BILL NUMBER: ABX2 1 CHAPTERED
BILL TEXT
CHAPTER 3
FILED WITH SECRETARY OF STATE MARCH 1, 2016
APPROVED BY GOVERNOR MARCH 1, 2016
PASSED THE SENATE FEBRUARY 29, 2016
PASSED THE ASSEMBLY FEBRUARY 29, 2016
AMENDED IN SENATE SEPTEMBER 3, 2015
INTRODUCED BY Assembly Members Thurmond, Bonta, and Maienschein and
Senators Beall and Cannella
(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)
(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)
JULY 2, 2015
An act 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.
LEGISLATIVE COUNSEL'S DIGEST
AB 1, Thurmond. Developmental services: Medi-Cal: funding.
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.
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.
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.
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.
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.
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.
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.
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.
Appropriation: yes.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 4519.5 of the Welfare and Institutions Code is
amended to read:
4519.5. (a) The department and the regional centers shall
annually collaborate to compile data in a uniform manner relating to
purchase of service authorization, utilization, and expenditure by
each regional center with respect to all of the following:
(1) The age of the consumer, categorized by the following:
(A) Birth to two years of age, inclusive.
(B) Three to 21 years of age inclusive.
(C) Twenty-two years of age and older.
(2) Race or ethnicity of the consumer.
(3) Primary language spoken by the consumer, and other related
details, as feasible.
(4) Disability detail, in accordance with the categories
established by subdivision (a) of Section 4512, and, if applicable, a
category specifying that the disability is unknown.
(5) Residence type, subcategorized by age, race or ethnicity, and
primary language.
(6) Number of instances when the written copy of the individual
program plan was provided at the request of the consumer and, when
appropriate, his or her parents, legal guardian or conservator, or
authorized representative, in a language other than a threshold
language, as defined by paragraph (3) of subdivision (a) of Section
1810.410 of Title 9 of the California Code of Regulations, if that
written copy was provided more than 60 days after the request.
(b) The data reported pursuant to subdivision (a) shall also
include the number and percentage of individuals, categorized by age,
race or ethnicity, and disability, and by residence type, as set
forth in paragraph (5) of subdivision (a), who have been determined
to be eligible for regional center services but are not receiving
purchase of service funds.
(c) By March 31, 2013, each regional center shall post the data
described in this section that is specific to the regional center on
its Internet Web site. Commencing on December 31, 2013, each regional
center shall annually post this data by December 31. Each regional
center shall maintain all previous years' data on its Internet Web
site.
(d) By March 31, 2013, the department shall post the information
described in this section on a statewide basis on its Internet Web
site. Commencing December 31, 2013, the department shall annually
post this information by December 31. The department shall maintain
all previous years' data on its Internet Web site. The department
shall also post notice of any regional center stakeholder meetings on
its Internet Web site.
(e) Within three months of compiling the data with the department,
and annually thereafter, each regional center shall meet with
stakeholders in one or more public meetings regarding the data. The
meeting or meetings shall be held separately from any meetings held
pursuant to Section 4660. The regional center shall provide
participants of these meetings with the data and any associated
information, and shall conduct a discussion of the data and the
associated information in a manner that is culturally and
linguistically appropriate for that community, including providing
alternative communication services, as required by Sections 11135 to
11139.7, inclusive, of the Government Code and implementing
regulations. Regional centers shall inform the department of the
scheduling of those public meetings 30 days prior to the meeting.
Notice of the meetings shall also be posted on the regional center's
Internet Web site 30 days prior to the meeting and shall be sent to
individual stakeholders and groups representing underserved
communities in a timely manner. Each regional center shall, in
holding the meetings required by this subdivision, consider the
language needs of the community and shall schedule the meetings at
times and locations designed to result in a high turnout by the
public and underserved communities.
(f) (1) Each regional center shall annually report to the
department regarding its implementation of the requirements of this
section. The report shall include, but shall not be limited to, all
of the following:
(A) Actions the regional center took to improve public attendance
and participation at stakeholder meetings, including, but not limited
to, attendance and participation by underserved communities.
(B) Copies of minutes from the meeting and attendee comments.
(C) Whether the data described in this section indicates a need to
reduce disparities in the purchase of services among consumers in
the regional center's catchment area. If the data does indicate that
need, the regional center's recommendations and plan to promote
equity, and reduce disparities, in the purchase of services.
(2) Each regional center and the department shall annually post
the reports required by paragraph (1) on its Internet Web site by
August 31.
(g) (1) The department shall consult with stakeholders, including
consumers and families that reflect the ethnic and language diversity
of regional center consumers, regional centers, advocates,
providers, the protection and advocacy agency described in Section
4901, and those entities designated as University Centers for
Excellence in Developmental Disabilities Education, Research, and
Service pursuant to Section 15061 of Title 42 of the United States
Code, to achieve the following objectives:
(A) Review the data compiled pursuant to subdivision (a).
(B) Identify barriers to equitable access to services and supports
among consumers and develop recommendations to help reduce
disparities in purchase of service expenditures.
(C) Encourage the development and expansion of culturally
appropriate services, service delivery, and service coordination.
(D) Identify best practices to reduce disparity and promote
equity.
