BILL ANALYSIS                                                                                                                                                                                                    Ó






                                  SENATE HUMAN
                               SERVICES COMMITTEE
                          Senator Leland Y. Yee, Chair


          BILL NO:       SB 579                                       
          S
          AUTHOR:        Berryhill                                    
          B
          VERSION:       April 9, 2013
          HEARING DATE:  April 23, 2013                               
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          FISCAL:        Yes                                          
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          CONSULTANT:    Mareva Brown                                

                                        

                                     SUBJECT
                                         
            Developmental services: Oversight Efficiency and Quality  
                               Enhancement Model

                                     SUMMARY  

          This bill shifts oversight of regional center service  
          providers from the Community Care Licensing division of the  
          state Department of Social Services (DSS) and the Licensing  
          and Certification Division of the state Department of  
          Public Health (CDPH) to specified regional centers under a  
          4-year pilot project, the Oversight Efficiency and Quality  
          Enhancement Model. Requires the Legislative Analyst's  
          Office to identify all of the financial and human resources  
          directed to current quality assurance activities for  
          specified licensed programs, to identify which costs are  
          federally funded and to determine which costs could be  
          federally funded under the oversight shift. Requires an  
          evaluation of the project, as specified.

                                     ABSTRACT  

           Existing law:
           

                                                         Continued---




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             1)   Establishes the California Community Care  
               Facilities Act and declares Legislative intent to  
               assure that all people who require services in the  
               community are provided with the appropriate range of  
               social rehabilitative, habilitative and treatment  
               services, including residential and nonresidential  
               programs tailored to their needs; to protect the legal  
               and human rights of a person in or receiving services  
               from a community care facility; to ensure the quality  
               of community care facilities by evaluating the care  
               and services provided, as specified, and other  
               provisions. (HSC 1500 et seq.)

             2)   Establishes within the DSS a branch to license and  
               certify community care facilities and defines  
               community care facilities, as specified. (HSC 1500 et  
               seq.)

             3)   Defines the type of care and services that may be  
               provided in a licensed community care facility, as  
               well as the staffing requirements necessary to hold a  
               license. (HSC 1502 et seq.)

             4)   Defines criteria necessary to become licensed,  
               including requirements for staffing levels and staff  
               background checks, licensure fees, the requirement to  
               share information with other agencies about employees  
               who have been the subject of disciplinary action, and  
               other specified requirements. (HSC 1520 et seq.)

             5)   Requires that every DSS-licensed facility be  
               subject to unannounced visits "as often as necessary  
               to ensure the quality of care provided" and no less  
               than once every five years, as specified. (HSC 1534)

             6)   Establishes within CDPH a branch to license and  
               oversee residential care facilities for the elderly,  
               which includes "health facilities" including  
               Intermediate Care Facilities for the Developmental  
               Disabled. (HSC 1569 et seq.) (HSC 1250 et seq.) 

             7)   Provides in the California Code of Regulations  
               specific requirements for licensing, oversight and  
               monitoring of community facilities. (CCR Title 17, 22)






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           This bill:
           
             1)   Declares Legislative findings that: 

                  a.        Evaluation of services by regional center  
                    providers is a critical component of the service  
                    system.

                  b.        It is duplicative and wasteful of state  
                    dollars and resources to have three state  
                    entities - DSS, DPH and the Department of  
                    Developmental Services (DDS) with its regional  
                    centers - charged with monitoring and maintaining  
                    quality services and supports.

                  c.        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 fiscal resources and  
                    reducing the wasteful use of state staff and  
                    service providers' time while simultaneously  
                    improving the lives of people with developmental  
                    disabilities in California.

             2)   Creates an Oversight Efficiency and Quality  
               Enhancement Model pilot project for 4  years,  
               beginning January 1, 2014, that shifts the authority  
               and resources to the DDS, in conjunction with the  
               pilot regional centers, to implement a unified  
               oversight and quality enhancement process, as  
               specified. 

