BILL NUMBER: AB 1244 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY APRIL 14, 2011
AMENDED IN ASSEMBLY MARCH 31, 2011
INTRODUCED BY Assembly Member Chesbro
(Coauthors: Assembly Members Ammiano and Beall)
FEBRUARY 18, 2011
An act to add Section 4685.8 to amend
Sections 4677 and 4678 of, repeal Section 4685.7 of, and to add
Article 4.5 (commencing with Section 4689.90) to Chapter 6 of
Division 4.5 of, the Welfare and Institutions Code, relating to
developmental services , and making an appropriation therefor
.
LEGISLATIVE COUNSEL'S DIGEST
AB 1244, as amended, Chesbro. Developmental services:
Self-Determination Program.
Under existing law, the Lanterman Developmental Disabilities
Services Act, the State Department of Developmental Services is
authorized to contract with regional centers to provide support and
services to individuals with developmental disabilities. Under
existing law, the regional centers purchase needed services and
supports for individuals with developmental disabilities through
approved service providers or arrange for their provision through
other publicly funded agencies. The services and supports to be
provided to a regional center consumer are contained in an individual
program plan (IPP), developed in accordance with prescribed
requirements. Existing law establishes, contingent upon approval of a
federal waiver, the Self-Directed Services Program, and requires the
program be available in every regional center catchment area to
provide participants, within an individual budget, and greater
control over needed services and supports.
This bill would repeal the provisions establishing
the Self-Directed Services Program and would, instead,
establish the Self-Determination Program to be available in every
regional center catchment area to enable individuals with
developmental disabilities to exercise their rights to make choices
in their own lives and would make conforming changes .
This bill would require that program participants be provided with a
capitated individual funding allocation, as prescribed, to be used
for the purchase of services and supports necessary to implement the
participant's individual program plan. This bill would require
the department to establish a risk pool fund to meet the
unanticipated needs of participants in the program and would
continuously appropriate the moneys in the fund to the department for
this purpose. This bill would require the department to take
all steps necessary to ensure federal financial participation is
available for all program services and supports by applying for
amendments to a specified federal waiver or by applying for a new
waiver.
Vote: majority 2/3 . Appropriation:
no yes . Fiscal committee: yes.
State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 4677 of the Welfare
and Institutions Code is amended to read:
4677. (a) (1) All parental fees collected by or for regional
centers shall be remitted to the State Treasury to be deposited in
the Developmental Disabilities Program Development Fund, which is
hereby created and hereinafter called the Program Development Fund.
The purpose of the Program Development Fund shall be to provide
resources needed to initiate new programs, and to expand or convert
existing programs. Within the context of, and consistent with,
approved priorities for program development in the state plan,
program development funds shall promote integrated residential, work,
instructional, social, civic, volunteer, and recreational services
and supports that increase opportunities for self-determination and
maximum independence of persons with developmental disabilities.
Notwithstanding any other provision of law or regulation to the
contrary, commencing July 1, 2009, parental fees remitted to the
State Treasury shall be deposited in accordance with Section 4784.
(2) In no event shall an allocation from the Program Development
Fund be granted for more than 24 months.
(b) (1) The State Council on Developmental Disabilities shall, at
least once every five years, request from all regional centers
information on the types and amounts of services and supports needed,
but currently unavailable.
(2) The state council shall work collaboratively with the
department and the Association of Regional Center Agencies to develop
standardized forms and protocols that shall be used by all regional
centers and area boards in collecting and reporting this information.
In addition to identifying services and supports that are needed,
but currently unavailable, the forms and protocols shall also solicit
input and suggestions on alternative and innovative service delivery
models that would address consumer needs.
(3) In addition to the information provided pursuant to paragraph
(2), the state council may utilize information from other sources,
including, but not limited to, public hearings, quality assurance
assessments conducted pursuant to Section 4571, regional center
reports on alternative service delivery submitted to the department
pursuant to Section 4669.2, and the annual report on
self-directed services produced pursuant to Section 4685.7
Self-Determination Program services produced pursuant to Section
4689.94 .
(4) The department shall provide additional information, as
requested by the state council.
(5) Based on the information provided by the regional centers and
other agencies, the state council shall develop an assessment of the
need for new, expanded, or converted community services and support,
and make that assessment available to the public. The assessment
shall include a discussion of the type and amount of services and
supports necessary but currently unavailable including the impact on
consumers with common characteristics, including, but not limited to,
disability, specified geographic regions, age, and ethnicity, face
distinct challenges. The assessment shall highlight alternative and
innovative service delivery models identified through their
assessment process.
(6) This needs assessment shall be conducted at least once every
five years and updated annually. The assessment shall be included in
the state plan and shall be provided to the department and to the
appropriate committees of the Legislature. The assessment and annual
updates shall be made available to the public. The State Council on
Developmental Disabilities, in consultation with the department,
shall make a recommendation to the Department of Finance as to the
level of funding for program development to be included in the
Governor's Budget, based upon this needs assessment.
(c) Parental fee schedules shall be evaluated pursuant to Section
4784 and adjusted annually, as needed, by the department, with the
approval of the state council. The July 1, 2009, parental fee
adjustment shall be exempt from this approval requirement. Fees for
out-of-home care shall bear an equitable relationship to the cost of
the care and the ability of the family to pay.
(d) In addition to parental fees and General Fund appropriations,
the Program Development Fund may be augmented by federal funds
available to the state for program development purposes, when these
funds are allotted to the Program Development Fund in the state plan.
The Program Development Fund is hereby appropriated to the
department, and subject to any allocations that may be made in the
annual Budget Act. In no event shall any of these funds revert to the
General Fund.
(e) The department may allocate funds from the Program Development
Fund for any legal purpose, provided that requests for proposals and
allocations are approved by the state council in consultation with
the department, and are consistent with the priorities for program
development in the state plan. Allocations from the Program
Development Fund shall take into consideration the following factors:
(1) The future fiscal impact of the allocations on other state
supported services and supports for persons with developmental
disabilities.
(2) The information on priority services and supports needed, but
currently unavailable, submitted by the regional centers.
Consistent with the level of need as determined in the state plan,
excess parental fees may be used for purposes other than programs
specified in subdivision (a) only when specifically appropriated to
the State Department of Developmental Services for those purposes.
(f) Under no circumstances shall the deposit of federal moneys
into the Program Development Fund be construed as requiring the State
Department of Developmental Services to comply with a definition of
"developmental disabilities" and "services for persons with
developmental disabilities" other than as specified in subdivisions
(a) and (b) of Section 4512 for the purposes of determining
eligibility for developmental services or for allocating parental
fees and state general funds deposited in the Program Development
Fund.
