Amended in Senate March 27, 2014

Senate BillNo. 1093


Introduced by Senator Liu

February 19, 2014


An actbegin insert to amend Sections 4629, 4519.5, and 4648 of the Welfare and Institutions Code,end insert relating to developmental services.

LEGISLATIVE COUNSEL’S DIGEST

SB 1093, as amended, Liu. Developmental services: regional centers: culturally and linguistically competent services.

begin delete

The

end delete

begin insert(1)end insertbegin insertend insertbegin insertTheend insert Lanterman Developmental Disabilities Services Act authorizes the State Department of Developmental Services to contract with regional centers to provide services and support to individuals with developmental disabilities. The services and supports to be provided to a regional centerbegin delete consumerend deletebegin insert consumer, which include services and supports that are directed toward the achievement and maintenance of an independent, productive, and normal life for the consumer such as daily living skills training,end insert are contained in an individual program plan or individualized family service plan developed in accordance with prescribed requirements.

This bill wouldbegin delete state the intent of the Legislature to enact legislation that requires regional centers to provide services in a culturally and linguistically competent manner, that reduces disparities in treatment based on racial, ethnic, and language differences that are identified by the purchase of service data, and that ensures that services are provided in the least restrictive environment, including, but not limited to, a consumer’s family home.end deletebegin insert require that independent living skills services be available to adult consumers who live in the home of a parent, relative, or another person.end insert

begin insert

(2) Existing law requires that contracts entered into with regional centers include annual performance objectives, including annual performance objectives that are specific, measurable, and, among other things, designed to develop services and supports identified as necessary to meet identified needs. Existing law also requires that each contract with a regional center specify steps to be taken to ensure contract compliance, and, if a regional center is placed on probation pursuant to these steps, requires the department to provide the appropriate area board with a copy of the correction plan, timeline, and any other action taken by the department.

end insert
begin insert

This bill would require that annual performance objectives, among other things, be designed to develop services and supports identified as necessary to meet identified needs, which includes culturally and linguistically appropriate services and supports. The bill would require that, if a regional center is placed on probation, the department also provide a copy of the correction plan, timeline, and any other action taken by the department to the Office of Clients’ Rights Advocacy.

end insert
begin insert

This bill would also require each regional center, in addition to those performance objectives, to develop a plan with specific and measurable objectives that include activities and timelines that will lead to an increase in the utilization of services by consumers impacted by purchase of service disparities. The bill would require a regional center to utilize a specified public process and consult with specified stakeholders in developing that plan.

end insert
begin insert

(3) Existing law requires the department and regional centers to annually collaborate to compile specified data relating to purchase of service authorization, utilization, and expenditure by each regional center and requires that data to include the number and percentage of individuals, categorized by age, race, or ethnicity, and disability, who have been determined to be eligible for regional center services, but who are not receiving purchase of service funds. Existing law requires each regional center and the department to annually post this information on their respective Internet Web sites, as prescribed, and requires each regional center to hold annual stakeholder meetings regarding the data.

end insert
begin insert

This bill would require the number and percentage of individuals who have been determined to be eligible for regional center services, but who are not receiving purchase of service funds, to be subcategorized by residence type. The bill would also require the department and each regional center to maintain all preceding years’ data on its Internet Web site. The bill would require that regional centers hold the annual stakeholder meetings regarding the data separately from a meeting of its board of directors, schedule the meetings at times and locations designed to result in a high turn out by the public and underserved communities, and, in holding the meetings, consider the language needs of the community.

end insert

Vote: majority. Appropriation: no. Fiscal committee: begin deleteno end deletebegin insertyesend insert. State-mandated local program: no.

The people of the State of California do enact as follows:

P3    1begin insert

begin insertSECTION 1.end insert  

end insert

begin insertSection 4629 of the end insertbegin insertWelfare and Institutions Codeend insert
2begin insert is amended to read:end insert

3

4629.  

(a) The state shall enter into five-year contracts with
4regional centers, subject to the annual appropriation of funds by
5the Legislature.

6(b) The contracts shall include a provision requiring each
7regional center to render services in accordance with applicable
8provision of state laws and regulations.

9(c) (1) The contracts shall include annual performance
10objectives that shall do both of the following:

11(A) Be specific, measurable, and designed to do all of the
12following:

13(i) Assist consumers to achieve life quality outcomes.

