Amended in Senate May 27, 2014

Amended in Senate April 24, 2014

Amended in Senate April 10, 2014

Amended in Senate March 27, 2014

Senate BillNo. 1093


Introduced by Senator Liu

February 19, 2014


An act to amend Sections 4519.5, 4629, 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 requires the State Department of Developmental Services to contract with regional centers to provide services and supports to individuals with developmental disabilities. The services and supports to be provided to a regional center consumer, 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 all adult consumers who live in the home of a parent, relative, or other person, or who live independently.

(2) Existing law requires that contracts entered into with regional centers include annual performance objectives, including annual performance objectives that are specific, measurable,begin delete and, among other things,end deletebegin insert andend insert designedbegin delete toend deletebegin insert to, among other things,end insert 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 performancebegin delete objectives, among other things,end deletebegin insert objectives toend insert be designedbegin delete toend deletebegin insert to, among other things,end insert 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 a specified clients’ rights advocacy contractor.

begin delete

This bill would also require each regional center, in addition to those performance objectives, to develop and implement 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.

end delete

(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 additionally require the data to include, and be categorized by, residence type and subcategorized by age, race or ethnicity, and primary language. 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 any meetings of its board of directors, schedule the meetings at times and locations designed to result in a high turnout by the public and underserved communities, and, in holding the meetings, consider the language needs of the community. The bill would require the regional centers to provide participants of these meetings with the data and associated information and to conduct a discussion of the data and associated information in a manner that is culturally and linguistically appropriate for that community, as specified.

begin insert

This bill would also require each regional center to annually report to the department specified information regarding its implementation of those provisions. The bill would require the reports to be posted on the department’s and each regional center’s Internet Web site by August 31 of each year.

end insert

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

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

P3    1

SECTION 1.  

Section 4519.5 of the Welfare and Institutions
2Code
is amended to read:

3

4519.5.  

(a) The department and the regional centers shall
4annually collaborate to compile data in a uniform manner relating
5to purchase of service authorization, utilization, and expenditure
6by each regional center with respect to all of the following:

7(1) The age of consumer, categorized by the following:

8(A) Birth to age two, inclusive.

9(B) Three to 21, inclusive.

10(C) Twenty-two and older.

11(2) Race or ethnicity of the consumer.

12(3) Primary language spoken by the consumer, and other related
13details, as feasible.

14(4) Disability detail, in accordance with the categories
15established by subdivision (a) of Section 4512, and, if applicable,
16a category specifying that the disability is unknown.

17(5) Residence type, subcategorized by age, race or ethnicity,
18and primary language.

19(b) The data reported pursuant to subdivision (a) shall also
20include the number and percentage of individuals, categorized by
21age, race or ethnicity, and disability, and by residence type, as set
22forth in paragraph (5) of subdivision (a), who have been determined
P4    1to be eligible for regional center services but are not receiving
2 purchase of service funds.

3(c) By March 31, 2013, each regional center shall post the data
4described in this section that is specific to the regional center on
5its Internet Web site. Commencing on December 31, 2013, each
6regional center shall annually post this data by December 31. Each
7regional center shall maintain all previous years’ data on its Internet
8Web site.

9(d) By March 31, 2013, the department shall post the information
10described in this section on a statewide basis on its Internet Web
11site. Commencing December 31, 2013, the department shall
12annually post this information by December 31. The department
13shall maintain all previous years’ data on its Internet Web site.
14The department shall also post notice of any regional center
15stakeholder meetings on its Internet Web site.