SEC. 2. Section 4678 of the Welfare and
Institutions Code is amended to read:
4678. (a) The State Council on Developmental Disabilities, in
implementing subdivision (b) of Section 4677, and with the support of
the State Department of Developmental Services, shall convene a
stakeholder workgroup on alternative and expanded options for
nonresidential services and supports. The workgroup shall include
persons with developmental disabilities, family members, providers,
and other system stakeholders. The workgroup shall develop
recommendations on how to best achieve all of the following:
(1) The development and expansion of community-based models that
provide an array of nonresidential options, including, but not
limited to, participation in integrated instructive, social, civic,
volunteer, and recreational activities.
(2) The development and expansion of community-based work
activities, including, but not limited to, customized employment
development, integrated job training, and employer-provided job
coaching.
(3) The expansion of work opportunities in the public sector.
(4) The increased utilization of existing models, including, but
not limited to, self-directed services
Self-Determination Program services , vouchers, family teaching
models, existing habilitation, and supported work vendors to
facilitate access to nontraditional community-based nonresidential
activities.
(5) Strategies to promote and duplicate successful and innovative
models developed in California and in other states.
(6) The identification of, and strategies to address, statutory,
regulatory, licensing, vendor-related, funding and other types of
barriers to achieving the goals identified in this act, including
strategies to improve individualization of services and supports by
increased flexibility in design, staffing, and compensation.
(b) By May 1, 2007, the State Council on Developmental
Disabilities shall submit recommendations from the workgroup to the
Governor and appropriate committees of the Legislature and may,
thereafter, incorporate subsequent recommendations into its state
plan developed pursuant to Section 4561.
SEC. 3. Section 4685.7 of the Welfare
and Institutions Code is repealed.
4685.7. (a) Contingent upon approval of a federal waiver, the
Self-Directed Services Program (SDS Program) is hereby established
and shall be available in every regional center catchment area to
provide participants, within an individual budget, greater control
over needed services and supports. The Self-Directed Services Program
shall be consistent with the requirements set forth in this section.
In order to provide opportunities to participate in the program, the
department shall adopt regulations, consistent with federal law, to
implement the procedures set forth in this section.
(b) For purposes of this section, the following definitions shall
apply:
(1) "Financial management services" means a service or function
that assists the participant to manage and direct the distribution of
funds contained in the individual budget. This may include, but is
not limited to, bill paying services and activities that facilitate
the employment of service workers by the participant, including, but
not limited to, federal, state, and local tax withholding payments,
unemployment compensation fees, setting of wages and benefits, wage
settlements, fiscal accounting, and expenditure reports. The
department shall establish specific qualifications which shall be
required of a financial management services provider.
(2) "Supports brokerage" means a service or function that assists
participants in making informed decisions about the individual
budget, and assists in locating, accessing and coordinating services
consistent with and reflecting a participant's needs and preferences.
The service is available to assist in identifying immediate and
long-term needs, developing options to meet those needs,
participating in the person-centered planning process and development
of the individual program plan, and obtaining identified supports
and services.
(3) "Supports broker" means a person, selected and directed by the
participant, who fulfills the supports brokerage service or function
and assists the participant in the SDS Program. Specific
qualifications shall be established by the department and required of
a supports broker provider.
(4) "Waiver" means a waiver of federal law pursuant to Section
1396n of Title 42 of the United States Code.
(5) "Independence Plus Self-Directed (IPSD) Waiver Program" or
"Self-Directed Waiver Program" means a federal waiver to the state's
Medicaid plan to allow a person with developmental disabilities who
needs or requires long-term supports and services, and when
appropriate, the person's family, greater opportunity to control his
or her own health and well-being by utilization of self-directed
services.
(6) "Self-directed services" or "SDS" means a voluntary delivery
system consisting of a defined and comprehensive mix of services and
supports, selected and directed by a participant, in order to meet
all or some of the objectives in his or her individual program plan.
Self-directed services are designed to assist the participant to
achieve personally defined outcomes in inclusive community settings.
Self-directed services shall include, but are not limited to, all
of the following:
(A) Home health aide services.
(B) Supported employment and prevocational services.
(C) Respite services.
(D) Supports broker functions and services.
(E) Financial management services and functions.
(F) Environmental accessibility adaptations.
(G) Skilled nursing.
(H) Transportation.
(I) Specialized medical equipment and supplies.
(J) Personal emergency response system.
(K) Integrative therapies.
(L) Vehicle adaptations.
(M) Communication support.
(N) Crises intervention.
(O) Nutritional consultation.
(P) Behavior intervention services.
(Q) Specialized therapeutic services.
(R) Family assistance and support.
(S) Housing access supports.
(T) Community living supports, including, but not limited to,
socialization, personal skill development, community participation,
recreation, leisure, home and personal care.
(U) Advocacy services.
(V) Individual training and education.
(W) Participant-designated goods and services.
(X) Training and education transition services.
The department shall include all of the services and supports
listed in this paragraph in the IPSD Waiver Program application.
Notwithstanding this paragraph, only services and supports included
in an approved IPSD Waiver shall be funded through the SDS Program.
(7) "Advocacy services" means services and supports that
facilitate the participant in exercising his or her legal, civil and
service rights to gain access to generic services and benefits that
the participant is entitled to receive. Advocacy services shall only
be provided when other sources of similar assistance are not
available to the participant, and when advocacy is directed towards
obtaining generic services.
(8) "Individual budget" means the amount of funding available to
the participant for the purchase of services and supports necessary
to implement an individual program plan. The individual budget shall
be constructed using a fair, equitable, and transparent methodology.
(9) "Risk pool" means an account that is available for use in
addressing the unanticipated needs of participants in the SDS
Program.
(10) "Participant" means an individual, and when appropriate, his
or her parents, legal guardian or conservator, or authorized
representative, who have been deemed eligible for, and have
voluntarily agreed to participate in, the SDS Program.
(c) Participation in the SDS Program is fully voluntary. A
participant may choose to participate in, and may choose to leave,
the SDS Program at any time. A regional center may not require
participation in the SDS Program as a condition of eligibility for,
or the delivery of, services and supports otherwise available under
this Division.
(d) The department shall develop informational materials about the
SDS Program. The department shall ensure that regional centers are
trained in the principles of SDS, the mechanics of the SDS Program
and the rights of consumers and families as candidates for, and
participants, in the SDS Program. Regional centers shall conduct
local meetings or forums to provide regional center consumers and
families with information about the SDS Program. All consumers and
families who express an interest in participating in the SDS program
shall receive an in-depth orientation, conducted by the regional
center, prior to enrollment in the program.
(e) Prior to enrollment in the SDS Program, and based on the
methodologies described below, an individual, and when appropriate,
his or her parents, legal guardian or conservator, or authorized
representative, shall be provided in writing two individual budget
amounts. If the individual, and when appropriate his parents, legal
guardian or conservator, or authorized representative, elects to
become a participant in the SDS Program, he or she shall choose which
of the two budget amounts provided will be used to implement their
individual program plan.
