BILL ANALYSIS                                                                                                                                                                                                    Ó






                                  SENATE HUMAN
                               SERVICES COMMITTEE
                          Senator Leland Y. Yee, Chair


          BILL NO:       SB 579                                       
          S
          AUTHOR:        Berryhill                                    
          B
          VERSION:       January 6, 2014
          HEARING DATE:  January 14, 2014                             
          5
          FISCAL:        Yes                                          
          7
                                                                      
          9
          CONSULTANT:    Mareva Brown                                  


                                        

                                     SUBJECT
                                         
          Developmental services: Commission on Oversight Efficiency  
          and Quality Enhancement
          Models.

                                     SUMMARY  

          This bill creates a 12-member commission to investigate  
          methods of streamlining oversight of programs that are  
          licensed by the Department of Social Services (DSS) and  
          vendorized by the Department of Developmental Services  
          (DDS). Additionally the bill states legislative intent that  
          DDS identify regional center catchment areas for voluntary  
          participation in a pilot project consistent with the  
          recommendations of the commission, and requires that  
          regional centers which are interested in participating in  
          the voluntary pilot project must collect baseline data on  
          existing processes, as specified.  It requires that the  
          commission recommend a strategy for creation of a uniform  
          data collection system, and establishes other requirements,  
          as specified.

                                     ABSTRACT  

                                                         Continued---




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           Existing law:
           
             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)   Defines the types 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.)

             3)   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.)

             4)   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)

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

             6)   Provides in the California Code of Regulations  
               specific processes and requirements for becoming a  
               vendor of services for clients of the state's 21  
               nonprofit Regional Centers. (CCR Title 17, Division 2)

             7)   Establishes a contractual relationship between DDS  
               and the Regional Centers and specifies the  





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               requirements for the Regional Centers to be able to  
               continue contracting with the state. (WIC 4620, et  
               seq.)

           This bill:
           
             1)   Declares legislative findings that: 

                  a.        Evaluation of services by Regional Center  
                    providers is a critical component of the service  
                    system.

                  b.        There is evidence that it is duplicative,  
                    confusing, and fails to produce data essential  
                    for service improvement to have three  
                    state-funded entities - DSS, DDS and the  
                    Department of Public Health (DPH) - charged with  
                    monitoring and maintaining quality services and  
                    supports for people with developmental  
                    disabilities. 

                  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)   Establishes a Commission on Oversight Efficiency  
               and Quality Enhancement Models to investigate methods  
               of implementing a unified and consistent oversight and  
               quality enhancement process.

             3)   Requires that the process 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 DSS.

             4)   Directs the commission to give the utmost attention  
               to ensuring that the results of its work do not reduce  
               the quality of oversight and monitoring of the health  





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               and safety of persons with developmental disabilities.  


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

             6)   States legislative intent that based upon  
               information analysis and recommendations of the  
               commission, DDS shall identify regional center  
               catchment areas for voluntary participation in a pilot  
               project consistent with the recommendations of the  
               commission. 

             7)   Establishes that the commission be composed of not  
               more than 12 members including:  

                  a.        Nine members - three each to be appointed  
                    to be appointed by the Governor, Senate Rules  
                    Committee and Speaker of the Assembly -- with the  
                    following qualifications:

                        i.             Each member must represent  
                         statewide organizations and have  
                         professional experience in quality assurance  
                         within the developmental disabilities field,  
                         and
                        ii.            Each appointing authority must  
                         appoint members who represent, as broadly as  
                         possible, each of the following areas:
                            1.                  The service provider  
                              community
                            2.                  The advocacy and  
                              consumer services community
                            3.                  Regional centers

                  b.        A representative may be appointed by each  
                    of the state departments of Developmental  
                    Services, Social Services and the California  
                    Health and Human Services Agency. 

             8)   Permits the commission to appoint advisory groups  
               to provide specialized input to assist the commission  
               in its work.






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             9)   Requires the commission to examine existing  
               regulations and statutes, and recommend changes to the  
               DDS, as specified.

             10)  Requires the commission to recommend, and include  
               in its final report, 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.

