Amended in Senate April 24, 2014

Amended in Senate April 10, 2014

Amended in Senate March 27, 2014

Senate BillNo. 1093


Introduced by Senator Liu

February 19, 2014


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

LEGISLATIVE COUNSEL’S DIGEST

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

(1) The Lanterman Developmental Disabilities Services Actbegin delete authorizesend deletebegin insert requiresend insert the State Department of Developmental Services to contract with regional centers to provide services andbegin delete supportend deletebegin insert supportsend insert to individuals with developmental disabilities. The services and supports to be provided to a regional center 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, are contained in an individual program plan or individualized family service plan developed in accordance with prescribed requirements.

This bill would require that independent living skills services be available to all adult consumers who live in the home of a parent, relative, or other person, or who live independently.

(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.

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 tobegin delete the Office of Clients’ Rights Advocacy.end deletebegin insert a specified clientsend insertbegin insert’ rights advocacy contractor.end insert

This bill would also require each regional center, in addition to those performance objectives, to develop and implement 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.

(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,begin delete race,end deletebegin insert raceend insert 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.

This bill would additionally require the data to includebegin delete 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, toend deletebegin insert, andend insert be categorized bybegin insert,end insert residence type and subcategorized by age, race or ethnicity, and primary language. 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 frombegin delete a meetingend deletebegin insert any meetingsend insert of its board of directors, schedule the meetings at times and locations designed to result in a highbegin delete turn outend deletebegin insert turnoutend insert by the public and underserved communities, and, in holding the meetings, consider the language needs of the community.begin insert The bill would require the regional centers to provide participants of these meetings with the data and associated information and to conduct a discussion of the data and associated information in a manner that is culturally and linguistically appropriate for that community, as specified.end insert

Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.

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

P3    1

SECTION 1.  

Section 4519.5 of the Welfare and Institutions
2Code
is amended to read:

3

4519.5.  

(a) The department and the regional centers shall
4annually collaborate to compile data in a uniform manner relating
5to purchase of service authorization, utilization, and expenditure
6by each regional center with respect to all of the following:

7(1) The age of consumer, categorized by the following:

8(A) Birth to age two, inclusive.

9(B) Three to 21, inclusive.

10(C) Twenty-two and older.

11(2) Race or ethnicity of the consumer.

12(3) Primary language spoken by the consumer, and other related
13details, as feasible.

14(4) Disability detail, in accordance with the categories
15established by subdivision (a) of Section 4512, and, if applicable,
16a category specifying that the disability is unknown.

17(5) Residence type, subcategorized by age, race or ethnicity,
18and primary language.

19(b) The data reported pursuant to subdivision (a) shall also
20include the number and percentage of individuals, categorized by
21age, race or ethnicity, and disability, and by residence type, as set
22forth in paragraph (5) of subdivision (a), who have been determined
23to be eligible for regional center services but are not receiving
24 purchase of service funds.

P4    1(c) By March 31, 2013, each regional center shall post the data
2described in this section that is specific to the regional center on
3its Internet Web site. Commencing on December 31, 2013, each
4regional center shall annually post this data by December 31. Each
5regional center shall maintain all previous years’ data on its Internet
6Web site.

7(d) By March 31, 2013, the department shall post the information
8described in this section on a statewide basis on its Internet Web
9site. Commencing December 31, 2013, the department shall
10annually post this information by December 31. The department
11shall maintain all previous years’ data on its Internet Web site.
12The department shall also post notice of any regional center
13stakeholder meetings on its Internet Web site.