             3)   Requires that the unified oversight and quality  
               enhancement model ensure the welfare, community  
               participation, health and safety of individuals with  
               developmental disabilities who are served in programs  
               licensed by DSS's division of community care licensing  
               (CCL) and DPH. 

             4)   Requires that the process enhance accountability  
               and quality review for services directly provided by  
               regional centers. 

             5)   Establishes legislative intent that if, at the  





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               conclusion of the pilot project, the pilot has  
               sufficiently met its goals and standards, as  
               specified, it shall be extended statewide.

             6)   Specifies that the Golden Gate Regional Center, the  
               Tri-Counties Regional Center, the San Diego Regional  
               Center, and two additional regional centers are to  
               participate in the pilot project on a voluntary basis,  
               as specified.

             7)   Requires each participating regional center by  
               February 1, 2014, to establish a local Quality  
               Enhancement Advisory Committee, including consumers,  
               family members, service providers, and advocates, to  
               provide input and feedback in the design,  
               implementation, and evaluation of the Oversight  
               Efficiency and Quality Enhancement Model. The  
               committee shall review pilot project data, as  
               specified.

             8)   Requires DDS and the pilot regional centers to  
               develop the structure for transfer of responsibilities  
               from the licensing branches of Social Services and  
               Public Health by April 1, 2014, as specified. The  
               licensing branches of DSS and DPH are required provide  
               staff to consult with DDS and the pilot regional  
               centers during this process.

             9)   Requires that the Oversight Efficiency and Quality  
               Enhancement Model focus on the impact of services on  
               consumers' lives, support the continuous investigation  
               and enhancement of the quality and impact of services,  
               and be informed by reliable data on service  
               effectiveness and consumer outcomes. 

             10)  Requires that the model do all of the following:

               a)     Be lean, simple, efficient, and understood by  
                 the people it serves and avoid unnecessary  
                 redundancies of process, permissions, oversight, and  
                 enforcement.

               b)     Base reviews on quality standards that, in  
                 accordance with Lanterman Developmental Disabilities  
                 Services Act principles, address individual  





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                 outcomes, including, but not limited to, health,  
                 safety, independence, choice, empowerment,  
                 inclusion, and participation in community life.

               c)     Recognize that service outcomes and  
                 effectiveness, the impact of services on consumers'  
                 lives, and satisfaction data will be key to ensuring  
                 quality.

               d)     Shift the focus of quality efforts to a service  
                 enhancement model that encourages and recognizes  
                 service provider and regional center improvements.

               e)     Include multiple options for proactive consumer  
                 protections, including screening for qualified  
                 providers, an emphasis on an evolving quality  
                 improvement system of coaching and mentoring service  
                 providers toward quality, and an immediate response  
                 capacity to address people in imminent danger.

               f)     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.

               g)     Enhance transparency, accountability, quality  
                 standards, and measurement processes for the  
                 services directly provided by regional centers.

               h)     Provide consumers, families, service providers,  
                 and regional center staff the opportunity to  
                 participate in system evaluation.

               i)     Ensure that the results of oversight, quality  
                 enhancement, and quality assurance review activities  
                 are available to people with developmental  
                 disabilities and their families in plain language so  
                 they can be informed consumers of the services that  
                 they receive.

             1)   Requires that by July 1, 2014, DDS and its  
               stakeholders do the following:

                  a.        Establish certification requirements for  





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                    new service providers and  standards for provider  
                    quality reviews, as specified, including for  
                    health, safety, quality of life outcomes,  
                    including community inclusion and participation,  
                    choice, friendship, and empowerment. Requires the  
                    requirements and stakeholders consider the  
                    principles identified (in Item 10, above),  
                    current regulatory and statutory requirements, as  
                    well as nationally accepted quality of life  
                    standards shall be considered in developing the  
                    model certification requirements and performance  
                    standards. 

                  b.        Replace current standards from Titles 17  
                    and 22 of the California Code of Regulations (for  
                    the specific services subject to the pilot  
                    project in the pilot regional center areas) with  
                    these new standards, as specified.

