BILL NUMBER: SB 834 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY JUNE 12, 2016
AMENDED IN ASSEMBLY MAY 25, 2016
INTRODUCED BY Committee on Budget and Fiscal Review
JANUARY 7, 2016
An act relating to the Budget Act of 2016.
An act to amend Section 1180.4 of the Health and Safety Code, to am
end Section 10430 of the Public Contract Code, to amend
Sections 4519.5, 4659.2, 4681.5, 4681.6, 4685.8, 4690.5, 4691.6,
4691.9, and 4870 of, to add Sections 4437, 4474.15, 4474.6, and 4572
to, and to repeal Section 4435.1 of, the Welfare and Institutions
Code, and to amend Section 15 of Chapter 3 of the Statutes of 2016,
Second Extraordinary Session, relating to developmental services, and
making an appropriation therefor, to take effect immediately, bill
related to the budget.
LEGISLATIVE COUNSEL'S DIGEST
SB 834, as amended, Committee on Budget and Fiscal Review.
Budget Act of 2016. Developmental services.
(1) Existing law vests in the State Department of Developmental
Services jurisdiction over developmental centers for the provision of
residential care to individuals with developmental disabilities,
including the Sonoma Developmental Center, the Fairview Developmental
Center, and the Porterville Developmental Center.
This bill would require the department to report quarterly to the
Joint Legislative Budget Committee the estimated amount of General
Fund expenditures used to backfill federal funding as a result of the
decertification of intermediate care facility units at the Sonoma
Developmental Center. The bill would also require, if the
intermediate care facility units at the Fairview Developmental Center
or the Porterville Developmental Center are decertified by the
federal government in the 2016-17 fiscal year, the department to
report quarterly to the Joint Legislative Budget Committee the
estimated amount of General Fund expenditures used to backfill
federal funding as a result of the decertification or
decertifications.
(2) Existing law requires the department to comply with procedural
requirements when closing a developmental center, including
submitting a detailed plan to the Legislature and holding at least
one public hearing. Existing law requires the State Department of
Developmental Services to submit, on or before October 1, 2015, a
plan to the Legislature to close one or more developmental centers.
This bill would require the department to include an update to the
Legislature in the 2017-18 May Revision regarding how the department
will ensure access to crisis services after the closure of a
developmental center and how the state will maintain its role in
providing residential services to those whom private sector vendors
cannot or will not serve. The bill would also require the department
to post on its Internet Web site a monthly progress report regarding
the development of residential capacity by each regional center, as
specified.
(3) Existing law requires the State Department of Developmental
Services to provide followup services to help ensure a smooth
transition to the community when an individual transitions from a
developmental center to a community living arrangement.
Existing law establishes the Medi-Cal program, administered by the
State Department of Health Care Services, under which basic health
care services are provided to qualified low-income persons. The
Medi-Cal program is, in part, governed and funded by federal Medicaid
provisions. Existing law authorizes the department to provide health
care services to beneficiaries through various models of managed
care, including through a comprehensive program of managed health
care plan services for Medi-Cal recipients residing in clearly
defined geographical areas.
This bill would require the State Department of Developmental
Services and the State Department of Health Care Services to
coordinate the transition of health care services for Medi-Cal
eligible consumers who are transitioning from a developmental center
into the community, as specified. The bill would require the State
Department of Health Care Services to issue transition requirements
for specified consumers. The bill would authorize the State
Department of Health Care Services to implement those provisions by
means of all-county letters, plan letters, plan or provider
bulletins, or similar instructions. The bill would provide that its
provisions shall be implemented only to the extent that any necessary
federal approvals are obtained and federal financial participation
is available.
(4) Existing law, the Lanterman Developmental Disabilities
Services Act, requires the State Department of Developmental Services
to contract with regional centers to provide services and supports
to individuals with developmental disabilities and their families.
Existing law also requires the department to implement an
improved, unified quality assessment system, as specified. Existing
law requires each regional center to, on or before August 1 of each
year, submit to the department and the State Council on Developmental
Disabilities a program budget plan for the subsequent budget year,
as specified.
This bill would require the department to, on or before February 1
of each year, report to the Legislature and post on its Internet Web
site specified supplemental budget information, including an
estimate for the annual budget for each developmental center and the
current fiscal year allocations of total and per capita funding for
operations and purchase of services for each regional center. The
bill would require the department to develop and implement a plan to
monitor, evaluate, and improve the quality of community-based
services through the use of a performance dashboard, to be published
annually and include, among other things, recognized quality and
access measures. The bill would require that, with the fiscal and
research resources included as part of the Budget Act of 2016, the
department annually assess specified data, including the performance
dashboard data.
(5) Existing law requires the State Department of Developmental
Services and regional centers to annually collaborate to compile
specified data relating to purchase of service authorization,
utilization, and expenditure by each regional center. Existing law
requires each regional center to annually report to the department
regarding its implementation of specified requirements and requires
the report to include, among other things, whether the data indicates
a need to reduce disparities in the purchase of services among
consumers in the regional center's catchment area, and if so, the
regional center's recommendations and plan to promote equity and
reduce disparities in the purchase of services. Existing law requires
the department to, subject to available funding, allocate funding to
regional centers to assist with the implementation of those
recommendations and plans.
This bill would require each regional center to consult with
stakeholders regarding activities that may be effective in addressing
disparities in the receipt of regional center services and the
regional center's proposed requests for the above-mentioned funding
and would also require each regional center to identify the
stakeholders consulted with and to include information on how it
incorporated stakeholder input into its requests. The bill would
require the department to review requests for funding within 45 days
from a specified deadline and would require each regional center to
report to the department, as specified, how the funding allocations
were used, among other things.
(6) Existing law requires regional center vendors that provide
residential services or supported living services, long-term health
care facilities, as defined, and acute psychiatric hospitals, as
defined, to report each death or serious injury of a person occurring
during, or related to, the use of seclusion, physical restraint, or
chemical restraint, as specified.
This bill would additionally require regional center vendors that
provide crisis services to make those reports. The bill would also
require regional center vendors that provide crisis or residential
services or supported living services, long-term health care
facilities, and acute psychiatric hospitals, to report any unexpected
or suspicious death, regardless of whether the cause is immediately
known, any allegation of sexual assault, as defined, in which the
alleged perpetrator is a staff member, service provider, or facility
employee or contractor, and any report made to the local law
enforcement agency in the jurisdiction in which the facility is
located that involves physical abuse, as defined, in which a staff
member, service provider, or facility employee or contractor is
implicated. In addition, the bill would require those entities to
report on a monthly basis, as specified, the number of incidents of
seclusion and the duration of time spent per incident in seclusion,
the number of incidents of the use of behavioral restraints and the
duration of time spent per incident of restraint, and the number of
times an involuntary emergency medication is used to control
behavior.
(7) Existing law requires the State Department of Developmental
Services, contingent upon approval of federal funding, to establish
and implement a state Self-Determination Program, as defined, that
would be available in every regional center catchment area to provide
participants and their families, within an individual budget,
increased flexibility and choice and greater control over decisions,
resources, and needed and desired services and supports to implement
their individual program plan (IPP), in accordance with prescribed
requirements. Existing law makes each regional center responsible for
implementing the Self-Determination Program, as specified. Existing
law also requires each regional center to contract with local
consumer of family-run organizations to conduct outreach through
local meetings and to collaborate with local consumer or family-run
organizations to jointly conduct training about the
Self-Determination Program. Existing law requires each regional
center to establish a local volunteer advisory committee to provide
oversight of the Self-Determination Program.
This bill would require each regional center to consult with the
local volunteer advisory committee in conducting the above-described
outreach and training and would authorize the advisory committee to
designate members to represent the committee at the training.
(8) The Lanterman Developmental Disabilities Services Act,
requires the State Department of Developmental Services to contract
with regional centers to provide respite services and supported
employment services. Existing law, effective June 9, 2016, and
commencing July 1, 2016, requires the rate for family-member provided
respite services authorized by the department and in operation on
June 30, 2016, to be increased by 5%.
This bill would additionally require the rates for out-of-home
respites services in effect on June 30, 2016, to be increased by 5%.
(9) Existing law requires the State Department of Developmental
Services to establish guidelines and oversee a program, to the extent
funds are appropriated in the annual Budget Act for this purpose, to
increase paid internship opportunities for individuals with
developmental disabilities, as specified, and to fund incentive
payments for these internships on and after July 1, 2016. Existing
law requires the program to be administered by community service
providers, subject to specified criteria. On and after July 1, 2016,
existing law also provides incentive payments for purposes of
increasing employment placements by providers of supported employment
services, as specified.
The bill would require the individual placed for employment to be
employed for at least 30 days in order for a provider to receive the
first incentive payment for an initial employment placement under
these provisions. The bill would clarify that these payments are not
available to providers that place individuals into internships, until
the individual transitions into a competitive integrated employment
placement. The bill would provide that these incentive payments apply
to regional center service providers, rather than providers of
supported employment services, and would prohibit payments made under
the program from being in addition to specified placement payments
for supported employment services. The bill would make other
clarifying changes to these provisions with regard to payments, as
specified.
(10) Existing law, the California Early Intervention Services Act,
provides a statewide system of coordinated, comprehensive,
family-centered, multidisciplinary, and interagency programs that are
responsible for providing appropriate early intervention services
and support to all eligible infants and toddlers, as defined, and
their families. The act requires these services to be provided
pursuant to the existing regional center system.
Existing law requires the State Department of Developmental
Services to contract with an organization representing one or more
family resource centers, as defined, to provide outreach,
information, and referral services for at-risk babies who are not
otherwise eligible for the early intervention services. Existing law
also requires regional centers to refer at-risk babies to the family
resource centers.
This bill would repeal the above requirement for the department to
contract with an organization representing one or more family
resource centers to provide outreach, information, and referral
services for at-risk babies, and would repeal the requirement that
regional centers refer at-risk babies to the family resource centers.
(11) Existing law requires the minimum wage for all industries, on
and after January 1, 2016, to be not less than $10 per hour.
Existing law requires the minimum wage for all industries to be not
less than specified amounts to be increased from January 1, 2017, to
January 1, 2022, inclusive, for employers employing 26 or more
employees and from January 1, 2018, to January 1, 2023, inclusive,
for employers employing 25 or fewer employees, except as specified.
Existing law sets forth the State Department of Developmental
Services's and the regional center's authority to establish provider
rates. Existing law prohibits certain provider rate increases but,
commencing July 1, 2014, authorizes increases to those rates as
necessary to adjust employee wages to meet the state minimum wage
law.
