Proposed Conference Report No. 1 February 22, 2016

Amended in Senate September 3, 2015

California Legislature—2015–16 Second Extraordinary Session

Assembly BillNo. 1


Introduced bybegin delete Assembly Member Bontaend deletebegin insert Assembly Member Thurmond, Senator Beall, Assembly Member Bonta, Assembly Member Maienschein, and Senator Cannellaend insert

begin insert

(Coauthors: Assembly Members Alejo, Atkins, Baker, Bigelow, Bloom, Bonilla, Brown, Burke, Calderon, Campos, Chau, Chiu, Chu, Cooley, Cooper, Dababneh, Dahle, Daly, Dodd, Eggman, Frazier, Gallagher, Cristina Garcia, Eduardo Garcia, Gatto, Gipson, Gomez, Gonzalez, Gordon, Gray, Roger Hernández, Holden, Irwin, Jones, Jones-Sawyer, Levine, Linder, Lopez, Low, Mathis, Mayes, McCarty, Medina, Mullin, Nazarian, O'Donnell, Olsen, Quirk, Rendon, Ridley-Thomas, Rodriguez, Salas, Santiago, Mark Stone, Ting, Waldron, Weber, Williams, and Wood)

end insert
begin insert

(Coauthors: Senators Allen, Block, De León, Galgiani, Glazer, Hall, Hancock, Hernandez, Hertzberg, Hill, Hueso, Jackson, Lara, Leno, Leyva, Liu, McGuire, Mendoza, Mitchell, Monning, Pan, Pavley, Roth, Wieckowski, and Wolk)

end insert

July 2, 2015


An actbegin delete relating to social services.end deletebegin insert to amend Sections 4519.5, 4639.5, 4652.5, 4689.8, 4690.5, 4691.6, 4691.9, and 4860 of, and to add Sections 4519.8, 4691.10, 4691.11, 4870, 14105.075, and 14105.195 to, the Welfare and Institutions Code, relating to human services financing, and making an appropriation therefor. end insert

LEGISLATIVE COUNSEL’S DIGEST

AB 1, as amended, begin deleteBontaend delete begin insertThurmondend insert. begin deleteMedi-Cal: developmental services: funding. end deletebegin insertDevelopmental services: Medi-Cal: funding.end insert

begin insert

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. Under existing law, regional centers purchase needed services for individuals with developmental disabilities through approved service providers or arrange for those services through other publicly funded agencies. Existing law establishes specified rates and wages to be paid to certain service providers and the rates to be paid for certain developmental services. Existing law requires that rates to be paid to other developmental service providers either be set by the department or negotiated between the regional center and the service provider.

end insert
begin insert

Existing law establishes the Medi-Cal program, administered by the State Department of Health Care Services, under which basic health care services are provided to qualified low-income persons. The Medi-Cal program is, in part, governed and funded by federal Medicaid Program provisions. Existing law requires, except as otherwise provided, Medi-Cal provider payments to be reduced, as specified.

end insert
begin insert

This bill would appropriate a specified sum to the State Department of Developmental Services to, commencing July 1, 2016, among other things, increase rates and wages for certain developmental services providers and fund incentive payments for competitive integrated employment opportunities and internships for individuals with developmental disabilities. The bill would require the department to submit a rate study to specified committees of the Legislature on or before March 1, 2019, regarding community-based services for individuals with developmental disabilities. The bill would require each regional center to report specified information to the department regarding increased funding for regional center operations. The bill would, for dates of service on or after August 1, 2016, increase the payment rates for intermediate care facilities and skilled nursing facilities that provide services to developmentally disabled individuals under the Medi-Cal program, as specified.

end insert
begin insert

The bill would also prohibit the State Department of Health Care Services from seeking to retroactively implement certain Medi-Cal provider payment reductions and limitations with regards to reimbursements for services provided by skilled nursing facilities that are distinct parts of general acute care hospitals for dates of service on or after June 1, 2011, and on or before September 30, 2013, and from seeking to recoup overpayments, as specified.

end insert
begin insert

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. Existing law requires each regional center to annually report to the department regarding the regional center’s implementation of these requirements, including whether the data indicates a need to reduce disparities in the purchase of services among consumers in the regional center’s catchment area and the regional center’s recommendations and plan to promote equity, and reduce disparities, in the purchase of services. Existing law requires the department to consult with specified stakeholders to review the data, develop recommendations to help reduce disparities in purchase of service expenditures, and encourage development and expansion of culturally appropriate services, among other things, and to report the status of its efforts during the 2016-17 legislative budget subcommittee hearing process.

end insert
begin insert

The bill would also require the department, subject to available funding, to allocate funding to regional centers to assist in implementing specified recommendations and plans, including the recommendations and plans of the regional centers to promote equity, and reduce disparities, in the purchase of services.

end insert
begin insert

Existing law requires an entity that receives payments between $250,000 and $500,000 per year from one or more regional centers to obtain either an independent audit or an independent review report of its financial statements, and requires an entity that receives payments that are equal to or more than $500,000 per year to obtain an independent audit.

end insert
begin insert

This bill would instead require an entity that receives payments between $500,000 and $2,000,000 from one or more regional centers to obtain an independent review report of its financial statements, and would authorize these entities to apply for, and require the regional center to grant, a 2-year exemption from this requirement if the regional center does not find issues in the independent review report that have an impact on regional center services. The bill would require an entity that receives payments from one or more regional centers that are equal to or more than $2,000,000 to obtain an independent audit and would authorize these entities to apply for, and require the regional center to grant, a 2-year exemption from the audit requirement if the audit resulted in an unmodified opinion, an unmodified opinion with additional communication, or a qualified opinion with issues that are not material. The bill would require a regional center to annually report to the State Department of Developmental Services any exemptions granted pursuant to these provisions.

end insert
begin delete

Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid Program provisions.

end delete
begin delete

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. Under existing law, the regional centers purchase needed services for individuals with developmental disabilities through approved service providers or arrange for those services through other publicly funded agencies.

end delete
begin delete

This bill would state the intent of the Legislature to enact legislation that establishes funding sources and mechanisms in order to provide additional support for, and access to, Medi-Cal and developmental services and that uses those funding sources and mechanisms to increase access, ensure network adequacy, improve quality, and minimize geographic and service shortages in the Medi-Cal program and to increase access to services provided through regional centers.

end delete

Vote: begin deletemajority end deletebegin insert23end insert. Appropriation: begin deleteno end deletebegin insertyesend insert. Fiscal committee: begin deleteno end deletebegin insertyesend insert. State-mandated local program: no.

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

P4    1begin insert

begin insertSECTION 1.end insert  

end insert

begin insertSection 4519.5 of the end insertbegin insertWelfare and Institutions
2Code
end insert
begin insert is amended to read:end insert

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 ofbegin insert theend insert consumer, categorized by the following:

8(A) Birth tobegin delete age two,end deletebegin insert two years of age,end insert inclusive.

