AB 1147: Disability Equity, Transparency, and Accountability Act of 2024.
- Session Year: 2023-2024
- House: Assembly
- Latest Version Date: 2024-09-28
Current Status:
Passed
(2024-09-28: Chaptered by Secretary of State - Chapter 902, Statutes of 2024.)
Introduced
In Committee
First Chamber
In Committee
Second Chamber
Enacted
The Lanterman Developmental Disabilities Services Act makes the State Department of Developmental Services responsible for providing various services and supports to individuals with developmental disabilities, and for ensuring the appropriateness and quality of those services and supports. Pursuant to that law, the department contracts with regional centers to provide services and supports to persons with developmental disabilities.
This bill would enact the Disability Equity, Transparency, and Accountability Act of 2024, which would make various changes to the act for purposes including providing increased oversight of regional center operations and performance.
The bill would prohibit a regional center employee from accepting gifts over $15 per year from specified entities and would require each regional center to establish a policy prohibiting regional center senior staff from hiring relatives, as specified. The bill also would, beginning on January 1, 2026, make regional centers subject to requirements of the California Public Records Act. Notwithstanding any other law, the bill would require access to records regarding an applicant for, or recipient of, services to be provided, upon request, to the applicant, recipient, or their authorized representative, as specified, unless expressly prohibited by law.
The bill would make related findings and declarations and state the legislative intent related to these provisions.
The Lanterman Developmental Disabilities Services Act makes the State Department of Developmental Services responsible for providing various services and supports to individuals with developmental disabilities, and for ensuring the appropriateness and quality of those services and supports. Pursuant to that law, the department contracts with regional centers to provide services and supports to persons with developmental disabilities.
This bill would enact the Disability Equity, Transparency, and Accountability Act of 2024, which would make various changes to the act for purposes including providing increased oversight of regional center operations and performance.
The bill would prohibit a regional center employee from accepting gifts over $15 per year from specified entities and would require each regional center to establish a policy prohibiting regional center senior staff from hiring relatives, as specified. The bill also would, beginning on January 1, 2026, make regional centers subject to requirements of the California Public Records Act. Notwithstanding any other law, the bill would require access to records regarding an applicant for, or recipient of, services to be provided, upon request, to the applicant, recipient, or their authorized representative, as specified, unless expressly prohibited by law.
The bill would make related findings and declarations and state the legislative intent related to these provisions.
The Lanterman Developmental Disabilities Services Act makes the State Department of Developmental Services responsible for providing various services and supports to individuals with developmental disabilities, and for ensuring the appropriateness and quality of those services and supports. Pursuant to that law, the department contracts with regional centers to provide services and supports to persons with developmental disabilities.
This bill would enact the Disability Equity Equity, Transparency, and Accountability Act of 2023, 2024, which would make various changes to the act for purposes including providing increased oversight of regional center operations and performance. The bill would require an evaluation of regional center performance by the department, which would be implemented using a common set of performance measures. The bill would require the department to establish standards, consisting of benchmarks above which indicate good performance and minimum benchmarks below which a regional center shall undertake efforts to improve, for these performance measures, as specified, by July 1, 2025. The bill would require the department, in consultation with stakeholders, including consumers and family members, to annually establish, update, and review these benchmarks.
Existing law requires the department, in consultation with stakeholders, to identify a valid and reliable quality assurance instrument that assesses consumer and family satisfaction, provision of services in a linguistically and competent manner, and personal outcomes, as specified.This bill would require the department by March 1, 2025, to advise the Legislature describing the extent to which the requirements of this section have been met, including the surveying of all consumers, including those who have not purchased services, and providing specific steps and the schedule by which these requirements will be met.Existing law declares the intent of the Legislature to ensure that the individual program plan (IPP) and provision of services and supports by the regional center system is centered on the individual and the family of the individual with developmental disabilities and takes into account the needs and preferences of the individual and the family, as prescribed. Existing law requires an IPP to be developed for any person who, following intake and assessment, is found to be eligible for regional center services, and requires these plans to be completed within 60 days of the completion of the assessment, as specified.This bill also would declare the intent of the Legislature to ensure that goals in any plan allow for innovation and nontraditional service delivery, as specified. The bill would require the service coordinator, as part of the initial IPP meeting and each review of the IPP, as specified, to provide the consumer or, if appropriate, their parents, legal guardian, conservator, or authorized representative, oral and written information about the Self-Determination Program, as prescribed. The bill would require the regional center service coordinator to provide specified information regarding the program within 5 business days of the consumer expressing interest.The bill would revise the criteria applicable to regional center governing boards with which the state contracts, including with respect to training and ongoing support, and executive director performance standards. The bill would require the department to establish and adopt a grievance procedure for governing board members, as specified. prohibit a regional center employee from accepting gifts over $15 per year from specified entities and would require each regional center to establish a policy prohibiting regional center senior staff from hiring relatives, as specified. The bill also would, beginning on January 1, 2025, 2026, make regional centers subject to requirements of the California Public Records Act. Notwithstanding any other law, the bill would require access to records regarding an applicant for, or recipient of, services to be provided, upon request, to the applicant, recipient, or their authorized representative, as specified, unless expressly prohibited by law.
This bill would incorporate additional changes to Section 4646 of the Welfare and Institutions Code proposed by SB 447 to be operative only if this bill and SB 447 are enacted and this bill is enacted last.The bill would make related findings and declarations and state the legislative intent related to these provisions.
The Lanterman Developmental Disabilities Services Act makes the State Department of Developmental Services responsible for providing various services and supports to individuals with developmental disabilities, and for ensuring the appropriateness and quality of those services and supports. Pursuant to that law, the department contracts with regional centers to provide services and supports to persons with developmental disabilities.
This bill would enact the Disability Equity and Accountability Act of 2023, which would make various changes to the act for purposes including gathering relevant data and providing increased oversight of regional center operations and performance. The bill would require an evaluation of regional center performance by the department, which would be implemented using a common set of performance measures. The bill would require the assessments to use performance measures in 7 specific domains: community integration, employment, equity in access, case management, client and family choice, experience and satisfaction, human and civil rights, and health and safety. The bill would require the department to establish standards standards, consisting of benchmarks above which indicate good performance and minimum benchmarks below which a regional center shall undertake efforts to improve, for these performance measures, as specified, by July 1, 2025. The bill would require the department, in consultation with stakeholders, including consumers and family members, to annually establish, update, and review a uniform process to be used by regional centers to develop corrective action plans that respond to below standard performance. The bill would require the department to oversee the process to develop a corrective action plan and assess corrective action undertaken by a regional center. these benchmarks.
The bill would require the department, as part of its planning process for the planning and development of a uniform, statewide data automation system, to develop a project charter, by March 1, 2025, for approval by the Secretary of the California Health and Human Services Agency and the Department of Technology. The bill would require the charter development process to include the participation and input of program consumers and families, researchers and quality and outcome evaluators, regional centers, and service providers. The bill would require the charter to include specified components, including, but not limited to, an impact statement, project guiding principles, and program goals, including maximizing the performance and business processes for the delivery of intellectual or developmental disabilities (IDD) system services to regional center consumers.Existing law requires the department, in consultation with stakeholders, to identify a valid and reliable quality assurance instrument that assesses consumer and family satisfaction, provision of services in a linguistically and competent manner, and personal outcomes, as specified.
This bill would require the department by March 1, 2025, to submit a report to advise the Legislature describing the extent to which the requirements of this section have not been met, including the surveying of all consumers, including those who have not purchased services, and providing specific steps and the schedule by which these requirements will be met.
Existing law declares the intent of the Legislature to ensure that the individual program plan (IPP) and provision of services and supports by the regional center system is centered on the individual and the family of the individual with developmental disabilities and takes into account the needs and preferences of the individual and the family, as prescribed. Existing law requires an IPP to be developed for any person who, following intake and assessment, is found to be eligible for regional center services, and requires these plans to be completed within 60 days of the completion of the assessment, as specified.
This bill also would declare the intent of the Legislature to ensure that goals in any plan allow for innovation and nontraditional service delivery, as specified. The bill would require the service coordinator, as part of the initial IPP meeting and each annual review of the IPP, as specified, to provide the consumer or, if appropriate, their parents, legal guardian, conservator, or authorized representative, oral and written information about the Self-Determination Program, as prescribed. The bill would require the regional center service coordinator to provide specified information regarding the program within 5 business days of the consumer expressing interest.
This bill would require the department to establish, by January 1, 2026, a common set of services and supports, including supported living services, and would require every regional center to make those services and supports available to consumers in negotiating, developing, and amending the IPP. The bill would also require the department to comprehensively review the current processes for vendorizing providers for the delivery of services and supports to regional center consumers and revise those processes to streamline the process and create a uniform statewide vendorization process. The bill would require the department to develop the revised process in consultation with the Association of Regional Center Agencies, consumers and their families, advocacy organizations, and service providers, as specified. The bill would revise existing complaint procedures for consumers and their representatives, including requiring the Director of Developmental Services to issue a written administrative decision within 30 days of receiving the complaint, and send a copy of the decision to the complainant, the director of the subject regional center or state-operated facility, and the service provider, as prescribed.The bill would revise the criteria applicable to regional center governing boards with which the state contracts, including with respect to training and ongoing support, and executive director performance standards. The bill would require the department to establish and adopt a grievance procedure for governing board members, as specified. The bill also would, beginning on January 1, 2025, make regional centers subject to requirements of the California Public Records Act. Notwithstanding any exemption from that act or any other law authorizing an entity to withhold a record, as specified, other law, the bill would require access to records regarding an applicant for, or recipient of, services to be provided, upon request, to the applicant, recipient, or their authorized representative, as specified, unless expressly prohibited by law.
This bill would incorporate additional changes to Section 4646 of the Welfare and Institutions Code proposed by SB 447 to be operative only if this bill and SB 447 are enacted and this bill is enacted last.
The Lanterman Developmental Disabilities Services Act makes the State Department of Developmental Services responsible for providing various services and supports to individuals with developmental disabilities, and for ensuring the appropriateness and quality of those services and supports. Pursuant to that law, the department contracts with regional centers to provide services and supports to persons with developmental disabilities.
This bill would enact the Disability Equity and Accountability Act of 2023, which would make various changes to the act for purposes including gathering relevant data and providing increased oversight of regional center operations and performance. The bill would require an evaluation of regional center performance by the department, which would be implemented using a common set of performance measures. The bill would require the assessments to use performance measures in 7 specific domains: community integration, employment, equity in access, case management, client and family choice, experience and satisfaction, human and civil rights, and health and safety. The bill would require the department to establish standards for these performance measures, as specified, by July 1, 2025. The bill would require the department, in consultation with stakeholders, including consumers and family members, to annually establish, update, and review a uniform process to be used by regional centers to develop corrective action plans that respond to below standard performance. The bill would require the department to oversee the process to develop a corrective action plan and assess corrective action undertaken by a regional center.
The bill would require the department, as part of its planning process for the planning and development of a uniform, statewide data automation system, to develop a project charter, by March 1, 2025, for approval by the Secretary of the California Health and Human Services Agency and the Department of Technology. The bill would require the charter development process to include the participation and input of program consumers and families, researchers and quality and outcome evaluators, regional centers, and service providers. The bill would require the charter to include specified components, including, but not limited to, an impact statement, project guiding principles, and program goals, including maximizing the performance and business processes for the delivery of intellectual or developmental disabilities (IDD) system services to regional center consumers.
Existing law requires the department, in consultation with stakeholders, to identify a valid and reliable quality assurance instrument that assesses consumer and family satisfaction, provision of services in a linguistically and competent manner, and personal outcomes, as specified.
This bill would require the department by March 1, 2025, to submit a report to the Legislature describing the extent to which the requirements of this section have not been met, including the surveying of all consumers, including those who have not purchased services, and providing specific steps and the schedule by which these requirements will be met.
Existing law declares the intent of the Legislature to ensure that the individual program plan (IPP) and provision of services and supports by the regional center system is centered on the individual and the family of the individual with developmental disabilities and takes into account the needs and preferences of the individual and the family, as prescribed. Existing law requires an IPP to be developed for any person who, following intake and assessment, is found to be eligible for regional center services, and requires these plans to be completed within 60 days of the completion of the assessment, as specified.
This bill also would declare the intent of the Legislature to ensure that goals in any plan allow for innovation and nontraditional service delivery, as specified. The bill would require the service coordinator, as part of the initial IPP meeting and each annual review of the IPP, as specified, to provide the consumer or, if appropriate, their parents, legal guardian, conservator, or authorized representative, oral and written information about the Self-Determination Program, as prescribed. The bill would require the regional center service coordinator to provide specified information regarding the program within 5 business days of the consumer expressing interest.
This bill would require the department to establish, by January 1, 2026, a common set of services and supports, including supported living services, and would require every regional center to make those services and supports available to consumers in negotiating, developing, and amending the IPP. The bill would also require the department to comprehensively review the current processes for vendorizing providers for the delivery of services and supports to regional center consumers and revise those processes to streamline the process and create a uniform statewide vendorization process. The bill would require the department to develop the revised process in consultation with the Association of Regional Center Agencies, consumers and their families, advocacy organizations, and service providers, as specified.
The bill would revise existing complaint procedures for consumers and their representatives, including requiring the Director of Developmental Services to issue a written administrative decision within 30 days of receiving the complaint, and send a copy of the decision to the complainant, the director of the subject regional center or state-operated facility, and the service provider, as prescribed.
The bill would revise the criteria applicable to regional center governing boards with which the state contracts, including with respect to training and ongoing support, and executive director performance standards. The bill would require the department to establish and adopt a grievance procedure for governing board members, as specified. The bill also would would, beginning on January 1, 2025, make regional centers subject to requirements of the California Public Records Act. Notwithstanding any exemption from that act or any other law authorizing an entity to withhold a record, as specified, the bill would require access to records regarding an applicant for, or recipient of, services to be provided, upon request, to the applicant, recipient, or their authorized representative, as specified, unless expressly prohibited by law.
The Lanterman Developmental Disabilities Services Act makes the State Department of Developmental Services responsible for providing various services and supports to individuals with developmental disabilities, and for ensuring the appropriateness and quality of those services and supports. Pursuant to that law, the department contracts with regional centers to provide services and supports to persons with developmental disabilities.
This bill would enact the Disability Equity and Accountability Act of 2023, which would make various changes to the act for purposes including gathering relevant data and providing increased oversight of regional center operations and performance. The bill would require an evaluation of regional center performance by the department, which would be implemented using a common set of performance measures. The bill would require the assessments to use performance measures in 7 specific domains: community integration, employment, equity in access, case management, client and family choice, experience and satisfaction, human and civil rights, and health and safety. The bill would require the department to establish standards for these performance measures, as specified, by July 1, 2024. 2025. The bill would require the department, in consultation with stakeholders, including consumers and family members, to annually establish, update, and review a uniform process to be used by regional centers to develop corrective action plans that respond to below standard performance. The bill would require the department to oversee the process to develop a corrective action plan and assess corrective action undertaken by a regional center.
The bill would require the department, as part of its planning process for the planning and development of a uniform, statewide data automation system, to develop a project charter, by March 1, 2024, 2025, for approval by the Secretary of the California Health and Human Services Agency and the Department of Technology. The bill would require the charter development process to include the participation and input of program consumers and families, researchers and quality and outcome evaluators, regional centers, and service providers. The bill would require the charter to include specified components, including, but not limited to, an impact statement, project guiding principles, and program goals, including maximizing the performance and business processes for the delivery of intellectual or developmental disabilities (IDD) system services to regional center consumers.
Existing law requires the department, in consultation with stakeholders, to identify a valid and reliable quality assurance instrument that assesses consumer and family satisfaction, provision of services in a linguistically and competent manner, and personal outcomes, as specified.
This bill would require the department by March 1, 2024, 2025, to submit a report to the Legislature describing the extent to which the requirements of this section have not been met, including the surveying of all consumers, including those who have not purchased services, and providing specific steps and the schedule by which these requirements will be met.
Existing law declares the intent of the Legislature to ensure that the individual program plan (IPP) and provision of services and supports by the regional center system is centered on the individual and the family of the individual with developmental disabilities and takes into account the needs and preferences of the individual and the family, as prescribed. Existing law requires an IPP to be developed for any person who, following intake and assessment, is found to be eligible for regional center services, and requires these plans to be completed within 60 days of the completion of the assessment, as specified.
This bill also would declare the intent of the Legislature for the IPP to be developed consistent with the federal Affordable Care Act, as specified, requiring community-based long-term services and supports be person-centered and self-directed, and ensuring to ensure that goals in any plan allow for innovation and nontraditional services service delivery. service delivery, as specified. The bill would require the service coordinator, as part of the initial IPP meeting and each annual review of the IPP, as specified, to provide the consumer or, if appropriate, their parents, legal guardian, conservator, or authorized representative, oral and written information about the Self-Determination Program, as prescribed. The bill would require the regional center service coordinator to provide specified information regarding the program within 5 business days of the consumer expressing interest.
This bill would require the department to establish, by January 1, 2025, 2026, a common set of services and supports, including supported living services, and would require every regional center to make those services and supports available to consumers in negotiating, developing, and amending the IPP. The bill would also require the department to comprehensively review the current processes for vendorizing providers for the delivery of services and supports to regional center consumers and revise those processes to streamline the process and create a uniform statewide vendorization process. The bill would require the department to develop the revised process in consultation with the Association of Regional Center Agencies, consumers and their families, advocacy organizations, and service providers, as specified.
The bill would revise existing complaint procedures for consumers and their representatives, including requiring complaints to be made to the Director of Developmental Services, and requiring the director Services to issue a written administrative decision within 30 days of receiving the complaint, and send a copy of the decision to the complainant, the director of the subject regional center or state-operated facility, and the service provider, as prescribed.
The bill would revise the criteria applicable to regional center governing boards with which the state contracts, including with respect to terms, the composition of nominating committees, and training. training and ongoing support, and executive director performance standards. The bill would require the department to establish and adopt a grievance procedure for governing board members, as specified. The bill also would make regional centers subject to requirements of the California Public Records Act. Notwithstanding any exemption to from that act or any other law authorizing an entity to withhold a record, as specified, the bill would require access to records regarding an applicant for, or recipient of, services to be provided, upon request, to the applicant, recipient, or their authorized representative, as specified, unless expressly prohibited by law.
The Lanterman Developmental Disabilities Services Act makes the State Department of Developmental Services responsible for providing various services and supports to individuals with developmental disabilities, and for ensuring the appropriateness and quality of those services and supports. Pursuant to that law, the department contracts with regional centers to provide services and supports to persons with developmental disabilities.
This bill would enact the Disability Equity and Accountability of 2023, which would make various changes to the act for purposes including gathering relevant data and providing increased oversight of regional center operations and performance. The bill would require an evaluation of regional center performance by the department, which would be implemented using a common set of performance measures. The bill would require the assessments to use performance measures in 7 specific domains: community integration, employment, equity in access, case management, client and family choice, experience and satisfaction, human and civil rights, and health and safety. The bill would require the department to establish standards for theses these performance measures, as specified, by July 1, 2024. The bill would require the department, in consultation with stakeholders, including consumers and family members, to annually establish, update, and review a uniform process to be used by regional centers to develop corrective action plans that respond to below standard performance. The bill would require the department to oversee the process to develop a corrective action plan and assess corrective action undertaken by a regional center.
The bill would require the department, as part of its planning process for the planning and development of a uniform, statewide data automation system, to develop a project charter, by March 1, 2024, for approval by the Secretary of the California Health and Human Services Agency and the Department of Technology. The bill would require the charter development process to include the participation and input of program consumers and families, researchers and quality and outcome evaluators, regional centers, and service providers. The bill would require the charter to include specified components, including, but not limited to, an impact statement, project guiding principles, and program goals, including maximizing the performance and business processes for the delivery of intellectual or developmental disabilities (IDD) system services to regional center consumers.
Existing law requires the department, in consultation with stakeholders, to identify a valid and reliable quality assurance instrument that assesses consumer and family satisfaction, provision of services in a linguistically and competent manner, and personal outcomes, as specified.
This bill would require the department by March 1, 2024, to submit a report to the Legislature describing the extent to which the requirements of this section have not been met, including the surveying of all consumers, including those who have not purchased services, and providing specific steps and the schedule by which these requirements will be met.
Existing law requires regional centers to conduct client assessments, and requires those assessments to be performed within 120 days following intake, and within no more than 60 days following initial intake if delay would expose the client to unnecessary risk to their health and safety, as specified.This bill would revise those timeframes to require an assessment to be completed within 60 days of intake, and within 30 days of intake for at-risk clients.Existing law declares the intent of the Legislature to ensure that the individual program plan (IPP) and provision of services and supports by the regional center system is centered on the individual and the family of the individual with developmental disabilities and takes into account the needs and preferences of the individual and the family, as prescribed. Existing law requires an IPP to be developed for any person who, following intake and assessment, is found to be eligible for regional center services, and requires these plans to be completed within 60 days of the completion of the assessment, as specified.
This bill also would declare the intent of the Legislature for the IPP to be developed consistent with the federal Affordable Care Act, as specified, requiring community-based long-term services and supports be person-centered and self-directed, and ensuring that goals in any plan allow for innovation and nontraditional services service delivery. The bill would authorize a regional center to exceed the time period for developing an IPP, if there is good cause, but no more than 60 days from intake. The bill would require a regional center that fails to meet the 30-day or 60-day deadline to provide the consumer with an adequate notice of action and notify the department of the reason for failure to meet the deadline.
This bill would require the department to establish, by January 1, 2025, a common set of services and supports, including supported living services, and would require every regional center to make those services and supports available to consumers in negotiating, developing, and amending the IPP. The bill would require the department, with respect to services and supports requested by a consumer that require an assessment, to complete that assessment within 30 days of the date of request, at no cost to the consumer, as specified. The bill would also require the department to comprehensively review the current processes for vendorizing providers for the delivery of services and supports to regional center consumers and revise those processes to streamline the process and create a uniform statewide vendorization process. The bill would require the department to develop the revised process in consultation with the Association of Regional Center Agencies, consumers and their families, advocacy organizations, and service providers, as specified.
The bill would revise existing complaint procedures for consumers and their representatives, including requiring complaints to be made to the Director of Developmental Services, and requiring the director to issue a written administrative decision within 30 days of receiving the complaint, and send a copy of the decision to the complainant, the director of the subject regional center or state-operated facility, and the service provider, as prescribed. The bill would require the department, no later than March 1, 2024, and annually thereafter, to submit a report to the Legislature and post on its internet website specified data relating to health and safety waivers requested and granted for consumers of developmental services.
The bill would revise the criteria applicable to regional center governing boards with which the state contracts, including with respect to terms, the composition of nominating committees, and training. The bill would require the department to establish and adopt a grievance procedure for governing board members, as specified. The bill also would make regional centers subject to requirements of the California Public Records Act. Notwithstanding any exemption to that act or any other law authorizing an entity to withhold a record, as specified, the bill would require access to records regarding an applicant for, or recipient of, services to be provided, upon request, to the applicant, recipient, or their authorized representative, as specified, unless expressly prohibited by law.
The Lanterman Developmental Disabilities Services Act makes the State Department of Developmental Services responsible for providing various services and supports to individuals with developmental disabilities, and for ensuring the appropriateness and quality of those services and supports. Pursuant to that law, the department contracts with regional centers to provide services and supports to persons with developmental disabilities.
This bill would enact the Disability Equity and Accountability of 2023, which would make various changes to the act for purposes including gathering relevant data and providing increased oversight of regional center operations and performance. The bill would require an evaluation of regional center performance by the department, which would be implemented using a common set of performance measures. The bill would require the assessments to use performance measures in 7 specific domains: community integration, employment, equity in access, case management, client and family choice, experience and satisfaction, human and civil rights, and health and safety. The bill would require the department to establish standards for theses performance measures, as specified, by July 1, 2024.
The bill would require the department, as part of its planning process for the planning and development of a uniform, statewide data automation system, to develop a project charter, by March 1, 2024, for approval by the Secretary of the California Health and Human Services Agency and the Department of Technology. The bill would require the charter development process to include the participation and input of program consumers and families, researchers and quality and outcome evaluators, regional centers, and service providers. The bill would require the charter to include specified components, including, but not limited to, an impact statement, project guiding principles, and program goals, including maximizing the performance and business processes for the delivery of intellectual or developmental disabilities (IDD) system services to regional center consumers.
Existing law requires the department, in consultation with stakeholders, to identify a valid and reliable quality assurance instrument that assesses consumer and family satisfaction, provision of services in a linguistically and competent manner, and personal outcomes, as specified.
This bill would require the department by March 1, 2024, to submit a report to the Legislature describing the extent to which the requirements of this section have not been met, including the surveying of all consumers, including those who have not purchased services, and providing specific steps and the schedule by which these requirements will be met.
Existing law requires regional centers to conduct client assessments, and requires those assessments to be performed within 120 days following intake, and within no more than 60 days following initial intake if delay would expose the client to unnecessary risk to their health and safety, as specified.
This bill would revise those timeframes to require an assessment to be completed within 60 days of intake, and within 30 days of intake for at-risk clients.
Existing law declares the intent of the Legislature to ensure that the individual program plan (IPP) and provision of services and supports by the regional center system is centered on the individual and the family of the individual with developmental disabilities and takes into account the needs and preferences of the individual and the family, as prescribed. Existing law requires an IPP to be developed for any person who, following intake and assessment, is found to be eligible for regional center services, and requires these plans to be completed within 60 days of the completion of the assessment, as specified.
This bill also would declare the intent of the Legislature for the IPP to be developed consistent with the federal Affordable Care Act, as specified, requiring community-based long-term services and supports be person-centered and self-directed, and ensuring that goals in any plan allow for innovation and nontraditional services service delivery. The bill would authorize a regional center to exceed the time period for developing an IPP, if there is good cause, but no more than 60 days from intake. The bill would require a regional center that fails to meet the 30-day or 60-day deadline to provide the consumer with an adequate notice of action and notify the department of the reason for failure to meet the deadline.
This bill would require the department to establish, by January 1, 2025, a common set of services and supports, including supported living services, and would require every regional center to make those services and supports available to consumers in negotiating, developing, and amending the IPP. The bill would require the department, with respect to services and supports requested by a consumer that require an assessment, to complete that assessment within 30 days of the date of request, at no cost to the consumer, as specified. The bill would also require the department to comprehensively review the current processes for vendorizing providers for the delivery of services and supports to regional center consumers and revise those processes to streamline the process and create a uniform statewide vendorization process. The bill would require the department to develop the revised process in consultation with the Association of Regional Center Agencies, consumers and their families, advocacy organizations, and service providers, as specified.
The bill would revise existing complaint procedures for consumers and their representatives, including requiring complaints to be made to the Director of Developmental Services, and requiring the director to issue a written administrative decision within 30 days of receiving the complaint, and send a copy of the decision to the complainant, the director of the subject regional center or state-operated facility, and the service provider, as prescribed. The bill would require the department, no later than March 1, 2024, and annually thereafter, to submit a report to the Legislature and post on its internet website specified data relating to health and safety waivers requested and granted for consumers of developmental services.
The bill would revise the criteria applicable to regional center governing boards with which the state contracts, including with respect to terms, the composition of nominating committees, and training. The bill would require the department to establish and adopt a grievance procedure for governing board members, as specified. The bill also would make regional centers subject to requirements of the California Public Records Act. Notwithstanding any exemption to that act or any other law authorizing an entity to withhold a record, as specified, the bill would require access to records regarding an applicant for, or recipient of, services to be provided, upon request, to the applicant, recipient, or their authorized representative, as specified, unless expressly prohibited by law.
The Lanterman Developmental Disabilities Services Act makes the State Department of Developmental Services responsible for providing various services and supports to individuals with developmental disabilities, and for ensuring the appropriateness and quality of those services and supports. Pursuant to that law, the department contracts with regional centers to provide services and supports to persons with developmental disabilities.
This bill would enact the Disability Equity and Accountability of 2023, which would make various changes to the act for purposes including gathering relevant data and providing increased oversight of regional center operations and performance. The bill would require an evaluation of regional center performance by the department, which would be implemented using a common set of performance measures. The bill would require the assessments to use performance measures in 7 specific domains: community integration, employment, equity in access, case management, client and family choice, experience and satisfaction, human and civil rights, and health and safety. The bill would require the department to establish standards for theses performance measures, as specified, by July 1, 2024.
The bill would require the department, as part of its planning process for the planning and development of a uniform, statewide data automation system, to develop a charter project charter, by March 1, 2024, for approval by the Secretary of the California Health and Human Services Agency and the Department of Technology. The bill would require the charter development process to include the participation and input of program consumers and families, researchers and quality and outcome evaluators, regional centers, and service providers. The bill would require the charter to include specified components, including, but not limited to, an impact statement, project guiding principles, and program goals, including maximizing the performance and business processes for the delivery of intellectual or developmental disabilities (IDD) system services to regional center consumers.
Existing law requires the department, in consultation with stakeholders, to identify a valid and reliable quality assurance instrument that assesses consumer and family satisfaction, provision of services in a linguistically and competent manner, and personal outcomes, as specified.
This bill would require the department by March 1, 2024, to submit a report to the Legislature describing the extent to which the requirements of this section have not been met, including the surveying of all consumers, including those who have not purchased services, and providing specific steps and the schedule by which these requirements will be met.
Existing law requires regional centers to conduct client assessments, and requires those assessments to be performed within 120 days following intake, and within no more than 60 days following initial intake if delay would expose the client to unnecessary risk to their health and safety, as specified.
This bill would revise those timeframes to require an assessment to be completed within 60 days of intake, and within 30 days of intake for at-risk clients.
Existing law declares the intent of the Legislature to ensure that the individual program plan (IPP) and provision of services and supports by the regional center system is centered on the individual and the family of the individual with developmental disabilities and takes into account the needs and preferences of the individual and the family, as prescribed. Existing law requires an IPP to be developed for any person who, following intake and assessment, is found to be eligible for regional center services, and requires these plans to be completed within 60 days of the completion of the assessment, as specified.
This bill also would declare the intent of the Legislature for the IPP to be developed consistent with the federal Affordable Care Act, as specified, requiring community-based long-term services and supports be person-centered and self-directed, and ensuring that goals in any plan allow for innovation and nontraditional services service delivery. The bill would authorize a regional center to exceed the time period for developing an IPP, if there is good cause, but no more than 60 days from intake. The bill would require a regional center that fails to meet the 30-day or 60-day deadline to provide the consumer with an adequate notice of action and notify the department of the reason for failure to meet the deadline.
This bill would require the department to establish, by January 1, 2025, a common set of services and supports, including supported living services, and would require every regional center to make those services and supports available to consumers in negotiating, developing, and amending the IPP. The bill would require the department, with respect to services and supports requested by a consumer that require an assessment, to complete that assessment within 30 days of the date of request, at no cost to the consumer, as specified. The bill would also require the department to comprehensively review the current processes for vendorizing providers for the delivery of services and supports to regional center consumers and revise those processes to streamline the process and create a uniform statewide vendorization process. The bill would require the department to develop the revised process in consultation with the Association of Regional Center Agencies, consumers and their families, advocacy organizations, and service providers, as specified.
The bill would revise existing complaint procedures for consumers and their representatives, including requiring complaints to be made to the Director of Developmental Services, and requiring the director to issue a written administrative decision within 30 days of receiving the complaint, and send a copy of the decision to the complainant, the director of the subject regional center or state-operated facility, and the service provider, as prescribed. The bill would require the department, no later than March 1, 2024, and annually thereafter, to submit a report to the Legislature and post on its internet website specified data relating to health and safety waivers requested and granted for consumers of developmental services.
The bill would revise the criteria applicable to regional center governing boards with which the state contracts, including with respect to terms, the composition of nominating committees, and training. The bill would require the department to establish and adopt a grievance procedure for governing board members, as specified. The bill also would make regional centers subject to requirements of the California Public Records Act.
The Lanterman Developmental Disabilities Services Act makes the State Department of Developmental Services responsible for providing various services and supports to individuals with developmental disabilities, and for ensuring the appropriateness and quality of those services and supports. Pursuant to that law, the department contracts with regional centers to provide services and supports to persons with developmental disabilities.
This bill would enact the Disability Equity and Accountability of 2023, which would make various changes to the act for purposes including gathering relevant data and providing increased oversight of regional center operations and performance. The bill would require an evaluation of regional center performance by the department, which would be implemented using a common set of performance measures. The bill would require the assessments to use performance measures in 7 specific domains: community integration, employment, equity in access, case management, client and family choice, experience and satisfaction, human and civil rights, and health and safety. The bill would require the department to establish standards for theses performance measures, as specified, by July 1, 2024.
The bill would require the department, as part of its planning process for the planning and development of a uniform, statewide data automation system, to develop a charter for approval by the Secretary of the California Health and Human Services Agency and the Department of Technology. The bill would require the charter development process to include the participation and input of program consumers and families, researchers and quality and outcome evaluators, regional centers, and service providers. The bill would require the charter to include specified components, including, but not limited to, an impact statement, project guiding principles, and program goals, including maximizing the performance and business processes for the delivery of intellectual or developmental disabilities (IDD) system services to regional center consumers.
Existing law requires the department, in consultation with stakeholders, to identify a valid and reliable quality assurance instrument that assesses consumer and family satisfaction, provision of services in a linguistically and competent manner, and personal outcomes, as specified.
This bill would require the department by March 1, 2024, to submit a report to the Legislature describing the extent to which the requirements of this section have not been met, including the surveying of all consumers, including those who have not purchased services, and providing specific steps and the schedule by which these requirements will be met.
Existing law requires regional centers to conduct client assessments, and requires those assessments to be performed within 120 days following intake, and within no more than 60 days following initial intake if delay would expose the client to unnecessary risk to their health and safety, as specified.
This bill would revise those timeframes to require an assessment to be completed within 60 days of intake, and within 30 days of intake for at-risk clients.
Existing law declares the intent of the Legislature to ensure that the individual program plan (IPP) and provision of services and supports by the regional center system is centered on the individual and the family of the individual with developmental disabilities and takes into account the needs and preferences of the individual and the family, as prescribed.
This bill also would declare the intent of the Legislature for the IPP to be developed consistent with the federal Affordable Care Act, as specified, requiring community-based long-term services and supports be person-centered and self-directed, and ensuring that goals in any plan allow for innovation and nontraditional services service delivery. The bill would revise existing complaint procedures for consumers and their representatives, including requiring complaints to be made to the Director of Developmental Services, and requiring the director to issue a written administrative decision within 30 days of receiving the complaint, and send a copy of the decision to the complainant, the director of the subject regional center or state-operated facility, and the service provider, as prescribed.
The bill would revise the criteria applicable to regional center governing boards with which the state contracts, including with respect to terms, the composition of nominating committees, and training. The bill would require the department to establish and adopt a grievance procedure for governing board members, as specified. The bill also would make regional centers subject to requirements of the California Public Records Act.
This act shall be known, and may be cited, as the Disability Equity, Transparency, and Accountability Act of 2024.
SEC. 2.(a)The Legislature finds and declares as follows:
(1)The State Department of Developmental Services is responsible for overseeing the coordination and delivery of services and care of individuals with intellectual and developmental disabilities through the Lanterman Developmental Disabilities Services Act.
(2)More than 450,000 Californians with developmental disabilities currently receive services and support funded by the department.
(3)The department contracts with 21 regional centers throughout California to coordinate service provisions to these individuals. These regional centers are private, nonprofit corporations that receive funding allocated by the Legislature and are overseen by the department. For the 202425 fiscal year, the state budget allocated fifteen billion three hundred million dollars ($15,300,000,000) to fund regional center services and operations statewide out of fifteen billion eight hundred million dollars ($15,800,000,000) appropriated for the entire program.
(4)California regional centers assert that they are not subject to the California Public Records Act because they are not state entities.
(5)The Legislature has included in the California Public Records Act nongovernmental entities, such as charter schools, that receive public funds and provide core governmental services.
(6)Without formal access to regional center information, there is a significant gap into the transparency of regional center operations and their budgets that makes it difficult to identify and change operational policies and practices generally, and in particular, those that disproportionally restrict services to communities of color.
(7)Regional centers carry out core governmental functions, and the limited statutory disclosure provisions that exist in the Lanterman Developmental Disabilities Services Act do not provide significant detail into the overall operation and spending of regional centers and their service authorization decisions.
(8)California has a strong policy preference in favor of providing public access to government records. Access to information concerning the conduct of the peoples business is a fundamental and necessary right of every person in this state. (Gov. Code, Sec. 7921.000.) In 2004, the right of public access was enshrined in the California Constitution with the passage of Proposition 59, which amended the California Constitution to specifically protect the right of the public to access and obtain government records, stating that [t]he people have the right of access to information concerning the conduct of the peoples business, and . . . the writings of public officials and agencies shall be open to public scrutiny. Ten years later, voters approved Proposition 42 to further increase public access to government records by requiring local agencies to comply with the California Public Records Act, and with any future amendments to the act, as provided. (Cal. Const., Art. I, Sec. 3(b)(7).)
(9)Regional centers receive the totality of their funding from the state and federal governments, which exceeds fifteen billion dollars ($15,000,000,000) in the 202425 fiscal year, for the purpose of providing services for Californians with developmental disabilities, and these services are a core governmental function and should be conducted in the open.
(b)It is the intent of the Legislature in enacting this act to ensure that all California regional centers are fully subject to the California Public Records Act in providing services to nearly 500,000 Californians with disabilities and their families, particularly since recent California State Auditor and Little Hoover Commission reports have found that stronger state oversight and transparency are needed to improve the quality and effectiveness of developmental services in California.
SEC. 3.Section 4581 of the Welfare and Institutions Code is amended to read:4581.(a)The Secretary of California Health and Human Services, in coordination with the State Department of Developmental Services, shall lead the development and implementation of the master plan for developmental services referenced in Governor Gavin Newsoms January 2024 Budget proposal and in the subsequent proclamation by the Governor that declared March 2024 as Developmental Disabilities Awareness Month.
(b)Other state entities that interact with the State Department of Developmental Services shall be included in discussions with the Master Plan for Developmental Services Committee as applicable. These entities shall include, but not be limited to, the State Department of Health Care Services, the State Department of Social Services, the Department of Rehabilitation, the California Department of Aging, the State Department of Education, and the agencies listed in subdivision (f).
(c)The Secretary of California Health and Human Services shall solicit input through the committee, or through other means, from individuals with intellectual and developmental disabilities and their families, professionals in the developmental services field, and a broad range of subject matter experts on topics that may include, but are not limited to, regional center board accountability and transparency and the evaluation of regional centers, including performance, equity, and diversity.
(d)When the California Health and Human Services Agency convenes meetings of the master plan committee, the information and materials about the work of the master plan committee shall be posted on the California Health and Human Services Agencys internet website in a timely manner.
(e)By March 15, 2025, the Secretary of California Health and Human Services shall submit an initial report to the Governor and the Legislature that summarizes the recommended components of the master plan resulting from the master plan committee advisory process, the community roundtable discussions, and the public comment received.
(f)The secretary and the director shall work with other state agencies and departments, as necessary, to identify policies, efficiencies, and strategies necessary to implement the master plan, which may include any of the following:
(1)The California Health and Human Services Agency.
(2)The Government Operations Agency.
(3)The State Department of Education.
(4)The Labor and Workforce Development Agency.
(5)The Transportation Agency.
(6)The Business, Consumer Services, and Housing Agency.
(7)The Behavioral Health Services Oversight and Accountability Commission.
(8)The office of the Treasurer.
(g)The workgroup shall solicit input from stakeholders and gather information on the experiences of Californians with intellectual and developmental disabilities and their families in the implementation process of the master plan.
(h)The Secretary of California Health and Human Services shall submit master plan implementation updates to the Governor and the Legislature annually beginning March 15, 2026, to March 15, 2036, inclusive. The updates shall include, but are not limited to, identification of any statutory changes, funding requirements, and changes to the departments new case management system considered necessary to effectively implement the plan.
(i)Any funding needed to support program enhancements proposed in the master plan is subject to an appropriation by the Legislature for those purposes.
(j)A report to be submitted pursuant to this section shall be submitted in compliance with Section 9795 of the Government Code.
SEC. 4.Section 4626.5 of the Welfare and Institutions Code is amended to read:4626.5.Each regional center shall submit a conflict-of-interest policy to the department by July 1, 2011, and shall post the policy on its internet website by August 1, 2011. The policy shall do, or comply with, all of the following:
(a)Contain the elements of this section and be consistent with applicable law.
(b)Define conflicts of interest.
(c)Identify positions within the regional center required to complete and file a conflict-of-interest statement.
(d)Facilitate disclosure of information to identify conflicts of interest.
(e)Require candidates for nomination, election, or appointment to a regional center board, and applicants for regional center director to disclose any potential or present conflicts of interest prior to being appointed, elected, or confirmed for hire by the regional center or the regional center governing board.
(f)Require the regional center and its governing board to regularly and consistently monitor and enforce compliance with its conflict-of-interest policy.
(g)Prohibit a regional center employee from accepting a gift or gifts from a service provider, consumer, or consumers family member valued over fifteen dollars ($15) per year.
(h)Establish a policy prohibiting regional center senior staff from hiring relatives at the center or any ancillary foundation and organization. The policy shall be included in the regional center contract and shall be included in training of the governing board.
SEC. 5.Section 4639.76 is added to the Welfare and Institutions Code, to read:4639.76.(a)A regional center with which the department maintains a contract pursuant to Section 4629 shall be subject to the California Public Records Act (Chapter 1 (commencing with Section 7920.000) of Division 10 of Title 1 of the Government Code).
(b)This section shall become operative on January 1, 2026.
SEC. 6.Section 4726 of the Welfare and Institutions Code is amended to read:4726.Notwithstanding any other law, access to records regarding an applicant for, or recipient of, services shall be provided, upon request, to the applicant, recipient, or their authorized representative, including the person appointed as a developmental services decisionmaker pursuant to Section 319, 361, or 726, for any purpose, including, but not limited to, the appeal process under this chapter, unless disclosure of the record is expressly prohibited by law.
This act shall be known, and may be cited, as the Disability Equity, Transparency, and Accountability Act of 2024.
SEC. 2.(a)The Legislature finds and declares as follows:
(1)The State Department of Developmental Services is responsible for overseeing the coordination and delivery of services and care of individuals with intellectual and developmental disabilities through the Lanterman Developmental Disabilities Services Act.
(2)More than 450,000 Californians with developmental disabilities currently receive services and support funded by the department.
(3)The department contracts with 21 regional centers throughout California to coordinate service provisions to these individuals. These regional centers are private, nonprofit corporations that receive funding allocated by the Legislature and are overseen by the department. For the 202425 fiscal year, the state budget allocated fifteen billion three hundred million dollars ($15,300,000,000) to fund regional center services and operations statewide out of fifteen billion eight hundred million dollars ($15,800,000,000) appropriated for the entire program.
(4)California regional centers assert that they are not subject to the California Public Records Act because they are not state entities.
(5)The Legislature has included in the California Public Records Act nongovernmental entities, such as charter schools, that receive public funds and provide core governmental services.
(6)Without formal access to regional center information, there is a significant gap into the transparency of regional center operations and their budgets that makes it difficult to identify and change operational policies and practices generally, and in particular, those that disproportionally restrict services to communities of color.
(7)Regional centers carry out core governmental functions, and the limited statutory disclosure provisions that exist in the Lanterman Developmental Disabilities Services Act do not provide significant detail into the overall operation and spending of regional centers and their service authorization decisions.
(8)California has a strong policy preference in favor of providing public access to government records. Access to information concerning the conduct of the peoples business is a fundamental and necessary right of every person in this state. (Gov. Code, Sec. 7921.000.) In 2004, the right of public access was enshrined in the California Constitution with the passage of Proposition 59, which amended the California Constitution to specifically protect the right of the public to access and obtain government records, stating that [t]he people have the right of access to information concerning the conduct of the peoples business, and . . . the writings of public officials and agencies shall be open to public scrutiny. Ten years later, voters approved Proposition 42 to further increase public access to government records by requiring local agencies to comply with the California Public Records Act, and with any future amendments to the act, as provided. (Cal. Const., Art. I, Sec. 3(b)(7).)
(9)Regional centers receive the totality of their funding from the state and federal governments, which exceeds fifteen billion dollars ($15,000,000,000) in the 202425 fiscal year, for the purpose of providing services for Californians with developmental disabilities, and these services are a core governmental function and should be conducted in the open.
(b)It is the intent of the Legislature in enacting this act to ensure that all California regional centers are fully subject to the California Public Records Act in providing services to nearly 500,000 Californians with disabilities and their families, particularly since recent California State Auditor and Little Hoover Commission reports have found that stronger state oversight and transparency are needed to improve the quality and effectiveness of developmental services in California.
SEC. 3.Section 4581 of the Welfare and Institutions Code is amended to read:4581.(a)The Secretary of California Health and Human Services, in coordination with the State Department of Developmental Services, shall lead the development and implementation of the master plan for developmental services referenced in Governor Gavin Newsoms January 2024 Budget proposal and in the subsequent proclamation by the Governor that declared March 2024 as Developmental Disabilities Awareness Month.
(b)Other state entities that interact with the State Department of Developmental Services shall be included in discussions with the Master Plan for Developmental Services Committee as applicable. These entities shall include, but not be limited to, the State Department of Health Care Services, the State Department of Social Services, the Department of Rehabilitation, the California Department of Aging, the State Department of Education, and the agencies listed in subdivision (f).
(c)The Secretary of California Health and Human Services shall solicit input through the committee, or through other means, from individuals with intellectual and developmental disabilities and their families, professionals in the developmental services field, and a broad range of subject matter experts on topics that may include, but are not limited to, regional center board accountability and transparency and the evaluation of regional centers, including performance, equity, and diversity.
(d)When the California Health and Human Services Agency convenes meetings of the master plan committee, the information and materials about the work of the master plan committee shall be posted on the California Health and Human Services Agencys internet website in a timely manner.
(e)By March 15, 2025, the Secretary of California Health and Human Services shall submit an initial report to the Governor and the Legislature that summarizes the recommended components of the master plan resulting from the master plan committee advisory process, the community roundtable discussions, and the public comment received.
(f)The secretary and the director shall work with other state agencies and departments, as necessary, to identify policies, efficiencies, and strategies necessary to implement the master plan, which may include any of the following:
(1)The California Health and Human Services Agency.
(2)The Government Operations Agency.
(3)The State Department of Education.
(4)The Labor and Workforce Development Agency.
(5)The Transportation Agency.
(6)The Business, Consumer Services, and Housing Agency.
(7)The Behavioral Health Services Oversight and Accountability Commission.
(8)The office of the Treasurer.
(g)The workgroup shall solicit input from stakeholders and gather information on the experiences of Californians with intellectual and developmental disabilities and their families in the implementation process of the master plan.
(h)The Secretary of California Health and Human Services shall submit master plan implementation updates to the Governor and the Legislature annually beginning March 15, 2026, to March 15, 2036, inclusive. The updates shall include, but are not limited to, identification of any statutory changes, funding requirements, and changes to the departments new case management system considered necessary to effectively implement the plan.
(i)Any funding needed to support program enhancements proposed in the master plan is subject to an appropriation by the Legislature for those purposes.
(j)A report to be submitted pursuant to this section shall be submitted in compliance with Section 9795 of the Government Code.
SEC. 4.Section 4626.5 of the Welfare and Institutions Code is amended to read:4626.5.Each regional center shall submit a conflict-of-interest policy to the department by July 1, 2011, and shall post the policy on its internet website by August 1, 2011. The policy shall do, or comply with, all of the following:
(a)Contain the elements of this section and be consistent with applicable law.
(b)Define conflicts of interest.
(c)Identify positions within the regional center required to complete and file a conflict-of-interest statement.
(d)Facilitate disclosure of information to identify conflicts of interest.
(e)Require candidates for nomination, election, or appointment to a regional center board, and applicants for regional center director to disclose any potential or present conflicts of interest prior to being appointed, elected, or confirmed for hire by the regional center or the regional center governing board.
(f)Require the regional center and its governing board to regularly and consistently monitor and enforce compliance with its conflict-of-interest policy.
(g)Prohibit a regional center employee from accepting a gift or gifts from a service provider, consumer, or consumers family member valued over fifteen dollars ($15) per year.
(h)Establish a policy prohibiting regional center senior staff from hiring relatives at the center or any ancillary foundation and organization. The policy shall be included in the regional center contract and shall be included in training of the governing board.
SEC. 5.Section 4639.76 is added to the Welfare and Institutions Code, to read:4639.76.(a)A regional center with which the department maintains a contract pursuant to Section 4629 shall be subject to the California Public Records Act (Chapter 1 (commencing with Section 7920.000) of Division 10 of Title 1 of the Government Code).
(b)This section shall become operative on January 1, 2026.
SEC. 6.Section 4726 of the Welfare and Institutions Code is amended to read:4726.Notwithstanding any other law, access to records regarding an applicant for, or recipient of, services shall be provided, upon request, to the applicant, recipient, or their authorized representative, including the person appointed as a developmental services decisionmaker pursuant to Section 319, 361, or 726, for any purpose, including, but not limited to, the appeal process under this chapter, unless disclosure of the record is expressly prohibited by law.
This act shall be known, and may be cited, as the Disability Equity Equity, Transparency, and Accountability Act of 2023. 2024.
SEC. 2.Section 4571 of the Welfare and Institutions Code is amended to read:4571.(a)It is the intent of the Legislature to ensure the well-being of consumers, taking into account their informed and expressed choices. It is further the intent of the Legislature to support the satisfaction and success of consumers through the delivery of quality services and supports. Evaluation of the services that consumers receive is a key aspect to the service system. Utilizing the information that consumers and their families provide about those services in a reliable and meaningful way is also critical to enable the department to assess the performance of the states developmental services system and to improve services for consumers in the future. To that end, the State Department of Developmental Services, on or before January 1, 2010, shall implement an improved, unified quality assessment system, in accordance with this section.(b)The department, in consultation with stakeholders, shall identify a valid and reliable quality assurance instrument that assesses consumer and family satisfaction, provision of services in a linguistically and culturally competent manner, and personal outcomes. The instrument shall do all of the following:(1)Provide nationally validated, benchmarked, consistent, reliable, and measurable data for the departments Quality Management System.(2)Enable the department and regional centers to compare the performance of Californias developmental services system against other states developmental services systems and to assess quality and performance among all of the regional centers.(3)Include outcome-based measures such as health, safety, well-being, relationships, interactions with people who do not have a disability, employment, quality of life, integration, choice, service, and consumer satisfaction.(4)Include outcome-based measures to evaluate the linguistic and cultural competency, including tribal culture competency, of regional center services that are provided to consumers across their lifetimes.(c)To the extent that funding is available, the instrument identified in subdivision (b) may be expanded to collect additional data requested by the State Council on Developmental Disabilities.(d)(1)The department shall contract with an independent agency or organization to implement, by January 1, 2010, the quality assurance instrument described in subdivision (b). The contractor shall be experienced in all of the following:(A)Designing valid quality assurance instruments for developmental service systems.(B)Tracking outcome-based measures such as health, safety, well-being, relationships, interactions with people who do not have a disability, employment, quality of life, integration, choice, service, and consumer satisfaction.(C)Developing data systems.(D)Data analysis and report preparation.(E)Assessments of the services received by consumers who are moved from developmental centers to the community, given the Legislatures historic recognition of a special obligation to ensure the well-being of these persons.(F)Issues related to linguistic and cultural competency.(2)Notwithstanding any other law, the contract and any amendments pursuant to this section shall be exempt from all of the following:(A)The personal services contracting requirements of Article 4 (commencing with Section 19130) of Chapter 5 of Part 2 of Division 5 of Title 2 of the Government Code.(B)The Public Contract Code, the State Contracting Manual, and the State Administration Manual.(C)The approval of the Department of General Services.(D)The approval of the Department of Technology.(3)The exemptions specified in paragraph (2) shall remain in effect until there is more than one available assessment that meets the criteria in subdivision (b) from an organization that also meets the criteria in this subdivision.(e)The department, in consultation with the contractor described in subdivision (d), shall establish the methodology by which the quality assurance instrument shall be administered, including, but not limited to, how often and to whom the quality assurance will be administered, and the design of a stratified, random sample among the entire population of consumers served by regional centers. The contractor shall provide aggregate information for all regional centers and the state as a whole. At the request of a consumer or the family member of a consumer, the survey shall be conducted in the primary language of the consumer or family member surveyed.(f)The department shall contract with the state council to collect data for the quality assurance instrument described in subdivision (b). If, during the data collection process, the state council identifies any suspected violation of the legal, civil, or service rights of a consumer, or if it determines that the health and welfare of a consumer is at risk, that information shall be provided immediately to the regional center providing case management services to the consumer. At the request of the consumer or family, when appropriate, a copy of the completed survey shall be provided to the regional center providing case management services to improve the consumers quality of services through the individual planning process.(g)The department, in consultation with stakeholders, shall annually review the data collected from and the findings of the quality assurance instrument described in subdivision (b) and accept recommendations regarding additional or different criteria for the quality assurance instrument in order to assess the performance of the states developmental services system and improve services for consumers.(h)(1)Each regional center shall annually present data collected from, and the findings of, the quality assurance instrument described in subdivision (b) for that regional center, at a public meeting of its governing board in order to assess the comparative performance of the regional center and identify needed improvements in services for consumers, including, but not limited to, case management services. Notice of this meeting shall also be posted on the regional centers internet website at least 30 days prior to the meeting and shall be sent to regional center consumers and families and individual stakeholders at least 30 days prior to the meeting. The governing board shall provide a sufficient public comment period so members of the public may provide comments. Each regional center, in holding the meeting required by this subdivision, shall ensure that the meeting and meeting materials provide language access, as required by state and federal law.(2)All regional center-specific reports generated by the department pursuant to this subdivision shall be made publicly available on the regional centers internet website in a machine-readable format, but shall not contain any personal identifying information about any person assessed.(3)Within 60 days following its annual presentation, each regional center shall submit a report to the department regarding its implementation of the requirements of this section. The report shall include, but shall not be limited to, both of the following:(A)Copies of the presentation described in paragraph (1), minutes from the meeting, and attendee comments.(B)The regional centers recommendations and plans to use the information to address regional center priorities, strategic directions to improve specific areas of performance, or both.(i)All reports generated pursuant to this section shall be made publicly available, but shall not contain any personal identifying information about any person assessed.(j)All data collected pursuant to subdivision (c) shall be provided to the state council, but shall not contain personal identifying information about the persons being surveyed.(k)Implementation of this section shall be subject to an annual appropriation of funds in the Budget Act for this purpose.(l)By March 1, 2025, the department shall advise the policy and budget subcommittees of the Legislature describing the extent to which the requirements of this section have been met, including the surveying of all consumers, including those with no purchase of services, and providing specific steps and the schedule by which these requirements will be met.SEC. 3.Section 4622 of the Welfare and Institutions Code is amended to read:4622.The state shall contract only with agencies, the governing boards of which conform to all of the following criteria:(a)The governing board shall be composed of individuals with demonstrated interest in, or knowledge of, developmental disabilities.(b)The membership of the governing board shall include persons with legal, management or board governance, financial, and developmental disability program expertise. Board governance expertise may not be acquired solely by serving on a regional center board. The governing board of the regional center shall include members with financial expertise and members with management or board governance expertise by August 15, 2020.(c)The membership of the governing board shall include representatives of the various categories of disability to be served by the regional center.(d)The governing board shall reflect the geographic and ethnic characteristics of the area to be served by the regional center.(e)A minimum of 50 percent of the members of the governing board shall be persons with developmental disabilities or their parents or legal guardians. No less than 25 percent of the members of the governing board shall be persons with developmental disabilities.(f)(1)Members of the governing board shall not be permitted to serve more than seven years within each eight-year period.(2)The board nominating committee shall solicit interests and nominations from the broader community through outreach. The committee shall interview candidates for the board and make recommendations to the governing board for election. During the meeting at which the board elects new members, a candidate may be nominated by a board member with a second by another board member for the open positions. A regional center executive director shall be prohibited from any involvement in the recruitment or election of governing board members.(g)(1)The department shall provide necessary training and support to these board members to facilitate their understanding and participation, including issues relating to linguistic and cultural competency. The training shall be developed with community input, including persons served and family members. Ongoing support by the department shall include surveying board members about their ability to meaningfully participate in, and understand the subjects and votes at, board meetings. If board members report that they are unable to meaningfully participate, the department shall work with the regional center and the board member to ensure adequate and appropriate accommodations are provided.(2)As part of its monitoring responsibility, the department shall review and approve the method by which training and support are provided to board members to ensure maximum understanding and participation by board members.(3)Each regional center shall post on its internet website information regarding the training and support provided to board members.(h)The governing board may appoint a consumers advisory committee composed of persons with developmental disabilities representing the various categories of disability served by the regional center.(i)The governing board shall appoint an advisory committee composed of a wide variety of persons representing the various categories of providers from which the regional center purchases client services. The advisory committee shall provide advice, guidance, recommendations, and technical assistance to the regional center board in order to assist the regional center in carrying out its mandated functions. The advisory committee shall designate one of its members to serve as a member of the regional center board.(j)(1)The governing board shall annually review the performance of the director of the regional center. The department shall establish guidelines for governing boards to measure executive director performance, including with respect to issues of equity and diversity.(2)The governing board shall annually review the performance of the regional center in providing services that are linguistically and culturally appropriate and may provide recommendations to the director of the regional center based on the results of that review.(k)A member of the board who is an employee or member of the governing board of a provider from which the regional center purchases client services shall not do any of the following:(1)Serve as an officer of the board.(2)Vote on any fiscal matter affecting the purchase of services from any regional center provider.(3)Vote on any issue other than as described in paragraph (2), in which the member has a financial interest, as defined in Section 87103 of the Government Code, and determined by the regional center board. The member shall provide a list of the members financial interests, as defined in Section 87103, to the regional center board.(l)The department shall establish, and each board shall adopt, an antiretaliation policy for board members that requires department approval for any reduction in services for consumer board members or the family member of family board members.(m)The department shall establish and adopt a grievance procedure whereby a governing board member who has concerns, complaints, or questions may contact a specific executive at the department.(n)This section does not prevent the appointment to a regional center governing board of a person who meets the criteria for more than one of the categories listed above.SEC. 2.(a)The Legislature finds and declares as follows:
(1)The State Department of Developmental Services is responsible for overseeing the coordination and delivery of services and care of individuals with intellectual and developmental disabilities through the Lanterman Developmental Disabilities Services Act.
(2)More than 450,000 Californians with developmental disabilities currently receive services and support funded by the department.
(3)The department contracts with 21 regional centers throughout California to coordinate service provisions to these individuals. These regional centers are private, nonprofit corporations that receive funding allocated by the Legislature and are overseen by the department. For the 202425 fiscal year, the state budget allocated fifteen billion three hundred million dollars ($15,300,000,000) to fund regional center services and operations statewide out of fifteen billion eight hundred million dollars ($15,800,000,000) appropriated for the entire program.
(4)California regional centers assert that they are not subject to the California Public Records Act because they are not state entities.
(5)The Legislature has included in the California Public Records Act nongovernmental entities, such as charter schools, that receive public funds and provide core governmental services.
(6)Without formal access to regional center information, there is a significant gap into the transparency of regional center operations and their budgets that makes it difficult to identify and change operational policies and practices generally, and in particular, those that disproportionally restrict services to communities of color.
(7)Regional centers carry out core governmental functions, and the limited statutory disclosure provisions that exist in the Lanterman Developmental Disabilities Services Act do not provide significant detail into the overall operation and spending of regional centers and their service authorization decisions.
(8)California has a strong policy preference in favor of providing public access to government records. Access to information concerning the conduct of the peoples business is a fundamental and necessary right of every person in this state. (Gov. Code, Sec. 7921.000.) In 2004, the right of public access was enshrined in the California Constitution with the passage of Proposition 59, which amended the California Constitution to specifically protect the right of the public to access and obtain government records, stating that [t]he people have the right of access to information concerning the conduct of the peoples business, and . . . the writings of public officials and agencies shall be open to public scrutiny. Ten years later, voters approved Proposition 42 to further increase public access to government records by requiring local agencies to comply with the California Public Records Act, and with any future amendments to the act, as provided. (Cal. Const., Art. I, Sec. 3(b)(7).)
(9)Regional centers receive the totality of their funding from the state and federal governments, which exceeds fifteen billion dollars ($15,000,000,000) in the 202425 fiscal year, for the purpose of providing services for Californians with developmental disabilities, and these services are a core governmental function and should be conducted in the open.
(b)It is the intent of the Legislature in enacting this act to ensure that all California regional centers are fully subject to the California Public Records Act in providing services to nearly 500,000 Californians with disabilities and their families, particularly since recent California State Auditor and Little Hoover Commission reports have found that stronger state oversight and transparency are needed to improve the quality and effectiveness of developmental services in California.
SEC. 3.Section 4581 of the Welfare and Institutions Code is amended to read:4581.(a)The Secretary of California Health and Human Services, in coordination with the State Department of Developmental Services, shall lead the development and implementation of the master plan for developmental services referenced in Governor Gavin Newsoms January 2024 Budget proposal and in the subsequent proclamation by the Governor that declared March 2024 as Developmental Disabilities Awareness Month.
(b)Other state entities that interact with the State Department of Developmental Services shall be included in discussions with the Master Plan for Developmental Services Committee as applicable. These entities shall include, but not be limited to, the State Department of Health Care Services, the State Department of Social Services, the Department of Rehabilitation, the California Department of Aging, the State Department of Education, and the agencies listed in subdivision (f).
(c)The Secretary of California Health and Human Services shall solicit input through the committee, or through other means, from individuals with intellectual and developmental disabilities and their families, professionals in the developmental services field, and a broad range of subject matter experts. experts on topics that may include, but are not limited to, regional center board accountability and transparency and the evaluation of regional centers, including performance, equity, and diversity.
(d)When the California Health and Human Services Agency convenes meetings of the master plan committee, the information and materials about the work of the master plan committee shall be posted on the California Health and Human Services Agencys internet website in a timely manner.
(e)By March 15, 2025, the Secretary of California Health and Human Services shall submit an initial report to the Governor and the Legislature that summarizes the recommended components of the master plan resulting from the master plan committee advisory process, the community roundtable discussions, and the public comment received.
(f)The secretary and the director shall work with other state agencies and departments, as necessary, to identify policies, efficiencies, and strategies necessary to implement the master plan, which may include any of the following:
(1)The California Health and Human Services Agency.
(2)The Government Operations Agency.
(3)The State Department of Education.
(4)The Labor and Workforce Development Agency.
(5)The Transportation Agency.
(6)The Business, Consumer Services, and Housing Agency.
(7)The Behavioral Health Services Oversight and Accountability Commission.
(8)The office of the Treasurer.
(g)The workgroup shall solicit input from stakeholders and gather information on the experiences of Californians with intellectual and developmental disabilities and their families in the implementation process of the master plan.
(h)The Secretary of California Health and Human Services shall submit master plan implementation updates to the Governor and the Legislature annually beginning March 15, 2026, to March 15, 2036, inclusive. The updates shall include, but are not limited to, identification of any statutory changes, funding requirements, and changes to the departments new case management system considered necessary to effectively implement the plan.
(i)Any funding needed to support program enhancements proposed in the master plan is subject to an appropriation by the Legislature for those purposes.
(j)A report to be submitted pursuant to this section shall be submitted in compliance with Section 9795 of the Government Code.
SEC. 4.Section 4626.5 of the Welfare and Institutions Code is amended to read:4626.5.Each regional center shall submit a conflict-of-interest policy to the department by July 1, 2011, and shall post the policy on its internet website by August 1, 2011. The policy shall do, or comply with, all of the following:
(a)Contain the elements of this section and be consistent with applicable law.
(b)Define conflicts of interest.
(c)Identify positions within the regional center required to complete and file a conflict-of-interest statement.
(d)Facilitate disclosure of information to identify conflicts of interest.
(e)Require candidates for nomination, election, or appointment to a regional center board, and applicants for regional center director to disclose any potential or present conflicts of interest prior to being appointed, elected, or confirmed for hire by the regional center or the regional center governing board.
(f)Require the regional center and its governing board to regularly and consistently monitor and enforce compliance with its conflict-of-interest policy.
(g)Prohibit a regional center employee from accepting a gift or gifts from a service provider, consumer, or consumers family member valued over fifteen dollars ($15) per year.
(h)Establish a policy prohibiting regional center senior staff from hiring relatives at the center or any ancillary foundation and organization. The policy shall be included in the regional center contract and shall be included in training of the governing board.
SEC. 5.Section 4629.1 is added to the Welfare and Institutions Code, to read:4629.1.(a)Notwithstanding any other law, the evaluation of regional center performance shall be implemented using a common set of performance measures administered by the department in conformance with the performance requirements under the regional center contracts pursuant to Section 4629, the performance incentives established under Section 4620.5, and the quality assessment instrument required under Section 4571. These measures shall be annually reported and made available to the public through posting of the measures results in machine-readable formats.(b)(1)By July 1, 2025, the department shall establish standards for each of the performance measures to support the provisions of subdivision (d) of Section 4629. The standards shall consist of benchmarks above which indicate good performance and a regional center may be eligible to receive rewards for good performance, and minimum benchmarks below which a regional center shall undertake efforts to improve. The department may offer technical assistance and training to regional centers not meeting performance measures from the department either directly or through subject matter experts and may facilitate the sharing of expertise and other resources from other regional centers that have met the performance measures.(2)The department, in consultation with stakeholders, including consumers and family members, shall annually establish, update, and review the established benchmarks.SEC. 6.SEC. 5.Section 4639.76 is added to the Welfare and Institutions Code, to read:4639.76.(a)A regional center with which the department maintains a contract pursuant to Section 4629 shall be subject to the California Public Records Act (Chapter 1 (commencing with Section 7920.000) of Division 10 of Title 1 of the Government Code).
(b)This section shall become operative on January 1, 2025. 2026.
SEC. 7.Section 4642 of the Welfare and Institutions Code is amended to read:4642.(a)(1)Any person believed to have a developmental disability, and any person believed to have a high risk of parenting an infant with a developmental disability shall be eligible for initial intake and assessment services in the regional centers. In addition, any infant having a high risk of becoming developmentally disabled may be eligible for initial intake and assessment services in the regional centers. For purposes of this section, high-risk infant means a child less than 36 months of age whose genetic, medical, or environmental history is predictive of a substantially greater risk for developmental disability than that for the general population. The department, in consultation with the State Department of Public Health, shall develop specific risk and service criteria for the high-risk infant program on or before July 1, 1983. These criteria may be modified in subsequent years based on analysis of actual clinical experience.(2)(A)Initial intake shall be performed within 15 working days following request for assistance. Initial intake shall include, but need not be limited to, information and advice about the nature and availability of services provided by the regional center and by other agencies in the community, including guardianship, conservatorship, income maintenance, mental health, housing, education, work activity and vocational training, medical, dental, recreational, and other services or programs that may be useful to persons with developmental disabilities or their families. Intake shall also include a decision to provide assessment.(B)For purposes of this section, request for assistance includes any initial contact or inquiry from an individual, or a person acting on their behalf, on the nature of services or supports available or provided by the regional center, and the individuals eligibility to receive them.(3)(A)The department shall create, with input from stakeholders, standardized information packets to be provided to any person seeking services from a regional center. There shall be one information packet related to services provided under the California Early Intervention Services Act and another information packet related to services provided under the Lanterman Developmental Disabilities Services Act. The information packets shall be translated to provide language access, as required by state and federal law, shall be reasonably culturally competent for diverse racial and ethnic communities, including immigrants and Native Americans, shall be available in alternative formats and alternative modes of communication, as required by federal law, and shall include, at a minimum, all of the following:(i)An overview of the regional center system.(ii)A resource guide for consumers and their families.(iii)Consumer rights, including the appeals procedures specified in Chapter 7 (commencing with Section 4700).(iv)Contact information for the regional center, the department, the office of clients rights advocacy, and the protection and advocacy agency specified in Division 4.7 (commencing with Section 4900).(v)Information on the Self-Determination Program, including the eligibility requirements specified in subdivision (d) of Section 4685.8.(B)Each regional center shall distribute the information packets at intake, upon transfer to receiving services under the Lanterman Developmental Disabilities Services Act, and upon request. Each regional center shall begin distributing the information packets within 60 days following the department providing the information packets and issuing directives regarding the distribution of the information packets. In addition to, and not in lieu of, this requirement, each regional center shall post the full content of the most updated information packet on its internet website.(b)A regional center shall communicate, with reasonable cultural competency, including Native American cultural competency, with the consumer and the consumers family pursuant to this section in their native language, including providing alternative communication services and alternative formats, as required by state and federal law.SEC. 8.Section 4646 of the Welfare and Institutions Code is amended to read:4646.(a)It is the intent of the Legislature to ensure that the individual program plan and provision of services and supports by the regional center system is centered on the individual and the family of the individual with developmental disabilities and takes into account the needs and preferences of the individual and the family, if appropriate, as well as promoting community integration, independent, productive, and normal lives, and stable and healthy environments. It is the further intent of the Legislature to ensure that goals in any plan allow for innovation and nontraditional service delivery and not be limited by the lack of easily identified services or supports, the provision of services to consumers and their families be effective in meeting the goals stated in the individual program plan, reflect the preferences and choices of the consumer, and reflect the cost-effective use of public resources.(b)Notwithstanding any other law, the individual program plan, including all assessments, shall be developed through a process of individualized needs determination and person-centered service planning requiring community-based, long-term services and supports to be person-centered, strengths-based, and self-directed. The individual with developmental disabilities and, if appropriate, the individuals parents, legal guardian or conservator, or authorized representative, shall have the opportunity to actively participate in the development of the plan. The individual shall lead the service planning process to the greatest extent possible.(c)An individual program plan shall be developed for any person who, following intake and assessment, is found to be eligible for regional center services. These plans shall be completed within 60 days of the completion of the assessment. At the time of intake, the regional center shall inform the consumer and, if appropriate, the consumers parents, legal guardian or conservator, or authorized representative, of the services available through the state council and the protection and advocacy agency designated by the Governor pursuant to federal law, and shall provide the address and telephone numbers of those agencies.(d)(1)As part of the initial individual program plan meeting and each review required by subdivision (b) of Section 4646.5, the consumer or, if appropriate, their parents, legal guardian, conservator, or authorized representative, shall be provided by the service coordinator oral and written information about the Self-Determination Program. The information shall include each of the provisions specified in subdivision (d) of Section 4685.8. Each individual program plan shall include a provision stating that the consumer or authorized representative was informed about the availability of the Self-Determination Program. If the consumer chooses not to participate in the program, the individual program plan shall include an explanation of the reason or reasons for that decision, or, if the consumer is ineligible for the program, the reason or reasons for that ineligibility.(2)If the consumer is interested in participating in the program or wants additional information or assistance, the service coordinator, within five business days of expressing the interest, shall provide the consumer a date for the Self-Determination Program orientation, training resources, dates of local volunteer Self-Determination Program advisory committee meetings, and other information to assist the consumer in participating in the program.(e)Individual program plans shall be prepared jointly by the planning team. Decisions concerning the consumers goals, objectives, and services and supports that will be included in the consumers individual program plan and purchased by the regional center or obtained from generic agencies shall be made by agreement between the regional center representative and the consumer or, if appropriate, the parents, legal guardian, conservator, or authorized representative at the program plan meeting.(f)Regional centers shall comply with the request of a consumer or, if appropriate, the request of the consumers parents, legal guardian, conservator, or authorized representative, that a designated representative receive written notice of all meetings to develop or revise the individual program plan and of all notices sent to the consumer pursuant to Section 4710. The designated representative may be a parent or family member.(g)Notwithstanding any other law, until June 30, 2024, a meeting regarding the provision of services and supports by the regional center, including a meeting to develop or revise the individual program plan, shall be held by remote electronic communications if requested by the consumer or, if appropriate, if requested by the consumers parents, legal guardian, conservator, or authorized representative.(h)At the conclusion of an individual program plan meeting, an authorized representative of the regional center shall provide to the consumer, in written or electronic format, a list of the agreed-upon services and supports, and, if known, the projected start date, the frequency and duration of the services and supports, and the provider. The authorized representative of the regional center shall sign the list of agreed-upon services and supports at that time. The consumer, or if appropriate, the consumers parent, legal guardian, conservator, or authorized representative shall sign the list of agreed-upon services and supports prior to its implementation. The consumer, or if appropriate, the consumers parent, legal guardian, conservator, or authorized representative, may elect to delay receipt of the list of agreed-upon services and supports pending final agreement, as described in subdivision (i). If the consumer, or if appropriate, the consumers parent, legal guardian, conservator, or authorized representative, elects to delay the receipt of the list of agreed-upon services and supports for 15 days, the list shall be provided in the preferred language of the consumer, or of the consumers parent, legal guardian, or authorized representative.(i)If a final agreement regarding the services and supports to be provided to the consumer cannot be reached at a program plan meeting, then a subsequent program plan meeting shall be convened within 15 days, or later at the request of the consumer or, if appropriate, the parents, legal guardian, conservator, or authorized representative or if agreed to by the planning team. The list of the agreed-upon services and supports described in subdivision (h) and signed by the authorized representative of the regional center shall be provided, in writing or electronically, at the conclusion of the subsequent program plan meeting, and shall be provided in the preferred language of the consumer, or of the consumers parent, legal guardian, conservator, or authorized representative. Additional program plan meetings may be held with the agreement of the regional center representative and the consumer or, if appropriate, the parents, legal guardian, conservator, or authorized representative.(j)An authorized representative of the regional center and the consumer or, if appropriate, the consumers parent, legal guardian, conservator, or authorized representative shall sign the individual program plan and the list of the agreed-upon services and supports prior to its implementation. If the consumer or, if appropriate, the consumers parent, legal guardian, conservator, or authorized representative, does not agree with all components of the individual program plan, the consumer may indicate that disagreement on the plan. Disagreement with specific plan components shall not prohibit the implementation of services and supports agreed to by the consumer or, if appropriate, the consumers parent, legal guardian, conservator, or authorized representative. If the consumer or, if appropriate, the consumers parent, legal guardian, conservator, or authorized representative, does not agree with the plan in whole or in part, the consumer shall be sent written notice of their appeal rights, as required by Sections 4701 and 4710.(k)(1)A regional center shall communicate in the consumers preferred language, or, if appropriate, the preferred language of the consumers family, legal guardian, conservator, or authorized representative, during the planning process for the individual program plan, including during the program plan meeting, and including providing alternative communication services, as required by Sections 11135 to 11139.8, inclusive, of the Government Code and implementing regulations.(2)A regional center shall provide alternative communication services, including providing copies of the list of services and supports, and the individual program plan in the preferred language of the consumer or the consumers family, legal guardian, conservator, or authorized representative, or both, as required by Sections 11135 to 11139.8, inclusive, of the Government Code and implementing regulations.(3)The preferred language of the consumer or the consumers family, legal guardian, conservator, or authorized representative, or both, shall be documented in the individual program plan.SEC. 8.5.Section 4646 of the Welfare and Institutions Code is amended to read:4646.(a)It is the intent of the Legislature to ensure that the individual program plan and provision of services and supports by the regional center system is centered on the individual and the family of the individual with developmental disabilities and takes into account the needs and preferences of the individual and the family, if appropriate, as well as promoting community integration, independent, productive, and normal lives, and stable and healthy environments. It is the further intent of the Legislature to ensure that goals in any plan allow for innovation and nontraditional service delivery and not be limited by the lack of easily identified services or supports, the provision of services to consumers and their families be effective in meeting the goals stated in the individual program plan, reflect the preferences and choices of the consumer, and reflect the cost-effective use of public resources.(b)Notwithstanding any other law, the individual program plan, including all assessments, shall be developed through a process of individualized needs determination and person-centered service planning requiring community-based, long-term services and supports to be person-centered, strengths-based, and self-directed. The individual with developmental disabilities and, if appropriate, the individuals parents, legal guardian or conservator, or authorized representative, shall have the opportunity to actively participate in the development of the plan. The individual shall lead the service planning process to the greatest extent possible.(c)An individual program plan shall be developed for any person who, following intake and assessment, is found to be eligible for regional center services. These plans shall be completed within 60 days of the completion of the assessment. At the time of intake, the regional center shall inform the consumer and, if appropriate, the consumers parents, legal guardian or conservator, or authorized representative, of the services available through the state council and the protection and advocacy agency designated by the Governor pursuant to federal law, and shall provide the address and telephone numbers of those agencies.(d)(1)As part of the initial individual program plan meeting and each review required by subdivision (b) of Section 4646.5, the consumer or, if appropriate, their parents, legal guardian, conservator, or authorized representative, shall be provided by the service coordinator oral and written information about the Self-Determination Program. The information shall include each of the provisions specified in subdivision (d) of Section 4685.8. Each individual program plan shall include a provision stating that the consumer or authorized representative was informed about the availability of the Self-Determination Program. If the consumer chooses not to participate in the program, the individual program plan shall include an explanation of the reason or reasons for that decision, or, if the consumer is ineligible for the program, the reason or reasons for that ineligibility.(2)If the consumer is interested in participating in the program or wants additional information or assistance, the service coordinator, within five business days of expressing the interest, shall provide the consumer a date for the Self-Determination Program orientation, training resources, dates of local volunteer Self-Determination Program advisory committee meetings, and other information to assist the consumer in participating in the program.(e)Individual program plans shall be prepared jointly by the planning team. Decisions concerning the consumers goals, objectives, and services and supports that will be included in the consumers individual program plan and purchased by the regional center or obtained from generic agencies shall be made by agreement between the regional center representative and the consumer or, if appropriate, the parents, legal guardian, conservator, or authorized representative at the program plan meeting.(f)Regional centers shall comply with the request of a consumer or, if appropriate, the request of the consumers parents, legal guardian, conservator, or authorized representative, that a designated representative receive written notice of all meetings to develop or revise the individual program plan and of all notices sent to the consumer pursuant to Section 4710. The designated representative may be a parent or family member.(g)Notwithstanding any other law, until June 30, 2024, a meeting regarding the provision of services and supports by the regional center, including a meeting to develop or revise the individual program plan, shall be held by remote electronic communications if requested by the consumer or, if appropriate, if requested by the consumers parents, legal guardian, conservator, or authorized representative.(h)At the conclusion of an individual program plan meeting, an authorized representative of the regional center shall provide to the consumer, in written or electronic format, a list of the agreed-upon services and supports, and, if known, the projected start date, the frequency and duration of the services and supports, and the provider. The authorized representative of the regional center shall sign the list of agreed-upon services and supports at that time. The consumer, or if appropriate, the consumers parent, legal guardian, conservator, or authorized representative shall sign the list of agreed-upon services and supports prior to its implementation. The consumer, or if appropriate, the consumers parent, legal guardian, conservator, or authorized representative, may elect to delay receipt of the list of agreed-upon services and supports pending final agreement, as described in subdivision (i). If the consumer, or if appropriate, the consumers parent, legal guardian, conservator, or authorized representative, elects to delay the receipt of the list of agreed-upon services and supports for 15 days, the list shall be provided in the preferred language of the consumer, or of the consumers parent, legal guardian, or authorized representative.(i)If a final agreement regarding the services and supports to be provided to the consumer cannot be reached at a program plan meeting, then a subsequent program plan meeting shall be convened within 15 days, or later at the request of the consumer or, if appropriate, the parents, legal guardian, conservator, or authorized representative or if agreed to by the planning team. The list of the agreed-upon services and supports described in subdivision (h) and signed by the authorized representative of the regional center shall be provided, in writing or electronically, at the conclusion of the subsequent program plan meeting, and shall be provided in the preferred language of the consumer, or of the consumers parent, legal guardian, conservator, or authorized representative. Additional program plan meetings may be held with the agreement of the regional center representative and the consumer or, if appropriate, the parents, legal guardian, conservator, or authorized representative.(j)An authorized representative of the regional center and the consumer or, if appropriate, the consumers parent, legal guardian, conservator, or authorized representative shall sign the individual program plan and the list of the agreed-upon services and supports prior to its implementation. If the consumer or, if appropriate, the consumers parent, legal guardian, conservator, or authorized representative, does not agree with all components of the individual program plan, the consumer may indicate that disagreement on the plan. Disagreement with specific plan components shall not prohibit the implementation of services and supports agreed to by the consumer or, if appropriate, the consumers parent, legal guardian, conservator, or authorized representative. If the consumer or, if appropriate, the consumers parent, legal guardian, conservator, or authorized representative, does not agree with the plan in whole or in part, the consumer shall be sent written notice of their appeal rights, as required by Sections 4701 and 4710.(k)(1)A regional center shall communicate in the consumers preferred language, or, if appropriate, the preferred language of the consumers family, legal guardian, conservator, or authorized representative, during the planning process for the individual program plan, including during the program plan meeting, and including providing alternative communication services, as required by Sections 11135 to 11139, inclusive, of the Government Code and implementing regulations.(2)A regional center shall provide alternative communication services, including providing copies of the list of services and supports, and the individual program plan in the preferred language of the consumer or the consumers family, legal guardian, conservator, or authorized representative, or both, as required by Sections 11135 to 11139, inclusive, of the Government Code and implementing regulations.(3)The preferred language of the consumer or the consumers family, legal guardian, conservator, or authorized representative, or both, shall be documented in the individual program plan.SEC. 9.Section 4646.5 of the Welfare and Institutions Code is amended to read:4646.5.(a)The planning process for the individual program plan described in Section 4646 shall include all of the following:(1)Gathering information and conducting assessments to determine the life goals, capabilities and strengths, preferences, barriers, and concerns or problems of the person with developmental disabilities. For children with developmental disabilities, this process should include a review of the strengths, preferences, and needs of the child and the family unit as a whole. Assessments shall be conducted by qualified individuals and performed in natural environments whenever possible. Information shall be taken from the consumer, the consumers parents and other family members, the consumers friends, advocates, authorized representative, if applicable, providers of services and supports, and other agencies. The assessment process shall reflect awareness of, and sensitivity to, the lifestyle and cultural background of the consumer and the family.(2)A statement of goals, based on the needs, preferences, and life choices of the individual with developmental disabilities, and a statement of specific, time-limited objectives for implementing the persons goals and addressing the persons needs. These objectives shall be stated in terms that allow measurement of progress or monitoring of service delivery. These goals and objectives should maximize opportunities for the consumer to develop relationships, be part of community life in the areas of community participation, housing, work, school, and leisure, increase control over the consumers life, acquire increasingly positive roles in community life, and develop competencies to help accomplish these goals.(3)In developing individual program plans for children, regional centers shall be guided by the principles, process, and services and support parameters set forth in Section 4685.(4)In developing an individual program plan for a transition age youth or working age adult, the planning team shall consider the Employment First Policy described in Chapter 14 (commencing with Section 4868).(5)A schedule of the type and amount of services and supports to be purchased by the regional center or obtained from generic agencies or other resources in order to achieve the individual program plan goals and objectives, and identification of the provider or providers of service responsible for attaining each objective, including, but not limited to, vendors, contracted providers, generic service agencies, and natural supports. The individual program plan shall specify the approximate scheduled start date for services and supports and shall contain timelines for actions necessary to begin services and supports, including generic services. In addition to the requirements of subdivision (h) of Section 4646, each regional center shall offer, and upon request provide, a written copy of the individual program plan to the consumer, and, if appropriate, the consumers parents, legal guardian or conservator, or authorized representative within 45 days of their request in a threshold language, as defined by paragraph (3) of subdivision (a) of Section 1810.410 of Title 9 of the California Code of Regulations.(6)If agreed to by the consumer, the parents, legally appointed guardian, or authorized representative of a minor consumer, or the legally appointed conservator of an adult consumer or the authorized representative, including those appointed pursuant to subdivision (a) of Section 4541, subdivision (b) of Section 4701.6, and subdivision (e) of Section 4705, a review of the general health status of the adult or child, including medical, dental, and mental health needs, shall be conducted. This review shall include a discussion of current medications, any observed side effects, and the date of the last review of the medication. Service providers shall cooperate with the planning team to provide any information necessary to complete the health status review. If any concerns are noted during the review, referrals shall be made to regional center clinicians or to the consumers physician, as appropriate. Documentation of health status and referrals shall be made in the consumers record by the service coordinator.(7)(A)The development of a transportation access plan for a consumer when all of the following conditions are met:(i)The regional center is purchasing private, specialized transportation services or services from a residential, day, or other provider, excluding vouchered service providers, to transport the consumer to and from day or work services.(ii)The planning team has determined that a consumers community integration and participation could be safe and enhanced through the use of public transportation services.(iii)The planning team has determined that generic transportation services are available and accessible.(B)To maximize independence and community integration and participation, the transportation access plan shall identify the services and supports necessary to assist the consumer in accessing public transportation and shall comply with Section 4648.35. These services and supports may include, but are not limited to, mobility training services and the use of transportation aides. Regional centers are encouraged to coordinate with local public transportation agencies.(8)A schedule of regular periodic review and reevaluation to ascertain that planned services have been provided, that objectives have been fulfilled within the times specified, and that consumers and families are satisfied with the individual program plan and its implementation.(b)For all active cases, individual program plans shall be reviewed and modified by the planning team, through the process described in Section 4646, as necessary, in response to the persons achievement or changing needs, and no less often than once every 24 months. If the consumer or, if appropriate, the consumers parents, legal guardian, authorized representative, or conservator requests an individual program plan review, the individual program plan shall be reviewed within 30 days after the request is submitted, or no later than 7 days after the request is submitted if necessary for the consumers health and safety or to maintain the consumer in their home.(c)(1)The department, with the participation of representatives of a statewide consumer organization, the Association of Regional Center Agencies, an organized labor organization representing service coordination staff, and the state council shall prepare training material and a standard format and instructions for the preparation of individual program plans, which embody an approach centered on the person and family.(2)Each regional center shall use the training materials and format prepared by the department pursuant to paragraph (1).(3)The department shall biennially review a random sample of individual program plans at each regional center to ensure that these plans are being developed and modified in compliance with Section 4646 and this section.SEC. 10.SEC. 6.Section 4726 of the Welfare and Institutions Code is amended to read:4726.Notwithstanding any other law, access to records regarding an applicant for, or recipient of, services shall be provided, upon request, to the applicant, recipient, or their authorized representative, including the person appointed as a developmental services decisionmaker pursuant to Section 319, 361, or 726, for any purpose, including, but not limited to, the appeal process under this chapter, unless disclosure of the record is expressly prohibited by law.
SEC. 11.Section 8.5 of this bill incorporates amendments to Section 4646 of the Welfare and Institutions Code proposed by both this bill and Senate Bill 447. That section of this bill shall only become operative if (1) both bills are enacted and become effective on or before January 1, 2024, (2) each bill amends Section 4646 of the Welfare and Institutions Code, and (3) this bill is enacted after Senate Bill 447, in which case Section 8 of this bill shall not become operative.This act shall be known, and may be cited, as the Disability Equity and Accountability Act of 2023.
SEC. 2.(a)The Legislature finds and declares as follows:(1)Recent reports and hearings by the California State Auditor, the Little Hoover Commission, and advocacy organizations have found that Californias service system for the over 400,000 children and adults with intellectual and developmental disabilities through the Lanterman Act, as overseen by the State Department of Developmental Services, which contracts with 21 regional centers, is failing in significant ways to deliver critical, adequate, and timely services to individuals and families. The result is that individuals and families, particularly those of color and tribal members living in rural areas and tribal reservations, are unable to timely access services and supports, resulting in barriers to their living independent, productive, and integrated lives in their communities.(2)Californias developmental disability service system is plagued with racial, ethnic, and geographic disparities that can dramatically impact the essential services received by children and adults with developmental disabilities. Systemic inequities and discrimination within Californias 21 regional centers broaden the gap between inclusive possibilities and segregated limitations. Data show Latinos are most negatively impacted by these disparities, but people who are clients of the lowest-performing regional centers are also significantly affected.(3)California spends nearly $13,000,000,000 annually on the administration and delivery of developmental services, but lacks a transparent, common, integrated, and coordinated model for the delivery and measurement of services throughout the 21 regional centers, resulting in poor outcomes, poor satisfaction levels by consumers and families, and disparate levels of available services and performance expectations.(4)The delivery of services through 21 separate private nonprofit regional centers with separate boards, funding, and delivery models was originally intended to ensure that the delivery of services could be more effectively delivered through nonstate entities. However, with the subsequent caseload and budget growth since the enactment of the Lanterman Act, local administration has become more disparate and less accountable. Boards of directors are untrained and are not providing the oversight needed of the regional centers. Stronger state oversight of regional centers by the State Department of Developmental Services is essential to ensure that services are equitably delivered, performance and outcomes are uniformly measured and reported, and the system is transparent and accountable to individuals and families.(5)The departments system lacks a statewide automated technology system for the delivery of services to persons with intellectual and developmental disabilities and, as a result, the current program is constrained by disparate automation systems, inadequate documentation, the lack of open system architecture, insufficient data to support administration of the system, and the lack of data to support program improvements for improving the quality of life outcomes through new service delivery methods.(6)Statewide uniformity of service delivery practices and procedures is essential to an effective program and to support necessary oversight and research for ongoing program improvements.(7)The departments technical infrastructure is over 40 years old. The lack of a statewide automation system does not meet current program needs and significantly contributes to the racial and geographic disparities in the delivery of services. California currently lacks clear and consistent service delivery outcomes for individuals with intellectual and developmental disabilities that sets high expectations for their quality of life, and must develop a system for measuring and quantifying the value of service delivery outcomes.(8)A previous effort to develop an intellectual and developmental disabilities (IDD) program technology system failed. As a result, the department and regional centers maintain a patchwork of at least three case management and fiscal systems that are not integrated and six legacy case management automation systems that lack integration, have dissimilar data sources, and are technically outdated.(9) In the 202122 annual budget the Legislature appropriated $6,000,000 to the State Department of Developmental Services for planning purposes related to the implementation of a uniform fiscal system and consumer electronic records management system. The department has not developed a vision or scope for a proposed system development approach.(b)Therefore, it is the intent of the Legislature in enacting this act to do all of the following:(1)Ensure that racial, ethnic, and geographic service disparities, including Native Americans living on or off tribal reservations, be systemically addressed and eliminated and that all people, regardless of their race or ethnicity or where they live, receive equitable access to services within the regional center system.(2)Ensure that all regional centers offer and provide a consistent and common set of services and that the services are delivered in a timely way.(3) Ensure that the delivery of all services and supports comply with federal law and guidance and are responsive to the needs and choices of beneficiaries receiving home- and community-based services, are person centered and strengths based, have high expectations for interdependence, self-direction, and competitive, integrated employment, provide support coordination to assist with a community-supported life, and achieve a more consistent and coordinated approach to the administration of policies and procedures across the state.(4)Provide the department with new tools for holding regional centers and service providers accountable through the development of a standardized and coordinated set of performance measures and related standards that establish targets and standards above which a regional center may receive incentives for improved performance, and a separate set of standards that require corrective action.(5)Improve regional center governance by establishing new standards and procedures for regional center governing boards to ensure they can more effectively represent the communities they serve by providing them with greater independence and protection from regional center retaliation.(6)Require the State Department of Developmental Services to develop a written project charter for the planning and development of a uniform statewide automation system that serves as a foundation document for the system development, which includes project guiding principles, scope, strategies and approach, and project governance, in order to provide transparency to the Legislature and the public on the system development as has been used with other statewide system development.SEC. 3.Section 4519.5 of the Welfare and Institutions Code is amended to read:4519.5.(a)The department and the regional centers shall annually collaborate to compile data in a uniform manner relating to purchase of service authorization, utilization, and expenditure by each regional center with respect to all of the following:(1)The age of the consumer, categorized by the following:(A)Birth to two years of age, inclusive.(B)Three to 21 years of age, inclusive.(C)Twenty-two years of age and older.(2)Race or ethnicity of the consumer.(3)Tribal affiliation. (4)Preferred language spoken by the consumer, and other related details, as feasible.(5)Disability detail, in accordance with the categories established by subdivision (a) of Section 4512, and, if applicable, a category specifying that the disability is unknown.(6)Residence type, subcategorized by age, race or ethnicity, and preferred language.(7)Number of instances when the written copy of the individual program plan was provided at the request of the consumer and, when appropriate, the consumers parents, legal guardian or conservator, or authorized representative, in a language other than a threshold language, as defined by paragraph (3) of subdivision (a) of Section 1810.410 of Title 9 of the California Code of Regulations, if that written copy was provided more than 60 days after the request.(8)Number of instances when the written copy of the individual program plan was provided at the request of the consumer and, when appropriate, the consumers parents, legal guardian or conservator, or authorized representative, in a threshold language, as defined by paragraph (3) of subdivision (a) of Section 1810.410 of Title 9 of the California Code of Regulations, if that written copy was provided more than 45 days after the request, in violation of paragraph (5) of subdivision (a) of Section 4646.5.(9)Beginning with data for the fiscal year of 202324, the numbers, percentages, and total and per capita expenditure and authorization amounts, by age, as applicable, according to race or ethnicity and preferred language, for all combined residence types and for consumers living in the family home, regarding the following service types:(A)Camping and associated travel expenses.(B)Social recreation activities.(C)Educational services.(D)Nonmedical therapies, including, but not limited to, specialized recreation, art, dance, music, and tribal culture and ceremony.(b)The data reported pursuant to subdivision (a) shall also include the number and percentage of individuals, categorized by age, race or ethnicity, and disability, and by residence type, as set forth in paragraph (6) of subdivision (a), who have been determined to be eligible for regional center services, but are not receiving purchase of service funds.(c)By March 31, 2013, each regional center shall post the data described in this section that are specific to the regional center on its internet website. Commencing on December 31, 2013, each regional center shall annually post these data by December 31. Each regional center shall maintain all previous years data on its internet website.(d)By March 31, 2013, the department shall post the information described in this section on a statewide basis on its internet website. Commencing December 31, 2013, the department shall annually post this information by December 31. The department shall maintain all previous years data on its internet website. The department shall also post notice of any regional center stakeholder meetings on its internet website.(e)Within three months of compiling the data with the department, and annually thereafter, each regional center shall meet with stakeholders in one or more public meetings regarding the data. The meeting or meetings shall be held separately from any meetings held pursuant to Section 4660. The regional center shall provide participants of these meetings with the data and any associated information related to improvements in the provision of developmental services to underserved communities and shall conduct a discussion of the data and the associated information in a manner that is culturally and linguistically appropriate for that community, including providing alternative communication services, as required by Sections 11135 to 11139.7, inclusive, of the Government Code and implementing regulations. Regional centers shall inform the department of the scheduling of those public meetings 30 days prior to the meeting. Notice of the meetings shall also be posted on the regional centers internet website 30 days prior to the meeting and shall be sent to individual stakeholders and groups representing underserved communities in a timely manner. Each regional center shall, in holding the meetings required by this subdivision, consider the language needs of the community and shall schedule the meetings at times and locations designed to result in a high turnout by the public and underserved communities.(f)(1)Each regional center shall annually report to the department regarding its implementation of the requirements of this section. The report shall include, but shall not be limited to, all of the following:(A)Actions the regional center took to improve public attendance and participation at stakeholder meetings, including, but not limited to, attendance and participation by underserved communities.(B)Copies of minutes from the meeting and attendee comments.(C)Whether the data described in this section indicate a need to reduce disparities in the purchase of services among consumers in the regional centers catchment area. If the data do indicate that need, the regional centers recommendations and plan to promote equity, and reduce disparities, in the purchase of services.(2)Each regional center and the department shall annually post the reports required by paragraph (1) on its internet website by August 31.(g)(1)The department shall consult with stakeholders, including consumers and families that reflect the ethnic and language diversity of regional center consumers, regional centers, advocates, providers, family resource centers, the protection and advocacy agency described in Section 4901, and those entities designated as University Centers for Excellence in Developmental Disabilities Education, Research, and Service pursuant to Section 15061 of Title 42 of the United States Code, to achieve the following objectives:(A)Review the data compiled pursuant to subdivision (a).(B)Identify barriers to equitable access to services and supports among consumers and develop recommendations to help reduce disparities in purchase of service expenditures.(C)Encourage the development and expansion of culturally appropriate services, service delivery, and service coordination.(D)Identify best practices to reduce disparity and promote equity.(2)The department shall report the status of its efforts to satisfy the requirements of paragraph (1) during the 201617 legislative budget subcommittee hearing process.(h)(1)Subject to available funding, the department shall allocate funding to regional centers or community-based organizations with department oversight to assist with implementation of the recommendations and plans developed pursuant to subdivisions (f) and (g). Activities funded through these allocations may include, but are not limited to, pay differentials supporting direct care bilingual staff of community-based service providers, parent or caregiver education programs, cultural competency training for regional center staff, outreach to underserved populations, or additional culturally appropriate service types or service delivery models.(2)Each regional center shall consult with stakeholders regarding activities that may be effective in addressing disparities in the receipt of regional center services and the regional centers proposed requests for the funding specified in paragraph (1). Each regional center shall identify the stakeholders it consulted with and include information on how it incorporated the input of stakeholders into its requests.(3)A community-based organization may submit a request for grant funding pursuant to this subdivision. The organization shall submit the request concurrently to the regional center of the jurisdiction in which the organization is located and to the department. The regional center shall provide the department with input regarding the request prior to the departments final determination on the request.(4)The department shall review requests for funding within 45 days from the deadline specified in the departments guidance to regional centers and community-based organizations.(5)Each regional center and community-based organization receiving funding shall report annually to the department, in a manner determined by the department, on how the funding allocations were used and shall include recommendations of priorities for activities that may be effective in addressing disparities, based on the consultation with stakeholders.(6)The department shall post the following information on its internet website:(A)By September 1 of any year in which grant funding is available and has not been allocated, a structure for the grant program, including all of the following information:(i)How community-based organizations reflecting groups that are disadvantaged by disparities in the purchase of services will be invited to participate in the grant program.(ii)How statewide strategies were considered.(iii)How the department will ensure grant funds are not used for activities that regional centers are otherwise required by statute or regulation to conduct.(iv)How funded activities will be evaluated.(B)By October 1 of any year in which grant funding is available and has not been allocated, the final invitation for requests for funding or another mechanism through which requests for funding are solicited.(C)By January 1 of any year in which grant funding has been allocated, a list of grant recipients, funding level per grant, and a description of the funded project.(D)By May 1 of any year in which the information is available, evaluation results from prior grants. To ensure the department complies with this subparagraph, regional centers and community-based organizations receiving funding shall provide the department, by March 1 of the same year, with an evaluation of funded activities and the effectiveness of those activities in reducing disparities in the purchase of services, to the extent information is available.(i)On or before December 31, 2021, the department shall 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 subdivision (h).(j)For the purposes of this section, the department shall require all of the following:(1)The use by the department and regional centers, when reporting data by race and ethnicity, of consistent classifications of race and ethnicity, based on categories current in use by the United States Census Bureau.(2)Confirmation of the race and ethnicity identification of each consumer at the time of the annual review of the consumers individual program plan (IPP).(3)When reporting by residence types, separate presentation of data for those in independent living services and those in supported living services.(4)Consistent standards and requirements for regional center internet websites, using the same placement and language for all information required by this division, including that data be posted in a machine-readable format.SEC. 4.Section 4519.20 is added to the Welfare and Institutions Code, to read:4519.20.As part of the departments planning process for the planning and development of a uniform statewide data automation system, the department, in consultation with stakeholders shall develop, by March 1, 2025, a project charter that shall be approved by the Secretary of the California Health and Human Services Agency and the Department of Technology. The charter development process shall include the participation and input of program consumers and families, researchers and quality and outcome evaluators, regional centers, and service providers. The project charter shall include all of the following:(a)An impact statement on the primary entities and individuals impacted by the system development.(b)Project guiding principles that are foundational to the project approach to be used throughout the planning, development, implementation, and maintenance of the system.(c)Project scope that addresses business problems required to be solved by the system, including all of the following:(1)Worker effectiveness and accountability that are constrained by the lack of timely, adequate, and accurate data, the lack of uniformity, and the current systems limited functionality.(2)Service delivery that is constrained by the lack of timely, adequate, accurate, and accessible data, the lack of clear understandable communication of information, lack of uniformity, and the systems limited functionality.(3)Current system maintainability that is constrained by disparate systems, inadequate documentation, the lack of open system architecture, and business changes.(4)Disparate systems, complex business rules, the number of locations and variability of local system delivery, and changes in the way of doing business.(5)Limited access of researchers and program evaluators to the set of person-level data that they need to assess program effectiveness.(d)Program goals, which shall include all of the following:(1)Maximizing the performance and the business processes for the delivery of intellectual or developmental disability (IDD) system services to consumers at the regional centers.(2)Improving data quality, privacy, confidentiality, and integration of all data sources at an individual level.(3)Enabling data-driven decisionmaking and performance measures for the effective administration of the program.(4)Improving the business processes administered by the department to support regional center service delivery.(5)Supporting access to individual-level data to support program evaluation and other research.(e)Technology goals that recognize that a statewide system solution not only meets requirements, but also ensures effective transition, while minimizing disruption to existing services.(f)Project strategies and approaches for development and implementation.(g)Project governance.(h)Technology that can readily be enhanced and modernized for the expected system life. In selecting the new system, consideration shall be given to the extent to which the candidate systems employ open architectures and standards and the future ability of the selected system to provide enhancements that will improve long-term effectiveness of program management of the statewide service delivery system. SEC. 5.SEC. 2.Section 4571 of the Welfare and Institutions Code is amended to read:4571.(a)It is the intent of the Legislature to ensure the well-being of consumers, taking into account their informed and expressed choices. It is further the intent of the Legislature to support the satisfaction and success of consumers through the delivery of quality services and supports. Evaluation of the services that consumers receive is a key aspect to the service system. Utilizing the information that consumers and their families provide about those services in a reliable and meaningful way is also critical to enable the department to assess the performance of the states developmental services system and to improve services for consumers in the future. To that end, the State Department of Developmental Services, on or before January 1, 2010, shall implement an improved, unified quality assessment system, in accordance with this section.
(b)The department, in consultation with stakeholders, shall identify a valid and reliable quality assurance instrument that assesses consumer and family satisfaction, provision of services in a linguistically and culturally competent manner, and personal outcomes. The instrument shall do all of the following:
(1)Provide nationally validated, benchmarked, consistent, reliable, and measurable data for the departments Quality Management System.
(2)Enable the department and regional centers to compare the performance of Californias developmental services system against other states developmental services systems and to assess quality and performance among all of the regional centers.
(3)Include outcome-based measures such as health, safety, well-being, relationships, interactions with people who do not have a disability, employment, quality of life, integration, choice, service, and consumer satisfaction.
(4)Include outcome-based measures to evaluate the linguistic and cultural competency, including tribal culture competency, of regional center services that are provided to consumers across their lifetimes.
(c)To the extent that funding is available, the instrument identified in subdivision (b) may be expanded to collect additional data requested by the State Council on Developmental Disabilities.
(d)(1)The department shall contract with an independent agency or organization to implement, by January 1, 2010, the quality assurance instrument described in subdivision (b). The contractor shall be experienced in all of the following:
(A)Designing valid quality assurance instruments for developmental service systems.
(B)Tracking outcome-based measures such as health, safety, well-being, relationships, interactions with people who do not have a disability, employment, quality of life, integration, choice, service, and consumer satisfaction.
(C)Developing data systems.
(D)Data analysis and report preparation.
(E)Assessments of the services received by consumers who are moved from developmental centers to the community, given the Legislatures historic recognition of a special obligation to ensure the well-being of these persons.
