
(b) The individual program plan is developed through a process of
individualized needs determination. The individual with developmental
disabilities and, where appropriate, his or her parents, legal
guardian or conservator, or authorized representative, shall have the
opportunity to actively participate in the development of the plan.
(c) An individual program plan shall be developed for any person
who, following intake and assessment, is found to be eligible for
regional center services. These plans shall be completed within 60
days of the completion of the assessment. At the time of intake, the
regional center shall inform the consumer and, where appropriate, his
or her parents, legal guardian or conservator, or authorized
representative, of the services available through the local area
board and the protection and advocacy agency designated by the
Governor pursuant to federal law, and shall provide the address and
telephone numbers of those agencies.
(d) Individual program plans shall be prepared jointly by the
planning team. Decisions concerning the consumer's goals, objectives,
and services and supports that will be included in the consumer's
individual program plan and purchased by the regional center or
obtained from generic agencies shall be made by agreement between the
regional center representative and the consumer or, where
appropriate, the parents, legal guardian, conservator, or authorized
representative at the program plan meeting.
(e) Regional centers shall comply with the request of a consumer,
or where appropriate, the request of his or her parents, legal
guardian, conservator, or authorized representative, that a
designated representative receive written notice of all meetings to
develop or revise his or her individual program plan and of all
notices sent to the consumer pursuant to Section 4710. The designated
representative may be a parent or family member.
(f) If a final agreement regarding the services and supports to be
provided to the consumer cannot be reached at a program plan
meeting, then a subsequent program plan meeting
shall be convened within 15 days, or later at
the request of the consumer or, when appropriate, the parents, legal
guardian, conservator, or authorized representative or when agreed
to by the planning team. Additional program plan meetings may be held
with the agreement of the regional center representative and the
consumer or, where appropriate, the parents, legal guardian,
conservator, or authorized representative.
(g) An authorized representative of the regional center and the
consumer or, where appropriate, his or her parents, legal guardian,
conservator, or authorized representative shall sign the individual
program plan prior to its implementation. If the consumer or, where
appropriate, his or her parents, legal guardian, conservator, or
authorized representative, does not agree with all components of the
plan, he or she may indicate that disagreement on the plan.
Disagreement with specific plan components shall not prohibit the
implementation of services and supports agreed to by the consumer or,
where appropriate, his or her parents, legal guardian, conservator,
or authorized representative. If the consumer or, where appropriate,
his or her parents, legal guardian, conservator, or authorized
representative, does not agree with the plan in whole or in part, he
or she shall be sent written notice of the fair hearing rights, as
required by Section 4701.
(h) Individual program plans and the provision of services and
supports shall be designed to meet the cultural preferences, values,
and lifestyle of the individual and, when appropriate, his or her
parent, legal guardian or conservator, or authorized representative,
and shall be provided in their native language. A copy of the
individual program plan shall be provided in their native language.
SEC. 8. Section 4646.5 of the Welfare
and Institutions Code is amended to read:
4646.5. (a) The planning process for the individual program plan
described in Section 4646 shall include all of the following:
(1) Gathering information and conducting assessments to determine
the life goals, capabilities and strengths, preferences, barriers,
and concerns or problems of the person with developmental
disabilities. For children with developmental disabilities, this
process should include a review of the strengths, preferences, and
needs of the child and the family unit as a whole. Assessments shall
be conducted by qualified individuals and performed in natural
environments whenever possible. Information shall be taken from the
consumer, his or her parents and other family members, his or her
friends, advocates, authorized representative, if applicable,
providers of services and supports, and other agencies. The
assessment process shall reflect awareness of, and sensitivity to,
the lifestyle and cultural background of the consumer and the family.
(2) A statement of goals, based on the needs, preferences, and
life choices of the individual with developmental disabilities, and a
statement of specific, time-limited objectives for implementing the
person's goals and addressing his or her needs. These objectives
shall be stated in terms that allow measurement of progress or
monitoring of service delivery. These goals and objectives should
maximize opportunities for the consumer to develop relationships, be
part of community life in the areas of community participation,
housing, work, school, and leisure, increase control over his or her
life, acquire increasingly positive roles in community life, and
develop competencies to help accomplish these goals.
(3) When developing individual program plans for children,
regional centers shall be guided by the principles, process, and
services and support parameters set forth in Section 4685.
