BILL ANALYSIS Ó
AB 563
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ASSEMBLY THIRD READING
AB
563 (Lopez)
As Amended May 4, 2015
Majority vote
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|Committee |Votes |Ayes |Noes |
| | | | |
| | | | |
|----------------+------+--------------------+--------------------|
|Human Services |7-0 |Chu, Mayes, | |
| | |Calderon, Lopez, | |
| | |Maienschein, | |
| | | | |
| | | | |
| | |Mark Stone, | |
| | |Thurmond | |
| | | | |
|----------------+------+--------------------+--------------------|
|Aging |6-0 |Brown, Hadley, | |
| | |Gipson, Levine, | |
| | |Lopez, Mathis | |
| | | | |
|----------------+------+--------------------+--------------------|
|Appropriations |17-0 |Gomez, Bigelow, | |
| | |Bonta, Calderon, | |
| | |Chang, Daly, | |
| | |Eggman, Gallagher, | |
| | | | |
| | | | |
| | |Eduardo Garcia, | |
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| | |Gordon, Holden, | |
| | |Jones, Quirk, | |
| | |Rendon, Wagner, | |
| | |Weber, Wood | |
| | | | |
| | | | |
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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 (CDA) to develop best practices
for providing culturally competent services and supports to
aging consumers with developmental and intellectual disabilities
by January 1, 2017.
2)Requires those best practices to include, at least, the
following:
a) Regional center protocols to enhance communication with,
and improve service delivery to, aging consumers with
developmental and intellectual disabilities.
b) Identification of services for inclusion in a consumer's
individual program plan, as appropriate, that can better
support aging consumers with developmental and intellectual
disabilities.
1)Requires DDS to conduct a two-year pilot program that implements
the best practices in three regional centers that reflect the
geographic diversity of the state.
2)Requires DDS to submit a report to the Legislature evaluating
the pilot program by January 1, 2020, including a determination
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of whether the best practices should be implemented statewide.
3)Establishes a January 1, 2021 sunset date for the pilot program.
EXISTING LAW:
1)Establishes an entitlement to services for individuals with
developmental disabilities under the Lanterman Developmental
Disabilities Services Act (Lanterman Act). (Welfare and
Institutions Code (WIC) Section 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 Section 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 Section 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 Section 4512)
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5)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 United States Code 3001 et
seq.)
6)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 Section 9000 et seq.)
7)Establishes the 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 Section 9100)
FISCAL EFFECT: According to the Assembly Appropriations
Committee, this bill will result in annual costs to DDS of
approximately $184,000 ($110,000 General Fund) for 1.5 positions
to develop best practices and guidelines for the pilot projects,
as well as unknown, but potentially significant costs to DDS to
implement the pilot projects. The bill lacks sufficient detail to
know the extent of the work required. Additional unknown costs to
DDS to compile and produce a report evaluating the pilot program
and determining whether the pilot program should be implemented
statewide
COMMENTS:
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Developmental services: The Lanterman Act (WIC Section 4500 et
seq.) guides the provision of services and supports for
Californians with developmental disabilities. Each individual
under the Lanterman 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 Lanterman Act. The 21 regional centers
serve 280,000 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.
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
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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 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
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 United
States (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 U.S.
population by 2050.
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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.
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.
----------------------------
<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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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 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."
Analysis Prepared by:
Myesha Jackson / HUM. S. / (916) 319-2089 FN:
0000618
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