9(B) Three tobegin delete 21,end deletebegin insert 21 years of ageend insert inclusive.

10(C) Twenty-twobegin insert years of ageend insert and older.

P5    1(2) Race or ethnicity of the consumer.

2(3) Primary language spoken by the consumer, and other related
3details, as feasible.

4(4) Disability detail, in accordance with the categories
5established by subdivision (a) of Section 4512, and, if applicable,
6a category specifying that the disability is unknown.

7(5) Residence type, subcategorized by age, race or ethnicity,
8and primary language.

9(6) Number of instances when the written copy of the individual
10program plan was provided at the request of the consumer and,
11when appropriate, his or her parents, legal guardian or conservator,
12or authorized representative, in a language other than a threshold
13language, as defined by paragraph (3) of subdivision (a) of Section
141810.410 of Title 9 of the California Code of Regulations, if that
15written copy was provided more than 60 days after the request.

16(b) The data reported pursuant to subdivision (a) shall also
17include the number and percentage of individuals, categorized by
18age, race or ethnicity, and disability, and by residence type, as set
19forth in paragraph (5) of subdivision (a), who have been determined
20to be eligible for regional center services but are not receiving
21purchase of service funds.

22(c) By March 31, 2013, each regional center shall post the data
23described in this section that is specific to the regional center on
24its Internet Web site. Commencing on December 31, 2013, each
25regional center shall annually post this data by December 31. Each
26regional center shall maintain all previous years’ data on its Internet
27Web site.

28(d) By March 31, 2013, the department shall post the information
29described in this section on a statewide basis on its Internet Web
30site. Commencing December 31, 2013, the department shall
31annually post this information by December 31. The department
32shall maintain all previous years’ data on its Internet Web site.
33The department shall also post notice of any regional center
34stakeholder meetings on its Internet Web site.

35(e) Within three months of compiling the data with the
36department, and annually thereafter, each regional center shall
37meet with stakeholders in one or more public meetings regarding
38the data. The meeting or meetings shall be held separately from
39any meetings held pursuant to Section 4660. The regional center
40shall provide participants of these meetings with the data and any
P6    1associated information, and shall conduct a discussion of the data
2and the associated information in a manner that is culturally and
3linguistically appropriate for that community, including providing
4alternative communication services, as required by Sections 11135
5to 11139.7, inclusive, of the Government Code and implementing
6regulations. Regional centers shall inform the department of the
7scheduling of those public meetings 30 days prior to the meeting.
8Notice of the meetings shall also be posted on the regional center’s
9Internet Web site 30 days prior to the meeting and shall be sent to
10individual stakeholders and groups representing underserved
11communities in a timely manner. Each regional center shall, in
12holding the meetings required by this subdivision, consider the
13language needs of the community and shall schedule the meetings
14at times and locations designed to result in a high turnout by the
15public and underserved communities.

16(f) (1) Each regional center shall annually report to the
17department regarding its implementation of the requirements of
18this section. The report shall include, but shall not be limited to,
19all of the following:

20(A) Actions the regional center took to improve public
21attendance and participation at stakeholder meetings, including,
22but not limited to, attendance and participation by underserved
23communities.

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

25(C) Whether the data described in this section indicates a need
26to reduce disparities in the purchase of services among consumers
27in the regional center’s catchment area. If the data does indicate
28that need, the regional center’s recommendations and plan to
29promote equity, and reduce disparities, in the purchase of services.

30(2) Each regional center and the department shall annually post
31the reports required by paragraph (1) on its Internet Web site by
32August 31.

33(g) (1) The department shall consult with stakeholders,
34including consumers and families that reflect the ethnic and
35language diversity of regional center consumers, regional centers,
36advocates, providers, the protection and advocacy agency described
37in Section 4901, and those entities designated as University Centers
38for Excellence in Developmental Disabilities Education, Research,
39and Service pursuant to Section 15061 of Title 42 of the United
40States Code, to achieve the following objectives:

P7    1(A) Review the data compiled pursuant to subdivision (a).

2(B) Identify barriers to equitable access to services and supports
3among consumers and develop recommendations to help reduce
4disparities in purchase of service expenditures.

5(C) Encourage the development and expansion of culturally
6appropriate services, service delivery, and service coordination.

7(D) Identify best practices to reduce disparity and promote
8equity.

9(2) The department shall report the status of its efforts to satisfy
10the requirements of paragraph (1) during the 2016-17 legislative
11budget subcommittee hearing process.

begin insert

12(h) Subject to available funding, the department shall allocate
13funding to regional centers to assist with implementation of the
14recommendations and plans developed pursuant to subdivisions
15(f) and (g). Activities funded through these allocations may include,
16but are not limited to, pay differentials supporting direct care
17bilingual staff of community-based service providers, parent or
18caregiver education programs, cultural competency training for
19regional center staff, outreach to underserved populations, or
20additional culturally appropriate service types or service delivery
21models.

end insert
22begin insert

begin insertSEC. 2.end insert  

end insert

begin insertSection 4519.8 is added to the end insertbegin insertWelfare and Institutions
23Code
end insert
begin insert, to read:end insert

begin insert
24

begin insert4519.8.end insert  

On or before March 1, 2019, the department shall
25submit a rate study to the appropriate fiscal and policy committees
26of the Legislature addressing the sustainability, quality, and
27transparency of community-based services for individuals with
28developmental disabilities. The department shall consult with
29stakeholders, through the developmental services task force
30process, in developing the study. The study shall include, but not
31be limited to, all of the following:

32(a) An assessment of the effectiveness of the methods used to
33pay each category of community service provider. This assessment
34shall include consideration of the following factors for each
35category of service provider:

36(1) Whether the current method of ratesetting for a service
37category provides an adequate supply of providers in that category,
38including, but not limited to, whether there is a sufficient supply
39of providers to enable consumers throughout the state to have a
40choice of providers, depending upon the nature of the service.

P8    1(2) A comparison of the estimated fiscal effects of alternative
2rate methodologies for each service provider category.

3(3) How different rate methodologies can incentivize outcomes
4for consumers.

5(b) An evaluation of the number and type of service codes for
6regional center services, including, but not limited to,
7recommendations for simplifying and making service codes more
8reflective of the level and types of services provided.

end insert
9begin insert

begin insertSEC. 3.end insert  

end insert

begin insertSection 4639.5 of the end insertbegin insertWelfare and Institutions Codeend insert
10begin insert is amended to read:end insert

11

4639.5.  

(a) By December 1 of each year, each regional center
12shall provide a listing to the State Department of Developmental
13Services a complete current salary schedule for all personnel
14classifications used by the regional center. The information shall
15be provided in a format prescribed by the department. The
16department shall provide this information to the public upon
17request. From February 1, 2009, to June 30, 2010, inclusive, the
18requirements of this subdivision shall not apply.

