AB 136

Bill Subjects

Abstract

(1) Existing law, the California Early Intervention Services Act, provides a statewide system of coordinated, comprehensive, family-centered, multidisciplinary, and interagency programs that are responsible for providing appropriate early intervention services and supports to all eligible infants and toddlers and their families. Under the act, direct services for eligible infants and toddlers and their families are provided by regional centers and local educational agencies. The act requires an eligible infant or toddler receiving services under the act to have an individualized family service plan, as specified. Existing law requires parents to be fully informed of their rights, including the right to invite another person, including a family member or an advocate or peer parent, to accompany them to any or all individualized family service plan meetings. This bill, until June 30, 2022, and at the request of the parent or legal guardian, would require an individualized family service plan meeting to be held by remote electronic communications and would include remote electronic communications as a method of delivering services. By imposing new duties on local educational agencies that provide services under the act, the bill would impose a state-mandated local program. (2) Existing law requires the State Department of Developmental Services and the State Department of Social Services to jointly implement a licensing program to provide special health care and intensive support services to adults in homelike community settings and specifically authorizes the departments to license and regulate Adult Residential Facilities for Persons with Special Health Care Needs (ARFPSHNs) . Existing law defines an ARFPSHN to mean any adult residential facility that provides 24-hour health care and intensive support services in a homelike setting that is licensed to serve up to five adults with developmental disabilities. This bill would expand that program to include licensing and regulation of Group Homes for Children with Special Health Care Needs (GHCSHNs) . The bill would define GHCSHN to mean a group home that provides 24-hour health care and intensive support services in a homelike setting that is licensed to serve up to five children or nonminor dependents with developmental disabilities. The bill would impose specified requirements on a GHCSHN, similar to those imposed on an ARFPSHN, including requirements relating to operable automatic fire sprinklers and alternative power sources, allowable rates, staffing, consumer admission criteria, and individual health care plans. The bill would require an administrator of a GHCSHN to complete a 40-hour certification training program and to meet other licensing or education requirements, as specified, and would require the individual health care plan team for a client at a GHCSHN to be composed of specified individuals, including the regional center service coordinator, the GHCSHN administrator, and the consumer's primary care physician, or other physician, as specified. (3) Existing law, the California Community Care Facilities Act, provides for the licensing and regulation of community care facilities by the State Department of Social Services. Under existing law, community care facilities include facilities that provide nonmedical residential care, day treatment, adult daycare, or foster family agency services. A person who violates the act, or who willfully or repeatedly violates any rule or regulation promulgated pursuant to the act, is guilty of a misdemeanor. This bill would require a GHCSHN to possess a community care facility license and would subject a GHCSHN to specified provisions under the act, including unannounced inspections, specified reporting requirements, and civil penalties for specified violations of the act. The bill would authorize a GHCSHN to allow a client who has been diagnosed as terminally ill to remain in the facility, or allow a child who has been diagnosed as terminally ill to be placed in the facility if that person is already receiving hospice services, if certain conditions are met. By making a GHCSHN subject to the licensing requirements under the act, the bill would expand the applicability of an existing crime, thereby imposing a state-mandated local program. Existing law defines a "community crisis home" for purposes of the act to mean a facility certified by the State Department of Developmental Services and licensed by the State Department of Social Services as an adult residential facility that provides 24-hour nonmedical care to individuals with developmental disabilities receiving regional center service, in need of crisis intervention services, and who would otherwise be at risk of admission to the acute crisis center at Fairview Developmental Center, Sonoma Developmental Center, an acute general hospital, acute psychiatric hospital, an institution for mental disease, or an out-of-state placement. This bill would eliminate the reference to the Sonoma Developmental Center for purposes of that definition. (4) Existing law establishes the jurisdiction of the juvenile court, which may adjudge a minor or nonminor to be a dependent or ward of the court under certain circumstances. Existing law authorizes a social worker or probation officer who has supervision over a dependent or ward of the court to place the child in specified homelike settings, including a group home for children. This bill would require those group homes to be vendored by a regional center. This bill would require a child or nonminor dependent who is a dependent or ward of the court, as specified, or who is in the custody of the county welfare department, who is or will be placed in a GHCSHN, to meet specified requirements, including that the child or nonminor dependent has a predictable and stable condition that can rapidly deteriorate, resulting in permanent injury or death, or that is dependent on specified medical treatment. The bill would also require a determination that the GHCSHN will provide the most effective and appropriate level of care for the child or