BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | AB 564|
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THIRD READING
Bill No: AB 564
Author: Eggman (D)
Amended: 9/1/15 in Senate
Vote: 21
SENATE HUMAN SERVICES COMMITTEE: 5- 0, 7/14/15
AYES: McGuire, Berryhill, Hancock, Liu, Nguyen
SENATE APPROPRIATIONS COMMITTEE: 7-0, 8/27/15
AYES: Lara, Bates, Beall, Hill, Leyva, Mendoza, Nielsen
ASSEMBLY FLOOR: 78-0, 6/2/15 - See last page for vote
SUBJECT: Regional centers: parental fees
SOURCE: Author
DIGEST: This bill recasts the existing Parental Fee Program
within the Department of Developmental Services (DDS) by, among
other things, calculating monthly parental fees based on a
percentage of the parents' annual income and authorizing a
credit of the equivalent of one day of the monthly parental fee
for each day a child spends 6 or more consecutive hours in a
24-hour period on a home visit. This bill prohibits a monthly
parental fee from exceeding the maximum monthly cost of caring
for a child or the cost of services provided, whichever is less,
and make other related changes.
ANALYSIS:
Existing law:
1)Establishes the Lanterman Developmental Disabilities Services
Act, which states that California is responsible for providing
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an array of services and supports sufficiently complete to
meet the needs and choices of each person with developmental
disabilities, regardless of age or degree of disability, and
at each stage of life and to support their integration into
the mainstream life of the community. (WIC 4500, et seq)
2)Establishes a system of nonprofit Regional Centers, overseen
by DDS, to provide fixed points of contact in the community
for all persons with developmental disabilities and their
families, to coordinate services and supports best suited to
them throughout their lifetime. (WIC 4620)
3)Requires a regional center to secure services and supports
that meet the needs of the consumer, as determined in the IPP,
and to give highest preference to those which would allow
minors with developmental disabilities to live with their
families, adult persons with developmental disabilities to
live as independently as possible in the community. (WIC 4648)
4)Requires parents of children under the age of 18 years who are
receiving 24-hour out-of-home care services through a regional
center, or who are residents of a state hospital pay a fee,
depending upon their ability to pay. Requires that this fee
not exceed the cost of caring for a normal child at home, as
determined by the director of DDS, or the cost of services
provided, whichever is less. Requires that DDS determine,
assess, and collect all parental fees, as specified,
regardless of whether the child is placed in the state
hospital or in a public or private community facility.
Prohibits parents from being charged for diagnosis or
counseling services received through the regional centers.
(WIC 4782)
5)Requires DDS to establish, annually review, and adjust as
needed, a schedule of parental fees and to revise it, as
specified, to reflect changes in economic conditions that
affect parents' ability to pay. (WIC 4784 (a) and (b))
6)Requires DDS, in establishing the amount a parent shall pay,
to take into account all of the following factors: (WIC 4784
(c))
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a) The current cost of caring for a child at home, as
determined by the most recent data available from the
United States Department of Agriculture's survey on the
cost of raising a child in California, adjusted for the
Consumer Price Index (CPI) from the survey date to the date
of payment adjustment.
b) Medical expenses incurred prior to regional center care.
c) Whether the child is living at home.
d) Parental payments for medical expenses, clothing,
incidentals, and other items considered necessary for the
normal rearing of a child.
e) Transportation expenses incurred in visiting a child.
7)Exempts from the parental fee families with an income below
the federal poverty level. (WIC 4784 (d))
8)Requires that fees be remitted to the Program Development Fund
of the state Treasury, as specified, to provide resources
needed to initiate new programs, consistent with approved
priorities for program development in the state plan. Requires
that excess fees, as defined, that are collected must be
available for expenditure by DDS to offset General Fund costs.
(WIC 4784 (f)(1)and (2))
This bill:
1) Strikes existing WIC 4784, which requires DDS to review
annually and adjust the formula for calculating parental fees
for children placed in out-of-home care as well as the
requirement to include in that calculation changes in
economic conditions that affect a parent's ability to pay and
other factors that the department must include in their
calculation of a parental fee.
2) Replaces it with a new WIC 4784, effective July 1, 2016,
that requires DDS to assess a monthly fee to parents of
children under 18 years of age who are receiving 24-hour
out-of-home care services through a regional center or as a
resident of a state hospital when the family's gross income
is above 200 percent of the federal poverty level.
