BILL ANALYSIS Ó
SB 982
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Date of Hearing: June 28 2016
ASSEMBLY COMMITTEE ON HUMAN SERVICES
Susan Bonilla, Chair
SB
982 (McGuire) - As Amended May 31, 2016
SENATE VOTE: 38-0
SUBJECT: State Department of Developmental Services:
developmental centers
SUMMARY: Requires the Department of Developmental Services
(DDS) to contract with an outside agency for the purposes of
conducting a longitudinal study to collect data on the quality
of life of residents of the Sonoma Developmental Center (SDC),
the Fairview Developmental Center (FDC), and the general
treatment area of the Porterville Developmental Center (PDC) who
transition out of the facilities due the closure of these
centers.
Specifically, this bill:
1)States Legislative intent to ensure the appropriate transition
of developmental center residents to community living
arrangements in response to the closure of SDC, FDC, and the
general treatment area of PDC, and to measure the unique needs
of this population, as specified.
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2)Requires DDS to contract with an independent agency or
organization to conduct a longitudinal study, beginning July
1, 2017, to assess the quality of life and outcomes of
developmental center residents who transition out of SDC, FDC,
and the general treatment area of PDC due to the closure of
these facilities. Further, requires the study to:
a) Supplement the quality assessment system established in
current law and make recommendations based on the collected
data as it pertains to health and safety, choice,
integration, and other similar factors, as specified; and
b) Be conducted each year concerning residents who move
from the developmental centers until two years following
the date the last resident moves from the developmental
centers.
3)Requires the contractor with whom DDS contracts to be
experienced in a number of areas, including, but not limited
to: designing valid tracking instruments and tracking the
quality of community programs, including outcome-based
measures such as health and safety, quality of life,
integration, choice, and consumer satisfaction.
4)Requires the contractor to perform the following duties:
a) Measure consumer and family satisfaction with services
provided, as specified;
b) Meet with each person, and the person's family, or legal
guardian or conservator, when appropriate, no less than
once per year to discuss quality of life and observe the
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person's services and supports; and
c) Meet with no fewer than two persons familiar with the
consumer, and interview staff and friends who know the
consumer best and review records, and use data collected
through the quality assurance instrument, as specified, in
the event that a consumer is not capable of communicating
his or her responses and a family member, or legal guardian
or conservator is not involved.
5)Allows DDS to contract with the same contractor used to
implement the quality assurance instrument, as specified, if
appropriate.
6)Requires DDS, for purposes of conducting the study, to:
a) Maintain and update contact information for former
residents of the centers who relocated as a result of the
closure of the centers;
b) Ensure, to the extent permitted by law, that researchers
conducting the study have access to data and other
information necessary to conduct the study, as specified;
and
c) Submit interim reports to the Legislature regarding the
study at the end of the first and second years of the study
and Submit the study to the Legislature upon its
completion, as specified.
EXISTING LAW:
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1)Establishes the Lanterman Developmental Disabilities Services
Act, which declares California's responsibility for providing
an array of services and supports to meet the needs of each
person with developmental disabilities in the least
restrictive environment, regardless of age or degree of
disability, and to support their integration into the
mainstream life of the community. (WIC 4500, et seq.)
