BILL ANALYSIS Ó
AB 918
Page 1
ASSEMBLY THIRD READING
AB
918 (Mark Stone)
As Amended May 28, 2015
Majority vote
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|Committee |Votes |Ayes |Noes |
| | | | |
| | | | |
|----------------+------+--------------------+----------------------|
|Health |18-0 |Bonta, Maienschein, | |
| | |Bonilla, Burke, | |
| | |Chávez, Chiu, | |
| | |Gomez, Gonzalez, | |
| | |Lackey, Nazarian, | |
| | |Patterson, | |
| | | | |
| | | | |
| | |Ridley-Thomas, | |
| | |Rodriguez, | |
| | |Santiago, | |
| | |Steinorth, | |
| | |Thurmond, Waldron, | |
| | |Wood | |
| | | | |
|----------------+------+--------------------+----------------------|
|Appropriations |17-0 |Gomez, Bigelow, | |
| | |Bonta, Calderon, | |
| | |Chang, Daly, | |
| | |Eggman, Gallagher, | |
| | | | |
AB 918
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| | | | |
| | |Eduardo Garcia, | |
| | |Gordon, Holden, | |
| | |Jones, Quirk, | |
| | |Rendon, Wagner, | |
| | |Weber, Wood | |
| | | | |
| | | | |
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SUMMARY: Requires the Secretary of California Health and Human
Services to establish a system of mandatory, consistent, timely,
and publicly accessible data collection related to data on
seclusion and restraint in community facilities serving aged and
developmentally disabled persons, as specified. Requires the
Department of Developmental Services (DDS) to publish on its Web
page the number of incidents of physical and chemical restraint in
community facilities, as specified. Requires community facilities
to report every death or serious injury of a person in seclusion
or in physical or chemical restraint no later than the close of
business day following the death or serious injury.
FISCAL EFFECT: According to the Assembly Appropriations
Committee, this bill would have minor and absorbable costs to DDS,
assuming facilities comply with reporting requirements. If
facilities don't comply, there could be cost pressure to enforce
the reporting requirements or to provide additional education and
training. Any cost pressure for enforcement or provider education
would depend on the robustness of the activities.
COMMENTS: According to the author, while existing law protects
individuals with developmental disorders in developmental centers
(DCs) from unreported use of seclusions and restraint, the
populations in these facilities are changing. State facilities
are beginning to close and more people are living in community
facilities. The author states that this move can be heralded as
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an important and beneficial move for those with developmental
disabilities, but it also leaves them vulnerable to the use of
seclusion and behavioral restraint as tactics to control behavior.
The author also states that the Legislature has made findings and
declarations indicating that the use of seclusions and restraints
is not a treatment nor does it positively change behavior. When
the state first implemented reporting and publishing requirements,
most individuals were living in DCs. However, now California is
moving individuals to community facilities, where no such
requirement exists. According to the author, California must
protect these vulnerable individuals, give consumers more
information when choosing a facility, and allow the government and
the designated protection and advocacy agency, Disability Rights
California (DRC), the ability to compare the use of seclusion and
restraint across facilities.
1)DCs. California provides services and support to individuals
with developmental disabilities in two ways. The vast
majorities of people live in their families' homes or other
community settings and receive state-funded services that are
coordinated by one of 21 non-profit corporations known as
regional centers. More than 99% of DDS consumers receive
services in this way under the Community Services Program. A
smaller number of individuals, or less than 1% of the DDS
caseload, live in three state-operated DCs and one
state-operated community facility. DDS operates three DCs:
Fairview (Orange County); Porterville (Tulare County); and,
Sonoma (Sonoma County). Among other services, Porterville also
provides secure treatment services. A fourth DC, Lanterman,
transitioned its last resident into community living on December
23, 2014. Services at all facilities involve the provision of
active treatment through residential and day programs on a
24-hour basis, including appropriate medical and dental care,
health maintenance activities, and assistance with activities of
daily living, training, education, and employment.
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2)Population Transitions. During a period of recent budget
deficits, the Legislature enacted numerous DDS budget reductions
and cost savings measures to yield General Fund savings. The
2012-13 budget imposed a moratorium on admissions to DCs except
for individuals involved in the criminal justice system, and
consumers in an acute crisis needing short-term stabilization.
The high costs to maintain and staff these facilities, coupled
with an emphasis on transitioning individuals back into their
community, have led to the closure and/or restructuring of many
DCs. The moratorium on DC admission as well as the need for the
availability of services in the community have led to a shift in
spending from the DCs to the community services programs. The
2015-16 budget reflects this change, as the budget for DCs has
decreased and the Community Services budget has increased.
DRC, the sponsors of the bill, write in support of the bill that
residents in DCs are moving from large state facilities and into
smaller community facilities. Family members and advocates are
concerned about the unknown and unreported use of behavioral
restraint and seclusion; dangerous practices that often result in
serious injuries, even death. The concern continues to grow as
individuals with behavioral challenges migrate from DCs where
there is public reporting and accountability to isolated community
settings where there is no public accountability regarding as to
the use of seclusion and behavioral restraint. People with
disabilities should live in the community with appropriate
services and supports; and there should be appropriate oversight
of community facilities that use dangerous restraint and seclusion
practices.
The National Association of Social Workers (NASW) writes that
through previous legislation, the state has attempted to reduce or
eliminate the use of seclusion or behavior restraints at state
facilities. Efforts have also been made to make the data on the
use of seclusion and restraints available to the public.
Currently, these laws do not apply to community facilities. NASW
argues this bill will require information about deaths or serious
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injury available to the protection and advocacy agency designated
by the Governor.
There is no known opposition to this bill.
Analysis Prepared by:
Paula Villescaz / HEALTH / (916) 319-2097 FN:
0000850