BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  SB 1160
                                                                  Page  1

          Date of Hearing:   August 6, 2014

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                  Mike Gatto, Chair

                    SB 1160 (Beall) - As Amended:  August 4, 2014 

          Policy Committee:                             Human  
          ServicesVote:7 - 0 

          Urgency:     No                   State Mandated Local Program:  
          No     Reimbursable:              

           SUMMARY  

          This bill adjusts the allowable job coach-to-consumer ratio for  
          group supported employment services provided to individuals with  
          developmental disabilities. Specifically, this bill:

          1)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.

          2)Authorizes the Department of Developmental Services (DDS) to  
            approve group services at the new job coach-to-consumer ratios  
            and adds criteria for DDS to consider when determining the  
            appropriateness of the job coach-to-consumer ratio for a new  
            or modified group.

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

          4)Contains chaptering out amendments to resolve conflicts with  
            SB 577 (Pavley). 
           
          FISCAL EFFECT  

          1)Ongoing, unknown but potentially significant, costs (GF and  
            federal funds) to DDS for additional job coaches to the extent  
            that existing employment groups split into smaller groups.  
            There are approximately 1,650 total supported employment  








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            groups serving 5,160 consumers. The bulk of those groups,  
            1,406, are three-person groups serving 4,218 consumers.  If  
            50% shifted to two-person groups, 351 new groups would be  
            formed with a corresponding increase in annual costs for job  
            coaches and other supports of approximately $5 million.

          2)Unknown impact on the utilization of group supported  
            employment services (GF and federal funds). By reducing the  
            minimum number of consumers required for group employment  
            services, this bill may increase demand for those services by  
            making it easier to set up two-consumer groups. Additionally,  
            by allowing individualized services to potentially continue  
            over a longer period of time (in some cases indefinitely) this  
            bill could increase demand for those services. 

            Costs associated with an increase in the use of supported  
            employment services will likely be a cost shift from other  
            services currently being used by eligible consumers. In most,  
            if not all, cases the foregone services are more expensive to  
            provide (average annual cost of supported employment services  
            is approximately $4,000 per consumer, work activity programs,  
            $5,300, and day programs, $11,700), thus any costs associated  
            with providing additional group supported employment services  
            will be largely offset by a corresponding reduction in costs  
            of other services and will likely result in an overall cost  
            savings.  The extent of this impact is unknown.

          3)Additionally, the state has negotiated a Home and  
            Community-Based Services for the Developmentally Disabled  
            Waiver (Waiver) which allows the Department to receive federal  
            matching funds for services provided to regional center  
            consumers. The purpose of this Waiver is to use state and  
            federal funds to allow consumers to remain in the community,  
            rather than being institutionalized. In some cases, the state  
            could use such funding to pay for a portion of the costs to  
            provide supported employment services under this bill.

           COMMENTS  

           1)Purpose  . According to the author, the unemployment rate for  
            people with intellectual and developmental disabilities (I/DD)  
            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 I/DD to work, many barriers exist that make it  








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            difficult.  The author maintains 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. In addition, many workers improve in their work  
            with experience over time. But the group of three has been  
            difficult to maintain because employers find that two workers  
            can now do what three were previously required to do. The  
            author notes without the authority for groups of two, the  
            group has had to be disbanded with all workers losing their  
            jobs. 

           2)Background  . California provides community-based services to  
            approximately 250,000 persons with developmental disabilities  
            and their families through a statewide system of 21 regional  
            centers. Regional centers are private, nonprofit agencies  
            under contract with the Department of Developmental Services  
            for the provision of various services and supports to people  
            with developmental disabilities. 

            Regional centers provide a variety of employment-related  
            services and supports to consumers, including work activity  
            programs (sometimes referred to as sheltered workshops) which  
            allow for consumers to work in groups in a structured  
            environment under the supervision of a regional center vendor,  
            and supported employment services, which assist consumers in  
            achieving employment in a traditional workplace. Typically,  
            supported employment services include various types of job  
            coaching to assist consumers in performing their duties and  
            working with coworkers, supervisors, and the public. Supported  
            employment services are available in groups of three to eight  
            consumers or individually, depending on the specific  
            consumer's needs. Individualized supported employment services  
            must decrease over time until stabilization of the consumer's  
            needs is achieved.

           3)Recent Amendments  . At the request of DDS, the author added  
            criteria for DDS to consider when determining the  
            appropriateness of the job coach-to-consumer ratio for a new  
            or modified employment group.  Based on past experience, DDS  
            anticipates an influx of requests to modify existing groups  
            from 1:3 to 1:2 and notes the costs associated with the  
            changes.  Accordingly, DDS remains concerned that cost  
            effectiveness is not among the criteria to consider when  








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            approving the new groups.

           4)Related Legislation  .

             a)   AB 1626 (Maienschein) would increase the rates paid  
               providers of individualized and group-supported employment  
               services. This bill is pending on the Senate Appropriations  
               Committee's Suspense File.

             b)   SB 577 (Pavley) requires the Department of Developmental  
               Services (DDS) to conduct a four-year demonstration project  
               to determine whether community-based vocational development  
               services increase integrated competitive employment  
               outcomes and reduce purchase of service costs for working  
               age adults. This bill is before this committee today. 

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


           Analysis Prepared by  :    Jennifer Swenson / APPR. / (916)  
          319-2081