BILL ANALYSIS                                                                                                                                                                                                    �




                                                                  SB 1160
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          Date of Hearing:   June 17, 2014

                        ASSEMBLY COMMITTEE ON HUMAN SERVICES
                                  Mark Stone, Chair
                     SB 1160 (Beall) - As Amended:  May 27, 2014

           SENATE VOTE :  37-0
           
          SUBJECT  :  Developmental services:  employment

           SUMMARY  :  Adjusts the allowable job-coach to consumer ratio for  
          group supported employment services provided to individuals with  
          developmental disabilities.

          Specifically,  this bill  :

          1)Declares a number of legislative findings related to the high  
            unemployment rate of individuals with developmental  
            disabilities and the need to provide ample employment  
            opportunities and support to these individuals, including job  
            training and individual supports that enable them to move  
            towards being economically self-sufficient, as specified.

          2)Reduces the minimum job coach-to-consumer ratio from 1:3 to  
            1:2 and makes a correlating change to the minimum number of  
            regional center consumers required to participate in group  
            supported employment from three to two.

          3)Redefines individualized services to mean job coaching and  
            other supported employment services, as specified, that  
            decrease over time, consistent with the consumer's individual  
            program plan and abilities, with the goal of achieving  
            stabilization, when possible.

           EXISTING LAW
           
          1)Establishes the Lanterman Act, under which the Department of  
            Developmental Services 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  









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            individual by the United States Constitution and laws and the  
            California Constitution and laws, the right to treatment and  
            habilitation services and supports in the least restrictive  
            environment.  (WIC 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)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)

          5)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)

          6)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(a))

          7)Defines group services to mean job coaching in a group  
            supported employment placement at a job coach-to-consumer  
            ratio of not less than 1 to 3 nor more than 1 to 8 where  
            services are funded by the regional center or the Department  
            of Rehabilitation.  Requires ongoing support services for  
            consumers receiving group services to be limited to job  
            coaching provided at the worksite.  (WIC 4851(r))

          8)Defines individualized services to mean job coaching and other  
            supported employment services for regional center-funded  
            consumers in a supported employment placement on or off the  
            job site that are provided at a job coach-to-consumer ratio of  
            1 to1 and that decrease over time until stabilization is  
            achieved.  (WIC 4851(s))










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           FISCAL EFFECT  :  According to the Senate Appropriations  
          Committee, this bill will have an unknown impact on the  
          utilization of group supported employment services (General Fund  
          and federal funds).

           COMMENTS  :  This bill seeks to ensure that employment  
          opportunities for individuals with developmental disabilities  
          are consistent with the state's Employment First policy and  
          maximize opportunities for more individualized support,  
          integration into the community, and greater independence.

           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 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 the Department of Developmental  
          Services (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  









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          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.   
          According to DDS consumer characteristics data, 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 First  :  The primary goal of California's Employment  
          First policy, the result of AB 1041 (Chesbro) Chapter 677,  
          Statutes of 2013, is to ensure that people with significant  
          disabilities are fully included in their communities and in the  
          workplace by making integrated, competitive employment the top  
          priority for working age individuals with developmental  
          disabilities.  Rather than limiting opportunities for  
          individuals with disabilities to programs that don't include  
          employment, or even work placements that limit tasks and wages,  
          Employment First policies across the country drive meaningful  
          participation of people with disabilities in typical, integrated  
          workplace settings where they are paid directly by an employer  
          and earn at least minimum wage.   
           
           Employment opportunities for individuals with developmental  
          disabilities  :  A 2012 report from the University of  
          Massachusetts, Boston's Institute for Community Inclusion cited  
          a 20.4% employment rate for Californian's with cognitive  
          disabilities in 2011, with only 14% served in integrated  












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          employment settings.<1> Additionally, data from the Employment  
          Development Department (EDD) for Californians in the workforce  
          with all disability types show that disabled persons are nearly  
          twice as likely to be working part time for non-economic reasons  
          as persons without disabilities. Individuals with developmental  
          disabilities continue to experience higher unemployment and  
          underemployment rates than people in the workforce without  
          disabilities, and the number of opportunities they have for  
          gainful employment in integrated settings continues to be  
          woefully low. 
           
          Regional centers contract with employment services programs and  
          providers to address the employment needs of individuals with  
          developmental disabilities.  Consumers are placed and hired into  
          jobs, in a number of employment settings, according to their  
          individual skills, needs and choices, and many are provided  
          support services on an individual or group basis.  In addition  
          to meeting the employment needs of the consumer and helping him  
          or her become more financially independent, work programs can  
          also greatly increase opportunities for community integration.

