Amended in Senate April 10, 2014

Amended in Senate March 27, 2014

Senate Bill No. 1093

Introduced by Senator Liu

February 19, 2014

An act to amend Sections begin insert 4519.5, end insert 4629, begin delete 4519.5, end delete and 4648 of the Welfare and Institutions Code, relating to developmental services.

LEGISLATIVE COUNSEL’S DIGEST

SB 1093, as amended, Liu. Developmental services: regional centers: culturally and linguistically competent services.

(1) The Lanterman Developmental Disabilities Services Act authorizes the State Department of Developmental Services to contract with regional centers to provide services and support to individuals with developmental disabilities. The services and supports to be provided to a regional center consumer, which include services and supports that are directed toward the achievement and maintenance of an independent, productive, and normal life for the consumer such as daily living skills training, are contained in an individual program plan or individualized family service plan developed in accordance with prescribed requirements.

This bill would require that independent living skills services be available to begin insert all end insert adult consumers who live in the home of a parent, relative, or begin delete another person. end delete begin insert other person, or who live independently. end insert

(2) Existing law requires that contracts entered into with regional centers include annual performance objectives, including annual performance objectives that are specific, measurable, and, among other things, designed to develop services and supports identified as necessary to meet identified needs. Existing law also requires that each contract with a regional center specify steps to be taken to ensure contract compliance, and, if a regional center is placed on probation pursuant to these steps, requires the department to provide the appropriate area board with a copy of the correction plan, timeline, and any other action taken by the department.

This bill would require that annual performance objectives, among other things, be designed to develop services and supports identified as necessary to meet identified needs, which includes culturally and linguistically appropriate services and supports. The bill would require that, if a regional center is placed on probation, the department also provide a copy of the correction plan, timeline, and any other action taken by the department to the Office of Clients’ Rights Advocacy.

This bill would also require each regional center, in addition to those performance objectives, to develop begin insert and implement end insert a plan with specific and measurable objectives that include activities and timelines that will lead to an increase in the utilization of services by consumers impacted by purchase of service disparities. The bill would require a regional center to utilize a specified public process and consult with specified stakeholders in developing that plan.

(3) Existing law requires the department and regional centers to annually collaborate to compile specified data relating to purchase of service authorization, utilization, and expenditure by each regional center and requires that data to include the number and percentage of individuals, categorized by age, race, or ethnicity, and disability, who have been determined to be eligible for regional center services, but who are not receiving purchase of service funds. Existing law requires each regional center and the department to annually post this information on their respective Internet Web sites, as prescribed, and requires each regional center to hold annual stakeholder meetings regarding the data.

This bill would begin insert additionally end insert require begin insert the data to include end insert the number and percentage of individuals who have been determined to be eligible for regional center services, but who are not receiving purchase of service funds, to be begin delete subcategorized by residence type. end delete begin insert categorized by residence type and subcategorized by age, race or ethnicity, and primary language. end insert The bill would also require the department and each regional center to maintain all preceding years’ data on its Internet Web site. The bill would require that regional centers hold the annual stakeholder meetings regarding the data separately from a meeting of its board of directors, schedule the meetings at times and locations designed to result in a high turn out by the public and underserved communities, and, in holding the meetings, consider the language needs of the community.

Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.

The people of the State of California do enact as follows:

begin insert

begin insert SECTION 1. end insert   

end insert

begin insert Section 4519.5 of the end insert begin insert Welfare and Institutions
Code end insert begin insert is amended to read: end insert

4519.5.  

(a) The department and the regional centers shall
annually collaborate to compile data in a uniform manner relating
to purchase of service authorization, utilization, and expenditure
by each regional center with respect to all of the following:

(1) The age of consumer, categorized by the following:

(A) Birth to age two, inclusive.

(B) Three to 21, inclusive.

(C) Twenty-two and older.

(2) Race or ethnicity of the consumer.

(3) Primary language spoken by the consumer, and other related
details, as feasible.

(4) Disability detail, in accordance with the categories
established by subdivision (a) of Section 4512, and, if applicable,
a category specifying that the disability is unknown.

begin insert

(5) Residence type, subcategorized by age, race or ethnicity,
and primary language.

end insert

(b) The data reported pursuant to subdivision (a) shall also
include the number and percentage of individuals, categorized by
age, race or ethnicity, and disability, begin insert and by residence type, as set
forth in paragraph (5) of subdivision (a), end insert who have been
determined to be eligible for regional center services but are not
receiving purchase of service funds.

