BILL ANALYSIS Ó
AB 564
Page 1
CONCURRENCE IN SENATE AMENDMENTS
AB
564 (Eggman)
As Amended September 1, 2015
Majority vote
--------------------------------------------------------------------
|ASSEMBLY: |78-0 |(June 2, 2015) |SENATE: |40-0 |(September 8, |
| | | | | |2015) |
| | | | | | |
| | | | | | |
--------------------------------------------------------------------
Original Committee Reference: HUM. S.
SUMMARY: Raises the income threshold for required participation
in the Parental Fee Program for families with children receiving
24-hour out-of-home care through a regional center and codifies
regulatory requirements related to the fee. Specifically, this
bill:
1)Makes the following changes to the Parental Fee Program as of
July 1, 2016:
a) Revises the requirement that the Department of
Developmental Services (DDS) assess a monthly fee to
parents with children receiving 24-hour out-of-home care
services through a regional center or as a resident of a
state hospital to only include those families with gross
incomes above 200% of the federal poverty level (FPL).
Requires the fee to be assessed beginning 60 days from the
AB 564
Page 2
date of the child's placement in 24-hour out-of-home care.
b) Codifies the requirement that the monthly parental fee
for a parent who fails to provide income documentation to
DDS within the required 30 days be equivalent to the
maximum monthly cost of caring for a child according to
national data, as specified. Further stipulates that the
monthly fee for a parent who later furnishes the
appropriate documentation shall be recalculated, as
specified, and retroactively adjusted based on the income
information provided.
c) Requires the monthly parental fee to be recalculated
every 12 months and within 60 days of the date a parent
notifies DDS of a change in family income or size, as
specified.
d) Authorizes DDS to grant a temporary waiver from paying
the monthly parental fee in cases where a family
experiences 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 client.
e) Grants a credit equal to one day of the monthly parental
fee to a parent who removes his or her child from a 24-hour
out-of-home care placement for a home visit for six or more
consecutive hours, as specified.
f) Codifies and expands the ability for a parent to appeal
DDS' determination of the amount of the parental fee, which
is currently allowed through state regulations. Provides
that an appeal can only consider disputes related to the
family income used to set the monthly parental fee and the
denial or amount of credit.
AB 564
Page 3
The Senate amendments:
1)Increase the threshold for a Parental Fee Program assessment
from 100% FPL to 200% FPL.
2)Recast and codify regulatory timelines for the furnishing of a
family's income information to DDS.
3)Codify the Parental Fee Program payment schedule.
4)Recast and codify regulatory provisions related to a family's
unavoidable, catastrophic loss by allowing DDS to temporarily
waive the monthly parental fee for a family rather than
authorizing DDS or the family's regional center to factor the
loss into the family's gross income calculation for purposes
of determining or adjusting the monthly parental fee amount.
5)Eliminate the requirement that DDS take into account certain
factors, such as medical, transportation, incidental, clothing
and other expenses, when establishing a monthly parental fee
amount.
6)Allow recalculation of a parental fee amount prior to annual
redetermination based on updated income information a family
provides to DDS.
7)Make other technical changes to conform to the revised
parental fee schedule and related requirements and push back
the effective date of this bill's provisions to July 1, 2016.
FISCAL EFFECT: According to the Senate Appropriations Committee,
this bill may have the following fiscal impact:
AB 564
Page 4
1)Likely one-time costs of about $150,000 to revise existing
formulas and procedures and to revise existing regulations by
the DDS (General Fund).
2)Projected annual revenue loss of about $190,000 due to changes
to the Parental Fee Structure (Program Development Fund), as
the bill exempts families with incomes between 100% and 200%
of the federal poverty level from paying fees, leading to a
reduction in annual fee revenues. In addition, the bill
authorizes families to request a recalculation of their fee
before the annual fee redetermination.
3)Unknown potential increase if fee revenues due to simplified
program requirements (Program Development Fund). According to
the DDS, the current structure of the program has led to
inconsistent application of fees across the state. By
simplifying the program rules, the 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 from calculating fee
levels. Also, 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.
