BILL ANALYSIS Ó SB 490 Page 1 Date of Hearing: June 30, 2015 ASSEMBLY COMMITTEE ON HUMAN SERVICES Kansen Chu, Chair SB 490 (Beall) - As Amended June 18, 2015 SENATE VOTE: 36-0 SUBJECT: Regional centers: audits. SUMMARY: Increases audit and financial review thresholds for regional center vendors. Specifically, this bill: 1)Clarifies that an audit or review of an entity that receives payment from one or more regional centers, pursuant to specified requirements, shall pertain to financial statements relating to payments made by regional centers. 2)Deletes the requirement that an entity that receives between $250,000 and $500,000 from one or more regional centers in a fiscal year must obtain an audit or review of its financial statements and instead triggers the requirement for an independent audit or independent review report of an entity's financial statements when the amount received from regional centers is between $500,000 and $2,000,000 during the entity's SB 490 Page 2 fiscal year. 3)Accordingly, increases the threshold for dollars received from a regional center that triggers an entity's requirement to obtain an independent audit of financial statements from $500,000 to $2,000,000 during a fiscal year. 4)Adds income from payments for social security benefits to the list of excluded income types for purposes of the audit requirement threshold. 5)Permits an entity that obtains an independent audit or independent review based on regional center payments of between $500,000 and $2 million to request a two-year exemption if the regional center does not find issues in the prior year's audit or review that has an impact on regional center services. Requires the regional center to grant the vendor request if that condition is met. 6)Permits an entity that is required to obtain an independent audit of its financial statements based on regional center payments of $2 million or more to apply to the regional center for an exemption subject to all of the following: a) If the independent audit for the prior year resulted in an unmodified opinion or an unmodified opinion with explanatory language, the regional center shall grant the entity a two-year exemption; and b) If the independent audit for the prior year resulted in a qualified opinion and the issues are not material and pervasive, the regional center shall grant the entity a two-year exemption, and the entity and the regional center shall continue to address issues raised in the independent audit, regardless of whether the exemption is granted; SB 490 Page 3 7)Requires a regional center to notify the Department of Developmental Services (DDS) of any exemption it grants to an entity that receives a qualified opinion report. EXISTING LAW: 1)Establishes an entitlement to services for individuals with developmental disabilities under the Lanterman Developmental Disabilities Services Act (Lanterman Act). (WIC 4500 et seq.) 2)Grants all individuals with developmental disabilities, among all other rights and responsibilities established for any individual by the United States Constitution and laws and the California Constitution and laws, the right to treatment and habilitation services and supports in the least restrictive environment. (WIC 4502) 3)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 DDS to contract with regional centers to provide case management services and arrange for or purchase services that meet the needs of individuals with developmental disabilities, as defined. (WIC 4620 et seq.) 4)Requires the development of an individual program plan (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) SB 490 Page 4 5)Creates a process by which regional centers may "vendorize" service providers, thereby providing a path to contract for services with that provider and ensuring maximum flexibility and availability of appropriate services and support for persons with developmental disabilities. (WIC 4648) 6)Authorizes regional centers to solicit an individual or agency through a request for proposals or other means to provide needed services or supports not presently available, provided it is necessary to expand the availability of needed services of good quality. (WIC 4648(e)(1)) 7)Requires regional centers to provide the consumer, his or her parent, legal guardian, or other appropriate authorized representative, as specified, at least annually, a statement of services and supports the regional center purchased, for the purpose of ensuring that the services are delivered. (WIC 4648(h)) 8)Authorizes DDS and regional centers to monitor services and supports purchased for regional center consumers without prior notice, as specified, and authorizes DDS to conduct fiscal reviews and audits of service providers' records. (WIC 4648.1(a)) 9)Requires that DDS and regional center staff involved in monitoring or auditing services provided to regional center consumers be granted access to a provider's grounds, buildings, service program, and all related records and documentation, as specified. (WIC 4648.1(b)) SB 490 Page 5 10)Requires that an entity receiving payments from one or more regional centers contract with an independent accounting firm for an audit or