BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | SB 1427|
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THIRD READING
Bill No: SB 1427
Author: Pavley (D)
Amended: 3/28/16
Vote: 21
SENATE HUMAN SERVICES COMMITTEE: 4-0, 4/12/16
AYES: McGuire, Berryhill, Hancock, Liu
NO VOTE RECORDED: Nguyen
SENATE APPROPRIATIONS COMMITTEE: 7-0, 5/27/16
AYES: Lara, Bates, Beall, Hill, McGuire, Mendoza, Nielsen
SUBJECT: Workforce development: developmentally disabled
individuals
SOURCE: California Disability Services Association
DIGEST: This bill requires the Department of Developmental
Services (DDS) to establish a Work Transition Project, as
specified, for regional centers to allow blended or braided
forms of integrated services, and to assist in the state's
efforts to reach compliance with the federal Home and
Community-Based Services (HCBS) Waiver regulations. This bill
authorizes DDS to waive regulatory requirements that inhibit the
provision of services in competitive integrated settings. This
bill also requires DDS to assess the decrease in time that it
takes a consumer under these provisions to become job ready and
to transition into an integrated work setting, and to report
that information to the Legislature, as specified.
ANALYSIS:
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Existing law:
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 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)
3)Establishes an Individual Program Plan (IPP) and defines that
planning process as the vehicle to ensure that services and
supports are customized to meet the needs of consumers. (WIC
4512)
4)Defines habilitation services as activities purchased for
regional center consumers, including services provided under
the Work Activity and Supported Employment programs to prepare
and maintain consumers at their highest level of vocation
functioning or to prepare them for referral to vocational
rehabilitation services. (WIC 4851)
5)Establishes an individual habilitation services plan and
specifies areas in which consumers must meet employment goals.
(WIC 4853, WIC 4854)
6)Requires a regional center to authorize appropriate services
for a consumer while he or she is on a waiting list for
services from the Department of Rehabilitation, as specified.
(WIC 4855)
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7)Establishes fees and hourly rates for service providers who
work with consumers in various job development and support
activities. (WIC 4860)
8)Establishes in federal law state reimbursements for achieving
work outcomes for individuals with disabilities, as specified.
(CFR 411.582)
9)Establishes an Employment First Policy in California to
prioritize opportunities for integrated, competitive
employment for individuals with developmental disabilities,
regardless of the severity of their disabilities, as
specified. (WIC 4869)
This bill:
1)Makes various findings and declarations, including legislative
intent that individuals do not lose vocational opportunities
as the result of changes to the federal HCBS rules, that
thousands of consumers in existing employment programs deserve
specific attention to ensure an opportunity for more
integrated work settings and that it is important that the
state implement a program of job discovery and job readiness
training to assist these individuals transition successfully
to competitive integrated employment.
2)Requires that on or before July 1, 2017, DDS shall establish a
Work Transition Project with guidelines and an approved
process for regional centers to allow blended or braided forms
of integrated services using allowable services under existing
state and federal law.
3)Requires that the project assist in the state's efforts to
reach compliance with the federal HCBS waiver regulations by
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March 31, 2019.
4)Permits a maximum of 75 hours per quarter, at no more than an
equivalent of $40 per hour to be authorized for vendors to
provide needed job readiness and support services aimed at
individualized transition services for consumers currently
placed in segregated work settings who choose to move toward
competitive integrated employment.
5)Defines "blended or braided forms of integrated services" to
mean services for a single consumer that are funded by
multiple agencies or entities and that work as a single
program.
6)Requires DDS to permit regional centers to customize skill
development and job readiness programs for consumers, as
appropriate, by partnering with work activity programs and
group supported employment vendors to transition those
consumers who choose to move towards integrated competitive
employment.
7)Permits DDS to waive, until March 31, 2019, regulatory
requirements that inhibit the provision of services in
competitive integrated settings.
8)Requires DDS to assess the decrease in time that it takes a
consumer under these provisions to become job ready and to
transition into an integrated work setting.