19(b) By December 1 of each year, each regional center shall
20report information to thebegin delete State Department of Developmental
21Servicesend delete
begin insert departmentend insert on all prior fiscal year expenditures from the
22regional center operations budget for all administrative services,
23including managerial, consultant, accounting, personnel, labor
24relations, and legal services, whether procured under a written
25contract or otherwise. Expenditures for the maintenance, repair,
26or purchase of equipment or property shall not be required to be
27reported for purposes of this subdivision. The report shall be
28prepared in a format prescribed by the department and shall include,
29at a minimum, for each recipient the amount of funds expended,
30the type of service, and purpose of the expenditure. The department
31shall provide this information to the public upon request. Regional
32centers shall not be required to prepare or submit the report required
33by this subdivision in 2009.

begin insert

34(c) Beginning July 1, 2016, and to the extent funds are
35appropriated in the annual Budget Act for this purpose, the
36department shall allocate thirty-one million one hundred thousand
37dollars ($31,100,000), plus any associated matching funds, to
38provide a salary increase, benefit increase, or both, excluding
39unfunded retirement liabilities, for regional center operations. Of
40this amount, twenty-nine million seven hundred thousand dollars
P9    1($29,700,000) shall be used for salary, benefit increases, or both,
2for regional center staff, and shall not supplant funding currently
3scheduled to be used for this purpose. These funds shall not be
4used to provide salary or benefit increases to regional center
5executive staff or for unfunded retirement liabilities. The remaining
6one million four hundred thousand dollars ($1,400,000) shall be
7used for an increase for administrative costs, consistent with those
8specified in subdivision (b) of Section 4629.7, for both regional
9centers and clients’ rights advocates contracts pursuant to
10subdivision (b) of Section 4433. Regional centers shall maintain
11documentation, subject to audit, on how this funding was allocated.

end insert
begin insert

12(d) By March 10, 2017, and again by October 1, 2017, and in
13a format prescribed by the department, each regional center shall
14report the following information to the department:

end insert
begin insert

15(1) The total amount provided to staff for purposes of subdivision
16(c).

end insert
begin insert

17(2) The position titles of staff receiving the increase and amounts
18of increases by title.

end insert
begin insert

19(3) The number of service coordinators receiving the increase.

end insert
begin insert

20(4) Data on staff turnover.

end insert
begin insert

21(5) The classification of expenditures and amount for each of
22the administrative costs outlined in subdivision (b) of Section
234629.7.

end insert
begin insert

24(6) The allocation methodology used by a regional center to
25distribute the funding.

end insert
begin insert

26(7) Any other information determined by the department.

end insert
begin insert

27(e) In its 2017-18 May Revision fiscal estimate, the department
28shall describe the implementation of the increase provided in
29subdivision (c), including, but not limited to, the data described
30in subdivision (d), aggregated by regional center and statewide,
31and the impact of the increase on caseload ratios.

end insert
begin insert

32(f) Any regional center that fails to report the information
33required by subdivision (d) to the department shall forfeit the
34increases described in subdivision (c).

end insert
35begin insert

begin insertSEC. 4.end insert  

end insert

begin insertSection 4652.5 of the end insertbegin insertWelfare and Institutions Codeend insert
36begin insert is amended to read:end insert

37

4652.5.  

(a) (1) An entitybegin delete receivingend deletebegin insert that receivesend insert payments
38from one or more regional centers shall contract with an
39independent accounting firmbegin delete for anend deletebegin insert to obtain an independentend insert audit
40orbegin insert independentend insert reviewbegin insert reportend insert of its financial statementsbegin insert relating
P10   1to payments made by regional centers,end insert
subject tobegin delete allend deletebegin insert bothend insert of the
2following:

3(A) begin deleteWhen end deletebegin insertIf end insertthe amount received from the regional center or
4regional centers during the entity’s fiscal year is more than or equal
5tobegin delete two hundred fifty thousand dollars ($250,000)end deletebegin insert five hundred
6thousand dollars ($500,000),end insert
but less thanbegin delete five hundred thousand
7dollars ($500,000),end delete
begin insert two million dollars ($2,000,000),end insert the entity
8shall obtain an independentbegin delete audit or independentend delete review report of
9its financial statements for the period. Consistent with Subchapter
1021 (commencing with Section 58800)begin insert of Chapter 3 of Division 2end insert
11 of Title 17 of the California Code of Regulations, this subdivision
12shall also apply to work activity program providers receiving less
13thanbegin delete two hundred fifty thousand dollars ($250,000).end deletebegin insert five hundred
14thousand dollars ($500,000).end insert

15(B) begin deleteWhen end deletebegin insertIf end insertthe amount received from the regional center or
16regional centers during the entity’s fiscal year is equal to or more
17thanbegin delete five hundred thousand dollars ($500,000),end deletebegin insert two million dollars
18($2,000,000),end insert
the entity shall obtain an independent audit of its
19financial statements for the period.

20(2) This requirement does not apply to payments made using
21usual and customary rates, as defined by Title 17 of the California
22Code of Regulations, for services provided by regional centers.

23(3) This requirement does not apply to state and local
24governmental agencies, the University of California, or the
25California State University.

26(b) An entity subject to subdivision (a) shall provide copies of
27the independent audit or independent review report required by
28subdivision (a), and accompanying management letters, to the
29vendoring regional center withinbegin delete 30 days after completion of the
30audit or review.end delete
begin insert nine months of the end of the fiscal year for the
31entity.end insert

32(c) Regional centersbegin delete receivingend deletebegin insert that receiveend insert the audit or review
33reports required by subdivision (b) shall review and require
34resolution by the entity for issues identified in the report that have
35an impact on regional center services. Regional centers shall take
36appropriate action, up to termination of vendorization, for lack of
37adequate resolution of issues.

38(d) Regional centers shall notify the department of all qualified
39opinion reports or reports noting significant issues that directly or
P11   1indirectly impact regional center services within 30 days after
2receipt. Notification shall include a plan for resolution of issues.

3(e) For purposes of this section, an independent review of
4financial statementsbegin delete mustend deletebegin insert shallend insert be performed by an independent
5accounting firm and shall cover, at a minimum, all of the following:

6(1) An inquiry as to the entity’s accounting principles and
7practices and methods used in applying them.

8(2) An inquiry as to the entity’s procedures for recording,
9classifying, and summarizing transactions and accumulating
10information.

11(3) Analytical procedures designed to identify relationships or
12items that appear to be unusual.

13(4) An inquiry about budgetary actions taken at meetings of the
14board of directors or other comparable meetings.

