Date of Hearing: June 26, 2019

ASSEMBLY COMMITTEE ON APPROPRIATIONS

Lorena Gonzalez, Chair

SBPCA Bill Id:SB 412

Author:(Stone) – As Amended Ver:April 2, 2019

Urgency: No State Mandated Local Program: No Reimbursable: No

SUMMARY:

This bill repeals the Family Cost Participation Program (FCPP) and deletes the requirement that a regional center assess an annual family program fee (AFPF). The FCPP and AFPF are fees charged to families whose annual adjusted gross income is over 400% of the Federal Poverty Level (FPL) for the entitlement services and supports their children receive under the Lanterman Developmental Disabilities Act (Lanterman Act).

FISCAL EFFECT:

1. Repeal of FCPP. The FCPP generates revenues of approximately $5 million annually. Repealing the FCPP would result in estimated savings of $546,000 ($350,000 GF) in regional center operations in 2019-20 and $1.09 million ($700,000 GF) ongoing. The savings in regional center operations would partially offset the loss of the revenues resulting in a net cost for the repeal of the FCPP of $1.95 million ($2.15 million GF) in 2019-20 and $3.9 million ($4.3 million GF) in 2020-21.
2. Repeal of the AFPF. Revenues from the AFPF fund the Program Development Fund which provides start-up funding for the Community Placement Plan Program (CPP). The Governor’s proposed budget estimates the AFPF would generate $1.28 million in revenues in 2019-20. Repealing the AFPF would result in a loss of revenue of $1.28 million, which would have to be offset to continue funding the CPP.

COMMENTS:

1. Purpose. This bill seeks to repeal two changes to the developmental services delivery system that were adopted amidst the recent economic downturn often referred to as the Great Recession.
2. Background. In California, the Lanterman Act, adopted in 1977, established that individuals with developmental disabilities and their families have the right to receive services and supports necessary to live independently in the community, regardless of income or public benefit eligibility. Developmental services are coordinated for eligible individuals through California’s 21 nonprofit regional centers.

The FCPP took effect on January 1, 2005, for parents of children aged three to 17, and in 2008, it was expanded to parents of children aged zero to three. The FCPP applies only to three regional center services: day care, respite and camping (camp services were suspended during the budget shortfalls of 2009 and have not been reinstated). The FCPP applies to a family receiving one of those three services if their child has a developmental disability or is eligible for early intervention services, is zero to 17 years of age, lives in the parents’ home, is not eligible for Medi-Cal and the family’s income is at or above 400% of the FPL (approximately $83,000 for a family of three).

The total amount a family must pay for the services provided is assessed on a sliding scale from 10% to 100% of the service cost, based on the number of persons living in the family home and the family’s income. For example, as of April 1, 2019, for a family of three making a gross annual income of $85,320 the parents would be responsible for paying 10% of the costs associated with their child’s day care, respite or camp services. If that same family had a gross annual income of $179,172 they would pay 60% of those same costs. The family pays their percentage owed directly to the service provider. A service provider may not charge a FCPP family more than they would charge the regional center for the service.

As of July 1, 2011, parents of children aged zero to 18 receiving regional center services whose adjusted gross family income is at or above 400% of the FPL are assessed an AFPF. If a family is receiving services through Medi-Cal or they are assessed a cost under the FCPP, the AFPF does not apply. Only one AFPF is assessed yearly, regardless of the number of the children in the household receiving services. If the family’s adjusted gross income is at least 400% of the FPL, but less than 800% of the FPL, the amount assessed is $150. If the family’s adjusted gross income is at or above 800% of the FPL the amount assessed is $200.

As a result of the economic downturn beginning about 10 years ago and in response to budgetary constraints, the State of California sought to reduce expenditures wherever possible, and DDS began implementing numerous cost-saving measures, including restrictions and freezes on vendor rates and reductions in regional center operations funding and provider payments. Extending the FCPP indefinitely and assessing an AFPF were two of the costs savings measures.

Legislative and budgetary efforts are ongoing to reverse some of the recessionary cuts to regional center services. This bill is part of that effort.

1. Prior Legislation.

ABX2 1 (Thurmond), Chapter 3, Statutes of 2016, appropriated, among other things, $287 million GF monies for increases to regional centers and community service providers in 2016-17, imposed reporting requirements to ensure proper allocation of funds and program accountability, and required DDS to conduct and submit to the Legislature a study examining the sustainability, quality and transparency of community-based services.

AB 104 (Committee on Budget), Chapter 37, Statutes of 2011, required regional centers to assess an AFPF from parents whose adjusted gross family income is at or above 400% of the FPL, and who meet certain criteria.

ABX3 5 (Committee on Budget), Chapter 3, Statutes of 2008, repealed the sunset of July 1, 2009, for the FCPP and extended indefinitely the FCPP requirements.

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

Date of Hearing: June 18, 2019

ASSEMBLY COMMITTEE ON HUMAN SERVICES

Eloise Gómez Reyes, Chair

SBPCA Bill Id:SB 412

Author:(Stone) – As Amended Ver:April 2, 2019

SENATE VOTE: 38-0

SUBJECT: Developmental services: fees

SUMMARY: Repeals the Family Cost Participation Program (FCPP) and deletes the requirement that a regional center assess an annual family program fee (AFPF). Specifically, this bill:

