BILL ANALYSIS �
Senate Appropriations Committee Fiscal Summary
Senator Kevin de Le�n, Chair
SB 1178 (Correa) - Developmental disabilities: housing.
Amended: May 5, 2014 Policy Vote: HS 4-0, T&H 11-0
Urgency: No Mandate: No
Hearing Date: May 19, 2014 Consultant: Brendan McCarthy
This bill meets the criteria for referral to the Suspense File.
Bill Summary: SB 1178 would dedicate projected savings from
redirecting persons with developmental disabilities from
institutional care to community placement and from leasing
developmental center facilities to support the development of
affordable housing for persons with developmental disabilities.
Fiscal Impact:
Unknown increase in spending to support affordable housing
for individuals with developmental disabilities (General
Fund). The potential savings from reducing or avoiding
institutionalization is unknown. Given the very high cost to
provide care in developmental centers and other
institutions, savings from shifting consumers to the
community could be considerable. Because this bill would
require projected savings from such transitions or avoided
institutionalization to be dedicated for existing programs,
the bill would reduce General Fund savings. The size of this
impact is unknown, but could easily be in the tens of
millions per year.
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 provide diagnostic and assessment
services to determine eligibility, convene planning teams to
develop an Individual Program Plan for each eligible consumer,
and either provide or obtain from generic agencies appropriate
services for each consumer in accordance with the individual
program plan.
In addition, the state operates developmental centers for
developmentally disabled individuals with significant health
care and service needs. At one time, the state operated eight
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developmental centers with a peak total population of 13,400.
Today the state operates four developmental centers with a
population of about 1,300 residents. Lanterman Developmental
Center is planned for closure by the end of 2014.
Historically, individuals were placed in developmental centers
(or state hospitals) because they had health care or support
needs that could not be met in a community setting. Over time,
services and supports available in the community have grown and
today many current developmental center residents or individuals
who once would have been developmental center residents are able
to reside in community settings with services and supports
coordinated by a regional center. The long-run trend is for
reduced residency in regional centers. There is a moratorium in
place preventing new admissions to developmental centers in most
circumstances.
There is no plan in place at this time for closure of the
remaining developmental centers. Current law requires the
Department to report to the Legislature on any planned closure
of a developmental center by April 1 of the year prior to the
fiscal year in which a closure is planned.
Proposed Law: SB 1178 would dedicate projected savings from
redirecting persons with developmental disabilities from
institutional care to community placement and from leasing
developmental center facilities to be used to support the
development of affordable housing for persons with developmental
disabilities.
Specific provisions of the bill would:
Define "institution" to mean a developmental center, a
mental health facility, or a skilled nursing facility;
Require monies saved by transitioning individuals from
institutionalization to the community and monies saved by
preventing institutionalization to be deposited in a new
special fund;
Describe the general method to be used to calculate the
savings, based on the difference in average cost for
institutionalized individuals and the average cost for
previous developmental center residents who have been
transitioned to the community, multiplied by the number of
individuals who have been transitioned to the community or
who have been deflected from institutionalization;
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Require any lease revenues from the state's developmental
center properties to be deposited in the fund;
Require the Department of Housing and Community Development
to use the monies deposited in the fund for two existing
affordable housing programs to provide housing to
individuals with developmental disabilities.
Staff Comments: Under the bill, a consumer would be considered
"deflected" from institutional care if his or her individual
program plan establishes that he or she needs additional
supports to avoid institutionalization. This determination would
be made by the regional center as part of the development of an
individual program plan. This process would allow the regional
centers to indirectly determine how much General Fund revenue
the state would be obligated to dedicate for affordable housing
programs under the bill.
Under current law, many developmental center residents and
regional center consumers are eligible for Medi-Cal. This allows
the state to use federal matching funds to pay for at least half
of the state's cost to provide certain services, such as skilled
nursing care. In recent years, the state has negotiated a Home
and Community-Based Services for the Developmentally Disabled
Waiver (the "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.
Federal matching funds for Medi-Cal are available to provide
specific services to individual Medi-Cal beneficiaries. Under
this bill, the savings achieved by avoiding institutionalization
are likely to include substantial federal funds. However,
federal law would not likely allow the state to redirect federal
funds for the intended purposes of this bill. It is not clear
whether, under the bill, the state General Fund would need to
contribute more funding to offset the fact that not all the
estimated savings could be used as intended by the bill.