BILL ANALYSIS                                                                                                                                                                                                    �



                                                                AB 1472
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        (  Without Reference to File  )

        CONCURRENCE IN SENATE AMENDMENTS
        AB 1472 (Budget Committee)
        As Amended  June 13, 2012
        Majority vote.  Budget Bill Appropriation Takes Effect Immediately
         
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        |ASSEMBLY:  |     |(March 22,      |SENATE: |24-15|(June 15,      |
        |           |     |2012)           |        |     |2012)          |
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                  (vote not relevant)                
         
         Original Committee Reference:    BUDGET  

         SUMMARY  :  Contains necessary statutory and technical changes to 
        implement changes to the Budget Act of 2012 for the Department of 
        Developmental Services.  

         The Senate amendments  delete the Assembly version of this bill, and 
        instead:

        1)Provide that the use of private health insurance to pay for early 
          intervention services for infants and toddlers with disabilities 
          under the California Early Intervention Services Act and Part C of 
          the federal Individuals with Disabilities Education Act may not 
          result in the loss of benefits due to an annual or lifetime health 
          insurance cap, may not negatively affect the availability of 
          health insurance for the individual or family, and may not be the 
          basis for increasing health insurance premiums for the individual 
          or family.

        2)Authorize an intermediate care facility/developmentally disabled, 
          or intermediate care facility/developmentally disabled 
          habilitative, with residents no younger than 10 years of age, to 
          utilize delayed egress devices in combination with secured 
          perimeters under specified conditions when approved by the 
          Department of Public Health and in accord with emergency 
          regulations promulgated by the Department of Developmental 
          Services (DDS).  Also authorizes a facility licensed as an adult 
          residential facility for people with developmental disabilities, 
          or a group home for children with developmental disabilities no 
          younger than 10 years of age that is eligible for federal funding 
          and is utilizing delayed egress devices to also utilize secured 
          perimeters under specified conditions and in accord with DDS's 








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          emergency regulations.  

        3)Decrease reliance on developmental centers (DCs), residential 
          facilities for which federal Medicaid funding is not available, 
          and out-of-state placements through several measures, detailed 
          below.  This redesign is anticipated to result in savings of $20 
          million General Fund annually:

           a)   Establish a statewide resource service to track specialty 
             services and coordinate the need for specialty services with 
             regional centers, and prioritizes the development of specialty 
             resources, including regional community crisis homes, when 
             allocating community placement plan funding;

           b)   Require regional centers to complete by December 31, 2015, 
             comprehensive assessments of specified developmental center 
             residents residing in a DC on July 1, 2012, and provides that 
             the assessments shall be provided to individual program 
             planning (IPP) teams to assist in determining the least 
             restrictive environment for the consumer and shall be updated 
             annually as part of the IPP process;

           c)   Require annual reporting to the Legislature by DDS, with 
             input provided by regional centers, on the outcomes of various 
             measures to reduce reliance on DCs, residential facilities for 
             which federal funding is not available, and out-of-state 
             placements;

           d)   Limit admissions to DCs to individuals with developmental 
             disabilities who are:

             i)     Committed by a court to Porterville DC, secure treatment 
               program:

                (1)       For the attainment of mental competence, pursuant 
                  to Penal Code provisions pertaining to persons determined 
                  to be incompetent to stand trial for criminal offenses;

                (2)       After involvement with the criminal justice 
                  system, a determination of incompetence to stand trial, 
                  and a finding that the individual is dangerous to himself, 
                  herself or others; or,

                (3)       For the attainment of mental competence pursuant 
                  to Welfare and Institutions Code provisions pertaining to 








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                  juvenile offenders.

             ii)    Committed by a court to Fairview DC due to an acute 
               crisis, as defined; or,

             iii)   Released from a DC on a provisional placement of up to 
               12 months and have an automatic right of return to the DC 
               during the period of provisional placement.

           e)   Require regional resource development program determinations 
             that admittance to a DC is necessary due to an acute crisis, as 
             defined, to include a regional center report detailing all 
             considered community-based options, excluding out-of-state 
             placements and specified placements that are ineligible for 
             federal Medicaid funding, and an explanation of why those 
             options cannot meet the consumer's needs;

           f)   Establish assessment and transition planning requirements, 
             including timelines, following court-ordered DC admissions due 
             to an acute crisis;

           g)   Limit court-ordered DC admissions due to an acute crisis to 
             six months unless specified conditions are met and the 
             committing court extends the commitment for an additional 
             period, not to exceed a total commitment period of one year.  
             Permits an additional 30-day extension only if the regional 
             center demonstrates significant progress toward implementing 
             the consumer's transition plan and extraordinary circumstances 
             exist beyond the regional center's control preventing the 
             regional center from obtaining the identified services and 
             supports within the timeline specified in the plan;

           h)   Revise provisions governing court-ordered DC placements and 
             stays of individuals with developmental disabilities (pursuant 
             to Welfare and Institutions Code Section 6500 et seq.), to 
             conform to the admission criteria and time limits for 
             placements at Fairview DC due to an acute crisis or Porterville 
             DC, secure treatment program, based on a determination of 
             dangerousness to self or others;

           i)   Prohibit regional centers from purchasing out-of-state 
             services without prior DDS authorization, and limits 
             authorization to six months, with a possible six-month 
             extension based on a determination that the consumer's needs 
             cannot be met in California.  Requires regional centers to 