This bill would authorize adjustment of prescribed provider rates
commencing January 1, 2017, if the adjustment is necessary in order
to pay employees no less than the increased minimum wage, as
described above.
(12) Existing law prohibits a regional center from approving a
service level for a residential service provider if the approval
would result in an increase in the rate to be paid to the provider
that is greater than the rate that is in effect on June 30, 2008,
unless the regional center demonstrates to the State Department of
Developmental Services that the approval is necessary to protect the
consumer's health or safety and the department has granted prior
written authorization.
This bill would additionally prohibit that approval if it would
result in an increase in state costs. The bill would require the
department to, effective July 1, 2016, establish a rate schedule for
residential community care facilities vendored to provide services to
a maximum of four persons with developmental disabilities. The bill
would exempt from the prohibition described above only residential
community care facilities vendored to provide services to a maximum
of four persons with developmental disabilities if either the
regional center demonstrates to the department that the approval is
necessary to protect the consumer's health or safety and the
department has granted prior written authorization or if the approved
service level is not higher than the service level in effect at the
time of implementation of the new rate schedule. The bill would
require regional centers to submit a specified report to the
department by February 1, 2017, regarding the number residential
community care facilities with those rates.
(13) Under existing law, the State Department of Social Services
regulates the licensure and operation of various care facilities,
including community care facilities and enhanced behavioral supports
homes. Existing law prohibits community care facilities, among other
health and care facilities, from using physical restraint or
containment as an extended procedure.
This bill would prohibit enhanced behavioral supports homes from
using physical restraint or containment for more than 15 consecutive
minutes, except as specified.
(14) Existing law provides that specified contracts entered into
by any state agency for goods, services, or other specified
activities, whether awarded through competitive bidding or not, are
void unless and until approved by the Department of General Services,
and requires denial of approval if the contract does not meet the
required specifications of the bidding process. That law exempts
certain transactions and contracts from that law, as specified.
This bill would make those laws inapplicable, subject to the
approval of the Director of Developmental Services, to specified
employees of the department for the purpose of the employee becoming
a vendor of a regional center for persons with developmental
disabilities, as specified.
(15) Existing law appropriates $287,000,000 to the State
Department of Developmental Services to, commencing July 1, 2016,
among other things, increase rates and wages for certain
developmental services providers and fund incentive payments for
competitive integrated employment opportunities and internships for
individuals with developmental disabilities.
This bill would appropriate $186,200,000 in reimbursements
associated with the above-mentioned appropriated funds to the State
Department of Developmental Services for the same specified purposes.
(16) This bill would declare that it is to take effect immediately
as a bill providing for appropriations related to the Budget Bill.
This bill would express the intent of the Legislature to enact
statutory changes relating to the Budget Act of 2016.
Vote: majority. Appropriation: no yes
. Fiscal committee: no yes .
State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 1180.4 of the Health
and Safety Code is amended to read:
1180.4. (a) A facility described in subdivision (a) of Section
1180.2 or subdivision (a) of Section 1180.3 shall conduct an initial
assessment of each person prior to a placement decision or upon
admission to the facility, or as soon thereafter as possible. This
assessment shall include input from the person and from someone whom
he or she desires to be present, such as a family member, significant
other, or authorized representative designated by the person, and if
the desired third party can be present at the time of admission.
This assessment shall also include, based on the information
available at the time of initial assessment, all of the following:
(1) A person's advance directive regarding deescalation or the use
of seclusion or behavioral restraints.
(2) Identification of early warning signs, triggers, and
precipitants that cause a person to escalate, and identification of
the earliest precipitant of aggression for persons with a known or
suspected history of aggressiveness, or persons who are currently
aggressive.
(3) Techniques, methods, or tools that would help the person
control his or her behavior.
(4) Preexisting medical conditions or any physical disabilities or
limitations that would place the person at greater risk during
restraint or seclusion.
(5) Any trauma history, including any history of sexual or
physical abuse that the affected person feels is relevant.
(b) A facility described in subdivision (a) of Section 1180.2 or
subdivision (a) of Section 1180.3 may use seclusion or behavioral
restraints for behavioral emergencies only when a person's behavior
presents an imminent danger of serious harm to self or others.
(c) A facility described in subdivision (a) of Section 1180.2 or
subdivision (a) of Section 1180.3 may shall
not use either of the following:
(1) A physical restraint or containment technique that obstructs a
person's respiratory airway or impairs the person's breathing or
respiratory capacity, including techniques in which a staff member
places pressure on a person's back or places his or her body weight
against the person's torso or back.
(2) A pillow, blanket, or other item covering the person's face as
part of a physical or mechanical restraint or containment process.
(d) A facility described in subdivision (a) of Section 1180.2 or
subdivision (a) of Section 1180.3 may shall
not use physical or mechanical restraint or containment on a
person who has a known medical or physical condition,
condition and where there is
reason to believe that the use would endanger the person's life or
seriously exacerbate the person's medical condition.
(e) (1) A facility described in subdivision (a) of Section 1180.2
or subdivision (a) of Section 1180.3 may
shall not use prone mechanical restraint on a person at risk
for positional asphyxiation as a result of one of the following risk
factors that are known to the provider:
(A) Obesity.
(B) Pregnancy.
(C) Agitated delirium or excited delirium syndromes.
(D) Cocaine, methamphetamine, or alcohol intoxication.
(E) Exposure to pepper spray.
(F) Preexisting heart disease, including, but not limited to, an
enlarged heart or other cardiovascular disorders.
(G) Respiratory conditions, including emphysema, bronchitis, or
asthma.
(2) Paragraph (1) shall not apply when written authorization has
been provided by a physician, made to accommodate a person's stated
preference for the prone position or because the physician judges
other clinical risks to take precedence. The written authorization
may not be a standing order, and shall be evaluated on a case-by-case
basis by the physician.
(f) A facility described in subdivision (a) of Section 1180.2 or
subdivision (a) of Section 1180.3 shall avoid the deliberate use of
prone containment techniques whenever possible, utilizing the best
practices in early intervention techniques, such as deescalation. If
prone containment techniques are used in an emergency situation, a
staff member shall observe the person for any signs of physical
duress throughout the use of prone containment. Whenever possible,
the staff member monitoring the person shall not be involved in
restraining the person.
(g) A facility described in subdivision (a) of Section 1180.2 or
subdivision (a) of Section 1180.3 may shall
not place a person in a facedown position with the person's
hands held or restrained behind the person's back.
(h) A facility described in subdivision (a) of Section 1180.2 or
subdivision (a) of Section 1180.3 may shall
not use physical restraint or containment as an extended
procedure. A facility described in subdivision (a) of Section
4684.80 of the Welfare and Institutions Code that is
licensed by the State Department of Social Services shall not use
physical restraint or containment for more than 15 consecutive
minutes. The department may, by regulation, authorize an exception to
the 15 minute maximum duration if necessary to protect the immediate
health and safet y of residents or others from risk of
imminent serious physical harm.
(i) A facility described in subdivision (a) of Section 1180.2 or
subdivision (a) of Section 1180.3 shall keep under constant,
face-to-face human observation a person who is in seclusion and in
any type of behavioral restraint at the same time. Observation by
means of video camera may be utilized only in facilities that are
already permitted to use video monitoring under federal regulations
specific to that facility.
(j) A facility described in subdivision (a) of Section 1180.2 or
subdivision (a) of Section 1180.3 shall afford to persons who are
restrained the least restrictive alternative and the maximum freedom
of movement, while ensuring the physical safety of the person and
others, and shall use the least number of restraint points.
(k) A person in a facility described in subdivision (a) of Section
1180.2 and subdivision (a) of Section 1180.3 has the right to be
free from the use of seclusion and behavioral restraints of any form
imposed as a means of coercion, discipline, convenience, or
retaliation by staff. This right includes, but is not limited to, the
right to be free from the use of a drug used in order to control
behavior or to restrict the person's freedom of movement, if that
drug is not a standard treatment for the person's medical or
psychiatric condition.
SEC. 2. Section 10430 of the Public
Contract Code is amended to read:
10430. This chapter does not apply to any of the following:
(a) The Regents of the University of California and the Trustees
of the California State University, except that Article 9 (commencing
with Section 10420) shall apply to the Trustees of the California
State University.
(b) (1) Transactions covered under Chapter 3 (commencing with
Section 12100), except that Sections 10365.5, 10410, and 10411 shall
apply to all transactions under that chapter.
(2) Notwithstanding paragraph (1), Section 10365.5 shall not apply
to incidental advice or suggestions made outside of the scope of a
consulting services contract.
(3) (A) Notwithstanding paragraph (1), Section 10365.5 shall not
apply to a contract that is part of a single competitive procurement
conducted in more than one stage for information technology goods or
services, when the Director of the Department of General Services and
the Chief Information Officer determine that there is no conflict of
interest under Section 10365.5 and that it is in the best interest
of the state to utilize this procurement method. Nothing in this
section shall preclude the applicability of Section 12112 to this
procurement method.
(B) The Department of General Services shall annually submit a
report on its Internet Web site describing each determination granted
pursuant to subparagraph (A), listing the basis for the
determination, and disclosing the total amount of money paid or to be
paid to the contractor under the contract that was the subject of
the determination. The department shall provide notice to the Joint
Legislative Budget Committee within 30 days of the posting of the
report.
(C) For purposes of this paragraph, "information technology" means
information technology goods or services, or both, as appropriate.
(c) Except as otherwise provided in this chapter, any entity
exempted from Section 10295. However, the Board of Governors of the
California Community Colleges shall be governed by this chapter,
except as provided in Sections 10295, 10335, and 10389. The
Department of Water Resources shall be governed by this chapter,
except as provided in Sections 10295.6, 10304.1, 10335, and 10340.
(d) Transactions covered under Chapter 10 (commencing with Section
4525) of Division 5 of Title 1 of the Government Code.
(e) Except as provided for in subdivision (c), members of boards
or commissions who receive no payment other than payment for each
meeting of the board or commission, payment for preparatory time, and
payment for per diem.
(f) The emergency purchase of protective vests for correctional
peace officers whose duties require routine contact with state prison
inmates. This subdivision shall remain operative only until January
1, 1987.
(g) Spouses of state officers or employees and individuals and
entities that employ spouses of state officers and employees, that
are vendored to provide services to regional center clients pursuant
to Section 4648 of the Welfare and Institutions Code if the vendor of
services, in that capacity, does not receive any material financial
benefit, distinguishable from the benefit to the public generally,
from any governmental decision made by the state officer or employee.