review of its financial statements subject to all of the following: a) When the amount received from the regional center or regional centers during the entity's fiscal year is more than or equal to two hundred fifty thousand dollars ($250,000) but less than five hundred thousand dollars ($500,000), the entity shall obtain an independent audit or independent review report of its financial statements for the period. This includes work activity program providers receiving less than two hundred fifty thousand dollars ($250,000), as specified; and b) When the amount received from the regional center or regional centers during the entity's fiscal year is equal to or more than five hundred thousand dollars ($500,000), the entity shall obtain an independent audit of its financial statements for the period. (WIC 4652.5 (a)(1)) 11)Excludes certain payment types, as specified, from consideration and exempts state and local agencies, the UC and CSU university systems from the audit requirement. (WIC 4652.5(a)(2) and (a)(3)) 12)Requires vendors to provide copies of the audit or review to the vendoring regional center within 30 days of completion, and requires regional centers to review them and require resolution of issues identified in the report that have an impact on regional center services. (WIC 4652.5(b)) 13)Requires regional centers to take appropriate action, which may entail termination of vendorization, for lack of adequate SB 490 Page 6 resolution of issues. (WIC 4652.5(c)) 14)Requires regional centers to notify DDS of all qualified opinion reports or reports noting significant issues that directly or indirectly impact regional center services within 30 days after receipt, and requires the notification to include a plan for resolution of issues. (WIC 4652.5 (d)) 15)Specifies that an independent review of financial statements must be performed by an independent accounting firm and requires the review to include at a minimum: a) An inquiry as to the entity's accounting principles and practices and methods used in applying them; b) An inquiry as to the entity's procedures for recording, classifying, and summarizing transactions and accumulating information; c) Analytical procedures designed to identify relationships or items that appear to be unusual; d) An inquiry about budgetary actions taken at meetings of the board of directors or other comparable meetings; e) An inquiry about whether the financial statements have been properly prepared in conformity with generally accepted accounting principles and whether any events subsequent to the date of the financial statements would have a material effect on the statements under review; and f) Working papers prepared in connection with a review of financial statements describing the items covered as well as any unusual items, including their disposition. (WIC 4652.5(e)) 16)Specifies that the independent review report shall cover, at a minimum, all of the following: SB 490 Page 7 a) Certification that the review was performed in accordance with standards established by the American Institute of Certified Public Accountants; b) Certification that the statements are the representations of management; c) Certification that the review consisted of inquiries and analytical procedures that are lesser in scope than those of an audit; and d) Certification that the accountant is not aware of any material modifications that need to be made to the statements for them to be in conformity with generally accepted accounting principles. (WIC 4652.5(f)) 17)Prohibits DDS from considering requests for adjustments to rates by an entity receiving regional center payments solely to fund either anticipated or unanticipated changes required for an entity to comply with the audit or review requirements, as specified. (WIC 4652.5(g)) 18)Requires every charitable corporation, commercial fundraiser for charitable purposes, unincorporated association, and trustee required to file reports with the Attorney General, as defined, that receives or accrues in any fiscal year gross revenue of two million dollars ($2,000,000) or more, exclusive of grants from, and contracts for services with, governmental entities for which the governmental entity requires an accounting of the funds received, to obtain an annual financial audit, as defined, and requires the audited financial statements to be available for public inspection no later than nine months after the close of the fiscal year to which the statements relate, as defined. (GOV 12586 (e)(1)) 19)Requires a regional center to audit records of service providers, as specified, to the extent the regional center determines it is necessary. (California Code of Regulations Title 17 §50606) SB 490 Page 8 FISCAL EFFECT: According to the April 23, 2015 Senate Appropriations Committee analysis, this bill is not likely to result in significant cost increases for regional center services. COMMENTS: Developmental services: The Lanterman Act (WIC § 4500 et seq.) 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 substantial disability for that individual. It includes intellectual disabilities, cerebral palsy, epilepsy, and autism spectrum disorder. 