(4) A schedule of the type and amount of services and supports to
be purchased by the regional center or obtained from generic agencies
or other resources in order to achieve the individual program plan
goals and objectives, and identification of the provider or providers
of service responsible for attaining each objective, including, but
not limited to, vendors, contracted providers, generic service
agencies, and natural supports. The individual program plan shall
specify the approximate scheduled start date for services and
supports and shall contain timelines for actions necessary to begin
services and supports, including generic services.
(5) When agreed to by the consumer, the parents, legally appointed
guardian, or authorized representative of a minor consumer, or the
legally appointed conservator of an adult consumer or the authorized
representative, including those appointed pursuant to subdivision (d)
of Section 4548, subdivision (b) of Section 4701.6, and subdivision
(e) of Section 4705, a review of the general health status of the
adult or child, including medical, dental, and mental health needs,
shall be conducted. This review shall include a discussion of current
medications, any observed side effects, and the date of last review
of the medication. Service providers shall cooperate with the
planning team to provide any information necessary to complete the
health status review. If any concerns are noted during the review,
referrals shall be made to regional center clinicians or to the
consumer's physician, as appropriate. Documentation of health status
and referrals shall be made in the consumer's record by the service
coordinator.
(6) (A) The development of a transportation access plan for a
consumer when all of the following conditions are met:
(i) The regional center is purchasing private, specialized
transportation services or services from a residential, day, or other
provider, excluding vouchered service providers, to transport the
consumer to and from day or work services.
(ii) The planning team has determined that a consumer's community
integration and participation could be safe and enhanced through the
use of public transportation services.
(iii) The planning team has determined that generic transportation
services are available and accessible.
(B) To maximize independence and community integration and
participation, the transportation access plan shall identify the
services and supports necessary to assist the consumer in accessing
public transportation and shall comply with Section 4648.35. These
services and supports may include, but are not limited to, mobility
training services and the use of transportation aides. Regional
centers are encouraged to coordinate with local public transportation
agencies.
(7) A schedule of regular periodic review and reevaluation to
ascertain that planned services have been provided, that objectives
have been fulfilled within the times specified, and that consumers
and families are satisfied with the individual program plan and its
implementation.
(b) For all active cases, individual program plans shall be
reviewed and modified by the planning team, through the process
described in Section 4646, as necessary, in response to the person's
achievement or changing needs, and no less often than once every
three years. If the consumer or, where appropriate, the consumer's
parents, legal guardian, authorized representative, or conservator
requests an individual program plan review, the individual program
shall be reviewed within 30 days after the request is submitted.
(c) (1) The department, with the participation of representatives
of a statewide consumer organization, the Association of Regional
Center Agencies, an organized labor organization representing service
coordination staff, and the Organization of Area Boards shall
prepare training material and a standard format and instructions for
the preparation of individual program plans, which embodies an
approach centered on the person and family.
(2) Each regional center shall use the training materials and
format prepared by the department pursuant to paragraph (1).
(3) The department shall biennially review a random sample of
individual program plans at each regional center to ensure that these
plans are being developed and modified in compliance with Section
4646 and this section.
(d) This section shall be implemented in a manner that meets the
cultural preferences, values, lifestyle, and native language of the
individual and, when appropriate, his or her parent, legal guardian
or conservator, or authorized representative.
SEC. 9. Section 4648 of the Welfare and
Institutions Code is amended to read:
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), 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 which 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 provision of
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
provision of law or regulation to the contrary, a regional center
shall not purchase new residential services from institutions for
mental disease, as described in Part 5 (commencing with Section 5900)
of Division 5, for which federal Medicaid funding is not available.
(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 federally eligible 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 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) 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.
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.
(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.
(i) Ensuring that individual program plans and the provision of
services and supports shall be designed to meet the cultural
preferences, values, and lifestyle of the individual and, when
appropriate, his or her parent, legal guardian or conservator, or
authorized representative, and shall be provided in their native
language.