(h) Subject to the approval of the Director of Developmental
Services, or his or her designee, a state employee of the department
who is qualified to provide necessary services for regional center
consumers, for the purpose of that employee becoming a vendor of a
regional center pursuant to Section 4648 of the Welfare and
Institutions Code. The state employee shall terminate employment with
any state agency or department before providing certification to the
regional center pursuant to paragraph (9) of subdivision (a) of
Section 54326 of Title 17 of the California Code of Regulations, as
part of the vendorization process. A contract entered into by a
regional center and a state employee, in his or her capacity as a
private citizen, to become a vendor of the regional center does not
constitute a state contract within the meaning of Section 1090 of the
Government Code. Accordingly, the state employee has no financial
interest in a state contract under these circumstances.
SEC. 3. Section 4435.1 of the Welfare
and Institutions Code is repealed.
4435.1. (a) Effective July 1, 2011, the department shall
establish a program for at-risk babies. For purposes of this section,
"at-risk baby" means a child under 36 months of age who is otherwise
not eligible for the California Early Intervention Program pursuant
to Title 14 (commencing with Section 95000) of the Government Code or
services provided under the Lanterman Developmental Disabilities
Services Act (Division 4.5 (commencing with Section 4500)) and whose
genetic, medical, developmental, or environmental history is
predictive of a substantially greater risk for developmental
disability than that for the general population, the presence of
which is diagnosed by qualified clinicians.
(b) Effective July 1, 2011, when a regional center intake and
assessment determination is that a baby is an at-risk baby as defined
in subdivision (a), the regional center shall, with parental
consent, refer the baby and family to the family resource center set
forth in subdivision (c) for outreach, information, and referral
services.
(c) Effective July 1, 2011, the department shall contract with an
organization representing one or more family resource centers which
receive federal funds from Subchapter III of the Individuals with
Disabilities Education Act (20 U.S.C. Sec. 1431, et seq.) to provide
outreach, information, and referral services to generic agencies for
children under 36 months of age who are otherwise not eligible for
the California Early Intervention Program pursuant to Title 14
(commencing with Section 95000) of the Government Code or services
provided under the Lanterman Developmental Disabilities Services Act
(Division 4.5 (commencing with Section 4500)). The organization with
which the department contracts shall be an organization that supports
families of young children with intellectual or developmental
disabilities, and those at risk of intellectual or developmental
disabilities by ensuring the continuance, expansion, promotion, and
quality of local family support services, including coordination,
outreach, and referral. Any contracts entered into pursuant to this
section shall be exempt from state contracting and procurement
requirements set forth in the Government and Public Contract Codes
and shall take effect immediately to protect the health and safety of
the children receiving the services.
(d) The contract described in subdivision (c) shall do both of the
following:
(1) Ensure the expeditious delivery of outreach, information, and
referral services to at-risk babies.
(2) Require the organization to establish a process with the
applicable regional center or centers for referral of the at-risk
baby to the regional center when the family resource center suspects
that the child may be eligible for services pursuant to the
California Early Intervention Program or the Lanterman Developmental
Disabilities Services Act.
SEC. 4. Section 4437 is added to the
Welfare and Institutions Code , to read:
4437. (a) The State Department of Developmental Services shall,
on or before February 1 of each year, report to the Legislature and
post on its Internet Web site supplemental budget information, which
shall include both of the following:
(1) For each developmental center, an estimate for the annual
budget, including a breakdown of the staffing costs for Porterville
Developmental Center's general treatment area and secured treatment
area.
(2) For each regional center, all of the following information:
(A) Current fiscal year allocations of total and per capita
funding for operations and purchase of services.
(B) The number of persons with developmental disabilities being
served by the regional center in the current fiscal year.
(C) The past fiscal year and current fiscal year information on
the funding for its community placement plan, including a breakdown
of the funding for startup, assessment, placement, and deflection.
(D) Staff information.
(b) A report to be submitted pursuant to subdivision (a) shall be
submitted in compliance with Section 9795 of the Government Code.
SEC. 5. Section 4474.15 is added to the
Welfare and Institutions Code , immediately
following Section 4474.11 , to read:
4474.15. (a) The State Department of Developmental Services shall
include an update to the Legislature in the 2017-18 May Revision
regarding how the department will provide access to crisis services
after the closure of a developmental center and how the state will
maintain its role in providing residential services to those whom
private sector vendors cannot or will not serve. As part of this
plan, the department shall assess the option of expanding the
community state staff program authorized in Section 4474.2 to allow
the department's employees to serve as regional crisis management
teams that provide assessment, consultation, and resolution for
persons with developmental disabilities in crisis in the community.
(b) The State Department of Developmental Services shall post on
its Internet Web site a monthly progress report regarding the
development of residential capacity by each regional center. The
report shall include information on monthly targets for individuals
moving out of a developmental center based on transition activities
and community resource development activities by each regional
center. The report shall also provide an explanation of any targets
that have not been met.
(c) (1) The requirement for submitting a report imposed under
subdivision (a) is inoperative on January 1, 2020, pursuant to
Section 10231.5 of the Government Code.
(2) A report to be submitted pursuant to subdivision (a) shall be
submitted in compliance with Section 9795 of the Government Code.
SEC. 6. Section 4474.6 is added to the
Welfare and Institutions Code , to read:
4474.6. (a) The State Department of Developmental Services and
the State Department of Health Care Services shall coordinate the
transition of health care services for Medi-Cal eligible consumers
who are transitioning from a developmental center into the community.
(b) In order to meet the unique medical health needs of consumers
who will be transitioning from a developmental center into the
community, whose individual program plans document the need for
coordinated medical and specialty care, and who are Medi-Cal
eligible, the State Department of Health Care Services shall issue
transition requirements including referral practices, service
authorization practices, coordination of case management services,
education and training services, and the management and sharing of
medical records, to applicable Medi-Cal managed care health plans and
monitor compliance. These transition requirements shall include, but
are not limited to, processes for individuals assigned to a Medi-Cal
managed care plan which promote coordination of care during and
following the transition, identification of providers prior to a
transition occurring, and the continuation of medically necessary
covered services. These processes shall be described in a transition
plan which will be shared with stakeholders prior to being finalized.
The final transition plan shall be submitted to the Joint
Legislative Budget Committee no later than December 31, 2016.
(c) Notwithstanding Chapter 3.5 (commencing with Section 11340) of
Part 1 of Division 3 of Title 2 of the Government Code, the State
Department of Health Care Services may implement, interpret, or make
specific this section, in whole or in part, by means of all-county
letters, plan letters, plan or provider bulletins, policy letters, or
other similar instructions, without taking regulatory action.
(d) The State Department of Health Care Services shall implement
this section only to the extent that any necessary federal approvals
are obtained and federal financial participation is available.
SEC. 7. Section 4519.5 of the Welfare
and Institutions Code is amended to read:
4519.5. (a) The department and the regional centers shall
annually collaborate to compile data in a uniform manner relating to
purchase of service authorization, utilization, and expenditure by
each regional center with respect to all of the following:
(1) The age of the consumer, categorized by the following:
(A) Birth to two years of age, inclusive.
(B) Three to 21 years of age age,
inclusive.
(C) Twenty-two years of age and older.
(2) Race or ethnicity of the consumer.
(3) Primary language spoken by the consumer, and other related
details, as feasible.
(4) Disability detail, in accordance with the categories
established by subdivision (a) of Section 4512, and, if applicable, a
category specifying that the disability is unknown.
(5) Residence type, subcategorized by age, race or ethnicity, and
primary language.
(6) Number of instances when the written copy of the individual
program plan was provided at the request of the consumer and, when
appropriate, his or her parents, legal guardian or conservator, or
authorized representative, in a language other than a threshold
language, as defined by paragraph (3) of subdivision (a) of Section
1810.410 of Title 9 of the California Code of Regulations, if that
written copy was provided more than 60 days after the request.
(b) The data reported pursuant to subdivision (a) shall also
include the number and percentage of individuals, categorized by age,
race or ethnicity, and disability, and by residence type, as set
forth in paragraph (5) of subdivision (a), who have been determined
to be eligible for regional center services
services, but are not receiving purchase of service funds.
(c) By March 31, 2013, each regional center shall post the data
described in this section that is specific to the regional center on
its Internet Web site. Commencing on December 31, 2013, each regional
center shall annually post this data by December 31. Each regional
center shall maintain all previous years' data on its Internet Web
site.
(d) By March 31, 2013, the department shall post the information
described in this section on a statewide basis on its Internet Web
site. Commencing December 31, 2013, the department shall annually
post this information by December 31. The department shall maintain
all previous years' data on its Internet Web site. The department
shall also post notice of any regional center stakeholder meetings on
its Internet Web site.
(e) Within three months of compiling the data with the department,
and annually thereafter, each regional center shall meet with
stakeholders in one or more public meetings regarding the data. The
meeting or meetings shall be held separately from any meetings held
pursuant to Section 4660. The regional center shall provide
participants of these meetings with the data and any associated
information, information related to
improvements in the provision of developmental services to
underserved communities and shall conduct a discussion of the
data and the associated information in a manner that is culturally
and linguistically appropriate for that community, including
providing alternative communication services, as required by Sections
11135 to 11139.7, inclusive, of the Government Code and implementing
regulations. Regional centers shall inform the department of the
scheduling of those public meetings 30 days prior to the meeting.
Notice of the meetings shall also be posted on the regional center's
Internet Web site 30 days prior to the meeting and shall be sent to
individual stakeholders and groups representing underserved
communities in a timely manner. Each regional center shall, in
holding the meetings required by this subdivision, consider the
language needs of the community and shall schedule the meetings at
times and locations designed to result in a high turnout by the
public and underserved communities.
(f) (1) Each regional center shall annually report to the
department regarding its implementation of the requirements of this
section. The report shall include, but shall not be limited to, all
of the following:
(A) Actions the regional center took to improve public attendance
and participation at stakeholder meetings, including, but not limited
to, attendance and participation by underserved communities.
(B) Copies of minutes from the meeting and attendee comments.
(C) Whether the data described in this section indicates a need to
reduce disparities in the purchase of services among consumers in
the regional center's catchment area. If the data does indicate that
need, the regional center's recommendations and plan to promote
equity, and reduce disparities, in the purchase of services.
(2) Each regional center and the department shall annually post
the reports required by paragraph (1) on its Internet Web site by
August 31.
