BILL ANALYSIS                                                                                                                                                                                                    






                                                                     AB 563


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          Date of Hearing:  April 30, 2015


                   ASSEMBLY COMMITTEE ON AGING AND LONG-TERM CARE


                                 Cheryl Brown, Chair


          AB 563  
          Lopez - As Amended April 21, 2015


          SUBJECT:  Developmental services.


          SUMMARY: Directs the California Department of Developmental  
          Services (DDS), in partnership with the California Department of  
          Aging (CDA), to develop best practices in providing services to  
          aging individuals with developmental and intellectual  
          disabilities.  Specifically, this bill:  


          1)Requires the California Department of Developmental Services  
            and the California Department of Aging to develop guidelines  
            and protocols establishing best practices for:


               a.     Communication with aging consumers with  
                 developmental and intellectual disabilities; and


               b.     Delivery of services to aging consumers with  
                 developmental and intellectual disabilities.  













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          2)Requires the California Department of Developmental Services  
            to conduct a two-year pilot program in three regional centers  
            that reflect geographic diversity within the state, along with  
            recommendations for implementation statewide.  


          3)Unless extended by legislation, repeals authorization for the  
            pilot on January 1, 2021.  


          EXISTING LAW:  


          1)Existing federal law, the Developmental Disabilities  
            Assistance and Bill of Rights Act of 2000 (P.L. 106-402)  
            established the State Council on Developmental Disabilities to  
            work to promote the core values of  self-determination,  
            independence, productivity, integration, and inclusion in all  
            aspects of community life, and to engage in advocacy, capacity  
            building, and systemic change activities that contribute to a  
            coordinated, consumer-and family-centered, consumer-and  
            family-directed, comprehensive system that includes the  
            provision of needed community services, individualized  
            supports, and other forms of assistance that promote  
            self-determination for individuals with developmental  
            disabilities and their families.  


          2)Establishes the Older Americans Act of 1965 (as amended in  
            2006, Public Law 109-365) in order to preserve the inherent  
            dignity of older individuals and assure equal opportunity to  
            the full and free enjoyment of, among other things; adequate  
            income in retirement; the best possible physical and mental  
            health which science can make available and without regard to  
            economic status; obtaining and maintaining suitable housing at  
            costs which older citizens can afford; full restorative  
            services for those who require institutional care, and a  
            comprehensive array of community-based, long-term care  
            services adequate to appropriately sustain older people in  











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            their communities and in their homes, including support to  
            family members and other persons providing voluntary care to  
            older individuals needing long-term care services; retirement  
            in health, honor, and dignity, after years of contribution to  
            the economy; participation in and contribution to meaningful  
            activity within the widest range of civic, cultural,  
            educational, training and recreational opportunities; freedom,  
            independence, and the free exercise of individual initiative  
            in planning and managing their own lives; full participation  
            in the planning and operation of community-based services and  
            programs provided for their benefit; and protection against  
            abuse, neglect, and exploitation.  





          3)Establishes the Lanterman Developmental Disabilities Services  
            Act which establishes the Department of Developmental  
            Services; clarifies that the State of California accepts  
            responsibility for persons with developmental disabilities,  
            and establishes an obligation to them which it must discharge  
            on behalf of them, their families and the communities in which  
            they live.  The Lanterman Act assures that the state addresses  
            the needs of individuals with developmental disabilities and  
            their families, and clarifies the roles in determining service  
            needs; and describes service options for consumers and their  
            families, pursuant to each individual program plan.  


          4)Establishes the Mello-Granlund Older Californians Act that  
            sets forth the state's commitment to its older population and  
            other populations served by the programs administered by the  
            California Department of Aging.  Specifies that CDA shall  
            ensure that programs and services provided through the Older  
            Americans Act and the Older  Californians Act in each planning  
            and service area are available to all older adults regardless  
            of physical or mental  disabilities, language barriers,  
            cultural or social isolation, including that caused by actual  











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            or perceived racial and ethnic status, ancestry, national  
            origin, religion, sex, gender, identity, marital status,  
            familial status, sexual orientation, or by any other basis set  
            forth in Section 12921 of the Government Code, or by  
            association with a person or persons with one or more of these  
            actual or perceived characteristics, that restrict an  
            individual's ability to perform normal daily tasks or that  
            threaten his or her capacity to live independently.  





          FISCAL EFFECT:  Unknown.


          COMMENTS:  


          Author's Statement: "Under existing law, the Department of  
          Developmental Services (DDS) 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/Developmental Disabilities (I/DD)  
          as the population continues to increase."  


          Background:  California developmental system supports 21  
          regional centers, and four developmental centers.  The  
          California Department of Aging contracts with 33 Area Agencies  
          on Aging.  Geographically, both systems cover the entire state.   
          Services and programs within both systems intersect more and  











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          more as families caring for developmental center clients become  
          eligible for area agency on aging services due to age, and  
          caregiving responsibilities.  Developmental center clients, too,  
          are living longer.  Demographic trends show a prospect of  
          greater interactions amongst the two systems more into the  
          future.  