1. Removes FCPP requirements by deleting provisions of current law that:
   1. Establish the FCPP in the Department of Developmental Services (DDS) for purposes of assessing a cost participation to parents who have a child with a developmental disability or is eligible for services under the California Early Intervention Services Act and to whom other criteria applies;
   2. Require DDS to develop and establish a FCPP schedule to be used by regional centers to assess the parents’ cost participation;
   3. Apply the FCPP to respite, day care, and camping services included in an individual program plan (IPP) or individualized family service plan (IFSP) for children zero through two years of age; and,
   4. Establish other criteria related to the application and administration of the FCPP.
2. Removes AFPF requirements by deleting provisions of current law that:
   1. Require, beginning on July 1, 2011, a regional center to assess an annual family program fee from parents whose adjusted gross family income is at or above 400% of the federal poverty level (FPL) based upon family size, and who have a child to whom the following conditions apply: the child has a developmental disability or is eligible for services under the California Early Intervention Services Act; the child is less than 18 years of age; the child lives with their parent; the child or family receives services beyond eligibility determination, needs assessment, and service coordination; and, the child does not receive services through the Medi-Cal program;
   2. Dictate by when and from whom an AFPF is to be assessed and collected;
   3. Require the AFPF for parents that meet the aforementioned qualifications be $200 per family, regardless of the number of children in the family with developmental disabilities or who are eligible for services under the California Early Intervention Services Act;
   4. Allow a regional center to grant exemption to the assessment of an AFP fee if the parents demonstrate: that an exemption is necessary to maintain the child in the family home; the existence of an extraordinary event that impacts the parents’ ability to pay the fee or the parents’ ability to meet the care and supervision needs of the child; and, the existence of a catastrophic loss that temporarily limits the ability of the parents to pay and creates a direct economic impact on the family;
   5. Prohibit services from delayed or denied for a consumer or child based upon the lack of payment of the AFPF; and,
   6. Establish other criteria related to the application and administration of the AFPF.
3. Makes technical and conforming changes.

EXISTING LAW:

1. Establishes an entitlement to services for individuals with developmental disabilities under the Lanterman Developmental Disabilities Services Act (Lanterman Act). (Welfare and Institutions Code [WIC] Section 4500 et seq.)
2. Grants all individuals with developmental disabilities, among all other rights and responsibilities established for any individual by the United States Constitution and laws and the California Constitution and laws, the right to treatment and habilitation services and supports in the least restrictive environment. (WIC 4502)
3. Establishes a system of 21 nonprofit regional centers throughout the state to identify needs and coordinate services for eligible individuals with developmental disabilities and requires the DDS to contract with regional centers to provide case management services and arrange for or purchase services that meet the needs of individuals with developmental disabilities, as defined. (WIC 4620 et seq.)
4. Creates a process by which regional centers may “vendorize” service providers, thereby providing a path to contract for services with that provider and ensuring maximum flexibility and availability of appropriate services and supports for persons with developmental disabilities. (WIC 4648)
5. Establishes the FCPP for purposes of assessing a cost participation to parents who have a child and to whom all of the following conditions apply: the child has a developmental disability, or is eligible for services under the California Early Intervention Services Act, as specified; the child is zero through 17 years of age; the child lives in the parents’ home; the child receives services and supports through the regional centers; and, the child is ineligible for Medi-Cal. (WIC 4783 et seq.)
6. Prohibits Aid to Families with Dependent Children-Foster Care (AFDC-FC) and Adoption Assistance Program (AAP) payments from being counted toward the gross income calculated for purposes of the FCPP, and further prohibits AFDC-FC recipients from being subject to FCPP program requirements. (WIC 4684 (c)(3))
7. Requires a regional center, effective July 1, 2011, to assess an AFPF from parents whose adjusted gross family income is at or above 400% of the FPL based upon family size and who have a child to whom all of the following apply: the child has a developmental disability, or is eligible for services under the California Early Intervention Services Act, as specified; the child is less than 18 years of age; the child lives with their parent(s); the child or family receives services beyond eligibility determination, needs assessment, and service coordination; and, the child does not receive services through Medi-Cal. (WIC 4785 et seq.)
8. Prohibits the AFPF from being assessed or collected if the child receives only respite, day care, or camping services from the regional center and a cost for participation is assessed pursuant to the FCPP. (WIC 4785 (a)(2))
9. Suspends the ability of a regional center to purchase certain services, including camping services and associated travel expenses; social recreation activities, except for those activities vendored as community based day programs; educational services for children three to 17, inclusive, years of age; and nonmedical therapies, including, but not limited to specialized recreation, art, dance, and music, pending implementation of the Individual Choice Budget. (WIC 4648.5 (a))

FISCAL EFFECT: According to the Senate Appropriations Committee on April 2, 2019, this bill may result in the following costs:

1. Repeal of FCPP: FCPP operating expenses, equipment, and total staff salary and benefits currently cost DDS $1.09 million ($700,000 General Fund [GF]) per year. Repealing the FCPP would result in a subsequent savings of $1.09 million per year for reducing regional center operations. The FCPP, however, generates revenues of approximately $5 million per year, which would be lost with the repeal. The net cost for the repeal of the FCPP would be $3.9 million ($4.3 million GF) per year; and,
2. Repeal of the AFPF: Revenues from the AFPF fund the Program Development Fund which provides start-up funding for the Community Placement Plan Program (CPP). The Governor’s proposed budget estimates the AFPF would generate $1.28 million in revenues in 2019-20. Repealing the AFPF would result in a loss of revenue of $1.28 million, which would have to be offset to continue funding the CPP.

COMMENTS:

Developmental Services: The Lanterman Developmental Disabilities Act (Lanterman Act), adopted in 1977, established that individuals with developmental disabilities and their families have the right to receive services and supports necessary to live independently in the community. The Lanterman Act outlines the rights of individuals and their families, what services are available to them, and how regional centers and service providers may best serve these individuals. The term “developmental disability” is defined as a disability that presents before an individual reaches 18 years of age, is expected to continue indefinitely, and is a significant disability for that individual; such disabilities include epilepsy, cerebral palsy, and autism spectrum disorder, among others. Additionally, part of the Lanterman Act’s legacy is the creation of California’s 21 regional centers, which are tasked with providing information to, and helping coordinate services and supports for, individuals with developmental disabilities and their families. It is important to note that regional centers do not directly provide services to individuals, but, rather, help link consumers and their families to service providers in the community.