(g) (1) The department shall consult with stakeholders, including
consumers and families that reflect the ethnic and language diversity
of regional center consumers, regional centers, advocates,
providers, the protection and advocacy agency described in Section
4901, and those entities designated as University Centers for
Excellence in Developmental Disabilities Education, Research, and
Service pursuant to Section 15061 of Title 42 of the United States
Code, to achieve the following objectives:
(A) Review the data compiled pursuant to subdivision (a).
(B) Identify barriers to equitable access to services and supports
among consumers and develop recommendations to help reduce
disparities in purchase of service expenditures.
(C) Encourage the development and expansion of culturally
appropriate services, service delivery, and service coordination.
(D) Identify best practices to reduce disparity and promote
equity.
(2) The department shall report the status of its efforts to
satisfy the requirements of paragraph (1) during the 2016-17
legislative budget subcommittee hearing process.
(h) (1) Subject to available funding, the
department shall allocate funding to regional centers to assist with
implementation of the recommendations and plans developed pursuant to
subdivisions (f) and (g). Activities funded through these
allocations may include, but are not limited to, pay differentials
supporting direct care bilingual staff of community-based service
providers, parent or caregiver education programs, cultural
competency training for regional center staff, outreach to
underserved populations, or additional culturally appropriate service
types or service delivery
models.
(2) Each regional center shall consult with stakeholders regarding
activities that may be effective in addressing disparities in the
receipt of regional center services and the regional center's
proposed requests for the funding specified in paragraph (1). Each
regional center shall identify the stakeholders it consulted with and
include information on how it incorporated the input of stakeholders
into its requests.
(3) The department shall review requests for funding within 45
days from the deadline specified in the department's guidance to
regional centers.
(4) Each regional center shall report to the department in the
annual report required by subdivision (f) how the funding allocations
were used and shall include recommendations of priorities for
activities that may be effective in addressing disparities, based on
the consultation with stakeholders.
SEC. 8. Section 4572 is added to the
Welfare and Institutions Code , to read:
4572. The State Department of Developmental Services shall
develop and implement a plan to monitor, evaluate, and improve the
quality of community-based services through the use of a performance
dashboard. The department shall work with stakeholders, including,
but not limited to, regional centers, consumer advocates, providers,
and the Legislature, on the development of the dashboard. The
dashboard shall be published annually and shall include, but not be
limited to, all of the following metrics:
(a) Recognized quality and access measures.
(b) Measures to indicate the movement toward compliance with the
federal Home and Community-Based Services Waiver rules (CMS 2249-F
and CMS 2296-F).
(c) Measures to evaluate the changes in the number of consumers
who work in competitive integrated employment.
(d) The number of complaints referred to the department pursuant
to subdivision (c) of Section 4731, for every 1,000 consumers served,
by each regional center.
(e) The number of administrative fair hearings held pursuant to
Article 3 (commencing with Section 4710) of Chapter 7, separated by
eligibility and service issues, for individuals ages three and over,
for every one thousand consumers served, by each regional center.
SEC. 9. Section 4659.2 of the Welfare
and Institutions Code is amended to read:
4659.2. (a) For the purposes of this section, the following
definitions apply:
(1) "Physical restraint" means any behavioral or mechanical
restraint, as defined in Section 1180.1 of the Health and Safety
Code.
(2) "Chemical restraint" means a drug that is used to control
behavior and that is used in a manner not required to treat the
patient's medical conditions.
(3) "Seclusion" means involuntary confinement of a person alone in
a room or an area as defined in subdivision (e) of Section 1180.1 of
the Health and Safety Code.
(4) "Long-term health care facility" means a facility, as defined
in Section 1418 of the Health and Safety Code, that is required to
report to a regional center pursuant to Section 54327 of Title 17 of
the California Code of Regulations.
(5) "Acute psychiatric hospital" means a facility, as defined in
subdivision (b) of Section 1250 of the Health and Safety Code,
including an institution for mental disease, that is a regional
center vendor.
(6) "Regional center vendor" means an agency, individual, or
service provider that a regional center has approved to provide
vendored or contracted services or supports pursuant to paragraph (3)
of subdivision (a) of Section 4648.
(b) (1) All regional center vendors that
provide crisis or residential services or supported living
services, long-term health care facilities, and acute psychiatric
hospitals shall report each to the agency
designated pursuant to subdivision (i) of Section 4900 all of the
following:
(A) Each death or serious injury
of a person occurring during, or related to, the use of seclusion,
physical restraint, or chemical restraint, or any combination
thereof, to the agency designated pursuant to subdivision
(i) of Section 4900 no thereof.
(B) Any unexpected or suspicious death, regardless of whether the
cause is immediately known.
(C) Any allegation of sexual assault, as defined in Section
15610.63, in which the alleged perpetrator is a staff member, service
provider, or facility employee or contractor.
(D) Any report made to the local law enforcement agency in the
jurisdiction in which the facility is located that involves physical
abuse, as defined in Section 15610.63, in which a staff member,
service provider, or facility employee or contractor is implicated.
(2) The reports described in paragraph
(1) shall be made no later than the close of the business day
following the death or serious injury. The report shall include the
encrypted identifier of the person involved, and the name, street
address, and telephone number of the facility.
(c) (1) On a monthly basis all regional center vendors that
provide crisis or residential services or supported living services,
long-term health care facilities, and acute psychiatric hospitals
shall report to the agency designated pursuant to subdivision (i) of
Section 4900 all of the following:
(A) The number of incidents of seclusion and the duration of time
spent per incident in seclusion.
(B) The number of incidents of the use of behavioral restraints
and the duration of time spent per incident of restraint.
(C) The number of times an involuntary emergency medication is
used to control behavior.
(2) The reports required pursuant to paragraph (1) shall include
the name, street address, and telephone number of the facility.
SEC. 10. Section 4681.5 of the Welfare
and Institutions Code is amended to read:
4681.5. (a) Notwithstanding any other
provision of law or regulation, no
a regional center may
shall not approve any a service
level for a residential service provider, as defined in Section
56005 56002 of Title 17 of the
California Code of Regulations, if the approval would result in an
increase in state costs or the rate to be paid to the
provider that is greater than the rate that is in effect on June 30,
2008, or, for residential service providers subject to
subdivision (b), unless the regional center demonstrates to the
department that the approval is necessary to protect the consumer's
health or safety and the department has granted prior written
authorization.
(b) Notwithstanding subdivision (a) or any other law or
regulation, the department shall, effective July 1, 2016, establish a
rate schedule for residential community care facilities vendored to
provide services to a maximum of four persons with developmental
disabilities.
(c) Community care facilities with rates established pursuant to
subdivision (b) are subject to the regulatory requirements contained
in Subchapter 4 (commencing with Section 56001) of Chapter 3 of
Division 2 of Title 17 of the California Code of Regulations.
(d) Rate changes made as a result of implementing the rate
schedule established pursuant to subdivision (b) for community care
facilities vendored to provide services to a maximum of four persons
with developmental disabilities are not subject to the restrictions
of subdivision (a) if the approved service level is not higher than
the service level in effect at the time of the change.
(e) No later than February 1, 2017, regional centers shall report
to the department on the number of residential community care
facilities with rates established pursuant to subdivision (b). The
report shall include, but not be limited to, both of the following:
(1) The number of facilities vendored since July 1, 2016, by
service level and vendored capacity.
(2) The number of facilities vendored prior to July 1, 2016, that
have subsequently been approved for a new rate, by service level,
vendored capacity, and prior vendored capacity, if applicable.
SEC. 11. Section 4681.6 of the Welfare
and Institutions Code is amended to read:
4681.6. (a) Notwithstanding any other law or regulation,
commencing July 1, 2008:
(1) A regional center shall not pay an existing residential
service provider, for services where rates are determined through a
negotiation between the regional center and the provider, a rate
higher than the rate in effect on June 30, 2008, unless the increase
is required by a contract between the regional center and the vendor
that is in effect on June 30, 2008, or the regional center
demonstrates that the approval is necessary to protect the consumer's
health or safety and the department has granted prior written
authorization.
(2) A regional center shall not negotiate a rate with a new
residential service provider, for services where rates are determined
through a negotiation between the regional center and the provider,
that is higher than the regional center's median rate for the same
service code and unit of service, or the statewide median rate for
the same service code and unit of service, whichever is lower. The
unit of service designation shall conform with an existing regional
center designation or, if none exists, a designation used to
calculate the statewide median rate for the same service. The
regional center shall annually certify to the department its median
rate for each negotiated rate service code, by designated unit of
service. This certification shall be subject to verification through
the department's biennial fiscal audit of the regional center.
(b) Notwithstanding subdivision (a), commencing July
January 1, 2014, 2017,
regional centers may negotiate a rate adjustment with
residential service providers regarding rates that are otherwise
restricted pursuant to subdivision (a), if the adjustment is
necessary in order to pay employees no less than the minimum wage as
established by Section 1182.12 of the Labor Code, as amended by
Chapter 351 4 of the Statutes of
2013, 2016, and only for the purpose of
adjusting payroll costs associated with the minimum wage increase.
The rate adjustment shall be specific to the unit of service
designation that is affected by the increased minimum wage, shall be
specific to payroll costs associated with any increase necessary to
adjust employee pay only to the extent necessary to bring pay into
compliance with the increased state minimum wage, and shall not be
used as a general wage enhancement for employees paid above the
minimum wage. Regional centers shall maintain documentation on the
process to determine, and the rationale for granting, any rate
adjustment associated with the minimum wage increase.
(c) Notwithstanding subdivision (a), commencing July 1, 2015,
regional centers may negotiate a rate adjustment with residential
service providers regarding rates that are otherwise restricted
pursuant to subdivision (a), if the adjustment is necessary to
implement Article 1.5 (commencing with Section 245) of Chapter 1 of
Part 1 of Division 2 of the Labor Code, as added by Chapter 317 of
the Statutes of 2014. The rate adjustment may be applied only if a
minimum of 24 hours or three days of paid sick leave per year was not
a benefit provided to employees as of June 30, 2015, and shall be
specific to payroll costs associated with any increase necessary to
compensate an employee up to a maximum of 24 hours or three days of
paid sick leave in each year of employment.
(d) For purposes of this section, "residential service provider"
includes Adult Residential Facilities for Persons with Special Health
Care Needs, as described in Section 4684.50.
(e) This section shall not apply to those services for which rates
are determined by the State Department of Health Care Services, or
the State Department of Developmental Services, or are usual and
customary.