15(5) An inquiry about whether the financial statements have been
16properly prepared in conformity with generally accepted accounting
17principles and whether any events subsequent to the date of the
18financial statements would have a material effect on the statements
19under review.

20(6) Working papers prepared in connection with a review of
21financial statements describing the items covered as well as any
22unusual items, including their disposition.

23(f) For purposes of this section, an independent review report
24shall cover, at a minimum, all of the following:

25(1) Certification that the review was performed in accordance
26with standards established by the American Institute of Certified
27Public Accountants.

28(2) Certification that the statements are the representations of
29management.

30(3) Certification that the review consisted of inquiries and
31analytical procedures that are lesser in scope than those of an audit.

32(4) Certification that the accountant is not aware of any material
33modifications that need to be made to the statements for them to
34be in conformity with generally accepted accounting principles.

35(g) The department shall not consider a request for adjustments
36to rates submitted in accordance with Title 17 of the California
37Code of Regulations by an entity receiving payments from one or
38more regional centers solely to fund either anticipated or
39unanticipated changes required to comply with this section.

begin insert

P12   1(h) (1) An entity required to obtain an independent review
2report of its financial statement pursuant to subparagraph (A) of
3paragraph (1) of subdivision (a) may apply to the regional center
4for, and the regional center shall grant, a two-year exemption from
5the independent review report requirement if the regional center
6does not find issues in the prior year’s independent review report
7that have an impact on regional center services.

end insert
begin insert

8(2) An entity required to obtain an independent audit of its
9financial statements pursuant to subparagraph (B) of paragraph
10(1) of subdivision (a) may apply to the regional center for an
11exemption from the independent audit requirement, subject to both
12of the following conditions:

end insert
begin insert

13(A) If the independent audit for the prior year resulted in an
14unmodified opinion or an unmodified opinion with additional
15communication, the regional center shall grant the entity a
16two-year exemption.

end insert
begin insert

17(B) If the independent audit for the prior year resulted in a
18qualified opinion and the issues are not material, the regional
19center shall grant the entity a two-year exemption. The entity and
20the regional center shall continue to address issues raised in this
21independent audit, regardless of whether the exemption is granted.

end insert
begin insert

22(3) A regional center shall annually report to the department
23any exemptions granted pursuant to this subdivision.

end insert
24begin insert

begin insertSEC. 5.end insert  

end insert

begin insertSection 4689.8 of the end insertbegin insertWelfare and Institutions Codeend insert
25begin insert is amended to read:end insert

26

4689.8.  

Notwithstanding any otherbegin delete provision ofend delete law or
27regulation, commencing July 1, 2008:

28(a) No regional center may pay an existing supported living
29service provider, for services where rates are determined through
30a negotiation between the regional center and the provider, a rate
31higher than the rate in effect on June 30, 2008, unless the increase
32is required by a contract between the regional center and the vendor
33that is in effect on June 30, 2008, or the regional center
34demonstrates that the approval is necessary to protect the
35consumer’s health or safety and the department has granted prior
36written authorization.

37(b) No regional center may negotiate a rate with a new supported
38living service provider, for services where rates are determined
39through a negotiation between the regional center and the provider,
40that is higher than the regional center’s median rate for the same
P13   1service code and unit of service, or the statewide median rate for
2the same service code and unit of service, whichever is lower. The
3unit of service designation shall conform with an existing regional
4center designation or, if none exists, a designation used to calculate
5the statewide median rate for the same service. The regional center
6shall annually certify to the State Department of Developmental
7Services its median rate for each negotiated rate service code, by
8designated unit of service. This certification shall be subject to
9verification through the department’s biennial fiscal audit of the
10regional center.

begin insert

11(c) Notwithstanding any other law or regulation, commencing
12July 1, 2016, and to the extent funds are appropriated in the annual
13Budget Act for this purpose, the rates in effect on June 30, 2016,
14for supported living services, as defined in Subchapter 19 of
15Chapter 3 of Division 2 of Title 17 of the California Code of
16Regulations, shall be increased by 5 percent. The increase shall
17be applied as a percentage, and the percentage shall be the same
18for all providers.

end insert
19begin insert

begin insertSEC. 6.end insert  

end insert

begin insertSection 4690.5 of the end insertbegin insertWelfare and Institutions Codeend insert
20begin insert is amended to read:end insert

21

4690.5.  

Notwithstanding any otherbegin delete provision ofend delete law or
22regulation, commencing July 1,begin delete 2006,end deletebegin insert 2016, and to the extent funds
23are appropriated in the annual Budget Act for this purpose,end insert
the
24rate for family member-provided respite services authorized by
25the department and in operation June 30,begin delete 2006,end deletebegin insert 2016,end insert shall be
26increased bybegin delete 3 percent, subject to funds specifically appropriated
27for this increase in the Budget Act of 2006.end delete
begin insert 5 percent.end insert The increase
28shall be applied as a percentage, and the percentage shall be the
29same for all providers.

30begin insert

begin insertSEC. 7.end insert  

end insert

begin insertSection 4691.6 of the end insertbegin insertWelfare and Institutions Codeend insert
31begin insert is amended to read:end insert

32

4691.6.  

(a) Notwithstanding any other law or regulation,
33commencing July 1, 2006, the community-based day program,
34work activity program, and in-home respite service agency rate
35schedules authorized by the department and in operation June 30,
362006, shall be increased by 3 percent, subject to funds specifically
37appropriated for this increase in the Budget Act of 2006. The
38increase shall be applied as a percentage, and the percentage shall
39be the same for all providers. Any subsequent increase shall be
P14   1governed by subdivisions (b), (c), (d), (e), (f), (g), (h), (i),begin delete andend delete (j),
2begin insert (k), and (l),end insert and Section 4691.9.

3(b) Notwithstanding any other law or regulation, the department
4shall not establish any permanent payment rate for a
5community-based day program or in-home respite service agency
6provider that has a temporary payment rate in effect on June 30,
72008, if the permanent payment rate would be greater than the
8temporary payment rate in effect on or after June 30, 2008, unless
9the regional center demonstrates to the department that the
10permanent payment rate is necessary to protect the consumers’
11health or safety.

12(c) Notwithstanding any other law or regulation, neither the
13department nor any regional center shall approve any program
14design modification or revendorization for a community-based
15day program or in-home respite service agency provider that would
16result in an increase in the rate to be paid to the vendor from the
17rate that is in effect on or after June 30, 2008, unless the regional
18 center demonstrates that the program design modification or
19revendorization is necessary to protect the consumers’ health or
20safety and the department has granted prior written authorization.

21(d) Notwithstanding any other law or regulation, the department
22shall not approve an anticipated rate adjustment for a
23community-based day program or in-home respite service agency
24provider that would result in an increase in the rate to be paid to
25the vendor from the rate that is in effect on or after June 30, 2008,
26unless the regional center demonstrates that the anticipated rate
27adjustment is necessary to protect the consumers’ health or safety.