14(e) Within three months of compiling the data with the
15department, and annually thereafter, each regional center shall
16meet with stakeholders in one or more public meetings regarding
17the data. The meeting or meetings shall be held separately frombegin delete a
18meetingend delete
begin insert any meetingsend insert held pursuant to Section 4660begin delete andend deletebegin insert. The
19regional centerend insert
shall providebegin delete the report andend deletebegin insert participants of these
20meetings with the data and any associated information, and shall
21conduct aend insert
discussion of the data andbegin insert the associatedend insert information
22inbegin delete an understandable form.end deletebegin insert a manner that is culturally and
23linguistically appropriate for that community, including providing
24alternative communication services, as required by Sections 11135
25to 11139.7, inclusive, of the Government Code and implementing
26regulations.end insert
Regional centers shall inform the department of the
27scheduling of those public meetings 30 days prior to the meeting.
28Notice of the meetings shall also be posted on the regional center’s
29Internet Web site 30 days prior to the meeting and shall be sent to
30individual stakeholders and groups representing underserved
31communities in a timely manner. Each regional center shall, in
32holding the meetings required by this subdivision, consider the
33language needs of the community and shall schedule the meetings
34at times and locations designed to result in a high turnout by the
35public and underserved communities.

36

SEC. 2.  

Section 4629 of the Welfare and Institutions Code is
37amended to read:

38

4629.  

(a) The state shall enter into five-year contracts with
39regional centers, subject to the annual appropriation of funds by
40the Legislature.

P5    1(b) The contracts shall include a provision requiring each
2regional center to render services in accordance with applicable
3provision of state laws and regulations.

4(c) (1) The contracts shall include annual performance
5objectives that shall do both of the following:

6(A) Be specific, measurable, and designed to do all of the
7following:

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

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

10(iii) Develop services and supports identified as necessary to
11meet identified needs, including culturally and linguistically
12appropriate services and supports.

13(B) Be developed through a public process as described in the
14department’s guidelines that includes, but is not limited to, all of
15the following:

16(i) Providing information, in an understandable form, to the
17community about regional center services and supports, including
18budget information and baseline data on services and supports and
19regional center operations.

20(ii) Conducting a public meeting where participants can provide
21input on performance objectives and using focus groups or surveys
22to collect information from the community.

23(iii) Circulating a draft of the performance objectives to the
24community for input prior to presentation at a regional center board
25meeting where additional public input will be taken and considered
26before adoption of the objectives.

27(2) In addition to the performance objectives developed pursuant
28to this section, the department may specify in the performance
29contract additional areas of service and support that require
30development or enhancement by the regional center. In determining
31those areas, the department shall consider public comments from
32individuals and organizations within the regional center catchment
33area, the distribution of services and supports within the regional
34center catchment area, and review how the availability of services
35and supports in the regional area catchment area compares with
36other regional center catchment areas.

37(3) In addition to the performance objectives developed pursuant
38to this section, the department shall require each regional center
39to develop and implement a plan with specific and measurable
40objectives that include activities and timelines that will lead to an
P6    1increase in the utilization of services by consumers impacted by
2the purchase of service disparities identified pursuant to Sections
34519.5 and 4519.6. In developing that plan, a regional center shall
4 utilize the public process described in subparagraph (B) of
5paragraph (1), and shall consider stakeholder input from the State
6Council on Developmental Disabilities, thebegin delete Office of Clients’
7Rights Advocacy,end delete
begin insert end insertbegin insertclients’ rights advocacy contractor identified
8in Section 4433,end insert
and the protection and advocacy agency described
9in Section 4901, and input gathered from meetings held pursuant
10to subdivision (e) of Section 4519.5.

11(d) Each contract with a regional center shall specify steps to
12be taken to ensure contract compliance, including, but not limited
13to, all of the following:

14(1) Incentives that encourage regional centers to meet or exceed
15performance standards.

16(2) Levels of probationary status for regional centers that do
17not meet, or are at risk of not meeting, performance standards. The
18department shall require that corrective action be taken by any
19regional center which is placed on probation. Corrective action
20may include, but is not limited to, mandated consultation with
21designated representatives of the Association of Regional Center
22Agencies or a management team designated by the department, or
23both. The department shall establish the specific timeline for the
24implementation of corrective action and monitor its
25implementation. When a regional center is placed on probation,
26the department shall provide the appropriate area board and the
27begin delete Office of Clients’ Rights Advocacyend deletebegin insert clients’ rights advocacy
28contractor identified in Section 4433end insert
with a copy of the correction
29plan, timeline, and any other action taken by the department
30relating to the probationary status of the regional center.