(2) The department shall report the status of its efforts to
satisfy the requirements of paragraph (1) during the 2016-17
legislative budget subcommittee hearing process.
(h) Subject to available funding, the department shall allocate
funding to regional centers to assist with implementation of the
recommendations and plans developed pursuant to subdivisions (f) and
(g). Activities funded through these allocations may include, but are
not limited to, pay differentials supporting direct care bilingual
staff of community-based service providers, parent or caregiver
education programs, cultural competency training for regional center
staff, outreach to underserved populations, or additional culturally
appropriate service types or service delivery models.
SEC. 2. Section 4519.8 is added to the Welfare and Institutions
Code, to read:
4519.8. On or before March 1, 2019, the department shall submit a
rate study to the appropriate fiscal and policy committees of the
Legislature addressing the sustainability, quality, and transparency
of community-based services for individuals with developmental
disabilities. The department shall consult with stakeholders, through
the developmental services task force process, in developing the
study. The study shall include, but not be limited to, all of the
following:
(a) An assessment of the effectiveness of the methods used to pay
each category of community service provider. This assessment shall
include consideration of the following factors for each category of
service provider:
(1) Whether the current method of ratesetting for a service
category provides an adequate supply of providers in that category,
including, but not limited to, whether there is a sufficient supply
of providers to enable consumers throughout the state to have a
choice of providers, depending upon the nature of the service.
(2) A comparison of the estimated fiscal effects of alternative
rate methodologies for each service provider category.
(3) How different rate methodologies can incentivize outcomes for
consumers.
(b) An evaluation of the number and type of service codes for
regional center services, including, but not limited to,
recommendations for simplifying and making service codes more
reflective of the level and types of services provided.
SEC. 3. Section 4639.5 of the Welfare and Institutions Code is
amended to read:
4639.5. (a) By December 1 of each year, each regional center
shall provide a listing to the State Department of Developmental
Services a complete current salary schedule for all personnel
classifications used by the regional center. The information shall be
provided in a format prescribed by the department. The department
shall provide this information to the public upon request. From
February 1, 2009, to June 30, 2010, inclusive, the requirements of
this subdivision shall not apply.
(b) By December 1 of each year, each regional center shall report
information to the department on all prior fiscal year expenditures
from the regional center operations budget for all administrative
services, including managerial, consultant, accounting, personnel,
labor relations, and legal services, whether procured under a written
contract or otherwise. Expenditures for the maintenance, repair, or
purchase of equipment or property shall not be required to be
reported for purposes of this subdivision. The report shall be
prepared in a format prescribed by the department and shall include,
at a minimum, for each recipient the amount of funds expended, the
type of service, and purpose of the expenditure. The department shall
provide this information to the public upon request. Regional
centers shall not be required to prepare or submit the report
required by this subdivision in 2009.
(c) Beginning July 1, 2016, and to the extent funds are
appropriated in the annual Budget Act for this purpose, the
department shall allocate thirty-one million one hundred thousand
dollars ($31,100,000), plus any associated matching funds, to provide
a salary increase, benefit increase, or both, excluding unfunded
retirement liabilities, for regional center operations. Of this
amount, twenty-nine million seven hundred thousand dollars
($29,700,000) shall be used for salary, benefit increases, or both,
for regional center staff, and shall not supplant funding currently
scheduled to be used for this purpose. These funds shall not be used
to provide salary or benefit increases to regional center executive
staff or for unfunded retirement liabilities. The remaining one
million four hundred thousand dollars ($1,400,000) shall be used for
an increase for administrative costs, consistent with those specified
in subdivision (b) of Section 4629.7, for both regional centers and
clients' rights advocates contracts pursuant to subdivision (b) of
Section 4433. Regional centers shall maintain documentation, subject
to audit, on how this funding was allocated.
(d) By March 10, 2017, and again by October 1, 2017, and in a
format prescribed by the department, each regional center shall
report the following information to the department:
(1) The total amount provided to staff for purposes of subdivision
(c).
(2) The position titles of staff receiving the increase and
amounts of increases by title.
(3) The number of service coordinators receiving the increase.
(4) Data on staff turnover.
(5) The classification of expenditures and amount for each of the
administrative costs outlined in subdivision (b) of Section 4629.7.
(6) The allocation methodology used by a regional center to
distribute the funding.
(7) Any other information determined by the department.
(e) In its 2017-18 May Revision fiscal estimate, the department
shall describe the implementation of the increase provided in
subdivision (c), including, but not limited to, the data described in
subdivision (d), aggregated by regional center and statewide, and
the impact of the increase on caseload ratios.
(f) Any regional center that fails to report the information
required by subdivision (d) to the department shall forfeit the
increases described in subdivision (c).
SEC. 4. Section 4652.5 of the Welfare and Institutions Code is
amended to read:
4652.5. (a) (1) An entity that receives payments from one or more
regional centers shall contract with an independent accounting firm
to obtain an independent audit or independent review report of its
financial statements relating to payments made by regional centers,
subject to both of the following:
(A) If the amount received from the regional center or regional
centers during the entity's fiscal year is more than or equal to five
hundred thousand dollars ($500,000), but less than two million
dollars ($2,000,000), the entity shall obtain an independent review
report of its financial statements for the period. Consistent with
Subchapter 21 (commencing with Section 58800) of Chapter 3 of
Division 2 of Title 17 of the California Code of Regulations, this
subdivision shall also apply to work activity program providers
receiving less than five hundred thousand dollars ($500,000).
