BILL ANALYSIS Ó
AB 2809
Page 1
ASSEMBLY THIRD READING
AB
2809 (Rodriguez)
As Amended May 27, 2016
Majority vote
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|Committee |Votes|Ayes |Noes |
| | | | |
| | | | |
| | | | |
|----------------+-----+----------------------+--------------------|
|Human Services |6-0 |Bonilla, Grove, | |
| | |Lopez, Maienschein, | |
| | |Mark Stone, Thurmond | |
| | | | |
|----------------+-----+----------------------+--------------------|
|Appropriations |19-0 |Gonzalez, Bigelow, | |
| | |Bloom, Bonilla, | |
| | |Bonta, Calderon, | |
| | |Chang, Daly, Eggman, | |
| | | | |
| | | | |
| | |Eduardo Garcia, | |
| | | | |
| | | | |
| | |Roger Hernández, | |
| | |Holden, Jones, | |
| | |Obernolte, Quirk, | |
| | |Santiago, Wagner, | |
| | |Weber, Wood | |
| | | | |
AB 2809
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| | | | |
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SUMMARY: Requires regional centers to provide certain
information in threshold languages and requires that parental
hardships be considered when determining the extent of parent
participation for certain services. Specifically, this bill:
1)Requires a regional center, at the time of development,
scheduled review, or modification of a consumer's individual
program plan (IPP) or individualized family service plan
(IFSP), to provide the consumer and/or certain other
individuals, in an understandable form and in the appropriate
threshold language(s), as specified, with a document
describing all of the following and the process for how to
obtain each:
a) Acquisition of transportation services for a minor
child, as specified;
b) Exemptions to the limitations on purchase of camping
services, social recreation activities, educational
services, and nonmedical therapies, as specified;
c) Exemptions to the limitations on purchase of certain
services for consumers ages 18 to 22 years old, as
specified; and
d) Exemptions to the limitations on purchase of respite
services, as specified.
2)Requires a regional center, at the beginning of each
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individual program plan (IPP) meeting, to provide a consumer
and other specified individuals information about the appeal
and complaint process in threshold languages, as specified and
appropriate.
3)Requires a regional center to provide the statement of
services and supports purchased for a consumer in the
threshold language(s), as specified, of the consumer and/or
his or her parents, legal guardian, conservator, or authorized
representative.
4)Requires the IPP or IFSP planning team, when determining the
extent of parent participation, to consider any relevant
hardships suffered by a parent or parents that may constitute
a barrier to the consumer accessing applied behavioral
analysis (ABA) or intensive behavioral intervention services
and that such hardships be documented in the IPP or IFSP and
be reviewed every six months, as specified. Further, requires
the regional center, if it determines that the extent of
parent participation should be adjusted due to a change in
circumstances, to provide adequate notice, as specified.
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 Section (WIC) 4500 et seq.)
2)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 Department of Developmental Services (DDS) to
contract with regional centers to provide case management
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services and arrange for or purchase services that meet the
needs of individuals with developmental disabilities, as
defined. (WIC 4620 et seq.)
3)Requires the development of an 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 4512)
4)Places various requirements on regional centers to communicate
and provide certain written materials in a consumer's and/or
family's or other designated individual's native language, as
specified. (Government Code Section (GOV) 95020(g); WIC
4642(b), 4643(d), 4646(h))
5)Defines "threshold language" to mean a language that has been
identified as the primary language, as specified, of 3,000
beneficiaries or 5% of the beneficiary population, whichever
is lower, in an identified geographic area. (9 California
Code of Regulations Section (CCR) 1810.410(a)(3))
6)Provides for exemptions to certain service limitations, as
specified, related to: transportation for minors; camping
services, social recreation activities, educational services,
and nonmedical therapies; certain services for consumers ages
18 to 22 years old; and respite services. (WIC 4648.35,
4648.5, 4648.55, 4686.5)
7)Defines "parent participation" for purposes of ABA or
intensive behavioral intervention services to include, but not
be limited to: completion of group instruction on the basics
of behavior intervention; implementation of intervention
strategies, according to the intervention plan; collection of
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data on behavioral strategies and submission of that data, as
specified; and participation in any needed clinical meetings.
(WIC 4686.2(d)(4))
8)Requires regional centers to only purchase ABA or intensive
behavioral intervention services when the parent(s) of minor
consumers receiving services participate in the intervention
plan for the consumers. (WIC 4686.2(b)(2))
FISCAL EFFECT: According to the Assembly Appropriations
Committee, this bill may result in the following costs:
1)One-time costs to regional centers to translate the statement
of services for Fiscal Year (FY) 2016-17 (6 months) of
approximately $1.5 million ($1 million General Fund). In
2017-18 and ongoing, the cost would be $3 million ($2 million
General Fund) plus an average growth rate of individuals with
a primary language other than English of 4.63%
2)One-time costs to DDS of approximately $14,000 (General Fund)
to translate information about the appeal and complaint
process, and exceptions and exemptions, into California's 13
non-English threshold languages. Translation cost for Spanish
is approximately $68 per hour and other languages are
approximately $90 per hour. Each translation is estimated to
take approximately 12 hours on average.