3) Requires the parental fee to be effective 60 days from the
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date of the child's admission to the 24-hour out-of-home
placement, and requires, for the purpose of assessing the
fee, that parents provide DDS with income documentation
within 30 days from the date of the request for such
documentation and requires that documentation to include a
copy of a parent's most recent federal tax return or a copy
of each parent's most recent paystub or employer-provided
earnings statement, or alternative verification, as defined.
4) Eliminates the requirement that parents between 100 and 200
percent of poverty pay a fee and otherwise sets the fee as
follows:
a) Parents who have a family income of 201 percent
through 300 percent of the current federal poverty level
shall be assessed a fee of 3 percent of their annual gross
income to be billed in monthly increments.
b) Parents who have a family income of 301 percent
through 400 percent of the current federal poverty level
shall be assessed a fee of 4 percent of their annual gross
income to be billed in monthly increments.
c) Parents who have a family income of 401 percent
through 500 percent of the current federal poverty level
shall be assessed a fee of 5 percent of their annual gross
income to be billed in monthly increments.
d) Parents who have a family income of 501 percent or
more of the current federal poverty level shall be
assessed a fee of 6 percent of their annual gross income
to be billed in monthly increments.
5) Requires that parents who fail to provide income
documentation to the department within 30 days of the date of
the department's request shall be assessed a maximum monthly
fee, as defined, but requires that fee be retroactively
adjusted based on income information provided, once the
parent provides appropriate documentation.
6) Prohibits any fee being charged that exceeds the maximum
cost of caring for a child, as defined, or the cost of the
services provided, whichever is less.
7) Requires that the parental fee be recalculated every 12
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months, and within 60 days of the date a parent notifies the
department of a change in family income or family size, as
specified.
8) Requires that parents of children placed in 24-hour
out-of-home care prior to July 1, 2016, shall have their
monthly parental fee recalculated pursuant to the provisions
of this section at the time of their annual fee
recalculation, or within 60 days of a parental request for
review by the department and receipt of the family's
completed family financial statement.
9) Permits DDS to grant a temporary waiver from paying the
monthly parental fee for parents who substantiate, with
receipts, an unavoidable and uninsured catastrophic loss with
direct economic impact on the family or significant
unreimbursed medical costs associated with care for a child
who is a regional center consumer.
10)Establishes that a parent is entitled to a credit of one
day's fee, as defined, if the parent removes their child from
the care facility for a home visit for any six consecutive
hours during a 24-hour period and requires that requests for
credits be post marked no later than 60 days from the child's
removal from the facility
11)Requires that failure to provide documentation and postmark
the request as specified shall result in a denial of credit
by the Department.
12)Requires that all fees collected by the program be deposited
into the Program Development Fund, as defined, to provide
resources needed to initiate new programs, consistent with
approved priorities in the state's plan, and expands the
option for the department to use fees to offset General Fund
costs.
13)Permits parents to appeal their monthly fee or the denial of
credit by submitting a written appeal request to the director
within 30 days, but limits the parent's appeal to disputes
concerning the family income used to set the monthly parental
fee and the denial or amount of credit.
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14)Requires DDS to provide written notice of the decision to
the appellant within 30 days of receipt of the appeal, and
requires all decisions regarding monthly parental fee appeals
be retroactive to the date the appealed monthly parental fee
was assessed.
15)Limits the Department's scope in considering the appeal to
the income documentation and the calculation of the monthly
parental fee that was used in making the original
determination.
Background
The Lanterman Developmental Disabilities Services Act
establishes an entitlement to services and supports for
Californians with developmental disabilities who are living in
their communities. A developmental disability is one that
originates before the age of 18, continues, or can be expected
to continue, indefinitely, and constitutes a substantial
disability. Approximately 290,000 children and adults with
developmental disabilities are served in community-based
programs and supported by state- and federally-funded services
that are coordinated by 21 nonprofit regional centers. Another
1,077 individuals live in four state-run institutions, including
three Developmental Centers, as of July 1. About 77 percent of
all consumers and 97 percent of child consumers live in the home
of a parent or guardian or in their own home.
Parental fee program. Established in the early years of the
Lanterman Act, the Parental Fee Program requires parents to pay
a share of cost if their children are under 18 years of age and
receive 24-hour out-of-home care, paid for by a regional center.
The current calculation requires the Director of DDS consider a
family's gross income, age of the child, travel expenses to
visit the child, medical expenses incurred prior to the
out-of-home placement, parental payments for specified items
"considered necessary in the normal rearing of a child," and
others. The parental fee is intended to be based on a parent's
ability to pay.