nonminor dependent in the least restrictive environment and be consistent with the short- and long-term goals for the child or nonminor dependent. To the extent that the bill would impose new duties on counties, the bill would impose a state-mandated local program. (5) Existing law, the Lanterman Developmental Disabilities Services Act, requires the State Department of Developmental Services to contract with regional centers to provide services and supports to individuals with developmental disabilities and their families. The services and supports to be provided to a regional center consumer are contained in an individual program plan, developed in accordance with prescribed requirements, and may include, but are not limited to, diagnosis, treatment, personal care, information and referral services, counseling, and specialized medical and dental care. Existing law sets forth the department's and the regional center's authority to establish provider rates and prohibits certain provider rate increases. This bill, until June 30, 2022, would require a meeting regarding the provision of services and supports by the regional center to be held by remote electronic communications if requested by the consumer or, if appropriate, if requested by the consumer's parents, legal guardian, conservator, or authorized representative. This bill, would require contracts between the department and regional centers to require the regional center to have, or contract for, implicit bias training and language access and cultural competency services and support, as specified. The bill would require the department to administer an enhanced language access and cultural competency initiative for individuals with developmental disabilities, their caregivers, and their family members and would require the department to require regional centers to implement this initiative through their contracts. The bill would also require regional centers to receive specialized funding allocations to facilitate applications for payments authorized to protect the health and safety of consumers, as specified, for non-English speaking individuals served. (6) Existing law, pending a specified certification by the Director of Developmental Services relating to the availability of funds, suspends the regional centers' authority to contract for camping services, social recreation services, educational services for children 3 to 17 years of age, inclusive, and nonmedical therapies, as specified. This bill would end that suspension June 30, 2021, make the provision inoperative on July 1, 2022, and repeal it on January 1, 2022. (7) Existing law requires a regional center contract to include specified staffing levels and expertise, including service coordinator-to-consumer ratios. Existing law requires a regional center to develop a plan of correction if it fails to maintain required service coordinator caseload ratios for two consecutive reporting periods, or otherwise demonstrates an inability to maintain appropriate staffing patterns. Existing law requires the plan of correction to be developed following input from specified entities and interested parties. This bill would impose certain public meeting and reporting requirements on regional centers each time that new funds are appropriated in the annual Budget Act to the department for allocation to regional centers with the stated purpose of reducing caseload ratios. The bill would require a regional center to hold at least one public meeting during the year the appropriation is made to receive stakeholder input to help inform the way the regional center allocates new positions funded through the allocation to that regional center. Under the bill, the public meeting would fulfill a regional center's requirement to gather input regarding a plan of correction, as described above, if the plan of correction is discussed during the meeting This bill would also require a regional center, on or before October 10 of the year of the appropriation of funds, and again by March 10 of that fiscal year, to report specified information to the department, including the number of new service coordinator positions created with the funds and data on current caseload ratios. (8) Existing law prohibits a regional center from placing or funding the placement of a consumer in an ARFPSHN unless the individual health care plan team has prepared a written individual health care plan that can be fully and immediately implemented upon the consumer's placement. This bill would apply that prohibition for a regional center placing or funding the placement of a consumer in a GHCSHN and would additionally require, for a GHCSHN, that the regional center consider and document every possible way to assist the child's family or guardian to maintain the child in the home of the family or guardian, as specified. (9) Existing law requires the department, on or before March 1, 2019, to submit a rate study to specified committees of the Legislature regarding community-based services for individuals with developmental disabilities. This bill would require the department to implement rate increases between April 1, 2022, and July 1, 2025, to raise service providers' rates to a specified amount reflected in the rate models that were included in the rate study described above. The bill would, however, subject the increases to a quality incentive program, as specified. The bill would require the department, with input from stakeholders, to develop quality measures, benchmarks, or both, for consumer outcomes and regional center and service provider performance. The bill would also require the department, on or before March 1, 2022, to provide a status update to the Legislature regarding progress toward implementing rate reform and creating an enhanced person-centered, outcomes-based system. (10) Existing law, commencing with the first planned quarterly briefing after January 1, 2020, requires the State Department of Developmental Services to provide information on topics at quarterly briefings with legislative staff of the appropriate policy and fiscal committees of the Legislature addressing, among