28(e) Notwithstanding any other law or regulation, except as set
29forth in subdivisions (f) and (i), the department shall not approve
30any rate adjustment for a work activity program that would result
31in an increase in the rate to be paid to the vendor from the rate that
32is in effect on or after June 30, 2008, unless the regional center
33demonstrates that the rate adjustment is necessary to protect the
34consumers’ health and safety and the department has granted prior
35written authorization.

36(f) Notwithstanding any other law or regulation, commencing
37July 1, 2014, the department may approve rate adjustments for a
38work activity program that demonstrates to the department that
39the rate adjustment is necessary in order to pay employees who,
40prior to July 1, 2014, were being compensated at a wage that is
P15   1less than the minimum wage established on and after July 1, 2014,
2by Section 1182.12 of the Labor Code, as amended by Chapter
3351 of the Statutes of 2013. The rate adjustment pursuant to this
4subdivision shall be specific to payroll costs associated with any
5increase necessary to adjust employee pay only to the extent
6necessary to bring pay into compliance with the increased state
7minimum wage, and shall not constitute a general wage
8enhancement for employees paid above the increased minimum
9wage.

10(g) Notwithstanding any other law or regulation, commencing
11July 1, 2014, community-based day program and in-home respite
12services agency providers with temporary payment rates set by
13the department may seek unanticipated rate adjustments from the
14department due to the impacts of the increased minimum wage as
15established by Section 1182.12 of the Labor Code, as amended by
16Chapter 351 of the Statutes of 2013. The rate adjustment shall be
17specific to payroll costs associated with any increase necessary to
18adjust employee pay only to the extent necessary to bring pay into
19compliance with the increased state minimum wage, and shall not
20constitute a general wage enhancement for employees paid above
21the increased minimum wage.

22(h) Notwithstanding any other law or regulation, commencing
23 January 1, 2015, the in-home respite service agency rate schedule
24authorized by the department and in operation December 31, 2014,
25shall be increased by 5.82 percent, subject to funds specifically
26appropriated for this increase for costs due to changes in federal
27regulations implementing the federal Fair Labor Standards Act of
281938 (29 U.S.C. Sec. 201 et seq.). The increase shall be applied
29as a percentage, and the percentage shall be the same for all
30applicable providers.

31(i) Notwithstanding any other law or regulation, commencing
32July 1, 2015, the department may approve rate adjustments for a
33work activity program that demonstrates to the department that
34the rate adjustment is necessary to implement Article 1.5
35(commencing with Section 245) of Chapter 1 of Part 1 of Division
362 of the Labor Code, as added by Chapter 317 of the Statutes of
372014. The rate adjustment may be applied only if a minimum of
3824 hours or three days of paid sick leave per year was not a benefit
39provided to employees as of June 30, 2015, and shall be specific
40to payroll costs associated with any increase necessary to
P16   1compensate an employee up to a maximum of 24 hours or three
2days of paid sick leave in each year of employment.

3(j) Notwithstanding any other law or regulation, commencing
4July 1, 2015, community-based day program and in-home respite
5services agency providers with temporary payment rates set by
6the department may seek unanticipated rate adjustments from the
7department if the adjustment is necessary to implement Article 1.5
8(commencing with Section 245) of Chapter 1 of Part 1 of Division
92 of the Labor Code, as added by Chapter 317 of the Statutes of
102014. The rate adjustment may be applied only if a minimum of
1124 hours or three days of paid sick leave per year was not a benefit
12provided to employees as of June 30, 2015, and shall be specific
13to payroll costs associated with any increase necessary to
14compensate an employee up to a maximum of 24 hours or three
15days of paid sick leave in each year of employment.

begin insert

16(k) Notwithstanding any other law or regulation, commencing
17July 1, 2016, and to the extent funds are appropriated in the annual
18Budget Act for this purpose, the in-home respite service agency
19rate schedule authorized by the department and in operation June
2030, 2016, shall be increased by 5 percent. The increase shall be
21applied as a percentage, and the percentage shall be the same for
22all providers.

end insert
begin insert

23(l) Notwithstanding any other law or regulation, commencing
24July 1, 2016, and to the extent funds are appropriated in the annual
25Budget Act for this purpose, the independent living service rate
26schedule authorized by the department and in operation June 30,
272016, shall be increased by 5 percent. The increase shall be applied
28as a percentage, and the percentage shall be the same for all
29providers.

end insert
30begin insert

begin insertSEC. 8.end insert  

end insert

begin insertSection 4691.9 of the end insertbegin insertWelfare and Institutions Codeend insert
31begin insert is amended to read:end insert

32

4691.9.  

(a) Notwithstanding any other law or regulation,
33commencing July 1, 2008:

34(1) A regional center shall not pay an existing service provider,
35for services where rates are determined through a negotiation
36between the regional center and the provider, a rate higher than
37the rate in effect on June 30, 2008, unless the increase is required
38by a contract between the regional center and the vendor that is in
39effect on June 30, 2008, or the regional center demonstrates that
P17   1the approval is necessary to protect the consumer’s health or safety
2and the department has granted prior written authorization.

3(2) A regional center shall not negotiate a rate with a new service
4provider, for services where rates are determined through a
5negotiation between the regional center and the provider, that is
6higher than the regional center’s median rate for the same service
7code and unit of service, or the statewide median rate for the same
8service code and unit of service, whichever is lower. The unit of
9service designation shall conform with an existing regional center
10designation or, if none exists, a designation used to calculate the
11statewide median rate for the same service. The regional center
12shall annually certify to the State Department of Developmental
13Services its median rate for each negotiated rate service code, by
14designated unit of service. This certification shall be subject to
15verification through the department’s biennial fiscal audit of the
16regional center.

17(b) Notwithstanding subdivision (a), commencing July 1, 2014,
18regional centers may negotiate a rate adjustment with providers
19regarding rates if the adjustment is necessary in order to pay
20 employees no less than the minimum wage as established by
21Section 1182.12 of the Labor Code, as amended by Chapter 351
22of the Statutes of 2013, and only for the purpose of adjusting
23payroll costs associated with the minimum wage increase. The
24rate adjustment shall be specific to the unit of service designation
25that is affected by the increased minimum wage, shall be specific
26to payroll costs associated with any increase necessary to adjust
27employee pay only to the extent necessary to bring pay into
28compliance with the increased state minimum wage, and shall not
29be used as a general wage enhancement for employees paid above
30the increased minimum wage. Regional centers shall maintain
31documentation on the process to determine, and the rationale for
32granting, any rate adjustment associated with the minimum wage
33increase.

