BILL ANALYSIS                                                                                                                                                                                                    Ó



          SENATE COMMITTEE ON HUMAN SERVICES
                             Senator Mike McGuire, Chair
                                2015 - 2016  Regular 

          Bill No:            SB 1226         Hearing Date:    April 12,  
          2016
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          |Author:    |Beall                                                |
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          |Version:   |March 28, 2016                                       |
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          |Urgency:   |No                     |Fiscal:    |No               |
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          |Consultant:|Debra Cooper                                         |
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                   Subject:  Regional centers:  audits and reviews


           SUMMARY
           
          This bill requires regional centers to submit to the California  
          Department of Developmental Services (DDS) copies of independent  
          audit reports for vendors of regional center services. The bill  
          requires DDS to analyze the reports, as specified, and  
          biannually report its findings to the Legislature in order to  
          identify and improve accounting practices and prevent potential  
          fraud. 


           ABSTRACT
           
          Existing law:

             1)   Defines, in California law, a "developmental disability"  
               as a disability that originates before the age of 18,  
               continues, or can be expected to continue, indefinitely,  
               and constitutes a substantial disability. This term  
               includes intellectual disability, cerebral palsy, epilepsy,  
               and autism. (WIC 4512)

             2)   Establishes, in California law, that DDS shall contract  
               with private non-profit regional centers to provide fixed  
               points of contact in the community for persons with  
               developmental disabilities and their families, so that  
               these persons may have access to the services and supports  








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               best suited to them throughout their lifetime. (WIC 4620)

             3)   Requires an entity receiving payments from one or more  
               regional centers to contract with an independent accounting  
               firm for an audit or review its financial statements, as  
               specified. (WIC 4652.5 (a)(1) 

             4)   Exempts state agencies, the UC and CSU university  
               systems and certain providers, as defined, from the audit  
               requirement. (WIC 4652.5. (a) (2), et seq.)

             5)   Requires regional centers to review audits or review  
               reports and resolve issues identified in the report that  
               have an impact on regional center services. Requires  
               regional centers to take appropriate action, up to  
               terminaton of vendorization, for lack of adequate  
               resolution of issues. (WIC 4652.5. (c))

             6)   Requires regional centers to notify DDS of all qualified  
               opinion reports or reports noting significant issues that  
               directly or indirectly impact regional center services  
               within 30 days after receipt, and requires the notification  
               include a plan for resolution of issues. (WIC 4652.5. (d))

          Special Session Legislation:
          
          Assembly Bill X2-1 makes a number of changes to the audit  
          requirements for vendors of regional center services.  The  
          changes in law will take effect 91 days after the end of the  
          extraordinary session, which is June 9, 2016.  Therefore, AB  
          X2-1 makes the following changes that relate to audits of  
          vendors of regional center services, effective June 9, 2016:  


             1)   Requires that an entity receiving payments from one or  
               more regional centers shall contract with an independent  
               accounting firm for an audit or review of its financial  
               statements relating to payments made by regional centers  
               subject to all of the following: 


                  a.        When the amount received from the regional  
                    center or regional centers during the entity's  
                    fiscal year is more than or equal to five hundred  









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                    thousand dollars ($500,000) but less than two  
                    million dollars ($2,000,000), the entity shall  
                    obtain an independent audit or independent review  
                    report of its financial statements for the period.  
                    This includes work activity program providers  
                    receiving less than five hundred thousand dollars  
                    ($500,000), as specified. 

                  b.        When the amount received from the regional  
                    center or regional centers during the entity's  
                    fiscal year is equal to or more than two million  
                    dollars ($2,000,000), the entity shall obtain an  
                    independent audit of its financial statements for  
                    the period. (WIC 4652.5 (a) (1))


             2)   Requires vendors to provide copies of the audit or  
               review to the vendoring regional center within nine  
               months of the end of the vendor's fiscal year. (WIC  
               4652.5. (b))


             3)   Permits an entity that obtains an independent review  
               based on regional center payments of between $500,000 and  
               $2 million to request a two-year exemption if the  
               regional center does not find issues in the prior year's  
               audit or review that has an impact on regional center  
               services. (WIC 4652.5. (h) (1))

             1)   Permits an entity that is required to obtain an  
               independent audit of its financial statements based on  
               regional center payments in excess of $2 million to apply  
               to the regional center for an exemption subject to all of  
               the following conditions:

                  a.        If the independent audit for the prior year  
                    resulted in an unmodified opinion or an unmodified  
                    opinion with explanatory language, the regional center  
                    shall grant the entity a two-year exemption.

                  b.        If the independent audit for the prior year  
                    resulted in a qualified opinion and the issues are not  
                    material, the regional center shall grant the entity a  
                    two-year exemption. However, the entity and the  









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                    regional center shall continue to address issues  
                    raised in this independent audit, regardless of  
                    whether the exemption is granted. (WIC 4652.5. (h)  
                    (2), et seq.)