                  c.        Establish performance standards for the  
                    regional centers piloting the project and ensure  
                    that these performance standards work in concert  
                    with the service provider standards and be  
                    aligned with the values of the Lanterman  
                    Developmental Disabilities Services Act and other  
                    principles, as specified. These standards shall  
                    address how the regional center's services have  
                    resulted in consumer or family empowerment and in  
                    more independent, productive, and normal lives  
                    for the persons served.

                  d.        Develop a uniform data collection system  
                    that is consistently deployed at each pilot  
                    regional center, as specified.

                  e.        Consider the experience and outcomes from  
                    the Agnews Developmental Center, Bay Area Quality  
                    Management System and current quality reviews of  
                    unlicensed Lanterman Developmental Disabilities  
                    Services Act support models, in developing the  
                    structure, standards, and data collection  
                    methodologies for the model.

             2)   Requires that between January 1 and June 30, 2014,  
               participating regional centers collect baseline data  





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               on existing quality assurance processes currently  
               covered by DSS and CDPH. Baseline data shall meet all  
               of the following requirements:

                  a.        Be collected by an independent third  
                    party surveying a statistically significant  
                    sample of regional center employees, service  
                    provider staff, and individuals and families  
                    providing or receiving those services.

                  b.        Address the satisfaction of regional  
                    center employees, service provider staff,  
                    individuals, and families with the current  
                    quality assurance system.

                  c.        Address the impact of services on  
                    consumers' lives, including, but not limited to,  
                    the areas of health, safety, community  
                    participation, friendship, empowerment, and  
                    choice.

                  d.        Address the effectiveness and efficiency  
                    of existing quality assurance processes,  
                    including training and related service provider  
                    support, as well as the quality and efficacy of  
                    regional center service provider relationships.

                  e.        Be made available to the pilot project's  
                    independent evaluator for comparison with pilot  
                    project data, as specified.

             1)   Requires the Legislative Analyst's Office conduct  
               to a study to identify all of the financial and human  
               resources expended by the licensing divisions of DSS  
               and CDPH, and by DDS, the regional centers, and  
               service providers in conducting  quality assurance  
               activities for the licensed programs identified in the  
               pilot project. The study shall determine quality  
               assurance costs that are covered by federal funds, and  
               recommend a means to reallocate funding through the  
               pilot model, as specified.

             2)   Requires that full implementation of the pilot  
               project and transfer of responsibilities begin on July  
               1, 2014 and defines quality review and oversight  





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               functions in the pilot regional center areas as  
               follows:

                  a.        Requires that DDS certify new programs  
                    and services for regional center consumers  
                    through a request for proposal process, instead  
                    of licensing them, as would be done under  
                    existing regulations and law.

                  b.        Requires a potential service provider to  
                    complete an initial application for certification  
                    with the local pilot regional center. The  
                    application shall then be submitted to DSS for  
                    issuance of a certificate, as specified.

                  c.        Requires DDS to certify all existing  
                    vendor programs in the pilot regional centers  
                    that are licensed either by DSS or CDPH prior to  
                    July 1, 2014, and prohibits those agencies from  
                    monitoring those vendors. 

                  d.        Requires that each certified program have  
                    an annual quality review conducted by pilot  
                    regional center staff and, depending on the  
                    findings of the annual quality reviews, a  
                    comprehensive quality enhancement and performance  
                    evaluation, as specified. 

                  e.        Requires that quality reviews and  
                    monitoring visits to be effective and efficient  
                    and be based upon performance standards, as  
                    specified.

                  f.        Requires all certified service providers  
                    to submit a training plan to all pilot regional  
                    centers for which they provide services, subject  
                    to approval by the regional center(s). Training  
                    shall emphasize continuous improvement and be  
                    proactive and responsive to the findings of  
                    quality reviews. Service providers shall be  
                    utilized as training resources for their own  
                    programs to assist other providers and develop  
                    self-assessment tools.

                  g.        Requires that complaints regarding  





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                    service provider performance be addressed by DDS  
                    and the pilot regional centers, as determined by  
                    DDS and the regional centers. 

