BILL ANALYSIS Ó
SENATE HUMAN
SERVICES COMMITTEE
Senator Leland Y. Yee, Chair
BILL NO: SB 577
S
AUTHOR: Pavley
B
VERSION: April 15, 2013
HEARING DATE: April 23, 2013
5
FISCAL: Yes
7
7
CONSULTANT: Mareva Brown
SUBJECT
Autism and other developmental disabilities: pilot program:
employment
SUMMARY
This bill requires development of a pilot program in
specified regional centers to help young adults with autism
and other developmental disabilities prepare for work.
Defines job exploration and discovery as a new category of
services provided for consumers in the regional center
system to enhance employment readiness, related social
skill development, access to postsecondary or career
technical education, outreach to employers and other job
readiness services, as specified. Establishes an Employment
Growth Fund and requires $200 per month be deposited for
each consumer who is enrolled in an employer-paid health
benefit plan or $1,000 be deposited for any consumer who
achieves the federally designated "substantial gainful
activity level," as specified. Requires that money in the
fund be paid to supported employment providers. Requires an
evaluation of the program, commits DDS to recommend
statewide expansion if the program proves successful and
sunsets the pilot on July 1, 2018, as specified.
Continued---
STAFF ANALYSIS OF SENATE BILL 577 (Pavley)
PageB
ABSTRACT
Existing law
1) Establishes the Lanterman Developmental
Disabilities Services Act, which declares California's
responsibility for providing an array of services and
supports to meet the needs of each person with
developmental disabilities in the least restrictive
environment, regardless of age or degree of
disability, and to support their integration into the
mainstream life of the community. (WIC 4500, et seq.)
2) Establishes a system of nonprofit Regional Centers
to provide fixed points of contact in the community
for all persons with developmental disabilities and
their families, to coordinate services and supports
best suited to them throughout their lifetime. (WIC
4620)
3) Establishes an Individual Program Plan (IPP) and
defines that planning process as the vehicle to ensure
that services and supports are customized to meet the
needs of consumers who are served by regional centers.
(WIC 4512)
4) Establishes an individual habilitation services
plan and specifies areas in which consumers must meet
individual employment goals. (WIC 4853, WIC 4854)
5) Defines habilitation services as activities
purchased for regional center consumers, including
services provided under the Work Activity and
Supported Employment programs to prepare and maintain
consumers at their highest level of vocation
functioning or to prepare them for referral to
vocational rehabilitation services. (WIC 4851)
6) Defines supported employment services as those
approved in the IPP for the purposes of achieving
supported employment as an outcome, as specified. (WIC
4851 (q))
7) Establishes fees and hourly rates for service
STAFF ANALYSIS OF SENATE BILL 577 (Pavley)
PageC
providers who work with consumers in various job
development and support activities. (WIC 4860)
8) Establishes in federal law state reimbursements for
achieving work outcomes for individuals with
disabilities, as specified. (CFR 411.582)
9) Establishes that the state will contract with
medical providers to treat Californians that qualify
for Medi-Cal, the state's insurance program for the
poor. (WIC 14043 et seq.)
This bill
1) Makes various legislative findings about the
importance of work in the lives of young adults with
developmental disabilities, their underemployment and
the necessity of a state-supported program to provide
specific support to ensure a consumer's academic and
employment success.
2) Declares legislative intent that, in order to
increase effectiveness and opportunity to gain
meaningful employment opportunities, habilitation
services be expanded to include job exploration and
discovery service, as defined.
3) Defines "job exploration and discovery" to mean:
a. Services provided to enhance employment
readiness.
b. Social skills development services
necessary to obtain and maintain employment and
to secure and support participation in internship
and volunteer opportunities.
c. Services to access and participate in
postsecondary education or career technical
education.
d. Services to develop resume and interview
skills.
e. Services to conduct targeted employer
outreach to secure employment.