31(e) In order to evaluate the regional center’s compliance with
32its contract performance objectives and legal obligations related
33to those objectives, the department shall do both of the following:

34(1) Annually assess each regional center’s achievement of its
35previous year’s objectives and make the assessment, including
36baseline data and performance objectives of the individual regional
37centers, available to the public. The department may make a special
38commendation of the regional centers that have best engaged the
39community in the development of contract performance objectives
P7    1and have made the most meaningful progress in meeting or
2exceeding contract performance objectives.

3(2) Monitor the activities of the regional center to ensure
4compliance with the provisions of its contracts, including, but not
5limited to, reviewing all of the following:

6(A) The regional center’s public process for compliance with
7the proceduresbegin delete setsend deletebegin insert setend insert forth in paragraph (2) of subdivision (c).

8(B) Each regional center’s performance objectives for
9compliance with the criteria set forth in paragraphs (1) to (3),
10inclusive, of subdivision (c).

11(C) Any public comments on regional center performance
12objectives sent to the department or to the regional centers, and
13soliciting public input on the public process and final performance
14standards.

15(f) The renewal of each contract shall be contingent upon
16compliance with the contract including, but not limited to, the
17performance objectives, as determined through the department’s
18evaluation.

19

SEC. 3.  

Section 4648 of the Welfare and Institutions Code is
20amended to read:

21

4648.  

In order to achieve the stated objectives of a consumer’s
22individual program plan, the regional center shall conduct activities,
23including, but not limited to, all of the following:

24(a) Securing needed services and supports.

25(1) It is the intent of the Legislature that services and supports
26assist individuals with developmental disabilities in achieving the
27greatest self-sufficiency possible and in exercising personal
28choices. The regional center shall secure services and supports
29that meet the needs of the consumer, as determined in the
30consumer’s individual program plan, and within the context of the
31individual program plan, the planning team shall give highest
32preference to those services and supports which would allow
33minors with developmental disabilities to live with their families,
34adult persons with developmental disabilities to live as
35independently as possible in the community, and that allow all
36consumers to interact with persons without disabilities in positive,
37meaningful ways.

38(2) (A) In implementing individual program plans, regional
39centers, through the planning team, shall first consider services
40and supports in natural community, home, work, and recreational
P8    1settings. Services and supports shall be flexible and individually
2tailored to the consumer and, where appropriate, his or her family.

3(B) In order to ensure that regional center services are provided
4in a culturally competent manner and available to consumers from
5diverse language, ethnic, and racial populations, independent living
6skills services shall be available to all adult consumers who live
7in the home of a parent, relative, or other person, or who live
8independently.

9(3) A regional center may, pursuant to vendorization or a
10contract, purchase services or supports for a consumer from any
11individual or agency which the regional center and consumer or,
12where appropriate, his or her parents, legal guardian, or
13conservator, or authorized representatives, determines will best
14accomplish all or any part of that consumer’s program plan.

15(A) Vendorization or contracting is the process for identification,
16selection, and utilization of service vendors or contractors, based
17on the qualifications and other requirements necessary in order to
18provide the service.

19(B) A regional center may reimburse an individual or agency
20for services or supports provided to a regional center consumer if
21the individual or agency has a rate of payment for vendored or
22contracted services established by the department, pursuant to this
23division, and is providing services pursuant to an emergency
24vendorization or has completed the vendorization procedures or
25has entered into a contract with the regional center and continues
26to comply with the vendorization or contracting requirements. The
27director shall adopt regulations governing the vendorization process
28to be utilized by the department, regional centers, vendors and the
29individual or agency requesting vendorization.

