from Kristie | http://educateadvocateca.com
California Association for Parent-Child Advocacy reports that Regional Centers are being gutted!
Regional centers are nonprofit private corporations that contract with the Department of Developmental Services to provide or coordinate services and supports for individuals with developmental disabilities. They have offices throughout California to provide a local resource to help find and access the many services available to individuals and their families.
Regional centers provide diagnosis and assessment of eligibility and help plan, access, coordinate and monitor the services and supports that are needed because of a developmental disability. There is no charge for the diagnosis and eligibility assessment.
| The California Association for Parent-Child Advocacy is a collaborative, statewide organization which monitors, analyzes, and responds to both legislative and policy initiatives which would affect the education and lifelong prospects for students with disabilities in California. | Educate. Advocate. CA. http://educateadvocateca.com | Educating ourselves as parents and caregivers to better Advocate for our children with special needs. |
proposed legislation: AB45x3
General Prohibitions
SEC. 13. Section 4648.5 is added to the
Welfare and Institutions Code , to read:
4648.5. (a) Notwithstanding any other provision of law or
regulations to the contrary, retroactive to July 1, 2009, a regional
centers' authority to purchase the following services shall be
suspended pending implementation of the Individual Choice Budget and
certification by the Director of Developmental Services that the
Individual Choice Budget has been implemented and will result in
state budget savings sufficient to offset the costs of providing the
following services:
(1) Camping services and associated travel expenses.
(2) Social recreation activities, except for those activities
vendored as community-based day programs.
(3) Educational services for children three to 17, inclusive,
years of age.
(4) Nonmedical therapies, including, but not limited to,
specialized recreation, art, dance, and music.
(b) For regional center consumers receiving services described in
subdivision (a) as part of their individual program plan (IPP) or
individualized family service plan (IFSP), the prohibition in
subdivision (a) shall take effect on August 1, 2009.
(c) An exemption may be granted on an individual basis in
extraordinary circumstances to permit purchase of a service
identified in subdivision (a) when the regional center determines
that the service is a primary or critical means for ameliorating the
physical, cognitive, or psychosocial effects of the consumer's
developmental disability, or the service is necessary to enable the
consumer to remain in his or her home and no alternative service is
available to meet the consumer's needs.
SEC. 14. Section 4648.6 is added to the
Welfare and Institutions Code , to read:
4648.6. The department, in consultation with stakeholders, shall
develop an alternative service delivery model that provides an
Individual Choice Budget for obtaining quality services and supports
which provides choice and flexibility within a finite budget that in
the aggregate reduces regional center purchase of service
expenditures, reduces reliance on the state general fund, and
maximizes federal financial participation in the delivery of
services. The individual budget will be determined using a fair,
equitable, transparent standardized process.
SEC. 15. Section 4659 of the Welfare
and Institutions Code is amended to read:
4659. (a) Except as otherwise provided in subdivision (b) or
(c) (e) , the regional center shall
identify and pursue all possible sources of funding for consumers
receiving regional center services. These sources shall include, but
not be limited to, both of the following:
(1) Governmental or other entities or programs required to provide
or pay the cost of providing services, including Medi-Cal, Medicare,
the Civilian Health and Medical Program for Uniform Services, school
districts, and federal supplemental security income and the state
supplementary program.
(2) Private entities, to the maximum extent they are liable for
the cost of services, aid, insurance, or medical assistance to the
consumer.
(b) Any revenues collected by a regional center pursuant to this
section shall be applied against the cost of services prior to use of
regional center funds for those services. This revenue shall not
result in a reduction in the regional center's purchase of services
budget, except as it relates to federal supplemental security income
and the state supplementary program.
(c) Retroactive to July 1, 2009, notwithstanding any other
provision of law or regulation to the contrary, regional centers
shall not purchase any service that would otherwise be available from
Medi-Cal, Medicare, the Civilian Health and Medical Program for
Uniform Services, In-Home Support Services, California Children's
Services, private insurance, or a health care service plan when a
consumer or a family meets the criteria of this coverage but chooses
not to pursue that coverage. If, on July 1, 2009, a regional center
is purchasing that service as part of a consumer's individual program
plan (IPP), the prohibition shall take effect on October 1, 2009.
(d) (1) Retroactive to July 1, 2009, notwithstanding any other
provision of law or regulation to the contrary, a regional center
shall not purchase medical or dental services for a consumer three
years of age or older unless the regional center is provided with
documentation of a Medi-Cal, private insurance, or a health care
service plan denial and the regional center determines that an appeal
by the consumer or family of the denial does not have merit. If, on
July 1, 2009, a regional center is purchasing the service as part of
a consumer's IPP, this provision shall take effect on August 1, 2009.
Regional centers may pay for medical or dental services during the
following periods:
(A) While coverage is being pursued, but before a denial is made.
(B) Pending a final administrative decision on the administrative
appeal if the family has provided to the regional center a
verification that an administrative appeal is being pursued.
(C) Until the commencement of services by Medi-Cal, private
insurance, or a health care service plan.
(2) When necessary, the consumer or family may receive assistance
from the regional center, the Clients' Rights Advocate funded by the
department, or area boards on developmental disabilities in pursuing
these appeals.
(c)
(e) This section shall not be construed to impose any
additional liability on the parents of children with developmental
disabilities, or to restrict eligibility for, or deny services to,
any individual who qualifies for regional center services but is
unable to pay.
(d)
(f) In order to best utilize generic resources,
federally funded programs, and private insurance programs for
individuals with developmental disabilities, the department and
regional centers shall engage in the following activities:
(1) Within existing resources, the department shall provide
training to regional centers, no less than once every two years, in
the availability and requirements of generic, federally funded and
private programs available to persons with developmental
disabilities, including, but not limited to, eligibility
requirements, the application process and covered services, and the
appeal process.