14(ii) Achieve meaningful progress above the current baselines.

15(iii) Develop services and supports identified as necessary to
16meet identifiedbegin delete needs.end deletebegin insert needs, including culturally and linguistically
17appropriate services and supports.end insert

18(B) Be developed through a public process as described in the
19department’s guidelines that includes, but is not limited to, all of
20the following:

21(i) Providing information, in an understandable form, to the
22community about regional center services and supports, including
23budget information and baseline data on services and supports and
24regional center operations.

25(ii) Conducting a public meeting where participants can provide
26input on performance objectives and using focus groups or surveys
27to collect information from the community.

P4    1(iii) Circulating a draft of the performance objectives to the
2community for input prior to presentation at a regional center board
3meeting where additional public input will be taken and considered
4before adoption of the objectives.

5(2) In addition to the performance objectives developed pursuant
6to this section, the department may specify in the performance
7contract additional areas of service and support that require
8development or enhancement by the regional center. In determining
9those areas, the department shall consider public comments from
10individuals and organizations within the regional center catchment
11area, the distribution of services and supports within the regional
12center catchment area, and review how the availability of services
13and supports in the regional area catchment area compares with
14other regional center catchment areas.

begin insert

15(3) In addition to the performance objectives developed pursuant
16to this section, the department shall require each regional center
17to develop a plan with specific and measurable objectives that
18include activities and timelines that will lead to an increase in the
19utilization of services by consumers impacted by the purchase of
20service disparities identified pursuant to Sections 4519.5 and
214519.6. In developing that plan, a regional center shall utilize the
22public process described in subparagraph (B) of paragraph (1),
23and shall consider stakeholder input from the State Council on
24Developmental Disabilities, the Office of Clients’ Rights Advocacy,
25and the protection and advocacy agency described in Section 4901,
26and input gathered from meetings held pursuant to subdivision (e)
27of Section 4519.5.

end insert

28(d) Each contract with a regional center shall specify steps to
29be taken to ensure contract compliance, including, but not limited
30to, all of the following:

31(1) Incentives that encourage regional centers to meet or exceed
32performance standards.

33(2) Levels of probationary status for regional centers that do
34not meet, or are at risk of not meeting, performance standards. The
35department shall require that corrective action be taken by any
36regional center which is placed on probation. Corrective action
37may include, but is not limited to, mandated consultation with
38designated representatives of the Association of Regional Center
39Agencies or a management team designated by the department, or
40both. The department shall establish the specific timeline for the
P5    1implementation of corrective action and monitor its
2implementation. When a regional center is placed on probation,
3the department shall provide the appropriate area boardbegin insert and the
4Office of Clients’ Rights Advocacyend insert
with a copy of the correction
5plan, timeline, and any other action taken by the department
6relating to the probationary status of the regional center.

7(e) In order to evaluate the regional center’s compliance with
8its contract performance objectives and legal obligations related
9to those objectives, the department shall do both of the following:

10(1) Annually assess each regional center’s achievement of its
11previous year’s objectives and make the assessment, including
12baseline data and performance objectives of the individual regional
13centers, available to the public. The department may make a special
14commendation of the regional centers that have best engaged the
15community in the development of contract performance objectives
16and have made the most meaningful progress in meeting or
17exceeding contract performance objectives.

18(2) Monitor the activities of the regional center to ensure
19compliance with the provisions of its contracts, including, but not
20limited to, reviewing all of the following:

21(A) The regional center’s public process for compliance with
22the procedures sets forth in paragraph (2) of subdivision (c).

23(B) Each regional center’s performance objectives for
24compliance with the criteria set forth inbegin delete paragraphend deletebegin insert paragraphsend insert (1)
25begin insert to (3), inclusive,end insert of subdivision (c).

26(C) Any public comments on regional center performance
27objectives sent to the department or to the regional centers, and
28soliciting public input on the public process and final performance
29standards.

30(f) The renewal of each contract shall be contingent upon
31compliance with the contract including, but not limited to, the
32performance objectives, as determined through the department’s
33evaluation.

34begin insert

begin insertSEC. 2.end insert  

end insert

begin insertSection 4519.5 of the end insertbegin insertWelfare and Institutions Codeend insert
35begin insert is amended to read:end insert

36

4519.5.  