(F)Issues related to linguistic and cultural competency.
(2)Notwithstanding any other law, the contract and any amendments pursuant to this section shall be exempt from all of the following:
(A)The personal services contracting requirements of Article 4 (commencing with Section 19130) of Chapter 5 of Part 2 of Division 5 of Title 2 of the Government Code.
(B)The Public Contract Code, the State Contracting Manual, and the State Administration Manual.
(C)The approval of the Department of General Services.
(D)The approval of the Department of Technology.
(3)The exemptions specified in paragraph (2) shall remain in effect until there is more than one available assessment that meets the criteria in subdivision (b) from an organization that also meets the criteria in this subdivision.
(e)The department, in consultation with the contractor described in subdivision (d), shall establish the methodology by which the quality assurance instrument shall be administered, including, but not limited to, how often and to whom the quality assurance will be administered, and the design of a stratified, random sample among the entire population of consumers served by regional centers. The contractor shall provide aggregate information for all regional centers and the state as a whole. At the request of a consumer or the family member of a consumer, the survey shall be conducted in the primary language of the consumer or family member surveyed.
(f)The department shall contract with the state council to collect data for the quality assurance instrument described in subdivision (b). If, during the data collection process, the state council identifies any suspected violation of the legal, civil, or service rights of a consumer, or if it determines that the health and welfare of a consumer is at risk, that information shall be provided immediately to the regional center providing case management services to the consumer. At the request of the consumer or family, when appropriate, a copy of the completed survey shall be provided to the regional center providing case management services to improve the consumers quality of services through the individual planning process.
(g)The department, in consultation with stakeholders, shall annually review the data collected from and the findings of the quality assurance instrument described in subdivision (b) and accept recommendations regarding additional or different criteria for the quality assurance instrument in order to assess the performance of the states developmental services system and improve services for consumers.
(h)(1)Each regional center shall annually present data collected from, and the findings of, the quality assurance instrument described in subdivision (b) for that regional center, at a public meeting of its governing board in order to assess the comparative performance of the regional center and identify needed improvements in services for consumers, including, but not limited to, case management services. Notice of this meeting shall also be posted on the regional centers internet website at least 30 days prior to the meeting and shall be sent to regional center consumers and families and individual stakeholders at least 30 days prior to the meeting. The governing board shall provide a sufficient public comment period so members of the public may provide comments. Each regional center, in holding the meeting required by this subdivision, shall ensure that the meeting and meeting materials provide language access, as required by state and federal law.
(2)All regional center-specific reports generated by the department pursuant to this subdivision shall be made publicly available on the regional centers internet website in a machine-readable format, but shall not contain any personal identifying information about any person assessed.
(3)Within 60 days following its annual presentation, each regional center shall submit a report to the department regarding its implementation of the requirements of this section. The report shall include, but shall not be limited to, both of the following:
(A)Copies of the presentation described in paragraph (1), minutes from the meeting, and attendee comments.
(B)The regional centers recommendations and plans to use the information to address regional center priorities, strategic directions to improve specific areas of performance, or both.
(i)All reports generated pursuant to this section shall be made publicly available, but shall not contain any personal identifying information about any person assessed.
(j)All data collected pursuant to subdivision (c) shall be provided to the state council, but shall not contain personal identifying information about the persons being surveyed.
(k)Implementation of this section shall be subject to an annual appropriation of funds in the Budget Act for this purpose.
(l)By March 1, 2025, the department shall submit a report to advise the policy and budget subcommittees of the Legislature describing the extent to which the requirements of this section have not been met, including the surveying of all consumers, including those with no purchase of services, and providing specific steps and the schedule by which these requirements will be met.
SEC. 6.Section 4620.6 is added to the Welfare and Institutions Code, to read:4620.6.(a)(1)To provide uniformity, consistency, and cost-effectiveness in the delivery of services by regional centers throughout the state, the department shall establish, by January 1, 2026, a common set of services and supports, including supported living services, that every regional center in the state shall make available to consumers in negotiating, developing, or amending the individualized program plan as required by Sections 4646 and 4646.5. The common set of services and supports shall be prominently posted on each regional centers internet website.(2)The department shall develop the common set of services and supports in consultation with the Association of Regional Center Agencies, consumers and their families, advocacy organizations, and service providers.(b)In each contract with a regional center, the department shall require the common set of services and supports developed pursuant to this section to be available to consumers in the development of an individual program plan.(c)It is the intent of the Legislature that this section not be construed to control or interfere with the discretion of the individual program planning team to determine the needs and services appropriate for each person with a developmental disability who is entitled to services under this division. It is further the intent of the Legislature that the common set of services and supports developed pursuant to this section shall be deemed the minimum level of services and supports and does not preclude other services and supports from being included in a negotiated individualized program plan.SEC. 7.SEC. 3.Section 4622 of the Welfare and Institutions Code is amended to read:4622.The state shall contract only with agencies, the governing boards of which conform to all of the following criteria:
(a)The governing board shall be composed of individuals with demonstrated interest in, or knowledge of, developmental disabilities.
(b)The membership of the governing board shall include persons with legal, management or board governance, financial, and developmental disability program expertise. Board governance expertise may not be acquired solely by serving on a regional center board. The governing board of the regional center shall include members with financial expertise and members with management or board governance expertise by August 15, 2020.
(c)The membership of the governing board shall include representatives of the various categories of disability to be served by the regional center.
(d)The governing board shall reflect the geographic and ethnic characteristics of the area to be served by the regional center.
(e)A minimum of 50 percent of the members of the governing board shall be persons with developmental disabilities or their parents or legal guardians. No less than 25 percent of the members of the governing board shall be persons with developmental disabilities.
(f)(1)Members of the governing board shall not be permitted to serve more than seven years within each eight-year period.
(2)The board nominating committee shall solicit interests and nominations from the broader community through outreach. The committee shall interview candidates for the board and make recommendations to the governing board for election. During the meeting at which the board elects new members, a candidate may be nominated by a board member with a second by another board member for the open positions. A regional center executive director shall be prohibited from any involvement in the recruitment or election of governing board members.
(g)(1)The department shall provide necessary training and support to these board members to facilitate their understanding and participation, including issues relating to linguistic and cultural competency. The training shall be developed with community input, including persons served and family members. Ongoing support by the department shall include surveying board members about their ability to meaningfully participate in, and understand the subjects and votes at, board meetings. If board members report that they are unable to meaningfully participate, the department shall work with the regional center and the board member to ensure adequate and appropriate accommodations are provided.
(2)As part of its monitoring responsibility, the department shall review and approve the method by which training and support are provided to board members to ensure maximum understanding and participation by board members.
(3)Each regional center shall post on its internet website information regarding the training and support provided to board members.
(h)The governing board may appoint a consumers advisory committee composed of persons with developmental disabilities representing the various categories of disability served by the regional center.
(i)The governing board shall appoint an advisory committee composed of a wide variety of persons representing the various categories of providers from which the regional center purchases client services. The advisory committee shall provide advice, guidance, recommendations, and technical assistance to the regional center board in order to assist the regional center in carrying out its mandated functions. The advisory committee shall designate one of its members to serve as a member of the regional center board.
(j)(1)The governing board shall annually review the performance of the director of the regional center. The department shall establish guidelines for governing boards to measure executive director performance, including with respect to issues of equity and diversity.
(2)The governing board shall annually review the performance of the regional center in providing services that are linguistically and culturally appropriate and may provide recommendations to the director of the regional center based on the results of that review.
(k)A member of the board who is an employee or member of the governing board of a provider from which the regional center purchases client services shall not do any of the following:
(1)Serve as an officer of the board.
(2)Vote on any fiscal matter affecting the purchase of services from any regional center provider.
(3)Vote on any issue other than as described in paragraph (2), in which the member has a financial interest, as defined in Section 87103 of the Government Code, and determined by the regional center board. The member shall provide a list of the members financial interests, as defined in Section 87103, to the regional center board.
(l)The department shall establish, and each board shall adopt, an antiretaliation policy for board members that requires department approval for any reduction in services for consumer board members or the family member of family board members.
(m)The department shall establish and adopt a grievance procedure whereby a governing board member who has concerns, complaints, or questions may contact a specific executive at the department.
(n)This section does not prevent the appointment to a regional center governing board of a person who meets the criteria for more than one of the categories listed above.
SEC. 8.SEC. 4.Section 4626.5 of the Welfare and Institutions Code is amended to read:4626.5.Each regional center shall submit a conflict-of-interest policy to the department by July 1, 2011, and shall post the policy on its internet website by August 1, 2011. The policy shall do, or comply with, all of the following:
(a)Contain the elements of this section and be consistent with applicable law.
(b)Define conflicts of interest.
(c)Identify positions within the regional center required to complete and file a conflict-of-interest statement.
(d)Facilitate disclosure of information to identify conflicts of interest.
(e)Require candidates for nomination, election, or appointment to a regional center board, and applicants for regional center director to disclose any potential or present conflicts of interest prior to being appointed, elected, or confirmed for hire by the regional center or the regional center governing board.
(f)Require the regional center and its governing board to regularly and consistently monitor and enforce compliance with its conflict-of-interest policy.
(g)Prohibit a regional center employee from accepting a gift or gifts from a service provider, consumer, or consumers family member valued over fifteen dollars ($15) per year.
(h)Establish a policy prohibiting regional center senior staff from hiring relatives at the center or any ancillary foundation and organization. The policy shall be included in the regional center contract and shall be included in training of the governing board.
SEC. 9.Section 4629.1 is added to the Welfare and Institutions Code, to read:4629.1.(a)Notwithstanding any other law, the evaluation of regional center performance shall be implemented using a common set of performance measures, which shall be administered by the department. This includes the performance requirements under the regional center contracts pursuant to Section 4629, the performance incentives established under Section 4620.5, and the quality assessment instrument required under Section 4571. These measures shall be annually reported and made available to the public through posting of the measures results in machine-readable formats.(b)(1)By July 1, 2025, the department shall establish standards for each measure above that contain thresholds above which a regional center may be eligible to receive rewards for good performance and thresholds below which a regional center may be subject to each level of probation required under Section 4629. The department shall establish the process for assessing corrective action undertaken by a regional center and the process by which a regional center may end its probation status.(2)The department, in consultation with stakeholders, including consumers and family members, shall annually establish, update, and review the standards related to good performance. (3)(A)The department, in consultation with stakeholders, including consumers and family members, shall annually establish, update, and review a uniform process to be used by regional centers to develop corrective action plans that respond to below standard performance.(B)The process shall include all of the following:(i)Technical assistance and training from the department either directly or through subject matter experts.(ii)The sharing of resources from other regional centers that have met the performance measures.(iii)Participation by the board of directors of the regional center in developing and monitoring the implementation of the corrective action plan in consultation with local stakeholders, including consumers and family members.(C)The department shall oversee the process to develop the corrective action plan and assess corrective action undertaken by the regional center.(c)The performance measures shall encompass the domains as itemized in subdivision (d). Additional measures may be adopted by the department as needed. Modification of the domain and measures shall be accomplished through a process of consultation that includes the engagement of stakeholders in a manner consistent with that required by subdivision (b) of Section 4620.5. The measures may be amended as reporting mechanisms mature as the department develops new information technology capabilities.(d)The performance measures for purposes of this section shall be organized under seven domains, as follows:(1)Community integration.(2)Employment.(3)Equity in service access.(4)Case management.(5)Consumer and family choice, experience, and satisfaction.(6)Human and civil rights.(7)Health and safety.SEC. 5.Section 4629.1 is added to the Welfare and Institutions Code, to read:4629.1.(a)Notwithstanding any other law, the evaluation of regional center performance shall be implemented using a common set of performance measures administered by the department in conformance with the performance requirements under the regional center contracts pursuant to Section 4629, the performance incentives established under Section 4620.5, and the quality assessment instrument required under Section 4571. These measures shall be annually reported and made available to the public through posting of the measures results in machine-readable formats.
(b)(1)By July 1, 2025, the department shall establish standards for each of the performance measures to support the provisions of subdivision (d) of Section 4629. The standards shall consist of benchmarks above which indicate good performance and a regional center may be eligible to receive rewards for good performance, and minimum benchmarks below which a regional center shall undertake efforts to improve. The department may offer technical assistance and training to regional centers not meeting performance measures from the department either directly or through subject matter experts and may facilitate the sharing of expertise and other resources from other regional centers that have met the performance measures.
(2)The department, in consultation with stakeholders, including consumers and family members, shall annually establish, update, and review the established benchmarks.
SEC. 10.SEC. 6.Section 4639.76 is added to the Welfare and Institutions Code, to read:4639.76.(a)A regional center with which the department maintains a contract pursuant to Section 4629 shall be subject to the California Public Records Act (Chapter 1 (commencing with Section 7920.000) of Division 10 of Title 1 of the Government Code).
(b)This section shall become operative on January 1, 2025.
SEC. 11.SEC. 7.Section 4642 of the Welfare and Institutions Code is amended to read:4642.(a)(1)Any person believed to have a developmental disability, and any person believed to have a high risk of parenting an infant with a developmental disability shall be eligible for initial intake and assessment services in the regional centers. In addition, any infant having a high risk of becoming developmentally disabled may be eligible for initial intake and assessment services in the regional centers. For purposes of this section, high-risk infant means a child less than 36 months of age whose genetic, medical, or environmental history is predictive of a substantially greater risk for developmental disability than that for the general population. The department, in consultation with the State Department of Public Health, shall develop specific risk and service criteria for the high-risk infant program on or before July 1, 1983. These criteria may be modified in subsequent years based on analysis of actual clinical experience.
(2)(A)Initial intake shall be performed within 15 working days following request for assistance. Initial intake shall include, but need not be limited to, information and advice about the nature and availability of services provided by the regional center and by other agencies in the community, including guardianship, conservatorship, income maintenance, mental health, housing, education, work activity and vocational training, medical, dental, recreational, and other services or programs that may be useful to persons with developmental disabilities or their families. Intake shall also include a decision to provide assessment.
(B)For purposes of this section, request for assistance includes any initial contact or inquiry from an individual, or a person acting on their behalf, on the nature of services or supports available or provided by the regional center, and the individuals eligibility to receive them.
(3)(A)The department shall create, with input from stakeholders, standardized information packets to be provided to any person seeking services from a regional center. There shall be one information packet related to services provided under the California Early Intervention Services Act and another information packet related to services provided under the Lanterman Developmental Disabilities Services Act. The information packets shall be translated to provide language access, as required by state and federal law, shall be reasonably culturally competent for diverse racial and ethnic communities, including immigrants and Native Americans, shall be available in alternative formats and alternative modes of communication, as required by federal law, and shall include, at a minimum, all of the following:
(i)An overview of the regional center system.
(ii)A resource guide for consumers and their families.
(iii)Consumer rights, including the appeals procedures specified in Chapter 7 (commencing with Section 4700).
(iv)Contact information for the regional center, the department, the office of clients rights advocacy, and the protection and advocacy agency specified in Division 4.7 (commencing with Section 4900).
(v)Information on the Self-Determination Program, including the eligibility requirements specified in subdivision (d) of Section 4685.8.
(B)Each regional center shall distribute the information packets at intake, upon transfer to receiving services under the Lanterman Developmental Disabilities Services Act, and upon request. Each regional center shall begin distributing the information packets within 60 days following the department providing the information packets and issuing directives regarding the distribution of the information packets. In addition to, and not in lieu of, this requirement, each regional center shall post the full content of the most updated information packet on its internet website.
(b)A regional center shall communicate, with reasonable cultural competency, including Native American cultural competency, with the consumer and the consumers family pursuant to this section in their native language, including providing alternative communication services and alternative formats, as required by state and federal law.
SEC. 12.Section 4646 of the Welfare and Institutions Code is amended to read:4646.(a)It is the intent of the Legislature to ensure that the individual program plan and provision of services and supports by the regional center system is centered on the individual and the family of the individual with developmental disabilities and takes into account the needs and preferences of the individual and the family, if appropriate, as well as promoting community integration, independent, productive, and normal lives, and stable and healthy environments. It is the further intent of the Legislature to ensure that goals in any plan allow for innovation and nontraditional service delivery and not be limited by the lack of easily identified services or supports, the provision of services to consumers and their families be effective in meeting the goals stated in the individual program plan, reflect the preferences and choices of the consumer, and reflect the cost-effective use of public resources.(b)(1)Notwithstanding any other law, the individual program plan, including all assessments, shall be developed through a process of individualized needs determination and person-centered service planning developed pursuant to, and consistent with, Section 2402(a) of the federal Affordable Care Act (Pub. L. 111-148) and amendments thereto, Section 441.725 of Title 42 of the Code of Federal Regulations, and federal guidance issued by the Centers for Medicare and Medicaid Services on June 6, 2014, requiring community-based, long-term services and supports to be person-centered, strengths-based, and self-directed. The individual with developmental disabilities and, if appropriate, the individuals parents, legal guardian or conservator, or authorized representative, shall have the opportunity to actively participate in the development of the plan. The individual shall lead the service planning process to the greatest extent possible.(c)An individual program plan shall be developed for any person who, following intake and assessment, is found to be eligible for regional center services. These plans shall be completed within 60 days of the completion of the assessment. At the time of intake, the regional center shall inform the consumer and, if appropriate, the consumers parents, legal guardian or conservator, or authorized representative, of the services available through the state council and the protection and advocacy agency designated by the Governor pursuant to federal law, and shall provide the address and telephone numbers of those agencies.(d)(1)As part of the initial individual program plan meeting and each annual review required by subdivision (b) of Section 4646.5, the consumer or, if appropriate, their parents, legal guardian, conservator, or authorized representative, shall be provided by the service coordinator oral and written information about the Self-Determination Program. The information shall include each of the provisions specified in subdivision (d) of Section 4685.8. Each individual program plan shall include a provision stating that the consumer or authorized representative was informed about the availability of the Self-Determination Program. If the consumer chooses not to participate in the program, the individual program plan shall include an explanation of the reason or reasons for that decision, or, if the consumer is ineligible for the program, the reason or reasons for that ineligibility. (2)If the consumer is interested in participating in the program or wants additional information or assistance, the service coordinator, within five business days of expressing the interest, shall provide the consumer a date for the Self-Determination Program orientation, training resources, dates of local volunteer Self-Determination Program advisory committee meetings, and other information to assist the consumer in participating in the program.(e)Individual program plans shall be prepared jointly by the planning team. Decisions concerning the consumers goals, objectives, and services and supports that will be included in the consumers individual program plan and purchased by the regional center or obtained from generic agencies shall be made by agreement between the regional center representative and the consumer or, if appropriate, the parents, legal guardian, conservator, or authorized representative at the program plan meeting.(f)Regional centers shall comply with the request of a consumer or, if appropriate, the request of the consumers parents, legal guardian, conservator, or authorized representative, that a designated representative receive written notice of all meetings to develop or revise the individual program plan and of all notices sent to the consumer pursuant to Section 4710. The designated representative may be a parent or family member.(g)Notwithstanding any other law, a meeting regarding the provision of services and supports by the regional center, including a meeting to develop or revise the individual program plan, shall be held by remote electronic communications if requested by the consumer or, if appropriate, if requested by the consumers parents, legal guardian, conservator, or authorized representative.(h)At the conclusion of an individual program plan meeting, an authorized representative of the regional center shall provide to the consumer, in written or electronic format, a list of the agreed-upon services and supports, and, if known, the projected start date, the frequency and duration of the services and supports, and the provider. The authorized representative of the regional center shall sign the list of agreed-upon services and supports at that time. The consumer, or if appropriate, the consumers parent, legal guardian, conservator, or authorized representative shall sign the list of agreed-upon services and supports prior to its implementation. The consumer, or if appropriate, the consumers parent, legal guardian, conservator, or authorized representative, may elect to delay receipt of the list of agreed-upon services and supports pending final agreement, as described in subdivision (h). If the consumer, or if appropriate, the consumers parent, legal guardian, conservator, or authorized representative, elects to delay the receipt of the list of agreed-upon services and supports for 15 days, the list shall be provided in the preferred language of the consumer, or of the consumers parent, legal guardian, or authorized representative.(i)If a final agreement regarding the services and supports to be provided to the consumer cannot be reached at a program plan meeting, then a subsequent program plan meeting shall be convened within 15 days, or later at the request of the consumer or, if appropriate, the parents, legal guardian, conservator, or authorized representative or if agreed to by the planning team. The list of the agreed-upon services and supports described in subdivision (h) and signed by the authorized representative of the regional center shall be provided, in writing or electronically, at the conclusion of the subsequent program plan meeting, and shall be provided in the preferred language of the consumer, or of the consumers parent, legal guardian, conservator, or authorized representative. Additional program plan meetings may be held with the agreement of the regional center representative and the consumer or, if appropriate, the parents, legal guardian, conservator, or authorized representative.(j)An authorized representative of the regional center and the consumer or, if appropriate, the consumers parent, legal guardian, conservator, or authorized representative shall sign the individual program plan and the list of the agreed-upon services and supports prior to its implementation. If the consumer or, if appropriate, the consumers parent, legal guardian, conservator, or authorized representative, does not agree with all components of the individual program plan, the consumer may indicate that disagreement on the plan. Disagreement with specific plan components shall not prohibit the implementation of services and supports agreed to by the consumer or, if appropriate, the consumers parent, legal guardian, conservator, or authorized representative. If the consumer or, if appropriate, the consumers parent, legal guardian, conservator, or authorized representative, does not agree with the plan in whole or in part, the consumer shall be sent written notice of their appeal rights, as required by Sections 4701 and 4710.(k)(1)A regional center shall communicate in the consumers preferred language, or, if appropriate, the preferred language of the consumers family, legal guardian, conservator, or authorized representative, during the planning process for the individual program plan, including during the program plan meeting, and including providing alternative communication services, as required by Sections 11135 to 11139.8, inclusive, of the Government Code and implementing regulations.(2)A regional center shall provide alternative communication services, including providing copies of the list of services and supports, and the individual program plan in the preferred language of the consumer or the consumers family, legal guardian, conservator, or authorized representative, or both, as required by Sections 11135 to 11139.8, inclusive, of the Government Code and implementing regulations.(3)The preferred language of the consumer or the consumers family, legal guardian, conservator, or authorized representative, or both, shall be documented in the individual program plan.SEC. 8.Section 4646 of the Welfare and Institutions Code is amended to read:4646.(a)It is the intent of the Legislature to ensure that the individual program plan and provision of services and supports by the regional center system is centered on the individual and the family of the individual with developmental disabilities and takes into account the needs and preferences of the individual and the family, if appropriate, as well as promoting community integration, independent, productive, and normal lives, and stable and healthy environments. It is the further intent of the Legislature to ensure that goals in any plan allow for innovation and nontraditional service delivery and not be limited by the lack of easily identified services or supports, the provision of services to consumers and their families be effective in meeting the goals stated in the individual program plan, reflect the preferences and choices of the consumer, and reflect the cost-effective use of public resources.
(b)The individual program plan is Notwithstanding any other law, the individual program plan, including all assessments, shall be developed through a process of individualized needs determination. determination and person-centered service planning requiring community-based, long-term services and supports to be person-centered, strengths-based, and self-directed. The individual with developmental disabilities and, if appropriate, the individuals parents, legal guardian or conservator, or authorized representative, shall have the opportunity to actively participate in the development of the plan. The individual shall lead the service planning process to the greatest extent possible.
(c)An individual program plan shall be developed for any person who, following intake and assessment, is found to be eligible for regional center services. These plans shall be completed within 60 days of the completion of the assessment. At the time of intake, the regional center shall inform the consumer and, if appropriate, the consumers parents, legal guardian or conservator, or authorized representative, of the services available through the state council and the protection and advocacy agency designated by the Governor pursuant to federal law, and shall provide the address and telephone numbers of those agencies.
(d)(1)As part of the initial individual program plan meeting and each review required by subdivision (b) of Section 4646.5, the consumer or, if appropriate, their parents, legal guardian, conservator, or authorized representative, shall be provided by the service coordinator oral and written information about the Self-Determination Program. The information shall include each of the provisions specified in subdivision (d) of Section 4685.8. Each individual program plan shall include a provision stating that the consumer or authorized representative was informed about the availability of the Self-Determination Program. If the consumer chooses not to participate in the program, the individual program plan shall include an explanation of the reason or reasons for that decision, or, if the consumer is ineligible for the program, the reason or reasons for that ineligibility.
(2)If the consumer is interested in participating in the program or wants additional information or assistance, the service coordinator, within five business days of expressing the interest, shall provide the consumer a date for the Self-Determination Program orientation, training resources, dates of local volunteer Self-Determination Program advisory committee meetings, and other information to assist the consumer in participating in the program.
(d)(e)Individual program plans shall be prepared jointly by the planning team. Decisions concerning the consumers goals, objectives, and services and supports that will be included in the consumers individual program plan and purchased by the regional center or obtained from generic agencies shall be made by agreement between the regional center representative and the consumer or, if appropriate, the parents, legal guardian, conservator, or authorized representative at the program plan meeting.
(e)(f)Regional centers shall comply with the request of a consumer or, if appropriate, the request of the consumers parents, legal guardian, conservator, or authorized representative, that a designated representative receive written notice of all meetings to develop or revise the individual program plan and of all notices sent to the consumer pursuant to Section 4710. The designated representative may be a parent or family member.
(f)(g)Notwithstanding any other law, until June 30, 2024, a meeting regarding the provision of services and supports by the regional center, including a meeting to develop or revise the individual program plan, shall be held by remote electronic communications if requested by the consumer or, if appropriate, if requested by the consumers parents, legal guardian, conservator, or authorized representative.
(g)(h)At the conclusion of an individual program plan meeting, an authorized representative of the regional center shall provide to the consumer, in written or electronic format, a list of the agreed-upon services and supports, and, if known, the projected start date, the frequency and duration of the services and supports, and the provider. The authorized representative of the regional center shall sign the list of agreed-upon services and supports at that time. The consumer, or if appropriate, the consumers parent, legal guardian, conservator, or authorized representative shall sign the list of agreed-upon services and supports prior to its implementation. The consumer, or if appropriate, the consumers parent, legal guardian, conservator, or authorized representative, may elect to delay receipt of the list of agreed-upon services and supports pending final agreement, as described in subdivision (h). (i). If the consumer, or if appropriate, the consumers parent, legal guardian, conservator, or authorized representative, elects to delay the receipt of the list of agreed-upon services and supports for 15 days, the list shall be provided in the preferred language of the consumer, or of the consumers parent, legal guardian, or authorized representative.
(h)(i)If a final agreement regarding the services and supports to be provided to the consumer cannot be reached at a program plan meeting, then a subsequent program plan meeting shall be convened within 15 days, or later at the request of the consumer or, if appropriate, the parents, legal guardian, conservator, or authorized representative or if agreed to by the planning team. The list of the agreed-upon services and supports described in subdivision (g) (h) and signed by the authorized representative of the regional center shall be provided, in writing or electronically, at the conclusion of the subsequent program plan meeting, and shall be provided in the preferred language of the consumer, or of the consumers parent, legal guardian, conservator, or authorized representative. Additional program plan meetings may be held with the agreement of the regional center representative and the consumer or, if appropriate, the parents, legal guardian, conservator, or authorized representative.
(i)(j)An authorized representative of the regional center and the consumer or, if appropriate, the consumers parent, legal guardian, conservator, or authorized representative shall sign the individual program plan and the list of the agreed-upon services and supports prior to its implementation. If the consumer or, if appropriate, the consumers parent, legal guardian, conservator, or authorized representative, does not agree with all components of the individual program plan, the consumer may indicate that disagreement on the plan. Disagreement with specific plan components shall not prohibit the implementation of services and supports agreed to by the consumer or, if appropriate, the consumers parent, legal guardian, conservator, or authorized representative. If the consumer or, if appropriate, the consumers parent, legal guardian, conservator, or authorized representative, does not agree with the plan in whole or in part, the consumer shall be sent written notice of their appeal rights, as required by Sections 4701 and 4710.
(j)(k)(1)A regional center shall communicate in the consumers preferred language, or, if appropriate, the preferred language of the consumers family, legal guardian, conservator, or authorized representative, during the planning process for the individual program plan, including during the program plan meeting, and including providing alternative communication services, as required by Sections 11135 to 11139.8, inclusive, of the Government Code and implementing regulations.
(2)A regional center shall provide alternative communication services, including providing copies of the list of services and supports, and the individual program plan in the preferred language of the consumer or the consumers family, legal guardian, conservator, or authorized representative, or both, as required by Sections 11135 to 11139.8, inclusive, of the Government Code and implementing regulations.
(3)The preferred language of the consumer or the consumers family, legal guardian, conservator, or authorized representative, or both, shall be documented in the individual program plan.
SEC. 8.5.Section 4646 of the Welfare and Institutions Code is amended to read:4646.(a)It is the intent of the Legislature to ensure that the individual program plan and provision of services and supports by the regional center system is centered on the individual and the family of the individual with developmental disabilities and takes into account the needs and preferences of the individual and the family, if appropriate, as well as promoting community integration, independent, productive, and normal lives, and stable and healthy environments. It is the further intent of the Legislature to ensure that the goals in any plan allow for innovation and nontraditional service delivery and not be limited by the lack of easily identified services or supports, the provision of services to consumers and their families be effective in meeting the goals stated in the individual program plan, reflect the preferences and choices of the consumer, and reflect the cost-effective use of public resources.
(b)The individual program plan is Notwithstanding any other law, the individual program plan, including all assessments, shall be developed through a process of individualized needs determination. determination and person-centered service planning requiring community-based, long-term services and supports to be person-centered, strengths-based, and self-directed. The individual with developmental disabilities and, if appropriate, the individuals parents, legal guardian or conservator, or authorized representative, shall have the opportunity to actively participate in the development of the plan. The individual shall lead the service planning process to the greatest extent possible.
(c)An individual program plan shall be developed for any person who, following intake and assessment, is found to be eligible for regional center services. These plans shall be completed within 60 days of the completion of the assessment. At the time of intake, the regional center shall inform the consumer and, if appropriate, the consumers parents, legal guardian or conservator, or authorized representative, of the services available through the state council and the protection and advocacy agency designated by the Governor pursuant to federal law, and shall provide the address and telephone numbers of those agencies.
(d)(1)As part of the initial individual program plan meeting and each review required by subdivision (b) of Section 4646.5, the consumer or, if appropriate, their parents, legal guardian, conservator, or authorized representative, shall be provided by the service coordinator oral and written information about the Self-Determination Program. The information shall include each of the provisions specified in subdivision (d) of Section 4685.8. Each individual program plan shall include a provision stating that the consumer or authorized representative was informed about the availability of the Self-Determination Program. If the consumer chooses not to participate in the program, the individual program plan shall include an explanation of the reason or reasons for that decision, or, if the consumer is ineligible for the program, the reason or reasons for that ineligibility.
(2)If the consumer is interested in participating in the program or wants additional information or assistance, the service coordinator, within five business days of expressing the interest, shall provide the consumer a date for the Self-Determination Program orientation, training resources, dates of local volunteer Self-Determination Program advisory committee meetings, and other information to assist the consumer in participating in the program.
(d)(e)Individual program plans shall be prepared jointly by the planning team. Decisions concerning the consumers goals, objectives, and services and supports that will be included in the consumers individual program plan and purchased by the regional center or obtained from generic agencies shall be made by agreement between the regional center representative and the consumer or, if appropriate, the parents, legal guardian, conservator, or authorized representative at the program plan meeting.
(e)(f)Regional centers shall comply with the request of a consumer or, if appropriate, the request of the consumers parents, legal guardian, conservator, or authorized representative, that a designated representative receive written notice of all meetings to develop or revise the individual program plan and of all notices sent to the consumer pursuant to Section 4710. The designated representative may be a parent or family member.
(f)(g)Notwithstanding any other law, until June 30, 2024, a meeting regarding the provision of services and supports by the regional center, including a meeting to develop or revise the individual program plan, shall be held by remote electronic communications if requested by the consumer or, if appropriate, if requested by the consumers parents, legal guardian, conservator, or authorized representative.
(g)(h)At the conclusion of an individual program plan meeting, an authorized representative of the regional center shall provide to the consumer, in written or electronic format, a list of the agreed-upon services and supports, and, if known, the projected start date, the frequency and duration of the services and supports, and the provider. The authorized representative of the regional center shall sign the list of agreed-upon services and supports at that time. The consumer, or if appropriate, the consumers parent, legal guardian, conservator, or authorized representative shall sign the list of agreed-upon services and supports prior to its implementation. The consumer, or if appropriate, the consumers parent, legal guardian, conservator, or authorized representative, may elect to delay receipt of the list of agreed-upon services and supports pending final agreement, as described in subdivision (h). (i). If the consumer, or if appropriate, the consumers parent, legal guardian, conservator, or authorized representative, elects to delay the receipt of the list of agreed-upon services and supports for 15 days, the list shall be provided in the preferred language of the consumer, or of the consumers parent, legal guardian, or authorized representative.
(h)(i)If a final agreement regarding the services and supports to be provided to the consumer cannot be reached at a program plan meeting, then a subsequent program plan meeting shall be convened within 15 days, or later at the request of the consumer or, if appropriate, the parents, legal guardian, conservator, or authorized representative or if agreed to by the planning team. The list of the agreed-upon services and supports described in subdivision (g) (h) and signed by the authorized representative of the regional center shall be provided, in writing or electronically, at the conclusion of the subsequent program plan meeting, and shall be provided in the preferred language of the consumer, or of the consumers parent, legal guardian, conservator, or authorized representative. Additional program plan meetings may be held with the agreement of the regional center representative and the consumer or, if appropriate, the parents, legal guardian, conservator, or authorized representative.
(i)(j)An authorized representative of the regional center and the consumer or, if appropriate, the consumers parent, legal guardian, conservator, or authorized representative shall sign the individual program plan and the list of the agreed-upon services and supports prior to its implementation. If the consumer or, if appropriate, the consumers parent, legal guardian, conservator, or authorized representative, does not agree with all components of the individual program plan, the consumer may indicate that disagreement on the plan. Disagreement with specific plan components shall not prohibit the implementation of services and supports agreed to by the consumer or, if appropriate, the consumers parent, legal guardian, conservator, or authorized representative. If the consumer or, if appropriate, the consumers parent, legal guardian, conservator, or authorized representative, does not agree with the plan in whole or in part, the consumer shall be sent written notice of their appeal rights, as required by Sections 4701 and 4710.
(j)(k)(1)A regional center shall communicate in the consumers preferred language, or, if appropriate, the preferred language of the consumers family, legal guardian, conservator, or authorized representative, during the planning process for the individual program plan, including during the program plan meeting, and including providing alternative communication services, as required by Sections 11135 to 11139.8, 11139, inclusive, of the Government Code and implementing regulations.
(2)A regional center shall provide alternative communication services, including providing copies of the list of services and supports, and the individual program plan in the preferred language of the consumer or the consumers family, legal guardian, conservator, or authorized representative, or both, as required by Sections 11135 to 11139.8, 11139, inclusive, of the Government Code and implementing regulations.
(3)The preferred language of the consumer or the consumers family, legal guardian, conservator, or authorized representative, or both, shall be documented in the individual program plan.
SEC. 13.Section 4646.4 of the Welfare and Institutions Code is amended to read:4646.4.(a)Regional centers shall ensure, at the time of development, scheduled review, or modification of a consumers individual program plan developed pursuant to Sections 4646 and 4646.5, or of an individualized family service plan pursuant to Section 95020 of the Government Code, the establishment of an internal process. This internal process shall ensure adherence with federal and state law and regulation, and if purchasing services and supports, shall ensure all of the following:(1)Conformance with the regional centers purchase of service policies, as approved by the department pursuant to subdivision (d) of Section 4434.(2)Utilization of generic services and supports if appropriate. The individualized family service planning team for infants and toddlers eligible under Section 95014 of the Government Code and the individual program plan team pursuant to Section 4646 may determine that a service provided by a generic agency, as defined by subdivision (g) of Section 4659.5, or a service or source of funding contained in Section 4659 identified in the individualized family service plan or individual program plan is not available, and, therefore, will be funded by the regional center.(3)Utilization of other services and sources of funding as contained in Section 4659.(4)Consideration of the familys responsibility for providing similar services and supports for a minor child without disabilities in identifying the consumers service and support needs as provided in the least restrictive and most appropriate setting. In this determination, regional centers shall take into account the consumers need for extraordinary care, services, supports and supervision, and the need for timely access to this care.(5)Commencing October 1, 2022, consideration of information obtained from the consumer and, if appropriate, the parents, legal guardian, conservator, or authorized representative about the consumers need for the services, barriers to service access, and other information.(b)At the time of development, scheduled review, or modification of a consumers individual program plan developed pursuant to Sections 4646 and 4646.5, or of an individualized family service plan pursuant to Section 95020 of the Government Code, the consumer, or, if appropriate, the parents, legal guardian, or conservator, shall provide copies of their health benefit cards under which the consumer is eligible to receive health benefits, including, but not limited to, private health insurance, a health care service plan, Medi-Cal, Medicare, and TRICARE. If the individual, or, if appropriate, the parents, legal guardians, or conservators, do not have health benefits, the regional center shall not use that fact to negatively impact the services that the individual may or may not receive from the regional center.(c)Final decisions regarding the consumers individual program plan shall be made pursuant to Section 4646.(d)Final decisions regarding the individualized family service plan shall be made pursuant to Section 95020 of the Government Code.SEC. 14.SEC. 9.Section 4646.5 of the Welfare and Institutions Code is amended to read:4646.5.(a)The planning process for the individual program plan described in Section 4646 shall include all of the following:
(1)Gathering information and conducting assessments to determine the life goals, capabilities and strengths, preferences, barriers, and concerns or problems of the person with developmental disabilities. For children with developmental disabilities, this process should include a review of the strengths, preferences, and needs of the child and the family unit as a whole. Assessments shall be conducted by qualified individuals and performed in natural environments whenever possible. Information shall be taken from the consumer, the consumers parents and other family members, the consumers friends, advocates, authorized representative, if applicable, providers of services and supports, and other agencies. The assessment process shall reflect awareness of, and sensitivity to, the lifestyle and cultural background of the consumer and the family.
(2)A statement of goals, based on the needs, preferences, and life choices of the individual with developmental disabilities, and a statement of specific, time-limited objectives for implementing the persons goals and addressing the persons needs. These objectives shall be stated in terms that allow measurement of progress or monitoring of service delivery. These goals and objectives should maximize opportunities for the consumer to develop relationships, be part of community life in the areas of community participation, housing, work, school, and leisure, increase control over the consumers life, acquire increasingly positive roles in community life, and develop competencies to help accomplish these goals.
(3)In developing individual program plans for children, regional centers shall be guided by the principles, process, and services and support parameters set forth in Section 4685.
(4)In developing an individual program plan for a transition age youth or working age adult, the planning team shall consider the Employment First Policy described in Chapter 14 (commencing with Section 4868).
(5)A schedule of the type and amount of services and supports to be purchased by the regional center or obtained from generic agencies or other resources in order to achieve the individual program plan goals and objectives, and identification of the provider or providers of service responsible for attaining each objective, including, but not limited to, vendors, contracted providers, generic service agencies, and natural supports. The individual program plan shall specify the approximate scheduled start date for services and supports and shall contain timelines for actions necessary to begin services and supports, including generic services. In addition to the requirements of subdivision (h) of Section 4646, each regional center shall offer, and upon request provide, a written copy of the individual program plan to the consumer, and, if appropriate, the consumers parents, legal guardian or conservator, or authorized representative within 45 days of their request in a threshold language, as defined by paragraph (3) of subdivision (a) of Section 1810.410 of Title 9 of the California Code of Regulations.
(6)If agreed to by the consumer, the parents, legally appointed guardian, or authorized representative of a minor consumer, or the legally appointed conservator of an adult consumer or the authorized representative, including those appointed pursuant to subdivision (a) of Section 4541, subdivision (b) of Section 4701.6, and subdivision (e) of Section 4705, a review of the general health status of the adult or child, including medical, dental, and mental health needs, shall be conducted. This review shall include a discussion of current medications, any observed side effects, and the date of the last review of the medication. Service providers shall cooperate with the planning team to provide any information necessary to complete the health status review. If any concerns are noted during the review, referrals shall be made to regional center clinicians or to the consumers physician, as appropriate. Documentation of health status and referrals shall be made in the consumers record by the service coordinator.
(7)(A)The development of a transportation access plan for a consumer when all of the following conditions are met:
(i)The regional center is purchasing private, specialized transportation services or services from a residential, day, or other provider, excluding vouchered service providers, to transport the consumer to and from day or work services.
(ii)The planning team has determined that a consumers community integration and participation could be safe and enhanced through the use of public transportation services.
(iii)The planning team has determined that generic transportation services are available and accessible.
(B)To maximize independence and community integration and participation, the transportation access plan shall identify the services and supports necessary to assist the consumer in accessing public transportation and shall comply with Section 4648.35. These services and supports may include, but are not limited to, mobility training services and the use of transportation aides. Regional centers are encouraged to coordinate with local public transportation agencies.
(8)A schedule of regular periodic review and reevaluation to ascertain that planned services have been provided, that objectives have been fulfilled within the times specified, and that consumers and families are satisfied with the individual program plan and its implementation.
(b)For all active cases, individual program plans shall be reviewed and modified by the planning team, through the process described in Section 4646, as necessary, in response to the persons achievement or changing needs, and no less often than once every 24 months. If the consumer or, if appropriate, the consumers parents, legal guardian, authorized representative, or conservator requests an individual program plan review, the individual program plan shall be reviewed within 30 days after the request is submitted, or no later than 7 days after the request is submitted if necessary for the consumers health and safety or to maintain the consumer in their home.
(c)(1)The department, with the participation of representatives of a statewide consumer organization, the Association of Regional Center Agencies, an organized labor organization representing service coordination staff, and the state council shall prepare training material and a standard format and instructions for the preparation of individual program plans, which embody a person-centered planning process consistent with federal law, regulations, and guidance. an approach centered on the person and family.
(2)The department shall require each regional center to use, for all new and modified individual program plans, Each regional center shall use the training materials and the standard format plan prepared by the department pursuant to paragraph (1) by no later than March 1, 2025. (1).
(3)The department shall biennially review a random sample of individual program plans at each regional center to ensure that these plans are being developed and modified in compliance with Section 4646 and this section.
SEC. 15.Section 4659 of the Welfare and Institutions Code is amended to read:4659.(a)Except as otherwise provided in subdivision (b), (d), or (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 centers purchase of services budget, except as it relates to federal supplemental security income and the state supplementary program.(c)Effective July 1, 2009, notwithstanding any other law or regulation, 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 Supportive Services, California Childrens 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 after being advised of the provisions of subdivision (d). If, on July 1, 2009, a regional center is purchasing that service as part of a consumers individual program plan (IPP), the prohibition shall take effect on October 1, 2009.(d)(1)Notwithstanding Section 4646.4, a regional center may request a consumer or family member to pursue a service or source of funding from an entity described in subdivision (a) or (c) of this section, or pursuant to subdivision (g) of Section 4659.5, if the request is documented with specificity in the individual program plan or individualized family plan and the plan contains detailed instructions for the consumer or family pursuing the service. The individual program plan or individualized family plan shall also specify the ways in which the regional center will initially assist the consumer or family to apply for and pursue the service or source of funding and specify that it will provide additional assistance when requested by the consumer or family.(2)The regional center shall purchase the service when the entity denies the service.(3)A consumer, or their family, shall not be required to appeal an entitys denial of the requested service for the regional center to purchase that service pursuant to this subdivision. The regional center may file an appeal on behalf of the consumer, but the appeal shall not delay the payment of the requested service by the regional center as specified in subparagraph (B) of paragraph (2).(4)This section does not prohibit a consumer or their family, where appropriate, from filing a formal appeal of an entitys denial of the service at issue, or a regional center from seeking reimbursement from the entity it believes is responsible for providing the service and from requesting assistance with filing the appeal or from utilizing assistance from other advocacy organizations.(e)This section shall not 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.(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.(g)To provide uniformity, consistency, and cost-effectiveness, to reduce barriers, and to increase the number of service providers throughout the state, the department shall comprehensively review the current processes for vendorizing providers for the delivery of services and supports to regional center consumers and revise those processes to streamline the process and create a uniform statewide vendorization process. The department shall develop the revised processes, in consultation with the Association of Regional Center Agencies, consumers and their families, advocacy organizations, and service providers.SEC. 16.Section 4685.8 of the Welfare and Institutions Code is amended to read:4685.8.(a)The department shall implement a statewide Self-Determination Program. The Self-Determination Program shall 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. As of July 1, 2021, the program shall begin to be available on a voluntary basis to all regional center consumers who are eligible for the Self-Determination Program.(b)The department, in establishing the statewide program, shall do both of the following:(1)Set targets and benchmarks as set forth in paragraph (1) of subdivision (r).(2)Address all of the following:(A)Oversight of expenditure of self-determined funds and the achievement of participant outcomes over time.(B)Increased participant control over which services and supports best meet the participants needs and the IPP objectives. A participants unique support system may include the purchase of existing service offerings from service providers or local businesses, hiring their own support workers, or negotiating unique service arrangements with local community resources.(C)Comprehensive person-centered planning, including an individual budget and services that are outcome based.(D)Consumer and family training to ensure understanding of the principles of self-determination, the planning process, and the management of budgets, services, and staff.(E)Choice of independent facilitators, who meet standards and certification requirements established by the department, and who can assist with the functions specified in paragraph (2) of subdivision (c).(F)Choice of financial management services providers who meet standards and certification requirements established by the department, and who can carry out the functions specified in paragraph (1) of subdivision (c).(G)Innovation that will more effectively allow participants to achieve their goals.(H)Long-term sustainability of the Self-Determination Program by doing all of the following:(i)Requiring IPP teams, when developing the individual budget, to determine the services, supports, and goods necessary for each consumer based on the needs and preferences of the consumer and, when appropriate, the consumers family, the effectiveness of each option in meeting the goals specified in the IPP, and the cost-effectiveness of each option, as specified in subparagraph (D) of paragraph (6) of subdivision (a) of Section 4648.(ii)The department may review final individual budgets that are at or above a spending threshold determined by the department of all individual budgets and use information from its review in the aggregate to develop additional program guidance and verify compliance with federal and state laws and other requirements.(c)For purposes of this section, the following definitions apply:(1)Financial management services means services or functions that assist the participant to manage and direct the distribution of funds contained in the individual budget, and ensure that the participant has the financial resources to implement their IPP throughout the year. These may include bill paying services and activities that facilitate the employment of service and support workers by the participant, including, but not limited to, fiscal accounting, tax withholding, compliance with relevant state and federal employment laws, assisting the participant in verifying provider qualifications, including criminal background checks, and expenditure reports. The financial management services provider shall meet the applicable requirements of Title 17 of the California Code of Regulations and other specific qualifications or certifications established by the department.(2)Independent facilitator means a person, selected and directed by the participant, who is not otherwise providing services to the participant pursuant to their IPP and is not employed by a person providing services to the participant. The independent facilitator may assist the participant in making informed decisions about the individual budget, and in locating, accessing, and coordinating services and supports consistent with the participants IPP. The independent facilitator is available to assist in identifying immediate and long-term needs, developing options to meet those needs, leading, participating, or advocating on behalf of the participant in the person-centered planning process and development of the IPP, and obtaining identified services and supports. The cost of the independent facilitator, if any, shall be paid by the participant out of the participants individual budget. An independent facilitator shall receive training in the principles of self-determination, the person-centered planning process, and the other responsibilities described in this paragraph at the independent facilitators own cost. The independent facilitator shall meet standards and certification requirements established by the department.(3)Individual budget means the amount of regional center purchase of service funding available to the participant for the purchase of services and supports necessary to implement the IPP. The individual budget shall be determined using a fair, equitable, and transparent methodology.(4)IPP means individual program plan, as described in Section 4646.(5)Participant means an individual and, when appropriate, the participants parents, legal guardian or conservator, or authorized representative, who has been deemed eligible for, and has voluntarily agreed to participate in, the Self-Determination Program.(6)Self-determination means a voluntary delivery system consisting of a defined and comprehensive mix of services and supports, selected and directed by a participant through person-centered planning, in order to meet the objectives in their IPP. Self-determination services and supports are designed to assist the participant to achieve personally defined outcomes in community settings that promote inclusion. The Self-Determination Program shall only fund services and supports provided pursuant to this division that the federal Centers for Medicare and Medicaid Services determines are eligible for federal financial participation.(7)Spending Plan means the plan the participant develops to use their available individual budget funds to purchase goods, services, and supports necessary to implement their individual program plan (IPP). The spending plan shall identify the cost of each good, service, and support that will be purchased with regional center funds. The total amount of the spending plan cannot exceed the amount of the individual budget. A copy of the spending plan shall be attached to the participants IPP.(d)Participation in the Self-Determination Program is fully voluntary. A participant may choose to participate in, and may choose to leave, the Self-Determination Program at any time. A regional center shall not require or prohibit participation in the Self-Determination Program as a condition of eligibility for, or the delivery of, services and supports otherwise available under this division. Participation in the Self-Determination Program shall be available to any regional center consumer who meets the following eligibility requirements:(1)The participant has a developmental disability, as defined in Section 4512, and is receiving services pursuant to this division.(2)The consumer does not live in a licensed long-term health care facility, as defined in paragraph (44) of subdivision (a) of Section 54302 of Title 17 of the California Code of Regulations. An individual and, when appropriate, the individuals parent, legal guardian or conservator, or authorized representative, who is not eligible to participate in the Self-Determination Program pursuant to this paragraph may request that the regional center provide person-centered planning services in order to make arrangements for transition to the Self-Determination Program, provided that the individual is reasonably expected to transition to the community within 90 days. In that case, the regional center shall initiate person-centered planning services within 60 days of that request.(3)The participant agrees to all of the following terms and conditions:(A)The participant shall receive an orientation that meets the standards set or developed by the department to the Self-Determination Program prior to enrollment, which includes the principles of self-determination, the role of the independent facilitator and the financial management services provider, person-centered planning, and development of a budget.(B)The participant shall utilize the services and supports available within the Self-Determination Program only when generic services and supports are not available.(C)The participant shall only purchase services and supports necessary to implement their IPP and shall comply with any and all other terms and conditions for participation in the Self-Determination Program described in this section.(D)The participant shall manage Self-Determination Program services and supports within the participants individual budget.(E)The participant shall utilize the services of a financial management services provider of their own choosing and who is vendored by a regional center and who meets the qualifications in paragraph (1) of subdivision (c).(F)The participant may utilize the services of an independent facilitator of their own choosing for the purpose of providing services and functions as described in paragraph (2) of subdivision (c). If the participant elects not to use an independent facilitator, the participant may use their regional center service coordinator to provide the services and functions described in paragraph (2) of subdivision (c).(G)If eligible, with the assistance of the regional center, if needed, timely apply for Medi-Cal in order to maximize federal funding. The participant may consider institutional deeming in order to qualify for Medi-Cal services.(e)A participant who is not Medi-Cal eligible may participate in the Self-Determination Program and receive self-determination services and supports if all other program eligibility requirements are met and the services and supports are otherwise eligible for federal financial participation.(f)The additional federal financial participation funds generated by the former participants of the self-determination pilot projects authorized pursuant to Section 13 of Chapter 1043 of the Statutes of 1998, as amended, or pursuant to Article 4 (commencing with Section 4669.2) of Chapter 5, shall be used to maximize the ability of Self-Determination Program participants to direct their own lives and to ensure the department and regional centers successfully implement the program as follows:(1)First, to offset the cost to the department for the criminal background check conducted pursuant to subdivision (v) and other administrative costs incurred by the department in implementing the Self-Determination Program.(2)With the remaining funds, the department, in consultation with stakeholders, including a statewide self-determination advisory workgroup, shall prioritize the use of the funds to meet the needs of participants, increase service access and equity, and reduce disparities, and to implement the program, including costs associated with all of the following:(A)Independent facilitators to assist with a participants initial person-centered planning meeting.(B)Development of the participants initial individual budget.(C)Joint training of consumers, family members, regional center staff, and members of the local volunteer advisory committee established pursuant to paragraph (1) of subdivision (w).(D)Regional center operations to increase support for transition to the Self-Determination Program or for caseload ratio enhancement.(E)To offset the costs to the regional centers in implementing the Self-Determination Program.(F)To support the Statewide Self-Determination Advisory Committee established pursuant to paragraph (2) of subdivision (w).(g)If at any time during participation in the Self-Determination Program a regional center determines that a participant is no longer eligible to continue in, or a participant voluntarily chooses to exit, the Self-Determination Program, the regional center shall provide for the participants transition from the Self-Determination Program to other services and supports. This transition shall include the development of a new IPP that reflects the services and supports necessary to meet the individuals needs. The regional center shall ensure that there is no gap in services and supports during the transition period.(h)An individual determined to be ineligible for or who voluntarily exits the Self-Determination Program shall be permitted to return to the Self-Determination Program upon meeting all applicable eligibility criteria and upon approval of the participants planning team, as described in subdivision (j) of Section 4512. An individual who has voluntarily exited the Self-Determination Program shall not return to the program for at least 12 months.(i)An individual who participates in the Self-Determination Program may elect to continue to receive self-determination services and supports if the individual transfers to another regional center catchment area, provided that the individual remains eligible for the Self-Determination Program pursuant to subdivision (d). The balance of the participants individual budget shall be reallocated to the regional center to which the participant transfers.(j)The IPP team shall utilize the person-centered planning process to develop the IPP for a participant. The IPP shall detail the goals and objectives of the participant that are to be met through the purchase of participant-selected services and supports. The IPP team shall determine the individual budget to ensure the budget assists the participant to achieve the outcomes set forth in the participants IPP and ensures their health and safety. The completed individual budget shall be attached to the IPP.(k)The participant shall implement their IPP, including choosing and purchasing the services and supports allowable under this section necessary to implement the plan. A participant is exempt from the cost control restrictions regarding the purchases of services and supports pursuant to Section 4648.5. A regional center shall not prohibit the purchase of any service or support that is otherwise allowable under this section.(l)A participant shall have all the rights established in Sections 4646 to 4646.6, inclusive, and Chapter 7 (commencing with Section 4700).(m)(1)Except as provided in paragraph (4), the IPP team shall determine the initial and any revised individual budget for the participant using the following methodology:(A)(i)Except as specified in clause (ii), for a participant who is a current consumer of the regional center, their individual budget shall be the total amount of the most recently available 12 months of purchase of service expenditures for the participant.(ii)An adjustment may be made to the amount specified in clause (i) if both of the following occur:(I)The IPP team determines that an adjustment to this amount is necessary due to a change in the participants circumstances, needs, or resources that would result in an increase or decrease in purchase of service expenditures, or the IPP team identifies prior needs or resources that were unaddressed in the IPP, which would have resulted in an increase or decrease in purchase of service expenditures. When adjusting the budget, the IPP team shall document the specific reason for the adjustment in the IPP.(II)The regional center certifies on the individual budget document that regional center expenditures for the individual budget, including any adjustment, would have occurred regardless of the individuals participation in the Self-Determination Program.(iii)For purposes of clauses (i) and (ii), the amount of the individual budget shall not be increased to cover the cost of the independent facilitator.(B)For a participant who is either newly eligible for regional center services or who does not have 12 months of purchase service expenditures, the participants individual budget shall be calculated as follows:(i)The IPP team shall identify the services and supports needed by the participant and available resources, as required by Section 4646.(ii)The regional center shall calculate the cost of providing the services and supports to be purchased by the regional center by using the average cost paid by the regional center for each service or support unless the regional center determines that the consumer has a unique need that requires a higher or lower cost. The IPP team also shall document the specific reason for the adjustment in the IPP. The regional center shall certify on the individual budget document that this amount would have been expended using regional center purchase of service funds regardless of the individuals participation in the Self-Determination Program.(iii)For purposes of clauses (i) and (ii), the amount of the individual budget shall not be increased to cover the cost of the independent facilitator.(2)The amount of the individual budget shall be available to the participant each year for the purchase of program services and supports. An individual budget shall be calculated no more than once in a 12-month period, unless revised to reflect a change in circumstances, needs, or resources of the participant using the process specified in clause (ii) of subparagraph (A) of paragraph (1).(3)The spending plan shall be assigned to uniform budget categories developed by the department in consultation with stakeholders and distributed according to the timing of the anticipated expenditures in the IPP and in a manner that ensures that the participant has the financial resources to implement the IPP throughout the year.(4)The department, in consultation with stakeholders, may develop alternative methodologies for individual budgets that are computed in a fair, transparent, and equitable manner and are based on consumer characteristics and needs, and that include a method for adjusting individual budgets to address a participants change in circumstances or needs.(n)Annually, participants may transfer up to 10 percent of the funds originally distributed to any budget category set forth in paragraph (3) of subdivision (m) to another budget category or categories. Transfers in excess of 10 percent of the original amount allocated to any budget category may be made upon the approval of the regional center or the participants IPP team.(o)Consistent with the implementation date of the IPP, the IPP team shall annually ascertain from the participant whether there are any circumstances or needs that require a change to the annual individual budget. Based on that review, the IPP team shall calculate a new individual budget consistent with the methodology identified in subdivision (m).(p)(1)The department, as it determines necessary, may adopt regulations to implement the procedures set forth in this section. Any regulations shall be adopted in accordance with the requirements of Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code.(2)Notwithstanding paragraph (1) and Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, and only to the extent that all necessary federal approvals are obtained, the department, without taking any further regulatory action, shall implement, interpret, or make specific this section by means of program directives or similar instructions until the time regulations are adopted. It is the intent of the Legislature that the department be allowed this temporary authority as necessary to implement program changes only until completion of the regulatory process.(q)The department, in consultation with stakeholders, shall develop informational materials about the Self-Determination Program. The department shall ensure that regional centers are trained in the principles of self-determination, the mechanics of the Self-Determination Program, and the rights of consumers and families as candidates for, and participants in, the Self-Determination Program.(r)Each regional center shall be responsible for implementing the Self-Determination Program as a term of its contract under Section 4629. As part of implementing the program, the regional center shall do all of the following:(1)Meet the Self-Determination Program targets approved by the department, meet benchmarks established by the department in areas including timely enrollment, diversity of consumers served, and reduction of disparities in the individual budget of participants from racial and ethnic communities, and be eligible for incentives for exceeding these targets and benchmarks once the department has established a performance incentives program.(2)Develop and implement an outreach and training plan about the Self-Determination Program for the diverse communities served by the regional center, including in congregate settings. Information shall be provided in plain language, in alternative formats and alternative modes of communication, and provide language access as required by state and federal law. Obtain input from stakeholders, including consumers and families, that reflect the ethnic and language diversity of the regional centers consumers, about the effectiveness of this outreach and training and other activities that may be effective in reducing disparities in these programs.(3)Annually report the enrollment, individual budget data, and purchase of service expenditure data for the Self-Determination Program consistent with the criteria in subdivisions (a) to (c), inclusive, of Section 4519.5.(4)Assist eligible participants and their families in applying for Medi-Cal, in order to maximize federal funding and assist interested participants who wish to pursue institutional deeming in order to qualify for Medi-Cal services.(5)At least annually, in addition to annual certification, conduct an additional review of all final individual budgets for participants at the regional center which are at or above a spending threshold that is specified by the department through directive consistent with federal and state requirements. This information may be used in the aggregate to provide training, program guidance, and verify compliance with state and federal requirements.(6)Review the spending plan to verify that goods and services eligible for federal financial participation are not used to fund goods or services available through generic agencies.(7)Contract with local consumer or family-run organizations and consult with the local volunteer advisory committee established pursuant to paragraph (1) of subdivision (w) to conduct outreach through local meetings or forums to consumers and their families to provide information about the Self-Determination Program and to help ensure that the program is available to a diverse group of participants, with special outreach to underserved communities.(8)Collaborate with the local consumer or family-run organizations identified in paragraph (1) to jointly conduct training about the Self-Determination Program. The regional center shall consult with the local volunteer advisory committee established pursuant to paragraph (1) of subdivision (w) in planning for the training, and the local volunteer advisory committee may designate members to represent the advisory committee at the training.(9)Train all service coordinators and fair hearing specialists in the principles of self-determination, the mechanics of the Self-Determination Program, and the rights of consumers and families. The training shall be conducted in collaboration with the local volunteer advisory committee.(10)Provide payment to the financial management services provider for spending plan expenses through a not less than semimonthly pay schedule.(11)Ensure that each individual plan includes the information required by subdivision (d) of Section 4646.(s)The financial management services provider shall provide the participant and the regional center service coordinator with a monthly individual budget statement that describes the amount of funds allocated by budget category, the amount spent in the previous 30-day period, and the amount of funding that remains available under the participants individual budget.(t)Only the financial management services provider is required to apply for vendorization in accordance with Subchapter 2 (commencing with Section 54300) of Chapter 3 of Division 2 of Title 17 of the California Code of Regulations for the Self-Determination Program. All other service and support providers shall not be on the federal debarment list and shall have applicable state licenses, certifications, or other state required documentation, including documentation of any other qualifications required by the department, but are exempt from the vendorization requirements set forth in Title 17 of the California Code of Regulations when serving participants in the Self-Determination Program.(u)The regional center shall pay the full costs of the participants financial management services provider.(v)To protect the health and safety of participants in the Self-Determination Program, the department shall require a criminal background check in accordance with all of the following:(1)The department shall issue a program directive that identifies nonvendored providers of services and supports who shall obtain a criminal background check pursuant to this subdivision. At a minimum, these staff shall include both of the following:(A)Individuals who provide direct personal care services to a participant.(B)Other nonvendored providers of services and supports for whom a criminal background check is requested by a participant or the participants financial management service.(2)Subject to the procedures and requirements of this subdivision, the department shall administer criminal background checks consistent with the departments authority and the process described in Sections 4689.2 to 4689.6, inclusive.(3)The department shall electronically submit to the Department of Justice fingerprint images and related information required by the Department of Justice of nonvendored providers of services and supports, as specified in paragraph (1), for purposes of obtaining information as to the existence and content of a record of state or federal convictions and state or federal arrests and also information as to the existence and content of a record of state or federal arrests for which the Department of Justice establishes that the person is free on bail or on their own recognizance pending trial or appeal.(4)When received, the Department of Justice shall forward to the Federal Bureau of Investigation requests for federal summary criminal history information received pursuant to this section. The Department of Justice shall review the information returned from the Federal Bureau of Investigation and compile and disseminate a response to the department.(5)The Department of Justice shall provide a state or federal response to the department pursuant to paragraph (1) of subdivision (p) of Section 11105 of the Penal Code.(6)The department shall request from the Department of Justice subsequent notification service, as provided pursuant to Section 11105.2 of the Penal Code, for persons described in paragraph (1).(7)The Department of Justice shall charge a fee sufficient to cover the cost of processing the request described in this subdivision.(8)The fingerprints of any provider of services and supports who is required to obtain a criminal background check shall be submitted to the Department of Justice prior to employment. The costs of the fingerprints and the financial management services administrative cost authorized by the department shall be paid by the services and supports provider or the providers employing agency. Any administrative costs incurred by the department pursuant to this subdivision shall be offset by the funds specified in subdivision (g).(9)If the criminal record information report shows a criminal history, the department shall take the steps specified in Section 4689.2. The department may prohibit a provider of services and supports from becoming employed, or continuing to be employed, based on the criminal background check, as authorized in Section 4689.6. The provider of services and supports who has been denied employment shall have the rights set forth in Section 4689.6.(10)The department may utilize a current department-issued criminal record clearance to enable a provider to serve more than one participant, as long as the criminal record clearance has been processed through the department and no subsequent arrest notifications have been received relative to the cleared applicant.(11)Consistent with subdivision (h) of Section 4689.2, the participant or financial management service that denies or terminates employment based on written notification from the department shall not incur civil liability or unemployment insurance liability.(w)To ensure the effective implementation of the Self-Determination Program and facilitate the sharing of best practices and training materials commencing with the implementation of the Self-Determination Program, local and statewide advisory committees shall be established as follows:(1)Each regional center shall establish a local volunteer advisory committee to provide oversight of the Self-Determination Program and identify a regional center liaison to the committee. The regional center and the State Council on Developmental Disabilities shall each appoint one-half of the membership of the committee. The committee shall consist of the regional center clients rights advocate, consumers, family members, and other advocates, and community leaders, including a representative from a family resource center. A majority of the committee shall be consumers and their family members. The committee shall reflect the multicultural diversity and geographic profile of the catchment area. The committee shall review the development and ongoing progress of the Self-Determination Program, including whether the program advances the principles of self-determination and is operating consistent with the requirements of this section, and may make ongoing recommendations for improvement to the regional center and the department. Annually, the regional center shall confirm, in writing, that the committee meets the requirements specified in this paragraph and provide the department with the name of the staff liaison and the names of the committee members, the positions they fill on the committee, and which entity appointed them to the committee.(2)The State Council on Developmental Disabilities shall form a volunteer committee, to be known as the Statewide Self-Determination Advisory Committee, comprised of the chairs of the 21 local advisory committees or their designees. The council shall convene the Statewide Self-Determination Advisory Committee twice annually, or more frequently in the sole discretion of the council. The Statewide Self-Determination Advisory Committee shall meet by teleconference or other means established by the council to identify self-determination best practices, effective consumer and family training materials, implementation concerns, systemic issues, ways to enhance the program, and recommendations regarding the most effective method for participants to learn of individuals who are available to provide services and supports. The council shall synthesize information received from the Statewide Self-Determination Advisory Committee, local advisory committees, and other sources, share the information with consumers, families, regional centers, and the department, and make recommendations, as appropriate, to increase the programs effectiveness in furthering the principles of self-determination.(x)The department shall annually provide the following information to the appropriate policy and fiscal committees of the Legislature:(1)Number and characteristics of participants, by regional center, including the number of participants who entered the program upon movement from a developmental center.(2)Types and amount of services and supports purchased under the Self-Determination Program, by regional center.(3)Range and average of individual budgets, by regional center, including adjustments to the budget to address the adjustments permitted in clause (ii) of subparagraph (A) of paragraph (1) of subdivision (m).(4)The number and outcome of appeals concerning individual budgets, by regional center.(5)The number and outcome of fair hearing appeals, by regional center.(6)The number of participants who voluntarily withdraw from the Self-Determination Program and a summary of the reasons why, by regional center.(7)The number of participants who are subsequently determined to no longer be eligible for the Self-Determination Program and a summary of the reasons why, by regional center.(y)(1)The State Council on Developmental Disabilities shall issue an interim report to the Legislature, in compliance with Section 9795 of the Government Code, no later than June 30, 2021, on the status of the Self-Determination Program authorized by this section, barriers to its implementation, and recommendations to enhance the effectiveness of the program. The interim report shall provide an update to the programs status, each regional centers cap on participation and progress toward that cap, the most recent statewide and per-regional-center participant count, and the historical trend in the statewide participation count since the start of the program. The department shall assist in providing available information to the council in order to facilitate the timely issuance of the report.(2)The council, in collaboration with the protection and advocacy agency identified in Section 4900 and the federally funded University Centers for Excellence in Developmental Disabilities Education, Research, and Service, may work with regional centers to survey participants regarding participant satisfaction under the Self-Determination Program and, when data is available, the traditional service delivery system, including the proportion of participants who report that their choices and decisions are respected and supported and who report that they are able to recruit and hire qualified service providers, and to identify barriers to participation and recommendations for improvement.(3)The council, in collaboration with the protection and advocacy agency identified in Section 4900 and the federally funded University Centers for Excellence in Developmental Disabilities Education, Research, and Service, shall issue a report to the Legislature, in compliance with Section 9795 of the Government Code, by June 30, 2023, on the status of the Self-Determination Program authorized by this section, and provide recommendations to enhance the effectiveness of the program. This review shall include the programs effectiveness in furthering the principles of self-determination, including all of the following:(A)Freedom, which includes the ability of adults with developmental disabilities to exercise the same rights as all citizens to establish, with freely chosen supporters, family and friends, where they want to live, with whom they want to live, how their time will be occupied, and who supports them; and for families to have the freedom to receive unbiased assistance of their own choosing when developing a plan and to select all personnel and supports to further the life goals of a minor child.(B)Authority, which includes the ability of a person with a disability, or family, to control a certain sum of dollars in order to purchase services and supports of their choosing.(C)Support, which includes the ability to arrange resources and personnel, both formal and informal, that will assist a person with a disability to live a life in the community that is rich in community participation and contributions.(D)Responsibility, which includes the ability of participants to take responsibility for decisions in their own lives and to be accountable for the use of public dollars, and to accept a valued role in their community through, for example, competitive employment, organizational affiliations, spiritual development, and general caring of others in their community.(E)Confirmation, which includes confirmation of the critical role of participants and their families in making decisions in their own lives and designing and operating the system that they rely on.SEC. 17.SEC. 10.Section 4726 of the Welfare and Institutions Code is amended to read:4726.Notwithstanding Section 5328, any exemption to the California Public Records Act (Division 10 (commencing with Section 7920.000) of Title 1 of the Government Code), or any other law that authorizes, but does not require, an entity to withhold all or part of a record on the basis of its confidentiality, any other law, access to records regarding an applicant for, or recipient of, services shall be provided, upon request, to the applicant, recipient, or their authorized representative, including the person appointed as a developmental services decisionmaker pursuant to Section 319, 361, or 726, for purposes, any purpose, including, but not limited to, the appeal process under this chapter, unless disclosure of the record is expressly prohibited by law.
SEC. 18.Section 4731 of the Welfare and Institutions Code is amended to read:4731.(a)Each consumer or any representative acting on behalf of any consumer or consumers, who believes that any right to which a consumer is entitled has been abused, punitively withheld, or improperly or unreasonably denied by a regional center, state-operated facility, or service provider, may pursue a complaint as provided in this section.(b)Initial referral of any complaint taken pursuant to this section shall be to the director of the regional center from which the consumer receives case management services. If the consumer resides in a state-operated facility, the complaint shall be made to the director of the state-operated facility. The director shall, within 20 business days of receiving a complaint, investigate the complaint and send a written proposed resolution to the complainant and, if applicable, to the service provider. The written proposed resolution shall include a telephone number and mailing address for referring the proposed resolution in accordance with subdivision (c).(c)If the complainant is not satisfied with the proposed resolution, the complainant may refer the complaint, in writing, to the Director of Developmental Services, within 15 days of receipt of the proposed resolution. The director, within 30 days of receiving a complaint, shall issue a written administrative decision and send a copy of the decision to the complainant, the director of the regional center or state-operated facility, and the service provider, if applicable. If there is no referral to the department, the proposed resolution shall become effective on the 20th working day following receipt by the complainant.(d)The department shall annually compile the number of complaints filed, by each regional center and state-operated facility, the subject matter of each complaint, and a summary of each decision, and post the compilation on its internet website at the end of each quarter. Copies of any decision included in the compilation shall be made available within 10 days, with all individually identifiable information redacted, to any person upon request.(e)This section shall not be used to resolve disputes concerning the nature, scope, or amount of services and supports that should be included in an individual program plan, for which there is an appeals procedure established in this division, or disputes regarding rates or audit appeals for which there is an appeals procedure established in regulations. Those disputes shall be resolved through the appeals procedure established by this division or in regulations.(f)All consumers or, if appropriate, their authorized representative, shall be notified in writing in their preferred language of the right to file a complaint pursuant to this section when they apply for services from a regional center or a state-operated facility, and at each regularly scheduled planning meeting.SEC. 11.Section 8.5 of this bill incorporates amendments to Section 4646 of the Welfare and Institutions Code proposed by both this bill and Senate Bill 447. That section of this bill shall only become operative if (1) both bills are enacted and become effective on or before January 1, 2024, (2) each bill amends Section 4646 of the Welfare and Institutions Code, and (3) this bill is enacted after Senate Bill 447, in which case Section 8 of this bill shall not become operative.
This act shall be known, and may be cited, as the Disability Equity and Accountability Act of 2023.
SEC. 2.(a)The Legislature finds and declares as follows:
(1)Recent reports and hearings by the California State Auditor, the Little Hoover Commission, and advocacy organizations have found that Californias service system for the over 400,000 children and adults with intellectual and developmental disabilities through the Lanterman Act, as overseen by the State Department of Developmental Services, which contracts with 21 regional centers, is failing in significant ways to deliver critical, adequate, and timely services to individuals and families. The result is that individuals and families, particularly those of color and tribal members living in rural areas and tribal reservations, are unable to timely access services and supports, resulting in barriers to their living independent, productive, and integrated lives in their communities.
(2)Californias developmental disability service system is plagued with racial, ethnic, and geographic disparities that can dramatically impact the essential services received by children and adults with developmental disabilities. Systemic inequities and discrimination within Californias 21 regional centers broaden the gap between inclusive possibilities and segregated limitations. Data show Latinos are most negatively impacted by these disparities, but people who are clients of the lowest-performing regional centers are also significantly affected.
(3)California spends nearly $13,000,000,000 annually on the administration and delivery of developmental services, but lacks a transparent, common, integrated, and coordinated model for the delivery and measurement of services throughout the 21 regional centers, resulting in poor outcomes, poor satisfaction levels by consumers and families, and disparate levels of available services and performance expectations.
(4)The delivery of services through 21 separate private nonprofit regional centers with separate boards, funding, and delivery models was originally intended to ensure that the delivery of services could be more effectively delivered through nonstate entities. However, with the subsequent caseload and budget growth since the enactment of the Lanterman Act, local administration has become more disparate and less accountable. Boards of directors are untrained and are not providing the oversight needed of the regional centers. Stronger state oversight of regional centers by the State Department of Developmental Services is essential to ensure that services are equitably delivered, performance and outcomes are uniformly measured and reported, and the system is transparent and accountable to individuals and families.
(5)The departments system lacks a statewide automated technology system for the delivery of services to persons with intellectual and developmental disabilities and, as a result, the current program is constrained by disparate automation systems, inadequate documentation, the lack of open system architecture, insufficient data to support administration of the system, and the lack of data to support program improvements for improving the quality of life outcomes through new service delivery methods.
(6)Statewide uniformity of service delivery practices and procedures is essential to an effective program and to support necessary oversight and research for ongoing program improvements.
(7)The departments technical infrastructure is over 40 years old. The lack of a statewide automation system does not meet current program needs and significantly contributes to the racial and geographic disparities in the delivery of services. California currently lacks clear and consistent service delivery outcomes for individuals with intellectual and developmental disabilities that sets high expectations for their quality of life, and must develop a system for measuring and quantifying the value of service delivery outcomes.
(8)A previous effort to develop an intellectual and developmental disabilities (IDD) program technology system failed. As a result, the department and regional centers maintain a patchwork of at least three case management and fiscal systems that are not integrated and six legacy case management automation systems that lack integration, have dissimilar data sources, and are technically outdated.
(9) In the 202122 annual budget the Legislature appropriated $6,000,000 to the State Department of Developmental Services for planning purposes related to the implementation of a uniform fiscal system and consumer electronic records management system. The department has not developed a vision or scope for a proposed system development approach.
(b)Therefore, it is the intent of the Legislature in enacting this act to do all of the following:
(1)Ensure that racial, ethnic, and geographic service disparities, including Native Americans living on or off tribal reservations, be systemically addressed and eliminated and that all people, regardless of their race or ethnicity or where they live, receive equitable access to services within the regional center system.
(2)Ensure that all regional centers offer and provide a consistent and common set of services and that the services are delivered in a timely way.
(3) Ensure that the delivery of all services and supports comply with federal law and guidance and are responsive to the needs and choices of beneficiaries receiving home- and community-based services, are person centered and strengths based, have high expectations for interdependence, self-direction, and competitive, integrated employment, provide support coordination to assist with a community-supported life, and achieve a more consistent and coordinated approach to the administration of policies and procedures across the state.
(4)Provide the department with new tools for holding regional centers and service providers accountable through the development of a standardized and coordinated set of performance measures and related standards that establish targets and standards above which a regional center may receive incentives for improved performance, and a separate set of standards that require corrective action.
(5)Improve regional center governance by establishing new standards and procedures for regional center governing boards to ensure they can more effectively represent the communities they serve by providing them with greater independence and protection from regional center retaliation.
(6)Require the State Department of Developmental Services to develop a written project charter for the planning and development of a uniform statewide automation system that serves as a foundation document for the system development, which includes project guiding principles, scope, strategies and approach, and project governance, in order to provide transparency to the Legislature and the public on the system development as has been used with other statewide system development.
SEC. 3.Section 4519.5 of the Welfare and Institutions Code is amended to read:4519.5.(a)The department and the regional centers shall annually collaborate to compile data in a uniform manner relating to purchase of service authorization, utilization, and expenditure by each regional center with respect to all of the following:
(1)The age of the consumer, categorized by the following:
(A)Birth to two years of age, inclusive.
(B)Three to 21 years of age, inclusive.
(C)Twenty-two years of age and older.
(2)Race or ethnicity of the consumer.
(3)Tribal affiliation.
(4)Preferred language spoken by the consumer, and other related details, as feasible.
(5)Disability detail, in accordance with the categories established by subdivision (a) of Section 4512, and, if applicable, a category specifying that the disability is unknown.
(6)Residence type, subcategorized by age, race or ethnicity, and preferred language.
(7)Number of instances when the written copy of the individual program plan was provided at the request of the consumer and, when appropriate, the consumers parents, legal guardian or conservator, or authorized representative, in a language other than a threshold language, as defined by paragraph (3) of subdivision (a) of Section 1810.410 of Title 9 of the California Code of Regulations, if that written copy was provided more than 60 days after the request.
(8)Number of instances when the written copy of the individual program plan was provided at the request of the consumer and, when appropriate, the consumers parents, legal guardian or conservator, or authorized representative, in a threshold language, as defined by paragraph (3) of subdivision (a) of Section 1810.410 of Title 9 of the California Code of Regulations, if that written copy was provided more than 45 days after the request, in violation of paragraph (5) of subdivision (a) of Section 4646.5.
(9)Beginning with data for the fiscal year of 202324, the numbers, percentages, and total and per capita expenditure and authorization amounts, by age, as applicable, according to race or ethnicity and preferred language, for all combined residence types and for consumers living in the family home, regarding the following service types:
(A)Camping and associated travel expenses.
(B)Social recreation activities.
(C)Educational services.
(D)Nonmedical therapies, including, but not limited to, specialized recreation, art, dance, music, and tribal culture and ceremony.
(b)The data reported pursuant to subdivision (a) shall also include the number and percentage of individuals, categorized by age, race or ethnicity, and disability, and by residence type, as set forth in paragraph (6) of subdivision (a), who have been determined to be eligible for regional center services, but are not receiving purchase of service funds.
(c)By March 31, 2013, each regional center shall post the data described in this section that are specific to the regional center on its internet website. Commencing on December 31, 2013, each regional center shall annually post these data by December 31. Each regional center shall maintain all previous years data on its internet website.
(d)By March 31, 2013, the department shall post the information described in this section on a statewide basis on its internet website. Commencing December 31, 2013, the department shall annually post this information by December 31. The department shall maintain all previous years data on its internet website. The department shall also post notice of any regional center stakeholder meetings on its internet website.
(e)Within three months of compiling the data with the department, and annually thereafter, each regional center shall meet with stakeholders in one or more public meetings regarding the data. The meeting or meetings shall be held separately from any meetings held pursuant to Section 4660. The regional center shall provide participants of these meetings with the data and any associated information related to improvements in the provision of developmental services to underserved communities and shall conduct a discussion of the data and the associated information in a manner that is culturally and linguistically appropriate for that community, including providing alternative communication services, as required by Sections 11135 to 11139.7, inclusive, of the Government Code and implementing regulations. Regional centers shall inform the department of the scheduling of those public meetings 30 days prior to the meeting. Notice of the meetings shall also be posted on the regional centers internet website 30 days prior to the meeting and shall be sent to individual stakeholders and groups representing underserved communities in a timely manner. Each regional center shall, in holding the meetings required by this subdivision, consider the language needs of the community and shall schedule the meetings at times and locations designed to result in a high turnout by the public and underserved communities.
(f)(1)Each regional center shall annually report to the department regarding its implementation of the requirements of this section. The report shall include, but shall not be limited to, all of the following:
(A)Actions the regional center took to improve public attendance and participation at stakeholder meetings, including, but not limited to, attendance and participation by underserved communities.
(B)Copies of minutes from the meeting and attendee comments.
(C)Whether the data described in this section indicate a need to reduce disparities in the purchase of services among consumers in the regional centers catchment area. If the data do indicate that need, the regional centers recommendations and plan to promote equity, and reduce disparities, in the purchase of services.
(2)Each regional center and the department shall annually post the reports required by paragraph (1) on its internet website by August 31.
(g)(1)The department shall consult with stakeholders, including consumers and families that reflect the ethnic and language diversity of regional center consumers, regional centers, advocates, providers, family resource centers, the protection and advocacy agency described in Section 4901, and those entities designated as University Centers for Excellence in Developmental Disabilities Education, Research, and Service pursuant to Section 15061 of Title 42 of the United States Code, to achieve the following objectives:
(A)Review the data compiled pursuant to subdivision (a).
(B)Identify barriers to equitable access to services and supports among consumers and develop recommendations to help reduce disparities in purchase of service expenditures.
(C)Encourage the development and expansion of culturally appropriate services, service delivery, and service coordination.
(D)Identify best practices to reduce disparity and promote equity.
(2)The department shall report the status of its efforts to satisfy the requirements of paragraph (1) during the 201617 legislative budget subcommittee hearing process.
(h)(1)Subject to available funding, the department shall allocate funding to regional centers or community-based organizations with department oversight to assist with implementation of the recommendations and plans developed pursuant to subdivisions (f) and (g). Activities funded through these allocations may include, but are not limited to, pay differentials supporting direct care bilingual staff of community-based service providers, parent or caregiver education programs, cultural competency training for regional center staff, outreach to underserved populations, or additional culturally appropriate service types or service delivery models.
(2)Each regional center shall consult with stakeholders regarding activities that may be effective in addressing disparities in the receipt of regional center services and the regional centers proposed requests for the funding specified in paragraph (1). Each regional center shall identify the stakeholders it consulted with and include information on how it incorporated the input of stakeholders into its requests.
(3)A community-based organization may submit a request for grant funding pursuant to this subdivision. The organization shall submit the request concurrently to the regional center of the jurisdiction in which the organization is located and to the department. The regional center shall provide the department with input regarding the request prior to the departments final determination on the request.
(4)The department shall review requests for funding within 45 days from the deadline specified in the departments guidance to regional centers and community-based organizations.
(5)Each regional center and community-based organization receiving funding shall report annually to the department, in a manner determined by the department, on how the funding allocations were used and shall include recommendations of priorities for activities that may be effective in addressing disparities, based on the consultation with stakeholders.
(6)The department shall post the following information on its internet website:
(A)By September 1 of any year in which grant funding is available and has not been allocated, a structure for the grant program, including all of the following information:
(i)How community-based organizations reflecting groups that are disadvantaged by disparities in the purchase of services will be invited to participate in the grant program.
(ii)How statewide strategies were considered.
(iii)How the department will ensure grant funds are not used for activities that regional centers are otherwise required by statute or regulation to conduct.
(iv)How funded activities will be evaluated.
(B)By October 1 of any year in which grant funding is available and has not been allocated, the final invitation for requests for funding or another mechanism through which requests for funding are solicited.
(C)By January 1 of any year in which grant funding has been allocated, a list of grant recipients, funding level per grant, and a description of the funded project.
(D)By May 1 of any year in which the information is available, evaluation results from prior grants. To ensure the department complies with this subparagraph, regional centers and community-based organizations receiving funding shall provide the department, by March 1 of the same year, with an evaluation of funded activities and the effectiveness of those activities in reducing disparities in the purchase of services, to the extent information is available.
(i)On or before December 31, 2021, the department shall 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 subdivision (h).
(j)For the purposes of this section, the department shall require all of the following:
(1)The use by the department and regional centers, when reporting data by race and ethnicity, of consistent classifications of race and ethnicity, based on categories current in use by the United States Census Bureau.
(2)Confirmation of the race and ethnicity identification of each consumer at the time of the annual review of the consumers individual program plan (IPP).
(3)When reporting by residence types, separate presentation of data for those in independent living services and those in supported living services.
(4)Consistent standards and requirements for regional center internet websites, using the same placement and language for all information required by this division, including that data be posted in a machine-readable format.
SEC. 4.Section 4519.20 is added to the Welfare and Institutions Code, to read:4519.20.As part of the departments planning process for the planning and development of a uniform statewide data automation system, the department, in consultation with stakeholders shall develop, by March 1, 2025, a project charter that shall be approved by the Secretary of the California Health and Human Services Agency and the Department of Technology. The charter development process shall include the participation and input of program consumers and families, researchers and quality and outcome evaluators, regional centers, and service providers. The project charter shall include all of the following:
(a)An impact statement on the primary entities and individuals impacted by the system development.
(b)Project guiding principles that are foundational to the project approach to be used throughout the planning, development, implementation, and maintenance of the system.
(c)Project scope that addresses business problems required to be solved by the system, including all of the following:
(1)Worker effectiveness and accountability that are constrained by the lack of timely, adequate, and accurate data, the lack of uniformity, and the current systems limited functionality.
(2)Service delivery that is constrained by the lack of timely, adequate, accurate, and accessible data, the lack of clear understandable communication of information, lack of uniformity, and the systems limited functionality.
(3)Current system maintainability that is constrained by disparate systems, inadequate documentation, the lack of open system architecture, and business changes.
(4)Disparate systems, complex business rules, the number of locations and variability of local system delivery, and changes in the way of doing business.
(5)Limited access of researchers and program evaluators to the set of person-level data that they need to assess program effectiveness.
(d)Program goals, which shall include all of the following:
(1)Maximizing the performance and the business processes for the delivery of intellectual or developmental disability (IDD) system services to consumers at the regional centers.
(2)Improving data quality, privacy, confidentiality, and integration of all data sources at an individual level.
(3)Enabling data-driven decisionmaking and performance measures for the effective administration of the program.
(4)Improving the business processes administered by the department to support regional center service delivery.
(5)Supporting access to individual-level data to support program evaluation and other research.
(e)Technology goals that recognize that a statewide system solution not only meets requirements, but also ensures effective transition, while minimizing disruption to existing services.
(f)Project strategies and approaches for development and implementation.
(g)Project governance.
(h)Technology that can readily be enhanced and modernized for the expected system life. In selecting the new system, consideration shall be given to the extent to which the candidate systems employ open architectures and standards and the future ability of the selected system to provide enhancements that will improve long-term effectiveness of program management of the statewide service delivery system.
SEC. 5.Section 4571 of the Welfare and Institutions Code is amended to read:4571.(a)It is the intent of the Legislature to ensure the well-being of consumers, taking into account their informed and expressed choices. It is further the intent of the Legislature to support the satisfaction and success of consumers through the delivery of quality services and supports. Evaluation of the services that consumers receive is a key aspect to the service system. Utilizing the information that consumers and their families provide about those services in a reliable and meaningful way is also critical to enable the department to assess the performance of the states developmental services system and to improve services for consumers in the future. To that end, the State Department of Developmental Services, on or before January 1, 2010, shall implement an improved, unified quality assessment system, in accordance with this section.
(b)The department, in consultation with stakeholders, shall identify a valid and reliable quality assurance instrument that assesses consumer and family satisfaction, provision of services in a linguistically and culturally competent manner, and personal outcomes. The instrument shall do all of the following:
(1)Provide nationally validated, benchmarked, consistent, reliable, and measurable data for the departments Quality Management System.
(2)Enable the department and regional centers to compare the performance of Californias developmental services system against other states developmental services systems and to assess quality and performance among all of the regional centers.
(3)Include outcome-based measures such as health, safety, well-being, relationships, interactions with people who do not have a disability, employment, quality of life, integration, choice, service, and consumer satisfaction.
(4)Include outcome-based measures to evaluate the linguistic and cultural competency, including tribal culture competency, of regional center services that are provided to consumers across their lifetimes.
(c)To the extent that funding is available, the instrument identified in subdivision (b) may be expanded to collect additional data requested by the State Council on Developmental Disabilities.
(d)(1)The department shall contract with an independent agency or organization to implement, by January 1, 2010, the quality assurance instrument described in subdivision (b). The contractor shall be experienced in all of the following:
(A)Designing valid quality assurance instruments for developmental service systems.
(B)Tracking outcome-based measures such as health, safety, well-being, relationships, interactions with people who do not have a disability, employment, quality of life, integration, choice, service, and consumer satisfaction.
(C)Developing data systems.
(D)Data analysis and report preparation.
(E)Assessments of the services received by consumers who are moved from developmental centers to the community, given the Legislatures historic recognition of a special obligation to ensure the well-being of these persons.
(F)Issues related to linguistic and cultural competency.
(2)Notwithstanding any other law, the contract and any amendments pursuant to this section shall be exempt from all of the following:
(A)The personal services contracting requirements of Article 4 (commencing with Section 19130) of Chapter 5 of Part 2 of Division 5 of Title 2 of the Government Code.
(B)The Public Contract Code, the State Contracting Manual, and the State Administration Manual.
(C)The approval of the Department of General Services.
(D)The approval of the Department of Technology.
(3)The exemptions specified in paragraph (2) shall remain in effect until there is more than one available assessment that meets the criteria in subdivision (b) from an organization that also meets the criteria in this subdivision.
(e)The department, in consultation with the contractor described in subdivision (d), shall establish the methodology by which the quality assurance instrument shall be administered, including, but not limited to, how often and to whom the quality assurance will be administered, and the design of a stratified, random sample among the entire population of consumers served by regional centers. The contractor shall provide aggregate information for all regional centers and the state as a whole. At the request of a consumer or the family member of a consumer, the survey shall be conducted in the primary language of the consumer or family member surveyed.
(f)The department shall contract with the state council to collect data for the quality assurance instrument described in subdivision (b). If, during the data collection process, the state council identifies any suspected violation of the legal, civil, or service rights of a consumer, or if it determines that the health and welfare of a consumer is at risk, that information shall be provided immediately to the regional center providing case management services to the consumer. At the request of the consumer or family, when appropriate, a copy of the completed survey shall be provided to the regional center providing case management services to improve the consumers quality of services through the individual planning process.
(g)The department, in consultation with stakeholders, shall annually review the data collected from and the findings of the quality assurance instrument described in subdivision (b) and accept recommendations regarding additional or different criteria for the quality assurance instrument in order to assess the performance of the states developmental services system and improve services for consumers.
(h)(1)Each regional center shall annually present data collected from, and the findings of, the quality assurance instrument described in subdivision (b) for that regional center, at a public meeting of its governing board in order to assess the comparative performance of the regional center and identify needed improvements in services for consumers, including, but not limited to, case management services. Notice of this meeting shall also be posted on the regional centers internet website at least 30 days prior to the meeting and shall be sent to regional center consumers and families and individual stakeholders at least 30 days prior to the meeting. The governing board shall provide a sufficient public comment period so members of the public may provide comments. Each regional center, in holding the meeting required by this subdivision, shall ensure that the meeting and meeting materials provide language access, as required by state and federal law.
(2)All regional center-specific reports generated by the department pursuant to this subdivision shall be made publicly available on the regional centers internet website in a machine-readable format, but shall not contain any personal identifying information about any person assessed.
(3)Within 60 days following its annual presentation, each regional center shall submit a report to the department regarding its implementation of the requirements of this section. The report shall include, but shall not be limited to, both of the following:
(A)Copies of the presentation described in paragraph (1), minutes from the meeting, and attendee comments.
(B)The regional centers recommendations and plans to use the information to address regional center priorities, strategic directions to improve specific areas of performance, or both.
(i)All reports generated pursuant to this section shall be made publicly available, but shall not contain any personal identifying information about any person assessed.
(j)All data collected pursuant to subdivision (c) shall be provided to the state council, but shall not contain personal identifying information about the persons being surveyed.
(k)Implementation of this section shall be subject to an annual appropriation of funds in the Budget Act for this purpose.
(l)By March 1, 2025, the department shall submit a report to the policy and budget subcommittees of the Legislature describing the extent to which the requirements of this section have not been met, including the surveying of all consumers, including those with no purchase of services, and providing specific steps and the schedule by which these requirements will be met.
SEC. 6.Section 4620.6 is added to the Welfare and Institutions Code, to read:4620.6.(a)(1)To provide uniformity, consistency, and cost-effectiveness in the delivery of services by regional centers throughout the state, the department shall establish, by January 1, 2026, a common set of services and supports, including supported living services, that every regional center in the state shall make available to consumers in negotiating, developing, or amending the individualized program plan as required by Sections 4646 and 4646.5. The common set of services and supports shall be prominently posted on each regional centers internet website.
(2)The department shall develop the common set of services and supports in consultation with the Association of Regional Center Agencies, consumers and their families, advocacy organizations, and service providers.
(b)In each contract with a regional center, the department shall require the common set of services and supports developed pursuant to this section to be available to consumers in the development of an individual program plan.
(c)It is the intent of the Legislature that this section not be construed to control or interfere with the discretion of the individual program planning team to determine the needs and services appropriate for each person with a developmental disability who is entitled to services under this division. It is further the intent of the Legislature that the common set of services and supports developed pursuant to this section shall be deemed the minimum level of services and supports and does not preclude other services and supports from being included in a negotiated individualized program plan.
SEC. 7.Section 4622 of the Welfare and Institutions Code is amended to read:4622.The state shall contract only with agencies, the governing boards of which conform to all of the following criteria:
(a)The governing board shall be composed of individuals with demonstrated interest in, or knowledge of, developmental disabilities.
(b)The membership of the governing board shall include persons with legal, management or board governance, financial, and developmental disability program expertise. Board governance expertise may not be acquired solely by serving on a regional center board. The governing board of the regional center shall include members with financial expertise and members with management or board governance expertise by August 15, 2020.
(c)The membership of the governing board shall include representatives of the various categories of disability to be served by the regional center.
(d)The governing board shall reflect the geographic and ethnic characteristics of the area to be served by the regional center.
(e)A minimum of 50 percent of the members of the governing board shall be persons with developmental disabilities or their parents or legal guardians. No less than 25 percent of the members of the governing board shall be persons with developmental disabilities.
(f)(1)Members of the governing board shall not be permitted to serve more than seven years within each eight-year period.
(2)The board nominating committee shall solicit interests and nominations from the broader community through outreach. The committee shall interview candidates for the board and make recommendations to the governing board for election. During the meeting at which the board elects new members, a candidate may be nominated by a board member with a second by another board member for the open positions. A regional center executive director shall be prohibited from any involvement in the recruitment or election of governing board members.
(g)(1)The department shall provide necessary training and support to these board members to facilitate their understanding and participation, including issues relating to linguistic and cultural competency. The training shall be developed with community input, including persons served and family members. Ongoing support by the department shall include surveying board members about their ability to meaningfully participate in, and understand the subjects and votes at, board meetings. If board members report that they are unable to meaningfully participate, the department shall work with the regional center and the board member to ensure adequate and appropriate accommodations are provided.
(2)As part of its monitoring responsibility, the department shall review and approve the method by which training and support are provided to board members to ensure maximum understanding and participation by board members.
(3)Each regional center shall post on its internet website information regarding the training and support provided to board members.
(h)The governing board may appoint a consumers advisory committee composed of persons with developmental disabilities representing the various categories of disability served by the regional center.
(i)The governing board shall appoint an advisory committee composed of a wide variety of persons representing the various categories of providers from which the regional center purchases client services. The advisory committee shall provide advice, guidance, recommendations, and technical assistance to the regional center board in order to assist the regional center in carrying out its mandated functions. The advisory committee shall designate one of its members to serve as a member of the regional center board.
(j)(1)The governing board shall annually review the performance of the director of the regional center. The department shall establish guidelines for governing boards to measure executive director performance, including with respect to issues of equity and diversity.
(2)The governing board shall annually review the performance of the regional center in providing services that are linguistically and culturally appropriate and may provide recommendations to the director of the regional center based on the results of that review.
(k)A member of the board who is an employee or member of the governing board of a provider from which the regional center purchases client services shall not do any of the following:
(1)Serve as an officer of the board.
(2)Vote on any fiscal matter affecting the purchase of services from any regional center provider.
(3)Vote on any issue other than as described in paragraph (2), in which the member has a financial interest, as defined in Section 87103 of the Government Code, and determined by the regional center board. The member shall provide a list of the members financial interests, as defined in Section 87103, to the regional center board.
(l)The department shall establish, and each board shall adopt, an antiretaliation policy for board members that requires department approval for any reduction in services for consumer board members or the family member of family board members.
(m)The department shall establish and adopt a grievance procedure whereby a governing board member who has concerns, complaints, or questions may contact a specific executive at the department.
(n)This section does not prevent the appointment to a regional center governing board of a person who meets the criteria for more than one of the categories listed above.
SEC. 8.Section 4626.5 of the Welfare and Institutions Code is amended to read:4626.5.Each regional center shall submit a conflict-of-interest policy to the department by July 1, 2011, and shall post the policy on its internet website by August 1, 2011. The policy shall do, or comply with, all of the following:
(a)Contain the elements of this section and be consistent with applicable law.
(b)Define conflicts of interest.
(c)Identify positions within the regional center required to complete and file a conflict-of-interest statement.
(d)Facilitate disclosure of information to identify conflicts of interest.
(e)Require candidates for nomination, election, or appointment to a regional center board, and applicants for regional center director to disclose any potential or present conflicts of interest prior to being appointed, elected, or confirmed for hire by the regional center or the regional center governing board.
(f)Require the regional center and its governing board to regularly and consistently monitor and enforce compliance with its conflict-of-interest policy.
(g)Prohibit a regional center employee from accepting a gift or gifts from a service provider, consumer, or consumers family member valued over fifteen dollars ($15) per year.
(h)Establish a policy prohibiting regional center senior staff from hiring relatives at the center or any ancillary foundation and organization. The policy shall be included in the regional center contract and shall be included in training of the governing board.
SEC. 9.Section 4629.1 is added to the Welfare and Institutions Code, to read:4629.1.(a)Notwithstanding any other law, the evaluation of regional center performance shall be implemented using a common set of performance measures, which shall be administered by the department. This includes the performance requirements under the regional center contracts pursuant to Section 4629, the performance incentives established under Section 4620.5, and the quality assessment instrument required under Section 4571. These measures shall be annually reported and made available to the public through posting of the measures results in machine-readable formats.
(b)(1)By July 1, 2025, the department shall establish standards for each measure above that contain thresholds above which a regional center may be eligible to receive rewards for good performance and thresholds below which a regional center may be subject to each level of probation required under Section 4629. The department shall establish the process for assessing corrective action undertaken by a regional center and the process by which a regional center may end its probation status.
(2)The department, in consultation with stakeholders, including consumers and family members, shall annually establish, update, and review the standards related to good performance.
(3)(A)The department, in consultation with stakeholders, including consumers and family members, shall annually establish, update, and review a uniform process to be used by regional centers to develop corrective action plans that respond to below standard performance.
(B)The process shall include all of the following:
(i)Technical assistance and training from the department either directly or through subject matter experts.
(ii)The sharing of resources from other regional centers that have met the performance measures.
(iii)Participation by the board of directors of the regional center in developing and monitoring the implementation of the corrective action plan in consultation with local stakeholders, including consumers and family members.
(C)The department shall oversee the process to develop the corrective action plan and assess corrective action undertaken by the regional center.
(c)The performance measures shall encompass the domains as itemized in subdivision (d). Additional measures may be adopted by the department as needed. Modification of the domain and measures shall be accomplished through a process of consultation that includes the engagement of stakeholders in a manner consistent with that required by subdivision (b) of Section 4620.5. The measures may be amended as reporting mechanisms mature as the department develops new information technology capabilities.
(d)The performance measures for purposes of this section shall be organized under seven domains, as follows:
(1)Community integration.
(2)Employment.
(3)Equity in service access.
(4)Case management.
(5)Consumer and family choice, experience, and satisfaction.
(6)Human and civil rights.
(7)Health and safety.
SEC. 10.Section 4639.76 is added to the Welfare and Institutions Code, to read:4639.76.(a)A regional center with which the department maintains a contract pursuant to Section 4629 shall be subject to the California Public Records Act (Chapter 1 (commencing with Section 7920.000) of Division 10 of Title 1 of the Government Code).
(b)This section shall become operative on January 1, 2025.
SEC. 11.Section 4642 of the Welfare and Institutions Code is amended to read:4642.(a)(1)Any person believed to have a developmental disability, and any person believed to have a high risk of parenting an infant with a developmental disability shall be eligible for initial intake and assessment services in the regional centers. In addition, any infant having a high risk of becoming developmentally disabled may be eligible for initial intake and assessment services in the regional centers. For purposes of this section, high-risk infant means a child less than 36 months of age whose genetic, medical, or environmental history is predictive of a substantially greater risk for developmental disability than that for the general population. The department, in consultation with the State Department of Public Health, shall develop specific risk and service criteria for the high-risk infant program on or before July 1, 1983. These criteria may be modified in subsequent years based on analysis of actual clinical experience.
(2)(A)Initial intake shall be performed within 15 working days following request for assistance. Initial intake shall include, but need not be limited to, information and advice about the nature and availability of services provided by the regional center and by other agencies in the community, including guardianship, conservatorship, income maintenance, mental health, housing, education, work activity and vocational training, medical, dental, recreational, and other services or programs that may be useful to persons with developmental disabilities or their families. Intake shall also include a decision to provide assessment.
(B)For purposes of this section, request for assistance includes any initial contact or inquiry from an individual, or a person acting on their behalf, on the nature of services or supports available or provided by the regional center, and the individuals eligibility to receive them.
(3)(A)The department shall create, with input from stakeholders, standardized information packets to be provided to any person seeking services from a regional center. There shall be one information packet related to services provided under the California Early Intervention Services Act and another information packet related to services provided under the Lanterman Developmental Disabilities Services Act. The information packets shall be translated to provide language access, as required by state and federal law, shall be reasonably culturally competent for diverse racial and ethnic communities, including immigrants and Native Americans, shall be available in alternative formats and alternative modes of communication, as required by federal law, and shall include, at a minimum, all of the following:
(i)An overview of the regional center system.
(ii)A resource guide for consumers and their families.
(iii)Consumer rights, including the appeals procedures specified in Chapter 7 (commencing with Section 4700).
(iv)Contact information for the regional center, the department, the office of clients rights advocacy, and the protection and advocacy agency specified in Division 4.7 (commencing with Section 4900).
(v)Information on the Self-Determination Program, including the eligibility requirements specified in subdivision (d) of Section 4685.8.
(B)Each regional center shall distribute the information packets at intake, upon transfer to receiving services under the Lanterman Developmental Disabilities Services Act, and upon request. Each regional center shall begin distributing the information packets within 60 days following the department providing the information packets and issuing directives regarding the distribution of the information packets. In addition to, and not in lieu of, this requirement, each regional center shall post the full content of the most updated information packet on its internet website.
(b)A regional center shall communicate, with reasonable cultural competency, including Native American cultural competency, with the consumer and the consumers family pursuant to this section in their native language, including providing alternative communication services and alternative formats, as required by state and federal law.
SEC. 12.Section 4646 of the Welfare and Institutions Code is amended to read:4646.(a)It is the intent of the Legislature to ensure that the individual program plan and provision of services and supports by the regional center system is centered on the individual and the family of the individual with developmental disabilities and takes into account the needs and preferences of the individual and the family, if appropriate, as well as promoting community integration, independent, productive, and normal lives, and stable and healthy environments. It is the further intent of the Legislature to ensure that goals in any plan allow for innovation and nontraditional service delivery and not be limited by the lack of easily identified services or supports, the provision of services to consumers and their families be effective in meeting the goals stated in the individual program plan, reflect the preferences and choices of the consumer, and reflect the cost-effective use of public resources.