                  h.        Requires pilot centers to investigate  
                    serious complaints, as defined, within 24 hours  
                    of receipt, or sooner if imminent danger is  
                    alleged. In cases of immediate danger to a  
                    consumer, the pilot regional center shall plan  
                    for relocation of the consumer. Requires that the  
                    complainant, if known, shall be advised of the  
                    outcome of the investigation and of any  
                    corrective actions required of the service  
                    provider.

                  i.        Establishes the right of DDS and the  
                    pilot regional centers to decertify a provider  
                    based upon a substantiated serious complaint; a  
                    serious, life threatening, preventable occurrence  
                    at the program; or a documented, established  
                    pattern of substandard performance that continues  
                    after notice and opportunity for corrective  
                    action have been provided.

                  j.        Requires DDS to monitor pilot regional  
                    center service quality and outcomes, hold pilot  
                    regional centers accountable for their  
                    performance, and use a service enhancement  
                    approach to encourage and recognize regional  
                    center improvements. Regional center annual  
                    quality service reviews shall include existing  
                    performance contracts with DDS, an annual survey  
                    by an independent third-party evaluator, as  
                    specified, and additional components as  
                    determined by the pilot regional centers and the  
                    department.

                  aa.       Requires the licensing divisions of DSS  
                    and CDPH to continue to be responsible for  
                    criminal background checks, as required by law,  
                    for service provider staff.

                  bb.       Requires DDS and the pilot regional  
                    centers to implement, test, and verify the  
                    Oversight Efficiency and Quality Enhancement  





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                    Model data collection system.

                  cc.       Requires DDS and the pilot regional  
                    centers to share with local advisory committees  
                    and statewide stakeholder organizations data and  
                    analysis service provider and regional center  
                    reviews. Pilot regional centers shall make  
                    available for review the service provider's  
                    quality reviews and quality enhancement and  
                    performance evaluation reviews. Prohibits reviews  
                    from containing identifiable consumer  
                    information.

             3)   Requires DDS to contract with an independent agency  
               by October 1, 2016, to evaluate the pilot project and  
               prepare a written report of its findings. In preparing  
               the contract, DDS is required to consult with DDS,  
               CDPH, the Association of Regional Center Agencies, and  
               stakeholder organizations, as specified. At minimum  
               the evaluation shall include:  

                  a.        A description of the structure and  
                    process of implementation of the Oversight  
                    Efficiency and Quality Enhancement Model.

                  b.        The number and characteristics of the  
                    service providers and programs subject to the  
                    pilot project, and the number of consumers  
                    served.

                  c.        The overall impact of the model on  
                    consumers, service providers, pilot regional  
                    centers, DDS, as specified.

                  d.        Consideration by DDS of the cost of  
                    quality assurance-related activities, and the  
                    effectiveness and efficiency of the model on the  
                    department's internal operations and  
                    relationships with pilot regional centers.

                  e.        Overall impressions, including, but not  
                    limited to, pilot project strengths, weaknesses,  
                    and recommendations for improvement of the model  
                    by employees of the department, pilot regional  
                    center participants, service provider  





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                    organizations and their staff, state licensing  
                    and monitoring personnel, and consumers and  
                    families, as specified.

                  f.        Satisfaction with the model by DDS  
                    employees, pilot regional center participants,  
                    provider organizations and their staff, state  
                    licensing and monitoring personnel, consumers,  
                    and families.

                  g.        Identification of the model's strongest  
                    performance standard areas, those most in need of  
                    improvement, and those with the greatest quality  
                    improvement for both service providers and pilot  
                    regional centers, as documented during the pilot  
                    project period.

                  h.        Aggregate and comparison data regarding  
                    service provider certification attainment and  
                    losses of certification.

                  i.        Identification of the types, amounts,  
                    qualifications, and sufficiency of staffing at  
                    the department and pilot regional centers to  
                    effectively implement the model.

                  j.        Costs and cost-effectiveness of the model  
                    as compared with the multiagency, statewide  
                    quality systems involved in services to people  
                    with developmental disabilities, as defined in  
                    the LAO report required by this bill. 

                  aa.       An analysis and summary findings of all  
                    pilot project consumers' special incident reports  
                                                                                              and unusual occurrences reported during the  
                    evaluation period, in comparison to special  
                    incident reports under the current quality  
                    assurance systems.

                  bb.       Recommendations for statewide application  
                    and expansion of the Oversight Efficiency and  
                    Quality Enhancement Model.

