BILL ANALYSIS Ó
AB 918
Page 1
CONCURRENCE IN SENATE AMENDMENTS
AB
918 (Mark Stone)
As Amended August 26, 2015
Majority vote
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|ASSEMBLY: | 77-0 | (June 2, |SENATE: |40-0 | (August 31, |
| | |2015) | | |2015) |
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Original Committee Reference: HEALTH
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.
The Senate amendments define "regional center vendor" as an
agency, individual, or service provider that a regional center
has approved to provide vendored or contracted services; specify
that acute psychiatric hospitals must also meet the requirements
of this bill, and; clarify that institutions for mental diseases
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that are regional center vendors meet the definition of an acute
psychiatric hospital.
FISCAL EFFECT: According to the Senate Appropriations
Committee, pursuant to Senate Rule 28.8, negligible state costs.
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 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
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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.
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 this 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
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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 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:
0001864