             2)   Requires a regional center to notify DDS annually of any  
               exemption it grants to an entity, as specified. (WIC  
               4652.5. (h) (3))

          This bill:

             1)   Requires the vendoring regional center to submit copies  
               of all independent audit reports to DDS for review. 

             2)   Requires DDS to determine if audit reports are effective  
               in preventing fraud and improving accounting practices  
               among vendors, and to report its findings to the  
               Legislature biannually, as specified.
           


          FISCAL IMPACT
           
          This bill has not been analyzed by a fiscal committee. 

           BACKGROUND AND DISCUSSION
           
          >Purpose of the bill

          According to the author, the vendor audit requirement,  
          established through budget trailer bill SB74 in 2011, was  
          intended to save the state more than $20 million annually  
          through increased accountability. However, as of March of 2014,  
          DDS has received fewer than 100 audits of concern and none of  
          them resulted in any defined savings. The cost to perform the  
          financial reviews and audits are borne solely by the vendors at  
          an average cost of $10,000 per audit and it is unclear if the  
          audits are achieving the intended result, according to the  
          author. Reporting the results of the audits is intended to allow  
          the Legislature to understand if the audits are effective in  
          reducing fraud and improving accounting practices, the author  
          states. 

          The Lanterman Act









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          The Lanterman Developmental Disabilities Services Act, passed in  
          1974, established an entitlement to services and supports for  
          Californians with developmental disabilities and set up an  
          extensive system to care for individuals who are living in their  
          communities. A developmental disability is defined in statute as  
          one that originates before the age of 18, continues, or can be  
          expected to continue, indefinitely, and constitutes a  
          substantial disability. Today, more than 290,000 children and  
          adults with developmental disabilities are served in  
          community-based programs and supported by state- and federally  
          funded services that are coordinated by local, nonprofit  
          regional centers. 

          The state's 21 regional centers vary considerably in size and  
          organization. According to statewide data from December 2015,  
          slightly more than half of the regional center population is  
          between age 18 and 61 years old; about two-thirds of all  
          consumers have an intellectual disability, three in 10 are  
          diagnosed with autism or a related disorder, and 18 percent are  
          identified as having severe behaviors, according to data  
          reported by the DDS. Statewide, 75 percent of consumers live in  
          the home of a parent or guardian. 

          Vendorization
          
          To be eligible to provide  services to a regional center client,  
          a provider must become a vendor of those services in the  
          specific regional center's catchment area. According to the DDS  
          website, "vendorization is the process for identification,  
          selection, and utilization of service providers based on the  
          qualifications and other requirements necessary in order to  
          provide the services. The vendorization process allows regional  
          centers to verify, prior to the provision of services to  
          consumers, that an applicant meets all of the requirements and  
          standards specified in regulations."

          In truth, regional centers must vendorize any applicant who  
          meets all the requirements for the service to be provided. The  
          DDS website notes that vendorization in no way obligates that  
          regional center to purchase service from that vendor. Applicants  
          who pass vendorization requirements are assigned a service code  
          and unique vendor identification number by the regional center,  
          which determines the appropriate vendor category for the service  









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          to be provided.

          Bureau of State Audits report
          
          In August 2010, the Bureau of State Audits released a report  
          entitled "Department of Developmental Services: A More Uniform  
          and Transparent Procurement and Rate-Setting Process Would  
          Improve the Cost-Effectiveness of Regional Centers." Among its  
          conclusions was that regional centers were not appropriately  
          monitoring expenditures of vendors and that the centers  
          themselves did not always document how rates are set, why  
          certain vendors are selected, or how contracts are procured;  
          "thus, in some cases, the ways in which regional centers  
          established payment rates and selected vendors had the  
          appearance of favoritism or fiscal irresponsibility."<1> The  
          audit prompted a Senate Human Services Committee hearing as well  
          as discussions in the Senate budget subcommittee about the need  
          for additional oversight of vendor expenditures. While DDS is  
          tasked with auditing service providers (WIC 4648.1), the  
          Department does not have sufficient resources to conduct audits  
          on many vendors and typically focuses solely on those that have  
          been brought to its attention. 

          Audit requirements
          
          Faced with dramatic fiscal shortfalls in 2011, and on the heels  
          of the BSA findings, the Administration and Legislature added a  
          requirement for vendors receiving more than $250,000 to obtain  
          either an independent audit or a lesser audit review to ensure  
          good bookkeeping practices (SB 74 Committee on Budget and Fiscal  
          Review, Chapter 9, Statutes of 2011). These financial thresholds  
          were recently increased this year in the special session  
          requiring vendors receiving more than $500,000 but less than $2  
          million to obtain an independent audit review and vendors  
          receiving more than $2 million to obtain an independent audit.  
          These requirements will go into effect June 9, 2016 (ABX2 1,  
          Chapter 3, Statutes of 2015-16 2nd Extraordinary Session).