30(C) Regulations shall include, but not be limited to: the vendor
31application process, and the basis for accepting or denying an
32application; the qualification and requirements for each category
33of services that may be provided to a regional center consumer
34through a vendor; requirements for emergency vendorization;
35procedures for termination of vendorization; the procedure for an
36individual or an agency to appeal any vendorization decision made
37by the department or regional center.

38(D) A regional center may vendorize a licensed facility for
39exclusive services to persons with developmental disabilities at a
40capacity equal to or less than the facility’s licensed capacity. A
P9    1facility already licensed on January 1, 1999, shall continue to be
2vendorized at their full licensed capacity until the facility agrees
3to vendorization at a reduced capacity.

4(E) Effective July 1, 2009, notwithstanding any other law or
5regulation, a regional center shall not newly vendor a State
6Department of Social Services licensed 24-hour residential care
7facility with a licensed capacity of 16 or more beds, unless the
8facility qualifies for receipt of federal funds under the Medicaid
9Program.

10(4) Notwithstanding subparagraph (B) of paragraph (3), a
11regional center may contract or issue a voucher for services and
12supports provided to a consumer or family at a cost not to exceed
13the maximum rate of payment for that service or support
14established by the department. If a rate has not been established
15by the department, the regional center may, for an interim period,
16contract for a specified service or support with, and establish a
17rate of payment for, any provider of the service or support
18necessary to implement a consumer’s individual program plan.
19Contracts may be negotiated for a period of up to three years, with
20annual review and subject to the availability of funds.

21(5) In order to ensure the maximum flexibility and availability
22of appropriate services and supports for persons with
23developmental disabilities, the department shall establish and
24maintain an equitable system of payment to providers of services
25and supports identified as necessary to the implementation of a
26consumers’ individual program plan. The system of payment shall
27include provision for a rate to ensure that the provider can meet
28the special needs of consumers and provide quality services and
29supports in the least restrictive setting as required by law.

30(6) The regional center and the consumer, or where appropriate,
31his or her parents, legal guardian, conservator, or authorized
32representative, including those appointed pursuant to subdivision
33(d) of Section 4548, subdivision (b) of Section 4701.6, or
34subdivision (e) of Section 4705, shall, pursuant to the individual
35program plan, consider all of the following when selecting a
36provider of consumer services and supports:

37(A) A provider’s ability to deliver quality services or supports
38which can accomplish all or part of the consumer’s individual
39program plan.

P10   1(B) A provider’s success in achieving the objectives set forth
2in the individual program plan.

3(C) When appropriate, the existence of licensing, accreditation,
4 or professional certification.

5(D) The cost of providing services or supports of comparable
6quality by different providers, if available, shall be reviewed, and
7the least costly available provider of comparable service, including
8the cost of transportation, who is able to accomplish all or part of
9the consumer’s individual program plan, consistent with the
10 particular needs of the consumer and family as identified in the
11individual program plan, shall be selected. In determining the least
12costly provider, the availability of federal financial participation
13shall be considered. The consumer shall not be required to use the
14least costly provider if it will result in the consumer moving from
15an existing provider of services or supports to more restrictive or
16less integrated services or supports.

17(E) The consumer’s choice of providers, or, where appropriate,
18the consumer’s parent’s, legal guardian’s, authorized
19representative’s, or conservator’s choice of providers.

20(7) No service or support provided by any agency or individual
21shall be continued unless the consumer or, where appropriate, his
22or her parents, legal guardian, or conservator, or authorized
23representative, including those appointed pursuant to subdivision
24(d) of Section 4548, subdivision (b) of Section 4701.6, or
25subdivision (e) of Section 4705, is satisfied and the regional center
26and the consumer or, when appropriate, the person’s parents or
27legal guardian or conservator agree that planned services and
28supports have been provided, and reasonable progress toward
29objectives have been made.

30(8) Regional center funds shall not be used to supplant the
31budget of any agency that has a legal responsibility to serve all
32members of the general public and is receiving public funds for
33providing those services.