Regional centers: Because regional centers do not directly provide services, their primary objective is to contract with and supply funding to vendors in the surrounding area to provide services to regional center consumers. However, before a vendor can provide services to a consumer, the vendor must undergo the “vendorization” process, in which the provider applies for contracts that enable them to serve individuals in the community. The vendorization process enables regional centers to verify that an applicant meets specific requirements and standards prior to the provision of services to consumers. While the vendorization process makes a provider eligible to provide services paid for by regional centers, there is no guarantee that a regional center will refer customers to any given vendor. It is also possible for a vendor to be vendorized by more than one regional center, which allows vendors to serve consumers in multiple catchment areas

Effects of the economic downturn: As a result of the economic downturn associated with the Great Recession, and in response to budgetary constraints, the State of California sought to reduce expenditures wherever possible, and DDS began implementing numerous cost-saving measures, including restrictions and freezes on vendor rates, and reductions in regional center operations funding and provider payments, in addition to the following.

Family Cost Participation Program (FCPP): The FCPP became effective upon the adoption of SB 1103 (Committee on Budget and Fiscal Review), Chapter 228, Statutes of 2004. Under the FCPP, families are required to share in the cost of services provided to their children if the following criteria are met:

• The child has a developmental disability or is eligible for services under the California Early Intervention Services Act;
• The child is zero through 17 years of age;
• The child lives in their parents’ home;
• The child is not eligible for Medi-Cal; and,
• Family income is at or above 400% of the FPL.

The FCPP only applies to the families of children who receive day care, respite, and/or camping services, though it should be noted that, under current law, a regional center’s ability to purchase camping services is suspended effective July 1, 2009. According to the U.S. Department of Health and Human Services, the 2019 FPL for a family of three is $21,330; in order to be subject to the requirements of the FCPP, a family of three would need a household income of at least $85,320.

While SB 1103 was initially signed into law several years before the Great Recession forced numerous budgetary cuts, it originally contained a provision that made inoperative the FCPP as of July 1, 2009, and repealed the FCPP as of January 1, 2010; however, ABX3 5 (Committee on Budget), Chapter 3, Statutes of 2008, in response to the Great Recession, extended the FCPP requirements indefinitely. The provisions of this bill would repeal the FCPP in its entirety.

Annual Family Program Fee (AFPF): Implemented by AB 104 (Committee on Budget), Chapter 37, Statutes of 2011, the AFPF leverages a fee on the parents of children who meet the following criteria:

• The child has a developmental disability or is eligible for services under the California Early Intervention Services Act;
• The child is less than 18 years of age;
• The child lives with their parents;
• The child or family receives services beyond eligibility determination, needs assessment, and services coordination; and,
• The child does not receive services through the Medi-Cal program.

It should be noted that regional centers may not assess an annual family program fee for children who receive respite, day care, or camping services and for whom a participation cost under the FCPP has been assessed.

Current law requires the AFPF be assessed at the time an individual program plan (IPP) is developed; however, a regional center may grant an exemption to the AFPF if the parent demonstrates that an exemption is necessary in order to keep the child in the family home, or if there exists an extraordinary event that impacts the parents’ ability to pay the fee or meet the care and supervision needs of the child. An exemption may also be granted in the event of a catastrophic loss that temporarily limits the ability of a parent to pay and creates a direct economic impact on the family. The provisions of this bill would repeal the AFPF in its entirety.

Need for this bill: This bill seeks to preserve one of the key principles of the Lanterman Act – that individuals with developmental disabilities are entitled to receive services and supports that enable them to live independently in the community – by repealing two changes to the developmental services delivery system that were adopted amidst the Great Recession. First, the bill repeals the FCPP, which, while introduced and adopted in 2004 was extended indefinitely in 2008, and partially shifted the responsibility to fund respite, day care, and camping services to some consumers’ families; and, second, repeals the AFPF, which requires regional centers to assess an annual fee for families of individuals with developmental disabilities to share in the cost of providing services.

According to the author, “California serves well over 300,000 individuals with developmental disabilities through contracts with independent, non-profit regional centers. Our great state has made a long-standing public policy commitment to support individuals with developmental disabilities to meet their unique goals in their home communities. However, during the Great Recession, the developmental disabilities services system was subjected to over $1 billion in cuts and funding reductions. Two of these cuts were the Family Cost Participation Program and the Annual Family Program Fee.

“The Family Cost Participation Program requires regional centers to pay for less respite, day care, and camp (now suspended) than a child needs based on family income. Families are expected to make-up the difference. The Annual Family Program Fee charges parents of children receiving other services based on income. These fees were created to raise money for the state during the Recession, making them, essentially, taxes on disability. [This bill] would simply repeal two of these cuts to disability services. By doing so, this bill removes an artificial barrier to access services.

“As the developmental services system continues to grow, it is incumbent on the state to prioritize overall stability and capacity to meet the variety of unique needs that arise from the combination of each person’s diagnosis, age, support need, preferences, and cultural values. [This bill] will help to keep the promise of the Lanterman Act for hundreds of thousands of Californians who rely on it.”

RELATED AND PRIOR LEGISLATION:

AB 261 (Mathis) of 2019 would have repealed the prohibition on a regional center’s ability to purchase camping services and associated travel expenses, and social recreation activities. AB 261 was held on the Assembly Appropriations suspense file.

AB 311 (Frazier) of 2019 would have repealed the requirement that activity centers, adult development centers, behavior management programs, and other look-alike day programs bill regional centers for services in terms of half and full days of service. AB 311 was held on the Assembly Appropriations suspense file.

AB 438 (Frazier) of 2019 would have repealed the mandated uniform holiday schedule for certain providers of regional center contracted services for individuals with developmental disabilities. AB 438 was held on the Assembly Appropriations suspense file.

AB 2522 (Chu) of 2018 would have restored the ability of regional centers to purchase non-required services, social recreation, camping, and educational services, and would have eliminated the FCPP, among other changes to the developmental services system. AB 2522 was held in the Assembly Human Services Committee.

ABX2 1 (Thurmond), Chapter 3, Statutes of 2016, appropriated, among other things, $287 million GF monies for increases to regional centers and community service providers in 2016- 17, imposed reporting requirements to ensure proper allocation of funds and program accountability, and required DDS to conduct and submit to the Legislature a study examining the sustainability, quality, and transparency of community-based services.