(a) The department and the regional centers shall
37annually collaborate to compile data in a uniform manner relating
38to purchase of service authorization, utilization, and expenditure
39by each regional center with respect to all of the following:

40(1) The age of consumer, categorized by the following:

P6    1(A) Birth to age two, inclusive.

2(B) Three to 21, inclusive.

3(C) Twenty-two and older.

4(2) Race or ethnicity of the consumer.

5(3) Primary language spoken by the consumer, and other related
6details, as feasible.

7(4) Disability detail, in accordance with the categories
8established by subdivision (a) of Section 4512, and, if applicable,
9a category specifying that the disability is unknown.

10(b) The data reported pursuant to subdivision (a) shall also
11include the number and percentage of individuals, categorized by
12age, race or ethnicity, and disability,begin insert and subcategorized by
13residence type,end insert
who have been determined to be eligible for
14regional center services but are not receiving purchase of service
15funds.

16(c) By March 31, 2013, each regional center shall post the data
17described in this section that is specific to the regional center on
18its Internet Web site. Commencing on December 31, 2013, each
19regional center shall annually post this data by December 31.begin insert Each
20regional center shall maintain all previous years’ data on its
21Internet Web site.end insert

22(d) By March 31, 2013, the department shall post the information
23described in this section on a statewide basis on its Internet Web
24site. Commencing December 31, 2013, the department shall
25annually post this information by December 31.begin insert The department
26shall maintain all previous years’ data on its Internet Web site.end insert

27 The department shall also post notice of any regional center
28stakeholder meetings on its Internet Web site.

29(e) Within three months of compiling the data with the
30 department, and annually thereafter, each regional center shall
31meet with stakeholders inbegin delete aend deletebegin insert one or moreend insert publicbegin delete meetingend deletebegin insert meetingsend insert
32 regarding the data.begin insert The meeting or meetings shall be held
33separately from a meeting held pursuant to Section 4660 and shall
34provide the report and discussion of the data and information in
35an understandable form.end insert
Regional centers shall inform the
36department of the scheduling of those public meetings 30 days
37prior to the meeting. Notice of the meetings shall also be posted
38on the regional center’s Internet Web site 30 days prior to the
39meeting and shall be sent to individual stakeholders and groups
40representing underserved communities in a timely manner.begin insert Each
P7    1regional center shall, in holding the meetings required by this
2subdivision, consider the language needs of the community and
3shall schedule the meetings at times and locations designed to
4result in a high turnout by the public and underserved communities.end insert

5begin insert

begin insertSEC. 3.end insert  

end insert

begin insertSection 4648 of the end insertbegin insertWelfare and Institutions Codeend insertbegin insert is
6amended to read:end insert

7

4648.  

In order to achieve the stated objectives of a consumer’s
8individual program plan, the regional center shall conduct activities,
9including, but not limited to, all of the following:

10(a) Securing needed services and supports.

11(1) It is the intent of the Legislature that services and supports
12assist individuals with developmental disabilities in achieving the
13greatest self-sufficiency possible and in exercising personal
14choices. The regional center shall secure services and supports
15that meet the needs of the consumer, as determined in the
16consumer’s individual program plan, and within the context of the
17individual program plan, the planning team shall give highest
18preference to those services and supports which would allow
19minors with developmental disabilities to live with their families,
20adult persons with developmental disabilities to live as
21independently as possible in the community, and that allow all
22consumers to interact with persons without disabilities in positive,
23meaningful ways.

24(2) begin insert(A)end insertbegin insertend insert In implementing individual program plans, regional
25centers, through the planning team, shall first consider services
26and supports in natural community, home, work, and recreational
27settings. Services and supports shall be flexible and individually
28tailored to the consumer and, where appropriate, his or her family.

begin insert

29(B) In order to ensure that regional center services are provided
30in a culturally competent manner and available to consumers from
31diverse language, ethnic, and racial populations, independent
32living skills services shall be available to adult consumers who
33live in the home of a parent, relative, or another person.

end insert

34(3) A regional center may, pursuant to vendorization or a
35contract, purchase services or supports for a consumer from any
36individual or agency which the regional center and consumer or,
37where appropriate, his or her parents, legal guardian, or
38conservator, or authorized representatives, determines will best
39accomplish all or any part of that consumer’s program plan.

