BILL ANALYSIS                                                                                                                                                                                                    �






                                  SENATE HUMAN
                               SERVICES COMMITTEE
                            Senator Jim Beall, Chair


          BILL NO:       AB 1626                                      
          A
          AUTHOR:        Maienschein                                  
          B
          VERSION:       February 10, 2014
          HEARING DATE:  June 10, 2014                                
          1
          FISCAL:        Yes                                          
          6
                                                                      
          2
          CONSULTANT:    Mareva Brown                                 
          6

                                        
                                     SUBJECT
                                         
                      Developmental services: habilitation

                                     SUMMARY  

          This bill would increase the hourly rate paid to providers  
          of individualized and group-supported employment services  
          from $30.82 to $34.24, and increase the fees paid to  
          interim program providers from $360 to $400 and $720 to  
          $800, respectively.

                                     ABSTRACT  

           Existing law  :

             1)   Establishes the Lanterman Developmental  
               Disabilities Services Act, which states  
                that California is responsible for providing an array  
               of services and supports sufficiently complete to meet  
               the needs and choices of each person with  
               developmental disabilities, regardless of age or  
               degree of disability, and at each stage of life and to  
               support their integration into the mainstream life of  
               the community. (WIC 4500, et al)  

                                                         Continued---




          STAFF ANALYSIS OF ASSEMBLY BILL 1626 (Maienschein)      
          PageB


          

              2)   Establishes a system of nonprofit Regional Centers  
               to provide fixed points of contact in the community  
               for all persons with developmental disabilities and  
               their families, to coordinate services and supports  
               best suited to them throughout their lifetime. (WIC  
               4620)  

              3)   Establishes an Individual Program Plan (IPP) and  
               defines that planning process as the vehicle to ensure  
               that services and supports are customized to meet the  
               needs of consumers who are served by regional centers.  
               (WIC 4512)  

              4)   Establishes an individual habilitation services  
               plan and specifies areas in which consumers must meet  
               individual employment goals. (WIC 4853, WIC 4854)  

              5)   Defines habilitation services as activities  
               purchased for regional center consumers, including  
               services provided under the Work Activity and  
               Supported Employment programs to prepare and maintain  
               consumers at their highest level of vocation  
               functioning or to prepare them for referral to  
               vocational rehabilitation services. (WIC 4851)  

              6)   Defines supported employment services as those  
               approved in the IPP to achieve supported employment as  
               an outcome, as specified. (WIC 4851 (q))  

              7)   Establishes fees and hourly rates for service  
               providers who work with consumers in various job  
               development and support activities. (WIC 4860)  

              8)   Requires that when an eligible regional center  
               consumer is placed on a Department of Rehabilitation  
               (DOR) waiting list for vocational rehabilitation, as  
               defined, the regional center shall authorize  
               appropriate services for the individual as needed  
               until services can be provided by the vocational  
               rehabilitation program. (WIC 4855)  
                 
              9)   Requires that when a regional center must authorize  
               services pending a consumer's acceptance from the DOR  
               wait list, the following fees shall apply: 





          STAFF ANALYSIS OF ASSEMBLY BILL 1626 (Maienschein)      
          PageC


          

                  a.        A $360 fee to the program provider upon  
                    intake of a consumer into a supported employment  
                    program. No fee shall be paid if that consumer  
                    completed a supported employment intake process  
                    with that same supported employment program  
                    within the previous 12 months.
                  b.        A $720 fee upon placement of a consumer  
                    in an integrated job, except that no fee shall be  
                    paid if that consumer is placed with another  
                    consumer or consumers assigned to the same job  
                    coach during the same hours of employment.
                  c.        A $720 fee after a 90-day retention of a  
                    consumer in a job, except that no fee shall be  
                    paid if that consumer has been placed with  
                    another consumer or consumers, assigned to the  
                    same job coach during the same hours of  
                    employment. (WIC 4860) 
           This bill:

              1)   Increases the hourly rate for supported employment  
               services provided to consumers receiving  
               individualized or group services from $30.82 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 from  
               $360 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 from $720 to $800. 

                                  FISCAL IMPACT  

          According to an analysis by the Assembly Committee on  
          Appropriations, increasing the rate paid to service  
          providers for supported employment would cost the  
          Department of Developmental Services (DDS) approximately  
          $10 million (GF) per year and the Department of  
          Rehabilitation (DOR) approximately $2.5 million (GF) per  
          year.

                            BACKGROUND AND DISCUSSION  





          STAFF ANALYSIS OF ASSEMBLY BILL 1626 (Maienschein)      
          PageD


          

           Purpose of the bill:
           
          According to the author, this bill addresses, in part,  
          California's commitment to serve persons with developmental  
          disabilities. Specifically, the bill seeks to raise the  
          statutory rate associated with helping persons with  
          developmental disabilities find and keep jobs. The author  
          states this rate has been artificially depressed due to  
          repeated state budget decisions, meaning that nearly every  
          community-based nonprofit agency serving this population  
          has been losing money in attempting to provide support for  
          meaningful employment for persons with developmental  
          disabilities who wish to work.

           Regional centers
           
          California's 21 regional centers are non-profit  
          organizations that provide local services and supports to  
          individuals through contracts with DDS. Regional centers  
          provide diagnosis and assessment of eligibility and help  
          plan, access, coordinate and monitor the services and  
          supports that are needed because of an individual's  
          developmental disability. Services for consumers are  
          determined through an individual program plan (IPP). A  
          developmental disability is defined as 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).  