AB 104 (Committee on Budget), Chapter 37, Statutes of 2011, required regional centers to assess an AFPF from parents whose adjusted gross family income is at or above 400% of the FPL, and who meet certain criteria.

ABX3 5 (Committee on Budget), Chapter 3, Statutes of 2008, repealed the sunset of July 1, 2009, for the FCPP and extended indefinitely the FCPP requirements.

SB 1103 (Committee on Budget and Fiscal Review), Chapter 228, Statutes of 2004, established the FCPP for purposes of assessing cost participation to parents who meet certain eligibility requirements, and made the FCPP inoperative on July 1, 2009, and repealed the FCPP as of January 1, 2010.

REGISTERED SUPPORT / OPPOSITION:

Support

Association Of Regional Center Agencies
Disability Rights California
Educate. Advocate.
San Diego Regional Center
State Council on Developmental Disabilities
The Arc of California / United Cerebral Palsy California Collaboration

Opposition

None on file

Analysis Prepared by: Kelsy Castillo / HUM. S. / (916) 319-2089

 THIRD READING  

Bill No: SB 412

Author: Stone (R)

Amended: 4/2/19

Vote: 21

SENATE HUMAN SERVICES COMMITTEE: 6-0, 4/22/19

AYES: Hurtado, Stone, Beall, Jackson, Pan, Wiener

SENATE APPROPRIATIONS COMMITTEE: 6-0, 5/16/19

AYES: Portantino, Bates, Bradford, Hill, Jones, Wieckowski

SUBJECT: Developmental services: fees

SOURCE: Association of Regional Center Agencies

DIGEST:

This bill repeals the Family Cost Participation Program (FCPP) and the Annual Family Program Fee (AFPF) for regional center services.

ANALYSIS:

Existing law:

1. Establishes the Lanterman Developmental Disabilities Services Act, which states that California is responsible for providing an array of services and supports sufficiently complete to meet the needs and choices of each person with developmental disabilities, regardless of age or degree of disability, and at each stage of life, and to support their integration into the mainstream life of the community. (WIC 4500, et seq.)
2. Establishes a system of nonprofit Regional Centers, overseen by the Department of Developmental Services (DDS), to provide fixed points of contact in the community for all persons with developmental disabilities and their families, to coordinate services and supports best suited to them throughout their lifetime. (WIC 4620)
3. Defines a “developmental disability” to mean a disability that originates before an individual attains 18 years of age which continues, or can be expected to continue, indefinitely and constitutes a substantial disability for that individual, including intellectual disability, cerebral palsy, epilepsy, and autism and related conditions, but excluding other handicapping conditions that are solely physical in nature. (WIC 4512(a))
4. Requires the provision of direct services to eligible infants and toddlers, from age zero to age 36 months, and their families by the regional center system for the purpose of early intervention. (GOV 95004)
5. Provides that an infant or toddler is eligible for these services if they have: a developmental delay of at least 33 percent in one or more areas of cognitive, communication, social or emotional adaptive, or physical and motor development; an established risk condition of known etiology, with a high probability of resulting in delayed development; or are considered at high risk of having a substantial developmental disability due to a combination of biomedical risk factors that are diagnosed by qualified personnel, as provided. (GOV 95014(a))
6. Creates the FCPP for the purpose of assessing a cost participation to parents who have a child that meets the following requirements: has a developmental disability or is eligible for early intervention services; is zero years of age through 17 years of age; lives in the parents’ home; receives services and supports purchased through the regional center; and is not eligible for Medi-Cal. (WIC 4783(a)(1))
7. Requires DDS to develop an FCPP schedule that shall be used by regional centers to assess the parents’ cost participation. Further requires the schedule consist of a sliding scale for families with an annual gross income not less than 400 percent of the federal poverty guideline, and that it be adjusted for the level of annual gross income and the number of persons living in the family home. (WIC 4783(a)(b))
8. Requires that the FCPP be applied only to respite, day care, and camping services as provided. (WIC 4783(c)-(d))
9. Modifies the FCPP amount assessed if there is more than one minor child living in the parents’ home and receiving services or supports paid for by the regional center, as provided. (WIC 4783(d))
10. Requires the regional center to be responsible for administering the FCPP and further requires the regional center to conduct assessments or reassessments to determine the cost participation amount as provided. (WIC 4783(f)-(g))
11. Provides for a process by which parents of children ages three through 17 may appeal and error in the amount of the parents’ costs participation, as provided, as well as a separate process for parents of children ages zero through two years of age. (WIC 4783(k)-(l))
12. Requires regional centers to assess an AFPF from parents whose adjusted gross family income is at or above 400 percent of the feral poverty level (FPL) based upon family size and who have a child to whom all of the following apply: the child has a developmental disability or is eligible for early intervention services; the child is less than 18 years of age; the child lives with their parents; the child or family receives services beyond eligibility determination, needs assessment, and service coordination; and the child does not receive services through the Medi-Cal program. (WIC 4785(a)(1))
13. Exempts families from the AFPF if their child only receives respite, day care, or camping services and a cost for participation is assessed to the parents under the FCP program. (WIC 4785(a)(2))
14. Requires the AFPF to be $200 for per family, regardless of the number of children in the family eligible for services, if their adjusted gross income is at or more than 800 percent of the FPL, for family’s whose adjusted gross income is at or more than 400 percent but less than 800 percent, the AFPF amount is $150. (WIC 4785(b))
15. Requires regional centers to administer the AFPF, as provided. (WIC 4785(c)-(e))
16. Allows regional centers to grant an exemption to the assessment of an AFPF if the parents demonstrate any of the following:
    1. That an exemption is necessary to maintain the child in the family home;
    2. The existence of an extraordinary event that impacts the parents’ ability to pay the fee or the parents’ ability to meet the care and supervision needs of the child; or
    3. The existence of a catastrophic loss that temporarily limits the ability of the parents to pay and creates a direct economic impact on the family. (WIC 4785(f))
17. Prohibits the delaying or denial of services for a consumer of child based upon the lack of payment of the AFPF. (WIC 4785(g))