             4)    Requires the independent evaluator to utilize data  
               provided by the new model system, interviews, surveys,  





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               focus groups, and other assessments of the pilot  
               project participant groups, as well as a comparison of  
               consumers' quality of life outcomes under the model to  
               baseline, and other specified measurements.

             5)   Requires that the independent evaluator's written  
               report be submitted to DDS which shall then circulate  
               it to licensing and certification divisions of DSS and  
               CDPH, and to the Association of Regional Center  
               Agencies. DDS also must submit the report to the  
               appropriate fiscal and policy committees of the  
               Legislature by July 1, 2017, and make it readily  
               available to the public. 

             6)   Permits DDS to administer the pilot project through  
               the issuance of written directives that shall have the  
               same force and effect as regulations, as specified,  
               and be exempt from the rulemaking provisions of the  
               Administrative Procedures Act.

             7)   Permits DDS to adopt emergency regulations to  
               implement this section, as is deemed to be necessary  
               for the immediate preservation of the public peace,  
               health and safety, or general welfare, per government  
               code, as specified. Also permits DDS to waive  
               regulations that pose a barrier to implementation of  
               the pilot project, as specified.

             8)   Requires that all aggregate and system-level  
               reports generated pursuant to this section shall be  
               made publicly available, but shall not contain the  
               personal identifying information of any consumer or  
               other individual.

             9)   Requires that the pilot project be implemented only  
               to the extent that funds are made available through an  
               appropriation in the annual Budget Act.


                                  FISCAL IMPACT  

          This bill has not been analyzed by a fiscal committee.








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                            BACKGROUND AND DISCUSSION  

           Purpose of the bill

           The author states that SB 579 would create a clearer  
          regulatory framework for those who provide services to  
          people with developmental disabilities. The author also  
          states that "while this bill serves to eliminate wasted  
          state funds from having duplicative agencies reviewing  
          programs, and the unnecessary costs to service providers in  
          staffing the redundant and sometimes contradictory, quality  
          reviews; the primary goal of this bill is increased safety  
          and efficiency through clarity."

          This bill would eliminate state oversight by the Community  
          Care Licensing Division of the Department of Social  
          Services and the Licensing and Certification Division of  
          the Department of Public Health for consumers who receive  
          services within the five regional centers piloting the  
          project. It would replace that oversight with a model, run  
          by the regional centers, with data collection and oversight  
          responsibilities by the Department of Developmental  
          Services.  

           Current Oversight activities 
           
          Community Care Licensing, Department of Social Services
          
          Currently, consumers who live or spend time in facilities  
          such as day programs or group residential homes are subject  
          to licensing oversight by DSS, similar to the oversight of  
          foster youth in group homes and others who live in  
          out-of-home non-medical group care, as well as children in  
          day care and adults in adult day care programs. The  
          services provided in these facilities vary according to the  
          needs of the individual, but typically include help with  
          medications and assistance with personal hygiene, dressing  
          and grooming.

          According to data from DSS, in 2013 there were more than  
          77,000 licensed community care facilities with a capacity  
          to serve 1.4 million residents. Prior to 2003, DSS was  
          required to visit most licensed facilities once per year  
          and family child care homes once every three years.   
          However, due to the state's ongoing budget deficit, the  





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          state eliminated these requirements in the 2003-04 budget  
          and limited visits to ten percent of facilities per year  
          based upon poor performance history. 

          Concerns about the lack of oversight by DSS led the  
          department to explore a program indicators project, which  
          would result in more frequent visits but of shorter  
          duration. This would allow licensing staff to view more  
          facilities each year, and  perform the traditional longer  
          inspections only if inspectors found indications that  
          facilities had problems that warranted a more thorough  
          look. In 2012-13, DSS reported that it had conducted 30  
          percent more random visits, 15 percent more total  
          inspections and issued 13 percent more citations than the  
          prior year. 