P8    1(A) Vendorization or contracting is the process for identification,
2selection, and utilization of service vendors or contractors, based
3on the qualifications and other requirements necessary in order to
4provide the service.

5(B) A regional center may reimburse an individual or agency
6for services or supports provided to a regional center consumer if
7the individual or agency has a rate of payment for vendored or
8contracted services established by the department, pursuant to this
9division, and is providing services pursuant to an emergency
10vendorization or has completed the vendorization procedures or
11has entered into a contract with the regional center and continues
12to comply with the vendorization or contracting requirements. The
13director shall adopt regulations governing the vendorization process
14to be utilized by the department, regional centers, vendors and the
15individual or agency requesting vendorization.

16(C) Regulations shall include, but not be limited to: the vendor
17application process, and the basis for accepting or denying an
18application; the qualification and requirements for each category
19of services that may be provided to a regional center consumer
20through a vendor; requirements for emergency vendorization;
21procedures for termination of vendorization; the procedure for an
22individual or an agency to appeal any vendorization decision made
23by the department or regional center.

24(D) A regional center may vendorize a licensed facility for
25exclusive services to persons with developmental disabilities at a
26capacity equal to or less than the facility’s licensed capacity. A
27facility already licensed on January 1, 1999, shall continue to be
28vendorized at their full licensed capacity until the facility agrees
29to vendorization at a reduced capacity.

30(E) Effective July 1, 2009, notwithstanding any other provision
31of law or regulation to the contrary, a regional center shall not
32newly vendor a State Department of Social Services licensed
3324-hour residential care facility with a licensed capacity of 16 or
34more beds, unless the facility qualifies for receipt of federal funds
35under the Medicaid Program.

36(4) Notwithstanding subparagraph (B) of paragraph (3), a
37regional center may contract or issue a voucher for services and
38supports provided to a consumer or family at a cost not to exceed
39the maximum rate of payment for that service or support
40established by the department. If a rate has not been established
P9    1by the department, the regional center may, for an interim period,
2contract for a specified service or support with, and establish a
3rate of payment for, any provider of the service or support
4necessary to implement a consumer’s individual program plan.
5Contracts may be negotiated for a period of up to three years, with
6annual review and subject to the availability of funds.

7(5) In order to ensure the maximum flexibility and availability
8of appropriate services and supports for persons with
9developmental disabilities, the department shall establish and
10maintain an equitable system of payment to providers of services
11and supports identified as necessary to the implementation of a
12consumers’ individual program plan. The system of payment shall
13include provision for a rate to ensure that the provider can meet
14the special needs of consumers and provide quality services and
15supports in the least restrictive setting as required by law.

16(6) The regional center and the consumer, or where appropriate,
17his or her parents, legal guardian, conservator, or authorized
18representative, including those appointed pursuant to subdivision
19(d) of Section 4548, subdivision (b) of Section 4701.6, or
20subdivision (e) of Section 4705, shall, pursuant to the individual
21program plan, consider all of the following when selecting a
22provider of consumer services and supports:

23(A) A provider’s ability to deliver quality services or supports
24which can accomplish all or part of the consumer’s individual
25program plan.

26(B) A provider’s success in achieving the objectives set forth
27in the individual program plan.

28(C) Where appropriate, the existence of licensing, accreditation,
29or professional certification.

30(D) The cost of providing services or supports of comparable
31quality by different providers, if available, shall be reviewed, and
32the least costly available provider of comparable service, including
33the cost of transportation, who is able to accomplish all or part of
34the consumer’s individual program plan, consistent with the
35 particular needs of the consumer and family as identified in the
36individual program plan, shall be selected. In determining the least
37costly provider, the availability of federal financial participation
38shall be considered. The consumer shall not be required to use the
39least costly provider if it will result in the consumer moving from
P10   1an existing provider of services or supports to more restrictive or
2less integrated services or supports.

3(E) The consumer’s choice of providers, or, where appropriate,
4the consumer’s parent’s, legal guardian’s, authorized
5representative’s, or conservator’s choice of providers.