This bill:

1. Repeals the FCPP.
2. Repeals the AFPF.
3. Makes technical, conforming changes and nonsubstantive changes.

Background

Developmental Disabilities and Regional Center Services. In California, a developmental disability is defined as one that originates before an individual attains 18 years of age which continues, or can be expected to continue, indefinitely and constitutes a substantial disability for that individual, including intellectual disability, cerebral palsy, epilepsy, and autism and related conditions, but excluding other handicapping conditions that are solely physical in nature. If an individual is determined to have a qualifying condition, then developmental services in California are considered an entitlement to care, regardless of income or public benefit eligibility. Developmental services are coordinated for eligible individuals through California’s 21 nonprofit regional centers.

Regional centers coordinate a robust array of services and supports for more than 340,000 Californians with developmental disabilities through an individual program plan (IPP). The IPP process was established to ensure that services and supports are customized to meet the needs of consumers served by regional centers. Regional center case managers must meet with the consumer and their family, as appropriate, annually to create a new IPP. The regional center also coordinates and pays for the services an individual receives, unless the family is part of the FCPP.

Services may include diagnosis, evaluation, treatment, and care coordination of services such as personal care, day care, special living arrangements, physical, occupational, and speech therapy. Additionally, consumers may receive training, education, supported employment, mental health services, recreation, counseling of the individual with a developmental disability and of his or her family, information and referral services, follow-along services, adaptive equipment and supplies, advocacy assistance, including self-advocacy training, assistance in locating a home, behavior training and behavior modification programs, camping, community integration services, community support, daily living skills training, emergency and crisis intervention, facilitating circles of support, habilitation, and many others. The regional center system can also provide respite for family caregivers, short-term out-of-home care, social skills training, specialized medical and dental care, telehealth services and supports, supported living arranges, technical and financial assistance, training for parents of children with developmental disabilities, vouchers, and transportation services necessary to ensure the delivery of services to persons with developmental disabilities.

FCPP. The FCPP took effect on January 1, 2005, for parents of children aged three to 17 and, in 2008, it was expanded to parents of children aged zero to three. The FCPP only applies to the following three regional center services: day care, respite, and/or camping. Camp services were suspended during the budget shortfalls of 2009 and have not been reinstated. Therefore, at this time, families would only be impacted by the repeal of FCPP if their child receives respite or day care services. The FCPP applies to families receiving one of those three services if there child has a developmental disability or is eligible for early intervention services, is zero to 17 years of age, lives in the parents’ home, and is not eligible for Medi-Cal. Additionally, the FCPP only applies to families’ whose income is at or above 400 percent of the FPL based upon family size.

California’s 21 regional centers are responsible for administering the FCPP. The regional center serving the family is responsible for notifying the family if they qualify for the FCPP and notifying the family of the amount they must pay. They determine this based on the family’s proof of gross annual income which the family must provide to the regional center within ten working days from the date the parents sign their child’s completed IPP. The family is responsible for notifying the regional center of any changes to their income or family size so that their FCPP amount may be adjusted.

The total amount a family must pay for the services provided is assessed on a sliding scale from 10 percent to 100 percent of the service cost, based on the number of persons living in the family home and the family’s income. For example, as of April 1, 2019, for a family of three making a gross annual income of $85,320 the parents would be responsible for paying 10 percent of the costs associated with their child’s day care, respite, or camp services. If that same family had a gross annual income of $179,172 they would be responsible for paying 60 percent of the costs associated with their child’s day care, respite, or camp services. The family pays their percentage owed directly to the service provider. The service provider thus receives their payments for the child’s services from both the regional center and the family. A service provider may not charge a FCPP family more than they would charge the regional center for the service.

AFPF. As of July 1, 2011, parents of children aged zero to 18 receiving regional center services whose adjusted gross family income is at or above 400 percent of the FPL are assessed an AFPF. If a family is receiving services through Medi-Cal or their child is receiving only respite, day care, or camping services from a regional center and they are assessed a cost under the FCPP, the AFPF does not apply. There is only one AFPF assessed yearly, regardless of the number of the children in the household receiving services.

The AFPF is administered by the family’s regional center. The assessment of the AFPF takes place at the time of development, scheduled review, or modification of the child’s IPP, at that time the parent completes an AFPF registration with their case worker. The amount of the AFPF is either $200 or $150 dollars depending on family’s adjusted gross income. If the family’s adjusted gross income is at or above 400 percent of the FPL, but less than 800 percent of the FPL the amount paid is $150. If the family’s adjusted gross income is at or more than 800 percent of the FPL the amount paid is $200.

A regional center may grant an exemption to the assessment of an AFPF to an otherwise qualifying family if the parents demonstrate that an exemption is necessary to: maintain the child in the family home; the existence of an extraordinary event that impacts the parents’ ability to pay the fee or the parents’ ability to meet care and supervision needs of the child; or in the instance of a catastrophic loss that temporarily limits the ability of the parents to pay and creates a direct economic impact on the family.

Comments

According to the author, this bill repeals the FCPP and the AFPF. The author points to a growing population of developmental services consumers as a need for the repeal of the FCPP and the AFPF, stating that “it is incumbent on the state to prioritize overall stability and capacity to meet the variety of unique needs that arise from the combination of each person’s diagnosis, age, support need, preferences, and cultural values.” Per the author, “SB 412 will help to keep the promise of the Lanterman Act for hundreds of thousands of Californians who rely on it.”

Related/Prior Legislation

AB 89 (Committee on Budget, Chapter 25, Statutes 2013) made various changes to the provision of development services, including the requirement that the California Health and Human Services Agency submit to the Legislature a master plan for the future of developmental services, as provided. Additionally, this bill created the AFPF.