other things, regional center accountability, transparency, and oversight efforts. This bill would require the department to provide information on, among other things, the development of GHCSHNs in those quarterly briefings. (11) Existing law prohibits the department from expending funds, and a regional center from expending funds allocated to it by the department, for the purchase of any service outside the state unless the Director of Developmental Services or the director's designee has received, reviewed, and approved a plan for out-of-state service in the consumer's individual program plan. Existing law requires the department to authorize for no more than 6 months the purchase of out-of-state services when the director determines the proposed service or an appropriate alternative, as determined by the director, is not available from resources and facilities within the state. Existing law requires an extension beyond 6 months to be based on a new and complete comprehensive assessment of the consumer's needs, a review of available options, and a determination that the consumer's needs cannot be met in California. Existing law requires, if a regional center places a consumer out of state, the regional center to prepare a specified report for inclusion in the consumer's individual program plan and review and update that report every 3 months. This bill, until December 31, 2021, would authorize the director to approve longer extensions for consumers who are receiving out-of-state services as of July 1, 2021, and would, until January 1 2022, decrease the frequency with which the report is required to be reviewed and updated for those consumers. (12) Existing law requires the department and regional centers to annually collaborate to compile specified data relating to purchase of service authorization, utilization, and expenditure by each regional center. Existing law requires the department to consult with specified stakeholders to review the data, identify barriers to access to services and supports, and encourage development and expansion of culturally appropriate services. Existing law requires the department, subject to available funding, to allocate funding to regional centers or community-based organizations with department oversight to assist with implementation of the recommendations and plans developed pursuant to those provisions. This bill would require the department, on or before December 31, 2021, to contract with an entity or entities with demonstrated experience in quantitative and qualitative data evaluation to design and conduct an independent evaluation of the efforts to promote equity and reduce disparities pursuant to those provisions. The bill would also require the department to establish a community navigator program and allocate funding for that program to promote the utilization of generic and regional center services, as specified. The bill would also require the department to consult stakeholders by August 31, 2021, and issue funding guidelines regarding the selection of community navigator programs. The bill would require a family resource center that receives funding pursuant to those provisions to report to the department, as specified, and for the department to post those reports on its internet website by November 1, 2022. (13) Existing law requires the department to be responsible for securing, providing, and coordinating training to assist regional center consumers and their families, regional centers, and services and supports providers in acquiring the skills, knowledge, and competencies to achieve the purposes of the act. Existing law requires each direct care staff person employed in a licensed community care facility that receives regional center funding to satisfactorily complete 2 35-hour competency-based training courses, as specified. This bill would require the department to develop and implement enhanced direct service professional training that promotes services that are person centered and culturally and linguistically sensitive, and that improve outcomes for individuals with intellectual and developmental disabilities, as specified. (14) Existing law defines a "developmental disability" for purposes of the Lanterman Developmental Disabilities Services Act as a disability that originates before an individual attains 18 years of age, continues, or can be expected to continue, indefinitely, and constitutes a substantial disability for the individual. Under existing law, "developmental disability" includes intellectual disability, cerebral palsy, epilepsy, autism, and disabling conditions found to be closely related to intellectual disability or that require treatment similar to that required for individuals with an intellectual disability, but does not include other handicapping conditions that are solely physical in nature. This bill would expand the definition of developmental disability to include a child who is 3 or 4 years of age who does not have one of the developmental disabilities listed above, but has significant functional limitations in at least 2 of the specified categories of major life activity, as determined by a regional center and as appropriate to the age of the child. The bill would establish provisional eligibility for regional center services on the basis of a disability for a child who meets these requirements. The bill would require that a child who is provisionally eligible be reassessed for continued eligibility for regional center services at least 90 days before turning 5 years of age. The bill would, among other things, require that an infant or toddler eligible for early intervention services from a regional center be assessed by the regional center at least 90 days prior to the date they turn 3 years of age for purposes of determining their ongoing eligibility, including provisional eligibility, for regional center services, as specified. (15) Existing law sets forth the duties of the regional centers, including the development of individual program plans, the purchase of needed services to implement the plan, and monitoring of the delivery of those services. To