(b)(1)Notwithstanding any other law, the individual program plan, including all assessments, shall be developed through a process of individualized needs determination and person-centered service planning developed pursuant to, and consistent with, Section 2402(a) of the federal Affordable Care Act (Pub. L. 111-148) and amendments thereto, Section 441.725 of Title 42 of the Code of Federal Regulations, and federal guidance issued by the Centers for Medicare and Medicaid Services on June 6, 2014, requiring community-based, long-term services and supports to be person-centered, strengths-based, and self-directed. The individual with developmental disabilities and, if appropriate, the individuals parents, legal guardian or conservator, or authorized representative, shall have the opportunity to actively participate in the development of the plan. The individual shall lead the service planning process to the greatest extent possible.
(c)An individual program plan shall be developed for any person who, following intake and assessment, is found to be eligible for regional center services. These plans shall be completed within 60 days of the completion of the assessment. At the time of intake, the regional center shall inform the consumer and, if appropriate, the consumers parents, legal guardian or conservator, or authorized representative, of the services available through the state council and the protection and advocacy agency designated by the Governor pursuant to federal law, and shall provide the address and telephone numbers of those agencies.
(d)(1)As part of the initial individual program plan meeting and each annual review required by subdivision (b) of Section 4646.5, the consumer or, if appropriate, their parents, legal guardian, conservator, or authorized representative, shall be provided by the service coordinator oral and written information about the Self-Determination Program. The information shall include each of the provisions specified in subdivision (d) of Section 4685.8. Each individual program plan shall include a provision stating that the consumer or authorized representative was informed about the availability of the Self-Determination Program. If the consumer chooses not to participate in the program, the individual program plan shall include an explanation of the reason or reasons for that decision, or, if the consumer is ineligible for the program, the reason or reasons for that ineligibility.
(2)If the consumer is interested in participating in the program or wants additional information or assistance, the service coordinator, within five business days of expressing the interest, shall provide the consumer a date for the Self-Determination Program orientation, training resources, dates of local volunteer Self-Determination Program advisory committee meetings, and other information to assist the consumer in participating in the program.
(e)Individual program plans shall be prepared jointly by the planning team. Decisions concerning the consumers goals, objectives, and services and supports that will be included in the consumers individual program plan and purchased by the regional center or obtained from generic agencies shall be made by agreement between the regional center representative and the consumer or, if appropriate, the parents, legal guardian, conservator, or authorized representative at the program plan meeting.
(f)Regional centers shall comply with the request of a consumer or, if appropriate, the request of the consumers parents, legal guardian, conservator, or authorized representative, that a designated representative receive written notice of all meetings to develop or revise the individual program plan and of all notices sent to the consumer pursuant to Section 4710. The designated representative may be a parent or family member.
(g)Notwithstanding any other law, a meeting regarding the provision of services and supports by the regional center, including a meeting to develop or revise the individual program plan, shall be held by remote electronic communications if requested by the consumer or, if appropriate, if requested by the consumers parents, legal guardian, conservator, or authorized representative.
(h)At the conclusion of an individual program plan meeting, an authorized representative of the regional center shall provide to the consumer, in written or electronic format, a list of the agreed-upon services and supports, and, if known, the projected start date, the frequency and duration of the services and supports, and the provider. The authorized representative of the regional center shall sign the list of agreed-upon services and supports at that time. The consumer, or if appropriate, the consumers parent, legal guardian, conservator, or authorized representative shall sign the list of agreed-upon services and supports prior to its implementation. The consumer, or if appropriate, the consumers parent, legal guardian, conservator, or authorized representative, may elect to delay receipt of the list of agreed-upon services and supports pending final agreement, as described in subdivision (h). If the consumer, or if appropriate, the consumers parent, legal guardian, conservator, or authorized representative, elects to delay the receipt of the list of agreed-upon services and supports for 15 days, the list shall be provided in the preferred language of the consumer, or of the consumers parent, legal guardian, or authorized representative.
(i)If a final agreement regarding the services and supports to be provided to the consumer cannot be reached at a program plan meeting, then a subsequent program plan meeting shall be convened within 15 days, or later at the request of the consumer or, if appropriate, the parents, legal guardian, conservator, or authorized representative or if agreed to by the planning team. The list of the agreed-upon services and supports described in subdivision (h) and signed by the authorized representative of the regional center shall be provided, in writing or electronically, at the conclusion of the subsequent program plan meeting, and shall be provided in the preferred language of the consumer, or of the consumers parent, legal guardian, conservator, or authorized representative. Additional program plan meetings may be held with the agreement of the regional center representative and the consumer or, if appropriate, the parents, legal guardian, conservator, or authorized representative.
(j)An authorized representative of the regional center and the consumer or, if appropriate, the consumers parent, legal guardian, conservator, or authorized representative shall sign the individual program plan and the list of the agreed-upon services and supports prior to its implementation. If the consumer or, if appropriate, the consumers parent, legal guardian, conservator, or authorized representative, does not agree with all components of the individual program plan, the consumer may indicate that disagreement on the plan. Disagreement with specific plan components shall not prohibit the implementation of services and supports agreed to by the consumer or, if appropriate, the consumers parent, legal guardian, conservator, or authorized representative. If the consumer or, if appropriate, the consumers parent, legal guardian, conservator, or authorized representative, does not agree with the plan in whole or in part, the consumer shall be sent written notice of their appeal rights, as required by Sections 4701 and 4710.
(k)(1)A regional center shall communicate in the consumers preferred language, or, if appropriate, the preferred language of the consumers family, legal guardian, conservator, or authorized representative, during the planning process for the individual program plan, including during the program plan meeting, and including providing alternative communication services, as required by Sections 11135 to 11139.8, inclusive, of the Government Code and implementing regulations.
(2)A regional center shall provide alternative communication services, including providing copies of the list of services and supports, and the individual program plan in the preferred language of the consumer or the consumers family, legal guardian, conservator, or authorized representative, or both, as required by Sections 11135 to 11139.8, inclusive, of the Government Code and implementing regulations.
(3)The preferred language of the consumer or the consumers family, legal guardian, conservator, or authorized representative, or both, shall be documented in the individual program plan.
SEC. 13.Section 4646.4 of the Welfare and Institutions Code is amended to read:4646.4.(a)Regional centers shall ensure, at the time of development, scheduled review, or modification of a consumers individual program plan developed pursuant to Sections 4646 and 4646.5, or of an individualized family service plan pursuant to Section 95020 of the Government Code, the establishment of an internal process. This internal process shall ensure adherence with federal and state law and regulation, and if purchasing services and supports, shall ensure all of the following:
(1)Conformance with the regional centers purchase of service policies, as approved by the department pursuant to subdivision (d) of Section 4434.
(2)Utilization of generic services and supports if appropriate. The individualized family service planning team for infants and toddlers eligible under Section 95014 of the Government Code and the individual program plan team pursuant to Section 4646 may determine that a service provided by a generic agency, as defined by subdivision (g) of Section 4659.5, or a service or source of funding contained in Section 4659 identified in the individualized family service plan or individual program plan is not available, and, therefore, will be funded by the regional center.
(3)Utilization of other services and sources of funding as contained in Section 4659.
(4)Consideration of the familys responsibility for providing similar services and supports for a minor child without disabilities in identifying the consumers service and support needs as provided in the least restrictive and most appropriate setting. In this determination, regional centers shall take into account the consumers need for extraordinary care, services, supports and supervision, and the need for timely access to this care.
(5)Commencing October 1, 2022, consideration of information obtained from the consumer and, if appropriate, the parents, legal guardian, conservator, or authorized representative about the consumers need for the services, barriers to service access, and other information.
(b)At the time of development, scheduled review, or modification of a consumers individual program plan developed pursuant to Sections 4646 and 4646.5, or of an individualized family service plan pursuant to Section 95020 of the Government Code, the consumer, or, if appropriate, the parents, legal guardian, or conservator, shall provide copies of their health benefit cards under which the consumer is eligible to receive health benefits, including, but not limited to, private health insurance, a health care service plan, Medi-Cal, Medicare, and TRICARE. If the individual, or, if appropriate, the parents, legal guardians, or conservators, do not have health benefits, the regional center shall not use that fact to negatively impact the services that the individual may or may not receive from the regional center.
(c)Final decisions regarding the consumers individual program plan shall be made pursuant to Section 4646.
(d)Final decisions regarding the individualized family service plan shall be made pursuant to Section 95020 of the Government Code.
SEC. 14.Section 4646.5 of the Welfare and Institutions Code is amended to read:4646.5.(a)The planning process for the individual program plan described in Section 4646 shall include all of the following:
(1)Gathering information and conducting assessments to determine the life goals, capabilities and strengths, preferences, barriers, and concerns or problems of the person with developmental disabilities. For children with developmental disabilities, this process should include a review of the strengths, preferences, and needs of the child and the family unit as a whole. Assessments shall be conducted by qualified individuals and performed in natural environments whenever possible. Information shall be taken from the consumer, the consumers parents and other family members, the consumers friends, advocates, authorized representative, if applicable, providers of services and supports, and other agencies. The assessment process shall reflect awareness of, and sensitivity to, the lifestyle and cultural background of the consumer and the family.
(2)A statement of goals, based on the needs, preferences, and life choices of the individual with developmental disabilities, and a statement of specific, time-limited objectives for implementing the persons goals and addressing the persons needs. These objectives shall be stated in terms that allow measurement of progress or monitoring of service delivery. These goals and objectives should maximize opportunities for the consumer to develop relationships, be part of community life in the areas of community participation, housing, work, school, and leisure, increase control over the consumers life, acquire increasingly positive roles in community life, and develop competencies to help accomplish these goals.
(3)In developing individual program plans for children, regional centers shall be guided by the principles, process, and services and support parameters set forth in Section 4685.
(4)In developing an individual program plan for a transition age youth or working age adult, the planning team shall consider the Employment First Policy described in Chapter 14 (commencing with Section 4868).
(5)A schedule of the type and amount of services and supports to be purchased by the regional center or obtained from generic agencies or other resources in order to achieve the individual program plan goals and objectives, and identification of the provider or providers of service responsible for attaining each objective, including, but not limited to, vendors, contracted providers, generic service agencies, and natural supports. The individual program plan shall specify the approximate scheduled start date for services and supports and shall contain timelines for actions necessary to begin services and supports, including generic services. In addition to the requirements of subdivision (h) of Section 4646, each regional center shall offer, and upon request provide, a written copy of the individual program plan to the consumer, and, if appropriate, the consumers parents, legal guardian or conservator, or authorized representative within 45 days of their request in a threshold language, as defined by paragraph (3) of subdivision (a) of Section 1810.410 of Title 9 of the California Code of Regulations.
(6)If agreed to by the consumer, the parents, legally appointed guardian, or authorized representative of a minor consumer, or the legally appointed conservator of an adult consumer or the authorized representative, including those appointed pursuant to subdivision (a) of Section 4541, subdivision (b) of Section 4701.6, and subdivision (e) of Section 4705, a review of the general health status of the adult or child, including medical, dental, and mental health needs, shall be conducted. This review shall include a discussion of current medications, any observed side effects, and the date of the last review of the medication. Service providers shall cooperate with the planning team to provide any information necessary to complete the health status review. If any concerns are noted during the review, referrals shall be made to regional center clinicians or to the consumers physician, as appropriate. Documentation of health status and referrals shall be made in the consumers record by the service coordinator.
(7)(A)The development of a transportation access plan for a consumer when all of the following conditions are met:
(i)The regional center is purchasing private, specialized transportation services or services from a residential, day, or other provider, excluding vouchered service providers, to transport the consumer to and from day or work services.
(ii)The planning team has determined that a consumers community integration and participation could be safe and enhanced through the use of public transportation services.
(iii)The planning team has determined that generic transportation services are available and accessible.
(B)To maximize independence and community integration and participation, the transportation access plan shall identify the services and supports necessary to assist the consumer in accessing public transportation and shall comply with Section 4648.35. These services and supports may include, but are not limited to, mobility training services and the use of transportation aides. Regional centers are encouraged to coordinate with local public transportation agencies.
(8)A schedule of regular periodic review and reevaluation to ascertain that planned services have been provided, that objectives have been fulfilled within the times specified, and that consumers and families are satisfied with the individual program plan and its implementation.
(b)For all active cases, individual program plans shall be reviewed and modified by the planning team, through the process described in Section 4646, as necessary, in response to the persons achievement or changing needs, and no less often than once every 24 months. If the consumer or, if appropriate, the consumers parents, legal guardian, authorized representative, or conservator requests an individual program plan review, the individual program plan shall be reviewed within 30 days after the request is submitted, or no later than 7 days after the request is submitted if necessary for the consumers health and safety or to maintain the consumer in their home.
(c)(1)The department, with the participation of representatives of a statewide consumer organization, the Association of Regional Center Agencies, an organized labor organization representing service coordination staff, and the state council shall prepare training material and a standard format and instructions for the preparation of individual program plans, which embody a person-centered planning process consistent with federal law, regulations, and guidance.
(2)The department shall require each regional center to use, for all new and modified individual program plans, the training materials and the standard format plan prepared by the department pursuant to paragraph (1) by no later than March 1, 2025.
(3)The department shall biennially review a random sample of individual program plans at each regional center to ensure that these plans are being developed and modified in compliance with Section 4646 and this section.
SEC. 15.Section 4659 of the Welfare and Institutions Code is amended to read:4659.(a)Except as otherwise provided in subdivision (b), (d), or (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 centers purchase of services budget, except as it relates to federal supplemental security income and the state supplementary program.
(c)Effective July 1, 2009, notwithstanding any other law or regulation, 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 Supportive Services, California Childrens 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 after being advised of the provisions of subdivision (d). If, on July 1, 2009, a regional center is purchasing that service as part of a consumers individual program plan (IPP), the prohibition shall take effect on October 1, 2009.
(d)(1)Notwithstanding Section 4646.4, a regional center may request a consumer or family member to pursue a service or source of funding from an entity described in subdivision (a) or (c) of this section, or pursuant to subdivision (g) of Section 4659.5, if the request is documented with specificity in the individual program plan or individualized family plan and the plan contains detailed instructions for the consumer or family pursuing the service. The individual program plan or individualized family plan shall also specify the ways in which the regional center will initially assist the consumer or family to apply for and pursue the service or source of funding and specify that it will provide additional assistance when requested by the consumer or family.
(2)The regional center shall purchase the service when the entity denies the service.
(3)A consumer, or their family, shall not be required to appeal an entitys denial of the requested service for the regional center to purchase that service pursuant to this subdivision. The regional center may file an appeal on behalf of the consumer, but the appeal shall not delay the payment of the requested service by the regional center as specified in subparagraph (B) of paragraph (2).
(4)This section does not prohibit a consumer or their family, where appropriate, from filing a formal appeal of an entitys denial of the service at issue, or a regional center from seeking reimbursement from the entity it believes is responsible for providing the service and from requesting assistance with filing the appeal or from utilizing assistance from other advocacy organizations.
(e)This section shall not 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.
(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.
(g)To provide uniformity, consistency, and cost-effectiveness, to reduce barriers, and to increase the number of service providers throughout the state, the department shall comprehensively review the current processes for vendorizing providers for the delivery of services and supports to regional center consumers and revise those processes to streamline the process and create a uniform statewide vendorization process. The department shall develop the revised processes, in consultation with the Association of Regional Center Agencies, consumers and their families, advocacy organizations, and service providers.
SEC. 16.Section 4685.8 of the Welfare and Institutions Code is amended to read:4685.8.(a)The department shall implement a statewide Self-Determination Program. The Self-Determination Program shall 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. As of July 1, 2021, the program shall begin to be available on a voluntary basis to all regional center consumers who are eligible for the Self-Determination Program.
(b)The department, in establishing the statewide program, shall do both of the following:
(1)Set targets and benchmarks as set forth in paragraph (1) of subdivision (r).
(2)Address all of the following:
(A)Oversight of expenditure of self-determined funds and the achievement of participant outcomes over time.
(B)Increased participant control over which services and supports best meet the participants needs and the IPP objectives. A participants unique support system may include the purchase of existing service offerings from service providers or local businesses, hiring their own support workers, or negotiating unique service arrangements with local community resources.
(C)Comprehensive person-centered planning, including an individual budget and services that are outcome based.
(D)Consumer and family training to ensure understanding of the principles of self-determination, the planning process, and the management of budgets, services, and staff.
(E)Choice of independent facilitators, who meet standards and certification requirements established by the department, and who can assist with the functions specified in paragraph (2) of subdivision (c).
(F)Choice of financial management services providers who meet standards and certification requirements established by the department, and who can carry out the functions specified in paragraph (1) of subdivision (c).
(G)Innovation that will more effectively allow participants to achieve their goals.
(H)Long-term sustainability of the Self-Determination Program by doing all of the following:
(i)Requiring IPP teams, when developing the individual budget, to determine the services, supports, and goods necessary for each consumer based on the needs and preferences of the consumer and, when appropriate, the consumers family, the effectiveness of each option in meeting the goals specified in the IPP, and the cost-effectiveness of each option, as specified in subparagraph (D) of paragraph (6) of subdivision (a) of Section 4648.
(ii)The department may review final individual budgets that are at or above a spending threshold determined by the department of all individual budgets and use information from its review in the aggregate to develop additional program guidance and verify compliance with federal and state laws and other requirements.
(c)For purposes of this section, the following definitions apply:
(1)Financial management services means services or functions that assist the participant to manage and direct the distribution of funds contained in the individual budget, and ensure that the participant has the financial resources to implement their IPP throughout the year. These may include bill paying services and activities that facilitate the employment of service and support workers by the participant, including, but not limited to, fiscal accounting, tax withholding, compliance with relevant state and federal employment laws, assisting the participant in verifying provider qualifications, including criminal background checks, and expenditure reports. The financial management services provider shall meet the applicable requirements of Title 17 of the California Code of Regulations and other specific qualifications or certifications established by the department.
(2)Independent facilitator means a person, selected and directed by the participant, who is not otherwise providing services to the participant pursuant to their IPP and is not employed by a person providing services to the participant. The independent facilitator may assist the participant in making informed decisions about the individual budget, and in locating, accessing, and coordinating services and supports consistent with the participants IPP. The independent facilitator is available to assist in identifying immediate and long-term needs, developing options to meet those needs, leading, participating, or advocating on behalf of the participant in the person-centered planning process and development of the IPP, and obtaining identified services and supports. The cost of the independent facilitator, if any, shall be paid by the participant out of the participants individual budget. An independent facilitator shall receive training in the principles of self-determination, the person-centered planning process, and the other responsibilities described in this paragraph at the independent facilitators own cost. The independent facilitator shall meet standards and certification requirements established by the department.
(3)Individual budget means the amount of regional center purchase of service funding available to the participant for the purchase of services and supports necessary to implement the IPP. The individual budget shall be determined using a fair, equitable, and transparent methodology.
(4)IPP means individual program plan, as described in Section 4646.
(5)Participant means an individual and, when appropriate, the participants parents, legal guardian or conservator, or authorized representative, who has been deemed eligible for, and has voluntarily agreed to participate in, the Self-Determination Program.
(6)Self-determination means a voluntary delivery system consisting of a defined and comprehensive mix of services and supports, selected and directed by a participant through person-centered planning, in order to meet the objectives in their IPP. Self-determination services and supports are designed to assist the participant to achieve personally defined outcomes in community settings that promote inclusion. The Self-Determination Program shall only fund services and supports provided pursuant to this division that the federal Centers for Medicare and Medicaid Services determines are eligible for federal financial participation.
(7)Spending Plan means the plan the participant develops to use their available individual budget funds to purchase goods, services, and supports necessary to implement their individual program plan (IPP). The spending plan shall identify the cost of each good, service, and support that will be purchased with regional center funds. The total amount of the spending plan cannot exceed the amount of the individual budget. A copy of the spending plan shall be attached to the participants IPP.
(d)Participation in the Self-Determination Program is fully voluntary. A participant may choose to participate in, and may choose to leave, the Self-Determination Program at any time. A regional center shall not require or prohibit participation in the Self-Determination Program as a condition of eligibility for, or the delivery of, services and supports otherwise available under this division. Participation in the Self-Determination Program shall be available to any regional center consumer who meets the following eligibility requirements:
(1)The participant has a developmental disability, as defined in Section 4512, and is receiving services pursuant to this division.
(2)The consumer does not live in a licensed long-term health care facility, as defined in paragraph (44) of subdivision (a) of Section 54302 of Title 17 of the California Code of Regulations. An individual and, when appropriate, the individuals parent, legal guardian or conservator, or authorized representative, who is not eligible to participate in the Self-Determination Program pursuant to this paragraph may request that the regional center provide person-centered planning services in order to make arrangements for transition to the Self-Determination Program, provided that the individual is reasonably expected to transition to the community within 90 days. In that case, the regional center shall initiate person-centered planning services within 60 days of that request.
(3)The participant agrees to all of the following terms and conditions:
(A)The participant shall receive an orientation that meets the standards set or developed by the department to the Self-Determination Program prior to enrollment, which includes the principles of self-determination, the role of the independent facilitator and the financial management services provider, person-centered planning, and development of a budget.
(B)The participant shall utilize the services and supports available within the Self-Determination Program only when generic services and supports are not available.
(C)The participant shall only purchase services and supports necessary to implement their IPP and shall comply with any and all other terms and conditions for participation in the Self-Determination Program described in this section.
(D)The participant shall manage Self-Determination Program services and supports within the participants individual budget.
(E)The participant shall utilize the services of a financial management services provider of their own choosing and who is vendored by a regional center and who meets the qualifications in paragraph (1) of subdivision (c).
(F)The participant may utilize the services of an independent facilitator of their own choosing for the purpose of providing services and functions as described in paragraph (2) of subdivision (c). If the participant elects not to use an independent facilitator, the participant may use their regional center service coordinator to provide the services and functions described in paragraph (2) of subdivision (c).
(G)If eligible, with the assistance of the regional center, if needed, timely apply for Medi-Cal in order to maximize federal funding. The participant may consider institutional deeming in order to qualify for Medi-Cal services.
(e)A participant who is not Medi-Cal eligible may participate in the Self-Determination Program and receive self-determination services and supports if all other program eligibility requirements are met and the services and supports are otherwise eligible for federal financial participation.
(f)The additional federal financial participation funds generated by the former participants of the self-determination pilot projects authorized pursuant to Section 13 of Chapter 1043 of the Statutes of 1998, as amended, or pursuant to Article 4 (commencing with Section 4669.2) of Chapter 5, shall be used to maximize the ability of Self-Determination Program participants to direct their own lives and to ensure the department and regional centers successfully implement the program as follows:
(1)First, to offset the cost to the department for the criminal background check conducted pursuant to subdivision (v) and other administrative costs incurred by the department in implementing the Self-Determination Program.
(2)With the remaining funds, the department, in consultation with stakeholders, including a statewide self-determination advisory workgroup, shall prioritize the use of the funds to meet the needs of participants, increase service access and equity, and reduce disparities, and to implement the program, including costs associated with all of the following:
(A)Independent facilitators to assist with a participants initial person-centered planning meeting.
(B)Development of the participants initial individual budget.
(C)Joint training of consumers, family members, regional center staff, and members of the local volunteer advisory committee established pursuant to paragraph (1) of subdivision (w).
(D)Regional center operations to increase support for transition to the Self-Determination Program or for caseload ratio enhancement.
(E)To offset the costs to the regional centers in implementing the Self-Determination Program.
(F)To support the Statewide Self-Determination Advisory Committee established pursuant to paragraph (2) of subdivision (w).
(g)If at any time during participation in the Self-Determination Program a regional center determines that a participant is no longer eligible to continue in, or a participant voluntarily chooses to exit, the Self-Determination Program, the regional center shall provide for the participants transition from the Self-Determination Program to other services and supports. This transition shall include the development of a new IPP that reflects the services and supports necessary to meet the individuals needs. The regional center shall ensure that there is no gap in services and supports during the transition period.
(h)An individual determined to be ineligible for or who voluntarily exits the Self-Determination Program shall be permitted to return to the Self-Determination Program upon meeting all applicable eligibility criteria and upon approval of the participants planning team, as described in subdivision (j) of Section 4512. An individual who has voluntarily exited the Self-Determination Program shall not return to the program for at least 12 months.
(i)An individual who participates in the Self-Determination Program may elect to continue to receive self-determination services and supports if the individual transfers to another regional center catchment area, provided that the individual remains eligible for the Self-Determination Program pursuant to subdivision (d). The balance of the participants individual budget shall be reallocated to the regional center to which the participant transfers.
(j)The IPP team shall utilize the person-centered planning process to develop the IPP for a participant. The IPP shall detail the goals and objectives of the participant that are to be met through the purchase of participant-selected services and supports. The IPP team shall determine the individual budget to ensure the budget assists the participant to achieve the outcomes set forth in the participants IPP and ensures their health and safety. The completed individual budget shall be attached to the IPP.
(k)The participant shall implement their IPP, including choosing and purchasing the services and supports allowable under this section necessary to implement the plan. A participant is exempt from the cost control restrictions regarding the purchases of services and supports pursuant to Section 4648.5. A regional center shall not prohibit the purchase of any service or support that is otherwise allowable under this section.
(l)A participant shall have all the rights established in Sections 4646 to 4646.6, inclusive, and Chapter 7 (commencing with Section 4700).
(m)(1)Except as provided in paragraph (4), the IPP team shall determine the initial and any revised individual budget for the participant using the following methodology:
(A)(i)Except as specified in clause (ii), for a participant who is a current consumer of the regional center, their individual budget shall be the total amount of the most recently available 12 months of purchase of service expenditures for the participant.
(ii)An adjustment may be made to the amount specified in clause (i) if both of the following occur:
(I)The IPP team determines that an adjustment to this amount is necessary due to a change in the participants circumstances, needs, or resources that would result in an increase or decrease in purchase of service expenditures, or the IPP team identifies prior needs or resources that were unaddressed in the IPP, which would have resulted in an increase or decrease in purchase of service expenditures. When adjusting the budget, the IPP team shall document the specific reason for the adjustment in the IPP.
(II)The regional center certifies on the individual budget document that regional center expenditures for the individual budget, including any adjustment, would have occurred regardless of the individuals participation in the Self-Determination Program.
(iii)For purposes of clauses (i) and (ii), the amount of the individual budget shall not be increased to cover the cost of the independent facilitator.
(B)For a participant who is either newly eligible for regional center services or who does not have 12 months of purchase service expenditures, the participants individual budget shall be calculated as follows:
(i)The IPP team shall identify the services and supports needed by the participant and available resources, as required by Section 4646.
(ii)The regional center shall calculate the cost of providing the services and supports to be purchased by the regional center by using the average cost paid by the regional center for each service or support unless the regional center determines that the consumer has a unique need that requires a higher or lower cost. The IPP team also shall document the specific reason for the adjustment in the IPP. The regional center shall certify on the individual budget document that this amount would have been expended using regional center purchase of service funds regardless of the individuals participation in the Self-Determination Program.
(iii)For purposes of clauses (i) and (ii), the amount of the individual budget shall not be increased to cover the cost of the independent facilitator.
(2)The amount of the individual budget shall be available to the participant each year for the purchase of program services and supports. An individual budget shall be calculated no more than once in a 12-month period, unless revised to reflect a change in circumstances, needs, or resources of the participant using the process specified in clause (ii) of subparagraph (A) of paragraph (1).
(3)The spending plan shall be assigned to uniform budget categories developed by the department in consultation with stakeholders and distributed according to the timing of the anticipated expenditures in the IPP and in a manner that ensures that the participant has the financial resources to implement the IPP throughout the year.
(4)The department, in consultation with stakeholders, may develop alternative methodologies for individual budgets that are computed in a fair, transparent, and equitable manner and are based on consumer characteristics and needs, and that include a method for adjusting individual budgets to address a participants change in circumstances or needs.
(n)Annually, participants may transfer up to 10 percent of the funds originally distributed to any budget category set forth in paragraph (3) of subdivision (m) to another budget category or categories. Transfers in excess of 10 percent of the original amount allocated to any budget category may be made upon the approval of the regional center or the participants IPP team.
(o)Consistent with the implementation date of the IPP, the IPP team shall annually ascertain from the participant whether there are any circumstances or needs that require a change to the annual individual budget. Based on that review, the IPP team shall calculate a new individual budget consistent with the methodology identified in subdivision (m).
(p)(1)The department, as it determines necessary, may adopt regulations to implement the procedures set forth in this section. Any regulations shall be adopted in accordance with the requirements of Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code.
(2)Notwithstanding paragraph (1) and Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, and only to the extent that all necessary federal approvals are obtained, the department, without taking any further regulatory action, shall implement, interpret, or make specific this section by means of program directives or similar instructions until the time regulations are adopted. It is the intent of the Legislature that the department be allowed this temporary authority as necessary to implement program changes only until completion of the regulatory process.
(q)The department, in consultation with stakeholders, shall develop informational materials about the Self-Determination Program. The department shall ensure that regional centers are trained in the principles of self-determination, the mechanics of the Self-Determination Program, and the rights of consumers and families as candidates for, and participants in, the Self-Determination Program.
(r)Each regional center shall be responsible for implementing the Self-Determination Program as a term of its contract under Section 4629. As part of implementing the program, the regional center shall do all of the following:
(1)Meet the Self-Determination Program targets approved by the department, meet benchmarks established by the department in areas including timely enrollment, diversity of consumers served, and reduction of disparities in the individual budget of participants from racial and ethnic communities, and be eligible for incentives for exceeding these targets and benchmarks once the department has established a performance incentives program.
(2)Develop and implement an outreach and training plan about the Self-Determination Program for the diverse communities served by the regional center, including in congregate settings. Information shall be provided in plain language, in alternative formats and alternative modes of communication, and provide language access as required by state and federal law. Obtain input from stakeholders, including consumers and families, that reflect the ethnic and language diversity of the regional centers consumers, about the effectiveness of this outreach and training and other activities that may be effective in reducing disparities in these programs.
(3)Annually report the enrollment, individual budget data, and purchase of service expenditure data for the Self-Determination Program consistent with the criteria in subdivisions (a) to (c), inclusive, of Section 4519.5.
(4)Assist eligible participants and their families in applying for Medi-Cal, in order to maximize federal funding and assist interested participants who wish to pursue institutional deeming in order to qualify for Medi-Cal services.
(5)At least annually, in addition to annual certification, conduct an additional review of all final individual budgets for participants at the regional center which are at or above a spending threshold that is specified by the department through directive consistent with federal and state requirements. This information may be used in the aggregate to provide training, program guidance, and verify compliance with state and federal requirements.
(6)Review the spending plan to verify that goods and services eligible for federal financial participation are not used to fund goods or services available through generic agencies.
(7)Contract with local consumer or family-run organizations and consult with the local volunteer advisory committee established pursuant to paragraph (1) of subdivision (w) to conduct outreach through local meetings or forums to consumers and their families to provide information about the Self-Determination Program and to help ensure that the program is available to a diverse group of participants, with special outreach to underserved communities.
(8)Collaborate with the local consumer or family-run organizations identified in paragraph (1) to jointly conduct training about the Self-Determination Program. The regional center shall consult with the local volunteer advisory committee established pursuant to paragraph (1) of subdivision (w) in planning for the training, and the local volunteer advisory committee may designate members to represent the advisory committee at the training.
(9)Train all service coordinators and fair hearing specialists in the principles of self-determination, the mechanics of the Self-Determination Program, and the rights of consumers and families. The training shall be conducted in collaboration with the local volunteer advisory committee.
(10)Provide payment to the financial management services provider for spending plan expenses through a not less than semimonthly pay schedule.
(11)Ensure that each individual plan includes the information required by subdivision (d) of Section 4646.
(s)The financial management services provider shall provide the participant and the regional center service coordinator with a monthly individual budget statement that describes the amount of funds allocated by budget category, the amount spent in the previous 30-day period, and the amount of funding that remains available under the participants individual budget.
(t)Only the financial management services provider is required to apply for vendorization in accordance with Subchapter 2 (commencing with Section 54300) of Chapter 3 of Division 2 of Title 17 of the California Code of Regulations for the Self-Determination Program. All other service and support providers shall not be on the federal debarment list and shall have applicable state licenses, certifications, or other state required documentation, including documentation of any other qualifications required by the department, but are exempt from the vendorization requirements set forth in Title 17 of the California Code of Regulations when serving participants in the Self-Determination Program.
(u)The regional center shall pay the full costs of the participants financial management services provider.
(v)To protect the health and safety of participants in the Self-Determination Program, the department shall require a criminal background check in accordance with all of the following:
(1)The department shall issue a program directive that identifies nonvendored providers of services and supports who shall obtain a criminal background check pursuant to this subdivision. At a minimum, these staff shall include both of the following:
(A)Individuals who provide direct personal care services to a participant.
(B)Other nonvendored providers of services and supports for whom a criminal background check is requested by a participant or the participants financial management service.
(2)Subject to the procedures and requirements of this subdivision, the department shall administer criminal background checks consistent with the departments authority and the process described in Sections 4689.2 to 4689.6, inclusive.
(3)The department shall electronically submit to the Department of Justice fingerprint images and related information required by the Department of Justice of nonvendored providers of services and supports, as specified in paragraph (1), for purposes of obtaining information as to the existence and content of a record of state or federal convictions and state or federal arrests and also information as to the existence and content of a record of state or federal arrests for which the Department of Justice establishes that the person is free on bail or on their own recognizance pending trial or appeal.
(4)When received, the Department of Justice shall forward to the Federal Bureau of Investigation requests for federal summary criminal history information received pursuant to this section. The Department of Justice shall review the information returned from the Federal Bureau of Investigation and compile and disseminate a response to the department.
(5)The Department of Justice shall provide a state or federal response to the department pursuant to paragraph (1) of subdivision (p) of Section 11105 of the Penal Code.
(6)The department shall request from the Department of Justice subsequent notification service, as provided pursuant to Section 11105.2 of the Penal Code, for persons described in paragraph (1).
(7)The Department of Justice shall charge a fee sufficient to cover the cost of processing the request described in this subdivision.
(8)The fingerprints of any provider of services and supports who is required to obtain a criminal background check shall be submitted to the Department of Justice prior to employment. The costs of the fingerprints and the financial management services administrative cost authorized by the department shall be paid by the services and supports provider or the providers employing agency. Any administrative costs incurred by the department pursuant to this subdivision shall be offset by the funds specified in subdivision (g).
(9)If the criminal record information report shows a criminal history, the department shall take the steps specified in Section 4689.2. The department may prohibit a provider of services and supports from becoming employed, or continuing to be employed, based on the criminal background check, as authorized in Section 4689.6. The provider of services and supports who has been denied employment shall have the rights set forth in Section 4689.6.
(10)The department may utilize a current department-issued criminal record clearance to enable a provider to serve more than one participant, as long as the criminal record clearance has been processed through the department and no subsequent arrest notifications have been received relative to the cleared applicant.
(11)Consistent with subdivision (h) of Section 4689.2, the participant or financial management service that denies or terminates employment based on written notification from the department shall not incur civil liability or unemployment insurance liability.
(w)To ensure the effective implementation of the Self-Determination Program and facilitate the sharing of best practices and training materials commencing with the implementation of the Self-Determination Program, local and statewide advisory committees shall be established as follows:
(1)Each regional center shall establish a local volunteer advisory committee to provide oversight of the Self-Determination Program and identify a regional center liaison to the committee. The regional center and the State Council on Developmental Disabilities shall each appoint one-half of the membership of the committee. The committee shall consist of the regional center clients rights advocate, consumers, family members, and other advocates, and community leaders, including a representative from a family resource center. A majority of the committee shall be consumers and their family members. The committee shall reflect the multicultural diversity and geographic profile of the catchment area. The committee shall review the development and ongoing progress of the Self-Determination Program, including whether the program advances the principles of self-determination and is operating consistent with the requirements of this section, and may make ongoing recommendations for improvement to the regional center and the department. Annually, the regional center shall confirm, in writing, that the committee meets the requirements specified in this paragraph and provide the department with the name of the staff liaison and the names of the committee members, the positions they fill on the committee, and which entity appointed them to the committee.
(2)The State Council on Developmental Disabilities shall form a volunteer committee, to be known as the Statewide Self-Determination Advisory Committee, comprised of the chairs of the 21 local advisory committees or their designees. The council shall convene the Statewide Self-Determination Advisory Committee twice annually, or more frequently in the sole discretion of the council. The Statewide Self-Determination Advisory Committee shall meet by teleconference or other means established by the council to identify self-determination best practices, effective consumer and family training materials, implementation concerns, systemic issues, ways to enhance the program, and recommendations regarding the most effective method for participants to learn of individuals who are available to provide services and supports. The council shall synthesize information received from the Statewide Self-Determination Advisory Committee, local advisory committees, and other sources, share the information with consumers, families, regional centers, and the department, and make recommendations, as appropriate, to increase the programs effectiveness in furthering the principles of self-determination.
(x)The department shall annually provide the following information to the appropriate policy and fiscal committees of the Legislature:
(1)Number and characteristics of participants, by regional center, including the number of participants who entered the program upon movement from a developmental center.
(2)Types and amount of services and supports purchased under the Self-Determination Program, by regional center.
(3)Range and average of individual budgets, by regional center, including adjustments to the budget to address the adjustments permitted in clause (ii) of subparagraph (A) of paragraph (1) of subdivision (m).
(4)The number and outcome of appeals concerning individual budgets, by regional center.
(5)The number and outcome of fair hearing appeals, by regional center.
(6)The number of participants who voluntarily withdraw from the Self-Determination Program and a summary of the reasons why, by regional center.
(7)The number of participants who are subsequently determined to no longer be eligible for the Self-Determination Program and a summary of the reasons why, by regional center.
(y)(1)The State Council on Developmental Disabilities shall issue an interim report to the Legislature, in compliance with Section 9795 of the Government Code, no later than June 30, 2021, on the status of the Self-Determination Program authorized by this section, barriers to its implementation, and recommendations to enhance the effectiveness of the program. The interim report shall provide an update to the programs status, each regional centers cap on participation and progress toward that cap, the most recent statewide and per-regional-center participant count, and the historical trend in the statewide participation count since the start of the program. The department shall assist in providing available information to the council in order to facilitate the timely issuance of the report.
(2)The council, in collaboration with the protection and advocacy agency identified in Section 4900 and the federally funded University Centers for Excellence in Developmental Disabilities Education, Research, and Service, may work with regional centers to survey participants regarding participant satisfaction under the Self-Determination Program and, when data is available, the traditional service delivery system, including the proportion of participants who report that their choices and decisions are respected and supported and who report that they are able to recruit and hire qualified service providers, and to identify barriers to participation and recommendations for improvement.
(3)The council, in collaboration with the protection and advocacy agency identified in Section 4900 and the federally funded University Centers for Excellence in Developmental Disabilities Education, Research, and Service, shall issue a report to the Legislature, in compliance with Section 9795 of the Government Code, by June 30, 2023, on the status of the Self-Determination Program authorized by this section, and provide recommendations to enhance the effectiveness of the program. This review shall include the programs effectiveness in furthering the principles of self-determination, including all of the following:
(A)Freedom, which includes the ability of adults with developmental disabilities to exercise the same rights as all citizens to establish, with freely chosen supporters, family and friends, where they want to live, with whom they want to live, how their time will be occupied, and who supports them; and for families to have the freedom to receive unbiased assistance of their own choosing when developing a plan and to select all personnel and supports to further the life goals of a minor child.
(B)Authority, which includes the ability of a person with a disability, or family, to control a certain sum of dollars in order to purchase services and supports of their choosing.
(C)Support, which includes the ability to arrange resources and personnel, both formal and informal, that will assist a person with a disability to live a life in the community that is rich in community participation and contributions.
(D)Responsibility, which includes the ability of participants to take responsibility for decisions in their own lives and to be accountable for the use of public dollars, and to accept a valued role in their community through, for example, competitive employment, organizational affiliations, spiritual development, and general caring of others in their community.
(E)Confirmation, which includes confirmation of the critical role of participants and their families in making decisions in their own lives and designing and operating the system that they rely on.
SEC. 17.Section 4726 of the Welfare and Institutions Code is amended to read:4726.Notwithstanding Section 5328, any exemption to the California Public Records Act (Division 10 (commencing with Section 7920.000) of Title 1 of the Government Code), or any other law that authorizes, but does not require, an entity to withhold all or part of a record on the basis of its confidentiality, access to records regarding an applicant for, or recipient of, services shall be provided, upon request, to the applicant, recipient, or their authorized representative, including the person appointed as a developmental services decisionmaker pursuant to Section 319, 361, or 726, for purposes, including, but not limited to, the appeal process under this chapter, unless disclosure of the record is expressly prohibited by law.
SEC. 18.Section 4731 of the Welfare and Institutions Code is amended to read:4731.(a)Each consumer or any representative acting on behalf of any consumer or consumers, who believes that any right to which a consumer is entitled has been abused, punitively withheld, or improperly or unreasonably denied by a regional center, state-operated facility, or service provider, may pursue a complaint as provided in this section.
(b)Initial referral of any complaint taken pursuant to this section shall be to the director of the regional center from which the consumer receives case management services. If the consumer resides in a state-operated facility, the complaint shall be made to the director of the state-operated facility. The director shall, within 20 business days of receiving a complaint, investigate the complaint and send a written proposed resolution to the complainant and, if applicable, to the service provider. The written proposed resolution shall include a telephone number and mailing address for referring the proposed resolution in accordance with subdivision (c).
(c)If the complainant is not satisfied with the proposed resolution, the complainant may refer the complaint, in writing, to the Director of Developmental Services, within 15 days of receipt of the proposed resolution. The director, within 30 days of receiving a complaint, shall issue a written administrative decision and send a copy of the decision to the complainant, the director of the regional center or state-operated facility, and the service provider, if applicable. If there is no referral to the department, the proposed resolution shall become effective on the 20th working day following receipt by the complainant.
(d)The department shall annually compile the number of complaints filed, by each regional center and state-operated facility, the subject matter of each complaint, and a summary of each decision, and post the compilation on its internet website at the end of each quarter. Copies of any decision included in the compilation shall be made available within 10 days, with all individually identifiable information redacted, to any person upon request.
(e)This section shall not be used to resolve disputes concerning the nature, scope, or amount of services and supports that should be included in an individual program plan, for which there is an appeals procedure established in this division, or disputes regarding rates or audit appeals for which there is an appeals procedure established in regulations. Those disputes shall be resolved through the appeals procedure established by this division or in regulations.
(f)All consumers or, if appropriate, their authorized representative, shall be notified in writing in their preferred language of the right to file a complaint pursuant to this section when they apply for services from a regional center or a state-operated facility, and at each regularly scheduled planning meeting.
This act shall be known, and may be cited, as the Disability Equity and Accountability Act of 2023.
SEC. 2.(a)The Legislature finds and declares as follows:
(1)Recent reports and hearings by the California State Auditor, the Little Hoover Commission, and advocacy organizations have found that Californias service system for the over 400,000 children and adults with intellectual and developmental disabilities through the Lanterman Act, as overseen by the State Department of Developmental Services, which contracts with 21 regional centers, is failing in significant ways to deliver critical, adequate, and timely services to individuals and families. The result is that individuals and families, particularly those of color and tribal members living in rural areas and tribal reservations, are unable to timely access services and supports, resulting in barriers to their living independent, productive, and integrated lives in their communities.
(2)Californias developmental disability service system is plagued with racial, ethnic, and geographic disparities that can dramatically impact the essential services received by children and adults with developmental disabilities. Systemic inequities and discrimination within Californias 21 regional centers broaden the gap between inclusive possibilities and segregated limitations. Data show Latinos are most negatively impacted by these disparities, but people who are clients of the lowest-performing regional centers are also significantly affected.
(3)California spends nearly $13,000,000,000 annually on the administration and delivery of developmental services, but lacks a transparent, common, integrated, and coordinated model for the delivery and measurement of services throughout the 21 regional centers, resulting in poor outcomes, poor satisfaction levels by consumers and families, and disparate levels of available services and performance expectations.
(4)The delivery of services through 21 separate private nonprofit regional centers with separate boards, funding, and delivery models was originally intended to ensure that the delivery of services could be more effectively delivered through nonstate entities. However, with the subsequent caseload and budget growth since the enactment of the Lanterman Act, local administration has become more disparate and less accountable. Boards of directors are untrained and are not providing the oversight needed of the regional centers. Stronger state oversight of regional centers by the State Department of Developmental Services is essential to ensure that services are equitably delivered, performance and outcomes are uniformly measured and reported, and the system is transparent and accountable to individuals and families.
(5)The departments system lacks a statewide automated technology system for the delivery of services to persons with intellectual and developmental disabilities and, as a result, the current program is constrained by disparate automation systems, inadequate documentation, the lack of open system architecture, insufficient data to support administration of the system, and the lack of data to support program improvements for improving the quality of life outcomes through new service delivery methods.
(6)Statewide uniformity of service delivery practices and procedures is essential to an effective program and to support necessary oversight and research for ongoing program improvements.
(7)The departments technical infrastructure is over 40 years old. The lack of a statewide automation system does not meet current program needs and significantly contributes to the racial and geographic disparities in the delivery of services. California currently lacks clear and consistent service delivery outcomes for individuals with intellectual and developmental disabilities that sets high expectations for their quality of life, and must develop a system for measuring and quantifying the value of service delivery outcomes.
(8)A previous effort to develop an intellectual and developmental disabilities (IDD) program technology system failed. As a result, the department and regional centers maintain a patchwork of at least three case management and fiscal systems that are not integrated and six legacy case management automation systems that lack integration, have dissimilar data sources, and are technically outdated.
(9) In the 202122 annual budget the Legislature appropriated $6,000,000 to the State Department of Developmental Services for planning purposes related to the implementation of a uniform fiscal system and consumer electronic records management system. The department has not developed a vision or scope for a proposed system development approach.
(b)Therefore, it is the intent of the Legislature in enacting this act to do all of the following:
(1)Ensure that racial, ethnic, and geographic service disparities, including Native Americans living on or off tribal reservations, be systemically addressed and eliminated and that all people, regardless of their race or ethnicity or where they live, receive equitable access to services within the regional center system.
(2)Ensure that all regional centers offer and provide a consistent and common set of services and that the services are delivered in a timely way.
(3) Ensure that the delivery of all services and supports comply with federal law and guidance and are responsive to the needs and choices of beneficiaries receiving home- and community-based services, are person centered and strengths based, have high expectations for interdependence, self-direction, and competitive, integrated employment, provide support coordination to assist with a community-supported life, and achieve a more consistent and coordinated approach to the administration of policies and procedures across the state.
(4)Provide the department with new tools for holding regional centers and service providers accountable through the development of a standardized and coordinated set of performance measures and related standards that establish targets and standards above which a regional center may receive incentives for improved performance, and a separate set of standards that require corrective action.
(5)Improve regional center governance by establishing new standards and procedures for regional center governing boards to ensure they can more effectively represent the communities they serve by providing them with greater independence and protection from regional center retaliation.
(6)Require the State Department of Developmental Services to develop a written project charter for the planning and development of a uniform statewide automation system that serves as a foundation document for the system development, which includes project guiding principles, scope, strategies and approach, and project governance, in order to provide transparency to the Legislature and the public on the system development as has been used with other statewide system development.
SEC. 3.Section 4519.5 of the Welfare and Institutions Code is amended to read:4519.5.(a)The department and the regional centers shall annually collaborate to compile data in a uniform manner relating to purchase of service authorization, utilization, and expenditure by each regional center with respect to all of the following:
(1)The age of the consumer, categorized by the following:
(A)Birth to two years of age, inclusive.
(B)Three to 21 years of age, inclusive.
(C)Twenty-two years of age and older.
(2)Race or ethnicity of the consumer.
(3)Tribal affiliation.
(4)Preferred language spoken by the consumer, and other related details, as feasible.
(5)Disability detail, in accordance with the categories established by subdivision (a) of Section 4512, and, if applicable, a category specifying that the disability is unknown.
(6)Residence type, subcategorized by age, race or ethnicity, and preferred language.
(7)Number of instances when the written copy of the individual program plan was provided at the request of the consumer and, when appropriate, the consumers parents, legal guardian or conservator, or authorized representative, in a language other than a threshold language, as defined by paragraph (3) of subdivision (a) of Section 1810.410 of Title 9 of the California Code of Regulations, if that written copy was provided more than 60 days after the request.
(8)Number of instances when the written copy of the individual program plan was provided at the request of the consumer and, when appropriate, the consumers parents, legal guardian or conservator, or authorized representative, in a threshold language, as defined by paragraph (3) of subdivision (a) of Section 1810.410 of Title 9 of the California Code of Regulations, if that written copy was provided more than 45 days after the request, in violation of paragraph (5) of subdivision (a) of Section 4646.5.
(9)Beginning with data for the fiscal year of 202324, the numbers, percentages, and total and per capita expenditure and authorization amounts, by age, as applicable, according to race or ethnicity and preferred language, for all combined residence types and for consumers living in the family home, regarding the following service types:
(A)Camping and associated travel expenses.
(B)Social recreation activities.
(C)Educational services.
(D)Nonmedical therapies, including, but not limited to, specialized recreation, art, dance, music, and tribal culture and ceremony.
(b)The data reported pursuant to subdivision (a) shall also include the number and percentage of individuals, categorized by age, race or ethnicity, and disability, and by residence type, as set forth in paragraph (6) of subdivision (a), who have been determined to be eligible for regional center services, but are not receiving purchase of service funds.
(c)By March 31, 2013, each regional center shall post the data described in this section that are specific to the regional center on its internet website. Commencing on December 31, 2013, each regional center shall annually post these data by December 31. Each regional center shall maintain all previous years data on its internet website.
(d)By March 31, 2013, the department shall post the information described in this section on a statewide basis on its internet website. Commencing December 31, 2013, the department shall annually post this information by December 31. The department shall maintain all previous years data on its internet website. The department shall also post notice of any regional center stakeholder meetings on its internet website.
(e)Within three months of compiling the data with the department, and annually thereafter, each regional center shall meet with stakeholders in one or more public meetings regarding the data. The meeting or meetings shall be held separately from any meetings held pursuant to Section 4660. The regional center shall provide participants of these meetings with the data and any associated information related to improvements in the provision of developmental services to underserved communities and shall conduct a discussion of the data and the associated information in a manner that is culturally and linguistically appropriate for that community, including providing alternative communication services, as required by Sections 11135 to 11139.7, inclusive, of the Government Code and implementing regulations. Regional centers shall inform the department of the scheduling of those public meetings 30 days prior to the meeting. Notice of the meetings shall also be posted on the regional centers internet website 30 days prior to the meeting and shall be sent to individual stakeholders and groups representing underserved communities in a timely manner. Each regional center shall, in holding the meetings required by this subdivision, consider the language needs of the community and shall schedule the meetings at times and locations designed to result in a high turnout by the public and underserved communities.
(f)(1)Each regional center shall annually report to the department regarding its implementation of the requirements of this section. The report shall include, but shall not be limited to, all of the following:
(A)Actions the regional center took to improve public attendance and participation at stakeholder meetings, including, but not limited to, attendance and participation by underserved communities.
(B)Copies of minutes from the meeting and attendee comments.
(C)Whether the data described in this section indicate a need to reduce disparities in the purchase of services among consumers in the regional centers catchment area. If the data do indicate that need, the regional centers recommendations and plan to promote equity, and reduce disparities, in the purchase of services.
(2)Each regional center and the department shall annually post the reports required by paragraph (1) on its internet website by August 31.
(g)(1)The department shall consult with stakeholders, including consumers and families that reflect the ethnic and language diversity of regional center consumers, regional centers, advocates, providers, family resource centers, the protection and advocacy agency described in Section 4901, and those entities designated as University Centers for Excellence in Developmental Disabilities Education, Research, and Service pursuant to Section 15061 of Title 42 of the United States Code, to achieve the following objectives:
(A)Review the data compiled pursuant to subdivision (a).
(B)Identify barriers to equitable access to services and supports among consumers and develop recommendations to help reduce disparities in purchase of service expenditures.
(C)Encourage the development and expansion of culturally appropriate services, service delivery, and service coordination.
(D)Identify best practices to reduce disparity and promote equity.
(2)The department shall report the status of its efforts to satisfy the requirements of paragraph (1) during the 201617 legislative budget subcommittee hearing process.
(h)(1)Subject to available funding, the department shall allocate funding to regional centers or community-based organizations with department oversight to assist with implementation of the recommendations and plans developed pursuant to subdivisions (f) and (g). Activities funded through these allocations may include, but are not limited to, pay differentials supporting direct care bilingual staff of community-based service providers, parent or caregiver education programs, cultural competency training for regional center staff, outreach to underserved populations, or additional culturally appropriate service types or service delivery models.
(2)Each regional center shall consult with stakeholders regarding activities that may be effective in addressing disparities in the receipt of regional center services and the regional centers proposed requests for the funding specified in paragraph (1). Each regional center shall identify the stakeholders it consulted with and include information on how it incorporated the input of stakeholders into its requests.
(3)A community-based organization may submit a request for grant funding pursuant to this subdivision. The organization shall submit the request concurrently to the regional center of the jurisdiction in which the organization is located and to the department. The regional center shall provide the department with input regarding the request prior to the departments final determination on the request.
(4)The department shall review requests for funding within 45 days from the deadline specified in the departments guidance to regional centers and community-based organizations.
(5)Each regional center and community-based organization receiving funding shall report annually to the department, in a manner determined by the department, on how the funding allocations were used and shall include recommendations of priorities for activities that may be effective in addressing disparities, based on the consultation with stakeholders.
(6)The department shall post the following information on its internet website:
(A)By September 1 of any year in which grant funding is available and has not been allocated, a structure for the grant program, including all of the following information:
(i)How community-based organizations reflecting groups that are disadvantaged by disparities in the purchase of services will be invited to participate in the grant program.
(ii)How statewide strategies were considered.
(iii)How the department will ensure grant funds are not used for activities that regional centers are otherwise required by statute or regulation to conduct.
(iv)How funded activities will be evaluated.
(B)By October 1 of any year in which grant funding is available and has not been allocated, the final invitation for requests for funding or another mechanism through which requests for funding are solicited.
(C)By January 1 of any year in which grant funding has been allocated, a list of grant recipients, funding level per grant, and a description of the funded project.
(D)By May 1 of any year in which the information is available, evaluation results from prior grants. To ensure the department complies with this subparagraph, regional centers and community-based organizations receiving funding shall provide the department, by March 1 of the same year, with an evaluation of funded activities and the effectiveness of those activities in reducing disparities in the purchase of services, to the extent information is available.
(i)On or before December 31, 2021, the department shall 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 subdivision (h).
(j)For the purposes of this section, the department shall require all of the following:
(1)The use by the department and regional centers, when reporting data by race and ethnicity, of consistent classifications of race and ethnicity, based on categories current in use by the United States Census Bureau.
(2)Confirmation of the race and ethnicity identification of each consumer at the time of the annual review of the consumers individual program plan (IPP).
(3)When reporting by residence types, separate presentation of data for those in independent living services and those in supported living services.
(4)Consistent standards and requirements for regional center internet websites, using the same placement and language for all information required by this division, including that data be posted in a machine-readable format.
SEC. 4.Section 4519.20 is added to the Welfare and Institutions Code, to read:4519.20.As part of the departments planning process for the planning and development of a uniform statewide data automation system, the department, in consultation with stakeholders shall develop, by March 1, 2024, 2025, a project charter that shall be approved by the Secretary of the California Health and Human Services Agency and the Department of Technology. The charter development process shall include the participation and input of program consumers and families, researchers and quality and outcome evaluators, regional centers, and service providers. The project charter shall include all of the following:
(a)An impact statement on the primary entities and individuals impacted by the system development.
(b)Project guiding principles that are foundational to the project approach to be used throughout the planning, development, implementation, and maintenance of the system.
(c)Project scope that addresses business problems required to be solved by the system, including all of the following:
(1)Worker effectiveness and accountability that are constrained by the lack of timely, adequate, and accurate data, the lack of uniformity, and the current systems limited functionality.
(2)Service delivery that is constrained by the lack of timely, adequate, accurate, and accessible data, the lack of clear understandable communication of information, lack of uniformity, and the systems limited functionality.
(3)Current system maintainability that is constrained by disparate systems, inadequate documentation, the lack of open system architecture, and business changes.
(4)Disparate systems, complex business rules, the number of locations and variability of local system delivery, and changes in the way of doing business.
(5)Limited access of researchers and program evaluators to the set of person-level data that they need to assess program effectiveness.
(d)Program goals, which shall include all of the following:
(1)Maximizing the performance and the business processes for the delivery of intellectual or developmental disability (IDD) system services to consumers at the regional centers.
(2)Improving data quality, privacy, confidentiality, and integration of all data sources at an individual level.
(3)Enabling data-driven decisionmaking and performance measures for the effective administration of the program.
(4)Improving the business processes administered by the department to support regional center service delivery.
(5)Supporting access to individual-level data to support program evaluation and other research.
(e)Technology goals that recognize that a statewide system solution not only meets requirements, but also ensures effective transition, while minimizing disruption to existing services.
(f)Project strategies and approaches for development and implementation.
(g)Project governance.
(h)Technology that can readily be enhanced and modernized for the expected system life. In selecting the new system, consideration shall be given to the extent to which the candidate systems employ open architectures and standards and the future ability of the selected system to provide enhancements that will improve long-term effectiveness of program management of the statewide service delivery system.
SEC. 5.Section 4571 of the Welfare and Institutions Code is amended to read:4571.(a)It is the intent of the Legislature to ensure the well-being of consumers, taking into account their informed and expressed choices. It is further the intent of the Legislature to support the satisfaction and success of consumers through the delivery of quality services and supports. Evaluation of the services that consumers receive is a key aspect to the service system. Utilizing the information that consumers and their families provide about those services in a reliable and meaningful way is also critical to enable the department to assess the performance of the states developmental services system and to improve services for consumers in the future. To that end, the State Department of Developmental Services, on or before January 1, 2010, shall implement an improved, unified quality assessment system, in accordance with this section.
(b)The department, in consultation with stakeholders, shall identify a valid and reliable quality assurance instrument that assesses consumer and family satisfaction, provision of services in a linguistically and culturally competent manner, and personal outcomes. The instrument shall do all of the following:
(1)Provide nationally validated, benchmarked, consistent, reliable, and measurable data for the departments Quality Management System.
(2)Enable the department and regional centers to compare the performance of Californias developmental services system against other states developmental services systems and to assess quality and performance among all of the regional centers.
(3)Include outcome-based measures such as health, safety, well-being, relationships, interactions with people who do not have a disability, employment, quality of life, integration, choice, service, and consumer satisfaction.
(4)Include outcome-based measures to evaluate the linguistic and cultural competency, including tribal culture competency, of regional center services that are provided to consumers across their lifetimes.
(c)To the extent that funding is available, the instrument identified in subdivision (b) may be expanded to collect additional data requested by the State Council on Developmental Disabilities.
(d)(1)The department shall contract with an independent agency or organization to implement, by January 1, 2010, the quality assurance instrument described in subdivision (b). The contractor shall be experienced in all of the following:
(A)Designing valid quality assurance instruments for developmental service systems.
(B)Tracking outcome-based measures such as health, safety, well-being, relationships, interactions with people who do not have a disability, employment, quality of life, integration, choice, service, and consumer satisfaction.
(C)Developing data systems.
(D)Data analysis and report preparation.
(E)Assessments of the services received by consumers who are moved from developmental centers to the community, given the Legislatures historic recognition of a special obligation to ensure the well-being of these persons.
(F)Issues related to linguistic and cultural competency.
(2)Notwithstanding any other law, the contract and any amendments pursuant to this section shall be exempt from all of the following:
(A)The personal services contracting requirements of Article 4 (commencing with Section 19130) of Chapter 5 of Part 2 of Division 5 of Title 2 of the Government Code.
(B)The Public Contract Code, the State Contracting Manual, and the State Administration Manual.
(C)The approval of the Department of General Services.
(D)The approval of the Department of Technology.
(3)The exemptions specified in paragraph (2) shall remain in effect until there is more than one available assessment that meets the criteria in subdivision (b) from an organization that also meets the criteria in this subdivision.
(e)The department, in consultation with the contractor described in subdivision (d), shall establish the methodology by which the quality assurance instrument shall be administered, including, but not limited to, how often and to whom the quality assurance will be administered, and the design of a stratified, random sample among the entire population of consumers served by regional centers. The contractor shall provide aggregate information for all regional centers and the state as a whole. At the request of a consumer or the family member of a consumer, the survey shall be conducted in the primary language of the consumer or family member surveyed.
(f)The department shall contract with the state council to collect data for the quality assurance instrument described in subdivision (b). If, during the data collection process, the state council identifies any suspected violation of the legal, civil, or service rights of a consumer, or if it determines that the health and welfare of a consumer is at risk, that information shall be provided immediately to the regional center providing case management services to the consumer. At the request of the consumer or family, when appropriate, a copy of the completed survey shall be provided to the regional center providing case management services to improve the consumers quality of services through the individual planning process.
(g)The department, in consultation with stakeholders, shall annually review the data collected from and the findings of the quality assurance instrument described in subdivision (b) and accept recommendations regarding additional or different criteria for the quality assurance instrument in order to assess the performance of the states developmental services system and improve services for consumers.
(h)(1)Each regional center shall annually present data collected from, and the findings of, the quality assurance instrument described in subdivision (b) for that regional center, at a public meeting of its governing board in order to assess the comparative performance of the regional center and identify needed improvements in services for consumers, including, but not limited to, case management services. Notice of this meeting shall also be posted on the regional centers internet website at least 30 days prior to the meeting and shall be sent to regional center consumers and families and individual stakeholders at least 30 days prior to the meeting. The governing board shall provide a sufficient public comment period so members of the public may provide comments. Each regional center, in holding the meeting required by this subdivision, shall ensure that the meeting and meeting materials provide language access, as required by state and federal law.
(2)All regional center-specific reports generated by the department pursuant to this subdivision shall be made publicly available on the regional centers internet website in a machine-readable format, but shall not contain any personal identifying information about any person assessed.
(3)Within 60 days following its annual presentation, each regional center shall submit a report to the department regarding its implementation of the requirements of this section. The report shall include, but shall not be limited to, both of the following:
(A)Copies of the presentation described in paragraph (1), minutes from the meeting, and attendee comments.
(B)The regional centers recommendations and plans to use the information to address regional center priorities, strategic directions to improve specific areas of performance, or both.
(i)All reports generated pursuant to this section shall be made publicly available, but shall not contain any personal identifying information about any person assessed.
(j)All data collected pursuant to subdivision (c) shall be provided to the state council, but shall not contain personal identifying information about the persons being surveyed.
(k)Implementation of this section shall be subject to an annual appropriation of funds in the Budget Act for this purpose.
(l)By March 1, 2024, 2025, the department shall submit a report to the policy and budget subcommittees of the Legislature describing the extent to which the requirements of this section have not been met, including the surveying of all consumers, including those with no purchase of services, and providing specific steps and the schedule by which these requirements will be met.
SEC. 6.Section 4620.6 is added to the Welfare and Institutions Code, to read:4620.6.(a)(1)To provide uniformity, consistency, and cost-effectiveness in the delivery of services by regional centers throughout the state, the department shall establish, by January 1, 2025, 2026, a common set of services and supports, including supported living services, that every regional center in the state shall make available to consumers in negotiating, developing, or amending the individualized program plan as required by Sections 4646 and 4646.5. The common set of services and supports shall be prominently posted on each regional centers internet website.
(2)The department shall develop the common set of services and supports in consultation with the Association of Regional Center Agencies, consumers and their families, advocacy organizations, and service providers.
(b)In each contract with a regional center, the department shall require the common set of services and supports developed pursuant to this section to be available to consumers in the development of an individual program plan.
(c)It is the intent of the Legislature that this section not be construed to control or interfere with the discretion of the individual program planning team to determine the needs and services appropriate for each person with a developmental disability who is entitled to services under this division. It is further the intent of the Legislature that the common set of services and supports developed pursuant to this section shall be deemed the minimum level of services and supports and does not preclude other services and supports from being included in a negotiated individualized program plan.
SEC. 7.Section 4622 of the Welfare and Institutions Code is amended to read:4622.The state shall contract only with agencies, the governing boards of which conform to all of the following criteria:
(a)The governing board shall be composed of individuals with demonstrated interest in, or knowledge of, developmental disabilities.
(b)The membership of the governing board shall include persons with legal, management or board governance, financial, and developmental disability program expertise. Board governance expertise may not be acquired solely by serving on a regional center board. The governing board of the regional center shall include members with financial expertise and members with management or board governance expertise by August 15, 2020.
(c)The membership of the governing board shall include representatives of the various categories of disability to be served by the regional center.
(d)The governing board shall reflect the geographic and ethnic characteristics of the area to be served by the regional center.
(e)A minimum of 50 percent of the members of the governing board shall be persons with developmental disabilities or their parents or legal guardians. No less than 25 percent of the members of the governing board shall be persons with developmental disabilities.
(f)(1)Members of the governing board shall not be permitted to serve more than a six-year term, and may return to the board for a subsequent term after five years. The members of each regional center governing board nominating committee shall be comprised of current board members and members of the community, and should be representative of the community served in the regional centers catchment area. seven years within each eight-year period.
(2)The board nominating committee shall solicit interests and nominations from the broader community through outreach. The committee shall interview candidates for the board and make recommendations to the governing board for election. During the meeting at which the board elects new members, a candidate may be nominated by a board member with a second by another board member for the open positions. A regional center executive director shall be prohibited from any involvement in the recruitment or election of governing board members.
(g)(1)The department shall provide necessary training and support to these board members to facilitate their understanding and participation, including issues relating to linguistic and cultural competency. The training shall be developed with community input, including persons served and family members. Ongoing support by the department shall include surveying board members about their ability to meaningfully participate in, and understand the subjects and votes at, board meetings. If board members report that they are unable to meaningfully participate, the department shall work with the regional center and the board member to ensure adequate and appropriate accommodations are provided.
(2)As part of its monitoring responsibility, the department shall review and approve the method by which training and support are provided to board members to ensure maximum understanding and participation by board members.
(3)Each regional center shall post on its internet website information regarding the training and support provided to board members.
(h)The governing board may appoint a consumers advisory committee composed of persons with developmental disabilities representing the various categories of disability served by the regional center.
(i)The governing board shall appoint an advisory committee composed of a wide variety of persons representing the various categories of providers from which the regional center purchases client services. The advisory committee shall provide advice, guidance, recommendations, and technical assistance to the regional center board in order to assist the regional center in carrying out its mandated functions. The advisory committee shall designate one of its members to serve as a member of the regional center board.
(j)(1)The governing board shall annually review the performance of the director of the regional center. The department shall establish guidelines for governing boards to measure executive director performance, including with respect to issues of equity and diversity.
(2)The governing board shall annually review the performance of the regional center in providing services that are linguistically and culturally appropriate and may provide recommendations to the director of the regional center based on the results of that review.
(k)A member of the board who is an employee or member of the governing board of a provider from which the regional center purchases client services shall not do any of the following:
(1)Serve as an officer of the board.
(2)Vote on any fiscal matter affecting the purchase of services from any regional center provider.
(3)Vote on any issue other than as described in paragraph (2), in which the member has a financial interest, as defined in Section 87103 of the Government Code, and determined by the regional center board. The member shall provide a list of the members financial interests, as defined in Section 87103, to the regional center board.
(l)The department shall establish, and each board shall adopt, an antiretaliation policy for board members that requires department approval for any reduction in services for consumer board members or the family member of family board members.
(m)The department shall establish and adopt a grievance procedure whereby a governing board member who has concerns, complaints, or questions may contact a specific executive at the department.
(n)This section does not prevent the appointment to a regional center governing board of a person who meets the criteria for more than one of the categories listed above.
SEC. 8.Section 4626.5 of the Welfare and Institutions Code is amended to read:4626.5.Each regional center shall submit a conflict-of-interest policy to the department by July 1, 2011, and shall post the policy on its internet website by August 1, 2011. The policy shall do, or comply with, all of the following:
(a)Contain the elements of this section and be consistent with applicable law.
(b)Define conflicts of interest.
(c)Identify positions within the regional center required to complete and file a conflict-of-interest statement.
(d)Facilitate disclosure of information to identify conflicts of interest.
(e)Require candidates for nomination, election, or appointment to a regional center board, and applicants for regional center director to disclose any potential or present conflicts of interest prior to being appointed, elected, or confirmed for hire by the regional center or the regional center governing board.
(f)Require the regional center and its governing board to regularly and consistently monitor and enforce compliance with its conflict-of-interest policy.
(g)Prohibit a regional center employee from accepting a gift or gifts from a service provider, consumer, or consumers family member valued over ten dollars ($10) fifteen dollars ($15) per year.
(h)Establish a policy prohibiting regional center senior staff from hiring relatives at the center or any ancillary foundation and organization. The policy shall be included in the regional center contract and shall be included in training of the governing board.
SEC. 9.Section 4629.1 is added to the Welfare and Institutions Code, to read:4629.1.(a)Notwithstanding any other law, the evaluation of regional center performance shall be implemented using a common set of performance measures, which shall be administered by the department. This includes the performance requirements under the regional center contracts pursuant to Section 4629, the performance incentives established under Section 4620.5, and the quality assessment instrument required under Section 4571. These measures shall be annually reported and made available to the public through posting of the measures results in machine-readable formats.
(b)(1)By July 1, 2024, 2025, the department shall establish standards for each measure above that contain thresholds above which a regional center may be eligible to receive rewards for good performance and thresholds below which a regional center may be subject to each level of probation required under Section 4629. The department shall establish the process for assessing corrective action undertaken by a regional center and the process by which a regional center may end its probation status.
(2)The department, in consultation with stakeholders, including consumers and family members, shall annually establish, update, and review the standards related to good performance.
(3)(A)The department, in consultation with stakeholders, including consumers and family members, shall annually establish, update, and review a uniform process to be used by regional centers to develop corrective action plans that respond to below standard performance.
(B)The process shall include all of the following:
(i)Technical assistance and training from the department either directly or through subject matter experts.
(ii)The sharing of resources from other regional centers that have met the performance measures.
(iii)Participation by the board of directors of the regional center in developing and monitoring the implementation of the corrective action plan in consultation with local stakeholders, including consumers and family members.
(C)The department shall oversee the process to develop the corrective action plan and assess corrective action undertaken by the regional center.
(c)The performance measures shall encompass the domains as itemized in subdivision (d). Additional measures may be adopted by the department as needed. Modification of the domain and measures shall be accomplished through a process of consultation that includes the engagement of stakeholders in a manner consistent with that required by subdivision (b) of Section 4620.5. The measures may be amended as reporting mechanisms mature as the department develops new information technology capabilities.
(d)The performance measures for purposes of this section shall be organized under seven domains, as follows:
(1)Community integration.
(2)Employment.
(3)Equity in service access.
(4)Case management.
(5)Consumer and family choice, experience, and satisfaction.
(6)Human and civil rights.
(7)Health and safety.
SEC. 10.Section 4639.76 is added to the Welfare and Institutions Code, to read:4639.76.A regional center with which the department maintains a contract pursuant to Section 4629 shall be subject to the California Public Records Act (Chapter 1 (commencing with Section 7920.000) of Division 10 of Title 1 of the Government Code).
SEC. 11.Section 4642 of the Welfare and Institutions Code is amended to read:4642.(a)(1)Any person believed to have a developmental disability, and any person believed to have a high risk of parenting an infant with a developmental disability shall be eligible for initial intake and assessment services in the regional centers. In addition, any infant having a high risk of becoming developmentally disabled may be eligible for initial intake and assessment services in the regional centers. For purposes of this section, high-risk infant means a child less than 36 months of age whose genetic, medical, or environmental history is predictive of a substantially greater risk for developmental disability than that for the general population. The department, in consultation with the State Department of Public Health, shall develop specific risk and service criteria for the high-risk infant program on or before July 1, 1983. These criteria may be modified in subsequent years based on analysis of actual clinical experience.
(2)(A)Initial intake shall be performed within 15 working days following request for assistance. Initial intake shall include, but need not be limited to, information and advice about the nature and availability of services provided by the regional center and by other agencies in the community, including guardianship, conservatorship, income maintenance, mental health, housing, education, work activity and vocational training, medical, dental, recreational, and other services or programs that may be useful to persons with developmental disabilities or their families. Intake shall also include a decision to provide assessment.
(B)For purposes of this section, request for assistance includes any initial contact or inquiry from an individual, or a person acting on their behalf, on the nature of services or supports available or provided by the regional center, and the individuals eligibility to receive them.
(3)(A)The department shall create, with input from stakeholders, standardized information packets to be provided to any person seeking services from a regional center. There shall be one information packet related to services provided under the California Early Intervention Services Act and another information packet related to services provided under the Lanterman Developmental Disabilities Services Act. The information packets shall be translated to provide language access, as required by state and federal law, shall be reasonably culturally competent for all diverse racial and ethnic communities, including immigrants and Native Americans, shall be available in alternative formats and alternative modes of communication, as required by federal law, and shall include, at a minimum, all of the following:
(i)An overview of the regional center system.
(ii)A resource guide for consumers and their families.
(iii)Consumer rights, including the appeals procedures specified in Chapter 7 (commencing with Section 4700).
(iv)Contact information for the regional center, the department, the office of clients rights advocacy, and the protection and advocacy agency specified in Division 4.7 (commencing with Section 4900).
(v)Information on the Self-Determination Program, including the eligibility requirements specified in subdivision (d) of Section 4685.8.
(B)Each regional center shall distribute the information packets at intake, upon transfer to receiving services under the Lanterman Developmental Disabilities Services Act, and upon request. Each regional center shall begin distributing the information packets within 60 days following the department providing the information packets and issuing directives regarding the distribution of the information packets. In addition to, and not in lieu of, this requirement, each regional center shall post the full content of the most updated information packet on its internet website.
(b)A regional center shall communicate, with reasonable cultural competency, including Native American cultural competency, with the consumer and the consumers family pursuant to this section in their native language, including providing alternative communication services and alternative formats, as required by state and federal law.
SEC. 12.Section 4646 of the Welfare and Institutions Code is amended to read:4646.(a)It is the intent of the Legislature to ensure that the individual program plan and provision of services and supports by the regional center system is centered on the individual and the family of the individual with developmental disabilities and takes into account the needs and preferences of the individual and the family, if appropriate, as well as promoting community integration, independent, productive, and normal lives, and stable and healthy environments. It is the further intent of the Legislature that individual program plans shall be developed consistent with the federal Affordable Care Act and the regulations and federal guidance adopted pursuant to the act requiring that community-based long-term services and supports be person-centered and self-directed. It is the further intent of the Legislature to ensure that goals in any plan allow for innovation and nontraditional service delivery and not be limited by the lack of easily identified services or supports, the provision of services to consumers and their families be effective in meeting the goals stated in the individual program plan, reflect the preferences and choices of the consumer, and reflect the cost-effective use of public resources.
(b)(1)Notwithstanding any other law, the individual program plan, including all assessments, shall be developed through a process of individualized needs determination and person-centered service planning developed pursuant to, and consistent with, Section 2402(a) of the federal Affordable Care Act (Pub. L. 111-148) and amendments thereto, Section 441.725 of Title 42 of the Code of Federal Regulations, and federal guidance issued by the Centers for Medicare and Medicaid Services on June 6, 2014, requiring community-based, long-term services and supports to be person-centered, strengths-based, and self-directed. The individual with developmental disabilities and, if appropriate, the individuals parents, legal guardian or conservator, or authorized representative, shall have the opportunity to actively participate in the development of the plan. The individual shall lead the service planning process to the greatest extent possible.
(c)An individual program plan shall be developed for any person who, following intake and assessment, is found to be eligible for regional center services. These plans shall be completed within 60 days of the completion of the assessment. At the time of intake, the regional center shall inform the consumer and, if appropriate, the consumers parents, legal guardian or conservator, or authorized representative, of the services available through the state council and the protection and advocacy agency designated by the Governor pursuant to federal law, and shall provide the address and telephone numbers of those agencies.
(d)(1)As part of the initial individual program plan meeting and each annual review required by subdivision (b) of Section 4646.5, the consumer or, if appropriate, their parents, legal guardian, conservator, or authorized representative, shall be provided by the service coordinator oral and written information about the Self-Determination Program. The information shall include each of the provisions specified in subdivision (d) of Section 4685.8. Each individual program plan shall include a provision stating that the consumer or authorized representative was informed about the availability of the Self-Determination Program. If the consumer chooses not to participate in the program, the individual program plan shall include an explanation of the reason or reasons for that decision, or, if the consumer is ineligible for the program, the reason or reasons for that ineligibility.
(2)If the consumer is interested in participating in the program or wants additional information or assistance, the service coordinator, within five business days of expressing the interest, shall provide the consumer a date for the Self-Determination Program orientation, training resources, dates of local volunteer Self-Determination Program advisory committee meetings, and other information to assist the consumer in participating in the program.
(e)Individual program plans shall be prepared jointly by the planning team. Decisions concerning the consumers goals, objectives, and services and supports that will be included in the consumers individual program plan and purchased by the regional center or obtained from generic agencies shall be made by agreement between the regional center representative and the consumer or, if appropriate, the parents, legal guardian, conservator, or authorized representative at the program plan meeting.
(f)Regional centers shall comply with the request of a consumer or, if appropriate, the request of the consumers parents, legal guardian, conservator, or authorized representative, that a designated representative receive written notice of all meetings to develop or revise the individual program plan and of all notices sent to the consumer pursuant to Section 4710. The designated representative may be a parent or family member.
(g)Notwithstanding any other law, a meeting regarding the provision of services and supports by the regional center, including a meeting to develop or revise the individual program plan, shall be held by remote electronic communications if requested by the consumer or, if appropriate, if requested by the consumers parents, legal guardian, conservator, or authorized representative.
(h)At the conclusion of an individual program plan meeting, an authorized representative of the regional center shall provide to the consumer, in written or electronic format, a list of the agreed-upon services and supports, and, if known, the projected start date, the frequency and duration of the services and supports, and the provider. The authorized representative of the regional center shall sign the list of agreed-upon services and supports at that time. The consumer, or if appropriate, the consumers parent, legal guardian, conservator, or authorized representative shall sign the list of agreed-upon services and supports prior to its implementation. The consumer, or if appropriate, the consumers parent, legal guardian, conservator, or authorized representative, may elect to delay receipt of the list of agreed-upon services and supports pending final agreement, as described in subdivision (h). If the consumer, or if appropriate, the consumers parent, legal guardian, conservator, or authorized representative, elects to delay the receipt of the list of agreed-upon services and supports for 15 days, the list shall be provided in the preferred language of the consumer, or of the consumers parent, legal guardian, or authorized representative.
(i)If a final agreement regarding the services and supports to be provided to the consumer cannot be reached at a program plan meeting, then a subsequent program plan meeting shall be convened within 15 days, or later at the request of the consumer or, if appropriate, the parents, legal guardian, conservator, or authorized representative or if agreed to by the planning team. The list of the agreed-upon services and supports described in subdivision (h) and signed by the authorized representative of the regional center shall be provided, in writing or electronically, at the conclusion of the subsequent program plan meeting, and shall be provided in the preferred language of the consumer, or of the consumers parent, legal guardian, conservator, or authorized representative. Additional program plan meetings may be held with the agreement of the regional center representative and the consumer or, if appropriate, the parents, legal guardian, conservator, or authorized representative.
(j)An authorized representative of the regional center and the consumer or, if appropriate, the consumers parent, legal guardian, conservator, or authorized representative shall sign the individual program plan and the list of the agreed-upon services and supports prior to its implementation. If the consumer or, if appropriate, the consumers parent, legal guardian, conservator, or authorized representative, does not agree with all components of the individual program plan, the consumer may indicate that disagreement on the plan. Disagreement with specific plan components shall not prohibit the implementation of services and supports agreed to by the consumer or, if appropriate, the consumers parent, legal guardian, conservator, or authorized representative. If the consumer or, if appropriate, the consumers parent, legal guardian, conservator, or authorized representative, does not agree with the plan in whole or in part, the consumer shall be sent written notice of their appeal rights, as required by Sections 4701 and 4710.
(k)(1)A regional center shall communicate in the consumers preferred language, or, if appropriate, the preferred language of the consumers family, legal guardian, conservator, or authorized representative, during the planning process for the individual program plan, including during the program plan meeting, and including providing alternative communication services, as required by Sections 11135 to 11139.8, inclusive, of the Government Code and implementing regulations.
(2)A regional center shall provide alternative communication services, including providing copies of the list of services and supports, and the individual program plan in the preferred language of the consumer or the consumers family, legal guardian, conservator, or authorized representative, or both, as required by Sections 11135 to 11139.8, inclusive, of the Government Code and implementing regulations.
(3)The preferred language of the consumer or the consumers family, legal guardian, conservator, or authorized representative, or both, shall be documented in the individual program plan.
SEC. 13.Section 4646.4 of the Welfare and Institutions Code is amended to read:4646.4.(a)Regional centers shall ensure, at the time of development, scheduled review, or modification of a consumers individual program plan developed pursuant to Sections 4646 and 4646.5, or of an individualized family service plan pursuant to Section 95020 of the Government Code, the establishment of an internal process. This internal process shall ensure adherence with federal and state law and regulation, and if purchasing services and supports, shall ensure all of the following:
(1)Conformance with the regional centers purchase of service policies, as approved by the department pursuant to subdivision (d) of Section 4434.
(2)Utilization of generic services and supports if appropriate. The individualized family service planning team for infants and toddlers eligible under Section 95014 of the Government Code and the individual program plan team pursuant to Section 4646 may determine that a service provided by a generic agency, as defined by subdivision (g) of Section 4659.5, or a service or source of funding contained in Section 4659 identified in the individualized family service plan or individual program plan is not available, and, therefore, will be funded by the regional center.
(3)Utilization of other services and sources of funding as contained in Section 4659.
(4)Consideration of the familys responsibility for providing similar services and supports for a minor child without disabilities in identifying the consumers service and support needs as provided in the least restrictive and most appropriate setting. In this determination, regional centers shall take into account the consumers need for extraordinary care, services, supports and supervision, and the need for timely access to this care.
(5)Commencing October 1, 2022, consideration of information obtained from the consumer and, if appropriate, the parents, legal guardian, conservator, or authorized representative about the consumers need for the services, barriers to service access, and other information.
(b)At the time of development, scheduled review, or modification of a consumers individual program plan developed pursuant to Sections 4646 and 4646.5, or of an individualized family service plan pursuant to Section 95020 of the Government Code, the consumer, or, if appropriate, the parents, legal guardian, or conservator, shall provide copies of their health benefit cards under which the consumer is eligible to receive health benefits, including, but not limited to, private health insurance, a health care service plan, Medi-Cal, Medicare, and TRICARE. If the individual, or, if appropriate, the parents, legal guardians, or conservators, do not have health benefits, the regional center shall not use that fact to negatively impact the services that the individual may or may not receive from the regional center.
(c)Final decisions regarding the consumers individual program plan shall be made pursuant to Section 4646.
(d)Final decisions regarding the individualized family service plan shall be made pursuant to Section 95020 of the Government Code.
SEC. 14.Section 4646.5 of the Welfare and Institutions Code is amended to read:4646.5.(a)The planning process for the individual program plan described in Section 4646 shall include all of the following:
(1)Gathering information and conducting assessments to determine the life goals, capabilities and strengths, preferences, barriers, and concerns or problems of the person with developmental disabilities. For children with developmental disabilities, this process should include a review of the strengths, preferences, and needs of the child and the family unit as a whole. Assessments shall be conducted by qualified individuals and performed in natural environments whenever possible. Information shall be taken from the consumer, the consumers parents and other family members, the consumers friends, advocates, authorized representative, if applicable, providers of services and supports, and other agencies. The assessment process shall reflect awareness of, and sensitivity to, the lifestyle and cultural background of the consumer and the family.
(2)A statement of goals, based on the needs, preferences, and life choices of the individual with developmental disabilities, and a statement of specific, time-limited objectives for implementing the persons goals and addressing the persons needs. These objectives shall be stated in terms that allow measurement of progress or monitoring of service delivery. These goals and objectives should maximize opportunities for the consumer to develop relationships, be part of community life in the areas of community participation, housing, work, school, and leisure, increase control over the consumers life, acquire increasingly positive roles in community life, and develop competencies to help accomplish these goals.
(3)In developing individual program plans for children, regional centers shall be guided by the principles, process, and services and support parameters set forth in Section 4685.
(4)In developing an individual program plan for a transition age youth or working age adult, the planning team shall consider the Employment First Policy described in Chapter 14 (commencing with Section 4868).
(5)A schedule of the type and amount of services and supports to be purchased by the regional center or obtained from generic agencies or other resources in order to achieve the individual program plan goals and objectives, and identification of the provider or providers of service responsible for attaining each objective, including, but not limited to, vendors, contracted providers, generic service agencies, and natural supports. The individual program plan shall specify the approximate scheduled start date for services and supports and shall contain timelines for actions necessary to begin services and supports, including generic services. In addition to the requirements of subdivision (h) of Section 4646, each regional center shall offer, and upon request provide, a written copy of the individual program plan to the consumer, and, if appropriate, the consumers parents, legal guardian or conservator, or authorized representative within 45 days of their request in a threshold language, as defined by paragraph (3) of subdivision (a) of Section 1810.410 of Title 9 of the California Code of Regulations.
(6)If agreed to by the consumer, the parents, legally appointed guardian, or authorized representative of a minor consumer, or the legally appointed conservator of an adult consumer or the authorized representative, including those appointed pursuant to subdivision (a) of Section 4541, subdivision (b) of Section 4701.6, and subdivision (e) of Section 4705, a review of the general health status of the adult or child, including medical, dental, and mental health needs, shall be conducted. This review shall include a discussion of current medications, any observed side effects, and the date of the last review of the medication. Service providers shall cooperate with the planning team to provide any information necessary to complete the health status review. If any concerns are noted during the review, referrals shall be made to regional center clinicians or to the consumers physician, as appropriate. Documentation of health status and referrals shall be made in the consumers record by the service coordinator.
(7)(A)The development of a transportation access plan for a consumer when all of the following conditions are met:
(i)The regional center is purchasing private, specialized transportation services or services from a residential, day, or other provider, excluding vouchered service providers, to transport the consumer to and from day or work services.
(ii)The planning team has determined that a consumers community integration and participation could be safe and enhanced through the use of public transportation services.
(iii)The planning team has determined that generic transportation services are available and accessible.
(B)To maximize independence and community integration and participation, the transportation access plan shall identify the services and supports necessary to assist the consumer in accessing public transportation and shall comply with Section 4648.35. These services and supports may include, but are not limited to, mobility training services and the use of transportation aides. Regional centers are encouraged to coordinate with local public transportation agencies.
(8)A schedule of regular periodic review and reevaluation to ascertain that planned services have been provided, that objectives have been fulfilled within the times specified, and that consumers and families are satisfied with the individual program plan and its implementation.
(b)For all active cases, individual program plans shall be reviewed and modified by the planning team, through the process described in Section 4646, as necessary, in response to the persons achievement or changing needs, and no less often than once every 12 24 months. If the consumer or, if appropriate, the consumers parents, legal guardian, authorized representative, or conservator requests an individual program plan review, the individual program plan shall be reviewed within 30 days after the request is submitted, or no later than 7 days after the request is submitted if necessary for the consumers health and safety or to maintain the consumer in their home.
(c)(1)The department, with the participation of representatives of a statewide consumer organization, the Association of Regional Center Agencies, an organized labor organization representing service coordination staff, and the state council shall prepare training material and a standard format and instructions for the preparation of individual program plans, which embody a person-centered planning process consistent with federal law, regulations, and guidance.
(2)The department shall require each regional center to use, for all new and modified individual program plans, the training materials and the standard format plan prepared by the department pursuant to paragraph (1) by no later than March 1, 2024. 2025.
(3)The department shall biennially review a random sample of individual program plans at each regional center to ensure that these plans are being developed and modified in compliance with Section 4646 and this section.
SEC. 15.Section 4659 of the Welfare and Institutions Code is amended to read:4659.(a)Except as otherwise provided in subdivision (b), (d), or (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 centers purchase of services budget, except as it relates to federal supplemental security income and the state supplementary program.
(c)Effective July 1, 2009, notwithstanding any other law or regulation, 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 Supportive Services, California Childrens 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 after being advised of the provisions of subdivision (d). If, on July 1, 2009, a regional center is purchasing that service as part of a consumers individual program plan (IPP), the prohibition shall take effect on October 1, 2009.
(d)(1) Notwithstanding Section 4646.4, a regional center may request a consumer or family member to pursue a service or source of funding from an entity described in subdivision (a) or (c) of this section, or pursuant to subdivision (g) of Section 4659.5, if the request is documented with specificity in the individual program plan or individualized family plan and the plan contains detailed instructions for the consumer or family pursuing the service. The individual program plan or individualized family plan shall also specify the ways in which the regional center will initially assist the consumer or family to apply for and pursue the service or source of funding and specify that it will provide additional assistance when requested by the consumer or family.
(2)The regional center shall purchase the service when the entity denies the service.
(3)A consumer, or their family, shall not be required to appeal an entitys denial of the requested service for the regional center to purchase that service pursuant to this subdivision. The regional center may file an appeal on behalf of the consumer, but the appeal shall not delay the payment of the requested service by the regional center as specified in subparagraph (B) of paragraph (2).
(4)This section does not prohibit a consumer or their family, where appropriate, from filing a formal appeal of an entitys denial of the service at issue, or a regional center from seeking reimbursement from the entity it believes is responsible for providing the service and from requesting assistance with filing the appeal or from utilizing assistance from other advocacy organizations.
(e)This section shall not 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.
(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.
(g)(1)To provide uniformity, consistency, and cost-effectiveness, to reduce barriers, and to increase the number of service providers throughout the state, the department shall comprehensively review the current processes for vendorizing providers for the delivery of services and supports to regional center consumers and revise those processes to streamline the process and create a uniform statewide vendorization process. The department shall develop the revised processes, in consultation with the Association of Regional Center Agencies, consumers and their families, advocacy organizations, and service providers.
(2)It is the intent of the Legislature to ensure that a service provider vendored in one regional center shall automatically, without additional requirements, be eligible to provide services in all regional centers. It is the further intent of the Legislature that this section shall not be construed to control or interfere with the discretion of the individual program planning team to determine the needs and services appropriate for each person with a developmental disability who is entitled to services under this division.SEC. 16.Section 4685.8 of the Welfare and Institutions Code is amended to read:4685.8.(a)The department shall implement a statewide Self-Determination Program. The Self-Determination Program shall 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. As of July 1, 2021, the program shall begin to be available on a voluntary basis to all regional center consumers who are eligible for the Self-Determination Program.
(b)The department, in establishing the statewide program, shall do both of the following:
(1)Set targets and benchmarks as set forth in paragraph (1) of subdivision (r).
(2)Address all of the following:
(A)Oversight of expenditure of self-determined funds and the achievement of participant outcomes over time.
(B)Increased participant control over which services and supports best meet the participants needs and the IPP objectives. A participants unique support system may include the purchase of existing service offerings from service providers or local businesses, hiring their own support workers, or negotiating unique service arrangements with local community resources.
(C)Comprehensive person-centered planning, including an individual budget and services that are outcome based.
(D)Consumer and family training to ensure understanding of the principles of self-determination, the planning process, and the management of budgets, services, and staff.
(E)Choice of independent facilitators, who meet standards and certification requirements established by the department, and who can assist with the functions specified in paragraph (2) of subdivision (c).
(F)Choice of financial management services providers who meet standards and certification requirements established by the department, and who can carry out the functions specified in paragraph (1) of subdivision (c).
(G)Innovation that will more effectively allow participants to achieve their goals.
(H)Long-term sustainability of the Self-Determination Program by doing all of the following:
(i)Requiring IPP teams, when developing the individual budget, to determine the services, supports, and goods necessary for each consumer based on the needs and preferences of the consumer and, when appropriate, the consumers family, the effectiveness of each option in meeting the goals specified in the IPP, and the cost-effectiveness of each option, as specified in subparagraph (D) of paragraph (6) of subdivision (a) of Section 4648.
(ii)The department may review final individual budgets that are at or above a spending threshold determined by the department of all individual budgets and use information from its review in the aggregate to develop additional program guidance and verify compliance with federal and state laws and other requirements.
(c)For purposes of this section, the following definitions apply:
(1)Financial management services means services or functions that assist the participant to manage and direct the distribution of funds contained in the individual budget, and ensure that the participant has the financial resources to implement their IPP throughout the year. These may include bill paying services and activities that facilitate the employment of service and support workers by the participant, including, but not limited to, fiscal accounting, tax withholding, compliance with relevant state and federal employment laws, assisting the participant in verifying provider qualifications, including criminal background checks, and expenditure reports. The financial management services provider shall meet the applicable requirements of Title 17 of the California Code of Regulations and other specific qualifications or certifications established by the department.
(2)Independent facilitator means a person, selected and directed by the participant, who is not otherwise providing services to the participant pursuant to their IPP and is not employed by a person providing services to the participant. The independent facilitator may assist the participant in making informed decisions about the individual budget, and in locating, accessing, and coordinating services and supports consistent with the participants IPP. The independent facilitator is available to assist in identifying immediate and long-term needs, developing options to meet those needs, leading, participating, or advocating on behalf of the participant in the person-centered planning process and development of the IPP, and obtaining identified services and supports. The cost of the independent facilitator, if any, shall be paid by the participant out of the participants individual budget. An independent facilitator shall receive training in the principles of self-determination, the person-centered planning process, and the other responsibilities described in this paragraph at the independent facilitators own cost. The independent facilitator shall meet standards and certification requirements established by the department.
(3)Individual budget means the amount of regional center purchase of service funding available to the participant for the purchase of services and supports necessary to implement the IPP. The individual budget shall be determined using a fair, equitable, and transparent methodology.
(4)IPP means individual program plan, as described in Section 4646.
(5)Participant means an individual and, when appropriate, the participants parents, legal guardian or conservator, or authorized representative, who has been deemed eligible for, and has voluntarily agreed to participate in, the Self-Determination Program.
(6)Self-determination means a voluntary delivery system consisting of a defined and comprehensive mix of services and supports, selected and directed by a participant through person-centered planning, in order to meet the objectives in their IPP. Self-determination services and supports are designed to assist the participant to achieve personally defined outcomes in community settings that promote inclusion. The Self-Determination Program shall only fund services and supports provided pursuant to this division that the federal Centers for Medicare and Medicaid Services determines are eligible for federal financial participation.
(7)Spending Plan means the plan the participant develops to use their available individual budget funds to purchase goods, services, and supports necessary to implement their individual program plan (IPP). The spending plan shall identify the cost of each good, service, and support that will be purchased with regional center funds. The total amount of the spending plan cannot exceed the amount of the individual budget. A copy of the spending plan shall be attached to the participants IPP.
(d)Participation in the Self-Determination Program is fully voluntary. A participant may choose to participate in, and may choose to leave, the Self-Determination Program at any time. A regional center shall not require or prohibit participation in the Self-Determination Program as a condition of eligibility for, or the delivery of, services and supports otherwise available under this division. Participation in the Self-Determination Program shall be available to any regional center consumer who meets the following eligibility requirements:
(1)The participant has a developmental disability, as defined in Section 4512, and is receiving services pursuant to this division.
(2)The consumer does not live in a licensed long-term health care facility, as defined in paragraph (44) of subdivision (a) of Section 54302 of Title 17 of the California Code of Regulations. An individual and, when appropriate, the individuals parent, legal guardian or conservator, or authorized representative, who is not eligible to participate in the Self-Determination Program pursuant to this paragraph may request that the regional center provide person-centered planning services in order to make arrangements for transition to the Self-Determination Program, provided that the individual is reasonably expected to transition to the community within 90 days. In that case, the regional center shall initiate person-centered planning services within 60 days of that request.
(3)The participant agrees to all of the following terms and conditions:
(A)The participant shall receive an orientation that meets the standards set or developed by the department to the Self-Determination Program prior to enrollment, which includes the principles of self-determination, the role of the independent facilitator and the financial management services provider, person-centered planning, and development of a budget.
(B)The participant shall utilize the services and supports available within the Self-Determination Program only when generic services and supports are not available.
(C)The participant shall only purchase services and supports necessary to implement their IPP and shall comply with any and all other terms and conditions for participation in the Self-Determination Program described in this section.
(D)The participant shall manage Self-Determination Program services and supports within the participants individual budget.
(E)The participant shall utilize the services of a financial management services provider of their own choosing and who is vendored by a regional center and who meets the qualifications in paragraph (1) of subdivision (c).
(F)The participant may utilize the services of an independent facilitator of their own choosing for the purpose of providing services and functions as described in paragraph (2) of subdivision (c). If the participant elects not to use an independent facilitator, the participant may use their regional center service coordinator to provide the services and functions described in paragraph (2) of subdivision (c).
(G)If eligible, with the assistance of the regional center, if needed, timely apply for Medi-Cal in order to maximize federal funding. The participant may consider institutional deeming in order to qualify for Medi-Cal services.
(e)A participant who is not Medi-Cal eligible may participate in the Self-Determination Program and receive self-determination services and supports if all other program eligibility requirements are met and the services and supports are otherwise eligible for federal financial participation.
(f)The additional federal financial participation funds generated by the former participants of the self-determination pilot projects authorized pursuant to Section 13 of Chapter 1043 of the Statutes of 1998, as amended, or pursuant to Article 4 (commencing with Section 4669.2) of Chapter 5, shall be used to maximize the ability of Self-Determination Program participants to direct their own lives and to ensure the department and regional centers successfully implement the program as follows:
(1)First, to offset the cost to the department for the criminal background check conducted pursuant to subdivision (v) and other administrative costs incurred by the department in implementing the Self-Determination Program.
(2)With the remaining funds, the department, in consultation with stakeholders, including a statewide self-determination advisory workgroup, shall prioritize the use of the funds to meet the needs of participants, increase service access and equity, and reduce disparities, and to implement the program, including costs associated with all of the following:
(A)Independent facilitators to assist with a participants initial person-centered planning meeting.
(B)Development of the participants initial individual budget.
(C)Joint training of consumers, family members, regional center staff, and members of the local volunteer advisory committee established pursuant to paragraph (1) of subdivision (w).
(D)Regional center operations to increase support for transition to the Self-Determination Program or for caseload ratio enhancement.
(E)To offset the costs to the regional centers in implementing the Self-Determination Program.
(F)To support the Statewide Self-Determination Advisory Committee established pursuant to paragraph (2) of subdivision (w).
(g)If at any time during participation in the Self-Determination Program a regional center determines that a participant is no longer eligible to continue in, or a participant voluntarily chooses to exit, the Self-Determination Program, the regional center shall provide for the participants transition from the Self-Determination Program to other services and supports. This transition shall include the development of a new IPP that reflects the services and supports necessary to meet the individuals needs. The regional center shall ensure that there is no gap in services and supports during the transition period.
(h)An individual determined to be ineligible for or who voluntarily exits the Self-Determination Program shall be permitted to return to the Self-Determination Program upon meeting all applicable eligibility criteria and upon approval of the participants planning team, as described in subdivision (j) of Section 4512. An individual who has voluntarily exited the Self-Determination Program shall not return to the program for at least 12 months.
(i)An individual who participates in the Self-Determination Program may elect to continue to receive self-determination services and supports if the individual transfers to another regional center catchment area, provided that the individual remains eligible for the Self-Determination Program pursuant to subdivision (d). The balance of the participants individual budget shall be reallocated to the regional center to which the participant transfers.
(j)The IPP team shall utilize the person-centered planning process to develop the IPP for a participant. The IPP shall detail the goals and objectives of the participant that are to be met through the purchase of participant-selected services and supports. The IPP team shall determine the individual budget to ensure the budget assists the participant to achieve the outcomes set forth in the participants IPP and ensures their health and safety. The completed individual budget shall be attached to the IPP.
(k)The participant shall implement their IPP, including choosing and purchasing the services and supports allowable under this section necessary to implement the plan. A participant is exempt from the cost control restrictions regarding the purchases of services and supports pursuant to Section 4648.5. A regional center shall not prohibit the purchase of any service or support that is otherwise allowable under this section.
(l)A participant shall have all the rights established in Sections 4646 to 4646.6, inclusive, and Chapter 7 (commencing with Section 4700).
(m)(1)Except as provided in paragraph (4), the IPP team shall determine the initial and any revised individual budget for the participant using the following methodology:
(A)(i)Except as specified in clause (ii), for a participant who is a current consumer of the regional center, their individual budget shall be the total amount of the most recently available 12 months of purchase of service expenditures for the participant.
(ii)An adjustment may be made to the amount specified in clause (i) if both of the following occur:
(I)The IPP team determines that an adjustment to this amount is necessary due to a change in the participants circumstances, needs, or resources that would result in an increase or decrease in purchase of service expenditures, or the IPP team identifies prior needs or resources that were unaddressed in the IPP, which would have resulted in an increase or decrease in purchase of service expenditures. When adjusting the budget, the IPP team shall document the specific reason for the adjustment in the IPP.
(II)The regional center certifies on the individual budget document that regional center expenditures for the individual budget, including any adjustment, would have occurred regardless of the individuals participation in the Self-Determination Program.
(iii)For purposes of clauses (i) and (ii), the amount of the individual budget shall not be increased to cover the cost of the independent facilitator.
(B)For a participant who is either newly eligible for regional center services or who does not have 12 months of purchase service expenditures, the participants individual budget shall be calculated as follows:
(i)The IPP team shall identify the services and supports needed by the participant and available resources, as required by Section 4646.
(ii)The regional center shall calculate the cost of providing the services and supports to be purchased by the regional center by using the average cost paid by the regional center for each service or support unless the regional center determines that the consumer has a unique need that requires a higher or lower cost. The IPP team also shall document the specific reason for the adjustment in the IPP. The regional center shall certify on the individual budget document that this amount would have been expended using regional center purchase of service funds regardless of the individuals participation in the Self-Determination Program.
(iii)For purposes of clauses (i) and (ii), the amount of the individual budget shall not be increased to cover the cost of the independent facilitator.
(2)The amount of the individual budget shall be available to the participant each year for the purchase of program services and supports. An individual budget shall be calculated no more than once in a 12-month period, unless revised to reflect a change in circumstances, needs, or resources of the participant using the process specified in clause (ii) of subparagraph (A) of paragraph (1).
(3)The spending plan shall be assigned to uniform budget categories developed by the department in consultation with stakeholders and distributed according to the timing of the anticipated expenditures in the IPP and in a manner that ensures that the participant has the financial resources to implement the IPP throughout the year.
(4)The department, in consultation with stakeholders, may develop alternative methodologies for individual budgets that are computed in a fair, transparent, and equitable manner and are based on consumer characteristics and needs, and that include a method for adjusting individual budgets to address a participants change in circumstances or needs.
(n)Annually, participants may transfer up to 10 percent of the funds originally distributed to any budget category set forth in paragraph (3) of subdivision (m) to another budget category or categories. Transfers in excess of 10 percent of the original amount allocated to any budget category may be made upon the approval of the regional center or the participants IPP team.
(o)Consistent with the implementation date of the IPP, the IPP team shall annually ascertain from the participant whether there are any circumstances or needs that require a change to the annual individual budget. Based on that review, the IPP team shall calculate a new individual budget consistent with the methodology identified in subdivision (m).