34(9) (A) A regional center may, directly or through an agency
35acting on behalf of the center, provide placement in, purchase of,
36or follow-along services to persons with developmental disabilities
37in, appropriate community living arrangements, including, but not
38limited to, support service for consumers in homes they own or
39 lease, foster family placements, health care facilities, and licensed
40community care facilities. In considering appropriate placement
P11   1alternatives for children with developmental disabilities, approval
2by the child’s parent or guardian shall be obtained before placement
3is made.

4(B) Effective July 1, 2012, notwithstanding any other law or
5regulation, a regional center shall not purchase residential services
6from a State Department of Social Services licensed 24-hour
7residential care facility with a licensed capacity of 16 or more
8beds. This prohibition on regional center purchase of residential
9services shall not apply to any of the following:

10(i) A residential facility with a licensed capacity of 16 or more
11beds that has been approved to participate in the department’s
12Home and Community Based Services Waiver or another existing
13waiver program or certified to participate in the Medi-Cal program.

14(ii) A residential facility service provider that has a written
15agreement and specific plan prior to July 1, 2012, with the
16vendoring regional center to downsize the existing facility by
17transitioning its residential services to living arrangements of 15
18beds or less or restructure the large facility to meet federal
19Medicaid eligibility requirements on or before June 30, 2013.

20(iii) A residential facility licensed as a mental health
21rehabilitation center by the State Department of Mental Health or
22successor agency under any of the following circumstances:

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

24(II) The facility has a department-approved plan in place by
25June 30, 2013, to transition to a program structure eligible for
26federal Medicaid funding, and this transition will be completed by
27June 30, 2014. The department may grant an extension for the date
28by which the transition will be completed if the facility
29demonstrates that it has made significant progress toward transition,
30and states with specificity the timeframe by which the transition
31will be completed and the specified steps that will be taken to
32accomplish the transition. A regional center may pay for the costs
33of care and treatment of a consumer residing in the facility on June
3430, 2012, until June 30, 2013, inclusive, and, if the facility has a
35department-approved plan in place by June 30, 2013, may continue
36to pay the costs under this subparagraph until June 30, 2014, or
37until the end of any period during which the department has granted
38an extension.

39(III) There is an emergency circumstance in which the regional
40center determines that it cannot locate alternate federally eligible
P12   1services to meet the consumer’s needs. Under such an emergency
2circumstance, an assessment shall be completed by the regional
3center as soon as possible and within 30 days of admission. An
4individual program plan meeting shall be convened immediately
5following the assessment to determine the services and supports
6needed for stabilization and to develop a plan to transition the
7consumer from the facility into the community. If transition is not
8expected within 90 days of admission, an individual program plan
9meeting shall be held to discuss the status of transition and to
10determine if the consumer is still in need of placement in the
11facility. Commencing October 1, 2012, this determination shall
12be made after also considering resource options identified by the
13statewide specialized resource service. If it is determined that
14emergency services continue to be necessary, the regional center
15shall submit an updated transition plan that can cover a period of
16up to 90 days. In no event shall placements under these emergency
17circumstances exceed 180 days.

18(C) (i) Effective July 1, 2012, notwithstanding any other law
19or regulation to the contrary, a regional center shall not purchase
20new residential services from, or place a consumer in, institutions
21for mental disease, as described in Part 5 (commencing with
22Section 5900) of Division 5, for which federal Medicaid funding
23is not available. Effective July 1, 2013, this prohibition applies
24regardless of the availability of federal funding.

25(ii) The prohibition described in clause (i) shall not apply to
26emergencies, as determined by the regional center, when a regional
27center cannot locate alternate services to meet the consumer’s
28needs. As soon as possible within 30 days of admission due to an
29emergency, an assessment shall be completed by the regional
30center. An individual program plan meeting shall be convened
31immediately following the assessment, to determine the services
32and supports needed for stabilization and to develop a plan to
33transition the consumer from the facility to the community. If
34transition is not expected within 90 days of admission, an
35emergency program plan meeting shall be held to discuss the status
36of the transition and to determine if the consumer is still in need
37of placement in the facility. If emergency services continue to be
38necessary, the regional center shall submit an updated transition
39plan to the department for an extension of up to 90 days. Placement
40shall not exceed 180 days.