(B) If the amount received from the regional center or regional
centers during the entity's fiscal year is equal to or more than two
million dollars ($2,000,000), the entity shall obtain an independent
audit of its financial statements for the period.
(2) This requirement does not apply to payments made using usual
and customary rates, as defined by Title 17 of the California Code of
Regulations, for services provided by regional centers.
(3) This requirement does not apply to state and local
governmental agencies, the University of California, or the
California State University.
(b) An entity subject to subdivision (a) shall provide copies of
the independent audit or independent review report required by
subdivision (a), and accompanying management letters, to the
vendoring regional center within nine months of the end of the fiscal
year for the entity.
(c) Regional centers that receive the audit or review reports
required by subdivision (b) shall review and require resolution by
the entity for issues identified in the report that have an impact on
regional center services. Regional centers shall take appropriate
action, up to termination of vendorization, for lack of adequate
resolution of issues.
(d) Regional centers shall notify the department of all qualified
opinion reports or reports noting significant issues that directly or
indirectly impact regional center services within 30 days after
receipt. Notification shall include a plan for resolution of issues.
(e) For purposes of this section, an independent review of
financial statements shall be performed by an independent accounting
firm and shall cover, at a minimum, all of the following:
(1) An inquiry as to the entity's accounting principles and
practices and methods used in applying them.
(2) An inquiry as to the entity's procedures for recording,
classifying, and summarizing transactions and accumulating
information.
(3) Analytical procedures designed to identify relationships or
items that appear to be unusual.
(4) An inquiry about budgetary actions taken at meetings of the
board of directors or other comparable meetings.
(5) An inquiry about whether the financial statements have been
properly prepared in conformity with generally accepted accounting
principles and whether any events subsequent to the date of the
financial statements would have a material effect on the statements
under review.
(6) Working papers prepared in connection with a review of
financial statements describing the items covered as well as any
unusual items, including their disposition.
(f) For purposes of this section, an independent review report
shall cover, at a minimum, all of the following:
(1) Certification that the review was performed in accordance with
standards established by the American Institute of Certified Public
Accountants.
(2) Certification that the statements are the representations of
management.
(3) Certification that the review consisted of inquiries and
analytical procedures that are lesser in scope than those of an
audit.
(4) Certification that the accountant is not aware of any material
modifications that need to be made to the statements for them to be
in conformity with generally accepted accounting principles.
(g) The department shall not consider a request for adjustments to
rates submitted in accordance with Title 17 of the California Code
of Regulations by an entity receiving payments from one or more
regional centers solely to fund either anticipated or unanticipated
changes required to comply with this section.
(h) (1) An entity required to obtain an independent review report
of its financial statement pursuant to subparagraph (A) of paragraph
(1) of subdivision (a) may apply to the regional center for, and the
regional center shall grant, a two-year exemption from the
independent review report requirement if the regional center does not
find issues in the prior year's independent review report that have
an impact on regional center services.
(2) An entity required to obtain an independent audit of its
financial statements pursuant to subparagraph (B) of paragraph (1) of
subdivision (a) may apply to the regional center for an exemption
from the independent audit requirement, subject to both of the
following conditions:
(A) If the independent audit for the prior year resulted in an
unmodified opinion or an unmodified opinion with additional
communication, the regional center shall grant the entity a two-year
exemption.
(B) If the independent audit for the prior year resulted in a
qualified opinion and the issues are not material, the regional
center shall grant the entity a two-year exemption. The entity and
the regional center shall continue to address issues raised in this
independent audit, regardless of whether the exemption is granted.
(3) A regional center shall annually report to the department any
exemptions granted pursuant to this subdivision.
SEC. 5. Section 4689.8 of the Welfare and Institutions Code is
amended to read:
4689.8. Notwithstanding any other law or regulation, commencing
July 1, 2008:
(a) No regional center may pay an existing supported living
service provider, for services where rates are determined through a
negotiation between the regional center and the provider, a rate
higher than the rate in effect on June 30, 2008, unless the increase
is required by a contract between the regional center and the vendor
that is in effect on June 30, 2008, or the regional center
demonstrates that the approval is necessary to protect the consumer's
health or safety and the department has granted prior written
authorization.
(b) No regional center may negotiate a rate with a new supported
living service provider, for services where rates are determined
through a negotiation between the regional center and the provider,
that is higher than the regional center's median rate for the same
service code and unit of service, or the statewide median rate for
the same service code and unit of service, whichever is lower. The
unit of service designation shall conform with an existing regional
center designation or, if none exists, a designation used to
calculate the statewide median rate for the same service. The
regional center shall annually certify to the State Department of
Developmental Services its median rate for each negotiated rate
service code, by designated unit of service. This certification shall
be subject to verification through the department's biennial fiscal
audit of the regional center.
