BILL ANALYSIS Ó
AB 563
Page A
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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New Horizons
Opposition
None on file.
Analysis Prepared by:Robert MacLaughlin / AGING & L.T.C. / (916)
319-3990