34(c) Notwithstanding any other law or regulation, commencing
35January 1, 2015, rates for personal assistance and supported living
36 services in effect on December 31, 2014, shall be increased by
375.82 percent, subject to funds specifically appropriated for this
38increase for costs due to changes in federal regulations
39implementing the federal Fair Labor Standards Act of 1938 (29
40U.S.C. Sec. 201 et seq.). The increase shall be applied as a
P18   1percentage, and the percentage shall be the same for all applicable
2providers. As used in this subdivision, both of the following
3definitions shall apply:

4(1) “Personal assistance” is limited only to those services
5provided by vendors classified by the regional center as personal
6assistance providers, pursuant to the miscellaneous services
7provisions contained in Title 17 of the California Code of
8Regulations.

9(2) “Supported living services” are limited only to those services
10defined as supported living services in Title 17 of the California
11Code of Regulations.

12(d) Notwithstanding subdivision (a), commencing July 1, 2015,
13regional centers may negotiate a rate adjustment with existing
14service providers for services for which rates are determined
15through negotiation between the regional center and the provider,
16if the adjustment is necessary to implement Article 1.5
17(commencing with Section 245) of Chapter 1 of Part 1 of Division
182 of the Labor Code, as added by Chapter 317 of the Statutes of
192014. The rate adjustment may be applied only if a minimum of
2024 hours or three days of paid sick leave per year was not a benefit
21provided to employees as of June 30, 2015, and shall be specific
22to payroll costs associated with any increase necessary to
23compensate an employee up to a maximum of 24 hours or three
24days of paid sick leave in each year of employment.

begin insert

25(e) Notwithstanding any other law or regulation, commencing
26July 1, 2016, and to the extent funds are appropriated in the annual
27Budget Act for this purpose, rates for transportation services in
28effect on June 30, 2016, shall be increased by 5 percent. The
29increase shall be applied as a percentage to existing rates, and
30the percentage shall be the same for all applicable providers.

end insert
begin delete

31(e)

end delete

32begin insert(f)end insert This section shall not apply to those services for which rates
33are determined by the State Department of Health Care Services,
34or the State Department of Developmental Services, or are usual
35and customary.

36begin insert

begin insertSEC. 9.end insert  

end insert

begin insertSection 4691.10 is added to the end insertbegin insertWelfare and Institutions
37Code
end insert
begin insert, to read:end insert

begin insert
38

begin insert4691.10.end insert  

(a) (1) Notwithstanding any other law or regulation,
39and to the extent funds are appropriated in the annual Budget Act
40for this purpose, the department shall provide a rate increase for
P19   1the purpose of enhancing wages and benefits for staff who spend
2a minimum of 75 percent of their time providing direct services to
3consumers. The department shall not allocate more than one
4hundred sixty-nine million five hundred thousand dollars
5($169,500,000) of the amount appropriated in the act that added
6this section for this purpose, plus any associated matching funds.
7The rate increase shall only apply to services for which rates are
8set by the department or through negotiations between the regional
9centers and service providers, and to the rates paid for supported
10employment services, as specified in subdivisions (a) and (b) of
11Section 4860, and vouchered community-based services, as
12specified in paragraph (7) of subdivision (c) of Section 4688.21.
13This section shall not apply to those services for which rates are
14determined by other entities, including, but not limited to, the State
15Department of Health Care Services or the State Department of
16Social Services, or are usual and customary.

17(2) For the purposes of this subdivision, “direct services” are
18services, supports, care, supervision, or assistance provided by
19staff directly to a consumer to address the consumer’s needs, as
20identified in the individual program plan, and include staff’s
21participation in training and other activities directly related to
22providing services to consumers, as well as program preparation
23functions as defined in Section 54302 of Title 17 of the California
24Code of Regulations. State employees participating in the
25Community State Staff Program are ineligible for the wage
26 increase described in this section.

27(b) The rate increase specified in subdivision (a) shall be
28implemented in the following manner:

29(1) With regional center participation, the department shall
30conduct a survey of a random sample of service providers in each
31service category eligible for the rate increase. The survey shall
32request information regarding all of the following and shall be
33returned to the regional center and department by April 15, 2016:

34(A) Number of employees who spend a minimum of 75 percent
35of their time providing direct services to consumers and their total
36salary, wage, and benefit costs.

37(B) Administrative costs as specified in subdivision (b) of Section
384629.7, including the number of employees and total salary, wage,
39and benefit costs associated with those administrative costs.

P20   1(C) Any other staff and their total salary, wage, and benefit
2costs that are not included in either subparagraph (A) or (B).

3(D) Any other costs to the provider, other than the costs
4described in subparagraphs (A) to (C), inclusive.

5(E) Any additional information, as requested by the department,
6to assist in the determination of rate increases.

7(2) The vendoring regional center shall certify that, to the best
8of its knowledge, the survey results accurately reflect the services
9provided by each surveyed service provider. The results from the
10survey shall be used by the department to determine the rate
11increase to be applied, by service category. The rate increase shall
12be the same for all eligible providers in each service category and
13is intended to provide comparable increases across service
14categories for staff providing direct services as described in
15subdivision (a).

16(3) By July 1, 2016, utilizing the data derived from paragraph
17(1), the department shall do both of the following:

18(A) For those service providers whose rates are set by the
19department, notify those providers and the associated regional
20centers of the amount by which the rates are to be increased.

21(B) For those service providers whose rates are set by
22negotiation with the regional center, notify the regional center of
23the amount by which the rates are to be increased.

24(4) With regional center participation, the department shall
25conduct a survey, in a format determined by the department, of all
26providers who received the rate increase described in subdivision
27(a). Providers shall submit the completed survey to the department
28by October 1, 2017. The survey shall request information on how
29the rate increase was used by providers and shall include, but is
30not limited to, the following:

31(A) Number of employees and their salary, wage, and benefit
32costs, and increases provided as a result of this subdivision.

33(B) Percentage of time each employee spends providing direct
34services.

35(C) Administrative expenses, consistent with subdivision (b) of
36Section 4629.7.

37(D) Any additional information as determined by the department.

38(c) Providers granted a rate increase pursuant to this section
39shall maintain documentation, subject to audit by the department
40or regional center, that the rate increase was used solely to
P21   1increase wages, salaries, and benefits of eligible staff members
2spending a minimum of 75 percent of their time providing direct
3services to consumers.

4(d) The rate increases calculated by the department pursuant
5to this section shall be effective July 1, 2016, and implemented as
6described in subdivision (b).

7(e) Any provider that fails to report the information required
8by paragraph (4) of subdivision (b) to the department by October
91, 2017, shall forfeit the increases described in subdivision (a).

