BILL ANALYSIS Ó
SB 1427
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Date of Hearing: August 3, 2016
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Lorena Gonzalez, Chair
SB 1427
(Pavley) - As Amended June 30, 2016
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|Policy |Human Services |Vote:|7 - 0 |
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Urgency: No State Mandated Local Program: NoReimbursable: No
SUMMARY:
This bill requires the Department of Developmental Services
(DDS), on or before July 1, 2017, to establish a Work Transition
Project (WTP), as specified, to facilitate the delivery of
integrated services and assist in state compliance with federal
Home and Community-Based Services (HCBS) Waiver regulations.
FISCAL EFFECT:
1)Likely annual costs in the range of $12 million to $27 million
(GF/federal funds) to establish a WTP with a process for
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regional centers to allow well-coordinated forms of integrated
services. The exact cost will depend on the number of
participants, the number of hours of participation, and
whether the hours are in addition to or in lieu of current
Day/WAP participation. This estimate assumes 1,000
participants who participate 10-15 hours per week in lieu of
equivalent hours of Day/WAP participation, accounts for the
enhanced rate of $40 per hour, and includes offsetting savings
for less than 52 weeks per year of use.
2)Likely one-time costs up to $150,000 for DDS to develop
program requirements, accountability measures, and data
collection requirements (GF/federal funds).
3)Likely ongoing administrative costs in the hundreds of
thousands per year for regional centers to administer and
monitor participation in the program (GF/federal funds).
COMMENTS:
1)Purpose. The author states, "California's Employment First
Policy and changes to the HCBS setting rule require the state
to increase opportunities for individuals with developmental
disabilities to achieve competitive, integrated employment.
The purpose of the HCBS rule is to ensure that individuals
receive services in settings that are integrated in and
support full access to the greater community, which includes
opportunities to seek employment and work in competitive and
integrated settings. In order to ensure continued federal
financial participation, services in California must follow
the new rules by March 2019.
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The bill would allow the blending of services so that
providers can engage in job discovery and job readiness with
their consumers to ensure that they have choice in their
employment goals. By using existing service categories, this
focused redesign allows the existing federal waivers to
finance these services during the time when the state is
working on the HCBS transition plan."
2)Background. Waivers enable states to apply for greater
flexibility in their use of federal Medicaid dollars. Section
1915(c) waivers, known as Home and Community-Based Services
(HCBS) waivers, permit states to use Medicaid dollars to
provide long-term care services in home- and community-based
settings as an alternative to the use of institutional
settings. A variety of services can be offered under an HCBS
waiver, including personal care, case management, adult day
health, habilitation, home health aide, and other services.
California's HCBS waiver provides a significant source of
federal funds to California; for 2016-17, the DDS budget
anticipates close to $1.7 billion in federal funds under the
HCBS waiver, to be used to pay for services for regional
center consumers and for regional center operations.
In 2014, the federal Centers for Medicare and Medicaid
Services (CMS) issued a new rule regarding HCBS waivers
reflecting, among other things, CMS's intent that individuals
receiving services through Medicaid's HCBS programs are able
to fully access the benefits of community living and receive
services in the most integrated setting. California must come
into full compliance with these regulations by March 2019.
Included among the many changes in the new regulations is the
requirement that individuals with developmental disabilities
be offered greater opportunity to obtain competitive,
integrated employment.
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In 2011-12, 13% of working age Californians with developmental
disabilities were found to be employed, compared to 73% of the
state's general population. For those regional center
consumers who are employed, the author contends that many will
see their employment threatened by the pending changes per the
new HCBS waiver rule, and that specific attention should be
given during the interim transition period such that these
individuals have reasonable access to more integrated work
settings of their choice. The author cites the need for job
discovery, soft skills training, and flexible employment
service models to help assist consumers in acquiring and
maintaining competitive, integrated employment.
3)Budget Appropriation. The Budget Act of 2016 appropriated $15
million for DDS to allocate to community service providers
based on demonstrated need to comply with the new federal HCBS
regulations. This bill requires that WTP services be eligible
to receive allocations from these funds. Staff notes that DSS
will establish a process for allocating these funds to
providers so that all providers have access on the same basis.
This bill establishes a separate process for a subset of
providers. The committee may wish to consider whether a
separate allocation process is necessary and appropriate.
4)Prior Legislation.
a) SB 577 (Pavley), Chapter 431, Statutes of 2014,
required, contingent upon the receipt of federal funding,
DDS to conduct a four-year demonstration project regarding
the impacts of community-based vocational development
services on employment outcomes for regional center
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consumers and on purchase-of-service costs for working-age
adults.
b) AB 1041 (Chesbro), Chapter 677, Statutes of 2013,
created a statewide Employment First Policy and set forth
requirements related to the inclusion of employment
opportunities and services in a regional center consumer's
individual program plan.
Analysis Prepared by:Jennifer Swenson / APPR. / (916)
319-2081