             11)  This data strategy shall address to the fullest  
               extent possible all of the following: 

                  a.        Service provider and regional performance
                  b.        Outcomes consistent with individual  
                    program plan goals
                  c.        Flexibility and implementation
                  d.        Field-based data entry and analysis
                  e.        Documentation, measurement and analysis  
                    of the strategy's implementation
                  f.        Usage of data currently being collected  
                    by regional centers and DDS
                  g.        Regional center and service provider  
                    resources needed to implement the strategy

             12)  Requires the commission to consider, but not be  
               limited to, the experience, outcomes and data provided  
               by the National Core Indicators project, the Agnews  
               Developmental Center and the 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  
               strategy's structure, standards and data collection  
               methodologies.

             13)  Requires the commission to review current sections  
               in Titles 17 and 22 of the California Code of  
               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. 

             14)  Requires that recommendations for the strategy and  





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               regulatory change reflect the following  
               characteristics: 

               a)     Be lean, simple, efficient, and understood by  
                 the people it serves and those who serve them
               b)     Avoid unnecessary redundancies of process,  
                 permissions, oversight, and enforcement
               c)     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
               d)     Require that outcome measures be consistent  
                 with performance measures for regional centers
               e)     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
               f)     Shift the focus of quality efforts to a service  
                 enhancement model that encourages and recognizes  
                 service provider and regional center improvements
               g)     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
               h)     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
               i)     Enhance transparency, accountability, quality  
                 standards, and measurement processes for the  
                 services directly provided by regional centers  
                 consistent with regional center performance  
                 contracts
               j)     Provide consumers, families, service providers  
                 and regional center staff the opportunity to  
                 participate in system evaluation
               aa)    Ensure that the results of oversight, quality  
                 enhancement and assurance review activities are  
                 available in plain language to people with  





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                 developmental disabilities and their families so  
                 they can be informed consumers of the services that  
                 they receive.

             1)   Requires that the commission determine no later  
               than June 30, 2015 the best methods of collecting  
               input on relevant statutes and sections of Titles 17  
               and 22 of the California Code of Regulations (CCR),  
               including but not limited to:

                  a.        Holding at least two public meetings,  
                    with one held in southern California and one held  
                    in northern California
                  b.        The electronic submission of comments

             2)   Requires the commission to request public input  
               concerning the revision, retention or removal of  
               relevant statutes and sections of Titles 17 and 22 of  
               the California Code of Regulations affecting only  
               programs meeting both of the following:

                  a.        Are under the partial or exclusive  
                    oversight of the Community Care Licensing  
                    Division of DSS, and 
                  b.        Provide services and supports exclusively  
                    or primarily to persons with developmental  
                    disabilities.

             3)   Requires the commission to solicit comment on issue  
               areas including, but not limited to the following:
                  a.        Certification and vendorization processes
                  b.        Complaints
                  c.        Quality oversight and monitoring  
                    requirements
                  d.        Decertification and de-vendorization  
                    processes
                  e.        Conflict and duplication in statutes and  
                    regulations

             4)   Requires that the commission review and compile the  
               input received based on its relevance to the criteria  
               described above in (14) by Sept. 30, 2016.

             5)   Requires the commission to submit a report to the  
               Legislature and DDS by December 31, 2016 with  





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               recommended changes to Titles 17 and 22 of the CCR and  
               any recommended statutory changes, as specified. The  
               report must also propose a process by which relevant  
               regulations and statutes governing the Licensing and  
               Certification Division at the State Department of  
               Public Health may be reviewed by a future commission,  
               if one is established. 

             6)   Requires that regional centers that wish to be  
               considered for participation in any program to pilot  
               new quality enhancement systems must collect baseline  
               data, as determined by the commission on existing  
               service quality and quality assurances processes in  
               programs and services that are licensed by DSS's  
               Community Care Licensing Division. This data must be  
               collected between January 1, 2016 and December 31,  
               2016.

             7)   Establishes a sunset date of January 1, 2018. 


                                  FISCAL IMPACT  

          This bill has not been analyzed by a fiscal committee.

                            BACKGROUND AND DISCUSSION  

           Bill history
           
          SB 579 originally was heard by this committee on April 23,  
          2013, but was not voted upon due to concerns about various  
          provisions. 

          That version of the bill would have eliminated oversight of  
          service providers by the Community Care Licensing Division  
          within DSS and the Licensing and Certification Division  
          within the CDPH for five regional centers piloting the  
          project. That oversight would have been replaced with a new  
          model, run by the five pilot regional centers, with  
          oversight and data collection responsibilities by  
          Developmental Services. It mandated a shift of funds from  
          DSS and DPH to Developmental Services to pay for the  
          oversight. Additionally, it required the Legislative  
          Analyst's Office to identify all of the financial and human  
          resources directed to current quality assurance activities  





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          for specified licensed programs, to identify which costs  
          are federally funded and to determine which costs could be  
          federally funded under the oversight shift. An evaluation  
          of the project was required.