(c) Notwithstanding any other law or regulation, commencing July
1, 2016, and to the extent funds are appropriated in the annual
Budget Act for this purpose, the rates in effect on June 30, 2016,
for supported living services, as defined in Subchapter 19 of Chapter
3 of Division 2 of Title 17 of the California Code of Regulations,
shall be increased by 5 percent. The increase shall be applied as a
percentage, and the percentage shall be the same for all providers.
SEC. 6. Section 4690.5 of the Welfare and Institutions Code is
amended to read:
4690.5. Notwithstanding any other law or regulation, commencing
July 1, 2016, and to the extent funds are appropriated in the annual
Budget Act for this purpose, the rate for family member-provided
respite services authorized by the department and in operation June
30, 2016, shall be increased by 5 percent. The increase shall be
applied as a percentage, and the percentage shall be the same for all
providers.
SEC. 7. Section 4691.6 of the Welfare and Institutions Code is
amended to read:
4691.6. (a) Notwithstanding any other law or regulation,
commencing July 1, 2006, the community-based day program, work
activity program, and in-home respite service agency rate schedules
authorized by the department and in operation June 30, 2006, shall be
increased by 3 percent, subject to funds specifically appropriated
for this increase in the Budget Act of 2006. The increase shall be
applied as a percentage, and the percentage shall be the same for all
providers. Any subsequent increase shall be governed by subdivisions
(b), (c), (d), (e), (f), (g), (h), (i), (j), (k), and (l), and
Section 4691.9.
(b) Notwithstanding any other law or regulation, the department
shall not establish any permanent payment rate for a community-based
day program or in-home respite service agency provider that has a
temporary payment rate in effect on June 30, 2008, if the permanent
payment rate would be greater than the temporary payment rate in
effect on or after June 30, 2008, unless the regional center
demonstrates to the department that the permanent payment rate is
necessary to protect the consumers' health or safety.
(c) Notwithstanding any other law or regulation, neither the
department nor any regional center shall approve any program design
modification or revendorization for a community-based day program or
in-home respite service agency provider that would result in an
increase in the rate to be paid to the vendor from the rate that is
in effect on or after June 30, 2008, unless the regional center
demonstrates that the program design modification or revendorization
is necessary to protect the consumers' health or safety and the
department has granted prior written authorization.
(d) Notwithstanding any other law or regulation, the department
shall not approve an anticipated rate adjustment for a
community-based day program or in-home respite service agency
provider that would result in an increase in the rate to be paid to
the vendor from the rate that is in effect on or after June 30, 2008,
unless the regional center demonstrates that the anticipated rate
adjustment is necessary to protect the consumers' health or safety.
(e) Notwithstanding any other law or regulation, except as set
forth in subdivisions (f) and (i), the department shall not approve
any rate adjustment for a work activity program that would result in
an increase in the rate to be paid to the vendor from the rate that
is in effect on or after June 30, 2008, unless the regional center
demonstrates that the rate adjustment is necessary to protect the
consumers' health and safety and the department has granted prior
written authorization.
(f) Notwithstanding any other law or regulation, commencing July
1, 2014, the department may approve rate adjustments for a work
activity program that demonstrates to the department that the rate
adjustment is necessary in order to pay employees who, prior to July
1, 2014, were being compensated at a wage that is less than the
minimum wage established on and after July 1, 2014, by Section
1182.12 of the Labor Code, as amended by Chapter 351 of the Statutes
of 2013. The rate adjustment pursuant to this subdivision shall be
specific to payroll costs associated with any increase necessary to
adjust employee pay only to the extent necessary to bring pay into
compliance with the increased state minimum wage, and shall not
constitute a general wage enhancement for employees paid above the
increased minimum wage.
(g) Notwithstanding any other law or regulation, commencing July
1, 2014, community-based day program and in-home respite services
agency providers with temporary payment rates set by the department
may seek unanticipated rate adjustments from the department due to
the impacts of the increased minimum wage as established by Section
1182.12 of the Labor Code, as amended by Chapter 351 of the Statutes
of 2013. The rate adjustment shall be specific to payroll costs
associated with any increase necessary to adjust employee pay only to
the extent necessary to bring pay into compliance with the increased
state minimum wage, and shall not constitute a general wage
enhancement for employees paid above the increased minimum wage.
(h) Notwithstanding any other law or regulation, commencing
January 1, 2015, the in-home respite service agency rate schedule
authorized by the department and in operation December 31, 2014,
shall be increased by 5.82 percent, subject to funds specifically
appropriated for this increase for costs due to changes in federal
regulations implementing the federal Fair Labor Standards Act of 1938
(29 U.S.C. Sec. 201 et seq.). The increase shall be applied as a
percentage, and the percentage shall be the same for all applicable
providers.
(i) Notwithstanding any other law or regulation, commencing July
1, 2015, the department may approve rate adjustments for a work
activity program that demonstrates to the department that the rate
adjustment is necessary to implement Article 1.5 (commencing with
Section 245) of Chapter 1 of Part 1 of Division 2 of the Labor Code,
as added by Chapter 317 of the Statutes of 2014. The rate adjustment
may be applied only if a minimum of 24 hours or three days of paid
sick leave per year was not a benefit provided to employees as of
June 30, 2015, and shall be specific to payroll costs associated with
any increase necessary to compensate an employee up to a maximum of
24 hours or three days of paid sick leave in each year of employment.