(c) By March 31, 2013, each regional center shall post the data
described in this section that is specific to the regional center on
its Internet Web site. Commencing on December 31, 2013, each
regional center shall annually post this data by December 31. begin insert Each
regional center shall maintain all previous years’ data on its
Internet Web site. end insert

(d) By March 31, 2013, the department shall post the information
described in this section on a statewide basis on its Internet Web
site. Commencing December 31, 2013, the department shall
annually post this information by December 31. begin insert The department
shall maintain all previous years’ data on its Internet Web site. end insert
The department shall also post notice of any regional center
stakeholder meetings on its Internet Web site.

(e) Within three months of compiling the data with the
department, and annually thereafter, each regional center shall
meet with stakeholders in begin delete a end delete begin insert one or more end insert public begin delete meeting end delete begin insert meetings end insert
regarding the data. begin insert The meeting or meetings shall be held
separately from a meeting held pursuant to Section 4660 and shall
provide the report and discussion of the data and information in
an understandable form. end insert Regional centers shall inform the
department of the scheduling of those public meetings 30 days
prior to the meeting. Notice of the meetings shall also be posted
on the regional center’s Internet Web site 30 days prior to the
meeting and shall be sent to individual stakeholders and groups
representing underserved communities in a timely manner. begin insert Each
regional center shall, in holding the meetings required by this
subdivision, consider the language needs of the community and
shall schedule the meetings at times and locations designed to
result in a high turnout by the public and underserved communities. end insert

begin delete SECTION 1. end delete
begin insert SEC. 2. end insert   

Section 4629 of the Welfare and Institutions Code is
amended to read:

4629.  

(a) The state shall enter into five-year contracts with
regional centers, subject to the annual appropriation of funds by
the Legislature.

(b) The contracts shall include a provision requiring each
regional center to render services in accordance with applicable
provision of state laws and regulations.

(c) (1) The contracts shall include annual performance
objectives that shall do both of the following:

(A) Be specific, measurable, and designed to do all of the
following:

(i) Assist consumers to achieve life quality outcomes.

(ii) Achieve meaningful progress above the current baselines.

(iii) Develop services and supports identified as necessary to
meet identified needs, including culturally and linguistically
appropriate services and supports.

(B) Be developed through a public process as described in the
department’s guidelines that includes, but is not limited to, all of
the following:

(i) Providing information, in an understandable form, to the
community about regional center services and supports, including
budget information and baseline data on services and supports and
regional center operations.

(ii) Conducting a public meeting where participants can provide
input on performance objectives and using focus groups or surveys
to collect information from the community.

(iii) Circulating a draft of the performance objectives to the
community for input prior to presentation at a regional center board
meeting where additional public input will be taken and considered
before adoption of the objectives.

(2) In addition to the performance objectives developed pursuant
to this section, the department may specify in the performance
contract additional areas of service and support that require
development or enhancement by the regional center. In determining
those areas, the department shall consider public comments from
individuals and organizations within the regional center catchment
area, the distribution of services and supports within the regional
center catchment area, and review how the availability of services
and supports in the regional area catchment area compares with
other regional center catchment areas.

(3) In addition to the performance objectives developed pursuant
to this section, the department shall require each regional center
to develop begin insert and implement end insert a plan with specific and measurable
objectives that include activities and timelines that will lead to an
increase in the utilization of services by consumers impacted by
the purchase of service disparities identified pursuant to Sections
4519.5 and 4519.6. In developing that plan, a regional center shall
utilize the public process described in subparagraph (B) of
paragraph (1), and shall consider stakeholder input from the State
Council on Developmental Disabilities, the Office of Clients’
Rights Advocacy, and the protection and advocacy agency
described in Section 4901, and input gathered from meetings held
pursuant to subdivision (e) of Section 4519.5.

(d) Each contract with a regional center shall specify steps to
be taken to ensure contract compliance, including, but not limited
to, all of the following:

(1) Incentives that encourage regional centers to meet or exceed
performance standards.