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. SB 490 Page 9 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, providing services such as residential placements, supported living services, respite care, transportation, day treatment programs, work support programs, and various social and therapeutic activities. 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. The Lanterman Act requires that the IPP promote community integration and maximize opportunities for each consumer to develop relationships, be part of community life, increase control over his or her life, and acquire increasingly positive roles in the community. The IPP must give the highest preference to those services and supports that allow minors to live with their families and adults to live as independently as possible in the community. Regional center vendors: Prior to being approved to receive funding from a regional center for providing services to a consumer, a service provider must become vendored by the regional center that oversees the catchment area in which the SB 490 Page 10 provider is located. This "vendorization" process includes verifying that the provider is qualified to provide the planned services and meets all other regulatory standards and requirements. It is important to note that vendorization makes a provider eligible to provide services paid for by the regional center, but does not guarantee the regional center will refer consumers. Furthermore, there is nothing precluding a vendor from being vendorized by more than one regional center. There are over 45,000 vendors that provide services paid for by regional centers in California. Audits and reviews: Independent accounting professionals complete audit reports to review whether financial records have been maintained in accordance with Generally Acceptable Accounting Principles (GAAP) and assess the financial status and stability of a business or company based on its assets and liabilities. Auditor opinion categories are as follows: a) An unmodified opinion, which is often called a clean opinion and is the best possible report category, is issued when an auditor determines that the financial records are presented fairly and free of any misrepresentations. An unmodified opinion also indicates that the financial records have been maintained in accordance with GAAP. This type of opinion is sometimes also called an "unqualified" opinion; b) A qualified opinion is issued when a company's financial records have not been maintained in accordance with GAAP but no misrepresentations are identified. This type of opinion indicates the reason that the audit report is not SB 490 Page 11 unqualified; c) An adverse opinion is issued when an auditor concludes that the audited financial statements do not adhere to the GAAP and do not fairly represent the organization's financial position. An auditor will often work with the organization to resolve or correct issues so the published audit can be either qualified or unqualified; and d) A disclaimer of opinion is provided when an auditor chooses not to issue an opinion, either due to significant uncertainties in the appropriateness of the materials, significant limitations in the scope of the audit, or if the auditor feels he or she cannot complete an impartial or independent audit of the organization. A review report is substantially smaller in scope than a full audit and does not result in the issuance of an opinion. The purpose of the review is to analyze the financial data of a business and make inquiries of the company's management in order to express limited assurances that the company is in conformity with GAAP. A Certified Public Accountant will issue either a clean review report, or will issue no report based on a material modification that needs to be made. Bureau of State Audits report: The Bureau of State Audits released a report in August 2010 entitled "Department of Developmental Services: A More Uniform and Transparent Procurement and RateSetting Process Would Improve the CostEffectiveness of Regional Centers. The report concluded that regional centers were not appropriately monitoring expenditures of vendors and that they did not always document why certain vendors are selected, how rates are set, or how contracts are procured. This raised concerns about favoritism and fiscal irresponsibility on the part of regional centers and also fueled conversations within the Legislature about the need for more vendor expenditure transparency and oversight. SB 490 Page 12 Regional center vendor audit requirements: SB 74 (Committee on Budget and Fiscal Review), Chapter 9, Statutes of 2011, a developmental services trailer bill, required that each regional center vendor receiving more than $250,000 submit to an independent audit or independent review report of its financial statements for the period. It also required vendors receiving $500,000 or more to obtain an independent audit of financial statements (they are not able to meet the statutory requirement with an independent review). These requirements were attached to estimated savings that would be derived through identifying and remedying poor billing practices and inappropriate