          

          Licensing and Certification Division, Department of Public  
          Health
          
          Consumers who live in facilities whose needs necessitate a  
          certain level of medical care are subject to license and  
          certification oversight by CDPH. These facilities include  
          intermediate care facilities for the developmentally  
          disabled, specialized nursing homes, and approximately 30  
          other types of health care facilities. CDPH conducts  
          approximately 27,000 complaint investigations annually.<1> 

          The Licensing and Certification program is housed within  
          CDPH's Center for Health Care Quality, which includes about  
          1,200 staff located in 14 District offices. It is the  
          largest division within CDPH. Among its duties is to act as  
          the "state survey agency" for the federal Centers for  
          Medicare and Medicaid (CMS). In that role, CDPH is  
          responsible for certifying to the federal government that  
          the health care facilities are eligible for payments under  
          CMS programs. CDPH makes a certification recommendation  
          after surveying the health care facilities and establishing  
          that they are in compliance with all federal Conditions of  
          Participation.

          -------------------------
          <1>  
          http://www.cdph.ca.gov/programs/LnC/Documents/LCSenateBudget 
          SubCommittee3Report.pdf




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          Among the concerns that CDPH addressed recently before the  
          Legislature were questions about whether there were  
          inconsistencies across surveys and whether investigators  
          were using too much discretion in issuing citations. CDPH  
          responded with additional training for its survey teams. 

          Sonoma Developmental Center's recent federal  
          decertification also focused on the role of CDPH. The  
          department was criticized in an Oct. 23, 2012 joint hearing  
          before the Senate Human Services Committee and Subcommittee  
          #3 of the Senate Budget and Fiscal Review Committee for not  
          taking stronger action sooner against the Sonoma  
          Developmental Center, which had substandard care in its  
          Intermediate Care Facility (ICF) units. Prior and  
          subsequent to that hearing, CDPH and the federal Centers  
          for Medicare and Medicaid Services issued a number of  
          citations and findings of immediate jeopardy at the  
          facility and currently Sonoma Developmental Center is  
          operating without federal certification and reimbursement  
          for four of its 10 ICF units. Among the findings were  
          improper training by Developmental Center staff in the use  
          of catheters, improper tracking of Benadryl's use and other  
          medical practice issues.
           
          Department of Developmental Services 
          
          The Lanterman Act and certain federal provisions require  
          DDS to oversee the state's 21 nonprofit regional centers  
          through its monitoring of each regional center's  
          contractual performance. To ensure that the regional  
          centers comply with requirements of the federal Medicaid  
          Home and Community-Based Services Waiver, DDS conducts  
          on-site program reviews and fiscal audits of the regional  
          centers. However, under a 1985 California Supreme Court  
          decision, there are limitations to the types of directives  
          Developmental Services can issue to the regional centers. 

           Federal licensing and certification requirements
           
          Most of the service providers that would fall into this  
          consolidated oversight model receive federal matching funds  
          for services provided by DDS and the regional centers. To  
          qualify for that funding, the federal government requires a  
          number of licensing oversight activities.






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           Consolidating oversight
           
          There have been many discussions over the past decade about  
          consolidating the licensing and certification  
          responsibilities of DSS and CDPH into a single agency,  
          including a proposal in Gov. Arnold Schwarzenegger's 2005  
          California Performance Review. That document suggested that  
          licensing and certification functions within California's  
          Health and Human Services agencies be consolidated with the  
          Department of Consumer Affairs (DCA), which houses 16  
          boards that oversee licensure or certification of 35  
          categories of health care professionals.<2>

               In total, the departments, agencies and boards oversee  
               approximately 58 different types of facilities and  
               programs, as well as more than 50 categories of health  
               and human services professionals. For some departments  
               and boards, the workload is enormous. For example, DSS  
               is currently responsible for licensure of  
               approximately 92,000 community care facilities, while  
               DHS licenses and monitors nearly 1,400 skilled nursing  
               facilities. The Medical Board of California is  
               responsible for licensure of more than 115,000  
               physicians, and the Board of Registered Nursing is  
               responsible for licensure of nearly 300,000 registered  
               nurses. Other departments and boards have somewhat  
               less daunting workloads.  California Performance  
               Review.