          The thresholds in 2011 were derived, in part, by a budget  
          ---------------------------
          <1> "Department of Developmental Services: A More Uniform and  
          Transparent Procurement and Rate-Setting Process Would Improve  
          the Cost-Effectiveness of Regional Centers," Bureau of State  
          Audits, Report No. 2009-118, August 2010, pg. 155









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          savings estimate that projected improved accounting procedures  
          and internal controls by vendors at this level would save about  
          1 percent in annual purchase of service costs. The audits were  
          not expected to find significant amounts of fraud; rather the  
          savings assumed that the audits would identify poor billing  
          practices, errors in billings and inappropriate transactions  
          that would otherwise be billed to regional centers. DDS would be  
          able to focus its audits on those vendors with qualified reports  
          or significant issues raised, according to a Department  
          description of the proposal. 

          Audit findings

          An audit report is completed by an independent accounting  
          professional to appraise the financial status of a business or  
          company. It considers a company's assets and liabilities, and  
          reviews whether financial records have been maintained in  
          accordance with Generally Acceptable Accounting Standards  
          (GAAS). There are four types of auditor opinions a business can  
          receive:

             a.   Unmodified opinion - Often called a clean opinion, and  
               formerly called an unqualified opinion, this is issued when  
               an auditor determines that the financial records are  
               presented fairly and free of any misrepresentations. In  
               addition, an unmodified opinion indicates that the  
               financial records have been maintained in accordance with  
               the GAAS. This is the best possible report.

             b.   Qualified opinion - In situations when a company's  
               financial records have not been maintained in accordance  
               with GAAS but no misrepresentations are identified, an  
               auditor will issue a qualified opinion, which highlights  
               the reason that the audit report is not unqualified.

             c.   Adverse opinion - When an auditor concludes that the  
               audited financial statements do not fairly represent the  
               organization's financial position and there are significant  
               departures from GAAS, an adverse opinion will be issued.  
               Often, an auditor will advise the organization that there  
               is a problem and work with them to resolve or correct  
               issues so the published audit can be either qualified or  
               unqualified. 










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             d.   Disclaimer of opinion - An auditor also may choose not  
               to issue an opinion, either due to significant  
               uncertainties in the appropriateness of the materials,  
               significant limitations in the scope of the audit or the  
               auditor feels he or she cannot be impartial or independent  
               about the business. 

          Related legislation:

          ABX2 1 (Thurmond, Chapter 3, Statutes of 2015-16 Second  
          Extraordinary Session) made adjustments to fiscal audit  
          requirements for regional center vendors working with the  
          developmentally disabled. It also clarified what monies were be  
          analyzed for audits and allowed exemptions to audits and reviews  
          under specific conditions. 

          SB 490 (Beall, 2015) readjusted audit threshold and reporting  
          requirements under SB 74. It made technical amendments to  
          clarify what monies can be counted toward the threshold and when  
          audits and financial reviews are submitted to regional centers.  
          It was held in the Assembly Appropriations Committee.
          
          SB 1259 (Emmerson, 2012) readjusted audit threshold  
          requirements. It was held in the Senate Appropriations  
          Committee.

          SB 74 (Committee on Budget and Fiscal Review, Chapter 9,  
          Statutes of 2011) established the audit requirements.



           COMMENTS
                                            
           The Governor's assumption in proposing the audits in the 2011  
          trailer bills was that the audits would save $39.5 million  
          (total funding) of which $21.3 million was general fund as part  
          of the mid-year 2011-12 savings. The assumption of cost savings  
          was based on a belief that poor billing practices, errors in  
          billings and inappropriate transactions billed to regional  
          centers resulted in about 1 percent annual losses. DDS reports  
          that it has no way to track cost savings from efficiencies in  
          business practices resulting from the audits and therefore no  
          way to measure actual savings from enactment of the audits. 










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          Since that time, the Association of Regional Center Agencies  
          (ARCA) reports that audit completion varies statewide. On  
          average, according to a 2015 ARCA survey of 18 of 21 regional  
          centers, 52 percent of vendors have completed audits with 99  
          percent of audits resulting in unqualified vendor opinions. DDS  
          reports that approximately 90 audits have been reported to the  
          department with problems. The original legislation did not  
          require regional centers to report to DDS the number of audits  
          or reviews completed successfully and the department does not  
          have any data on overall compliance with the audit requirement,  
          nor does it know which vendors have passed with clean audits or  
          reviews. 

          The adjustment in the financial threshold for audits under ABX2  
          1 is expected to result in nearly 70 percent of providers being  
          eliminated from the audit requirement: only 410 vendors would be  
          required to obtain an independent audit from a total of 1,381  
          currently eligible vendors. 



           POSITIONS
                                           
          Support:       
               ResCoalition
               Alliance Supporting People with Intellectual and  
          Developmental Disabilities

          Oppose:
               None received.

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