          Since that hearing, the author has amended the bill twice.  
          The current version removes the transfer of licensing  
          oversight from DSS and DPH to the Regional Centers. It  
          deletes the required LAO study, which has instead been  
          requested directly by the author. Instead, it creates a  
          12-member commission appointed by the Legislature and  
          Administration to review overlapping licensing and  
          regulatory schemes and requires the commission to submit a  
          report with recommended changes to the Legislature and to  
          DDS no later than September 30, 2016. It also mandates that  
          the commission hold at least two public meetings, in  
          Southern and Northern California, as well as provide a  
          mechanism to accept public comments electronically. 

          While the current version of the bill deletes the elaborate  
          provisions of the pilot project, it states legislative  
          intent that DDS identify regional center catchment areas  
          for voluntary participation in a pilot project consistent  
          with the recommendations of the commission. It requires  
          that the regional centers interested in participating in  
          the voluntary pilot project must collect baseline data - to  
          be specified by the commission - from January to December  
          2016 on existing service quality and quality assurance  
          processes.  

          It also requires that the commission recommend a strategy  
          for creation of a uniform data collection system, as  
          specified. The current version of the bill additionally  
          links outcome measurements of the new oversight model with  
          Regional Center performance contracts.  

          This version of the bill maintains the original language  
          that would create a new regulatory system based on 10  
          characteristics including shifting the focus of quality  
          efforts to a service enhancement model that encourages and  
          recognizes service provider and regional center  
          improvements.

           Purpose of the bill
           





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          The author states that it is very important to examine the  
          redundant and duplicative structure for the evaluation of  
          services and supports that individuals with developmental  
          disabilities receive from the Regional Centers. He states  
          that this redundancy is a wasteful use of limited state  
          resources and not effective at improving the quality of  
          services. 

           Current oversight activities 
           
          Community Care Licensing, Department of Social Services
          
          Facilities serving consumers with developmental  
          disabilities such as day programs or group residential  
          homes are subject to licensing oversight by DSS. The  
          services provided in these facilities vary according to the  
          needs of the individual, but typically include help with  
          personal hygiene, dressing and grooming, and medication  
          assistance but exclude medical care provided by licensed  
          health care providers.

          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  
          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 Key Indicators Tool, which resulted  
          in more frequent visits but of shorter duration. This  
          allows licensing staff to view more facilities each year,  
          and perform the traditional longer inspections only if  
          inspectors find indications that facilities have 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
          





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          Consumers who live in facilities whose needs necessitate a  
          certain level of medical care are subject to licensure 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.

          Department of Developmental Services 
          
          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 1,350 people  
          who resided in developmental centers as of January 1, 2014.  


          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 (HCBS) 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. 

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




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          Regional Centers
           
           California's 21 regional centers are non-profit  
          organizations that provide local services and supports to  
          individuals through contracts with individual vendors.  
          Oversight of the regional center system 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 and  
          oversight of 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.

           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. A  
          proposal in Gov. Arnold Schwarzenegger's 2005 California  
          Performance Review 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>

          Even if oversight were consolidated, the requirements of  
          each type of licensing entity are so unique and complex  
          that there still would need to be specialists. CDPH, for  
          example, functions as the state-designated survey agency  
          for the Centers for Medicaid and Medicare Services, a role  
          which requires the staff to receive 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. CDPH reports that it may  
          take as long as three years to get a new licensing  
          specialist to complete the federal training in order for  
          them to be able to perform surveys for the Centers for  
          -------------------------
          <2>  
          http://cpr.ca.gov/CPR_Report/Issues_and_Recommendations/Chap 
          ter_2_Health_and_Human_Services/HHS21.html




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          Medicaid and Medicare Services. 
           
          Comments

           Concerns about contradictory regulations for facilities  
          that provide services to individuals with developmental  
          disabilities have been discussed for many years, however  
          without a thorough review of the overlapping and  
          contradictory regulations and statutes, it has been  
          difficult to evaluate the issue or determine a solution.   
          This bill would create a structure to facilitate that  
          evaluation, led by advocates and providers with expertise  
          in this area. Although this study is timely and  
          appropriate, this bill does not address several structural  
          problems with the commission. 
           
