BILL ANALYSIS                                                                                                                                                                                                    �



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          ASSEMBLY THIRD READING
          AB 1626 (Maienschein)
          As Amended  February 10, 2014
          Majority vote 

           HUMAN SERVICES      7-0         APPROPRIATIONS      17-0        
           
           ----------------------------------------------------------------- 
          |Ayes:|Stone, Maienschein,       |Ayes:|Gatto, Bigelow,           |
          |     |Ammiano,                  |     |Bocanegra, Bradford, Ian  |
          |     |Ian Calderon, Garcia,     |     |Calderon, Campos,         |
          |     |Grove, Hall               |     |Donnelly, Eggman, Gomez,  |
          |     |                          |     |Holden, Jones, Linder,    |
          |     |                          |     |Pan, Quirk,               |
          |     |                          |     |Ridley-Thomas, Wagner,    |
          |     |                          |     |Weber                     |
          |-----+--------------------------+-----+--------------------------|
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           SUMMARY  :  Increases the rates and fees paid to supported  
          employment services providers for regional center consumers.   
          Specifically,  this bill  :

          1)Increases the hourly rate for supported employment services  
            provided to consumers receiving individualized or group  
            services to $34.24.

          2)Increases the fee regional centers pay interim program  
            providers to complete the intake process for a consumer  
            entering a supported employment program to $400.

          3)Increases the fee paid for placement of a consumer in an  
            integrated job and the fee paid after a consumer is retained  
            in a job for 90 days to $800 apiece. 

           EXISTING LAW  : 

          1)Establishes the Lanterman Developmental Disabilities Services  
            Act (Lanterman Act), under which the Department of  
            Developmental Services (DDS) is authorized to contract with  
            private non-profit regional centers to provide case management  
            services and arrange for, or purchase, services that meet the  
            needs of individuals with developmental disabilities, as  
            defined.  Welfare and Institutions Code (WIC) Section 4500 et  








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            seq.)

          2)Grants all individuals with developmental disabilities, among  
            all other rights and responsibilities established for any  
            individual by the United States Constitution and laws and the  
            California Constitution and laws, the right to treatment and  
            habilitation services and supports in the least restrictive  
            environment.  (WIC Section 4502)

          3)Requires the development of an Individual Program Plan (IPP)  
            for each regional center consumer, which specifies services to  
            be provided to the consumer, based on an individualized needs  
            determination.  (WIC Section 4512)

          4)States the Legislature's intent that habilitation services for  
            adults with developmental disabilities be planned and provided  
            in a manner that enables persons with developmental  
            disabilities to approximate the pattern of everyday living  
            available to nondisabled people of the same age.  (WIC Section  
            4850)

          5)Defines "habilitation services" as community-based services  
            purchased or provided for adults with developmental  
            disabilities, including services provided under the Work  
            Activity Program and the Supported Employment Program, to  
            prepare and maintain them at their highest level of vocational  
            functioning, or to prepare them for referral to vocational  
            rehabilitation services.  (WIC Section 4851)

          6)Requires a regional center to authorize appropriate  
            habilitation services for a consumer while he or she awaits  
            service authorization from the Department of Rehabilitation  
            (DOR) if the regional center has referred that consumer to the  
            DOR for vocational rehabilitation services, and the consumer  
            is put on a waiting list.  (WIC Section 4855)

          7)Establishes the following rates and fees to be paid to interim  
            providers of rehabilitation services that are authorized by  
            the regional center for the period during which a consumer is  
            on a waiting list for vocational services from the DOR:

             a)   A rate of $30.82 per hour for supported employment  
               services provided to consumers receiving individualized or  
               group services;








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             b)   A $360 fee to be paid to a program provider upon intake  
               of a consumer into a supported employment program;

             c)   A $720 fee to be paid upon placement of a consumer in an  
               integrated job, as specified; and,

             d)   A $720 fee to be paid after a 90-day retention period of  
               a consumer in a job, as specified.  (WIC Section 4860)

           FISCAL EFFECT  :  According to the Assembly Appropriations  
          Committee, this bill will result in annual costs of  
          approximately $10 million (General Fund) to Department of Social  
          Services (DSS) and $2.5 million (General Fund) to Department of  
          Rehabilitation for increasing the rates paid to service  
          providers for supported employment.

           COMMENTS  :  This bill seeks to increase the statutorily-set  
          supported employment rates and one-time intake, placement and  
          maintenance fees to the levels achieved in 2006, which were  
          maintained until a 10% cut was applied in the 2008-09 Budget  
          Act.  

          The Lanterman Act (WIC Section 4500 et seq.) guides the  
          provision of services and supports for Californians with  
          developmental disabilities.  Each individual under the Lanterman  
          Act, typically referred to as a "consumer," is legally entitled  
          to treatment and habilitation services and supports in the least  
          restrictive environment.  Lanterman Act services are designed to  
          enable all consumers to live more independent and productive  
          lives in the community. 

          The term "developmental disability" means a disability that  
          originates before an individual attains 18 years of age, is  
          expected to continue indefinitely, and constitutes a substantial  
          disability for that individual.  It includes intellectual  
          disabilities, cerebral palsy, epilepsy, and autism spectrum  
          disorders (ASD).  Other developmental disabilities are those  
          disabling conditions similar to an intellectual disability that  
          require treatment (i.e., care and management) similar to that  
          required by individuals with an intellectual disability.  This  
          does not include conditions that are solely psychiatric or  
          physical in nature, and the conditions must occur before age 18,  
          result in a substantial disability, be likely to continue  








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          indefinitely, and involve brain damage or dysfunction.  Examples  
          of conditions might include intracranial neoplasms, degenerative  
          brain disease or brain damage associated with accidents. 