(1) The methodologies and formulae for determining the two
individual budget amounts shall be detailed in departmental
regulations, as follows:
(A) One individual budget amount shall equal 90 percent of the
annual purchase of services costs for the individual. The annual
costs shall reflect the average annual costs for the previous two
fiscal years for the individual.
(B) One individual budget amount shall equal 90 percent of the
annual per capita purchase of service costs for the previous two
fiscal years for consumers with similar characteristics, who do not
receive services through the SDS Program, based on factors including,
but not limited to, age, type of residence, type of disability and
ability, functional skills, and whether the individual is in
transition. This budget methodology shall be constructed using data
available on the State Department of Developmental Services
information system.
(2) Once a participant has selected an individual budget amount,
that individual budget amount shall be available to the participant
each year for the purchase of self-directed services until a new
individual budget amount has been determined. An individual budget
amount shall be calculated no more than once in a 12-month period.
(3) As determined by the participant, the individual budget shall
be distributed among the following budget categories in order to
implement the IPP:
(A) Community Living.
(B) Health and Clinical Services.
(C) Employment.
(D) Training and Education.
(E) Environment and Medical Supports.
(F) Transportation.
(4) Annually, participants may transfer up to 10 percent of the
funds originally distributed to any budget category set forth in
paragraph (3), to another budget category or categories. Transfers in
excess of 10 percent of the original amount allocated to any budget
category may be made upon the approval of the regional center.
Regional centers may only deny a transfer if necessary to protect the
health and safety of the participant.
(5) The regional center shall annually ascertain from the
participant whether there are any circumstances that require a change
to the annual individual budget amount. The department shall detail
in regulations the process by which this annual review shall be
achieved.
(6) A regional center's calculation of an individual budget amount
may be appealed to the executive director of the regional center, or
his or her designee, within 30 days after receipt of the budget
amount. The executive director shall issue a written decision within
10 working days. The decision of the executive director may be
appealed to the Director of Developmental Services, or his or her
designee, within 15 days of receipt of the written decision. The
decision of the department is final.
(f) The department shall establish a risk pool fund to meet the
unanticipated needs of participants in the SDS Program. The fund
shall be administered by the department. Notwithstanding Section
13340 of the Government Code, all moneys in the fund shall be
continuously appropriated to the department, without regard to fiscal
years, for the purpose of funding services and supports pursuant to
this subdivision.
(1) The risk pool shall be funded at the equivalent of 5 percent
of the historic annual purchase of service costs for consumers
participating in the SDS Program.
(2) The risk pool shall be allocated by the department to regional
centers through a process specified by the department.
(3) The risk pool may be used only in the event of substantial
change in a participant's service and support needs that were not
known at the time the individual budget was set, including an urgent
need to relocate a residence, and catastrophic injury or illness.
(4) The risk pool may be accessed by a participant more than once
in a lifetime.
(g) In the first year of the SDS Program, the department shall
provide for establishment of savings to the General Fund equivalent
to 5 percent of the historic annual purchase of service costs for SDS
program participants. In subsequent fiscal years, the department
shall annually provide for establishment of savings to the General
Fund equivalent to 5 percent of the annual purchase of services costs
for SDS Program participants, averaged over the prior two fiscal
years.
(h) A regional center may advance funds to a financial management
services entity pursuant to SDS Program regulations to facilitate
development of a participant's individual budget and transition into
the SDS Program.
(i) Participation in the SDS Program shall be available to any
regional center consumer who meets the following eligibility
requirements.
(1) The participant is three years of age or older.
(2) The participant has a developmental disability, as defined in
Section 4512.
(3) The participant does not live in a licensed long-term health
care facility, as defined in paragraph (44) of subdivision (a) of
Section 54302 of Title 17 of the California Code of Regulations, or a
residential facility, as defined in paragraph (55) of subdivision
(a) of Section 54302 of Title 17 of the California Code of
Regulations, or receive day program or habilitation services, as
defined in paragraph (16) or (34) of subdivision (a) of Section 54302
of Title 17 of the California Code of Regulations, respectively. An
individual, and when appropriate, his or her parent, legal guardian
or conservator, or authorized representative, who is not eligible to
participate in the SDS Program pursuant to this paragraph, may
request that the regional center provide person-centered planning
services in order to make arrangements for transition to the SDS
Program. In that case, the regional center shall initiate
person-centered planning services within 60 days of a request.
(4) The participant agrees to all of the following terms and
conditions:
(A) The participant shall undergo an in-depth orientation to the
SDS Program prior to enrollment.
(B) The participant shall agree to utilize the services and
supports available within the SDS Program only when generic services
cannot be accessed, and except for Medi-Cal state plan benefits when
applicable.
(C) The participant shall consent to use only services necessary
to implement his or her individual program plan as described in the
IPSD Waiver Program, and as defined in paragraph (6) of subdivision
(b), as an available service in the SDS Program, and shall agree to
comply with any and all other terms and conditions for participation
in the SDS Program described in this section.
(D) The participant shall manage self-directed services within the
individual budget amount, chosen pursuant to subdivision (e).
(E) The participant shall utilize the services of a financial
management services entity of his or her own choosing. A financial
management services provider may either be hired or designated by the
participant. A designated financial management services provider
shall perform services on a nonpaid basis. An individual or a parent
of an individual in the SDS Program shall provide financial
management services only as a designated provider and only if the
capacity to fulfill the roles and responsibilities as described in
the financial management services provider qualifications can be
demonstrated to the regional center.
(F) The participant shall utilize the services of a supports
broker of his or her own choosing for the purpose of providing
services and functions as described in paragraphs (2) and (3) of
subdivision (b). A supports broker may either be hired or designated
by the participant. A designated supports broker shall perform
support brokerage services on a nonpaid basis. An individual or a
parent of an individual in the SDS Program shall provide supports
brokerage services or his or her designated representative shall
provide the services only as a designated provider and only if the
capacity to fulfill the role and responsibilities as described in the
supports broker provider qualifications can be demonstrated to the
financial management services entity.
(j) A participant who is not Medi-Cal eligible may participate in
the SDS Program without IPSD Waiver Program enrollment and receive
self-directed services if all other IPSD Waiver Program eligibility
requirements are met.
(k) The planning team, established pursuant to subdivision (j) of
Section 4512, shall utilize the person-centered planning process to
develop the Individual Program Plan (IPP) for an SDS participant. The
IPP shall detail the goals and objectives of the participant that
are to be met through the purchase of participant selected services
and supports.
(l) The participant shall implement his or her IPP, including
choosing the services and supports allowable under this section
necessary to implement the plan. A regional center may not prohibit
the purchase of any service
or support that is otherwise allowable under this section.
(m) An adult may designate an authorized representative to effect
the implementation. The representative shall meet all of the
following requirements:
(1) He or she shall demonstrate knowledge and understanding of the
participant's needs and preferences.
