BILL ANALYSIS Ó
AB 563
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Date of Hearing: April 14, 2015
ASSEMBLY COMMITTEE ON HUMAN SERVICES
Kansen Chu, Chair
AB 563
(Lopez) - As Introduced February 24, 2015
SUBJECT: Developmental services
SUMMARY: Establishes a pilot program to address the needs of
aging individuals with developmental and intellectual
disabilities.
Specifically, this bill:
1)Requires the Department of Developmental Services (DDS) and
the California Department of Aging to develop guidelines and
protocols establishing best practices for providing services
and supports to aging consumers with developmental and
intellectual disabilities by January 1, 2017.
2)Requires DDS to conduct a two-year pilot program that
implements those guidelines and protocols in three regional
centers, and requires DDS to submit a report to the
Legislature evaluating the pilot program by January 1, 2020,
as specified.
3)Establishes a January 1, 2021 sunset date for the pilot
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program.
EXISTING LAW:
1)Establishes an entitlement to services for individuals with
developmental disabilities under the Lanterman Developmental
Disabilities Services Act (Lanterman Act). (WIC 4500 et seq.)
2)Grants all individuals with developmental disabilities, among
all other rights and responsibilities established for any
individual by the United States Constitution and laws and the
California Constitution and laws, the right to treatment and
habilitation services and supports in the least restrictive
environment. (WIC 4502)
3)Establishes a system of 21 nonprofit regional centers
throughout the state to identify needs and coordinate services
for eligible individuals with developmental disabilities and
requires the DDS to contract with regional centers to provide
case management services and arrange for or purchase services
that meet the needs of individuals with developmental
disabilities, as defined. (WIC 4620 et seq.)
4)Requires the development of an individual program plan (IPP)
for each regional center consumer, which specifies services to
be provided to the consumer, based on his or her
individualized needs determination and preferences, and
defines that planning process as the vehicle to ensure that
services and supports are customized to meet the needs of
consumers who are served by regional centers. (WIC 4512)
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5)Requires the IPP planning processes to include:
a) A statement of the individual's goals and objectives, a
schedule of the type and nature of services to be provided
and other information and considerations, as specified;
b) Review and modification, as necessary, by the regional
center's planning team no less frequently than every three
years; and
c) Statewide training and review of the IPP plan creation,
as specified. (WIC 4646.5)
1)Establishes the federal Older American's Act, under which a
national network of state agencies on aging and area agencies
on aging (AAAs) provide home- and community-based services
that help older adults remain healthy and independent.
Programs include nutrition, job training, senior centers,
caregiver support, transportation, health promotion, benefits
enrollment, and elder abuse prevention. (42 U.S.C. 3001 et
seq.)
2)Establishes the Mello-Granlund Older Californians Act, which
reflects the federal Older Americans Act and provides
state-funded programs and services for older adults and people
with disabilities. (WIC 9000 et seq.)
3)Establishes the California Department of Aging (CDA) within
the California Health and Human Services Agency for the
purpose of providing leadership to the AAAs in developing
systems of home- and community-based services that maintain
individuals in their own homes or least restrictive, homelike
environments. (WIC 9100)
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FISCAL EFFECT: Unknown
COMMENTS:
Developmental services: The Lanterman Act (WIC § 4500 et seq.)
guides the provision of services and supports for Californians
with developmental disabilities. Each individual under the Act,
typically referred to as a "consumer," is legally entitled to
treatment and habilitation services and supports in the least
restrictive environment. Lanterman Act services are designed to
enable all consumers to live more independent and productive
lives in the community.
The term "developmental disability" means a disability that
originates before an individual attains 18 years of age, is
expected to continue indefinitely, and constitutes a substantial
disability for that individual. It includes intellectual
disabilities, cerebral palsy, epilepsy, and autism spectrum
disorders (ASD). Other developmental disabilities are those
disabling conditions similar to an intellectual disability that
require treatment (i.e., care and management) similar to that
required by individuals with an intellectual disability.
Direct responsibility for implementation of the Lanterman Act
service system is shared by DDS and 21 regional centers, which
are private nonprofit entities, established pursuant to the
Lanterman Act, that contract with DDS to carry out many of the
state's responsibilities under the Act. The 21 regional centers
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serve 279,000 consumers, providing services such as residential
placements, supported living services, respite care,
transportation, day treatment programs, work support programs,
and various social and therapeutic activities. Approximately
1,100 consumers reside at one of California's three
Developmental Centers-and one state-operated, specialized
community facility-which provide 24-hour habilitation and
medical and social treatment services.
Services provided to people with developmental disabilities are
outlined in an IPP, which is developed by the IPP
team-including, among others, the consumer, his or her legally
authorized representative, and one or more regional center
representatives-and is based on the consumer's needs and
choices. The Lanterman Act requires that the IPP promote
community integration and maximize opportunities for each
consumer to develop relationships, be part of community life,
increase control over his or her life, and acquire increasingly
positive roles in the community. The IPP must give the highest
preference to those services and supports that allow minors to
live with their families and adults to live as independently as
possible in the community.