2)Establishes the jurisdiction of DDS over state developmental
centers, including Sonoma, Fairview and Porterville
developmental centers and the responsibility of each facility
to create bylaws and rules, as specified. (WIC 4440)
3)Requires DDS to submit a detailed plan to the Legislature when
it proposes closure of a developmental center no later than
April 1 immediately prior to the fiscal year in which the plan
is to be implemented, and as a part of the Governor's proposed
budget. (WIC 4474.1. (a))
4)Establishes a system of nonprofit regional centers to provide
fixed points of contact in the community for all persons with
developmental disabilities and their families, to coordinate
services and supports best suited to them throughout their
lifetime. (WIC 4620)
5)Requires DDS to implement an improved, unified quality
assessment system, and expresses Legislative intent that this
system will ensure the well-being of consumers, taking into
account their informed and expressed choices. Requires DDS
with its stakeholders to identify a valid and reliable quality
assurance instrument, as specified, and to contract with an
entity with experience in tracking outcomes and developing
data systems. (WIC 4571)
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6)Requires DDS, in consultation with the contractor, to
establish the methodology by which the quality assurance
instrument shall be administered, including, but not limited
to, how often and to whom the quality assurance will be
administered, and the design of a stratified, random sample
among the entire population of consumers served by regional
centers. Further, requires the contractor to provide
aggregate information for regional centers and the state as a
whole. (WIC 4571 (e))
FISCAL EFFECT: According to the Senate Appropriations Committee
on May 27, 2016, this bill may result in ongoing costs of
$500,000 (General Fund and federal funds) per year for several
years for an independent contractor to undertake the required
study.
COMMENTS:
The Lanterman Developmental Disabilities Act of 1969: Also
known as the Lanterman Act, this legislation forms the basis of
the State's commitment to provide individuals with developmental
disabilities a variety of supports and services which are
overseen and administered by DDS. Under the Lanterman Act, a
developmental disability is defined as a "substantial
disability" that starts before age 18 and is expected to
continue indefinitely; such disabilities include cerebral palsy,
epilepsy, and autism, among others. Services for these
individuals are currently distributed through two distinct
tracks.
Regional Centers : Community-based services are coordinated
through California's 21 regional centers which assess
eligibility and develop individual program plans (IPPs) through
an interdisciplinary team. Funded through DDS, regional centers
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served an estimated 290,496 consumers in 2015-16 according to
the Legislative Analyst's Office. Services and supports can
include housing, activity and employment programs, in-home care,
transportation, and other support services that enable
individuals to lead independent lives in the community. A
majority of those receiving services through regional centers
are low-income individuals enrolled in Medi-Cal. More than 99%
of DDS consumers receive services under the Community Services
Program, meaning these consumers live in the community with
their parents or other relatives, in their own houses or
apartments, or in residential facilities or group homes designed
to meet their needs.
Developmental Centers : In addition to the 21 regional centers,
DDS operates three 24-hour facilities, known as developmental
centers: Fairview Developmental Center (FDC) in Orange County,
Porterville Developmental Center (PDC) in Tulare County, and
Sonoma Developmental Center (SDC) in Sonoma County. In
2015-16, approximately 1,000 consumers received care and
supervision in a DC. Each DC is licensed by the Department of
Public Health (DPH) and certified by DPH on behalf of the
federal Centers for Medicare and Medicaid Services (CMS) as
skilled nursing facilities, intermediate care facilities for the
developmentally disabled, and general acute care hospitals.
Developmental centers are licensed and certified to provide a
broad array of services based on each resident's IPP, including
nursing services, assistance with activities of daily living,
specialized rehabilitative services, individualized dietary
services, and vocational or other day programs.
Developmental Center closures: Over the past 15 years DPH, CMS,
and the U.S. Department of Justice have identified problems in
California's developmental centers, including inadequate care,
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insufficient staffing, and insufficient reporting and
investigation of instances of abuse and neglect. In January
2014, the Task Force on the Future of the Developmental Centers
convened by the Administration released a plan for the long-term
future of the developmental centers. In May 2015, Governor
Brown's administration announced plans to initiate and develop
closure plans for the state's remaining developmental centers,
except for the secure treatment program at Porterville DC (and a
smaller facility at Canyon Springs in Riverside County).
Currently the administration's intent is to have the last
developmental center closure completed by 2021.
Quality of life assessments: Since 1993, DDS has utilized a
number of tracking projects to ensure quality of life is
maintained when residents of developmental centers transition to
the community.