9)Requires DDS to report to the budget committee of each house
of the Legislature during the annual budget process regarding
the use of these provisions and the measurable outcomes, as
specified.
Background
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California's 21 nonprofit regional centers are part of a system
of care for individuals with developmental disabilities overseen
by DDS. DDS is responsible for coordinating care and providing
services for nearly 290,000 people who live in their
communities, and about 1,000 people who lived in developmental
centers as of March 2016. Regional centers provide diagnosis and
assessment of eligibility and, if consumers qualify for
services, case management to help to plan, access, coordinate
and monitor the services and supports that are needed. Services
for consumers are determined through an IPP.
Employment. AB 287 (Beall, Chapter 231, Statutes of 2009)
required that the State Council on Developmental Disabilities
establish a standing Employment First Committee to identify
strategies, best practices, and incentives, and to develop an
Employment First Policy. The Policy's goal was to increase the
number of people with developmental disabilities who are
employed in integrated work, self-employment, and
microenterprises, and earning wages at or above minimum wage.
A subsequent report, released in 2011, found that 26.5 percent
of working-age adults with developmental disabilities live below
the federal poverty line compared with 13 percent of adults in
the general population. Other findings included a need for
additional supports for individuals to prepare for and maintain
employment. That report, and a subsequent report in 2012,
prompted a number of legislative efforts, including SB 577
(Pavley, Chapter 431, Statutes of 2014) which established a
four-year pilot project to create community-based vocational
development services to teach "softer" interpersonal skills to
consumers, and to evaluate whether those skills are important to
succeed in supported employment. The pilot was not enacted.
Individual and group employment. There are a variety of ways for
consumers to be supported in a work environment. Typically,
regional centers contract with employment services programs and
providers to address the employment needs of individuals with
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developmental disabilities. Consumers are placed in jobs
according to their individual skills, needs and choices, and
provided support services on an individual basis or in a group.
Work Activity Programs are employment services programs in a
sheltered work environment for consumers who have acquired basic
vocational and independent living skills. Consumers are paid at
a daily per capita rate based on productivity. As of May 2015,
there were 108 Work Activity Program vendors and about 9,600
consumers in the program, according to DDS data.
Supported Employment Programs are community-based rehabilitation
programs that focus on helping consumers obtain, retain or
maintain employment in integrated settings either individually
or in groups. Often supported employment includes a job coach
that provides on-the-job services and training, and wages paid
directly to the consumer by the employer. Supported employment
can either be tailored to an individual, or performed with a
group. According to data from DDS, as of May 2015, there were
167 group employment vendors and approximately 5,900 consumers.
Individual supported employment, which is not the focus of this
bill, employed about 188 vendors and nearly, 4,400 individual
participants.
Home and Community-Based Services waiver changes. On January 10,
2014, the federal Centers for Medicare and Medicaid Services
(CMS) released a new "final rule" summarizing key changes in its
requirements for states' home and community-based services
waivers. The rule affects three types of waivers, all of which
are applied in California to serve populations including
individuals with developmental disabilities. Elements of the new
requirements include that an individual has a lease or other
legally enforceable agreement providing similar protections, has
privacy in their living unit including lockable doors and a
choice of roommates, controls his or her own schedule and can
access food at any time, among other practices. Experts believe
that group work paid at sub-minimum wages will not be supported
under the new HCBS rule but that consumers will need to be
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employed in integrated settings and with a full salary.
On August 14, 2015, the Department of Health Care Services
submitted the Statewide Transition Plan for home and
community-based settings to CMS for approval. The state is
currently negotiating elements of its plan with CMS. The state
must be in full compliance with the new HCBS guidelines in order
to receive federal funding by March 2019.
Comments
This bill seeks to move a group of consumers who currently are
in group employment activities into competitive integrated
employment, as is preferred by the new HCBS ruling, by creating
a transition program for individuals to learn social and other
soft job skills. This bill creates a time-limited opportunity to
braid funding from various state departments and regional center
vendors to support consumers in obtaining independent
employment.