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             submit, by December 31, 2012, a transition plan for all 
             consumers residing out of state as of June 20, 2012, for whom 
             the regional center is purchasing services;

           j)   Prohibit regional centers from purchasing residential 
             services from a mental health rehabilitation center unless the 
             facility is eligible for federal Medicaid funding; or has an 
             approved plan in place to transition to a Medicaid-eligible 
             program structure within specified timeframes; or, in the event 
             of an emergency when alternative, federally eligible services 
             cannot be located, for no longer than six months; and,

           aa)  Prohibit regional centers from purchasing residential 
             services from an institution for mental disease (IMD) for which 
             federal Medicaid funding is not available, except in 
             emergencies, subject to specified assessment and transition 
             planning requirements.  Requires comprehensive assessments 
             prior to the consumer's next scheduled IPP meeting for any 
             consumer residing in an IMD as of July 1, 2012.

        4)Authorize the use of technology, including telecommunication 
          technology, when feasible and recommended by the IPP team to 
          facilitate better and cost-effective services for consumers and 
          family members and, as appropriate, for training for providers.  
          Permits the use of technology in lieu of a consumer's in-person 
          appearance at judicial proceedings or administrative hearings only 
          with informed consent of the consumer or, when appropriate, the 
          consumer's legally authorized representative.  These provisions 
          are anticipated to result in saving of $2 million General Fund. 

        5)Expand the availability of adult residential facilities for 
          persons with special health care needs (ARFPSHNs) to consumers of 
          any regional center moving from a DC; and, with prior DDS 
          authorization, to consumers of any regional center not residing in 
          a DC who meet the requirements for admission to an ARFPSHN if 
          there is a vacancy, if no DC resident from any regional center 
          meets the requirements for admission, and if the placement is 
          necessary to protect the consumer's health or safety.

        6)Delete provisions of current law requiring independent assessments 
          of consumers receiving supported living services who have 
          supported living costs, or an initial recommendation for service 
          costs, that exceed 125% of the annual statewide average cost of 
          supported living services.  Instead, requires that IPP teams 
          complete a standardized assessment questionnaire at the time of 








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          development, review, or modification of a consumer's IPP to assist 
          in determining whether the supported living services provided or 
          recommended are necessary and sufficient and that the most 
          cost-effective methods of supported living services are utilized.  
          Requires the questionnaire to be developed with input from 
          regional centers and other stakeholders and posted on the DDS Web 
          site by June 30, 2012.  These provisions are anticipated to result 
          in net savings of $4.2 million General Fund. 

        7)Require regional centers, commencing July 1, 2012, until June 30, 
          2013, to reduce certain payments for services and supports by 
          1.25%, and extends authorization of temporary modification of 
          personnel requirements, functions, or qualifications, or staff 
          training requirements, as well as prescribed annual review and 
          reporting requirements for affected providers, until June 30, 
          2012.  Also suspends specified regional center staffing level and 
          staff expertise requirements until June 30, 2013.  This extension 
          is anticipated to result in savings of $30.7 million General Fund. 


        8)Require DDS and each regional center to annually report and post 
          on its Web site purchase-of-service authorization, utilization, 
          and expenditure data, by regional center, with respect to 
          ethnicity, age, primary language, and disability, and requires 
          each regional center to meet with stakeholders in a public meeting 
          regarding the data.

        9)Establish the intent of the Legislature that if a reduction of $50 
          million to the developmental services system is triggered by a 
          specified provision of the Budget Act during the 2012-13 fiscal 
          year, the impacts of that reduction should be kept as far away as 
          possible from the direct services and needs of DDS consumers.  To 
          that end, the bill identifies a variety of strategies that might 
          assist the department in carrying out that intent.  Additionally, 
          this bill requires the department to consider input from 
          prescribed stakeholders as necessary to develop savings proposals 
          related to this trigger.

        10)Add an appropriation allowing this bill to take effect 
          immediately upon enactment.  

         AS PASSED BY THE ASSEMBLY  , this bill expressed the intent of the 
        Legislature to enact statutory changes relating to the Budget Act of 
        2012.









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         Analysis Prepared by  :   Nicole Vazquez / BUDGET / (916) 319-2099


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