4) Requires that a job exploration and discovery plan
be developed if those services are determined to be a
STAFF ANALYSIS OF SENATE BILL 577 (Pavley)
PageD
necessary step to achieve a supported employment
outcome.
5) Establishes the rate for job exploration and
discovery services to be $40 per hour for a maximum of
75 hours per calendar quarter for all services
identified and provided in the job exploration and
discovery plan, as specified.
6) Requires DDS to establish a pilot program for young
adults to help them obtain integrated employment with
sufficient wages and benefits to decrease, over time,
their dependency on public financial support.
7) Requires that the pilot program:
a. Develop and implement a new model for
providing employment services to autistic
individuals and individuals with other
developmental disabilities, or modify an existing
model for providing those services.
b. Identify existing support services that
may be modified or combined with supplemental
services to provide skills assessment, training,
and transition services.
c. Use available federal and state incentive
programs.
d. Create financial incentives for
employment service providers who help the
individuals served in the pilot program find and
retain jobs that pay wages that equal or exceed
the Social Security Administration's substantial
gainful activity level, or result in the
individual obtaining employer-based health
benefits.
e. Develop and implement a protocol for
collecting and evaluating data regarding the
outcomes of participants in the pilot program.
8) Identifies the regional center catchment areas for
participation in the pilot project as: Golden Gate,
East Bay, Tri-Counties, Orange County, San Diego and
Alta California regional centers.
9) Requires DDS and the Department of Finance to
STAFF ANALYSIS OF SENATE BILL 577 (Pavley)
PageE
establish by July 1, 2014, the Employment Growth Fund,
to consist of monies appropriated by the Legislature
from cost savings associated with the gainful
employment and reduced need for supportive services by
consumers participating in the pilot project, as
specified.
10) Requires $200 be allocated to the fund for each
month a consumer in the pilot project is enrolled in
an employer-paid health benefit plan. This funding
shall be allocated from funds payable to the state
Department of Health Care Services (DHCS) pursuant to
the Medi-Cal program to the extent authorized by
federal law for each Medi-Cal eligible consumer of
regional center services.
11) Requires $1,000 be allocated to the fund on a
one-time basis from the Department of Rehabilitation
for each consumer of regional center services who
earns a monthly wage that exceeds the substantial
gainful activity level, as established by the federal
Social Security Administration, for at least nine
consecutive months, if the Department of
Rehabilitation (DOR) has received cost reimbursement
in that amount from the federal government pursuant to
the federal Ticket to Work program. This sum shall be
allocated on a one-time basis for each consumer who
meets that criteria.
12) Requires that these funds be deposited quarterly
into the Employment Growth Fund.
13) Requires each participating regional center to
submit to DDS:
a. Information regarding each consumer who
receives Medi-Cal benefits and is subsequently
enrolled in an employer-paid health plan.
b. Information regarding each consumer who
earns a monthly wage that exceeds the substantial
gainful activity level, as specified.
14) Requires DDS beginning July 1, 2015 to allocate
funds from the Employment Growth Fund to supported
employment providers who assist consumers to attain
STAFF ANALYSIS OF SENATE BILL 577 (Pavley)
PageF
either threshold of employee-paid health benefits or
substantial gainful activity level, as established by
the federal Social Security Administration resulting
in a state incentive paid to DOR by the federal SSA.
15) Requires DDS to do the following:
a. Annually determine the average cost of
providing adult developmental center services to
persons with developmental disabilities in the
regional centers participating in the pilot
program and compare that average cost to the
actual cost of providing supported employment
services to consumers in the pilot program.
b. Requires DDS to allocate to the
Employment Growth Fund 50 percent of the savings
if the average cost of adult developmental center
services is higher than the actual costs of the
supported employment services provided to any
consumer who meets either threshold, as
specified.
c. Prepare an annual report of the number of
pilot program participants and estimated total
cost savings to the state across departments as a
result of the program.
d. Design and implement an evaluation of the
pilot program and submit a recommendation to the
Legislature that the program be expanded
statewide if it results in a 10 percent or
greater average annual increase in the number of
individuals who receive habilitative services
through the pilot program being placed in
supported employment.