16(e) Within three months of compiling the data with the
17department, and annually thereafter, each regional center shall
18meet with stakeholders in one or more public meetings regarding
19the data. The meeting or meetings shall be held separately from
20any meetings held pursuant to Section 4660. The regional center
21shall provide participants of these meetings with the data and any
22associated information, and shall conduct a discussion of the data
23and the associated information in a manner that is culturally and
24linguistically appropriate for that community, including providing
25alternative communication services, as required by Sections 11135
26to 11139.7, inclusive, of the Government Code and implementing
27regulations. Regional centers shall inform the department of the
28scheduling of those public meetings 30 days prior to the meeting.
29Notice of the meetings shall also be posted on the regional center’s
30Internet Web site 30 days prior to the meeting and shall be sent to
31individual stakeholders and groups representing underserved
32communities in a timely manner. Each regional center shall, in
33holding the meetings required by this subdivision, consider the
34language needs of the community and shall schedule the meetings
35at times and locations designed to result in a high turnout by the
36public and underserved communities.

begin insert

37(f) (1) Each regional center shall annually report to the
38department regarding its implementation of the requirements of
39this section. The report shall include, but shall not be limited to,
40all of the following:

end insert
begin insert

P5    1(A) Actions the regional center took to improve public
2attendance and participation at stakeholder meetings, including,
3but not limited to, attendance and participation by underserved
4communities.

end insert
begin insert

5(B) Copies of minutes from the meeting and attendee comments.

end insert
begin insert

6(C) Whether the data described in this section indicates a need
7to reduce disparities in the purchase of services among consumers
8in the regional center’s catchment area. If the data does indicate
9that need, the regional center’s recommendations and plan to
10promote equity, and reduce disparities, in the purchase of services.

end insert
begin insert

11(2) Each regional center and the department shall annually post
12the reports required by paragraph (1) on its Internet Web site by
13August 31.

end insert
14

SEC. 2.  

Section 4629 of the Welfare and Institutions Code is
15amended to read:

16

4629.  

(a) The state shall enter into five-year contracts with
17regional centers, subject to the annual appropriation of funds by
18the Legislature.

19(b) The contracts shall include a provision requiring each
20regional center to render services in accordance with applicable
21provision of state laws and regulations.

22(c) (1) The contracts shall include annual performance
23objectives that shall do both of the following:

24(A) Be specific, measurable, and designed to do all of the
25following:

26(i) Assist consumers to achieve life quality outcomes.

27(ii) Achieve meaningful progress above the current baselines.

28(iii) Develop services and supports identified as necessary to
29meet identified needs, including culturally and linguistically
30appropriate services and supports.

31(B) Be developed through a public process as described in the
32department’s guidelines that includes, but is not limited to, all of
33the following:

34(i) Providing information, in an understandable form, to the
35community about regional center services and supports, including
36budget information and baseline data on services and supports and
37 regional center operations.

38(ii) Conducting a public meeting where participants can provide
39input on performance objectives and using focus groups or surveys
40to collect information from the community.

P6    1(iii) Circulating a draft of the performance objectives to the
2community for input prior to presentation at a regional center board
3meeting where additional public input will be taken and considered
4before adoption of the objectives.

5(2) In addition to the performance objectives developed pursuant
6to this section, the department may specify in the performance
7contract additional areas of service and support that require
8development or enhancement by the regional center. In determining
9those areas, the department shall consider public comments from
10individuals and organizations within the regional center catchment
11area, the distribution of services and supports within the regional
12center catchment area, and review how the availability of services
13and supports in the regional area catchment area compares with
14other regional center catchment areas.

begin delete

15(3) In addition to the performance objectives developed pursuant
16to this section, the department shall require each regional center
17to develop and implement a plan with specific and measurable
18objectives that include activities and timelines that will lead to an
19increase in the utilization of services by consumers impacted by
20the purchase of service disparities identified pursuant to Sections
214519.5 and 4519.6. In developing that plan, a regional center shall
22 utilize the public process described in subparagraph (B) of
23paragraph (1), and shall consider stakeholder input from the State
24Council on Developmental Disabilities, the clients’ rights advocacy
25contractor identified in Section 4433, and the protection and
26advocacy agency described in Section 4901, and input gathered
27from meetings held pursuant to subdivision (e) of Section 4519.5.

end delete

28(d) Each contract with a regional center shall specify steps to
29be taken to ensure contract compliance, including, but not limited
30to, all of the following:

31(1) Incentives that encourage regional centers to meet or exceed
32performance standards.