SEC. 12. Section 4685.8 of the Welfare
and Institutions Code is amended to read:
4685.8. (a) The department shall implement a statewide
Self-Determination Program. The Self-Determination Program shall be
available in every regional center catchment area to provide
participants and their families, within an individual budget,
increased flexibility and choice, and greater control over decisions,
resources, and needed and desired services and supports to implement
their IPP. The statewide Self-Determination Program shall be phased
in over three years, and during this phase-in period, shall serve up
to 2,500 regional center consumers, inclusive of the remaining
participants in the self-determination pilot projects authorized
pursuant to Section 13 of Chapter 1043 of the Statutes of 1998, as
amended, and Article 4 (commencing with Section 4669.2) of Chapter 5.
Following the phase-in period, the program shall be available on a
voluntary basis to all regional center consumers, including residents
in developmental centers who are moving to the community, who are
eligible for the Self-Determination Program. The program shall be
available to individuals who reflect the disability, ethnic, and
geographic diversity of the state. The Department of Finance may
approve, upon a request from the department and no sooner than 30
days following notification to the Joint Legislative Budget
Committee, an increase to the number of consumers served by the
Self-Determination Program before the end of the three-year phase-in
period.
(b) The department, in establishing the statewide program, shall
do both of the following:
(1) For the first three years of the Self-Determination Program,
determine, as part of the contracting process described in Sections
4620 and 4629, the number of participants each regional center shall
serve in its Self-Determination Program. To ensure that the program
is available on an equitable basis to participants in all regional
center catchment areas, the number of Self-Determination Program
participants in each regional center shall be based on the relative
percentage of total consumers served by the regional centers minus
any remaining participants in the self-determination pilot projects
authorized pursuant to Section 13 of Chapter 1043 of the Statutes of
1998, as amended, and Article 4 (commencing with Section 4669.2) of
Chapter 5 or another equitable basis.
(2) Ensure all of the following:
(A) Oversight of expenditure of self-determined funds and the
achievement of participant outcomes over time.
(B) Increased participant control over which services and supports
best meet his or her needs and the IPP objectives. A participant's
unique support system may include the purchase of existing service
offerings from service providers or local businesses, hiring his or
her own support workers, or negotiating unique service arrangements
with local community resources.
(C) Comprehensive person-centered planning, including an
individual budget and services that are outcome based.
(D) Consumer and family training to ensure understanding of the
principles of self-determination, the planning process, and the
management of budgets, services, and staff.
(E) Choice of independent facilitators who can assist with the
person-centered planning process and choice of financial management
services providers vendored by regional centers who can assist with
payments and provide employee-related services.
(F) Innovation that will more effectively allow participants to
achieve their goals.
(c) For purposes of this section, the following definitions apply:
(1) "Financial management services" means services or functions
that assist the participant to manage and direct the distribution of
funds contained in the individual budget, and ensure that the
participant has the financial resources to implement his or her IPP
throughout the year. These may include bill paying services and
activities that facilitate the employment of service and support
workers by the participant, including, but not limited to, fiscal
accounting, tax withholding, compliance with relevant state and
federal employment laws, assisting the participant in verifying
provider qualifications, including criminal background checks, and
expenditure reports. The financial management services provider shall
meet the requirements of Sections 58884, 58886, and 58887 of Title
17 of the California Code of Regulations and other specific
qualifications established by the department. The costs of financial
management services shall be paid by the participant out of his or
her individual budget, except for the cost of obtaining the criminal
background check specified in subdivision (w).
(2) "Independent facilitator" means a person, selected and
directed by the participant, who is not otherwise providing services
to the participant pursuant to his or her IPP and is not employed by
a person providing services to the participant. The independent
facilitator may assist the participant in making informed decisions
about the individual budget, and in locating, accessing, and
coordinating services and supports consistent with the participant's
IPP. He or she is available to assist in identifying immediate and
long-term needs, developing options to meet those needs, leading,
participating, or advocating on behalf of the participant in the
person-centered planning process and development of the IPP, and
obtaining identified services and supports. The cost of the
independent facilitator, if any, shall be paid by the participant out
of his or her individual budget. An independent facilitator shall
receive training in the principles of self-determination, the
person-centered planning process, and the other responsibilities
described in this paragraph at his or her own cost.
(3) "Individual budget" means the amount of regional center
purchase of service funding available to the participant for the
purchase of services and supports necessary to implement the IPP. The
individual budget shall be determined using a fair, equitable, and
transparent methodology.
(4) "IPP" means individual program plan, as described in Section
4646.
(5) "Participant" means an individual, and when appropriate, his
or her parents, legal guardian or conservator, or authorized
representative, who has been deemed eligible for, and has voluntarily
agreed to participate in, the Self-Determination Program.
(6) "Self-determination" means a voluntary delivery system
consisting of a defined and comprehensive mix of services and
supports, selected and directed by a participant through
person-centered planning, in order to meet the objectives in his or
her IPP. Self-determination services and supports are designed to
assist the participant to achieve personally defined outcomes in
community settings that promote inclusion. The Self-Determination
Program shall only fund services and supports provided pursuant to
this division that the federal Centers for Medicare and Medicaid
Services determines are eligible for federal financial participation.
(d) Participation in the Self-Determination Program is fully
voluntary. A participant may choose to participate in, and may choose
to leave, the Self-Determination Program at any time. A regional
center shall not require or prohibit participation in the
Self-Determination Program as a condition of eligibility for, or the
delivery of, services and supports otherwise available under this
division. Participation in the Self-Determination Program shall be
available to any regional center consumer who meets the following
eligibility requirements:
(1) The participant has a developmental disability, as defined in
Section 4512, and is receiving services pursuant to this division.
(2) The consumer does not live in a licensed long-term health care
facility, as defined in paragraph (44) of subdivision (a) of Section
54302 of Title 17 of the California Code of Regulations. An
individual, and when appropriate his or her parent, legal guardian or
conservator, or authorized representative, who is not eligible to
participate in the Self-Determination Program pursuant to this
paragraph may request that the regional center provide
person-centered planning services in order to make arrangements for
transition to the Self-Determination Program, provided that he or she
is reasonably expected to transition to the community within 90
days. In that case, the regional center shall initiate
person-centered planning services within 60 days of that request.
(3) The participant agrees to all of the following terms and
conditions:
(A) The participant shall receive an orientation to the
Self-Determination Program prior to enrollment, which includes the
principles of self-determination, the role of the independent
facilitator and the financial management services provider,
person-centered planning, and development of a budget.
(B) The participant shall utilize the services and supports
available within the Self-Determination Program only when generic
services and supports are not available.
(C) The participant shall only purchase services and supports
necessary to implement his or her IPP and shall comply with any and
all other terms and conditions for participation in the
Self-Determination Program described in this section.
(D) The participant shall manage Self-Determination Program
services and supports within his or her individual budget.
(E) The participant shall utilize the services of a financial
management services provider of his or her own choosing and who is
vendored by a regional center.
(F) The participant may utilize the services of an independent
facilitator of his or her own choosing for the purpose of providing
services and functions as described in paragraph (2) of subdivision
(c). If the participant elects not to use an independent facilitator,
he or she may use his or her regional center service coordinator to
provide the services and functions described in paragraph (2) of
subdivision (c).
(e) A participant who is not Medi-Cal eligible may participate in
the Self-Determination Program and receive self-determination
services and supports if all other program eligibility requirements
are met and the services and supports are otherwise eligible for
federal financial participation.
(f) An individual receiving services and supports under a
self-determination pilot project authorized pursuant to Section 13 of
Chapter 1043 of the Statutes of 1998, as amended, or pursuant to
Article 4 (commencing with Section 4669.2) of Chapter 5, may elect to
continue to receive self-determination services and supports
pursuant to this section or the regional center shall provide for the
participant's transition from the self-determination pilot program
to other services and supports. This transition shall include the
development of a new IPP that reflects the services and supports
necessary to meet the individual's needs. The regional center shall
ensure that there is no gap in services and supports during the
transition period.
(g) The additional federal financial participation funds generated
by the former participants of the self-determination pilot projects
authorized pursuant to Section 13 of Chapter 1043 of the Statutes of
1998, as amended, or pursuant to Article 4 (commencing with Section
4669.2) of Chapter 5, shall be used as follows:
(1) First, to offset the cost to the department for the criminal
background check conducted pursuant to subdivision (w) and other
administrative costs incurred by the department in implementing the
Self-Determination Program.
(2) With the remaining funds, to offset the costs to the regional
centers in implementing the Self-Determination Program, including,
but not limited to, operations costs for caseload ratio enhancement,
training for regional center staff, costs associated with the
participant's initial person-centered planning meeting, the
development of the participant's initial individual budget, and the
costs associated with training consumers and family members.
(h) If at any time during participation in the Self-Determination
Program a regional center determines that a participant is no longer
eligible to continue in, or a participant voluntarily chooses to
exit, the Self-Determination Program, the regional center shall
provide for the participant's transition from the Self-Determination
Program to other services and supports. This transition shall include
the development of a new IPP that reflects the services and supports
necessary to meet the individual's needs. The regional center shall
ensure that there is no gap in services and supports during the
transition period.
(i) An individual determined to be ineligible for or who
voluntarily exits the Self-Determination Program shall be permitted
to return to the Self-Determination Program upon meeting all
applicable eligibility criteria and upon approval of the participant'
s planning team, as described in subdivision (j) of Section 4512. An
individual who has voluntarily exited the Self-Determination Program
shall not return to the program for at least 12 months. During the
first three years of the program, the individual's right to return to
the program is conditioned on his or her regional center not having
reached the participant cap imposed by paragraph (1) of subdivision
(b).
(j) An individual who participates in the Self-Determination
Program may elect to continue to receive self-determination services
and supports if he or she transfers to another regional center
catchment area, provided that he or she remains eligible for the
Self-Determination Program pursuant to subdivision (d). The balance
of the participant's individual budget shall be reallocated to the
regional center to which he or she transfers.
(k) The IPP team shall utilize the person-centered planning
process to develop the IPP for a participant. The IPP shall detail
the goals and objectives of the participant that are to be met
through the purchase of participant-selected services and
supports. The IPP team shall determine
the individual budget to ensure the budget assists the participant
to achieve the outcomes set forth in his or her IPP and ensures his
or her health and safety. The completed individual budget shall be
attached to the IPP.