AB 5XXX (Committee on Budget, Chapter 3, Statutes 2008, Third Extraordinary Session), among various other changes, applied the FCPP to early intervention services, thus applying it to qualifying children aged zero to three.

SB 1103 (Committee on Budget and Fiscal Review, Chapter 228, Statutes 2004), among various other changes, created the FCPP for qualifying children aged three to 17 who receive applicable developmental disability services.

FISCAL EFFECT: Appropriation: No Fiscal Com.: Yes Local: No

According to the Senate Appropriations Committee, this bill presents the following costs:

• Repeal of FCPP. FCPP operating expenses, equipment, and total staff salary and benefits currently cost the Department of Developmental Services (DDS) $1.09 million ($700,000 GF) per year. Repealing the FCPP would result in a subsequent savings of $1.09 million per year for reducing regional center operations. The FCPP, however, generates revenues of approximately $5 million per year, which would be lost with the repeal. The net cost for the repeal of the FCPP would be $3.9 million ($4.3 million GF) per year.
• Repeal of AFPF. Revenues from the AFPF fund the Program Development Fund which provides start-up funding for the Community Placement Plan Program (CPP). The Governor’s proposed budget estimates the AFPF would generate $1.28 million in revenues in 2019-20. Repealing the AFPF would result in a loss of revenue of $1.28 million, which would have to be offset to continue funding the CPP.

SUPPORT: (Verified 5/16/19)

Association of Regional Center Agencies (source)

Disability Rights California
Educate. Advocate.

The Arc and United Cerebral Palsy California Collaboration

OPPOSITION: (Verified 5/16/19)

None received

Prepared by: Marisa Shea / HUMAN S. /

5/18/19 12:57:30

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SENATE COMMITTEE ON APPROPRIATIONS

Senator Anthony Portantino, Chair

2019 - 2020 Regular Session

SB 412 (Stone) - Developmental services: fees

Bill Summary:

SB 412 would repeal the Family Cost Participation Program (FCPP) and the Annual Family Program Fee (AFPF) for regional center services.

Fiscal Impact:

Repeal of FCPP

FCPP operating expenses, equipment, and total staff salary and benefits currently cost the Department of Developmental Services (DDS) $1.09 million ($700,000 GF) per year. Repealing the FCPP would result in a subsequent savings of $1.09 million per year for reducing regional center operations. The FCPP, however, generates revenues of approximately $5 million per year, which would be lost with the repeal. The net cost for the repeal of the FCPP would be $3.9 million ($4.3 million GF) per year.

Repeal of AFPF

Revenues from the AFPF fund the Program Development Fund which provides start-up funding for the Community Placement Plan Program (CPP). The Governor’s proposed budget estimates the AFPF would generate $1.28 million in revenues in 2019-20. Repealing the AFPF would result in a loss of revenue of $1.28 million, which would have to be offset to continue funding the CPP.

Background:

In California, if an individual is determined to have a developmental disability, then developmental services are considered an entitlement to care, regardless of income or public benefit eligibility. Developmental services are coordinated for eligible individuals through California’s 21 nonprofit regional centers.

The FCPP took effect on January 1, 2005 for parents of children aged three to 17, and in 2008, it was expanded to parents of children aged zero to three. The FCPP only applies to the following three regional center services: day care, respite, and/or camping (camp services were suspended during the budget shortfalls of 2009 and have not been reinstated). The FCPP applies to families receiving one of those three services if their child has a developmental disability or is eligible for early intervention services, is zero to 17 years of age, lives in the parents’ home, and is not eligible for Medi-Cal, and the family’s income is at or above 400 percent of the federal poverty limit.

The total amount a family must pay for the services provided is assessed on a sliding scale from 10 percent to 100 percent of the service cost, based on the number of persons living in the family home and the family’s income. For example, as of April 1, 2019 for a family of three making a gross annual income of $85,320 the parents would be responsible for paying 10 percent of the costs associated with their child’s day care, respite, or camp services. If that same family had a gross annual income of $179,172 they would be responsible for paying 60 percent of the costs associated with their child’s day care, respite, or camp services. The family pays their percentage owed directly to the service provider. The service provider thus receives their payments for the child’s services from both the regional center and the family. A service provider may not charge a FCPP family more than they would charge the regional center for the service.

As of July 1, 2011, parents of children aged zero to 18 receiving regional center services whose adjusted gross family income is at or above 400 percent of the FPL are assessed an AFPF. If a family is receiving services through Medi-Cal or their child is receiving only respite, day care, or camping services from a regional center and they are assessed a cost under the FCPP, the AFPF does not apply. There is only one AFPF assessed yearly, regardless of the number of the children in the household receiving services. The amount of the AFPF is either $200 or $150 dollars depending on family’s adjusted gross income. If the family’s adjusted gross income is at or above 400 percent of the FPL, but less than 800 percent of the FPL the amount paid is $150. If the family’s adjusted gross income is at or more than 800 percent of the FPL the amount paid is $200.

Proposed Law:

This bill would repeal the FCPP and the AFPF.

Related Legislation:

AB 89 (Committee on Budget, Chapter 25, Statutes of 2013) among other things, created the AFPF.

AB X-3 5 (Committee on Budget, Chapter 3, Statutes of 2008) among other things, applied the FCPP to early intervention services, thus applying it to qualifying children aged zero to three.

SB 1103 (Committee on Budget and Fiscal Review, Chapter 228, Statutes 2004) among other things, created the FCPP for qualifying children aged three to 17 who receive applicable developmental disability services.

Staff Comments:

In 2009, DDS worked with stakeholders to produce and submit to the legislature two sets of savings proposals resulting in $334 million in General Fund savings from DDS’s annual budget in response to the state’s fiscal crisis. That year represents the most severe cuts, but cost saving measures were being made prior to and after 2009 in order to preserve the entitlement to services and supports that the Lanterman Act provides to Californian’s with qualifying disabilities. Over recent years, through the budgetary process, some of the cuts made to DDS’s budget during the years of fiscal crisis have been restored or improved.

