BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  SB 577
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          Date of Hearing:   June 17, 2014

                        ASSEMBLY COMMITTEE ON HUMAN SERVICES
                                  Mark Stone, Chair
                     SB 577 (Pavley) - As Amended:  May 20, 2014

           SENATE VOTE :  32-0
           
          SUBJECT  :  Autism and other developmental disabilities:  
          employment.

           SUMMARY  :  Establishes a new community-based vocational  
          development service to better support and prepare individuals  
          with developmental disabilities for employment.

          Specifically,  this bill  :

          1)Declares legislative findings pertaining to the difficulties  
            individuals with developmental disabilities experience when  
            seeking employment and the need to adequately assess the  
            skills and needs of individuals with developmental  
            disabilities who are seeking jobs in order to promote  
            employment success, as specified.

          2)States the intent of the Legislature that habilitation  
            services for individuals with developmental disabilities  
            include community-based vocational developmental services to  
            enhance community employment readiness, develop social skills  
            necessary for successful community employment, and build a  
            network of community and employment opportunities for  
            individuals with developmental disabilities.

          3)Establishes and defines community-based vocational development  
            services as all of the following:

             a)   Services provided to enhance community employment  
               readiness, which may include the use of discovery and job  
               exploration opportunities;

             b)   Social skill development services necessary to obtain  
               and maintain community employment;

             c)   Services to use internship, apprenticeship, and  
               volunteer opportunities to provide community-based  
               vocational development skills development opportunities;








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             d)   Services to access and participate in postsecondary  
               education or career technical education; and

             e)   Building a network of community and employment  
               opportunities.

          1)Requires the development of a community-based vocational  
            development services plan, as specified, if such services are  
            deemed necessary to help a person with a developmental  
            disability achieve a supported employment outcome. 

          2)Requires the habilitation service provider and the regional  
            center to review the plan for community-based vocational  
            services semiannually, as specified.

          3)Authorizes the provision of community-based vocational  
            development services in conjunction with other community-based  
            day services for no more than 30 hours of services per week  
            for up to two years and authorizes such services beyond two  
            years if the consumer is making significant progress toward  
            his or her habilitation services objectives, as specified.

          4)Establishes a new forty dollar ($40) per hour rate for the  
            provision of services identified in a consumer's  
            community-based vocational development services plan for a  
            maximum of 75 hours per calendar quarter.

          5)Requires the Department of Developmental Services (DDS) to  
            secure federal Medicaid funding prior to the implementation of  
            community-based vocational development services. 

          EXISTING LAW  

          1)Establishes the Lanterman Developmental Disabilities Services  
            Act (Lanterman Act), under which 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.  (WIC 4500 et 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  








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            habilitation services and supports in the least restrictive  
            environment.  (WIC 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 4512)

          4)States the Legislature's intent that habilitation services for  
            adults with developmental disabilities be planned and provided  
            in a manner that enables them to approximate the pattern of  
            everyday living available to nondisabled people of the same  
            age.  (WIC 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 4851)

          6)Requires a work activity program to which a consumer has been  
            referred for habilitation services to submit a work skills  
            evaluation report to the regional centers, which includes  
            information about the skills and productivity of the consumer,  
            to be used to determine the appropriateness of the work  
            placement.  (WIC 4853)

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

          8)Establishes the following rates and fees to be paid to interim  
            providers of vocational 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 Department of Rehabilitation:

             a)   A rate of thirty dollars and eighty-two cents ($30.82)  
               per hour for supported employment services provided to  








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               consumers receiving individualized or group services;

             b)   A three-hundred-sixty-dollar ($360) fee to be paid to a  
               program provider upon intake of a consumer into a supported  
               employment program;

             c)   A seven-hundred-twenty-dollar ($720) fee to be paid upon  
               placement of a consumer in an integrated job, as specified;  
               and

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

          1)Establishes an Employment First Policy in California to  
            prioritize opportunities for integrated, competitive  
            employment for individuals with developmental disabilities,  
            regardless of the severity of their disabilities, as  
            specified. (WIC 4869)


           FISCAL EFFECT  :  This bill is keyed non-fiscal by the Office of  
          Legislative Counsel.   