(p)(1)The department, as it determines necessary, may adopt regulations to implement the procedures set forth in this section. Any regulations shall be adopted in accordance with the requirements of Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code.
(2)Notwithstanding paragraph (1) and Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, and only to the extent that all necessary federal approvals are obtained, the department, without taking any further regulatory action, shall implement, interpret, or make specific this section by means of program directives or similar instructions until the time regulations are adopted. It is the intent of the Legislature that the department be allowed this temporary authority as necessary to implement program changes only until completion of the regulatory process.
(q)The department, in consultation with stakeholders, shall develop informational materials about the Self-Determination Program. The department shall ensure that regional centers are trained in the principles of self-determination, the mechanics of the Self-Determination Program, and the rights of consumers and families as candidates for, and participants in, the Self-Determination Program.
(r)Each regional center shall be responsible for implementing the Self-Determination Program as a term of its contract under Section 4629. As part of implementing the program, the regional center shall do all of the following:
(1)Meet the Self-Determination Program targets approved by the department, meet benchmarks established by the department in areas including timely enrollment, diversity of consumers served, and reduction of disparities in the individual budget of participants from racial and ethnic communities, and be eligible for incentives for exceeding these targets and benchmarks once the department has established a performance incentives program.
(2)Develop and implement an outreach and training plan about the Self-Determination Program for the diverse communities served by the regional center, including in congregate settings. Information shall be provided in plain language, in alternative formats and alternative modes of communication, and provide language access as required by state and federal law. Obtain input from stakeholders, including consumers and families, that reflect the ethnic and language diversity of the regional centers consumers, about the effectiveness of this outreach and training and other activities that may be effective in reducing disparities in these programs.
(3)Annually report the enrollment, individual budget data, and purchase of service expenditure data for the Self-Determination Program consistent with the criteria in subdivisions (a) to (c), inclusive, of Section 4519.5.
(4)Assist eligible participants and their families in applying for Medi-Cal, in order to maximize federal funding and assist interested participants who wish to pursue institutional deeming in order to qualify for Medi-Cal services.
(5)At least annually, in addition to annual certification, conduct an additional review of all final individual budgets for participants at the regional center which are at or above a spending threshold that is specified by the department through directive consistent with federal and state requirements. This information may be used in the aggregate to provide training, program guidance, and verify compliance with state and federal requirements.
(6)Review the spending plan to verify that goods and services eligible for federal financial participation are not used to fund goods or services available through generic agencies.
(7)Contract with local consumer or family-run organizations and consult with the local volunteer advisory committee established pursuant to paragraph (1) of subdivision (w) to conduct outreach through local meetings or forums to consumers and their families to provide information about the Self-Determination Program and to help ensure that the program is available to a diverse group of participants, with special outreach to underserved communities.
(8)Collaborate with the local consumer or family-run organizations identified in paragraph (1) to jointly conduct training about the Self-Determination Program. The regional center shall consult with the local volunteer advisory committee established pursuant to paragraph (1) of subdivision (w) in planning for the training, and the local volunteer advisory committee may designate members to represent the advisory committee at the training.
(9)Train all service coordinators and fair hearing specialists in the principles of self-determination, the mechanics of the Self-Determination Program, and the rights of consumers and families. The training shall be conducted in collaboration with the local volunteer advisory committee.
(10)Provide payment to the financial management services provider for spending plan expenses through a not less than semimonthly pay schedule.
(11)Ensure that each individual plan includes the information required by subdivision (d) of Section 4646.
(s)The financial management services provider shall provide the participant and the regional center service coordinator with a monthly individual budget statement that describes the amount of funds allocated by budget category, the amount spent in the previous 30-day period, and the amount of funding that remains available under the participants individual budget.
(t)Only the financial management services provider is required to apply for vendorization in accordance with Subchapter 2 (commencing with Section 54300) of Chapter 3 of Division 2 of Title 17 of the California Code of Regulations for the Self-Determination Program. All other service and support providers shall not be on the federal debarment list and shall have applicable state licenses, certifications, or other state required documentation, including documentation of any other qualifications required by the department, but are exempt from the vendorization requirements set forth in Title 17 of the California Code of Regulations when serving participants in the Self-Determination Program.
(u)The regional center shall pay the full costs of the participants financial management services provider.
(v)To protect the health and safety of participants in the Self-Determination Program, the department shall require a criminal background check in accordance with all of the following:
(1)The department shall issue a program directive that identifies nonvendored providers of services and supports who shall obtain a criminal background check pursuant to this subdivision. At a minimum, these staff shall include both of the following:
(A)Individuals who provide direct personal care services to a participant.
(B)Other nonvendored providers of services and supports for whom a criminal background check is requested by a participant or the participants financial management service.
(2)Subject to the procedures and requirements of this subdivision, the department shall administer criminal background checks consistent with the departments authority and the process described in Sections 4689.2 to 4689.6, inclusive.
(3)The department shall electronically submit to the Department of Justice fingerprint images and related information required by the Department of Justice of nonvendored providers of services and supports, as specified in paragraph (1), for purposes of obtaining information as to the existence and content of a record of state or federal convictions and state or federal arrests and also information as to the existence and content of a record of state or federal arrests for which the Department of Justice establishes that the person is free on bail or on their own recognizance pending trial or appeal.
(4)When received, the Department of Justice shall forward to the Federal Bureau of Investigation requests for federal summary criminal history information received pursuant to this section. The Department of Justice shall review the information returned from the Federal Bureau of Investigation and compile and disseminate a response to the department.
(5)The Department of Justice shall provide a state or federal response to the department pursuant to paragraph (1) of subdivision (p) of Section 11105 of the Penal Code.
(6)The department shall request from the Department of Justice subsequent notification service, as provided pursuant to Section 11105.2 of the Penal Code, for persons described in paragraph (1).
(7)The Department of Justice shall charge a fee sufficient to cover the cost of processing the request described in this subdivision.
(8)The fingerprints of any provider of services and supports who is required to obtain a criminal background check shall be submitted to the Department of Justice prior to employment. The costs of the fingerprints and the financial management services administrative cost authorized by the department shall be paid by the services and supports provider or the providers employing agency. Any administrative costs incurred by the department pursuant to this subdivision shall be offset by the funds specified in subdivision (g).
(9)If the criminal record information report shows a criminal history, the department shall take the steps specified in Section 4689.2. The department may prohibit a provider of services and supports from becoming employed, or continuing to be employed, based on the criminal background check, as authorized in Section 4689.6. The provider of services and supports who has been denied employment shall have the rights set forth in Section 4689.6.
(10)The department may utilize a current department-issued criminal record clearance to enable a provider to serve more than one participant, as long as the criminal record clearance has been processed through the department and no subsequent arrest notifications have been received relative to the cleared applicant.
(11)Consistent with subdivision (h) of Section 4689.2, the participant or financial management service that denies or terminates employment based on written notification from the department shall not incur civil liability or unemployment insurance liability.
(w)To ensure the effective implementation of the Self-Determination Program and facilitate the sharing of best practices and training materials commencing with the implementation of the Self-Determination Program, local and statewide advisory committees shall be established as follows:
(1)Each regional center shall establish a local volunteer advisory committee to provide oversight of the Self-Determination Program and identify a regional center liaison to the committee. The regional center and the State Council on Developmental Disabilities shall each appoint one-half of the membership of the committee. The committee shall consist of the regional center clients rights advocate, consumers, family members, and other advocates, and community leaders, including a representative from a family resource center. A majority of the committee shall be consumers and their family members. The committee shall reflect the multicultural diversity and geographic profile of the catchment area. The committee shall review the development and ongoing progress of the Self-Determination Program, including whether the program advances the principles of self-determination and is operating consistent with the requirements of this section, and may make ongoing recommendations for improvement to the regional center and the department. Annually, the regional center shall confirm, in writing, that the committee meets the requirements specified in this paragraph and provide the department with the name of the staff liaison and the names of the committee members, the positions they fill on the committee, and which entity appointed them to the committee.
(2)The State Council on Developmental Disabilities shall form a volunteer committee, to be known as the Statewide Self-Determination Advisory Committee, comprised of the chairs of the 21 local advisory committees or their designees. The council shall convene the Statewide Self-Determination Advisory Committee twice annually, or more frequently in the sole discretion of the council. The Statewide Self-Determination Advisory Committee shall meet by teleconference or other means established by the council to identify self-determination best practices, effective consumer and family training materials, implementation concerns, systemic issues, ways to enhance the program, and recommendations regarding the most effective method for participants to learn of individuals who are available to provide services and supports. The council shall synthesize information received from the Statewide Self-Determination Advisory Committee, local advisory committees, and other sources, share the information with consumers, families, regional centers, and the department, and make recommendations, as appropriate, to increase the programs effectiveness in furthering the principles of self-determination.
(x)The department shall annually provide the following information to the appropriate policy and fiscal committees of the Legislature:
(1)Number and characteristics of participants, by regional center, including the number of participants who entered the program upon movement from a developmental center.
(2)Types and amount of services and supports purchased under the Self-Determination Program, by regional center.
(3)Range and average of individual budgets, by regional center, including adjustments to the budget to address the adjustments permitted in clause (ii) of subparagraph (A) of paragraph (1) of subdivision (m).
(4)The number and outcome of appeals concerning individual budgets, by regional center.
(5)The number and outcome of fair hearing appeals, by regional center.
(6)The number of participants who voluntarily withdraw from the Self-Determination Program and a summary of the reasons why, by regional center.
(7)The number of participants who are subsequently determined to no longer be eligible for the Self-Determination Program and a summary of the reasons why, by regional center.
(y)(1)The State Council on Developmental Disabilities shall issue an interim report to the Legislature, in compliance with Section 9795 of the Government Code, no later than June 30, 2021, on the status of the Self-Determination Program authorized by this section, barriers to its implementation, and recommendations to enhance the effectiveness of the program. The interim report shall provide an update to the programs status, each regional centers cap on participation and progress toward that cap, the most recent statewide and per-regional-center participant count, and the historical trend in the statewide participation count since the start of the program. The department shall assist in providing available information to the council in order to facilitate the timely issuance of the report.
(2)The council, in collaboration with the protection and advocacy agency identified in Section 4900 and the federally funded University Centers for Excellence in Developmental Disabilities Education, Research, and Service, may work with regional centers to survey participants regarding participant satisfaction under the Self-Determination Program and, when data is available, the traditional service delivery system, including the proportion of participants who report that their choices and decisions are respected and supported and who report that they are able to recruit and hire qualified service providers, and to identify barriers to participation and recommendations for improvement.
(3)The council, in collaboration with the protection and advocacy agency identified in Section 4900 and the federally funded University Centers for Excellence in Developmental Disabilities Education, Research, and Service, shall issue a report to the Legislature, in compliance with Section 9795 of the Government Code, by June 30, 2023, on the status of the Self-Determination Program authorized by this section, and provide recommendations to enhance the effectiveness of the program. This review shall include the programs effectiveness in furthering the principles of self-determination, including all of the following:
(A)Freedom, which includes the ability of adults with developmental disabilities to exercise the same rights as all citizens to establish, with freely chosen supporters, family and friends, where they want to live, with whom they want to live, how their time will be occupied, and who supports them; and for families to have the freedom to receive unbiased assistance of their own choosing when developing a plan and to select all personnel and supports to further the life goals of a minor child.
(B)Authority, which includes the ability of a person with a disability, or family, to control a certain sum of dollars in order to purchase services and supports of their choosing.
(C)Support, which includes the ability to arrange resources and personnel, both formal and informal, that will assist a person with a disability to live a life in the community that is rich in community participation and contributions.
(D)Responsibility, which includes the ability of participants to take responsibility for decisions in their own lives and to be accountable for the use of public dollars, and to accept a valued role in their community through, for example, competitive employment, organizational affiliations, spiritual development, and general caring of others in their community.
(E)Confirmation, which includes confirmation of the critical role of participants and their families in making decisions in their own lives and designing and operating the system that they rely on.
SEC. 17.Section 4726 of the Welfare and Institutions Code is amended to read:4726.Notwithstanding Section 5328, any exemption to the California Public Records Act (Division 10 (commencing with Section 7920.000) of Title 1 of the Government Code), or any other law that authorizes, but does not require, an entity to withhold all or part of a record on the basis of its confidentiality, access to records regarding an applicant for, or recipient of, services shall be provided, upon request, to the applicant, recipient, or their authorized representative, including the person appointed as a developmental services decisionmaker pursuant to Section 319, 361, or 726, for purposes, including, but not limited to, the appeal process under this chapter, unless disclosure of the record is expressly prohibited by law.
SEC. 18.Section 4731 of the Welfare and Institutions Code is amended to read:4731.(a)Each consumer or any representative acting on behalf of any consumer or consumers, who believes that any right to which a consumer is entitled has been abused, punitively withheld, or improperly or unreasonably denied by a regional center, state-operated facility, or service provider, may pursue a complaint as provided in this section.
(b)Initial referral of any complaint taken pursuant to this section shall be to the director of the regional center from which the consumer receives case management services. If the consumer resides in a state-operated facility, the complaint shall be made to the director of the state-operated facility. The director shall, within 20 business days of receiving a complaint, investigate the complaint and send a written proposed resolution to the complainant and, if applicable, to the service provider. The written proposed resolution shall include a telephone number and mailing address for referring the proposed resolution in accordance with subdivision (c).
(b)Any complaint made pursuant to this section shall be made to(c)If the complainant is not satisfied with the proposed resolution, the complainant may refer the complaint, in writing, to the Director of Developmental Services. Services, within 15 days of receipt of the proposed resolution. The director, within 30 days of receiving a complaint, shall issue a written administrative decision and send a copy of the decision to the complainant, the director of the regional center or state-operated facility, and the service provider, if applicable. If there is no referral to the department, the proposed resolution shall become effective on the 20th working day following receipt by the complainant.
(c)(d)The department, on a quarterly basis, shall department shall annually compile the number of complaints filed, by each regional center and state-operated facility, the subject matter of each complaint, and a summary of each decision, and post the compilation on its internet website at the end of each quarter. Copies of any decision included in the compilation shall be made available within 10 days, with all individually identifiable information redacted, to any person upon request.
(d)(e)This section shall not be used to resolve disputes concerning the nature, scope, or amount of services and supports that should be included in an individual program plan, for which there is an appeals procedure established in this division, or disputes regarding rates or audit appeals for which there is an appeals procedure established in regulations. Those disputes shall be resolved through the appeals procedure established by this division or in regulations.
(e)(f)All consumers or, if appropriate, their authorized representative, shall be notified in writing in their preferred language of the right to file a complaint pursuant to this section when they apply for services from a regional center or a state-operated facility, and at each regularly scheduled planning meeting.
This act shall be known, and may be cited, as the Disability Equity and Accountability Act of 2023.
SEC. 2.(a)The Legislature finds and declares as follows:
(1)Recent reports and hearings by the California State Auditor, the Little Hoover Commission, and advocacy organizations have found that Californias service system for the over 400,000 children and adults with intellectual and developmental disabilities through the Lanterman Act, as overseen by the State Department of Developmental Services, which contracts with 21 regional centers, is failing in significant ways to deliver critical, adequate, and timely services to individuals and families. The result is that individuals and families, particularly those of color, color and tribal members living in rural areas and tribal reservations, are unable to timely access services and supports, resulting in barriers to their living independent, productive, and integrated lives in their communities.
(2)Californias developmental disability service system is plagued with racial, ethnic, and geographic disparities that can dramatically impact the essential services received by children and adults with developmental disabilities. Systemic inequities and discrimination within Californias 21 regional centers broaden the gap between inclusive possibilities and segregated limitations. Data show Latinos are most negatively impacted by these disparities, but people who are clients of the lowest-performing regional centers are also significantly affected.
(3)California spends nearly $13,000,000,000 annually on the administration and delivery of developmental services, but lacks a transparent, common, integrated, and coordinated model for the delivery and measurement of services throughout the 21 regional centers, resulting in poor outcomes, poor satisfaction levels by consumers and families, and disparate levels of available services and performance expectations.
(4)The delivery of services through 21 separate private nonprofit regional centers with separate boards, funding, and delivery models was originally intended to ensure that the delivery of services could be more effectively delivered through nonstate entities. However, with the subsequent caseload and budget growth since the enactment of the Lanterman Act, local administration has become more disparate and less accountable. Boards of directors are untrained and are not providing the oversight needed of the regional centers. Stronger state oversight of regional centers by the State Department of Developmental Services is essential to ensure that services are equitably delivered, performance and outcomes are uniformly measured and reported, and the system is transparent and accountable to individuals and families.
(5)The departments system lacks a statewide automated technology system for the delivery of services to persons with intellectual and developmental disabilities and, as a result, the current program is constrained by disparate automation systems, inadequate documentation, the lack of open system architecture, insufficient data to support administration of the system, and the lack of data to support program improvements for improving the quality of life outcomes through new service delivery methods.
(6)Statewide uniformity of service delivery practices and procedures is essential to an effective program and to support necessary oversight and research for ongoing program improvements.
(7)The departments technical infrastructure is over 40 years old. The lack of a statewide automation system does not meet current program needs and significantly contributes to the racial and geographic disparities in the delivery of services. California currently lacks clear and consistent service delivery outcomes for individuals with intellectual and developmental disabilities that sets high expectations for their quality of life, and must develop a system for measuring and quantifying the value of service delivery outcomes.
(8)A previous effort to develop an intellectual and developmental disabilities (IDD) program technology system failed. As a result, the department and regional centers maintain a patchwork of at least three case management and fiscal systems that are not integrated and six legacy case management automation systems that lack integration, have dissimilar data sources, and are technically outdated.
(9) In the 202122 annual budget the Legislature appropriated $6,000,000 to the State Department of Developmental Services for planning purposes related to the implementation of a uniform fiscal system and consumer electronic records management system. The department has not developed a vision or scope for a proposed system development approach.
(b)Therefore, it is the intent of the Legislature in enacting this act to do all of the following:
(1)Ensure that racial, ethnic, and geographic service disparities disparities, including Native Americans living on or off tribal reservations, be systemically addressed and eliminated and that all people, regardless of their race or ethnicity or where they live, receive equitable access to services within the regional center system.
(2)Ensure that all regional centers offer and provide a consistent and common set of services and that the services are delivered in a timely way.
(3) Ensure that the delivery of all services and supports comply with federal law and guidance and are responsive to the needs and choices of beneficiaries receiving home- and community-based services, are person centered and strengths based, have high expectations for interdependence, self-direction, and competitive, integrated employment, provide support coordination to assist with a community-supported life, and achieve a more consistent and coordinated approach to the administration of policies and procedures across the state.
(4)Provide the department with new tools for holding regional centers and service providers accountable through the development of a standardized and coordinated set of performance measures and related standards that establish targets and standards above which a regional center may receive incentives for improved performance, and a separate set of standards that require corrective action.
(5)Improve regional center governance by establishing new standards and procedures for regional center governing boards to ensure they can more effectively represent the communities they serve by providing them with greater independence and protection from regional center retaliation.
(6)Require the State Department of Developmental Services to develop a written project charter for the planning and development of a uniform statewide automation system that serves as a foundation document for the system development, which includes project guiding principles, scope, strategies and approach, and project governance, in order to provide transparency to the Legislature and the public on the system development as has been used with other statewide system development.
SEC. 3.Section 4519.5 of the Welfare and Institutions Code is amended to read:4519.5.(a)The department and the regional centers shall annually collaborate to compile data in a uniform manner relating to purchase of service authorization, utilization, and expenditure by each regional center with respect to all of the following:
(1)The age of the consumer, categorized by the following:
(A)Birth to two years of age, inclusive.
(B)Three to 21 years of age, inclusive.
(C)Twenty-two years of age and older.
(2)Race or ethnicity of the consumer.
(3)Tribal affiliation.
(3)(4)Preferred language spoken by the consumer, and other related details, as feasible.
(4)(5)Disability detail, in accordance with the categories established by subdivision (a) of Section 4512, and, if applicable, a category specifying that the disability is unknown.
(5)(6)Residence type, subcategorized by age, race or ethnicity, and preferred language.
(6)(7)Number of instances when the written copy of the individual program plan was provided at the request of the consumer and, when appropriate, the consumers parents, legal guardian or conservator, or authorized representative, in a language other than a threshold language, as defined by paragraph (3) of subdivision (a) of Section 1810.410 of Title 9 of the California Code of Regulations, if that written copy was provided more than 60 days after the request.
(7)(8)Number of instances when the written copy of the individual program plan was provided at the request of the consumer and, when appropriate, the consumers parents, legal guardian or conservator, or authorized representative, in a threshold language, as defined by paragraph (3) of subdivision (a) of Section 1810.410 of Title 9 of the California Code of Regulations, if that written copy was provided more than 45 days after the request, in violation of paragraph (5) of subdivision (a) of Section 4646.5.
(8)(9)Beginning with data for the fiscal year of 202324, the numbers, percentages, and total and per capita expenditure and authorization amounts, by age, as applicable, according to race or ethnicity and preferred language, for all combined residence types and for consumers living in the family home, regarding the following service types:
(A)Camping and associated travel expenses.
(B)Social recreation activities.
(C)Educational services.
(D)Nonmedical therapies, including, but not limited to, specialized recreation, art, dance, and music. music, and tribal culture and ceremony.
(b)The data reported pursuant to subdivision (a) shall also include the number and percentage of individuals, categorized by age, race or ethnicity, and disability, and by residence type, as set forth in paragraph (5) (6) of subdivision (a), who have been determined to be eligible for regional center services, but are not receiving purchase of service funds.
(c)By March 31, 2013, each regional center shall post the data described in this section that are specific to the regional center on its internet website. Commencing on December 31, 2013, each regional center shall annually post these data by December 31. Each regional center shall maintain all previous years data on its internet website.
(d)By March 31, 2013, the department shall post the information described in this section on a statewide basis on its internet website. Commencing December 31, 2013, the department shall annually post this information by December 31. The department shall maintain all previous years data on its internet website. The department shall also post notice of any regional center stakeholder meetings on its internet website.
(e)Within three months of compiling the data with the department, and annually thereafter, each regional center shall meet with stakeholders in one or more public meetings regarding the data. The meeting or meetings shall be held separately from any meetings held pursuant to Section 4660. The regional center shall provide participants of these meetings with the data and any associated information related to improvements in the provision of developmental services to underserved communities and shall conduct a discussion of the data and the associated information in a manner that is culturally and linguistically appropriate for that community, including providing alternative communication services, as required by Sections 11135 to 11139.7, inclusive, of the Government Code and implementing regulations. Regional centers shall inform the department of the scheduling of those public meetings 30 days prior to the meeting. Notice of the meetings shall also be posted on the regional centers internet website 30 days prior to the meeting and shall be sent to individual stakeholders and groups representing underserved communities in a timely manner. Each regional center shall, in holding the meetings required by this subdivision, consider the language needs of the community and shall schedule the meetings at times and locations designed to result in a high turnout by the public and underserved communities.
(f)(1)Each regional center shall annually report to the department regarding its implementation of the requirements of this section. The report shall include, but shall not be limited to, all of the following:
(A)Actions the regional center took to improve public attendance and participation at stakeholder meetings, including, but not limited to, attendance and participation by underserved communities.
(B)Copies of minutes from the meeting and attendee comments.
(C)Whether the data described in this section indicate a need to reduce disparities in the purchase of services among consumers in the regional centers catchment area. If the data do indicate that need, the regional centers recommendations and plan to promote equity, and reduce disparities, in the purchase of services.
(2)Each regional center and the department shall annually post the reports required by paragraph (1) on its internet website by August 31.
(g)(1)The department shall consult with stakeholders, including consumers and families that reflect the ethnic and language diversity of regional center consumers, regional centers, advocates, providers, family resource centers, the protection and advocacy agency described in Section 4901, and those entities designated as University Centers for Excellence in Developmental Disabilities Education, Research, and Service pursuant to Section 15061 of Title 42 of the United States Code, to achieve the following objectives:
(A)Review the data compiled pursuant to subdivision (a).
(B)Identify barriers to equitable access to services and supports among consumers and develop recommendations to help reduce disparities in purchase of service expenditures.
(C)Encourage the development and expansion of culturally appropriate services, service delivery, and service coordination.
(D)Identify best practices to reduce disparity and promote equity.
(2)The department shall report the status of its efforts to satisfy the requirements of paragraph (1) during the 201617 legislative budget subcommittee hearing process.
(h)(1)Subject to available funding, the department shall allocate funding to regional centers or community-based organizations with department oversight to assist with implementation of the recommendations and plans developed pursuant to subdivisions (f) and (g). Activities funded through these allocations may include, but are not limited to, pay differentials supporting direct care bilingual staff of community-based service providers, parent or caregiver education programs, cultural competency training for regional center staff, outreach to underserved populations, or additional culturally appropriate service types or service delivery models.
(2)Each regional center shall consult with stakeholders regarding activities that may be effective in addressing disparities in the receipt of regional center services and the regional centers proposed requests for the funding specified in paragraph (1). Each regional center shall identify the stakeholders it consulted with and include information on how it incorporated the input of stakeholders into its requests.
(3)A community-based organization may submit a request for grant funding pursuant to this subdivision. The organization shall submit the request concurrently to the regional center of the jurisdiction in which the organization is located and to the department. The regional center shall provide the department with input regarding the request prior to the departments final determination on the request.
(4)The department shall review requests for funding within 45 days from the deadline specified in the departments guidance to regional centers and community-based organizations.
(5)Each regional center and community-based organization receiving funding shall report annually to the department, in a manner determined by the department, on how the funding allocations were used and shall include recommendations of priorities for activities that may be effective in addressing disparities, based on the consultation with stakeholders.
(6)The department shall post the following information on its internet website:
(A)By September 1 of any year in which grant funding is available and has not been allocated, a structure for the grant program, including all of the following information:
(i)How community-based organizations reflecting groups that are disadvantaged by disparities in the purchase of services will be invited to participate in the grant program.
(ii)How statewide strategies were considered.
(iii)How the department will ensure grant funds are not used for activities that regional centers are otherwise required by statute or regulation to conduct.
(iv)How funded activities will be evaluated.
(B)By October 1 of any year in which grant funding is available and has not been allocated, the final invitation for requests for funding or another mechanism through which requests for funding are solicited.
(C)By January 1 of any year in which grant funding has been allocated, a list of grant recipients, funding level per grant, and a description of the funded project.
(D)By May 1 of any year in which the information is available, evaluation results from prior grants. To ensure the department complies with this subparagraph, regional centers and community-based organizations receiving funding shall provide the department, by March 1 of the same year, with an evaluation of funded activities and the effectiveness of those activities in reducing disparities in the purchase of services, to the extent information is available.
(i)On or before December 31, 2021, the department shall 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 subdivision (h).
(j)For the purposes of this section, the department shall require all of the following:
(1)The use by the department and regional centers, when reporting data by race and ethnicity, of consistent classifications of race and ethnicity, based on categories current in use by the United States Census Bureau.
(2)Confirmation of the race and ethnicity identification of each consumer at the time of the annual review of the consumers individual program plan (IPP).
(3)When reporting by residence types, separate presentation of data for those in independent living services and those in supported living services.
(4)Consistent standards and requirements for regional center internet websites, using the same placement and language for all information required by this division, including that data be posted in a machine-readable format.
SEC. 4.Section 4519.20 is added to the Welfare and Institutions Code, to read:4519.20.As part of the departments planning process for the planning and development of a uniform statewide data automation system, the department, in consultation with stakeholders shall develop, by March 1, 2024, a project charter that shall be approved by the Secretary of the California Health and Human Services Agency and the Department of Technology. The charter development process shall include the participation and input of program consumers and families, researchers and quality and outcome evaluators, regional centers, and service providers. The project charter shall include all of the following:
(a)An impact statement on the primary entities and individuals impacted by the system development.
(b)Project guiding principles that are foundational to the project approach to be used throughout the planning, development, implementation, and maintenance of the system.
(c)Project scope that addresses business problems required to be solved by the system, including all of the following:
(1)Worker effectiveness and accountability that are constrained by the lack of timely, adequate, and accurate data, the lack of uniformity, and the current systems limited functionality.
(2)Service delivery that is constrained by the lack of timely, adequate, accurate, and accessible data, the lack of clear understandable communication of information, lack of uniformity, and the systems limited functionality.
(3)Current system maintainability that is constrained by disparate systems, inadequate documentation, the lack of open system architecture, and business changes.
(4)Disparate systems, complex business rules, the number of locations and variability of local system delivery, and changes in the way of doing business.
(5)Limited access of researchers and program evaluators to the set of person-level data that they need to assess program effectiveness.
(d)Program goals, which shall include all of the following:
(1)Maximizing the performance and the business processes for the delivery of intellectual or developmental disability (IDD) system services to consumers at the regional centers.
(2)Improving data quality, privacy, confidentiality, and integration of all data sources at an individual level.
(3)Enabling data-driven decisionmaking and performance measures for the effective administration of the program.
(4)Improving the business processes administered by the department to support regional center service delivery.
(5)Supporting access to individual-level data to support program evaluation and other research.
(e)Technology goals that recognize that a statewide system solution not only meets requirements, but also ensures effective transition, while minimizing disruption to existing services.
(f)Project strategies and approaches for development and implementation.
(g)Project governance.
(h)Technology that can readily be enhanced and modernized for the expected system life. In selecting the new system, consideration shall be given to the extent to which the candidate systems employ open architectures and standards and the future ability of the selected system to provide enhancements that will improve long-term effectiveness of program management of the statewide service delivery system.
SEC. 5.Section 4571 of the Welfare and Institutions Code is amended to read:4571.(a)It is the intent of the Legislature to ensure the well-being of consumers, taking into account their informed and expressed choices. It is further the intent of the Legislature to support the satisfaction and success of consumers through the delivery of quality services and supports. Evaluation of the services that consumers receive is a key aspect to the service system. Utilizing the information that consumers and their families provide about those services in a reliable and meaningful way is also critical to enable the department to assess the performance of the states developmental services system and to improve services for consumers in the future. To that end, the State Department of Developmental Services, on or before January 1, 2010, shall implement an improved, unified quality assessment system, in accordance with this section.
(b)The department, in consultation with stakeholders, shall identify a valid and reliable quality assurance instrument that assesses consumer and family satisfaction, provision of services in a linguistically and culturally competent manner, and personal outcomes. The instrument shall do all of the following:
(1)Provide nationally validated, benchmarked, consistent, reliable, and measurable data for the departments Quality Management System.
(2)Enable the department and regional centers to compare the performance of Californias developmental services system against other states developmental services systems and to assess quality and performance among all of the regional centers.
(3)Include outcome-based measures such as health, safety, well-being, relationships, interactions with people who do not have a disability, employment, quality of life, integration, choice, service, and consumer satisfaction.
(4)Include outcome-based measures to evaluate the linguistic and cultural competency competency, including tribal culture competency, of regional center services that are provided to consumers across their lifetimes.
(c)To the extent that funding is available, the instrument identified in subdivision (b) may be expanded to collect additional data requested by the State Council on Developmental Disabilities.
(d)(1)The department shall contract with an independent agency or organization to implement, by January 1, 2010, the quality assurance instrument described in subdivision (b). The contractor shall be experienced in all of the following:
(A)Designing valid quality assurance instruments for developmental service systems.
(B)Tracking outcome-based measures such as health, safety, well-being, relationships, interactions with people who do not have a disability, employment, quality of life, integration, choice, service, and consumer satisfaction.
(C)Developing data systems.
(D)Data analysis and report preparation.
(E)Assessments of the services received by consumers who are moved from developmental centers to the community, given the Legislatures historic recognition of a special obligation to ensure the well-being of these persons.
(F)Issues related to linguistic and cultural competency.
(2)Notwithstanding any other law, the contract and any amendments pursuant to this section shall be exempt from all of the following:
(A)The personal services contracting requirements of Article 4 (commencing with Section 19130) of Chapter 5 of Part 2 of Division 5 of Title 2 of the Government Code.
(B)The Public Contract Code, the State Contracting Manual, and the State Administration Manual.
(C)The approval of the Department of General Services.
(D)The approval of the Department of Technology.
(3)The exemptions specified in paragraph (2) shall remain in effect until there is more than one available assessment that meets the criteria in subdivision (b) from an organization that also meets the criteria in this subdivision.
(e)The department, in consultation with the contractor described in subdivision (d), shall establish the methodology by which the quality assurance instrument shall be administered, including, but not limited to, how often and to whom the quality assurance will be administered, and the design of a stratified, random sample among the entire population of consumers served by regional centers. The contractor shall provide aggregate information for all regional centers and the state as a whole. At the request of a consumer or the family member of a consumer, the survey shall be conducted in the primary language of the consumer or family member surveyed.
(f)The department shall contract with the state council to collect data for the quality assurance instrument described in subdivision (b). If, during the data collection process, the state council identifies any suspected violation of the legal, civil, or service rights of a consumer, or if it determines that the health and welfare of a consumer is at risk, that information shall be provided immediately to the regional center providing case management services to the consumer. At the request of the consumer or family, when appropriate, a copy of the completed survey shall be provided to the regional center providing case management services to improve the consumers quality of services through the individual planning process.
(g)The department, in consultation with stakeholders, shall annually review the data collected from and the findings of the quality assurance instrument described in subdivision (b) and accept recommendations regarding additional or different criteria for the quality assurance instrument in order to assess the performance of the states developmental services system and improve services for consumers.
(h)(1)Each regional center shall annually present data collected from, and the findings of, the quality assurance instrument described in subdivision (b) for that regional center, at a public meeting of its governing board in order to assess the comparative performance of the regional center and identify needed improvements in services for consumers, including, but not limited to, case management services. Notice of this meeting shall also be posted on the regional centers internet website at least 30 days prior to the meeting and shall be sent to regional center consumers and families and individual stakeholders at least 30 days prior to the meeting. The governing board shall provide a sufficient public comment period so members of the public may provide comments. Each regional center, in holding the meeting required by this subdivision, shall ensure that the meeting and meeting materials provide language access, as required by state and federal law.
(2)All regional center-specific reports generated by the department pursuant to this subdivision shall be made publicly available on the regional centers internet website in a machine-readable format, but shall not contain any personal identifying information about any person assessed.
(3)Within 60 days following its annual presentation, each regional center shall submit a report to the department regarding its implementation of the requirements of this section. The report shall include, but shall not be limited to, both of the following:
(A)Copies of the presentation described in paragraph (1), minutes from the meeting, and attendee comments.
(B)The regional centers recommendations and plans to use the information to address regional center priorities, strategic directions to improve specific areas of performance, or both.
(i)All reports generated pursuant to this section shall be made publicly available, but shall not contain any personal identifying information about any person assessed.
(j)All data collected pursuant to subdivision (c) shall be provided to the state council, but shall not contain personal identifying information about the persons being surveyed.
(k)Implementation of this section shall be subject to an annual appropriation of funds in the Budget Act for this purpose.
(l)By March 1, 2024, the department shall submit a report to the policy and budget subcommittees of the Legislature describing the extent to which the requirements of this section have not been met, including the surveying of all consumers, including those with no purchase of services, and providing specific steps and the schedule by which these requirements will be met.
SEC. 6.Section 4620.6 is added to the Welfare and Institutions Code, to read:4620.6.(a)(1)To provide uniformity, consistency, and cost-effectiveness in the delivery of services by regional centers throughout the state, the department shall establish, by January 1, 2025, a common set of services and supports, including supported living services, that every regional center in the state shall make available to consumers in negotiating, developing, or amending the individualized program plan as required by Sections 4646 and 4646.5. The common set of services and supports shall be prominently posted on each regional centers internet website.
(2)The department shall develop the common set of services and supports in consultation with the Association of Regional Center Agencies, consumers and their families, advocacy organizations, and service providers.
(b)In each contract with a regional center, the department shall require the common set of services and supports developed pursuant to this section to be available to consumers in the development of an individual program plan.
(c)It is the intent of the Legislature that this section not be construed to control or interfere with the discretion of the individual program planning team to determine the needs and services appropriate for each person with a developmental disability who is entitled to services under this division. It is further the intent of the Legislature that the common set of services and supports developed pursuant to this section shall be deemed the minimum level of services and supports and does not preclude other services and supports from being included in a negotiated individualized program plan.
SEC. 7.Section 4622 of the Welfare and Institutions Code is amended to read:4622.The state shall contract only with agencies, the governing boards of which conform to all of the following criteria:
(a)The governing board shall be composed of individuals with demonstrated interest in, or knowledge of, developmental disabilities.
(b)The membership of the governing board shall include persons with legal, management or board governance, financial, and developmental disability program expertise. Board governance expertise may not be acquired solely by serving on a regional center board. The governing board of the regional center shall include members with financial expertise and members with management or board governance expertise by August 15, 2020.
(c)The membership of the governing board shall include representatives of the various categories of disability to be served by the regional center.
(d)The governing board shall reflect the geographic and ethnic characteristics of the area to be served by the regional center.
(e)A minimum of 50 percent of the members of the governing board shall be persons with developmental disabilities or their parents or legal guardians. No less than 25 percent of the members of the governing board shall be persons with developmental disabilities.
(f)(1)Members of the governing board shall not be permitted to serve more than a six-year term, and may return to the board for a subsequent term after five years. The members of each regional center governing board nominating committee shall be comprised of current board members and members of the community, and should be representative of the community served in the regional centers catchment area.
(2)The board nominating committee shall solicit interests and nominations from the broader community through outreach. The committee shall interview candidates for the board and make recommendations to the governing board for election. During the meeting at which the board elects new members, a candidate may be nominated by a board member with a second by another board member for the open positions. A regional center executive director shall be prohibited from any involvement in the recruitment or election of governing board members.
(g)(1)The department shall provide necessary training and support to these board members to facilitate their understanding and participation, including issues relating to linguistic and cultural competency. The training shall be developed with community input, including persons served and family members. Ongoing support by the department shall include surveying board members about their ability to meaningfully participate in, and understand the subjects and votes at, board meetings. If board members report that they are unable to meaningfully participate, the department shall work with the regional center and the board member to ensure adequate and appropriate accommodations are provided.
(2)As part of its monitoring responsibility, the department shall review and approve the method by which training and support are provided to board members to ensure maximum understanding and participation by board members.
(3)Each regional center shall post on its internet website information regarding the training and support provided to board members.
(h)The governing board may appoint a consumers advisory committee composed of persons with developmental disabilities representing the various categories of disability served by the regional center.
(i)The governing board shall appoint an advisory committee composed of a wide variety of persons representing the various categories of providers from which the regional center purchases client services. The advisory committee shall provide advice, guidance, recommendations, and technical assistance to the regional center board in order to assist the regional center in carrying out its mandated functions. The advisory committee shall designate one of its members to serve as a member of the regional center board.
(j)(1)The governing board shall annually review the performance of the director of the regional center. The department shall establish guidelines for governing boards to measure executive director performance, including with respect to issues of equity and diversity.
(2)The governing board shall annually review the performance of the regional center in providing services that are linguistically and culturally appropriate and may provide recommendations to the director of the regional center based on the results of that review.
(k)A member of the board who is an employee or member of the governing board of a provider from which the regional center purchases client services shall not do any of the following:
(1)Serve as an officer of the board.
(2)Vote on any fiscal matter affecting the purchase of services from any regional center provider.
(3)Vote on any issue other than as described in paragraph (2), in which the member has a financial interest, as defined in Section 87103 of the Government Code, and determined by the regional center board. The member shall provide a list of the members financial interests, as defined in Section 87103, to the regional center board.
(l)The department shall establish, and each board shall adopt, an antiretaliation policy for board members that requires department approval for any reduction in services for consumer board members or the family member of family board members.
(m)The department shall establish and adopt a grievance procedure whereby a governing board member who has concerns, complaints, or questions may contact a specific executive at the department.
(n)This section does not prevent the appointment to a regional center governing board of a person who meets the criteria for more than one of the categories listed above.
SEC. 8.Section 4626.5 of the Welfare and Institutions Code is amended to read:4626.5.Each regional center shall submit a conflict-of-interest policy to the department by July 1, 2011, and shall post the policy on its internet website by August 1, 2011. The policy shall do, or comply with, all of the following:
(a)Contain the elements of this section and be consistent with applicable law.
(b)Define conflicts of interest.
(c)Identify positions within the regional center required to complete and file a conflict-of-interest statement.
(d)Facilitate disclosure of information to identify conflicts of interest.
(e)Require candidates for nomination, election, or appointment to a regional center board, and applicants for regional center director to disclose any potential or present conflicts of interest prior to being appointed, elected, or confirmed for hire by the regional center or the regional center governing board.
(f)Require the regional center and its governing board to regularly and consistently monitor and enforce compliance with its conflict-of-interest policy.
(g)Prohibit a regional center employee from accepting a gift or gifts from a service provider, consumer, or consumers family member valued over ten dollars ($10) per year.
(h)Establish a policy prohibiting regional center senior staff from hiring relatives at the center or any ancillary foundation and organization. The policy shall be included in the regional center contract and shall be included in training of the governing board.
SEC. 9.Section 4629.1 is added to the Welfare and Institutions Code, to read:4629.1.(a)Notwithstanding any other law, the evaluation of regional center performance shall be implemented using a common set of performance measures, which shall be administered by the department. This includes the performance requirements under the regional center contracts pursuant to Section 4629, the performance incentives established under Section 4620.5, and the quality assessment instrument required under Section 4571. These measures shall be annually reported and made available to the public through posting of the measures results in machine-readable formats.
(b)(1)By July 1, 2024, the department shall establish standards for each measure above, for which a regional center may receive rewards for good performance, and a separate set of minimal standards, below which the regional center is above that contain thresholds above which a regional center may be eligible to receive rewards for good performance and thresholds below which a regional center may be subject to each level of probation required under Section 4629. The department shall establish the process for assessing corrective action undertaken by a regional center and the process by which a regional center may end its probation status.
(2)The department, in consultation with stakeholders, including consumers and family members, shall annually establish, update, and review the standards related to good performance.
(3)(A)The department, in consultation with stakeholders, including consumers and family members, shall annually establish, update, and review a uniform process to be used by regional centers to develop corrective action plans that respond to below standard performance.
(B)The process shall include all of the following:
(i)Technical assistance and training from the department either directly or through subject matter experts.
(ii)The sharing of resources from other regional centers that have met the performance measures.
(iii)Participation by the board of directors of the regional center in developing and monitoring the implementation of the corrective action plan in consultation with local stakeholders, including consumers and family members.
(C)The department shall oversee the process to develop the corrective action plan and assess corrective action undertaken by the regional center.
(c)The performance measures shall encompass the domains and the associated measures as itemized in subdivision (d). Additional measures may be adopted by the department as needed. Modification of the domain and measures shall be accomplished through a process of consultation that includes the engagement of stakeholders in a manner consistent with that required by subdivision (b) of Section 4620.5. The measures may be amended as reporting mechanisms mature as the department develops new information technology capabilities.
(d)The performance measures for purposes of this section shall be organized under seven domains, as follows:
(1)Community integration, including all of the following:(A)The percentage of consumers who report spending their days primarily with people without disabilities who are not paid to be with them.(B)The percentage of consumers who report they feel part of their communities, participate in community activities, know their neighbors, and have friends.(C)The percentage of minor consumers living in licensed group homes or other institutional settings.(D)The percentage of adult consumers living in licensed group homes, intermediate care facilities, or other institutional settings.(E)The percentage of adult consumers living in their own homes with independent living services.(F)The percentage of adult consumers living in their own homes with supported living services.(G)The percentage of adult consumers seeking affordable and accessible housing.(H)The percentage of adult consumers that have secured housing outside of their family home, if desired.(2)Employment, including all of the following:(A)The percentage of adult consumers in competitive, integrated employment and the length of time in the job.(B)The percentage of employed adult consumers reporting increased wages and opportunities for advancement.(C)The percentage of employed adult consumers reporting satisfaction with their jobs with the ability to learn new skills and interact with coworkers.(D)The average per capita annual wages of employed adult consumers.(E)The percentage of participants in the paid internship program that led to permanent employment.(F)The average hourly wage for competitive, integrated employment.(G)The average number of hours per week in competitive, integrated employment.(H)The percentage of adult consumers in competitive, integrated employment, by race and ethnicity.(3)Equity in service access, including all of the following:(A)Per capita spending, by race and ethnicity.(B)Per capita spending, by primary language.(C)Timely eligibility determination, by race and ethnicity.(D)Access to Early Start services, by race and ethnicity.(E)Per capita spending on adult consumers, by residence type and by race and ethnicity.(F)Per capita spending on adult consumers, by residence type and regional center.(G)The percentage of consumers with no purchase of services, by regional center.(H)The percentage of consumers with no purchase of services, by race and ethnicity.(4)Case management, including all of the following:(A)Timeliness of intake for eligibility.(B)Timeliness of initiation of services for Early Start.(C)Timeliness of development of IPPs.(D)Timeliness of delivery of IPP services after authorization.(E)Share of consumers reporting that the regional center service coordinator assisted them in attaining generic resources.(F)Responsiveness of service coordinator.(G)Consumer or family directs their own person-centered planning process.(H)Timeliness of translated IPPs and other documents.(5)Consumer and family choice, experience, and satisfaction, including all of the following:(A)Overall satisfaction and happiness.(B)Service coordinator cultural competency.(C)Service coordinator who speaks consumers language.(D)Access to approved services.(E)Access to services provided by individuals who speak the consumers language.(F)Consumers report they are treated with dignity and respect.(G)Access to the Self-Determination Program.(H)The ability to select their services and providers from among a range of choices.(I)The ability to select the place where they live, with whom they live, and who supports them.(J)The percentage of consumers who report having a way to communicate and express choices and decisions.(K)The percentage of consumers or families who report that they understand the information provided to them by their regional center.(L)The percentage of consumers or families reporting they feel comfortable in their interactions with the regional center, and if they are aware they can change their service coordinator.(6)Human and civil rights, including all of the following:(A)The number of special incident reports, and number of incidents of seclusion and restraint or other types of abuse by regional center.(B)The percentage of consumers reporting they have a private space, if they live out of their family home.(C)The percentage of adult consumers who vote in elections.(D)The percentage of adult consumers who are conserved.(7)Health and safety, including all of the following:(A)Hospitalization and mortality rates among regional center consumers.(B)The percentage of consumers receiving regular preventative care, vaccinations, and cancer screenings.(1)Community integration.
(2)Employment.
(3)Equity in service access.
(4)Case management.
(5)Consumer and family choice, experience, and satisfaction.
(6)Human and civil rights.
(7)Health and safety.
SEC. 10.Section 4639.76 is added to the Welfare and Institutions Code, to read:4639.76.A regional center with which the department maintains a contract pursuant to Section 4629 shall be subject to the California Public Records Act (Chapter 1 (commencing with Section 7920.000) of Division 10 of Title 1 of the Government Code).
SEC. 11.Section 4642 of the Welfare and Institutions Code is amended to read:4642.(a)(1)Any person believed to have a developmental disability, and any person believed to have a high risk of parenting an infant with a developmental disability shall be eligible for initial intake and assessment services in the regional centers. In addition, any infant having a high risk of becoming developmentally disabled may be eligible for initial intake and assessment services in the regional centers. For purposes of this section, high-risk infant means a child less than 36 months of age whose genetic, medical, or environmental history is predictive of a substantially greater risk for developmental disability than that for the general population. The department, in consultation with the State Department of Public Health, shall develop specific risk and service criteria for the high-risk infant program on or before July 1, 1983. These criteria may be modified in subsequent years based on analysis of actual clinical experience.
(2)(A)Initial intake shall be performed within 15 working days following request for assistance. Initial intake shall include, but need not be limited to, information and advice about the nature and availability of services provided by the regional center and by other agencies in the community, including guardianship, conservatorship, income maintenance, mental health, housing, education, work activity and vocational training, medical, dental, recreational, and other services or programs that may be useful to persons with developmental disabilities or their families. Intake shall also include a decision to provide assessment.
(B)For purposes of this section, request for assistance includes any initial contact or inquiry from an individual, or a person acting on their behalf, on the nature of services or supports available or provided by the regional center, and the individuals eligibility to receive them.
(3)(A)The department shall create, with input from stakeholders, standardized information packets to be provided to any person seeking services from a regional center. There shall be one information packet related to services provided under the California Early Intervention Services Act and another information packet related to services provided under the Lanterman Developmental Disabilities Services Act. The information packets shall be translated to provide language access, as required by state and federal law, shall be culturally competent for all racial and ethnic communities, including immigrants and Native Americans, shall be available in alternative formats and alternative modes of communication, as required by federal law, and shall include, at a minimum, all of the following:
(i)An overview of the regional center system.
(ii)A resource guide for consumers and their families.
(iii)Consumer rights, including the appeals procedures specified in Chapter 7 (commencing with Section 4700).
(iv)Contact information for the regional center, the department, the office of clients rights advocacy, and the protection and advocacy agency specified in Division 4.7 (commencing with Section 4900).
(v)Information on the Self-Determination Program, including the eligibility requirements specified in subdivision (d) of Section 4685.8.
(B)Each regional center shall distribute the information packets at intake, upon transfer to receiving services under the Lanterman Developmental Disabilities Services Act, and upon request. Each regional center shall begin distributing the information packets within 60 days following the department providing the information packets and issuing directives regarding the distribution of the information packets. In addition to, and not in lieu of, this requirement, each regional center shall post the full content of the most updated information packet on its internet website.
(b)A regional center shall communicate communicate, with cultural competency, including Native American cultural competency, with the consumer and the consumers family pursuant to this section in their native language, including providing alternative communication services and alternative formats, as required by state and federal law.
SEC. 12.Section 4643 of the Welfare and Institutions Code is amended to read:4643.(a)If assessment is needed, the regional center shall require the assessment to be completed within 60 days following initial intake. Assessment shall be commenced as soon as possible, and in no event more than 30 days following initial intake when any delay would expose the client to unnecessary risk to their health and safety or to significant further delay in mental or physical development, or the client would be at imminent risk of placement in a more restrictive environment. Assessment may include collection and review of available historical diagnostic data, provision or procurement of necessary tests and evaluations, and summarization of developmental levels and service needs and is conditional upon receipt of the release of information specified in subdivision (b).(b)In determining if an individual meets the definition of developmental disability contained in subdivision (a) of Section 4512, the regional center may consider evaluations and tests, including, but not limited to, intelligence tests, adaptive functioning tests, neurological and neuropsychological tests, diagnostic tests performed by a physician, psychiatric tests, and other tests or evaluations that have been performed by, and are available from, other sources.(c)At the time of assessment, the individual, or, where appropriate, the parents, legal guardian, or conservator, shall provide copies of any health benefit cards under which the consumer is eligible to receive health benefits, including, but not limited to, private health insurance, a health care service plan, Medi-Cal, Medicare, and TRICARE. If the individual, or where appropriate, the parents, legal guardians, or conservators, have no such benefits, the regional center shall not use that fact to negatively impact the services that the individual may or may not receive from the regional center.(d)A regional center shall communicate with the consumer and the consumers family pursuant to this section in their preferred language, including providing alternative communication services, as required by Sections 11135 to 11139.7, inclusive, of the Government Code and implementing regulations.SEC. 13.SEC. 12.Section 4646 of the Welfare and Institutions Code is amended to read:4646.(a)It is the intent of the Legislature to ensure that the individual program plan and provision of services and supports by the regional center system is centered on the individual and the family of the individual with developmental disabilities and takes into account the needs and preferences of the individual and the family, if appropriate, as well as promoting community integration, independent, productive, and normal lives, and stable and healthy environments. It is the further intent of the Legislature that individual program plans shall be developed consistent with the federal Affordable Care Act and the regulations and federal guidance adopted pursuant to the act requiring that community-based long-term services and supports be person-centered and self-directed. It is the further intent of the Legislature to ensure that goals in any plan allow for innovation and nontraditional service delivery and not be limited by the lack of easily identified services or supports, the provision of services to consumers and their families be effective in meeting the goals stated in the individual program plan, reflect the preferences and choices of the consumer, and reflect the cost-effective use of public resources.
(b)(1)Notwithstanding any other law, the individual program plan, including all assessments, shall be developed through a process of individualized needs determination and person-centered service planning developed pursuant to, and consistent with, Section 2402(a) of the federal Affordable Care Act (Pub. L. 111-148) and amendments thereto, Section 441.725 of Title 42 of the Code of Federal Regulations, and federal guidance issued by the Centers for Medicare and Medicaid Services on June 6, 2014, requiring community-based, long-term services and supports to be person-centered, strengths-based, and self-directed. The individual with developmental disabilities and, if appropriate, the individuals parents, legal guardian or conservator, or authorized representative, shall have the opportunity to actively participate in the development of the plan. The individual shall lead the service planning process to the greatest extent possible.
(c)An individual program plan shall be developed for any person who, following intake and assessment, is found to be eligible for regional center services. An initial assessment agreement shall be completed and provided to the consumer within 30 days of an intake unless there is good cause for the regional center to exceed the 30-day time period, but in no event shall the assessment be completed any later than 60 days from the intake. If the assessment is not completed within the 30- or 60-day time period, as applicable, the regional center shall provide the consumer with an adequate notice of action, which shall be subject to Chapter 7 (commencing with Section 4700), and shall notify the department of the reason for not meeting the deadline. These plans shall be completed within 60 days of the completion of the assessment. At the time of intake, the regional center shall inform the consumer and, if appropriate, the consumers parents, legal guardian or conservator, or authorized representative, of the services available through the state council and the protection and advocacy agency designated by the Governor pursuant to federal law, and shall provide the address and telephone numbers of those agencies.
(d)(1)As part of the initial individual program plan meeting and each annual review required by subdivision (b) of Section 4646.5, the consumer or, if appropriate, their parents, legal guardian, conservator, or authorized representative, shall be provided by the service coordinator oral and written information about the Self-Determination Program. The information shall include each of the provisions specified in subdivision (d) of Section 4685. 4685.8. Each individual program plan shall include a provision stating that the consumer or authorized representative was informed about the availability of the Self-Determination Program. If the consumer chooses not to participate in the program, the individual program plan shall include an explanation of the reason or reasons for that decision, or, if the consumer is ineligible for the program, the reason or reasons for that ineligibility.
(2)If the consumer is interested in participating in the program or wants additional information or assistance, the service coordinator, within five days of expressing the interest, shall provide the consumer a date for the Self-Determination Program orientation, training resources, dates of local volunteer Self-Determination Program advisory committee meetings, and other information to assist the consumer in participating in the program.
(e)Individual program plans shall be prepared jointly by the planning team. Decisions concerning the consumers goals, objectives, and services and supports that will be included in the consumers individual program plan and purchased by the regional center or obtained from generic agencies shall be made by agreement between the regional center representative and the consumer or, if appropriate, the parents, legal guardian, conservator, or authorized representative at the program plan meeting.
(f)Regional centers shall comply with the request of a consumer or, if appropriate, the request of the consumers parents, legal guardian, conservator, or authorized representative, that a designated representative receive written notice of all meetings to develop or revise the individual program plan and of all notices sent to the consumer pursuant to Section 4710. The designated representative may be a parent or family member.
(g)Notwithstanding any other law, a meeting regarding the provision of services and supports by the regional center, including a meeting to develop or revise the individual program plan, shall be held by remote electronic communications if requested by the consumer or, if appropriate, if requested by the consumers parents, legal guardian, conservator, or authorized representative.
(h)At the conclusion of an individual program plan meeting, an authorized representative of the regional center shall provide to the consumer, in written or electronic format, a list of the agreed-upon services and supports and the start date, the frequency and duration of the services and supports, and the provider, and a summary page written in plain language. The identified services and supports specified in an individual program plan referred to a provider shall begin on the date specified in the plan. In the event the services or supports are not started by the provider within 45 days of the specified start date, a referral shall be made within 14 days to another provider for delivery of the specified services and supports. supports, and, if known, the projected start date, the frequency and duration of the services and supports, and the provider. The authorized representative of the regional center shall sign the list of agreed-upon services and supports at that time. The consumer, or if appropriate, the consumers parent, legal guardian, conservator, or authorized representative shall sign the list of agreed-upon services and supports prior to its implementation. The consumer, or if appropriate, the consumers parent, legal guardian, conservator, or authorized representative, may elect to delay receipt of the list of agreed-upon services and supports pending final agreement, as described in subdivision (h). If the consumer, or if appropriate, the consumers parent, legal guardian, conservator conservator, or authorized representative, elects to delay the receipt of the list of agreed-upon services and supports for 15 days, the list shall be provided in the preferred language of the consumer, or of the consumers parent, legal guardian, or authorized representative.
(i)If a final agreement regarding the services and supports to be provided to the consumer cannot be reached at a program plan meeting, then a subsequent program plan meeting shall be convened within 15 days, or later at the request of the consumer or, if appropriate, the parents, legal guardian, conservator, or authorized representative or if agreed to by the planning team. The list of the agreed-upon services and supports described in subdivision (h) and signed by the authorized representative of the regional center shall be provided, in writing or electronically, at the conclusion of the subsequent program plan meeting, and shall be provided in the preferred language of the consumer, or of the consumers parent, legal guardian, conservator, or authorized representative. Additional program plan meetings may be held with the agreement of the regional center representative and the consumer or, if appropriate, the parents, legal guardian, conservator, or authorized representative.
(j)An authorized representative of the regional center and the consumer or, if appropriate, the consumers parent, legal guardian, conservator, or authorized representative shall sign the individual program plan and the list of the agreed-upon services and supports prior to its implementation. If the consumer or, if appropriate, the consumers parent, legal guardian, conservator, or authorized representative, does not agree with all components of the individual program plan, the consumer may indicate that disagreement on the plan. Disagreement with specific plan components shall not prohibit the implementation of services and supports agreed to by the consumer or, if appropriate, the consumers parent, legal guardian, conservator, or authorized representative. If the consumer or, if appropriate, the consumers parent, legal guardian, conservator, or authorized representative, does not agree with the plan in whole or in part, the consumer shall be sent written notice of their appeal rights, as required by Sections 4701 and 4710.
(k)(1)A regional center shall communicate in the consumers preferred language, or, if appropriate, the preferred language of the consumers family, legal guardian, conservator, or authorized representative, during the planning process for the individual program plan, including during the program plan meeting, and including providing alternative communication services, as required by Sections 11135 to 11139.8, inclusive, of the Government Code and implementing regulations.
(2)A regional center shall provide alternative communication services, including providing copies of the list of services and supports, and the individual program plan in the preferred language of the consumer or the consumers family, legal guardian, conservator, or authorized representative, or both, as required by Sections 11135 to 11139.8, inclusive, of the Government Code and implementing regulations.
(3)The preferred language of the consumer or the consumers family, legal guardian, conservator, or authorized representative, or both, shall be documented in the individual program plan.
SEC. 14.SEC. 13.Section 4646.4 of the Welfare and Institutions Code is amended to read:4646.4.(a)Regional centers shall ensure, at the time of development, scheduled review, or modification of a consumers individual program plan developed pursuant to Sections 4646 and 4646.5, or of an individualized family service plan pursuant to Section 95020 of the Government Code, the establishment of an internal process. This internal process shall ensure adherence with federal and state law and regulation, and if purchasing services and supports, shall ensure all of the following:
(1)Conformance with the regional centers purchase of service policies, as approved by the department pursuant to subdivision (d) of Section 4434.
(2)Utilization of generic services and supports if appropriate. The individualized family service planning team for infants and toddlers eligible under Section 95014 of the Government Code and the individual program plan team pursuant to Section 4646 may determine that a service provided by a generic agency, as defined by subdivision (g) of Section 4659.5, or a service or source of funding contained in Section 4659 identified in the individualized family service plan or individual program plan is not available, and, therefore, will be funded by the regional center.
(3)Utilization of other services and sources of funding as contained in Section 4659.
(4)Consideration of the familys responsibility for providing similar services and supports for a minor child without disabilities in identifying the consumers service and support needs as provided in the least restrictive and most appropriate setting. In this determination, regional centers shall take into account the consumers need for extraordinary care, services, supports and supervision, and the need for timely access to this care.
(5)Commencing October 1, 2022, consideration of information obtained from the consumer and, if appropriate, the parents, legal guardian, conservator, or authorized representative about the consumers need for the services, barriers to service access, and other information.
(b)At the time of development, scheduled review, or modification of a consumers individual program plan developed pursuant to Sections 4646 and 4646.5, or of an individualized family service plan pursuant to Section 95020 of the Government Code, the consumer, or, if appropriate, the parents, legal guardian, or conservator, shall provide copies of their health benefit cards under which the consumer is eligible to receive health benefits, including, but not limited to, private health insurance, a health care service plan, Medi-Cal, Medicare, and TRICARE. If the individual, or, if appropriate, the parents, legal guardians, or conservators, do not have health benefits, the regional center shall not use that fact to negatively impact the services that the individual may or may not receive from the regional center.
(c)Final decisions regarding the consumers individual program plan shall be made pursuant to Section 4646.
(d)Final decisions regarding the individualized family service plan shall be made pursuant to Section 95020 of the Government Code.
SEC. 15.SEC. 14.Section 4646.5 of the Welfare and Institutions Code is amended to read:4646.5.(a)The planning process for the individual program plan described in Section 4646 shall include all of the following:
(1)Gathering information and conducting assessments to determine the life goals, capabilities and strengths, preferences, barriers, and concerns or problems of the person with developmental disabilities. For children with developmental disabilities, this process should include a review of the strengths, preferences, and needs of the child and the family unit as a whole. Assessments shall be conducted by qualified individuals and performed in natural environments whenever possible. Information shall be taken from the consumer, the consumers parents and other family members, the consumers friends, advocates, authorized representative, if applicable, providers of services and supports, and other agencies. The assessment process shall reflect awareness of, and sensitivity to, the lifestyle and cultural background of the consumer and the family.
(2)A statement of goals, based on the needs, preferences, and life choices of the individual with developmental disabilities, and a statement of specific, time-limited objectives for implementing the persons goals and addressing the persons needs. These objectives shall be stated in terms that allow measurement of progress or monitoring of service delivery. These goals and objectives should maximize opportunities for the consumer to develop relationships, be part of community life in the areas of community participation, housing, work, school, and leisure, increase control over the consumers life, acquire increasingly positive roles in community life, and develop competencies to help accomplish these goals.
(3)In developing individual program plans for children, regional centers shall be guided by the principles, process, and services and support parameters set forth in Section 4685.
(4)In developing an individual program plan for a transition age youth or working age adult, the planning team shall consider the Employment First Policy described in Chapter 14 (commencing with Section 4868).
(5)A schedule of the type and amount of services and supports to be purchased by the regional center or obtained from generic agencies or other resources in order to achieve the individual program plan goals and objectives, and identification of the provider or providers of service responsible for attaining each objective, including, but not limited to, vendors, contracted providers, generic service agencies, and natural supports. The individual program plan shall specify the approximate scheduled start date for services and supports and shall contain timelines for actions necessary to begin services and supports, including generic services. In addition to the requirements of subdivision (h) of Section 4646, each regional center shall offer, and upon request provide, a written copy of the individual program plan to the consumer, and, if appropriate, the consumers parents, legal guardian or conservator, or authorized representative within 45 days of their request in a threshold language, as defined by paragraph (3) of subdivision (a) of Section 1810.410 of Title 9 of the California Code of Regulations.
(6)If agreed to by the consumer, the parents, legally appointed guardian, or authorized representative of a minor consumer, or the legally appointed conservator of an adult consumer or the authorized representative, including those appointed pursuant to subdivision (a) of Section 4541, subdivision (b) of Section 4701.6, and subdivision (e) of Section 4705, a review of the general health status of the adult or child, including medical, dental, and mental health needs, shall be conducted. This review shall include a discussion of current medications, any observed side effects, and the date of the last review of the medication. Service providers shall cooperate with the planning team to provide any information necessary to complete the health status review. If any concerns are noted during the review, referrals shall be made to regional center clinicians or to the consumers physician, as appropriate. Documentation of health status and referrals shall be made in the consumers record by the service coordinator.
(7)(A)The development of a transportation access plan for a consumer when all of the following conditions are met:
(i)The regional center is purchasing private, specialized transportation services or services from a residential, day, or other provider, excluding vouchered service providers, to transport the consumer to and from day or work services.
(ii)The planning team has determined that a consumers community integration and participation could be safe and enhanced through the use of public transportation services.
(iii)The planning team has determined that generic transportation services are available and accessible.
(B)To maximize independence and community integration and participation, the transportation access plan shall identify the services and supports necessary to assist the consumer in accessing public transportation and shall comply with Section 4648.35. These services and supports may include, but are not limited to, mobility training services and the use of transportation aides. Regional centers are encouraged to coordinate with local public transportation agencies.
(8)A schedule of regular periodic review and reevaluation to ascertain that planned services have been provided, that objectives have been fulfilled within the times specified, and that consumers and families are satisfied with the individual program plan and its implementation.
(b)For all active cases, individual program plans shall be reviewed and modified by the planning team, through the process described in Section 4646, as necessary, in response to the persons achievement or changing needs, and no less often than once every 12 months. If the consumer or, if appropriate, the consumers parents, legal guardian, authorized representative, or conservator requests an individual program plan review, the individual program plan shall be reviewed within 30 days after the request is submitted, or no later than 7 days after the request is submitted if necessary for the consumers health and safety or to maintain the consumer in their home.
(c)(1)The department, with the participation of representatives of a statewide consumer organization, the Association of Regional Center Agencies, an organized labor organization representing service coordination staff, and the state council shall prepare training material and a standard format and instructions for the preparation of individual program plans, which embody a person-centered planning process consistent with federal law, regulations, and guidance.
(2)The department shall require each regional center to use, for all new and modified individual program plans, the training materials and the standard format plan prepared by the department pursuant to paragraph (1) by no later than March 1, 2024.
(3)The department shall biennially review a random sample of individual program plans at each regional center to ensure that these plans are being developed and modified in compliance with Section 4646 and this section.
SEC. 16.Section 4646.51 is added to the Welfare and Institutions Code, to read:4646.51.(a)If any services or supports that require an assessment are requested by a consumer at any time after an individual program plan is in place, and for as long as the individual remains eligible for services, the assessment shall be completed, at no cost to the consumer, within 30 days from the date of request.(b)(1)If the assessment recommends services or supports, the services or supports shall be authorized by the regional center within seven days and the consumer shall be referred to a provider within seven days from the date of the authorization.(2)If the services or supports are not commenced by the provider within 45 days of the referral, a referral shall be made to another provider within seven days for the specified services and supports.(c)A consumer shall be entitled to an adequate notice of action and the appeal procedures in Chapter 7 (commencing with Section 4700) if the regional center does not comply with the deadlines specified in this section.SEC. 17.Section 4647 of the Welfare and Institutions Code is amended to read:4647.(a)Pursuant to Section 4640.7, service coordination shall include those activities necessary to implement an individual program plan, including, but not limited to, participation in the individual program plan process; assurance that the planning team considers all appropriate options for meeting each individual program plan objective; securing, through purchasing or by obtaining from generic agencies or other resources, services and supports specified in the persons individual program plan; coordination of service and support programs; collection and dissemination of information; and monitoring implementation of the plan to ascertain that objectives have been fulfilled and to assist in revising the plan as necessary, and ensuring service coordinators are accessible to consumers and their representatives by telephone and other electronic means, which shall include responding to consumer inquiries within two business days of the inquiry.(b)The regional center shall ensure that every consumer has a service coordinator who shall be responsible for implementing, overseeing, and monitoring each individual program plan. The service coordinator may be an employee of the regional center or may be a qualified individual or employee of an agency with whom the regional center has contracted to provide service coordination services, or persons described in Section 4647.2. The regional center shall provide the consumer or, where appropriate, the consumers parents, legal guardian, or conservator or authorized representative, with written notification of any temporary or permanent change in the assigned service coordinator within 10 business days. A person shall not continue to serve as a service coordinator for any individual program plan unless there is agreement by all parties that the person should continue to serve as service coordinator.(c)Where appropriate, a consumer or the consumers parents or other family members, legal guardian, or conservator, may perform all or part of the duties of the service coordinator described in this section if the regional center director agrees and it is feasible.(d)If a person described in subdivision (c) is designated as the service coordinator, that person shall not deviate from the agreed-upon program plan and shall provide any reasonable information and reports required by the regional center director.(e)If a person described in subdivision (c) is designated as the service coordinator, the regional center shall provide ongoing information and support as necessary, to assist the person to perform all or part of the duties of service coordinator.SEC. 18.SEC. 15.Section 4659 of the Welfare and Institutions Code is amended to read:4659.(a)Except as otherwise provided in subdivision (b), (d), or (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 centers purchase of services budget, except as it relates to federal supplemental security income and the state supplementary program.
(c)Effective July 1, 2009, notwithstanding any other law or regulation, 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 Supportive Services, California Childrens 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 after being advised of the provisions of subdivision (d). If, on July 1, 2009, a regional center is purchasing that service as part of a consumers individual program plan (IPP), the prohibition shall take effect on October 1, 2009.
(d)(1) Notwithstanding Section 4646.4, a regional center may request a consumer or family member to pursue a service or source of funding from an entity described in subdivision (a) or (c) of this section, or pursuant to subdivision (g) of Section 4659.5, if the request is documented with specificity in the individual program plan or individualized family plan and the plan contains detailed instructions for the consumer or family pursuing the service. The individual program plan or individualized family plan shall also specify the ways in which the regional center will initially assist the consumer or family to apply for and pursue the service or source of funding and specify that it will provide additional assistance when requested by the consumer or family.
(2)The regional center shall purchase the service when either of the following occurs: the entity denies the service.
(A)The entity denies the service.(B)The entity does not provide the requested service within 45 days from the date of the request, or 15 days after the statutory or regulatory time limit, if any, for the entity to make an initial decision, whichever is shorter.(3)A consumer, or their family, shall not be required to appeal an entitys denial of the requested service for the regional center to purchase that service pursuant to this subdivision. The regional center may file an appeal on behalf of the consumer, but the appeal shall not delay the payment of the requested service by the regional center as specified in subparagraph (B) of paragraph (2).
(4)This section does not prohibit a consumer or their family, where appropriate, from filing a formal appeal of an entitys denial of the service at issue, or a regional center from seeking reimbursement from the entity it believes is responsible for providing the service and from requesting assistance with filing the appeal or from utilizing assistance from other advocacy organizations.
(e)This section shall not 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.
(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.
(g)(1)To provide uniformity, consistency, and cost-effectiveness, to reduce barriers, and to increase the number of service providers throughout the state, the department shall comprehensively review the current processes for vendorizing providers for the delivery of services and supports to regional center consumers and revise those processes to streamline the process and create a uniform statewide vendorization process. The department shall develop the revised processes, in consultation with the Association of Regional Center Agencies, consumers and their families, advocacy organizations, and service providers.
(2)It is the intent of the Legislature to ensure that a service provider vendored in one regional center shall automatically, without additional requirements, be eligible to provide services in all regional centers. It is the further intent of the Legislature that this section shall not be construed to control or interfere with the discretion of the individual program planning team to determine the needs and services appropriate for each person with a developmental disability who is entitled to services under this division.
SEC. 19.Section 4659.3 is added to the Welfare and Institutions Code, to read:4659.3.(a)No later than March 1, 2024, and on March 1 annually thereafter, the department shall submit a report to the Legislature and post on its internet website the following data, statewide and for each regional center, broken down by qualifying disability category, race or ethnicity, and age categories 021 years of age, 2264 years of age, and 65 years of age and over: (1)The number of consumers for whom health and safety waivers have been requested. (2)The number of consumers for whom health and safety waivers have been granted.(3)The number of days elapsed between the date on which the department received the health and safety waiver request worksheet from the service provider and the date the service provider was notified of the outcome.(4)The percentage of health and safety waiver requests that are due to behavioral challenges. (b)The department shall also post on its internet website brief summaries, with any individual identifying information redacted, of the health and safety risks and challenges, and the service changes that are necessary to protect the health and safety, of the affected consumer or consumers, contained in each health and safety waiver request worksheet received by the department.SEC. 20.SEC. 16.Section 4685.8 of the Welfare and Institutions Code is amended to read:4685.8.(a)The department shall implement a statewide Self-Determination Program. The Self-Determination Program shall 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. As of July 1, 2021, the program shall begin to be available on a voluntary basis to all regional center consumers who are eligible for the Self-Determination Program.
(b)The department, in establishing the statewide program, shall do both of the following:
(1)Set targets and benchmarks as set forth in paragraph (1) of subdivision (r).
(2)Address all of the following:
(A)Oversight of expenditure of self-determined funds and the achievement of participant outcomes over time.
(B)Increased participant control over which services and supports best meet the participants needs and the IPP objectives. A participants unique support system may include the purchase of existing service offerings from service providers or local businesses, hiring their own support workers, or negotiating unique service arrangements with local community resources.
(C)Comprehensive person-centered planning, including an individual budget and services that are outcome based.
(D)Consumer and family training to ensure understanding of the principles of self-determination, the planning process, and the management of budgets, services, and staff.
(E)Choice of independent facilitators, who meet standards and certification requirements established by the department, and who can assist with the functions specified in paragraph (2) of subdivision (c).
(F)Choice of financial management services providers who meet standards and certification requirements established by the department, and who can carry out the functions specified in paragraph (1) of subdivision (c).
(G)Innovation that will more effectively allow participants to achieve their goals.
(H)Long-term sustainability of the Self-Determination Program by doing all of the following:
(i)Requiring IPP teams, when developing the individual budget, to determine the services, supports, and goods necessary for each consumer based on the needs and preferences of the consumer and, when appropriate, the consumers family, the effectiveness of each option in meeting the goals specified in the IPP, and the cost-effectiveness of each option, as specified in subparagraph (D) of paragraph (6) of subdivision (a) of Section 4648.
(ii)The department may review final individual budgets that are at or above a spending threshold determined by the department of all individual budgets and use information from its review in the aggregate to develop additional program guidance and verify compliance with federal and state laws and other requirements.
(c)For purposes of this section, the following definitions apply:
(1)Financial management services means services or functions that assist the participant to manage and direct the distribution of funds contained in the individual budget, and ensure that the participant has the financial resources to implement their IPP throughout the year. These may include bill paying services and activities that facilitate the employment of service and support workers by the participant, including, but not limited to, fiscal accounting, tax withholding, compliance with relevant state and federal employment laws, assisting the participant in verifying provider qualifications, including criminal background checks, and expenditure reports. The financial management services provider shall meet the applicable requirements of Title 17 of the California Code of Regulations and other specific qualifications or certifications established by the department.
(2)Independent facilitator means a person, selected and directed by the participant, who is not otherwise providing services to the participant pursuant to their IPP and is not employed by a person providing services to the participant. The independent facilitator may assist the participant in making informed decisions about the individual budget, and in locating, accessing, and coordinating services and supports consistent with the participants IPP. The independent facilitator is available to assist in identifying immediate and long-term needs, developing options to meet those needs, leading, participating, or advocating on behalf of the participant in the person-centered planning process and development of the IPP, and obtaining identified services and supports. The cost of the independent facilitator, if any, shall be paid by the participant out of the participants individual budget. An independent facilitator shall receive training in the principles of self-determination, the person-centered planning process, and the other responsibilities described in this paragraph at the independent facilitators own cost. The independent facilitator shall meet standards and certification requirements established by the department.
(3)Individual budget means the amount of regional center purchase of service funding available to the participant for the purchase of services and supports necessary to implement the IPP. The individual budget shall be determined using a fair, equitable, and transparent methodology.
(4)IPP means individual program plan, as described in Section 4646.
(5)Participant means an individual and, when appropriate, the participants parents, legal guardian or conservator, or authorized representative, who has been deemed eligible for, and has voluntarily agreed to participate in, the Self-Determination Program.
(6)Self-determination means a voluntary delivery system consisting of a defined and comprehensive mix of services and supports, selected and directed by a participant through person-centered planning, in order to meet the objectives in their IPP. Self-determination services and supports are designed to assist the participant to achieve personally defined outcomes in community settings that promote inclusion. The Self-Determination Program shall only fund services and supports provided pursuant to this division that the federal Centers for Medicare and Medicaid Services determines are eligible for federal financial participation.
(7)Spending Plan means the plan the participant develops to use their available individual budget funds to purchase goods, services, and supports necessary to implement their individual program plan (IPP). The spending plan shall identify the cost of each good, service, and support that will be purchased with regional center funds. The total amount of the spending plan cannot exceed the amount of the individual budget. A copy of the spending plan shall be attached to the participants IPP.
(d)Participation in the Self-Determination Program is fully voluntary. A participant may choose to participate in, and may choose to leave, the Self-Determination Program at any time. A regional center shall not require or prohibit participation in the Self-Determination Program as a condition of eligibility for, or the delivery of, services and supports otherwise available under this division. Participation in the Self-Determination Program shall be available to any regional center consumer who meets the following eligibility requirements:
(1)The participant has a developmental disability, as defined in Section 4512, and is receiving services pursuant to this division.
(2)The consumer does not live in a licensed long-term health care facility, as defined in paragraph (44) of subdivision (a) of Section 54302 of Title 17 of the California Code of Regulations. An individual and, when appropriate, the individuals parent, legal guardian or conservator, or authorized representative, who is not eligible to participate in the Self-Determination Program pursuant to this paragraph may request that the regional center provide person-centered planning services in order to make arrangements for transition to the Self-Determination Program, provided that the individual is reasonably expected to transition to the community within 90 days. In that case, the regional center shall initiate person-centered planning services within 60 days of that request.
(3)The participant agrees to all of the following terms and conditions:
(A)The participant shall receive an orientation that meets the standards set or developed by the department to the Self-Determination Program prior to enrollment, which includes the principles of self-determination, the role of the independent facilitator and the financial management services provider, person-centered planning, and development of a budget.
(B)The participant shall utilize the services and supports available within the Self-Determination Program only when generic services and supports are not available.
(C)The participant shall only purchase services and supports necessary to implement their IPP and shall comply with any and all other terms and conditions for participation in the Self-Determination Program described in this section.
(D)The participant shall manage Self-Determination Program services and supports within the participants individual budget.
(E)The participant shall utilize the services of a financial management services provider of their own choosing and who is vendored by a regional center and who meets the qualifications in paragraph (1) of subdivision (c).
(F)The participant may utilize the services of an independent facilitator of their own choosing for the purpose of providing services and functions as described in paragraph (2) of subdivision (c). If the participant elects not to use an independent facilitator, the participant may use their regional center service coordinator to provide the services and functions described in paragraph (2) of subdivision (c).
(G)If eligible, with the assistance of the regional center, if needed, timely apply for Medi-Cal in order to maximize federal funding. The participant may consider institutional deeming in order to qualify for Medi-Cal services.
(e)A participant who is not Medi-Cal eligible may participate in the Self-Determination Program and receive self-determination services and supports if all other program eligibility requirements are met and the services and supports are otherwise eligible for federal financial participation.
(f)The additional federal financial participation funds generated by the former participants of the self-determination pilot projects authorized pursuant to Section 13 of Chapter 1043 of the Statutes of 1998, as amended, or pursuant to Article 4 (commencing with Section 4669.2) of Chapter 5, shall be used to maximize the ability of Self-Determination Program participants to direct their own lives and to ensure the department and regional centers successfully implement the program as follows:
(1)First, to offset the cost to the department for the criminal background check conducted pursuant to subdivision (v) and other administrative costs incurred by the department in implementing the Self-Determination Program.
(2)With the remaining funds, the department, in consultation with stakeholders, including a statewide self-determination advisory workgroup, shall prioritize the use of the funds to meet the needs of participants, increase service access and equity, and reduce disparities, and to implement the program, including costs associated with all of the following:
(A)Independent facilitators to assist with a participants initial person-centered planning meeting.
(B)Development of the participants initial individual budget.
(C)Joint training of consumers, family members, regional center staff, and members of the local volunteer advisory committee established pursuant to paragraph (1) of subdivision (w).
(D)Regional center operations to increase support for transition to the Self-Determination Program or for caseload ratio enhancement.
(E)To offset the costs to the regional centers in implementing the Self-Determination Program.
(F)To support the Statewide Self-Determination Advisory Committee established pursuant to paragraph (2) of subdivision (w).
(g)If at any time during participation in the Self-Determination Program a regional center determines that a participant is no longer eligible to continue in, or a participant voluntarily chooses to exit, the Self-Determination Program, the regional center shall provide for the participants transition from the Self-Determination Program to other services and supports. This transition shall include the development of a new IPP that reflects the services and supports necessary to meet the individuals needs. The regional center shall ensure that there is no gap in services and supports during the transition period.
(h)An individual determined to be ineligible for or who voluntarily exits the Self-Determination Program shall be permitted to return to the Self-Determination Program upon meeting all applicable eligibility criteria and upon approval of the participants planning team, as described in subdivision (j) of Section 4512. An individual who has voluntarily exited the Self-Determination Program shall not return to the program for at least 12 months.
(i)An individual who participates in the Self-Determination Program may elect to continue to receive self-determination services and supports if the individual transfers to another regional center catchment area, provided that the individual remains eligible for the Self-Determination Program pursuant to subdivision (d). The balance of the participants individual budget shall be reallocated to the regional center to which the participant transfers.
(j)The IPP team shall utilize the person-centered planning process to develop the IPP for a participant. The IPP shall detail the goals and objectives of the participant that are to be met through the purchase of participant-selected services and supports. The IPP team shall determine the individual budget to ensure the budget assists the participant to achieve the outcomes set forth in the participants IPP and ensures their health and safety. The completed individual budget shall be attached to the IPP.
(k)The participant shall implement their IPP, including choosing and purchasing the services and supports allowable under this section necessary to implement the plan. A participant is exempt from the cost control restrictions regarding the purchases of services and supports pursuant to Section 4648.5. A regional center shall not prohibit the purchase of any service or support that is otherwise allowable under this section.
(l)A participant shall have all the rights established in Sections 4646 to 4646.6, inclusive, and Chapter 7 (commencing with Section 4700).
(m)(1)Except as provided in paragraph (4), the IPP team shall determine the initial and any revised individual budget for the participant using the following methodology:
(A)(i)Except as specified in clause (ii), for a participant who is a current consumer of the regional center, their individual budget shall be the total amount of the most recently available 12 months of purchase of service expenditures for the participant.
(ii)An adjustment may be made to the amount specified in clause (i) if both of the following occur:
(I)The IPP team determines that an adjustment to this amount is necessary due to a change in the participants circumstances, needs, or resources that would result in an increase or decrease in purchase of service expenditures, or the IPP team identifies prior needs or resources that were unaddressed in the IPP, which would have resulted in an increase or decrease in purchase of service expenditures. When adjusting the budget, the IPP team shall document the specific reason for the adjustment in the IPP.
(II)The regional center certifies on the individual budget document that regional center expenditures for the individual budget, including any adjustment, would have occurred regardless of the individuals participation in the Self-Determination Program.
(iii)For purposes of clauses (i) and (ii), the amount of the individual budget shall not be increased to cover the cost of the independent facilitator.
(B)For a participant who is either newly eligible for regional center services or who does not have 12 months of purchase service expenditures, the participants individual budget shall be calculated as follows:
(i)The IPP team shall identify the services and supports needed by the participant and available resources, as required by Section 4646.
(ii)The regional center shall calculate the cost of providing the services and supports to be purchased by the regional center by using the average cost paid by the regional center for each service or support unless the regional center determines that the consumer has a unique need that requires a higher or lower cost. The IPP team also shall document the specific reason for the adjustment in the IPP. The regional center shall certify on the individual budget document that this amount would have been expended using regional center purchase of service funds regardless of the individuals participation in the Self-Determination Program.
(iii)For purposes of clauses (i) and (ii), the amount of the individual budget shall not be increased to cover the cost of the independent facilitator.
(2)The amount of the individual budget shall be available to the participant each year for the purchase of program services and supports. An individual budget shall be calculated no more than once in a 12-month period, unless revised to reflect a change in circumstances, needs, or resources of the participant using the process specified in clause (ii) of subparagraph (A) of paragraph (1).
(3)The spending plan shall be assigned to uniform budget categories developed by the department in consultation with stakeholders and distributed according to the timing of the anticipated expenditures in the IPP and in a manner that ensures that the participant has the financial resources to implement the IPP throughout the year.
(4)The department, in consultation with stakeholders, may develop alternative methodologies for individual budgets that are computed in a fair, transparent, and equitable manner and are based on consumer characteristics and needs, and that include a method for adjusting individual budgets to address a participants change in circumstances or needs.
(n)Annually, participants may transfer up to 10 percent of the funds originally distributed to any budget category set forth in paragraph (3) of subdivision (m) to another budget category or categories. Transfers in excess of 10 percent of the original amount allocated to any budget category may be made upon the approval of the regional center or the participants IPP team.
(o)Consistent with the implementation date of the IPP, the IPP team shall annually ascertain from the participant whether there are any circumstances or needs that require a change to the annual individual budget. Based on that review, the IPP team shall calculate a new individual budget consistent with the methodology identified in subdivision (m).
(p)(1)The department, as it determines necessary, may adopt regulations to implement the procedures set forth in this section. Any regulations shall be adopted in accordance with the requirements of Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code.
(2)Notwithstanding paragraph (1) and Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, and only to the extent that all necessary federal approvals are obtained, the department, without taking any further regulatory action, shall implement, interpret, or make specific this section by means of program directives or similar instructions until the time regulations are adopted. It is the intent of the Legislature that the department be allowed this temporary authority as necessary to implement program changes only until completion of the regulatory process.
(q)The department, in consultation with stakeholders, shall develop informational materials about the Self-Determination Program. The department shall ensure that regional centers are trained in the principles of self-determination, the mechanics of the Self-Determination Program, and the rights of consumers and families as candidates for, and participants in, the Self-Determination Program.
(r)Each regional center shall be responsible for implementing the Self-Determination Program as a term of its contract under Section 4629. As part of implementing the program, the regional center shall do all of the following:
(1)Meet the Self-Determination Program targets approved by the department, meet benchmarks established by the department in areas including timely enrollment, diversity of consumers served, and reduction of disparities in the individual budget of participants from racial and ethnic communities, and be eligible for incentives for exceeding these targets and benchmarks once the department has established a performance incentives program.
(2)Develop and implement an outreach and training plan about the Self-Determination Program for the diverse communities served by the regional center, including in congregate settings. Information shall be provided in plain language, in alternative formats and alternative modes of communication, and provide language access as required by state and federal law. Obtain input from stakeholders, including consumers and families, that reflect the ethnic and language diversity of the regional centers consumers, about the effectiveness of this outreach and training and other activities that may be effective in reducing disparities in these programs.
(3)Annually report the enrollment, individual budget data, and purchase of service expenditure data for the Self-Determination Program consistent with the criteria in subdivisions (a) to (c), inclusive, of Section 4519.5.
(4)Assist eligible participants and their families in applying for Medi-Cal, in order to maximize federal funding and assist interested participants who wish to pursue institutional deeming in order to qualify for Medi-Cal services.
(5)At least annually, in addition to annual certification, conduct an additional review of all final individual budgets for participants at the regional center which are at or above a spending threshold that is specified by the department through directive consistent with federal and state requirements. This information may be used in the aggregate to provide training, program guidance, and verify compliance with state and federal requirements.
(6)Review the spending plan to verify that goods and services eligible for federal financial participation are not used to fund goods or services available through generic agencies.
(7)Contract with local consumer or family-run organizations and consult with the local volunteer advisory committee established pursuant to paragraph (1) of subdivision (w) to conduct outreach through local meetings or forums to consumers and their families to provide information about the Self-Determination Program and to help ensure that the program is available to a diverse group of participants, with special outreach to underserved communities.
(8)Collaborate with the local consumer or family-run organizations identified in paragraph (1) to jointly conduct training about the Self-Determination Program. The regional center shall consult with the local volunteer advisory committee established pursuant to paragraph (1) of subdivision (w) in planning for the training, and the local volunteer advisory committee may designate members to represent the advisory committee at the training.
(9)Train all service coordinators and fair hearing specialists in the principles of self-determination, the mechanics of the Self-Determination Program, and the rights of consumers and families. The training shall be conducted in collaboration with the local volunteer advisory committee.
(10)Provide payment to the financial management services provider for spending plan expenses through a not less than semimonthly pay schedule.
(11)Ensure that each individual plan includes the information required by subdivision (d) of Section 4646.
(s)The financial management services provider shall provide the participant and the regional center service coordinator with a monthly individual budget statement that describes the amount of funds allocated by budget category, the amount spent in the previous 30-day period, and the amount of funding that remains available under the participants individual budget.
(t)Only the financial management services provider is required to apply for vendorization in accordance with Subchapter 2 (commencing with Section 54300) of Chapter 3 of Division 2 of Title 17 of the California Code of Regulations for the Self-Determination Program. All other service and support providers shall not be on the federal debarment list and shall have applicable state licenses, certifications, or other state required documentation, including documentation of any other qualifications required by the department, but are exempt from the vendorization requirements set forth in Title 17 of the California Code of Regulations when serving participants in the Self-Determination Program.
(u)The regional center shall pay the full costs of the participants financial management services provider.
(v)To protect the health and safety of participants in the Self-Determination Program, the department shall require a criminal background check in accordance with all of the following:
(1)The department shall issue a program directive that identifies nonvendored providers of services and supports who shall obtain a criminal background check pursuant to this subdivision. At a minimum, these staff shall include both of the following:
(A)Individuals who provide direct personal care services to a participant.
(B)Other nonvendored providers of services and supports for whom a criminal background check is requested by a participant or the participants financial management service.
(2)Subject to the procedures and requirements of this subdivision, the department shall administer criminal background checks consistent with the departments authority and the process described in Sections 4689.2 to 4689.6, inclusive.
(3)The department shall electronically submit to the Department of Justice fingerprint images and related information required by the Department of Justice of nonvendored providers of services and supports, as specified in paragraph (1), for purposes of obtaining information as to the existence and content of a record of state or federal convictions and state or federal arrests and also information as to the existence and content of a record of state or federal arrests for which the Department of Justice establishes that the person is free on bail or on their own recognizance pending trial or appeal.
(4)When received, the Department of Justice shall forward to the Federal Bureau of Investigation requests for federal summary criminal history information received pursuant to this section. The Department of Justice shall review the information returned from the Federal Bureau of Investigation and compile and disseminate a response to the department.
(5)The Department of Justice shall provide a state or federal response to the department pursuant to paragraph (1) of subdivision (p) of Section 11105 of the Penal Code.
(6)The department shall request from the Department of Justice subsequent notification service, as provided pursuant to Section 11105.2 of the Penal Code, for persons described in paragraph (1).
(7)The Department of Justice shall charge a fee sufficient to cover the cost of processing the request described in this subdivision.
(8)The fingerprints of any provider of services and supports who is required to obtain a criminal background check shall be submitted to the Department of Justice prior to employment. The costs of the fingerprints and the financial management services administrative cost authorized by the department shall be paid by the services and supports provider or the providers employing agency. Any administrative costs incurred by the department pursuant to this subdivision shall be offset by the funds specified in subdivision (g).
(9)If the criminal record information report shows a criminal history, the department shall take the steps specified in Section 4689.2. The department may prohibit a provider of services and supports from becoming employed, or continuing to be employed, based on the criminal background check, as authorized in Section 4689.6. The provider of services and supports who has been denied employment shall have the rights set forth in Section 4689.6.
(10)The department may utilize a current department-issued criminal record clearance to enable a provider to serve more than one participant, as long as the criminal record clearance has been processed through the department and no subsequent arrest notifications have been received relative to the cleared applicant.
(11)Consistent with subdivision (h) of Section 4689.2, the participant or financial management service that denies or terminates employment based on written notification from the department shall not incur civil liability or unemployment insurance liability.
(w)To ensure the effective implementation of the Self-Determination Program and facilitate the sharing of best practices and training materials commencing with the implementation of the Self-Determination Program, local and statewide advisory committees shall be established as follows:
(1)Each regional center shall establish a local volunteer advisory committee to provide oversight of the Self-Determination Program and identify a regional center liaison to the committee. The regional center and the State Council on Developmental Disabilities shall each appoint one-half of the membership of the committee. The committee shall consist of the regional center clients rights advocate, consumers, family members, and other advocates, and community leaders, including a representative from a family resource center. A majority of the committee shall be consumers and their family members. The committee shall reflect the multicultural diversity and geographic profile of the catchment area. The committee shall review the development and ongoing progress of the Self-Determination Program, including whether the program advances the principles of self-determination and is operating consistent with the requirements of this section, and may make ongoing recommendations for improvement to the regional center and the department. Annually, the regional center shall confirm, in writing, that the committee meets the requirements specified in this paragraph and provide the department with the name of the staff liaison and the names of the committee members, the positions they fill on the committee, and which entity appointed them to the committee.
(2)The State Council on Developmental Disabilities shall form a volunteer committee, to be known as the Statewide Self-Determination Advisory Committee, comprised of the chairs of the 21 local advisory committees or their designees. The council shall convene the Statewide Self-Determination Advisory Committee twice annually, or more frequently in the sole discretion of the council. The Statewide Self-Determination Advisory Committee shall meet by teleconference or other means established by the council to identify self-determination best practices, effective consumer and family training materials, implementation concerns, systemic issues, ways to enhance the program, and recommendations regarding the most effective method for participants to learn of individuals who are available to provide services and supports. The council shall synthesize information received from the Statewide Self-Determination Advisory Committee, local advisory committees, and other sources, share the information with consumers, families, regional centers, and the department, and make recommendations, as appropriate, to increase the programs effectiveness in furthering the principles of self-determination.
(x)The department shall annually provide the following information to the appropriate policy and fiscal committees of the Legislature:
(1)Number and characteristics of participants, by regional center, including the number of participants who entered the program upon movement from a developmental center.
(2)Types and amount of services and supports purchased under the Self-Determination Program, by regional center.
(3)Range and average of individual budgets, by regional center, including adjustments to the budget to address the adjustments permitted in clause (ii) of subparagraph (A) of paragraph (1) of subdivision (m).
(4)The number and outcome of appeals concerning individual budgets, by regional center.
(5)The number and outcome of fair hearing appeals, by regional center.
(6)The number of participants who voluntarily withdraw from the Self-Determination Program and a summary of the reasons why, by regional center.
(7)The number of participants who are subsequently determined to no longer be eligible for the Self-Determination Program and a summary of the reasons why, by regional center.
(y)(1)The State Council on Developmental Disabilities shall issue an interim report to the Legislature, in compliance with Section 9795 of the Government Code, no later than June 30, 2021, on the status of the Self-Determination Program authorized by this section, barriers to its implementation, and recommendations to enhance the effectiveness of the program. The interim report shall provide an update to the programs status, each regional centers cap on participation and progress toward that cap, the most recent statewide and per-regional-center participant count, and the historical trend in the statewide participation count since the start of the program. The department shall assist in providing available information to the council in order to facilitate the timely issuance of the report.
(2)The council, in collaboration with the protection and advocacy agency identified in Section 4900 and the federally funded University Centers for Excellence in Developmental Disabilities Education, Research, and Service, may work with regional centers to survey participants regarding participant satisfaction under the Self-Determination Program and, when data is available, the traditional service delivery system, including the proportion of participants who report that their choices and decisions are respected and supported and who report that they are able to recruit and hire qualified service providers, and to identify barriers to participation and recommendations for improvement.
(3)The council, in collaboration with the protection and advocacy agency identified in Section 4900 and the federally funded University Centers for Excellence in Developmental Disabilities Education, Research, and Service, shall issue a report to the Legislature, in compliance with Section 9795 of the Government Code, by June 30, 2023, on the status of the Self-Determination Program authorized by this section, and provide recommendations to enhance the effectiveness of the program. This review shall include the programs effectiveness in furthering the principles of self-determination, including all of the following:
(A)Freedom, which includes the ability of adults with developmental disabilities to exercise the same rights as all citizens to establish, with freely chosen supporters, family and friends, where they want to live, with whom they want to live, how their time will be occupied, and who supports them; and for families to have the freedom to receive unbiased assistance of their own choosing when developing a plan and to select all personnel and supports to further the life goals of a minor child.
(B)Authority, which includes the ability of a person with a disability, or family, to control a certain sum of dollars in order to purchase services and supports of their choosing.
(C)Support, which includes the ability to arrange resources and personnel, both formal and informal, that will assist a person with a disability to live a life in the community that is rich in community participation and contributions.
(D)Responsibility, which includes the ability of participants to take responsibility for decisions in their own lives and to be accountable for the use of public dollars, and to accept a valued role in their community through, for example, competitive employment, organizational affiliations, spiritual development, and general caring of others in their community.
(E)Confirmation, which includes confirmation of the critical role of participants and their families in making decisions in their own lives and designing and operating the system that they rely on.
SEC. 21.SEC. 17.Section 4726 of the Welfare and Institutions Code is amended to read:4726.Notwithstanding Section 5328, any exemption to the California Public Records Act (Division 10 (commencing with Section 7920.000) of Title 1 of the Government Code), or any other law that authorizes, but does not require, an entity to withhold all or part of a record on the basis of its confidentiality, access to records regarding an applicant for, or recipient of, services shall be provided, upon request, to the applicant, recipient, or their authorized representative, including the person appointed as a developmental services decisionmaker pursuant to Section 319, 361, or 726, for purposes purposes, including, but not limited to, the appeal process under this chapter, unless disclosure of the record is expressly prohibited by law.
SEC. 22.SEC. 18.Section 4731 of the Welfare and Institutions Code is amended to read:4731.(a)Each consumer or any representative acting on behalf of any consumer or consumers, who believes that any right to which a consumer is entitled has been abused, punitively withheld, or improperly or unreasonably denied by a regional center, state-operated facility, or service provider, may pursue a complaint as provided in this section.
(b)Any complaint made pursuant to this section shall be made to the Director of Developmental Services. The director, within 30 days of receiving a complaint, shall issue a written administrative decision and send a copy of the decision to the complainant, the director of the regional center or state-operated facility, and the service provider, if applicable.
(c)The department, on a quarterly basis, shall compile the number of complaints filed, by each regional center and state-operated facility, the subject matter of each complaint, and a summary of each decision, and post the compilation on its internet website at the end of each quarter. Copies of any decision included in the compilation shall be made available within 10 days, with all individually identifiable information redacted, to any person upon request.
(d)This section shall not be used to resolve disputes concerning the nature, scope, or amount of services and supports that should be included in an individual program plan, for which there is an appeals procedure established in this division, or disputes regarding rates or audit appeals for which there is an appeals procedure established in regulations. Those disputes shall be resolved through the appeals procedure established by this division or in regulations.
(e)All consumers or, if appropriate, their authorized representative, shall be notified in writing in their preferred language of the right to file a complaint pursuant to this section when they apply for services from a regional center or a state-operated facility, and at each regularly scheduled planning meeting.
This act shall be known, and may be cited, as the Disability Equity and Accountability Act of 2023.
SEC. 2.(a)The Legislature finds and declares as follows:
(1)Recent reports and hearings by the California State Auditor, the Little Hoover Commission, and advocacy organizations have found that Californias service system for the over 400,000 children and adults with intellectual and developmental disabilities through the Lanterman Act, as overseen by the State Department of Developmental Services, which contracts with 21 regional centers, is failing in significant ways to deliver critical, adequate, and timely services to individuals and families. The result is that individuals and families, particularly those of color, are unable to timely access services and supports, resulting in barriers to their living independent, productive, and integrated lives in their communities.
(2)Californias developmental disability service system is plagued with racial, ethnic, and geographic disparities that can dramatically impact the essential services received by children and adults with developmental disabilities. Systemic inequities and discrimination within Californias 21 regional centers broaden the gap between inclusive possibilities and segregated limitations. Data show Latinos are most negatively impacted by these disparities, but people who are clients of the lowest-performing regional centers are also significantly affected.
(3)California spends nearly $13,000,000,000 annually on the administration and delivery of developmental services, but lacks a transparent, common, integrated, and coordinated model for the delivery and measurement of services throughout the 21 regional centers, resulting in poor outcomes, poor satisfaction levels by consumers and families, and disparate levels of available services and performance expectations.
(4)The delivery of services through 21 separate private nonprofit regional centers with separate boards, funding, and delivery models was originally intended to ensure that the delivery of services could be more effectively delivered through nonstate entities. However, with the subsequent caseload and budget growth since the enactment of the Lanterman Act, local administration has become more disparate and less accountable. Boards of directors are untrained and are not providing the oversight needed of the regional centers. Stronger state oversight of regional centers by the State Department of Developmental Services is essential to ensure that services are equitably delivered, performance and outcomes are uniformly measured and reported, and the system is transparent and accountable to individuals and families.
(5)The departments system lacks a statewide automated technology system for the delivery of services to persons with intellectual and developmental disabilities and, as a result, the current program is constrained by disparate automation systems, inadequate documentation, the lack of open system architecture, insufficient data to support administration of the system, and the lack of data to support program improvements for improving the quality of life outcomes through new service delivery methods.
(6)Statewide uniformity of service delivery practices and procedures is essential to an effective program and to support necessary oversight and research for ongoing program improvements.
(7)The departments technical infrastructure is over 40 years old. The lack of a statewide automation system does not meet current program needs and significantly contributes to the racial and geographic disparities in the delivery of services. California currently lacks clear and consistent service delivery outcomes for individuals with intellectual and developmental disabilities that sets high expectations for their quality of life, and must develop a system for measuring and quantifying the value of service delivery outcomes.
(8)A previous effort to develop an intellectual and developmental disabilities (IDD) program technology system failed. As a result, the department and regional centers maintain a patchwork of at least three case management and fiscal systems that are not integrated and six legacy case management automation systems that lack integration, have dissimilar data sources, and are technically outdated.
(9) In the 202122 annual budget the Legislature appropriated $6,000,000 to the State Department of Developmental Services for planning purposes related to the implementation of a uniform fiscal system and consumer electronic records management system. The department has not developed a vision or scope for a proposed system development approach.
(b)Therefore, it is the intent of the Legislature in enacting this act to do all of the following:
(1)Ensure that racial, ethnic, and geographic service disparities be systemically addressed and eliminated and that all people, regardless of their race or ethnicity or where they live, receive equitable access to services within the regional center system.
(2)Ensure that all regional centers offer and provide a consistent and common set of services and that the services are delivered in a timely way.
(3) Ensure that the delivery of all services and supports comply with federal law and guidance and are responsive to the needs and choices of beneficiaries receiving home- and community-based services, are person centered and strengths based, have high expectations for interdependence, self-direction, and competitive, integrated employment, provide support coordination to assist with a community-supported life, and achieve a more consistent and coordinated approach to the administration of policies and procedures across the state.
(4)Provide the department with new tools for holding regional centers and service providers accountable through the development of a standardized and coordinated set of performance measures and related standards that establish targets and standards above which a regional center may receive incentives for improved performance, and a separate set of standards that require corrective action.
(5)Improve regional center governance by establishing new standards and procedures for regional center governing boards to ensure they can more effectively represent the communities they serve by providing them with greater independence and protection from regional center retaliation.
(6)Require the State Department of Developmental Services to develop a written project charter for the planning and development of a uniform statewide automation system that serves as a foundation document for the system development, which includes project guiding principles, scope, strategies and approach, and project governance, in order to provide transparency to the Legislature and the public on the system development as has been used with other statewide system development.
SEC. 3.Section 4519.5 of the Welfare and Institutions Code is amended to read:4519.5.(a)The department and the regional centers shall annually collaborate to compile data in a uniform manner relating to purchase of service authorization, utilization, and expenditure by each regional center with respect to all of the following:
(1)The age of the consumer, categorized by the following:
(A)Birth to two years of age, inclusive.
(B)Three to 21 years of age, inclusive.
(C)Twenty-two years of age and older.