The two programs this bill proposes to repeal are fees charged to families whose annual adjusted gross income is over 400 percent of the FPL for the entitlement services and supports their children receive.

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SENATE COMMITTEE ON HUMAN SERVICES

Senator Hurtado, Chair

2019 - 2020 Regular

Bill No: SB 412

Subject: Developmental services: fees

SUMMARY

This bill repeals the Family Cost Participation Program (FCPP) and the Annual Family Program Fee (AFPF) for regional center services.

ABSTRACT

Existing Law:

1. Establishes the Lanterman Developmental Disabilities Services Act, which states that California is responsible for providing an array of services and supports sufficiently complete to meet the needs and choices of each person with developmental disabilities, regardless of age or degree of disability, and at each stage of life, and to support their integration into the mainstream life of the community. (WIC 4500, et seq.)
2. Establishes a system of nonprofit Regional Centers, overseen by the Department of Developmental Services (DDS), to provide fixed points of contact in the community for all persons with developmental disabilities and their families, to coordinate services and supports best suited to them throughout their lifetime. (WIC 4620)
3. Defines a “developmental disability” to mean a disability that originates before an individual attains 18 years of age which continues, or can be expected to continue, indefinitely and constitutes a substantial disability for that individual, including intellectual disability, cerebral palsy, epilepsy, and autism and related conditions, but excluding other handicapping conditions that are solely physical in nature. (WIC 4512(a))
4. Requires the provision of direct services to eligible infants and toddlers, from age zero to age 36 months, and their families by the regional center system for the purpose of early intervention. (GOV 95004)
5. Provides that an infant or toddler is eligible for these services if they have: a developmental delay of at least 33 percent in one or more areas of cognitive, communication, social or emotional adaptive, or physical and motor development; an established risk condition of known etiology, with a high probability of resulting in delayed development; or are considered at high risk of having a substantial developmental disability due to a combination of biomedical risk factors that are diagnosed by qualified personnel, as provided. (GOV 95014(a))
6. Creates the FCPP for the purpose of assessing a cost participation to parents who have a child that meets the following requirements: has a developmental disability or is eligible for early intervention services; is zero years of age through 17 years of age; lives in the parents’ home; receives services and supports purchased through the regional center; and is not eligible for Medi-Cal. (WIC 4783(a)(1))
7. Requires the Department of Developmental Services (DDS) to develop a FCPP schedule that shall be used by regional centers to assess the parents’ cost participation. Further requires the schedule consist of a sliding scale for families with an annual gross income not less than 400 percent of the federal poverty guideline, and that it be adjusted for the level of annual gross income and the number of persons living in the family home. (WIC 4783(a)(b))
8. Requires FCPP be applied only to respite, day care, and camping services as provided. (WIC 4783(c)-(d))
9. Modifies the FCPP amount assessed if there is more than one minor child living in the parents’ home and receiving services or supports paid for by the regional center, as provided. (WIC 4783(d))
10. Requires the regional center to be responsible for administering the FCPP and further requires the regional center to conduct assessments or reassessments to determine the cost participation amount as provided. (WIC 4783(f)-(g))
11. Provides for a process by which parents of children ages three through 17 may appeal and error in the amount of the parents’ costs participation, as provided, as well as a separate process for parents of children ages zero through two years of age. (WIC 4783(k)-(l))
12. Requires regional centers to assess an AFPF from parents whose adjusted gross family income is at or above 400 percent of the feral poverty level (FPL) based upon family size and who have a child to whom all of the following apply: the child has a developmental disability or is eligible for early intervention services; the child is less than 18 years of age; the child lives with their parents; the child or family receives services beyond eligibility determination, needs assessment, and service coordination; and the child does not receive services through the Medi-Cal program. (WIC 4785(a)(1))
13. Exempts families from the AFPF if their child only receives respite, day care, or camping services and a cost for participation is assessed to the parents under the FCP program. (WIC 4785(a)(2))
14. Requires the AFPF to be $200 for per family, regardless of the number of children in the family eligible for services, if their adjusted gross income is at or more than 800 percent of the FPL, for family’s whose adjusted gross income is at or more than 400 percent but less than 800 percent, the AFPF amount is $150. (WIC 4785(b))
15. Requires regional centers to administer the AFPF, as provided. (WIC 4785(c)-(e))
16. Allows regional centers to grant an exemption to the assessment of an AFPF if the parents demonstrate any of the following:
    1. That an exemption is necessary to maintain the child in the family home;
    2. The existence of an extraordinary event that impacts the parents’ ability to pay the fee or the parents’ ability to meet the care and supervision needs of the child; or
    3. The existence of a catastrophic loss that temporarily limits the ability of the parents to pay and creates a direct economic impact on the family. (WIC 4785(f))
17. Prohibits the delaying or denial of services for a consumer of child based upon the lack of payment of the AFPF. (WIC 4785(g))

This Bill:

1. Repeals the FCP program.
2. Repeals the AFPF.
3. Makes technical, conforming changes and nonsubstantive changes.

FISCAL IMPACT

This bill has not yet been analyzed by a fiscal committee.

BACKGROUND AND DISCUSSION

Purpose of the Bill:

According to the author, this bill repeals the FCPP and the AFPF. The author points to a growing population of developmental services consumers as a need for the repeal of the FCPP and the AFPF, stating that “it is incumbent on the state to prioritize overall stability and capacity to meet the variety of unique needs that arise from the combination of each person’s diagnosis, age, support need, preferences, and cultural values.” Per the author, “SB 412 will help to keep the promise of the Lanterman Act for hundreds of thousands of Californians who rely on it.”

Developmental Disabilities and Regional Center Services

In California, a developmental disability is defined as one that originates before an individual attains 18 years of age which continues, or can be expected to continue, indefinitely and constitutes a substantial disability for that individual, including intellectual disability, cerebral palsy, epilepsy, and autism and related conditions, but excluding other handicapping conditions that are solely physical in nature. If an individual is determined to have a qualifying condition, then developmental services in California are considered an entitlement to care, regardless of income or public benefit eligibility. Developmental services are coordinated for eligible individuals through California’s 21 nonprofit regional centers.

