BILL NUMBER: SB 579 AMENDED
BILL TEXT
AMENDED IN SENATE SEPTEMBER 11, 2013
AMENDED IN SENATE APRIL 9, 2013
INTRODUCED BY Senator Berryhill
(Coauthor: Senator Emmerson)
FEBRUARY 22, 2013
An act to add Section 4751 to the Welfare and Institutions Code,
relating to developmental services.
LEGISLATIVE COUNSEL'S DIGEST
SB 579, as amended, Berryhill. Developmental services:
Commission on Oversight Efficiency and Quality Enhancement
Model.
The Lanterman Developmental Disabilities Services Act authorizes
the State Department of Developmental Services 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, developed in accordance with prescribed requirements.
The California Community Care Facilities Act provides for the
licensure and regulation of community care facilities, including
residential facilities, adult day programs, small family homes, and
group homes, by the State Department of Social Services.
Existing law requires the State Department of Public Health to
license and regulate various types of health facilities, and requires
the State Department of Public Health and the State Department of
Developmental Services to jointly develop and implement licensing
regulations appropriate for intermediate care
facilities/developmentally disabled-nursing and intermediate care
facility/developmentally disabled-continuous nursing.
This bill would establish the Commission on the Oversight
Efficiency and Quality Enhancement Model to investigate methods of
implementing a unified oversight and quality enhancement process that
ensures the welfare, community participation, health, and safety of
individuals with developmental disabilities who are served in
programs licensed by the Community Care Licensing Division of the
State Department of Social Services. The bill would require the
process to also enhance accountability and quality review processes
for the services directly provided by regional centers. The bill
would state the intent of the Legislature that the State Department
of Developmental Services identify regional center catchment areas
for voluntary participation in a pilot project consistent with the
recommendations of the commission. The bill would require, by
February 14, 2015, the State Department of Developmental Services,
the State Council on Developmental Disabilities, and the Association
of Regional Center Agencies to select representatives to serve on the
commission, as prescribed.
The bill would require the commission to develop a uniform data
collection system that provides reliable, valid, and actionable data
from multiple stakeholder perspectives to be consistently deployed at
regional centers. This bill would require the commission to rewiew
current regulatory standards to better focus on reliable data to
measure outcomes for individuals served and the impact of services on
the lives of individuals and their families, in accordance with
prescribed characteristics. The bill would require the commission, by
March 30, 2015, to determine the best methods for collecting input
on relevant regulatory standards and to request public input on those
standards, as specified. The bill would require the commission to
review and compile, by September 30, 2015, the input received and to
submit, by December 30, 2015, its recommendations to the State
Department of Developmental Services.
This bill would require the commission to create a process to
review relevant regulations governing the Licensing and Certification
Division of the State Department of Public Health and to report on
that process to the Legislature by December 31, 2015.
This bill would require regional centers that seek consideration
for participation in any program to pilot new quality enhancement
systems to collect baseline data, as determined by the department, in
programs and services for people with developmental disabilities
that are licensed by the Community Care Licensing Division of the
State Department of Social Services.
This bill would, commencing January 1, 2014, and to the extent
that funds are made available, establish a 41/2 year Oversight
Efficiency and Quality Enhancement Model pilot project in specified
regional center catchment areas to implement a unified oversight and
quality enhancement process, as specified, shifting the oversight of
the service providers from the Community Care Licensing Division of
the State Department of Social Services and the Licensing and
Certification Division of the State Department of Public Health to
the department and the pilot regional centers.
This bill would require the Legislative Analyst's Office to
conduct a study identifying all of the financial and human resources
expended in relation to current quality assurance activities for the
licensed programs identified in the pilot project and to determine
the amount of current quality assurance costs that are covered by
federal dollars and what could be federally funded if the system and
waiver were changed. The bill, by October 1, 2016, would also require
the department to contract with an independent agency or
organization to evaluate the pilot project and prepare a written
report of its findings.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 4571 is added to the
Welfare and Institutions Code , to read:
4571. (a) The Legislature finds and declares all of the
following:
(1) Evaluation of the services that people with developmental
disabilities receive from both service providers and regional centers
is a critical component of the service system.
(2) There is evidence that the current system, in which three
state-funded entities, the State Department of Developmental
Services, the regional centers, and the Community Care Licensing
Division of the State Department of Social Services, are charged with
monitoring and maintaining quality services and supports for people
with developmental disabilities, is duplicative and confusing and
fails to produce data essential for service improvement.
(3) The efficiency and efficacy of the oversight and quality
review processes can be significantly enhanced by unifying the
current duplicative quality review system, thus conserving limited
state and service providers' resources while simultaneously improving
the lives of people with developmental disabilities in California.
(b) The Commission on the Oversight Efficiency and Quality
Enhancement Model shall be established to investigate methods of
implementing a unified oversight and quality enhancement process.
This process shall ensure the welfare, community participation,
health, and safety of all those with developmental disabilities who
are served in programs currently licensed by the Community Care
Licensing Division of the State Department of Social Services. This
process shall also enhance accountability and quality review
processes for the services directly provided by regional centers. At
the conclusion of the investigation, it is the intent of the
Legislature that, based upon the information, analysis, and
recommendations of the commission, the State Department of
Developmental Services shall identify regional center catchment areas
for voluntary participation in a pilot project consistent with the
recommendations of the commission.
(c) (1) (A) On or before February 14, 2015, State Department of
Developmental Services, the State Council on Developmental
Disabilities, and the Association of Regional Center Agencies shall
each select three representatives to serve on the commission, for a
total of nine representatives.
(B) Each agency shall select each of the following types of
representatives to serve on the commission:
(i) One representative who is a service provider, or an employee
of a service provider.
(ii) One representative who is an individual served by a regional
center, or the family member of that individual.