(2)Race or ethnicity of the consumer.
(3)Preferred language spoken by the consumer, and other related details, as feasible.
(4)Disability detail, in accordance with the categories established by subdivision (a) of Section 4512, and, if applicable, a category specifying that the disability is unknown.
(5)Residence type, subcategorized by age, race or ethnicity, and preferred language.
(6)Number of instances when the written copy of the individual program plan was provided at the request of the consumer and, when appropriate, the consumers parents, legal guardian or conservator, or authorized representative, in a language other than a threshold language, as defined by paragraph (3) of subdivision (a) of Section 1810.410 of Title 9 of the California Code of Regulations, if that written copy was provided more than 60 days after the request.
(7)Number of instances when the written copy of the individual program plan was provided at the request of the consumer and, when appropriate, the consumers parents, legal guardian or conservator, or authorized representative, in a threshold language, as defined by paragraph (3) of subdivision (a) of Section 1810.410 of Title 9 of the California Code of Regulations, if that written copy was provided more than 45 days after the request, in violation of paragraph (5) of subdivision (a) of Section 4646.5.
(8)Beginning with data for the fiscal year of 202324, the numbers, percentages, and total and per capita expenditure and authorization amounts, by age, as applicable, according to race or ethnicity and preferred language, for all combined residence types and for consumers living in the family home, regarding the following service types:
(A)Camping and associated travel expenses.
(B)Social recreation activities.
(C)Educational services.
(D)Nonmedical therapies, including, but not limited to, specialized recreation, art, dance, and music.
(b)The data reported pursuant to subdivision (a) shall also include the number and percentage of individuals, categorized by age, race or ethnicity, and disability, and by residence type, as set forth in paragraph (5) of subdivision (a), who have been determined to be eligible for regional center services, but are not receiving purchase of service funds.
(c)By March 31, 2013, each regional center shall post the data described in this section that are specific to the regional center on its internet website. Commencing on December 31, 2013, each regional center shall annually post these data by December 31. Each regional center shall maintain all previous years data on its internet website.
(d)By March 31, 2013, the department shall post the information described in this section on a statewide basis on its internet website. Commencing December 31, 2013, the department shall annually post this information by December 31. The department shall maintain all previous years data on its internet website. The department shall also post notice of any regional center stakeholder meetings on its internet website.
(e)Within three months of compiling the data with the department, and annually thereafter, each regional center shall meet with stakeholders in one or more public meetings regarding the data. The meeting or meetings shall be held separately from any meetings held pursuant to Section 4660. The regional center shall provide participants of these meetings with the data and any associated information related to improvements in the provision of developmental services to underserved communities and shall conduct a discussion of the data and the associated information in a manner that is culturally and linguistically appropriate for that community, including providing alternative communication services, as required by Sections 11135 to 11139.7, inclusive, of the Government Code and implementing regulations. Regional centers shall inform the department of the scheduling of those public meetings 30 days prior to the meeting. Notice of the meetings shall also be posted on the regional centers internet website 30 days prior to the meeting and shall be sent to individual stakeholders and groups representing underserved communities in a timely manner. Each regional center shall, in holding the meetings required by this subdivision, consider the language needs of the community and shall schedule the meetings at times and locations designed to result in a high turnout by the public and underserved communities.
(f)(1)Each regional center shall annually report to the department regarding its implementation of the requirements of this section. The report shall include, but shall not be limited to, all of the following:
(A)Actions the regional center took to improve public attendance and participation at stakeholder meetings, including, but not limited to, attendance and participation by underserved communities.
(B)Copies of minutes from the meeting and attendee comments.
(C)Whether the data described in this section indicate a need to reduce disparities in the purchase of services among consumers in the regional centers catchment area. If the data do indicate that need, the regional centers recommendations and plan to promote equity, and reduce disparities, in the purchase of services.
(2)Each regional center and the department shall annually post the reports required by paragraph (1) on its internet website by August 31.
(g)(1)The department shall consult with stakeholders, including consumers and families that reflect the ethnic and language diversity of regional center consumers, regional centers, advocates, providers, family resource centers, the protection and advocacy agency described in Section 4901, and those entities designated as University Centers for Excellence in Developmental Disabilities Education, Research, and Service pursuant to Section 15061 of Title 42 of the United States Code, to achieve the following objectives:
(A)Review the data compiled pursuant to subdivision (a).
(B)Identify barriers to equitable access to services and supports among consumers and develop recommendations to help reduce disparities in purchase of service expenditures.
(C)Encourage the development and expansion of culturally appropriate services, service delivery, and service coordination.
(D)Identify best practices to reduce disparity and promote equity.
(2)The department shall report the status of its efforts to satisfy the requirements of paragraph (1) during the 201617 legislative budget subcommittee hearing process.
(h)(1)Subject to available funding, the department shall allocate funding to regional centers or community-based organizations with department oversight to assist with implementation of the recommendations and plans developed pursuant to subdivisions (f) and (g). Activities funded through these allocations may include, but are not limited to, pay differentials supporting direct care bilingual staff of community-based service providers, parent or caregiver education programs, cultural competency training for regional center staff, outreach to underserved populations, or additional culturally appropriate service types or service delivery models.
(2)Each regional center shall consult with stakeholders regarding activities that may be effective in addressing disparities in the receipt of regional center services and the regional centers proposed requests for the funding specified in paragraph (1). Each regional center shall identify the stakeholders it consulted with and include information on how it incorporated the input of stakeholders into its requests.
(3)A community-based organization may submit a request for grant funding pursuant to this subdivision. The organization shall submit the request concurrently to the regional center of the jurisdiction in which the organization is located and to the department. The regional center shall provide the department with input regarding the request prior to the departments final determination on the request.
(4)The department shall review requests for funding within 45 days from the deadline specified in the departments guidance to regional centers and community-based organizations.
(5)Each regional center and community-based organization receiving funding shall report annually to the department, in a manner determined by the department, on how the funding allocations were used and shall include recommendations of priorities for activities that may be effective in addressing disparities, based on the consultation with stakeholders.
(6)The department shall post the following information on its internet website:
(A)By September 1 of any year in which grant funding is available and has not been allocated, a structure for the grant program, including all of the following information:
(i)How community-based organizations reflecting groups that are disadvantaged by disparities in the purchase of services will be invited to participate in the grant program.
(ii)How statewide strategies were considered.
(iii)How the department will ensure grant funds are not used for activities that regional centers are otherwise required by statute or regulation to conduct.
(iv)How funded activities will be evaluated.
(B)By October 1 of any year in which grant funding is available and has not been allocated, the final invitation for requests for funding or another mechanism through which requests for funding are solicited.
(C)By January 1 of any year in which grant funding has been allocated, a list of grant recipients, funding level per grant, and a description of the funded project.
(D)By May 1 of any year in which the information is available, evaluation results from prior grants. To ensure the department complies with this subparagraph, regional centers and community-based organizations receiving funding shall provide the department, by March 1 of the same year, with an evaluation of funded activities and the effectiveness of those activities in reducing disparities in the purchase of services, to the extent information is available.
(i)On or before December 31, 2021, the department shall 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 subdivision (h).
(j)For the purposes of this section, the department shall require all of the following:
(1)The use by the department and regional centers, when reporting data by race and ethnicity, of consistent classifications of race and ethnicity, based on categories current in use by the United States Census Bureau.
(2)Confirmation of the race and ethnicity identification of each consumer at the time of the annual review of the consumers individual program plan (IPP).
(3)When reporting by residence types, separate presentation of data for those in independent living services and those in supported living services.
(4)Consistent standards and requirements for regional center internet websites, using the same placement and language for all information required by this division, including that data be posted in a machine-readable format.
SEC. 4.Section 4519.20 is added to the Welfare and Institutions Code, to read:4519.20.As part of the departments planning process for the planning and development of a uniform statewide data automation system, the department, in consultation with stakeholders shall develop, by March 1, 2024, a project charter that shall be approved by the Secretary of the California Health and Human Services Agency and the Department of Technology. The charter development process shall include the participation and input of program consumers and families, researchers and quality and outcome evaluators, regional centers, and service providers. The project charter shall include all of the following:
(a)An impact statement on the primary entities and individuals impacted by the system development.
(b)Project guiding principles that are foundational to the project approach to be used throughout the planning, development, implementation, and maintenance of the system.
(c)Project scope that addresses business problems required to be solved by the system, including all of the following:
(1)Worker effectiveness and accountability that are constrained by the lack of timely, adequate, and accurate data, the lack of uniformity, and the current systems limited functionality.
(2)Service delivery that is constrained by the lack of timely, adequate, accurate, and accessible data, the lack of clear understandable communication of information, lack of uniformity, and the systems limited functionality.
(3)Current system maintainability that is constrained by disparate systems, inadequate documentation, the lack of open system architecture, and business changes.
(4)Disparate systems, complex business rules, the number of locations and variability of local system delivery, and changes in the way of doing business.
(5)Limited access of researchers and program evaluators to the set of person-level data that they need to assess program effectiveness.
(d)Program goals, which shall include all of the following:
(1)Maximizing the performance and the business processes for the delivery of intellectual or developmental disability (IDD) system services to consumers at the regional centers.
(2)Improving data quality, privacy, confidentiality, and integration of all data sources at an individual level.
(3)Enabling data-driven decisionmaking and performance measures for the effective administration of the program.
(4)Improving the business processes administered by the department to support regional center service delivery.
(5)Supporting access to individual-level data to support program evaluation and other research.
(e)Technology goals that recognize that a statewide system solution not only meets requirements, but also ensures effective transition, while minimizing disruption to existing services.
(f)Project strategies and approaches for development and implementation.
(g)Project governance.
(h)Technology that can readily be enhanced and modernized for the expected system life. In selecting the new system, consideration shall be given to the extent to which the candidate systems employ open architectures and standards and the future ability of the selected system to provide enhancements that will improve long-term effectiveness of program management of the statewide service delivery system.
SEC. 5.Section 4571 of the Welfare and Institutions Code is amended to read:4571.(a)It is the intent of the Legislature to ensure the well-being of consumers, taking into account their informed and expressed choices. It is further the intent of the Legislature to support the satisfaction and success of consumers through the delivery of quality services and supports. Evaluation of the services that consumers receive is a key aspect to the service system. Utilizing the information that consumers and their families provide about those services in a reliable and meaningful way is also critical to enable the department to assess the performance of the states developmental services system and to improve services for consumers in the future. To that end, the State Department of Developmental Services, on or before January 1, 2010, shall implement an improved, unified quality assessment system, in accordance with this section.
(b)The department, in consultation with stakeholders, shall identify a valid and reliable quality assurance instrument that assesses consumer and family satisfaction, provision of services in a linguistically and culturally competent manner, and personal outcomes. The instrument shall do all of the following:
(1)Provide nationally validated, benchmarked, consistent, reliable, and measurable data for the departments Quality Management System.
(2)Enable the department and regional centers to compare the performance of Californias developmental services system against other states developmental services systems and to assess quality and performance among all of the regional centers.
(3)Include outcome-based measures such as health, safety, well-being, relationships, interactions with people who do not have a disability, employment, quality of life, integration, choice, service, and consumer satisfaction.
(4)Include outcome-based measures to evaluate the linguistic and cultural competency of regional center services that are provided to consumers across their lifetimes.
(c)To the extent that funding is available, the instrument identified in subdivision (b) may be expanded to collect additional data requested by the State Council on Developmental Disabilities.
(d)(1)The department shall contract with an independent agency or organization to implement, by January 1, 2010, the quality assurance instrument described in subdivision (b). The contractor shall be experienced in all of the following:
(A)Designing valid quality assurance instruments for developmental service systems.
(B)Tracking outcome-based measures such as health, safety, well-being, relationships, interactions with people who do not have a disability, employment, quality of life, integration, choice, service, and consumer satisfaction.
(C)Developing data systems.
(D)Data analysis and report preparation.
(E)Assessments of the services received by consumers who are moved from developmental centers to the community, given the Legislatures historic recognition of a special obligation to ensure the well-being of these persons.
(F)Issues related to linguistic and cultural competency.
(2)Notwithstanding any other law, the contract and any amendments pursuant to this section shall be exempt from all of the following:
(A)The personal services contracting requirements of Article 4 (commencing with Section 19130) of Chapter 5 of Part 2 of Division 5 of Title 2 of the Government Code.
(B)The Public Contract Code, the State Contracting Manual, and the State Administration Manual.
(C)The approval of the Department of General Services.
(D)The approval of the Department of Technology.
(3)The exemptions specified in paragraph (2) shall remain in effect until there is more than one available assessment that meets the criteria in subdivision (b) from an organization that also meets the criteria in this subdivision.
(e)The department, in consultation with the contractor described in subdivision (d), shall establish the methodology by which the quality assurance instrument shall be administered, including, but not limited to, how often and to whom the quality assurance will be administered, and the design of a stratified, random sample among the entire population of consumers served by regional centers. The contractor shall provide aggregate information for all regional centers and the state as a whole. At the request of a consumer or the family member of a consumer, the survey shall be conducted in the primary language of the consumer or family member surveyed.
(f)The department shall contract with the state council to collect data for the quality assurance instrument described in subdivision (b). If, during the data collection process, the state council identifies any suspected violation of the legal, civil, or service rights of a consumer, or if it determines that the health and welfare of a consumer is at risk, that information shall be provided immediately to the regional center providing case management services to the consumer. At the request of the consumer or family, when appropriate, a copy of the completed survey shall be provided to the regional center providing case management services to improve the consumers quality of services through the individual planning process.
(g)The department, in consultation with stakeholders, shall annually review the data collected from and the findings of the quality assurance instrument described in subdivision (b) and accept recommendations regarding additional or different criteria for the quality assurance instrument in order to assess the performance of the states developmental services system and improve services for consumers.
(h)(1)Each regional center shall annually present data collected from, and the findings of, the quality assurance instrument described in subdivision (b) for that regional center, at a public meeting of its governing board in order to assess the comparative performance of the regional center and identify needed improvements in services for consumers, including, but not limited to, case management services. Notice of this meeting shall also be posted on the regional centers internet website at least 30 days prior to the meeting and shall be sent to regional center consumers and families and individual stakeholders at least 30 days prior to the meeting. The governing board shall provide a sufficient public comment period so members of the public may provide comments. Each regional center, in holding the meeting required by this subdivision, shall ensure that the meeting and meeting materials provide language access, as required by state and federal law.
(2)All regional center-specific reports generated by the department pursuant to this subdivision shall be made publicly available on the regional centers internet website in a machine-readable format, but shall not contain any personal identifying information about any person assessed.
(3)Within 60 days following its annual presentation, each regional center shall submit a report to the department regarding its implementation of the requirements of this section. The report shall include, but shall not be limited to, both of the following:
(A)Copies of the presentation described in paragraph (1), minutes from the meeting, and attendee comments.
(B)The regional centers recommendations and plans to use the information to address regional center priorities, strategic directions to improve specific areas of performance, or both.
(i)All reports generated pursuant to this section shall be made publicly available, but shall not contain any personal identifying information about any person assessed.
(j)All data collected pursuant to subdivision (c) shall be provided to the state council, but shall not contain personal identifying information about the persons being surveyed.
(k)Implementation of this section shall be subject to an annual appropriation of funds in the Budget Act for this purpose.
(l)By March 1, 2024, the department shall submit a report to the policy and budget subcommittees of the Legislature describing the extent to which the requirements of this section have not been met, including the surveying of all consumers, including those with no purchase of services, and providing specific steps and the schedule by which these requirements will be met.
SEC. 6.Section 4620.6 is added to the Welfare and Institutions Code, to read:4620.6.(a)(1)To provide uniformity, consistency, and cost-effectiveness in the delivery of services by regional centers throughout the state, the department shall establish, by January 1, 2025, a common set of services and supports, including supported living services, that every regional center in the state shall make available to consumers in negotiating, developing, or amending the individualized program plan as required by Sections 4646 and 4646.5. The common set of services and supports shall be prominently posted on each regional centers internet website.
(2)The department shall develop the common set of services and supports in consultation with the Association of Regional Center Agencies, consumers and their families, advocacy organizations, and service providers.
(b)In each contract with a regional center, the department shall require the common set of services and supports developed pursuant to this section to be available to consumers in the development of an individual program plan.
(c)It is the intent of the Legislature that this section not be construed to control or interfere with the discretion of the individual program planning team to determine the needs and services appropriate for each person with a developmental disability who is entitled to services under this division.
SEC. 7.Section 4622 of the Welfare and Institutions Code is amended to read:4622.The state shall contract only with agencies, the governing boards of which conform to all of the following criteria:
(a)The governing board shall be composed of individuals with demonstrated interest in, or knowledge of, developmental disabilities.
(b)The membership of the governing board shall include persons with legal, management or board governance, financial, and developmental disability program expertise. Board governance expertise may not be acquired solely by serving on a regional center board. The governing board of the regional center shall include members with financial expertise and members with management or board governance expertise by August 15, 2020.
(c)The membership of the governing board shall include representatives of the various categories of disability to be served by the regional center.
(d)The governing board shall reflect the geographic and ethnic characteristics of the area to be served by the regional center.
(e)A minimum of 50 percent of the members of the governing board shall be persons with developmental disabilities or their parents or legal guardians. No less than 25 percent of the members of the governing board shall be persons with developmental disabilities.
(f)(1)Members of the governing board shall not be permitted to serve more than a six-year term, and may return to the board for a subsequent term after five years. The members of each regional center governing board nominating committee shall be comprised of current board members and members of the community, and should be representative of the community served in the regional centers catchment area.
(2)The board nominating committee shall solicit interests and nominations from the broader community through outreach. The committee shall interview candidates for the board and make recommendations to the governing board for election. During the meeting at which the board elects new members, a candidate may be nominated by a board member with a second by another board member for the open positions. A regional center executive director shall be prohibited from any involvement in the recruitment or election of governing board members.
(g)(1)The department shall provide necessary training and support to these board members to facilitate their understanding and participation, including issues relating to linguistic and cultural competency. The training shall be developed with community input, including persons served and family members. Ongoing support by the department shall include surveying board members about their ability to meaningfully participate in, and understand the subjects and votes at, board meetings. If board members report that they are unable to meaningfully participate, the department shall work with the regional center and the board member to ensure adequate and appropriate accommodations are provided.
(2)As part of its monitoring responsibility, the department shall review and approve the method by which training and support are provided to board members to ensure maximum understanding and participation by board members.
(3)Each regional center shall post on its internet website information regarding the training and support provided to board members.
(h)The governing board may appoint a consumers advisory committee composed of persons with developmental disabilities representing the various categories of disability served by the regional center.
(i)The governing board shall appoint an advisory committee composed of a wide variety of persons representing the various categories of providers from which the regional center purchases client services. The advisory committee shall provide advice, guidance, recommendations, and technical assistance to the regional center board in order to assist the regional center in carrying out its mandated functions. The advisory committee shall designate one of its members to serve as a member of the regional center board.
(j)(1)The governing board shall annually review the performance of the director of the regional center. The department shall establish guidelines for governing boards to measure executive director performance, including with respect to issues of equity and diversity.
(2)The governing board shall annually review the performance of the regional center in providing services that are linguistically and culturally appropriate and may provide recommendations to the director of the regional center based on the results of that review.
(k)A member of the board who is an employee or member of the governing board of a provider from which the regional center purchases client services shall not do any of the following:
(1)Serve as an officer of the board.
(2)Vote on any fiscal matter affecting the purchase of services from any regional center provider.
(3)Vote on any issue other than as described in paragraph (2), in which the member has a financial interest, as defined in Section 87103 of the Government Code, and determined by the regional center board. The member shall provide a list of the members financial interests, as defined in Section 87103, to the regional center board.
(l)The department shall establish, and each board shall adopt, an antiretaliation policy for board members that requires department approval for any reduction in services for consumer board members or the family member of family board members.
(m)The department shall establish and adopt a grievance procedure whereby a governing board member who has concerns, complaints, or questions may contact a specific executive at the department.
(n)This section does not prevent the appointment to a regional center governing board of a person who meets the criteria for more than one of the categories listed above.
SEC. 8.Section 4626.5 of the Welfare and Institutions Code is amended to read:4626.5.Each regional center shall submit a conflict-of-interest policy to the department by July 1, 2011, and shall post the policy on its internet website by August 1, 2011. The policy shall do, or comply with, all of the following:
(a)Contain the elements of this section and be consistent with applicable law.
(b)Define conflicts of interest.
(c)Identify positions within the regional center required to complete and file a conflict-of-interest statement.
(d)Facilitate disclosure of information to identify conflicts of interest.
(e)Require candidates for nomination, election, or appointment to a regional center board, and applicants for regional center director to disclose any potential or present conflicts of interest prior to being appointed, elected, or confirmed for hire by the regional center or the regional center governing board.
(f)Require the regional center and its governing board to regularly and consistently monitor and enforce compliance with its conflict-of-interest policy.
(g)Prohibit a regional center employee from accepting a gift or gifts from a service provider, consumer, or consumers family member valued over ten dollars ($10) per year.
(h)Establish a policy prohibiting regional center senior staff from hiring relatives at the center or any ancillary foundation and organization. The policy shall be included in the regional center contract and shall be included in training of the governing board.
SEC. 9.Section 4629.1 is added to the Welfare and Institutions Code, to read:4629.1.(a)Notwithstanding any other law, the evaluation of regional center performance shall be implemented using a common set of performance measures, which shall be administered by the department. This includes the performance requirements under the regional center contracts pursuant to Section 4629, the performance incentives established under Section 4620.5, and the quality assessment instrument required under Section 4571. These measures shall be annually reported and made available to the public through posting of the measures results in machine-readable formats.
(b)By July 1, 2024, the department shall establish standards for each measure above, for which a regional center may receive rewards for good performance, and a separate set of minimal standards, below which the regional center is subject to each level of probation required under Section 4629. The department shall establish the process for assessing corrective action undertaken by a regional center and the process by which a regional center may end its probation status.
(c)The performance measures shall encompass the domains and the associated measures as itemized in subdivision (d). Additional measures may be adopted by the department as needed. Modification of the domain and measures shall be accomplished through a process of consultation that includes the engagement of stakeholders in a manner consistent with that required by subdivision (b) of Section 4620.5. The measures may be amended as reporting mechanisms mature as the department develops new information technology capabilities.
(d)The performance measures for purposes of this section shall be organized under seven domains, as follows:
(1)Community integration, including all of the following:
(A)The percentage of consumers who report spending their days primarily with people without disabilities who are not paid to be with them.
(B)The percentage of consumers who report they feel part of their communities, participate in community activities, know their neighbors, and have friends.
(C)The percentage of minor consumers living in licensed group homes or other institutional settings.
(D)The percentage of adult consumers living in licensed group homes, intermediate care facilities, or other institutional settings.
(E)The percentage of adult consumers living in their own homes with independent living services.
(F)The percentage of adult consumers living in their own homes with supported living services.
(G)The percentage of adult consumers seeking affordable and accessible housing.
(H)The percentage of adult consumers that have secured housing outside of their family home, if desired.
(2)Employment, including all of the following:
(A)The percentage of adult consumers in competitive, integrated employment and the length of time in the job.
(B)The percentage of employed adult consumers reporting increased wages and opportunities for advancement.
(C)The percentage of employed adult consumers reporting satisfaction with their jobs with the ability to learn new skills and interact with coworkers.
(D)The average per capita annual wages of employed adult consumers.
(E)The percentage of participants in the paid internship program that led to permanent employment.
(F)The average hourly wage for competitive, integrated employment.
(G)The average number of hours per week in competitive, integrated employment.
(H)The percentage of adult consumers in competitive, integrated employment, by race and ethnicity.
(3)Equity in service access, including all of the following:
(A)Per capita spending, by race and ethnicity.
(B)Per capita spending, by primary language.
(C)Timely eligibility determination, by race and ethnicity.
(D)Access to Early Start services, by race and ethnicity.
(E)Per capita spending on adult consumers, by residence type and by race and ethnicity.
(F)Per capita spending on adult consumers, by residence type and regional center.
(G)The percentage of consumers with no purchase of services, by regional center.
(H)The percentage of consumers with no purchase of services, by race and ethnicity.
(4)Case management, including all of the following:
(A)Timeliness of intake for eligibility.
(B)Timeliness of initiation of services for Early Start.
(C)Timeliness of development of IPPs.
(D)Timeliness of delivery of IPP services after authorization.
(E)Share of consumers reporting that the regional center service coordinator assisted them in attaining generic resources.
(F)Responsiveness of service coordinator.
(G)Consumer or family directs their own person-centered planning process.
(H)Timeliness of translated IPPs and other documents.
(5)Consumer and family choice, experience, and satisfaction, including all of the following:
(A)Overall satisfaction and happiness.
(B)Service coordinator cultural competency.
(C)Service coordinator who speaks consumers language.
(D)Access to approved services.
(E)Access to services provided by individuals who speak the consumers language.
(F)Consumers report they are treated with dignity and respect.
(G)Access to the Self-Determination Program.
(H)The ability to select their services and providers from among a range of choices.
(I)The ability to select the place where they live, with whom they live, and who supports them.
(J)The percentage of consumers who report having a way to communicate and express choices and decisions.
(K)The percentage of consumers or families who report that they understand the information provided to them by their regional center.
(L)The percentage of consumers or families reporting they feel comfortable in their interactions with the regional center, and if they are aware they can change their service coordinator.
(6)Human and civil rights, including all of the following:
(A)The number of special incident reports, and number of incidents of seclusion and restraint or other types of abuse by regional center.
(B)The percentage of consumers reporting they have a private space, if they live out of their family home.
(C)The percentage of adult consumers who vote in elections.
(D)The percentage of adult consumers who are conserved.
(7)Health and safety, including all of the following:
(A)Hospitalization and mortality rates among regional center consumers.
(B)The percentage of consumers receiving regular preventative care, vaccinations, and cancer screenings.
SEC. 10.Section 4639.76 is added to the Welfare and Institutions Code, to read:4639.76.A regional center with which the department maintains a contract pursuant to Section 4629 shall be subject to the California Public Records Act (Chapter 1 (commencing with Section 7920.000) of Division 10 of Title 1 of the Government Code).
SEC. 11.Section 4642 of the Welfare and Institutions Code is amended to read:4642.(a)(1)Any person believed to have a developmental disability, and any person believed to have a high risk of parenting an infant with a developmental disability shall be eligible for initial intake and assessment services in the regional centers. In addition, any infant having a high risk of becoming developmentally disabled may be eligible for initial intake and assessment services in the regional centers. For purposes of this section, high-risk infant means a child less than 36 months of age whose genetic, medical, or environmental history is predictive of a substantially greater risk for developmental disability than that for the general population. The department, in consultation with the State Department of Public Health, shall develop specific risk and service criteria for the high-risk infant program on or before July 1, 1983. These criteria may be modified in subsequent years based on analysis of actual clinical experience.
(2)(A)Initial intake shall be performed within 15 working days following request for assistance. Initial intake shall include, but need not be limited to, information and advice about the nature and availability of services provided by the regional center and by other agencies in the community, including guardianship, conservatorship, income maintenance, mental health, housing, education, work activity and vocational training, medical, dental, recreational, and other services or programs that may be useful to persons with developmental disabilities or their families. Intake shall also include a decision to provide assessment.
(B)For purposes of this section, request for assistance includes any initial contact or inquiry from an individual, or a person acting on their behalf, on the nature of services or supports available or provided by the regional center, and the individuals eligibility to receive them.
(3)(A)The department shall create, with input from stakeholders, standardized information packets to be provided to any person seeking services from a regional center. There shall be one information packet related to services provided under the California Early Intervention Services Act and another information packet related to services provided under the Lanterman Developmental Disabilities Services Act. The information packets shall be translated to provide language access, as required by state and federal law, shall be available in alternative formats and alternative modes of communication, as required by federal law, and shall include, at a minimum, all of the following:
(i)An overview of the regional center system.
(ii)A resource guide for consumers and their families.
(iii)Consumer rights, including the appeals procedures specified in Chapter 7 (commencing with Section 4700).
(iv)Contact information for the regional center, the department, the office of clients rights advocacy, and the protection and advocacy agency specified in Division 4.7 (commencing with Section 4900).
(v)Information on the Self-Determination Program, including the eligibility requirements specified in subdivision (d) of Section 4685.8.
(B)Each regional center shall distribute the information packets at intake, upon transfer to receiving services under the Lanterman Developmental Disabilities Services Act, and upon request. Each regional center shall begin distributing the information packets within 60 days following the department providing the information packets and issuing directives regarding the distribution of the information packets. In addition to, and not in lieu of, this requirement, each regional center shall post the full content of the most updated information packet on its internet website.
(b)A regional center shall communicate with the consumer and the consumers family pursuant to this section in their native language, including providing alternative communication services and alternative formats, as required by state and federal law.
SEC. 12.Section 4643 of the Welfare and Institutions Code is amended to read:4643.(a)If assessment is needed, the regional center shall require the assessment to be completed within 60 days following initial intake. Assessment shall be commenced as soon as possible, and in no event more than 30 days following initial intake when any delay would expose the client to unnecessary risk to their health and safety or to significant further delay in mental or physical development, or the client would be at imminent risk of placement in a more restrictive environment. Assessment may include collection and review of available historical diagnostic data, provision or procurement of necessary tests and evaluations, and summarization of developmental levels and service needs and is conditional upon receipt of the release of information specified in subdivision (b).
(b)In determining if an individual meets the definition of developmental disability contained in subdivision (a) of Section 4512, the regional center may consider evaluations and tests, including, but not limited to, intelligence tests, adaptive functioning tests, neurological and neuropsychological tests, diagnostic tests performed by a physician, psychiatric tests, and other tests or evaluations that have been performed by, and are available from, other sources.
(c)At the time of assessment, the individual, or, where appropriate, the parents, legal guardian, or conservator, shall provide copies of any health benefit cards under which the consumer is eligible to receive health benefits, including, but not limited to, private health insurance, a health care service plan, Medi-Cal, Medicare, and TRICARE. If the individual, or where appropriate, the parents, legal guardians, or conservators, have no such benefits, the regional center shall not use that fact to negatively impact the services that the individual may or may not receive from the regional center.
(d)A regional center shall communicate with the consumer and the consumers family pursuant to this section in their preferred language, including providing alternative communication services, as required by Sections 11135 to 11139.7, inclusive, of the Government Code and implementing regulations.
SEC. 13.Section 4646 of the Welfare and Institutions Code is amended to read:4646.(a)It is the intent of the Legislature to ensure that the individual program plan and provision of services and supports by the regional center system is centered on the individual and the family of the individual with developmental disabilities and takes into account the needs and preferences of the individual and the family, if appropriate, as well as promoting community integration, independent, productive, and normal lives, and stable and healthy environments. It is the further intent of the Legislature that individual program plans shall be developed consistent with the federal Affordable Care Act and the regulations and federal guidance adopted pursuant to the act requiring that community-based long-term services and supports be person-centered and self-directed. It is the further intent of the Legislature to ensure that goals in any plan allow for innovation and nontraditional service delivery and not be limited by the lack of easily identified services or supports, the provision of services to consumers and their families be effective in meeting the goals stated in the individual program plan, reflect the preferences and choices of the consumer, and reflect the cost-effective use of public resources.
(b)(1)Notwithstanding any other law, the individual program plan, including all assessments, shall be developed through a process of individualized needs determination and person-centered service planning developed pursuant to, and consistent with, Section 2402(a) of the federal Affordable Care Act (Pub. L. 111-148) and amendments thereto, Section 441.725 of Title 42 of the Code of Federal Regulations, and federal guidance issued by the Centers for Medicare and Medicaid Services on June 6, 2014, requiring community-based, long-term services and supports to be person-centered, strengths-based, and self-directed. The individual with developmental disabilities and, if appropriate, the individuals parents, legal guardian or conservator, or authorized representative, shall have the opportunity to actively participate in the development of the plan. The individual shall lead the service planning process to the greatest extent possible.
(c)An individual program plan shall be developed for any person who, following intake and assessment, is found to be eligible for regional center services. An initial assessment agreement shall be completed and provided to the consumer within 30 days of an intake unless there is good cause for the regional center to exceed the 30-day time period, but in no event shall the assessment be completed any later than 60 days from the intake. If the assessment is not completed within the 30- or 60-day time period, as applicable, the regional center shall provide the consumer with an adequate notice of action, which shall be subject to Chapter 7 (commencing with Section 4700), and shall notify the department of the reason for not meeting the deadline. At the time of intake, the regional center shall inform the consumer and, if appropriate, the consumers parents, legal guardian or conservator, or authorized representative, of the services available through the state council and the protection and advocacy agency designated by the Governor pursuant to federal law, and shall provide the address and telephone numbers of those agencies.
(d)(1)As part of the initial individual program plan meeting and each annual review required by subdivision (b) of Section 4646.5, the consumer or, if appropriate, their parents, legal guardian, conservator, or authorized representative, shall be provided by the service coordinator oral and written information about the Self-Determination Program. The information shall include each of the provisions specified in subdivision (d) of Section 4685. Each individual program plan shall include a provision stating that the consumer or authorized representative was informed about the availability of the Self-Determination Program. If the consumer chooses not to participate in the program, the individual program plan shall include an explanation of the reason or reasons for that decision, or, if the consumer is ineligible for the program, the reason or reasons for that ineligibility.
(2)If the consumer is interested in participating in the program or wants additional information or assistance, the service coordinator, within five days of expressing the interest, shall provide the consumer a date for the Self-Determination Program orientation, training resources, dates of local volunteer Self-Determination Program advisory committee meetings, and other information to assist the consumer in participating in the program.
(e)Individual program plans shall be prepared jointly by the planning team. Decisions concerning the consumers goals, objectives, and services and supports that will be included in the consumers individual program plan and purchased by the regional center or obtained from generic agencies shall be made by agreement between the regional center representative and the consumer or, if appropriate, the parents, legal guardian, conservator, or authorized representative at the program plan meeting.
(f)Regional centers shall comply with the request of a consumer or, if appropriate, the request of the consumers parents, legal guardian, conservator, or authorized representative, that a designated representative receive written notice of all meetings to develop or revise the individual program plan and of all notices sent to the consumer pursuant to Section 4710. The designated representative may be a parent or family member.
(g)Notwithstanding any other law, a meeting regarding the provision of services and supports by the regional center, including a meeting to develop or revise the individual program plan, shall be held by remote electronic communications if requested by the consumer or, if appropriate, if requested by the consumers parents, legal guardian, conservator, or authorized representative.
(h)At the conclusion of an individual program plan meeting, an authorized representative of the regional center shall provide to the consumer, in written or electronic format, a list of the agreed-upon services and supports and the start date, the frequency and duration of the services and supports, and the provider, and a summary page written in plain language. The identified services and supports specified in an individual program plan referred to a provider shall begin on the date specified in the plan. In the event the services or supports are not started by the provider within 45 days of the specified start date, a referral shall be made within 14 days to another provider for delivery of the specified services and supports. The authorized representative of the regional center shall sign the list of agreed-upon services and supports at that time. The consumer, or if appropriate, the consumers parent, legal guardian, conservator, or authorized representative shall sign the list of agreed-upon services and supports prior to its implementation. The consumer, or if appropriate, the consumers parent, legal guardian, conservator, or authorized representative, may elect to delay receipt of the list of agreed-upon services and supports pending final agreement, as described in subdivision (h). If the consumer, or if appropriate, the consumers parent, legal guardian, conservator or authorized representative, elects to delay the receipt of the list of agreed-upon services and supports for 15 days, the list shall be provided in the preferred language of the consumer, or of the consumers parent, legal guardian, or authorized representative.
(i)If a final agreement regarding the services and supports to be provided to the consumer cannot be reached at a program plan meeting, then a subsequent program plan meeting shall be convened within 15 days, or later at the request of the consumer or, if appropriate, the parents, legal guardian, conservator, or authorized representative or if agreed to by the planning team. The list of the agreed-upon services and supports described in subdivision (h) and signed by the authorized representative of the regional center shall be provided, in writing or electronically, at the conclusion of the subsequent program plan meeting, and shall be provided in the preferred language of the consumer, or of the consumers parent, legal guardian, conservator, or authorized representative. Additional program plan meetings may be held with the agreement of the regional center representative and the consumer or, if appropriate, the parents, legal guardian, conservator, or authorized representative.
(j)An authorized representative of the regional center and the consumer or, if appropriate, the consumers parent, legal guardian, conservator, or authorized representative shall sign the individual program plan and the list of the agreed-upon services and supports prior to its implementation. If the consumer or, if appropriate, the consumers parent, legal guardian, conservator, or authorized representative, does not agree with all components of the individual program plan, the consumer may indicate that disagreement on the plan. Disagreement with specific plan components shall not prohibit the implementation of services and supports agreed to by the consumer or, if appropriate, the consumers parent, legal guardian, conservator, or authorized representative. If the consumer or, if appropriate, the consumers parent, legal guardian, conservator, or authorized representative, does not agree with the plan in whole or in part, the consumer shall be sent written notice of their appeal rights, as required by Sections 4701 and 4710.
(k)(1)A regional center shall communicate in the consumers preferred language, or, if appropriate, the preferred language of the consumers family, legal guardian, conservator, or authorized representative, during the planning process for the individual program plan, including during the program plan meeting, and including providing alternative communication services, as required by Sections 11135 to 11139.8, inclusive, of the Government Code and implementing regulations.
(2)A regional center shall provide alternative communication services, including providing copies of the list of services and supports, and the individual program plan in the preferred language of the consumer or the consumers family, legal guardian, conservator, or authorized representative, or both, as required by Sections 11135 to 11139.8, inclusive, of the Government Code and implementing regulations.
(3)The preferred language of the consumer or the consumers family, legal guardian, conservator, or authorized representative, or both, shall be documented in the individual program plan.
SEC. 14.Section 4646.4 of the Welfare and Institutions Code is amended to read:4646.4.(a)Regional centers shall ensure, at the time of development, scheduled review, or modification of a consumers individual program plan developed pursuant to Sections 4646 and 4646.5, or of an individualized family service plan pursuant to Section 95020 of the Government Code, the establishment of an internal process. This internal process shall ensure adherence with federal and state law and regulation, and if purchasing services and supports, shall ensure all of the following:
(1)Conformance with the regional centers purchase of service policies, as approved by the department pursuant to subdivision (d) of Section 4434.
(2)Utilization of generic services and supports if appropriate. The individualized family service planning team for infants and toddlers eligible under Section 95014 of the Government Code and the individual program plan team pursuant to Section 4646 may determine that a service provided by a generic agency, as defined by subdivision (g) of Section 4659.5, or a service or source of funding contained in Section 4659 identified in the individualized family service plan or individual program plan is not available, and, therefore, will be funded by the regional center.
(3)Utilization of other services and sources of funding as contained in Section 4659.
(4)Consideration of the familys responsibility for providing similar services and supports for a minor child without disabilities in identifying the consumers service and support needs as provided in the least restrictive and most appropriate setting. In this determination, regional centers shall take into account the consumers need for extraordinary care, services, supports and supervision, and the need for timely access to this care.
(5)Commencing October 1, 2022, consideration of information obtained from the consumer and, if appropriate, the parents, legal guardian, conservator, or authorized representative about the consumers need for the services, barriers to service access, and other information.
(b)At the time of development, scheduled review, or modification of a consumers individual program plan developed pursuant to Sections 4646 and 4646.5, or of an individualized family service plan pursuant to Section 95020 of the Government Code, the consumer, or, if appropriate, the parents, legal guardian, or conservator, shall provide copies of their health benefit cards under which the consumer is eligible to receive health benefits, including, but not limited to, private health insurance, a health care service plan, Medi-Cal, Medicare, and TRICARE. If the individual, or, if appropriate, the parents, legal guardians, or conservators, do not have health benefits, the regional center shall not use that fact to negatively impact the services that the individual may or may not receive from the regional center.
(c)Final decisions regarding the consumers individual program plan shall be made pursuant to Section 4646.
(d)Final decisions regarding the individualized family service plan shall be made pursuant to Section 95020 of the Government Code.
SEC. 15.Section 4646.5 of the Welfare and Institutions Code is amended to read:4646.5.(a)The planning process for the individual program plan described in Section 4646 shall include all of the following:
(1)Gathering information and conducting assessments to determine the life goals, capabilities and strengths, preferences, barriers, and concerns or problems of the person with developmental disabilities. For children with developmental disabilities, this process should include a review of the strengths, preferences, and needs of the child and the family unit as a whole. Assessments shall be conducted by qualified individuals and performed in natural environments whenever possible. Information shall be taken from the consumer, the consumers parents and other family members, the consumers friends, advocates, authorized representative, if applicable, providers of services and supports, and other agencies. The assessment process shall reflect awareness of, and sensitivity to, the lifestyle and cultural background of the consumer and the family.
(2)A statement of goals, based on the needs, preferences, and life choices of the individual with developmental disabilities, and a statement of specific, time-limited objectives for implementing the persons goals and addressing the persons needs. These objectives shall be stated in terms that allow measurement of progress or monitoring of service delivery. These goals and objectives should maximize opportunities for the consumer to develop relationships, be part of community life in the areas of community participation, housing, work, school, and leisure, increase control over the consumers life, acquire increasingly positive roles in community life, and develop competencies to help accomplish these goals.
(3)In developing individual program plans for children, regional centers shall be guided by the principles, process, and services and support parameters set forth in Section 4685.
(4)In developing an individual program plan for a transition age youth or working age adult, the planning team shall consider the Employment First Policy described in Chapter 14 (commencing with Section 4868).
(5)A schedule of the type and amount of services and supports to be purchased by the regional center or obtained from generic agencies or other resources in order to achieve the individual program plan goals and objectives, and identification of the provider or providers of service responsible for attaining each objective, including, but not limited to, vendors, contracted providers, generic service agencies, and natural supports. The individual program plan shall specify the approximate scheduled start date for services and supports and shall contain timelines for actions necessary to begin services and supports, including generic services. In addition to the requirements of subdivision (h) of Section 4646, each regional center shall offer, and upon request provide, a written copy of the individual program plan to the consumer, and, if appropriate, the consumers parents, legal guardian or conservator, or authorized representative within 45 days of their request in a threshold language, as defined by paragraph (3) of subdivision (a) of Section 1810.410 of Title 9 of the California Code of Regulations.
(6)If agreed to by the consumer, the parents, legally appointed guardian, or authorized representative of a minor consumer, or the legally appointed conservator of an adult consumer or the authorized representative, including those appointed pursuant to subdivision (a) of Section 4541, subdivision (b) of Section 4701.6, and subdivision (e) of Section 4705, a review of the general health status of the adult or child, including medical, dental, and mental health needs, shall be conducted. This review shall include a discussion of current medications, any observed side effects, and the date of the last review of the medication. Service providers shall cooperate with the planning team to provide any information necessary to complete the health status review. If any concerns are noted during the review, referrals shall be made to regional center clinicians or to the consumers physician, as appropriate. Documentation of health status and referrals shall be made in the consumers record by the service coordinator.
(7)(A)The development of a transportation access plan for a consumer when all of the following conditions are met:
(i)The regional center is purchasing private, specialized transportation services or services from a residential, day, or other provider, excluding vouchered service providers, to transport the consumer to and from day or work services.
(ii)The planning team has determined that a consumers community integration and participation could be safe and enhanced through the use of public transportation services.
(iii)The planning team has determined that generic transportation services are available and accessible.
(B)To maximize independence and community integration and participation, the transportation access plan shall identify the services and supports necessary to assist the consumer in accessing public transportation and shall comply with Section 4648.35. These services and supports may include, but are not limited to, mobility training services and the use of transportation aides. Regional centers are encouraged to coordinate with local public transportation agencies.
(8)A schedule of regular periodic review and reevaluation to ascertain that planned services have been provided, that objectives have been fulfilled within the times specified, and that consumers and families are satisfied with the individual program plan and its implementation.
(b)For all active cases, individual program plans shall be reviewed and modified by the planning team, through the process described in Section 4646, as necessary, in response to the persons achievement or changing needs, and no less often than once every 12 months. If the consumer or, if appropriate, the consumers parents, legal guardian, authorized representative, or conservator requests an individual program plan review, the individual program plan shall be reviewed within 30 days after the request is submitted, or no later than 7 days after the request is submitted if necessary for the consumers health and safety or to maintain the consumer in their home.
(c)(1)The department, with the participation of representatives of a statewide consumer organization, the Association of Regional Center Agencies, an organized labor organization representing service coordination staff, and the state council shall prepare training material and a standard format and instructions for the preparation of individual program plans, which embody a person-centered planning process consistent with federal law, regulations, and guidance.
(2)The department shall require each regional center to use, for all new and modified individual program plans, the training materials and the standard format plan prepared by the department pursuant to paragraph (1) by no later than March 1, 2024.
(3)The department shall biennially review a random sample of individual program plans at each regional center to ensure that these plans are being developed and modified in compliance with Section 4646 and this section.
SEC. 16.Section 4646.51 is added to the Welfare and Institutions Code, to read:4646.51.(a)If any services or supports that require an assessment are requested by a consumer at any time after an individual program plan is in place, and for as long as the individual remains eligible for services, the assessment shall be completed, at no cost to the consumer, within 30 days from the date of request.
(b)(1)If the assessment recommends services or supports, the services or supports shall be authorized by the regional center within seven days and the consumer shall be referred to a provider within seven days from the date of the authorization.
(2)If the services or supports are not commenced by the provider within 45 days of the referral, a referral shall be made to another provider within seven days for the specified services and supports.
(c)A consumer shall be entitled to an adequate notice of action and the appeal procedures in Chapter 7 (commencing with Section 4700) if the regional center does not comply with the deadlines specified in this section.
SEC. 17.Section 4647 of the Welfare and Institutions Code is amended to read:4647.(a)Pursuant to Section 4640.7, service coordination shall include those activities necessary to implement an individual program plan, including, but not limited to, participation in the individual program plan process; assurance that the planning team considers all appropriate options for meeting each individual program plan objective; securing, through purchasing or by obtaining from generic agencies or other resources, services and supports specified in the persons individual program plan; coordination of service and support programs; collection and dissemination of information; and monitoring implementation of the plan to ascertain that objectives have been fulfilled and to assist in revising the plan as necessary, and ensuring service coordinators are accessible to consumers and their representatives by telephone and other electronic means, which shall include responding to consumer inquiries within two business days of the inquiry.
(b)The regional center shall ensure that every consumer has a service coordinator who shall be responsible for implementing, overseeing, and monitoring each individual program plan. The service coordinator may be an employee of the regional center or may be a qualified individual or employee of an agency with whom the regional center has contracted to provide service coordination services, or persons described in Section 4647.2. The regional center shall provide the consumer or, where appropriate, the consumers parents, legal guardian, or conservator or authorized representative, with written notification of any temporary or permanent change in the assigned service coordinator within 10 business days. A person shall not continue to serve as a service coordinator for any individual program plan unless there is agreement by all parties that the person should continue to serve as service coordinator.
(c)Where appropriate, a consumer or the consumers parents or other family members, legal guardian, or conservator, may perform all or part of the duties of the service coordinator described in this section if the regional center director agrees and it is feasible.
(d)If a person described in subdivision (c) is designated as the service coordinator, that person shall not deviate from the agreed-upon program plan and shall provide any reasonable information and reports required by the regional center director.
(e)If a person described in subdivision (c) is designated as the service coordinator, the regional center shall provide ongoing information and support as necessary, to assist the person to perform all or part of the duties of service coordinator.
SEC. 18.Section 4659 of the Welfare and Institutions Code is amended to read:4659.(a)Except as otherwise provided in subdivision (b), (d), or (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 centers purchase of services budget, except as it relates to federal supplemental security income and the state supplementary program.
(c)Effective July 1, 2009, notwithstanding any other law or regulation, 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 Supportive Services, California Childrens 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 after being advised of the provisions of subdivision (d). If, on July 1, 2009, a regional center is purchasing that service as part of a consumers individual program plan (IPP), the prohibition shall take effect on October 1, 2009.
(d)(1) Notwithstanding Section 4646.4, a regional center may request a consumer or family member to pursue a service or source of funding from an entity described in subdivision (a) or (c) of this section, or pursuant to subdivision (g) of Section 4659.5, if the request is documented with specificity in the individual program plan or individualized family plan and the plan contains detailed instructions for the consumer or family pursuing the service. The individual program plan or individualized family plan shall also specify the ways in which the regional center will initially assist the consumer or family to apply for and pursue the service or source of funding and specify that it will provide additional assistance when requested by the consumer or family.
(2)The regional center shall purchase the service when either of the following occurs:
(A)The entity denies the service.
(B)The entity does not provide the requested service within 45 days from the date of the request, or 15 days after the statutory or regulatory time limit, if any, for the entity to make an initial decision, whichever is shorter.
(3)A consumer, or their family, shall not be required to appeal an entitys denial of the requested service for the regional center to purchase that service pursuant to this subdivision. The regional center may file an appeal on behalf of the consumer, but the appeal shall not delay the payment of the requested service by the regional center as specified in subparagraph (B) of paragraph (2).
(4)This section does not prohibit a consumer or their family, where appropriate, from filing a formal appeal of an entitys denial of the service at issue, or a regional center from seeking reimbursement from the entity it believes is responsible for providing the service and from requesting assistance with filing the appeal or from utilizing assistance from other advocacy organizations.
(e)This section shall not 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.
(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.
(g)(1)To provide uniformity, consistency, and cost-effectiveness, to reduce barriers, and to increase the number of service providers throughout the state, the department shall comprehensively review the current processes for vendorizing providers for the delivery of services and supports to regional center consumers and revise those processes to streamline the process and create a uniform statewide vendorization process. The department shall develop the revised processes, in consultation with the Association of Regional Center Agencies, consumers and their families, advocacy organizations, and service providers.
(2)It is the intent of the Legislature to ensure that a service provider vendored in one regional center shall automatically, without additional requirements, be eligible to provide services in all regional centers. It is the further intent of the Legislature that this section shall not be construed to control or interfere with the discretion of the individual program planning team to determine the needs and services appropriate for each person with a developmental disability who is entitled to services under this division.
SEC. 19.Section 4659.3 is added to the Welfare and Institutions Code, to read:4659.3.(a)No later than March 1, 2024, and on March 1 annually thereafter, the department shall submit a report to the Legislature and post on its internet website the following data, statewide and for each regional center, broken down by qualifying disability category, race or ethnicity, and age categories 021 years of age, 2264 years of age, and 65 years of age and over:
(1)The number of consumers for whom health and safety waivers have been requested.
(2)The number of consumers for whom health and safety waivers have been granted.
(3)The number of days elapsed between the date on which the department received the health and safety waiver request worksheet from the service provider and the date the service provider was notified of the outcome.
(4)The percentage of health and safety waiver requests that are due to behavioral challenges.
(b)The department shall also post on its internet website brief summaries, with any individual identifying information redacted, of the health and safety risks and challenges, and the service changes that are necessary to protect the health and safety, of the affected consumer or consumers, contained in each health and safety waiver request worksheet received by the department.
SEC. 20.Section 4685.8 of the Welfare and Institutions Code is amended to read:4685.8.(a)The department shall implement a statewide Self-Determination Program. The Self-Determination Program shall 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. As of July 1, 2021, the program shall begin to be available on a voluntary basis to all regional center consumers who are eligible for the Self-Determination Program.
(b)The department, in establishing the statewide program, shall do both of the following:
(1)Set targets and benchmarks as set forth in paragraph (1) of subdivision (r).
(2)Address all of the following:
(A)Oversight of expenditure of self-determined funds and the achievement of participant outcomes over time.
(B)Increased participant control over which services and supports best meet the participants needs and the IPP objectives. A participants unique support system may include the purchase of existing service offerings from service providers or local businesses, hiring their own support workers, or negotiating unique service arrangements with local community resources.
(C)Comprehensive person-centered planning, including an individual budget and services that are outcome based.
(D)Consumer and family training to ensure understanding of the principles of self-determination, the planning process, and the management of budgets, services, and staff.
(E)Choice of independent facilitators, who meet standards and certification requirements established by the department, and who can assist with the functions specified in paragraph (2) of subdivision (c).
(F)Choice of financial management services providers who meet standards and certification requirements established by the department, and who can carry out the functions specified in paragraph (1) of subdivision (c).
(G)Innovation that will more effectively allow participants to achieve their goals.
(H)Long-term sustainability of the Self-Determination Program by doing all of the following:
(i)Requiring IPP teams, when developing the individual budget, to determine the services, supports, and goods necessary for each consumer based on the needs and preferences of the consumer and, when appropriate, the consumers family, the effectiveness of each option in meeting the goals specified in the IPP, and the cost-effectiveness of each option, as specified in subparagraph (D) of paragraph (6) of subdivision (a) of Section 4648.
(ii)The department may review final individual budgets that are at or above a spending threshold determined by the department of all individual budgets and use information from its review in the aggregate to develop additional program guidance and verify compliance with federal and state laws and other requirements.
(c)For purposes of this section, the following definitions apply:
(1)Financial management services means services or functions that assist the participant to manage and direct the distribution of funds contained in the individual budget, and ensure that the participant has the financial resources to implement their IPP throughout the year. These may include bill paying services and activities that facilitate the employment of service and support workers by the participant, including, but not limited to, fiscal accounting, tax withholding, compliance with relevant state and federal employment laws, assisting the participant in verifying provider qualifications, including criminal background checks, and expenditure reports. The financial management services provider shall meet the applicable requirements of Title 17 of the California Code of Regulations and other specific qualifications or certifications established by the department.
(2)Independent facilitator means a person, selected and directed by the participant, who is not otherwise providing services to the participant pursuant to their IPP and is not employed by a person providing services to the participant. The independent facilitator may assist the participant in making informed decisions about the individual budget, and in locating, accessing, and coordinating services and supports consistent with the participants IPP. The independent facilitator is available to assist in identifying immediate and long-term needs, developing options to meet those needs, leading, participating, or advocating on behalf of the participant in the person-centered planning process and development of the IPP, and obtaining identified services and supports. The cost of the independent facilitator, if any, shall be paid by the participant out of the participants individual budget. An independent facilitator shall receive training in the principles of self-determination, the person-centered planning process, and the other responsibilities described in this paragraph at the independent facilitators own cost. The independent facilitator shall meet standards and certification requirements established by the department.
(3)Individual budget means the amount of regional center purchase of service funding available to the participant for the purchase of services and supports necessary to implement the IPP. The individual budget shall be determined using a fair, equitable, and transparent methodology.
(4)IPP means individual program plan, as described in Section 4646.
(5)Participant means an individual and, when appropriate, the participants parents, legal guardian or conservator, or authorized representative, who has been deemed eligible for, and has voluntarily agreed to participate in, the Self-Determination Program.
(6)Self-determination means a voluntary delivery system consisting of a defined and comprehensive mix of services and supports, selected and directed by a participant through person-centered planning, in order to meet the objectives in their IPP. Self-determination services and supports are designed to assist the participant to achieve personally defined outcomes in community settings that promote inclusion. The Self-Determination Program shall only fund services and supports provided pursuant to this division that the federal Centers for Medicare and Medicaid Services determines are eligible for federal financial participation.
(7)Spending Plan means the plan the participant develops to use their available individual budget funds to purchase goods, services, and supports necessary to implement their individual program plan (IPP). The spending plan shall identify the cost of each good, service, and support that will be purchased with regional center funds. The total amount of the spending plan cannot exceed the amount of the individual budget. A copy of the spending plan shall be attached to the participants IPP.
(d)Participation in the Self-Determination Program is fully voluntary. A participant may choose to participate in, and may choose to leave, the Self-Determination Program at any time. A regional center shall not require or prohibit participation in the Self-Determination Program as a condition of eligibility for, or the delivery of, services and supports otherwise available under this division. Participation in the Self-Determination Program shall be available to any regional center consumer who meets the following eligibility requirements:
(1)The participant has a developmental disability, as defined in Section 4512, and is receiving services pursuant to this division.
(2)The consumer does not live in a licensed long-term health care facility, as defined in paragraph (44) of subdivision (a) of Section 54302 of Title 17 of the California Code of Regulations. An individual and, when appropriate, the individuals parent, legal guardian or conservator, or authorized representative, who is not eligible to participate in the Self-Determination Program pursuant to this paragraph may request that the regional center provide person-centered planning services in order to make arrangements for transition to the Self-Determination Program, provided that the individual is reasonably expected to transition to the community within 90 days. In that case, the regional center shall initiate person-centered planning services within 60 days of that request.
(3)The participant agrees to all of the following terms and conditions:
(A)The participant shall receive an orientation that meets the standards set or developed by the department to the Self-Determination Program prior to enrollment, which includes the principles of self-determination, the role of the independent facilitator and the financial management services provider, person-centered planning, and development of a budget.
(B)The participant shall utilize the services and supports available within the Self-Determination Program only when generic services and supports are not available.
(C)The participant shall only purchase services and supports necessary to implement their IPP and shall comply with any and all other terms and conditions for participation in the Self-Determination Program described in this section.
(D)The participant shall manage Self-Determination Program services and supports within the participants individual budget.
(E)The participant shall utilize the services of a financial management services provider of their own choosing and who is vendored by a regional center and who meets the qualifications in paragraph (1) of subdivision (c).
(F)The participant may utilize the services of an independent facilitator of their own choosing for the purpose of providing services and functions as described in paragraph (2) of subdivision (c). If the participant elects not to use an independent facilitator, the participant may use their regional center service coordinator to provide the services and functions described in paragraph (2) of subdivision (c).
(G)If eligible, with the assistance of the regional center, if needed, timely apply for Medi-Cal in order to maximize federal funding. The participant may consider institutional deeming in order to qualify for Medi-Cal services.
(e)A participant who is not Medi-Cal eligible may participate in the Self-Determination Program and receive self-determination services and supports if all other program eligibility requirements are met and the services and supports are otherwise eligible for federal financial participation.
(f)The additional federal financial participation funds generated by the former participants of the self-determination pilot projects authorized pursuant to Section 13 of Chapter 1043 of the Statutes of 1998, as amended, or pursuant to Article 4 (commencing with Section 4669.2) of Chapter 5, shall be used to maximize the ability of Self-Determination Program participants to direct their own lives and to ensure the department and regional centers successfully implement the program as follows:
(1)First, to offset the cost to the department for the criminal background check conducted pursuant to subdivision (v) and other administrative costs incurred by the department in implementing the Self-Determination Program.
(2)With the remaining funds, the department, in consultation with stakeholders, including a statewide self-determination advisory workgroup, shall prioritize the use of the funds to meet the needs of participants, increase service access and equity, and reduce disparities, and to implement the program, including costs associated with all of the following:
(A)Independent facilitators to assist with a participants initial person-centered planning meeting.
(B)Development of the participants initial individual budget.
(C)Joint training of consumers, family members, regional center staff, and members of the local volunteer advisory committee established pursuant to paragraph (1) of subdivision (w).
(D)Regional center operations to increase support for transition to the Self-Determination Program or for caseload ratio enhancement.
(E)To offset the costs to the regional centers in implementing the Self-Determination Program.
(F)To support the Statewide Self-Determination Advisory Committee established pursuant to paragraph (2) of subdivision (w).
(g)If at any time during participation in the Self-Determination Program a regional center determines that a participant is no longer eligible to continue in, or a participant voluntarily chooses to exit, the Self-Determination Program, the regional center shall provide for the participants transition from the Self-Determination Program to other services and supports. This transition shall include the development of a new IPP that reflects the services and supports necessary to meet the individuals needs. The regional center shall ensure that there is no gap in services and supports during the transition period.
(h)An individual determined to be ineligible for or who voluntarily exits the Self-Determination Program shall be permitted to return to the Self-Determination Program upon meeting all applicable eligibility criteria and upon approval of the participants planning team, as described in subdivision (j) of Section 4512. An individual who has voluntarily exited the Self-Determination Program shall not return to the program for at least 12 months.
(i)An individual who participates in the Self-Determination Program may elect to continue to receive self-determination services and supports if the individual transfers to another regional center catchment area, provided that the individual remains eligible for the Self-Determination Program pursuant to subdivision (d). The balance of the participants individual budget shall be reallocated to the regional center to which the participant transfers.
(j)The IPP team shall utilize the person-centered planning process to develop the IPP for a participant. The IPP shall detail the goals and objectives of the participant that are to be met through the purchase of participant-selected services and supports. The IPP team shall determine the individual budget to ensure the budget assists the participant to achieve the outcomes set forth in the participants IPP and ensures their health and safety. The completed individual budget shall be attached to the IPP.
(k)The participant shall implement their IPP, including choosing and purchasing the services and supports allowable under this section necessary to implement the plan. A participant is exempt from the cost control restrictions regarding the purchases of services and supports pursuant to Section 4648.5. A regional center shall not prohibit the purchase of any service or support that is otherwise allowable under this section.
(l)A participant shall have all the rights established in Sections 4646 to 4646.6, inclusive, and Chapter 7 (commencing with Section 4700).
(m)(1)Except as provided in paragraph (4), the IPP team shall determine the initial and any revised individual budget for the participant using the following methodology:
(A)(i)Except as specified in clause (ii), for a participant who is a current consumer of the regional center, their individual budget shall be the total amount of the most recently available 12 months of purchase of service expenditures for the participant.
(ii)An adjustment may be made to the amount specified in clause (i) if both of the following occur:
(I)The IPP team determines that an adjustment to this amount is necessary due to a change in the participants circumstances, needs, or resources that would result in an increase or decrease in purchase of service expenditures, or the IPP team identifies prior needs or resources that were unaddressed in the IPP, which would have resulted in an increase or decrease in purchase of service expenditures. When adjusting the budget, the IPP team shall document the specific reason for the adjustment in the IPP.
(II)The regional center certifies on the individual budget document that regional center expenditures for the individual budget, including any adjustment, would have occurred regardless of the individuals participation in the Self-Determination Program.
(iii)For purposes of clauses (i) and (ii), the amount of the individual budget shall not be increased to cover the cost of the independent facilitator.
(B)For a participant who is either newly eligible for regional center services or who does not have 12 months of purchase service expenditures, the participants individual budget shall be calculated as follows:
(i)The IPP team shall identify the services and supports needed by the participant and available resources, as required by Section 4646.
(ii)The regional center shall calculate the cost of providing the services and supports to be purchased by the regional center by using the average cost paid by the regional center for each service or support unless the regional center determines that the consumer has a unique need that requires a higher or lower cost. The IPP team also shall document the specific reason for the adjustment in the IPP. The regional center shall certify on the individual budget document that this amount would have been expended using regional center purchase of service funds regardless of the individuals participation in the Self-Determination Program.
(iii)For purposes of clauses (i) and (ii), the amount of the individual budget shall not be increased to cover the cost of the independent facilitator.
(2)The amount of the individual budget shall be available to the participant each year for the purchase of program services and supports. An individual budget shall be calculated no more than once in a 12-month period, unless revised to reflect a change in circumstances, needs, or resources of the participant using the process specified in clause (ii) of subparagraph (A) of paragraph (1).
(3)The spending plan shall be assigned to uniform budget categories developed by the department in consultation with stakeholders and distributed according to the timing of the anticipated expenditures in the IPP and in a manner that ensures that the participant has the financial resources to implement the IPP throughout the year.
(4)The department, in consultation with stakeholders, may develop alternative methodologies for individual budgets that are computed in a fair, transparent, and equitable manner and are based on consumer characteristics and needs, and that include a method for adjusting individual budgets to address a participants change in circumstances or needs.
(n)Annually, participants may transfer up to 10 percent of the funds originally distributed to any budget category set forth in paragraph (3) of subdivision (m) to another budget category or categories. Transfers in excess of 10 percent of the original amount allocated to any budget category may be made upon the approval of the regional center or the participants IPP team.
(o)Consistent with the implementation date of the IPP, the IPP team shall annually ascertain from the participant whether there are any circumstances or needs that require a change to the annual individual budget. Based on that review, the IPP team shall calculate a new individual budget consistent with the methodology identified in subdivision (m).
(p)(1)The department, as it determines necessary, may adopt regulations to implement the procedures set forth in this section. Any regulations shall be adopted in accordance with the requirements of Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code.
(2)Notwithstanding paragraph (1) and Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, and only to the extent that all necessary federal approvals are obtained, the department, without taking any further regulatory action, shall implement, interpret, or make specific this section by means of program directives or similar instructions until the time regulations are adopted. It is the intent of the Legislature that the department be allowed this temporary authority as necessary to implement program changes only until completion of the regulatory process.
(q)The department, in consultation with stakeholders, shall develop informational materials about the Self-Determination Program. The department shall ensure that regional centers are trained in the principles of self-determination, the mechanics of the Self-Determination Program, and the rights of consumers and families as candidates for, and participants in, the Self-Determination Program.
(r)Each regional center shall be responsible for implementing the Self-Determination Program as a term of its contract under Section 4629. As part of implementing the program, the regional center shall do all of the following:
(1)Meet the Self-Determination Program targets approved by the department, meet benchmarks established by the department in areas including timely enrollment, diversity of consumers served, and reduction of disparities in the individual budget of participants from racial and ethnic communities, and be eligible for incentives for exceeding these targets and benchmarks once the department has established a performance incentives program.
(2)Develop and implement an outreach and training plan about the Self-Determination Program for the diverse communities served by the regional center, including in congregate settings. Information shall be provided in plain language, in alternative formats and alternative modes of communication, and provide language access as required by state and federal law. Obtain input from stakeholders, including consumers and families, that reflect the ethnic and language diversity of the regional centers consumers, about the effectiveness of this outreach and training and other activities that may be effective in reducing disparities in these programs.
(3)Annually report the enrollment, individual budget data, and purchase of service expenditure data for the Self-Determination Program consistent with the criteria in subdivisions (a) to (c), inclusive, of Section 4519.5.
(4)Assist eligible participants and their families in applying for Medi-Cal, in order to maximize federal funding and assist interested participants who wish to pursue institutional deeming in order to qualify for Medi-Cal services.
(5)At least annually, in addition to annual certification, conduct an additional review of all final individual budgets for participants at the regional center which are at or above a spending threshold that is specified by the department through directive consistent with federal and state requirements. This information may be used in the aggregate to provide training, program guidance, and verify compliance with state and federal requirements.
(6)Review the spending plan to verify that goods and services eligible for federal financial participation are not used to fund goods or services available through generic agencies.
(7)Contract with local consumer or family-run organizations and consult with the local volunteer advisory committee established pursuant to paragraph (1) of subdivision (w) to conduct outreach through local meetings or forums to consumers and their families to provide information about the Self-Determination Program and to help ensure that the program is available to a diverse group of participants, with special outreach to underserved communities.
(8)Collaborate with the local consumer or family-run organizations identified in paragraph (1) to jointly conduct training about the Self-Determination Program. The regional center shall consult with the local volunteer advisory committee established pursuant to paragraph (1) of subdivision (w) in planning for the training, and the local volunteer advisory committee may designate members to represent the advisory committee at the training.
(9)Train all service coordinators and fair hearing specialists in the principles of self-determination, the mechanics of the Self-Determination Program, and the rights of consumers and families. The training shall be conducted in collaboration with the local volunteer advisory committee.
(10)Provide payment to the financial management services provider for spending plan expenses through a not less than semimonthly pay schedule.
(11)Ensure that each individual plan includes the information required by subdivision (d) of Section 4646.
(s)The financial management services provider shall provide the participant and the regional center service coordinator with a monthly individual budget statement that describes the amount of funds allocated by budget category, the amount spent in the previous 30-day period, and the amount of funding that remains available under the participants individual budget.
(t)Only the financial management services provider is required to apply for vendorization in accordance with Subchapter 2 (commencing with Section 54300) of Chapter 3 of Division 2 of Title 17 of the California Code of Regulations for the Self-Determination Program. All other service and support providers shall not be on the federal debarment list and shall have applicable state licenses, certifications, or other state required documentation, including documentation of any other qualifications required by the department, but are exempt from the vendorization requirements set forth in Title 17 of the California Code of Regulations when serving participants in the Self-Determination Program.
(u)The regional center shall pay the full costs of the participants financial management services provider.
(v)To protect the health and safety of participants in the Self-Determination Program, the department shall require a criminal background check in accordance with all of the following:
(1)The department shall issue a program directive that identifies nonvendored providers of services and supports who shall obtain a criminal background check pursuant to this subdivision. At a minimum, these staff shall include both of the following:
(A)Individuals who provide direct personal care services to a participant.
(B)Other nonvendored providers of services and supports for whom a criminal background check is requested by a participant or the participants financial management service.
(2)Subject to the procedures and requirements of this subdivision, the department shall administer criminal background checks consistent with the departments authority and the process described in Sections 4689.2 to 4689.6, inclusive.
(3)The department shall electronically submit to the Department of Justice fingerprint images and related information required by the Department of Justice of nonvendored providers of services and supports, as specified in paragraph (1), for purposes of obtaining information as to the existence and content of a record of state or federal convictions and state or federal arrests and also information as to the existence and content of a record of state or federal arrests for which the Department of Justice establishes that the person is free on bail or on their own recognizance pending trial or appeal.
(4)When received, the Department of Justice shall forward to the Federal Bureau of Investigation requests for federal summary criminal history information received pursuant to this section. The Department of Justice shall review the information returned from the Federal Bureau of Investigation and compile and disseminate a response to the department.
(5)The Department of Justice shall provide a state or federal response to the department pursuant to paragraph (1) of subdivision (p) of Section 11105 of the Penal Code.
(6)The department shall request from the Department of Justice subsequent notification service, as provided pursuant to Section 11105.2 of the Penal Code, for persons described in paragraph (1).
(7)The Department of Justice shall charge a fee sufficient to cover the cost of processing the request described in this subdivision.
(8)The fingerprints of any provider of services and supports who is required to obtain a criminal background check shall be submitted to the Department of Justice prior to employment. The costs of the fingerprints and the financial management services administrative cost authorized by the department shall be paid by the services and supports provider or the providers employing agency. Any administrative costs incurred by the department pursuant to this subdivision shall be offset by the funds specified in subdivision (g).
(9)If the criminal record information report shows a criminal history, the department shall take the steps specified in Section 4689.2. The department may prohibit a provider of services and supports from becoming employed, or continuing to be employed, based on the criminal background check, as authorized in Section 4689.6. The provider of services and supports who has been denied employment shall have the rights set forth in Section 4689.6.
(10)The department may utilize a current department-issued criminal record clearance to enable a provider to serve more than one participant, as long as the criminal record clearance has been processed through the department and no subsequent arrest notifications have been received relative to the cleared applicant.
(11)Consistent with subdivision (h) of Section 4689.2, the participant or financial management service that denies or terminates employment based on written notification from the department shall not incur civil liability or unemployment insurance liability.
(w)To ensure the effective implementation of the Self-Determination Program and facilitate the sharing of best practices and training materials commencing with the implementation of the Self-Determination Program, local and statewide advisory committees shall be established as follows:
(1)Each regional center shall establish a local volunteer advisory committee to provide oversight of the Self-Determination Program and identify a regional center liaison to the committee. The regional center and the State Council on Developmental Disabilities shall each appoint one-half of the membership of the committee. The committee shall consist of the regional center clients rights advocate, consumers, family members, and other advocates, and community leaders, including a representative from a family resource center. A majority of the committee shall be consumers and their family members. The committee shall reflect the multicultural diversity and geographic profile of the catchment area. The committee shall review the development and ongoing progress of the Self-Determination Program, including whether the program advances the principles of self-determination and is operating consistent with the requirements of this section, and may make ongoing recommendations for improvement to the regional center and the department. Annually, the regional center shall confirm, in writing, that the committee meets the requirements specified in this paragraph and provide the department with the name of the staff liaison and the names of the committee members, the positions they fill on the committee, and which entity appointed them to the committee.
(2)The State Council on Developmental Disabilities shall form a volunteer committee, to be known as the Statewide Self-Determination Advisory Committee, comprised of the chairs of the 21 local advisory committees or their designees. The council shall convene the Statewide Self-Determination Advisory Committee twice annually, or more frequently in the sole discretion of the council. The Statewide Self-Determination Advisory Committee shall meet by teleconference or other means established by the council to identify self-determination best practices, effective consumer and family training materials, implementation concerns, systemic issues, ways to enhance the program, and recommendations regarding the most effective method for participants to learn of individuals who are available to provide services and supports. The council shall synthesize information received from the Statewide Self-Determination Advisory Committee, local advisory committees, and other sources, share the information with consumers, families, regional centers, and the department, and make recommendations, as appropriate, to increase the programs effectiveness in furthering the principles of self-determination.
(x)The department shall annually provide the following information to the appropriate policy and fiscal committees of the Legislature:
(1)Number and characteristics of participants, by regional center, including the number of participants who entered the program upon movement from a developmental center.
(2)Types and amount of services and supports purchased under the Self-Determination Program, by regional center.
(3)Range and average of individual budgets, by regional center, including adjustments to the budget to address the adjustments permitted in clause (ii) of subparagraph (A) of paragraph (1) of subdivision (m).
(4)The number and outcome of appeals concerning individual budgets, by regional center.
(5)The number and outcome of fair hearing appeals, by regional center.
(6)The number of participants who voluntarily withdraw from the Self-Determination Program and a summary of the reasons why, by regional center.
(7)The number of participants who are subsequently determined to no longer be eligible for the Self-Determination Program and a summary of the reasons why, by regional center.
(y)(1)The State Council on Developmental Disabilities shall issue an interim report to the Legislature, in compliance with Section 9795 of the Government Code, no later than June 30, 2021, on the status of the Self-Determination Program authorized by this section, barriers to its implementation, and recommendations to enhance the effectiveness of the program. The interim report shall provide an update to the programs status, each regional centers cap on participation and progress toward that cap, the most recent statewide and per-regional-center participant count, and the historical trend in the statewide participation count since the start of the program. The department shall assist in providing available information to the council in order to facilitate the timely issuance of the report.
(2)The council, in collaboration with the protection and advocacy agency identified in Section 4900 and the federally funded University Centers for Excellence in Developmental Disabilities Education, Research, and Service, may work with regional centers to survey participants regarding participant satisfaction under the Self-Determination Program and, when data is available, the traditional service delivery system, including the proportion of participants who report that their choices and decisions are respected and supported and who report that they are able to recruit and hire qualified service providers, and to identify barriers to participation and recommendations for improvement.
(3)The council, in collaboration with the protection and advocacy agency identified in Section 4900 and the federally funded University Centers for Excellence in Developmental Disabilities Education, Research, and Service, shall issue a report to the Legislature, in compliance with Section 9795 of the Government Code, by June 30, 2023, on the status of the Self-Determination Program authorized by this section, and provide recommendations to enhance the effectiveness of the program. This review shall include the programs effectiveness in furthering the principles of self-determination, including all of the following:
(A)Freedom, which includes the ability of adults with developmental disabilities to exercise the same rights as all citizens to establish, with freely chosen supporters, family and friends, where they want to live, with whom they want to live, how their time will be occupied, and who supports them; and for families to have the freedom to receive unbiased assistance of their own choosing when developing a plan and to select all personnel and supports to further the life goals of a minor child.
(B)Authority, which includes the ability of a person with a disability, or family, to control a certain sum of dollars in order to purchase services and supports of their choosing.
(C)Support, which includes the ability to arrange resources and personnel, both formal and informal, that will assist a person with a disability to live a life in the community that is rich in community participation and contributions.
(D)Responsibility, which includes the ability of participants to take responsibility for decisions in their own lives and to be accountable for the use of public dollars, and to accept a valued role in their community through, for example, competitive employment, organizational affiliations, spiritual development, and general caring of others in their community.
(E)Confirmation, which includes confirmation of the critical role of participants and their families in making decisions in their own lives and designing and operating the system that they rely on.
SEC. 21.Section 4726 of the Welfare and Institutions Code is amended to read:4726.Notwithstanding Sections 4639.76 and 5328, Section 5328, any exemption to the California Public Records Act (Division 10 (commencing with Section 7920.000) of Title 1 of the Government Code), or any other law that authorizes, but does not require, an entity to withhold all or part of a record on the basis of its confidentiality, access to records shall be provided to regarding an applicant for, or recipient of, services or to shall be provided, upon request, to the applicant, recipient, or their authorized representative, including the person appointed as a developmental services decisionmaker pursuant to Section 319, 361, or 726, for purposes of including, but not limited to, the appeal process under this chapter. chapter, unless disclosure of the record is expressly prohibited by law.
SEC. 22.Section 4731 of the Welfare and Institutions Code is amended to read:4731.(a)Each consumer or any representative acting on behalf of any consumer or consumers, who believes that any right to which a consumer is entitled has been abused, punitively withheld, or improperly or unreasonably denied by a regional center, state-operated facility, or service provider, may pursue a complaint as provided in this section.
(b)Any complaint made pursuant to this section shall be made to the Director of Developmental Services. The director, within 30 days of receiving a complaint, shall issue a written administrative decision and send a copy of the decision to the complainant, the director of the regional center or state-operated facility, and the service provider, if applicable.
(c)The department, on a quarterly basis, shall compile the number of complaints filed, by each regional center and state-operated facility, the subject matter of each complaint, and a summary of each decision, and post the compilation on its internet website at the end of each quarter. Copies of any decision included in the compilation shall be made available within 10 days, with all individually identifiable information redacted, to any person upon request.
(d)This section shall not be used to resolve disputes concerning the nature, scope, or amount of services and supports that should be included in an individual program plan, for which there is an appeals procedure established in this division, or disputes regarding rates or audit appeals for which there is an appeals procedure established in regulations. Those disputes shall be resolved through the appeals procedure established by this division or in regulations.
(e)All consumers or, if appropriate, their authorized representative, shall be notified in writing in their preferred language of the right to file a complaint pursuant to this section when they apply for services from a regional center or a state-operated facility, and at each regularly scheduled planning meeting.
This act shall be known, and may be cited, as the Disability Equity and Accountability Act of 2023.
SEC. 2.(a)The Legislature finds and declares as follows:
(1)Recent reports and hearings by the California State Auditor, the Little Hoover Commission, and advocacy organizations have found that Californias service system for the over 400,000 children and adults with intellectual and developmental disabilities through the Lanterman Act, as overseen by the State Department of Developmental Services, which contracts with 21 regional centers, is failing in significant ways to deliver critical, adequate, and timely services to individuals and families. The result is that individuals and families, particularly those of color, are unable to timely access services and supports, resulting in barriers to their living independent, productive, and integrated lives in their communities.
(2)Californias developmental disability service system is plagued with racial, ethnic, and geographic disparities that can dramatically impact the essential services received by children and adults with developmental disabilities. Systemic inequities and discrimination within Californias 21 regional centers broaden the gap between inclusive possibilities and segregated limitations. Data show Latinos are most negatively impacted by these disparities, but people who are clients of the lowest-performing regional centers are also significantly affected.
(3)California spends nearly $13,000,000,000 annually on the administration and delivery of developmental services, but lacks a transparent, common, integrated, and coordinated model for the delivery and measurement of services throughout the 21 regional centers, resulting in poor outcomes, poor satisfaction levels by consumer consumers and families, and disparate levels of available services and performance expectations.
(4)The delivery of services through 21 separate private nonprofit regional centers with separate boards, funding, and delivery models was originally intended to ensure that the delivery of services could be more effectively delivered through nonstate entities. However, with the subsequent caseload and budget growth since the enactment of the Lanterman Act, local administration has become more disparate and less accountable. Boards of directors are untrained and are not providing the oversight needed of the regional centers. Stronger state oversight of regional centers by the State Department of Developmental Services is essential to ensure that services are equitably delivered, performance and outcomes are uniformly measured and reported, and the system is transparent and accountable to individuals and families.
(5)The departments system lacks a statewide automated technology system for the delivery of services to persons with intellectual and developmental disabilities and, as a result, the current program is constrained by disparate automation systems, inadequate documentation, the lack of open system architecture, insufficient data to support administration of the system, and the lack of data to support program improvements for improving the quality of life outcomes through new service delivery methods.
(6)Statewide uniformity of service delivery practices and procedures is essential to an effective program and to support necessary oversight and research for ongoing program improvements.
(7)The departments technical infrastructure is over 40 years old. The lack of a statewide automation system does not meet current program needs and significantly contributes to the racial and geographic disparities in the delivery of services. California currently lacks clear and consistent service delivery outcomes for individuals with intellectual and developmental disabilities that sets high expectations for their quality of life, and must develop a system for measuring and quantifying the value of service delivery outcomes.
(8)A previous effort to develop an intellectual and developmental disabilities (IDD) program technology system failed. As a result, the department and regional centers maintain a patchwork of at least three case management and fiscal systems that are not integrated and six legacy case management automation systems that lack integration, have dissimilar data sources, and are technically outdated.
(9) In the 202122 annual budget the Legislature appropriated $6,000,000 to the State Department of Developmental Services for planning purposes related to the implementation of a uniform fiscal system and consumer electronic records management system. The department has not developed a vision or scope for a proposed system development approach.
(b)Therefore, it is the intent of the Legislature in enacting this act to do all of the following:
(1)Ensure that racial, ethnic, and geographic service disparities be systemically addressed and eliminated and that all people, regardless of their race or ethnicity or where they live, receive equitable access to services within the regional center system.
(2)Ensure that all regional centers offer and provide a consistent and common set of services and that the services are delivered in a timely way.
(3) Ensure that the delivery of all services and supports comply with federal law and guidance and are responsive to the needs and choices of beneficiaries receiving home- and community-based services, are person-centered and strengths-based, person centered and strengths based, have high expectations for interdependence, self-direction, and competitive competitive, integrated employment, provide support coordination to assist with a community supported community-supported life, and achieve a more consistent and coordinated approach to the administration of policies and procedures across the state.
(4)Provide the department with new tools for holding regional centers and service providers accountable through the development of a standardized and coordinated set of performance measures and related standards that establish targets and standards above which a regional center may receive incentives for improved performance, and a separate set of standards that require corrective action.
(5)Improve regional center governance by establishing new standards and procedures for regional center governing boards to ensure they can more effectively represent the communities they serve by providing them with greater independence and protection from regional center retaliation.
(6)Require the State Department of Developmental Services to develop a written project charter for the planning and development of a uniform statewide automation system that serves as a foundation document for the system development, which includes project guiding principles, scope, strategies and approach, and project governance, in order to provide transparency to the Legislature and the public on the system development as has been used with other statewide system development.
SEC. 3.Section 4519.5 of the Welfare and Institutions Code is amended to read:4519.5.(a)The department and the regional centers shall annually collaborate to compile data in a uniform manner relating to purchase of service authorization, utilization, and expenditure by each regional center with respect to all of the following:
(1)The age of the consumer, categorized by the following:
(A)Birth to two years of age, inclusive.
(B)Three to 21 years of age, inclusive.
(C)Twenty-two years of age and older.
(2)Race or ethnicity of the consumer.
(3)Preferred language spoken by the consumer, and other related details, as feasible.
(4)Disability detail, in accordance with the categories established by subdivision (a) of Section 4512, and, if applicable, a category specifying that the disability is unknown.
(5)Residence type, subcategorized by age, race or ethnicity, and preferred language.
(6)Number of instances when the written copy of the individual program plan was provided at the request of the consumer and, when appropriate, the consumers parents, legal guardian or conservator, or authorized representative, in a language other than a threshold language, as defined by paragraph (3) of subdivision (a) of Section 1810.410 of Title 9 of the California Code of Regulations, if that written copy was provided more than 60 days after the request.
(7)Number of instances when the written copy of the individual program plan was provided at the request of the consumer and, when appropriate, the consumers parents, legal guardian or conservator, or authorized representative, in a threshold language, as defined by paragraph (3) of subdivision (a) of Section 1810.410 of Title 9 of the California Code of Regulations, if that written copy was provided more than 45 days after the request, in violation of paragraph (5) of subdivision (a) of Section 4646.5.
(8)Beginning with data for the fiscal year of 202324, the numbers, percentages, and total and per capita expenditure and authorization amounts, by age, as applicable, according to race or ethnicity and preferred language, for all combined residence types and for consumers living in the family home, regarding the following service types:
(A)Camping and associated travel expenses.
(B)Social recreation activities.
(C)Educational services.
(D)Nonmedical therapies, including, but not limited to, specialized recreation, art, dance, and music.
(b)The data reported pursuant to subdivision (a) shall also include the number and percentage of individuals, categorized by age, race or ethnicity, and disability, and by residence type, as set forth in paragraph (5) of subdivision (a), who have been determined to be eligible for regional center services, but are not receiving purchase of service funds.
(c)By March 31, 2013, each regional center shall post the data described in this section that are specific to the regional center on its internet website. Commencing on December 31, 2013, each regional center shall annually post these data by December 31. Each regional center shall maintain all previous years data on its internet website.
(d)By March 31, 2013, the department shall post the information described in this section on a statewide basis on its internet website. Commencing December 31, 2013, the department shall annually post this information by December 31. The department shall maintain all previous years data on its internet website. The department shall also post notice of any regional center stakeholder meetings on its internet website.
(e)Within three months of compiling the data with the department, and annually thereafter, each regional center shall meet with stakeholders in one or more public meetings regarding the data. The meeting or meetings shall be held separately from any meetings held pursuant to Section 4660. The regional center shall provide participants of these meetings with the data and any associated information related to improvements in the provision of developmental services to underserved communities and shall conduct a discussion of the data and the associated information in a manner that is culturally and linguistically appropriate for that community, including providing alternative communication services, as required by Sections 11135 to 11139.7, inclusive, of the Government Code and implementing regulations. Regional centers shall inform the department of the scheduling of those public meetings 30 days prior to the meeting. Notice of the meetings shall also be posted on the regional centers internet website 30 days prior to the meeting and shall be sent to individual stakeholders and groups representing underserved communities in a timely manner. Each regional center shall, in holding the meetings required by this subdivision, consider the language needs of the community and shall schedule the meetings at times and locations designed to result in a high turnout by the public and underserved communities.
(f)(1)Each regional center shall annually report to the department regarding its implementation of the requirements of this section. The report shall include, but shall not be limited to, all of the following:
(A)Actions the regional center took to improve public attendance and participation at stakeholder meetings, including, but not limited to, attendance and participation by underserved communities.
(B)Copies of minutes from the meeting and attendee comments.
(C)Whether the data described in this section indicate a need to reduce disparities in the purchase of services among consumers in the regional centers catchment area. If the data do indicate that need, the regional centers recommendations and plan to promote equity, and reduce disparities, in the purchase of services.
(2)Each regional center and the department shall annually post the reports required by paragraph (1) on its internet website by August 31.
(g)(1)The department shall consult with stakeholders, including consumers and families that reflect the ethnic and language diversity of regional center consumers, regional centers, advocates, providers, family resource centers, the protection and advocacy agency described in Section 4901, and those entities designated as University Centers for Excellence in Developmental Disabilities Education, Research, and Service pursuant to Section 15061 of Title 42 of the United States Code, to achieve the following objectives:
(A)Review the data compiled pursuant to subdivision (a).
(B)Identify barriers to equitable access to services and supports among consumers and develop recommendations to help reduce disparities in purchase of service expenditures.
(C)Encourage the development and expansion of culturally appropriate services, service delivery, and service coordination.
(D)Identify best practices to reduce disparity and promote equity.
(2)The department shall report the status of its efforts to satisfy the requirements of paragraph (1) during the 201617 legislative budget subcommittee hearing process.
(h)(1)Subject to available funding, the department shall allocate funding to regional centers or community-based organizations with department oversight to assist with implementation of the recommendations and plans developed pursuant to subdivisions (f) and (g). Activities funded through these allocations may include, but are not limited to, pay differentials supporting direct care bilingual staff of community-based service providers, parent or caregiver education programs, cultural competency training for regional center staff, outreach to underserved populations, or additional culturally appropriate service types or service delivery models.
(2)Each regional center shall consult with stakeholders regarding activities that may be effective in addressing disparities in the receipt of regional center services and the regional centers proposed requests for the funding specified in paragraph (1). Each regional center shall identify the stakeholders it consulted with and include information on how it incorporated the input of stakeholders into its requests.
(3)A community-based organization may submit a request for grant funding pursuant to this subdivision. The organization shall submit the request concurrently to the regional center of the jurisdiction in which the organization is located and to the department. The regional center shall provide the department with input regarding the request prior to the departments final determination on the request.
(4)The department shall review requests for funding within 45 days from the deadline specified in the departments guidance to regional centers and community-based organizations.
(5)Each regional center and community-based organization receiving funding shall report annually to the department, in a manner determined by the department, on how the funding allocations were used and shall include recommendations of priorities for activities that may be effective in addressing disparities, based on the consultation with stakeholders.
(6)The department shall post the following information on its internet website:
(A)By September 1 of any year in which grant funding is available and has not been allocated, a structure for the grant program, including all of the following information:
(i)How community-based organizations reflecting groups that are disadvantaged by disparities in the purchase of services will be invited to participate in the grant program.
(ii)How statewide strategies were considered.
(iii)How the department will ensure grant funds are not used for activities that regional centers are otherwise required by statute or regulation to conduct.
(iv)How funded activities will be evaluated.
(B)By October 1 of any year in which grant funding is available and has not been allocated, the final invitation for requests for funding or another mechanism through which requests for funding are solicited.
(C)By January 1 of any year in which grant funding has been allocated, a list of grant recipients, funding level per grant, and a description of the funded project.
(D)By May 1 of any year in which the information is available, evaluation results from prior grants. To ensure the department complies with this subparagraph, regional centers and community-based organizations receiving funding shall provide the department, by March 1 of the same year, with an evaluation of funded activities and the effectiveness of those activities in reducing disparities in the purchase of services, to the extent information is available.
(i)On or before December 31, 2021, the department shall 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 subdivision (h).
(j)For the purposes of this section, the department shall require all of the following:
(1)The use by the department and regional centers, when reporting data by race and ethnicity, of consistent classifications of race and ethnicity, based on categories current in use by the United States Census Bureau.
(2)Confirmation of the race and ethnicity identification of each consumer at the time of the annual review of the consumers individual program plan (IPP).
(3)When reporting by residence types, separate presentation of data for those in independent living services and those in supported living services.
(4)Consistent standards and requirements for regional center internet websites, using the same placement and language for all information required by this division, including that data be posted in a machine-readable format.
SEC. 4.Section 4519.20 is added to the Welfare and Institutions Code, to read:4519.20.As part of the departments planning process for the planning and development of a uniform statewide data automation system, the department, in consultation with stakeholders shall develop, by _____, March 1, 2024, a project charter that shall be approved by the Secretary of the California Health and Human Services Agency and the Department of Technology. The charter development process shall include the participation and input of program consumers and families, researchers and quality and outcome evaluators, regional centers, and service providers. The project charter shall include all of the following:
(a)An impact statement on the primary entities and individuals impacted by the system development.
(b)Project guiding principles that are foundational to the project approach to be used throughout the planning, development, implementation, and maintenance of the system.
(c)Project scope that addresses business problems required to be solved by the system, including all of the following:
(1)Worker effectiveness and accountability that are constrained by the lack of timely, adequate, and accurate data, the lack of uniformity, and the current systems limited functionality.
(2)Service delivery that is constrained by the lack of timely, adequate, accurate accurate, and accessible data, the lack of clear understandable communication of information, lack of uniformity, and the systems limited functionality.
(3)Current system maintainability that is constrained by disparate systems, inadequate documentation, the lack of open system architecture, and business changes.
(4)Disparate systems, complex business rules, the number of locations and variability of local system delivery, and changes in the way of doing business.
(5)Limited access of researchers and program evaluators to the set of person-level data that they need to assess program effectiveness.
(d)Program goals, which shall include all of the following:
(1)Maximizing the performance and the business processes for the delivery of intellectual or developmental disability (IDD) system services to consumers at the regional centers.
(2)Improving data quality, privacy, confidentiality, and integration of all data sources at an individual level.
(3)Enabling data-driven decisionmaking and performance measures for the effective administration of the program.
(4)Improving the business processes administered by the department to support regional center service delivery.
(5)Supporting access to individual level individual-level data to support program evaluation and other research.
(e)Technology goals that recognize that a statewide system solution not only meets requirements, but also ensures effective transition, while minimizing disruption to existing services.
(f)Project strategies and approaches for development and implementation.
(g)Project governance.
(h)Technology that can readily be enhanced and modernized for the expected system life. In selecting the new system, consideration shall be given to the extent to which the candidate systems employ open architectures and standards and the future ability of the selected system to provide enhancements that will improve long-term effectiveness of program management of the statewide service delivery system.
SEC. 5.Section 4571 of the Welfare and Institutions Code is amended to read:4571.(a)It is the intent of the Legislature to ensure the well-being of consumers, taking into account their informed and expressed choices. It is further the intent of the Legislature to support the satisfaction and success of consumers through the delivery of quality services and supports. Evaluation of the services that consumers receive is a key aspect to the service system. Utilizing the information that consumers and their families provide about those services in a reliable and meaningful way is also critical to enable the department to assess the performance of the states developmental services system and to improve services for consumers in the future. To that end, the State Department of Developmental Services, on or before January 1, 2010, shall implement an improved, unified quality assessment system, in accordance with this section.
(b)The department, in consultation with stakeholders, shall identify a valid and reliable quality assurance instrument that assesses consumer and family satisfaction, provision of services in a linguistically and culturally competent manner, and personal outcomes. The instrument shall do all of the following:
(1)Provide nationally validated, benchmarked, consistent, reliable, and measurable data for the departments Quality Management System.
(2)Enable the department and regional centers to compare the performance of Californias developmental services system against other states developmental services systems and to assess quality and performance among all of the regional centers.
(3)Include outcome-based measures such as health, safety, well-being, relationships, interactions with people who do not have a disability, employment, quality of life, integration, choice, service, and consumer satisfaction.
(4)Include outcome-based measures to evaluate the linguistic and cultural competency of regional center services that are provided to consumers across their lifetimes.
(c)To the extent that funding is available, the instrument identified in subdivision (b) may be expanded to collect additional data requested by the State Council on Developmental Disabilities.
(d)(1)The department shall contract with an independent agency or organization to implement, by January 1, 2010, the quality assurance instrument described in subdivision (b). The contractor shall be experienced in all of the following:
(A)Designing valid quality assurance instruments for developmental service systems.
(B)Tracking outcome-based measures such as health, safety, well-being, relationships, interactions with people who do not have a disability, employment, quality of life, integration, choice, service, and consumer satisfaction.
(C)Developing data systems.
(D)Data analysis and report preparation.
(E)Assessments of the services received by consumers who are moved from developmental centers to the community, given the Legislatures historic recognition of a special obligation to ensure the well-being of these persons.
(F)Issues related to linguistic and cultural competency.
(2)Notwithstanding any other law, the contract and any amendments pursuant to this section shall be exempt from all of the following:
(A)The personal services contracting requirements of Article 4 (commencing with Section 19130) of Chapter 5 of Part 2 of Division 5 of Title 2 of the Government Code.
(B)The Public Contract Code, the State Contracting Manual, and the State Administration Manual.
(C)The approval of the Department of General Services.
(D)The approval of the Department of Technology.
(3)The exemptions specified in paragraph (2) shall remain in effect until there is more than one available assessment that meets the criteria in subdivision (b) from an organization that also meets the criteria in this subdivision.
(e)The department, in consultation with the contractor described in subdivision (d), shall establish the methodology by which the quality assurance instrument shall be administered, including, but not limited to, how often and to whom the quality assurance will be administered, and the design of a stratified, random sample among the entire population of consumers served by regional centers. The contractor shall provide aggregate information for all regional centers and the state as a whole. At the request of a consumer or the family member of a consumer, the survey shall be conducted in the primary language of the consumer or family member surveyed.
(f)The department shall contract with the state council to collect data for the quality assurance instrument described in subdivision (b). If, during the data collection process, the state council identifies any suspected violation of the legal, civil, or service rights of a consumer, or if it determines that the health and welfare of a consumer is at risk, that information shall be provided immediately to the regional center providing case management services to the consumer. At the request of the consumer or family, when appropriate, a copy of the completed survey shall be provided to the regional center providing case management services to improve the consumers quality of services through the individual planning process.
(g)The department, in consultation with stakeholders, shall annually review the data collected from and the findings of the quality assurance instrument described in subdivision (b) and accept recommendations regarding additional or different criteria for the quality assurance instrument in order to assess the performance of the states developmental services system and improve services for consumers.
(h)(1)Each regional center shall annually present data collected from, and the findings of, the quality assurance instrument described in subdivision (b) for that regional center, at a public meeting of its governing board in order to assess the comparative performance of the regional center and identify needed improvements in services for consumers, including, but not limited to, case management services. Notice of this meeting shall also be posted on the regional centers internet website at least 30 days prior to the meeting and shall be sent to regional center consumers and families and individual stakeholders at least 30 days prior to the meeting. The governing board shall provide a sufficient public comment period so members of the public may provide comments. Each regional center, in holding the meeting required by this subdivision, shall ensure that the meeting and meeting materials provide language access, as required by state and federal law.
(2)All regional center-specific reports generated by the department pursuant to this subdivision shall be made publicly available on the regional centers internet website in a machine-readable format, but shall not contain any personal identifying information about any person assessed.
(3)Within 60 days following its annual presentation, each regional center shall submit a report to the department regarding its implementation of the requirements of this section. The report shall include, but shall not be limited to, both of the following:
(A)Copies of the presentation described in paragraph (1), minutes from the meeting, and attendee comments.
(B)The regional centers recommendations and plans to use the information to address regional center priorities, strategic directions to improve specific areas of performance, or both.
(i)All reports generated pursuant to this section shall be made publicly available, but shall not contain any personal identifying information about any person assessed.
(j)All data collected pursuant to subdivision (c) shall be provided to the state council, but shall not contain personal identifying information about the persons being surveyed.
(k)Implementation of this section shall be subject to an annual appropriation of funds in the Budget Act for this purpose.
(l)By March 1, 2024, the department shall submit a report to the policy and budget subcommittees of the Legislature describing the extent to which the requirements of this section have not been met, including the surveying of all consumers, including those with no purchase of services, and providing specific steps and the schedule by which these requirements will be met.
SEC. 6.Section 4620.6 is added to the Welfare and Institutions Code, to read:4620.6.(a)(1)To provide uniformity, consistency, and cost-effectiveness in the delivery of services by regional centers throughout the state, the department shall establish, by January 1, 2025, a common set of services and supports, including supported living services, that every regional center in the state shall make available to consumers in negotiating, developing, or amending the individualized program plan as required by Sections 4646 and 4646.5. The common set of services and supports shall be prominently posted on each regional centers internet website.
(2)The department shall develop the common set of services and supports in consultation with the Association of Regional Center Agencies, consumers and their families, advocacy organizations, and service providers.
(b)In each contract with a regional center, the department shall require the common set of services and supports developed pursuant to this section to be available to consumers in the development of an individual program plan.
(c)It is the intent of the Legislature that this section not be construed to control or interfere with the discretion of the individual program planning team to determine the needs and services appropriate for each person with a developmental disability who is entitled to services under this division.
SEC. 6.SEC. 7.Section 4622 of the Welfare and Institutions Code is amended to read:4622.The state shall contract only with agencies, the governing boards of which conform to all of the following criteria:
(a)The governing board shall be composed of individuals with demonstrated interest in, or knowledge of, developmental disabilities.
(b)The membership of the governing board shall include persons with legal, management or board governance, financial, and developmental disability program expertise. Board governance expertise may not be acquired solely by serving on a regional center board. The governing board of the regional center shall include members with financial expertise and members with management or board governance expertise by August 15, 2020.
(c)The membership of the governing board shall include representatives of the various categories of disability to be served by the regional center.
(d)The governing board shall reflect the geographic and ethnic characteristics of the area to be served by the regional center.
(e)A minimum of 50 percent of the members of the governing board shall be persons with developmental disabilities or their parents or legal guardians. No less than 25 percent of the members of the governing board shall be persons with developmental disabilities.
(f)(1)Members of the governing board shall not be permitted to serve more than a six-year term, and may return to the board for a subsequent term after five years. The members of each regional center governing board nominating committee shall be comprised of current board members and members of the community, and should be representative of the community served in the regional centers catchment area.
(2)The board nominating committee shall solicit interests and nominations from the broader community through outreach. The committee shall interview candidates for the board and make recommendations to the governing board for election. During the meeting at which the board elects new members, a candidate may be nominated by a board member with a second by another board member for the open positions. A regional center executive director shall be prohibited from any involvement in the recruitment or election of governing board members.
(g)(1)The department shall provide necessary training and support to these board members to facilitate their understanding and participation, including issues relating to linguistic and cultural competency. The training shall be developed with community input, including persons served and family members. Ongoing support by the department shall include surveying board members about their ability to meaningfully participate in, and understand the subjects and votes at, board meetings. If board members report that they are unable to meaningfully participate, the department shall work with the regional center and the board member to ensure adequate and appropriate accommodations are provided.
(2)As part of its monitoring responsibility, the department shall review and approve the method by which training and support are provided to board members to ensure maximum understanding and participation by board members.
(3)Each regional center shall post on its internet website information regarding the training and support provided to board members.
(h)The governing board may appoint a consumers advisory committee composed of persons with developmental disabilities representing the various categories of disability served by the regional center.
(i)The governing board shall appoint an advisory committee composed of a wide variety of persons representing the various categories of providers from which the regional center purchases client services. The advisory committee shall provide advice, guidance, recommendations, and technical assistance to the regional center board in order to assist the regional center in carrying out its mandated functions. The advisory committee shall designate one of its members to serve as a member of the regional center board.
(j)(1)The governing board shall annually review the performance of the director of the regional center. The department shall establish guidelines for governing boards to measure executive director performance, including with respect to issues of equity and diversity.
(2)The governing board shall annually review the performance of the regional center in providing services that are linguistically and culturally appropriate and may provide recommendations to the director of the regional center based on the results of that review.
(k)A member of the board who is an employee or member of the governing board of a provider from which the regional center purchases client services shall not do any of the following:
(1)Serve as an officer of the board.
(2)Vote on any fiscal matter affecting the purchase of services from any regional center provider.
(3)Vote on any issue other than as described in paragraph (2), in which the member has a financial interest, as defined in Section 87103 of the Government Code, and determined by the regional center board. The member shall provide a list of the members financial interests, as defined in Section 87103, to the regional center board.
(l)The department shall establish, and each board shall adopt, an antiretaliation policy for board members that requires department approval for any reduction in services for consumer board members or the family member of family board members.
(m)The department shall establish and adopt a grievance procedure whereby a governing board member who has concerns, complaints, or questions may contact a specific executive at the department.
(n)This section does not prevent the appointment to a regional center governing board of a person who meets the criteria for more than one of the categories listed above.
SEC. 7.SEC. 8.Section 4626.5 of the Welfare and Institutions Code is amended to read:4626.5.Each regional center shall submit a conflict-of-interest policy to the department by July 1, 2011, and shall post the policy on its internet website by August 1, 2011. The policy shall do, or comply with, all of the following:
(a)Contain the elements of this section and be consistent with applicable law.
(b)Define conflicts of interest.
(c)Identify positions within the regional center required to complete and file a conflict-of-interest statement.
(d)Facilitate disclosure of information to identify conflicts of interest.
(e)Require candidates for nomination, election, or appointment to a regional center board, and applicants for regional center director to disclose any potential or present conflicts of interest prior to being appointed, elected, or confirmed for hire by the regional center or the regional center governing board.
(f)Require the regional center and its governing board to regularly and consistently monitor and enforce compliance with its conflict-of-interest policy.
(g)Prohibit a regional center employee from accepting a gift or gifts from a service provider, consumer, or consumers family member valued over ten dollars ($10) per year.