(2) Levels of probationary status for regional centers that do
not meet, or are at risk of not meeting, performance standards. The
department shall require that corrective action be taken by any
regional center which is placed on probation. Corrective action
may include, but is not limited to, mandated consultation with
designated representatives of the Association of Regional Center
Agencies or a management team designated by the department, or
both. The department shall establish the specific timeline for the
implementation of corrective action and monitor its
implementation. When a regional center is placed on probation,
the department shall provide the appropriate area board and the
Office of Clients’ Rights Advocacy with a copy of the correction
plan, timeline, and any other action taken by the department
relating to the probationary status of the regional center.

(e) In order to evaluate the regional center’s compliance with
its contract performance objectives and legal obligations related
to those objectives, the department shall do both of the following:

(1) Annually assess each regional center’s achievement of its
previous year’s objectives and make the assessment, including
baseline data and performance objectives of the individual regional
centers, available to the public. The department may make a special
commendation of the regional centers that have best engaged the
community in the development of contract performance objectives
and have made the most meaningful progress in meeting or
exceeding contract performance objectives.

(2) Monitor the activities of the regional center to ensure
compliance with the provisions of its contracts, including, but not
limited to, reviewing all of the following:

(A) The regional center’s public process for compliance with
the procedures sets forth in paragraph (2) of subdivision (c).

(B) Each regional center’s performance objectives for
compliance with the criteria set forth in paragraphs (1) to (3),
inclusive, of subdivision (c).

(C) Any public comments on regional center performance
objectives sent to the department or to the regional centers, and
soliciting public input on the public process and final performance
standards.

(f) The renewal of each contract shall be contingent upon
compliance with the contract including, but not limited to, the
performance objectives, as determined through the department’s
evaluation.

begin delete

SEC. 2.  

Section 4519.5 of the Welfare and Institutions Code
is amended to read:

4519.5.  

(a) The department and the regional centers shall
annually collaborate to compile data in a uniform manner relating
to purchase of service authorization, utilization, and expenditure
by each regional center with respect to all of the following:

(1) The age of consumer, categorized by the following:

(A) Birth to age two, inclusive.

(B) Three to 21, inclusive.

(C) Twenty-two and older.

(2) Race or ethnicity of the consumer.

(3) Primary language spoken by the consumer, and other related
details, as feasible.

(4) Disability detail, in accordance with the categories
established by subdivision (a) of Section 4512, and, if applicable,
a category specifying that the disability is unknown.

(b) The data reported pursuant to subdivision (a) shall also
include the number and percentage of individuals, categorized by
age, race or ethnicity, and disability, and subcategorized by
residence type, who have been determined to be eligible for
regional center services but are not receiving purchase of service
funds.

(c) By March 31, 2013, each regional center shall post the data
described in this section that is specific to the regional center on
its Internet Web site. Commencing on December 31, 2013, each
regional center shall annually post this data by December 31. Each
regional center shall maintain all previous years’ data on its Internet
Web site.

(d) By March 31, 2013, the department shall post the information
described in this section on a statewide basis on its Internet Web
site. Commencing December 31, 2013, the department shall
annually post this information by December 31. The department
shall maintain all previous years’ data on its Internet Web site.
The department shall also post notice of any regional center
stakeholder meetings on its Internet Web site.

(e) Within three months of compiling the data with the
department, and annually thereafter, each regional center shall
meet with stakeholders in one or more public meetings regarding
the data. The meeting or meetings shall be held separately from a
meeting held pursuant to Section 4660 and shall provide the report
and discussion of the data and information in an understandable
form. Regional centers shall inform the department of the
scheduling of those public meetings 30 days prior to the meeting.
Notice of the meetings shall also be posted on the regional center’s
Internet Web site 30 days prior to the meeting and shall be sent to
individual stakeholders and groups representing underserved
communities in a timely manner. Each regional center shall, in
holding the meetings required by this subdivision, consider the
language needs of the community and shall schedule the meetings
at times and locations designed to result in a high turnout by the
public and underserved communities.

end delete

SEC. 3.  

Section 4648 of the Welfare and Institutions Code is
amended to read:

4648.  

In order to achieve the stated objectives of a consumer’s
individual program plan, the regional center shall conduct activities,
including, but not limited to, all of the following:

(a) Securing needed services and supports.