33(2) Levels of probationary status for regional centers that do
34not meet, or are at risk of not meeting, performance standards. The
35department shall require that corrective action be taken by any
36regional center which is placed on probation. Corrective action
37may include, but is not limited to, mandated consultation with
38designated representatives of the Association of Regional Center
39Agencies or a management team designated by the department, or
40both. The department shall establish the specific timeline for the
P7    1implementation of corrective action and monitor its
2implementation. When a regional center is placed on probation,
3the department shall provide the appropriate area board and the
4clients’ rights advocacy contractor identified in Section 4433 with
5a copy of the correction plan, timeline, and any other action taken
6by the department relating to the probationary status of the regional
7center.

8(e) In order to evaluate the regional center’s compliance with
9its contract performance objectives and legal obligations related
10to those objectives, the department shall do both of the following:

11(1) Annually assess each regional center’s achievement of its
12previous year’s objectives and make the assessment, including
13baseline data and performance objectives of the individual regional
14centers, available to the public. The department may make a special
15commendation of the regional centers that have best engaged the
16community in the development of contract performance objectives
17and have made the most meaningful progress in meeting or
18exceeding contract performance objectives.

19(2) Monitor the activities of the regional center to ensure
20compliance with the provisions of its contracts, including, but not
21limited to, reviewing all of the following:

22(A) The regional center’s public process for compliance with
23the procedures set forth in paragraph (2) of subdivision (c).

24(B) Each regional center’s performance objectives for
25compliance with the criteria set forth in paragraphs (1)begin delete to (3),
26inclusive,end delete
begin insert and (2)end insert of subdivision (c).

27(C) Any public comments on regional center performance
28objectives sent to the department or to the regional centers, and
29soliciting public input on the public process and final performance
30standards.

31(f) The renewal of each contract shall be contingent upon
32compliance with the contract including, but not limited to, the
33performance objectives, as determined through the department’s
34evaluation.

35

SEC. 3.  

Section 4648 of the Welfare and Institutions Code is
36amended to read:

37

4648.  

In order to achieve the stated objectives of a consumer’s
38individual program plan, the regional center shall conduct activities,
39including, but not limited to, all of the following:

40(a) Securing needed services and supports.

P8    1(1) It is the intent of the Legislature that services and supports
2assist individuals with developmental disabilities in achieving the
3greatest self-sufficiency possible and in exercising personal
4choices. The regional center shall secure services and supports
5that meet the needs of the consumer, as determined in the
6consumer’s individual program plan, and within the context of the
7individual program plan, the planning team shall give highest
8preference to those services and supports which would allow
9minors with developmental disabilities to live with their families,
10adult persons with developmental disabilities to live as
11independently as possible in the community, and that allow all
12consumers to interact with persons without disabilities in positive,
13meaningful ways.

14(2) (A) In implementing individual program plans, regional
15centers, through the planning team, shall first consider services
16and supports in natural community, home, work, and recreational
17settings. Services and supports shall be flexible and individually
18tailored to the consumer and,begin delete whereend deletebegin insert whenend insert appropriate, his or her
19family.

20(B)  begin deleteIn order to ensure that regional center services are provided
21in a culturally competent manner and available to consumers from
22diverse language, ethnic, and racial populations, independent end delete

23begin insertIndependent end insertliving skills services shall be available to all adult
24consumers who live in the home of a parent, relative, or other
25person, or who live independently.

26(3) A regional center may, pursuant to vendorization or a
27contract, purchase services or supports for a consumer from any
28individual or agency which the regional center and consumer or,
29where appropriate, his or her parents, legal guardian, or
30conservator, or authorized representatives, determines will best
31accomplish all or any part of that consumer’s program plan.

32(A) Vendorization or contracting is the process for identification,
33selection, and utilization of service vendors or contractors, based
34on the qualifications and other requirements necessary in order to
35provide the service.