(j) Notwithstanding any other law or regulation, commencing July
1, 2015, community-based day program and in-home respite services
agency providers with temporary payment rates set by the department
may seek unanticipated rate adjustments from the department if the
adjustment is necessary to implement Article 1.5 (commencing with
Section 245) of Chapter 1 of Part 1 of Division 2 of the Labor Code,
as added by Chapter 317 of the Statutes of 2014. The rate adjustment
may be applied only if a minimum of 24 hours or three days of paid
sick leave per year was not a benefit provided to employees as of
June 30, 2015, and shall be specific to payroll costs associated with
any increase necessary to compensate an employee up to a maximum of
24 hours or three days of paid sick leave in each year of employment.
(k) Notwithstanding any other law or regulation, commencing
July 1, 2016, and to the extent funds are appropriated in the annual
Budget Act for this purpose, the in-home respite service agency rate
schedule authorized by the department and in operation June 30, 2016,
shall be increased by 5 percent. The increase shall be applied as a
percentage, and the percentage shall be the same for all providers.
(l) Notwithstanding any other law or regulation, commencing July
1, 2016, and to the extent funds are appropriated in the annual
Budget Act for this purpose, the independent living service rate
schedule authorized by the department and in operation June 30, 2016,
shall be increased by 5 percent. The increase shall be applied as a
percentage, and the percentage shall be the same for all providers.
SEC. 8. Section 4691.9 of the Welfare and Institutions Code is
amended to read:
4691.9. (a) Notwithstanding any other law or regulation,
commencing July 1, 2008:
(1) A regional center shall not pay an existing service provider,
for services where rates are determined through a negotiation between
the regional center and the provider, a rate higher than the rate in
effect on June 30, 2008, unless the increase is required by a
contract between the regional center and the vendor that is in effect
on June 30, 2008, or the regional center demonstrates that the
approval is necessary to protect the consumer's health or safety and
the department has granted prior written authorization.
(2) A regional center shall not negotiate a rate with a new
service provider, for services where rates are determined through a
negotiation between the regional center and the provider, that is
higher than the regional center's median rate for the same service
code and unit of service, or the statewide median rate for the same
service code and unit of service, whichever is lower. The unit of
service designation shall conform with an existing regional center
designation or, if none exists, a designation used to calculate the
statewide median rate for the same service. The regional center shall
annually certify to the State Department of Developmental Services
its median rate for each negotiated rate service code, by designated
unit of service. This certification shall be subject to verification
through the department's biennial fiscal audit of the regional
center.
(b) Notwithstanding subdivision (a), commencing July 1, 2014,
regional centers may negotiate a rate adjustment with providers
regarding rates if the adjustment is necessary in order to pay
employees no less than the minimum wage as established by Section
1182.12 of the Labor Code, as amended by Chapter 351 of the Statutes
of 2013, and only for the purpose of adjusting payroll costs
associated with the minimum wage increase. The rate adjustment shall
be specific to the unit of service designation that is affected by
the increased minimum wage, shall be specific to payroll costs
associated with any increase necessary to adjust employee pay only to
the extent necessary to bring pay into compliance with the increased
state minimum wage, and shall not be used as a general wage
enhancement for employees paid above the increased minimum wage.
Regional centers shall maintain documentation on the process to
determine, and the rationale for granting, any rate adjustment
associated with the minimum wage increase.
(c) Notwithstanding any other law or regulation, commencing
January 1, 2015, rates for personal assistance and supported living
services in effect on December 31, 2014, shall be increased by 5.82
percent, subject to funds specifically appropriated for this increase
for costs due to changes in federal regulations implementing the
federal Fair Labor Standards Act of 1938 (29 U.S.C. Sec. 201 et
seq.). The increase shall be applied as a percentage, and the
percentage shall be the same for all applicable providers. As used in
this subdivision, both of the following definitions shall apply:
(1) "Personal assistance" is limited only to those services
provided by vendors classified by the regional center as personal
assistance providers, pursuant to the miscellaneous services
provisions contained in Title 17 of the California Code of
Regulations.
(2) "Supported living services" are limited only to those services
defined as supported living services in Title 17 of the California
Code of Regulations.
(d) Notwithstanding subdivision (a), commencing July 1, 2015,
regional centers may negotiate a rate adjustment with existing
service providers for services for which rates are determined through
negotiation between the regional center and the provider, if the
adjustment is necessary to implement Article 1.5 (commencing with
Section 245) of Chapter 1 of Part 1 of Division 2 of the Labor Code,
as added by Chapter 317 of the Statutes of 2014. The rate adjustment
may be applied only if a minimum of 24 hours or three days of paid
sick leave per year was not a benefit provided to employees as of
June 30, 2015, and shall be specific to payroll costs associated with
any increase necessary to compensate an employee up to a maximum of
24 hours or three days of paid sick leave in each year of employment.
(e) Notwithstanding any other law or regulation, commencing July
1, 2016, and to the extent funds are appropriated in the annual
Budget Act for this purpose, rates for transportation services in
effect on June 30, 2016, shall be increased by 5 percent. The
increase shall be applied as a percentage to existing rates, and the
percentage shall be the same for all applicable providers.
