BILL ANALYSIS                                                                                                                                                                                                    






                                  SENATE HUMAN
                               SERVICES COMMITTEE
                            Senator Carol Liu, Chair


          BILL NO:       AB 2702                                      
          A
          AUTHOR:        Chesbro                                      
          B
          VERSION:       April 20, 2010
          HEARING DATE:  June 22, 2010                                
          2
          FISCAL:        Appropriations                               
          7
                                                                      
          0
          CONSULTANT:                                                 
          2
          Park
                                        

                                     SUBJECT
                                         
                     Developmental services: planning teams

                                     SUMMARY  

          Recasts the requirement in current law, for regional  
          centers to ensure that, in developing, reviewing, or  
          modifying a consumer's individual program plan (IPP) or  
          individualized family service plan (IFSP), all decisions  
          must be made pursuant to procedures established in the  
          Lanterman Developmental Disabilities Services Act  
          (Lanterman Act) or California Early Intervention Services  
          Act (CEISA), as notwithstanding any other provision of law.

                                     ABSTRACT  

          Existing law:
          
          1.Establishes the Lanterman Act, under which the Department  
            of Developmental Services (DDS) contracts with 21 private  
            non-profit regional centers to provide case management  
            services and arrange for, or purchase, services that meet  
            the needs of individuals with developmental disabilities,  
            as defined.
                                                         Continued---



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          2.Requires an individual program plan to be developed for  
            every individual over the age of 36 months who is  
            eligible for regional center services.  Requires the  
            individual program plan to identify the services and  
            supports to be purchased by the regional center or  
            obtained from other agencies.

          3.Defines "planning team" to mean the individual with a  
            developmental disability or disabilities; the parents or  
            legally appointed guardian of a minor consumer or the  
            legally appointed conservator of an adult consumer, or an  
            authorized representative; one or more regional center  
            representatives, including the designated regional center  
            service coordinator; and any individual, including a  
            service provider, invited by the consumer or the parents  
            or legally appointed guardian of a minor consumer or the  
            legally appointed conservator of an adult consumer, or  
            the authorized representative.

          4.Provides that individual program plans shall be prepared  
            jointly by the planning team, and that decisions  
            concerning the consumer's goals, objectives, and services  
            and supports to be included in the individual program  
            plan shall be made by agreement between the regional  
            center representative and the consumer or, where  
            appropriate, the parents, legal guardian, conservator, or  
            authorized representative at the program plan meeting.

          5.Establishes the CEISA and Early Start Program, funded  
            through Part C of the federal Individuals with  
            Disabilities Education Act, to promote a coordinated  
            family service system for children from birth to 36  
            months who have a developmental delay or an established  
            risk condition.

          6.Requires regional centers to share primary responsibility  
            for provision of early intervention services with local  
            education agencies.  Requires an individualized family  
            service plan to be developed for each eligible child,  
            delineating the child's levels of development, desired  
            outcomes, services to be provided, and methods to be used  
            to determine the child's progress.

          7.Requires that final decisions regarding the individual  




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            program plan or individualized family service plan be  
            made pursuant to the procedures for individual program  
            plan and individualized family service plan development  
            set forth in the Lanterman Act or CEISA, respectively.

          This bill:

          1.Recasts the requirement in current law, for regional  
            centers to ensure that, in developing, reviewing, or  
            modifying a consumer's individual program plan (IPP) or  
            individualized family service plan (IFSP), all decisions  
            must be made pursuant to procedures established in the  
            Lanterman Developmental Disabilities Services Act  
            (Lanterman Act) or California Early Intervention Services  
            Act (CEISA), as notwithstanding any other provision of  
            law.


                                  FISCAL IMPACT  

          According to the Assembly Appropriations Committee, no  
          direct fiscal impact to regional centers or DDS.

                            BACKGROUND AND DISCUSSION  

          Author's statement
          The author states that, in 1977, the Legislature passed and  
          Governor Ronald Reagan signed the Lanterman Act, a  
          groundbreaking law guaranteeing persons with intellectual  
          and developmental disabilities the supports and services  
          necessary to lead the life of equal citizens. The author  
          believes that a key concept of the Lanterman Act is that  
          each person's plan for those services is to be developed by  
          a program planning team consisting of the person with  
          disabilities, his or her advocate (parent, legal guardian,  
          conservator, or authorized representative), the service  
          coordinator working for the regional center that acts as  
          the state's agent in payment for the services, and others  
          invited by the person with the disabilities or his or her  
          advocate. The author notes that, if the team cannot agree  
          after full consultation, there is a process for bringing  
          them to consensus; and, if there still is no consensus, the  
          person with disabilities or his or her advocate receives  
          written notice of the person's right to appeal to a fair  
          hearing. The author further notes that each plan must  




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          demonstrate the cost-effective use of public resources.

          The author believes that expenditures for services in the  
          community have increased in recent years principally due to  
          case load increases caused by the alarming growth in fetal  
          alcoholism spectrum disorders and by the release of people  
          with disabilities from state institutions called  
          developmental centers into the community. The author states  
          that, in an effort to control expenditures, the Legislature  
          and governor have adopted language in some cases that  
          created a lack of clarity about the roles of participants  
          in the planning process. The author believes this has  
          resulted in making the process less cost-effective and  
          creating more appeals.