36(B) A regional center may reimburse an individual or agency
37for services or supports provided to a regional center consumer if
38the individual or agency has a rate of payment for vendored or
39contracted services established by the department, pursuant to this
40division, and is providing services pursuant to an emergency
P9    1vendorization or has completed the vendorization procedures or
2has entered into a contract with the regional center and continues
3to comply with the vendorization or contracting requirements. The
4director shall adopt regulations governing the vendorization process
5to be utilized by the department, regional centers, vendors and the
6individual or agency requesting vendorization.

7(C) Regulations shall include, but not be limited to: the vendor
8application process, and the basis for accepting or denying an
9application; the qualification and requirements for each category
10of services that may be provided to a regional center consumer
11through a vendor; requirements for emergency vendorization;
12procedures for termination of vendorization; the procedure for an
13individual or an agency to appeal any vendorization decision made
14by the department or regional center.

15(D) A regional center may vendorize a licensed facility for
16exclusive services to persons with developmental disabilities at a
17capacity equal to or less than the facility’s licensed capacity. A
18facility already licensed on January 1, 1999, shall continue to be
19vendorized at their full licensed capacity until the facility agrees
20to vendorization at a reduced capacity.

21(E) Effective July 1, 2009, notwithstanding any other law or
22regulation, a regional center shall not newly vendor a State
23Department of Social Services licensed 24-hour residential care
24facility with a licensed capacity of 16 or more beds, unless the
25facility qualifies for receipt of federal funds under the Medicaid
26Program.

27(4) Notwithstanding subparagraph (B) of paragraph (3), a
28regional center may contract or issue a voucher for services and
29supports provided to a consumer or family at a cost not to exceed
30the maximum rate of payment for that service or support
31established by the department. If a rate has not been established
32by the department, the regional center may, for an interim period,
33contract for a specified service or support with, and establish a
34rate of payment for, any provider of the service or support
35necessary to implement a consumer’s individual program plan.
36Contracts may be negotiated for a period of up to three years, with
37annual review and subject to the availability of funds.

38(5) In order to ensure the maximum flexibility and availability
39of appropriate services and supports for persons with
40developmental disabilities, the department shall establish and
P10   1maintain an equitable system of payment to providers of services
2and supports identified as necessary to the implementation of a
3consumers’ individual program plan. The system of payment shall
4include provision for a rate to ensure that the provider can meet
5the special needs of consumers and provide quality services and
6supports in the least restrictive setting as required by law.

7(6) The regional center and the consumer, or where appropriate,
8his or her parents, legal guardian, conservator, or authorized
9representative, including those appointed pursuant to subdivision
10(d) of Section 4548, subdivision (b) of Section 4701.6, or
11subdivision (e) of Section 4705, shall, pursuant to the individual
12program plan, consider all of the following when selecting a
13provider of consumer services and supports:

14(A) A provider’s ability to deliver quality services or supports
15which can accomplish all or part of the consumer’s individual
16program plan.

17(B) A provider’s success in achieving the objectives set forth
18in the individual program plan.

19(C) When appropriate, the existence of licensing, accreditation,
20 or professional certification.

21(D) The cost of providing services or supports of comparable
22quality by different providers, if available, shall be reviewed, and
23the least costly available provider of comparable service, including
24the cost of transportation, who is able to accomplish all or part of
25the consumer’s individual program plan, consistent with the
26 particular needs of the consumer and family as identified in the
27individual program plan, shall be selected. In determining the least
28costly provider, the availability of federal financial participation
29shall be considered. The consumer shall not be required to use the
30least costly provider if it will result in the consumer moving from
31an existing provider of services or supports to more restrictive or
32less integrated services or supports.

33(E) The consumer’s choice of providers, or, where appropriate,
34the consumer’s parent’s, legal guardian’s, authorized
35representative’s, or conservator’s choice of providers.

36(7) No service or support provided by any agency or individual
37shall be continued unless the consumer or, where appropriate, his
38or her parents, legal guardian, or conservator, or authorized
39representative, including those appointed pursuant to subdivision
40(d) of Section 4548, subdivision (b) of Section 4701.6, or
P11   1subdivision (e) of Section 4705, is satisfied and the regional center
2and the consumer or, when appropriate, the person’s parents or
3legal guardian or conservator agree that planned services and
4supports have been provided, and reasonable progress toward
5objectives have been made.