(2) Regional centers shall disseminate information and training to
all service coordinators regarding the availability and requirements
of generic, federally funded and private insurance programs on the
local level.
(3) (A) To ensure that these services and
supports are provided in the most cost-effective and beneficial
manner, regional centers may utilize innovative service-delivery
mechanisms, including, but not limited to, vouchers; alternative
respite options such as foster families, vacant community facility
beds, crisis child care facilities; group training for parents
on behavioral intervention techniques in lieu of some or all of the
in-home parent training component of the behavioral intervention
services; purchase of neighborhood preschool services and needed
qualified personnel in lieu of infant development programs; and
alternative child care options such as supplemental support to
generic child care facilities and parent child care cooperatives.
(B) Retroactive to July 1, 2009, at the time of development,
review, or modification of a child's individualized family service
plan or individual program plan, the regional center shall consider
both of the following:
(i) The use of group training for parents on behavioral
intervention techniques in lieu of some or all of the in-home parent
training component of the behavioral intervention services.
(ii) The purchase of neighborhood preschool services and needed
qualified personnel in lieu of infant development programs.
(4) If the parent of any child receiving services and supports
from a regional center believes that the regional center is not
offering adequate assistance to enable the family to keep the child
at home, the parent may initiate a request for fair hearing as
established in this division. A family shall not be required to start
a placement process or to commit to placing a child in order to
receive requested services.
(5) Nothing in this section shall be construed to encourage the
continued residency of adult children in the home of their parents
when that residency is not in the best interests of the person.
(6) When purchasing or providing a voucher for day care services
for parents who are caring for children at home, the regional center
may pay only the cost of the day care service that exceeds the cost
of providing day care services to a child without disabilities. The
regional center may pay in excess of this amount when a family can
demonstrate a financial need and when doing so will enable the child
to remain in the family home.
(7) A regional center may purchase or provide a voucher for
diapers for children three years of age or older. A regional center
may purchase or provide vouchers for diapers under three years of age
when a family can demonstrate a financial need and when doing so
will enable the child to remain in the family home.
SEC. 29. (a) The State Department of Developmental
Services shall provide information to the Assembly Committee on
Budget and the Senate Committee on Budget and Fiscal Review during
budget hearings for the 2010-11 fiscal year regarding the effect on
the developmental service system of the specific cost containment
measures implemented to achieve up to three hundred thirty-four
million dollars ($334,000,000) in General Fund reductions for the
2009-10 fiscal year pursuant to Item 4300-101-0001 of Section 2.00 of
the Budget Act of 2009.
(b) The department shall continue to convene, as appropriate, a
stakeholder review process to obtain information and comments about
implementation of the cost containment measures and their effect on
the developmental service system. The stakeholder review process
shall include statewide organizations representing the interests of
consumers, family members, service providers, and statewide advocacy
organizations, as well as policy and fiscal staff of the Legislature.
LEAST COSTLY PROVIDER
D) The cost of providing services or supports of comparable
quality by different providers, if available , shall be
reviewed, and the least costly available provider of comparable
service, including the cost of transportation, who is able to
accomplish all or part of the consumer's individual program plan,
consistent with the particular needs of the consumer and family as
identified in the individual program plan, shall be
selected. In determining the least costly provider, the availability
of federal financial participation shall be considered. The consumer
shall not be required to use the least costly provider if it will
result in the consumer moving from an existing provider of services
or supports to more restrictive or less integrated services or
supports .
Early Start
SECTION 1. Section 95004 of the
Government Code , as amended by Section 1 of Chapter 3 of
the 3rd Extraordinary Session of the Statutes of 2008, is amended to
read:
95004. The early intervention services specified in this title
shall be provided as follows:
(a) Direct services for eligible infants and toddlers and their
families shall be provided pursuant to the existing regional center
system under the Lanterman Developmental Disabilities Services Act
(Division 4.5 (commencing with Section 4500) of the Welfare and
Institutions Code) and the existing local education agency system
under appropriate sections of Part 30 (commencing with Section 56000)
of the Education Code and regulations adopted pursuant thereto, and
Part C of the Individuals with Disabilities Education Act (20 U.S.C.
Sec. 1431 et seq.).
(b) (1) In providing services under this title, regional centers
shall comply with the Lanterman Developmental Disabilities Services
Act (Division 4.5 (commencing with Section 4500) of the Welfare and
Institutions Code, and its implementing regulations (Division 2
(commencing with Section 50201) of Title 17 of the California Code of
Regulations) including, but not limited to, those provisions
relating to vendorization and ratesetting, and the Family Cost
Participation Program, except where compliance with those provisions
would result in any delays in, the provision of early intervention,
or otherwise conflict with this title and the regulations
implementing this title (Chapter 2 (commencing with Section 52000) of
Division 2 of Title 17 of the California Code of Regulations), or
Part C of the Individuals with Disabilities Education Act (20 U.S.C.
Sec. 1431) et seq. 1431 et seq.) , and
applicable federal regulations contained in Part 303 (commencing with
Section 303.1) of Title 34 of the Code of Federal Regulations.
Notwithstanding any other law or regulation to the contrary, a family'
s private insurance for medical services or a health care service
plan identified in the individualized family service plan, other than
for evaluation and assessment, shall be used in compliance with
applicable federal and state law and regulation.
(2) When compliance with this subdivision would result in any
delays in the provision of early intervention services for the
provision of any of these services, the department may authorize a
regional center to use a special service code that allows immediate
procurement of the service.