           COMMENTS  :  This bill establishes a community-based vocational  
          development service to ensure individuals with developmental  
          disabilities who desire to work and need additional basic skills  
          training and education are better prepared for employment and  
          experience better employment outcomes.

           Background  :  The Lanterman Act (WIC � 4500 et seq.) guides the  
          provision of services and supports for Californians with  
          developmental disabilities.  Each individual under the 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  








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          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.  

          Direct responsibility for implementation of the Lanterman Act  
          service system is shared by 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 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 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  
          Individual Program Plan (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 Department of Rehabilitation  
          (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 supported employment 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  :  While DOR is charged with helping people  
          with disabilities obtain and maintain employment, supporters of  
          this bill claim that people with developmental disabilities need  
          additional vocational development to ensure success in the  
          workplace.  Current statute outlines a process for evaluating a  
          consumer's readiness for the workplace and the appropriateness  
          of the chosen workplace.  However, there is no explicit language  
          in statute that requires attention to work-related "soft skills"  
          needs and the provision of these services prior to employment if  
          it is determined that the consumer may not yet be prepared for  
          employment in an integrated work environment.  Furthermore,  








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          supporters of the bill state that many individuals with  
          developmental disabilities are placed in inappropriate job  
          placements, and the current process facilitates more traditional  
          settings (e.g., warehouses and grocery stores), and does not  
          promote non-traditional placements (e.g., jobs in a medical or  
          technical field), which might better meet the consumer's  
          interests and goals and could lead to long-term employment.

          Expressing the need for this bill, the author states:

          "In California, the employment rates for people with autism and  
          other developmental disabilities are appalling.  According to  
          the 2010-2011 Department of Developmental Services report on  
          employment and day services, as the number of individuals in  
          regional centers has risen from 2007-2011, the percentage of  
          working age regional center clients that are employed has  
          steadily decreased to 12.5%.  The 2011-12 National Core  
          Indicators survey of 5,532 regional center clients indicated  
          that less than 5% of those surveyed had a job in an integrated  
          competitive employment setting.

          "[This bill] will help increase opportunities for individuals  
          with autism and other developmental disabilities to gain  
          integrated, competitive, community employment and career  
          advancement by helping individuals develop general,  
          non-job-task-specific strengths and skills."

           RECOMMENDED AMENDMENTS  :

          1)Because this bill creates a new provider rate for a service  
            for which there is currently no evidence to prove its  
            efficacy, the author may wish to consider establishing a pilot  
            project to test community-based vocational development  
            services before rolling out the services statewide.  Committee  
            staff recommends the following amendments to Section 4850,  
            beginning on page 3 of the bill, to establish a pilot program,  
            consistent with current language in the bill that makes  
            implementation contingent on the receipt of federal funds for  
            this purpose:

          4850.
          (a) The Legislature reaffirms its intent that habilitation  
          services for adults with developmental disabilities should be  
          planned and provided as a part of a continuum and that  
          habilitation services should be available to enable persons with  








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          developmental disabilities to approximate the pattern of  
          everyday living available to nondisabled people of the same age.

          (b) The Legislature further intends that habilitation services  
          shall be provided to adults with developmental disabilities as  
          specified in this chapter in order to guarantee the rights  
          stated in Section 4502.

          (c) The Legislature further intends that, in order to increase  
          effectiveness and opportunity to gain meaningful integrated  
          employment opportunities, habilitation services shall also  
          provide community-based vocational development services to  
          enhance community employment readiness, develop social skills  
          necessary for successful community employment, and build a  
          network of community and employment opportunities for  
          individuals with developmental disabilities.
          
          (1) The Department of Developmental Services shall conduct a  
          four-year demonstration project to test whether community-based  
          vocational development services will increase integrated  
          competitive employment outcomes and reduce purchase of service  
          costs for working age adults.

