SB 579, as amended, Berryhill. Developmental services: Commission on Oversight Efficiency and Quality Enhancement Models.
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 Oversight Efficiency and Quality Enhancement Models to investigate methods of implementing a unified and consistent 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 require the Governor, Senate Committee on Rules, and the Speaker of the Assembly to appoint members to serve on the commission, as prescribedbegin insert, and the State Department of Developmental Services, the State Department of Social Services, and the California Health and Human Services Agency to appoint nonvoting ex officio membersend insert. The bill would require the State Department of Developmental Services to provide staff support to the commission.
The bill would require the commission to recommend a strategy for uniform data collection that provides reliable, valid, and actionable data from multiple stakeholder perspectives and that may be consistently deployed at regional centers. This bill would require the commission to review current regulations and relevant statutes 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 commissionbegin insert to convene no sooner than July 1, 2016, andend insert, bybegin delete June 30, 2015,end deletebegin insert September 30, 2016,end insert to determine the best methods for collecting input on relevant regulatory standards and statutes, 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 2016,end deletebegin insert 2017,end insert the input received and to submit, by December 31,begin delete 2016,end deletebegin insert
2017,end insert a report on its recommended regulatory and statutory changes to the Legislature and the State Department of Developmental Services.
These provisions would be repealed on January 1,begin delete 2018.end deletebegin insert 2019.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 4751 is added to the Welfare and
2Institutions Code, to read:
(a) The Legislature finds and declares all of the
4following:
5(1) Evaluation of the services that people with developmental
6disabilities receive from both service providers and regional centers
7is a critical component of the service system.
8(2) There is evidence that the current system, in which three
9state-funded entities, the State Department of Developmental
10Services, the regional centers, and the Community Care Licensing
11Division of the State Department of Social Services, are charged
12
with monitoring and maintainingbegin insert highend insert quality services and supports
13for people with developmental disabilities, isbegin delete duplicative and begin insert duplicative, confusing,end insert and fails to produce data essential
14confusingend delete
15for service improvement.
16(3) The efficiency and efficacy of the oversight and quality
17review processes can be significantly enhanced bybegin delete unifyingend delete
18begin insert reviewingend insert
the currentbegin delete duplicativeend delete quality review systembegin insert and
19removing counterproductive duplicationsend insert, thus conserving limited
20state and service providers’ resources while simultaneously
21improving the lives of people with developmental disabilities in
22California.
23(b) The Commission on Oversight Efficiency and Quality
24Enhancement Models is established to investigate methods of
25implementing a unified and consistent oversight and quality
26enhancement process. This process shall ensure the welfare,
27community participation, health, and safety of all those with
28developmental disabilities who are served in programs currently
29licensed by the Community Care Licensing
Division of the State
30Department of Social Services. The commission shall give the
31utmost attention to ensure that the results of its work do not reduce
32the quality of oversight and monitoring of the health and safety of
33persons with developmental disabilities. This process shall also
34enhance accountability and quality review processes for the
35services directly provided by regional centers.
P4 1(c) begin insert(1)end insertbegin insert end insert The commission shall be composed of not more than
212begin delete members as follows:end deletebegin insert members.end insert
3(2) Members shall have an understanding of the developmental
4services system, including the responsibilities of service providers,
5regional centers, and the Community Care Licensing Division of
6the State Department of Social Services. Members appointed to
7the commission shall have both of the following:
8(A) Experience in the developmental services system.
end insertbegin insert
9(B) An understanding of the impact of statutes and regulations
10on providing services in the developmental services system.
36 11(1)
end delete12(3) Membership of the commission shall be as follows:
end insert
13begin insert(A)end insert Three public members appointed by the Senate Committee
14on Rules, with one appointee who is from the advocacy community,
15one appointee who is a provider of day program services, and one
16appointee who represents regional centers.
3 17(2)
end delete
18begin insert(B)end insert Three public members appointed by the Speaker of the
19Assembly, with one
appointee who is a consumer or family
20member, one appointee who is a provider of residential services,
21and one appointee who represents regional centers.
7 22(3)
end delete
23begin insert(C)end insert Three public members appointed by the Governor with the
24consent of the Senate. The Governor shall request and consider
25nominations of persons from the advocacy community, the provider
26community, the regional center system, consumers and family
27members, and subject experts in data collection and licensing
28oversight for these appointments.
13 29(4)
end delete
30begin insert(D)end insert The State Department of Developmental Services, the State
31Department of Social Services, and the California Health and
32Human Services Agencybegin delete mayend deletebegin insert
shallend insert each selectbegin delete a representativeend delete
33begin insert
an ex officio, nonvoting memberend insert to participate on the commission.
34(d) The State Department of Developmental Services shall
35provide staff support to the commission.
36(e) The commission may appoint advisory groups to provide
37specialized input to assist the commission in its work.
38(f) The commission shall examine existing regulations and
39
statutes,begin insert beginning with, but not limited to, areas of
40counterproductive duplication,end insert and recommend changes to the
P5 1State Department of Developmental Services, as specified in
2subdivision (h).
3(g) (1) The commission shall recommend, and include in its
4final report, a strategy for uniform data collection that provides
5reliable, valid, and actionable data from multiple stakeholder
6perspectives and that may be consistently deployed at regional
7centers. The strategy shall address, to the fullest extent possible,
8all of the following:
9(A) Service provider and regionalbegin insert centerend insert performance.
10(B) Outcomes consistent with individual program plan goals.
11(C) Flexibility of implementation.
12(D) Field-based data entry and analysis.
13(E) Documentation, measurement, and analysis of the strategy’s
14implementation.