(2) He or she shall be willing and able to comply with SDS Program
requirements.
(3) He or she shall be at least 18 years of age.
(4) He or she shall be approved by the participant to act in the
capacity of a representative.
(n) The participant, or his or her authorized representative and
the regional center case manager shall receive a monthly budget
statement that describes the amount of funds allocated by budget
category, the amount spent in the previous 30-day period, and the
amount of funding that remains available under the participant's
individual budget.
(o) If at any time during participation in the SDS Program a
regional center determines that an individual is no longer eligible
to continue based on the criteria described in subdivision (i), or a
participant voluntarily chooses to exit the SDS Program, the regional
center shall provide for the participant's transition from the SDS
Program to other services and supports. This shall include the
development of a new individual program plan that reflects the
services and supports necessary to meet the individual's needs. The
regional center shall ensure that there is no gap in services and
supports during the transition period.
(1) Upon determination of ineligibility pursuant to this
subdivision, the regional center shall inform the participant in
writing of his or her ineligibility, the reason for the determination
of ineligibility and shall provide a written notice of the fair
hearing rights, as required by Section 4701.
(2) An individual determined ineligible, or who voluntarily exits
the SDS Program, shall be permitted to return to the SDS Program upon
meeting all applicable eligibility criteria and after a minimum of
12 months time has elapsed.
(p) A participant in the SDS Program shall have all the rights
established in Chapter 7 (commencing with Section 4700), except as
provided under paragraph (6) of subdivision (e).
(q) Only a financial management services provider is required to
apply for vendorization in accordance with Subchapter 2 (commencing
with Section 54300) of Chapter 3 of Title 17 of the California Code
of Regulations, for the SDS Program. All other service providers
shall have applicable state licenses, certifications, or other state
required documentation, but are exempt from the vendorization
requirements set forth in Title 17 of the California Code of
Regulations. The financial management services entity shall ensure
and document that all service providers meet specified requirements
for any service that may be delivered to the participant.
(r) A participant in the SDS Program may request, at no charge to
the participant or the regional center, criminal history background
checks for persons seeking employment as a service provider and
providing direct care services to the participant.
(1) Criminal history records checks pursuant to this subdivision
shall be performed and administered as described in subdivision (b)
and subdivisions (d) to (h), inclusive, of Section 4689.2, and
Sections 4689.4 to 4689.6, inclusive, and shall apply to
vendorization of providers and hiring of employees to provide
services for family home agencies and family homes.
(2) The department may enter into a written agreement with the
Department of Justice to implement this subdivision.
(s) A participant enrolled in the SDS Program pursuant to this
section and utilizing an individual budget for services and supports
is exempt from Section 4783 and from the Family Cost Participation
Program.
(t) Notwithstanding any provision of law, an individual receiving
services and supports under the self-determination projects
established pursuant to Section 4685.5 may elect to continue to
receive self-determination services within his or her current scope
and existing procedures and parameters. Participation in a
self-determination project pursuant to Section 4685.5 may only be
terminated upon a participant's voluntary election and qualification
to receive services under another delivery system.
(u) Each regional center shall be responsible for implementing an
SDS Program as a term of its contract under Section 4629.
(v) Commencing January 10, 2008, the department shall annually
provide the following information to the policy and fiscal committees
of the Legislature:
(1) Number and characteristics of participants, by regional
center.
(2) Types and ranking of services and supports purchased under the
SDS Program, by regional center.
(3) Range and average of individual budgets, by regional center.
(4) Utilization of the risk pool, including range and average
individual budget augmentations and type of service, by regional
centers.
(5) Information regarding consumer satisfaction under the SDS
Program and, when data is available, the traditional service delivery
system, by regional center.
(6) The proportion of participants who report that their choices
and decisions are respected and supported.
(7) The proportion of participants who report they are able to
recruit and hire qualified service providers.
(8) The number and outcome of individual budget appeals, by
regional center.
(9) The number and outcome of fair hearing appeals, by regional
center.
(10) The number of participants who voluntarily withdraw from
participation in the SDS Program and a summary of the reasons why, by
regional center.
(11) The number of participants who are subsequently determined to
no longer be eligible for the SDS Program and a summary of the
reasons why, by regional center.
(12) Identification of barriers to participation and
recommendations for program improvements.
(13) A comparison of average annual expenditures for individuals
with similar characteristics not participating in the SDS Program.
SEC. 4. Article 4.5 (commencing with Section
4689.90) is added to Chapter 6 of Division 4.5 of the
Welfare and Institutions Code , to read:
Article 4.5. Self-Determination Program
4689.90. For the purposes of this section, the following
definitions shall apply:
(a) "Advocacy services" means services and supports that
facilitate the participant in exercising his or her legal, civil, and
service rights to gain access to generic services and benefits that
the participant is entitled to receive. Advocacy services shall be
provided only when other sources of similar assistance are not
available to the participant, and when advocacy is directed towards
obtaining generic services.
(b) "Financial management service" means a conflict of interest
free service or function that assists the participant to manage and
direct the distribution of funds contained in the individual
allocation. This may include, but is not limited to, bill paying
services and activities that facilitate the employment of service
workers by the participant, including, but not limited to, federal,
state, and local tax withholding payments, unemployment compensation
fees, establishing benefits, fiscal accounting, and expenditure
reports. The financial management service shall provide to the
department workforce and expenditure information as required in this
article. The department shall establish specific qualifications which
shall be required of a financial management services provider and
contract with one entity to provide financial management services
statewide.
(c) "Individual allocation" means the amount of funding available
to the participant for the purchase of services and supports
necessary to implement an individual program plan (IPP). The
individual allocation shall be constructed using a fair, equitable,
and transparent methodology that includes, but is not limited to,
consumer characteristics and needs.
(d) "Individual budget" means an individually created and designed
expenditure plan, developed by the participant, for purchases to be
made within the individual allocation to achieve the core quality
outcomes relevant to the participant and meet the participant's IPP
goals.
(e) "Participant" means an individual, and when appropriate, his
or her parents, legal guardian or conservator, or authorized
representative, who has been deemed eligible for, and have
voluntarily agreed to participate in, the Self-Determination Program.
(f) "Public Employment Relations Board" or "board" means the board
established pursuant to Article 2 (commencing with Section 3541) of
Chapter 10.7 of Division 4 of Title 1 of the Government Code.
(g) "Risk pool" means an account that is available for use in
addressing the unanticipated needs of participants in the
Self-Determination Program.
(h) "Self-Determination Program" or "SD Program" means a voluntary
delivery system consisting of a defined and comprehensive mix of
services and supports, selected and directed by a participant, in
order to meet all or some of the objectives in his or her IPP.