          (2) The Department of Developmental Services shall select up to  
          five volunteer regional centers, reflecting the State's  
          geographic diversity, to participate in the demonstration  
          project, which will be implemented when the department has  
          secured federal Medicaid funding for community-based vocational  
          development services.

          (A) If, based on outcomes of the demonstration project, the  
          department determines that community-based vocational  
          development services improve employment outcomes and result in  
          cost savings, the department may, in its sole discretion, expand  
          the availability of community-based vocational development  
          services statewide.

          (B) If the department, based on its assessment of employment  
          outcomes and cost savings, does not determine that  
          community-based vocational development services should be  
          expanded statewide, the demonstration project shall end four  
          years from the date of implementation.
           
          2)It is the intent of the author that community-based vocational  
            development services, or the combination of such services  








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            along with other community-based day services, be provided  
            consistent with a consumer's IPP, not to exceed the maximum  
            number of authorized hours of day services.  However, current  
            language in the bill could be interpreted to grant 30 hours  
            per week of community-based vocational development services in  
            addition to the authorized amount of other day services.   
            Additionally, because the services created in the bill are to  
            occur as an intermediate step toward more appropriate and  
            successful employment opportunities, they should be  
            time-limited to ensure they do not take the place of actual  
            employment.  In order to clarify the language, consistent with  
            the author's intent, committee staff recommends the following  
            amendments to Section 4854(d) on page 7 of the bill:

          (d) Community-based vocational development services may be  
          provided in lieu of hours of participation in  conjunction with  
          other community-based day services, and shall not increase the  
          total weekly hours of community-based day services, as  
          determined by the consumer's planning team, for  no more than 30  
          hours of service a week for  up to two years. Community-based  
          vocational development services may be authorized beyond the  
          initial two years, if the consumer, his or her habilitation  
          service provider, and the regional center determine and document  
          at each semiannual review that the consumer is making  
          significant progress toward the habilitation services  
          objectives, for no more than an additional two years.

           RELATED LEGISLATION  :

          AB 1041 (Chesbro) Chapter 677, Statutes of 2013, established the  
          "Employment First Policy" for Californians with developmental  
          disabilities, which includes a requirement that regional centers  
          provide consumers 16 years of age or older information about the  
          Employment First Policy, options for integrated competitive  
          employment, and services and supports, including postsecondary  
          education, that are available to enable the consumer to  
          transition from school to work, and to achieve the outcomes of  
          obtaining and maintaining integrated competitive employment.
          
          AB 1626 (Maienschein) 2014, increases the rates and fees paid to  
          supported employment services providers for regional center  
          consumers.

          SB 1160 (Beall) 2014, reduces the minimum job coach-to-consumer  
          ratio for supported employment services and ensures that support  








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          for consumers who receive individualized job coaching services  
          only decreases over time with the goal of achieving  
          stabilization if such a goal is appropriate and consistent with  
          a consumer's IPP.

           REGISTERED SUPPORT / OPPOSITION  :

           Support 
           
          Alameda County Board of Supervisors 
          Alameda County Developmental Disabilities Council 
          Association of Regional Center Agencies 
          Autism Society of Los Angeles
          Autism Society San Diego 
          CA Disability Services Association (CDSA) 
          California Federation of Teachers 
          California State Council on Developmental Disabilities 
          Center for Autism and related Disorders (CARD) 
          Developmental Disabilities Area Board 10
          Disability Rights California 
          Disability Rights Education & Defense Fund (DREDF) 
          East Bay Developmental Disabilities Legislative Coalition 
          Easter Seal California 
          Friends of Children with Special Needs FCSN) 
          Futures Explored 
          Jay Nolan Community Services 
          National Association of Social Workers, California Chapter  
          (NASW-CA) 
          SEIU CA 
          The Alliance 
          The ARC and United Cerebral Palsy California Collaboration 
           
            Opposition 
           
          None on file.

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