6(8) Regional center funds shall not be used to supplant the
7budget of any agency that has a legal responsibility to serve all
8members of the general public and is receiving public funds for
9providing those services.

10(9) (A) A regional center may, directly or through an agency
11acting on behalf of the center, provide placement in, purchase of,
12or follow-along services to persons with developmental disabilities
13in, appropriate community living arrangements, including, but not
14limited to, support service for consumers in homes they own or
15 lease, foster family placements, health care facilities, and licensed
16community care facilities. In considering appropriate placement
17alternatives for children with developmental disabilities, approval
18by the child’s parent or guardian shall be obtained before placement
19is made.

20(B) Effective July 1, 2012, notwithstanding any other law or
21regulation, a regional center shall not purchase residential services
22from a State Department of Social Services licensed 24-hour
23residential care facility with a licensed capacity of 16 or more
24beds. This prohibition on regional center purchase of residential
25services shall not apply to any of the following:

26(i) A residential facility with a licensed capacity of 16 or more
27beds that has been approved to participate in the department’s
28 Home and Community Based Services Waiver or another existing
29waiver program or certified to participate in the Medi-Cal program.

30(ii) A residential facility service provider that has a written
31agreement and specific plan prior to July 1, 2012, with the
32vendoring regional center to downsize the existing facility by
33transitioning its residential services to living arrangements of 15
34beds or less or restructure the large facility to meet federal
35Medicaid eligibility requirements on or before June 30, 2013.

36(iii) A residential facility licensed as a mental health
37rehabilitation center by the State Department ofbegin delete Mental Healthend delete
38begin insert State Hospitalsend insert or successor agency under any of the following
39circumstances:

40(I) The facility is eligible for Medicaid reimbursement.

P12   1(II) The facility has a department-approved plan in place by
2June 30, 2013, to transition to a program structure eligible for
3federal Medicaid funding, and this transition will be completed by
4June 30, 2014. The department may grant an extension for the date
5by which the transition will be completed if the facility
6demonstrates that it has made significant progress toward transition,
7and states with specificity the timeframe by which the transition
8will be completed and the specified steps that will be taken to
9accomplish the transition. A regional center may pay for the costs
10of care and treatment of a consumer residing in the facility on June
1130, 2012, until June 30, 2013, inclusive, and, if the facility has a
12department-approved plan in place by June 30, 2013, may continue
13to pay the costs under this subparagraph until June 30, 2014, or
14until the end of any period during which the department has granted
15an extension.

16(III) There is an emergency circumstance in which the regional
17center determines that it cannot locate alternate federally eligible
18services to meet the consumer’s needs. Under such an emergency
19circumstance, an assessment shall be completed by the regional
20center as soon as possible and within 30 days of admission. An
21individual program plan meeting shall be convened immediately
22following the assessment to determine the services and supports
23needed for stabilization and to develop a plan to transition the
24consumer from the facility into the community. If transition is not
25expected within 90 days of admission, an individual program plan
26meeting shall be held to discuss the status of transition and to
27determine if the consumer is still in need of placement in the
28facility. Commencing October 1, 2012, this determination shall
29be made after also considering resource options identified by the
30statewide specialized resource service. If it is determined that
31emergency services continue to be necessary, the regional center
32shall submit an updated transition plan that can cover a period of
33up to 90 days. In no event shall placements under these emergency
34circumstances exceed 180 days.

35(C) (i) Effective July 1, 2012, notwithstanding any other law
36or regulation to the contrary, a regional center shall not purchase
37new residential services from, or place a consumer in, institutions
38for mental disease, as described in Part 5 (commencing with
39Section 5900) of Division 5, for which federal Medicaid funding
P13   1is not available. Effective July 1, 2013, this prohibition applies
2regardless of the availability of federal funding.