(h)Establish a policy prohibiting regional center senior staff from hiring relatives at the center or any ancillary foundation and organization. The policy shall be included in the regional center contract and shall be included in training of the governing board.
SEC. 8.SEC. 9.Section 4629.1 is added to the Welfare and Institutions Code, to read:4629.1.(a)Notwithstanding any other law, the evaluation of regional center performance shall be implemented using a common set of performance measures, which shall be administered by the department. This includes the performance requirements under the regional center contracts pursuant to Section 4629, the performance incentives established under Section 4620.5, and the quality assessment instrument required under Section 4571. These measures shall be annually reported and made available to the public through posting of the measures results in machine-readable formats.
(b)By July 1, 2024, the department shall establish standards for each measure above, for which a regional center may receive rewards for good performance, and a separate set of minimal standards, below which the regional center is subject to each level of probation required under Section 4629. The department shall establish the process for assessing corrective action undertaken by a regional center and the process by which a regional center may end its probation status.
(c)The performance measures shall encompass the domains and the associated measures as itemized in subdivision (d). Additional measures may be adopted by the department as needed. Modification of the domain and measures shall be accomplished through a process of consultation that includes the engagement of stakeholders in a manner consistent with that required by subdivision (b) of Section 4620.5. The measures may be amended as reporting mechanisms mature as the department develops new information technology capabilities.
(d)The performance measures for purposes of this section shall be organized under seven domains, as follows:
(1)Community integration, including all of the following:
(A)The percentage of consumers who report spending their days primarily with people without disabilities who are not paid to be with them.
(B)The percentage of consumers who report they feel part of their communities, participate in community activities, know their neighbors, and have friends.
(C)The percentage of minor consumers living in licensed group homes or other institutional settings.
(D)The percentage of adult consumers living in licensed group homes, intermediate care facilities, or other institutional settings.
(E)The percentage of adult consumers living in their own homes with independent living services.
(F)The percentage of adult consumers living in their own homes with supported living services.
(G)The percentage of adult consumers seeking affordable and accessible housing.
(H)The percentage of adult consumers that have secured housing outside of their family home, if desired.
(2)Employment, including all of the following:
(A)The percentage of adult consumers in competitive competitive, integrated employment and the length of time in the job.
(B)The percentage of employed adult consumers reporting increased wages and opportunities for advancement.
(C)The percentage of employed adult consumers reporting satisfaction with their jobs with the ability to learn new skills and interact with coworkers.
(D)The average per capita annual wages of employed adult consumers.
(E)The percentage of participants in the paid internship program that led to permanent employment.
(F)The average hourly wage for competitive, integrated employment.
(G)The average number of hours per week in competitive, integrated employment.
(H)The percentage of adult consumers in competitive competitive, integrated employment, by race and ethnicity.
(3)Equity in service access, including all of the following:
(A)Per capita spending, by race and ethnicity.
(B)Per capita spending, by primary language.
(C)Timely eligibility determination, by race and ethnicity.
(D)Access to Early Start services services, by race and ethnicity.
(E)Per capita spending on adult consumers, by residence type and by race and ethnicity.
(F)Per capita spending on adult consumers, by residence type and regional center.
(G)The percentage of consumers with no purchase of services, by regional center.
(H)The percentage of consumers with no purchase of services, by race and ethnicity.
(4)Case management, including all of the following:
(A)Timeliness of intake for eligibility.
(B)Timeliness of initiation of services for Early Start.
(C)Timeliness of development of IPPs.
(D)Timeliness of delivery of IPP services after authorization.
(E)Share of consumers reporting that the regional center service coordinator assisted them in attaining generic resources.
(F)Responsiveness of service coordinator.
(G)Consumer or family directs their own person-centered planning process.
(H)Timeliness of translated IPPs and other documents.
(5)Consumer and family choice, experience, and satisfaction, including all of the following:
(A)Overall satisfaction and happiness.
(B)Service coordinator cultural competency.
(C)Service coordinator who speaks consumers language.
(D)Access to approved services.
(E)Access to services provided by individuals who speak the consumers language.
(F)Consumers report they are treated with dignity and respect.
(G)Access to the Self-Determination Program.
(H)The ability to select their services and providers from among a range of choices.
(I)The ability to select the place where they live, with whom they live, and who supports them.
(J)The percentage of consumers who report having a way to communicate and express choices and decisions.
(K)The percentage of consumers or families who report that they understand the information provided to them by their regional center.
(L)The percentage of consumers or families reporting they feel comfortable in their interactions with the regional center, and if they are aware they can change their service coordinator.
(6)Human and civil rights, including all of the following:
(A)The number of special incident reports, and number of incidents of seclusion and restraint or other types of abuse by regional center.
(B)The percentage of consumers reporting they have a private space, if they live out of their family home.
(C)The percentage of adult consumers who vote in elections.
(D)The percentage of adult consumers who are conserved.
(7)Health and safety, including all of the following:
(A)Hospitalization and mortality rates among regional center consumers.
(B)The percentage of consumers receiving regular preventative care, vaccinations, and cancer screenings.
SEC. 9.SEC. 10.Section 4639.76 is added to the Welfare and Institutions Code, to read:4639.76.A regional center with which the department maintains a contract pursuant to Section 4629 shall be subject to the California Public Records Act (Chapter 1 (commencing with Section 7920.000) of Division 10 of Title 1 of the Government Code).
SEC. 10.SEC. 11.Section 4642 of the Welfare and Institutions Code is amended to read:4642.(a)(1)Any person believed to have a developmental disability, and any person believed to have a high risk of parenting an infant with a developmental disability shall be eligible for initial intake and assessment services in the regional centers. In addition, any infant having a high risk of becoming developmentally disabled may be eligible for initial intake and assessment services in the regional centers. For purposes of this section, high-risk infant means a child less than 36 months of age whose genetic, medical, or environmental history is predictive of a substantially greater risk for developmental disability than that for the general population. The department, in consultation with the State Department of Public Health, shall develop specific risk and service criteria for the high-risk infant program on or before July 1, 1983. These criteria may be modified in subsequent years based on analysis of actual clinical experience.
(2)(A)Initial intake shall be performed within 15 working days following request for assistance. Initial intake shall include, but need not be limited to, information and advice about the nature and availability of services provided by the regional center and by other agencies in the community, including guardianship, conservatorship, income maintenance, mental health, housing, education, work activity and vocational training, medical, dental, recreational, and other services or programs that may be useful to persons with developmental disabilities or their families. Intake shall also include a decision to provide assessment.
(B)For purposes of this section, request for assistance includes any initial contact or inquiry from an individual, or a person acting on their behalf, on the nature of services or supports available or provided by the regional center, and the individuals eligibility to receive them.
(3)(A)The department shall create, with input from stakeholders, standardized information packets to be provided to any person seeking services from a regional center. There shall be one information packet related to services provided under the California Early Intervention Services Act and another information packet related to services provided under the Lanterman Developmental Disabilities Services Act. The information packets shall be translated to provide language access, as required by state and federal law, shall be available in alternative formats and alternative modes of communication, as required by federal law, and shall include, at a minimum, all of the following:
(i)An overview of the regional center system.
(ii)A resource guide for consumers and their families.
(iii)Consumer rights, including the appeals procedures specified in Chapter 7 (commencing with Section 4700).
(iv)Contact information for the regional center, the department, the office of clients rights advocacy, and the protection and advocacy agency specified in Division 4.7 (commencing with Section 4900).
(v)Information on the Self-Determination Program, including the eligibility requirements specified in subdivision (d) of Section 4685.8.
(B)Each regional center shall distribute the information packets at intake, upon transfer to receiving services under the Lanterman Developmental Disabilities Services Act, and upon request. Each regional center shall begin distributing the information packets within 60 days following the department providing the information packets and issuing directives regarding the distribution of the information packets. In addition to, and not in lieu of, this requirement, each regional center shall post the full content of the most updated information packet on its internet website.
(b)A regional center shall communicate with the consumer and the consumers family pursuant to this section in their native language, including providing alternative communication services and alternative formats, as required by state and federal law.
SEC. 11.SEC. 12.Section 4643 of the Welfare and Institutions Code is amended to read:4643.(a)If assessment is needed, the regional center shall require the assessment to be completed within 60 days following initial intake. Assessment shall be commenced as soon as possible, and in no event more than 30 days following initial intake when any delay would expose the client to unnecessary risk to their health and safety or to significant further delay in mental or physical development, or the client would be at imminent risk of placement in a more restrictive environment. Assessment may include collection and review of available historical diagnostic data, provision or procurement of necessary tests and evaluations, and summarization of developmental levels and service needs and is conditional upon receipt of the release of information specified in subdivision (b).
(b)In determining if an individual meets the definition of developmental disability contained in subdivision (a) of Section 4512, the regional center may consider evaluations and tests, including, but not limited to, intelligence tests, adaptive functioning tests, neurological and neuropsychological tests, diagnostic tests performed by a physician, psychiatric tests, and other tests or evaluations that have been performed by, and are available from, other sources.
(c)At the time of assessment, the individual, or, where appropriate, the parents, legal guardian, or conservator, shall provide copies of any health benefit cards under which the consumer is eligible to receive health benefits, including, but not limited to, private health insurance, a health care service plan, Medi-Cal, Medicare, and TRICARE. If the individual, or where appropriate, the parents, legal guardians, or conservators, have no such benefits, the regional center shall not use that fact to negatively impact the services that the individual may or may not receive from the regional center.
(d)A regional center shall communicate with the consumer and the consumers family pursuant to this section in their preferred language, including providing alternative communication services, as required by Sections 11135 to 11139.7, inclusive, of the Government Code and implementing regulations.
SEC. 12.SEC. 13.Section 4646 of the Welfare and Institutions Code is amended to read:4646.(a)It is the intent of the Legislature to ensure that the individual program plan and provision of services and supports by the regional center system is centered on the individual and the family of the individual with developmental disabilities and takes into account the needs and preferences of the individual and the family, if appropriate, as well as promoting community integration, independent, productive, and normal lives, and stable and healthy environments. It is the further intent of the Legislature that individual program plans shall be developed consistent with the federal Affordable Care Act and the regulations and federal guidance adopted pursuant to the act requiring that community-based long-term services and supports be person-centered and self-directed. It is the further intent of the Legislature to ensure that goals in any plan allow for innovation and nontraditional service delivery and not be limited by the lack of easily identified services or supports, the provision of services to consumers and their families be effective in meeting the goals stated in the individual program plan, reflect the preferences and choices of the consumer, and reflect the cost-effective use of public resources.
(b)(1)Notwithstanding any other law, the individual program plan plan, including all assessments, shall be developed through a process of individualized needs determination and person-centered service planning developed pursuant to, and consistent with, Section 2402(a) of the federal Affordable Care Act (Pub. L. 111-148) and amendments thereto, Section 441.725 of Title 42 of the Code of Federal Regulations, and federal guidance issued by the Centers for Medicaid and Medicare Medicare and Medicaid Services on June 6, 2014, requiring community-based, long-term services and supports to be person-centered, strengths-based, and self-directed. The individual with developmental disabilities and, if appropriate, the individuals parents, legal guardian or conservator, or authorized representative, shall have the opportunity to actively participate in the development of the plan. The individual shall lead the service planning process to the greatest extent possible.
(c)An individual program plan shall be developed for any person who, following intake and assessment, is found to be eligible for regional center services. A final An initial assessment agreement shall be completed and provided to the consumer within 30 days of an intake unless there is good cause for the regional center to exceed the 30-day time period, but in no event shall the assessment be completed any later than 60 days from the intake unless the consumer or, if appropriate, the parents, legal guardian, conservator, or authorized representative request additional time pursuant to subdivision (h). If a completed assessment recommends the delivery of services, those services shall be provided within seven days of the receipt of the assessment by the regional center. intake. If the assessment is not completed within the 30- or 60-day time period, as applicable, the regional center shall provide the consumer with an adequate notice of action, which shall be subject to Chapter 7 (commencing with Section 4700), and shall notify the department of the reason for not meeting the deadline. At the time of intake, the regional center shall inform the consumer and, if appropriate, the consumers parents, legal guardian or conservator, or authorized representative, of the services available through the state council and the protection and advocacy agency designated by the Governor pursuant to federal law, and shall provide the address and telephone numbers of those agencies.
(d)(1)As part of the initial individual program plan meeting and each annual review required by subdivision (b) of Section 4646.5, the consumer or, if appropriate, their parents, legal guardian, conservator, or authorized representative, shall be provided by the service coordinator oral and written information about the Self-Determination Program. The information shall include each of the provisions specified in subdivision (d) of Section 4685. Each individual program plan shall include a provision stating that the consumer or authorized representative was informed about the availability of the Self-Determination Program. If the consumer chooses not to participate in the program, the individual program plan shall include an explanation of the reason or reasons for that decision, or, if the consumer is ineligible for the program, the reason or reasons for that ineligibility.
(2)If the consumer is interested in participating in the program or wants additional information or assistance, the service coordinator, within five days of expressing the interest, shall provide the consumer a date for the Self-Determination Program orientation, training resources, dates of local volunteer Self-Determination Program advisory committee meetings, and other information to assist the consumer in participating in the program.
(e)Individual program plans shall be prepared jointly by the planning team. Decisions concerning the consumers goals, objectives, and services and supports that will be included in the consumers individual program plan and purchased by the regional center or obtained from generic agencies shall be made by agreement between the regional center representative and the consumer or, if appropriate, the parents, legal guardian, conservator, or authorized representative at the program plan meeting.
(f)Regional centers shall comply with the request of a consumer or, if appropriate, the request of the consumers parents, legal guardian, conservator, or authorized representative, that a designated representative receive written notice of all meetings to develop or revise the individual program plan and of all notices sent to the consumer pursuant to Section 4710. The designated representative may be a parent or family member.
(g)Notwithstanding any other law, a meeting regarding the provision of services and supports by the regional center, including a meeting to develop or revise the individual program plan, shall be held by remote electronic communications if requested by the consumer or, if appropriate, if requested by the consumers parents, legal guardian, conservator, or authorized representative.
(h)At the conclusion of an individual program plan meeting, an authorized representative of the regional center shall provide to the consumer, in written or electronic format, a list of the agreed-upon services and supports and the start date, the frequency and duration of the services and supports, and the provider, and a summary page written in plain language. The identified services and supports specified in an individual program plan referred to a provider shall begin on the date specified in the plan. In the event the services or supports are not started by the provider within 45 days of the specified start date, a referral shall be made within 14 days to another provider for delivery of the specified services and supports. The authorized representative of the regional center shall sign the list of agreed-upon services and supports at that time. The consumer, or if appropriate, the consumers parent, legal guardian, conservator, or authorized representative shall sign the list of agreed-upon services and supports prior to its implementation. The consumer, or if appropriate, the consumers parent, legal guardian, conservator, or authorized representative, may elect to delay receipt of the list of agreed-upon services and supports pending final agreement, as described in subdivision (h). If the consumer, or if appropriate, the consumers parent, legal guardian, conservator, or conservator or authorized representative, elects to delay the receipt of the list of agreed-upon services and supports for 15 days, the list shall be provided in the preferred language of the consumer, or of the consumers parent, legal guardian, or authorized representative.
(i)If a final agreement regarding the services and supports to be provided to the consumer cannot be reached at a program plan meeting, then a subsequent program plan meeting shall be convened within 15 days, or later at the request of the consumer or, if appropriate, the parents, legal guardian, conservator, or authorized representative or if agreed to by the planning team. The list of the agreed-upon services and supports described in subdivision (h) and signed by the authorized representative of the regional center shall be provided, in writing or electronically, at the conclusion of the subsequent program plan meeting, and shall be provided in the preferred language of the consumer, or of the consumers parent, legal guardian, conservator, or authorized representative. Additional program plan meetings may be held with the agreement of the regional center representative and the consumer or, if appropriate, the parents, legal guardian, conservator, or authorized representative.
(j)An authorized representative of the regional center and the consumer or, if appropriate, the consumers parent, legal guardian, conservator, or authorized representative shall sign the individual program plan and the list of the agreed-upon services and supports prior to its implementation. If the consumer or, if appropriate, the consumers parent, legal guardian, conservator, or authorized representative, does not agree with all components of the individual program plan, the consumer may indicate that disagreement on the plan. Disagreement with specific plan components shall not prohibit the implementation of services and supports agreed to by the consumer or, if appropriate, the consumers parent, legal guardian, conservator, or authorized representative. If the consumer or, if appropriate, the consumers parent, legal guardian, conservator, or authorized representative, does not agree with the plan in whole or in part, the consumer shall be sent written notice of their appeal rights, as required by Sections 4701 and 4710.
(k)(1)A regional center shall communicate in the consumers preferred language, or, if appropriate, the preferred language of the consumers family, legal guardian, conservator, or authorized representative, during the planning process for the individual program plan, including during the program plan meeting, and including providing alternative communication services, as required by Sections 11135 to 11139.8, inclusive, of the Government Code and implementing regulations.
(2)A regional center shall provide alternative communication services, including providing copies of the list of services and supports, and the individual program plan in the preferred language of the consumer or the consumers family, legal guardian, conservator, or authorized representative, or both, as required by Sections 11135 to 11139.8, inclusive, of the Government Code and implementing regulations.
(3)The preferred language of the consumer or the consumers family, legal guardian, conservator, or authorized representative, or both, shall be documented in the individual program plan.
SEC. 13.SEC. 14.Section 4646.4 of the Welfare and Institutions Code is amended to read:4646.4.(a)Regional centers shall ensure, at the time of development, scheduled review, or modification of a consumers individual program plan developed pursuant to Sections 4646 and 4646.5, or of an individualized family service plan pursuant to Section 95020 of the Government Code, the establishment of an internal process. This internal process shall ensure adherence with federal and state law and regulation, and if purchasing services and supports, shall ensure all of the following:
(1)Conformance with the regional centers purchase of service policies, as approved by the department pursuant to subdivision (d) of Section 4434.
(2)Utilization of generic services and supports if appropriate. The individualized family service planning team for infants and toddlers eligible under Section 95014 of the Government Code and the individual program plan team pursuant to Section 4646 may determine that a service provided by a generic agency, as defined by subdivision (g) of Section 4659.5, or a service or source of funding contained in Section 4659 identified in the individualized family service plan or individual program plan is not available, and, therefore, will be funded by the regional center.
(3)Utilization of other services and sources of funding as contained in Section 4659.
(4)Consideration of the familys responsibility for providing similar services and supports for a minor child without disabilities in identifying the consumers service and support needs as provided in the least restrictive and most appropriate setting. In this determination, regional centers shall take into account the consumers need for extraordinary care, services, supports and supervision, and the need for timely access to this care.
(5)Commencing October 1, 2022, consideration of information obtained from the consumer and, if appropriate, the parents, legal guardian, conservator, or authorized representative about the consumers need for the services, barriers to service access, and other information.
(b)At the time of development, scheduled review, or modification of a consumers individual program plan developed pursuant to Sections 4646 and 4646.5, or of an individualized family service plan pursuant to Section 95020 of the Government Code, the consumer, or, if appropriate, the parents, legal guardian, or conservator, shall provide copies of their health benefit cards under which the consumer is eligible to receive health benefits, including, but not limited to, private health insurance, a health care service plan, Medi-Cal, Medicare, and TRICARE. If the individual, or, if appropriate, the parents, legal guardians, or conservators, do not have health benefits, the regional center shall not use that fact to negatively impact the services that the individual may or may not receive from the regional center.
(c)Final decisions regarding the consumers individual program plan shall be made pursuant to Section 4646.
(d)Final decisions regarding the individualized family service plan shall be made pursuant to Section 95020 of the Government Code.
SEC. 14.SEC. 15.Section 4646.5 of the Welfare and Institutions Code is amended to read:4646.5.(a)The planning process for the individual program plan described in Section 4646 shall include all of the following:
(1)Gathering information and conducting assessments to determine the life goals, capabilities and strengths, preferences, barriers, and concerns or problems of the person with developmental disabilities. For children with developmental disabilities, this process should include a review of the strengths, preferences, and needs of the child and the family unit as a whole. Assessments shall be conducted by qualified individuals and performed in natural environments whenever possible. Information shall be taken from the consumer, the consumers parents and other family members, the consumers friends, advocates, authorized representative, if applicable, providers of services and supports, and other agencies. The assessment process shall reflect awareness of, and sensitivity to, the lifestyle and cultural background of the consumer and the family.
(2)A statement of goals, based on the needs, preferences, and life choices of the individual with developmental disabilities, and a statement of specific, time-limited objectives for implementing the persons goals and addressing the persons needs. These objectives shall be stated in terms that allow measurement of progress or monitoring of service delivery. These goals and objectives should maximize opportunities for the consumer to develop relationships, be part of community life in the areas of community participation, housing, work, school, and leisure, increase control over the consumers life, acquire increasingly positive roles in community life, and develop competencies to help accomplish these goals.
(3)In developing individual program plans for children, regional centers shall be guided by the principles, process, and services and support parameters set forth in Section 4685.
(4)In developing an individual program plan for a transition age youth or working age adult, the planning team shall consider the Employment First Policy described in Chapter 14 (commencing with Section 4868).
(5)A schedule of the type and amount of services and supports to be purchased by the regional center or obtained from generic agencies or other resources in order to achieve the individual program plan goals and objectives, and identification of the provider or providers of service responsible for attaining each objective, including, but not limited to, vendors, contracted providers, generic service agencies, and natural supports. The individual program plan shall specify the approximate scheduled start date for services and supports and shall contain timelines for actions necessary to begin services and supports, including generic services. In addition to the requirements of subdivision (h) of Section 4646, each regional center shall offer, and upon request provide, a written copy of the individual program plan to the consumer, and, if appropriate, the consumers parents, legal guardian or conservator, or authorized representative within 45 days of their request in a threshold language, as defined by paragraph (3) of subdivision (a) of Section 1810.410 of Title 9 of the California Code of Regulations.
(6)If agreed to by the consumer, the parents, legally appointed guardian, or authorized representative of a minor consumer, or the legally appointed conservator of an adult consumer or the authorized representative, including those appointed pursuant to subdivision (a) of Section 4541, subdivision (b) of Section 4701.6, and subdivision (e) of Section 4705, a review of the general health status of the adult or child, including medical, dental, and mental health needs, shall be conducted. This review shall include a discussion of current medications, any observed side effects, and the date of the last review of the medication. Service providers shall cooperate with the planning team to provide any information necessary to complete the health status review. If any concerns are noted during the review, referrals shall be made to regional center clinicians or to the consumers physician, as appropriate. Documentation of health status and referrals shall be made in the consumers record by the service coordinator.
(7)(A)The development of a transportation access plan for a consumer when all of the following conditions are met:
(i)The regional center is purchasing private, specialized transportation services or services from a residential, day, or other provider, excluding vouchered service providers, to transport the consumer to and from day or work services.
(ii)The planning team has determined that a consumers community integration and participation could be safe and enhanced through the use of public transportation services.
(iii)The planning team has determined that generic transportation services are available and accessible.
(B)To maximize independence and community integration and participation, the transportation access plan shall identify the services and supports necessary to assist the consumer in accessing public transportation and shall comply with Section 4648.35. These services and supports may include, but are not limited to, mobility training services and the use of transportation aides. Regional centers are encouraged to coordinate with local public transportation agencies.
(8)A schedule of regular periodic review and reevaluation to ascertain that planned services have been provided, that objectives have been fulfilled within the times specified, and that consumers and families are satisfied with the individual program plan and its implementation.
(b)For all active cases, individual program plans shall be reviewed and modified by the planning team, through the process described in Section 4646, as necessary, in response to the persons achievement or changing needs, and no less often than once every 12 months. If the consumer or, if appropriate, the consumers parents, legal guardian, authorized representative, or conservator requests an individual program plan review, the individual program plan shall be reviewed within 30 days after the request is submitted, or no later than 7 days after the request is submitted if necessary for the consumers health and safety or to maintain the consumer in their home.
(c)(1)The department, with the participation of representatives of a statewide consumer organization, the Association of Regional Center Agencies, an organized labor organization representing service coordination staff, and the state council shall prepare training material and a standard format and instructions for the preparation of individual program plans, which embody a person-centered planning process consistent with federal law, regulations regulations, and guidance.
(2)The department shall require each regional center to use, for all new and modified individual program plans, the training materials and the standard format plan prepared by the department pursuant to paragraph (1) by no later than March 1, 2024.
(3)The department shall biennially review a random sample of individual program plans at each regional center to ensure that these plans are being developed and modified in compliance with Section 4646 and this section.
SEC. 16.Section 4646.51 is added to the Welfare and Institutions Code, to read:4646.51.(a)If any services or supports that require an assessment are requested by a consumer at any time after an individual program plan is in place, and for as long as the individual remains eligible for services, the assessment shall be completed, at no cost to the consumer, within 30 days from the date of request.
(b)(1)If the assessment recommends services or supports, the services or supports shall be authorized by the regional center within seven days and the consumer shall be referred to a provider within seven days from the date of the authorization.
(2)If the services or supports are not commenced by the provider within 45 days of the referral, a referral shall be made to another provider within seven days for the specified services and supports.
(c)A consumer shall be entitled to an adequate notice of action and the appeal procedures in Chapter 7 (commencing with Section 4700) if the regional center does not comply with the deadlines specified in this section.
SEC. 15.SEC. 17.Section 4647 of the Welfare and Institutions Code is amended to read:4647.(a)Pursuant to Section 4640.7, service coordination shall include those activities necessary to implement an individual program plan, including, but not limited to, participation in the individual program plan process; assurance that the planning team considers all appropriate options for meeting each individual program plan objective; securing, through purchasing or by obtaining from generic agencies or other resources, services and supports specified in the persons individual program plan; coordination of service and support programs; collection and dissemination of information; and monitoring implementation of the plan to ascertain that objectives have been fulfilled and to assist in revising the plan as necessary, and ensuring service coordinators are accessible to consumers and their representatives by telephone and other electronic means, which shall include responding to consumer inquiries within 48 hours two business days of the inquiry.
(b)The regional center shall ensure that every consumer has a service coordinator who shall be responsible for implementing, overseeing, and monitoring each individual program plan. The service coordinator may be an employee of the regional center or may be a qualified individual or employee of an agency with whom the regional center has contracted to provide service coordination services, or persons described in Section 4647.2. The regional center shall provide the consumer or, where appropriate, the consumers parents, legal guardian, or conservator or authorized representative, with written notification of any temporary or permanent change in the assigned service coordinator within 10 business days. A person shall not continue to serve as a service coordinator for any individual program plan unless there is agreement by all parties that the person should continue to serve as service coordinator.
(c)Where appropriate, a consumer or the consumers parents or other family members, legal guardian, or conservator, may perform all or part of the duties of the service coordinator described in this section if the regional center director agrees and it is feasible.
(d)If a person described in subdivision (c) is designated as the service coordinator, that person shall not deviate from the agreed-upon program plan and shall provide any reasonable information and reports required by the regional center director.
(e)If any a person described in subdivision (c) is designated as the service coordinator, the regional center shall provide ongoing information and support as necessary, to assist the person to perform all or part of the duties of service coordinator.
SEC. 16.SEC. 18.Section 4659 of the Welfare and Institutions Code is amended to read:4659.(a)Except as otherwise provided in subdivision (b), (d), or (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 centers purchase of services budget, except as it relates to federal supplemental security income and the state supplementary program.
(c)Effective July 1, 2009, notwithstanding any other law or regulation, 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 Supportive Services, California Childrens 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 after being advised of the provisions of subdivision (d). If, on July 1, 2009, a regional center is purchasing that service as part of a consumers individual program plan (IPP), the prohibition shall take effect on October 1, 2009.
(d)(1) Notwithstanding Section 4646.4, a regional center may request a consumer or family member to pursue a service or source of funding from an entity described in subdivision (a) or (c) of this section, or pursuant to subdivision (g) of Section 4659.5, if the request is documented with specificity in the individual program plan or individualized family plan and the plan contains detailed instructions for the consumer or family pursuing the service. The individual program plan or individualized family plan shall also specify the ways in which the regional center will initially assist the consumer or family to apply for and pursue the service or source of funding and specify that it will provide additional assistance when requested by the consumer or family.
(2)The regional center shall purchase the service when either of the following occurs:
(A)The entity denies the service.
(B)The entity does not provide the requested service within 45 days from the date of the request, or 15 days after the statutory or regulatory time limit, if any, for the entity to make an initial decision, whichever is shorter.
(3)A consumer, or their family, shall not be required to appeal an entitys denial of the requested service for the regional center to purchase that service pursuant to this subdivision. The regional center may file an appeal on behalf of the consumer, but the appeal shall not delay the payment of the requested service by the regional center as specified in subparagraph (B) of paragraph (2).
(4)This section does not prohibit a consumer or their family, where appropriate, from filing a formal appeal of an entitys denial of the service at issue, or a regional center from seeking reimbursement from the entity it believes is responsible for providing the service and from requesting assistance with filing the appeal or from utilizing assistance from other advocacy organizations.
(e)This section shall not 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.
(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 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.
(g)(1)To provide uniformity, consistency, and cost-effectiveness, to reduce barriers, and to increase the number of service providers throughout the state, the department shall comprehensively review the current processes for vendorizing providers for the delivery of services and supports to regional center consumers and revise those processes to streamline the process and create a uniform statewide vendorization process. The department shall develop the revised processes, in consultation with the Association of Regional Center Agencies, consumers and their families, advocacy organizations, and service providers.
(2)It is the intent of the Legislature to ensure that a service provider vendored in one regional center shall automatically, without additional requirements, be eligible to provide services in all regional centers. It is the further intent of the Legislature that this section shall not be construed to control or interfere with the discretion of the individual program planning team to determine the needs and services appropriate for each person with a developmental disability who is entitled to services under this division.
SEC. 19.Section 4659.3 is added to the Welfare and Institutions Code, to read:4659.3.(a)No later than March 1, 2024, and on March 1 annually thereafter, the department shall submit a report to the Legislature and post on its internet website the following data, statewide and for each regional center, broken down by qualifying disability category, race or ethnicity, and age categories 021 years of age, 2264 years of age, and 65 years of age and over:
(1)The number of consumers for whom health and safety waivers have been requested.
(2)The number of consumers for whom health and safety waivers have been granted.
(3)The number of days elapsed between the date on which the department received the health and safety waiver request worksheet from the service provider and the date the service provider was notified of the outcome.
(4)The percentage of health and safety waiver requests that are due to behavioral challenges.
(b)The department shall also post on its internet website brief summaries, with any individual identifying information redacted, of the health and safety risks and challenges, and the service changes that are necessary to protect the health and safety, of the affected consumer or consumers, contained in each health and safety waiver request worksheet received by the department.
SEC. 17.SEC. 20.Section 4685.8 of the Welfare and Institutions Code is amended to read:4685.8.(a)The department shall implement a statewide Self-Determination Program. The Self-Determination Program shall 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. As of July 1, 2021, the program shall begin to be available on a voluntary basis to all regional center consumers who are eligible for the Self-Determination Program.
(b)The department, in establishing the statewide program, shall do both of the following:
(1)Set targets and benchmarks as set forth in paragraph (1) of subdivision (r).
(2)Address all of the following:
(A)Oversight of expenditure of self-determined funds and the achievement of participant outcomes over time.
(B)Increased participant control over which services and supports best meet the participants needs and the IPP objectives. A participants unique support system may include the purchase of existing service offerings from service providers or local businesses, hiring their own support workers, or negotiating unique service arrangements with local community resources.
(C)Comprehensive person-centered planning, including an individual budget and services that are outcome based.
(D)Consumer and family training to ensure understanding of the principles of self-determination, the planning process, and the management of budgets, services, and staff.
(E)Choice of independent facilitators, who meet standards and certification requirements established by the department, and who can assist with the functions specified in paragraph (2) of subdivision (c).
(F)Choice of financial management services providers who meet standards and certification requirements established by the department, and who can carry out the functions specified in paragraph (1) of subdivision (c).
(G)Innovation that will more effectively allow participants to achieve their goals.
(H)Long-term sustainability of the Self-Determination Program by doing all of the following:
(i)Requiring IPP teams, when developing the individual budget, to determine the services, supports supports, and goods necessary for each consumer based on the needs and preferences of the consumer, and consumer and, when appropriate appropriate, the consumers family, and the effectiveness of each option in meeting the goals specified in the IPP, and the cost effectiveness cost-effectiveness of each option, as specified in subparagraph (D) of paragraph (6) of subdivision (a) of Section 4648.
(ii)The department may review final individual budgets that are at or above a spending threshold determined by the department of all individual budgets and use information from its review in the aggregate to develop additional program guidance and verify compliance with federal and state laws and other requirements.
(c)For purposes of this section, the following definitions apply:
(1)Financial management services means services or functions that assist the participant to manage and direct the distribution of funds contained in the individual budget, and ensure that the participant has the financial resources to implement their IPP throughout the year. These may include bill paying services and activities that facilitate the employment of service and support workers by the participant, including, but not limited to, fiscal accounting, tax withholding, compliance with relevant state and federal employment laws, assisting the participant in verifying provider qualifications, including criminal background checks, and expenditure reports. The financial management services provider shall meet the applicable requirements of Title 17 of the California Code of Regulations and other specific qualifications or certifications established by the department.
(2)Independent facilitator means a person, selected and directed by the participant, who is not otherwise providing services to the participant pursuant to their IPP and is not employed by a person providing services to the participant. The independent facilitator may assist the participant in making informed decisions about the individual budget, and in locating, accessing, and coordinating services and supports consistent with the participants IPP. The independent facilitator is available to assist in identifying immediate and long-term needs, developing options to meet those needs, leading, participating, or advocating on behalf of the participant in the person-centered planning process and development of the IPP, and obtaining identified services and supports. The cost of the independent facilitator, if any, shall be paid by the participant out of the participants individual budget. An independent facilitator shall receive training in the principles of self-determination, the person-centered planning process, and the other responsibilities described in this paragraph at the independent facilitators own cost. The independent facilitator shall meet standards and certification requirements established by the department.
(3)Individual budget means the amount of regional center purchase of service funding available to the participant for the purchase of services and supports necessary to implement the IPP. The individual budget shall be determined using a fair, equitable, and transparent methodology.
(4)IPP means individual program plan, as described in Section 4646.
(5)Participant means an individual, and individual and, when appropriate, the participants parents, legal guardian or conservator, or authorized representative, who has been deemed eligible for, and has voluntarily agreed to participate in, the Self-Determination Program.
(6)Self-determination means a voluntary delivery system consisting of a defined and comprehensive mix of services and supports, selected and directed by a participant through person-centered planning, in order to meet the objectives in their IPP. Self-determination services and supports are designed to assist the participant to achieve personally defined outcomes in community settings that promote inclusion. The Self-Determination Program shall only fund services and supports provided pursuant to this division that the federal Centers for Medicare and Medicaid Services determines are eligible for federal financial participation.
(7)Spending Plan means the plan the participant develops to use their available individual budget funds to purchase goods, services, and supports necessary to implement their individual program plan (IPP). The spending plan shall identify the cost of each good, service, and support that will be purchased with regional center funds. The total amount of the spending plan cannot exceed the amount of the individual budget. A copy of the spending plan shall be attached to the participants IPP.
(d)Participation in the Self-Determination Program is fully voluntary. A participant may choose to participate in, and may choose to leave, the Self-Determination Program at any time. A regional center shall not require or prohibit participation in the Self-Determination Program as a condition of eligibility for, or the delivery of, services and supports otherwise available under this division. Participation in the Self-Determination Program shall be available to any regional center consumer who meets the following eligibility requirements:
(1)The participant has a developmental disability, as defined in Section 4512, and is receiving services pursuant to this division.
(2)The consumer does not live in a licensed long-term health care facility, as defined in paragraph (44) of subdivision (a) of Section 54302 of Title 17 of the California Code of Regulations. An individual, and when appropriate individual and, when appropriate, the individuals parent, legal guardian or conservator, or authorized representative, who is not eligible to participate in the Self-Determination Program pursuant to this paragraph may request that the regional center provide person-centered planning services in order to make arrangements for transition to the Self-Determination Program, provided that the individual is reasonably expected to transition to the community within 90 days. In that case, the regional center shall initiate person-centered planning services within 60 days of that request.
(3)The participant agrees to all of the following terms and conditions:
(A)The participant shall receive an orientation that meets the standards set or developed by the department to the Self-Determination Program prior to enrollment, which includes the principles of self-determination, the role of the independent facilitator and the financial management services provider, person-centered planning, and development of a budget.
(B)The participant shall utilize the services and supports available within the Self-Determination Program only when generic services and supports are not available.
(C)The participant shall only purchase services and supports necessary to implement their IPP and shall comply with any and all other terms and conditions for participation in the Self-Determination Program described in this section.
(D)The participant shall manage Self-Determination Program services and supports within the participants individual budget.
(E)The participant shall utilize the services of a financial management services provider of their own choosing and who is vendored by a regional center and who meets the qualifications in paragraph (1) of subdivision (c).
(F)The participant may utilize the services of an independent facilitator of their own choosing for the purpose of providing services and functions as described in paragraph (2) of subdivision (c). If the participant elects not to use an independent facilitator, the participant may use their regional center service coordinator to provide the services and functions described in paragraph (2) of subdivision (c).
(G)If eligible, with the assistance of the regional center, if needed, timely apply for Medi-Cal in order to maximize federal funding. The participant may consider institutional deeming in order to qualify for Medi-Cal services.
(e)A participant who is not Medi-Cal eligible may participate in the Self-Determination Program and receive self-determination services and supports if all other program eligibility requirements are met and the services and supports are otherwise eligible for federal financial participation.
(f)The additional federal financial participation funds generated by the former participants of the self-determination pilot projects authorized pursuant to Section 13 of Chapter 1043 of the Statutes of 1998, as amended, or pursuant to Article 4 (commencing with Section 4669.2) of Chapter 5, shall be used to maximize the ability of Self-Determination Program participants to direct their own lives and to ensure the department and regional centers successfully implement the program as follows:
(1)First, to offset the cost to the department for the criminal background check conducted pursuant to subdivision (v) and other administrative costs incurred by the department in implementing the Self-Determination Program.
(2)With the remaining funds, the department, in consultation with stakeholders, including a statewide self-determination advisory workgroup, shall prioritize the use of the funds to meet the needs of participants, increase service access and equity, and reduce disparities, and to implement the program, including costs associated with all of the following:
(A)Independent facilitators to assist with a participants initial person-centered planning meeting.
(B)Development of the participants initial individual budget.
(C)Joint training of consumers, family members, regional center staff, and members of the local volunteer advisory committee established pursuant to paragraph (1) of subdivision (w).
(D)Regional center operations to increase support for transition to the Self-Determination Program or for caseload ratio enhancement.
(E)To offset the costs to the regional centers in implementing the Self-Determination Program.
(F)To support the Statewide Self-Determination Advisory Committee established pursuant to paragraph (2) of subdivision (w).
(g)If at any time during participation in the Self-Determination Program a regional center determines that a participant is no longer eligible to continue in, or a participant voluntarily chooses to exit, the Self-Determination Program, the regional center shall provide for the participants transition from the Self-Determination Program to other services and supports. This transition shall include the development of a new IPP that reflects the services and supports necessary to meet the individuals needs. The regional center shall ensure that there is no gap in services and supports during the transition period.
(h)An individual determined to be ineligible for or who voluntarily exits the Self-Determination Program shall be permitted to return to the Self-Determination Program upon meeting all applicable eligibility criteria and upon approval of the participants planning team, as described in subdivision (j) of Section 4512. An individual who has voluntarily exited the Self-Determination Program shall not return to the program for at least 12 months.
(i)An individual who participates in the Self-Determination Program may elect to continue to receive self-determination services and supports if the individual transfers to another regional center catchment area, provided that the individual remains eligible for the Self-Determination Program pursuant to subdivision (d). The balance of the participants individual budget shall be reallocated to the regional center to which the participant transfers.
(j)The IPP team shall utilize the person-centered planning process to develop the IPP for a participant. The IPP shall detail the goals and objectives of the participant that are to be met through the purchase of participant-selected services and supports. The IPP team shall determine the individual budget to ensure the budget assists the participant to achieve the outcomes set forth in the participants IPP and ensures their health and safety. The completed individual budget shall be attached to the IPP.
(k)The participant shall implement their IPP, including choosing and purchasing the services and supports allowable under this section necessary to implement the plan. A participant is exempt from the cost control restrictions regarding the purchases of services and supports pursuant to Section 4648.5. A regional center shall not prohibit the purchase of any service or support that is otherwise allowable under this section.
(l)A participant shall have all the rights established in Sections 4646 to 4646.6, inclusive, and Chapter 7 (commencing with Section 4700).
(m)(1)Except as provided in paragraph (4), the IPP team shall determine the initial and any revised individual budget for the participant using the following methodology:
(A)(i)Except as specified in clause (ii), for a participant who is a current consumer of the regional center, their individual budget shall be the total amount of the most recently available 12 months of purchase of service expenditures for the participant.
(ii)An adjustment may be made to the amount specified in clause (i) if both of the following occur:
(I)The IPP team determines that an adjustment to this amount is necessary due to a change in the participants circumstances, needs, or resources that would result in an increase or decrease in purchase of service expenditures, or the IPP team identifies prior needs or resources that were unaddressed in the IPP, which would have resulted in an increase or decrease in purchase of service expenditures. When adjusting the budget, the IPP team shall document the specific reason for the adjustment in the IPP.
(II)The regional center certifies on the individual budget document that regional center expenditures for the individual budget, including any adjustment, would have occurred regardless of the individuals participation in the Self-Determination Program.
(iii)For purposes of clauses (i) and (ii), the amount of the individual budget shall not be increased to cover the cost of the independent facilitator.
(B)For a participant who is either newly eligible for regional center services or who does not have 12 months of purchase service expenditures, the participants individual budget shall be calculated as follows:
(i)The IPP team shall identify the services and supports needed by the participant and available resources, as required by Section 4646.
(ii)The regional center shall calculate the cost of providing the services and supports to be purchased by the regional center by using the average cost paid by the regional center for each service or support unless the regional center determines that the consumer has a unique need that requires a higher or lower cost. The IPP team also shall document the specific reason for the adjustment in the IPP. The regional center shall certify on the individual budget document that this amount would have been expended using regional center purchase of service funds regardless of the individuals participation in the Self-Determination Program.
(iii)For purposes of clauses (i) and (ii), the amount of the individual budget shall not be increased to cover the cost of the independent facilitator.
(2)The amount of the individual budget shall be available to the participant each year for the purchase of program services and supports. An individual budget shall be calculated no more than once in a 12-month period, unless revised to reflect a change in circumstances, needs, or resources of the participant using the process specified in clause (ii) of subparagraph (A) of paragraph (1).
(3)The spending plan shall be assigned to uniform budget categories developed by the department in consultation with stakeholders and distributed according to the timing of the anticipated expenditures in the IPP and in a manner that ensures that the participant has the financial resources to implement the IPP throughout the year.
(4)The department, in consultation with stakeholders, may develop alternative methodologies for individual budgets that are computed in a fair, transparent, and equitable manner and are based on consumer characteristics and needs, and that include a method for adjusting individual budgets to address a participants change in circumstances or needs.
(n)Annually, participants may transfer up to 10 percent of the funds originally distributed to any budget category set forth in paragraph (3) of subdivision (m) to another budget category or categories. Transfers in excess of 10 percent of the original amount allocated to any budget category may be made upon the approval of the regional center or the participants IPP team.
(o)Consistent with the implementation date of the IPP, the IPP team shall annually ascertain from the participant whether there are any circumstances or needs that require a change to the annual individual budget. Based on that review, the IPP team shall calculate a new individual budget consistent with the methodology identified in subdivision (m).
(p)(1)The department, as it determines necessary, may adopt regulations to implement the procedures set forth in this section. Any regulations shall be adopted in accordance with the requirements of Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code.
(2)Notwithstanding paragraph (1) and Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, and only to the extent that all necessary federal approvals are obtained, the department, without taking any further regulatory action, shall implement, interpret, or make specific this section by means of program directives or similar instructions until the time regulations are adopted. It is the intent of the Legislature that the department be allowed this temporary authority as necessary to implement program changes only until completion of the regulatory process.
(q)The department, in consultation with stakeholders, shall develop informational materials about the Self-Determination Program. The department shall ensure that regional centers are trained in the principles of self-determination, the mechanics of the Self-Determination Program, and the rights of consumers and families as candidates for, and participants in, the Self-Determination Program.
(r)Each regional center shall be responsible for implementing the Self-Determination Program as a term of its contract under Section 4629. As part of implementing the program, the regional center shall do all of the following:
(1)Meet the Self-Determination Program targets approved by the department, meet benchmarks established by the department in areas including timely enrollment, diversity of consumers served, and reduction of disparities in the individual budget of participants from racial and ethnic communities, and be eligible for incentives for exceeding these targets and benchmarks once the department has established a performance incentives program.
(2)Develop and implement an outreach and training plan about the Self-Determination program Program for the diverse communities served by the regional center, including in congregate settings. Information shall be provided in plain language, in alternative formats and alternative modes of communication communication, and provide language access as required by state and federal law. Obtain input from stakeholders, including consumers and families families, that reflect the ethnic and language diversity of the regional centers consumers, about the effectiveness of this outreach and training and other activities that may be effective in reducing disparities in these programs.
(3)Annually report the enrollment, individual budget data, and purchase of service expenditure data for the Self-Determination Program consistent with the criteria in subdivisions (a) to (c), inclusive, of Section 4519.5.
(4)Assist eligible participants and their families in applying for Medi-Cal, in order to maximize federal funding and assist interested participants who wish to pursue institutional deeming in order to qualify for Medi-Cal services.
(5)At least annually, in addition to annual certification, conduct an additional review of all final individual budgets for participants at the regional center which are at or above a spending threshold that is specified by the department through directive consistent with federal and state requirements. This information may be used in the aggregate to provide training, program guidance, and verify compliance with state and federal requirements.
(6)Review the spending plan to verify that goods and services eligible for federal financial participation are not used to fund goods or services available through generic agencies.
(7)Contract with local consumer or family-run organizations and consult with the local volunteer advisory committee established pursuant to paragraph (1) of subdivision (w) to conduct outreach through local meetings or forums to consumers and their families to provide information about the Self-Determination Program and to help ensure that the program is available to a diverse group of participants, with special outreach to underserved communities.
(8)Collaborate with the local consumer or family-run organizations identified in paragraph (1) to jointly conduct training about the Self-Determination Program. The regional center shall consult with the local volunteer advisory committee established pursuant to paragraph (1) of subdivision (w) in planning for the training, and the local volunteer advisory committee may designate members to represent the advisory committee at the training.
(9)Train all service coordinators and fair hearing specialists in the principles of self-determination, the mechanics of the Self-Determination Program, and the rights of consumers and families. The training shall be conducted in collaboration with the local volunteer advisory committee.
(10)Provide payment to the financial management services provider for spending plan expenses through a not less than semi-monthly semimonthly pay schedule.
(11)Ensure that each individual plan includes the information required by subdivision (d) of Section 4646.
(s)The financial management services provider shall provide the participant and the regional center service coordinator with a monthly individual budget statement that describes the amount of funds allocated by budget category, the amount spent in the previous 30-day period, and the amount of funding that remains available under the participants individual budget.
(t)Only the financial management services provider is required to apply for vendorization in accordance with Subchapter 2 (commencing with Section 54300) of Chapter 3 of Division 2 of Title 17 of the California Code of Regulations for the Self-Determination Program. All other service and support providers shall not be on the federal debarment list and shall have applicable state licenses, certifications, or other state required documentation, including documentation of any other qualifications required by the department, but are exempt from the vendorization requirements set forth in Title 17 of the California Code of Regulations when serving participants in the Self-Determination Program.
(u)The regional center shall pay the full costs of the participants financial management services provider.
(v)To protect the health and safety of participants in the Self-Determination Program, the department shall require a criminal background check in accordance with all of the following:
(1)The department shall issue a program directive that identifies nonvendored providers of services and supports who shall obtain a criminal background check pursuant to this subdivision. At a minimum, these staff shall include both of the following:
(A)Individuals who provide direct personal care services to a participant.
(B)Other nonvendored providers of services and supports for whom a criminal background check is requested by a participant or the participants financial management service.
(2)Subject to the procedures and requirements of this subdivision, the department shall administer criminal background checks consistent with the departments authority and the process described in Sections 4689.2 to 4689.6, inclusive.
(3)The department shall electronically submit to the Department of Justice fingerprint images and related information required by the Department of Justice of nonvendored providers of services and supports, as specified in paragraph (1), for purposes of obtaining information as to the existence and content of a record of state or federal convictions and state or federal arrests and also information as to the existence and content of a record of state or federal arrests for which the Department of Justice establishes that the person is free on bail or on their own recognizance pending trial or appeal.
(4)When received, the Department of Justice shall forward to the Federal Bureau of Investigation requests for federal summary criminal history information received pursuant to this section. The Department of Justice shall review the information returned from the Federal Bureau of Investigation and compile and disseminate a response to the department.
(5)The Department of Justice shall provide a state or federal response to the department pursuant to paragraph (1) of subdivision (p) of Section 11105 of the Penal Code.
(6)The department shall request from the Department of Justice subsequent notification service, as provided pursuant to Section 11105.2 of the Penal Code, for persons described in paragraph (1).
(7)The Department of Justice shall charge a fee sufficient to cover the cost of processing the request described in this subdivision.
(8)The fingerprints of any provider of services and supports who is required to obtain a criminal background check shall be submitted to the Department of Justice prior to employment. The costs of the fingerprints and the financial management services administrative cost authorized by the department shall be paid by the services and supports provider or the providers employing agency. Any administrative costs incurred by the department pursuant to this subdivision shall be offset by the funds specified in subdivision (g).
(9)If the criminal record information report shows a criminal history, the department shall take the steps specified in Section 4689.2. The department may prohibit a provider of services and supports from becoming employed, or continuing to be employed, based on the criminal background check, as authorized in Section 4689.6. The provider of services and supports who has been denied employment shall have the rights set forth in Section 4689.6.
(10)The department may utilize a current department-issued criminal record clearance to enable a provider to serve more than one participant, as long as the criminal record clearance has been processed through the department and no subsequent arrest notifications have been received relative to the cleared applicant.
(11)Consistent with subdivision (h) of Section 4689.2, the participant or financial management service that denies or terminates employment based on written notification from the department shall not incur civil liability or unemployment insurance liability.
(w)To ensure the effective implementation of the Self-Determination Program and facilitate the sharing of best practices and training materials commencing with the implementation of the Self-Determination Program, local and statewide advisory committees shall be established as follows:
(1)Each regional center shall establish a local volunteer advisory committee to provide oversight of the Self-Determination Program and identify a regional center liaison to the committee. The regional center and the State Council on Developmental Disabilities shall each appoint one-half of the membership of the committee. The committee shall consist of the regional center clients rights advocate, consumers, family members, and other advocates, and community leaders, including a representative from a family resource center. A majority of the committee shall be consumers and their family members. The committee shall reflect the multicultural diversity and geographic profile of the catchment area. The committee shall review the development and ongoing progress of the Self-Determination Program, including whether the program advances the principles of self-determination and is operating consistent with the requirements of this section, and may make ongoing recommendations for improvement to the regional center and the department. Annually, the regional center shall confirm, in writing, that the committee meets the requirements specified in this paragraph and provide the department with the name of the staff liaison and the names of the committee members, the positions they fill on the committee, and which entity appointed them to the committee.
(2)The State Council on Developmental Disabilities shall form a volunteer committee, to be known as the Statewide Self-Determination Advisory Committee, comprised of the chairs of the 21 local advisory committees or their designees. The council shall convene the Statewide Self-Determination Advisory Committee twice annually, or more frequently in the sole discretion of the council. The Statewide Self-Determination Advisory Committee shall meet by teleconference or other means established by the council to identify self-determination best practices, effective consumer and family training materials, implementation concerns, systemic issues, ways to enhance the program, and recommendations regarding the most effective method for participants to learn of individuals who are available to provide services and supports. The council shall synthesize information received from the Statewide Self-Determination Advisory Committee, local advisory committees, and other sources, share the information with consumers, families, regional centers, and the department, and make recommendations, as appropriate, to increase the programs effectiveness in furthering the principles of self-determination.
(x)The department shall annually provide the following information to the appropriate policy and fiscal committees of the Legislature:
(1)Number and characteristics of participants, by regional center, including the number of participants who entered the program upon movement from a developmental center.
(2)Types and amount of services and supports purchased under the Self-Determination Program, by regional center.
(3)Range and average of individual budgets, by regional center, including adjustments to the budget to address the adjustments permitted in clause (ii) of subparagraph (A) of paragraph (1) of subdivision (m).
(4)The number and outcome of appeals concerning individual budgets, by regional center.
(5)The number and outcome of fair hearing appeals, by regional center.
(6)The number of participants who voluntarily withdraw from the Self-Determination Program and a summary of the reasons why, by regional center.
(7)The number of participants who are subsequently determined to no longer be eligible for the Self-Determination Program and a summary of the reasons why, by regional center.
(y)(1)The State Council on Developmental Disabilities shall issue an interim report to the Legislature, in compliance with Section 9795 of the Government Code, no later than June 30, 2021, on the status of the Self-Determination Program authorized by this section, barriers to its implementation, and recommendations to enhance the effectiveness of the program. The interim report shall provide an update to the programs status, each regional centers cap on participation and progress toward that cap, the most recent statewide and per-regional-center participant count, and the historical trend in the statewide participation count since the start of the program. The department shall assist in providing available information to the council in order to facilitate the timely issuance of the report.
(2)The council, in collaboration with the protection and advocacy agency identified in Section 4900 and the federally funded University Centers for Excellence in Developmental Disabilities Education, Research, and Service, may work with regional centers to survey participants regarding participant satisfaction under the Self-Determination Program and, when data is available, the traditional service delivery system, including the proportion of participants who report that their choices and decisions are respected and supported and who report that they are able to recruit and hire qualified service providers, and to identify barriers to participation and recommendations for improvement.
(3)The council, in collaboration with the protection and advocacy agency identified in Section 4900 and the federally funded University Centers for Excellence in Developmental Disabilities Education, Research, and Service, shall issue a report to the Legislature, in compliance with Section 9795 of the Government Code, by June 30, 2023, on the status of the Self-Determination Program authorized by this section, and provide recommendations to enhance the effectiveness of the program. This review shall include the programs effectiveness in furthering the principles of self-determination, including all of the following:
(A)Freedom, which includes the ability of adults with developmental disabilities to exercise the same rights as all citizens to establish, with freely chosen supporters, family and friends, where they want to live, with whom they want to live, how their time will be occupied, and who supports them; and for families to have the freedom to receive unbiased assistance of their own choosing when developing a plan and to select all personnel and supports to further the life goals of a minor child.
(B)Authority, which includes the ability of a person with a disability, or family, to control a certain sum of dollars in order to purchase services and supports of their choosing.
(C)Support, which includes the ability to arrange resources and personnel, both formal and informal, that will assist a person with a disability to live a life in the community that is rich in community participation and contributions.
(D)Responsibility, which includes the ability of participants to take responsibility for decisions in their own lives and to be accountable for the use of public dollars, and to accept a valued role in their community through, for example, competitive employment, organizational affiliations, spiritual development, and general caring of others in their community.
(E)Confirmation, which includes confirmation of the critical role of participants and their families in making decisions in their own lives and designing and operating the system that they rely on.
SEC. 18.SEC. 21.Section 4726 of the Welfare and Institutions Code is amended to read:4726.Notwithstanding Sections 4639.76 and 5328, access to records shall be provided to an applicant for, or recipient of, services or to their authorized representative, including the person appointed as a developmental services decisionmaker pursuant to Section 319, 361, or 726, for purposes of the appeal process under this chapter.
SEC. 19.SEC. 22.Section 4731 of the Welfare and Institutions Code is amended to read:4731.(a)Each consumer or any representative acting on behalf of any consumer or consumers, who believes that any right to which a consumer is entitled has been abused, punitively withheld, or improperly or unreasonably denied by a regional center, state-operated facility, or service provider, may pursue a complaint as provided in this section.
(b)Any complaint made pursuant to this section shall be made to the Director of Developmental Services. The director, within 30 days of receiving a complaint, shall issue a written administrative decision and send a copy of the decision to the complainant, the director of the regional center or state-operated facility, and the service provider, if applicable.
(c)The department, on a quarterly basis, shall compile the number of complaints filed, by each regional center and state-operated facility, the subject matter of each complaint, and a summary of each decision, and post the compilation on its internet website at the end of each quarter. Copies of any decision included in the compilation shall be made available within 10 days, with all individually identifiable information redacted, to any person upon request.
(d)This section shall not be used to resolve disputes concerning the nature, scope, or amount of services and supports that should be included in an individual program plan, for which there is an appeals procedure established in this division, or disputes regarding rates or audit appeals for which there is an appeals procedure established in regulations. Those disputes shall be resolved through the appeals procedure established by this division or in regulations.
(e)All consumers or, if appropriate, their authorized representative, shall be notified in writing in their preferred language of the right to file a complaint pursuant to this section when they apply for services from a regional center or a state-operated facility, and at each regularly scheduled planning meeting.
This act shall be known, and may be cited, as the Disability Equity and Accountability Act of 2023.
SEC. 2.(a)The Legislature finds and declares as follows:
(1)Recent reports and hearings by the California State Auditor, the Little Hoover Commission, and advocacy organizations have found that Californias service system for the over 400,000 children and adults with intellectual and developmental disabilities through the Lanterman Act, as overseen by the State Department of Developmental Services, which contracts with 21 regional centers, is failing in significant ways to deliver critical, adequate, and timely services to individuals and families. The result is that individuals and families, particularly those of color, are unable to timely access services and supports, resulting in barriers to their living independent, productive, and integrated lives in their communities.
(2)Californias developmental disability service system is plagued with racial, ethnic, and geographic disparities that can dramatically impact the essential services received by children and adults with developmental disabilities. Systemic inequities and discrimination within Californias 21 regional centers broaden the gap between inclusive possibilities and segregated limitations. Data show Latinos are most negatively impacted by these disparities, but people who are clients of the lowest-performing regional centers are also significantly affected.
(3)California spends nearly $13,000,000,000 annually on the administration and delivery of developmental services, but lacks a transparent, common, integrated, and coordinated model for the delivery and measurement of services throughout the 21 regional centers, resulting in poor outcomes, poor satisfaction levels by consumer and families, and disparate levels of available services and performance expectations.
(4)The delivery of services through 21 separate private nonprofit regional centers with separate boards, funding, and delivery models was originally intended to ensure that the delivery of services could be more effectively delivered through nonstate entities. However, with the subsequent caseload and budget growth since the enactment of the Lanterman Act, local administration has become more disparate and less accountable. Boards of directors are untrained and are not providing the oversight needed of the regional centers. Stronger state oversight of regional centers by the State Department of Developmental Services is essential to ensure that services are equitably delivered, performance and outcomes are uniformly measured and reported, and the system is transparent and accountable to individuals and families.
(5)The departments system lacks a statewide automated technology system for the delivery of services to persons with intellectual and developmental disabilities and, as a result, the current program is constrained by disparate automation systems, inadequate documentation, the lack of open system architecture, insufficient data to support administration of the system, and the lack of data to support program improvements for improving the quality of life outcomes through new service delivery methods.
(6)Statewide uniformity of service delivery practices and procedures is essential to an effective program and to support necessary oversight and research for ongoing program improvements.
(7)The departments technical infrastructure is over 40 years old. The lack of a statewide automation system does not meet current program needs and significantly contributes to the racial and geographic disparities in the delivery of services. California currently lacks clear and consistent service delivery outcomes for individuals with intellectual and developmental disabilities that sets high expectations for their quality of life, and must develop a system for measuring and quantifying the value of service delivery outcomes.
(8)A previous effort to develop an intellectual and developmental disabilities (IDD) program technology system failed. As a result, the department and regional centers maintain a patchwork of at least three case management and fiscal systems that are not integrated and six legacy case management automation systems that lack integration, have dissimilar data sources, and are technically outdated.
(9) In the 202122 annual budget the Legislature appropriated $6,000,000 to the State Department of Developmental Services for planning purposes related to the implementation of a uniform fiscal system and consumer electronic records management system. The department has not developed a vision or scope for a proposed system development approach.
(b)Therefore, it is the intent of the Legislature in enacting this act to do all of the following:
(1)Ensure that racial, ethnic, and geographic service disparities be systemically addressed and eliminated and that all people, regardless of their race or ethnicity or where they live, receive equitable access to services within the regional center system.
(2)Ensure that all regional centers offer and provide a consistent and common set of services and that the services are delivered in a timely way.
(3) Ensure that the delivery of all services and supports comply with federal law and guidance and are responsive to the needs and choices of beneficiaries receiving home- and community-based services, are person-centered and strengths-based, have high expectations for interdependence, self-direction, and competitive integrated employment, provide support coordination to assist with a community supported life, and achieve a more consistent and coordinated approach to the administration of policies and procedures across the state.
(4)Provide the department with new tools for holding regional centers and service providers accountable through the development of a standardized and coordinated set of performance measures and related standards that establish targets and standards above which a regional center may receive incentives for improved performance, and a separate set of standards that require corrective action.
(5)Improve regional center governance by establishing new standards and procedures for regional center governing boards to ensure they can more effectively represent the communities they serve by providing them with greater independence and protection from regional center retaliation.
(6)Require the State Department of Developmental Services to develop a written project charter for the planning and development of a uniform statewide automation system that serves as a foundation document for the system development, which includes project guiding principles, scope, strategies and approach, and project governance, in order to provide transparency to the Legislature and the public on the system development as has been used with other statewide system development.
SEC. 3.Section 4519.5 of the Welfare and Institutions Code is amended to read:4519.5.(a)The department and the regional centers shall annually collaborate to compile data in a uniform manner relating to purchase of service authorization, utilization, and expenditure by each regional center with respect to all of the following:
(1)The age of the consumer, categorized by the following:
(A)Birth to two years of age, inclusive.
(B)Three to 21 years of age, inclusive.
(C)Twenty-two years of age and older.
(2)Race or ethnicity of the consumer.
(3)Preferred language spoken by the consumer, and other related details, as feasible.
(4)Disability detail, in accordance with the categories established by subdivision (a) of Section 4512, and, if applicable, a category specifying that the disability is unknown.
(5)Residence type, subcategorized by age, race or ethnicity, and preferred language.
(6)Number of instances when the written copy of the individual program plan was provided at the request of the consumer and, when appropriate, the consumers parents, legal guardian or conservator, or authorized representative, in a language other than a threshold language, as defined by paragraph (3) of subdivision (a) of Section 1810.410 of Title 9 of the California Code of Regulations, if that written copy was provided more than 60 days after the request.
(7)Number of instances when the written copy of the individual program plan was provided at the request of the consumer and, when appropriate, the consumers parents, legal guardian or conservator, or authorized representative, in a threshold language, as defined by paragraph (3) of subdivision (a) of Section 1810.410 of Title 9 of the California Code of Regulations, if that written copy was provided more than 45 days after the request, in violation of paragraph (5) of subdivision (a) of Section 4646.5.
(8)Beginning with data for the fiscal year of 202324, the numbers, percentages, and total and per capita expenditure and authorization amounts, by age, as applicable, according to race or ethnicity and preferred language, for all combined residence types and for consumers living in the family home, regarding the following service types:
(A)Camping and associated travel expenses.
(B)Social recreation activities.
(C)Educational services.
(D)Nonmedical therapies, including, but not limited to, specialized recreation, art, dance, and music.
(b)The data reported pursuant to subdivision (a) shall also include the number and percentage of individuals, categorized by age, race or ethnicity, and disability, and by residence type, as set forth in paragraph (5) of subdivision (a), who have been determined to be eligible for regional center services, but are not receiving purchase of service funds.
(c)By March 31, 2013, each regional center shall post the data described in this section that are specific to the regional center on its website. Commencing on December 31, 2013, each regional center shall annually post these data by December 31. Each regional center shall maintain all previous years data on its website.
(d)By March 31, 2013, the department shall post the information described in this section on a statewide basis on its website. Commencing December 31, 2013, the department shall annually post this information by December 31. The department shall maintain all previous years data on its website. The department shall also post notice of any regional center stakeholder meetings on its website.
(e)Within three months of compiling the data with the department, and annually thereafter, each regional center shall meet with stakeholders in one or more public meetings regarding the data. The meeting or meetings shall be held separately from any meetings held pursuant to Section 4660. The regional center shall provide participants of these meetings with the data and any associated information related to improvements in the provision of developmental services to underserved communities and shall conduct a discussion of the data and the associated information in a manner that is culturally and linguistically appropriate for that community, including providing alternative communication services, as required by Sections 11135 to 11139.7, inclusive, of the Government Code and implementing regulations. Regional centers shall inform the department of the scheduling of those public meetings 30 days prior to the meeting. Notice of the meetings shall also be posted on the regional centers website 30 days prior to the meeting and shall be sent to individual stakeholders and groups representing underserved communities in a timely manner. Each regional center shall, in holding the meetings required by this subdivision, consider the language needs of the community and shall schedule the meetings at times and locations designed to result in a high turnout by the public and underserved communities.
(f)(1)Each regional center shall annually report to the department regarding its implementation of the requirements of this section. The report shall include, but shall not be limited to, all of the following:
(A)Actions the regional center took to improve public attendance and participation at stakeholder meetings, including, but not limited to, attendance and participation by underserved communities.
(B)Copies of minutes from the meeting and attendee comments.
(C)Whether the data described in this section indicate a need to reduce disparities in the purchase of services among consumers in the regional centers catchment area. If the data do indicate that need, the regional centers recommendations and plan to promote equity, and reduce disparities, in the purchase of services.
(2)Each regional center and the department shall annually post the reports required by paragraph (1) on its website by August 31.
(g)(1)The department shall consult with stakeholders, including consumers and families that reflect the ethnic and language diversity of regional center consumers, regional centers, advocates, providers, family resource centers, the protection and advocacy agency described in Section 4901, and those entities designated as University Centers for Excellence in Developmental Disabilities Education, Research, and Service pursuant to Section 15061 of Title 42 of the United States Code, to achieve the following objectives:
(A)Review the data compiled pursuant to subdivision (a).
(B)Identify barriers to equitable access to services and supports among consumers and develop recommendations to help reduce disparities in purchase of service expenditures.
(C)Encourage the development and expansion of culturally appropriate services, service delivery, and service coordination.
(D)Identify best practices to reduce disparity and promote equity.
(2)The department shall report the status of its efforts to satisfy the requirements of paragraph (1) during the 201617 legislative budget subcommittee hearing process.
(h)(1)Subject to available funding, the department shall allocate funding to regional centers or community-based organizations with department oversight to assist with implementation of the recommendations and plans developed pursuant to subdivisions (f) and (g). Activities funded through these allocations may include, but are not limited to, pay differentials supporting direct care bilingual staff of community-based service providers, parent or caregiver education programs, cultural competency training for regional center staff, outreach to underserved populations, or additional culturally appropriate service types or service delivery models.
(2)Each regional center shall consult with stakeholders regarding activities that may be effective in addressing disparities in the receipt of regional center services and the regional centers proposed requests for the funding specified in paragraph (1). Each regional center shall identify the stakeholders it consulted with and include information on how it incorporated the input of stakeholders into its requests.
(3)A community-based organization may submit a request for grant funding pursuant to this subdivision. The organization shall submit the request concurrently to the regional center of the jurisdiction in which the organization is located and to the department. The regional center shall provide the department with input regarding the request prior to the departments final determination on the request.
(4)The department shall review requests for funding within 45 days from the deadline specified in the departments guidance to regional centers and community-based organizations.
(5)Each regional center and community-based organization receiving funding shall report annually to the department, in a manner determined by the department, on how the funding allocations were used and shall include recommendations of priorities for activities that may be effective in addressing disparities, based on the consultation with stakeholders.
(6)The department shall post the following information on its website:
(A)By September 1 of any year in which grant funding is available and has not been allocated, a structure for the grant program, including all of the following information:
(i)How community-based organizations reflecting groups that are disadvantaged by disparities in the purchase of services will be invited to participate in the grant program.
(ii)How statewide strategies were considered.
(iii)How the department will ensure grant funds are not used for activities that regional centers are otherwise required by statute or regulation to conduct.
(iv)How funded activities will be evaluated.
(B)By October 1 of any year in which grant funding is available and has not been allocated, the final invitation for requests for funding or another mechanism through which requests for funding are solicited.
(C)By January 1 of any year in which grant funding has been allocated, a list of grant recipients, funding level per grant, and a description of the funded project.
(D)By May 1 of any year in which the information is available, evaluation results from prior grants. To ensure the department complies with this subparagraph, regional centers and community-based organizations receiving funding shall provide the department, by March 1 of the same year, with an evaluation of funded activities and the effectiveness of those activities in reducing disparities in the purchase of services, to the extent information is available.
(i)On or before December 31, 2021, the department shall 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 subdivision (h).
(j)For the purposes of this section, the department shall require all of the following:
(1)The use by the department and regional centers, when reporting data by race and ethnicity, of consistent classifications of race and ethnicity, based on categories current in use by the United States Census Bureau.
(2)Confirmation of the race and ethnicity identification of each consumer at the time of the annual review of the consumers individual program plan (IPP).
(3)When reporting by residence types, separate presentation of data for those in independent living services and those in supported living services.
(4)Consistent standards and requirements for regional center internet websites, using the same placement and language for all information required by this division, including that data be posted in a machine-readable format.
SEC. 4.Section 4519.20 is added to the Welfare and Institutions Code, to read:4519.20.As part of the departments planning process for the planning and development of a uniform statewide data automation system, the department, in consultation with stakeholders shall develop, by _____, a project charter that shall be approved by the Secretary of the California Health and Human Services Agency and the Department of Technology. The charter development process shall include the participation and input of program consumers and families, researchers and quality and outcome evaluators, regional centers, and service providers. The project charter shall include all of the following:
(a)An impact statement on the primary entities and individuals impacted by the system development.
(b)Project guiding principles that are foundational to the project approach to be used throughout the planning, development, implementation, and maintenance of the system.
(c)Project scope that addresses business problems required to be solved by the system, including all of the following:
(1)Worker effectiveness and accountability that are constrained by the lack of timely, adequate, and accurate data, the lack of uniformity, and the current systems limited functionality.
(2)Service delivery that is constrained by the lack of timely, adequate, accurate and accessible data, the lack of clear understandable communication of information, lack of uniformity, and the systems limited functionality.
(3)Current system maintainability that is constrained by disparate systems, inadequate documentation, the lack of open system architecture, and business changes.
(4)Disparate systems, complex business rules, the number of locations and variability of local system delivery, and changes in the way of doing business.
(5)Limited access of researchers and program evaluators to the set of person-level data that they need to assess program effectiveness.
(d)Program goals, which shall include all of the following:
(1)Maximizing the performance and the business processes for the delivery of intellectual or developmental disability (IDD) system services to consumers at the regional centers.
(2)Improving data quality, privacy, confidentiality, and integration of all data sources at an individual level.
(3)Enabling data-driven decisionmaking and performance measures for the effective administration of the program.
(4)Improving the business processes administered by the department to support regional center service delivery.
(5)Supporting access to individual level data to support program evaluation and other research.
(e)Technology goals that recognize that a statewide system solution not only meets requirements, but also ensures effective transition, while minimizing disruption to existing services.
(f)Project strategies and approaches for development and implementation.
(g)Project governance.
(h)Technology that can readily be enhanced and modernized for the expected system life. In selecting the new system, consideration shall be given to the extent to which the candidate systems employ open architectures and standards and the future ability of the selected system to provide enhancements that will improve long-term effectiveness of program management of the statewide service delivery system.
SEC. 5.Section 4571 of the Welfare and Institutions Code is amended to read:4571.(a)It is the intent of the Legislature to ensure the well-being of consumers, taking into account their informed and expressed choices. It is further the intent of the Legislature to support the satisfaction and success of consumers through the delivery of quality services and supports. Evaluation of the services that consumers receive is a key aspect to the service system. Utilizing the information that consumers and their families provide about those services in a reliable and meaningful way is also critical to enable the department to assess the performance of the states developmental services system and to improve services for consumers in the future. To that end, the State Department of Developmental Services, on or before January 1, 2010, shall implement an improved, unified quality assessment system, in accordance with this section.
(b)The department, in consultation with stakeholders, shall identify a valid and reliable quality assurance instrument that assesses consumer and family satisfaction, provision of services in a linguistically and culturally competent manner, and personal outcomes. The instrument shall do all of the following:
(1)Provide nationally validated, benchmarked, consistent, reliable, and measurable data for the departments Quality Management System.
(2)Enable the department and regional centers to compare the performance of Californias developmental services system against other states developmental services systems and to assess quality and performance among all of the regional centers.
(3)Include outcome-based measures such as health, safety, well-being, relationships, interactions with people who do not have a disability, employment, quality of life, integration, choice, service, and consumer satisfaction.
(4)Include outcome-based measures to evaluate the linguistic and cultural competency of regional center services that are provided to consumers across their lifetimes.
(c)To the extent that funding is available, the instrument identified in subdivision (b) may be expanded to collect additional data requested by the State Council on Developmental Disabilities.
(d)(1)The department shall contract with an independent agency or organization to implement, by January 1, 2010, the quality assurance instrument described in subdivision (b). The contractor shall be experienced in all of the following:
(A)Designing valid quality assurance instruments for developmental service systems.
(B)Tracking outcome-based measures such as health, safety, well-being, relationships, interactions with people who do not have a disability, employment, quality of life, integration, choice, service, and consumer satisfaction.
(C)Developing data systems.
(D)Data analysis and report preparation.
(E)Assessments of the services received by consumers who are moved from developmental centers to the community, given the Legislatures historic recognition of a special obligation to ensure the well-being of these persons.
(F)Issues related to linguistic and cultural competency.
(2)Notwithstanding any other law, the contract and any amendments pursuant to this section shall be exempt from all of the following:
(A)The personal services contracting requirements of Article 4 (commencing with Section 19130) of Chapter 5 of Part 2 of Division 5 of Title 2 of the Government Code.
(B)The Public Contract Code, the State Contracting Manual, and the State Administration Manual.
(C)The approval of the Department of General Services.
(D)The approval of the Department of Technology.
(3)The exemptions specified in paragraph (2) shall remain in effect until there is more than one available assessment that meets the criteria in subdivision (b) from an organization that also meets the criteria in this subdivision.
(e)The department, in consultation with the contractor described in subdivision (d), shall establish the methodology by which the quality assurance instrument shall be administered, including, but not limited to, how often and to whom the quality assurance will be administered, and the design of a stratified, random sample among the entire population of consumers served by regional centers. The contractor shall provide aggregate information for all regional centers and the state as a whole. At the request of a consumer or the family member of a consumer, the survey shall be conducted in the primary language of the consumer or family member surveyed.
(f)The department shall contract with the state council to collect data for the quality assurance instrument described in subdivision (b). If, during the data collection process, the state council identifies any suspected violation of the legal, civil, or service rights of a consumer, or if it determines that the health and welfare of a consumer is at risk, that information shall be provided immediately to the regional center providing case management services to the consumer. At the request of the consumer or family, when appropriate, a copy of the completed survey shall be provided to the regional center providing case management services to improve the consumers quality of services through the individual planning process.
(g)The department, in consultation with stakeholders, shall annually review the data collected from and the findings of the quality assurance instrument described in subdivision (b) and accept recommendations regarding additional or different criteria for the quality assurance instrument in order to assess the performance of the states developmental services system and improve services for consumers.
(h)(1)Each regional center shall annually present data collected from, and the findings of, the quality assurance instrument described in subdivision (b) for that regional center, at a public meeting of its governing board in order to assess the comparative performance of the regional center and identify needed improvements in services for consumers, including, but not limited to, case management services. Notice of this meeting shall also be posted on the regional centers internet website at least 30 days prior to the meeting and shall be sent to regional center consumers and families and individual stakeholders at least 30 days prior to the meeting. The governing board shall provide a sufficient public comment period so members of the public may provide comments. Each regional center, in holding the meeting required by this subdivision, shall ensure that the meeting and meeting materials provide language access, as required by state and federal law.
(2)All regional center-specific reports generated by the department pursuant to this subdivision shall be made publicly available on the regional centers internet website in a machine-readable format, but shall not contain any personal identifying information about any person assessed.
(3)Within 60 days following its annual presentation, each regional center shall submit a report to the department regarding its implementation of the requirements of this section. The report shall include, but shall not be limited to, both of the following:
(A)Copies of the presentation described in paragraph (1), minutes from the meeting, and attendee comments.
(B)The regional centers recommendations and plans to use the information to address regional center priorities, strategic directions to improve specific areas of performance, or both.
(i)All reports generated pursuant to this section shall be made publicly available, but shall not contain any personal identifying information about any person assessed.
(j)All data collected pursuant to subdivision (c) shall be provided to the state council, but shall not contain personal identifying information about the persons being surveyed.
(k)Implementation of this section shall be subject to an annual appropriation of funds in the Budget Act for this purpose.
(l)By March 1, 2024, the department shall submit a report to the policy and budget subcommittees of the Legislature describing the extent to which the requirements of this section have not been met, including the surveying of all consumers, including those with no purchase of services, and providing specific steps and the schedule by which these requirements will be met.
SEC. 6.Section 4622 of the Welfare and Institutions Code is amended to read:4622.The state shall contract only with agencies, the governing boards of which conform to all of the following criteria:
(a)The governing board shall be composed of individuals with demonstrated interest in, or knowledge of, developmental disabilities.
(b)The membership of the governing board shall include persons with legal, management or board governance, financial, and developmental disability program expertise. Board governance expertise may not be acquired solely by serving on a regional center board. The governing board of the regional center shall include members with financial expertise and members with management or board governance expertise by August 15, 2020.
(c)The membership of the governing board shall include representatives of the various categories of disability to be served by the regional center.
(d)The governing board shall reflect the geographic and ethnic characteristics of the area to be served by the regional center.
(e)A minimum of 50 percent of the members of the governing board shall be persons with developmental disabilities or their parents or legal guardians. No less than 25 percent of the members of the governing board shall be persons with developmental disabilities.
(f)(1)Members of the governing board shall not be permitted to serve more than seven years within each eight-year period. a six-year term, and may return to the board for a subsequent term after five years. The members of each regional center governing board nominating committee shall be comprised of current board members and members of the community, and should be representative of the community served in the regional centers catchment area.
(2)The board nominating committee shall solicit interests and nominations from the broader community through outreach. The committee shall interview candidates for the board and make recommendations to the governing board for election. During the meeting at which the board elects new members, a candidate may be nominated by a board member with a second by another board member for the open positions. A regional center executive director shall be prohibited from any involvement in the recruitment or election of governing board members.
(g)(1)The regional center department shall provide necessary training and support to these board members to facilitate their understanding and participation, including issues relating to linguistic and cultural competency. The training shall be developed with community input, including persons served and family members. Ongoing support by the department shall include surveying board members about their ability to meaningfully participate in, and understand the subjects and votes at, board meetings. If board members report that they are unable to meaningfully participate, the department shall work with the regional center and the board member to ensure adequate and appropriate accommodations are provided.
(2)As part of its monitoring responsibility, the department shall review and approve the method by which training and support are provided to board members to ensure maximum understanding and participation by board members.
(3)Each regional center shall post on its internet website information regarding the training and support provided to board members.
(h)The governing board may appoint a consumers advisory committee composed of persons with developmental disabilities representing the various categories of disability served by the regional center.
(i)The governing board shall appoint an advisory committee composed of a wide variety of persons representing the various categories of providers from which the regional center purchases client services. The advisory committee shall provide advice, guidance, recommendations, and technical assistance to the regional center board in order to assist the regional center in carrying out its mandated functions. The advisory committee shall designate one of its members to serve as a member of the regional center board.
(j)(1)The governing board shall annually review the performance of the director of the regional center. The department shall establish guidelines for governing boards to measure executive director performance, including with respect to issues of equity and diversity.
(2)The governing board shall annually review the performance of the regional center in providing services that are linguistically and culturally appropriate and may provide recommendations to the director of the regional center based on the results of that review.
(k)No A member of the board who is an employee or member of the governing board of a provider from which the regional center purchases client services shall not do any of the following:
(1)Serve as an officer of the board.
(2)Vote on any fiscal matter affecting the purchase of services from any regional center provider.
(3)Vote on any issue other than as described in paragraph (2), in which the member has a financial interest, as defined in Section 87103 of the Government Code, and determined by the regional center board. The member shall provide a list of the members financial interests, as defined in Section 87103, to the regional center board.
Nothing in this section shall prevent the appointment to a regional center governing board of a person who meets the criteria for more than one of the categories listed above.(l)The department shall establish, and each board shall adopt, an antiretaliation policy for board members that requires department approval for any reduction in services for consumer board members or the family member of family board members.
(m)The department shall establish and adopt a grievance procedure whereby a governing board member who has concerns, complaints, or questions may contact a specific executive at the department.
(n)This section does not prevent the appointment to a regional center governing board of a person who meets the criteria for more than one of the categories listed above.
SEC. 7.Section 4626.5 of the Welfare and Institutions Code is amended to read:4626.5.Each regional center shall submit a conflict-of-interest policy to the department by July 1, 2011, and shall post the policy on its Internet Web site internet website by August 1, 2011. The policy shall do, or comply with, all of the following:
(a)Contain the elements of this section and be consistent with applicable law.
(b)Define conflicts of interest.
(c)Identify positions within the regional center required to complete and file a conflict-of-interest statement.
(d)Facilitate disclosure of information to identify conflicts of interest.
(e)Require candidates for nomination, election, or appointment to a regional center board, and applicants for regional center director to disclose any potential or present conflicts of interest prior to being appointed, elected, or confirmed for hire by the regional center or the regional center governing board.
(f)Require the regional center and its governing board to regularly and consistently monitor and enforce compliance with its conflict-of-interest policy.
(g)Prohibit a regional center employee from accepting a gift or gifts from a service provider, consumer, or consumers family member valued over ten dollars ($10) per year.
(h)Establish a policy prohibiting regional center senior staff from hiring relatives at the center or any ancillary foundation and organization. The policy shall be included in the regional center contract and shall be included in training of the governing board.
SEC. 8.Section 4629.1 is added to the Welfare and Institutions Code, to read:4629.1.(a)Notwithstanding any other law, the evaluation of regional center performance shall be implemented using a common set of performance measures, which shall be administered by the department. This includes the performance requirements under the regional center contracts pursuant to Section 4629, the performance incentives established under Section 4620.5, and the quality assessment instrument required under Section 4571. These measures shall be annually reported and made available to the public through posting of the measures results in machine-readable formats.
(b)By July 1, 2024, the department shall establish standards for each measure above, for which a regional center may receive rewards for good performance, and a separate set of minimal standards, below which the regional center is subject to each level of probation required under Section 4629. The department shall establish the process for assessing corrective action undertaken by a regional center and the process by which a regional center may end its probation status.
(c)The performance measures shall encompass the domains and the associated measures as itemized in subdivision (d). Additional measures may be adopted by the department as needed. Modification of the domain and measures shall be accomplished through a process of consultation that includes the engagement of stakeholders in a manner consistent with that required by subdivision (b) of Section 4620.5. The measures may be amended as reporting mechanisms mature as the department develops new information technology capabilities.
(d)The performance measures for purposes of this section shall be organized under seven domains, as follows:
(1)Community integration, including all of the following:
(A)The percentage of consumers who report spending their days primarily with people without disabilities who are not paid to be with them.
(B)The percentage of consumers who report they feel part of their communities, participate in community activities, know their neighbors, and have friends.
(C)The percentage of minor consumers living in licensed group homes or other institutional settings.
(D)The percentage of adult consumers living in licensed group homes, intermediate care facilities, or other institutional settings.
(E)The percentage of adult consumers living in their own homes with independent living services.
(F)The percentage of adult consumers living in their own homes with supported living services.
(G)The percentage of adult consumers seeking affordable and accessible housing.
(H)The percentage of adult consumers that have secured housing outside of their family home, if desired.
(2)Employment, including all of the following:
(A)The percentage of adult consumers in competitive integrated employment and the length of time in the job.
(B)The percentage of employed adult consumers reporting increased wages and opportunities for advancement.
(C)The percentage of employed adult consumers reporting satisfaction with their jobs with the ability to learn new skills and interact with coworkers.
(D)The average per capita annual wages of employed adult consumers.
(E)The percentage of participants in the paid internship program that led to permanent employment.
(F)The average hourly wage for competitive, integrated employment.
(G)The average number of hours per week in competitive, integrated employment.
(H)The percentage of adult consumers in competitive integrated employment, by race and ethnicity.
(3)Equity in service access, including all of the following:
(A)Per capita spending, by race and ethnicity.
(B)Per capita spending, by primary language.
(C)Timely eligibility determination, by race and ethnicity.
(D)Access to Early Start services by race and ethnicity.
(E)Per capita spending on adult consumers, by residence type and by race and ethnicity.
(F)Per capita spending on adult consumers, by residence type and regional center.
(G)The percentage of consumers with no purchase of services, by regional center.
(H)The percentage of consumers with no purchase of services, by race and ethnicity.
(4)Case management, including all of the following:
(A)Timeliness of intake for eligibility.
(B)Timeliness of initiation of services for Early Start.
(C)Timeliness of development of IPPs.
(D)Timeliness of delivery of IPP services after authorization.
(E)Share of consumers reporting that the regional center service coordinator assisted them in attaining generic resources.
(F)Responsiveness of service coordinator.
(G)Consumer or family directs their own person-centered planning process.
(H)Timeliness of translated IPPs and other documents.
(5)Consumer and family choice, experience, and satisfaction, including all of the following:
(A)Overall satisfaction and happiness.
(B)Service coordinator cultural competency.
(C)Service coordinator who speaks consumers language.
(D)Access to approved services.
(E)Access to services provided by individuals who speak the consumers language.
(F)Consumers report they are treated with dignity and respect.
(G)Access to the Self-Determination Program.
(H)The ability to select their services and providers from among a range of choices.
(I)The ability to select the place where they live, with whom they live, and who supports them.
(J)The percentage of consumers who report having a way to communicate and express choices and decisions.
(K)The percentage of consumers or families who report that they understand the information provided to them by their regional center.
(L)The percentage of consumers or families reporting they feel comfortable in their interactions with the regional center, and if they are aware they can change their service coordinator.
(6)Human and civil rights, including all of the following:
(A)The number of special incident reports, and number of incidents of seclusion and restraint or other types of abuse by regional center.
(B)The percentage of consumers reporting they have a private space, if they live out of their family home.
(C)The percentage of adult consumers who vote in elections.
(D)The percentage of adult consumers who are conserved.
(7)Health and safety, including all of the following:
(A)Hospitalization and mortality rates among regional center consumers.
(B)The percentage of consumers receiving regular preventative care, vaccinations, and cancer screenings.
SEC. 9.Section 4639.76 is added to the Welfare and Institutions Code, to read:4639.76.A regional center with which the department maintains a contract pursuant to Section 4629 shall be subject to the California Public Records Act (Chapter 1 (commencing with Section 7920.000) of Division 10 of Title 1 of the Government Code).
SEC. 10.Section 4642 of the Welfare and Institutions Code is amended to read:4642.(a)(1)Any person believed to have a developmental disability, and any person believed to have a high risk of parenting a developmentally disabled infant an infant with a developmental disability shall be eligible for initial intake and assessment services in the regional centers. In addition, any infant having a high risk of becoming developmentally disabled may be eligible for initial intake and assessment services in the regional centers. For purposes of this section, high-risk infant means a child less than 36 months of age whose genetic, medical, or environmental history is predictive of a substantially greater risk for developmental disability than that for the general population. The department, in consultation with the State Department of Public Health, shall develop specific risk and service criteria for the high-risk infant program on or before July 1, 1983. These criteria may be modified in subsequent years based on analysis of actual clinical experience.
(2)Initial intake shall be performed within 15 working days following request for assistance. Initial intake shall include, but need not be limited to, information and advice about the nature and availability of services provided by the regional center and by other agencies in the community, including guardianship, conservatorship, income maintenance, mental health, housing, education, work activity and vocational training, medical, dental, recreational, and other services or programs that may be useful to persons with developmental disabilities or their families. Intake shall also include a decision to provide assessment.
(3)(A)The department shall create, with input from stakeholders, standardized information packets to be provided to any person seeking services from a regional center. There shall be one information packet related to services provided under the California Early Intervention Services Act and another information packet related to services provided under the Lanterman Developmental Disabilities Services Act. The information packets shall be translated to provide language access, as required by state and federal law, shall be available in alternative formats and alternative modes of communication, as required by federal law, and shall include, at a minimum, all of the following:
(i)An overview of the regional center system.
(ii)A resource guide for consumers and their families.
(iii)Consumer rights. rights, including the appeals procedures specified in Chapter 7 (commencing with Section 4700).
(iv)Contact information for the regional center, the department, the office of clients rights advocacy, and the protection and advocacy agency specified in Division 4.7 (commencing with Section 4900).
(v)Information on the Self-Determination Program, including the eligibility requirements specified in subdivision (d) of Section 4685.8.
(B)Each regional center shall distribute the information packets at intake, upon transfer to receiving services under the Lanterman Developmental Disabilities Services Act, and upon request. Each regional center shall begin distributing the information packets within 60 days following the department providing the information packets and issuing directives regarding the distribution of the information packets. In addition to, and not in lieu of, this requirement, each regional center shall post the full content of the most updated information packet on its internet website.
(b)A regional center shall communicate with the consumer and the consumers family pursuant to this section in their native language, including providing alternative communication services and alternative formats, as required by state and federal law.
SEC. 11.Section 4643 of the Welfare and Institutions Code is amended to read:4643.(a)If assessment is needed, the assessment shall be performed within 120 days regional center shall require the assessment to be completed within 60 days following initial intake. Assessment shall be performed commenced as soon as possible possible, and in no event more than 60 30 days following initial intake where when any delay would expose the client to unnecessary risk to his or her their health and safety or to significant further delay in mental or physical development, or the client would be at imminent risk of placement in a more restrictive environment. Assessment may include collection and review of available historical diagnostic data, provision or procurement of necessary tests and evaluations, and summarization of developmental levels and service needs and is conditional upon receipt of the release of information specified in subdivision (b).
(b)In determining if an individual meets the definition of developmental disability contained in subdivision (a) of Section 4512, the regional center may consider evaluations and tests, including, but not limited to, intelligence tests, adaptive functioning tests, neurological and neuropsychological tests, diagnostic tests performed by a physician, psychiatric tests, and other tests or evaluations that have been performed by, and are available from, other sources.
(c)At the time of assessment, the individual, or, where appropriate, the parents, legal guardian, or conservator, shall provide copies of any health benefit cards under which the consumer is eligible to receive health benefits, including, but not limited to, private health insurance, a health care service plan, Medi-Cal, Medicare, and TRICARE. If the individual, or where appropriate, the parents, legal guardians, or conservators, have no such benefits, the regional center shall not use that fact to negatively impact the services that the individual may or may not receive from the regional center.
(d)A regional center shall communicate with the consumer and his or her the consumers family pursuant to this section in their native preferred language, including providing alternative communication services, as required by Sections 11135 to 11139.7, inclusive, of the Government Code and implementing regulations.
SEC. 12.Section 4646 of the Welfare and Institutions Code is amended to read:4646.(a)It is the intent of the Legislature to ensure that the individual program plan and provision of services and supports by the regional center system is centered on the individual and the family of the individual with developmental disabilities and takes into account the needs and preferences of the individual and the family, if appropriate, as well as promoting community integration, independent, productive, and normal lives, and stable and healthy environments. It is the further intent of the Legislature to ensure that individual program plans shall be developed consistent with the federal Affordable Care Act and the regulations and federal guidance adopted pursuant to the act requiring that community-based long-term services and supports be person-centered and self-directed. It is the further intent of the Legislature to ensure that goals in any plan allow for innovation and nontraditional service delivery and not be limited by the lack of easily identified services or supports, the provision of services to consumers and their families be effective in meeting the goals stated in the individual program plan, reflect the preferences and choices of the consumer, and reflect the cost-effective use of public resources.
(b)The (1)Notwithstanding any other law, the individual program plan is shall be developed through a process of individualized needs determination. determination and person-centered service planning developed pursuant to, and consistent with, Section 2402(a) of the federal Affordable Care Act (Pub. L. 111-148) and amendments thereto, Section 441.725 of Title 42 of the Code of Federal Regulations, and federal guidance issued by the Centers for Medicaid and Medicare Services on June 6, 2014, requiring community-based, long-term services and supports to be person-centered, strengths-based, and self-directed. The individual with developmental disabilities and, if appropriate, the individuals parents, legal guardian or conservator, or authorized representative, shall have the opportunity to actively participate in the development of the plan. The individual shall lead the service planning process to the greatest extent possible.
(c)An individual program plan shall be developed for any person who, following intake and assessment, is found to be eligible for regional center services. These plans shall be completed within 60 days of the completion of the assessment. A final assessment agreement shall be completed and provided to the consumer within 30 days of an intake unless there is good cause for the regional center to exceed the 30-day time period, but in no event shall the assessment be completed any later than 60 days from the intake unless the consumer or, if appropriate, the parents, legal guardian, conservator, or authorized representative request additional time pursuant to subdivision (h). If a completed assessment recommends the delivery of services, those services shall be provided within seven days of the receipt of the assessment by the regional center. At the time of intake, the regional center shall inform the consumer and, if appropriate, the consumers parents, legal guardian or conservator, or authorized representative, of the services available through the state council and the protection and advocacy agency designated by the Governor pursuant to federal law, and shall provide the address and telephone numbers of those agencies.
(d)(1)As part of the initial individual program plan meeting and each annual review required by subdivision (b) of Section 4646.5, the consumer or, if appropriate, their parents, legal guardian, conservator, or authorized representative, shall be provided by the service coordinator oral and written information about the Self-Determination Program. The information shall include each of the provisions specified in subdivision (d) of Section 4685. Each individual program plan shall include a provision stating that the consumer or authorized representative was informed about the availability of the Self-Determination Program. If the consumer chooses not to participate in the program, the individual program plan shall include an explanation of the reason or reasons for that decision, or, if the consumer is ineligible for the program, the reason or reasons for that ineligibility.
(2)If the consumer is interested in participating in the program or wants additional information or assistance, the service coordinator, within five days of expressing the interest, shall provide the consumer a date for the Self-Determination Program orientation, training resources, dates of local volunteer Self-Determination Program advisory committee meetings, and other information to assist the consumer in participating in the program.
(d)(e)Individual program plans shall be prepared jointly by the planning team. Decisions concerning the consumers goals, objectives, and services and supports that will be included in the consumers individual program plan and purchased by the regional center or obtained from generic agencies shall be made by agreement between the regional center representative and the consumer or, if appropriate, the parents, legal guardian, conservator, or authorized representative at the program plan meeting.
(e)(f)Regional centers shall comply with the request of a consumer or, if appropriate, the request of the consumers parents, legal guardian, conservator, or authorized representative, that a designated representative receive written notice of all meetings to develop or revise the individual program plan and of all notices sent to the consumer pursuant to Section 4710. The designated representative may be a parent or family member.
(f)(g)Notwithstanding any other law, until June 30, 2023, a meeting regarding the provision of services and supports by the regional center, including a meeting to develop or revise the individual program plan, shall be held by remote electronic communications if requested by the consumer or, if appropriate, if requested by the consumers parents, legal guardian, conservator, or authorized representative.
(g)(h)At the conclusion of an individual program plan meeting, an authorized representative of the regional center shall provide to the consumer, in written or electronic format, a list of the agreed-upon services and supports, and, if known, the projected supports and the start date, the frequency and duration of the services and supports, and the provider. provider, and a summary page written in plain language. The identified services and supports specified in an individual program plan referred to a provider shall begin on the date specified in the plan. In the event the services or supports are not started by the provider within 45 days of the specified start date, a referral shall be made within 14 days to another provider for delivery of the specified services and supports. The authorized representative of the regional center shall sign the list of agreed-upon services and supports at that time. The consumer, or if appropriate, the consumers parent, legal guardian, conservator, or authorized representative shall sign the list of agreed-upon services and supports prior to its implementation. The consumer, or if appropriate, the consumers parent, legal guardian, conservator, or authorized representative, may elect to delay receipt of the list of agreed-upon services and supports pending final agreement, as described in subdivision (h). If the consumer, or if appropriate, the consumers parent, legal guardian, conservator, or authorized representative, elects to delay the receipt of the list of agreed-upon services and supports for 15 days, the list shall be provided in the preferred language of the consumer, or of the consumers parent, legal guardian, or authorized representative.
(h)(i)If a final agreement regarding the services and supports to be provided to the consumer cannot be reached at a program plan meeting, then a subsequent program plan meeting shall be convened within 15 days, or later at the request of the consumer or, if appropriate, the parents, legal guardian, conservator, or authorized representative or if agreed to by the planning team. The list of the agreed-upon services and supports described in subdivision (g) (h) and signed by the authorized representative of the regional center shall be provided, in writing or electronically, at the conclusion of the subsequent program plan meeting, and shall be provided in the preferred language of the consumer, or of the consumers parent, legal guardian, conservator, or authorized representative. Additional program plan meetings may be held with the agreement of the regional center representative and the consumer or, if appropriate, the parents, legal guardian, conservator, or authorized representative.
(i)(j)An authorized representative of the regional center and the consumer or, if appropriate, the consumers parent, legal guardian, conservator, or authorized representative shall sign the individual program plan and the list of the agreed-upon services and supports prior to its implementation. If the consumer or, if appropriate, the consumers parent, legal guardian, conservator, or authorized representative, does not agree with all components of the individual program plan, the consumer may indicate that disagreement on the plan. Disagreement with specific plan components shall not prohibit the implementation of services and supports agreed to by the consumer or, if appropriate, the consumers parent, legal guardian, conservator, or authorized representative. If the consumer or, if appropriate, the consumers parent, legal guardian, conservator, or authorized representative, does not agree with the plan in whole or in part, the consumer shall be sent written notice of their appeal rights, as required by Sections 4701 and 4710.
(j)(k)(1)A regional center shall communicate in the consumers preferred language, or, if appropriate, the preferred language of the consumers family, legal guardian, conservator, or authorized representative, during the planning process for the individual program plan, including during the program plan meeting, and including providing alternative communication services, as required by Sections 11135 to 11139.8, inclusive, of the Government Code and implementing regulations.
(2)A regional center shall provide alternative communication services, including providing copies of the list of services and supports, and the individual program plan in the preferred language of the consumer or the consumers family, legal guardian, conservator, or authorized representative, or both, as required by Sections 11135 to 11139.8, inclusive, of the Government Code and implementing regulations.
(3)The preferred language of the consumer or the consumers family, legal guardian, conservator, or authorized representative, or both, shall be documented in the individual program plan.
SEC. 13.Section 4646.4 of the Welfare and Institutions Code is amended to read:4646.4.(a)Regional centers shall ensure, at the time of development, scheduled review, or modification of a consumers individual program plan developed pursuant to Sections 4646 and 4646.5, or of an individualized family service plan pursuant to Section 95020 of the Government Code, the establishment of an internal process. This internal process shall ensure adherence with federal and state law and regulation, and if purchasing services and supports, shall ensure all of the following:
(1)Conformance with the regional centers purchase of service policies, as approved by the department pursuant to subdivision (d) of Section 4434.
(2)Utilization of generic services and supports if appropriate. The individualized family service planning team for infants and toddlers eligible under Section 95014 of the Government Code and the individual program plan team pursuant to Section 4646 may determine that a medical service identified in the individualized family service plan is not available through the familys private health insurance policy or health care service plan and therefore, in compliance with the timely provision of service requirements contained in Part 303 (commencing with Section 303.1) of Title 34 of the Code of Federal Regulations, service provided by a generic agency, as defined by subdivision (g) of Section 4659.5, or a service or source of funding contained in Section 4659 identified in the individualized family service plan or individual program plan is not available, and, therefore, will be funded by the regional center.
(3)Utilization of other services and sources of funding as contained in Section 4659.
(4)Consideration of the familys responsibility for providing similar services and supports for a minor child without disabilities in identifying the consumers service and support needs as provided in the least restrictive and most appropriate setting. In this determination, regional centers shall take into account the consumers need for extraordinary care, services, supports and supervision, and the need for timely access to this care.
(5)Commencing October 1, 2022, consideration of information obtained from the consumer and, if appropriate, the parents, legal guardian, conservator, or authorized representative about the consumers need for the services, barriers to service access, and other information.
(b)At the time of development, scheduled review, or modification of a consumers individual program plan developed pursuant to Sections 4646 and 4646.5, or of an individualized family service plan pursuant to Section 95020 of the Government Code, the consumer, or, if appropriate, the parents, legal guardian, or conservator, shall provide copies of their health benefit cards under which the consumer is eligible to receive health benefits, including, but not limited to, private health insurance, a health care service plan, Medi-Cal, Medicare, and TRICARE. If the individual, or, if appropriate, the parents, legal guardians, or conservators, do not have health benefits, the regional center shall not use that fact to negatively impact the services that the individual may or may not receive from the regional center.
(c)Final decisions regarding the consumers individual program plan shall be made pursuant to Section 4646.
(d)Final decisions regarding the individualized family service plan shall be made pursuant to Section 95020 of the Government Code.
SEC. 14.Section 4646.5 of the Welfare and Institutions Code is amended to read:4646.5.(a)The planning process for the individual program plan described in Section 4646 shall include all of the following:
(1)Gathering information and conducting assessments to determine the life goals, capabilities and strengths, preferences, barriers, and concerns or problems of the person with developmental disabilities. For children with developmental disabilities, this process should include a review of the strengths, preferences, and needs of the child and the family unit as a whole. Assessments shall be conducted by qualified individuals and performed in natural environments whenever possible. Information shall be taken from the consumer, the consumers parents and other family members, the consumers friends, advocates, authorized representative, if applicable, providers of services and supports, and other agencies. The assessment process shall reflect awareness of, and sensitivity to, the lifestyle and cultural background of the consumer and the family.
(2)A statement of goals, based on the needs, preferences, and life choices of the individual with developmental disabilities, and a statement of specific, time-limited objectives for implementing the persons goals and addressing the persons needs. These objectives shall be stated in terms that allow measurement of progress or monitoring of service delivery. These goals and objectives should maximize opportunities for the consumer to develop relationships, be part of community life in the areas of community participation, housing, work, school, and leisure, increase control over the consumers life, acquire increasingly positive roles in community life, and develop competencies to help accomplish these goals.
(3)In developing individual program plans for children, regional centers shall be guided by the principles, process, and services and support parameters set forth in Section 4685.
(4)In developing an individual program plan for a transition age youth or working age adult, the planning team shall consider the Employment First Policy described in Chapter 14 (commencing with Section 4868).
(5)A schedule of the type and amount of services and supports to be purchased by the regional center or obtained from generic agencies or other resources in order to achieve the individual program plan goals and objectives, and identification of the provider or providers of service responsible for attaining each objective, including, but not limited to, vendors, contracted providers, generic service agencies, and natural supports. The individual program plan shall specify the approximate scheduled start date for services and supports and shall contain timelines for actions necessary to begin services and supports, including generic services. In addition to the requirements of subdivision (h) of Section 4646, each regional center shall offer, and upon request provide, a written copy of the individual program plan to the consumer, and, if appropriate, the consumers parents, legal guardian or conservator, or authorized representative within 45 days of their request in a threshold language, as defined by paragraph (3) of subdivision (a) of Section 1810.410 of Title 9 of the California Code of Regulations.