P13   1(iii) To the extent feasible, prior to any admission, the regional
2center shall consider resource options identified by the statewide
3specialized resource service established pursuant to subdivision
4(b) of Section 4418.25.

5(iv) The clients’ rights advocate shall be notified of each
6admission and individual program planning meeting pursuant to
7this subparagraph and may participate in all individual program
8planning meetings unless the consumer objects on his or her own
9behalf.

10(v) Regional centers shall complete a comprehensive assessment
11of any consumer residing in an institution for mental disease as of
12July 1, 2012, for which federal Medicaid funding is not available,
13and for any consumer residing in an institution for mental disease
14as of July 1, 2013, without regard to federal funding. The
15comprehensive assessment shall be completed prior to the
16consumer’s next scheduled individual program plan meeting and
17shall include identification of the services and supports needed
18and the timeline for identifying or developing those services needed
19to transition the consumer back to the community. Effective
20October 1, 2012, the regional center shall also consider resource
21options identified by the statewide specialized resource service.
22For each individual program plan meeting convened pursuant to
23this subparagraph, the clients’ rights advocate for the regional
24center shall be notified of the meeting and may participate in the
25meeting unless the consumer objects on his or her own behalf.

26(D) Each person with developmental disabilities placed by the
27regional center in a community living arrangement shall have the
28rights specified in this division. These rights shall be brought to
29the person’s attention by any means necessary to reasonably
30communicate these rights to each resident, provided that, at a
31minimum, the Director of Developmental Services prepare,
32provide, and require to be clearly posted in all residential facilities
33and day programs a poster using simplified language and pictures
34that is designed to be more understandable by persons with
35cognitive disabilities and that the rights information shall also be
36available through the regional center to each residential facility
37and day program in alternative formats, including, but not limited
38to, other languages, braille, and audio tapes, when necessary to
39meet the communication needs of consumers.

P14   1(E) Consumers are eligible to receive supplemental services
2including, but not limited to, additional staffing, pursuant to the
3process described in subdivision (d) of Section 4646. Necessary
4additional staffing that is not specifically included in the rates paid
5to the service provider may be purchased by the regional center if
6the additional staff are in excess of the amount required by
7regulation and the individual’s planning team determines the
8additional services are consistent with the provisions of the
9individual program plan. Additional staff should be periodically
10reviewed by the planning team for consistency with the individual
11program plan objectives in order to determine if continued use of
12the additional staff is necessary and appropriate and if the service
13is producing outcomes consistent with the individual program plan.
14Regional centers shall monitor programs to ensure that the
15additional staff is being provided and utilized appropriately.

16(10) Emergency and crisis intervention services including, but
17not limited to, mental health services and behavior modification
18services, may be provided, as needed, to maintain persons with
19developmental disabilities in the living arrangement of their own
20choice. Crisis services shall first be provided without disrupting a
21person’s living arrangement. If crisis intervention services are
22unsuccessful, emergency housing shall be available in the person’s
23home community. If dislocation cannot be avoided, every effort
24shall be made to return the person to his or her living arrangement
25of choice, with all necessary supports, as soon as possible.

26(11) Among other service and support options, planning teams
27shall consider the use of paid roommates or neighbors, personal
28assistance, technical and financial assistance, and all other service
29and support options which would result in greater self-sufficiency
30for the consumer and cost-effectiveness to the state.

31(12) When facilitation as specified in an individual program
32plan requires the services of an individual, the facilitator shall be
33of the consumer’s choosing.