16) Sunsets the program on July 2018 and repeals it as
of January 1, 2019.
FISCAL IMPACT
This bill has not been analyzed by a fiscal committee.
BACKGROUND AND DISCUSSION
STAFF ANALYSIS OF SENATE BILL 577 (Pavley)
PageG
Author's purpose
The author states that employment rates for people with
autism and other developmental disabilities are appalling
in California. In 2009, only 14 percent of working-age
regional center clients were employed in any kind of job
for any number of hours per week, according to the author.
The 2010 National Core Indicators survey of over 8,724
regional center clients indicated that fewer than 5 percent
surveyed had a job in integrated competitive employment.
The author states that people with autism and other
developmental disabilities who work in paid integrated
settings in the community have a higher quality of life,
better health outcomes, more access to social relationships
and greater community participation. In addition, the
author states, consumers who work use less publicly funded
healthcare, fewer publicly funded services and pay taxes
like everyone else that works. Yet California's funding
structure for employment service delivery perversely
encourages the placement of people with autism and other
developmental disabilities in non-work day services and
segregated low paying jobs with little to no future,
according to the author.
Regional centers
California's 21 nonprofit regional centers are part of a
system of care for individuals with developmental
disabilities overseen by 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 nearly 260,000 people 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 an individual's
developmental disability. Services for consumers are
determined through an individual program plan (IPP).
STAFF ANALYSIS OF SENATE BILL 577 (Pavley)
PageH
Employment first efforts
In 2009, the Legislature and Governor required that the
State Council on Developmental Disabilities establish a
standing Employment First Committee to identify strategies,
best practices, and incentives, and to develop an
Employment First Policy. The goal of the policy was to
increase the number of people with developmental
disabilities who are employed in integrated work,
self-employment, and microenterprises, and in the number
earning wages at or above minimum wage. The council also is
required to provide an annual report to the Legislature
outlining its work and making recommendations.
In 2011, the State Council released its first report which
included findings that 26.5 percent of working age adults
with developmental disabilities live below the federal
poverty line compared with 13 percent of same-aged adults
in the general population. Other findings included a need
for additional supports for individuals to prepare for and
maintain employment. That report, and a subsequent report
last year, prompted a number of legislative efforts to
require regional centers to adopt an "employment first"
philosophy when assessing individuals for services, as well
as other efforts.<1>
Federal incentives through DOR
The California Department of Rehabilitation works in
partnership with consumers and other stakeholders to
provide services and advocacy resulting in employment,
independent living and equality for individuals with
disabilities. Among the services is Vocational
Rehabilitation, which includes employment counseling
training and education, mobility and transportation aids,
job search and placement assistance. To be eligible for
services, an individual must have a physical or mental
impairment that substantially impedes his or her ability to
secure employment and that require Vocational
Rehabilitation services to prepare for, secure, retain or
regain employment. An individual must also be able to
-------------------------
<1>
http://www.scdd.ca.gov/res/docs/pdf/HQ-%20Employment%20First
%20Report%208-9-11.pdf
STAFF ANALYSIS OF SENATE BILL 577 (Pavley)
PageI
benefit from DOR services in obtaining employment in an
integrated setting.
The federal Social Security Administration reimburses DOR
for reasonable and necessary costs incurred in providing
Vocational Rehabilitation services to a social security
disability beneficiary or social security income recipient.
In order to receive reimbursement, the state must
demonstrate that:
The individual served was a disability beneficiary
at the time services were provided.
The services contributed to the beneficiary's
employment at the Substantial Gainful Activity level,
which includes a minimum of nine months work within a
12-month period and earnings above $1,040 for a
non-blind recipient in 2013.
That there were estimated savings to the state's
general fund as a result of the person going to work
and no longer receiving state-funded benefits.