6(7) No service or support provided by any agency or individual
7shall be continued unless the consumer or, where appropriate, his
8or her parents, legal guardian, or conservator, or authorized
9representative, including those appointed pursuant to subdivision
10(d) of Section 4548, subdivision (b) of Section 4701.6, or
11subdivision (e) of Section 4705, is satisfied and the regional center
12and the consumer or, when appropriate, the person’s parents or
13legal guardian or conservator agree that planned services and
14supports have been provided, and reasonable progress toward
15objectives have been made.

16(8) Regional center funds shall not be used to supplant the
17budget of any agency that has a legal responsibility to serve all
18members of the general public and is receiving public funds for
19providing those services.

20(9) (A) A regional center may, directly or through an agency
21acting on behalf of the center, provide placement in, purchase of,
22or follow-along services to persons with developmental disabilities
23in, appropriate community living arrangements, including, but not
24limited to, support service for consumers in homes they own or
25 lease, foster family placements, health care facilities, and licensed
26community care facilities. In considering appropriate placement
27alternatives for children with developmental disabilities, approval
28by the child’s parent or guardian shall be obtained before placement
29is made.

30(B) Effective July 1, 2012, notwithstanding any other law or
31regulation to the contrary, a regional center shall not purchase
32residential services from a State Department of Social Services
33licensed 24-hour residential care facility with a licensed capacity
34of 16 or more beds. This prohibition on regional center purchase
35of residential services shall not apply to any of the following:

36(i) A residential facility with a licensed capacity of 16 or more
37beds that has been approved to participate in the department’s
38Home and Community Based Services Waiver or another existing
39waiver program or certified to participate in the Medi-Cal program.

P11   1(ii) A residential facility service provider that has a written
2agreement and specific plan prior to July 1, 2012, with the
3vendoring regional center to downsize the existing facility by
4transitioning its residential services to living arrangements of 15
5beds or less or restructure the large facility to meet federal
6Medicaid eligibility requirements on or before June 30, 2013.

7(iii) A residential facility licensed as a mental health
8rehabilitation center by the State Department of Mental Health or
9successor agency under any of the following circumstances:

10(I) The facility is eligible for Medicaid reimbursement.

11(II) The facility has a department-approved plan in place by
12June 30, 2013, to transition to a program structure eligible for
13federal Medicaid funding, and this transition will be completed by
14June 30, 2014. The department may grant an extension for the date
15by which the transition will be completed if the facility
16demonstrates that it has made significant progress toward transition,
17and states with specificity the timeframe by which the transition
18will be completed and the specified steps that will be taken to
19accomplish the transition. A regional center may pay for the costs
20of care and treatment of a consumer residing in the facility on June
2130, 2012, until June 30, 2013, inclusive, and, if the facility has a
22department-approved plan in place by June 30, 2013, may continue
23to pay the costs under this subparagraph until June 30, 2014, or
24until the end of any period during which the department has granted
25an extension.

26(III) There is an emergency circumstance in which the regional
27center determines that it cannot locate alternate federally eligible
28services to meet the consumer’s needs. Under such an emergency
29circumstance, an assessment shall be completed by the regional
30center as soon as possible and within 30 days of admission. An
31individual program plan meeting shall be convened immediately
32following the assessment to determine the services and supports
33needed for stabilization and to develop a plan to transition the
34consumer from the facility into the community. If transition is not
35expected within 90 days of admission, an individual program plan
36meeting shall be held to discuss the status of transition and to
37determine if the consumer is still in need of placement in the
38facility. Commencing October 1, 2012, this determination shall
39be made after also considering resource options identified by the
40statewide specialized resource service. If it is determined that
P12   1emergency services continue to be necessary, the regional center
2shall submit an updated transition plan that can cover a period of
3up to 90 days. In no event shall placements under these emergency
4circumstances exceed 180 days.

5(C) (i) Effective July 1, 2012, notwithstanding any other law
6or regulation to the contrary, a regional center shall not purchase
7new residential services from, or place a consumer in, institutions
8for mental disease, as described in Part 5 (commencing with
9Section 5900) of Division 5, for which federal Medicaid funding
10is not available. Effective July 1, 2013, this prohibition applies
11regardless of the availability of federal funding.

