Amended in Senate January 6, 2014

Amended in Senate September 11, 2013

Amended in Senate April 9, 2013

Senate Bill No. 579

Introduced by Senator Berryhill

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(Coauthor: Senator Emmerson)

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February 22, 2013

An act to add begin insert and repeal end insert Section 4751 begin delete to end delete begin insert of end insert 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 begin delete Model. end delete begin insert Models. end insert

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 begin delete the end delete Oversight Efficiency and Quality Enhancement begin delete Model end delete begin insert Models end insert to investigate methods of implementing a unified begin insert and consistent end insert 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 begin delete 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 end delete begin insert require the Governor, Senate Committee on Rules, and the Speaker of the Assembly to appoint members end insert to serve on the commission, as prescribed.

The bill would require the commission to begin delete develop a end delete begin insert recommend a strategy for end insert uniform data collection begin delete system end delete that provides reliable, valid, and actionable data from multiple stakeholder perspectives begin delete to be end delete begin insert and that may be end insert consistently deployed at regional centers. This bill would require the commission to begin delete rewiew end delete begin insert review end insert current begin delete regulatory standards end delete begin insert regulations and relevant statutes end insert 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 begin delete March end delete begin insert June end insert 30, 2015, to determine the best methods for collecting input on relevant regulatory standards begin insert and statutes, end insert and to request public input on those standards, as specified. The bill would require the commission to review and compile, by September 30, begin delete 2015, end delete begin insert 2016, end insert the input received and to submit, by December begin delete 30, 2015, its recommendations end delete begin insert 31, 2016, a report on its recommended regulatory and statutory changes end insert to begin insert the Legislature and end insert the State Department of Developmental Services.

This bill would require the commission to begin delete create end delete begin insert propose, in its report, end insert a process begin delete to review end delete begin insert by which end insert relevant regulations begin insert and statutes end insert governing the Licensing and Certification Division of the State Department of Public Health begin delete and to report on that process to the Legislature by December 31, 2015. end delete begin insert may be reviewed by a future commission. end insert

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 begin delete department, end delete begin insert commission, end insert 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. begin insert These provisions would be repealed on January 1, 2018. end insert

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 begin delete 4571 end delete begin insert 4751 end insert is added to the Welfare and
Institutions Code, to read:

begin delete 4571. end delete
begin insert 4751. end insert   

(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 begin delete the end delete Oversight Efficiency and Quality
Enhancement begin delete Model shall be end delete begin insert Models is end insert established to investigate
methods of implementing a unified begin insert and consistent end insert 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. begin insert The commission shall give the
utmost attention to ensure that the results of its work do not reduce
the quality of oversight and monitoring of the health and safety of
persons with developmental disabilities. end insert 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.

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(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.

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(c) The commission shall be composed of not more than 12
members.

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(1) The Governor, the Senate Committee on Rules, and the
Speaker of the Assembly shall each appoint three members to serve
on the commission consistent with subparagraphs (A) and (B).

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(A) The appointed members shall meet both of the following
requirements:

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(i) Have professional experience in quality assurance within
the developmental disabilities field.

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(ii) Represent statewide organizations.

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(B) Each appointing authority shall appoint a member
representing, as broadly as possible, each of the following areas:

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(i) The service provider community.

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(ii) The advocacy and consumer services community.

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(iii) Regional centers.

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(2) The State Department of Developmental Services, the State
Department of Social Services, and the California Health and
Human Services Agency may each select a representative to
participate on the commission.

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(d) The commission may appoint advisory groups to provide
specialized input to assist the commission in its work.

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(2)

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begin insert (e) end insert  The commission shall examine existing regulations and
begin insert statutes, and end insert recommend changes to the State Department of
Developmental Services, as specified in subdivision begin delete (d) end delete begin insert (g) end insert .

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(3)

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begin insert (f) end insert begin insert   end insert begin insert (1) end insert  The commission shall begin delete develop a end delete begin insert recommend, and include
in its final report, a strategy for end insert uniform data collection begin delete system end delete
that provides reliable, valid, and actionable data from multiple
stakeholder perspectives begin delete to be end delete begin insert and that may be end insert consistently
deployed at regional centers. The begin delete 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. end delete begin insert strategy shall address, to the
fullest extent possible, all of the following: end insert

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(A) Service provider and regional performance.

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(B) Outcomes consistent with individual program plan goals.

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(C) Flexibility of implementation.

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(D) Field-based data entry and analysis.

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(E) Documentation, measurement, and analysis of the strategy’s
implementation.

