BILL ANALYSIS                                                                                                                                                                                                    �



                                                                      



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          |SENATE RULES COMMITTEE            |                   SB 382|
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                                 THIRD READING


          Bill No:  SB 382
          Author:   Liu (D), et al.
          Amended:  5/31/11
          Vote:     21

           
           SENATE HUMAN SERVICES COMMITTEE  :  7-0, 4/26/11
          AYES:  Liu, Emmerson, Berryhill, Hancock, Strickland, 
            Wright, Yee

           SENATE JUDICIARY COMMITTEE  :  5-0, 5/3/11
          AYES:  Evans, Harman, Blakeslee, Corbett, Leno

           SENATE APPROPRIATIONS COMMITTEE  :  8-0, 5/26/11
          AYES:  Kehoe, Walters, Alquist, Lieu, Pavley, Price, 
            Runner, Steinberg
          NO VOTE RECORDED:  Emmerson


           SUBJECT  :    Developmental services:  regional centers:  
          complaints

           SOURCE  :     Author


           DIGEST  :    This bill permits the performance objective part 
          of the Department of Developmental Services (DDS) contract 
          with a regional center to include specified criteria 
          related to complaints and individual program plan services, 
          requires DDS to develop processes and procedures to address 
          retaliation against regional center employees and vendors, 
          requires regional centers to post a list of vendors and 
          their rates on their Internet Web sites, and clarifies the 
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          selection of least costly providers.

           ANALYSIS  :    Existing law, the Lanterman Developmental 
          Disabilities Services Act (Lanterman Act), generally 
          provides state services to persons with developmental 
          disabilities and establishes rights of those individuals to 
          receive such services.  (Welfare and Institutions Code 
          Section 4500 et seq.)

          Existing law requires contracts entered into between the 
          DDS and regional centers to include provisions requiring 
          each regional center to render services in accordance with 
          applicable state laws and regulations.  (Welfare and 
          Institutions Code Section 4629(b))

          Existing federal law prohibits personnel actions against 
          any employee because of the exercise of any appeal, 
          complaint, or grievance right granted by any law, rule, or 
          regulation.  (5 United States Code Section 2302) 

          Existing state law, the California Whistleblower Protection 
          Act, prohibits employers from retaliating against an 
          employee who discloses information to a government or law 
          enforcement agency where the employee has reasonable cause 
          to believe that the information discloses a violation of 
          federal or state laws or regulations.  (Labor Code Section 
          1102.5(b))

          This bill:

          1. Permits each performance contract with a regional center 
             to include specified criteria based on regional center 
             (RC) track record on complaints, state hearings, and 
             compliance with the individual program plan (IPP).

          2. Requires the DDS, in conjunction with the Association of 
             Regional Center Agencies and other stakeholders, to 
             develop processes and procedures to address issues of 
             retaliation against RC employees and vendors, as 
             specified.  The stakeholder process as well as the 
             development of the processes and procedures would 
             require considerable, unabsorbable, staff time.

          3. Requires RCs, commencing January 1, 2012, to report 







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             annually to the department the total number of 
             complaints they received within a single fiscal year. 

          4. Requires DDS, commencing January 1, 2012, to report 
             specified RC complaint information to the Legislature 
             annually and to develop annual performance objectives 
             for each RC based on the complaint information.  DDS 
             currently receives complaint information from RCs that 
             varies by type of complaint.  

          5. Requires RCs, commencing July 1, 2013, and annually 
             thereafter, to publish a directory of vendorized service 
             providers on its Internet Web site and any relevant 
             negotiated rates.  There would be cost pressure on RCs 
             to collect and display this information in a meaningful 
             way.

          6. Makes clarifying changes with regard to the selection of 
             least costly providers.

          7. Permits DDS to issue any necessary guidance to aid RCs 
             in demonstrating compliance with individual program 
             plans.  DDS would be required to utilize the results of 
             these reviews, when necessary, to develop annual 
             performance objectives for RCs.

