BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                     SB 490


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          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  








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            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;









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          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)








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          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))








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          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  








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            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:









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              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)








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          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.  










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          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  








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          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  








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               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.









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          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  








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          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.








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          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.














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          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









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          Opposition


          None on file.




          Analysis Prepared by:Myesha Jackson / HUM. S. / (916)  
          319-2089