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(F) Usage of data currently being collected by regional centers
and the State Department of Developmental Services.

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(G) Regional center and service provider resource needs to
implement the strategy.

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(4)

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begin insert (2) end insert  The commission shall consider begin delete the experience and outcomes
from end delete begin insert , but is not limited to, the experience, outcomes, and data
provided by the National Core Indicators, end insert the Agnews
Developmental Center, begin insert and the end insert Bay Area Quality Management
begin delete System end delete begin insert System, end insert and from current quality reviews of unlicensed
Lanterman Developmental Disabilities Services Act support
models, including family home agencies and supported living, in
developing the begin insert strategy’s end insert structure, standards, and data collection
begin delete methodologies for the system. end delete begin insert methodologies. end insert

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(d)

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begin insert (g) end insert  The commission shall review current begin delete standards end delete begin insert sections end insert in
Titles 17 and 22 of the California Code of Regulations begin insert and relevant
statutes end insert 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 begin delete system design end delete
begin insert the strategy end insert 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.

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(e)

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begin insert (h) end insert begin insert   end insert begin insert (1) end insert  On or before begin delete March end delete begin insert June end insert 30, 2015, the commission
shall determine the best methods of collecting input on relevant
begin insert statutes and end insert sections of Titles 17 and 22 of the California Code of
Regulations.

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(1)

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begin insert (2) end insert  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.

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(2)

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begin insert (3) end insert  The commission shall request public input concerning the
revision, retention, or removal of relevant begin insert statutes and end insert sections of
Titles 17 and 22 of the California Code of begin delete Regulations. end delete begin insert Regulations
affecting only programs meeting both of the following: end insert

begin insert (A) end insert begin insert   end insert begin insert Under the partial or exclusive oversight of the Community
Care Licensing Division of the State Department of Social Services. end insert

begin insert (B) end insert begin insert   end insert begin insert Provide services and supports exclusively or primarily to
persons with developmental disabilities. end insert

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(A)

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begin insert (4) end insert  The commission shall solicit comment on issue areas
including, but not limited to, the following:

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(i)

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begin insert (A) end insert  Certification and vendorization processes.

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(ii)

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begin insert (B) end insert  Complaints.

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(iii)

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begin insert (C) end insert  Quality oversight and monitoring requirements.

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(iv)

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begin insert (D) end insert  Decertification and devendorization processes.

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(E) Conflict and duplication in statutes and regulations.

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(B) The commission shall take comment on the following
regulations:

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(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.

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(ii) Sections 56003, 56005, and 56009 of Article 2 of Subchapter
4 of Chapter 3 of Title 17 of the California Code of Regulations.

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(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.

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(iv) Sections 56712, 56732, and 56742 of Subchapter 5 of
Chapter 3 of Division 2 of Title 17 of the Code of Regulations.

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(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.

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(f)

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begin insert (i) end insert begin insert   end insert begin insert (1) end insert  On or before September 30, begin delete 2015, end delete begin insert 2016, end insert the commission
shall review and compile the input received based on its relevance
to the criteria described in subdivision begin delete (d) end delete begin insert (g) end insert . On or before
December 31, begin delete 2015, end delete begin insert 2016, end insert the commission shall submit to begin insert the
Legislature and end insert the State Department of Developmental Services
begin insert a report on end insert its recommended changes to Titles 17 and 22 of the
California Code of begin delete Regulations. end delete begin insert Regulations and any recommended
statutory changes. end insert The commission shall also recommend, based
on input received, the most effective entity or entities for enforcing
the regulations.

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(g) On or before March 30, 2015, the commission shall create

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begin insert (2) end insert begin insert   end insert begin insert In its report, the commission shall propose end insert a process begin delete to
review end delete begin insert by which end insert relevant regulations begin insert and statutes end insert governing the
Licensing and Certification Division of the State Department of
Public Health, guided by the criteria described in subdivision begin delete (d).
The commission shall report on this process to the Legislature on
or before December 31, 2015. end delete begin insert (g), may be reviewed by a future
commission if one is established. end insert

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(h)

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begin insert (j) end insert  From January 1, begin delete 2015, end delete begin insert 2016, end insert to December begin delete 1, 2015, end delete begin insert 31, 2016, end insert
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.

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(k) A report to be submitted pursuant to subdivision (i) shall be
submitted in compliance with Section 9795 of the Government
Code.

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(l) This section shall remain in effect only until January 1, 2018,
and as of that date is repealed, unless a later enacted statute, that
is enacted before January 1, 2018, deletes or extends that date.

end insert