15(F) Usage of data currently being collected by regional centers
16and the State Department of Developmental Services.
17(G) Regionalbegin delete center andend deletebegin insert center,end insert
service providerbegin insert, and
18government oversight agencyend insert
resource needs to implement the
19strategy.
20(2) The commission shall consider, but is not limited to, the
21experience, outcomes, and data provided by the National Core
22Indicators, the Agnews Developmental Center, and the Bay Area
23Quality Management System, and from current quality reviews of
24unlicensed Lanterman Developmental Disabilities Services Act
25support models, including family home agencies and supported
26living, in developing the strategy’s structure, standards, and data
27collection methodologies.
28(h) The commission shall review current sections in Titles 17
29and 22 of the California Code of Regulations and relevant statutes
30to better focus on reliable data to measure outcomes for individuals
31served and the impact of services on the lives of individuals and
32their
familiesbegin insert, with a recognition of the importance of more
33effectively integrating consumers in the communityend insert.
34Recommendations forbegin insert bothend insert the strategy andbegin insert statutory andend insert
35 regulatorybegin delete changeend deletebegin insert changesend insert shall reflect the following
36characteristics:
37(1) Be lean, simple, efficient, and understood by the people
38served and those who serve them.
39(2) Avoid
unnecessary redundancies of process, permissions,
40oversight, and enforcement.
P6 1(3) Base objective reviews on quality standards that, in
2accordance with Lanterman Developmental Disabilities Services
3Act principles, addressbegin delete individual outcomesend deletebegin insert individually
4determined outcomes identified in the individual program plan
5(IPP) as determined by the planning teamend insert, including, but not
6limited to, health, safety, independence, choice, empowerment,
7inclusion, and participation in community life. Outcome measures
8are to be consistent with performance measures for regional centers.
9(4) Base subjective reviews of the impact on individuals and
10families
on satisfaction data collected by an independent third
11party that surveys a statistically significant sample of service
12providers and individuals and families providing or receiving those
13services.
14(5) Shift the focus of qualitybegin insert assuranceend insert efforts to a service
15enhancement model that encourages and recognizes service
16provider and regional center improvements.
17(6) Include multiple options for proactive consumer protections,
18including screening for qualified providers, an emphasis on an
19evolving improvement system of coaching and mentoring service
20providers toward quality, and an immediate response capacity to
21address people in imminent danger.
22(7) Report aggregate service and individual outcomes to
23highlight excellence, innovation, and satisfaction in the services
24provided and in the lives of individuals with developmental
25disabilities.
26(8) Enhance transparency, accountability, quality standards, and
27measurement processes for the services directly provided by
28regional centers consistent with regional center performance
29contracts.
30(9) Provide consumers, families, service providers, and regional
31center staff the opportunity to participate in system evaluation.
32(10) Ensure that the results of oversight, quality enhancement,
33and assurance review activities are available in plain language to
34people with developmental disabilities and their families so they
35can
be informed consumers of the services that they receive.
36(i) (1) begin deleteOn end deletebegin insertThe commission shall convene no sooner than July
371, 2016.end insert
38begin insert(2)end insertbegin insert end insertbegin insertOnend insert or beforebegin delete June 30, 2015,end deletebegin insert September 30, 2016,end insert the
39commission shall determine the best methods of collecting input
P7 1on relevant statutes and sections
of Titles 17 and 22 of the
2California Code of Regulations.
20 3(2)
end delete
4begin insert(3)end insert These methods shall include, but not be limited to, the
5following:
6(A) At least two public meetings, with one meeting held in
7southern California and one meeting held in northern California.
8(B) The electronic submission of comments.
25 9(3)
end delete
10begin insert(4)end insert The commission shall request public input concerning the
11revision, retention, or removal of relevant statutes and sections of
12Titles 17 and 22 of the California Code of Regulations affecting
13only programsbegin delete meetingend deletebegin insert that areend insert both of the following:
14(A) Under the partial or exclusive oversight of the Community
15Care Licensing Division of the State Department of Social Services.
16(B) Provide services and supports exclusively or primarily to
17persons with developmental disabilities.
33 18(4)
end delete
19begin insert(5)end insert The commission shall solicit comment on issue areas
20including, but not limited to, the following:
21(A) Certification and vendorization processes.
22(B) Complaints.
23(C) Quality oversight and monitoring requirements.
24(D) Decertification and devendorization processes.
25(E) Conflict and duplication in statutes and regulations.
26(j) On or before September
30,begin delete 2016,end deletebegin insert 2017,end insert the commission
27shall review and compile the input received based on its relevance
28to the criteria described in subdivision (h). On or before December
2931,begin delete 2016,end deletebegin insert 2017,end insert the commission shall submit to the Legislature
30and the State Department of Developmental Services a report on
31its recommended changes to Titles 17 and 22 of the California
32Code of Regulations and any recommended statutory changes.
33The commission shall also recommend, based onbegin insert its review of theend insert
34 input
received, the most effective entity or entities for enforcing
35the regulations.
36(k) A report to be submitted pursuant to subdivision (j) shall be
37submitted in compliance with Section 9795 of the Government
38Code.begin insert There shall be no right or obligation on the part of the state
39to implement the recommendations of the commission, except that
40those recommendations may be enacted by statute or regulation.end insert
P8 1(l) This section shall remain in effect only until January 1,begin delete 2018,end delete
2begin insert
2019,end insert and as of that date is repealed, unless a later enacted statute,
3that is enacted before January 1,begin delete 2018,end deletebegin insert 2019,end insert deletes or extends
4that date.
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