Self-determination services and supports are designed to assist the
participant to achieve personally defined outcomes in inclusive
community settings. Self-determination services and supports shall
include, but are not limited to, all of the following:
(1) Home health aide services.
(2) Employment and self-employment supports including individual
placement supported employment.
(3) Respite services.
(4) Supports broker functions and services.
(5) Financial management services and functions.
(6) Environmental accessibility adaptations.
(7) Skilled nursing.
(8) Transportation.
(9) Specialized medical equipment and supplies.
(10) Personal emergency response system.
(11) Integrative therapies.
(12) Vehicle adaptations.
(13) Communication support including interpretive or translation
services.
(14) Crises intervention.
(15) Nutritional consultation.
(16) Behavior intervention services.
(17) Specialized therapeutic services.
(18) Family assistance and support.
(19) Housing access supports.
(20) Community living supports, including, but not limited to,
socialization, personal skill development, community participation,
recreation, and leisure.
(21) In-home and personal care supports.
(22) Advocacy services.
(23) Individual training and education, including, but not limited
to, adult education and support to attend community college.
(24) Participant-designated goods and services.
(25) Training and education transition services.
(i) "Self-Determination support worker" or "SD support worker"
means a person who has been selected and employed by a participant
for an average of at least 25 hours per month over a two-month period
to provide the relevant SD services and supports described in
subdivision (h), but does not include licensed professionals and
workers providing services purchased from agencies or other
organizations where the worker is solely under the employ of those
organizations.
(j) "Supports broker" means a person, selected and directed by the
participant, who fulfills the supports brokerage service or function
and assists the participant in the SD Program.
(k) "Supports brokerage" means a conflict of interest free service
or function that assists participants in making informed decisions
about how to develop their budget from the individual allocation,
assists in locating, accessing, and coordinating services consistent
with and reflecting a participant's needs and preferences and
negotiating with providers. A supports brokerage service is available
to assist in identifying immediate and long-term needs, developing
options to meet those needs, participating in the person-centered
planning process and development of the IPP, and obtaining identified
services and supports.
4689.91. (a) (1) The Self-Determination Program is hereby
established and shall be available in every regional center catchment
area to enable individuals with developmental disabilities to
exercise their rights to make choices in their own lives and access
services and supports as described in subdivision (j) of Section
4502. The program shall give participants greater control over access
to, and the flexibility to access, a wide range of needed and
desired services and supports, including, but not limited to, hiring
their own workers and purchasing needed items. The SD Program shall
be consistent with the requirements set forth in this section.
(2) SD Program participants shall be provided with a capitated
individual funding allocation computed in a fair, transparent, and
equitable manner, based on consumer characteristics and needs. The
allocation shall be used for the purchase of services and supports
necessary to implement the participant's individual program plan
(IPP).
(b) The SD Program shall be designed to promote, and shall be
evaluated against, core quality outcomes for the participants,
including, but not limited to, all of the following:
(1) Participants' welfare, health, and safety.
(2) Participants living in a place called home, including living
with family, friends, or on one's own; adult participants' living
arrangements are under their own control.
(3) Participants having meaningful participation and membership in
their own community.
(4) Participants maintaining reciprocal long-term relationships,
including relationships that assist the participant to live a
healthy, included life.
(5) Participants of working age generating private income, through
typical jobs in regular employment settings or through
self-employment.
(6) Participants having access to or control over transportation.
(c) Participation in the SD Program is fully voluntary. A
participant may choose to participate in, and may choose to leave,
the SD Program at any time. A regional center may not require
participation in the SD Program as a condition of eligibility for, or
the delivery of, services and supports otherwise available under
this division. Participation in the SD Program shall be available to
any regional center consumer who meets the following eligibility
requirements:
(1) The participant is three years of age or older.
(2) The participant, and when appropriate his or her parents,
legal guardian or conservator, or authorized representative, agrees
to all of the following terms and conditions:
(A) The participant shall agree to utilize the services and
supports available within the SD Program only when generic services
cannot be accessed, and except for Medi-Cal state plan benefits when
applicable.
(B) The participant shall consent to use only services necessary
to implement his or her IPP, as an available service in the SD
Program, and shall agree to comply with any and all other terms and
conditions for participation in the SD Program described in this
section.
(C) The participant shall manage SD Program services within the
individual allocation amount.
(D) The participant shall utilize the services of the conflict of
interest free financial management services entity.
(E) The participant shall utilize the services of supports broker
of his or her own choosing for the purpose of providing services and
functions as described in subdivisions (j) and (k) of Section
4689.90. A supports broker may either be hired or designated by the
participant. A designated supports broker shall perform support
brokerage services on a nonpaid basis. An individual or a parent of
an individual in the SD Program shall provide supports brokerage
services only as an unpaid designated provider.
(3) A participant who is not Medi-Cal eligible may participate in
the SD Program and receive SD Program services if all other program
eligibility requirements are met.
(d) An adult may designate an authorized representative to
participate in the program on his or her behalf. The representative
shall meet all of the following requirements:
(1) He or she shall demonstrate knowledge and understanding of the
participant's needs and preferences.
(2) He or she shall be willing and able to comply with SD Program
requirements.
(3) He or she shall be at least 18 years of age.
(4) He or she shall be approved by the participant to act in the
capacity of a representative.
(e) Notwithstanding any provision of law, an individual receiving
services and supports under the self-determination pilot projects
originally established pursuant to Section 13 of Chapter 80 of the
Statutes of 1998, as amended, may elect to continue to receive
self-determination services within his or her current scope and
existing procedures and parameters. Participation in
self-determination projects originally authorized pursuant to Section
13 of Chapter 80 of the Statutes of 1998, as amended, may only be
terminated upon a participant's voluntary election and qualification
to receive services under another delivery system.
(f) The SD Program shall be phased in during the first year in the
five regional centers with self-determination pilot projects that
were originally authorized by Section 13 of Chapter 80 of the
Statutes of 1998, as amended. In the second year, each regional
center shall be responsible for implementing an SD Program as a term
of its contract under Section 4629.
4689.92. (a) The department shall develop informational materials
about the SD Program. The department shall ensure that regional
centers are trained in the principles of the SD Program, the
mechanics of the SD Program, and the rights of consumers and families
as candidates for, and participants in, the SD Program. Regional
centers shall conduct local meetings or forums to provide regional
center consumers and families with information about the SD Program.
Regional centers shall make available to consumers and families who
express an interest in participating in the SD program a timely
in-depth orientation; however, enrollment in the SD program shall not
be delayed or conditioned on the orientation.
(b) Prior to enrollment in the SD Program, and based on the
methodology described in this subdivision, an individual, and when
appropriate, his or her parents, legal guardian or conservator, or
authorized representative, shall be provided in writing with the
individual allocation amount that would be provided for developing
his or her individual budget to implement his or her IPP. The
individual, and when appropriate his parents, legal guardian or
conservator, or authorized representative, may then elect to
participate in the SD Program.
