BILL NUMBER: AB 1244 AMENDED
BILL TEXT
AMENDED IN SENATE JULY 5, 2011
AMENDED IN ASSEMBLY MAY 27, 2011
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 amend Sections 4677 and 4678 of, to add Article 4.5
(commencing with Section 4689.90) to Chapter 6 of Division 4.5 of,
and to 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 of,
the Welfare and Institutions Code, relating to developmental
services.
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 to be available in every regional center catchment area to
provide participants, within an individual budget, greater control
over needed services and supports.
This bill would repeal the provisions establishing the
Self-Directed Services Program and would, instead, contingent upon
approval of federal Medicaid matching funding, 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. 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. Appropriation: no. 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-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 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-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.
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 toward obtaining generic services.
(b) "Financial management service" means a conflict of
interest 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
has 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. 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
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) Contingent upon approval of federal Medicaid
matching funding, 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 , increased
flexibility and choice over, and the ability 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.
(7) Participants having access to a defined and comprehensive mix
of services and supports that are selected and directed by a
participant.
(8) Participants controlling and achieving personally defined
outcomes in inclusive community settings.
(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 a
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
Program a timely in-depth orientation; however,
enrollment in the SD program 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 methodology
shall specify the mechanism by which a consumer's individual
allocation shall be adjusted to allow for increased wages established
in the base compensation package established in subdivision (a) of
Section 4689.93. 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 paragraphs (1) to (8), inclusive, of 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
paragraphs (1) to (8), inclusive, of 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 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
participant-selected services and supports. The
planning team shall also review the individual budget to ensure the
budget assists the participant to achieve the relevant
core quality outcomes, assures outcomes
identified in paragraphs (1) to (8), inclusive, of subdivision (b) of
Section 4689.91, ensures 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 is
hereby administered by the department.
(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 7.5 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
toward offsetting costs to the state of the SD
Program with the remainder to be returned as savings to the General
Fund. Program costs to the state shall include, but not be limited
to, training of consumers, family members, regional centers, and
service brokers, caseload ratio improvement, and service broker
support for participants' initial person centered
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
participants' health, welfare, and safety, address the goals of
the IPP and the core quality outcomes specified in paragraphs
(1) to (8), inclusive, of 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 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.
(h) 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.
(i) 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).
(j) 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.
(k) 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 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.
(4) The adequacy of the risk pool established pursuant to
subdivision (d) of Section 4689.92.
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 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.