(l) The participant shall implement his or her IPP, including
choosing and purchasing the services and supports allowable under
this section necessary to implement the plan. A participant is exempt
from the cost control restrictions regarding the purchases of
services and supports pursuant to Sections 4648.5 and 4686.5. A
regional center shall not prohibit the purchase of any service or
support that is otherwise allowable under this section.
(m) A participant shall have all the rights established in
Sections 4646 to 4646.6, inclusive, and Chapter 7 (commencing with
Section 4700).
(n) (1) Except as provided in paragraph (4), the IPP team shall
determine the initial and any revised individual budget for the
participant using the following methodology:
(A) (i) Except as specified in clause (ii), for a participant who
is a current consumer of the regional center, his or her individual
budget shall be the total amount of the most recently available 12
months of purchase of service expenditures for the participant.
(ii) An adjustment may be made to the amount specified in clause
(i) if both of the following occur:
(I) The IPP team determines that an adjustment to this amount is
necessary due to a change in the participant's circumstances, needs,
or resources that would result in an increase or decrease in purchase
of service expenditures, or the IPP team identifies prior needs or
resources that were unaddressed in the IPP, which would have resulted
in an increase or decrease in purchase of service expenditures.
(II) The regional center certifies on the individual budget
document that regional center expenditures for the individual budget,
including any adjustment, would have occurred regardless of the
individual's participation in the Self-Determination Program.
(iii) For purposes of clauses (i) and (ii), the amount of the
individual budget shall not be increased to cover the cost of the
independent facilitator or the financial management services.
(B) For a participant who is either newly eligible for regional
center services or who does not have 12 months of purchase service
expenditures, his or her individual budget shall be calculated as
follows:
(i) The IPP team shall identify the services and supports needed
by the participant and available resources, as required by Section
4646.
(ii) The regional center shall calculate the cost of providing the
services and supports to be purchased by the regional center by
using the average cost paid by the regional center for each service
or support unless the regional center determines that the consumer
has a unique need that requires a higher or lower cost. The regional
center shall certify on the individual budget document that this
amount would have been expended using regional center purchase of
service funds regardless of the individual's participation in the
Self-Determination Program.
(iii) For purposes of clauses (i) and (ii), the amount of the
individual budget shall not be increased to cover the cost of the
independent facilitator or the financial management services.
(2) The amount of the individual budget shall be available to the
participant each year for the purchase of program services and
supports. An individual budget shall be calculated no more than once
in a 12-month period, unless revised to reflect a change in
circumstances, needs, or resources of the participant using the
process specified in clause (ii) of subparagraph (A) of paragraph
(1).
(3) The individual budget shall be assigned to uniform budget
categories developed by the department in consultation with
stakeholders and distributed according to the timing of the
anticipated expenditures in the IPP and in a manner that ensures that
the participant has the financial resources to implement his or her
IPP throughout the year.
(4) The department, in consultation with stakeholders, may develop
alternative methodologies for individual budgets that are computed
in a fair, transparent, and equitable manner and are based on
consumer characteristics and needs, and that include a method for
adjusting individual budgets to address a participant's change in
circumstances or needs.
(o) Annually, participants may transfer up to 10 percent of the
funds originally distributed to any budget category set forth in
paragraph (3) of subdivision (n) to another budget category or
categories. Transfers in excess of 10 percent of the original amount
allocated to any budget category may be made upon the approval of the
regional center or the participant's IPP team.
(p) Consistent with the implementation date of the IPP, the IPP
team shall annually ascertain from the participant whether there are
any circumstances or needs that require a change to the annual
individual budget. Based on that review, the IPP team shall calculate
a new individual budget consistent with the methodology identified
in subdivision (n).
(q) (1) On or before December 31, 2014, the department shall apply
for federal Medicaid funding for the Self-Determination Program by
doing one or more of the following:
(A) Applying for a state plan amendment.
(B) Applying for an amendment to a current home- and
community-based waiver for individuals with developmental
disabilities.
(C) Applying for a new waiver.
(D) Seeking to maximize federal financial participation through
other means.
(2) To the extent feasible, the state plan amendment, waiver, or
other federal request described in paragraph (1) shall incorporate
the eligibility requirements, benefits, and operational requirements
set forth in this section. Except for the provisions of subdivisions
(k), (m), (p), and this subdivision, the department may modify
eligibility requirements, benefits, and operational requirements as
needed to secure approval of federal funding.
(3) Contingent upon approval of federal funding, the
Self-Determination Program shall be established.
(r) (1) The department, as it determines necessary, may adopt
regulations to implement the procedures set forth in this section.
Any regulations shall be adopted in accordance with the requirements
of Chapter 3.5 (commencing with Section 11340) of Part 1 of Division
3 of Title 2 of the Government Code.
(2) Notwithstanding paragraph (1) and Chapter 3.5 (commencing with
Section 11340) of Part 1 of Division 3 of Title 2 of the Government
Code, and only to the extent that all necessary federal approvals are
obtained, the department, without taking any further regulatory
action, shall implement, interpret, or make specific this section by
means of program directives or similar instructions until the time
regulations are adopted. It is the intent of the Legislature that the
department be allowed this temporary authority as necessary to
implement program changes only until completion of the regulatory
process.
(s) The department, in consultation with stakeholders, shall
develop informational materials about the Self-Determination Program.
The department shall ensure that regional centers are trained in the
principles of self-determination, the mechanics of the
Self-Determination Program, and the rights of consumers and families
as candidates for, and participants in, the Self-Determination
Program.
(t) Each regional center shall be responsible for implementing the
Self-Determination Program as a term of its contract under Section
4629. As part of implementing the program, the regional center shall
do both of the following:
(1) Contract with local consumer or family-run organizations
and consult with the local volunteer advisory committee established
pursuant to paragraph (1) of subdivision (x) to conduct
outreach through local meetings or forums to consumers and their
families to provide information about the Self-Determination Program
and to help ensure that the program is available to a diverse group
of participants, with special outreach to underserved communities.
(2) Collaborate with the local consumer or family-run
organizations identified in paragraph (1) to jointly conduct training
about the Self-Determination Program. The regional center shall
consult with the local volunteer advisory committee established
pursuant to paragraph (1) of subdivision (x) in planning for the
training, and the local volunteer advisory committee may designate
members to represent the advisory committee at the training.
(u) The financial management services provider shall provide the
participant and the regional center service coordinator with a
monthly individual budget statement that describes the amount of
funds allocated by budget category, the amount spent in the previous
30-day period, and the amount of funding that remains available under
the participant's individual budget.
(v) Only the financial management services provider is required to
apply for vendorization in accordance with Subchapter 2 (commencing
with Section 54300) of Chapter 3 of Division 2 of Title 17 of the
California Code of Regulations for the Self-Determination Program.
All other service and support providers shall not be on the federal
debarment list and shall have applicable state licenses,
certifications, or other state required documentation, including
documentation of any other qualifications required by the department,
but are exempt from the vendorization requirements set forth in
Title 17 of the California Code of Regulations when serving
participants in the Self-Determination Program.
(w) To protect the health and safety of participants in the
Self-Determination Program, the department shall require a criminal
background check in accordance with all of the following:
(1) The department shall issue a program directive that identifies
nonvendored providers of services and supports who shall obtain a
criminal background check pursuant to this subdivision. At a minimum,
these staff shall include both of the following:
(A) Individuals who provide direct personal care services to a
participant.
(B) Other nonvendored providers of services and supports for whom
a criminal background check is requested by a participant or the
participant's financial management service.
(2) Subject to the procedures and requirements of this
subdivision, the department shall administer criminal background
checks consistent with the department's authority and the process
described in Sections 4689.2 to 4689.6, inclusive.
(3) The department shall electronically submit to the Department
of Justice fingerprint images and related information required by the
Department of Justice of nonvendored providers of services and
supports, as specified in paragraph (1), for purposes of obtaining
information as to the existence and content of a record of state or
federal convictions and state or federal arrests and also information
as to the existence and content of a record of state or federal
arrests for which the Department of Justice establishes that the
person is free on bail or on his or her recognizance pending trial or
appeal.
(4) When received, the Department of Justice shall forward to the
Federal Bureau of Investigation requests for federal summary criminal
history information received pursuant to this section. The
Department of Justice shall review the information returned from the
Federal Bureau of Investigation and compile and disseminate a
response to the department.
(5) The Department of Justice shall provide a state or federal
response to the department pursuant to paragraph (1) of subdivision
(p) of Section 11105 of the Penal Code.
(6) The department shall request from the Department of Justice
subsequent notification service, as provided pursuant to Section
11105.2 of the Penal Code, for persons described in paragraph (1).
(7) The Department of Justice shall charge a fee sufficient to
cover the cost of processing the request described in this
subdivision.
(8) The fingerprints of any provider of services and supports who
is required to obtain a criminal background check shall be submitted
to the Department of Justice prior to employment. The costs of the
fingerprints and the financial management service's administrative
cost authorized by the department shall be paid by the services and
supports provider or his or her employing agency. Any administrative
costs incurred by the department pursuant to this subdivision shall
be offset by the funds specified in subdivision (g).
(9) If the criminal record information report shows a criminal
history, the department shall take the steps specified in Section
4689.2. The department may prohibit a provider of services and
supports from becoming employed, or continuing to be employed, based
on the criminal background check, as authorized in Section 4689.6.
The provider of services and supports who has been denied employment
shall have the rights set forth in Section 4689.6.
(10) The department may utilize a current department-issued
criminal record clearance to enable a provider to serve more than one
participant, as long as the criminal record clearance has been
processed through the department and no subsequent arrest
notifications have been received relative to the cleared applicant.
(11) Consistent with subdivision (h) of Section 4689.2, the
participant or financial management service that denies or terminates
employment based on written notification from the department shall
not incur civil liability or unemployment insurance liability.
(x) To ensure the effective implementation of the
Self-Determination Program and facilitate the sharing of best
practices and training materials commencing with the implementation
of the Self-Determination Program, local and statewide advisory
committees shall be established as follows:
(1) Each regional center shall establish a local volunteer
advisory committee to provide oversight of the Self-Determination
Program. The regional center and the State Council on Developmental
Disabilities shall each appoint one-half of the membership of the
committee. The committee shall consist of the regional center clients'
rights advocate, consumers, family members, and other advocates, and
community leaders. A majority of the committee shall be consumers
and their family members. The committee shall reflect the
multicultural diversity and geographic profile of the catchment area.