provide more uniformity and consistency in the administrative practices and services of regional centers throughout the state, promote appropriateness of services, maximize efficiency of funding, and improve cost-effectiveness, among other things, existing law requires the department, in collaboration with stakeholders, to develop best practices for the administrative management of regional centers and for regional centers to use when purchasing services for consumers and families. This bill would require the department, beginning as early as possible after July 1, 2021, but no later than September 1, 2021, to convene a workgroup composed of specified individuals, including regional center representatives and service providers, to make recommendations to the department for the development of standard performance improvement indicators and benchmarks to incentivize high-quality regional center operations. By January 10, 2022, the bill would require the department to provide a status update based on recommendations provided by the stakeholder workgroup, with an additional status update at the time of the Governor's May Revision. (16) Existing law requires contracts between the department and regional centers to specify the service area and the categories of persons that regional centers shall be expected to serve, as specified. Existing law requires regional centers to conduct casefinding activities, including notification of availability of service in English and other languages that may be appropriate to the service area, as specified. This bill, subject to an appropriation, would require the department to establish and implement a system that promotes equity in access to services for regional center consumers by providing a pay differential to direct service professionals who can communicate in a language or medium other than English, as defined, as part of their regular job duties. The bill would specify various conditions for a direct service professional to meet in order to be eligible for the bilingual or multilingual differential, including that they pass an examination certifying their ability to communicate in the language or medium other than English. The bill would authorize the department to adopt emergency regulations to implement those provisions, as specified. The bill would require the department to provide a report to the Legislature detailing its plan to implement those provisions, as specified. (17) Under existing law, the regional centers purchase needed services and supports for individuals with developmental disabilities through approved service providers, or arrange for their provision through other publicly funded agencies. The services and supports to be provided to a regional center consumer are contained in an individual program plan (IPP) , developed in accordance with prescribed requirements. Existing law requires the department, contingent upon approval of federal funding, to establish and implement a statewide Self-Determination Program, as defined, that would be available in every regional center catchment area to provide participants and their families, within an individual budget, increased flexibility and choice, and greater control over decisions, resources, and needed and desired services and supports to implement their IPP, in accordance with prescribed requirements. Under existing law, the statewide Self-Determination Program is phased in over 3 years to serve up to 2,500 regional center consumers and then is available to all regional center consumers on a voluntary basis, as specified. Existing law also requires the department and regional centers to annually collaborate to compile data relating to, among other things, the purchase of service authorization, utilization, and expenditure by each regional center. This bill would require that, as of July 1, 2021, the Self-Determination Program be available to all eligible regional center consumers, and would eliminate the provisions related to the phase in of the program. The bill would require the program to set specified targets and benchmarks, address a choice of financial management services providers who meet standards and certification requirements established by the department, and address the long-term sustainability of the program, among other requirements. The bill would require the department, in implementing the program, to prioritize the use of funds to increase service access and equity and reduce disparities. The bill would add new requirements on the regional centers and financial management services providers in implementing the program, as specified. The bill would also require a participant, if eligible, and with the assistance of the regional center, if needed, to timely apply for Medi-Cal in order to maximize federal funding. The bill would authorize a participant to consider institutional deeming in order to qualify for Medi-Cal services. In implementing a regional center consumer's IPP under the program, the bill would require the IPP team to follow certain cost-effectiveness of services requirements, as specified. This bill would require the department to establish an Office of the Self-Determination Program Ombudsperson to be headed by an individual to be known as the Self-Determination Program Ombudsperson. The bill would require the Director of the Department of Developmental Services, as soon as practicable, to appoint an ombudsperson qualified by training and experience to perform the duties of the office for a term of 4 years. The bill would require the office to be an independent and autonomous entity within the department and would prescribe specified duties and rights of the office, including providing information and assisting regional center consumers and their families in understanding their rights under the Self-Determination Program and annually compiling and reporting relevant data to the appropriate policy and fiscal committees of the Legislature, as specified. (18) Existing law requires the State Department of Developmental Services, subject to specified state and federal funding, to provide a rate increase for