10(f) In its 2017-18 May Revision fiscal estimate, the department
11shall describe the implementation of the increases provided
12pursuant to this section.

end insert
13begin insert

begin insertSEC. 10.end insert  

end insert

begin insertSection 4691.11 is added to the end insertbegin insertWelfare and
14Institutions Code
end insert
begin insert, to read:end insert

begin insert
15

begin insert4691.11.end insert  

Notwithstanding any other law or regulation, and to
16the extent funds are appropriated in the annual Budget Act for this
17purpose, the department shall allocate no more than nine million
18nine hundred thousand dollars ($9,900,000) plus any associated
19matching funds for the purpose of administrative expenses for
20service providers. The department shall provide a rate increase
21for the purpose of administrative expenses that shall apply only
22to providers for which rates are set by the department or through
23negotiations between the regional centers and service providers,
24and to the rates paid for supported employment services, as
25specified in subdivisions (a) and (b) of Section 4860, and vouchered
26community-based services, as specified in paragraph (7) of
27subdivision (c) of Section 4688.21. This increase shall be
28determined using the information collected pursuant to subdivision
29(b) of Section 4691.10. This increase shall be consistent for
30providers within each service category and is intended to provide
31comparable increases for administrative expenses across service
32categories. This section shall not apply to those services for which
33rates are determined by other entities, including, but not limited
34to, the State Department of Health Care Services or the State
35Department of Social Services, or are usual and customary.

end insert
36begin insert

begin insertSEC. 11.end insert  

end insert

begin insertSection 4860 of the end insertbegin insertWelfare and Institutions Codeend insertbegin insert is
37amended to read:end insert

38

4860.  

(a) (1) The hourly rate for supported employment
39services provided to consumers receiving individualized services
40begin delete shall be thirty dollars and eighty-two cents ($30.82).end deletebegin insert is thirty-four
P22   1dollars and twenty-four cents ($34.24). The rate shall be adjusted
2by the department pursuant to subdivision (a) of Sections 4691.10
3and 4691.11.end insert

4(2) Job coach hours spent in travel to consumer worksites may
5be reimbursable for individualized services only when the job
6coach travels from the vendor’s headquarters to the consumer’s
7worksite or from one consumer’s worksite to another, and only
8when the travel is one way.

9(b) The hourly rate for group servicesbegin delete shall be thirty dollars and
10eighty-two cents ($30.82),end delete
begin insert is thirty-four dollars and twenty-four
11cents ($34.24),end insert
regardless of the number of consumers served in
12the group. Consumers in a group shall be scheduled to start and
13end work at the same time, unless an exception that takes into
14consideration the consumer’s compensated work schedule is
15approved in advance by the regional center. The department, in
16consultation with stakeholders, shall adopt regulations to define
17the appropriate grounds for granting these exceptions. When the
18number of consumers in a supported employment placement group
19drops to fewer than the minimum required in subdivision (r) of
20Section 4851, the regional center may terminate funding for the
21group services in that group, unless, within 90 days, the program
22provider adds one or more regional centers, or Department of
23Rehabilitation-funded supported employment consumers to the
24group.begin insert The rate shall be adjusted by the department pursuant to
25subdivision (a) of Sections 4691.10 and end insert
begin insert4691.11.end insert

26(c) Job coaching hours for group services shall be allocated on
27a prorated basis between a regional center and the Department of
28Rehabilitation when regional center and Department of
29Rehabilitation consumers are served in the same group.

30(d) When Section 4855 applies, fees shall be authorized for the
31following:

32(1) A three-hundred-sixty-dollar ($360) fee shall be paid to the
33program provider upon intake of a consumer into a supported
34employment program. No fee shall be paid if that consumer
35completed a supported employment intake process with that same
36supported employment program within the previous 12 months.

37(2) A seven-hundred-twenty-dollar ($720) fee shall be paid
38upon placement of a consumer in an integrated job, except that no
39fee shall be paid if that consumer is placed with another consumer
P23   1or consumers assigned to the same job coach during the same hours
2of employment.

3(3) A seven-hundred-twenty-dollar ($720) fee shall be paid after
4a 90-day retention of a consumer in a job, except that no fee shall
5be paid if that consumer has been placed with another consumer
6or consumers, assigned to the same job coach during the same
7hours of employment.

8(e) Notwithstanding paragraph (4) of subdivision (a) of Section
94648, the regional center shall pay the supported employment
10program rates established by this section.

begin insert

11(f) The department, with regional center participation, shall
12conduct an annual survey of providers, in a format determined by
13the department, to collect the following information:

end insert
begin insert

14(1) The number of employment placements in the previous 12
15months.

end insert
begin insert

16(2) Types of employment in which consumers are placed.

end insert
begin insert

17(3) The cost components of the rates in subdivisions (a) and (b),
18including, but not limited to, the amount used for hourly wages of
19job coaches, administration, and placement search costs.

end insert
begin insert

20(4) The number of hours each consumer works and the
21consumer’s hourly wage.

end insert
begin insert

22(5) Any other information determined by the department.

end insert
begin insert

23(g) In its 2017-18 May Revision fiscal estimate, the department
24shall describe the results of the survey described in subdivision
25(f).

end insert
26begin insert

begin insertSEC. 12.end insert  

end insert

begin insertSection 4870 is added to the end insertbegin insertWelfare and Institutions
27Code
end insert
begin insert, to read:end insert

begin insert
28

begin insert4870.end insert  

(a) To encourage competitive integrated employment
29opportunities statewide for individuals with developmental
30disabilities, the department shall establish guidelines and oversee
31a program, to the extent funds are appropriated in the annual
32Budget Act for this purpose, to increase paid internship
33opportunities for individuals with developmental disabilities that
34produce outcomes consistent with the individual program plan.
35The department shall consult with the State Council on
36Developmental Disabilities, regional centers, employers, supported
37employment provider organizations, and clients’ rights advocates,
38to establish a program that shall be administered by community
39service providers and that meets all of the following criteria:

P24   1(1) Payments for internships shall not exceed ten thousand four
2hundred dollars ($10,400) per year for each individual placed in
3an internship.

4(2) Placements shall be made into competitive, integrated work
5environments.

6(3) Placements shall be made into internships that develop skills
7that will facilitate paid employment opportunities in the future.

8(4) Regional centers shall increase awareness of these
9internships to consumers outside of current employment programs
10through outreach to consumers once the program is implemented,
11as well as during the individual program plan process.

12(b) The department shall require annual reporting by regional
13centers and vendors that ensures program accountability and
14achievement of program goals. This shall include, but is not limited
15 to, all of the following:

16(1) The number of interns placed who might not otherwise have
17achieved the placement absent this internship program.

18(2) Types of employment in which interns are placed.

19(3) Length of internships.

20(4) Demographic information of interns.

21(5) Amount of each intern placement payment.

22(6) Employment-related supports provided by another agency
23or individual to the intern.

24(7) Number of interns who subsequently entered paid
25employment, including salary and benefit information.

26(8) Any additional information, as determined by the department.