(f) This section shall not apply to those services for which rates
are determined by the State Department of Health Care Services, or
the State Department of Developmental Services, or are usual and
customary.
SEC. 9. Section 4691.10 is added to the Welfare and Institutions
Code, to read:
4691.10. (a) (1) Notwithstanding any other law or regulation, and
to the extent funds are appropriated in the annual Budget Act for
this purpose, the department shall provide a rate increase for the
purpose of enhancing wages and benefits for staff who spend a minimum
of 75 percent of their time providing direct services to consumers.
The department shall not allocate more than one hundred sixty-nine
million five hundred thousand dollars ($169,500,000) of the amount
appropriated in the act that added this section for this purpose,
plus any associated matching funds. The rate increase shall only
apply to services for which rates are set by the department or
through negotiations between the regional centers and service
providers, and to the rates paid for supported employment services,
as specified in subdivisions (a) and (b) of Section 4860, and
vouchered community-based services, as specified in paragraph (7) of
subdivision (c) of Section 4688.21. This section shall not apply to
those services for which rates are determined by other entities,
including, but not limited to, the State Department of Health Care
Services or the State Department of Social Services, or are usual and
customary.
(2) For the purposes of this subdivision, "direct services" are
services, supports, care, supervision, or assistance provided by
staff directly to a consumer to address the consumer's needs, as
identified in the individual program plan, and include staff's
participation in training and other activities directly related to
providing services to consumers, as well as program preparation
functions as defined in Section 54302 of Title 17 of the California
Code of Regulations. State employees participating in the Community
State Staff Program are ineligible for the wage increase described in
this section.
(b) The rate increase specified in subdivision (a) shall be
implemented in the following manner:
(1) With regional center participation, the department shall
conduct a survey of a random sample of service providers in each
service category eligible for the rate increase. The survey shall
request information regarding all of the following and shall be
returned to the regional center and department by April 15, 2016:
(A) Number of employees who spend a minimum of 75 percent of their
time providing direct services to consumers and their total salary,
wage, and benefit costs.
(B) Administrative costs as specified in subdivision (b) of
Section 4629.7, including the number of employees and total salary,
wage, and benefit costs associated with those administrative costs.
(C) Any other staff and their total salary, wage, and benefit
costs that are not included in either subparagraph (A) or (B).
(D) Any other costs to the provider, other than the costs
described in subparagraphs (A) to (C), inclusive.
(E) Any additional information, as requested by the department, to
assist in the determination of rate increases.
(2) The vendoring regional center shall certify that, to the best
of its knowledge, the survey results accurately reflect the services
provided by each surveyed service provider. The results from the
survey shall be used by the department to determine the rate increase
to be applied, by service category. The rate increase shall be the
same for all eligible providers in each service category and is
intended to provide comparable increases across service categories
for staff providing direct services as described in subdivision (a).
(3) By July 1, 2016, utilizing the data derived from paragraph
(1), the department shall do both of the following:
(A) For those service providers whose rates are set by the
department, notify those providers and the associated regional
centers of the amount by which the rates are to be increased.
(B) For those service providers whose rates are set by negotiation
with the regional center, notify the regional center of the amount
by which the rates are to be increased.
(4) With regional center participation, the department shall
conduct a survey, in a format determined by the department, of all
providers who received the rate increase described in subdivision
(a). Providers shall submit the completed survey to the department by
October 1, 2017. The survey shall request information on how the
rate increase was used by providers and shall include, but is not
limited to, the following:
(A) Number of employees and their salary, wage, and benefit costs,
and increases provided as a result of this subdivision.
(B) Percentage of time each employee spends providing direct
services.
(C) Administrative expenses, consistent with subdivision (b) of
Section 4629.7.
(D) Any additional information as determined by the department.
(c) Providers granted a rate increase pursuant to this section
shall maintain documentation, subject to audit by the department or
regional center, that the rate increase was used solely to increase
wages, salaries, and benefits of eligible staff members spending a
minimum of 75 percent of their time providing direct services to
consumers.
(d) The rate increases calculated by the department pursuant to
this section shall be effective July 1, 2016, and implemented as
described in subdivision (b).
(e) Any provider that fails to report the information required by
paragraph (4) of subdivision (b) to the department by October 1,
2017, shall forfeit the increases described in subdivision (a).
(f) In its 2017-18 May Revision fiscal estimate, the department
shall describe the implementation of the increases provided pursuant
to this section.
SEC. 10. Section 4691.11 is added to the Welfare and Institutions
Code, to read:
4691.11. Notwithstanding any other law or regulation, and to the
extent funds are appropriated in the annual Budget Act for this
purpose, the department shall allocate no more than nine million nine
hundred thousand dollars ($9,900,000) plus any associated matching
funds for the purpose of administrative expenses for service
providers. The department shall provide a rate increase for the
purpose of administrative expenses that shall apply only to providers
for which rates are set by the department or through negotiations
between the regional centers and service providers, and to the rates
paid for supported employment services, as specified in subdivisions
(a) and (b) of Section 4860, and vouchered community-based services,
as specified in paragraph (7) of subdivision (c) of Section 4688.21.