3)On-going costs of approximately $50,000 (General Fund)
annually to provide the above information in threshold
languages at IPP and IFSP development, modification, and
review meetings. Approximately 500,000 meetings occur
annually. This assumes the information can be provided in two
pages at $0.05 per page.
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4)Unknown costs, but likely in the low millions (General Fund),
associated with the parental participation hardship
adjustment. Costs would be expected from the likely decreased
effectiveness of behavior intervention with reduced or no
parent participation leading to a potential need to continue
those services for a longer period of time.
COMMENTS:
Developmental services: Direct responsibility for
implementation of the Lanterman Act service system is shared by
the Department of Developmental Services (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 approximately 290,000 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. Approximately 1,005 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.
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.
In July of 2009, a number of state budget cuts were adopted in
response to the budget shortfall resulting in large part from
the national economic crisis. DDS had to make a number of cuts
at this time; the department worked with stakeholders to
identify over $300 million in General Fund savings. Examples of
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some of the many actions taken include: limiting transportation
for minor children to when the family provides documentation
that they cannot provide transportation themselves; suspending
the purchase of camping services, certain social recreation
activities, educational services, and non-medical therapies,
except in cases where exemptions are granted; restricting the
amount of respite services that may be purchased, except in
cases where exemptions are granted; and providing for a standard
that parent participation is critical to the success of the
intervention plan and requiring regional centers to purchase ABA
or intensive behavioral intervention services only when the
parent agrees to participate in the intervention plan.
Threshold languages: Including English, 207 languages are
spoken in the state. The California Code of Regulations (9
CCR 1810.410 (a)(3)) defines "threshold language" to mean a
language that has been identified as the primary language, as
specified, of 3,000 beneficiaries or 5% of the beneficiary
population, whichever is lower, in an identified geographic
area. A 2015 Budget Trailer bill (SB 82 (Senate Committee on
Budget and Fiscal Review), Chapter 23, Statutes of 2015), among
other things, required each regional center to offer, and upon
request provide, a written copy of the IPP to the consumer and,
when appropriate, his or her parents, legal guardian or
conservator, or authorized representative within 45 days of the
request in a threshold language. For each regional center
catchment area, the threshold languages are defined by the
county or counties served by that regional center.
Recent special session actions: The Governor convened a special
legislative session in June 2015 to address, among other things,
funding rate increases for community service providers of
services for individuals with developmental disabilities. One
result of that special session was the passage of AB 1 X2
(Thurmond), Chapter 3, Statutes of 2016, signed by the Governor
on March 1 of this year, which appropriated $287 million General
Fund to regional centers and community services providers in
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2016-17 in additional to leveraging an estimated $186 million in
federal funding. Approximately 60% of the General Fund spending
is marked for rate increases to go towards salaries and benefits
for staff that provide direct care to consumers. Among other
spending augmentations, AB 1 X2 also included a fixed
appropriation of $11 million to promote equity and reduce
disparities in the purchase of services, to be used for
activities such as cultural competency training, parent
education, and supporting bilingual regional center staff.
Need for this bill: According to the author, "For people with
developmental disabilities, health disparities can result in
significant health, social, and economic consequences.
California's diverse language and ethnic communities account for
about 60% of its population. In recent years, access to
developmental services has been significantly limited due to
severe budget cuts, with minority populations particularly
adversely affected. In 2011, a Los Angeles Times series
reported significant disparities in the funding of developmental
services based on race, ethnicity, and language. Consumers and
family members who are limited English proficient have the right
to culturally and linguistically competent information about
accessing developmental services available through regional
centers, including information on the process for obtaining
certain services through statutory exemptions and meeting other
affirmative requirements. Additionally, the level of parent
participation required to access intensive behavioral
intervention services is often too burdensome to meet for some
families who are low-income and/or who are limited English
proficient, and the law should provide for some flexibility in
authorizing for these services by accounting for hardship
factors."
RELATED AND PRIOR LEGISLATION
SB 1034 (Mitchell) of the current legislative session, among
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other things, would prohibit lack of parent or caregiver
participation from being used to deny or reduce medically
necessary behavioral health treatment, as specified. This bill
was heard in the Senate Appropriations Committee on May 27th.
AB 1 X2 (Thurmond), Chapter 3, Statutes of 2016, among other
things, implemented targeted rate increases for the
community-based developmental services system.
SB 82 (Senate Committee on Budget and Fiscal Review), Chapter
23, Statutes of 2015, among other things, required each regional
center to offer, and upon request provide, a written copy of the
IPP to the consumer and, when appropriate, his or her parents,
legal guardian or conservator, or authorized representative
within 45 days of his, her, or their request in a threshold
language, as defined, and further required the department and
regional centers to annually collaborate to compile data on the
number of instances in which an IPP was provided in this manner.
SB 555 (Correa), Chapter 685, Statutes of 2013, placed various
requirements on regional centers to communicate and provide
certain written materials in a consumer's and/or family's or
other designated individual's native language, as specified.
AB 9 X4 (Evans), Chapter 9, Statutes of 2009, contained
necessary changes to enact modifications to the 2009 Budget Act,
including, but not limited to, suspending and limiting certain
services for regional center consumers.
Analysis Prepared by:
Daphne Hunt / HUM. S. / (916) 319-2089 FN:
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