(c) Services shall be provided by family resource centers that
provide, but are not limited to, parent-to-parent support,
information dissemination and referral, public awareness, family
professional collaboration activities, and transition assistance for
families.
(d) Existing obligations of the state to provide these services at
state expense shall not be expanded.
(e) It is the intent of the Legislature that services be provided
in accordance with Sections 303.124, 303.126, and 303.527 of Title 34
of the Code of Federal Regulations.
SEC. 2. Section 95014 of the Government
Code is amended to read:
95014. (a) The term "eligible infant or toddler" for the purposes
of this title means infants and toddlers from birth through two
years of age, for whom a need for early intervention services, as
specified in the federal Individuals with Disabilities Education Act
(20 U.S.C. Sec. 1431 et seq.) and applicable regulations, is
documented by means of assessment and evaluation as required in
Sections 95016 and 95018 and who meet one of the following criteria:
(1) Infants and toddlers with a developmental delay in one or more
of the following five areas: cognitive development; physical and
motor development, including vision and hearing; communication
development; social or emotional development; or adaptive
development. Developmentally delayed infants and toddlers are those
who are determined to have a significant difference between the
expected level of development for their age and their current level
of functioning. This determination shall be made by qualified
personnel who are recognized by, or part of, a multidisciplinary
team, including the parents. A significant difference is defined
as a 33-percent delay in one developmental area before 24 months of
age, or, at 24 months of age or older, either a delay of 50 percent
in one developmental area or a 33-percent delay in two or more
developmental areas. The age for use in determination of eligibility
for the Early Intervention Program shall be the age of the infant or
toddler on the date of the initial referral to the Early Intervention
Program.
(2) Infants and toddlers with established risk conditions, who are
infants and toddlers with conditions of known etiology or conditions
with established harmful developmental consequences. The conditions
shall be diagnosed by a qualified personnel recognized by, or part
of, a multidisciplinary team, including the parents. The condition
shall be certified as having a high probability of leading to
developmental delay if the delay is not evident at the time of
diagnosis.
(3) Infants and toddlers who are at high risk of having
substantial developmental disability due to a combination of
biomedical risk factors, the presence of which is diagnosed by
qualified clinicians recognized by, or part of, a multidisciplinary
team, including the parents.
(b) Regional centers and local educational agencies shall be
responsible for ensuring that eligible infants and toddlers are
served as follows:
(1) The State Department of Developmental Services and regional
centers shall be responsible for the provision of appropriate early
intervention services in accordance with that
are required for California's participation in Part C of the
federal Individuals with Disabilities Education Act (20 U.S.C. Sec.
1431 et seq.) for all infants eligible under Section 95014, except
for those infants with solely a visual, hearing, or severe orthopedic
impairment, or any combination of those impairments, who meet the
criteria in Sections 56026 and 56026.5 of the Education Code, and in
Section 3030(a), (b), (d), or (e) of, and Section 3031 of, Title 5 of
the California Code of Regulations.
(2) The State Department of Education and local educational
agencies shall be responsible for the provision of appropriate early
intervention services in accordance with Part C of the federal
Individuals with Disabilities Education Act (20 U.S.C. Sec. 1431 et
seq.) for infants with solely a visual, hearing, or severe orthopedic
impairment, or any combination of those impairments, who meet the
criteria in Sections 56026 and 56026.5 of the Education Code, and in
Section 3030(a), (b), (d), or (e) of, and Section 3031 of, Title 5 of
the California Code of Regulations, and who are not eligible for
services under the Lanterman Developmental Disabilities Services Act
(Division 4.5 (commencing with Section 4500) of the Welfare and
Institutions Code).
(c) For infants and toddlers and their families who are eligible
to receive services from both a regional center and a local
educational agency, the regional center shall be the agency
responsible for providing or purchasing appropriate early
intervention services that are beyond the mandated responsibilities
of local educational agencies and that are required for
California's participation in Part C of the federal Individuals with
Disabilities Education Act (20 U.S.C. Sec. 1431 et seq.) . The
local educational agency shall provide special education services up
to its funded program capacity as established annually by the State
Department of Education in consultation with the State Department of
Developmental Services and the Department of Finance.
(d) No agency or multidisciplinary team, including any agency
listed in Section 95012, shall presume or determine eligibility,
including eligibility for medical services, for any other agency.
However, regional centers and local educational agencies shall
coordinate intake, evaluation, assessment, and individualized family
service plans for infants and toddlers and their families who are
served by an agency.
(e) Upon termination of the program pursuant to Section 95003, the
State Department of Developmental Services shall be responsible for
the payment of services pursuant to this title.
SEC. 3. Section 95020 of the Government
Code is amended to read:
95020. (a) An eligible infant or toddler shall have an
individualized family service plan. The individualized family service
plan shall be used in place of an individualized education program
required pursuant to Sections 4646 and 4646.5 of the Welfare and
Institutions Code, the individualized program plan required pursuant
to Section 56340 of the Education Code, or any other applicable
service plan.
(b) For an infant or toddler who has been evaluated for the first
time, a meeting to share the results of the evaluation, to determine
eligibility and, for children who are eligible, to develop the
initial individualized family service plan shall be conducted within
45 calendar days of receipt of the written referral. Evaluation
results and determination of eligibility may be shared in a meeting
with the family prior to the individualized family service plan.
Written parent consent to evaluate and assess shall be obtained
within the 45-day timeline. A regional center, local educational
agency, or the designee of one of those entities shall initiate and
conduct this meeting. Families shall be afforded the opportunity to
participate in all decisions regarding eligibility and services.