For families with income at or above 100 percent of the Federal
Poverty Level, fees range from $59 to $1,877 per month, based on
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family size and income. Currently, 559 are children in the
Parental Fee Program and approximately 4,300 children statewide
are in out-of-home residential care. Money from the Parental Fee
Program is required by statute to be deposited into the Program
Development Fund, which is used to initiate new programs
consistent with the California Developmental Disabilities State
Plan. Excess funds must be used to offset the Department's
General Fund expenses. This bill relaxes that requirement.
State auditor review. A January 2015 report by the California
State Auditor found that the program was riddled with errors and
inconsistencies that placed some parents at a significant
disadvantage. The report noted that as a result of staff error
and inconsistent interpretations and processes, parents with
similar financial circumstances may be assessed substantially
different levels of fees. Auditors reviewed approximately 10
percent of the cases in the program and found that the process
DDS uses to assess parental fees is "riddled with unnecessary
delays, lack of documentation, incorrect calculations, and
inconsistent staff interpretations. For instance, because
Developmental Services does not hold regional centers
accountable for providing required reports of children newly
placed in out-of-home care, months or even years pass before
Developmental Services becomes aware of the need to assess fees
on certain families."
The audit found incorrectly assessed fees by hundreds of dollars
per month due to staff errors, and inconsistent documentation-
verification was required of some families but not others. The
auditor concluded that because the appeals process considers
expenses and deductions that are not taken into account in the
initial fee assessment, 95 percent of all appeals result in a
fee reduction, underscoring the inconsistency in both the
original calculation, and the appeal. The annual amount of
unbilled fees ranges from $740,000 to $1.1 million, according to
the auditor.
FISCAL EFFECT:
Appropriation: No Fiscal Com.: Yes Local: No
According to a Senate Appropriations Committee analysis, this
bill would result in one-time costs of about $150,000 (General
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Fund) to revise existing formulas and procedures and to revise
existing DDS regulations. It projected an annual revenue loss of
about $190,000 due to changes to the Parental Fee Structure
(Program Development Fund). The analysis also identified a
potential increase in fee revenues resulting from simplified
program requirements. By simplifying the program rules, DDS
indicates that compliance with the program's requirements may
actually increase, increasing overall fee revenues. For example,
a simpler, more consistent fee structure is likely to reduce
appeals and eliminate the subjectivity in calculating fees. A
recent audit of the program found that there are significant
amounts of uncollected fees. In part, this may be due to
resistance to paying fees by families who feel that their fee
calculations were unfair.
SUPPORT: (Verified8/28/15)
State Council on Developmental Disabilities
OPPOSITION: (Verified8/28/15)
None received
ARGUMENTS IN SUPPORT: According to the author, this bill
will fix problems in the parental fee program which a state
audit found to be "riddled with unnecessary delays, lack of
documentation, incorrect calculations and inconsistent staff
interpretations." The author requested a California State
Auditor review of the program after being contacted by a
constituent whose 15-year old child was placed out-of-home in a
24-hour care facility in Los Angeles. The constituent reported
dramatic fee increases, and when consulting with other families,
found significant differences in fees from family to family.
When he filed an appeal, the constituent was subject to a
lengthy and convoluted process, which ultimately resulted in a
reduction in fees. The Auditor found similar issues statewide.
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ASSEMBLY FLOOR: 78-0, 6/2/15
AYES: Achadjian, Alejo, Travis Allen, Baker, Bigelow, Bloom,
Bonilla, Bonta, Brough, Brown, Burke, Calderon, Campos, Chang,
Chau, Chiu, Chu, Cooley, Cooper, Dababneh, Dahle, Daly, Dodd,
Eggman, Frazier, Beth Gaines, Gallagher, Cristina Garcia,
Eduardo Garcia, Gatto, Gipson, Gomez, Gonzalez, Gordon, Gray,
Hadley, Harper, Roger Hernández, Holden, Irwin, Jones,
Jones-Sawyer, Kim, Lackey, Levine, Linder, Lopez, Low,
Maienschein, Mathis, Mayes, McCarty, Medina, Melendez, Mullin,
Nazarian, Obernolte, O'Donnell, Olsen, Patterson, Perea,
Quirk, Rendon, Ridley-Thomas, Rodriguez, Salas, Santiago,
Steinorth, Mark Stone, Thurmond, Ting, Wagner, Waldron, Weber,
Wilk, Williams, Wood, Atkins
NO VOTE RECORDED: Chávez, Grove
Prepared by:Mareva Brown / HUMAN S. / (916) 651-1524
9/1/15 20:22:41
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