The committee shall review the development and ongoing progress of
the Self-Determination Program, including whether the program
advances the principles of self-determination and is operating
consistent with the requirements of this section, and may make
ongoing recommendations for improvement to the regional center and
the department.
(2) The State Council on Developmental Disabilities shall form a
volunteer committee, to be known as the Statewide Self-Determination
Advisory Committee, comprised of the chairs of the 21 local advisory
committees or their designees. The council shall convene the
Statewide Self-Determination Advisory Committee twice annually, or
more frequently in the sole discretion of the council. The Statewide
Self-Determination Advisory Committee shall meet by teleconference or
other means established by the council to identify
self-determination best practices, effective consumer and family
training materials, implementation concerns, systemic issues, ways to
enhance the program, and recommendations regarding the most
effective method for participants to learn of individuals who are
available to provide services and supports. The council shall
synthesize information received from the Statewide Self-Determination
Advisory Committee, local advisory committees, and other sources,
share the information with consumers, families, regional centers, and
the department, and make recommendations, as appropriate, to
increase the program's effectiveness in furthering the principles of
self-determination.
(y) Commencing January 10, 2017, the department shall annually
provide the following information to the appropriate policy and
fiscal committees of the Legislature:
(1) Number and characteristics of participants, by regional
center, including the number of participants who entered the program
upon movement from a developmental center.
(2) Types and amount of services and supports purchased under the
Self-Determination Program, by regional center.
(3) Range and average of individual budgets, by regional center,
including adjustments to the budget to address the adjustments
permitted in clause (ii) of subparagraph (A) of paragraph (1) of
subdivision (n).
(4) The number and outcome of appeals concerning individual
budgets, by regional center.
(5) The number and outcome of fair hearing appeals, by regional
center.
(6) The number of participants who voluntarily withdraw from the
Self-Determination Program and a summary of the reasons why, by
regional center.
(7) The number of participants who are subsequently determined to
no longer be eligible for the Self-Determination Program and a
summary of the reasons why, by regional center.
(z) (1) The State Council on Developmental Disabilities, in
collaboration with the protection and advocacy agency identified in
Section 4900 and the federally funded University Centers for
Excellence in Developmental Disabilities Education, Research, and
Service, may work with regional centers to survey participants
regarding participant satisfaction under the Self-Determination
Program and, when data is available, the traditional service delivery
system, including the proportion of participants who report that
their choices and decisions are respected and supported and who
report that they are able to recruit and hire qualified service
providers, and to identify barriers to participation and
recommendations for improvement.
(2) The council, in collaboration with the protection and advocacy
agency identified in Section 4900 and the federally funded
University Centers for Excellence in Developmental Disabilities
Education, Research, and Service, shall issue a report to the
Legislature, in compliance with Section 9795 of the Government Code,
no later than three years following the approval of the federal
funding on the status of the Self-Determination Program authorized by
this section, and provide recommendations to enhance the
effectiveness of the program. This review shall include the program's
effectiveness in furthering the principles of self-determination,
including all of the following:
(A) Freedom, which includes the ability of adults with
developmental disabilities to exercise the same rights as all
citizens to establish, with freely chosen supporters, family and
friends, where they want to live, with whom they want to live, how
their time will be occupied, and who supports them; and for families
to have the freedom to receive unbiased assistance of their own
choosing when developing a plan and to select all personnel and
supports to further the life goals of a minor child.
(B) Authority, which includes the ability of a person with a
disability, or family, to control a certain sum of dollars in order
to purchase services and supports of their choosing.
(C) Support, which includes the ability to arrange resources and
personnel, both formal and informal, that will assist a person with a
disability to live a life in his or her community that is rich in
community participation and contributions.
(D) Responsibility, which includes the ability of participants to
take responsibility for decisions in their own lives and to be
accountable for the use of public dollars, and to accept a valued
role in their community through, for example, competitive employment,
organizational affiliations, spiritual development, and general
caring of others in their community.
(E) Confirmation, which includes confirmation of the critical role
of participants and their families in making decisions in their own
lives and designing and operating the system that they rely on.
SEC. 13. Section 4690.5 of the Welfare
and Institutions Code is amended to read:
4690.5. Notwithstanding any other law or regulation, commencing
July 1, 2016, and to the extent funds are appropriated in the annual
Budget Act for this purpose, the rate for family member-provided
respite services authorized by the department and in
operation effect on June 30, 2016, and the
rates for out-of-home respite services in ef fect on June
30, 2016, shall be increased by 5 percent. The increase shall
be applied as a percentage, and the percentage shall be the same for
all providers.
SEC. 14. Section 4691.6 of the Welfare
and Institutions Code is amended to read:
4691.6. (a) Notwithstanding any other law or regulation,
commencing July 1, 2006, the community-based day program, work
activity program, and in-home respite service agency rate schedules
authorized by the department and in operation June 30, 2006, shall be
increased by 3 percent, subject to funds specifically appropriated
for this increase in the Budget Act of 2006. The increase shall be
applied as a percentage, and the percentage shall be the same for all
providers. Any subsequent increase shall be governed by subdivisions
(b), (c), (d), (e), (f), (g), (h), (i), (j), (k), and (l), and
Section 4691.9.
(b) Notwithstanding any other law or regulation, the department
shall not establish any permanent payment rate for a community-based
day program or in-home respite service agency provider that has a
temporary payment rate in effect on June 30, 2008, if the permanent
payment rate would be greater than the temporary payment rate in
effect on or after June 30, 2008, unless the regional center
demonstrates to the department that the permanent payment rate is
necessary to protect the consumers' health or safety.
(c) Notwithstanding any other law or regulation, neither the
department nor any regional center shall approve any program design
modification or revendorization for a community-based day program or
in-home respite service agency provider that would result in an
increase in the rate to be paid to the vendor from the rate that is
in effect on or after June 30, 2008, unless the regional center
demonstrates that the program design modification or revendorization
is necessary to protect the consumers' health or safety and the
department has granted prior written authorization.
(d) Notwithstanding any other law or regulation, the department
shall not approve an anticipated rate adjustment for a
community-based day program or in-home respite service agency
provider that would result in an increase in the rate to be paid to
the vendor from the rate that is in effect on or after June 30, 2008,
unless the regional center demonstrates that the anticipated rate
adjustment is necessary to protect the consumers' health or safety.
(e) Notwithstanding any other law or regulation, except as set
forth in subdivisions (f) and (i), the department shall not approve
any rate adjustment for a work activity program that would result in
an increase in the rate to be paid to the vendor from the rate that
is in effect on or after June 30, 2008, unless the regional center
demonstrates that the rate adjustment is necessary to protect the
consumers' health and safety and the department has granted prior
written authorization.
(f) Notwithstanding any other law or regulation, commencing
July 1, 2014, January 1, 2017, the
department may approve rate adjustments for a work activity program
that demonstrates to the department that the rate adjustment is
necessary in order to pay employees who, prior to July 1,
2014, January 1, 2017, were being compensated at
a wage that is less than the minimum wage established on and after
July 1, 2014, January 1, 2017, by
Section 1182.12 of the Labor Code, as amended by Chapter 351
of the Statutes of 2013. Chapter 4 of the Statutes of
2016. The rate adjustment pursuant to this subdivision shall
be specific to payroll costs associated with any increase necessary
to adjust employee pay only to the extent necessary to bring pay into
compliance with the increased state minimum wage, and shall not
constitute a general wage enhancement for employees paid above the
increased minimum wage.
(g) Notwithstanding any other law or regulation, commencing
July 1, 2014, January 1, 2017,
community-based day program and in-home respite services agency
providers with temporary payment rates set by the department may seek
unanticipated rate adjustments from the department due to the
impacts of the increased minimum wage as established by Section
1182.12 of the Labor Code, as amended by Chapter 351 of the
Statutes of 2013. Chapter 4 of the Statutes of 2016.
The rate adjustment shall be specific to payroll costs
associated with any increase necessary to adjust employee pay only to
the extent necessary to bring pay into compliance with the increased
state minimum wage, and shall not constitute a general wage
enhancement for employees paid above the increased minimum wage.
(h) Notwithstanding any other law or regulation, commencing
January 1, 2015, the in-home respite service agency rate schedule
authorized by the department and in operation December 31, 2014,
shall be increased by 5.82 percent, subject to funds specifically
appropriated for this increase for costs due to changes in federal
regulations implementing the federal Fair Labor Standards Act of 1938
(29 U.S.C. Sec. 201 et seq.). The increase shall be applied as a
percentage, and the percentage shall be the same for all applicable
providers.
(i) Notwithstanding any other law or regulation, commencing July
1, 2015, the department may approve rate adjustments for a work
activity program that demonstrates to the department that the rate
adjustment is necessary to implement Article 1.5 (commencing with
Section 245) of Chapter 1 of Part 1 of Division 2 of the Labor Code,
as added by Chapter 317 of the Statutes of 2014. The rate adjustment
may be applied only if a minimum of 24 hours or three days of paid
sick leave per year was not a benefit provided to employees as of
June 30, 2015, and shall be specific to payroll costs associated with
any increase necessary to compensate an employee up to a maximum of
24 hours or three days of paid sick leave in each year of employment.
(j) Notwithstanding any other law or regulation, commencing July
1, 2015, community-based day program and in-home respite services
agency providers with
temporary payment rates set by the department may seek unanticipated
rate adjustments from the department if the adjustment is necessary
to implement Article 1.5 (commencing with Section 245) of Chapter 1
of Part 1 of Division 2 of the Labor Code, as added by Chapter 317 of
the Statutes of 2014. The rate adjustment may be applied only if a
minimum of 24 hours or three days of paid sick leave per year was not
a benefit provided to employees as of June 30, 2015, and shall be
specific to payroll costs associated with any increase necessary to
compensate an employee up to a maximum of 24 hours or three days of
paid sick leave in each year of employment.
(k) Notwithstanding any other law or regulation, commencing July
1, 2016, and to the extent funds are appropriated in the annual
Budget Act for this purpose, the in-home respite service agency rate
schedule authorized by the department and in operation June 30, 2016,
shall be increased by 5 percent. The increase shall be applied as a
percentage, and the percentage shall be the same for all providers.
(l) Notwithstanding any other law or regulation, commencing July
1, 2016, and to the extent funds are appropriated in the annual
Budget Act for this purpose, the independent living service rate
schedule authorized by the department and in operation June 30, 2016,
shall be increased by 5 percent. The increase shall be applied as a
percentage, and the percentage shall be the same for all providers.
