BILL ANALYSIS �
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|SENATE RULES COMMITTEE | SB 1012|
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UNFINISHED BUSINESS
Bill No: SB 1012
Author: Senate Budget and Fiscal Review Committee
Amended: 6/13/12
Vote: 21
PRIOR VOTES NOT RELEVANT
ASSEMBLY FLOOR : Not available
SUBJECT : Developmental Services Budget Trailer Bill
SOURCE : Author
DIGEST : This bill contains necessary statutory and
technical changes to implement developmental Services
provisions of the Budget Act of 2012.
Assembly Amendments delete the Senate version of the bill
which contained intent language only and add the above
language instead.
ANALYSIS : The Department of Developmental Services (DDS)
administers services for persons with developmental
disabilities. The services are provided in the community
through 21 Regional Centers and also in state-run
Developmental Center institutions (DCs). Services and
supports provided range from day programs to transportation
or residential care. Determination of which services an
individual consumer needs is made through the process of
developing an Individualized Program Plan (IPP) (or
CONTINUED
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Individual Family Service Plan if the consumer is an
infant/toddler three years of age or younger).
Individuals with developmental disabilities have a number
of residential options. Ninety-nine percent of DDS
consumers receive community-based services and live with
parents or other relatives, in their own houses or
apartments, or in group homes (of various models) designed
to meet their medical or behavioral needs. Another
approximately 1,800 individuals reside in four
state-operated DCs and one state-operated community
facility. Consistent with national trends that support
integrated services and reduced reliance on state
institutions, California has been reducing its use of DCs
as a placement for individuals with developmental
disabilities for several decades.
Due to lower than anticipated revenue projections, the
Department of Finance announced in December 2011, that
DDS's 2011-12 budget will be reduced by $100 million
General Fund (GF) in accordance with A.B. 121, Chapter 41,
(Statutes of 2011). The proposed budget for 2012-13
includes the full year impact of the revenue trigger
reduction for DDS of $200 million GF. Several of the
policy changes necessary to implement this reduction are
included in the provisions of this bill.
This bill includes the following provisions:
1. Consistent with federal requirements, provides 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. Decreases reliance on developmental centers (DCs),
residential facilities for which federal Medicaid
funding is not available, and out-of-state placements
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through several measures, including those detailed
below, which are intended to redesign services for
individuals with challenging service needs. This
redesign is anticipated to result in savings of $20
million GF annually.
A. Establishes a statewide resource service to track
specialty services and coordinate with regional
centers, and prioritizes the development of specialty
resources, including regional community crisis homes,
when allocating community placement plan funding
B. Requires 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 shared with IPP teams to assist in determining the
least restrictive environment for the consumer.
C. Expands the availability of adult residential
facilities for persons with special health care needs
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 if:
There is a vacancy.
No DC resident from any regional center
meets the requirements for admission.
The placement is necessary to protect the
consumer's health or safety.
D. Establishes new restrictions on admissions to DCs
by limiting them to individuals with developmental
disabilities who are:
(1) Committed by a court to Porterville DC for
secure treatment:
(a) For the attainment of mental
competence, pursuant to Penal Code
provisions pertaining to persons determined
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to be incompetent to stand trial for
criminal offenses.
(b) 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.
(c) For the attainment of mental
competence pursuant to Welfare and
Institutions Code provisions pertaining to
juvenile offenders.
(2) Committed by a court to Fairview DC due to
an acute crisis, as defined.
(3) 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. Requires 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 at the time of the determination.
F. Establishes assessment and transition planning
requirements, including timelines, following
court-ordered DC admissions due to an acute crisis.
G. Limits 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
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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. Revises 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. Prohibits 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
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. Prohibits 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.
K. Prohibits 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.
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L. Authorizes certain facilities, 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 a state
department and in accord with emergency regulations
promulgated by DDS.
M. Requires 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.
3. Authorizes the use of technology, including
telecommunication, when feasible and recommended by the
IPP team to facilitate better and cost-effective
services. Restricts the use of technology in lieu of a
consumer's in-person appearance at judicial proceedings
or administrative hearings to only circumstances in
which the consumer (or, when appropriate, the consumer's
legally authorized representative) has provided informed
consent. These provisions are anticipated to result in
savings of $2.0 million GF.
4. Deletes 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
percent of the annual statewide average cost. Instead,
requires that IPP teams complete a standardized
assessment questionnaire at specified times to assist in
determining whether the supported living services
provided or recommended are necessary, sufficient, and
cost-effective. 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 GF.
5. Reduces, from July 1, 2012, until June 30, 2013,
payments to Regional Centers and providers of specified
services by 1.25 percent. A payment reduction of three
percent was initiated in 2009. It was increased to 4.25
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percent on July 1, 2012 and is scheduled to sunset June
30, 2012. This bill extends the reduction for one
additional year, but at a lower amount. This provision
is anticipated to result in savings of $30.7 million GF.
Correspondingly, extends authorization for temporary
modifications 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, 2013. Also
suspends specified regional center staffing level and
staff expertise requirements until June 30, 2013.
6. Requires 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 race or ethnicity, age,
primary language, and disability, and requires each
regional center to meet with stakeholders in a public
meeting regarding this data.
7. Establishes 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 DDS in carrying out that intent.
Additionally, this bill requires the DDS to consider
input from prescribed stakeholders as necessary to
develop savings proposals related to this trigger.
FISCAL EFFECT : Appropriation: No Fiscal Com.: No
Local: No
DLW:do 6/15/12 Senate Floor Analyses
SUPPORT/OPPOSITION: NONE RECEIVED
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