          Even if oversight were consolidated, the requirements of  
          each type of licensing entity is so unique and complex that  
          there still would likely need to be specialists within a  
          single oversight entity. CDPH, for example, functions as  
          the state-designated survey agency for the Centers for  
          Medicaid and Medicare Services which requires federally  
          certified training. Within the licensing and certification  
          division are specialists in licensing of nursing homes,  
          intermediate care facilities for the developmentally  
          disabled, and other medically involved facilities. So  
          specialized are the licensing protocols that a single  
          facility, such as a Developmental Center, may require  
          separate specialists to perform federal licensure surveys  
          -------------------------
          <2>  
          http://cpr.ca.gov/CPR_Report/Issues_and_Recommendations/Chap 
          ter_2_Health_and_Human_Services/HHS21.html




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          on, for example, the licensed General Acute Care Hospital,  
          or the Intermediate Care Facility for the Developmentally  
          Disabled. CDPH reports that it may take as long as three  
          years to get a new licensing specialist through the federal  
          training in order for them to be able to perform surveys  
          for the Centers for Medicaid and Medicare Services. 

           Regional Center oversight 

           Regional Centers are part of a system of care overseen by  
          the Department of Developmental Services (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 with  
          developmental disabilities 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. 

          Historically, the regional centers have been praised for  
          providing services that are tailored to local needs and  
          responsive to individuals in communities, and criticized  
          for their inconsistency across the state. While DDS sets  
          some common rates, there are variations in services and  
          historic rate variations across the regional center system.  


          Oversight of the state's 21 nonprofit regional centers was  
          the subject of a Legislative hearing in 2011, following  
          publication of a Bureau of State Audits report that  
          outlined concerns about contracting irregularities. In  
          response to those findings, a number of bills were  
          introduced and passed that required regional centers to  
          post information on their websites to provide more  
          transparency in their transactions with vendors. One issue  
          in obtaining transparency is that regional centers, as  
          nonprofits, are not subject to the same degree of public  
          scrutiny as state agencies.

           Bureau of State Audit report
           
          In August 2010, the Bureau of State Audits (BSA) released a  





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          report, "Department of Developmental Services: A More  
          Uniform and Transparent Procurement and RateSetting Process  
          Would Improve the CostEffectiveness of Regional Centers.  
          Among the findings was that while DDS performed its  
          required monitoring functions as specified, there still was  
          little oversight of regional center practices or of the  
          regional center oversight of its vendoring process. 

               The law and regulations do not prescribe the format,  
               content, or quality of rate negotiations between  
               vendors and regional centers, nor do they require the  
               regional centers to document the negotiation process.  
               Given the problems we found at the regional centers we  
               visited ? increased oversight of these rate  
               determinations appears to be warranted. (BSA p. 21)

          Among the specific findings by the BSA were a lack of  
          documentation of procedures  for approving and processing  
          invoices for services at two of the six audited regional  
          centers, one vendor's deliberate submission of inaccurate  
          transportation billing spreadsheets and the regional  
          center's failure to catch these inconsistencies and another  
          regional center's apparent awarding of a contract based  
          upon the amount of money it had to allocate rather than  
          service provision. The final example, which involved a  
          $950,000 contract to a transportation broker that the  
          regional center also was negotiating with for a service  
          contract, resulted in that regional center being sanctioned  
          by DDS after the BSA revealed the information.