(c) Parents shall be fully informed of their rights, including the
right to invite another person, including a family member or an
advocate or peer parent, or any or all of them, to accompany them to
any or all individualized family service plan meetings. With parental
consent, a referral shall be made to the local family resource
center or network.
(d) The individualized family service plan shall be in writing and
shall address all of the following:
(1) A statement of the infant's or toddler's present levels of
physical development including vision, hearing, and health status,
cognitive development, communication development, social and
emotional development, and adaptive developments.
(2) With the concurrence of the family, a statement of the family'
s concerns, priorities, and resources related to meeting the special
developmental needs of the eligible infant or toddler.
(3) A statement of the major outcomes expected to be achieved for
the infant or toddler and family where services for the family are
related to meeting the special developmental needs of the eligible
infant or toddler.
(4) The criteria, procedures, and timelines used to determine the
degree to which progress toward achieving the outcomes is being made
and whether modifications or revisions are necessary.
(5) (A) A statement of the specific early
intervention services necessary to meet the unique needs of the
infant or toddler as identified in paragraph (3), including, but not
limited to, the frequency, intensity, location, duration, and method
of delivering the services, and ways of providing services in natural
generic environments , including group training for
parents on behavioral intervention techniques in lieu of some or all
of the in-home parent training component of the behavior intervention
services, and purchase of neighborhood preschool services and needed
qualified personnel in lieu of infant development programs .
(B) Retroactive to July 1, 2009, at the time of development,
review, or modification of an infant's or toddler's individualized
family service plan, the regional center shall consider both of the
following:
(i) The use of group training for parents on behavior intervention
techniques, in lieu of some or all of the in-home parent training
component of the behavior intervention services.
(ii) The purchase of neighborhood preschool services and needed
qualified personnel, in lieu of infant development programs.
(6) A statement of the agency responsible for providing the
identified services.
(7) The name of the service coordinator who shall be responsible
for facilitating implementation of the plan and coordinating with
other agencies and persons.
(8) The steps to be taken to ensure transition of the infant or
toddler upon reaching three years of age to other appropriate
services. These may include, as appropriate, special education or
other services offered in natural environments.
(9) The projected dates for the initiation of services in
paragraph (5) and the anticipated duration of those services.
(e) Each service identified on the individualized family service
plan shall be designated as one of three types:
(1) An early intervention service, as defined in subsection (4) of
Section 1432 of Title 20 of the United States Code, and applicable
regulations, that is provided or purchased through the regional
center, local educational agency, or other participating agency. The
State Department of Health Care Services, State Department of Social
Services, State Department of Mental Health, and State Department of
Alcohol and Drug Programs shall provide services in accordance with
state and federal law and applicable regulations, and up to the level
of funding as appropriated by the Legislature. Early intervention
services identified on an individualized family service plan that
exceed the funding, statutory, and regulatory requirements of these
departments shall be provided or purchased by regional centers or
local educational agencies under subdivisions (b) and (c) of Section
95014. The State Department of Health Care Services, State Department
of Social Services, State Department of Mental Health, and State
Department of Alcohol and Drug Programs shall not be required to
provide early intervention services over their existing funding,
statutory, and regulatory requirements.
(2) Another service, other than those specified in paragraph (1),
which the eligible infant or toddler or his or her family may receive
from other state programs, subject to the eligibility standards of
those programs.
(3) A referral to a nonrequired service that may be provided to an
eligible infant or toddler or his or her family. Nonrequired
services are those services that are not defined as early
intervention services or do not relate to meeting the special
developmental needs of an eligible infant or toddler related to the
disability, but which that may be
helpful to the family. The granting or denial of nonrequired services
by a public or private agency is not subject to appeal under this
title. Notwithstanding any other provision of law or regulation
to the contrary, retroactive to July 1, 2009, with the exception of
durable medical equipment, regional centers shall not purchase
nonrequired services, but may refer a family to a nonrequired service
that may be available to an eligible infant or toddler or his or her
family.
(f) An annual review, and other periodic reviews, of the
individualized family service plan for an infant or toddler and the
infant's or toddler's family shall be conducted to determine the
degree of progress that is being made in achieving the outcomes
specified in the plan and whether modification or revision of the
outcomes or services is necessary. The frequency, participants,
purpose, and required processes for annual and periodic reviews shall
be consistent with the statutes and regulations under Part C of the
federal Individuals with Disabilities Education Act (20 U.S.C. Sec.
1431 et seq.) and this title, and shall be specified in regulations
adopted pursuant to Section 95028.
SEC. 4. Section 95021 is added to the
Government Code , to read:
95021. (a) Retroactive to July 1, 2009, notwithstanding any other
provision of law or regulation to the contrary, any vendor who
provides applied behavioral analysis (ABA) services or intensive
behavioral intervention services, or both, as defined in subdivision
(d), shall:
(1) Conduct a behavioral assessment of each infant or toddler to
whom the vendor provides these services.
(2) Design an intervention plan that shall include the service
type, number of hours, and parent participation needed to achieve the
goals and objectives of the infant or toddler, as set forth in his
or her individualized family service plan (IFSP). The intervention
plan shall also set forth the frequency at which the progress of the
infant or toddler shall be evaluated and reported.
(3) Provide a copy of the intervention plan to the regional center
for review and consideration by the planning team members.
(b) Retroactive to July 1, 2009, notwithstanding any other
provision of law or regulation to the contrary, regional centers
shall:
(1) Only purchase ABA services or intensive behavioral
intervention services that reflect evidence-based practices, promote
positive social behaviors, and ameliorate behaviors that interfere
with learning and social interactions.