Regional centers coordinate a robust array of services and supports for more than 340,000 Californians with developmental disabilities through an individual program plan (IPP). The IPP process was established to ensure that services and supports are customized to meet the needs of consumers served by regional centers. Regional center case managers must meet with the consumer and their family, as appropriate, annually to create a new IPP. The regional center also coordinates and pays for the services an individual receives, unless the family is part of the FCPP.

Services may include diagnosis, evaluation, treatment, and care coordination of services such as personal care, day care, special living arrangements, physical, occupational, and speech therapy. Additionally, consumers may receive training, education, supported employment, mental health services, recreation, counseling of the individual with a developmental disability and of his or her family, information and referral services, follow-along services, adaptive equipment and supplies, advocacy assistance, including self-advocacy training, assistance in locating a home, behavior training and behavior modification programs, camping, community integration services, community support, daily living skills training, emergency and crisis intervention, facilitating circles of support, habilitation, and many others. The regional center system can also provide respite for family caregivers, short-term out-of-home care, social skills training, specialized medical and dental care, telehealth services and supports, supported living arranges, technical and financial assistance, training for parents of children with developmental disabilities, vouchers, and transportation services necessary to ensure the delivery of services to persons with developmental disabilities.

Family Cost Participation Program (FCPP)

The FCPP took effect on January 1, 2005 for parents of children aged three to 17 and in 2008 it was expanded to parents of children aged zero to three. The FCPP only applies to the following three regional center services: day care, respite, and/or camping. Camp services were suspended during the budget shortfalls of 2009 and have not been reinstated. Therefore, at this time, families would only be impacted by the repeal of FCPP if their child receives respite or day care services. The FCPP applies to families receiving one of those three services if there child has a developmental disability or is eligible for early intervention services, is zero to 17 years of age, lives in the parents’ home, and is not eligible for Medi-Cal. Additionally, the FCPP only applies to families’ whose income is at or above 400 percent of the FPL based upon family size.

California’s 21 regional centers are responsible for administering the FCPP. The regional center serving the family is responsible for notifying the family if they qualify for the FCPP and notifying the family of the amount they must pay. They determine this based on the family’s proof of gross annual income which the family must provide to the regional center within ten working days from the date the parents sign their child’s completed IPP. The family is responsible for notifying the regional center of any changes to their income or family size so that their FCPP amount may be adjusted.

The total amount a family must pay for the services provided is assessed on a sliding scale from 10 percent to 100 percent of the service cost, based on the number of persons living in the family home and the family’s income. For example, as of April 1, 2019 for a family of three making a gross annual income of $85,320 the parents would be responsible for paying 10 percent of the costs associated with their child’s day care, respite, or camp services. If that same family had a gross annual income of $179,172 they would be responsible for paying 60 percent of the costs associated with their child’s day care, respite, or camp services. The family pays their percentage owed directly to the service provider. The service provider thus receives their payments for the child’s services from both the regional center and the family. A service provider may not charge a FCPP family more than they would charge the regional center for the service.

Annual Family Program Fee (AFPF)

As of July 1, 2011, parents of children aged zero to 18 receiving regional center services whose adjusted gross family income is at or above 400 percent of the FPL are assessed an AFPF. If a family is receiving services through Medi-Cal or their child is receiving only respite, day care, or camping services from a regional center and they are assessed a cost under the FCPP, the AFPF does not apply. There is only one AFPF assessed yearly, regardless of the number of the children in the household receiving services.

The AFPF is administered by the family’s regional center. The assessment of the AFPF takes place at the time of development, scheduled review, or modification of the child’s IPP, at that time the parent completes an AFPF registration with their case worker. The amount of the AFPF is either $200 or $150 dollars depending on family’s adjusted gross income. If the family’s adjusted gross income is at or above 400 percent of the FPL, but less than 800 percent of the FPL the amount paid is $150. If the family’s adjusted gross income is at or more than 800 percent of the FPL the amount paid is $200.

A regional center may grant an exemption to the assessment of an AFPF to an otherwise qualifying family if the parents demonstrate that an exemption is necessary to: maintain the child in the family home; the existence of an extraordinary event that impacts the parents’ ability to pay the fee or the parents’ ability to meet care and supervision needs of the child; or in the instance of a catastrophic loss that temporarily limits the ability of the parents to pay and creates a direct economic impact on the family.

Related/Prior Legislation:

AB 89 (Committee on Budget, Chapter 25, Statutes 2013) made various changes to the provision of development services, including the requirement that California Health and Human Services Agency submit to the Legislature a master plan for the future of developmental services, as provided. Additionally, this bill created the AFPF.

AB 5XXX (Committee on Budget, Chapter 3, Statutes 2008) among various other changes, this bill applied the FCPP to early intervention services, thus applying it to qualifying children aged zero to three.

SB 1103 (Committee on Budget and Fiscal Review, Chapter 228, Statutes 2004) among various other changes, this bill created the FCPP for qualifying children aged three to 17 who receive applicable developmental disability services.

COMMENTS

In 2009, DDS worked with stakeholders to produce and submit to the legislature two sets of savings proposals resulting in $334 million in General Fund savings from DDS’s annual budget in response to the state’s fiscal crisis. That year represents the most severe cuts, but cost saving measures were being made prior to and after 2009 in order to preserve the entitlement to services and supports that the Lanterman Act provides to Californian’s with qualifying disabilities.

The two programs this bill proposes to repeal are fees charged to families whose annual adjusted gross income is over 400 percent of the FPL for the entitlement services and supports their children receive. Over recent years, through the budgetary process, some of the cuts made to DDS’s budget during the years of fiscal crisis have been restored or improved. It may be time to consider whether fees applied to some families for entitlement services and supports are still appropriate.

POSITIONS

Support:

Association of Regional Center Agencies (ARCA) (Sponsor)

The Arc and United Cerebral Palsy California Collaboration

Oppose:

None received

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