(1) It is the intent of the Legislature that services and supports
assist individuals with developmental disabilities in achieving the
greatest self-sufficiency possible and in exercising personal
choices. The regional center shall secure services and supports
that meet the needs of the consumer, as determined in the
consumer’s individual program plan, and within the context of the
individual program plan, the planning team shall give highest
preference to those services and supports which would allow
minors with developmental disabilities to live with their families,
adult persons with developmental disabilities to live as
independently as possible in the community, and that allow all
consumers to interact with persons without disabilities in positive,
meaningful ways.

(2) (A) In implementing individual program plans, regional
centers, through the planning team, shall first consider services
and supports in natural community, home, work, and recreational
settings. Services and supports shall be flexible and individually
tailored to the consumer and, where appropriate, his or her family.

(B) In order to ensure that regional center services are provided
in a culturally competent manner and available to consumers from
diverse language, ethnic, and racial populations, independent living
skills services shall be available to begin insert all end insert adult consumers who live
in the home of a parent, relative, or begin delete another person. end delete begin insert other person,
or who live independently. end insert

(3) A regional center may, pursuant to vendorization or a
contract, purchase services or supports for a consumer from any
individual or agency which the regional center and consumer or,
where appropriate, his or her parents, legal guardian, or
conservator, or authorized representatives, determines will best
accomplish all or any part of that consumer’s program plan.

(A) Vendorization or contracting is the process for identification,
selection, and utilization of service vendors or contractors, based
on the qualifications and other requirements necessary in order to
provide the service.

(B) A regional center may reimburse an individual or agency
for services or supports provided to a regional center consumer if
the individual or agency has a rate of payment for vendored or
contracted services established by the department, pursuant to this
division, and is providing services pursuant to an emergency
vendorization or has completed the vendorization procedures or
has entered into a contract with the regional center and continues
to comply with the vendorization or contracting requirements. The
director shall adopt regulations governing the vendorization process
to be utilized by the department, regional centers, vendors and the
individual or agency requesting vendorization.

(C) Regulations shall include, but not be limited to: the vendor
application process, and the basis for accepting or denying an
application; the qualification and requirements for each category
of services that may be provided to a regional center consumer
through a vendor; requirements for emergency vendorization;
procedures for termination of vendorization; the procedure for an
individual or an agency to appeal any vendorization decision made
by the department or regional center.

(D) A regional center may vendorize a licensed facility for
exclusive services to persons with developmental disabilities at a
capacity equal to or less than the facility’s licensed capacity. A
facility already licensed on January 1, 1999, shall continue to be
vendorized at their full licensed capacity until the facility agrees
to vendorization at a reduced capacity.

(E) Effective July 1, 2009, notwithstanding any other begin delete provision
of end delete law or begin delete regulation to the contrary, end delete begin insert regulation, end insert a regional center
shall not newly vendor a State Department of Social Services
licensed 24-hour residential care facility with a licensed capacity
of 16 or more beds, unless the facility qualifies for receipt of federal
funds under the Medicaid Program.

(4) Notwithstanding subparagraph (B) of paragraph (3), a
regional center may contract or issue a voucher for services and
supports provided to a consumer or family at a cost not to exceed
the maximum rate of payment for that service or support
established by the department. If a rate has not been established
by the department, the regional center may, for an interim period,
contract for a specified service or support with, and establish a
rate of payment for, any provider of the service or support
necessary to implement a consumer’s individual program plan.
Contracts may be negotiated for a period of up to three years, with
annual review and subject to the availability of funds.

(5) In order to ensure the maximum flexibility and availability
of appropriate services and supports for persons with
developmental disabilities, the department shall establish and
maintain an equitable system of payment to providers of services
and supports identified as necessary to the implementation of a
consumers’ individual program plan. The system of payment shall
include provision for a rate to ensure that the provider can meet
the special needs of consumers and provide quality services and
supports in the least restrictive setting as required by law.

(6) The regional center and the consumer, or where appropriate,
his or her parents, legal guardian, conservator, or authorized
representative, including those appointed pursuant to subdivision
(d) of Section 4548, subdivision (b) of Section 4701.6, or
subdivision (e) of Section 4705, shall, pursuant to the individual
program plan, consider all of the following when selecting a
provider of consumer services and supports:

(A) A provider’s ability to deliver quality services or supports
which can accomplish all or part of the consumer’s individual
program plan.