(1) The methodology and formulae for determining the individual
allocation amount shall be computed in a fair, transparent, and
equitable manner, that includes, but is not be limited to, consumer
characteristics and needs. The department shall meet with the
Self-Determination Program Advisory Committee, established pursuant
to Section 4689.94, to receive their input on developing the
methodology.
(2) The individual allocation amount shall equal 90 percent of the
annual per capita purchase of service costs for the previous fiscal
year for consumers with similar characteristics, who do not receive
services through the SD Program. The allocation methodology shall be
constructed using data available on the State Department of
Developmental Services' information system, including, but not
limited to, age, type of residence, type of disability and ability,
functional skills, support needs, and whether the individual is in
transition. Until the first full year of historical data is
available, the department shall adjust the allocation to estimate the
impact of service reductions resulting from the Budget Act of 2011.
(3) The allocation methodology shall provide for additional
necessary resources when a participant is transitioning from a family
home or a congregate setting to living independently.
(4) Once an individual, and when appropriate his or her parents,
legal guardian or conservator, or authorized representative, has
elected to become an SD Program participant, his or her individual
allocation amount shall be available to the participant each year for
the purchase of SD Program services until a new individual
allocation amount has been determined. An individual allocation
amount shall be calculated no more than once in a 12-month period.
(5) A regional center's calculation of an individual allocation
amount may be appealed to the executive director of the regional
center, or his or her designee, within 30 days after receipt of the
allocation amount. The executive director of the regional center
shall issue a written decision within 10 working days. The decision
of the executive director may be appealed to the Director of
Developmental Services, or his or her designee, within 15 days of
receipt of the written decision. The decision of the department is
final.
(c) Once an individual, and when appropriate his parents, legal
guardian or conservator, or authorized representative, has elected to
become an SD Program participant and his or her individual
allocation amount has been determined, the following shall occur:
(1) A regional center shall advance funds to the financial
management services entity to support a participant's hiring of a
supports broker.
(2) The participant, and when appropriate his parents, legal
guardian or conservator, or authorized representative, with the
assistance of the service broker and other members of his or her
circle of support if appropriate, shall develop a person-centered
plan and individual budget within the amount of the individual
allocation. The plan and budget shall be designed to assist the
participant to achieve the relevant core quality outcomes specified
in subdivision (b) of Section 4689.91.
(3) The individual budget shall distribute the allocation,
including expenditures for services and supports, among the following
categories based on the core quality outcomes specified in
subdivision (b) of Section 4689.91:
(A) Welfare, health, and safety.
(B) Supports for living in a place called home.
(C) Meaningful participation and membership in the community
including, but not limited to, socialization, recreational, and
educational opportunities.
(D) Developing and maintaining long-term relationships.
(E) Generating income, supports for employment or self-employment.
(F) Transportation.
(4) A participant may not use any portion of his or her individual
allocation to purchase services from a licensed long-term health
care facility, as defined in paragraph (44) of subdivision (a) of
Section 54302 of Title 17 of the California Code of Regulations, or a
residential facility, as defined in paragraph (55) of subdivision
(a) of Section 54302 of Title 17 of the California Code of
Regulations. A participant may not use his or her individual
allocation to purchase complete day program or habilitation services,
as defined in paragraph (16) or (34) of subdivision (a) of Section
54302 of Title 17 of the California Code of Regulations,
respectively. However, a participant may use a portion of his or her
individual allocation to negotiate for specific periodic or one-time
services from a day
program or habilitation services provider. A participant may also use
a portion of his or her allocation to purchase job development and
job coaching services for individual placement supported employment.
(5) Consumers currently living in a licensed long-term health care
facility, as defined in paragraph (44) of subdivision (a) of Section
54302 of Title 17 of the California Code of Regulations, or a
residential facility, as defined in paragraph (55) of subdivision (a)
of Section 54302 of Title 17 of the California Code of Regulations,
or receiving day program or habilitation services, as defined in
paragraph (16) or (34) of subdivision (a) of Section 54302 of Title
17 of the California Code of Regulations, respectively, may request
that the regional center provide person-centered planning services in
order to make arrangements for transition to the SD Program. In that
case, the regional center shall initiate person-centered planning
services within 30 days of a request pursuant to paragraphs (1) and
(2).
(6) The planning team, established pursuant to subdivision (j) of
Section 4512, shall review and utilize the person-centered plan
developed in paragraph (2) to develop the IPP for the participant.
The IPP shall detail the goals and objectives of the participant that
are to be met through the purchase of participant selected services
and supports. The planning team shall also review the individual
budget to ensure the budget assists the participant to achieve the
core quality outcomes, assures his or her health and safety, and
implements his or her IPP goals. The completed budget shall be
attached to the IPP.
(7) The participant shall implement his or her IPP, including
choosing the services and supports allowable under this section
necessary to implement the plan. A regional center may not prohibit
the purchase of any service or support that is otherwise allowable
under this section.
(8) Annually, participants may transfer up to 20 percent of the
funds originally distributed to any budget category set forth in
paragraph (3), to another budget category or categories. Transfers in
excess of 20 percent of the original amount allocated to any budget
category may be made upon the approval of the regional center.
Regional centers may only deny a transfer if necessary to protect the
health and safety of the participant.
(9) Consistent with the implementation date of the IPP, the
regional center shall annually ascertain from the participant whether
there are any circumstances that require a change to the annual
individual allocation amount as calculated pursuant to subdivision
(b). Based on that review, the regional center shall calculate a new
budget amount based on the methodology described in subdivision (b).
The participant may choose the new budget amount, or continue using
the current amount. The IPP shall be amended to reflect any changes
in the allocation.
(d) The department shall establish a risk pool fund to meet the
unanticipated needs of participants in the SD Program. The fund are
hereby administered by the department. Notwithstanding Section 13340
of the Government Code, all moneys in the fund are hereby
continuously appropriated to the department, without regard to fiscal
year, for the purpose of funding services and supports pursuant to
this subdivision.
(1) The risk pool shall be funded at the equivalent of 2.5 percent
of the historical annual purchase of service costs for consumers
participating in the SD Program, as determined for consumers of
similar characteristics pursuant to paragraph (2) of subdivision (b).
(2) The risk pool shall be allocated by the department to regional
centers through a process specified by the department.
(3) The risk pool may be used only in the event of substantial
change in a participant's service and support needs that were not
known at the time the individual allocation was set including, but
not limited to, an urgent need to relocate a residence or to prevent
or respond to significant injury or illness.
(4) The risk pool may be accessed by a participant more than once
in a lifetime.
(e) The department shall allocate 2.5 percent of the historical
annual purchase of service costs for consumers participating in the
SD Program, as determined for consumers of similar characteristics
pursuant to paragraph (2) of subdivision (b), towards offsetting
costs to the state of the SD Program, including, but not limited to,
training, caseload ratio improvement, and service broker support for
participants' initial person centered planning and budget plan
development.