          Some consumers participate in Work Activity Programs, which  
          provide work adjustment and supported habilitation services in a  
          sheltered workshop setting in which consumers are 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.  

          Indicative of widespread support for policy changes that focus  
          on more individualized and integrated employment opportunities  
          and supports, the United States Department of Justice and the  
          state of Rhode Island recently entered into a settlement  
          agreement to avoid placing individuals with developmental  
          disabilities in segregated work environments and facility-based  
          day programs.  This settlement agreement, entered into on April  
          ---------------------------
          <1> Butterworth, J., Hall, A.C., Smith, F. A., Migliore, A.,  
          Winsor, J., Domin, D., & Sulewski, J. (2013).  StateData: The  
          national report on employment services and outcomes. Boston, MA:  
          University of Massachusetts Boston, Institute for Community  
          Inclusion.









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          8, 2014, was the country's first statewide agreement to  
          eliminate reliance on sheltered workshop settings and segregated  
          day programs, both of which often result in the exclusion of  
          integrated and supported employment opportunities and day  
          program services.  Although the settlement agreement will impact  
          the lives of around 3,250 Rhode Island residents with  
          developmental disabilities over the next 10 years, federal  
          officials have indicated that it could actually affect 450,000  
          individuals across the country that spend their days in  
          sheltered workshops and day treatment facilities. 

           Need for this bill  :  The current job coach-to-consumer ratio for  
          group SEP settings is no less than 1:3 and no more than 1:8.  By  
          reducing the lower end of the scale to a ratio of 1:2, this bill  
          will potentially increase the number of employers willing to  
          hire individuals who are working as part of a supported  
          employment group, as the employers will be able to better  
          accommodate two consumers plus a job coach instead of three.   
          This bill also seeks to ensure that the individualized job  
          coaching services provided to some consumers won't decrease for  
          the sake of stabilization in cases where workplace stabilization  
          isn't achieved.  More individualized attention given to the work  
          support needs of consumers can facilitate integration with other  
          employees and can greatly improve workplace success.

          In expressing the need for this bill, the author states:

          "The unemployment rate for people with intellectual and  
          developmental disabilities is nearly 80%.  Workers with  
          disabilities need assistance in preparing for a job, finding  
          that job, getting hired and retaining that job over time.  In  
          spite of the desires of many people with Intellectual and  
          Developmental Disabilities (I/DD) to work, many barriers exist  
          that make it difficult.  Since the law governing supported  
          employment was first created, the minimum group size of at least  
          three consumers has limited the ability of many small businesses  
          to employ persons with I/DD and has reduced the degree of  
          integration of workers into their work environment...Another  
          issue has been workers improve in their work with experience  
          over time. But the 'group of three' has been difficult to  
          maintain because employers may find that two workers can now do  
          what three were previously required to do. Without the authority  
          for group of two, the group has had to be disbanded with all  
          workers losing their jobs. "










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           RECOMMENDED AMENDMENTS  :

          1)Subdivision (a) of the uncodified intent language in this bill  
            implies that state budget cuts are the reason for California's  
            high rate of unemployment and underemployment among people  
            with developmental disabilities.  While budget cuts have  
            impacted purchase of services throughout the regional center  
            system, including supported employment, this subdivision does  
            not take into account external factors throughout history that  
            may have contributed to the low employment rates, and it has  
            little correlation with the codified language in the bill.  
            Committee staff recommends the following amendment:

            On page 2, strike out lines 2 through 10

          2)Committee staff also recommends the following technical  
            amendment:

            On page 5, line 33, strike out "individualized" and insert:

            individual
           
          RELATED LEGISLATION  :
           
           AB 1626 (Maienschein) 2014, increases the hourly rate paid to  
          providers of individualized and group-supported employment  
          services to $34.24, and increase the fees paid to interim  
          program providers to $400 and $800, respectively.

          AB 954 (Maienschein) 2013, was identical to AB 1626  
          (Maienschein). It died on the Assembly Appropriations Committee  
          suspense file.

          SB 577 (Pavley) 2013-14, establishes "community-based vocational  
          development services" to enhance employment readiness for  
          individuals by exploring job options, and developing social  
          skills necessary for the workforce, makes other changes.

          AB 1041 (Chesbro) Chapter 677, Statutes of 2013, created the  
          state's Employment First Policy, which requires regional centers  
          to provide consumers aged 16 and older with information about  
          employment, options for integrated competitive employment,  
          post-secondary education options, and other information.

           REGISTERED SUPPORT / OPPOSITION  :









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           Support 
           
          Association of Regional Center Agencies (ARCA)
          Association of Regional Center Agencies
          California Disability Services Association 
          The Alliance 
          Toolworks 
           
            Opposition 
           
          Non on file.

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