(B) A provider’s success in achieving the objectives set forth
in the individual program plan.

(C)  begin delete Where end delete begin insert When end insert appropriate, the existence of licensing,
accreditation, or professional certification.

(D) The cost of providing services or supports of comparable
quality by different providers, if available, shall be reviewed, and
the least costly available provider of comparable service, including
the cost of transportation, who is able to accomplish all or part of
the consumer’s individual program plan, consistent with the
particular needs of the consumer and family as identified in the
individual program plan, shall be selected. In determining the least
costly provider, the availability of federal financial participation
shall be considered. The consumer shall not be required to use the
least costly provider if it will result in the consumer moving from
an existing provider of services or supports to more restrictive or
less integrated services or supports.

(E) The consumer’s choice of providers, or, where appropriate,
the consumer’s parent’s, legal guardian’s, authorized
representative’s, or conservator’s choice of providers.

(7) No service or support provided by any agency or individual
shall be continued unless the consumer or, where appropriate, his
or her parents, legal guardian, or conservator, or authorized
representative, including those appointed pursuant to subdivision
(d) of Section 4548, subdivision (b) of Section 4701.6, or
subdivision (e) of Section 4705, is satisfied and the regional center
and the consumer or, when appropriate, the person’s parents or
legal guardian or conservator agree that planned services and
supports have been provided, and reasonable progress toward
objectives have been made.

(8) Regional center funds shall not be used to supplant the
budget of any agency that has a legal responsibility to serve all
members of the general public and is receiving public funds for
providing those services.

(9) (A) A regional center may, directly or through an agency
acting on behalf of the center, provide placement in, purchase of,
or follow-along services to persons with developmental disabilities
in, appropriate community living arrangements, including, but not
limited to, support service for consumers in homes they own or
lease, foster family placements, health care facilities, and licensed
community care facilities. In considering appropriate placement
alternatives for children with developmental disabilities, approval
by the child’s parent or guardian shall be obtained before placement
is made.

(B) Effective July 1, 2012, notwithstanding any other law or
begin delete regulation to the contrary, end delete begin insert regulation, end insert a regional center shall not
purchase residential services from a State Department of Social
Services licensed 24-hour residential care facility with a licensed
capacity of 16 or more beds. This prohibition on regional center
purchase of residential services shall not apply to any of the
following:

(i) A residential facility with a licensed capacity of 16 or more
beds that has been approved to participate in the department’s
Home and Community Based Services Waiver or another existing
waiver program or certified to participate in the Medi-Cal program.

(ii) A residential facility service provider that has a written
agreement and specific plan prior to July 1, 2012, with the
vendoring regional center to downsize the existing facility by
transitioning its residential services to living arrangements of 15
beds or less or restructure the large facility to meet federal
Medicaid eligibility requirements on or before June 30, 2013.

(iii) A residential facility licensed as a mental health
rehabilitation center by the State Department of Mental Health or
successor agency under any of the following circumstances:

(I) The facility is eligible for Medicaid reimbursement.

(II) The facility has a department-approved plan in place by
June 30, 2013, to transition to a program structure eligible for
federal Medicaid funding, and this transition will be completed by
June 30, 2014. The department may grant an extension for the date
by which the transition will be completed if the facility
demonstrates that it has made significant progress toward transition,
and states with specificity the timeframe by which the transition
will be completed and the specified steps that will be taken to
accomplish the transition. A regional center may pay for the costs
of care and treatment of a consumer residing in the facility on June
30, 2012, until June 30, 2013, inclusive, and, if the facility has a
department-approved plan in place by June 30, 2013, may continue
to pay the costs under this subparagraph until June 30, 2014, or
until the end of any period during which the department has granted
an extension.

(III) There is an emergency circumstance in which the regional
center determines that it cannot locate alternate federally eligible
services to meet the consumer’s needs. Under such an emergency
circumstance, an assessment shall be completed by the regional
center as soon as possible and within 30 days of admission. An
individual program plan meeting shall be convened immediately
following the assessment to determine the services and supports
needed for stabilization and to develop a plan to transition the
consumer from the facility into the community. If transition is not
expected within 90 days of admission, an individual program plan
meeting shall be held to discuss the status of transition and to
determine if the consumer is still in need of placement in the
facility. Commencing October 1, 2012, this determination shall
be made after also considering resource options identified by the
statewide specialized resource service. If it is determined that
emergency services continue to be necessary, the regional center
shall submit an updated transition plan that can cover a period of
up to 90 days. In no event shall placements under these emergency
circumstances exceed 180 days.