SEC. 10. Section 4685 of the Welfare
and Institutions Code is amended to read:
4685. (a) Consistent with state and federal law, the Legislature
finds and declares that children with developmental disabilities most
often have greater opportunities for educational and social growth
when they live with their families. The Legislature further finds and
declares that the cost of providing necessary services and supports
which enable a child with developmental disabilities to live at home
is typically equal to or lower than the cost of providing out-of-home
placement. The Legislature places a high priority on providing
opportunities for children with developmental disabilities to live
with their families, when living at home is the preferred objective
in the child's individual program plan.
(b) It is the intent of the Legislature that regional centers
provide or secure family support services that do all of the
following:
(1) Respect and support the decisionmaking authority of the
family.
(2) Be flexible and creative in meeting the unique and individual
needs of families as they evolve over time.
(3) Recognize and build on family strengths, natural supports, and
existing community resources.
(4) Be designed to meet the cultural preferences, native
language, values, and lifestyles of families.
(5) Focus on the entire family and promote the inclusion of
children with disabilities in all aspects of school and community.
(c) In order to provide opportunities for children to live with
their families, the following procedures shall be adopted:
(1) The department and regional centers shall give a very high
priority to the development and expansion of services and supports
designed to assist families that are caring for their children at
home, when that is the preferred objective in the individual program
plan. This assistance may include, but is not limited to specialized
medical and dental care, special training for parents, infant
stimulation programs, respite for parents, homemaker services,
camping, day care, short-term out-of-home care, child care,
counseling, mental health services, behavior modification programs,
special adaptive equipment such as wheelchairs, hospital beds,
communication devices, and other necessary appliances and supplies,
and advocacy to assist persons in securing income maintenance,
educational services, and other benefits to which they are entitled.
(2) When children with developmental disabilities live with their
families, the individual program plan shall include a family plan
component which describes those services and supports necessary to
successfully maintain the child at home. Regional centers shall
consider every possible way to assist families in maintaining their
children at home, when living at home will be in the best interest of
the child, before considering out-of-home placement alternatives.
When the regional center first becomes aware that a family may
consider an out-of-home placement, or is in need of additional
specialized services to assist in caring for the child in the home,
the regional center shall meet with the family to discuss the
situation and the family's current needs, solicit from the family
what supports would be necessary to maintain the child in the home,
and utilize creative and innovative ways of meeting the family's
needs and providing adequate supports to keep the family together, if
possible.
(3) (A) To ensure that these services and supports are provided in
the most cost-effective and beneficial manner, regional centers may
utilize innovative service-delivery mechanisms, including, but not
limited to, vouchers; alternative respite options such as foster
families, vacant community facility beds, crisis child care
facilities; group training for parents on behavioral intervention
techniques in lieu of some or all of the in-home parent training
component of the behavioral intervention services; purchase of
neighborhood preschool services and needed qualified personnel in
lieu of infant development programs; and alternative child care
options such as supplemental support to generic child care facilities
and parent child care cooperatives.
(B) Effective July 1, 2009, at the time of development, review, or
modification of a child's individualized family service plan or
individual program plan, the regional center shall consider both of
the following:
(i) The use of group training for parents on behavioral
intervention techniques in lieu of some or all of the in-home parent
training component of the behavioral intervention services.
(ii) The purchase of neighborhood preschool services and needed
qualified personnel in lieu of infant development programs.
(4) If the parent of any child receiving services and supports
from a regional center believes that the regional center is not
offering adequate assistance to enable the family to keep the child
at home, the parent may initiate a request for fair hearing as
established in this division. A family shall not be required to start
a placement process or to commit to placing a child in order to
receive requested services.
(5) Nothing in this section shall be construed to encourage the
continued residency of adult children in the home of their parents
when that residency is not in the best interests of the person.
(6) When purchasing or providing a voucher for day care services
for parents who are caring for children at home, the regional center
may pay only the cost of the day care service that exceeds the cost
of providing day care services to a child without disabilities. The
regional center may pay in excess of this amount when a family can
demonstrate a financial need and when doing so will enable the child
to remain in the family home.
(7) A regional center may purchase or provide a voucher for
diapers for children three years of age or older. A regional center
may purchase or provide vouchers for diapers under three years of age
when a family can demonstrate a financial need and when doing so
will enable the child to remain in the family home.
SECTION 1. It is the intent of the Legislature
to enact legislation that would require an individual program plan,
or individual family services plan, to consider the needs of the
consumer, and his or her family, in order to provide services and
supports in a culturally and linguistically appropriate manner.