Department of Aging and Area Agencies on Aging: The California
Department of Aging (CDA) administers programs that serve older
and disabled adults, as well as family caregivers and residents
in long-term care facilities. These include basic nutrition
assistance, transportation services, in-home assistance,
caregiver support, health promotion, elder abuse prevention,
services that help older adults find employment, and other
services that help older and disabled individuals live
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independently in the community. CDA's programs are administered
using funds allocated under the federal Older Americans Act, the
Older Californians Act, the Medi-Cal program, and public and
private grants.
CDA contracts with 33 AAAs throughout California, which are
responsible for planning, coordinating and directly managing
programs and services CDA oversees. CDA also contracts directly
with agencies that operate the Multipurpose Senior Services
Program, which provides social and health care management
services to help frail individuals avoid or delay
institutionalization. Approximately 80% of the money for AAA
programs is appropriated to the state from the federal
government.
Aging and developmental disabilities: According to the U.S.
Census Bureau, the nation's population is expected to grow from
314 million in 2012 to 400 million in 2050 (a 27% increase),
while the population of individuals age 65 and older is expected
to increase by 94% during that same period of time, and is
expected to make up more than 20% of the projected US population
by 2050.
Regional centers are also experiencing an increase in the number
of older individuals they serve. As of December 2014, 17,600
regional center consumers were between 52 and 61 years of age,
and 10,069 were 62 years of age and older, accounting for 7.25%
and 4.15% of the total regional center caseload, respectively.
By way of comparison, the number of regional center consumers
between 52 and 61 years of age in 2004 was 10,614, and there
were 4,845 individuals age 62 and older. Compared to 2004, the
2014 figure for consumers age 62 and older represents an
increase of 5,224 consumers and an additional 1.4% of the
overall caseload.
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The University of Illinois at Chicago's Institute on Disability
and Human Development released a report in 2012, Bridging the
aging and developmental disabilities service networks:
Challenges and best practices, which outlines the unique service
needs of aging individuals with developmental disabilities.
Within the report, the authors estimate that the number of
individuals over age 60 living in the community with
developmental disabilities will increase considerably in the
coming decades, reaching 1.4 million by 2030. They go on to
state that increased life expectancy is one of the major factors
contributing to the growing number of older individuals with
developmental disabilities, with the mean age of death being 66
years in 1993, compared to 59 years in the 1970s and 33 years in
the 1930s. <1>
Down Syndrome: According to the National Down Syndrome Society,
6,000 babies born in the U.S. each year have Down Syndrome.
Because it is included in the etiology of intellectual
disability, over 18,000 individuals with Down Syndrome are
currently served by California's regional centers.
While data shows that, overall, individuals with intellectual
and developmental disabilities are experiencing increasingly
longer average lifespans, the needs of regional center consumers
with Down Syndrome have a particular connection to the needs of
many older adults without developmental disabilities. This is
because Down Syndrome is the result of a person having a whole
or partial extra copy of chromosome 21, one of the chromosomes
---------------------------
<1> Factor, A., Heller, T., & Janicki, M. (2012). Bridging the
aging and developmental disabilities service networks:
Challenges and best practices. Chicago: Institute on Disability
and Human Development, University of Illinois at Chicago.
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associated with Alzheimer's disease. According to the
Alzheimer's Association, the percentage of individuals with
Alzheimer's age 65 and older is nearly six times higher among
individuals with Down Syndrome than the percentage of people of
the same age group without Down Syndrome.
Need for this bill: According to the author, "Under existing
law, the Department of Developmental services is required to
contract with the Regional Centers to provide needed services to
individuals with developmental disabilities through all stages
of their lives. Currently the Regional Center system provides
specific services for infants, children, adolescents and adults.
There is no specific Regional Center unit that addresses the
unique needs of older adults. Within the developmental
disability system, several individuals and programs have
independently attempted to fill the service gap that is not met
by the current DDS/Regional Center system. This is indicative
of the significant needs of older adults with intellectual and
developmental disabilities, as the population continues to
increase."
Recommended amendments: While the increasing number of older
individuals served by regional centers does call for greater
attention to be focused on their changing needs, this bill is
not entirely clear as to whether the best practices that are
developed will dictate new services that will be sought from
providers that contract with the regional centers or new
practices the regional centers will execute as they interact
with consumers and their families.
Additionally, this bill establishes a pilot program in three
regional centers, but there is no indication as to how the
regional centers will be chosen for the pilot. This bill also
does not include language regarding the potential expansion of
the pilot so that aging consumers in other regional centers
throughout the state might benefit from implementation of the
identified best practices.
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Committee staff recommends the bill be amended to do the
following:
1)Clarify whether the best practices to be implemented pertain
to actual services that will be included in a consumer's IPP,
when appropriate, or the general practices of the regional
centers when they interact with aging consumers, or both.
2)Identify a process for selection of the three regional centers
to be included in the initial pilot program.
3)Indicate when and how the identified best practices will be
implemented in other regional centers.
DOUBLE REFERRAL . This bill has been double-referred. Should
this bill pass out of this committee, it will be referred to the
Assembly Committee on Aging and Long-Term Care.
REGISTERED SUPPORT / OPPOSITION:
Support
New Horizons
The Adult Skills Center (TASC)
United Cerebral Palsy of Los Angeles
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Valley Village
Opposition
None on file.
Analysis Prepared by:Myesha Jackson / HUM. S. / (916) 319-2089