specified developmental services, including supported employment services and vouchered community-based services. Existing law also requires the department, subject to those same conditions, to provide a rate increase to independent living programs, infant development programs, and early start specialized therapeutic services. Existing law suspends those rate increases on December 31, 2021, unless the Department of Finance makes a specified determination regarding General Fund revenues and expenditures. This bill would repeal that conditional suspension, thereby increasing those rates indefinitely. (19) Existing law generally prohibits a regional center from compensating certain vendors for providing any service to a consumer on specified holidays and generally prohibits a regional center from compensating certain entities for transporting a consumer to receive those services for any of the listed holidays. This bill would repeal that prohibition. (20) To encourage competitive integrated employment opportunities statewide for individuals with developmental disabilities, existing law requires the department to establish guidelines and oversee a program, to the extent funds are appropriated in the annual Budget Act for this purpose, to increase paid internship opportunities for individuals with developmental disabilities that produce outcomes consistent with the IPP. Existing law imposes various requirements on this internship program, including the maximum payment for internships and regional center reporting requirements on payments for internship placements. This bill would establish additional payment standards for this program, including a payment of $750 to be made to a regional center service provider that, on or after July 1, 2021, places an individual in a paid internship opportunity if the individual remains in the paid internship after 30 consecutive days. The bill, as of July 1, 2021, until June 30, 2025, would establish competitive integrated employment incentive payments for individuals who remain in competitive integrated employment for prescribed periods of time. The bill would also require the department, subject to an appropriation in the Budget Act, to establish, by December 31, 2021, a program to increase pathways to competitive integrated employment that meets specified requirements. (21) Existing law grants the department jurisdiction over various state hospitals, referred to as developmental centers, that provide care to persons with developmental disabilities. Existing law requires the department, no later than April 1, as specified, to submit a detailed plan to the Legislature whenever the department proposes the closure of a state developmental center. Existing law prohibits the admission of a person to a developmental center except under certain circumstances, including when the person is experiencing an acute crisis and is committed by a court to the acute crisis center at the Fairview Developmental Center or the Sonoma Developmental Center. Existing law includes those acute crisis centers in the definition of an acute crisis home and establishes certain procedures to be followed prior to, and following, a consumer's admission to an acute crisis home. Existing law authorizes the department to execute leases, lease-purchases, or leases with the option to purchase for real property necessary for the establishment or maintenance of Stabilization, Training, Assistance and Reintegration (STAR) homes to serve as acute crisis homes operated by the department. This bill would, among other things, modify the definition of "acute crisis home operated by the department" to mean real property used to provide STAR services. The bill would make various changes to reflect the closures of certain state developmental centers. (22) Existing law provides that a petition for the commitment of a person with a developmental disability to the department may be filed in the county in which that person is physically present. This bill would authorize a petition for the commitment of a person with a developmental disability to the department who is in acute crisis to be filed in the superior court of the county that determined the question of acute crisis or the county in which the acute crisis home is located. (23) Existing law, until June 30, 2021, authorizes a court to commit an individual who meets specified criteria for admission to Canyon Springs Community Facility. This bill would extend that authorization until June 30, 2022. (24) Existing law requires a state department, board, or commission to obtain prior approval of the Department of General Services to engage in any lease activity and subjects a lease agreement to approval by the department. Existing law exempts the State Department of Developmental Services from the requirement to receive approval from the Department of General Services for the lease, lease-purchase, or lease with the option to purchase the Stabilization, Training, Assistance and Reintegration (STAR) homes known as North STAR Home 1 and North STAR Home 2, both located in the City of Vacaville. This bill would instead exempt the State Department of Developmental Services from the requirement to receive approval from the Department of General Services for the lease, lease-purchase, or lease with the option to purchase 5 STAR homes. (25) This bill would appropriate $6,000,000 from the Home and Community-Based Services American Rescue Plan Fund to the State Department of Developmental Services for one-time planning purposes related to the implementation of a uniform fiscal system and consumer electronic records management system. (26) The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that with regard to certain mandates no reimbursement is required by this act for a specified reason. With regard to any other mandates, this bill would provide that, if the Commission on State Mandates determines that the bill contains costs so mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above. (27) This bill would declare that it is to take effect immediately as a bill providing for appropriations related to the Budget Bill.