BILL ANALYSIS                                                                                                                                                                                                    






                                                                       AB 563


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          ASSEMBLY THIRD READING


          AB  
          563 (Lopez)


          As Amended  May 4, 2015


          Majority vote


           ----------------------------------------------------------------- 
          |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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