(iii) One representative who is a professional with experience in
quality systems or reviews.
(C) The commission may select up to three additional public
members to serve on the commission to meet representational or
expertise needs.
(2) The commission shall examine existing regulations and
recommend changes to the State Department of Developmental Services,
as specified in subdivision (d).
(3) The commission shall develop a uniform data collection system
that provides reliable, valid, and actionable data from multiple
stakeholder perspectives to be consistently deployed at regional
centers. The data system shall include information on service
provider and regional center performance, as well as outcomes
consistent with individual program plan goals. The data system shall
be flexible, and have the capacity to allow field-based data entry
and analysis and to document, measure, and analyze the implementation
of the model. To the extent possible, data currently being collected
by regional centers or the department shall be utilized in the data
system.
(4) The commission shall consider the experience and outcomes from
the Agnews Developmental Center, Bay Area Quality Management System
and from current quality reviews of unlicensed Lanterman
Developmental Disabilities Services Act support models, including
family home agencies and supported living, in developing the
structure, standards, and data collection methodologies for the
system.
(d) The commission shall review current standards in Titles 17 and
22 of the California Code of Regulations to better focus on reliable
data to measure outcomes for individuals served and the impact of
services on the lives of individuals and their families.
Recommendations for system design and regulatory change shall reflect
the following characteristics:
(1) Be lean, simple, efficient, and understood by the people
served and those who serve them.
(2) Avoid unnecessary redundancies of process, permissions,
oversight, and enforcement.
(3) Base objective reviews on quality standards that, in
accordance with Lanterman Developmental Disabilities Services Act
principles, address individual outcomes, including, but not limited
to, health, safety, independence, choice, empowerment, inclusion, and
participation in community life. Outcome measures are to be
consistent with performance measures for regional centers.
(4) Base subjective reviews of the impact on individuals and
families on satisfaction data collected by an independent third party
that surveys a statistically significant sample of service providers
and individuals and families providing or receiving those services.
(5) Shift the focus of quality efforts to a service enhancement
model that encourages and recognizes service provider and regional
center improvements.
(6) Include multiple options for proactive consumer protections,
including screening for qualified providers, an emphasis on an
evolving improvement system of coaching and mentoring service
providers toward quality, and an immediate response capacity to
address people in imminent danger.
(7) Report aggregate service and individual outcomes to highlight
excellence, innovation, and satisfaction in the services provided and
in the lives of individuals with developmental disabilities.
(8) Enhance transparency, accountability, quality standards, and
measurement processes for the services directly provided by regional
centers consistent with regional center performance contracts.
(9) Provide consumers, families, service providers, and regional
center staff the opportunity to participate in system evaluation.
(10) Ensure that the results of oversight, quality enhancement,
and assurance review activities are available in plain language to
people with developmental disabilities and their families so they can
be informed consumers of the services that they receive.
(e) On or before March 30, 2015, the commission shall determine
the best methods of collecting input on relevant sections of Titles
17 and 22 of the California Code of Regulations.
(1) These methods shall include, but not be limited to, the
following:
(A) At least two public meetings, with one meeting held in
southern California and one meeting held in northern California.
(B) The electronic submission of comments.
(2) The commission shall request public input concerning the
revision, retention, or removal of relevant sections of Titles 17 and
22 of the California Code of Regulations.
(A) The commission shall solicit comment on issue areas including,
but not limited to, the following:
(i) Certification and vendorization processes.
(ii) Complaints.
(iii) Quality oversight and monitoring requirements.
(iv) Decertification and devendorization processes.
(B) The commission shall take comment on the following
regulations:
(i) Articles 2 (commencing with Section 54302), 4 (commencing with
Section 54370), and 5 (commencing with Section 54830) of Subchapter
2 of Chapter 3 of Division 2 of Title 17 of the California Code of
Regulations.
(ii) Sections 56003, 56005, and 56009 of Article 2 of Subchapter 4
of Chapter 3 of Title 17 of the California Code of Regulations.
(iii) Articles 3 (commencing with Section 56013), 5 (commencing
with Section 56022), 8 (commencing with Section 56046), 9 (commencing
with Section 56053), and 11 (commencing with Section 56061) of
Subchapter 4 of Chapter 3 of Division 2 of Title 17 of the California
Code of Regulations.
(iv) Sections 56712, 56732, and 56742 of Subchapter 5 of Chapter 3
of Division 2 of Title 17 of the Code of Regulations.
(v) Chapters 3 (commencing with Section 82000), 4 (commencing with
Section 83000), 5 (commencing with Section 84000), and 6 (commencing
with Section 85000) of Division 6 of Title 22 of the Code of
Regulations.
(f) On or before September 30, 2015, the commission shall review
and compile the input received based on its relevance to the criteria
described in subdivision (d). On or before December 31, 2015, the
commission shall submit to the State Department of Developmental
Services its recommended changes to Titles 17 and 22 of the
California Code of Regulations. The commission shall also recommend,
based on input received, the most effective entity or entities for
enforcing the regulations.
(g) On or before March 30, 2015, the commission shall create a
process to review relevant regulations governing the Licensing and
Certification Division of the State Department of Public Health,
guided by the criteria described in subdivision (d). The commission
shall report on this process to the Legislature on or before December
31, 2015.
(h) From January 1, 2015, to December 1, 2015, inclusive, regional
centers that seek consideration for participation in any program to
pilot new quality enhancement systems shall collect baseline data, as
determined by the commission, on existing service quality and
quality assurance processes in programs and services for people with
developmental disabilities that are licensed by the Community Care
Licensing Division of the State Department of Social Services.
All matter omitted in this version of the bill appears in the bill as
amended in the Senate, April 9, 2013. (JR11)