COMMENTS:
Developmental services: The Lanterman Act guides the provision
of services and supports for Californians with developmental
disabilities. Each individual under the 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
individuals served 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
AB 564
Page 5
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 Act. The 21 regional centers
serve 280,000 consumers and contract with providers, on their
behalf, to deliver services such as residential placements,
supported living services, respite care, transportation, day
treatment programs, work support programs, and various social
and therapeutic activities. Less than 1,100 consumers reside at
one of California's three Developmental Centers - and one
state-operated, specialized community facility - which provide
24-hour habilitation and medical and social treatment services.
Out-of-home care: Residence types available to regional center
consumers who are not able to remain safely at home vary based
on the level of services needed, which dictate criteria such as
staffing levels, the physical aspects of a facility, and
programming. These residence types include community care
homes, such as adult residential facilities, foster family
homes, independent living and supported living settings, skilled
nursing facilities (SNF) and intermediate care facilities (ICF),
developmental centers, and community treatment facilities, among
others.
According to April 2015 data, nearly 77% of individuals served
by regional centers live with their parents or in their own
homes, while 96.76% of children (ages zero to 17) live with
their parents. The other 3.24% (or 4,295 children) live in
out-of-home, primarily community care settings. There aren't any
children living in independent living or supported living
AB 564
Page 6
settings, nor are there any children living in the state's
developmental centers.
Parental Fee Program: Established in the early years of the
Lanterman Act, the Parental Fee Program was put into statute to
require parents of children who are under 18 years of age and
receive 24-hour out-of-home care, paid for by a regional center,
to pay a share of cost based on their ability to pay. The money
DDS receives from the Parental Fee Program is required by law to
be remitted to the State Treasury for deposit into the Program
Development Fund, which is used to initiate new programs
consistent with the California Developmental Disabilities State
Plan.
Parental fees are established for families with income at or
above 100% of the Federal Poverty Level, and they range from $59
to $1,877 per month, based on family size and income. As of
April 2015, there were 559 children in the Parental Fee Program.
If parents are unhappy with the determination that they are
required to pay a parental fee, or if they wish to dispute the
actual monthly amount, they must submit a written request to
appeal the determination or the amount within 30 days of
receiving notification from DDS stating that they are to pay a
parental fee. Within 30 days of receiving the appeal and all
pertinent financial information from a family, DDS is required
to review the appeal and provide written notice of the decision
to the appellant and the appropriate regional center.
A January 2015 California State Auditor report called into
question whether implementation of the Parental Fee Program was
effective and equitable. The Auditor found that DDS was using
gross income and annual expenses when first determining a
parent's ability to pay, and then using net income and monthly
household expenses in the appeal process. This resulted in a
recommendation that DDS eliminate inconsistencies between the
information used for initial fee determinations and the
information used when an appeal is filed.
AB 564
Page 7
Current law requires the parental fee schedule to exempt
families with income below 100% of poverty from assessment and
payment of a parental fee and establishes a number of factors
that DDS must consider when determining the parental fee amount
parents are required to pay. These factors include:
1)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;
2)Medical expenses incurred prior to regional center care;
3)Whether the child is living at home;
4)Parental payments for medical expenses, clothing, incidentals,
and other items considered necessary for the normal rearing of
a child; and
5)Transportation expenses incurred in visiting a child.
Additionally, Parental Fee Program regulations permit DDS to
allow claims for major unusual expenses that limit a family's
available resources, which can be used to adjust the family's
gross income used to determine a parent's ability to pay and the
amount of the fee. These expense allowances include
expenditures that consume a substantial portion of the family's
gross income, as well as expenditures over which parents have no
AB 564
Page 8
control (e.g., natural disaster, catastrophic uninsured casualty
loss, death of an immediate family member, extreme medical
expense).
Need for this bill: By increasing the income threshold for
application of the monthly parental fee, as well as codifying
and clarifying requirements related to the furnishing of
information to DDS, potential temporary waivers of the fee due
to unforeseen circumstances, and potential fee adjustment prior
to annual redetermination without a formal appeal, the author
seeks to provide more fairness, consistency and transparency in
the implementation of the Parental Fee Program for families with
children in 24-hour out-of-home care.
Analysis Prepared by:
Myesha Jackson / HUM. S. / (916) 319-2089 FN:
0001974