34(13) The community support may be provided to assist
35individuals with developmental disabilities to fully participate in
36community and civic life, including, but not limited to, programs,
37services, work opportunities, business, and activities available to
38persons without disabilities. This facilitation shall include, but not
39be limited to, any of the following:

P15   1(A) Outreach and education to programs and services within
2the community.

3(B) Direct support to individuals which would enable them to
4more fully participate in their community.

5(C) Developing unpaid natural supports when possible.

6(14) When feasible and recommended by the individual program
7planning team, for purposes of facilitating better and cost-effective
8services for consumers or family members, technology, including
9telecommunication technology, may be used in conjunction with
10other services and supports. Technology in lieu of a consumer’s
11in-person appearances at judicial proceedings or administrative
12due process hearings may be used only if the consumer or, when
13appropriate, the consumer’s parent, legal guardian, conservator,
14or authorized representative, gives informed consent. Technology
15may be used in lieu of, or in conjunction with, in-person training
16for providers, as appropriate.

17(15) Other services and supports may be provided as set forth
18in Sections 4685, 4686, 4687, 4688, and 4689, when necessary.

19(16) Notwithstanding any other law or regulation, effective July
201, 2009, regional centers shall not purchase experimental
21treatments, therapeutic services, or devices that have not been
22clinically determined or scientifically proven to be effective or
23safe or for which risks and complications are unknown.
24Experimental treatments or therapeutic services include
25experimental medical or nutritional therapy when the use of the
26product for that purpose is not a general physician practice. For
27regional center consumers receiving these services as part of their
28individual program plan (IPP) or individualized family service
29plan (IFSP) on July 1, 2009, this prohibition shall apply on August
301, 2009.

31(b) (1) Advocacy for, and protection of, the civil, legal, and
32service rights of persons with developmental disabilities as
33established in this division.

34(2) Whenever the advocacy efforts of a regional center to secure
35or protect the civil, legal, or service rights of any of its consumers
36prove ineffective, the regional center or the person with
37developmental disabilities or his or her parents, legal guardian, or
38other representative may request the area board to initiate action
39under the provisions defining area board advocacy functions
40established in this division.

P16   1(c) The regional center may assist consumers and families
2directly, or through a provider, in identifying and building circles
3of support within the community.

4(d) In order to increase the quality of community services and
5protect consumers, the regional center shall, when appropriate,
6take either of the following actions:

7(1) Identify services and supports that are ineffective or of poor
8quality and provide or secure consultation, training, or technical
9assistance services for any agency or individual provider to assist
10that agency or individual provider in upgrading the quality of
11services or supports.

12(2) Identify providers of services or supports that may not be
13in compliance with local, state, and federal statutes and regulations
14and notify the appropriate licensing or regulatory authority, or
15request the area board to investigate the possible noncompliance.

16(e) When necessary to expand the availability of needed services
17of good quality, a regional center may take actions that include,
18but are not limited to, the following:

19(1) Soliciting an individual or agency by requests for proposals
20or other means, to provide needed services or supports not presently
21available.

22(2) Requesting funds from the Program Development Fund,
23pursuant to Section 4677, or community placement plan funds
24designated from that fund, to reimburse the startup costs needed
25to initiate a new program of services and supports.

26(3) Using creative and innovative service delivery models,
27including, but not limited to, natural supports.

28(f) Except in emergency situations, a regional center shall not
29provide direct treatment and therapeutic services, but shall utilize
30appropriate public and private community agencies and service
31providers to obtain those services for its consumers.

32(g) When there are identified gaps in the system of services and
33supports, or when there are identified consumers for whom no
34provider will provide services and supports contained in his or her
35individual program plan, the department may provide the services
36and supports directly.

37(h) At least annually, regional centers shall provide the
38consumer, his or her parents, legal guardian, conservator, or
39authorized representative a statement of services and supports the
40regional center purchased for the purpose of ensuring that they are
P17   1delivered. The statement shall include the type, unit, month, and
2cost of services and supports purchased.



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