(2) Only purchase ABA or intensive behavioral intervention
services when the parent or parents of an infant or toddler receiving
services participate in the intervention plan for the infant or
toddler, given the critical nature of parent participation to the
success of the intervention plan.
(3) Not purchase either ABA or intensive behavioral intervention
services for purposes of providing respite, day care, or school
services.
(4) Discontinue purchasing ABA or intensive behavioral
intervention services for an infant or toddler when his or her
treatment goals and objectives, as described under subdivision (a),
are achieved. ABA or intensive behavioral intervention services shall
not be discontinued until the goals and objectives are reviewed and
updated as required in paragraph (5) and shall be discontinued only
if those updated treatment goals and objectives do not require ABA or
intensive behavioral intervention services.
(5) For each infant or toddler, evaluate the vendor's intervention
plan and number of service hours for ABA or intensive behavioral
intervention no less than every six months, consistent with
evidence-based practices. If necessary, the intervention plan's
treatment goals and objectives shall be updated and revised.
(6) Not reimburse a parent for participating in a behavioral
services treatment program.
(c) For infants and toddlers receiving ABA or behavioral
intervention services on July 1, 2009, as part of their IFSP,
subdivision (b) shall apply on August 1, 2009.
(d) For purposes of this section the following definitions shall
apply:
(1) "Applied behavioral analysis" means the design,
implementation, and evaluation of systematic instructional and
environmental modifications to promote positive social behaviors and
reduce or ameliorate behaviors which interfere with learning and
social interaction.
(2) "Intensive behavioral intervention" means any form of applied
behavioral analysis that is comprehensive, designed to address all
domains of functioning, and provided in multiple settings for no more
than 40 hours per week, across all settings, depending on the
individual's needs and progress. Interventions can be delivered in a
one-to-one ratio or small group format, as appropriate.
(3) "Evidence-based practice" means a decisionmaking process which
integrates the best available scientifically rigorous research,
clinical expertise, and individual's characteristics. Evidence-based
practice is an approach to treatment rather than a specific
treatment. Evidence-based practice promotes the collection,
interpretation, integration, and continuous evaluation of valid,
important, and applicable individual- or family-reported,
clinically-observed, and research-supported evidence. The best
available evidence, matched to infant or toddler circumstances and
preferences, is applied to ensure the quality of clinical judgments
and facilitates the most cost-effective care.
(4) "Parent" has the same meaning as defined in paragraph (15) of
subdivision (b) of Section 52000 of Title 17 of the California Code
of Regulations.
(5) "Parent participation" shall include, but shall not be limited
to, the following meanings:
(A) Completion of group instruction on the basics of behavior
intervention.
(B) Implementation of intervention strategies according to the
intervention plan.
(C) If needed, collection of data on behavioral strategies and
submission of that data to the provider for incorporation into
progress reports.
(D) Participation in any needed clinical meetings.
(E) Purchase of suggested behavior modification materials or
community involvement if a reward system is used.
SEC. 6. Section 4435 is added to the
Welfare and Institutions Code , to read:
4435. (a) The department shall establish a prevention program for
at-risk babies. For purposes of this section, "at-risk baby" means a
child under 36 months of age who is otherwise not eligible for the
California Early Intervention Program pursuant to Title 14
(commencing with Section 95000) of the Government Code or services
provided under the Lanterman Developmental Disabilities Services Act
(Division 4.5 (commencing with Section 4500)) and whose genetic,
medical, developmental, or environmental history is predictive of a
substantially greater risk for developmental disability than that for
the general population, the presence of which is diagnosed by
qualified clinicians.
(b) This program shall provide intake, assessment, case
management, and referral to generic agencies. For purposes of this
section, "generic agency" means any agency that has a legal
responsibility to serve the general public and that is receiving
public funds for providing these services.
(c) The department shall allocate to each regional center, subject
to appropriation, specific funding for this program. A regional
center's total expenditures for purchasing or providing services
under the prevention program shall not exceed the funding allocated
in its contract for this purpose.
(d) The department shall establish policies and procedures for
implementation of the prevention program by regional centers. These
policies and procedures shall define other services included in this
program and the process for appealing denial of eligibility for the
prevention program.
Supported Living
SEC. 24. Section 4689 of the Welfare
and Institutions Code is amended to read:
4689. Consistent with state and federal law, the Legislature
places a high priority on providing opportunities for adults with
developmental disabilities, regardless of the degree of disability,
to live in homes that they own or lease with support available as
often and for as long as it is needed, when that is the preferred
objective in the individual program plan. In order to provide
opportunities for adults to live in their own homes, the following
procedures shall be adopted:
(a) The department and regional centers shall ensure that
supported living arrangements adhere to the following principles:
(1) Consumers shall be supported in living arrangements which are
typical of those in which persons without disabilities reside.
(2) The services or supports that a consumer receives shall change
as his or her needs change without the consumer having to move
elsewhere.
(3) The consumer's preference shall guide decisions concerning
where and with whom he or she lives.
(4) Consumers shall have control over the environment within their
own home.
(5) The purpose of furnishing services and supports to a consumer
shall be to assist that individual to exercise choice in his or her
life while building critical and durable relationships with other
individuals.
(6) The services or supports shall be flexible and tailored to a
consumer's needs and preferences.
(7) Services and supports are most effective when furnished where
a person lives and within the context of his or her day-to-day
activities.
(8) Consumers shall not be excluded from supported living
arrangements based solely on the nature and severity of their
disabilities.
(b) Regional centers may contract with agencies or individuals to
assist consumers in securing their own homes and to provide consumers
with the supports needed to live in their own homes.