Reimbursable expenses to the state are limited to direct
costs purchased by the Department of Rehabilitation from
vendors or outside sources, administrative, counseling and
placement costs provided by DOR employees and tracking
costs for up to nine months after case closure, as approved
by the Social Security Administration. According to DOR,
the average reimbursement is between $2,000 and $3,000. A
reimbursement claim is disallowed by the Social Security
Administration if payment to the Vocational Rehabilitation
agency would be greater than the estimated savings if
benefits were eventually terminated or reduced, thus
resulting in no "net savings" to the trust fund or general
fund.
DOR states additionally that Social Security Administration
reimbursements currently are dedicated to fund the
Independent Living Centers.
Related legislation
AB 287 (Beall) Chapter 231, Statutes of 2009 established an
"Employment First" effort for the State to undertake, which
has led to the State Council on Developmental Disabilities
to put together an "Employment First" policy and several
STAFF ANALYSIS OF SENATE BILL 577 (Pavley)
PageJ
attempts to get that policy passed into law.
AB 1041 (Chesbro, 2013) Requires regional centers to ensure
that consumers, beginning at 16 years of age, are provided
with information about options for integrated competitive
employment and other services including postsecondary
education, available to enable the consumer to transition
from school to work, and to achieve the outcomes of
obtaining and maintaining integrated competitive
employment.
AB 1112 (Ammiano, 2013) Requires that the hourly rate paid
to providers of individualized and group-supported
employment services be consistent with the Department of
Rehabilitation rate structure policy.
AB 954 (Mainenschein, 2013) Increases the hourly rate paid
to providers of individualized and group-supported
employment services from $30.82 to $34.24 and the fees paid
to the interim program providers from $360 or $720 to $400
and $800, respectively.
Comments
The bill's sponsor has stated that intermediary services
are needed to prepare some individuals with developmental
disabilities, including young adults with autism, prior to
being to be able to participate in the Vocational
Rehabilitation program at DOR. Many of these young adults
need to learn to interpret social cues related to the
workplace and have other unique training needs in order to
be successful in DOR's program. The job exploration and
discovery training outlined in this bill would be separate
from job coaching and other pre-employment assessment and
skills training.
In addition to setting up a separate job description and
hourly wage for vendors who would perform this training,
this bill would establish a state fund to collect
reimbursements between other state agencies that result
from individuals in the DDS system obtaining and
maintaining employment. For each regional center employee
who obtains employer health benefits, the state would be
required to deposit $200 monthly into the fund. For each
regional center consumer who maintains sustained work for
STAFF ANALYSIS OF SENATE BILL 577 (Pavley)
PageK
nine months under federal Social Security Administration
regulations, and for which DOR is reimbursed expenses, DOR
must deposit $1,000 into the fund. The fund is authorized
solely to pay supported employment providers who assist
consumers to attain either threshold.
This bill has many unresolved fiscal questions and involves
general fund shifts from two state departments into the
newly established fund. It also requires DDS to evaluate
the difference in cost between a consumer served in a
developmental center and a consumer served in the pilot
project and to deposit 50 percent of the "savings" in
developmental center costs into the same fund.
Should SB 577 move forward to the Appropriations committee,
staff recommends the author clarify how developmental
center "savings" are to be established if a consumer does
not move from a developmental center into the program. This
bill also needs clarification around which consumers are
eligible for DOR reimbursement - while the intent language
implies that it would be just for consumers who participate
in the pilot program, the language in 4870 (b) (1) (B)
indicates that any regional center consumer for whom DOR
receives reimbursement must have $1,000 allocated to the
fund.
Additionally, the author should clarify the types of data
to be collected and reported to DDS by the regional
centers.
POSITIONS
Support: California Federation of Teachers
Disability Rights California
East Bay Innovations
Futures Explored, Inc.
Service Employees International Union (SEIU)
California
Oppose: None received
STAFF ANALYSIS OF SENATE BILL 577 (Pavley)
PageL
-- END --