BILL ANALYSIS �
AB 1244
Page 1
Date of Hearing: May 11, 2011
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Felipe Fuentes, Chair
AB 1244 (Chesbro) - As Amended: April 14, 2011
Policy Committee: Human
ServicesVote:4 - 2
Urgency: No State Mandated Local Program:
No Reimbursable:
SUMMARY
This bill creates for individuals with developmental
disabilities within the Department of Developmental Services
(DDS) regional center system a new Self-Determination Program
(SD Program).
FISCAL EFFECT
1)One-time costs potentially in excess of several hundred
thousand dollars GF for the workload associated with creating
the new SD program.
2)As written, this bill sets aside 2.5% of the funding to cover
the cost of administration and requires that the program
establish a 5% GF savings over the current purchase of service
program. However, the administrative costs for components
required by the bill, including the enhanced staff to consumer
ratio, far exceed the 2.5% set aside. Therefore, it is
unlikely that this program will result in a 5% GF savings;
however it may be cost neutral on an on-going basis.
SUMMARY, continued
Specifically, this bill:
1)Creates an SD program which makes available to individuals
with developmental disabilities a capitated individual funding
allocation that enables them to exercise their right to make
choices in their lives and access services and supports they
choose to implement their individual program plans (IPPs).
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2)Requires regional centers to maintain a service coordinator to
consumer ratio of 1 to 62.
3)Provides that participation in the SD Program is voluntary and
that a participant may choose to participate or leave at any
time.
4)Provides that the SD Program will be available to any consumer
age three or older who agrees to meet specified program
requirements.
5)Specifies that in the first year the program will only be
available in the five regional centers that are currently part
of an existing self-determination pilot program and that in
the second year all other regional centers will be required to
implement the program.
6)Specifies a specific funding formula for individual
allocations.
7)Requires DDS to establish and administer a risk pool that is
funded by an amount equivalent to 2.5% of the historical
annual purchase of service costs of consumers in the SD
program and continuously appropriates the funds in the pool.
8)Requires DDS to use 2.5% of the historical annual purchase of
services costs toward offsetting SD Program state costs.
9)Requires DDS to annual provide for GF savings of 5% of the
annual purchase of services costs for the SD program
participants compared to consumers with similar
characteristics who are not participating in the program.
10)Requires that DDS establish a statewide SD Program Advisory
Committee, with more than 50% of the Committee comprised of SD
Program participants and family members representing the
geographic, ethnic and language diversity of the state.
11)Requires DDS, commencing January 10, 2013, to provide
specified information and data on implementation of the SD
Program to the Committee and to the policy and fiscal
committees of the Legislature.
COMMENTS
AB 1244
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1)Rationale . The intent of this legislation is to recast and
improve upon the Self-Determination pilot project that was
implemented more than a decade ago. This bill repeals that
program and replaces it with a slightly modified program. It
also requires that the new program start in the five regional
centers that conducted the original pilot and then be
implemented statewide. The author notes that the
Self-Determination Program contained in this legislation has
the potential to provide short and long-term cost savings to
the state, while giving regional center clients flexibility
within a capitated service budget as an alternative to the
traditional regional center service system.
2)California's Developmental Services System . The California
system assists approximately 244,000 individuals with
developmental disabilities and their families through a
statewide system of 21 regional centers. Of the $4.5 billion
($2.4 billion GF) proposed for the 2011-12 budget year, $3.8
billion ($2 billion GF) is for services provided through the
regional centers. The system employs 90,000 workers. Almost
99% of consumers receive community-based services and live
with their parents or other relatives, in their own homes or
apartments, or in group homes that are designed to meet their
medical and behavioral needs.
In addition, the state's four Developmental Centers (Fairview,
Lanterman, Porterville, and Sonoma) and one smaller, community
facility (Canyon Springs) provide 24-hour care to about 1,979
individuals with developmental disabilities. The DCs provide a
full range of care, including medical and recreational
services.
3)Self-Determination Pilot Projects . SB 1038 (Thompson; Chapter
1043, Statutes of 1998) authorized the planning and
implementation of self-determination pilot projects at three
RCs: East Los Angeles Regional Center, Tri-Counties Regional
Center, and Redwood Coast Regional Center. Two other regional
centers (Kern Regional Center and San Diego Regional Center)
also created independent self-determination pilots through
approval of alternative service delivery models pursuant to
W&I Code Section 4669.2. The pilot programs, which vary
somewhat among the five participating RCs, were limited to a
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total of approximately 140 consumers. These
self-determination pilot programs are ongoing and, reportedly,
successful, with a high level of participant satisfaction.
4)Self-Directed Services Program (SDS Program) . AB 131
(Committee on Budget; Chapter 80, Statutes of 2005) repealed
the statutory section establishing the self-determination
pilot projects and added Section 4685.7 of the W&I Code to
establish, contingent upon approval of a federal waiver,
self-directed services statewide. DDS filed an SDS Waiver
application with the federal Centers for Medicare & Medicaid
Services (CMS) on April 2, 2008; however, it has still not
been approved. Therefore, the SDS Program has never been
implemented.
Analysis Prepared by : Julie Salley-Gray / APPR. / (916)
319-2081