spending of regional center dollars. The estimated savings projection was 1% in regional center purchase of services costs, and a DDS description of the proposal indicated that it would allow the department to focus its own audits on those vendors with qualified reports or significant issues raised during the independent audits. According to the sponsors of this bill, financial review costs can range from $2,000 to $4,000, while the cost for impacted vendors to have an audit conducted is often between $6,000 and $14,000. Need for this bill: According to the author, the current review and audit requirements are overly financially burdensome for the vendors required to obtain them without quite resulting in the intended results or reaching the estimated savings target attached to the requirements in SB 74. The author states that there are a number of ambiguities in SB 74 that this bill seeks to clarify, including through ensuring that only monies paid by regional centers to a provider should be subject to an audit or review. Under current law, vendors are required to provide copies of their fiscal review or audit to their vendoring regional center within 30 days of completion. However, because this requirement does not indicate a timeline for completion, some vendors avoid the 30-day submission requirement by not complying with their SB 490 Page 13 respective audit or review requirements. Recent author's amendments to this bill seek to ensure the reviews and audits are occurring and information is being reported to regional centers by requiring that the information be submitted to regional centers within nine months of the end of the fiscal year for the vendor rather than tying the submission date to the completion date. Staff comments: Because DDS has no way to track the fiscal impact of the audit requirement, there is no way to verify whether its enactment under SB 74 has resulted in the anticipated amount of cost savings, either through improved accounting and billing practices or the deterrent effect of increased scrutiny of financial records. Association of Regional Center Agencies (ARCA) data show that audit completion varies throughout the state. An ARCA survey of 18 of the state's 21 regional centers revealed a 52% independent audit compliance rate among vendors with 99% of those audits resulting in unqualified vendor opinions. DDS reports that approximately 90 audits across 10 regional centers have been reported to the Department for a plan of correction since enactment of the requirement. It is important to note that the information gathered during a review is insufficient to establish whether corrective action might be needed. There were 2,214 entities required to obtain an independent review or audit in 2013-14, 1,381 of which received $500,000 or more from regional centers and were required to meet the higher audit standard. This bill eliminates the audit and review requirements for vendors that receive between $250,000 and $500,000 annually from regional centers, thereby eliminating the requirement for any information to be gathered for 833 vendors. Additionally, by raising the audit threshold from $500,000 to $2 million in regional center dollars received, almost 70% of providers would no longer have to meet their current audit requirement, which leaves only 410 vendors out of the 1,381 currently required to obtain an independent audit. SB 490 Page 14 The author of this bill seeks to provide some financial relief to developmental services providers through eliminating audit and review requirements for a number of vendors and allowing a clean audit or review to result in a two-year exemption from the independent audit or independent review requirement. However, committee staff believes it will be of utmost importance for the state to promote transparency and additional oversight of how dollars are spent within the developmental services system in the coming years. The committee may wish to revisit the audit standards in developmental services-related regulations and statute as conversations about rate-setting and rate methodologies continue between the Legislature and the Administration. PRIOR LEGISLATION: SB 1259 (Emmerson) 2012, would have authorize two-year exemptions from audit requirements similar to provisions of this bill. It died on the Senate Appropriations Suspense File. SB 74 (Committee on Budget and Fiscal Review) Chapter 9, Statutes of 2011, established the audit and review requirements, among other provisions. DOUBLE REFERRAL . This bill has been double-referred. Should this bill pass out of this committee, it will be referred to the Assembly Appropriations Committee. SB 490 Page 15 REGISTERED SUPPORT / OPPOSITION: Support ResCoalition - sponsor Association of Regional Center Agencies (ARCA) California Disability Services Association (CDSA) Cerebral Palsy Center for the Bay Area Community Residential Care Association of California Independent Options State Council on Developmental Disabilities The Alliance The Arc and United Cerebral Palsy California Collaboration Trinity CHANGE SB 490 Page 16 Opposition None on file. Analysis Prepared by:Myesha Jackson / HUM. S. / (916) 319-2089