(f) The regional center service coordinator shall assist consumers
and when appropriate his or her parents, legal guardian or
conservator, or authorized representative, in understanding the SD
Program service option, assist participants to understand their
rights, responsibilities and opportunities under the SD Program, and
provide information on locating service brokers. The regional center
service coordinator shall, as required by this section, determine the
SD Program participant's individual allocation amount, participate
in the IPP, approve the initial individual budget and amendments to
the budget, ensure plans and services are adequate to ensure the
participants health, welfare, and safety, address the goals of the
IPP and the core quality outcomes specified in subdivision (b) of
Section 4689.91, monitor for abuse, fraud, and exploitation, monitor
the quarterly budget report for rate of expenditure and consistency
with the budget plan, annually ascertain from the participant whether
there are any circumstances that require a change to the annual
individual allocation amount, conduct quarterly visits as required by
the department, and assist the participant to access the risk pool
in the event of a substantial change in a participant's service and
support needs that were not known at the time the individual
allocation was set. Regional centers, therefore, shall provide an
average service coordinator-to-consumer ratio of 1 to 62 for all SD
Program participants. To the maximum extent possible, regional
centers shall assign SD Program participants to service coordinators
with a designated SD Program caseload.
(g) The department shall annually provide for savings to the
General Fund equivalent to 5 percent of the annual purchase of
services costs for SD Program participants, as determined for
consumers of similar characteristics pursuant to paragraph (2) of
subdivision (b).
(h) The financial management service shall send to the participant
and the regional center case manager a quarterly statement that
describes the amount of allocation by budget category, the amount
spent in the previous 90-day period, and the amount of funding that
remains available under the participant's individual budget.
(i) If at any time during participation in the SD Program a
regional center determines that an individual is no longer eligible
to continue based on the eligibility criteria described in
subdivision (c) of Section 4689.91, or a participant voluntarily
chooses to exit the SD Program, the regional center shall provide for
the participant's transition from the SD Program to other services
and supports. This shall include the development of a new individual
program plan that reflects the services and supports necessary to
meet the individual's needs. The regional center shall ensure that
there is no gap in services and supports during the transition
period.
(1) Upon determination of ineligibility pursuant to this
subdivision, the regional center shall inform the participant in
writing of his or her ineligibility, the reason for the determination
of ineligibility and shall provide a written notice of the fair
hearing rights, as required by Section 4701.
(2) An individual determined to be ineligible, or who voluntarily
exits the SD Program, shall be permitted to return to the SD Program
upon meeting all applicable eligibility criteria and after a minimum
of 12 months time has elapsed.
(j) A participant in the SD Program shall have all the rights
established in Chapter 7 (commencing with Section 4700), except as
provided under paragraph (5) of subdivision (b).
(k) Only the financial management service provider is required to
apply for vendorization in accordance with subchapter 2 (commencing
with Section 54300) of Chapter 3 of Title 17 of the California Code
of Regulations, for the SD Program. All other service providers shall
have applicable state licenses, certifications, or other state
required documentation, but are exempt from the vendorization
requirements set forth in Title 17 of the California Code of
Regulations. The financial management services entity shall ensure
and document that all service providers meet specified requirements
for any service that may be delivered to the participant.
(l) A participant enrolled in the SD Program pursuant to this
section and utilizing an individual allocation for services and
supports is exempt from Section 4783, the Family Cost Participation
Program, and cost control restrictions, including, but not limited to
purchases of services pursuant to Sections 4648.35, 4648.5, and
4659, subparagraph (B) of paragraph (3) of subdivision (c) of Section
4685, Sections 4686.2, 4686.5, and 4689, and purchase of service
best practices enacted pursuant to 4620.3.
4689.93. (a) The Legislature finds and declares that SD Program
support workers are the foundation necessary for SD Program
participants to access full community participation and employment
opportunities and to pursue a life of meaning in the ways that they
choose.
(b) Participants shall have the right to utilize their individual
allocation to employ SD support workers of their choice, hire,
supervise, direct, schedule, evaluate, train, and terminate
employment of SD support workers. Except for the limited purposes set
forth herein, the state shall not be deemed the employer of SD
support workers for any purpose.
(c) The state shall support the quality, availability, and
stability of direct support workers by establishing a base
compensation package to ensure decent pay standards for workers in
the program. Individuals may use their allocation and private sources
of funds to pay SD support workers above the base established by the
state, develop job descriptions, and otherwise organize and
incentivize their SD support workers.
(d) SD support workers may form, join, and participate in the
activities of labor organizations of their own choosing in order to
engage in collective negotiations with the department with regard to
all matters specified in paragraph (4).
(1) Within 10 days of receipt of a request from a labor
organization that represents SD support workers, the department shall
provide the following information concerning SD support workers:
(A) Name, address, telephone number, and any unique personal
identification generated by the department.
(B) Wage rates earned by each SD support worker.
(C) Hours of services provided by each SD support worker. The
department shall be required to collect the information on no less
than a quarterly basis from any financial management services
providers that process payments for SD support workers.
(2) A labor organization that represents SD support workers may
petition the Board to be designated as the exclusive negotiating
representative of SD support workers in the state.
(A) The only appropriate bargaining unit of SD support workers
shall consist of all SD support workers in the state.
(B) If a labor organization that represents SD support workers
petitions the Board to be designated as the negotiating
representative for SD support workers and provides written
authorization from a majority of the total number of workers in the
unit as of January of the year in which the petition is made, the
Board shall designate that organization as the exclusive negotiating
representative for all SD support workers in the unit.
(C) If a labor organization that represents SD support workers
petitions to be designated as the negotiating representative for all
SD support workers in the unit and provides written authorization to
serve as the negotiating representative from at least 30 percent of
the workers in the unit, an election shall be held pursuant to Board
policies and procedures within 90 days after the day on which the
petition is filed. The Board shall designate the labor organization
that prevails in the election the exclusive negotiating
representative for all SD support workers in the unit.
(3) The designated exclusive negotiating representative pursuant
to paragraph (2) shall be the negotiating representative for all SD
support workers in the unit for the purposes of this subdivision.
(A) An SD support worker may refuse to join or participate in the
activities of the designated negotiating representative.
(B) The designated negotiating representative shall represent all
SD support workers in the bargaining unit fairly and without
discrimination and without regard to whether the workers are members
of the labor organization designated as the negotiating
representative.
(C) The designated negotiating representative may charge a
reasonable fair share service fee to bargaining unit nonmembers, who
meet the minimum hour criteria described in subdivision (i) of
Section 4689.9, for representing them in negotiations, contract
administration, and other activities. The costs covered by the fair
share service fee pursuant to this section may include, but are not
limited to, costs associated with representing SD support workers
pursuant to paragraph (4).The fair share service fee shall not exceed
the annual dues paid by members of the labor organization designated
as the negotiating representative of SD support workers.