12(ii) The prohibition described in clause (i) shall not apply to
13emergencies, as determined by the regional center, when a regional
14center cannot locate alternate services to meet the consumer’s
15needs. As soon as possible within 30 days of admission due to an
16emergency, an assessment shall be completed by the regional
17 center. An individual program plan meeting shall be convened
18immediately following the assessment, to determine the services
19and supports needed for stabilization and to develop a plan to
20transition the consumer from the facility to the community. If
21transition is not expected within 90 days of admission, an
22emergency program plan meeting shall be held to discuss the status
23of the transition and to determine if the consumer is still in need
24of placement in the facility. If emergency services continue to be
25necessary, the regional center shall submit an updated transition
26plan to the department for an extension of up to 90 days. Placement
27shall not exceed 180 days.

28(iii) To the extent feasible, prior to any admission, the regional
29center shall consider resource options identified by the statewide
30specialized resource service established pursuant to subdivision
31(b) of Section 4418.25.

32(iv) The clients’ rights advocate shall be notified of each
33admission and individual program planning meeting pursuant to
34this subparagraph and may participate in all individual program
35planning meetings unless the consumer objects on his or her own
36behalf.

37(v) Regional centers shall complete a comprehensive assessment
38of any consumer residing in an institution for mental disease as of
39July 1, 2012, for which federal Medicaid funding is not available,
40and for any consumer residing in an institution for mental disease
P13   1as of July 1, 2013, without regard to federal funding. The
2comprehensive assessment shall be completed prior to the
3consumer’s next scheduled individual program plan meeting and
4shall include identification of the services and supports needed
5and the timeline for identifying or developing those services needed
6to transition the consumer back to the community. Effective
7October 1, 2012, the regional center shall also consider resource
8options identified by the statewide specialized resource service.
9For each individual program plan meeting convened pursuant to
10this subparagraph, the clients’ rights advocate for the regional
11center shall be notified of the meeting and may participate in the
12meeting unless the consumer objects on his or her own behalf.

13(D) Each person with developmental disabilities placed by the
14regional center in a community living arrangement shall have the
15rights specified in this division. These rights shall be brought to
16the person’s attention by any means necessary to reasonably
17communicate these rights to each resident, provided that, at a
18minimum, the Director of Developmental Services prepare,
19provide, and require to be clearly posted in all residential facilities
20and day programs a poster using simplified language and pictures
21that is designed to be more understandable by persons with
22cognitive disabilities and that the rights information shall also be
23available through the regional center to each residential facility
24and day program in alternative formats, including, but not limited
25to, other languages, braille, and audio tapes, when necessary to
26meet the communication needs of consumers.

27(E) Consumers are eligible to receive supplemental services
28including, but not limited to, additional staffing, pursuant to the
29process described in subdivision (d) of Section 4646. Necessary
30additional staffing that is not specifically included in the rates paid
31to the service provider may be purchased by the regional center if
32the additional staff are in excess of the amount required by
33regulation and the individual’s planning team determines the
34additional services are consistent with the provisions of the
35individual program plan. Additional staff should be periodically
36reviewed by the planning team for consistency with the individual
37program plan objectives in order to determine if continued use of
38the additional staff is necessary and appropriate and if the service
39is producing outcomes consistent with the individual program plan.
P14   1Regional centers shall monitor programs to ensure that the
2additional staff is being provided and utilized appropriately.

3(10) Emergency and crisis intervention services including, but
4not limited to, mental health services and behavior modification
5services, may be provided, as needed, to maintain persons with
6developmental disabilities in the living arrangement of their own
7choice. Crisis services shall first be provided without disrupting a
8person’s living arrangement. If crisis intervention services are
9unsuccessful, emergency housing shall be available in the person’s
10home community. If dislocation cannot be avoided, every effort
11shall be made to return the person to his or her living arrangement
12of choice, with all necessary supports, as soon as possible.

13(11) Among other service and support options, planning teams
14shall consider the use of paid roommates or neighbors, personal
15assistance, technical and financial assistance, and all other service
16and support options which would result in greater self-sufficiency
17for the consumer and cost-effectiveness to the state.

18(12) When facilitation as specified in an individual program
19plan requires the services of an individual, the facilitator shall be
20of the consumer’s choosing.

21(13) The community support may be provided to assist
22individuals with developmental disabilities to fully participate in
23community and civic life, including, but not limited to, programs,
24services, work opportunities, business, and activities available to
25persons without disabilities. This facilitation shall include, but not
26be limited to, any of the following:

27(A) Outreach and education to programs and services within
28the community.