(c) The range of supported living services and supports available
include, but are not limited to, assessment of consumer needs;
assistance in finding, modifying and maintaining a home; facilitating
circles of support to encourage the development of unpaid and
natural supports in the community; advocacy and self-advocacy
facilitation; development of employment goals; social, behavioral,
and daily living skills training and support; development and
provision of 24-hour emergency response systems; securing and
maintaining adaptive equipment and supplies; recruiting, training,
and hiring individuals to provide personal care and other assistance,
including in-home supportive services workers, paid neighbors, and
paid roommates; providing respite and emergency relief for personal
care attendants; and facilitating community participation. Assessment
of consumer needs may begin before 18 years of age to enable the
consumer to move to his or her own home when he or she reaches 18
years of age.
(d) Regional centers shall provide information and education to
consumers and their families about supported living principles and
services.
(e) Regional centers shall monitor and ensure the quality of
services and supports provided to individuals living in homes that
they own or lease. Monitoring shall take into account all of the
following:
(1) Adherence to the principles set forth in this section.
(2) Whether the services and supports outlined in the consumer's
individual program plan are congruent with the choices and needs of
the individual.
(3) Whether services and supports described in the consumer's
individual program plan are being delivered.
(4) Whether services and supports are having the desired effects.
(5) Whether the consumer is satisfied with the services and
supports.
(f) The planning team, established pursuant to subdivision (j) of
Section 4512, for a consumer receiving supported living services
shall confirm that all appropriate and available sources of natural
and generic supports have been utilized to the fullest extent
possible for that consumer.
(g) Regional centers shall utilize the same supported living
provider for consumers who reside in the same domicile, provided that
each individual consumer's particular needs can still be met
pursuant to his or her individual program plans.
(h) Rent, mortgage, and lease payments of a supported living home
and household expenses shall be the responsibility of the consumer
and any roommate who resides with the consumer.
(i) A regional center shall not make rent, mortgage, or lease
payments on a supported living home, or pay for household expenses of
consumers receiving supported living services, except under the
following circumstances:
(1) If all of the following conditions are met, a regional center
may make rent, mortgage, or lease payments as follows:
(A) The regional center executive director verifies in writing
that making the rent, mortgage, or lease payments or paying for
household expenses is required to meet the specific care needs unique
to the individual consumer as set forth in an addendum to the
consumer's individual program plan, and is required when a consumer's
demonstrated medical, behavioral, or psychiatric condition presents
a health and safety risk to himself or herself, or another.
(B) During the time period that a regional center is making rent,
mortgage, or lease payments, or paying for household expenses, the
supported living services vendor shall assist the consumer in
accessing all sources of generic and natural supports consistent with
the needs of the consumer.
(C) The regional center shall not make rent, mortgage, or lease
payments on a supported living home or pay for household expenses for
more than six months, unless the regional center finds that it is
necessary to meet the individual consumer's particular needs pursuant
to the consumer's individual program plan. The regional center shall
review a finding of necessity on a quarterly basis and the regional
center executive director shall annually verify in an addendum to the
consumer's individual program plan that the requirements set forth
in subparagraph (A) continue to be met.
(2) A regional center that has been contributing to rent,
mortgage, or lease payments or paying for household expenses prior to
July 1, 2009, shall at the time of development, review, or
modification of a consumer's individual program plan determine if the
conditions in paragraph (1) are met. If the planning team determines
that these contributions are no longer appropriate under this
section, a reasonable time for transition, not to exceed six months,
retroactive to July 1, 2009, shall be permitted.
(j) All paid roommates and live-in support staff in supported
living arrangements in which regional centers have made rent,
mortgage, or lease payments, or have paid for household expenses
pursuant to subdivision (i) shall pay their share of the rent,
mortgage, or lease payments or household expenses for the supported
living home, subject to the requirements of Industrial Welfare
Commission Order No. 15-2001 and the Housing Choice Voucher Program,
as set forth in Section 1437f of Title 42 of the United States Code.
(k) Regional centers shall ensure that the supported living
services vendors' administrative costs are necessary and reasonable,
given the particular services that they are providing and the number
of consumers to whom the vendor provides services. Administrative
costs shall be limited to allowable costs for community-based day
programs, as defined in Section 57434 of Title 17 of the California
Code of Regulations, or its successor.
(l) Regional centers shall ensure that the most cost-effective of
the rate methodologies is utilized to determine the negotiated rate
for vendors of supported living services, consistent with Section
4689.8 and Title 17 of the California Code of Regulations.
(m) For purposes of this section, "household expenses" means
general living expenses and includes, but is not limited to,
utilities paid and food consumed within the home.
(n) A supported living services provider shall provide assistance
to a consumer who is a Medi-Cal beneficiary in applying for in-home
supportive services, as set forth in Section 12300, within five days
of the consumer moving into a supported living services arrangement.
SEC. 25. Section 4689.05 is added to the
Welfare and Institutions Code , to read:
4689.05. (a) A regional center shall not purchase supportive
services, as defined in Section 12300, for a consumer who meets the
criteria to receive, but declines to apply for, in-home supportive
services (IHSS) benefits, as set forth in Section 12300, except as
set forth in subdivision (d).
(b) Consistent with Section 4648, a regional center shall not
purchase supported living services for a consumer to supplant IHSS.
(c) Between the date that a consumer applies for IHSS and the date
that a consumer's application for IHSS is approved, a regional
center shall not purchase supportive services for the consumer at a
rate that exceeds the IHSS hourly rate, which includes the IHSS
provider hourly wage, the provider's hourly payroll taxes, and the
hourly administrative costs, for the county in which the consumer
resides.