               Developmental Services provided little direct  
               oversight through existing monitoring efforts of how  
               regional centers establish rates. Within this  
               framework, we found-based on our review of a sample of  
               regional-center-established rates-that the regional  
               centers often do not retain support demonstrating that  
               they established rates using an appropriate level of  
               analysis. We also found that they sometimes  
               established rates using inappropriate processes that  
               gave the appearance of favoritism toward certain  
               vendors or fiscal irresponsibility. (BSA, p. 28)

           Comments

           This bill eliminates all oversight of regional center  





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          vendors by the state licensing and certification entities  
          charged with protecting consumer health and safety in the  
          five pilot regional centers. Instead it vests this  
          oversight with the regional centers, with certification  
          responsibility and some high-level oversight by DDS. As  
          noted by the BSA in 2010 and in legislation dating to the  
          current session, there are ongoing concerns about the  
          transparency of some regional center interactions with  
          vendors.
           
          Fiscal timeline
           
          This bill establishes July 1, 2014 as the start date for  
          the regional centers and DDS to begin certifying providers  
          in lieu of DSS or DPH licensure. It also establishes  
          funding beginning on that date. While at least one pilot  
          regional center has said that they can perform any  
          preparation activities within the existing budget, it is  
          unclear that DDS will be able to assemble stakeholders and  
          establish a new oversight system within the time allotted  
          and within existing budgetary resources. 
          
          In establishing certification and decertification  
          requirements for vendors along with input from  
          stakeholders, this bill requires DDS to replace all current  
          standards from Titles 17 and 22 of the California Code of  
          Regulations and to develop requirements and performance  
          standards that support the development, maintenance, and  
          continuous improvement of innovative, cost-effective  
          services. It also requires DDS to establish monitoring  
          standards for DDS and the regional centers as well as  
          requirements for emergency relocation of consumers, if  
          warranted. And it requires DDS to develop a uniform data  
          collection system that is consistently deployed at each  
          pilot regional center.

          Staff recommends moving the implementation date to July 1,  
          2016.


          
           LAO request
           
          This bill requires the Legislative Analyst's Office to  
          conduct a study to identify all of the financial and human  





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          resources expended by the licensing divisions of DSS and  
          CDPH, and by DDS, the regional centers, and service  
          providers, to determine quality assurance costs that are  
          covered by federal funds, and to recommend a means to  
          reallocate funding through the pilot model, as specified.

          This language is unnecessary as the LAO is responsive to  
          member requests. 

          Staff recommends removing the LAO requirement and instead  
          having the member make this request directly.

           Concerns about removing outside oversight
           
          While there has been concern about potential conflicting  
          licensing requirements and program guidelines for  
          individuals with developmental disabilities, the solution  
          may not be to remove outside oversight, as this bill does,  
          nor to revise all existing licensing statutes. Furthermore,  
          it is unclear whether the federal Centers for Medicaid and  
          Medicare Services would permit a nonprofit entity to  
          perform the federal certification  role that DPH currently  
          has. Without federally approved certification, the  
          providers would not be eligible for federal matching funds.  
          This bill would remove the role of DPH automatically,  
          without consideration of the federal funding implications.  
          Additionally, this bill would vest the pilot regional  
          centers with oversight of DDS consumers in an acute care  
          hospital, nursing home, or intermediate care facility for  
          the developmentally disabled, including those residing at  
          the state's Developmental Centers, such as Sonoma. Given  
          the current licensing and certification issues with Sonoma  
          Developmental Center, a change in oversight could delay the  
          recertification process with the federal government, which  
          is anticipated to be completed in 2014.

          Staff recommends the bill be amended to use the existing  
          DDS and stakeholder workgroup process to review overlapping  
          oversight and licensure issues and to consider the best  
          process to address this, including whether placing this  
          responsibility with the nonprofit regional centers is the  
          best method to address consolidation of oversight. 
               
           Related legislation
           





          STAFF ANALYSIS OF SENATE BILL 579 (Berryhill)           
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          AB 364 (Ian Calderon) 2013  Requires the DSS to visit a  
          community care facility and a residential care facility for  
          the elderly once every two years, instead of the current  
          requirement that they be visited no less than once every  
          five years.   
                    







                                    POSITIONS  

          Support:       Association of Regional Center Agencies  
          (sponsor) 
                         Cal-TASH
                         Partnerships With Industry    
                         San Diego Regional Center
                         7  individuals 

          Oppose:   None received






                                   -- END --