This increase shall be determined using the information collected
pursuant to subdivision (b) of Section 4691.10. This increase shall
be consistent for providers within each service category and is
intended to provide comparable increases for administrative expenses
across service categories. This section shall not apply to those
services for which rates are determined by other entities, including,
but not limited to, the State Department of Health Care Services or
the State Department of Social Services, or are usual and customary.
SEC. 11. Section 4860 of the Welfare and Institutions Code is
amended to read:
4860. (a) (1) The hourly rate for supported employment services
provided to consumers receiving individualized services is
thirty-four dollars and twenty-four cents ($34.24). The rate shall be
adjusted by the department pursuant to subdivision (a) of Sections
4691.10 and 4691.11.
(2) Job coach hours spent in travel to consumer worksites may be
reimbursable for individualized services only when the job coach
travels from the vendor's headquarters to the consumer's worksite or
from one consumer's worksite to another, and only when the travel is
one way.
(b) The hourly rate for group services is thirty-four dollars and
twenty-four cents ($34.24), regardless of the number of consumers
served in the group. Consumers in a group shall be scheduled to start
and end work at the same time, unless an exception that takes into
consideration the consumer's compensated work schedule is approved in
advance by the regional center. The department, in consultation with
stakeholders, shall adopt regulations to define the appropriate
grounds for granting these exceptions. When the number of consumers
in a supported employment placement group drops to fewer than the
minimum required in subdivision (r) of Section 4851, the regional
center may terminate funding for the group services in that group,
unless, within 90 days, the program provider adds one or more
regional centers, or Department of Rehabilitation-funded supported
employment consumers to the group. The rate shall be adjusted by the
department pursuant to subdivision (a) of Sections 4691.10 and
4691.11.
(c) Job coaching hours for group services shall be allocated on a
prorated basis between a regional center and the Department of
Rehabilitation when regional center and Department of Rehabilitation
consumers are served in the same group.
(d) When Section 4855 applies, fees shall be authorized for the
following:
(1) A three-hundred-sixty-dollar ($360) fee shall be paid to the
program provider upon intake of a consumer into a supported
employment program. No fee shall be paid if that consumer completed a
supported employment intake process with that same supported
employment program within the previous 12 months.
(2) A seven-hundred-twenty-dollar ($720) fee shall be paid upon
placement of a consumer in an integrated job, except that no fee
shall be paid if that consumer is placed with another consumer or
consumers assigned to the same job coach during the same hours of
employment.
(3) A seven-hundred-twenty-dollar ($720) fee shall be paid after a
90-day retention of a consumer in a job, except that no fee shall be
paid if that consumer has been placed with another consumer or
consumers, assigned to the same job coach during the same hours of
employment.
(e) Notwithstanding paragraph (4) of subdivision (a) of Section
4648, the regional center shall pay the supported employment program
rates established by this section.
(f) The department, with regional center participation, shall
conduct an annual survey of providers, in a format determined by the
department, to collect the following information:
(1) The number of employment placements in the previous 12 months.
(2) Types of employment in which consumers are placed.
(3) The cost components of the rates in subdivisions (a) and (b),
including, but not limited to, the amount used for hourly wages of
job coaches, administration, and placement search costs.
(4) The number of hours each consumer works and the consumer's
hourly wage.
(5) Any other information determined by the department.
(g) In its 2017-18 May Revision fiscal estimate, the department
shall describe the results of the survey described in subdivision
(f).
SEC. 12. Section 4870 is added to the Welfare and Institutions
Code, to read:
4870. (a) To encourage competitive integrated employment
opportunities statewide for individuals with developmental
disabilities, the department shall establish guidelines and oversee a
program, to the extent funds are appropriated in the annual Budget
Act for this purpose, to increase paid internship opportunities for
individuals with developmental disabilities that produce outcomes
consistent with the individual program plan. The department shall
consult with the State Council on Developmental Disabilities,
regional centers, employers, supported employment provider
organizations, and clients' rights advocates, to establish a program
that shall be administered by community service providers and that
meets all of the following criteria:
(1) Payments for internships shall not exceed ten thousand four
hundred dollars ($10,400) per year for each individual placed in an
internship.
(2) Placements shall be made into competitive, integrated work
environments.
(3) Placements shall be made into internships that develop skills
that will facilitate paid employment opportunities in the future.
(4) Regional centers shall increase awareness of these internships
to consumers outside of current employment programs through outreach
to consumers once the program is implemented, as well as during the
individual program plan process.
(b) The department shall require annual reporting by regional
centers and vendors that ensures program accountability and
achievement of program goals. This shall include, but is not limited
to, all of the following:
(1) The number of interns placed who might not otherwise have
achieved the placement absent this internship program.
(2) Types of employment in which interns are placed.
(3) Length of internships.
(4) Demographic information of interns.
(5) Amount of each intern placement payment.
(6) Employment-related supports provided by another agency or
individual to the intern.
(7) Number of interns who subsequently entered paid employment,
including salary and benefit information.
(8) Any additional information, as determined by the department.
(c) The department shall include in its annual May Revision fiscal
estimate a description of the implementation of the program,
including, but not limited to, a description of the stakeholder
consultation, the data described in subdivision (b), aggregated by
regional center and statewide, and any recommendations for program
changes that may be necessary or desirable to maximize program
effectiveness and accountability.