(d) A regional center executive director may waive the
requirements set forth in subdivision (a) if the executive director
finds that extraordinary circumstances warrant the waiver, and that a
finding is documented in an addendum to the consumer's individual
program plan.
Respite Changes
SEC. 20. Section 4686.5 is added to the
Welfare and Institutions Code , to read:
4686.5. (a) Retroactive to July 1, 2009, notwithstanding any
other provision of law or regulation to the contrary, all of the
following shall apply:
(1) A regional center may only purchase respite services when the
care and supervision needs of a consumer exceed that of an individual
of the same age without developmental disabilities.
(2) A regional center shall not purchase more than 21 days of
out-of-home respite services in a fiscal year nor more than 90 hours
of in-home respite services in a quarter, for a consumer.
(3) (A) A regional center may grant an exemption to the
requirements set forth in paragraphs (1) and (2) if it is
demonstrated that the intensity of the consumer's care and
supervision needs are such that additional respite is necessary to
maintain the consumer in the family home, or there is an
extraordinary event that impacts the family member's ability to meet
the care and supervision needs of the consumer.
(B) For purposes of this section, "family member" means an
individual who:
(i) Has a consumer residing with him or her.
(ii) Is responsible for the 24-hour care and supervision of the
consumer.
(iii) Is not a licensed or certified residential care facility or
foster family home receiving funds from any public agency or regional
center for the care and supervision provided. Notwithstanding this
provision, a relative who receives foster care funds shall not be
precluded from receiving respite.
(4) A regional center shall not purchase day care services to
replace or supplant respite services. For purposes of this section,
"day care" is defined as regularly provided care, protection, and
supervision of a consumer living in the home of his or her parents,
for periods of less than 24 hours per day, while the parents are
engaged in employment outside of the home or educational activities
leading to employment, or both.
(5) A regional center shall only consider in-home supportive
services a generic resource when the approved in-home supportive
services meets the respite need as identified in the consumer's
individual program plan (IPP) or individualized family service plan
(IFSP).
(b) For consumers receiving respite services, on July 1, 2009, as
part of their IPP or IFSP, subdivision (a) shall apply on August 1,
2009.
(c) This section shall remain in effect until implementation of
the individual choice budget pursuant to Section 4648.6 and
certification by the Director of the Department of Developmental
Services that the individual choice budget has been implemented and
will result in state budget savings sufficient to offset the costs
associated with the repeal of this section. This section shall be
repealed on the date of certification.
Minors out of home Placement Fees
SEC. 27. Section 4784 of the Welfare
and Institutions Code is amended to read:
4784. (a) The Director of Developmental Services shall establish,
annually review, and adjust as needed, a schedule of parental fees
for services received through the regional centers. This
Retroactive to July 1, 2009, this schedule shall
be revised to reflect changes in economic conditions that affect
parents' ability to pay the fee, but not to exceed an inflationary
factor as determined by the department.
(b) The parental fee schedule established pursuant to this section
shall be exempt from Chapter 3.5 (commencing with Section 11340) of
Part 1 of Division 3 of Title 2 of the Government Code.
(c) In establishing the amount parents shall pay, the director
shall take into account all of the following factors:
(1) Medical expenses incurred prior to regional center care.
(2) Whether the child is living at home.
(3) Parental payments for medical expenses, clothing, incidentals,
and other items considered necessary to the normal rearing of a
child.
(4) Transportation expenses incurred in visiting a child.
(d) All parental payments shall be deposited in the Program
Development Fund established in Chapter 6 (commencing with Section
4670) to provide resources needed to initiate new programs,
consistent with approved priorities for program development in the
state plan.
(1) The current cost of caring for a child at home, as determined
by the most recent data available from the United States Department
of Agriculture's survey on the cost of raising a child in California,
adjusted for the Consumer Price Index (CPI) from the survey date to
the date of payment adjustment.
(2) Medical expenses incurred prior to regional center care.
(3) Whether the child is living at home.
(4) Parental payments for medical expenses, clothing, incidentals,
and other items considered necessary for the normal rearing of a
child.
(5) Transportation expenses incurred in visiting a child.
(d) The parental fee schedule shall exempt families with an income
below the federal poverty level from assessment and payment of the
parental fee.
(e) (1) The adjusted fee shall be assessed in full for children,
when the out-of-home placement commences on or after July 1, 2009.
(2) For children placed out-of-home prior to July 1, 2009, the
department shall determine the increase in the parental fee above the
amount assessed using the fee schedule in effect on June 30, 2009.
This fee increase shall be implemented over three years, with
one-third of the increase added to the fee on July 1, 2009, one-third
of the increase added to the fee on July 1, 2010, and the final
third added to the fee on July 1, 2011.
(f) Notwithstanding any other provision of law or regulation to
the contrary, retroactive to July 1, 2009, all fees collected shall
be remitted to the State Treasury to be deposited as follows:
(1) Fees collected up to the amount that would be assessed using
the fee schedule in effect on June 30, 2009, shall be deposited into
the Program Development Fund established in Chapter 6 (commencing
with Section 4670) to provide resources needed to initiate new
programs, consistent with approved priorities for program development
in the state plan.
(2) Fees collected using the July 1, 2009, schedule that are
greater than the amount that would have been assessed using the fee
schedule in effect on June 30, 2009, shall be deposited into the
Program Development Fund and shall be available for expenditure by
the department to offset General Fund costs.