This bill is similar to SB 577 (Pavley, Chapter 431, and
Statutes of 2014) which established a four-year pilot project,
contingent upon federal funding. Both bills created the same
rate structure and similar job skills training. Implementation
of SB 577 has been stalled by a lack of federal approval while
the state's HCBS waiver is pending, as has approval of all new
services and HCBS-related waivers that seek federal funding.
This bill's sponsors hope that by removing the federal funding
requirement and permitting instead braided and blended funding
for existing categories of services, that these programs will be
established prior to completion of the HCBS waiver process and
enactment of SB 577.
Prior Legislation
SB 577 (Pavley, Chapter 431, Statutes of 2014) established a
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four-year pilot project to create and evaluate whether
community-based vocational development services are determined
to be a necessary step to achieve a supported employment
outcome. The pilot has not been enacted.
AB 1041 (Chesbro, Chapter 677, Statutes of 2013) expanded the
definition of competitive integrated employment and required
regional centers to ensure that consumers, beginning at 16 years
of age, are provided with information about options for
integrated competitive employment and other services, including
postsecondary education.
AB 287 (Beall, Chapter 231, and Statutes of 2009) established an
"Employment First" effort for the State to undertake, which has
led to the State Council on Developmental Disabilities to put
together an "Employment First" policy and several attempts to
get that policy passed into law.
FISCAL EFFECT: Appropriation: No Fiscal
Com.:YesLocal: No
According to the Senate Appropriations Committee, this bill
would result in likely one-time costs up to $150,000 for DDS to
develop program requirements, accountability measures, and data
collection requirements (General Fund and federal funds).
Additionally, this bill would have likely ongoing administrative
costs in the hundreds of thousands per year for regional centers
to administer and monitor participation in the program (General
Fund and federal funds). There would additionally be likely
costs of $5 million to $10 million per year to provide
additional job readiness and support services to regional center
consumers currently participating in work activity programs or
group supported employment programs (General Fund and federal
funds).
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The Appropriations analysis noted that there are about currently
about 15,000 regional center consumers who participate in one of
these two programs. Assuming that 10% of those consumers
participate in the program authorized in the bill and that those
consumers, on average, receive the newly authorized services for
two quarters, total net costs for those new services would be
about $8 million per year. (This includes an offsetting
reduction in service hours those consumers are currently
receiving.)
As a result, the analysis concluded there would likely be annual
savings in the millions per year (General Fund and federal
funds): To the extent that the new services authorized in the
bill improve the employment prospects of regional center
consumers, it is likely that consumers will shift from more
expensive work activity programs and group supported employment
programs to less expensive individual supported employment
programs (wherein consumers are employed in the community, with
ongoing assistance from regional center vendors). For example,
if 50% of program participants are able to shift to individual
supported employment, annual savings would be about $3 million
per year.
The Appropriations analysis also noted that the increased costs
for a regional center consumer using the new services would
likely only occur for the first year or two, whereas savings
would continue as long as the consumer stays in individual
supported employment. Thus the savings would increase over time
while program costs are likely to remain relatively flat.
SUPPORT: (Verified 5/27/16)
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California Disability Services Association (source)
Futures Explored, Inc.
The Arc and United Cerebral Palsy California Collaboration
OPPOSITION: (Verified 5/27/16)
None received
ARGUMENTS IN SUPPORT: According to the bill's sponsor, this
bill provides a pathway to transition consumers into different
employment services which are required by the California
Employment First Policy and changes to the federal HCBS settings
rule. "Often the consumers are technically competent to move
into competitive integrated employment, but lack the soft skills
to do so. ? SB 1427 would allow providers to blend or braid
integrated services to provide training on those skills."
Prepared by:Mareva Brown / HUMAN S. / (916) 651-1524
5/28/16 17:08:39
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