27(c) The department shall include in its annual May Revision
28fiscal estimate a description of the implementation of the program,
29including, but not limited to, a description of the stakeholder
30consultation, the data described in subdivision (b), aggregated by
31regional center and statewide, and any recommendations for
32program changes that may be necessary or desirable to maximize
33program effectiveness and accountability.

34(d) Consistent with the individual program plan, the program
35shall increase sustained and appropriate competitive integrated
36employment placements by providers of supported employment
37services, as defined in subdivision (p) of Section 4851, as follows:

38(1) A payment of one thousand dollars ($1,000) to the supported
39employment services provider for initial placements made on or
40after July 1, 2016, in competitive integrated employment, as defined
P25   1in subdivision (o) of Section 4851 and subdivision (d) of Section
24868.

3(2) An additional payment of one thousand two hundred fifty
4dollars ($1,250) to the supported employment services provider
5for an individual described in paragraph (1) who remains in
6competitive integrated employment for six consecutive months.

7(3) An additional payment of one thousand five hundred dollars
8($1,500) to the supported employment services provider for an
9individual described in paragraphs (1) and (2) who remains in
10competitive integrated employment for 12 consecutive months.

11(e) Regional centers shall annually report to the department
12the payments for placements pursuant to subdivision (d). The
13information shall be reported in a format determined by the
14department, and shall include the number of individuals placed in
15internships or other employment as described in this section each
16year.

end insert
17begin insert

begin insertSEC. 13.end insert  

end insert

begin insertSection 14105.075 is added to the end insertbegin insertWelfare and
18Institutions Code
end insert
begin insert, to read:end insert

begin insert
19

begin insert14105.075.end insert  

(a) Notwithstanding any other law, for dates of
20service on or after August 1, 2016, payments to intermediate care
21facilities for the developmentally disabled that are licensed
22pursuant to subdivision (e), (g), or (h) of Section 1250 of the Health
23and Safety Code, and to facilities providing continuous skilled
24nursing care to developmentally disabled individuals pursuant to
25the pilot project established by Section 14132.20, as determined
26by the applicable methodology for setting reimbursement rates for
27those facilities, shall be the reimbursement rates that were
28applicable to those facilities in the 2008-09 rate year, increased
29by 3.7 percent. Payments to the facilities pursuant to this section
30shall also include the projected cost of complying with new state
31or federal mandates to the extent applicable to the reimbursement
32methodology associated with the type of facility.

33(b) The director shall seek any necessary federal approvals to
34implement this section. This section shall not be implemented until
35the necessary federal approval is obtained, and only to the extent
36federal financial participation is available. If, and only to the
37extent, federal approval is obtained to implement this section, the
38payments resulting from the application of subdivision (a) shall
39be implemented retroactively to August 1, 2016, or any later
P26   1effective date identified in the federal approval that is obtained,
2as applicable.

end insert
3begin insert

begin insertSEC. 14.end insert  

end insert

begin insertSection 14105.195 is added to the end insertbegin insertWelfare and
4Institutions Code
end insert
begin insert, to read:end insert

begin insert
5

begin insert14105.195.end insert  

(a) Notwithstanding Sections 14105.191 and
614105.192, the department shall not seek to retroactively implement
7the reductions and limitations to the reimbursement for services
8provided by skilled nursing facilities that are distinct parts of
9general acute care hospitals set forth in Sections 14105.191 and
1014105.192 for dates of service on or after June 1, 2011, and on or
11before September 30, 2013. For purposes of this section, “distinct
12part” has the same meaning as defined in Section 72041 of Title
1322 of the California Code of Regulations.

14(b) The department shall not seek to recoup any overpayments
15from skilled nursing facilities that are distinct parts of general
16acute care hospitals resulting from the reductions and limitations
17to the reimbursement for these facilities pursuant to Sections
1814105.191 and 14105.192 for dates of service on or after June 1,
192011, and on or before September 30, 2013.

20(c) Notwithstanding Chapter 3.5 (commencing with Section
2111340) of Part 1 of Division 3 of Title 2 of the Government Code,
22the department may implement this section by means of provider
23bulletins or notices, policy letters, or other similar instructions,
24without taking regulatory action.

end insert
25begin insert

begin insertSEC. 15.end insert  

end insert
begin insert

(a) The sum of two hundred eighty-seven million
26dollars ($287,000,000) is hereby appropriated from the General
27Fund to the State Department of Developmental Services to provide
28all of the following, effective July 1, 2016:

end insert
begin insert

29(1) Twenty-nine million seven hundred thousand dollars
30($29,700,000) for regional centers for staff, in an allocation to be
31determined by the department.

end insert
begin insert

32(2) One million four hundred thousand dollars ($1,400,000) for
33regional centers for administrative costs, in an allocation to be
34determined by the department. This amount includes an amount
35to be allocated by the department for regional center clients’ rights
36advocates contracts pursuant to subdivision (b) of Section 4433.

end insert
begin insert

37(3) Nine million nine hundred thousand dollars ($9,900,000)
38for administrative costs for service providers, in an allocation to
39be determined by the department.

end insert
begin insert

P27   1(4) One hundred sixty-nine million five hundred thousand dollars
2($169,500,000) for a rate increase for staff providing direct
3services employed by a community-based provider organization,
4in a manner to be determined by the department.

end insert
begin insert

5(5) A 5-percent rate increase for supported and independent
6living services.

end insert
begin insert

7(6) Twenty million dollars ($20,000,000) for competitive
8integrated employment incentive payments.

end insert
begin insert

9(7) A 5-percent rate increase for in-home and out-of-home
10respite services.

end insert
begin insert

11(8) A 5-percent increase for transportation services.

end insert
begin insert

12(9) A three-dollar-and-forty-two-cent ($3.42) per hour rate
13increase for supported employment providers.

end insert
begin insert

14(10) Eleven million dollars ($11,000,000) for bilingual staff at
15regional centers and implementing plans and recommendations
16to address disparities.

end insert
begin insert

17(b) These funds shall be available for encumbrance until June
1830, 2017, and available for expenditure until June 30, 2019.

end insert
19begin insert

begin insertSEC. 16.end insert  

end insert
begin insert

The increases in rates and payments provided for in
20this act shall be effective July 1, 2016, and August 1, 2016, as
21expressly provided in this act, unless otherwise provided in this
22act.

end insert
begin delete
23

SECTION 1.  

It is the intent of the Legislature to enact
24legislation that does both of the following:

25(a) Establishes funding sources and mechanisms in order to
26provide additional support for, and access to, Medi-Cal and
27developmental services.

28(b) Uses the funding sources and mechanisms described in
29subdivision (a) to increase access, ensure network adequacy,
30improve quality, and minimize geographic and service shortages
31in the Medi-Cal program and to increase access to services
32provided through regional centers.

end delete


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