(d) Consistent with the individual program plan, the program shall
increase sustained and appropriate competitive integrated employment
placements by providers of supported employment services, as defined
in subdivision (p) of Section 4851, as follows:
(1) A payment of one thousand dollars ($1,000) to the supported
employment services provider for initial placements made on or after
July 1, 2016, in competitive integrated employment, as defined in
subdivision (o) of Section 4851 and subdivision (d) of Section 4868.
(2) An additional payment of one thousand two hundred fifty
dollars ($1,250) to the supported employment services provider for an
individual described in paragraph (1) who remains in competitive
integrated employment for six consecutive months.
(3) An additional payment of one thousand five hundred dollars
($1,500) to the supported employment services provider for an
individual described in paragraphs (1) and (2) who remains in
competitive integrated employment for 12 consecutive months.
(e) Regional centers shall annually report to the department the
payments for placements pursuant to subdivision (d). The information
shall be reported in a format determined by the department, and shall
include the number of individuals placed in internships or other
employment as described in this section each year.
SEC. 13. Section 14105.075 is added to the Welfare and
Institutions Code, to read:
14105.075. (a) Notwithstanding any other law, for dates of
service on or after August 1, 2016, payments to intermediate care
facilities for the developmentally disabled that are licensed
pursuant to subdivision (e), (g), or (h) of Section 1250 of the
Health and Safety Code, and to facilities providing continuous
skilled nursing care to developmentally disabled individuals pursuant
to the pilot project established by Section 14132.20, as determined
by the applicable methodology for setting reimbursement rates for
those facilities, shall be the reimbursement rates that were
applicable to those facilities in the 2008-09 rate year, increased by
3.7 percent. Payments to the facilities pursuant to this section
shall also include the projected cost of complying with new state or
federal mandates to the extent applicable to the reimbursement
methodology associated with the type of facility.
(b) The director shall seek any necessary federal approvals to
implement this section. This section shall not be implemented until
the necessary federal approval is obtained, and only to the extent
federal financial participation is available. If, and only to the
extent, federal approval is obtained to implement this section, the
payments resulting from the application of subdivision (a) shall be
implemented retroactively to August 1, 2016, or any later effective
date identified in the federal approval that is obtained, as
applicable.
SEC. 14. Section 14105.195 is added to the Welfare and
Institutions Code, to read:
14105.195. (a) Notwithstanding Sections 14105.191 and 14105.192,
the department shall not seek to retroactively implement the
reductions and limitations to the reimbursement for services provided
by skilled nursing facilities that are distinct parts of general
acute care hospitals set forth in Sections 14105.191 and 14105.192
for dates of service on or after June 1, 2011, and on or before
September 30, 2013. For purposes of this section, "distinct part" has
the same meaning as defined in Section 72041 of Title 22 of the
California Code of Regulations.
(b) The department shall not seek to recoup any overpayments from
skilled nursing facilities that are distinct parts of general acute
care hospitals resulting from the reductions and limitations to the
reimbursement for these facilities pursuant to Sections 14105.191 and
14105.192 for dates of service on or after June 1, 2011, and on or
before September 30, 2013.
(c) Notwithstanding Chapter 3.5 (commencing with Section 11340) of
Part 1 of Division 3 of Title 2 of the Government Code, the
department may implement this section by means of provider bulletins
or notices, policy letters, or other similar instructions, without
taking regulatory action.
SEC. 15. (a) The sum of two hundred eighty-seven million dollars
($287,000,000) is hereby appropriated from the General Fund to the
State Department of Developmental Services to provide all of the
following, effective July 1, 2016:
(1) Twenty-nine million seven hundred thousand dollars
($29,700,000) for regional centers for staff, in an allocation to be
determined by the department.
(2) One million four hundred thousand dollars ($1,400,000) for
regional centers for administrative costs, in an allocation to be
determined by the department. This amount includes an amount to be
allocated by the department for regional center clients' rights
advocates contracts pursuant to subdivision (b) of Section 4433.
(3) Nine million nine hundred thousand dollars ($9,900,000) for
administrative costs for service providers, in an allocation to be
determined by the department.
(4) One hundred sixty-nine million five hundred thousand dollars
($169,500,000) for a rate increase for staff providing direct
services employed by a community-based provider organization, in a
manner to be determined by the department.
(5) A 5-percent rate increase for supported and independent living
services.
(6) Twenty million dollars ($20,000,000) for competitive
integrated employment incentive payments.
(7) A 5-percent rate increase for in-home and out-of-home respite
services.
(8) A 5-percent increase for transportation services.
(9) A three-dollar-and-forty-two-cent ($3.42) per hour rate
increase for supported employment providers.
(10) Eleven million dollars ($11,000,000) for bilingual staff at
regional centers and implementing plans and recommendations to
address disparities.
(b) These funds shall be available for encumbrance until June 30,
2017, and available for expenditure until June 30, 2019.
SEC. 16. The increases in rates and payments provided for in this
act shall be effective July 1, 2016, and August 1, 2016, as expressly
provided in this act, unless otherwise provided in this act.