(4) The designated negotiating representative of SD support
workers shall negotiate with the department concerning the terms and
conditions of workers' participation in the SD Program including all
of the following:
(A) The base compensation package mandated by this article.
(B) Access to benefits for SD support workers.
(C) Payment procedures.
(D) Training and career development opportunities.
(E) Deduction of membership dues and fair share service fees.
(5) The designated negotiating representative of SD support
workers shall not negotiate over terms and conditions of employment
reserved for the participant pursuant to subdivisions (b) and (c).
(6) The designated negotiating representative of SD support
workers shall not call or direct a strike or any other form of work
stoppage.
(7) The Board's jurisdiction shall include all matters related to
the representation of SD support workers.
(e) A participant in the SD Program may request, at no charge to
the participant or the regional center, criminal history background
checks for persons seeking employment as a service provider and
providing direct care services to the participant.
(1) Criminal history records checks pursuant to this subdivision
shall be performed and administered as described in subdivision (b)
and subdivisions (d) to (h), inclusive, of Section 4689.2, and
Sections 4689.4 to 4689.6, inclusive, and shall apply to
vendorization of providers and hiring of employees to provide
services for family home agencies and family homes.
(2) The department may enter into a written agreement with the
Department of Justice to implement this subdivision.
4689.94. (a) The department shall establish a statewide
Self-Determination Program Advisory Committee. Greater than 50
percent of the committee shall be comprised of SD Program
participants and their family members representing the geographic,
ethnic, and language diversity of the state. Other committee members
shall include representatives from the State Council on Developmental
Disabilities, Disability Rights California, a University Center for
Excellence in Developmental Disabilities, regional centers, and a
labor representative of regional center employees. The committee
shall meet at least semiannually and participate in system oversight
and advise with respect to ongoing system design and implementation
and SD support worker wages, benefits, training, and career
development. In addition, the committee shall meet with the
department at least twice during the initial development phase of the
SD Program to provide input on the methodology for calculating
individual allocations and other initial implementation issues.
(b) Notwithstanding Section 10231.5 of the Government Code,
commencing January 10, 2013, the department shall annually provide
the following information to the SD Program Advisory Committee and to
the policy and fiscal committees of the Legislature:
(1) The number and characteristics of participants, by regional
center.
(2) The range and average of individual allocations, by regional
center.
(3) Utilization of the risk pool, including range and average
individual allocation augmentations and type of service, by regional
center.
(4) The proportion of participants who report that their choices
and decisions are respected and supported.
(5) Detailed workforce metrics for SD support workers including
wages, hours worked, and length of time on the job.
(6) The number and outcome of individual allocation appeals, by
regional center.
(7) The number and outcome of fair hearing appeals, by regional
center.
(8) The number of participants who voluntarily withdraw from
participation in the SD Program and a summary of the reasons why, by
regional center.
(9) The number of participants who are subsequently determined to
no longer be eligible for the SD Program and a summary of the reasons
why, by regional center.
(10) Identification of barriers to participation and
recommendations for program improvements.
(11) A comparison of average annual expenditures for individuals
with similar characteristics not participating in the SD Program.
(c) Notwithstanding Section 10231.5 of the Government Code,
commencing June 30, 2015, and at three year intervals, the department
shall submit an SD program evaluation to the relevant policy
committees of the Legislature and the SD Program Advisory Committee.
The evaluation shall be developed in consultation with the advisory
committee and shall be based on the core quality outcomes described
in subdivision (b) of Section 4689.91 and also include a summary of
all of the following:
(1) The types and ranking of services and supports purchased under
the SD Program, by regional center.
(2) Consumer satisfaction under the SD Program and, when data is
available, the traditional service delivery system, by regional
center.
(3) The proportion of participants who report they are able to
recruit, hire, and retain qualified service providers.
4689.95. It is the intent of the Legislature that the purchase of
services and supports through the SD Program be eligible for federal
Medicaid match funding. The department shall take all steps
necessary to ensure federal financial participation is available for
all SD Program services and supports by applying for amendments to
the current home and community-based waiver for individuals with
developmental disabilities or for a new waiver pursuant to Section
1396n of Title 42 of the United States Code. The department shall
seek to maximize federal financial participation by applying for an
enhanced federal match through the federal Community First Choice
Option pursuant to Section 1396n(k) of Title 42 of the United States
Code.
SECTION 1. Section 4685.8 is added to the
Welfare and Institutions Code, to read:
4685.8. (a) (1) The Self-Determination Program (SD Program) is
hereby established and shall be available in every regional center
catchment area to enable individuals with developmental disabilities
to exercise their rights to make choices in their own lives, as
described in subdivision (j) of Section 4502. The program shall give
participants greater control over access to, and the flexibility to
access, a wide range of needed and desired services and supports,
including, but not limited to, hiring their own workers and
purchasing needed items. The SD Program shall be consistent with the
requirements set forth in this section.
(2) SD Program participants shall be provided with a capitated
individual funding allocation computed in a fair, transparent, and
equitable manner, based on consumer characteristics and needs. The
allocation shall be used for the purchase of services and supports
necessary to implement the participant's individual program plan.
(b) The Self-Determination Program shall be designed to promote,
and shall be evaluated against, core quality outcomes for the
participants, including, but not limited to, all of the following:
(1) Participants' welfare, health, and safety.
(2) Whether participants are living in a place called home, under
one's own control, including living with family, friends, or on one's
own.
(3) Whether participants have meaningful participation and
membership in their own community.
(4) Whether participants are maintaining reciprocal long-term
relationships, including relationships that assist the participant to
live a healthy, included life.
(5) Whether participants are generating private income, through
typical jobs in regular employment settings or through
self-employment.
(6) Whether participants have control over transportation.
(c) It is the intent of the Legislature that the purchase of
services and supports through the SD Program be eligible for federal
Medicaid match funding. The department shall take all steps necessary
to ensure federal financial participation is available for all SD
Program services and supports by applying for amendments to the
current home and community-based waiver for individuals with
developmental disabilities or for a new waiver pursuant to Section
1396n of Title 42 of the United States Code. The department shall
seek to maximize federal financial participation by applying for an
enhanced federal match through the federal Community First Choice
Option pursuant to Section 1396n(k) of Title 42 of the United States
Code.
(d) Individuals shall have the right to utilize their allocation
to hire workers of their choice, and supervise, direct, schedule,
evaluate, train, and terminate employees. The state shall support the
quality, availability, and stability of direct support workers by
establishing a base compensation package to ensure decent pay
standards for workers in this program. Individuals may use their
allocation and private sources of funds to pay direct support workers
above the base established by the state, develop job descriptions,
and otherwise organize and incentivize their support workers.