(6)If agreed to by the consumer, the parents, legally appointed guardian, or authorized representative of a minor consumer, or the legally appointed conservator of an adult consumer or the authorized representative, including those appointed pursuant to subdivision (a) of Section 4541, subdivision (b) of Section 4701.6, and subdivision (e) of Section 4705, a review of the general health status of the adult or child, including medical, dental, and mental health needs, shall be conducted. This review shall include a discussion of current medications, any observed side effects, and the date of the last review of the medication. Service providers shall cooperate with the planning team to provide any information necessary to complete the health status review. If any concerns are noted during the review, referrals shall be made to regional center clinicians or to the consumers physician, as appropriate. Documentation of health status and referrals shall be made in the consumers record by the service coordinator.
(7)(A)The development of a transportation access plan for a consumer when all of the following conditions are met:
(i)The regional center is purchasing private, specialized transportation services or services from a residential, day, or other provider, excluding vouchered service providers, to transport the consumer to and from day or work services.
(ii)The planning team has determined that a consumers community integration and participation could be safe and enhanced through the use of public transportation services.
(iii)The planning team has determined that generic transportation services are available and accessible.
(B)To maximize independence and community integration and participation, the transportation access plan shall identify the services and supports necessary to assist the consumer in accessing public transportation and shall comply with Section 4648.35. These services and supports may include, but are not limited to, mobility training services and the use of transportation aides. Regional centers are encouraged to coordinate with local public transportation agencies.
(8)A schedule of regular periodic review and reevaluation to ascertain that planned services have been provided, that objectives have been fulfilled within the times specified, and that consumers and families are satisfied with the individual program plan and its implementation.
(b)For all active cases, individual program plans shall be reviewed and modified by the planning team, through the process described in Section 4646, as necessary, in response to the persons achievement or changing needs, and no less often than once every three years. 12 months. If the consumer or, if appropriate, the consumers parents, legal guardian, authorized representative, or conservator requests an individual program plan review, the individual program plan shall be reviewed within 30 days after the request is submitted, or no later than 7 days after the request is submitted if necessary for the consumers health and safety or to maintain the consumer in their home.
(c)(1)The department, with the participation of representatives of a statewide consumer organization, the Association of Regional Center Agencies, an organized labor organization representing service coordination staff, and the state council shall prepare training material and a standard format and instructions for the preparation of individual program plans, which embody an approach centered on the person and family. a person-centered planning process consistent with federal law, regulations and guidance.
(2)Each regional center shall use the training materials and format prepared by the department pursuant to paragraph (1).(2)The department shall require each regional center to use, for all new and modified individual program plans, the training materials and the standard format plan prepared by the department pursuant to paragraph (1) by no later than March 1, 2024.
(3)The department shall biennially review a random sample of individual program plans at each regional center to ensure that these plans are being developed and modified in compliance with Section 4646 and this section.
SEC. 15.Section 4647 of the Welfare and Institutions Code is amended to read:4647.(a)Pursuant to Section 4640.7, service coordination shall include those activities necessary to implement an individual program plan, including, but not limited to, participation in the individual program plan process; assurance that the planning team considers all appropriate options for meeting each individual program plan objective; securing, through purchasing or by obtaining from generic agencies or other resources, services and supports specified in the persons individual program plan; coordination of service and support programs; collection and dissemination of information; and monitoring implementation of the plan to ascertain that objectives have been fulfilled and to assist in revising the plan as necessary. necessary, and ensuring service coordinators are accessible to consumers and their representatives by telephone and other electronic means, which shall include responding to consumer inquiries within 48 hours of the inquiry.
(b)The regional center shall assign ensure that every consumer has a service coordinator who shall be responsible for implementing, overseeing, and monitoring each individual program plan. The service coordinator may be an employee of the regional center or may be a qualified individual or employee of an agency with whom the regional center has contracted to provide service coordination services, or persons described in Section 4647.2. The regional center shall provide the consumer or, where appropriate, his or her the consumers parents, legal guardian, or conservator or authorized representative, with written notification of any temporary or permanent change in the assigned service coordinator within 10 business days. No person shall A person shall not continue to serve as a service coordinator for any individual program plan unless there is agreement by all parties that the person should continue to serve as service coordinator.
(c)Where appropriate, a consumer or the consumers parents or other family members, legal guardian, or conservator, may perform all or part of the duties of the service coordinator described in this section if the regional center director agrees and it is feasible.
(d)If any a person described in subdivision (c) is designated as the service coordinator, that person shall not deviate from the agreed-upon program plan and shall provide any reasonable information and reports required by the regional center director.
(e)If any a person described in subdivision (c) is designated as the service coordinator, the regional center shall provide ongoing information and support as necessary, to assist the person to perform all or part of the duties of service coordinator.
SEC. 16.Section 4659 of the Welfare and Institutions Code is amended to read:4659.(a)Except as otherwise provided in subdivision (b) (b), (d), or (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 centers purchase of services budget, except as it relates to federal supplemental security income and the state supplementary program.
(c)Effective July 1, 2009, notwithstanding any other law or regulation, 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 Childrens 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. coverage after being advised of the provisions of subdivision (d). If, on July 1, 2009, a regional center is purchasing that service as part of a consumers individual program plan (IPP), the prohibition shall take effect on October 1, 2009.
(d)(1)Effective July 1, 2009, notwithstanding any other law or regulation, 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 consumers 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 the state council in pursuing these appeals.(d)(1) Notwithstanding Section 4646.4, a regional center may request a consumer or family member to pursue a service or source of funding from an entity described in subdivision (a) or (c) of this section, or pursuant to subdivision (g) of Section 4659.5, if the request is documented with specificity in the individual program plan or individualized family plan and the plan contains detailed instructions for the consumer or family pursuing the service. The individual program plan or individualized family plan shall also specify the ways in which the regional center will initially assist the consumer or family to apply for and pursue the service or source of funding and specify that it will provide additional assistance when requested by the consumer or family.
(2)The regional center shall purchase the service when either of the following occurs:
(A)The entity denies the service.
(B)The entity does not provide the requested service within 45 days from the date of the request, or 15 days after the statutory or regulatory time limit, if any, for the entity to make an initial decision, whichever is shorter.
(3)A consumer, or their family, shall not be required to appeal an entitys denial of the requested service for the regional center to purchase that service pursuant to this subdivision. The regional center may file an appeal on behalf of the consumer, but the appeal shall not delay the payment of the requested service by the regional center as specified in subparagraph (B) of paragraph (2).
(4)This section does not prohibit a consumer or their family, where appropriate, from filing a formal appeal of an entitys denial of the service at issue, or a regional center from seeking reimbursement from the entity it believes is responsible for providing the service and from requesting assistance with filing the appeal or from utilizing assistance from other advocacy organizations.
(e)This section shall not 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.
(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.
SEC. 17.Section 4685.8 of the Welfare and Institutions Code is amended to read:4685.8.(a)The department shall implement a statewide Self-Determination Program. The Self-Determination Program shall 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. As of July 1, 2021, the program shall begin to be available on a voluntary basis to all regional center consumers who are eligible for the Self-Determination Program.
(b)The department, in establishing the statewide program, shall do both of the following:
(1)Set targets and benchmarks as set forth in paragraph (1) of subdivision (r).
(2)Address all of the following:
(A)Oversight of expenditure of self-determined funds and the achievement of participant outcomes over time.
(B)Increased participant control over which services and supports best meet the participants needs and the IPP objectives. A participants unique support system may include the purchase of existing service offerings from service providers or local businesses, hiring their own support workers, or negotiating unique service arrangements with local community resources.
(C)Comprehensive person-centered planning, including an individual budget and services that are outcome based.
(D)Consumer and family training to ensure understanding of the principles of self-determination, the planning process, and the management of budgets, services, and staff.
(E)Choice of independent facilitators, who meet standards and certification requirements established by the department, and who can assist with the functions specified in paragraph (2) of subdivision (c).
(F)Choice of financial management services providers who meet standards and certification requirements established by the department, and who can carry out the functions specified in paragraph (1) of subdivision (c).
(G)Innovation that will more effectively allow participants to achieve their goals.
(H)Long-term sustainability of the Self-Determination Program by doing all of the following:
(i)Requiring IPP teams, when developing the individual budget, to determine the services, supports and goods necessary for each consumer based on the needs and preferences of the consumer, and when appropriate the consumers family, and the effectiveness of each option in meeting the goals specified in the IPP, and the cost effectiveness of each option, as specified in subparagraph (D) of paragraph (6) of subdivision (a) of Section 4648.
(ii)The department may review final individual budgets that are at or above a spending threshold determined by the department of all individual budgets and use information from its review in the aggregate to develop additional program guidance and verify compliance with federal and state laws and other requirements.
(c)For purposes of this section, the following definitions apply:
(1)Financial management services means services or functions that assist the participant to manage and direct the distribution of funds contained in the individual budget, and ensure that the participant has the financial resources to implement their IPP throughout the year. These may include bill paying services and activities that facilitate the employment of service and support workers by the participant, including, but not limited to, fiscal accounting, tax withholding, compliance with relevant state and federal employment laws, assisting the participant in verifying provider qualifications, including criminal background checks, and expenditure reports. The financial management services provider shall meet the applicable requirements of Title 17 of the California Code of Regulations and other specific qualifications or certifications established by the department.
(2)Independent facilitator means a person, selected and directed by the participant, who is not otherwise providing services to the participant pursuant to their IPP and is not employed by a person providing services to the participant. The independent facilitator may assist the participant in making informed decisions about the individual budget, and in locating, accessing, and coordinating services and supports consistent with the participants IPP. The independent facilitator is available to assist in identifying immediate and long-term needs, developing options to meet those needs, leading, participating, or advocating on behalf of the participant in the person-centered planning process and development of the IPP, and obtaining identified services and supports. The cost of the independent facilitator, if any, shall be paid by the participant out of the participants individual budget. An independent facilitator shall receive training in the principles of self-determination, the person-centered planning process, and the other responsibilities described in this paragraph at the independent facilitators own cost. The independent facilitator shall meet standards and certification requirements established by the department.
(3)Individual budget means the amount of regional center purchase of service funding available to the participant for the purchase of services and supports necessary to implement the IPP. The individual budget shall be determined using a fair, equitable, and transparent methodology.
(4)IPP means individual program plan, as described in Section 4646.
(5)Participant means an individual, and when appropriate, the participants parents, legal guardian or conservator, or authorized representative, who has been deemed eligible for, and has voluntarily agreed to participate in, the Self-Determination Program.
(6)Self-determination means a voluntary delivery system consisting of a defined and comprehensive mix of services and supports, selected and directed by a participant through person-centered planning, in order to meet the objectives in their IPP. Self-determination services and supports are designed to assist the participant to achieve personally defined outcomes in community settings that promote inclusion. The Self-Determination Program shall only fund services and supports provided pursuant to this division that the federal Centers for Medicare and Medicaid Services determines are eligible for federal financial participation.
(7)Spending Plan means the plan the participant develops to use their available individual budget funds to purchase goods, services, and supports necessary to implement their individual program plan (IPP). The spending plan shall identify the cost of each good, service, and support that will be purchased with regional center funds. The total amount of the spending plan cannot exceed the amount of the individual budget. A copy of the spending plan shall be attached to the participants IPP.
(d)Participation in the Self-Determination Program is fully voluntary. A participant may choose to participate in, and may choose to leave, the Self-Determination Program at any time. A regional center shall not require or prohibit participation in the Self-Determination Program as a condition of eligibility for, or the delivery of, services and supports otherwise available under this division. Participation in the Self-Determination Program shall be available to any regional center consumer who meets the following eligibility requirements:
(1)The participant has a developmental disability, as defined in Section 4512, and is receiving services pursuant to this division.
(2)The consumer does not live in a licensed long-term health care facility, as defined in paragraph (44) of subdivision (a) of Section 54302 of Title 17 of the California Code of Regulations. An individual, and when appropriate the individuals parent, legal guardian or conservator, or authorized representative, who is not eligible to participate in the Self-Determination Program pursuant to this paragraph may request that the regional center provide person-centered planning services in order to make arrangements for transition to the Self-Determination Program, provided that the individual is reasonably expected to transition to the community within 90 days. In that case, the regional center shall initiate person-centered planning services within 60 days of that request.
(3)The participant agrees to all of the following terms and conditions:
(A)The participant shall receive an orientation that meets the standards set or developed by the department to the Self-Determination Program prior to enrollment, which includes the principles of self-determination, the role of the independent facilitator and the financial management services provider, person-centered planning, and development of a budget.
(B)The participant shall utilize the services and supports available within the Self-Determination Program only when generic services and supports are not available.
(C)The participant shall only purchase services and supports necessary to implement their IPP and shall comply with any and all other terms and conditions for participation in the Self-Determination Program described in this section.
(D)The participant shall manage Self-Determination Program services and supports within the participants individual budget.
(E)The participant shall utilize the services of a financial management services provider of their own choosing and who is vendored by a regional center and who meets the qualifications in paragraph (1) of subdivision (c).
(F)The participant may utilize the services of an independent facilitator of their own choosing for the purpose of providing services and functions as described in paragraph (2) of subdivision (c). If the participant elects not to use an independent facilitator, the participant may use their regional center service coordinator to provide the services and functions described in paragraph (2) of subdivision (c).
(G)If eligible, with the assistance of the regional center, if needed, timely apply for Medi-Cal in order to maximize federal funding. The participant may consider institutional deeming in order to qualify for Medi-Cal services.
(e)A participant who is not Medi-Cal eligible may participate in the Self-Determination Program and receive self-determination services and supports if all other program eligibility requirements are met and the services and supports are otherwise eligible for federal financial participation.
(f)The additional federal financial participation funds generated by the former participants of the self-determination pilot projects authorized pursuant to Section 13 of Chapter 1043 of the Statutes of 1998, as amended, or pursuant to Article 4 (commencing with Section 4669.2) of Chapter 5, shall be used to maximize the ability of Self-Determination Program participants to direct their own lives and to ensure the department and regional centers successfully implement the program as follows:
(1)First, to offset the cost to the department for the criminal background check conducted pursuant to subdivision (v) and other administrative costs incurred by the department in implementing the Self-Determination Program.
(2)With the remaining funds, the department, in consultation with stakeholders, including a statewide self-determination advisory workgroup, shall prioritize the use of the funds to meet the needs of participants, increase service access and equity, and reduce disparities, and to implement the program, including costs associated with all of the following:
(A)Independent facilitators to assist with a participants initial person-centered planning meeting.
(B)Development of the participants initial individual budget.
(C)Joint training of consumers, family members, regional center staff, and members of the local volunteer advisory committee established pursuant to paragraph (1) of subdivision (w).
(D)Regional center operations to increase support for transition to the Self-Determination Program or for caseload ratio enhancement.
(E)To offset the costs to the regional centers in implementing the Self-Determination Program.
(F)To support the Statewide Self-Determination Advisory Committee established pursuant to paragraph (2) of subdivision (w).
(g)If at any time during participation in the Self-Determination Program a regional center determines that a participant is no longer eligible to continue in, or a participant voluntarily chooses to exit, the Self-Determination Program, the regional center shall provide for the participants transition from the Self-Determination Program to other services and supports. This transition shall include the development of a new IPP that reflects the services and supports necessary to meet the individuals needs. The regional center shall ensure that there is no gap in services and supports during the transition period.
(h)An individual determined to be ineligible for or who voluntarily exits the Self-Determination Program shall be permitted to return to the Self-Determination Program upon meeting all applicable eligibility criteria and upon approval of the participants planning team, as described in subdivision (j) of Section 4512. An individual who has voluntarily exited the Self-Determination Program shall not return to the program for at least 12 months.
(i)An individual who participates in the Self-Determination Program may elect to continue to receive self-determination services and supports if the individual transfers to another regional center catchment area, provided that the individual remains eligible for the Self-Determination Program pursuant to subdivision (d). The balance of the participants individual budget shall be reallocated to the regional center to which the participant transfers.
(j)The IPP team shall utilize the person-centered planning process to develop the IPP for a participant. The IPP shall detail the goals and objectives of the participant that are to be met through the purchase of participant-selected services and supports. The IPP team shall determine the individual budget to ensure the budget assists the participant to achieve the outcomes set forth in the participants IPP and ensures their health and safety. The completed individual budget shall be attached to the IPP.
(k)The participant shall implement their IPP, including choosing and purchasing the services and supports allowable under this section necessary to implement the plan. A participant is exempt from the cost control restrictions regarding the purchases of services and supports pursuant to Section 4648.5. A regional center shall not prohibit the purchase of any service or support that is otherwise allowable under this section.
(l)A participant shall have all the rights established in Sections 4646 to 4646.6, inclusive, and Chapter 7 (commencing with Section 4700).
(m)(1)Except as provided in paragraph (4), the IPP team shall determine the initial and any revised individual budget for the participant using the following methodology:
(A)(i)Except as specified in clause (ii), for a participant who is a current consumer of the regional center, their individual budget shall be the total amount of the most recently available 12 months of purchase of service expenditures for the participant.
(ii)An adjustment may be made to the amount specified in clause (i) if both of the following occur:
(I)The IPP team determines that an adjustment to this amount is necessary due to a change in the participants circumstances, needs, or resources that would result in an increase or decrease in purchase of service expenditures, or the IPP team identifies prior needs or resources that were unaddressed in the IPP, which would have resulted in an increase or decrease in purchase of service expenditures. When adjusting the budget, the IPP team shall document the specific reason for the adjustment in the IPP.
(II)The regional center certifies on the individual budget document that regional center expenditures for the individual budget, including any adjustment, would have occurred regardless of the individuals participation in the Self-Determination Program.
(iii)For purposes of clauses (i) and (ii), the amount of the individual budget shall not be increased to cover the cost of the independent facilitator.
(B)For a participant who is either newly eligible for regional center services or who does not have 12 months of purchase service expenditures, the participants individual budget shall be calculated as follows:
(i)The IPP team shall identify the services and supports needed by the participant and available resources, as required by Section 4646.
(ii)The regional center shall calculate the cost of providing the services and supports to be purchased by the regional center by using the average cost paid by the regional center for each service or support unless the regional center determines that the consumer has a unique need that requires a higher or lower cost. The IPP team also shall document the specific reason for the adjustment in the IPP. The regional center shall certify on the individual budget document that this amount would have been expended using regional center purchase of service funds regardless of the individuals participation in the Self-Determination Program.
(iii)For purposes of clauses (i) and (ii), the amount of the individual budget shall not be increased to cover the cost of the independent facilitator.
(2)The amount of the individual budget shall be available to the participant each year for the purchase of program services and supports. An individual budget shall be calculated no more than once in a 12-month period, unless revised to reflect a change in circumstances, needs, or resources of the participant using the process specified in clause (ii) of subparagraph (A) of paragraph (1).
(3)The spending plan shall be assigned to uniform budget categories developed by the department in consultation with stakeholders and distributed according to the timing of the anticipated expenditures in the IPP and in a manner that ensures that the participant has the financial resources to implement the IPP throughout the year.
(4)The department, in consultation with stakeholders, may develop alternative methodologies for individual budgets that are computed in a fair, transparent, and equitable manner and are based on consumer characteristics and needs, and that include a method for adjusting individual budgets to address a participants change in circumstances or needs.
(n)Annually, participants may transfer up to 10 percent of the funds originally distributed to any budget category set forth in paragraph (3) of subdivision (m) to another budget category or categories. Transfers in excess of 10 percent of the original amount allocated to any budget category may be made upon the approval of the regional center or the participants IPP team.
(o)Consistent with the implementation date of the IPP, the IPP team shall annually ascertain from the participant whether there are any circumstances or needs that require a change to the annual individual budget. Based on that review, the IPP team shall calculate a new individual budget consistent with the methodology identified in subdivision (m).
(p)(1)The department, as it determines necessary, may adopt regulations to implement the procedures set forth in this section. Any regulations shall be adopted in accordance with the requirements of Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code.
(2)Notwithstanding paragraph (1) and Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, and only to the extent that all necessary federal approvals are obtained, the department, without taking any further regulatory action, shall implement, interpret, or make specific this section by means of program directives or similar instructions until the time regulations are adopted. It is the intent of the Legislature that the department be allowed this temporary authority as necessary to implement program changes only until completion of the regulatory process.
(q)The department, in consultation with stakeholders, shall develop informational materials about the Self-Determination Program. The department shall ensure that regional centers are trained in the principles of self-determination, the mechanics of the Self-Determination Program, and the rights of consumers and families as candidates for, and participants in, the Self-Determination Program.
(r)Each regional center shall be responsible for implementing the Self-Determination Program as a term of its contract under Section 4629. As part of implementing the program, the regional center shall do all of the following:
(1)Meet the Self-Determination targets approved by the department, meet benchmarks established by the department in areas including timely enrollment, diversity of consumers served, and reduction of disparities in the individual budget of participants from racial and ethnic communities, and be eligible for incentives for exceeding these targets and benchmarks once the department has established a performance incentives program.
(2)Develop and implement an outreach and training plan about the Self-Determination program for the diverse communities served by the regional center, including in congregate settings. Information shall be provided in plain language, in alternative formats and alternative modes of communication and provide language access as required by state and federal law. Obtain input from stakeholders, including consumers and families that reflect the ethnic and language diversity of the regional centers consumers, about the effectiveness of this outreach and training and other activities that may be effective in reducing disparities in these programs.
(3)Annually report the enrollment, individual budget data, and purchase of service expenditure data for the Self-Determination Program consistent with the criteria in subdivisions (a) to (c), inclusive, of Section 4519.5.
(4)Assist eligible participants and their families in applying for Medi-Cal, in order to maximize federal funding and assist interested participants who wish to pursue institutional deeming in order to qualify for Medi-Cal services.
(5)At least annually, in addition to annual certification, conduct an additional review of all final individual budgets for participants at the regional center which are at or above a spending threshold that is specified by the department through directive consistent with federal and state requirements. This information may be used in the aggregate to provide training, program guidance, and verify compliance with state and federal requirements.
(6)Review the spending plan to verify that goods and services eligible for federal financial participation are not used to fund goods or services available through generic agencies.
(7)Contract with local consumer or family-run organizations and consult with the local volunteer advisory committee established pursuant to paragraph (1) of subdivision (w) to conduct outreach through local meetings or forums to consumers and their families to provide information about the Self-Determination Program and to help ensure that the program is available to a diverse group of participants, with special outreach to underserved communities.
(8)Collaborate with the local consumer or family-run organizations identified in paragraph (1) to jointly conduct training about the Self-Determination Program. The regional center shall consult with the local volunteer advisory committee established pursuant to paragraph (1) of subdivision (w) in planning for the training, and the local volunteer advisory committee may designate members to represent the advisory committee at the training.
(9)Train all service coordinators and fair hearing specialists in the principles of self-determination, the mechanics of the Self-Determination Program, and the rights of consumers and families. The training shall be conducted in collaboration with the local volunteer advisory committee.
(10)Provide payment to the financial management services provider for spending plan expenses through a not less than semi-monthly pay schedule.
(11)Ensure that each individual plan includes the information required by subdivision (d) of Section 4646.
(s)The financial management services provider shall provide the participant and the regional center service coordinator with a monthly individual budget statement that describes the amount of funds allocated by budget category, the amount spent in the previous 30-day period, and the amount of funding that remains available under the participants individual budget.
(t)Only the financial management services provider is required to apply for vendorization in accordance with Subchapter 2 (commencing with Section 54300) of Chapter 3 of Division 2 of Title 17 of the California Code of Regulations for the Self-Determination Program. All other service and support providers shall not be on the federal debarment list and shall have applicable state licenses, certifications, or other state required documentation, including documentation of any other qualifications required by the department, but are exempt from the vendorization requirements set forth in Title 17 of the California Code of Regulations when serving participants in the Self-Determination Program.
(u)The regional center shall pay the full costs of the participants financial management services provider.
(v)To protect the health and safety of participants in the Self-Determination Program, the department shall require a criminal background check in accordance with all of the following:
(1)The department shall issue a program directive that identifies nonvendored providers of services and supports who shall obtain a criminal background check pursuant to this subdivision. At a minimum, these staff shall include both of the following:
(A)Individuals who provide direct personal care services to a participant.
(B)Other nonvendored providers of services and supports for whom a criminal background check is requested by a participant or the participants financial management service.
(2)Subject to the procedures and requirements of this subdivision, the department shall administer criminal background checks consistent with the departments authority and the process described in Sections 4689.2 to 4689.6, inclusive.
(3)The department shall electronically submit to the Department of Justice fingerprint images and related information required by the Department of Justice of nonvendored providers of services and supports, as specified in paragraph (1), for purposes of obtaining information as to the existence and content of a record of state or federal convictions and state or federal arrests and also information as to the existence and content of a record of state or federal arrests for which the Department of Justice establishes that the person is free on bail or on their own recognizance pending trial or appeal.
(4)When received, the Department of Justice shall forward to the Federal Bureau of Investigation requests for federal summary criminal history information received pursuant to this section. The Department of Justice shall review the information returned from the Federal Bureau of Investigation and compile and disseminate a response to the department.
(5)The Department of Justice shall provide a state or federal response to the department pursuant to paragraph (1) of subdivision (p) of Section 11105 of the Penal Code.
(6)The department shall request from the Department of Justice subsequent notification service, as provided pursuant to Section 11105.2 of the Penal Code, for persons described in paragraph (1).
(7)The Department of Justice shall charge a fee sufficient to cover the cost of processing the request described in this subdivision.
(8)The fingerprints of any provider of services and supports who is required to obtain a criminal background check shall be submitted to the Department of Justice prior to employment. The costs of the fingerprints and the financial management services administrative cost authorized by the department shall be paid by the services and supports provider or the providers employing agency. Any administrative costs incurred by the department pursuant to this subdivision shall be offset by the funds specified in subdivision (g).
(9)If the criminal record information report shows a criminal history, the department shall take the steps specified in Section 4689.2. The department may prohibit a provider of services and supports from becoming employed, or continuing to be employed, based on the criminal background check, as authorized in Section 4689.6. The provider of services and supports who has been denied employment shall have the rights set forth in Section 4689.6.
(10)The department may utilize a current department-issued criminal record clearance to enable a provider to serve more than one participant, as long as the criminal record clearance has been processed through the department and no subsequent arrest notifications have been received relative to the cleared applicant.
(11)Consistent with subdivision (h) of Section 4689.2, the participant or financial management service that denies or terminates employment based on written notification from the department shall not incur civil liability or unemployment insurance liability.
(w)To ensure the effective implementation of the Self-Determination Program and facilitate the sharing of best practices and training materials commencing with the implementation of the Self-Determination Program, local and statewide advisory committees shall be established as follows:
(1)Each regional center shall establish a local volunteer advisory committee to provide oversight of the Self-Determination Program and identify a regional center liaison to the committee. The regional center and the State Council on Developmental Disabilities shall each appoint one-half of the membership of the committee. The committee shall consist of the regional center clients rights advocate, consumers, family members, and other advocates, and community leaders, including a representative from a family resource center. A majority of the committee shall be consumers and their family members. The committee shall reflect the multicultural diversity and geographic profile of the catchment area. The committee shall review the development and ongoing progress of the Self-Determination Program, including whether the program advances the principles of self-determination and is operating consistent with the requirements of this section, and may make ongoing recommendations for improvement to the regional center and the department. Annually, the regional center shall confirm, in writing, that the committee meets the requirements specified in this paragraph and provide the department with the name of the staff liaison and the names of the committee members, the positions they fill on the committee, and which entity appointed them to the committee.
(2)The State Council on Developmental Disabilities shall form a volunteer committee, to be known as the Statewide Self-Determination Advisory Committee, comprised of the chairs of the 21 local advisory committees or their designees. The council shall convene the Statewide Self-Determination Advisory Committee twice annually, or more frequently in the sole discretion of the council. The Statewide Self-Determination Advisory Committee shall meet by teleconference or other means established by the council to identify self-determination best practices, effective consumer and family training materials, implementation concerns, systemic issues, ways to enhance the program, and recommendations regarding the most effective method for participants to learn of individuals who are available to provide services and supports. The council shall synthesize information received from the Statewide Self-Determination Advisory Committee, local advisory committees, and other sources, share the information with consumers, families, regional centers, and the department, and make recommendations, as appropriate, to increase the programs effectiveness in furthering the principles of self-determination.
(x)The department shall annually provide the following information to the appropriate policy and fiscal committees of the Legislature:
(1)Number and characteristics of participants, by regional center, including the number of participants who entered the program upon movement from a developmental center.
(2)Types and amount of services and supports purchased under the Self-Determination Program, by regional center.
(3)Range and average of individual budgets, by regional center, including adjustments to the budget to address the adjustments permitted in clause (ii) of subparagraph (A) of paragraph (1) of subdivision (m).
(4)The number and outcome of appeals concerning individual budgets, by regional center.
(5)The number and outcome of fair hearing appeals, by regional center.
(6)The number of participants who voluntarily withdraw from the Self-Determination Program and a summary of the reasons why, by regional center.
(7)The number of participants who are subsequently determined to no longer be eligible for the Self-Determination Program and a summary of the reasons why, by regional center.
(y)(1)The State Council on Developmental Disabilities shall issue an interim report to the Legislature, in compliance with Section 9795 of the Government Code, no later than June 30, 2021, on the status of the Self-Determination Program authorized by this section, barriers to its implementation, and recommendations to enhance the effectiveness of the program. The interim report shall provide an update to the programs status, each regional centers cap on participation and progress toward that cap, the most recent statewide and per-regional-center participant count, and the historical trend in the statewide participation count since the start of the program. The department shall assist in providing available information to the council in order to facilitate the timely issuance of the report.
(2)The council, in collaboration with the protection and advocacy agency identified in Section 4900 and the federally funded University Centers for Excellence in Developmental Disabilities Education, Research, and Service, may work with regional centers to survey participants regarding participant satisfaction under the Self-Determination Program and, when data is available, the traditional service delivery system, including the proportion of participants who report that their choices and decisions are respected and supported and who report that they are able to recruit and hire qualified service providers, and to identify barriers to participation and recommendations for improvement.
(3)The council, in collaboration with the protection and advocacy agency identified in Section 4900 and the federally funded University Centers for Excellence in Developmental Disabilities Education, Research, and Service, shall issue a report to the Legislature, in compliance with Section 9795 of the Government Code, by June 30, 2023, on the status of the Self-Determination Program authorized by this section, and provide recommendations to enhance the effectiveness of the program. This review shall include the programs effectiveness in furthering the principles of self-determination, including all of the following:
(A)Freedom, which includes the ability of adults with developmental disabilities to exercise the same rights as all citizens to establish, with freely chosen supporters, family and friends, where they want to live, with whom they want to live, how their time will be occupied, and who supports them; and for families to have the freedom to receive unbiased assistance of their own choosing when developing a plan and to select all personnel and supports to further the life goals of a minor child.
(B)Authority, which includes the ability of a person with a disability, or family, to control a certain sum of dollars in order to purchase services and supports of their choosing.
(C)Support, which includes the ability to arrange resources and personnel, both formal and informal, that will assist a person with a disability to live a life in the community that is rich in community participation and contributions.
(D)Responsibility, which includes the ability of participants to take responsibility for decisions in their own lives and to be accountable for the use of public dollars, and to accept a valued role in their community through, for example, competitive employment, organizational affiliations, spiritual development, and general caring of others in their community.
(E)Confirmation, which includes confirmation of the critical role of participants and their families in making decisions in their own lives and designing and operating the system that they rely on.
SEC. 18.Section 4726 of the Welfare and Institutions Code is amended to read:4726.Notwithstanding Section 5328, Sections 4639.76 and 5328, access to records shall be provided to an applicant for, or recipient of, services or to their authorized representative, including the person appointed as a developmental services decisionmaker pursuant to Section 319, 361, or 726, for purposes of the appeal process under this chapter.
SEC. 19.Section 4731 of the Welfare and Institutions Code is amended to read:4731.(a)Each consumer or any representative acting on behalf of any consumer or consumers, who believes that any right to which a consumer is entitled has been abused, punitively withheld, or improperly or unreasonably denied by a regional center, state-operated facility, or service provider, may pursue a complaint as provided in this section.
(b)Initial referral of any complaint taken pursuant to this section shall be to the director of the regional center from which the consumer receives case management services. If the consumer resides in a state-operated facility, the complaint shall be made to the director of the state-operated facility. The director shall, within 20 working days of receiving a complaint, investigate the complaint and send a written proposed resolution to the complainant and, if applicable, to the service provider. The written proposed resolution shall include a telephone number and mailing address for referring the proposed resolution in accordance with subdivision (c).(c)If the complainant is not satisfied with the proposed resolution, the complainant may refer the complaint, in writing, to the Director of Developmental Services within 15 working days of receipt of the proposed resolution. The director shall, within 45 days of receiving a complaint, issue a written administrative decision and send a copy of the decision to the complainant, the director of the regional center or state-operated facility, and the service provider, if applicable. If there is no referral to the department, the proposed resolution shall become effective on the 20th working day following receipt by the complainant.(b)Any complaint made pursuant to this section shall be made to the Director of Developmental Services. The director, within 30 days of receiving a complaint, shall issue a written administrative decision and send a copy of the decision to the complainant, the director of the regional center or state-operated facility, and the service provider, if applicable.
(d)(c)The department shall annually department, on a quarterly basis, shall compile the number of complaints filed, by each regional center and state-operated facility, the subject matter of each complaint, and a summary of each decision. Copies shall be made available decision, and post the compilation on its internet website at the end of each quarter. Copies of any decision included in the compilation shall be made available within 10 days, with all individually identifiable information redacted, to any person upon request.
(e)(d)This section shall not be used to resolve disputes concerning the nature, scope, or amount of services and supports that should be included in an individual program plan, for which there is an appeals procedure established in this division, or disputes regarding rates or audit appeals for which there is an appeals procedure established in regulations. Those disputes shall be resolved through the appeals procedure established by this division or in regulations.
(f)(e)All consumers or, if appropriate, their authorized representative, shall be notified in writing in their preferred language of the right to file a complaint pursuant to this section when they apply for services from a regional center or a state-operated facility, and at each regularly scheduled planning meeting.
|
Date
|
Status
|
|---|---|
| Sep 28, 2024 | Chaptered by Secretary of State - Chapter 902, Statutes of 2024. |
| Sep 28, 2024 | Approved by the Governor. |
| Sep 12, 2024 | Enrolled and presented to the Governor at 4 p.m. |
| Aug 31, 2024 | Senate amendments concurred in. To Engrossing and Enrolling. (Ayes 77. Noes 0.). |
| Aug 31, 2024 | In Assembly. Concurrence in Senate amendments pending. |
| Aug 30, 2024 | Read third time. Passed. Ordered to the Assembly. (Ayes 40. Noes 0.). |
| Aug 26, 2024 | Read second time. Ordered to third reading. |
| Aug 22, 2024 | Read third time and amended. Ordered to second reading. |
| Aug 5, 2024 | Read second time. Ordered to third reading. |
| Jul 3, 2024 | Ordered to second reading. |
| Jul 3, 2024 | From inactive file. |
| Sep 13, 2023 | Ordered to inactive file at the request of Senator Menjivar. |
| Sep 5, 2023 | Read second time. Ordered to third reading. |
| Sep 1, 2023 | Read second time and amended. Ordered returned to second reading. |
| Sep 1, 2023 | From committee: Amend, and do pass as amended. (Ayes 7. Noes 0.) (September 1). |
| Aug 14, 2023 | In committee: Referred to APPR suspense file. |
| Jul 13, 2023 | Read second time and amended. Re-referred to Com. on APPR. |
| Jul 12, 2023 | From committee: Amend, and do pass as amended and re-refer to Com. on APPR. (Ayes 11. Noes 0.) (July 11). |
| Jul 10, 2023 | From committee chair, with author's amendments: Amend, and re-refer to committee. Read second time, amended, and re-referred to Com. on JUD. |
| Jul 5, 2023 | From committee: Do pass and re-refer to Com. on JUD. (Ayes 5. Noes 0.) (July 3). Re-referred to Com. on JUD. |
| Jun 14, 2023 | Referred to Coms. on HUMAN S. and JUD. |
| Jun 1, 2023 | In Senate. Read first time. To Com. on RLS. for assignment. |
| May 31, 2023 | Read third time. Passed. Ordered to the Senate. (Ayes 80. Noes 0. Page 2021.) |
| May 22, 2023 | Read second time. Ordered to third reading. |
| May 19, 2023 | Read second time and amended. Ordered returned to second reading. |
| May 19, 2023 | From committee: Amend, and do pass as amended. (Ayes 11. Noes 0.) (May 18). |
| May 18, 2023 | Joint Rule 62(a), file notice suspended. (Page 1580.) |
| May 17, 2023 | In committee: Set, first hearing. Referred to APPR. suspense file. |
| May 3, 2023 | In committee: Hearing postponed by committee. |
| Apr 19, 2023 | From committee: Do pass and re-refer to Com. on APPR. (Ayes 7. Noes 0.) (April 18). Re-referred to Com. on APPR. |
| Apr 12, 2023 | Re-referred to Com. on HUM. S. |
| Apr 11, 2023 | From committee: Do pass and re-refer to Com. on HUM. S. with recommendation: To Consent Calendar. (Ayes 11. Noes 0.) (April 11). Re-referred to Com. on HUM. S. |
| Apr 11, 2023 | From committee chair, with author's amendments: Amend, and re-refer to Com. on HUM. S. Read second time and amended. |
| Mar 28, 2023 | Re-referred to Com. on JUD. |
| Mar 27, 2023 | From committee chair, with author's amendments: Amend, and re-refer to Com. on JUD. Read second time and amended. |
| Mar 20, 2023 | Re-referred to Coms. on JUD. and HUM. S. pursuant to Assembly Rule 96. |
| Mar 2, 2023 | Referred to Coms. on HUM. S. and JUD. |
| Feb 17, 2023 | From printer. May be heard in committee March 19. |
| Feb 16, 2023 | Read first time. To print. |
|
Date
|
Description
|
Location
|
Votes
|
|
|---|---|---|---|---|
| Aug 31, 2024 | AB 1147 Addis Concurrence in Senate Amendments | Assembly Floor |
Passed |
|
| Aug 30, 2024 | Assembly 3rd Reading AB1147 Addis et al. By Menjivar | Senate Floor |
Passed |
|
| Sep 1, 2023 | Do pass as amended | Senate Standing Committee on Appropriations |
Passed |
|
| Aug 14, 2023 | Placed on suspense file | Senate Standing Committee on Appropriations |
Passed |
|
| Jul 11, 2023 | Do pass as amended, but first amend, and re-refer to the Committee on [Appropriations] | Senate Standing Committee on Judiciary |
Passed |
|
| Jul 3, 2023 | Do pass, but first be re-referred to the Committee on [Judiciary] | Senate Standing Committee on Human Services |
Passed |
|
| May 31, 2023 | AB 1147 Addis Assembly Third Reading | Assembly Floor |
Passed |
|
| May 18, 2023 | Do pass as amended. | Assembly Standing Committee on Appropriations |
Passed |
|
| Apr 18, 2023 | Do pass and be re-referred to the Committee on [Appropriations] | Assembly Standing Committee on Human Services |
Passed |
|
| Apr 11, 2023 | Do pass and be re-referred to the Committee on [Human Services] with recommendation: To Consent Calendar | Assembly Standing Committee on Judiciary |
Passed |
This list shows positions taken on this bill by organizations on the date displayed, which is linked to the original source.
Positions by individuals are not included.
|
Organization
|
Position
|
Date
|
|---|---|---|
| Alameda County Board of Supervisors | ** Support | |
| Association Of Regional Center Agencies | ** Against | |
| Autism Society Los Angeles | ** Support | |
| Autism Support Community | ** Support | |
| Autism Support Community | * Support | Apr 18, 2023 |
| Buildability | ** Support | |
| California Commission on Aging | * Support | Apr 18, 2023 |
| California News Publishers Association | ** Support | |
| City of Downey | * Support | Apr 18, 2023 |
| City of Stockton | * Support | Jul 3, 2023 |
| DIR Floortime Coalition of California | ** Support | |
| Disability Rights California | ** Support | |
| Disability Voices United | ** Support | |
| Down Syndrome Association of Santa Barbara County | ** Support | |
| Eastern Los Angeles Regional Center | * Support | Apr 18, 2023 |
| Eastern Los Angeles Regional Center | * Support | Apr 18, 2023 |
| Easterseals Northern California | ** Support | |
| Integrated Community Collaborative | ** Support | |
| Korean SDP Network | * Support | Apr 18, 2023 |
| Little Hoover Commission | ** Support | |
| Momentum | ** Support | |
| Momentum Agencies | ** Support | |
| North Bay Regional Center | * Against | Jul 3, 2023 |
| Padres Mentores | * Support | Apr 18, 2023 |
| Parents Helping Parents | ** Support | |
| Pragnya | ** Support | |
| PRAGNYA - Preparing Resources & Alliances Galvanizing Neurodiversity Acculturation | * Support | Apr 18, 2023 |
| PRAGNYA - Preparing Resources & Alliances Galvanizing Neurodiversity Acculturation | * Support | Apr 18, 2023 |
| PRAGNYA - Preparing Resources & Alliances Galvanizing Neurodiversity Acculturation | * Support | Apr 18, 2023 |
| PRAGNYA - Preparing Resources & Alliances Galvanizing Neurodiversity Acculturation | * Support | Apr 18, 2023 |
| Propel I Forward Alliance | ** Support | |
| Public Counsel | ** Support | |
| Redwood Coast Regional Center | * Support | Apr 18, 2023 |
| San Diego Regional Center | * Against | Jul 3, 2023 |
| Scdd | ** Support | |
| Self Determination Program | * Support | Apr 18, 2023 |
| Special Needs Network, Inc. | ** Support | |
| Stanford IDD Law and Policy Project - SIDDLAPP | * Support | Apr 18, 2023 |
| Yurok Tribe | ** Support |
CONCURRENCE IN SENATE AMENDMENTS
CSA1 Bill Id:AB 1147
Author:(Addis and Garcia)
As Amended Ver:August 22, 2024
Majority vote
SUMMARY
Deletes, revises, and adds requirements for the Department of Developmental Services (DDS) and the regional centers that coordinate services for the eligible population.
Senate Amendments
- Align the bill with codified budget bill language creating a Master Plan for Developmental Disabilities.
- Remove the following provisions: revised data reporting requirements, development of a project charter related to the data automation system, establishment of a common set of services and supports, revisions related to generic services, review of processes for vendorizing providers, and revisions to the complaint process.
- Add provisions that require regional centers to prohibit regional center employees from accepting gifts, and establish a policy prohibiting regional center senior staff from hiring relatives.
- Add a delayed implementation date for provisions related to California Public Records Act.
COMMENTS
For a detailed description of this bill and background see the Assembly Human Services Committee's analysis.
Recent and ongoing oversight discussions: California State Auditor and the Little Hoover Commission. In June 2022, the California State Auditor found a number of deficiencies in the developmental disabilities system that negatively impact services, particularly for people of color. The audit of three regional centers, which collectively serve more than 65,000 consumers, found that they have neither sufficient staff nor funding. The audit found regional centers struggles with a number of issues due to inaction from DDS. The key findings include: regional centers have insufficient staffing because DDS has not ensured adequate funding was received, regional centers are not monitoring vendors appropriately, DDS and regional centers are failing to monitor access to convenient services, and DDS does not provide adequate oversight on consumer complaints with regional centers. The State Auditor made the following recommendations to DDS:
- Work with regional centers as necessary to update the core staffing formula so that it aligns with actual regional center staffing costs.
- Provide vendor monitoring training so that regional centers understand the statutory requirements for vendor monitoring.
- Establish standards for measuring how convenient it is for consumers to access services.
- Ensure that regional centers provide statutorily required information to consumers about how to file a consumer rights complaint.
- Issue guidance to regional centers and develop best practices to ensure that regional centers complete complaint investigations within statutory deadlines."
The Little Hoover Commission held a series of public meetings in the fall of 2022 to discuss the disparities plaguing California's developmental disabilities system and released a study in April 2023. At one of the public meetings in the fall of 2022, comments from regional centers, DDS, and advocates were made discussing problems and possible steps forward. DDS' director, in their written testimony posted on The Little Hoover's Website, committed to:
- Develop a Strategic Plan;
- Host meetings with regional center representatives to hear directly from individuals and families;
- Direct regional centers to develop community engagement plans;
- Work with the Association of Regional Center Agencies (ARCA) to develop and implement standardized intake standards;
- Work with community partners to identify and implement assessment tools and process used in determining early start eligibility;
- Work with ARCA to establish a streamlined and standardized vendorization process; and,
- Continue to build capacity for data fluency, prioritize data integrity, usefulness and transparency.
Equity Implications: Individuals living with developmental disabilities rely on services from regional centers to live independently and effectively integrate into the community. As outlined above, regional centers have been severely underperforming for years which is having an adverse effect on the population who relies on these services. While some of the issues can be traced back to cost saving measures implemented during the Great Recession, the impact has been profound on the community. There is clear inequity between different race and ethnicities as well geographically that is not improving despite grants issued over the last several years. Although unclear the best way to achieve equity, the spending data shows a clear inequity on services provided. For almost a decade, heightened attention has been given to disparities in regional center spending and service provision; data from DDS indicate that, statewide, per capita spending for services for a Latino consumer was $12,152 in 2021 compared to $28,143 for a White consumer. In 2015, statewide data showed that Latino consumers utilize services for which they are authorized at a lower rate (76.6%) than White consumers (82.7%).
According to the Author
"Regional centers play a critical role in California's developmental disability system by providing assessments, determining eligibility, and coordinating the services for those with intellectual and developmental disabilities. Despite California's network of centers that serve nearly 400,000 individuals, numerous issues plague the system, including a lack of transparency, accountability, and disparities in the services provided. Not only has this undermined confidence in California's developmental disability system, but it has failed to serve the Californians that need these services most. [This bill], the Disability Equity & Accountability Act, enacts several reforms to help ensure that all people, regardless of their race or ethnicity or where they live, receive equitable access to services within the regional center system and that all regional centers offer and provide a consistent and common set of services and that the services are delivered in a timely way. It is time that we provide accountability, transparency, and fairness to Californians with disabilities and their families."
Arguments in Support
Supporters state, "[This bill] proposes key reforms to the Lanterman Act. These reforms are designed to strengthen the ability of the Department of Developmental Services (DDS) to provide effective oversight of the state's 21 regional centers, address racial, ethnic, and geographic disparities, improve outcomes for people with intellectual and developmental disabilities (I/DD), provide greater transparency, and increase confidence and trust in California's developmental disability service system."
Arguments in Opposition
No opposition on file.
FISCAL COMMENTS
According to the Senate Appropriations Committee on September 1, 2023, unknown, ongoing General Fund costs for the DDS and regional centers to comply with the provisions of the bill.
VOTES:
ASM JUDICIARY: 11-0-0
YES: Maienschein, Essayli, Connolly, Dixon, Haney, Kalra, Pacheco, Papan, Reyes, Robert Rivas, Sanchez
ASM HUMAN SERVICES: 7-0-1
YES: Jackson, Sanchez, Alanis, Arambula, Bryan, Calderon, Garcia
ABS, ABST OR NV: Bonta
ASM APPROPRIATIONS: 11-0-5
YES: Holden, Bryan, Calderon, Wendy Carrillo, Mike Fong, Hart, Lowenthal, Papan, Pellerin, Weber, Ortega
ABS, ABST OR NV: Megan Dahle, Dixon, Mathis, Robert Rivas, Sanchez
ASSEMBLY FLOOR: 80-0-0
YES: Addis, Aguiar-Curry, Alanis, Alvarez, Arambula, Bains, Bauer-Kahan, Bennett, Berman, Boerner, Bonta, Bryan, Calderon, Juan Carrillo, Wendy Carrillo, Cervantes, Chen, Connolly, Megan Dahle, Davies, Dixon, Essayli, Flora, Mike Fong, Vince Fong, Friedman, Gabriel, Gallagher, Garcia, Gipson, Grayson, Haney, Hart, Holden, Hoover, Irwin, Jackson, Jones-Sawyer, Kalra, Lackey, Lee, Low, Lowenthal, Maienschein, Mathis, McCarty, McKinnor, Muratsuchi, Stephanie Nguyen, Ortega, Pacheco, Papan, Jim Patterson, Joe Patterson, Pellerin, Petrie-Norris, Quirk-Silva, Ramos, Reyes, Luz Rivas, Robert Rivas, Rodriguez, Blanca Rubio, Sanchez, Santiago, Schiavo, Soria, Ta, Ting, Valencia, Villapudua, Waldron, Wallis, Ward, Weber, Wicks, Wilson, Wood, Zbur, Rendon
SENATE FLOOR: 40-0-0
YES: Allen, Alvarado-Gil, Archuleta, Ashby, Atkins, Becker, Blakespear, Bradford, Caballero, Cortese, Dahle, Dodd, Durazo, Eggman, Glazer, Gonzalez, Grove, Hurtado, Jones, Laird, Limón, McGuire, Menjivar, Min, Newman, Nguyen, Niello, Ochoa Bogh, Padilla, Portantino, Roth, Rubio, Seyarto, Skinner, Smallwood-Cuevas, Stern, Umberg, Wahab, Wiener, Wilk
UPDATED
VERSION: August 22, 2024
CONSULTANT: Alexandria Smith / HUM. S. / (916) 319-2089 FN: 0004708
SENATE RULES COMMITTEE Office of Senate Floor Analyses (916) 651-1520 Fax: (916) 327-4478 | AB 1147 |
THIRD READING
Bill No: AB 1147
Author: Addis (D) and Garcia (D), et al.
Amended: 8/22/24 in Senate
Vote: 21
SENATE HUMAN SERVICES COMMITTEE: 5-0, 7/3/23
AYES: Alvarado-Gil, Ochoa Bogh, Hurtado, Menjivar, Wahab
SENATE JUDICIARY COMMITTEE: 11-0, 7/11/23
AYES: Umberg, Wilk, Allen, Ashby, Caballero, Durazo, Laird, Min, Niello, Stern, Wiener
SENATE APPROPRIATIONS COMMITTEE: 7-0, 9/1/23
AYES: Portantino, Jones, Ashby, Bradford, Seyarto, Wahab, Wiener
ASSEMBLY FLOOR: 80-0, 5/31/23 - See last page for vote
SUBJECT: Disability Equity, Transparency, and Accountability Act of 2024
SOURCE: Disability Voices United
Integrated Community Collaborative
DIGEST:
This bill revises and adds requirements for the Department of Developmental Services (DDS) and the regional centers that coordinate services for individuals with developmental disabilities to include increased transparency processes.
Senate Floor Amendments of 8/22/24 enact changes requested by the Department of Social Services and narrow the scope of the study.
ANALYSIS:
Existing law:
- Establishes the Lanterman Developmental Disabilities Services Act (Lanterman Act), which states that California is responsible for providing a range 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.)
- Establishes a system of nonprofit Regional Centers, overseen by DDS, to provide fixed points of contract 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)
- Requires the Secretary of California Health and Human Services, in coordination with DDS, to lead the development and implementation of the Master Plan for Developmental Services. (WIC 4581, et seq.)
- Makes all information and records obtained in the course of providing services under the Lanterman Act, to either voluntary or involuntary recipients of services, confidential. (WIC 5328(a))
- Provides that the people have the right of access to information concerning the conduct of the people’s business and, therefore, the writings of public officials and agencies are be open to public scrutiny. Specifies that any law or rule that limits the public right of access shall be adopted with findings demonstrating the interest protected by the limitation. (CA Constitution, Art. I, Section 3)
This bill:
- Establishes the Disability, Equity, Transparency, and Accountability Act of 2024.
- Makes legislative findings and declarations about the developmental services system, regional centers, and California Public Records Act.
- Specifies the topics the Secretary of California Health and Human Services must solicit input through the Master Plan for Developmental Services Committee on, which may include, but are not limited to, regional center board accountability and transparency and the evaluation of regional centers, including performance, equity, and diversity.
- Prohibits a regional center employee from accepting a gift or gifts from a service provider, consumer, or consumer’s family member valued over fifteen dollars per year.
- Establishes a policy prohibiting regional center senior staff from hiring relatives at the center or any ancillary foundation and organization. Specifies that this policy shall be included in the regional center contract and be included in training of the governing board.
- Requires a regional center contracted with DDS, as specified, to be subject to the California Public Records Act (PRA) (Chapter 1 (commencing with Section 7920.000) of Division 10 of Title 1 of the Government Code) commencing January 1, 2026.
- Requires access to records regarding an applicant for or recipient of services to be provided, upon request, to the applicant, recipient, or their authorized representative, as specified, for any purpose, including, but not limited to, the appeal process, unless disclosure of the record is expressly prohibited by law.
Comments
Lanterman Act. In 1969, the Lanterman Developmental Disabilities Act established that individuals with developmental disabilities and their families have a right to receive the necessary supports and services required to live independently in the community. The Lanterman Act enumerates the rights of individuals with developmental disabilities, as well as the rights of their families, what services and supports are available to these individuals, and how regional centers and service providers work together to provide these supports and services. The term “developmental disability” is defined as a disability that originates before a person reaches 18 years of age, is expected to continue indefinitely, and is a significant disability for the individual; such disabilities include, among others: epilepsy, autism spectrum disorder, intellectual disability, and cerebral palsy.
In addition to establishing the rights of individuals, the Lanterman Act also created California’s regional center system, comprised of 21 nonprofit regional centers throughout the state whose primary purpose is to connect individuals with services in the community. Regional centers coordinate a robust array of services and supports for more than 329,000 individuals with developmental disabilities in California.
Access to Records. Existing law requires a regional center to adopt, maintain, and post on its internet website a Board-approved policy regarding transparency and access to public information, including access to annual independent audits, biannual fiscal audits conducted by DDS, annual reports, contract awards, purchase of service policies, a list of all vendors, Board meeting agendas and minutes, annual and year-end performance contracts entered into with DDS, and salaries and wages for all administrative management positions, among other records. Existing law also requires DDS to maintain a transparency portal on its internet website to allow consumers, families, and the public to access provider and regional center information.
Existing law establishes the California Public Records Act, which provides that specified public records of public entities, including public agencies and state agencies, are subject to inspection at all times, and states every person has a right to inspect any public record, as specified. DDS and records held by DDS are subject to the PRA, however, regional centers and their records are not, as they are private, nonprofit entities.
This bill would establish that access to records regarding an applicant for, or recipient of, services shall be provided upon request to the applicant, recipient, or authorized representative. Proponents of this bill suggest that certain regional center data and documents, including internal operating policies and desk manuals used to make decisions to provide services, such as policies outlining copay schedules, are not submitted to DDS and therefore not available to be subject to public records requests through DDS, nor are they made publicly available by regional centers. Proponents assert that the existence of hidden decision making rules narrows the scope of entitlement to developmental services.
FISCAL EFFECT: Appropriation: No Fiscal Com.: Yes Local: No
According to the Senate Appropriations Committee, “Unknown, ongoing General Fund costs for the DDS and regional centers to comply with the provisions of the bill.”
SUPPORT: (8/22/24)
Disability Voices United (co-source)
Integrated Community Collaborative (co-source)
326 Private Citizens
Alameda County Board of Supervisors
Autism Society Los Angeles
Autism Support Community
Buildability
California News Publishers Association
Dir/floortime Coalition of California
Dirfloortime Coalition of California
Disability Rights California
Disability Voices United (UNREG)
Down Syndrome Association of Santa Barbara County
Easterseals Northern California
Little Hoover Commission
Momentum
Parents Helping Parents
Pragnya
Propel I Forward Alliance (PIFA)
Public Counsel
Scdd
Special Needs Network, INC.
Yurok Tribe
OPPOSITION: (8/22/24)
Association of Regional Center Agencies
ARGUMENTS IN SUPPORT: According to Disability Voices Unites (DVU), “AB 1147 requires that regional centers be subject to the Public Records Act, allowing for greater public oversight. The sponsors have submitted proposed amendments to the Appropriations Committee that they estimate would make any costs for the bill minor but absorbable and $126,000 for implementing the Public Records Act provision.”
ARGUMENTS IN OPPOSITION: According to Association of Regional Center Agencies (ARCA), “AB 1147 would subject regional centers to the California Public Records Act (PRA). We estimate this will cost $9,809,285 annually to hire the necessary new, specialized staff at each of the 21 regional centers. ARCA and its member regional centers are committed to transparency. Not only is [this approach] expensive, it lacks equity in access.”
ASSEMBLY FLOOR: 80-0, 5/31/23
AYES: Addis, Aguiar-Curry, Alanis, Alvarez, Arambula, Bains, Bauer-Kahan, Bennett, Berman, Boerner, Bonta, Bryan, Calderon, Juan Carrillo, Wendy Carrillo, Cervantes, Chen, Connolly, Megan Dahle, Davies, Dixon, Essayli, Flora, Mike Fong, Vince Fong, Friedman, Gabriel, Gallagher, Garcia, Gipson, Grayson, Haney, Hart, Holden, Hoover, Irwin, Jackson, Jones-Sawyer, Kalra, Lackey, Lee, Low, Lowenthal, Maienschein, Mathis, McCarty, McKinnor, Muratsuchi, Stephanie Nguyen, Ortega, Pacheco, Papan, Jim Patterson, Joe Patterson, Pellerin, Petrie-Norris, Quirk-Silva, Ramos, Reyes, Luz Rivas, Robert Rivas, Rodriguez, Blanca Rubio, Sanchez, Santiago, Schiavo, Soria, Ta, Ting, Valencia, Villapudua, Waldron, Wallis, Ward, Weber, Wicks, Wilson, Wood, Zbur, Rendon
Prepared by: Diana Dominguez / HUMAN S. / (916) 651-1524
8/25/24 12:49:22
**** END ****
SENATE RULES COMMITTEE Office of Senate Floor Analyses (916) 651-1520 Fax: (916) 327-4478 | AB 1147 |
THIRD READING
Bill No: AB 1147
Author: Addis (D) and Garcia (D), et al.
Amended: 9/1/23 in Senate
Vote: 21
SENATE HUMAN SERVICES COMMITTEE: 5-0, 7/3/23
AYES: Alvarado-Gil, Ochoa Bogh, Hurtado, Menjivar, Wahab
SENATE JUDICIARY COMMITTEE: 11-0, 7/11/23
AYES: Umberg, Wilk, Allen, Ashby, Caballero, Durazo, Laird, Min, Niello, Stern, Wiener
SENATE APPROPRIATIONS COMMITTEE: 7-0, 9/1/23
AYES: Ashby, Bradford, Jones, Portantino, Seyarto, Wahab, Wiener
ASSEMBLY FLOOR: 80-0, 5/31/23 - See last page for vote
SUBJECT: Disability Equity and Accountability Act of 2023
SOURCE: Disability Voices United
Integrated Community Collaborative
DIGEST:
This bill deletes, revises, and adds requirements for the Department of Developmental Services (DDS) and the regional centers that coordinate services for the eligible population to include process standardization and increased transparency processes.
ANALYSIS:
Existing law:
- Establishes the Lanterman Developmental Disabilities Services Act (Lanterman Act), which states that California is responsible for providing a range 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.)
- Establishes a system of nonprofit Regional Centers, overseen by DDS, to provide fixed points of contract 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)
- Establishes an Individual Program Plan (IPP) as the process to ensure that services and supports are customized to meet the needs of consumers who are served by regional centers for the purpose of alleviating a developmental disability or toward the social, personal, physical, or economic habilitation or rehabilitation of an individual with a developmental disability, or toward the achievement and maintenance of independent, productive, and normal lives. (WIC 4512(b))
- Requires decisions concerning the consumer’s goals, objectives, and services and supports included in their IPP to be made by agreement between the regional center representative and the consumer or, when appropriate, the consumer’s parents, legal guardian, conservator, or authorized representative, at the program plan meeting. (WIC 4646(d))
- Requires the IPP planning processes to include:
- A statement of the individual’s goals and objectives, a schedule of the type and nature of services to be provided and other information and considerations, as specified;
- Review and modification, as necessary, by the regional center’s planning team no less frequently than every three years; and
- Statewide training and review of the IPP plan creation, as specified. (WIC 4646.5)
- Provides the dispute process when a regional center believes that a generic agency is legally obligated to fund or provide services described in an IPP for children under age six. (WIC 4659.5)
- Makes all information and records obtained in the course of providing services under the Lanterman Act, to either voluntary or involuntary recipients of services, confidential. (WIC 5328(a))
- Provides that the people have the right of access to information concerning the conduct of the people’s business and, therefore, the writings of public officials and agencies are be open to public scrutiny. Specifies that any law or rule that limits the public right of access shall be adopted with findings demonstrating the interest protected by the limitation. (California Constitution, Art. I, Section 3)
This bill deletes, revises, and adds requirements for the Department of Developmental Services (DDS) and the regional centers that coordinate services for the eligible population to include process standardization and increased transparency processes.
Comments
Purpose of the bill. According to the author, “Regional centers play a critical role in California’s developmental disability system by providing assessments, determining eligibility, and coordinating the services for those with intellectual and developmental disabilities. Despite California’s network of centers that serve nearly 400,000 individuals, numerous issues plague the system, including a lack of transparency, accountability, and disparities in the services provided. Not only has this undermined confidence in California’s developmental disability system, but it has failed to serve the Californians that need these services most. AB 1147, the Disability Equity & Accountability Act, enacts several reforms to help ensure that all people, regardless of their race or ethnicity or where they live, receive equitable access to services within the regional center system and that all regional centers offer and provide a consistent and common set of services and that the services are delivered in a timely way. It is time that we provide accountability, transparency, and fairness to Californians with disabilities and their families.”
Lanterman Act. In 1969, the Lanterman Developmental Disabilities Act established that individuals with developmental disabilities and their families have a right to receive the necessary supports and services required to live independently in the community. The Lanterman Act enumerates the rights of individuals with developmental disabilities, as well as the rights of their families, what services and supports are available to these individuals, and how regional centers and service providers work together to provide these supports and services. The term “developmental disability” is defined as a disability that originates before a person reaches 18 years of age, is expected to continue indefinitely, and is a significant disability for the individual; such disabilities include, among others: epilepsy, autism spectrum disorder, intellectual disability, and cerebral palsy.
In addition to establishing the rights of individuals, the Lanterman Act also created California’s regional center system, comprised of 21 nonprofit regional centers throughout the state whose primary purpose is to connect individuals with services in the community. Regional centers coordinate a robust array of services and supports for more than 329,000 individuals with developmental disabilities in California.
Recent Oversight Reports. In June 2022, the California State Auditor published findings on a number of deficiencies in the developmental disabilities system that negatively impact services, particularly for people of color. The audit of three regional centers, which collectively serve more than 65,000 consumers, found that they have neither sufficient staff nor funding. The audit found regional centers struggle with a number of issues due to inaction from DDS. The key findings included: regional centers have exceeded their service coordinators’ maximum caseload ratios because DDS has not adequately addressed funding issues, regional centers are not monitoring vendors appropriately, and DDS does not provide adequate oversight on regional centers’ processes for resolving consumer rights violations complaints.
The Little Hoover Commission held a series of public meetings in the fall of 2022 to discuss the disparities affecting California’s DDS system and released a study in April 2023. The study included recommendations to increase consistency in client experiences across regional centers, strengthen state oversight of the developmental disabilities system, strengthen and enhance support for regional center governing boards, and improve service coordination.
Regional Center Governance. Direct responsibility for implementation of the Lanterman Act’s service system is shared by DDS and a statewide network of 21 regional centers, which are private, community-based nonprofit entities that contract with DDS to carry out many of the state’s responsibilities. Regional centers are governed by a Board of Directors whose members are a part of the community, consumers who receive services, or a representative of someone who receives services from the regional center. The Board is responsible for hiring and overseeing the Executive Director, who is tasked with the day-to-day management of the regional center. DDS establishes contracts with regional centers that include specific and measurable performance objectives. Every year, DDS reviews each regional center’s performance data for compliance with their contracts and posts them on their website.
Regional Center Accountability Performance Measures. AB 136 (Committee on Budget, Chapter 76, Statutes of 2021), a budget trailer bill, required DDS to convene a workgroup to make recommendations to the department for the development of standard performance improvement indicators and benchmarks to incentivize high-quality regional center operations. The trailer bill specified the makeup of the stakeholder group, priority areas for performance indicators, surveys to assess consumer and family experience and recommendations, and an annual stakeholder-based process for DDS to use to evaluate the success of a quality improvement process, among other required topics for recommendation. DDS has hosted 14 Regional Center Measures Workgroup meetings since September 2021.
Individual Program Plan (IPP). Services for individuals with intellectual and developmental disabilities are outlined in an IPP, which is developed according to the needs and personal choices of the individual. The IPP is developed by an IPP team, which often includes the consumer, their legally authorized representative, and one or more Regional Center representatives. The IPP serves as a tool to maximize the opportunities for each consumer to develop relationships, integrate into community life, increase control over their life, and obtain positive roles in the community. The IPP is required to prioritize the services and supports that allow minors to live with their families and adults to live in the community as independently as possible.
In November 2021, a coalition of disability rights advocates released a report titled Unfair Hearings: How People with Intellectual & Developmental Disabilities Lack Access to Justice in California[1]. The report found that 90% of survey respondents reported at least one problem with the IPP process, with the most common complaint being that no one authorized to make a decision on behalf of the regional center attended their IPP. In addition, many respondents reported believing that the fair hearing system is inaccessible, opaque, and biased toward regional centers. Further, the report found that 72% of fair hearings are withdrawn, likely showing that many individuals and families give up due to the complexities of the process and the inability to hire a lawyer; and consumers win or partially win fewer than 5% of cases filed. This issue was later addressed through trailer bill language to establish a broad reform to the fair hearing process.
Self-Determination Program. In 2013, SB 468 (Emmerson, Chapter 683, Statutes of 2013) established a statewide Self-Determination Program, contingent upon funding, to provide individuals and their families with more freedom, control, and responsibility in choosing services and supports to help them meet objectives in their IPP. After an IPP is developed, an individual must request a budget meeting where a 12-month budget and spending plan are developed based on the IPP needs and goals. Then, a financial management service and payer model are selected, and the individual or their representative can then begin hiring service providers.
The Self-Determination Program is available to all eligible individuals receiving services from a regional center. However, data broken down into race and ethnicity demographics shows that enrollment are not proportionate. The Legislative Analyst Office (LAO)’s 2023-24 Budget report[2] on DDS states that “white consumers comprise a plurality of [Self-Determination Program] participants (45 percent), despite making up only 30 percent of all DDS consumers. By comparison, Latino consumers comprise only 23 percent of [Self-Determination Program] participants, but 40 percent of all DDS consumers.”
Access to Records. Existing law requires a regional center to adopt, maintain, and post on its internet website a Board-approved policy regarding transparency and access to public information, including access to annual independent audits, biannual fiscal audits conducted by DDS, annual reports, contract awards, purchase of service policies, a list of all vendors, Board meeting agendas and minutes, annual and year-end performance contracts entered into with DDS, and salaries and wages for all administrative management positions, among other records. Existing law also requires DDS to maintain a transparency portal on its internet website to allow consumers, families, and the public to access provider and regional center information.
Existing law establishes the California Public Records Act (Division 10 of Title 1 of Government Code, commencing with 7920.000), which provides that specified public records of public entities, including public agencies and state agencies, as defined, are subject to inspection at all times, and states every person has a right to inspect any public record, as specified. DDS and records held by DDS are subject to the PRA, however, regional centers and their records are not, as they are private, nonprofit entities.
This bill establishes that access to records regarding an applicant for, or recipient of, services shall be provided upon request to the applicant, recipient, or authorized representative. Proponents of this bill suggest that certain regional center data and documents, including internal operating policies and desk manuals used to make decisions to provide services, such as policies outlining copay schedules, are not submitted to DDS and therefore not available to be subject to public records requests through DDS, nor are they made publicly available by regional centers. Proponents assert that the existence of hidden decision making rules narrows the scope of entitlement to developmental services.
Related/Prior Legislation
AB 1957 (Wilson, Chapter 314, Statutes of 2022) added additional data points to the set of data that DDS and regional centers must report.
AB 1 X2 (Thurmond, Chapter 3, Statutes of 2016) authorized the Service Access and Equity grant program through which $11 million in ongoing General Fund resources for DDS was provided to assist regional centers in reducing purchase of service disparities.
SB 468 (Emmerson, Chapter 683, Statutes of 2013) established the statewide Self-Determination Program to provide individuals and their families with more freedom, control, and responsibility in choosing services and supports to help them meet objectives in their IPP.
AB 9 X4 (Evans, Chapter 9, Statutes of 2009) contained changes to enact modifications to the Budget Act of 2009, including, but not limited to, suspending and limiting certain services for Regional Center consumers.
FISCAL EFFECT: Appropriation: No Fiscal Com.: Yes Local: No
According to the Senate Appropriations Committee, “Unknown, ongoing General Fund costs for the DDS and regional centers to comply with the provisions of the bill.”
SUPPORT: (Verified 9/2/23)
Disability Voices United (co-source)
Integrated Community Collaborative (co-source)
Alameda County Board of Supervisors
Autism Society Los Angeles
Autism Support Community
Buildability
California News Publishers Association
Dirfloortime Coalition of California
Disability Rights California
Disability Voices United
Down Syndrome Association of Santa Barbara County
Easterseals Northern California
Little Hoover Commission
Momentum
Parents Helping Parents
Pragnya
Propel I Forward Alliance
Public Counsel
Scdd
Special Needs Network, Inc.
Yurok Tribe
OPPOSITION: (Verified 9/2/23)
Association of Regional Center Agencies
ARGUMENTS IN SUPPORT: According to Disability Voices Unites (DVU), “AB 1147 proposes key reforms to the Lanterman Act. These reforms are designed to strengthen the ability of the Department of Developmental Services (DDS) to provide effective oversight of the state’s 21 regional centers, address racial, ethnic, and geographic disparities, improve outcomes for people with intellectual and developmental disabilities (I/DD), provide greater transparency, and increase confidence and trust in California’s developmental disability service system. The much-needed reforms to the regional center system provided by AB 1147 include improvements to regional center board governance, conflicts of interest policies, and to the development and coordination of statewide performance measures for regional centers and service providers. In addition, AB 1147 requires that regional centers be subject to the Public Records Act, allowing for greater public oversight. The sponsors have submitted proposed amendments to the Appropriations Committee that they estimate would make any costs for the bill minor but absorbable and $126,000 for implementing the Public Records Act provision that does not go into effect until January 1, 2025.”
ARGUMENTS IN OPPOSITION: According to Association of Regional Center Agencies (ARCA), “Section 7 proposes several changes to regional center board processes that have the unintentional but cumulative effect of reducing the independence, strength, and inclusivity of regional center boards. We have had multiple conversations with the sponsors on these concerns, and while there was agreement on some of broader points being made, the approach we suggest has been rejected. Section 7 as currently drafted will significantly, though presumably unintentionally, harm the work of regional center boards and their individual members. […] Section 10 of AB 1147 would subject regional centers to the California Public Records Act (PRA) starting January 1, 2025. Section 17 also references this requirement. We estimate this will cost $9,809,285 annually to hire the necessary new, specialized staff at each of the 21 regional centers. […] ARCA and its member regional centers are committed to transparency in both these areas. This is why the Public Records Act is the wrong approach to this. Not only is it more expensive, it lacks equity in access.”
ASSEMBLY FLOOR: 80-0, 5/31/23
AYES: Addis, Aguiar-Curry, Alanis, Alvarez, Arambula, Bains, Bauer-Kahan, Bennett, Berman, Boerner, Bonta, Bryan, Calderon, Juan Carrillo, Wendy Carrillo, Cervantes, Chen, Connolly, Megan Dahle, Davies, Dixon, Essayli, Flora, Mike Fong, Vince Fong, Friedman, Gabriel, Gallagher, Garcia, Gipson, Grayson, Haney, Hart, Holden, Hoover, Irwin, Jackson, Jones-Sawyer, Kalra, Lackey, Lee, Low, Lowenthal, Maienschein, Mathis, McCarty, McKinnor, Muratsuchi, Stephanie Nguyen, Ortega, Pacheco, Papan, Jim Patterson, Joe Patterson, Pellerin, Petrie-Norris, Quirk-Silva, Ramos, Reyes, Luz Rivas, Robert Rivas, Rodriguez, Blanca Rubio, Sanchez, Santiago, Schiavo, Soria, Ta, Ting, Valencia, Villapudua, Waldron, Wallis, Ward, Weber, Wicks, Wilson, Wood, Zbur, Rendon
Prepared by: Diana Dominguez / HUMAN S. / (916) 651-1524
9/4/23 8:53:02
**** END ****
SENATE COMMITTEE ON
Senator Anthony Portantino, Chair
2023 - 2024 Regular Session
AB 1147 (Addis) - Disability Equity and Accountability Act of 2023
Version: | Policy Vote: |
Urgency: | Mandate: |
Hearing Date: | Consultant: |
Bill Summary:
AB 1147 would revise and add requirements for the Department of Developmental Services (DDS) and regional centers to include process standardization, data and reporting requirements, and increased transparency processes.
*********** ANALYSIS ADDENDUM – SUSPENSE FILE ***********
The following information is revised to reflect amendments
adopted by the committee on September 1, 2023
Fiscal Impact:
Unknown, ongoing General Fund costs for the DDS and regional centers to comply with the provisions of the bill.
Author Amendments:
Author amendments, among other changes, delete the following provisions: revised data reporting requirements, development of a project charter related to the data automation system, establishment of a common set of services and supports, revisions related to generic services, review of processes for vendorizing providers, and revisions to the complaint process.
-- END --
SENATE COMMITTEE ON APPROPRIATIONS
Senator Anthony Portantino, Chair
2023 - 2024 Regular Session
AB 1147 (Addis) - Disability Equity and Accountability Act of 2023
Version: July 13, 2023 | Policy Vote: HUMAN S. 5 - 0, JUD. 11 - 0 |
Urgency: No | Mandate: No |
Hearing Date: August 14, 2023 | Consultant: Agnes Lee |
Bill Summary:
AB 1147 would revise and add requirements for the Department of Developmental Services (DDS) and regional centers to include process standardization, data and reporting requirements, and increased transparency processes.
Fiscal Impact:
Unknown, potentially significant ongoing General Fund costs for the DDS and regional centers to comply with the provisions of the bill.
Background:
DDS is responsible for administering the Lanterman Developmental Disabilities Services Act (Lanterman Act). The Lanterman Act establishes that individuals with developmental disabilities and their families have a right to receive the necessary supports and services required to live independently in the community. In addition to establishing the rights of individuals, the Lanterman Act also created California’s regional center system, comprised of 21 nonprofit regional centers throughout the state whose primary purpose is to connect individuals with services in the community. Services for individuals with intellectual and developmental disabilities are outlined in an individual program plan, which is developed according to the needs and personal choices of the individual. Services may include, but are not limited to, diagnosis, evaluation, treatment, and care coordination of services such as personal care, day care, special living arrangements, and physical, occupational, and speech therapy.
In June 2022, the California State Auditor published findings on a number of deficiencies in the developmental disabilities system that negatively impact services, particularly for people of color. The audit of three regional centers, which collectively serve more than 65,000 consumers, found that they have neither sufficient staff nor funding. The audit found regional centers struggle with a number of issues due to inaction from DDS. The key findings included: regional centers have exceeded their service coordinators’ maximum caseload ratios because DDS has not adequately addressed funding issues, regional centers are not monitoring vendors appropriately, and DDS does not provide adequate oversight on regional centers’ processes for resolving consumer rights violations complaints.
Proposed Law:
Specific provisions of the bill would:
- Revise data reporting requirements, including requiring DDS and regional centers, when reporting data by race and ethnicity, to use consistent classifications of race and ethnicity, based on categories current in use by the United States Census Bureau.
- Require DDS, as part of its planning and development of a uniform statewide data automation system, to develop by March 1, 2025, in consultation with stakeholders, a project charter, as specified.
- Require DDS, by March 1, 2025, to submit a report to the Legislature describing the extent to which the existing requirements regarding the quality assurance instrument have not been met, including the surveying of all consumers, including those with no purchase of services, and providing specific steps and the schedule by which these requirements will be met.
- Require DDS to establish, by January 1, 2026, a common set of services and supports, including supported living services, that every regional center in the state must make available to consumers in negotiating, developing, or amending the individual program plan.
- Modify the requirements for the boards of the agencies with which DDS may contract as regional centers.
- Prohibit a regional center employee from accepting a gift or gifts from a service provider, consumer, or consumer’s family member valued over $15 per year; and establish a policy prohibiting regional center senior staff from hiring relatives at the center or any ancillary foundation and organization.
- Require the evaluation of regional center performance to be implemented using a common set of performance measures, as specified.
- Require that a regional center with which the department maintains a contract is subject to the California Public Records Act.
- Add requirements to the development of the individual program plan.
- Make changes to the requirements for regional centers to purchase services, including prohibiting a consumer, or their family, from being required to appeal another entity’s denial of the requested service, as specified.
- Require DDS to review the current processes for vendorizing providers for the delivery of services and supports to regional center consumers and revise those processes to streamline the process and create a uniform statewide vendorization process.
- Revise the process by which a consumer or any representative acting on behalf of any consumer or consumers, who believes that any right to which a consumer is entitled has been abused, punitively withheld, or improperly or unreasonably denied by a regional center, state-operated facility, or service provider, may pursue complaints.
Related Legislation:
AB 649 (Wilson) would specify that a consumer or family is not required to appeal the denial of services from another agency, as specified, in order for a regional center to purchase those services as part of a consumer’s individual program plan. The bill is on the suspense file in this committee.
AB 121 (Committee on Budget, Chapter 44, Statutes of 2023), among other provisions, added requirements for DDS and regional centers aimed at improving program outcomes.
-- END --
SENATE COMMITTEE ON APPROPRIATIONS
Senator Anthony Portantino, Chair
2023 - 2024 Regular Session
AB 1147 (Addis) - Disability Equity and Accountability Act of 2023
Version: July 13, 2023 | Policy Vote: HUMAN S. 5 - 0, JUD. 11 - 0 |
Urgency: No | Mandate: No |
Hearing Date: August 14, 2023 | Consultant: Agnes Lee |
Bill Summary:
AB 1147 would revise and add requirements for the Department of Developmental Services (DDS) and regional centers to include process standardization, data and reporting requirements, and increased transparency processes.
Fiscal Impact:
Unknown, potentially significant ongoing General Fund costs for the DDS and regional centers to comply with the provisions of the bill.
Background:
DDS is responsible for administering the Lanterman Developmental Disabilities Services Act (Lanterman Act). The Lanterman Act establishes that individuals with developmental disabilities and their families have a right to receive the necessary supports and services required to live independently in the community. In addition to establishing the rights of individuals, the Lanterman Act also created California’s regional center system, comprised of 21 nonprofit regional centers throughout the state whose primary purpose is to connect individuals with services in the community. Services for individuals with intellectual and developmental disabilities are outlined in an individual program plan, which is developed according to the needs and personal choices of the individual. Services may include, but are not limited to, diagnosis, evaluation, treatment, and care coordination of services such as personal care, day care, special living arrangements, and physical, occupational, and speech therapy.
In June 2022, the California State Auditor published findings on a number of deficiencies in the developmental disabilities system that negatively impact services, particularly for people of color. The audit of three regional centers, which collectively serve more than 65,000 consumers, found that they have neither sufficient staff nor funding. The audit found regional centers struggle with a number of issues due to inaction from DDS. The key findings included: regional centers have exceeded their service coordinators’ maximum caseload ratios because DDS has not adequately addressed funding issues, regional centers are not monitoring vendors appropriately, and DDS does not provide adequate oversight on regional centers’ processes for resolving consumer rights violations complaints.
Proposed Law:
Specific provisions of the bill would:
- Revise data reporting requirements, including requiring DDS and regional centers, when reporting data by race and ethnicity, to use consistent classifications of race and ethnicity, based on categories current in use by the United States Census Bureau.
- Require DDS, as part of its planning and development of a uniform statewide data automation system, to develop by March 1, 2025, in consultation with stakeholders, a project charter, as specified.
- Require DDS, by March 1, 2025, to submit a report to the Legislature describing the extent to which the existing requirements regarding the quality assurance instrument have not been met, including the surveying of all consumers, including those with no purchase of services, and providing specific steps and the schedule by which these requirements will be met.
- Require DDS to establish, by January 1, 2026, a common set of services and supports, including supported living services, that every regional center in the state must make available to consumers in negotiating, developing, or amending the individual program plan.
- Modify the requirements for the boards of the agencies with which DDS may contract as regional centers.
- Prohibit a regional center employee from accepting a gift or gifts from a service provider, consumer, or consumer’s family member valued over $15 per year; and establish a policy prohibiting regional center senior staff from hiring relatives at the center or any ancillary foundation and organization.
- Require the evaluation of regional center performance to be implemented using a common set of performance measures, as specified.
- Require that a regional center with which the department maintains a contract is subject to the California Public Records Act.
- Add requirements to the development of the individual program plan.
- Make changes to the requirements for regional centers to purchase services, including prohibiting a consumer, or their family, from being required to appeal another entity’s denial of the requested service, as specified.
- Require DDS to review the current processes for vendorizing providers for the delivery of services and supports to regional center consumers and revise those processes to streamline the process and create a uniform statewide vendorization process.
- Revise the process by which a consumer or any representative acting on behalf of any consumer or consumers, who believes that any right to which a consumer is entitled has been abused, punitively withheld, or improperly or unreasonably denied by a regional center, state-operated facility, or service provider, may pursue complaints.
Related Legislation:
AB 649 (Wilson) would specify that a consumer or family is not required to appeal the denial of services from another agency, as specified, in order for a regional center to purchase those services as part of a consumer’s individual program plan. The bill is on the suspense file in this committee.
AB 121 (Committee on Budget, Chapter 44, Statutes of 2023), among other provisions, added requirements for DDS and regional centers aimed at improving program outcomes.
-- END --
Senator Thomas Umberg, Chair
2023-2024 Regular Session
Bill No: AB 1147 (Author:Addis)
Version: July 10, 2023
Hearing Date: July 11, 2023
Fiscal: Yes
Urgency: No
Consultant: AWM
SUBJECT
Disability Equity and Accountability Act of 2023
DIGEST
This bill enacts the Disability Equity and Accountability Act of 2023, which makes various changes to the Lanterman Developmental Disabilities Services Act (Lanterman Act) to reform and provide transparency into the regional centers that provide services and supports to persons with developmental disabilities.
EXECUTIVE SUMMARY
The Lanterman Act establishes 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, at each stage of life. The Department of Developmental Services (DDS) is tasked with overseeing the coordination and delivery of services and supports under the Lanterman Act, which it does by contracting with 21 regional centers throughout the state. The regional centers, in turn, contract with vendors to provide services, and work with persons with developmental disabilities and their supporters (often family members) to determine what services should be provided.
In recent years, both the California State Auditor and the Little Hoover Commission have reported that the regional centers are failing to live up to their obligations of providing services to Californians with developmental disabilities. In particular, the Little Hoover Commission found that regional centers are not providing services equally across racial and ethnic groups and geographic locations, as well as inconsistencies in data reporting. DDS has implemented some measures to improve the regional centers, but the author and sponsors contend that more efforts are necessary.
This bill, the Disability Equity and Accountability Act of 2023, is intended to improve the regional centers’ operations and provide advocates and the public with greater transparency. The brunt of the reforms, which deal with the internal operations of the regional centers, were considered by the Senate Human Services Committee. This Committee has jurisdiction over one key provision: the application of the California Public Records Act (CPRA) to the regional centers. According to the author and sponsors, while current law requires regional centers to make certain information public, the scope of the publicly available information is inadequate to allow for meaningful public oversight into the regional centers’ expenditures of public funds in order to serve members of the public. In order to give the regional centers time to adapt to the CPRA’s obligations, the author has agreed to delay the implementation of the CPRA to regional centers until January 1, 2025.
This bill is sponsored by Disability Voices United and the Integrated Community Collaborative, and is supported by Autism Society Los Angeles, the California State Council on Developmental Disabilities, Disability Rights California, Momentum Agencies, PRAGNYA, Public Counsel, Special Needs Network, Inc., and one individual. This bill is opposed by the Association of Regional Center Agencies. The Senate Human Services Committee passed this bill with a vote of 5-0.
PROPOSED CHANGES TO THE LAW
Existing law:
- Establishes the Lanterman 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, at each stage of life; and governs the provision of services to persons with developmental disabilities covered by the Lanterman Act. (Welf. & Inst. Code, div. 4.5, §§ 4500 et seq.)
- Defines, for purposes of the Lanterman Act, the following relevant terms:
- “Developmental disability” means 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 that individual, and includes intellectual disability, cerebral palsy, epilepsy, and autism, as well as other disabling conditions found to be closely related to intellectual disability. Children who do not have a defined developmental disability may nevertheless be eligible for regional center services if they present specified functional limitations.
- “Services and supports for persons with developmental disabilities” means specialized services and supports or special adaptations of generic services and supports directed toward the alleviation of a developmental disability or toward the social, personal, physical, or economic habilitation or rehabilitation of an individual with a developmental disability, or toward the achievement and maintenance of an independent, productive, and normal life. The determination of which services and supports are necessary is made through an individualized plan process, as specified.
- “Consumer” means a person who has a disability that meets the definition of developmental disability. (Welf. & Inst. Code, § 4512.)
- Requires the State, in order to carry out many of its responsibilities under the Lanterman Act, to contract with appropriate agencies to provide fixed points of contact in the community for consumers and their families, so that these persons may have access to the appropriate services and supports, known as “regional centers.” Regional centers should be accessible to every family in need of their services and the design and activities of regional centers should reflect a strong commitment to the delivery of direct service coordination; all other operational expenditures of regional centers should be necessary to support and enhance the delivery of direct service coordination and services and supports identified in IPPs. (Welf. & Inst. Code, § 4620.)
- Requires DDS to oversee the regional centers and ensure that they meet their statutory, regulatory, and contractual obligations in providing services to persons with developmental disabilities. (Welf. & Inst. Code, § 4501.)
- As part of its responsibility to monitor regional centers, DDS must collect and review printed materials issued by the regional centers, including, but not limited to, purchase of service policies and other policies, guidelines, or assessment tools utilized by regional centers when determining the service needs of a consumer, instructions and training materials for regional center staff, board meeting agendas and minutes, and general policy and notifications provided to all providers and consumers and families. (Welf. & Inst. Code, § 4434(d).)
- Requires DDS and the regional enters to collaborate annually to compile data in a uniform manner relating to purchases and expenditures with respect to all of the following:
- The age of the consumer, in specified brackets.
- The race or ethnicity of the consumer.
- The preferred language spoken by the consumer, plus related details if feasible.
- The disability details of the consumer, as specified.
- Residence type, subcategorized by age, race or ethnicity, and preferred language.
- Specified information regarding the provision of a consumer’s IPP, on request.
- Beginning in fiscal year 2023-2024, the numbers, percentages, and total and per capita expenditure and authorization amounts, by age, as applicable, according to race or ethnicity and preferred language, for all combined residence types and for consumers living in the family home, regarding (1) camping and recreational expenses, (2) social recreation activities, (3) educational services, and (4) nonmedical therapies, including specialized recreation, art, dance, and music. (Welf. & Inst. Code, § 4519.5(a).)
- Requires the data reported under 5) to include the number of persons who have determined to be eligible for regional center services, but who are not receiving purchase of service funds, and specified demographic information about those persons. (Welf. & Inst. Code, § 4519.5(b).)
- Requires each regional center to post its own information reported under 5)-6) on its website annually, including all prior years’ information, and DDS to post the statewide information reported under 5)-6) on its website, including all prior years’ information. Each regional center shall meet with stakeholders in public meetings to discuss the data annually, as specified. (Welf. & Inst. Code, § 4519.5(c)-(e).)
- Requires DDS, in consultation with stakeholders, to identify a valid and reliable quality assurance instrument that assesses consumer and family satisfaction, provision of services in a linguistically and culturally competent manner, and personal outcomes; among other things, the instrument shall include outcome-based measures to evaluate linguistic and cultural competency of regional center services that are provided to consumers across their lifetimes. (Welf. & Inst. Code, § 4571.)
- Establishes criteria for the agencies with which DDS may contract to serve as regional centers, including specified requirements for the agencies’ boards. (Welf. & Inst. Code, § 4622.)
- Requires each regional center to submit a conflict-of-interest policy, including specified information, to DDS and post the policy on its website. (Welf. & Inst. Code, § 4626.5.)
- Establishes initial intake assessment procedures for any person who is believed to have a developmental disability and any person believed to have a high risk of parenting a developmentally disabled infant, and required DDS to create standardized information packets to be provided to any person seeking services from a regional center that shall be distributed at intake and other specified occasions. (Welf. & Inst. Code, § 4642.)
- Requires regional centers to develop IPPs for any person who, following intake and assessment, is found to be eligible for regional center services, developed through specified processes and including specified information. (Welf. & Inst. Code, §§ 4646-4646.5.)
- Requires regional centers to identify and pursue all possible sources of funding for consumers receiving regional center services, which shall be applied against the cost of providing services, and with certain limitations on services that may be provided without documentation of a Medi-Cal denial of services and a determination that an appeal does not have merit. (Welf. & Inst. Code, § 4659.)
- Requires DDS to implement a statewide Self-Determination Program which shall be available in every regional center catchment area to provide participants and their families with increased flexibility and choice, and greater control over decisions, to implement their IPPs. (Welf. & Inst. Code, § 4685.8.)
- Requires every regional center to have an appeals process for resolving conflicts between the regional center and recipients of, or applicants for, service, and that access to records shall be provided to an applicant for, or recipient of, services or their authorized representative, for purposes of an appeal, notwithstanding the general requirement that information and records obtained in the course of providing services are confidential. (Welf. & Inst. Code, §§ 4705, 4726, 5328.)
- Establishes a complaint procedure for each consumer or representative of a consumer or consumers who believes that any right has been abused, punitively withheld, or improperly or unreasonably denied by a regional center; if the complaint is not satisfied by the resolution proposed by the regional center, they may seek administrative review by DDS, which must issue a written administrative decision. DDS must annually compile the information related to the complaints filed and make copies available to any person upon request. (Welf. & Inst. Code, § 4731.)
- Establishes the California Public Records Act (CPRA), which finds and declares that access to information concerning the conduct of the people's business is a fundamental and necessary right of every person in this state, and sets forth procedures by which public records may be requested, subject to certain exceptions. (Gov. Code, tit. 1, div. 10, §§ 7920.00 et seq.)
This bill:
- Establishes the Disability Equity and Accountability Act of 2023.
- Makes findings and declarations regarding the failures of California’s service system for adults and children with intellectual disabilities through the Lanterman Act, including serious racial, ethnic, and geographic disparities among regional centers which can dramatically impact the essential services received by children and adults with developmental disabilities.
- States that it is the intent of the Legislature to do all of the following:
- Ensure that the delivery of all services and supports comply with federal law and guidance and are responsive to the needs and choices of beneficiaries receiving home- and community-based services, are person centered and strengths based, have high expectations for interdependence, self-direction, and competitive, integrated employment, provide support coordination to assist with a community-supported life, and achieve a more consistent and coordinated approach to the administration of policies and procedures across the state.
- Ensure that all regional centers offer and provide a consistent and common set of services and that the services are delivered in a timely way.
- Ensure that the delivery of all services and supports comply with federal law and guidance and are responsive to the needs and choices of beneficiaries receiving home- and community-based services; are person centered and strengths based; have high expectations for interdependence, self-direction, and competitive, integrated employment; provide support coordination to assist with a community-supported life; and achieve a more consistent and coordinated approach to the administration of policies and procedures across the state.
- Provide the department with new tools for holding regional centers and service providers accountable through the development of a standardized and coordinated set of performance measures and related standards that establish targets and standards above which a regional center may receive incentives for improved performance, and a separate set of standards that require corrective action.
- Improve regional center governance by establishing new standards and procedures for regional center governing boards to ensure they can more effectively represent the communities they serve by providing them with greater independence and protection from regional center retaliation.
- Require DDS to develop a written project charter for the planning and development of a uniform statewide automation system that serves as a foundation document for the system development, which includes project guiding principles, scope, strategies and approach, and project governance, in order to provide transparency to the Legislature and the public on the system development as has been used with other statewide system development.
- Provides that regional centers are subject to the records disclosure requirements of the CPRA.
- Provides that, notwithstanding any exemption to the PRA, an applicant for, or recipient of, services who is appealing a regional center decision shall receive access to their records on request, unless the disclosure is expressly provided by law.
- Requires DDS to mandate, for purposes of its data collection, the use of consistent classifications of race and ethnicity and consistent standards and requirements for regional center websites; and to collect information relating to consumers’ tribal affiliation.
- Requires, as part of DDS’s planning process for the planning and development of a uniform statewide data automation system, DSS to develop, by March 1, 2025, a project charter that includes specified information and goals.
- Requires DDS, by March 1, 2025, to submit a report to the policy and budget subcommittees of the Legislature describing the extent to which the requirements relating to DSS’s unified quality assessment system are not being met, and providing specific steps and the schedule by which these requirements will be met.
- Requires DDS, by January 1, 2026, to establish a common set of services and supports that every regional center in the state shall make available to consumers in negotiating, developing, or amending an IPP.
- Modifies the requirements for the boards of the agencies with which DDS may contract as regional centers.
- Establishes procedures by which DDS shall conduct evaluations of regional centers and by which corrective action plans shall be developed and assessed.
- Adds requirements relating to cultural competency in the regional assistance intake process.
- Modifies the requirements for and the processes by which an IPP is developed and reviewed.
- Modifies the circumstances under which a regional center may ask a consumer or family member to seek Medi-Cal or other funding for services provided by the regional center.
- Requires DDS to review its current processes for vendorizing providers for the delivery of services and supports to regional centers, revise those processes, and create a uniform statewide vendorization process.
- Modifies the consumer complaint process to require that a complaint first be made to the director of the regional center, who shall propose a solution within 20 days; if the complainant is not satisfied, they may refer the complaint to the director of DDS within 15 days of receiving the proposed resolution, and the director shall issue a written administrative decision within 30 days. If there is no referral of the complaint, the proposed resolution shall become effective on the 20th working day following receipt by the complainant.
COMMENTS
- Author’s comment
Regional centers play a critical role in California’s developmental disability system by providing assessments, determining eligibility, and coordinating the services for those with intellectual and developmental disabilities. Despite California’s network of centers that serve nearly 400,000 individuals, numerous issues plague the system, including a lack of transparency, accountability, and disparities in the services provided. Not only has this undermined confidence in California’s developmental disability system, but it has failed to serve the Californians that need these services most. AB 1147, the Disability Equity & Accountability Act, enacts several reforms to help ensure that all people, regardless of their race or ethnicity or where they live, receive equitable access to services within the regional center system and that all regional centers offer and provide a consistent and common set of services and that the services are delivered in a timely way. It is time that we provide accountability, transparency, and fairness to Californians with disabilities and their families.
2. Background on the Lanterman Act and regional centers
Since the Lanterman Act was enacted in 1977, California “has accepted responsibility for providing services and supports to residents with intellectual and developmental disabilities.”[1] Under the Lanterman Act:
[DDS] is responsible for overseeing the coordination and delivery of care, custody, and treatment of individuals with intellectual and developmental disabilities. More than 380,000 Californians receive services and supports through the Lanterman Act. DDS contracts with 21 regional centers throughout California to coordinate service provision to these individuals. These regional centers are private, nonprofit corporations that receive funding and oversight from DDS. In fiscal year 2021–22, the state budget allocated $6.5 billion to support regional centers statewide.[2]
The regional centers that have contracts with DDS then enter into their own contracts with vendors to provide a variety of services to consumers.[3] The services and supports provided by the regional centers are to help the consumers “live as independently as possible…To many individuals and families, the state’s developmental disabilities services offer a critical lifeline.”[4]
3. Regional centers are underfunded and are not providing sufficient services, particularly for people of color
In the last year, two separate reports have detailed the numerous shortcomings in regional centers’ provision of care.
In 2022, the State Auditor released a report on its audit of three regional centers.[5] The first conclusion was that all of the regional centers in the State were failing to comply with limitations on service coordinator caseloads for at least one consumer group[6] due to DDS’s consistent failure to update its salary formula or perform the analysis necessary to determine the ongoing cost of hiring the number of service coordinators required by law.[7] Unsurprisingly, the lack of service coordinators left regional centers unable to provide the kind of services and responsiveness that the Legislature has sought to provide to consumers.[8] Additionally, the Auditor concluded that (1) DDS has not ensured that regional centers are adequately monitoring vendors;[9] (2) DDS and the regional centers do not systematically monitor whether consumers experience difficulties in accessing services;[10] and (3) DDS has not provided adequate oversight of the regional centers’ response to consumer complaints.[11]
Nearly a year later, in April 2023, the Little Hoover Commission found “persistent and ongoing disparities in the availability and quality of services [provided by regional centers] among racial and ethnic groups and among geographic localities.”[12] The Commission also found “inconsistencies in data reporting, technologies, vendorization processes, support for regional center governing boards, and availability of client support.”[13] The report made seven recommendations for improvement:
- Increase consistency in client experiences across regional centers.
- Target and reduce racial and ethnic disparities.
- Strengthen state oversight of the developmental disabilities system.
- Modernize technology.
- Standardize the vendorization process.
- Strengthen and enhance support for regional center governing boards.
- Improve service coordination.[14]
The impetus for recommendation #2 is especially troubling; the Commission found persistent disparities in the delivery of services on the basis of race and ethnicity, even after the State invested $66 million to reduce those disparities.[15] “To date, no one has satisfactorily explained the cause of these inequities,” but, as the Commission concluded, “these inequities must be addressed.”[16]
4. This bill implements several reforms in the regional centers, including making the regional centers subject to the CPRA
This bill makes numerous changes to the statutes governing the operation and governance of the regional centers, many of which were recommended by the State Auditor and the Little Hoover Commission. The internal workings of the regional centers are generally within the jurisdiction of the Senate Human Services Committee, which heard this bill first; the analysis of that Committee is incorporated here by reference. This Committee’s jurisdiction arises from the provision of the bill that makes the regional centers subject to the CPRA.
Because the regional centers are technically private entities—even though they serve a public purpose and are funded with public funds[17]—they are not subject to the CPRA’s disclosure requirements. Of course, information that a regional center provides to DDS becomes subject to the CPRA once it is in DDS’s possession. The Association of Regional Center Agencies (ARCA), writing in opposition, notes that the regional centers already provide an array of documents to DDS so that DDS can perform its oversight obligations; those documents can be obtained through a CPRA request to DDS.[18] Regional centers are also required to post specific information online, including certain information relating to the purchase of service policies and other guidelines and information about the vendors used by the regional centers.[19] The question, therefore, is whether the regional centers’ limited disclosures are sufficient, or whether it is appropriate to give the public the same access to the regional centers’ documents as they are entitled to for documents of public entities. The author and sponsors argue that, although they can obtain some information from DDS once it is passed along from the regional centers, the available information is insufficient to truly determine whether the regional centers are fulfilling their obligations or the sources of regional centers’ failures. Moreover, given that both the State Auditor and the Little Hoover Commission found that DDS’s oversight of the regional centers was lacking,[20] the author and sponsors argue that relying on information filtered through DDS (and often obtained only after considerable delay and expense) prevents true transparency.
The State generally has a strong policy preference in favor of providing public access to government records: access to information concerning the conduct of the people’s business is a fundamental and necessary right of every person in this state.[21] In 2004, the right of public access was enshrined in the California Constitution with the passage of Proposition 59,[22] which amended the California Constitution to specifically protect the right of the public to access and obtain government records, stating that “[t]he people have the right of access to information concerning the conduct of the people’s business, and… the writings of public officials and agencies shall be open to public scrutiny.”[23] Ten years later, voters approved Proposition 42[24] to further increase public access to government records by requiring local agencies to comply with the CPRA,[25] and with any future amendments to the CPRA, as provided.[26]
The CPRA casts a broad net: a public record is any writing containing information relating to the conduct of the public’s business prepared, owned, used, or retained by any public agency regardless of physical form or characteristics.[27] Public records are open to inspection at all times during the office hours of a public agency for inspection by the public, unless exempted.[28] The CPRA allows a public agency 10 days or, in specified “unusual circumstances,” within 14 days of the 10-day period to disclose the requested public record, and authorizes the agency to charge a fee for its “direct costs of duplication” to the record.[29]
There is precedent for applying the CPRA to private entities. As ARCA notes, charter schools are subject to the CPRA.[30] The CPRA was extended to charter schools legislatively[31] after Attorney General Becerra issued guidance on the issue; the guidance looked at the function served by charter schools (to be equivalent to public schools) and charter schools’ source of funding (taxpayer money) and concluded:
Receiving funding from the state for the purpose of educating public schoolchildren to require that corporate charter schools’ business—which is also the people’s business—is conducted in the open.[32]
This rationale seems to hold true for regional centers as well. Regional centers receive money from the State for the purpose of providing services and benefits to the State’s residents with developmental disabilities. If anything, the regional centers land even more squarely in the public domain than charter schools: while charter schools are a quasi-private alternative to public schools, regional centers are the public option. DDS’s obligation to provide services to Californians with developmental disabilities is fulfilled by the regional centers acting at the direction of DDS. Other areas of law hold that the State cannot avoid its legal constraints by directing the actions of a private actor;[33] the obverse proposition—that a private entity cannot avoid the legal obligations of the State when it is conducting State business at the direction of, and funded by, the State—seems logically to follow.[34]
To be sure, compliance with the CPRA is no mean feat. The CPRA is an extensive body of law and requires sensitive information to be redacted from otherwise-inspectable documents.[35] But the people’s right to access public records—affirmed by the voters twice in two decades—is not contingent on convenience. Allowing a public body to opt out of the CPRA because compliance is cumbersome would thwart the purpose of the CPRA. At the same time, the move from limited disclosure obligations to full CPRA compliance requires institutional adaptation—to establish procedures, become familiar with the exemptions, and ensure the organization has the capacity to handle incoming requests. To give the regional centers some breathing room, the author has agreed to delay the implementation of the CPRA to regional centers until January 1, 2025.
5. Amendments
As noted above, the author has agreed to amend the bill to make the application of the CPRA to regional centers effective on January 1, 2025.
6. Arguments in support and opposition
This bill is supported by a number of organizations that advocate for the rights of Californians with disabilities, who argue that this bill is necessary to reform the regional centers and allow them to engage in effective public oversight. For example, Disability Voices United, one of the sponsors of the bill, writes:
Clients and families should be able to see how they are being individually served and how their regional centers are doing with all their clients. To accomplish the transparency goal, the bill directs DDS, as part of planning for implementation of a new information technology system, to develop a written project charter for the system development which includes project guiding principles, scope, strategies and approach, and project governance, to provide transparency to the Legislature and the public. The bill also requires that regional centers be subject to the Public Records Act, requires DDS and regional centers to collect standardized racial and ethnicity data aligned with federal census data categories, and directs DDS to report statewide and regional center data on health and safety waivers.
The State Council on Developmental Disabilities also writes in support:
Different reports and feedback from stakeholders have gleaned disparities in services provided by regional centers. These reports, including the State Auditor Report, have found that stronger state oversight and transparency are needed to improve quality and effectiveness of developmental services. Though DDS has started initiatives to address these inequities, much remains to be done to address challenges in the regional center system. AB 1147 will enact significant needed reforms at regional centers to ensure that services are equitable, provided efficiently, and ensure overall accountability.
