BILL ANALYSIS                                                                                                                                                                                                    




                   Senate Appropriations Committee Fiscal Summary
                           Senator Christine Kehoe, Chair

                                           1129 (Wiggins)
          
          Hearing Date:  5/10/2010        Amended: 5/4/2010
          Consultant: Katie Johnson       Policy Vote: Human Serv. 3-1
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          ____
          BILL SUMMARY:  SB 1129 would provide that a person with a  
          developmental disability served by any regional center may  
          access intensive behavioral intervention services at the Sonoma  
          Developmental Center (SDC) when it is determined that he or she  
          is a danger to himself or herself or others, and when he or she  
          has a pending hearing related to a such a situation.
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          __
                            Fiscal Impact (in thousands)

           Major Provisions         2010-11      2011-12       2012-13     Fund
                                                                  
          Services purchased       unknown, but potentially inGeneral/*
          at SDC by RCs            the hundreds of thousands     Federal
                                   to millions depending on the 
                                   number of consumers
          *See staff comments
          _________________________________________________________________ 
          ____

          STAFF COMMENTS: This bill meets the criteria for referral to the  
          Suspense File.

          This bill would permit a regional center (RC) to purchase  
          intensive behavioral intervention services at the Sonoma  
          Developmental Center (SDC) for persons who are not residents of  
          SDC. This bill would permit individuals to be temporary  
          residents of SDC when they would receive intensive behavioral  
          intervention at SDC even though the RC would purchase the  
          services. It is unclear what the funding source would be for  
          this bill because RCs do not currently purchase services from a  
          developmental center (DC). Costs related to DC residents are  
          currently paid directly by the state.

          21 non-profit RCs purchase services for approximately over  
          240,000 clients of all ages through community vendors registered  
          with DDS, including respite and day programs. In contrast, the  










          DCs are licensed general acute care hospitals, skilled-nursing  
          facilities, and intermediate care facilities that serve a  
          population of 2,130 full-time residents. The DCs do not  
          currently provide inpatient or outpatient services to RC clients  
          other than their own residents.

          Existing law provides that if a person is determined to be a  
          danger to himself or herself or others, he or she would enter a  
          DC through a court commitment process. Prior to the commitment  
          hearing, a court could order the alleged dangerous person to be  
          left in the charge of his or her parent or to be placed in a DC,  
          a psychiatric hospital or in any other suitable placement that  
          would be the least restrictive residential environment as  
          recommended by the person's RC and a DC, when applicable. SDC  
          intensive behavioral intervention beds are licensed as  
          intermediate care facility beds, which also exist in the  
          community. It would be unlikely that a court would consider  
          temporary  
          Page 2
          SB 1129 (Wiggins)

          residence in SDC, a state hospital, as the least restrictive  
          residential placement for a person requiring such services when  
          those services would be available in a licensed community care  
          facility.

          This bill would permit any RC to choose to provide intensive  
          behavioral services at SDC instead of in a community  
          intermediate care facility regardless of whether or not the  
          placement was the most appropriate or the least restrictive  
          residential environment, as per existing law. This bill would  
          require a consumer receiving intensive behavioral intervention  
          to be considered a temporary resident at SDC and would prohibit  
          such a consumer from remaining a resident for a period exceeding  
          six months without a review by the regional center and SDC. 

          It costs the state approximately $25,000 per DC resident per  
          month. DCs are paid as follows according to the FY 2009-2010  
          budget: 96 percent General Fund and 4 percent other funds, the  
          State Lottery, and federal funds. Accordingly, the state could  
          expect to pay a similar per resident per month amount for any  
          temporary resident at SDC pursuant to this bill. Although it is  
          unknown how many consumers statewide would access these services  
          at SDC, if RCs chose to purchase services from SDC for at least  
          one consumer per regional center for a single month, costs would  
          be $575,000. If a single person in the state were to be placed  










          temporarily in SDC for intensive behavioral intervention for up  
          to six months, as permitted by this bill, the cost would be  
          approximately $150,000, as compared to a community placement  
          which has less overhead and fewer staff and is an overall less  
          expensive placement.

          This bill would provide that intensive behavioral intervention  
          services at SDC would be funded through existing resources and  
          that no additional General Fund moneys would be appropriated.  
          DDS cut $334 million in its FY 2009-2010 budget and a $25  
          million cut is expected from its FY 2010-2011 budget. It is  
          unlikely that DDS could absorb these costs.