Coffelt Quality Tracking Project : Between 1993-1998 DDS agreed
to develop a contract with an independent consultant to track
individuals placed in the community and to monitor their
satisfaction with their living arrangements and the quality of
services and supports they were receiving. The study assessed
consumer and family satisfaction, case management activities,
independence, productivity, integration, choice and
self-determination, service delivery patterns, health, safety,
psychoactive medication usage, qualities of home settings and
costs of services. Ultimately the study concluded that
improvements were made among those who moved to the community in
self-care abilities, social behaviors, and integration; however
the study also found that fewer individuals had paid jobs in the
community and were earning less money in the community than they
had in the developmental centers, and the use of sedatives and
psychotropic medications had increased.
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Stockton Developmental Center Longitudinal Quality of Life
Study : In 1995, DDS agreed to complete a three-year
longitudinal study in three phases in order to track consumer
outcomes and the quality of life of individuals moving from
Stockton Developmental Center upon its closure in 1996. A
contract was entered into between DDS and CSU Sacramento and the
study began by interviewing residents in Stockton Developmental
Center in 1995 before their move to the community. One to two
years later the residents were interviewed again on subjects
similar to those discussed in the Coffelt project. Many of the
residents however were moved to different developmental centers
as suitable placements in the community could not be found;
these residents later formed the basis for the founding of the
Secure Treatment Program at Porterville.
SB 391 (Solis and Ducheny), Chapter 294, Statutes of 1997 : In
1997 and in response to concerns expressed by the California
Association for State Hospital Parent Councils for the Retarded
and Protection and Advocacy, SB 391 was signed into law. The
legislation added Section 4418.1 to the Welfare and Institutions
Code and codified requirements for tracking individuals moving
from developmental centers in order to ensure long-term
well-being and self-sufficiency. The legislation also required
DDS to contract with an independent contractor to complete an
annual Quality of Life survey on all persons who moved from DCs
to the community since April 1993.
National Core Indicator (NCI) Survey : In 2009, SB 391 was
repealed and was replaced by Welfare and Institutions Code
Section 4571 which implemented the National Core Indicator (NCI)
Survey, a nation-wide quality assessment survey used by DDS to
monitor the performance of developmental disabilities service
system as well as regional center performance in providing
services and supports to consumers. Conducted by the State
Council on Developmental Disabilities, the survey collects data
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on consumer and family satisfaction, quality of services,
linguistic and cultural competency, and personal results.
Need for this bill: According to the author's office, "In the
2015 May Revision, the Governor announced the closure of the
remaining three developmental centers in California. This means
in the next five years over 1,000 developmental center residents
- the most medically fragile in the state system - will be
transitioning into the community system with no developmental
center to fall back on if the placement fails. [This bill]
requires a longitudinal quality of life study to monitor and
evaluate the transition process and ensure our state follows
through with its commitment to provide appropriate services to
developmentally disabled Californians. Currently, there is
therefore no way to track specific developmental center movers.
[This bill] will aid in the transition by assuring families that
their loved ones are receiving quality care. Additionally, it
would enable the State to learn from and correct any challenges
that may arise from the transition in real time, and would
provide transparency and accountability on the state's
investment and responsibility to the Developmentally Disabled
community. Given the fact that there will NO LONGER be any
developmental centers to fall back on if residents have
challenges in the community, a comprehensive longitudinal study
should be required."
PRIOR LEGISLATION
SB 391 (Solis and Ducheny), Chapter 294, Statutes of 1997,
codified in statute the State's obligation to track individuals
moving from developmental centers into the community. It also
specified that beginning July 1, 1998, an independent contractor
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must provide a report to the Governor, the Legislature, and DDS
outlining activities and findings of the annual Quality of Life
survey.
REGISTERED SUPPORT / OPPOSITION:
Support
Sonoma County Board of Supervisors
Opposition
None on file.
Analysis Prepared by:Kelsy Castillo / HUM. S. / (916)
319-2089