(C) (i) Effective July 1, 2012, notwithstanding any other law
or regulation to the contrary, a regional center shall not purchase
new residential services from, or place a consumer in, institutions
for mental disease, as described in Part 5 (commencing with
Section 5900) of Division 5, for which federal Medicaid funding
is not available. Effective July 1, 2013, this prohibition applies
regardless of the availability of federal funding.

(ii) The prohibition described in clause (i) shall not apply to
emergencies, as determined by the regional center, when a regional
center cannot locate alternate services to meet the consumer’s
needs. As soon as possible within 30 days of admission due to an
emergency, an assessment shall be completed by the regional
center. An individual program plan meeting shall be convened
immediately following the assessment, to determine the services
and supports needed for stabilization and to develop a plan to
transition the consumer from the facility to the community. If
transition is not expected within 90 days of admission, an
emergency program plan meeting shall be held to discuss the status
of the transition and to determine if the consumer is still in need
of placement in the facility. If emergency services continue to be
necessary, the regional center shall submit an updated transition
plan to the department for an extension of up to 90 days. Placement
shall not exceed 180 days.

(iii) To the extent feasible, prior to any admission, the regional
center shall consider resource options identified by the statewide
specialized resource service established pursuant to subdivision
(b) of Section 4418.25.

(iv) The clients’ rights advocate shall be notified of each
admission and individual program planning meeting pursuant to
this subparagraph and may participate in all individual program
planning meetings unless the consumer objects on his or her own
behalf.

(v) Regional centers shall complete a comprehensive assessment
of any consumer residing in an institution for mental disease as of
July 1, 2012, for which federal Medicaid funding is not available,
and for any consumer residing in an institution for mental disease
as of July 1, 2013, without regard to federal funding. The
comprehensive assessment shall be completed prior to the
consumer’s next scheduled individual program plan meeting and
shall include identification of the services and supports needed
and the timeline for identifying or developing those services needed
to transition the consumer back to the community. Effective
October 1, 2012, the regional center shall also consider resource
options identified by the statewide specialized resource service.
For each individual program plan meeting convened pursuant to
this subparagraph, the clients’ rights advocate for the regional
center shall be notified of the meeting and may participate in the
meeting unless the consumer objects on his or her own behalf.

(D) Each person with developmental disabilities placed by the
regional center in a community living arrangement shall have the
rights specified in this division. These rights shall be brought to
the person’s attention by any means necessary to reasonably
communicate these rights to each resident, provided that, at a
minimum, the Director of Developmental Services prepare,
provide, and require to be clearly posted in all residential facilities
and day programs a poster using simplified language and pictures
that is designed to be more understandable by persons with
cognitive disabilities and that the rights information shall also be
available through the regional center to each residential facility
and day program in alternative formats, including, but not limited
to, other languages, braille, and audio tapes, when necessary to
meet the communication needs of consumers.

(E) Consumers are eligible to receive supplemental services
including, but not limited to, additional staffing, pursuant to the
process described in subdivision (d) of Section 4646. Necessary
additional staffing that is not specifically included in the rates paid
to the service provider may be purchased by the regional center if
the additional staff are in excess of the amount required by
regulation and the individual’s planning team determines the
additional services are consistent with the provisions of the
individual program plan. Additional staff should be periodically
reviewed by the planning team for consistency with the individual
program plan objectives in order to determine if continued use of
the additional staff is necessary and appropriate and if the service
is producing outcomes consistent with the individual program plan.
Regional centers shall monitor programs to ensure that the
additional staff is being provided and utilized appropriately.

(10) Emergency and crisis intervention services including, but
not limited to, mental health services and behavior modification
services, may be provided, as needed, to maintain persons with
developmental disabilities in the living arrangement of their own
choice. Crisis services shall first be provided without disrupting a
person’s living arrangement. If crisis intervention services are
unsuccessful, emergency housing shall be available in the person’s
home community. If dislocation cannot be avoided, every effort
shall be made to return the person to his or her living arrangement
of choice, with all necessary supports, as soon as possible.