           Employment First Policy 

           AB 287 (Beall) Chapter 231, Statutes of 2009 required the  
          State Council on Developmental Disabilities to establish a  
          standing Employment First Committee to identify strategies,  
          best practices, and incentives, and to develop an  
          Employment First Policy. The goal of the policy was to  
          increase the number of people with developmental  
          disabilities who are employed in integrated work,  
          self-employment, and microenterprises, and in the number  
          earning wages at or above minimum wage. The council is  
          required to report annually to the Legislature outlining  
          its work and making recommendations. 





          STAFF ANALYSIS OF ASSEMBLY BILL 1626 (Maienschein)      
          PageE


          

          In 2011, the State Council released its first report which  
          included findings that 26.5 percent of working age adults  
          with developmental disabilities live below the federal  
          poverty line compared with 13 percent of same-aged adults  
          in the general population. Other findings included a need  
          for additional supports for individuals to prepare for and  
          maintain employment.  That report, and a subsequent report  
          last year,<1> led to the passage of AB 1041 (Chesbro)  
          Chapter 677, Statutes of 2013, which created a statewide  
          Employment First Policy. Regional centers are required to  
          include integrated employment opportunities and services in  
          a regional center consumer's IPP, as specified. 


           Department of Rehabilitation
           
          The California Department of Rehabilitation provides  
          services to consumers that result in  employment,  
          independent living and equality for individuals with  
          disabilities.  Among the services is Vocational  
          Rehabilitation, which includes employment counseling  
          training and education, mobility and transportation aids,  
          job search and placement assistance. To be eligible for  
          services, an individual must have a physical or mental  
          impairment that substantially impedes his or her ability to  
          secure employment and that requires Vocational  
          Rehabilitation services to prepare for, secure, retain or  
          regain employment. An individual must also be able to  
          benefit from DOR services in obtaining employment in an  
          integrated setting. 

           Supported Employment Rates
           
          While most other rates for regional center services may  
          vary based on a number of unique factors, the $30.82  
          per-hour rate for individual and group-based job coaching  
          is set in statute. This rate applies whether these services  
          provided through DOR or DDS. 

          Generally, consumers are referred for job coaching services  
          from their regional center to DOR. However, when DOR is at  
          -------------------------
          <1>  
          http://www.scdd.ca.gov/res/docs/pdf/HQ-%20Employment%20First 
          %20Report%208-9-11.pdf




          STAFF ANALYSIS OF ASSEMBLY BILL 1626 (Maienschein)      
          PageF


          
          capacity, based on language in WIC 4855, DDS consumers and  
          other DOR applicants may be placed on a waiting list for  
          services. If a regional center consumer is wait-listed,  
          statute permits a regional center to refer directly to a  
          provider using statutorily set rates, until space is  
          available in the DOR programs. This bill seeks to increase  
          the hourly rate as well as the intake, job placement and  
          job retention fees paid to a vendor when a consumer is  
          placed into the program by a regional center. The hourly  
          rate proposed in this bill would return to the rates  
          established in 2006. That rate was reduced in 2008, when  
          budget shortfalls led to a 10 percent cut.

           Service Provider Rates
           
          A study released in January 2014 by the Association of  
          Regional Center Agencies (ARCA) identified a number of  
          needed consequences of insufficient provider rates. Rates  
          within the Developmental Services system have been frozen  
          and / or cut repeatedly in the past decade, even prior to  
          massive budget reductions that were taken to address budget  
          shortfalls in the Great Recession.

          The report, entitled "Inadequate Rates for Service  
          Provision in California," concluded that the goal of  
          quality services and achievement of outcomes for consumers  
          is "unachievable within the limitations of the current  
          rates." It noted that longstanding underfunding of the  
          service system undermines progress and the adequacy of the  
          community-based provider network.

           Related legislation: 
           
          AB 954 (Maienschein) 2013, was identical to this language.  
          It was held in the Assembly Appropriations Committee's  
          Suspense File.

          SB 577 (Pavley) 2013, requires the development and  
          semiannual review of a plan if community-based  
          prevocational services are determined to be a necessary  
          step to achieve a supported employment outcome for adult  
          consumers of regional centers.  Establishes an hourly rate  
          for community-based prevocational services of $40 per hour  
          for a maximum of 75 hours per calendar quarter for all  
          services identified and provided in the plan. SB 577 will  





          STAFF ANALYSIS OF ASSEMBLY BILL 1626 (Maienschein)      
          PageG


          
          be heard in the Assembly Human Services committee this  
          month.

          AB 1041 (Chesbro) Chapter 677, Statutes of 2013, created a  
          statewide Employment First Policy and sets forth  
          requirements related to the inclusion of integrated  
          employment opportunities and services in a regional center  
          consumer's individual program plan (IPP). 

          AB 287 (Beall) Chapter 231, Statutes of 2009, established  
          an Employment First Committee within the State Council on  
          Developmental Disabilities, which established a statewide  
          Employment First Policy that provided the foundation of AB  
          1041.


                                   PRIOR VOTES  

          Assembly Floor      77 - 0
          Assembly Appropriations  17 - 0
          Assembly Human Services    7 - 0


                                    POSITIONS  

          Support:       Association of Regional Center Agencies
                         Center for Autism and Related Disorders
                         East Bay Developmental Disabilities  
                    Legislative Coalition                              
                                                                       
                         
                         Exceptional Children's Foundation
                         Futures Explored
                         San Diego - Imperial Counties Developmental  
          Services, Inc.
                         State Council on Developmental Disabilities
                         SoCal APSE
                         The Arc and United Cerebral Palsy California

                         1 individual


          Oppose:   None received







          STAFF ANALYSIS OF ASSEMBLY BILL 1626 (Maienschein)      
          PageH


          

                                   -- END --