          In an effort to assure efficient use of scarce public social  
          service resources, the author is encouraging the promotion of  
          the benefits of the two systems, and prepare to position  
          services strategically to reduce the likelihood of duplication.   
          The author notes that the normal aging process for developmental  
          system clients is often complicated by a lifetime of reduced  
          mobility, poorer general health, medications, and surgeries.   
          The more severe the developmental disability, the greater risk -  
          and earlier onset - of the diseases commonly associated with  
          aging.  

          As people with intellectual and developmental disabilities are  
          living longer, it is very likely that service providers for both  
          the community of people with intellectual and/or developmental  
          Disabilities (I/DD) and service providers for the growing  
          population of older adults, have much to gain from each other as  
          they strategize to promote similar core values related to  
          self-determination, choice, independence, dignity, productivity,  
          and inclusion in all aspects of community life for their  
          corresponding populations.  For instance, clients of both the  
          developmental services system, and the patchwork of services for  
          older adults, is generally associated with a family unit (73%  
          and 84% respectively) that provides care and protection, and are  
          therefore inherent components of any discussion about their  
          needs.  





          According to the Department of Developmental Services, "(T)he  
          aging of parents or family members directly affects the demand  











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          for developmental services."  For instance: "?an aging caregiver  
          may require an increased level of services and supports to  
          maintain their family member in the home.  When these caregivers  
          die, or are no longer able to support their loved ones,  
          alternative living arrangements must be developed or located."   
          The Department notes that almost all forms of out-of-home care  
          are more expensive than supporting a person in their own home,  
          and their own data shows that the percentage of consumers living  
          out of home increases as they age.<1>





          Researchers from the University of Colorado noted a decade ago:  
          "?the mean age at death for persons with mental retardation was  
          66 years in 1993 - up from 19 years in the 1930s and 59 in the  
          1970s.  The mean age at death for the general population in 1993  
          was 70 years.  Longevity has also increased dramatically for  
          persons with Down syndrome.  Average age at death for persons  
          with Down syndrome in the 1920s was 9 years; it rose to 31 in  
          the 1960s and to 56 in 1993,<2>" which lead DDS to conclude  
          that: "?consumers' increasing longevity means that services and  
          supports will be provided, not only for a relatively longer  
          period of time, but the needs will be greater or of higher  
          intensity especially during the later years."





          According to a 2012 study by the University of Illinois at  
          Chicago and funded by the U.S. Administration on Developmental  
          ---------------------------


          <1> California Department of Developmental Services. Controlling  
          Regional Center Costs, 2007
          <2> David Braddock, et al., The State of the States in  
          Developmental Disabilities - 2005, Department of
          Psychiatry and Coleman Institute for Cognitive Disabilities, The  
          University of Colorado, p. 60.








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          Disabilities, "Bridging the Aging and Developmental Disabilities  
          Service Networks, Challenges and Best Practices," people with  
          developmental disabilities are aging at unprecedented rates and  
          have unique health and service needs.  Adults with developmental  
          disabilities have a higher risk of developing chronic health  
          conditions at younger ages than other adults, due to the  
          confluence of biological factors related to syndromes 


          and associated disabilities.  The report highlights multiple  
          initiatives which would benefit from collaborative relationships  
          between those who advocate for the developmentally disabled, and  
          those who advocate for the aged.  Citing a time of dramatic  
          policy change, the report recommends that agencies improve  
          efficiency and coordination to better serve people with  
          developmental disabilities and their families by better  
          understanding the age-related needs and best practices in  
          meeting those needs through research and evaluation.  





          Support:  The California Commission on Aging, the principle  
          advocate for older adults in California, states that individuals  
          with developmental disabilities require a unique set of services  
          as they age, which are not currently in place.  By establishing  
          guidelines and protocol, the state will create a means to assure  
          individuals with developmental disabilities age successfully  
          with optimal independence.  

          New Horizons, a southern California non-profit agency that  
          provides job training and placement, education, counseling,  
          residential services, and social programs for developmentally  
          disabled adults, state that appropriate accommodations, and  
          suitable care for adults with developmental disabilities is  
          sorely needed.  

          Opposition:  None











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          Dual Referral:  AB 563 was previously heard by the Assembly  
          Committee on Human Services where it passed on a vote of 7-0 on  
          April 14, 2015.





           Recommended Amendment:


           


          On page 1, line 5, after the word "providing", insert:  
          culturally competent.





          REGISTERED SUPPORT / OPPOSITION:




          Support


          The Adult Skills Center (TASC)


          California Commission on Aging












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                                                                     Page I



          New Horizons




          Opposition


          None on file.




          Analysis Prepared by:Robert MacLaughlin / AGING & L.T.C. / (916)  
          319-3990