(11) Among other service and support options, planning teams
shall consider the use of paid roommates or neighbors, personal
assistance, technical and financial assistance, and all other service
and support options which would result in greater self-sufficiency
for the consumer and cost-effectiveness to the state.

(12) When facilitation as specified in an individual program
plan requires the services of an individual, the facilitator shall be
of the consumer’s choosing.

(13) The community support may be provided to assist
individuals with developmental disabilities to fully participate in
community and civic life, including, but not limited to, programs,
services, work opportunities, business, and activities available to
persons without disabilities. This facilitation shall include, but not
be limited to, any of the following:

(A) Outreach and education to programs and services within
the community.

(B) Direct support to individuals which would enable them to
more fully participate in their community.

(C) Developing unpaid natural supports when possible.

(14) When feasible and recommended by the individual program
planning team, for purposes of facilitating better and cost-effective
services for consumers or family members, technology, including
telecommunication technology, may be used in conjunction with
other services and supports. Technology in lieu of a consumer’s
in-person appearances at judicial proceedings or administrative
due process hearings may be used only if the consumer or, when
appropriate, the consumer’s parent, legal guardian, conservator,
or authorized representative, gives informed consent. Technology
may be used in lieu of, or in conjunction with, in-person training
for providers, as appropriate.

(15) Other services and supports may be provided as set forth
in Sections 4685, 4686, 4687, 4688, and 4689, when necessary.

(16) Notwithstanding any other begin delete provision of end delete law or begin delete regulation
to the contrary, end delete begin insert regulation, end insert effective July 1, 2009, regional centers
shall not purchase experimental treatments, therapeutic services,
or devices that have not been clinically determined or scientifically
proven to be effective or safe or for which risks and complications
are unknown. Experimental treatments or therapeutic services
include experimental medical or nutritional therapy when the use
of the product for that purpose is not a general physician practice.
For regional center consumers receiving these services as part of
their individual program plan (IPP) or individualized family service
plan (IFSP) on July 1, 2009, this prohibition shall apply on August
1, 2009.

(b) (1) Advocacy for, and protection of, the civil, legal, and
service rights of persons with developmental disabilities as
established in this division.

(2) Whenever the advocacy efforts of a regional center to secure
or protect the civil, legal, or service rights of any of its consumers
prove ineffective, the regional center or the person with
developmental disabilities or his or her parents, legal guardian, or
other representative may request the area board to initiate action
under the provisions defining area board advocacy functions
established in this division.

(c) The regional center may assist consumers and families
directly, or through a provider, in identifying and building circles
of support within the community.

(d) In order to increase the quality of community services and
protect consumers, the regional center shall, when appropriate,
take either of the following actions:

(1) Identify services and supports that are ineffective or of poor
quality and provide or secure consultation, training, or technical
assistance services for any agency or individual provider to assist
that agency or individual provider in upgrading the quality of
services or supports.

(2) Identify providers of services or supports that may not be
in compliance with local, state, and federal statutes and regulations
and notify the appropriate licensing or regulatory authority, or
request the area board to investigate the possible noncompliance.

(e) When necessary to expand the availability of needed services
of good quality, a regional center may take actions that include,
but are not limited to, the following:

(1) Soliciting an individual or agency by requests for proposals
or other means, to provide needed services or supports not presently
available.

(2) Requesting funds from the Program Development Fund,
pursuant to Section 4677, or community placement plan funds
designated from that fund, to reimburse the startup costs needed
to initiate a new program of services and supports.

(3) Using creative and innovative service delivery models,
including, but not limited to, natural supports.

(f) Except in emergency situations, a regional center shall not
provide direct treatment and therapeutic services, but shall utilize
appropriate public and private community agencies and service
providers to obtain those services for its consumers.

(g)  begin delete Where end delete begin insert When end insert there are identified gaps in the system of
services and begin delete supports end delete begin insert supports, end insert or begin delete where end delete begin insert when end insert there are identified
consumers for whom no provider will provide services and supports
contained in his or her individual program plan, the department
may provide the services and supports directly.

(h) At least annually, regional centers shall provide the
consumer, his or her parents, legal guardian, conservator, or
authorized representative a statement of services and supports the
regional center purchased for the purpose of ensuring that they are
delivered. The statement shall include the type, unit, month, and
cost of services and supports purchased.