Day Programs
SEC. 26. Section 4692 is added to the
Welfare and Institutions Code , to read:
4692. (a) Retroactive to August 1, 2009, subject to subdivisions
(c) and (e), regional centers shall not compensate a work activity
program, activity center, adult development center, behavior
management program, social recreation program, adaptive skills
trainer, infant development program, program support group (day
service), socialization training program, client/parent support
behavior intervention training program, community integration
training program, community activities support service, or creative
arts program, as defined in Title 17 of the California Code of
Regulations, for providing any service to a consumer on any of the
following holidays:
(1) January 1.
(2) The third Monday in January.
(3) The third Monday in February.
(4) March 31.
(5) The last Monday in May.
(6) July 4.
(7) The first Monday in September.
(8) November 11.
(9) Thanksgiving Day.
(10) December 25.
(11) The four business days between December 25 and January 1.
(b) Retroactive to August 1, 2009, subject to subdivisions (c) and
(e), regional centers shall not compensate a transportation
vendor/family member, transportation company,
transportation/additional component vendor, transportation broker,
transportation assistant/vendor, transportation vendor/auto driver,
or transportation vendor/public or rental car agency or taxi, in
accordance with Title 17 of the California Code of Regulations, for
transporting any consumer to receive services from any of the vendors
specified in subdivision (a) for any of the holidays set forth in
paragraphs (1) to (11), inclusive, of subdivision (a).
(c) If a holiday listed in this section falls on a Saturday or a
Sunday, the following Monday shall be deemed to be the holiday in
lieu of the day observed.
(d) Contracts between the vendors described in this section and
regional centers shall reflect the holiday closures set forth in this
section and shall be renegotiated accordingly, as necessary.
(e) The department may adjust the holidays set forth in
subdivision (a) through a program directive. This directive shall be
provided to the regional centers and posted on the department's
Internet Web site at least 60 days prior to the effective date of the
change in holiday.
ABA
SEC. 19. Section 4686.2 is added to the
Welfare and Institutions Code , to read:
4686.2. (a) Retroactive to July 1, 2009, notwithstanding any
other provision of law or regulation to the contrary, any vendor who
provides applied behavioral analysis (ABA) services, or intensive
behavioral intervention services or both, as defined in subdivision
(d), shall:
(1) Conduct a behavioral assessment of each consumer to whom the
vendor provides these services.
(2) Design an intervention plan that shall include the service
type, number of hours and parent participation needed to achieve the
consumer's goals and objectives, as set forth in the consumer's
individual program plan (IPP) or individualized family service plan
(IFSP). The intervention plan shall also set forth the frequency at
which the consumer's progress shall be evaluated and reported.
(3) Provide a copy of the intervention plan to the regional center
for review and consideration by the planning team members.
(b) Retroactive to July 1, 2009, notwithstanding any other
provision of law or regulation to the contrary, regional centers
shall:
(1) Only purchase ABA services or intensive behavioral
intervention services that reflect evidence-based practices, promote
positive social behaviors, and ameliorate behaviors that interfere
with learning and social interactions.
(2) Only purchase ABA or intensive behavioral intervention
services when the parent or parents of minor consumers receiving
services participate in the intervention plan for the consumers,
given the critical nature of parent participation to the success of
the intervention plan.
(3) Not purchase either ABA or intensive behavioral intervention
services for purposes of providing respite, day care, or school
services.
(4) Discontinue purchasing ABA or intensive behavioral
intervention services for a consumer when the consumer's treatment
goals and objectives, as described under subdivision (a), are
achieved. ABA or intensive behavioral intervention services shall not
be discontinued until the goals and objectives are reviewed and
updated as required in paragraph (5) and shall be discontinued only
if those updated treatment goals and objectives do not require ABA or
intensive behavioral intervention services.
(5) For each consumer, evaluate the vendor's intervention plan and
number of service hours for ABA or intensive behavioral intervention
no less than every six months, consistent with evidence-based
practices. If necessary, the intervention plan's treatment goals and
objectives shall be updated and revised.
(6) Not reimburse a parent for participating in a behavioral
services treatment program.
(c) For consumers receiving ABA or behavioral intervention
services on July 1, 2009, as part of their IPP or IFSP, subdivision
(b) shall apply on August 1, 2009.
(d) For purposes of this section the following definitions shall
apply:
(1) "Applied behavioral analysis" means the design,
implementation, and evaluation of systematic instructional and
environmental modifications to promote positive social behaviors and
reduce or ameliorate behaviors which interfere with learning and
social interaction.
(2) "Intensive behavioral intervention" means any form of applied
behavioral analysis that is comprehensive, designed to address all
domains of functioning, and provided in multiple settings for no more
than 40 hours per week, across all settings, depending on the
individual's needs and progress. Interventions can be delivered in a
one-to-one ratio or small group format, as appropriate.
(3) "Evidence-based practice" means a decisionmaking process that
integrates the best available scientifically rigorous research,
clinical expertise, and individual's characteristics. Evidence-based
practice is an approach to treatment rather than a specific
treatment. Evidence-based practice promotes the collection,
interpretation, integration, and continuous evaluation of valid,
important, and applicable individual- or family-reported,
clinically-observed, and research-supported evidence. The best
available evidence, matched to consumer circumstances and
preferences, is applied to ensure the quality of clinical judgments
and facilitates the most cost-effective care.
(4) "Parent participation" shall include, but shall not be limited
to, the following meanings:
(A) Completion of group instruction on the basics of behavior
intervention.
(B) Implementation of intervention strategies, according to the
intervention plan.
(C) If needed, collection of data on behavioral strategies and
submission of that data to the provider for incorporation into
progress reports.
(D) Participation in any needed clinical meetings.
(E) Purchase of suggested behavior modification materials or
community involvement if a reward system is used.
For the Bill Language please go too http://www.cdcan.us/budgetbillsjune2009.htm