29(B) Direct support to individuals which would enable them to
30more fully participate in their community.

31(C) Developing unpaid natural supports when possible.

32(14) When feasible and recommended by the individual program
33planning team, for purposes of facilitating better and cost-effective
34services for consumers or family members, technology, including
35telecommunication technology, may be used in conjunction with
36other services and supports. Technology in lieu of a consumer’s
37in-person appearances at judicial proceedings or administrative
38due process hearings may be used only if the consumer or, when
39appropriate, the consumer’s parent, legal guardian, conservator,
40or authorized representative, gives informed consent. Technology
P15   1may be used in lieu of, or in conjunction with, in-person training
2for providers, as appropriate.

3(15) Other services and supports may be provided as set forth
4in Sections 4685, 4686, 4687, 4688, and 4689, when necessary.

5(16) Notwithstanding any other provision of law or regulation
6to the contrary, effective July 1, 2009, regional centers shall not
7purchase experimental treatments, therapeutic services, or devices
8that have not been clinically determined or scientifically proven
9to be effective or safe or for which risks and complications are
10unknown. Experimental treatments or therapeutic services include
11experimental medical or nutritional therapy when the use of the
12product for that purpose is not a general physician practice. For
13regional center consumers receiving these services as part of their
14individual program plan (IPP) or individualized family service
15plan (IFSP) on July 1, 2009, this prohibition shall apply on August
161, 2009.

17(b) (1) Advocacy for, and protection of, the civil, legal, and
18service rights of persons with developmental disabilities as
19established in this division.

20(2) Whenever the advocacy efforts of a regional center to secure
21or protect the civil, legal, or service rights of any of its consumers
22prove ineffective, the regional center or the person with
23developmental disabilities or his or her parents, legal guardian, or
24other representative may request the area board to initiate action
25under the provisions defining area board advocacy functions
26established in this division.

27(c) The regional center may assist consumers and families
28directly, or through a provider, in identifying and building circles
29of support within the community.

30(d) In order to increase the quality of community services and
31protect consumers, the regional center shall, when appropriate,
32take either of the following actions:

33(1) Identify services and supports that are ineffective or of poor
34quality and provide or secure consultation, training, or technical
35assistance services for any agency or individual provider to assist
36that agency or individual provider in upgrading the quality of
37services or supports.

38(2) Identify providers of services or supports that may not be
39in compliance with local, state, and federal statutes and regulations
P16   1and notify the appropriate licensing or regulatory authority, or
2request the area board to investigate the possible noncompliance.

3(e) When necessary to expand the availability of needed services
4of good quality, a regional center may take actions that include,
5but are not limited to, the following:

6(1) Soliciting an individual or agency by requests for proposals
7or other means, to provide needed services or supports not presently
8available.

9(2) Requesting funds from the Program Development Fund,
10pursuant to Section 4677, or community placement plan funds
11designated from that fund, to reimburse the startup costs needed
12to initiate a new program of services and supports.

13(3) Using creative and innovative service delivery models,
14including, but not limited to, natural supports.

15(f) Except in emergency situations, a regional center shall not
16provide direct treatment and therapeutic services, but shall utilize
17appropriate public and private community agencies and service
18providers to obtain those services for its consumers.

19(g) Where there are identified gaps in the system of services
20and supports or where there are identified consumers for whom
21no provider will provide services and supports contained in his or
22her individual program plan, the department may provide the
23services and supports directly.

24(h) At least annually, regional centers shall provide the
25consumer, his or her parents, legal guardian, conservator, or
26authorized representative a statement of services and supports the
27regional center purchased for the purpose of ensuring that they are
28delivered. The statement shall include the type, unit, month, and
29cost of services and supports purchased.

begin delete
30

SECTION 1.  

It is the intent of the Legislature to enact
31legislation that does all of the following:

32(a) Requires regional centers to provide services in a culturally
33and linguistically competent manner.

34(b) Reduces disparities in treatment based on racial, ethnic, and
35language differences that are identified by the purchase of service
36data.

37(c) Ensures that services are provided in the least restrictive
38environment, including, but not limited to, a consumer’s family
39home.

end delete


O

    98