3(ii) The prohibition described in clause (i) shall not apply to
4emergencies, as determined by the regional center, when a regional
5center cannot locate alternate services to meet the consumer’s
6needs. As soon as possible within 30 days of admission due to an
7emergency, an assessment shall be completed by the regional
8center. An individual program plan meeting shall be convened
9immediately following the assessment, to determine the services
10and supports needed for stabilization and to develop a plan to
11transition the consumer from the facility to the community. If
12transition is not expected within 90 days of admission, an
13emergency program plan meeting shall be held to discuss the status
14of the transition and to determine if the consumer is still in need
15of placement in the facility. If emergency services continue to be
16necessary, the regional center shall submit an updated transition
17plan to the department for an extension of up to 90 days. Placement
18shall not exceed 180 days.

19(iii) To the extent feasible, prior to any admission, the regional
20center shall consider resource options identified by the statewide
21specialized resource service established pursuant to subdivision
22(b) of Section 4418.25.

23(iv) The clients’ rights advocate shall be notified of each
24admission and individual program planning meeting pursuant to
25this subparagraph and may participate in all individual program
26planning meetings unless the consumer objects on his or her own
27behalf.

28(v) Regional centers shall complete a comprehensive assessment
29of any consumer residing in an institution for mental disease as of
30July 1, 2012, for which federal Medicaid funding is not available,
31and for any consumer residing in an institution for mental disease
32as of July 1, 2013, without regard to federal funding. The
33comprehensive assessment shall be completed prior to the
34consumer’s next scheduled individual program plan meeting and
35shall include identification of the services and supports needed
36and the timeline for identifying or developing those services needed
37to transition the consumer back to the community. Effective
38October 1, 2012, the regional center shall also consider resource
39options identified by the statewide specialized resource service.
40For each individual program plan meeting convened pursuant to
P14   1this subparagraph, the clients’ rights advocate for the regional
2center shall be notified of the meeting and may participate in the
3meeting unless the consumer objects on his or her own behalf.

4(D) Each person with developmental disabilities placed by the
5regional center in a community living arrangement shall have the
6rights specified in this division. These rights shall be brought to
7the person’s attention by any means necessary to reasonably
8communicate these rights to each resident, provided that, at a
9minimum, the Director of Developmental Services prepare,
10provide, and require to be clearly posted in all residential facilities
11and day programs a poster using simplified language and pictures
12that is designed to be more understandable by persons with
13cognitive disabilities and that the rights information shall also be
14available through the regional center to each residential facility
15and day program in alternative formats, including, but not limited
16to, other languages, braille, and audio tapes, when necessary to
17meet the communication needs of consumers.

18(E) Consumers are eligible to receive supplemental services
19including, but not limited to, additional staffing, pursuant to the
20process described in subdivision (d) of Section 4646. Necessary
21additional staffing that is not specifically included in the rates paid
22to the service provider may be purchased by the regional center if
23the additional staff are in excess of the amount required by
24regulation and the individual’s planning team determines the
25additional services are consistent with the provisions of the
26individual program plan. Additional staff should be periodically
27reviewed by the planning team for consistency with the individual
28program plan objectives in order to determine if continued use of
29the additional staff is necessary and appropriate and if the service
30is producing outcomes consistent with the individual program plan.
31Regional centers shall monitor programs to ensure that the
32additional staff is being provided and utilized appropriately.

33(10) Emergency and crisis intervention services including, but
34not limited to, mental health services and behavior modification
35services, may be provided, as needed, to maintain persons with
36developmental disabilities in the living arrangement of their own
37choice. Crisis services shall first be provided without disrupting a
38person’s living arrangement. If crisis intervention services are
39unsuccessful, emergency housing shall be available in the person’s
40home community. If dislocation cannot be avoided, every effort
P15   1shall be made to return the person to his or her living arrangement
2of choice, with all necessary supports, as soon as possible.

3(11) Among other service and support options, planning teams
4shall consider the use of paid roommates or neighbors, personal
5assistance, technical and financial assistance, and all other service
6and support options which would result in greater self-sufficiency
7for the consumer and cost-effectiveness to the state.

8(12) When facilitation as specified in an individual program
9plan requires the services of an individual, the facilitator shall be
10of the consumer’s choosing.