          Individual program plan and individualized family services  
          plan 
          The Lanterman Act serves individuals with a developmental  
          disability (or disabilities) that originates before an  
          individual's 18th birthday, and continues, or can be  
          expected to continue, indefinitely, and constitutes a  
          substantial disability for that individual. Individuals  
          with mental retardation, cerebral palsy, epilepsy, and  
          autism are also served through the Lanterman Act, as are  
          individuals with disabling conditions found to be closely  
          related to mental retardation or to require treatment  
          similar to that required for individuals with mental  
          retardation.

          The individual with a developmental disability (or  
          disabilities) and, where appropriate, his or her parents,  
          legal guardian or conservator, or authorized  
          representative, must have the opportunity to actively  
          participate in the development of the IPP.  The planning  
          process includes gathering information and conducting  
          assessments to determine the life goals, capabilities and  
          strengths, preferences, barriers, and concerns or problems  
          of the person with developmental disabilities and, in the  
          case of children, of the family unit as a whole.  The IPP  
          includes a statement of goals, based on the needs,  
          preferences and life choices of the individual, and a  
          statement of specific time-limited objectives for  
          implementing the person's goals and addressing his or her  
          needs.  It also includes a schedule of the type and amount  
          of services and supports to be purchased by the regional  




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          center or obtained from generic agencies or other resources  
          to achieve the IPP goals and objectives.  The process for  
          reviewing and modifying the IPP is the same as the process  
          for IPP development.

          Similar procedures are followed for children from birth to  
          36 months who have a developmental delay or an established  
          risk condition and are eligible for services under the  
          CEISA through the Early Start Program.  Each such eligible  
          infant or toddler is required to have an IFSP.  Families  
          must be afforded the opportunity to participate in all  
          decisions regarding eligibility and services.  The IFSP  
          must address the child's present levels of development, the  
          family's concerns, priorities, and resources to meet the  
          child's developmental needs, a statement of major outcomes  
          expected, and a statement of the specific early  
          intervention services necessary to meet the infant or  
          toddler's unique needs.  Regional centers develop the IFSP  
          and share responsibility for provision of early  
          intervention services with local education agencies.
          
          Arguments in support
          The sponsor of this bill, The Arc of California, asserts  
          that some regional center staff members have mistakenly cut  
          people off services without consultation, a result no one  
          intended.  Disability Rights California (DRC) states that  
          it is aware of some circumstances where the IPP requirement  
          has been circumvented, as well as circumstances where some  
          regional centers have not informed families of exemptions  
          to changes made by the trailer bill. DRC proposes  
          additional amendments to the bill to strengthen rights.  
          Supporters believe that the bill will protect and preserve  
          the entitlement and the rights of the developmentally  
          disabled who are the most vulnerable members of our  
          community.

          Related/prior legislation
          ABX4 9 (Evans), Chapter 9, Statutes of 2009-10 4th  
          Extraordinary Session, enacted changes related to the area  
          of developmental services necessary to enact modifications  
          to the 2009-10 budget.  All of the changes occur, unless  
          otherwise specified, at the time of the development,  
          scheduled review, or modification of a client's individual  
          program plan or individual family service plan. The bill  
          affected purchase of services; made modifications to the  




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          Early Intervention Services Act; and established  
          requirements for least costly alternatives, negotiation of  
          rates, and uniform holiday schedule, among others changes.

          AB 1183 (Committee on Budget), Chapter 758, Statutes of  
          2008, among other things,  required the establishment of an  
          internal regional center review process in conjunction with  
          the development, review, or modification of IPPs and IFSPs,  
          to ensure adherence with federal and state law when  
          purchasing services and supports.


                                   PRIOR VOTES
           
          Assembly Floor:     65 - 7
          Assembly Appropriations:12 - 0
          Assembly Human Services:  5 - 1


                                     COMMENTS
           
          1.Interaction with current law and trailer bill.  It is  
            unclear how this measure would impact changes made by  
            ABX4 9 (Evans), Chapter 9, Statutes of 2009-10, 4th  
            Extraordinary Session, or current law.  In responding to  
            a request for technical assistance from committee staff,  
            DDS staff indicate that the bill is almost identical to  
            existing language in the Lanterman Act, and that the  
            "notwithstanding any other provision of law" may  
            introduce ambiguity and detract from the clarity in  
            existing statute.  DDS states that regional centers are  
            already mandated to ensure that IPPs and IFSPs are  
            developed, reviewed, and modified pursuant to procedures  
            established in the Lanterman Act and the California Early  
            Intervention Services Act.  DDS also expresses concerns  
            about the effect of this measure on changes made through  
            the DDS trailer bill last year.

                                    POSITIONS  

          Support:  The Arc of California (sponsor) 
                    ABC Adult Day Programs, Mendocino County
                    California Communities United Institute
                    Children's Law Center of Los Angeles
                    Developmental Disabilities Area Board 10




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                    Disability Rights California
                    United Association of California Careproviders
                    635 individuals
                    
          Oppose:None received.


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