          Direct responsibility for implementation of the Lanterman Act  
          service system is shared by the DDS and 21 regional centers,  
          which are private nonprofit entities, established pursuant to  
          the Lanterman Act, that contract with DDS to carry out many of  
          the state's responsibilities under the Lanterman Act.  The  
          principal roles of regional centers include intake and  
          assessment, individualized program plan development, case  
          management, and securing services through generic agencies or  
          purchasing services provided by vendors.  Regional centers also  
          share primary responsibility with local education agencies for  
          provision of early intervention services under the California  
          Early Intervention Services Act.  

          The 21 regional centers throughout the state serve over 270,000  
          consumers who receive services such as residential placements,  
          supported living services, respite care, transportation, day  
          treatment programs, work support programs, and various social  
          and therapeutic activities.  Approximately 1,300 consumers  
          reside at one of California's four Developmental Centers-and one  
          state-operated, specialized community facility-which provide  
          24-hour habilitation and medical and social treatment services.   
          Over 130,000 regional center consumers are of working age.

          Services provided to people with developmental disabilities are  
          determined through an individual planning process.  Under this  
          process, planning teams-which include, among others, the  
          consumer, his or her legally authorized representative, and one  
          or more regional center representatives-jointly prepare an IPP  
          based on the consumer's needs and choices.  The Lanterman Act  
          requires that the IPP promote community integration and maximize  
          opportunities for each consumer to develop relationships, be  
          part of community life, increase control over his or her life,  
          and acquire increasingly positive roles in the community.  The  
          IPP must give the highest preference to those services and  
          supports that allow minors to live with their families and  
          adults to live as independently as possible in the community. 

          Employment Services:  Regional centers contract with employment  
          services programs and providers to address the employment needs  
          of individuals with developmental disabilities.  Consumers are  








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          placed in jobs according to their individual skills, needs and  
          choices, and they are provided support services on an individual  
          or group basis.  In addition to meeting the employment needs of  
          the consumer, work programs can also greatly increase  
          opportunities for community integration for consumers.  
           
          Work Activity Programs (WAPs) are employment services programs  
          in a sheltered work environment for consumers who have acquired  
          basic vocational and independent living skills.  All WAP work is  
          paid at a daily per capita rate based on productivity.   
          Alternatively, Supported Employment Programs (SEPs) are  
          community-based rehabilitation programs that focus on helping  
          consumers obtain, retain or maintain employment in integrated  
          settings.  SEPs often involve job coaches that provide  
          on-the-job services and training, and wages paid directly to the  
          consumer by the employer.  If it is determined that some form of  
          supported employment would best meet the employment needs of a  
          consumer, a regional center will refer the consumer to the DOR,  
          which is responsible for increasing employment opportunities in  
          the community and providing time-limited employment services to  
          individuals with disabilities.  If a regional center consumer  
          needs long-term support to continue in their place of  
          employment, the responsibility for providing a job coach and  
          maintaining supportive services shifts back to DDS.

          DOR provides and pays for three tiers of employment-related  
          services, with set corresponding rates, for individuals with  
          developmental disabilities.  These include:  intake to determine  
          employment needs and develop a plan of action; placement in a  
          particular job; and retention for 90-days in a particular job.

          Need for this bill:  Although all of the rates and fees included  
          in WIC Section 4860 have applied to regional centers in the  
          past, the only rates that apply to services currently paid for  
          by the regional centers are the individual- and group-based  
          hourly job coaching rates for supported employment (which the  
          author seeks to increase from $30.82 to $34.24).  Conversely,  
          the fees established in this section, which the bill also  
          increases, are intended to be paid by the regional centers to  
          program providers only when WIC Section 4855 applies, or in  
          other words, when a consumer is referred to DOR by the regional  
          center and is placed on a waiting list.  In this instance, the  
          regional center would be responsible for paying the indicated  
          fees while the consumer awaits services from DOR.  However,  








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          while there may be a waiting list within the DOR service and  
          rate structure for people with developmental disabilities again  
          in the future, consumers who are referred today are given equal  
          consideration among individuals that do not have developmental  
          disabilities and are not placed on waiting lists.  

          While the elimination of the DOR waitlist for individuals with  
          developmental disabilities would seem to eliminate the need for  
          the fee increases in the bill, the increases sought will result  
          in fee increases for providers of services through DOR, as DOR  
          bases its uniform service structure for individuals with  
          developmental disabilities-including applicable rates and  
          fees-on WIC Section 4860.  Essentially, the rate and fee  
          increases included in this bill will apply to consumers  
          regardless of whether the services outlined in this Section are  
          paid for by the regional centers or through DOR.

          The author states, "[This bill] simply restores these rates to  
          the 2006 level in the hopes of creating more opportunities for  
          Californians with developmental disabilities to become  
          productive, working members of our communities.  Just as in  
          2006, there is no partisan disagreement over whether we want to  
          help this population be successful in achieving independent,  
          fulfilled lives, and there are other efficiencies in this system  
          that should be examined in prioritizing our expenditures in  
          support of this population."
           

          Analysis Prepared by  :    Myesha Jackson / HUM. S. / (916)  
          319-2089 


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