11(13) The community support may be provided to assist
12individuals with developmental disabilities to fully participate in
13community and civic life, including, but not limited to, programs,
14services, work opportunities, business, and activities available to
15persons without disabilities. This facilitation shall include, but not
16be limited to, any of the following:

17(A) Outreach and education to programs and services within
18the community.

19(B) Direct support to individuals which would enable them to
20more fully participate in their community.

21(C) Developing unpaid natural supports when possible.

22(14) When feasible and recommended by the individual program
23planning team, for purposes of facilitating better and cost-effective
24services for consumers or family members, technology, including
25telecommunication technology, may be used in conjunction with
26other services and supports. Technology in lieu of a consumer’s
27in-person appearances at judicial proceedings or administrative
28due process hearings may be used only if the consumer or, when
29appropriate, the consumer’s parent, legal guardian, conservator,
30or authorized representative, gives informed consent. Technology
31may be used in lieu of, or in conjunction with, in-person training
32for providers, as appropriate.

33(15) Other services and supports may be provided as set forth
34in Sections 4685, 4686, 4687, 4688, and 4689, when necessary.

35(16) Notwithstanding any other law or regulation, effective July
361, 2009, regional centers shall not purchase experimental
37treatments, therapeutic services, or devices that have not been
38clinically determined or scientifically proven to be effective or
39safe or for which risks and complications are unknown.
40Experimental treatments or therapeutic services include
P16   1experimental medical or nutritional therapy when the use of the
2product for that purpose is not a general physician practice. For
3regional center consumers receiving these services as part of their
4individual program plan (IPP) or individualized family service
5plan (IFSP) on July 1, 2009, this prohibition shall apply on August
61, 2009.

7(b) (1) Advocacy for, and protection of, the civil, legal, and
8service rights of persons with developmental disabilities as
9established in this division.

10(2) Whenever the advocacy efforts of a regional center to secure
11or protect the civil, legal, or service rights of any of its consumers
12prove ineffective, the regional center or the person with
13developmental disabilities or his or her parents, legal guardian, or
14other representative may request the area board to initiate action
15under the provisions defining area board advocacy functions
16established in this division.

17(c) The regional center may assist consumers and families
18directly, or through a provider, in identifying and building circles
19of support within the community.

20(d) In order to increase the quality of community services and
21protect consumers, the regional center shall, when appropriate,
22take either of the following actions:

23(1) Identify services and supports that are ineffective or of poor
24quality and provide or secure consultation, training, or technical
25assistance services for any agency or individual provider to assist
26that agency or individual provider in upgrading the quality of
27services or supports.

28(2) Identify providers of services or supports that may not be
29in compliance with local, state, and federal statutes and regulations
30and notify the appropriate licensing or regulatory authority, or
31request the area board to investigate the possible noncompliance.

32(e) When necessary to expand the availability of needed services
33of good quality, a regional center may take actions that include,
34but are not limited to, the following:

35(1) Soliciting an individual or agency by requests for proposals
36or other means, to provide needed services or supports not presently
37available.

38(2) Requesting funds from the Program Development Fund,
39pursuant to Section 4677, or community placement plan funds
P17   1designated from that fund, to reimburse the startup costs needed
2to initiate a new program of services and supports.

3(3) Using creative and innovative service delivery models,
4including, but not limited to, natural supports.

5(f) Except in emergency situations, a regional center shall not
6provide direct treatment and therapeutic services, but shall utilize
7appropriate public and private community agencies and service
8providers to obtain those services for its consumers.

9(g) When there are identified gaps in the system of services and
10supports, or when there are identified consumers for whom no
11provider will provide services and supports contained in his or her
12individual program plan, the department may provide the services
13and supports directly.

14(h) At least annually, regional centers shall provide the
15consumer, his or her parents, legal guardian, conservator, or
16authorized representative a statement of services and supports the
17regional center purchased for the purpose of ensuring that they are
18delivered. The statement shall include the type, unit, month, and
19cost of services and supports purchased.



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