           Funding and staffing

          This bill requires the 12-member commission to produce a  
          number of products, including a report to the Department,  
          to the Legislature that evaluates and recommends changes in  
          regulations and statute. It requires the commission hold  
          two public meetings, and collect public comment  
          electronically. It requires the commission to evaluate and  
          recommend a data system for use statewide. However, the  
          bill provides no staff to conduct research, produce reports  
          or perform administrative functions necessary for this  
          commission. Furthermore it requires commissioners to travel  
          to both ends of the state but does not address whether  
          commissioners receive travel compensation or per diem pay.

             1.   Staff recommends the author identify a department  
               or agency that will provide staff and other  
               administrative tasks to the commission. Staff also  
               recommends the author consider the language that  
               established the Disability Access Commission,<3> and  
               other commissions to establish an administrative  
               structure, specify reimbursement and per diem  
               expenses, acknowledge Bagley-Keene open meeting  
               regulations and address other commission structural  
               necessities. 

             2.   Staff recommends identifying appointees to be  
               appointed by the specific entities. Specifically: 
             -----------------------
          <3> California Government Code Sections 8299-8299.11




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               WIC 4751 (c) The commission shall be composed of not  
               more than 12 members.

                (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).
               (A) The appointed members shall meet both of the  
               following requirements:
               (i) Have professional experience in quality assurance  
               within the developmental disabilities field.
               (ii) Represent statewide organizations.
               (B) Each appointing authority shall appoint a member  
               representing, as broadly as possible, each of the  
               following areas:
               (i) The service provider community.
               (ii) The advocacy and consumer services community.
               (iii) Regional centers.
                
               (a) Three public members appointed by the Senate  
               Committee on Rules, with one appointee from the  
               advocacy community, one appointee who is a provider of  
               day program services, and one appointee representing  
               the Regional Centers.
               (b) Three public members appointed by the Speaker of  
               the Assembly, with one appointee being a consumer or  
               family member, one appointee who is a provider of  
               residential services, and one appointee representing  
               the Regional Centers.
               (c) Three public members appointed by the Governor,  
               with the consent of the Senate. The Governor shall  
               request and consider nominations from the advocacy  
               community, the provider community, the regional center  
               system, consumers and family members, and subject  
               experts in data collection and licensing oversight for  
               these appointments.

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





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               its work.
               
          Pilot project assumes commission's conclusion

          This bill requires the commission to "investigate methods  
          of implementing a unified and consistent oversight and  
          quality enhancement process" that will ensure the welfare,  
          community participation, health, and safety of all those  
          with developmental disabilities who are served in programs  
          currently licensed by DSS, while giving utmost attention to  
          not reducing the quality of oversight. It directs the  
          Commission to look at specific regulations, and at statute,  
          in evaluating redundancy and conflicting language. It  
          directs the commission to identify a strategy for data  
          collection and regulatory change that upholds 10  
          characteristics of oversight. However, it leaves open the  
          question of whether that can be accomplished within the  
          existing oversight structure and how far-reaching the  
          changes will need to be. The report is due to the  
          Legislature and DDS on September 30, 2016.

          By establishing legislative intent to create a pilot  
          project from the recommendations, and by requiring  
          interested regional centers to begin collecting baseline  
          data on January 1, 2016, this presumes an outcome before  
          the Commission has finished its work. Furthermore, it  
          requires collection of baseline data, to be determined by  
          the commission, nine months before the commission  
          recommends a strategy. This directive may cause confusion  
          and unrealistic expectations among regional centers. 

             3.   Should the bill move forward, staff recommends the  
               author consider striking language relating to the  
               pilot program until it is clear that a pilot is  
               appropriate.
          


                                    POSITIONS  

          Support:       Association of Regional Center Agencies  
          (sponsor)
                         Autistry Studios
                         California Disability Services Association
                         Center for Autism and Related Disorders 





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                         Community Gatepath
                         Dominican University of California
                         Golden Gate Regional Center
                         Lifehouse
                         Opportunity for Independence       
                         Premier Healthcare Services        
                         San Diego Regional Center
                         The Arc/United Cerebral Palsy California  
                    Collaboration
                         The Alliance
                         The Cedars of Marin
                         United Cerebral Palsy/WORK, Inc.
                         34 Individuals



          Oppose:   None






                                   -- END --