           Background

           California's regional center system consists of 21 private 
          nonprofit regional centers, which serve more than 240,000 
          developmentally disabled individuals and their families.  
          Regional centers employ more than 6,000 people, who secure 
          the necessary supports and services outlined in the IPP 
          from a variety of service providers. 

          Regional centers were created in statute as private 
          nonprofit entities to carry out many of the state's 
          responsibilities under the Lanterman Act, under contract 
          with DDS.  Regional centers "assist persons with 
          developmental disabilities and their families in securing 
          those services and supports which maximize opportunities 
          and choices in living, working, learning and recreating in 
          the community."  The main roles of regional centers include 
          intake and assessment, individualized program plan 







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          development, case management, and securing services through 
          generic agencies (schools, county mental health 
          departments, Medi-Cal, Social Security Administration, 
          community agencies, etc.) and/or by purchasing services 
          from providers, whom regional centers have responsibility 
          for "vendoring." (Vendorization is the process by which a 
          service provider, upon meeting minimum qualifications set 
          in regulations, can become eligible to provide services to 
          consumers and receive payment from regional centers.)  
          Regional centers purchase services such as transportation, 
          health care, day programs and residential care provided by 
          community care facilities, and generally pay for services 
          if an individual's private insurance does not cover, or the 
          individual has no private coverage, or where "generic" 
          services provided through other programs, entities, or 
          agencies are not available.

          The relationship between DDS and regional centers is 
          primarily contractual, with oversight being conducted 
          through a variety of audits.  DDS has performance contracts 
          with regional centers through which DDS monitors progress 
          and follows up when a regional center fails to maintain an 
          acceptable level of compliance with performance objectives 
          or make progress toward meeting them.  DDS may impose 
          corrective actions on a regional center, additional 
          contract provisions, and levels of probation.  DDS also 
          performs biennial (or annual, if warranted) fiscal audits 
          of regional centers.  Additionally, for the purpose of 
          ensuring the regional center is meeting federal 
          requirements pursuant to the Home and Community Based 
          Services waiver, DDS staff visit each regional center every 
          other year and review records, interview consumers and 
          staff, and visit program sites.  DDS must also review 
          regional center purchase of service policies to prevent a 
          regional center from utilizing a policy that violates the 
          Lanterman Act.

          As private nonprofit entities, regional centers have, to 
          the extent not prescribed or proscribed by law or 
          regulation, the ability to control their own affairs and 
          meet the goals of the Lanterman Act with a high degree of 
          flexibility and variability, given that the Lanterman Act 
          is anchored in individualized supports and services.  While 
          the audits and performance contracts provide some measure 







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          of oversight of regional centers, regional centers have 
          considerable authority over key elements of the Lanterman 
          Act, including development of the IPP, selection of vendors 
          (within the IPP process), and establishment of certain 
          vendor payment rates.

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes   
          Local:  No

          According to the Senate Appropriations Committee:

                         Fiscal Impact (in thousands)

           Major Provisions      2011-12     2012-13     2013-14     Fund  

          RCs list of vendor-           Unknown, potentially 
          significant         General/
          negotiated rates    cost pressure on RCs          Federal

           SUPPORT  :   (Verified  5/31/11)

          Disability Rights California
          ResCoalition
          Service Employees International Union Developmental 
          Disabilities Council


           ARGUMENTS IN SUPPORT :    The author writes, "�SB 382] seeks 
          to provide DDS �Department of Developmental Services] with 
          more tools to conduct oversight, while using the preferred 
          contract relationship between DDS and regional centers to 
          make improvements in regional center performance.  In a 
          time of large scale changes driven by the state's fiscal 
          crisis, it is critical for DDS and regional centers to 
          monitor and address how changes are being implemented in a 
          decentralized system such as the regional center system."


          CTW:kc  5/31/11   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

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