SEC. 15. Section 4691.9 of the Welfare
and Institutions Code is amended to read:
4691.9. (a) Notwithstanding any other law or regulation,
commencing July 1, 2008:
(1) A regional center shall not pay an existing service provider,
for services where rates are determined through a negotiation between
the regional center and the provider, a rate higher than the rate in
effect on June 30, 2008, unless the increase is required by a
contract between the regional center and the vendor that is in effect
on June 30, 2008, or the regional center demonstrates that the
approval is necessary to protect the consumer's health or safety and
the department has granted prior written authorization.
(2) A regional center shall not negotiate a rate with a new
service provider, for services where rates are determined through a
negotiation between the regional center and the provider, that is
higher than the regional center's median rate for the same service
code and unit of service, or the statewide median rate for the same
service code and unit of service, whichever is lower. The unit of
service designation shall conform with an existing regional center
designation or, if none exists, a designation used to calculate the
statewide median rate for the same service. The regional center shall
annually certify to the State Department of Developmental Services
its median rate for each negotiated rate service code, by designated
unit of service. This certification shall be subject to verification
through the department's biennial fiscal audit of the regional
center.
(b) Notwithstanding subdivision (a), commencing July 1,
2014, January 1, 2017, regional centers may
negotiate a rate adjustment with providers regarding rates if the
adjustment is necessary in order to pay employees no less than the
minimum wage as established by Section 1182.12 of the Labor Code, as
amended by Chapter 351 of the Statutes of 2013,
Chapter 4 of the Statutes of 2016, and only for the
purpose of adjusting payroll costs associated with the minimum wage
increase. The rate adjustment shall be specific to the unit of
service designation that is affected by the increased minimum wage,
shall be specific to payroll costs associated with any increase
necessary to adjust employee pay only to the extent necessary to
bring pay into compliance with the increased state minimum wage, and
shall not be used as a general wage enhancement for employees paid
above the increased minimum wage. Regional centers shall maintain
documentation on the process to determine, and the rationale for
granting, any rate adjustment associated with the minimum wage
increase.
(c) Notwithstanding any other law or regulation, commencing
January 1, 2015, rates for personal assistance and supported living
services in effect on December 31, 2014, shall be increased by 5.82
percent, subject to funds specifically appropriated for this increase
for costs due to changes in federal regulations implementing the
federal Fair Labor Standards Act of 1938 (29 U.S.C. Sec. 201 et
seq.). The increase shall be applied as a percentage, and the
percentage shall be the same for all applicable providers. As used in
this subdivision, both of the following definitions shall apply:
(1) "Personal assistance" is limited only to those services
provided by vendors classified by the regional center as personal
assistance providers, pursuant to the miscellaneous services
provisions contained in Title 17 of the California Code of
Regulations.
(2) "Supported living services" are limited only to those services
defined as supported living services in Title 17 of the California
Code of Regulations.
(d) Notwithstanding subdivision (a), commencing July 1, 2015,
regional centers may negotiate a rate adjustment with existing
service providers for services for which rates are determined through
negotiation between the regional center and the provider, if the
adjustment is necessary to implement Article 1.5 (commencing with
Section 245) of Chapter 1 of Part 1 of Division 2 of the Labor Code,
as added by Chapter 317 of the Statutes of 2014. The rate adjustment
may be applied only if a minimum of 24 hours or three days of paid
sick leave per year was not a benefit provided to employees as of
June 30, 2015, and shall be specific to payroll costs associated with
any increase necessary to compensate an employee up to a maximum of
24 hours or three days of paid sick leave in each year of employment.
(e) Notwithstanding any other law or regulation, commencing July
1, 2016, and to the extent funds are appropriated in the annual
Budget Act for this purpose, rates for transportation services in
effect on June 30, 2016, shall be increased by 5 percent. The
increase shall be applied as a percentage to existing rates, and the
percentage shall be the same for all applicable providers.
(f) This section shall not apply to those services for which rates
are determined by the State Department of Health Care Services, or
the State Department of Developmental Services, or are usual and
customary.
SEC. 16. Section 4870 of the Welfare
and Institutions Code is amended to read:
4870. (a) To encourage competitive integrated employment
opportunities statewide for individuals with developmental
disabilities, the department shall establish guidelines and oversee a
program, to the extent funds are appropriated in the annual Budget
Act for this purpose, to increase paid internship opportunities for
individuals with developmental disabilities that produce outcomes
consistent with the individual program plan. The department shall
consult with the State Council on Developmental Disabilities,
regional centers, employers, supported employment provider
organizations, and clients' rights advocates, to establish a program
that shall be administered by community service providers and that
meets all of the following criteria:
(1) Payments for internships shall not exceed ten thousand four
hundred dollars ($10,400) per year for each individual placed in an
internship.
(2) Placements shall be made into competitive, integrated work
environments.
(3) Placements shall be made into internships that develop skills
that will facilitate paid employment opportunities in the future.
(4) Regional centers shall increase awareness of these internships
to consumers outside of current employment programs through outreach
to consumers once the program is implemented, as well as during the
individual program plan process.
(b) The department shall require annual reporting by regional
centers and vendors that ensures program accountability and
achievement of program goals. This shall include, but is not limited
to, all of the following:
(1) The number of interns placed who might not otherwise have
achieved the placement absent this internship program.
(2) Types of employment in which interns are placed.
(3) Length of internships.
(4) Demographic information of interns.
(5) Amount of each intern placement payment.
(6) Employment-related supports provided by another agency or
individual to the intern.
(7) Number of interns who subsequently entered paid employment,
including salary and benefit information.
(8) Any additional information, as determined by the department.
(c) The department shall include in its annual May Revision fiscal
estimate a description of the implementation of the program,
including, but not limited to, a description of the stakeholder
consultation, the data described in subdivision (b), aggregated by
regional center and statewide, and any recommendations for program
changes that may be necessary or desirable to maximize program
effectiveness and accountability.
(d) Consistent with the individual program plan, the program shall
increase sustained and appropriate competitive integrated employment
placements by providers of supported employment services,
as defined in subdivision (p) of Section 4851,
regional center service providers, as follows:
(1) A payment of one thousand dollars ($1,000) shall be made
to the supported employment services
regional center service provider for initial
placements made on or after July 1, 2016, in competitive integrated
employment, that, on or after July 1, 2016, places an
individual into competitive integrated employment, and the individual
is still competitively employed after 30 consecutive days, as
defined described in subdivision (o) of
Section 4851 and subdivision (d) of Section 4868.
(2) An additional payment of one thousand two hundred fifty
dollars ($1,250) shall be made to the supported
employment services regional center service
provider for an individual described in paragraph (1) who remains in
competitive integrated employment for six consecutive months.
(3) An additional payment of one thousand five hundred dollars
($1,500) shall be made to the supported
employment services regional center service
provider for an individual described in paragraphs (1) and (2) who
remains in competitive integrated employment for 12 consecutive
months.
(e) Regional centers shall annually report to the department the
payments for placements pursuant to subdivision (d). The information
shall be reported in a format determined by the department, and shall
include the number of individuals placed in internships or other
employment as described in this section each year.
(f) The payments made pursuant to this section shall not be in
addition to the placement payments made pursuant to subdivision (d)
of Section 4860.
(g) Regional center service providers that place individuals into
internships under subdivision (a) are not eligible for the employment
placement incentives under this section, until the individual is
transitioned into a competitive integrated employment placement that
is not funded as an internship.
SEC. 17. Section 15 of Chapter 3 of the Statutes
of 2016, Second Extraordinary Session, is amended to read:
SEC. 15. (a) The sum of two hundred eighty-seven million dollars
($287,000,000) is hereby appropriated from the General Fund to the
State Department of Developmental Services to provide all of the
following, effective July 1, 2016:
(1) Twenty-nine million seven hundred thousand dollars
($29,700,000) for regional centers for staff, in an allocation to be
determined by the department.
(2) One million four hundred thousand dollars ($1,400,000) for
regional centers for administrative costs, in an allocation to be
determined by the department. This amount includes an amount to be
allocated by the department for regional center clients' rights
advocates contracts pursuant to subdivision (b) of Section 4433.
(3) Nine million nine hundred thousand dollars ($9,900,000) for
administrative costs for service providers, in an allocation to be
determined by the department.
(4) One hundred sixty-nine million five hundred thousand dollars
($169,500,000) for a rate increase for staff providing direct
services employed by a community-based provider organization, in a
manner to be determined by the department.
(5) A 5-percent rate increase for supported and independent living
services.
(6) Twenty million dollars ($20,000,000) for competitive
integrated employment incentive payments.
(7) A 5-percent rate increase for in-home and out-of-home respite
services.
(8) A 5-percent increase for transportation services.
(9) A three-dollar-and-forty-two-cent ($3.42) per hour rate
increase for supported employment providers.
(10) Eleven million dollars ($11,000,000) for bilingual staff at
regional centers and implementing plans and recommendations to
address disparities.
(b) The sum of one hundred eighty-six million two hundred thousand
dollars ($186,200,000) in reimbursements associated with the funds
appropriated in subdivision (a) is hereby appropriated to the State
Department of Developmental Services for the purposes specified in
subdivision (a).
(b)
(c) These funds shall be available for encumbrance
or expenditure until June 30, 2017, and available for
expenditure liquidation until June 30, 2019.
SEC. 18. With the fiscal and research resources
included as part of the Budget Act of 2016, the State Department of
Developmental Services shall annually assess disparities data
reported by regional centers, caseload ratio requirements by regional
centers, and performance dashboard data, collected pursuant to
Section 4572 of the Welfare and Institutions Code, as it becomes
available.
SEC. 19. (a) The State Department of Developmental
Services shall report quarterly to the Joint Legislative Budget
Committee the estimated amount of General Fund expenditures used to
backfill federal funding as a result of the decertification of
intermediate care facility units at the Sonoma Developmental Center.
(b) If the intermediate care facility units at the Fairview
Developmental Center or the Porterville Developmental Center are
decertified by the federal government in the 2016-17 fiscal year, the
State Department of Developmental Services shall report quarterly to
the Joint Legislative Budget Committee the estimated amount of
General Fund expenditures used to backfill federal funding as a
result of the decertification or decertifications.
SEC. 20. This act is a bill providing for
appropriations related to the Budget Bill within the meaning of
subdivision (e) of Section 12 of Article IV of the California
Constitution, has been identified as related to the budget in the
Budget Bill, and shall take effect immediately.
SECTION 1. It is the intent of the Legislature
to enact statutory changes, relating to the Budget Act of 2016.