ARCA opposes the bill’s extension of the CPRA to the regional centers, arguing that the regional centers’ provision of data to DDS, and DDS’s ability to request information from the regional centers, provides sufficient transparency:
The sponsors indicated a primary and specific concern is public access to information about how service delivery decisions are made. DDS already has the authority to collect this information under Welfare and Institutions Code § 4434(d), which would then make this information available through requests under the California Public Records Act, in the same fashion as data is available from any other state agency.
ARCA and its member regional centers are committed to transparency in this area and do not believe this information should only be available to those who request it through a duplicative expansion of the formalized Public Records Act process.
In lieu of the bill’s CPRA provisions, ARCA suggests that the existing statutes requiring regional centers to post certain policy and purchasing information online could be broadened.
SUPPORT
Disability Voices United (co-sponsor)
Integrated Community Collaborative (co-sponsor)
Autism Society Los Angeles
California State Council on Developmental Disabilities
Disability Rights California
Momentum Agencies
PRAGNYA
Public Counsel
Special Needs Network, Inc.
One individual
OPPOSITION
Association of Regional Center Agencies
RELATED LEGISLATION
Pending Legislation: None known.
Prior Legislation:
AB 445 (Calderon, Ch. 149, Stats. 2021) eliminated the requirement that DDS, through regional enters, collect the social security numbers for of the parents of consumers.
AB 2935 (Mathis, 2020) would have required DDS, in consultation with regional centers and other stakeholders to determine the most appropriate open, machine-readable format to be used by DDS and regional centers when disclosing numeric data to the public; and specified that these requirements would not have affected the applicability of the PRA to regional centers. AB 2935 died in the Assembly Human Services Committee.
AB 823 (Arambula, 2020) would have required a regional center to post memoranda of understanding with county mental health agencies on its website. AB 823 died in the Senate Rules Committee.
SB 126 (Leyva, Ch. 3, Stats. 2019) made charter schools subject to the CPRA.
AB 959 (Holden, Ch. 474, Stats. 2017) required DSS to establish and maintain a page on its website that included services purchased or provided to consumers by regional centers and descriptions of those services, and regional centers to include a link to the DSS page on their websites.
PRIOR VOTES:
Senate Human Services Committee (Ayes 5, Noes 0)
Assembly Floor (Ayes 80, Noes 0)
Assembly Appropriations Committee (Ayes 11, Noes 0)
Assembly Human Services Committee (Ayes 7, Noes 0)
Assembly Judiciary Committee (Ayes 11, Noes 0)
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Auditor for the State of California, Report 2021-107, Department of Developmental Services: It Has Not Ensured That Regional Centers Have the Necessary Resources to Effectively Serve Californians With Intellectual and Developmental Disabilities (Jun. 2022), p. 5 (State Auditor’s Report). ↑
Ibid. ↑
Ibid. ↑
Little Hoover Com., A System in Distress: Caring for Californians with Developmental Disabilities (Apr. 2023), p. 7 (Little Hoover Report). ↑
State Auditor’s Report, supra, at p. 7. ↑
Id. at p. 13. ↑
Ibid. ↑
Id. at pp. 16-17. ↑
Id. at p. 21. ↑
Id. at p. 25. ↑
Id. at p. 28. ↑
Little Hoover Report, supra, at p. 5. ↑
Ibid. ↑
Id. at pp. 5-6. ↑
Id. at p. 11. ↑
Ibid. ↑
State Auditor’s Report, supra, at p. 5. ↑
See Welf. & Inst. Code, § 4434(d). ↑
Welf. & Inst. Code, § 4629.5. ↑
State Auditor’s Report, supra, at pp. 25-32; Little Hoover Report, supra, at pp. 12-14. ↑
Gov. Code, § 7921.000. ↑
Prop. 59, as approved by the voters, Gen. Elec. (Nov. 3, 2004). Prop. 59 was placed on the ballot by a unanimous vote of both houses of the Legislature. (SCA 1 (Burton, Ch. 1, Stats. 2004). ↑
Cal. Const., art. I, § 3 (b)(1). ↑
Prop. 42, as approved by the voters, Prim. Elec. (Jun. 3, 2014). Prop. 42 was placed on the ballot by a unanimous vote of both houses of the Legislature. (SCA 3 (Leno, Ch. 123, Stats. 2013). ↑
The Ralph M. Brown Act is the open meetings laws that apply to local agencies. (Gov. Code §§ 59450 et. seq.) ↑
Cal. Const., art. I, sec. 3 (b)(7). ↑
Gov. Code § 7920.530. ↑
Gov. Cod § 7922.252. ↑
Gov. Code §§ 7922.530(a), 7922.5353. ↑
Ed. Code, § 47604.1. ARCA states that charter schools are the only non-public entities covered by the CPRA, but at least one other private body serving a public function—the California Interscholastic Federation—is required to comply with the CPRA. (See id., § 33353.) ↑
SB 126 (Leyva, Ch. 3, Stats. 2019). ↑
101 Ops. Cal. Atty. Gen. 92 (2018), p. 10. ↑
See, e.g., Skinner v. Railway Labor Executives’ Ass’n (1989) 489 U.S. 615-616 (where federal regulations directed railroad companies to conduct toxicological testing of railroad employees, the tests were treated as a governmental search subject to the Fourth Amendment). ↑
See, e.g., Lebron v. National R.R. Passenger Corp. (1995) 513 U.S. 374, 397-399 (Amtrak, though technically a private corporation, is properly considered a part of the government for the purposes of the First Amendment). ↑
E.g., Gov. Code, §§ 7922.000, 7927.700 ↑
SENATE COMMITTEE ON HUMAN SERVICES
Senator Alvarado-Gil, Chair
2023 - 2024 Regular
Bill No: | AB 1147 | ||
Author: | Addis | ||
Version: | May 19, 2023 | Hearing Date: | July 3, 2023 |
Urgency: | No | Fiscal: | Yes |
Consultant: | Diana Dominguez | ||
Subject: Disability Equity and Accountability Act of 2023
SUMMARY
This bill deletes, revises, and adds requirements for the Department of Developmental Services (DDS) and the regional centers that coordinate services for the eligible population to include process standardization, data and reporting requirements, and increased transparency processes.
ABSTRACT
Existing law:
- Establishes the Lanterman Developmental Disabilities Services Act (Lanterman Act), which states that California is responsible for providing a range 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.)
- Establishes a system of nonprofit Regional Centers, overseen by DDS, to provide fixed points of contract 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)
- Establishes an Individual Program Plan (IPP) as the process to ensure that services and supports are customized to meet the needs of consumers who are served by regional centers for the purpose of alleviating a developmental disability or toward the social, personal, physical, or economic habilitation or rehabilitation of an individual with a developmental disability, or toward the achievement and maintenance of independent, productive, and normal lives. (WIC 4512(b))
- Requires decisions concerning the consumer’s goals, objectives, and services and supports included in their IPP to be made by agreement between the regional center representative and the consumer or, when appropriate, the consumer’s parents, legal guardian, conservator, or authorized representative, at the program plan meeting. (WIC 4646(d))
- Requires the IPP planning processes to include:
- A statement of the individual’s goals and objectives, a schedule of the type and nature of services to be provided and other information and considerations, as specified;
- Review and modification, as necessary, by the regional center’s planning team no less frequently than every three years; and
- Statewide training and review of the IPP plan creation, as specified. (WIC 4646.5)
- A statement of the individual’s goals and objectives, a schedule of the type and nature of services to be provided and other information and considerations, as specified;
- Provides the dispute process when a regional center believes that a generic agency is legally obligated to fund or provide services described in an IPP for children under age six. (WIC 4659.5)
- Makes all information and records obtained in the course of providing services under the Lanterman Act, to either voluntary or involuntary recipients of services, confidential. (WIC 5328(a))
- Provides that the people have the right of access to information concerning the conduct of the people’s business and, therefore, the writings of public officials and agencies are be open to public scrutiny. Specifies that any law or rule that limits the public right of access shall be adopted with findings demonstrating the interest protected by the limitation. (California Constitution, Art. I, Section 3)
This bill:
- Makes findings and declarations about the Developmental Services systems, its limitations, lack of transparency, and need for accountability.
- States it is the intent of the Legislature to ensure all people, regardless of race, ethnicity, or where they live, receive equitable access to services within the regional center system; ensure the delivery of all services and supports are responsive to the needs and choices of beneficiaries and are person centered and strengths based; provide DDS with new tools for holding regional centers and service providers accountable; improve regional center governance; and require transparency for the planning and development of a uniform statewide automation system.
Data Collection and Reporting
- Expands the data that DDS and the regional centers must annually compile to do both of the following:
- Add Tribal affiliation as a data category, and
- Expand the category of nonmedical therapies, including, but not limited to, specialized recreation, art, dance, and music to include tribal culture and ceremony.
- Add Tribal affiliation as a data category, and
- Establishes that DDS will require all of the following for purposes of annual data compilation in collaboration with the regional centers:
- The use by DDS and regional centers, when reporting data by race and ethnicity, of consistent classifications of race and ethnicity, based on categories currently in use by the U.S. Census Bureau;
- Confirmation of the race and ethnicity identification of each consumer at the time of the annual review of the consumer’s individual program plan (IPP);
- When reporting by residence types, separate presentation of data for those in independent living services and those in supported living services; and
- Consistent standards and requirements for regional center internet websites, using the same placement and language for all required information, including that data be posted in a machine-readable format.
- The use by DDS and regional centers, when reporting data by race and ethnicity, of consistent classifications of race and ethnicity, based on categories currently in use by the U.S. Census Bureau;
Data System Development Oversight
- Requires DDS, in consultation with stakeholders, to develop, by March 1, 2024, a project charter that shall be approved by the Secretary of the California Health and Human Services Agency (CalHHS) and the California Department of Technology (CDT) as part of the department’s planning process for the planning and development of a uniform statewide data automation system. Further requires the charter development process to include the participation and input of program consumers and families, researchers, and quality and outcome evaluators, regional centers, and service providers. Requires the project charter to include all of the following:
- An impact statement on the primary entities and individuals impacted by the system development;
- Project guiding principles foundational to the project approach to be used throughout the planning, development, implementation, and maintenance of the system;
- A project scope that addresses business problems required to be solved by the system, including all of the following:
- Worker effectiveness and accountability that are constrained by the lack of timely, adequate, and accurate data, the lack of uniformity, and the current system’s limited functionality;
- Service delivery that is constrained by the lack of timely, adequate, accurate, and accessible data, the lack of clear understandable communication of information, lack of uniformity, and the system’s limited functionality;
- Current system maintainability that is constrained by disparate systems, inadequate documentation, the lack of open system architecture, and business changes;
- Disparate systems, complex business rules, the number of locations and variability of local system delivery, and changes in the way of doing business; and
- Limited access of researchers and program evaluators to the set of person-level data that they need to assess program effectiveness;
- Worker effectiveness and accountability that are constrained by the lack of timely, adequate, and accurate data, the lack of uniformity, and the current system’s limited functionality;
- Program goals, which shall include all of the following:
- Maximizing the performance and the business processes for the delivery of IDD system services to consumers at the regional centers;
- Improving data quality, privacy, confidentiality, and integration of all data sources at an individual level;
- Enabling data-driven decision making and performance measures for the effective administration of the program;
- Improving the business processes administered by the department to support regional center service delivery; and
- Supporting access to individual-level data to support program evaluation and other research;
- Maximizing the performance and the business processes for the delivery of IDD system services to consumers at the regional centers;
- Technology goals that recognize that a statewide system solution both meets requirements and ensures effective transition while minimizing disruption to existing services;
- Project strategies and approaches for development and implementation;
- Project governance; and
- Technology that can readily be enhanced and modernized for the expected system life, as specified.
- An impact statement on the primary entities and individuals impacted by the system development;
Report on Quality Assurance and Surveying
- Requires DDS to submit a report to the policy and budget subcommittees of the Legislature, by March 1, 2024, describing the extent to which the requirements to existing law regarding quality assurance have not been met, including the surveying of all consumers, including those with no purchase of services, and providing specific steps and a schedule outlining when these requirements will be met.
Common Set of Services at Regional Centers
- Requires DDS to establish, by January 1, 2025, a common set of services and supports, including supported living services (SLS), that every regional center in the state shall make available to consumers in negotiating, developing, or amending the IPP, and requires the common set of services and supports to be prominently posted on each regional center’s internet website. Further requires DDS to develop the common set of services and supports in consultation with the Association of Regional Center Agencies (ARCA), consumers and their families, advocacy organizations, and service providers.
- Requires DDS to require in each contract with a regional center the common set of services and supports to be available to consumers in the development of an IPP.
- States the intent of the Legislature that the common set of services and supports should not be construed as controlling or interfering with the discretion of the IPP planning team to determine the needs and services appropriate for each person with a developmental disability who is entitled to services; instead, the intent of the Legislature is that the common set of services and supports shall be the minimum level of services and supports, and does not preclude other services and supports from being included in a negotiated IPP.
Regional Center Governing Boards
- Changes the term length of members of the governing boards of regional center agencies contracted with the state from up to seven years within each eight-year period to a six-year term with the ability to rejoin the board for a subsequent term after five years.
- Requires the members of each regional center governing board nominating committee to be comprised of current board members and members of the community, and be representative of the community served in the regional center’s catchment area. Further requires the board nominating committee to conduct outreach to the community to solicit nominations, interview candidates for the board, and make recommendations to the governing board for election. Further specifies procedures for candidate nomination, and specifies a regional center executive director shall be prohibited from any involvement in the recruitment or election of governing board members.
- Changes the responsibility of providing necessary training and support for regional center board members from the regional center to DDS. Makes further requirements for the development of training and ongoing support provided by DDS.
- Requires DDS to establish guidelines for governing boards to measure executive director performance, including with respect to issues of equity and diversity.
- Requires DDS to establish, and each board to adopt, an anti-retaliation policy for board members that requires DDS approval for any reduction in services for consumer board members or the family member of family board members.
- Requires DDS to establish and adopt a grievance procedure with which a governing board member who has concerns, complaints, or questions may contact an executive at DDS.
Anti-Favoritism
- Prohibits a regional center employee from accepting a gift or gifts from a service provider, consumer, or consumer’s family member valued over ten dollars per year.
- Establishes a policy prohibiting regional center senior staff from hiring relatives at the center or any ancillary foundation and organization. Specifies that this policy shall be included in the regional center contract and be included in training of the governing board.
Regional Center Accountability Performance Measures
- Requires the evaluation of regional center performance, as specified, to be implemented using a common set of performance measures administered by DDS. Requires these measures to be annually reported and made available to the public through posting of the measures results in machine-readable formats.
- Requires DDS, by July 1, 2024, to establish standards for each performance measure that contains thresholds above which a regional center may be eligible to receive rewards for good performance and thresholds below which a regional center may be subject to each level of probation, as specified. Requires DDS to establish the process for assessing corrective action undertaken by a regional center and the process by which a regional center may end its probation status.
- Requires DDS, in consultation with stakeholders, to annually establish, update, and review the standards related to good performance. Further requires DDS, in consultation with stakeholders, to annually establish, update, and review a uniform process to be used by regional centers to develop corrective action plans that respond to below-standard performance and include all of the following:
- Technical assistance and training from DDS either directly or through subject matter experts;
- The sharing of resources from other regional centers that have met the performance measures; and
- Participation by the board of directors of the regional center in developing and monitoring the implementation of the corrective action plan in consultation with local stakeholders.
- Technical assistance and training from DDS either directly or through subject matter experts;
- Requires DDS to oversee the process to develop the corrective action plan and assess corrective action undertaken by a regional center.
- Requires the performance measures to encompass and be organized under seven domains, as follows:
- Community integration;
- Employment;
- Equity in service access;
- Case management;
- Consumer and family choice, experience, and satisfaction;
- Human and civil rights; and
- Health and safety.
- Community integration;
- Allows DDS to adopt additional measures as needed. Specifies that modification of the domain and measures shall be accomplished through a consultative process that includes the engagement of stakeholders, as specified.
California Public Records Act
- Requires a regional center contracted with DDS, as specified, to be subject to the California Public Records Act (PRA) (Chapter 1 (commencing with Section 7920.000) of Division 10 of Title 1 of the Government Code).
- Defines “request for assistance” to include any initial contact or inquiry from an individual, or a person acting on their behalf, on the nature of services or supports available or provided by the regional center, and the individual’s eligibility to receive them.
- Requires access to records, as specified, to be provided, upon request, to the applicant, recipient, or their authorized representative for purposes including, but not limited to, the appeal process, notwithstanding any exemption to the California PRA or any other law that authorizes, but does not require, an entity to withhold all or part of a record on the basis of its confidentiality.
Self-Determination Program
- Requires standardized information packets created by DDS to be culturally competent for all racial and ethnic communities, including immigrants and Native Americans, and to additionally include appeals and procedures, as specified, and information on the Self-Determination Program, as specified.
- Requires a regional center to communicate with cultural competency, including Native American cultural competency, with the consumer and the consumer’s family, as specified.
Individual Program Plans (IPPs)
- Revises the intent of the Legislature that IPPs shall be developed consistent with the federal Affordable Care Act (ACA) and the regulations and federal guidance adopted pursuant to the act requiring community-based long-term services and supports be person-centered and self-directed. Further states the intent of the Legislature to ensure that goals in any IPP allow for innovation and nontraditional service delivery and not be limited by the lack of easily identified services or supports.
- Requires an IPP, including all assessments, to be developed through person-centered service planning developed pursuant to and consistent with federal law, regulations, and guidance, as specified. States that the individual shall lead the service planning process to the greatest extent possible.
- Requires, as part of the IPP plan meeting and each annual review, the service coordinator to provide oral and written information about the Self-Determination Program, as specified, to the consumer or authorized representative. Requires, if the consumer chooses not to participate in the program, the IPP to include an explanation of the reason for that decision, or, if the consumer is ineligible for the program, the reason for that ineligibility.
- Requires a service coordinator, within five days, to provide the consumer resources related to the Self-Determination Program if the consumer is interested in participating in the program or wants additional information or assistance.
- Strikes language establishing a sunset date of June 30, 2023 for IPP meetings to be held by remote electronic communications if requested by the consumer or authorized representative.
- Authorizes an IPP team to determine that a service provided by a generic agency, as defined, or a service or source of funding, as defined, identified in the individualized family service plan or IPP is not available, and, therefore, will be funded by the regional center.
- Changes the requirement for IPPs for all active cases to be reviewed and modified by the planning team from no less than once every three years to no less often than once every 12 months.
- Specifies that training materials and a standard format and instructions for the preparation of IPPs shall embody a person-centered planning process consistent with federal law, regulations, and guidance.
- Requires DDS to oversee that each regional center use, for all new and modified IPPs, training materials and standard format plan, as specified, by no later than March 1, 2024.
Purchase of Service and Vendorization
- Authorizes a regional center to request a consumer or family member to pursue a service or source of funding from an entity, as specified, if the request is documented in the IPP. Requires the IPP to specify the ways in which the regional center will initially assist the consumer or family to apply for and pursue the service or source of funding and specify that it will provide additional assistance when requested by the consumer or family. Authorizes the regional center to purchase the service when the entity denies the service, and specifies that a consumer or their family shall not be required to appeal an entity’s denial of the requested service for a regional center to purchase that service. Strikes language stating 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 denial from an entity and the regional center determines that an appeal of the denial by the consumer or family does not have merit.
- Requires DDS to comprehensively review the current processes for vendorizing providers for the delivery of services and supports to regional center consumers and revise those processes to streamline the process and create a uniform statewide vendorization process. Requires DDS to develop the revised processes in consultation with ARCA, consumers and their families, advocacy organizations, and service providers.
- States the intent of the Legislature to ensure that a service provider vendored in a regional center shall automatically, without additional requirements, be eligible to provide services in all regional centers. States the intent of the Legislature that this should not be construed to control or interfere with the discretion of the IPP team to determine the needs and services appropriate for each person with a developmental disability who is entitled to services.
Complaints Reporting
- Strikes language requiring initial referral of any complaint to be sent to the director of a regional center. Instead requires any complaint be made to the Director of DDS. Requires the Director of DDS, within 30 days of receipt, to issue a written administrative decision and send a copy of the decision to the complainant, the director of the regional center or state-operated facility, and the service provider, if applicable.
- Requires DDS, on a quarterly basis, rather than annual, to compile the number of complaints filed by each regional center and state-operated facility, the subject matter of each complaint, and a summary of each decision, and to post the compilation on its internet website at the end of each quarter. Also requires copies of any decision included in the compilation to be made available within 10 days, with all individually identifiable information redacted, to any person upon request.
FISCAL IMPACT
According to the Assembly Appropriations Committee, this bill will result in ongoing General Fund (GF) costs of an unknown amount, potentially in the high-tens of millions of dollars, or more, to fund the changes in the bill. DDS was unable to provide a fiscal estimate at the time of this writing. The author has requested $75 million in the state budget for this proposal. The Association of Regional Center Agencies (ARCA) provides a GF cost estimate in the mid-hundreds of millions of dollars based on a detailed cost estimate that includes both regional center staff and purchase of services costs. According to ARCA’s analysis, estimated regional center costs to comply with the California Public Records Act are approximately $467,000 annually per regional center.
BACKGROUND AND DISCUSSION
Purpose of the bill:
According to the author, “Regional centers play a critical role in California’s developmental disability system by providing assessments, determining eligibility, and coordinating the services for those with intellectual and developmental disabilities. Despite California’s network of centers that serve nearly 400,000 individuals, numerous issues plague the system, including a lack of transparency, accountability, and disparities in the services provided. Not only has this undermined confidence in California’s developmental disability system, but it has failed to serve the Californians that need these services most. AB 1147, the Disability Equity & Accountability Act, enacts several reforms to help ensure that all people, regardless of their race or ethnicity or where they live, receive equitable access to services within the regional center system and that all regional centers offer and provide a consistent and common set of services and that the services are delivered in a timely way. It is time that we provide accountability, transparency, and fairness to Californians with disabilities and their families.”
Lanterman Act
In 1969, the Lanterman Developmental Disabilities Act established that individuals with developmental disabilities and their families have a right to receive the necessary supports and services required to live independently in the community. The Lanterman Act enumerates the rights of individuals with developmental disabilities, as well as the rights of their families, what services and supports are available to these individuals, and how regional centers and service providers work together to provide these supports and services. The term “developmental disability” is defined as a disability that originates before a person reaches 18 years of age, is expected to continue indefinitely, and is a significant disability for the individual; such disabilities include, among others: epilepsy, autism spectrum disorder, intellectual disability, and cerebral palsy.
In addition to establishing the rights of individuals, the Lanterman Act also created California’s regional center system, comprised of 21 nonprofit regional centers throughout the state whose primary purpose is to connect individuals with services in the community. Regional centers coordinate a robust array of services and supports for more than 329,000 individuals with developmental disabilities in California.
Recent Oversight Reports
In June 2022, the California State Auditor published findings[1] on a number of deficiencies in the developmental disabilities system that negatively impact services, particularly for people of color. The audit of three regional centers, which collectively serve more than 65,000 consumers, found that they have neither sufficient staff nor funding. The audit found regional centers struggle with a number of issues due to inaction from DDS. The key findings included: regional centers have exceeded their service coordinators’ maximum caseload ratios because DDS has not adequately addressed funding issues, regional centers are not monitoring vendors appropriately, and DDS does not provide adequate oversight on regional centers’ processes for resolving consumer rights violations complaints. The State Auditor made the following recommendations to DDS:
- Work with regional centers as necessary to update the core staffing formula so that it aligns with actual regional center staffing costs.
- Provide vendor monitoring training so that regional centers understand the statutory requirements for vendor monitoring.
- Establish standards for measuring how convenient it is for consumers to access services.
- Ensure that regional centers provide statutorily required information to consumers about how to file a consumer rights complaint.
- Issue guidance to regional centers and develop best practices to ensure that regional centers complete complaint investigations within statutory deadlines.
The Little Hoover Commission held a series of public meetings in the fall of 2022 to discuss the disparities affecting California’s DDS system and released a study[2] in April 2023. The study included seven recommendations:
- Increase consistency in client experiences across regional centers.
- Target and reduce racial and ethnic disparities.
- Strengthen state oversight of the developmental disabilities system.
- Modernize technology.
- Standardize the vendorization process.
- Strengthen and enhance support for regional center governing boards.
- Improve service coordination.
This bill seeks to make changes to increase equity, accountability, and transparency in the DDS system in response to these reports and their recommendations.
Regional Center Governance
Direct responsibility for implementation of the Lanterman Act’s service system is shared by DDS and a statewide network of 21 regional centers, which are private, community-based nonprofit entities that contract with DDS to carry out many of the state’s responsibilities. Regional centers are governed by a Board of Directors whose members are a part of the community, consumers who receive services, or a representative of someone who receives services from the regional center. The Board is responsible for hiring and overseeing the Executive Director, who is tasked with the day-to-day management of the regional center. DDS establishes contracts with regional centers that include specific and measurable performance objectives. Every year, DDS reviews each regional center’s performance data for compliance with their contracts and posts them on their website.
This bill makes a number of changes to regional center governance and operations in an effort, according to proponents of this measure, to increase transparency and accountability as well as encourage equity gaps to shrink disparities. This bill revises the standards and procedures for regional center governance such as more limits on board members’ terms of service, a more open board nominating process, and more standardized training for board members to be conducted by DDS instead of the regional center.
ARCA has voiced concerns with changing the current statute related to Board member term limits. ARCA stated that this could weaken Boards, making them more reliant on, and giving more power to, a regional center’s executive director. ARCA has also stated that it is challenging to recruit Board members, and changing current law would make both recruitment and retention of Board members more difficult. Other stakeholders have also acknowledged the difficulty of recruiting Board members. In addition, regional centers must adhere to requirements in law regarding the makeup of Board membership, such as professional members and racial and ethnic demographics representative of the community served. According to stakeholders, changing the law around Board member term limits could make compliance with these requirements more difficult.
Regional Center Services
Regional center services may include diagnosis, evaluation, treatment, and care coordination of services such as personal care, day care, special living arrangements, and physical, occupational, and speech therapy. Additional services include, but are not limited to mental health services, recreation, counseling for the individual served and their family, assistance locating a home, behavior training and modification programs, emergency and crisis intervention, 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, training for parents of children with developmental disabilities, and transportation services necessary to ensure the delivery of services to persons with developmental disabilities.
This bill requires DDS to establish a uniform set of services for all regional centers to provide uniformity, consistency and cost-effective delivery of services.
Regional Center Accountability Performance Measures
AB 136 (Committee on Budget, Statutes of 2021), a budget trailer bill, required DDS to convene a workgroup to make recommendations to the department for the development of standard performance improvement indicators and benchmarks to incentivize high-quality regional center operations. The trailer bill specified the makeup of the stakeholder group, priority areas for performance indicators, surveys to assess consumer and family experience and recommendations, and an annual stakeholder-based process for DDS to use to evaluate the success of a quality improvement process, among other required topics for recommendation. DDS has hosted 14 Regional Center Measures Workgroup meetings since September 2021.
Proponents of this bill have expressed dissatisfaction at the slow nature of the workgroup process and described limited opportunities to provide meaningful input during meetings.
This bill would require DDS to evaluate regional center performance, and require DDS to establish standards for certain performance measures by July 1, 2024, including thresholds above which a regional center may receive rewards for good performance and thresholds below which a regional center may be placed on probation and provided technical assistance by DDS.
Vendorization Process
Service providers must be vendored by a regional center before they can provide and be reimbursed for services. DDS and regional centers use the term “vendorization” to describe the approval process involved in preparing to provide services to regional center consumers, which typically involves obtaining additional licenses or approvals from other state and local agencies prior to becoming a vendor.
DDS reported at The Little Hoover Commission public meetings that stakeholders have expressed frustration with the differences in how services are provided among regional centers. DDS also reported it has already undertaken standardization efforts.
This bill will require DDS and stakeholders to review the current vendorization process and create streamlined uniform processes for all regional centers. Further, the bill states legislative intent that if approved by one regional center, then the vendor should be considered approved by all other regional centers.
Payer of Last Resort
Under the Lanterman Act, regional centers are considered the “payer of last resort,” meaning individuals and families must first exhaust all other “generic resources” available to them, as outlined in existing law above, including funds from state and federal programs and private insurance before regional centers may purchase a requested service. During the Great Recession, AB 9 X4 (Evans, Chapter 9, Statutes of 2009), a budget trailer bill, was signed into law and made various cost-cutting changes, including prohibiting regional centers from purchasing services for a client who is enrolled in Medi-Cal, has private insurance, or is covered by a health care service plan, unless an appeal for requested services is being pursued by the client. Because of these rules, consumers report significant hurdles to accessing services in a timely manner.
This bill revises the current requirements around payer of last resort and purchasing of generic services by only permitting a regional center to request the consumer seek services through state and federal programs or private insurance if it is documented in the IPP with detailed instruction on pursuing the service. Further, this bill would require that the regional center would have to provide the services if this request was denied or if the entity does not provide the requested service within 45 days from the date of the request, or 15 days after the statutory or regulatory time limit.
Individual Program Plan (IPP)
Services for individuals with intellectual and developmental disabilities are outlined in an IPP, which is developed according to the needs and personal choices of the individual. The IPP is developed by an IPP team, which often includes the consumer, their legally authorized representative, and one or more Regional Center representatives. The IPP serves as a tool to maximize the opportunities for each consumer to develop relationships, integrate into community life, increase control over their life, and obtain positive roles in the community. The IPP is required to prioritize the services and supports that allow minors to live with their families and adults to live in the community as independently as possible.
In November 2021, a coalition of disability rights advocates released a report titled Unfair Hearings: How People with Intellectual & Developmental Disabilities Lack Access to Justice in California[3]. The report found that 90% of survey respondents reported at least one problem with the IPP process, with the most common complaint being that no one authorized to make a decision on behalf of the regional center attended their IPP. In addition, many respondents reported believing that the fair hearing system is inaccessible, opaque, and biased toward regional centers. Further, the report found that 72% of fair hearings are withdrawn, likely showing that many individuals and families give up due to the complexities of the process and the inability to hire a lawyer; and consumers win or partially win fewer than 5% of cases filed. This issue was later addressed through trailer bill language to establish a broad reform to the fair hearing process.
This bill would require an IPP, including all assessments, to be developed through person-centered service planning, and require that the individual or consumer shall lead the service planning process to the greatest extent possible. This bill also requires that complaints are made to DDS and a decision must be issued within 30 days instead of the current 45 days. DDS would also have to post, on a quarterly basis, all complaints received on their internet website with redacted personal information.
This bill would also strike sunset language related to remote meetings, effectively making permanent the ability for consumers and their families to meet remotely upon request. Proponents of this bill assert that the ability to conduct remote meetings supports consumers’ preferences and best interests, especially if their family or other representative lives far away.
Self-Determination Program
In 2013, SB 468 (Emmerson, Chapter 683, Statutes of 2013) established a statewide Self-Determination Program, contingent upon funding, to provide individuals and their families with more freedom, control, and responsibility in choosing services and supports to help them meet objectives in their IPP. After an IPP is developed, an individual must request a budget meeting where a 12-month budget and spending plan are developed based on the IPP needs and goals. Then, a financial management service and payer model are selected, and the individual or their representative can then begin hiring service providers.
The Self-Determination Program is available to all eligible individuals receiving services from a regional center. However, data broken down into race and ethnicity demographics shows that enrollment are not proportionate. The Legislative Analyst Office (LAO)’s 2023-24 Budget report[4] on DDS states that “white consumers comprise a plurality of [Self-Determination Program] participants (45 percent), despite making up only 30 percent of all DDS consumers. By comparison, Latino consumers comprise only 23 percent of [Self-Determination Program] participants, but 40 percent of all DDS consumers.”
This bill would require regional centers to inform individuals about the Self-Determination Program during a request for assistance and during the IPP meetings. This bill will also require documentation from coordinators indicating if the individual is interested and if they are not interested, a reason for not wanting to participate. Furthermore, the regional center must provide information within five days of a consumer requesting information about the Self-Determination Program.
Ongoing Racial Disparities in Developmental Services
There is a longstanding documentation about disparities in the amount of spending on services amongst racial and ethnic groups. According to DDS, within the regional center system, 24% of individuals served speak a language other than English and 72% of all consumers served by DDS are non-white; however, studies consistently find that communities of color are less likely to receive regional center services, and receive lower than average per capita purchase of service compared to white individuals. Some stakeholders state this may be in part due to other factors, such as age demographics within racial/ethnic groups and cultural preferences for care services. Several DDS initiatives are currently underway with have the goal of improving language access and reducing disparities within the developmental services system more broadly.
Beginning in 2011-12, state law required all regional centers to annually publish data on the amount spent on services for consumers disaggregated by the race/ethnicity of these consumers. These data consistently have shown large disparities in the average amounts spent among these groups. Since 2016-17, the state has invested $11 million annually for equity grants. The existing and available data has not shown much change. In a 2023-24 budget report[5], the LAO pointed out a possible reason is because the state lacks an understanding of what is causing the disparities.
This bill adds more reporting-specific requirements. Under this bill, DDS must submit an annual report with statewide and regional center data, broken down by qualifying disability category, race and ethnicity, and age categories with the number of consumers for whom health and safety waivers have been requested and granted, as well as the number of days elapsed between the date on which DDS received the health and safety waiver request worksheet from the service provider and the date the service provider was notified of the outcome.
Public Records Act (PRA)
Existing law requires a regional center to adopt, maintain, and post on its internet website a Board-approved policy regarding transparency and access to public information, including access to annual independent audits, biannual fiscal audits conducted by DDS, annual reports, contract awards, purchase of service policies, a list of all vendors, Board meeting agendas and minutes, annual and year-end performance contracts entered into with DDS, and salaries and wages for all administrative management positions, among other records. Existing law also requires DDS to maintain a transparency portal on its internet website to allow consumers, families, and the public to access provider and regional center information.
Existing law establishes the California PRA (Division 10 of Title 1 of Government Code, commencing with 7920.000), which provides that specified public records of public entities, including public agencies and state agencies, as defined, are subject to inspection at all times, and states every person has a right to inspect any public record, as specified. DDS and records held by DDS are subject to the PRA, however, regional centers and their records are not, as they are private, nonprofit entities.
This bill would establish that regional centers are subject to the PRA. Proponents of this bill suggest that certain regional center data and documents, including internal operating policies and desk manuals used to make decisions to provide services, such as policies outlining copay schedules, are not submitted to DDS and therefore not available to be subject to the PRA through DDS, nor are they made publicly available by regional centers. Proponents assert that the existence of hidden decision making rules narrows the scope of entitlement to developmental services.
Other stakeholders have asserted that making regional centers subject to the PRA is duplicative of data and documents available through a public records request of DDS. Stakeholders have also cited concerns with the need for confidentiality and estimated the statewide cost to regional centers related to redacting confidential information to be $10 million annually. ARCA states that charter schools are the only non-governmental entity subject to the PRA.
Related legislation:
AB 649 (Wilson) removes the requirement for a consumer or family to appeal the denial of services from a developmental services agency before receiving assistance from a regional center, and permits a regional center to purchase services those as part of the consumer’s IPP. AB 649 has been referred to the Senate Appropriations Committee.
AB 1957 (Wilson, Chapter 314, Statutes of 2022) added additional data points to the set of data that DDS and regional centers must report.
AB 1 X2 (Thurmond, Chapter 3, Statutes of 2016) authorized the Service Access and Equity grant program through which $11 million in ongoing General Fund resources for DDS was provided to assist regional centers in reducing purchase of service disparities.
SB 468 (Emmerson, Chapter 683, Statutes of 2013) established the statewide Self-Determination Program to provide individuals and their families with more freedom, control, and responsibility in choosing services and supports to help them meet objectives in their IPP.
AB 9 X4 (Evans, Chapter 9, Statutes of 2009) contained changes to enact modifications to the Budget Act of 2009, including, but not limited to, suspending and limiting certain services for Regional Center consumers.
COMMENTS
Double Referral: This bill has been double-referred. Should this bill pass out of this Committee, it will be referred to the Senate Committee on Judiciary.
This bill is seeking major reforms that will impact the delivery of developmental services. These reforms impact regional center governance, regional center accountability and oversight by DDS, IPPs, timeliness for access to services and programs, standardization of services across all regional centers, and new data reporting for increased transparency.
DDS is currently implementing a series of reforms through several initiatives and workgroups. As of May 2023, DDS has 47 initiatives in progress, including initiatives related to establishing a community navigator program, complaint and appeal process reform, increasing employment opportunities, increasing eligibility, modernizing IT systems, implementing the 2019 rate study, regional center performance measures, and the Self-Determination Program. This bill seeks to make a variety of changes to DDS and regional center operations, which may impact the implementation of current initiatives and projects.
Proponents of this bill acknowledge that DDS has many initiatives underway, but state they are mostly related to navigation, and that these initiatives and workgroups are siloed, reactive, ad hoc, and opaque. Proponents view this bill as a comprehensive and coordinated reform effort to gain more insight and input into system wide decision making processes for individuals with developmental disabilities, their families, and advocates.
Proposed Amendments: The author has agree to take the attached amendments in this Committee as author’s amendments. The amendments do the following: revise intent language, extend reporting deadlines, revise term limits for regional center boards to seven years within each eight-year period, make changes to the complaint procedure, increase the gift amount from $10 to $15, revise the IPP review cycle from every 12 months to every 24 months, and other clarifying changes.
PRIOR VOTES
Assembly Floor: | 80 - 0 |
Assembly Appropriations Committee: | 11 - 0 |
Assembly Human Services Committee: | 7 - 0 |
Assembly Judiciary Committee: | 11 - 0 |
POSITIONS
Support:
Disability Voices United (Co-Sponsor)
Integrated Community Collaborative (Co-Sponsor)
Autism Society Los Angeles
California State Council on Developmental Disabilities
Dirfloortime Coalition of California
Easterseals Northern California
Momentum
Parents Helping Parents
Public Counsel
Oppose:
None received
Committee Amendments
SECTION 1.
This act shall be known, and may be cited, as the Disability Equity and Accountability Act of 2023.
SEC. 2.
(a) The Legislature finds and declares as follows:
(1) Recent reports and hearings by the California State Auditor, the Little Hoover Commission, and advocacy organizations have found that California’s service system for the over 400,000 children and adults with intellectual and developmental disabilities through the Lanterman Act, as overseen by the State Department of Developmental Services, which contracts with 21 regional centers, is failing in significant ways to deliver critical, adequate, and timely services to individuals and families. The result is that individuals and families, particularly those of color and tribal members living in rural areas and tribal reservations, are unable to timely access services and supports, resulting in barriers to their living independent, productive, and integrated lives in their communities.
(2) California’s developmental disability service system is plagued with racial, ethnic, and geographic disparities that can dramatically impact the essential services received by children and adults with developmental disabilities. Systemic inequities and discrimination within California’s 21 regional centers broaden the gap between inclusive possibilities and segregated limitations. Data show Latinos are most negatively impacted by these disparities, but people who are clients of the lowest-performing regional centers are also significantly affected.
(3) California spends nearly $13,000,000,000 annually on the administration and delivery of developmental services, but lacks a transparent, common, integrated, and coordinated model for the delivery and measurement of services throughout the 21 regional centers, resulting in poor outcomes, poor satisfaction levels by consumers and families, and disparate levels of available services and performance expectations.
(4) The delivery of services through 21 separate private nonprofit regional centers with separate boards, funding, and delivery models was originally intended to ensure that the delivery of services could be more effectively delivered through nonstate entities. However, with the subsequent caseload and budget growth since the enactment of the Lanterman Act, local administration has become more disparate and less accountable. Boards of directors are untrained and are not providing the oversight needed of the regional centers. Stronger state oversight of regional centers by the State Department of Developmental Services is essential to ensure that services are equitably delivered, performance and outcomes are uniformly measured and reported, and the system is transparent and accountable to individuals and families.
(5) The department’s system lacks a statewide automated technology system for the delivery of services to persons with intellectual and developmental disabilities and, as a result, the current program is constrained by disparate automation systems, inadequate documentation, the lack of open system architecture, insufficient data to support administration of the system, and the lack of data to support program improvements for improving the quality of life outcomes through new service delivery methods.
(6) Statewide uniformity of service delivery practices and procedures is essential to an effective program and to support necessary oversight and research for ongoing program improvements.
(7) The department’s technical infrastructure is over 40 years old. The lack of a statewide automation system does not meet current program needs and significantly contributes to the racial and geographic disparities in the delivery of services. California currently lacks clear and consistent service delivery outcomes for individuals with intellectual and developmental disabilities that sets high expectations for their quality of life, and must develop a system for measuring and quantifying the value of service delivery outcomes.
(8) A previous effort to develop an intellectual and developmental disabilities (IDD) program technology system failed. As a result, the department and regional centers maintain a patchwork of at least three case management and fiscal systems that are not integrated and six legacy case management automation systems that lack integration, have dissimilar data sources, and are technically outdated.
(9) In the 2021–22 annual budget the Legislature appropriated $6,000,000 to the State Department of Developmental Services for planning purposes related to the implementation of a uniform fiscal system and consumer electronic records management system. The department has not developed a vision or scope for a proposed system development approach.
(b) Therefore, it is the intent of the Legislature in enacting this act to do all of the following:
(1) Ensure that racial, ethnic, and geographic service disparities, including Native Americans living on or off tribal reservations, be systemically addressed and eliminated and that all people, regardless of their race or ethnicity or where they live, receive equitable access to services within the regional center system.
(2) Ensure that all regional centers offer and provide a consistent and common set of services and that the services are delivered in a timely way.
(3) Ensure that the delivery of all services and supports comply with federal law and guidance and are responsive to the needs and choices of beneficiaries receiving home- and community-based services, are person centered and strengths based, have high expectations for interdependence, self-direction, and competitive, integrated employment, provide support coordination to assist with a community-supported life, and achieve a more consistent and coordinated approach to the administration of policies and procedures across the state.
(4) Provide the department with new tools for holding regional centers and service providers accountable through the development of a standardized and coordinated set of performance measures and related standards that establish targets and standards above which a regional center may receive incentives for improved performance, and a separate set of standards that require corrective action.
(5) Improve regional center governance by establishing new standards and procedures for regional center governing boards to ensure they can more effectively represent the communities they serve by providing them with greater independence and protection from regional center retaliation.
(6) Require the State Department of Developmental Services to develop a written project charter for the planning and development of a uniform statewide automation system that serves as a foundation document for the system development, which includes project guiding principles, scope, strategies and approach, and project governance, in order to provide transparency to the Legislature and the public on the system development as has been used with other statewide system development.
SEC. 3.
Section 4519.5 of the Welfare and Institutions Code is amended to read:
4519.5.
(a) The department and the regional centers shall annually collaborate to compile data in a uniform manner relating to purchase of service authorization, utilization, and expenditure by each regional center with respect to all of the following:
(1) The age of the consumer, categorized by the following:
(A) Birth to two years of age, inclusive.
(B) Three to 21 years of age, inclusive.
(C) Twenty-two years of age and older.
(2) Race or ethnicity of the consumer.
(3) Tribal affiliation.
(4) Preferred language spoken by the consumer, and other related details, as feasible.
(5) Disability detail, in accordance with the categories established by subdivision (a) of Section 4512, and, if applicable, a category specifying that the disability is unknown.
(6) Residence type, subcategorized by age, race or ethnicity, and preferred language.
(7) Number of instances when the written copy of the individual program plan was provided at the request of the consumer and, when appropriate, the consumer’s parents, legal guardian or conservator, or authorized representative, in a language other than a threshold language, as defined by paragraph (3) of subdivision (a) of Section 1810.410 of Title 9 of the California Code of Regulations, if that written copy was provided more than 60 days after the request.
(8) Number of instances when the written copy of the individual program plan was provided at the request of the consumer and, when appropriate, the consumer’s parents, legal guardian or conservator, or authorized representative, in a threshold language, as defined by paragraph (3) of subdivision (a) of Section 1810.410 of Title 9 of the California Code of Regulations, if that written copy was provided more than 45 days after the request, in violation of paragraph (5) of subdivision (a) of Section 4646.5.
(9) Beginning with data for the fiscal year of 2023–24, the numbers, percentages, and total and per capita expenditure and authorization amounts, by age, as applicable, according to race or ethnicity and preferred language, for all combined residence types and for consumers living in the family home, regarding the following service types:
(A) Camping and associated travel expenses.
(B) Social recreation activities.
(C) Educational services.
(D) Nonmedical therapies, including, but not limited to, specialized recreation, art, dance, music, and tribal culture and ceremony.
(b) The data reported pursuant to subdivision (a) shall also include the number and percentage of individuals, categorized by age, race or ethnicity, and disability, and by residence type, as set forth in paragraph (6) of subdivision (a), who have been determined to be eligible for regional center services, but are not receiving purchase of service funds.
(c) By March 31, 2013, each regional center shall post the data described in this section that are specific to the regional center on its internet website. Commencing on December 31, 2013, each regional center shall annually post these data by December 31. Each regional center shall maintain all previous years’ data on its internet website.
(d) By March 31, 2013, the department shall post the information described in this section on a statewide basis on its internet website. Commencing December 31, 2013, the department shall annually post this information by December 31. The department shall maintain all previous years’ data on its internet website. The department shall also post notice of any regional center stakeholder meetings on its internet website.
(e) Within three months of compiling the data with the department, and annually thereafter, each regional center shall meet with stakeholders in one or more public meetings regarding the data. The meeting or meetings shall be held separately from any meetings held pursuant to Section 4660. The regional center shall provide participants of these meetings with the data and any associated information related to improvements in the provision of developmental services to underserved communities and shall conduct a discussion of the data and the associated information in a manner that is culturally and linguistically appropriate for that community, including providing alternative communication services, as required by Sections 11135 to 11139.7, inclusive, of the Government Code and implementing regulations. Regional centers shall inform the department of the scheduling of those public meetings 30 days prior to the meeting. Notice of the meetings shall also be posted on the regional center’s internet website 30 days prior to the meeting and shall be sent to individual stakeholders and groups representing underserved communities in a timely manner. Each regional center shall, in holding the meetings required by this subdivision, consider the language needs of the community and shall schedule the meetings at times and locations designed to result in a high turnout by the public and underserved communities.
(f) (1) Each regional center shall annually report to the department regarding its implementation of the requirements of this section. The report shall include, but shall not be limited to, all of the following:
(A) Actions the regional center took to improve public attendance and participation at stakeholder meetings, including, but not limited to, attendance and participation by underserved communities.
(B) Copies of minutes from the meeting and attendee comments.
(C) Whether the data described in this section indicate a need to reduce disparities in the purchase of services among consumers in the regional center’s catchment area. If the data do indicate that need, the regional center’s recommendations and plan to promote equity, and reduce disparities, in the purchase of services.
(2) Each regional center and the department shall annually post the reports required by paragraph (1) on its internet website by August 31.
(g) (1) The department shall consult with stakeholders, including consumers and families that reflect the ethnic and language diversity of regional center consumers, regional centers, advocates, providers, family resource centers, the protection and advocacy agency described in Section 4901, and those entities designated as University Centers for Excellence in Developmental Disabilities Education, Research, and Service pursuant to Section 15061 of Title 42 of the United States Code, to achieve the following objectives:
(A) Review the data compiled pursuant to subdivision (a).
(B) Identify barriers to equitable access to services and supports among consumers and develop recommendations to help reduce disparities in purchase of service expenditures.
(C) Encourage the development and expansion of culturally appropriate services, service delivery, and service coordination.
(D) Identify best practices to reduce disparity and promote equity.
(2) The department shall report the status of its efforts to satisfy the requirements of paragraph (1) during the 2016–17 legislative budget subcommittee hearing process.
(h) (1) Subject to available funding, the department shall allocate funding to regional centers or community-based organizations with department oversight to assist with implementation of the recommendations and plans developed pursuant to subdivisions (f) and (g). Activities funded through these allocations may include, but are not limited to, pay differentials supporting direct care bilingual staff of community-based service providers, parent or caregiver education programs, cultural competency training for regional center staff, outreach to underserved populations, or additional culturally appropriate service types or service delivery models.
(2) Each regional center shall consult with stakeholders regarding activities that may be effective in addressing disparities in the receipt of regional center services and the regional center’s proposed requests for the funding specified in paragraph (1). Each regional center shall identify the stakeholders it consulted with and include information on how it incorporated the input of stakeholders into its requests.
(3) A community-based organization may submit a request for grant funding pursuant to this subdivision. The organization shall submit the request concurrently to the regional center of the jurisdiction in which the organization is located and to the department. The regional center shall provide the department with input regarding the request prior to the department’s final determination on the request.
(4) The department shall review requests for funding within 45 days from the deadline specified in the department’s guidance to regional centers and community-based organizations.
(5) Each regional center and community-based organization receiving funding shall report annually to the department, in a manner determined by the department, on how the funding allocations were used and shall include recommendations of priorities for activities that may be effective in addressing disparities, based on the consultation with stakeholders.
(6) The department shall post the following information on its internet website:
(A) By September 1 of any year in which grant funding is available and has not been allocated, a structure for the grant program, including all of the following information:
(i) How community-based organizations reflecting groups that are disadvantaged by disparities in the purchase of services will be invited to participate in the grant program.
(ii) How statewide strategies were considered.
(iii) How the department will ensure grant funds are not used for activities that regional centers are otherwise required by statute or regulation to conduct.
(iv) How funded activities will be evaluated.
(B) By October 1 of any year in which grant funding is available and has not been allocated, the final invitation for requests for funding or another mechanism through which requests for funding are solicited.
(C) By January 1 of any year in which grant funding has been allocated, a list of grant recipients, funding level per grant, and a description of the funded project.
(D) By May 1 of any year in which the information is available, evaluation results from prior grants. To ensure the department complies with this subparagraph, regional centers and community-based organizations receiving funding shall provide the department, by March 1 of the same year, with an evaluation of funded activities and the effectiveness of those activities in reducing disparities in the purchase of services, to the extent information is available.
(i) On or before December 31, 2021, the department shall 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 subdivision (h).
(j) For the purposes of this section, the department shall require all of the following:
(1) The use by the department and regional centers, when reporting data by race and ethnicity, of consistent classifications of race and ethnicity, based on categories current in use by the United States Census Bureau.
(2) Confirmation of the race and ethnicity identification of each consumer at the time of the annual review of the consumer’s individual program plan (IPP).
(3) When reporting by residence types, separate presentation of data for those in independent living services and those in supported living services.
(4) Consistent standards and requirements for regional center internet websites, using the same placement and language for all information required by this division, including that data be posted in a machine-readable format.
SEC. 4.
Section 4519.20 is added to the Welfare and Institutions Code, to read:
4519.20.
As part of the department’s planning process for the planning and development of a uniform statewide data automation system, the department, in consultation with stakeholders shall develop, by March 1, 2024 2025, a project charter that shall be approved by the Secretary of the California Health and Human Services Agency and the Department of Technology. The charter development process shall include the participation and input of program consumers and families, researchers and quality and outcome evaluators, regional centers, and service providers. The project charter shall include all of the following:
(a) An impact statement on the primary entities and individuals impacted by the system development.
(b) Project guiding principles that are foundational to the project approach to be used throughout the planning, development, implementation, and maintenance of the system.
(c) Project scope that addresses business problems required to be solved by the system, including all of the following:
(1) Worker effectiveness and accountability that are constrained by the lack of timely, adequate, and accurate data, the lack of uniformity, and the current system’s limited functionality.
(2) Service delivery that is constrained by the lack of timely, adequate, accurate, and accessible data, the lack of clear understandable communication of information, lack of uniformity, and the system’s limited functionality.
(3) Current system maintainability that is constrained by disparate systems, inadequate documentation, the lack of open system architecture, and business changes.
(4) Disparate systems, complex business rules, the number of locations and variability of local system delivery, and changes in the way of doing business.
(5) Limited access of researchers and program evaluators to the set of person-level data that they need to assess program effectiveness.
(d) Program goals, which shall include all of the following:
(1) Maximizing the performance and the business processes for the delivery of intellectual or developmental disability (IDD) system services to consumers at the regional centers.
(2) Improving data quality, privacy, confidentiality, and integration of all data sources at an individual level.
(3) Enabling data-driven decisionmaking and performance measures for the effective administration of the program.
(4) Improving the business processes administered by the department to support regional center service delivery.
(5) Supporting access to individual-level data to support program evaluation and other research.
(e) Technology goals that recognize that a statewide system solution not only meets requirements, but also ensures effective transition, while minimizing disruption to existing services.
(f) Project strategies and approaches for development and implementation.
(g) Project governance.
(h) Technology that can readily be enhanced and modernized for the expected system life. In selecting the new system, consideration shall be given to the extent to which the candidate systems employ open architectures and standards and the future ability of the selected system to provide enhancements that will improve long-term effectiveness of program management of the statewide service delivery system.
SEC. 5.
Section 4571 of the Welfare and Institutions Code is amended to read:
4571.
(a) It is the intent of the Legislature to ensure the well-being of consumers, taking into account their informed and expressed choices. It is further the intent of the Legislature to support the satisfaction and success of consumers through the delivery of quality services and supports. Evaluation of the services that consumers receive is a key aspect to the service system. Utilizing the information that consumers and their families provide about those services in a reliable and meaningful way is also critical to enable the department to assess the performance of the state’s developmental services system and to improve services for consumers in the future. To that end, the State Department of Developmental Services, on or before January 1, 2010, shall implement an improved, unified quality assessment system, in accordance with this section.
(b) The department, in consultation with stakeholders, shall identify a valid and reliable quality assurance instrument that assesses consumer and family satisfaction, provision of services in a linguistically and culturally competent manner, and personal outcomes. The instrument shall do all of the following:
(1) Provide nationally validated, benchmarked, consistent, reliable, and measurable data for the department’s Quality Management System.
(2) Enable the department and regional centers to compare the performance of California’s developmental services system against other states’ developmental services systems and to assess quality and performance among all of the regional centers.
(3) Include outcome-based measures such as health, safety, well-being, relationships, interactions with people who do not have a disability, employment, quality of life, integration, choice, service, and consumer satisfaction.
(4) Include outcome-based measures to evaluate the linguistic and cultural competency, including tribal culture competency, of regional center services that are provided to consumers across their lifetimes.
(c) To the extent that funding is available, the instrument identified in subdivision (b) may be expanded to collect additional data requested by the State Council on Developmental Disabilities.
(d) (1) The department shall contract with an independent agency or organization to implement, by January 1, 2010, the quality assurance instrument described in subdivision (b). The contractor shall be experienced in all of the following:
(A) Designing valid quality assurance instruments for developmental service systems.
(B) Tracking outcome-based measures such as health, safety, well-being, relationships, interactions with people who do not have a disability, employment, quality of life, integration, choice, service, and consumer satisfaction.
(C) Developing data systems.
(D) Data analysis and report preparation.
(E) Assessments of the services received by consumers who are moved from developmental centers to the community, given the Legislature’s historic recognition of a special obligation to ensure the well-being of these persons.
(F) Issues related to linguistic and cultural competency.
(2) Notwithstanding any other law, the contract and any amendments pursuant to this section shall be exempt from all of the following:
(A) The personal services contracting requirements of Article 4 (commencing with Section 19130) of Chapter 5 of Part 2 of Division 5 of Title 2 of the Government Code.
(B) The Public Contract Code, the State Contracting Manual, and the State Administration Manual.
(C) The approval of the Department of General Services.
(D) The approval of the Department of Technology.
(3) The exemptions specified in paragraph (2) shall remain in effect until there is more than one available assessment that meets the criteria in subdivision (b) from an organization that also meets the criteria in this subdivision.
(e) The department, in consultation with the contractor described in subdivision (d), shall establish the methodology by which the quality assurance instrument shall be administered, including, but not limited to, how often and to whom the quality assurance will be administered, and the design of a stratified, random sample among the entire population of consumers served by regional centers. The contractor shall provide aggregate information for all regional centers and the state as a whole. At the request of a consumer or the family member of a consumer, the survey shall be conducted in the primary language of the consumer or family member surveyed.
(f) The department shall contract with the state council to collect data for the quality assurance instrument described in subdivision (b). If, during the data collection process, the state council identifies any suspected violation of the legal, civil, or service rights of a consumer, or if it determines that the health and welfare of a consumer is at risk, that information shall be provided immediately to the regional center providing case management services to the consumer. At the request of the consumer or family, when appropriate, a copy of the completed survey shall be provided to the regional center providing case management services to improve the consumer’s quality of services through the individual planning process.
(g) The department, in consultation with stakeholders, shall annually review the data collected from and the findings of the quality assurance instrument described in subdivision (b) and accept recommendations regarding additional or different criteria for the quality assurance instrument in order to assess the performance of the state’s developmental services system and improve services for consumers.
(h) (1) Each regional center shall annually present data collected from, and the findings of, the quality assurance instrument described in subdivision (b) for that regional center, at a public meeting of its governing board in order to assess the comparative performance of the regional center and identify needed improvements in services for consumers, including, but not limited to, case management services. Notice of this meeting shall also be posted on the regional center’s internet website at least 30 days prior to the meeting and shall be sent to regional center consumers and families and individual stakeholders at least 30 days prior to the meeting. The governing board shall provide a sufficient public comment period so members of the public may provide comments. Each regional center, in holding the meeting required by this subdivision, shall ensure that the meeting and meeting materials provide language access, as required by state and federal law.
(2) All regional center-specific reports generated by the department pursuant to this subdivision shall be made publicly available on the regional center’s internet website in a machine-readable format, but shall not contain any personal identifying information about any person assessed.
(3) Within 60 days following its annual presentation, each regional center shall submit a report to the department regarding its implementation of the requirements of this section. The report shall include, but shall not be limited to, both of the following:
(A) Copies of the presentation described in paragraph (1), minutes from the meeting, and attendee comments.
(B) The regional center’s recommendations and plans to use the information to address regional center priorities, strategic directions to improve specific areas of performance, or both.
(i) All reports generated pursuant to this section shall be made publicly available, but shall not contain any personal identifying information about any person assessed.
(j) All data collected pursuant to subdivision (c) shall be provided to the state council, but shall not contain personal identifying information about the persons being surveyed.
(k) Implementation of this section shall be subject to an annual appropriation of funds in the Budget Act for this purpose.
(l) By March 1, 2024 2025, the department shall submit a report to the policy and budget subcommittees of the Legislature describing the extent to which the requirements of this section have not been met, including the surveying of all consumers, including those with no purchase of services, and providing specific steps and the schedule by which these requirements will be met.
SEC. 6.
Section 4620.6 is added to the Welfare and Institutions Code, to read:
4620.6.
(a) (1) To provide uniformity, consistency, and cost-effectiveness in the delivery of services by regional centers throughout the state, the department shall establish, by January 1, 2025 2026, a common set of services and supports, including supported living services, that every regional center in the state shall make available to consumers in negotiating, developing, or amending the individualized program plan as required by Sections 4646 and 4646.5. The common set of services and supports shall be prominently posted on each regional center’s internet website.
(2) The department shall develop the common set of services and supports in consultation with the Association of Regional Center Agencies, consumers and their families, advocacy organizations, and service providers.
(b) In each contract with a regional center, the department shall require the common set of services and supports developed pursuant to this section to be available to consumers in the development of an individual program plan.
(c) It is the intent of the Legislature that this section not be construed to control or interfere with the discretion of the individual program planning team to determine the needs and services appropriate for each person with a developmental disability who is entitled to services under this division. It is further the intent of the Legislature that the common set of services and supports developed pursuant to this section shall be deemed the minimum level of services and supports and does not preclude other services and supports from being included in a negotiated individualized program plan.
SEC. 7.
Section 4622 of the Welfare and Institutions Code is amended to read:
4622.
The state shall contract only with agencies, the governing boards of which conform to all of the following criteria:
(a) The governing board shall be composed of individuals with demonstrated interest in, or knowledge of, developmental disabilities.
(b) The membership of the governing board shall include persons with legal, management or board governance, financial, and developmental disability program expertise. Board governance expertise may not be acquired solely by serving on a regional center board. The governing board of the regional center shall include members with financial expertise and members with management or board governance expertise by August 15, 2020.
(c) The membership of the governing board shall include representatives of the various categories of disability to be served by the regional center.
(d) The governing board shall reflect the geographic and ethnic characteristics of the area to be served by the regional center.
(e) A minimum of 50 percent of the members of the governing board shall be persons with developmental disabilities or their parents or legal guardians. No less than 25 percent of the members of the governing board shall be persons with developmental disabilities.
(f) (1) Members of the governing board shall not be permitted to serve more than seven years within each eight-year period. a six-year term, and may return to the board for a subsequent term after five years. The members of each regional center governing board nominating committee shall be comprised of current board members and members of the community, and should be representative of the community served in the regional center’s catchment area.
(2) The board nominating committee shall solicit interests and nominations from the broader community through outreach. The committee shall interview candidates for the board and make recommendations to the governing board for election. During the meeting at which the board elects new members, a candidate may be nominated by a board member with a second by another board member for the open positions. A regional center executive director shall be prohibited from any involvement in the recruitment or election of governing board members.
(g) (1) The department shall provide necessary training and support to these board members to facilitate their understanding and participation, including issues relating to linguistic and cultural competency. The training shall be developed with community input, including persons served and family members. Ongoing support by the department shall include surveying board members about their ability to meaningfully participate in, and understand the subjects and votes at, board meetings. If board members report that they are unable to meaningfully participate, the department shall work with the regional center and the board member to ensure adequate and appropriate accommodations are provided.
(2) As part of its monitoring responsibility, the department shall review and approve the method by which training and support are provided to board members to ensure maximum understanding and participation by board members.
(3) Each regional center shall post on its internet website information regarding the training and support provided to board members.
(h) The governing board may appoint a consumers’ advisory committee composed of persons with developmental disabilities representing the various categories of disability served by the regional center.
(i) The governing board shall appoint an advisory committee composed of a wide variety of persons representing the various categories of providers from which the regional center purchases client services. The advisory committee shall provide advice, guidance, recommendations, and technical assistance to the regional center board in order to assist the regional center in carrying out its mandated functions. The advisory committee shall designate one of its members to serve as a member of the regional center board.
(j) (1) The governing board shall annually review the performance of the director of the regional center. The department shall establish guidelines for governing boards to measure executive director performance, including with respect to issues of equity and diversity.
(2) The governing board shall annually review the performance of the regional center in providing services that are linguistically and culturally appropriate and may provide recommendations to the director of the regional center based on the results of that review.
(k) A member of the board who is an employee or member of the governing board of a provider from which the regional center purchases client services shall not do any of the following:
(1) Serve as an officer of the board.
(2) Vote on any fiscal matter affecting the purchase of services from any regional center provider.
(3) Vote on any issue other than as described in paragraph (2), in which the member has a financial interest, as defined in Section 87103 of the Government Code, and determined by the regional center board. The member shall provide a list of the member’s financial interests, as defined in Section 87103, to the regional center board.
(l) The department shall establish, and each board shall adopt, an antiretaliation policy for board members that requires department approval for any reduction in services for consumer board members or the family member of family board members.
(m) The department shall establish and adopt a grievance procedure whereby a governing board member who has concerns, complaints, or questions may contact a specific executive at the department.
(n) This section does not prevent the appointment to a regional center governing board of a person who meets the criteria for more than one of the categories listed above.
SEC. 8.
Section 4626.5 of the Welfare and Institutions Code is amended to read:
4626.5.
Each regional center shall submit a conflict-of-interest policy to the department by July 1, 2011, and shall post the policy on its internet website by August 1, 2011. The policy shall do, or comply with, all of the following:
(a) Contain the elements of this section and be consistent with applicable law.
(b) Define conflicts of interest.
(c) Identify positions within the regional center required to complete and file a conflict-of-interest statement.
(d) Facilitate disclosure of information to identify conflicts of interest.
(e) Require candidates for nomination, election, or appointment to a regional center board, and applicants for regional center director to disclose any potential or present conflicts of interest prior to being appointed, elected, or confirmed for hire by the regional center or the regional center governing board.
(f) Require the regional center and its governing board to regularly and consistently monitor and enforce compliance with its conflict-of-interest policy.
(g) Prohibit a regional center employee from accepting a gift or gifts from a service provider, consumer, or consumer’s family member valued over ten dollars ($10) fifteen dollars ($15) per year.
(h) Establish a policy prohibiting regional center senior staff from hiring relatives at the center or any ancillary foundation and organization. The policy shall be included in the regional center contract and shall be included in training of the governing board.
SEC. 9.
Section 4629.1 is added to the Welfare and Institutions Code, to read:
4629.1.
(a) Notwithstanding any other law, the evaluation of regional center performance shall be implemented using a common set of performance measures, which shall be administered by the department. This includes the performance requirements under the regional center contracts pursuant to Section 4629, the performance incentives established under Section 4620.5, and the quality assessment instrument required under Section 4571. These measures shall be annually reported and made available to the public through posting of the measures results in machine-readable formats.
(b) (1) By July 1, 2024, the department shall establish standards for each measure above that contain thresholds above which a regional center may be eligible to receive rewards for good performance and thresholds below which a regional center may be subject to each level of probation required under Section 4629. The department shall establish the process for assessing corrective action undertaken by a regional center and the process by which a regional center may end its probation status.
(2) The department, in consultation with stakeholders, including consumers and family members, shall annually establish, update, and review the standards related to good performance.
(3) (A) The department, in consultation with stakeholders, including consumers and family members, shall annually establish, update, and review a uniform process to be used by regional centers to develop corrective action plans that respond to below standard performance.
(B) The process shall include all of the following:
(i) Technical assistance and training from the department either directly or through subject matter experts.
(ii) The sharing of resources from other regional centers that have met the performance measures.
(iii) Participation by the board of directors of the regional center in developing and monitoring the implementation of the corrective action plan in consultation with local stakeholders, including consumers and family members.
(C) The department shall oversee the process to develop the corrective action plan and assess corrective action undertaken by the regional center.
(c) The performance measures shall encompass the domains as itemized in subdivision (d). Additional measures may be adopted by the department as needed. Modification of the domain and measures shall be accomplished through a process of consultation that includes the engagement of stakeholders in a manner consistent with that required by subdivision (b) of Section 4620.5. The measures may be amended as reporting mechanisms mature as the department develops new information technology capabilities.
(d) The performance measures for purposes of this section shall be organized under seven domains, as follows:
(1) Community integration.
(2) Employment.
(3) Equity in service access.
(4) Case management.
(5) Consumer and family choice, experience, and satisfaction.
(6) Human and civil rights.
(7) Health and safety.
SEC. 10.
Section 4639.76 is added to the Welfare and Institutions Code, to read:
4639.76.
A regional center with which the department maintains a contract pursuant to Section 4629 shall be subject to the California Public Records Act (Chapter 1 (commencing with Section 7920.000) of Division 10 of Title 1 of the Government Code).
SEC. 11.
Section 4642 of the Welfare and Institutions Code is amended to read:
4642.
(a) (1) Any person believed to have a developmental disability, and any person believed to have a high risk of parenting an infant with a developmental disability shall be eligible for initial intake and assessment services in the regional centers. In addition, any infant having a high risk of becoming developmentally disabled may be eligible for initial intake and assessment services in the regional centers. For purposes of this section, “high-risk infant” means a child less than 36 months of age whose genetic, medical, or environmental history is predictive of a substantially greater risk for developmental disability than that for the general population. The department, in consultation with the State Department of Public Health, shall develop specific risk and service criteria for the high-risk infant program on or before July 1, 1983. These criteria may be modified in subsequent years based on analysis of actual clinical experience.
(2) (A) Initial intake shall be performed within 15 working days following request for assistance. Initial intake shall include, but need not be limited to, information and advice about the nature and availability of services provided by the regional center and by other agencies in the community, including guardianship, conservatorship, income maintenance, mental health, housing, education, work activity and vocational training, medical, dental, recreational, and other services or programs that may be useful to persons with developmental disabilities or their families. Intake shall also include a decision to provide assessment.
(B) For purposes of this section, “request for assistance” includes any initial contact or inquiry from an individual, or a person acting on their behalf, on the nature of services or supports available or provided by the regional center, and the individual’s eligibility to receive them.
(3) (A) The department shall create, with input from stakeholders, standardized information packets to be provided to any person seeking services from a regional center. There shall be one information packet related to services provided under the California Early Intervention Services Act and another information packet related to services provided under the Lanterman Developmental Disabilities Services Act. The information packets shall be translated to provide language access, as required by state and federal law, shall be reasonably culturally competent for all diverse racial and ethnic communities, including immigrants and Native Americans, shall be available in alternative formats and alternative modes of communication, as required by federal law, and shall include, at a minimum, all of the following:
(i) An overview of the regional center system.
(ii) A resource guide for consumers and their families.
(iii) Consumer rights, including the appeals procedures specified in Chapter 7 (commencing with Section 4700).
(iv) Contact information for the regional center, the department, the office of clients’ rights advocacy, and the protection and advocacy agency specified in Division 4.7 (commencing with Section 4900).
(v) Information on the Self-Determination Program, including the eligibility requirements specified in subdivision (d) of Section 4685.8.
(B) Each regional center shall distribute the information packets at intake, upon transfer to receiving services under the Lanterman Developmental Disabilities Services Act, and upon request. Each regional center shall begin distributing the information packets within 60 days following the department providing the information packets and issuing directives regarding the distribution of the information packets. In addition to, and not in lieu of, this requirement, each regional center shall post the full content of the most updated information packet on its internet website.
(b) A regional center shall communicate, with reasonable cultural competency, including Native American cultural competency, with the consumer and the consumer’s family pursuant to this section in their native language, including providing alternative communication services and alternative formats, as required by state and federal law.
SEC. 12.
Section 4646 of the Welfare and Institutions Code is amended to read:
4646.
(a) It is the intent of the Legislature to ensure that the individual program plan and provision of services and supports by the regional center system is centered on the individual and the family of the individual with developmental disabilities and takes into account the needs and preferences of the individual and the family, if appropriate, as well as promoting community integration, independent, productive, and normal lives, and stable and healthy environments. It is the further intent of the Legislature that individual program plans shall be developed consistent with the federal Affordable Care Act and the regulations and federal guidance adopted pursuant to the act requiring that community-based long-term services and supports be person-centered and self-directed. It is the further intent of the Legislature to ensure that goals in any plan allow for innovation and nontraditional service delivery and not be limited by the lack of easily identified services or supports, the provision of services to consumers and their families be effective in meeting the goals stated in the individual program plan, reflect the preferences and choices of the consumer, and reflect the cost-effective use of public resources.
(b) (1) Notwithstanding any other law, the individual program plan, including all assessments, shall be developed through a process of individualized needs determination and person-centered service planning developed pursuant to, and consistent with, Section 2402(a) of the federal Affordable Care Act (Pub. L. 111-148) and amendments thereto, Section 441.725 of Title 42 of the Code of Federal Regulations, and federal guidance issued by the Centers for Medicare and Medicaid Services on June 6, 2014, requiring community-based, long-term services and supports to be person-centered, strengths-based, and self-directed. The individual with developmental disabilities and, if appropriate, the individual’s parents, legal guardian or conservator, or authorized representative, shall have the opportunity to actively participate in the development of the plan. The individual shall lead the service planning process to the greatest extent possible.
(c) An individual program plan shall be developed for any person who, following intake and assessment, is found to be eligible for regional center services. These plans shall be completed within 60 days of the completion of the assessment. At the time of intake, the regional center shall inform the consumer and, if appropriate, the consumer’s parents, legal guardian or conservator, or authorized representative, of the services available through the state council and the protection and advocacy agency designated by the Governor pursuant to federal law, and shall provide the address and telephone numbers of those agencies.
(d) (1) As part of the initial individual program plan meeting and each annual review required by subdivision (b) of Section 4646.5, the consumer or, if appropriate, their parents, legal guardian, conservator, or authorized representative, shall be provided by the service coordinator oral and written information about the Self-Determination Program. The information shall include each of the provisions specified in subdivision (d) of Section 4685.8. Each individual program plan shall include a provision stating that the consumer or authorized representative was informed about the availability of the Self-Determination Program. If the consumer chooses not to participate in the program, the individual program plan shall include an explanation of the reason or reasons for that decision, or, if the consumer is ineligible for the program, the reason or reasons for that ineligibility.
(2) If the consumer is interested in participating in the program or wants additional information or assistance, the service coordinator, within five working days of expressing the interest, shall provide the consumer a date for the Self-Determination Program orientation, training resources, dates of local volunteer Self-Determination Program advisory committee meetings, and other information to assist the consumer in participating in the program.
(e) Individual program plans shall be prepared jointly by the planning team. Decisions concerning the consumer’s goals, objectives, and services and supports that will be included in the consumer’s individual program plan and purchased by the regional center or obtained from generic agencies shall be made by agreement between the regional center representative and the consumer or, if appropriate, the parents, legal guardian, conservator, or authorized representative at the program plan meeting.
(f) Regional centers shall comply with the request of a consumer or, if appropriate, the request of the consumer’s parents, legal guardian, conservator, or authorized representative, that a designated representative receive written notice of all meetings to develop or revise the individual program plan and of all notices sent to the consumer pursuant to Section 4710. The designated representative may be a parent or family member.
(g) Notwithstanding any other law, a meeting regarding the provision of services and supports by the regional center, including a meeting to develop or revise the individual program plan, shall 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.
(h) At the conclusion of an individual program plan meeting, an authorized representative of the regional center shall provide to the consumer, in written or electronic format, a list of the agreed-upon services and supports, and, if known, the projected start date, the frequency and duration of the services and supports, and the provider. The authorized representative of the regional center shall sign the list of agreed-upon services and supports at that time. The consumer, or if appropriate, the consumer’s parent, legal guardian, conservator, or authorized representative shall sign the list of agreed-upon services and supports prior to its implementation. The consumer, or if appropriate, the consumer’s parent, legal guardian, conservator, or authorized representative, may elect to delay receipt of the list of agreed-upon services and supports pending final agreement, as described in subdivision (h). If the consumer, or if appropriate, the consumer’s parent, legal guardian, conservator, or authorized representative, elects to delay the receipt of the list of agreed-upon services and supports for 15 days, the list shall be provided in the preferred language of the consumer, or of the consumer’s parent, legal guardian, or authorized representative.
(i) If a final agreement regarding the services and supports to be provided to the consumer cannot be reached at a program plan meeting, then a subsequent program plan meeting shall be convened within 15 days, or later at the request of the consumer or, if appropriate, the parents, legal guardian, conservator, or authorized representative or if agreed to by the planning team. The list of the agreed-upon services and supports described in subdivision (h) and signed by the authorized representative of the regional center shall be provided, in writing or electronically, at the conclusion of the subsequent program plan meeting, and shall be provided in the preferred language of the consumer, or of the consumer’s parent, legal guardian, conservator, or authorized representative. Additional program plan meetings may be held with the agreement of the regional center representative and the consumer or, if appropriate, the parents, legal guardian, conservator, or authorized representative.
(j) An authorized representative of the regional center and the consumer or, if appropriate, the consumer’s parent, legal guardian, conservator, or authorized representative shall sign the individual program plan and the list of the agreed-upon services and supports prior to its implementation. If the consumer or, if appropriate, the consumer’s parent, legal guardian, conservator, or authorized representative, does not agree with all components of the individual program plan, the consumer may indicate that disagreement on the plan. Disagreement with specific plan components shall not prohibit the implementation of services and supports agreed to by the consumer or, if appropriate, the consumer’s parent, legal guardian, conservator, or authorized representative. If the consumer or, if appropriate, the consumer’s parent, legal guardian, conservator, or authorized representative, does not agree with the plan in whole or in part, the consumer shall be sent written notice of their appeal rights, as required by Sections 4701 and 4710.
(k) (1) A regional center shall communicate in the consumer’s preferred language, or, if appropriate, the preferred language of the consumer’s family, legal guardian, conservator, or authorized representative, during the planning process for the individual program plan, including during the program plan meeting, and including providing alternative communication services, as required by Sections 11135 to 11139.8, inclusive, of the Government Code and implementing regulations.
(2) A regional center shall provide alternative communication services, including providing copies of the list of services and supports, and the individual program plan in the preferred language of the consumer or the consumer’s family, legal guardian, conservator, or authorized representative, or both, as required by Sections 11135 to 11139.8, inclusive, of the Government Code and implementing regulations.
(3) The preferred language of the consumer or the consumer’s family, legal guardian, conservator, or authorized representative, or both, shall be documented in the individual program plan.
SEC. 13.
Section 4646.4 of the Welfare and Institutions Code is amended to read:
4646.4.
(a) Regional centers shall ensure, at the time of development, scheduled review, or modification of a consumer’s individual program plan developed pursuant to Sections 4646 and 4646.5, or of an individualized family service plan pursuant to Section 95020 of the Government Code, the establishment of an internal process. This internal process shall ensure adherence with federal and state law and regulation, and if purchasing services and supports, shall ensure all of the following:
(1) Conformance with the regional center’s purchase of service policies, as approved by the department pursuant to subdivision (d) of Section 4434.
(2) Utilization of generic services and supports if appropriate. The individualized family service planning team for infants and toddlers eligible under Section 95014 of the Government Code and the individual program plan team pursuant to Section 4646 may determine that a service provided by a generic agency, as defined by subdivision (g) of Section 4659.5, or a service or source of funding contained in Section 4659 identified in the individualized family service plan or individual program plan is not available, and, therefore, will be funded by the regional center.
(3) Utilization of other services and sources of funding as contained in Section 4659.
(4) Consideration of the family’s responsibility for providing similar services and supports for a minor child without disabilities in identifying the consumer’s service and support needs as provided in the least restrictive and most appropriate setting. In this determination, regional centers shall take into account the consumer’s need for extraordinary care, services, supports and supervision, and the need for timely access to this care.
(5) Commencing October 1, 2022, consideration of information obtained from the consumer and, if appropriate, the parents, legal guardian, conservator, or authorized representative about the consumer’s need for the services, barriers to service access, and other information.
(b) At the time of development, scheduled review, or modification of a consumer’s individual program plan developed pursuant to Sections 4646 and 4646.5, or of an individualized family service plan pursuant to Section 95020 of the Government Code, the consumer, or, if appropriate, the parents, legal guardian, or conservator, shall provide copies of their health benefit cards under which the consumer is eligible to receive health benefits, including, but not limited to, private health insurance, a health care service plan, Medi-Cal, Medicare, and TRICARE. If the individual, or, if appropriate, the parents, legal guardians, or conservators, do not have health benefits, the regional center shall not use that fact to negatively impact the services that the individual may or may not receive from the regional center.
(c) Final decisions regarding the consumer’s individual program plan shall be made pursuant to Section 4646.
(d) Final decisions regarding the individualized family service plan shall be made pursuant to Section 95020 of the Government Code.
SEC. 14.
Section 4646.5 of the Welfare and Institutions Code is amended to read:
4646.5.
(a) The planning process for the individual program plan described in Section 4646 shall include all of the following:
(1) Gathering information and conducting assessments to determine the life goals, capabilities and strengths, preferences, barriers, and concerns or problems of the person with developmental disabilities. For children with developmental disabilities, this process should include a review of the strengths, preferences, and needs of the child and the family unit as a whole. Assessments shall be conducted by qualified individuals and performed in natural environments whenever possible. Information shall be taken from the consumer, the consumer’s parents and other family members, the consumer’s friends, advocates, authorized representative, if applicable, providers of services and supports, and other agencies. The assessment process shall reflect awareness of, and sensitivity to, the lifestyle and cultural background of the consumer and the family.
(2) A statement of goals, based on the needs, preferences, and life choices of the individual with developmental disabilities, and a statement of specific, time-limited objectives for implementing the person’s goals and addressing the person’s needs. These objectives shall be stated in terms that allow measurement of progress or monitoring of service delivery. These goals and objectives should maximize opportunities for the consumer to develop relationships, be part of community life in the areas of community participation, housing, work, school, and leisure, increase control over the consumer’s life, acquire increasingly positive roles in community life, and develop competencies to help accomplish these goals.
(3) In developing individual program plans for children, regional centers shall be guided by the principles, process, and services and support parameters set forth in Section 4685.
(4) In developing an individual program plan for a transition age youth or working age adult, the planning team shall consider the Employment First Policy described in Chapter 14 (commencing with Section 4868).
(5) A schedule of the type and amount of services and supports to be purchased by the regional center or obtained from generic agencies or other resources in order to achieve the individual program plan goals and objectives, and identification of the provider or providers of service responsible for attaining each objective, including, but not limited to, vendors, contracted providers, generic service agencies, and natural supports. The individual program plan shall specify the approximate scheduled start date for services and supports and shall contain timelines for actions necessary to begin services and supports, including generic services. In addition to the requirements of subdivision (h) of Section 4646, each regional center shall offer, and upon request provide, a written copy of the individual program plan to the consumer, and, if appropriate, the consumer’s parents, legal guardian or conservator, or authorized representative within 45 days of their request in a threshold language, as defined by paragraph (3) of subdivision (a) of Section 1810.410 of Title 9 of the California Code of Regulations.
(6) If agreed to by the consumer, the parents, legally appointed guardian, or authorized representative of a minor consumer, or the legally appointed conservator of an adult consumer or the authorized representative, including those appointed pursuant to subdivision (a) of Section 4541, subdivision (b) of Section 4701.6, and subdivision (e) of Section 4705, a review of the general health status of the adult or child, including medical, dental, and mental health needs, shall be conducted. This review shall include a discussion of current medications, any observed side effects, and the date of the last review of the medication. Service providers shall cooperate with the planning team to provide any information necessary to complete the health status review. If any concerns are noted during the review, referrals shall be made to regional center clinicians or to the consumer’s physician, as appropriate. Documentation of health status and referrals shall be made in the consumer’s record by the service coordinator.
(7) (A) The development of a transportation access plan for a consumer when all of the following conditions are met:
(i) The regional center is purchasing private, specialized transportation services or services from a residential, day, or other provider, excluding vouchered service providers, to transport the consumer to and from day or work services.
(ii) The planning team has determined that a consumer’s community integration and participation could be safe and enhanced through the use of public transportation services.
(iii) The planning team has determined that generic transportation services are available and accessible.
(B) To maximize independence and community integration and participation, the transportation access plan shall identify the services and supports necessary to assist the consumer in accessing public transportation and shall comply with Section 4648.35. These services and supports may include, but are not limited to, mobility training services and the use of transportation aides. Regional centers are encouraged to coordinate with local public transportation agencies.
(8) A schedule of regular periodic review and reevaluation to ascertain that planned services have been provided, that objectives have been fulfilled within the times specified, and that consumers and families are satisfied with the individual program plan and its implementation.
(b) For all active cases, individual program plans shall be reviewed and modified by the planning team, through the process described in Section 4646, as necessary, in response to the person’s achievement or changing needs, and no less often than once every 12 24 months. If the consumer or, if appropriate, the consumer’s parents, legal guardian, authorized representative, or conservator requests an individual program plan review, the individual program plan shall be reviewed within 30 days after the request is submitted, or no later than 7 days after the request is submitted if necessary for the consumer’s health and safety or to maintain the consumer in their home.
(c) (1) The department, with the participation of representatives of a statewide consumer organization, the Association of Regional Center Agencies, an organized labor organization representing service coordination staff, and the state council shall prepare training material and a standard format and instructions for the preparation of individual program plans, which embody a person-centered planning process consistent with federal law, regulations, and guidance.
(2) The department shall require each regional center to use, for all new and modified individual program plans, the training materials and the standard format plan prepared by the department pursuant to paragraph (1) by no later than March 1, 2024 2025.
(3) The department shall biennially review a random sample of individual program plans at each regional center to ensure that these plans are being developed and modified in compliance with Section 4646 and this section.
SEC. 15.
Section 4659 of the Welfare and Institutions Code is amended to read:
4659.
(a) Except as otherwise provided in subdivision (b), (d), or (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) Effective July 1, 2009, notwithstanding any other law or regulation, 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 Supportive 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 after being advised of the provisions of subdivision (d). 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) Notwithstanding Section 4646.4, a regional center may request a consumer or family member to pursue a service or source of funding from an entity described in subdivision (a) or (c) of this section, or pursuant to subdivision (g) of Section 4659.5, if the request is documented with specificity in the individual program plan or individualized family plan and the plan contains detailed instructions for the consumer or family pursuing the service. The individual program plan or individualized family plan shall also specify the ways in which the regional center will initially assist the consumer or family to apply for and pursue the service or source of funding and specify that it will provide additional assistance when requested by the consumer or family.
(2) The regional center shall purchase the service when the entity denies the service.
(3) A consumer, or their family, shall not be required to appeal an entity’s denial of the requested service for the regional center to purchase that service pursuant to this subdivision. The regional center may file an appeal on behalf of the consumer, but the appeal shall not delay the payment of the requested service by the regional center as specified in subparagraph (B) of paragraph (2).
(4) This section does not prohibit a consumer or their family, where appropriate, from filing a formal appeal of an entity’s denial of the service at issue, or a regional center from seeking reimbursement from the entity it believes is responsible for providing the service and from requesting assistance with filing the appeal or from utilizing assistance from other advocacy organizations.
(e) This section shall not 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.
(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.
(g) (1) To provide uniformity, consistency, and cost-effectiveness, to reduce barriers, and to increase the number of service providers throughout the state, the department shall comprehensively review the current processes for vendorizing providers for the delivery of services and supports to regional center consumers and revise those processes to streamline the process and create a uniform statewide vendorization process. The department shall develop the revised processes, in consultation with the Association of Regional Center Agencies, consumers and their families, advocacy organizations, and service providers.
(2) It is the intent of the Legislature to ensure that a service provider vendored in one regional center shall automatically, without additional requirements, be eligible to provide services in all regional centers. It is the further intent of the Legislature that this section shall not be construed to control or interfere with the discretion of the individual program planning team to determine the needs and services appropriate for each person with a developmental disability who is entitled to services under this division.
SEC. 16.
Section 4685.8 of the Welfare and Institutions Code is amended to read:
4685.8.
(a) The department shall implement a statewide Self-Determination Program. The Self-Determination Program shall 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. As of July 1, 2021, the program shall begin to be available on a voluntary basis to all regional center consumers who are eligible for the Self-Determination Program.
(b) The department, in establishing the statewide program, shall do both of the following:
(1) Set targets and benchmarks as set forth in paragraph (1) of subdivision (r).
(2) Address all of the following:
(A) Oversight of expenditure of self-determined funds and the achievement of participant outcomes over time.
(B) Increased participant control over which services and supports best meet the participant’s needs and the IPP objectives. A participant’s unique support system may include the purchase of existing service offerings from service providers or local businesses, hiring their own support workers, or negotiating unique service arrangements with local community resources.
(C) Comprehensive person-centered planning, including an individual budget and services that are outcome based.
(D) Consumer and family training to ensure understanding of the principles of self-determination, the planning process, and the management of budgets, services, and staff.
(E) Choice of independent facilitators, who meet standards and certification requirements established by the department, and who can assist with the functions specified in paragraph (2) of subdivision (c).
(F) Choice of financial management services providers who meet standards and certification requirements established by the department, and who can carry out the functions specified in paragraph (1) of subdivision (c).
(G) Innovation that will more effectively allow participants to achieve their goals.
(H) Long-term sustainability of the Self-Determination Program by doing all of the following:
(i) Requiring IPP teams, when developing the individual budget, to determine the services, supports, and goods necessary for each consumer based on the needs and preferences of the consumer and, when appropriate, the consumer’s family, the effectiveness of each option in meeting the goals specified in the IPP, and the cost-effectiveness of each option, as specified in subparagraph (D) of paragraph (6) of subdivision (a) of Section 4648.
(ii) The department may review final individual budgets that are at or above a spending threshold determined by the department of all individual budgets and use information from its review in the aggregate to develop additional program guidance and verify compliance with federal and state laws and other requirements.
(c) For purposes of this section, the following definitions apply:
(1) “Financial management services” means services or functions that assist the participant to manage and direct the distribution of funds contained in the individual budget, and ensure that the participant has the financial resources to implement their IPP throughout the year. These may include bill paying services and activities that facilitate the employment of service and support workers by the participant, including, but not limited to, fiscal accounting, tax withholding, compliance with relevant state and federal employment laws, assisting the participant in verifying provider qualifications, including criminal background checks, and expenditure reports. The financial management services provider shall meet the applicable requirements of Title 17 of the California Code of Regulations and other specific qualifications or certifications established by the department.
(2) “Independent facilitator” means a person, selected and directed by the participant, who is not otherwise providing services to the participant pursuant to their IPP and is not employed by a person providing services to the participant. The independent facilitator may assist the participant in making informed decisions about the individual budget, and in locating, accessing, and coordinating services and supports consistent with the participant’s IPP. The independent facilitator is available to assist in identifying immediate and long-term needs, developing options to meet those needs, leading, participating, or advocating on behalf of the participant in the person-centered planning process and development of the IPP, and obtaining identified services and supports. The cost of the independent facilitator, if any, shall be paid by the participant out of the participant’s individual budget. An independent facilitator shall receive training in the principles of self-determination, the person-centered planning process, and the other responsibilities described in this paragraph at the independent facilitator’s own cost. The independent facilitator shall meet standards and certification requirements established by the department.
(3) “Individual budget” means the amount of regional center purchase of service funding available to the participant for the purchase of services and supports necessary to implement the IPP. The individual budget shall be determined using a fair, equitable, and transparent methodology.
(4) “IPP” means individual program plan, as described in Section 4646.
(5) “Participant” means an individual and, when appropriate, the participant’s parents, legal guardian or conservator, or authorized representative, who has been deemed eligible for, and has voluntarily agreed to participate in, the Self-Determination Program.
(6) “Self-determination” means a voluntary delivery system consisting of a defined and comprehensive mix of services and supports, selected and directed by a participant through person-centered planning, in order to meet the objectives in their IPP. Self-determination services and supports are designed to assist the participant to achieve personally defined outcomes in community settings that promote inclusion. The Self-Determination Program shall only fund services and supports provided pursuant to this division that the federal Centers for Medicare and Medicaid Services determines are eligible for federal financial participation.
(7) “Spending Plan” means the plan the participant develops to use their available individual budget funds to purchase goods, services, and supports necessary to implement their individual program plan (IPP). The spending plan shall identify the cost of each good, service, and support that will be purchased with regional center funds. The total amount of the spending plan cannot exceed the amount of the individual budget. A copy of the spending plan shall be attached to the participant’s IPP.
(d) Participation in the Self-Determination Program is fully voluntary. A participant may choose to participate in, and may choose to leave, the Self-Determination Program at any time. A regional center shall not require or prohibit participation in the Self-Determination Program as a condition of eligibility for, or the delivery of, services and supports otherwise available under this division. Participation in the Self-Determination Program shall be available to any regional center consumer who meets the following eligibility requirements:
(1) The participant has a developmental disability, as defined in Section 4512, and is receiving services pursuant to this division.
(2) The consumer does not live in a licensed long-term health care facility, as defined in paragraph (44) of subdivision (a) of Section 54302 of Title 17 of the California Code of Regulations. An individual and, when appropriate, the individual’s parent, legal guardian or conservator, or authorized representative, who is not eligible to participate in the Self-Determination Program pursuant to this paragraph may request that the regional center provide person-centered planning services in order to make arrangements for transition to the Self-Determination Program, provided that the individual is reasonably expected to transition to the community within 90 days. In that case, the regional center shall initiate person-centered planning services within 60 days of that request.
(3) The participant agrees to all of the following terms and conditions:
(A) The participant shall receive an orientation that meets the standards set or developed by the department to the Self-Determination Program prior to enrollment, which includes the principles of self-determination, the role of the independent facilitator and the financial management services provider, person-centered planning, and development of a budget.
(B) The participant shall utilize the services and supports available within the Self-Determination Program only when generic services and supports are not available.
(C) The participant shall only purchase services and supports necessary to implement their IPP and shall comply with any and all other terms and conditions for participation in the Self-Determination Program described in this section.
(D) The participant shall manage Self-Determination Program services and supports within the participant’s individual budget.
(E) The participant shall utilize the services of a financial management services provider of their own choosing and who is vendored by a regional center and who meets the qualifications in paragraph (1) of subdivision (c).
(F) The participant may utilize the services of an independent facilitator of their own choosing for the purpose of providing services and functions as described in paragraph (2) of subdivision (c). If the participant elects not to use an independent facilitator, the participant may use their regional center service coordinator to provide the services and functions described in paragraph (2) of subdivision (c).
(G) If eligible, with the assistance of the regional center, if needed, timely apply for Medi-Cal in order to maximize federal funding. The participant may consider institutional deeming in order to qualify for Medi-Cal services.
(e) A participant who is not Medi-Cal eligible may participate in the Self-Determination Program and receive self-determination services and supports if all other program eligibility requirements are met and the services and supports are otherwise eligible for federal financial participation.
(f) The additional federal financial participation funds generated by the former participants of the self-determination pilot projects authorized pursuant to Section 13 of Chapter 1043 of the Statutes of 1998, as amended, or pursuant to Article 4 (commencing with Section 4669.2) of Chapter 5, shall be used to maximize the ability of Self-Determination Program participants to direct their own lives and to ensure the department and regional centers successfully implement the program as follows:
(1) First, to offset the cost to the department for the criminal background check conducted pursuant to subdivision (v) and other administrative costs incurred by the department in implementing the Self-Determination Program.
(2) With the remaining funds, the department, in consultation with stakeholders, including a statewide self-determination advisory workgroup, shall prioritize the use of the funds to meet the needs of participants, increase service access and equity, and reduce disparities, and to implement the program, including costs associated with all of the following:
(A) Independent facilitators to assist with a participant’s initial person-centered planning meeting.
(B) Development of the participant’s initial individual budget.
(C) Joint training of consumers, family members, regional center staff, and members of the local volunteer advisory committee established pursuant to paragraph (1) of subdivision (w).
(D) Regional center operations to increase support for transition to the Self-Determination Program or for caseload ratio enhancement.
(E) To offset the costs to the regional centers in implementing the Self-Determination Program.
(F) To support the Statewide Self-Determination Advisory Committee established pursuant to paragraph (2) of subdivision (w).
(g) If at any time during participation in the Self-Determination Program a regional center determines that a participant is no longer eligible to continue in, or a participant voluntarily chooses to exit, the Self-Determination Program, the regional center shall provide for the participant’s transition from the Self-Determination Program to other services and supports. This transition shall include the development of a new IPP that reflects the services and supports necessary to meet the individual’s needs. The regional center shall ensure that there is no gap in services and supports during the transition period.
(h) An individual determined to be ineligible for or who voluntarily exits the Self-Determination Program shall be permitted to return to the Self-Determination Program upon meeting all applicable eligibility criteria and upon approval of the participant’s planning team, as described in subdivision (j) of Section 4512. An individual who has voluntarily exited the Self-Determination Program shall not return to the program for at least 12 months.
(i) An individual who participates in the Self-Determination Program may elect to continue to receive self-determination services and supports if the individual transfers to another regional center catchment area, provided that the individual remains eligible for the Self-Determination Program pursuant to subdivision (d). The balance of the participant’s individual budget shall be reallocated to the regional center to which the participant transfers.
(j) The IPP team shall utilize the person-centered planning process to develop the IPP for a participant. The IPP shall detail the goals and objectives of the participant that are to be met through the purchase of participant-selected services and supports. The IPP team shall determine the individual budget to ensure the budget assists the participant to achieve the outcomes set forth in the participant’s IPP and ensures their health and safety. The completed individual budget shall be attached to the IPP.
(k) The participant shall implement their IPP, including choosing and purchasing the services and supports allowable under this section necessary to implement the plan. A participant is exempt from the cost control restrictions regarding the purchases of services and supports pursuant to Section 4648.5. A regional center shall not prohibit the purchase of any service or support that is otherwise allowable under this section.
(l) A participant shall have all the rights established in Sections 4646 to 4646.6, inclusive, and Chapter 7 (commencing with Section 4700).
(m) (1) Except as provided in paragraph (4), the IPP team shall determine the initial and any revised individual budget for the participant using the following methodology:
(A) (i) Except as specified in clause (ii), for a participant who is a current consumer of the regional center, their individual budget shall be the total amount of the most recently available 12 months of purchase of service expenditures for the participant.
(ii) An adjustment may be made to the amount specified in clause (i) if both of the following occur:
(I) The IPP team determines that an adjustment to this amount is necessary due to a change in the participant’s circumstances, needs, or resources that would result in an increase or decrease in purchase of service expenditures, or the IPP team identifies prior needs or resources that were unaddressed in the IPP, which would have resulted in an increase or decrease in purchase of service expenditures. When adjusting the budget, the IPP team shall document the specific reason for the adjustment in the IPP.
(II) The regional center certifies on the individual budget document that regional center expenditures for the individual budget, including any adjustment, would have occurred regardless of the individual’s participation in the Self-Determination Program.
(iii) For purposes of clauses (i) and (ii), the amount of the individual budget shall not be increased to cover the cost of the independent facilitator.
(B) For a participant who is either newly eligible for regional center services or who does not have 12 months of purchase service expenditures, the participant’s individual budget shall be calculated as follows:
(i) The IPP team shall identify the services and supports needed by the participant and available resources, as required by Section 4646.
(ii) The regional center shall calculate the cost of providing the services and supports to be purchased by the regional center by using the average cost paid by the regional center for each service or support unless the regional center determines that the consumer has a unique need that requires a higher or lower cost. The IPP team also shall document the specific reason for the adjustment in the IPP. The regional center shall certify on the individual budget document that this amount would have been expended using regional center purchase of service funds regardless of the individual’s participation in the Self-Determination Program.
(iii) For purposes of clauses (i) and (ii), the amount of the individual budget shall not be increased to cover the cost of the independent facilitator.
(2) The amount of the individual budget shall be available to the participant each year for the purchase of program services and supports. An individual budget shall be calculated no more than once in a 12-month period, unless revised to reflect a change in circumstances, needs, or resources of the participant using the process specified in clause (ii) of subparagraph (A) of paragraph (1).
(3) The spending plan shall be assigned to uniform budget categories developed by the department in consultation with stakeholders and distributed according to the timing of the anticipated expenditures in the IPP and in a manner that ensures that the participant has the financial resources to implement the IPP throughout the year.
(4) The department, in consultation with stakeholders, may develop alternative methodologies for individual budgets that are computed in a fair, transparent, and equitable manner and are based on consumer characteristics and needs, and that include a method for adjusting individual budgets to address a participant’s change in circumstances or needs.
(n) Annually, participants may transfer up to 10 percent of the funds originally distributed to any budget category set forth in paragraph (3) of subdivision (m) to another budget category or categories. Transfers in excess of 10 percent of the original amount allocated to any budget category may be made upon the approval of the regional center or the participant’s IPP team.
(o) Consistent with the implementation date of the IPP, the IPP team shall annually ascertain from the participant whether there are any circumstances or needs that require a change to the annual individual budget. Based on that review, the IPP team shall calculate a new individual budget consistent with the methodology identified in subdivision (m).
(p) (1) The department, as it determines necessary, may adopt regulations to implement the procedures set forth in this section. Any regulations shall be adopted in accordance with the requirements of Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code.
(2) Notwithstanding paragraph (1) and Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, and only to the extent that all necessary federal approvals are obtained, the department, without taking any further regulatory action, shall implement, interpret, or make specific this section by means of program directives or similar instructions until the time regulations are adopted. It is the intent of the Legislature that the department be allowed this temporary authority as necessary to implement program changes only until completion of the regulatory process.
(q) The department, in consultation with stakeholders, shall develop informational materials about the Self-Determination Program. The department shall ensure that regional centers are trained in the principles of self-determination, the mechanics of the Self-Determination Program, and the rights of consumers and families as candidates for, and participants in, the Self-Determination Program.
(r) Each regional center shall be responsible for implementing the Self-Determination Program as a term of its contract under Section 4629. As part of implementing the program, the regional center shall do all of the following:
(1) Meet the Self-Determination Program targets approved by the department, meet benchmarks established by the department in areas including timely enrollment, diversity of consumers served, and reduction of disparities in the individual budget of participants from racial and ethnic communities, and be eligible for incentives for exceeding these targets and benchmarks once the department has established a performance incentives program.
(2) Develop and implement an outreach and training plan about the Self-Determination Program for the diverse communities served by the regional center, including in congregate settings. Information shall be provided in plain language, in alternative formats and alternative modes of communication, and provide language access as required by state and federal law. Obtain input from stakeholders, including consumers and families, that reflect the ethnic and language diversity of the regional center’s consumers, about the effectiveness of this outreach and training and other activities that may be effective in reducing disparities in these programs.
(3) Annually report the enrollment, individual budget data, and purchase of service expenditure data for the Self-Determination Program consistent with the criteria in subdivisions (a) to (c), inclusive, of Section 4519.5.
(4) Assist eligible participants and their families in applying for Medi-Cal, in order to maximize federal funding and assist interested participants who wish to pursue institutional deeming in order to qualify for Medi-Cal services.
(5) At least annually, in addition to annual certification, conduct an additional review of all final individual budgets for participants at the regional center which are at or above a spending threshold that is specified by the department through directive consistent with federal and state requirements. This information may be used in the aggregate to provide training, program guidance, and verify compliance with state and federal requirements.
(6) Review the spending plan to verify that goods and services eligible for federal financial participation are not used to fund goods or services available through generic agencies.
(7) Contract with local consumer or family-run organizations and consult with the local volunteer advisory committee established pursuant to paragraph (1) of subdivision (w) to conduct outreach through local meetings or forums to consumers and their families to provide information about the Self-Determination Program and to help ensure that the program is available to a diverse group of participants, with special outreach to underserved communities.
(8) Collaborate with the local consumer or family-run organizations identified in paragraph (1) to jointly conduct training about the Self-Determination Program. The regional center shall consult with the local volunteer advisory committee established pursuant to paragraph (1) of subdivision (w) in planning for the training, and the local volunteer advisory committee may designate members to represent the advisory committee at the training.
(9) Train all service coordinators and fair hearing specialists in the principles of self-determination, the mechanics of the Self-Determination Program, and the rights of consumers and families. The training shall be conducted in collaboration with the local volunteer advisory committee.
(10) Provide payment to the financial management services provider for spending plan expenses through a not less than semimonthly pay schedule.
(11) Ensure that each individual plan includes the information required by subdivision (d) of Section 4646.
(s) The financial management services provider shall provide the participant and the regional center service coordinator with a monthly individual budget statement that describes the amount of funds allocated by budget category, the amount spent in the previous 30-day period, and the amount of funding that remains available under the participant’s individual budget.
(t) Only the financial management services provider is required to apply for vendorization in accordance with Subchapter 2 (commencing with Section 54300) of Chapter 3 of Division 2 of Title 17 of the California Code of Regulations for the Self-Determination Program. All other service and support providers shall not be on the federal debarment list and shall have applicable state licenses, certifications, or other state required documentation, including documentation of any other qualifications required by the department, but are exempt from the vendorization requirements set forth in Title 17 of the California Code of Regulations when serving participants in the Self-Determination Program.
(u) The regional center shall pay the full costs of the participant’s financial management services provider.
(v) To protect the health and safety of participants in the Self-Determination Program, the department shall require a criminal background check in accordance with all of the following:
(1) The department shall issue a program directive that identifies nonvendored providers of services and supports who shall obtain a criminal background check pursuant to this subdivision. At a minimum, these staff shall include both of the following:
(A) Individuals who provide direct personal care services to a participant.
(B) Other nonvendored providers of services and supports for whom a criminal background check is requested by a participant or the participant’s financial management service.
(2) Subject to the procedures and requirements of this subdivision, the department shall administer criminal background checks consistent with the department’s authority and the process described in Sections 4689.2 to 4689.6, inclusive.
(3) The department shall electronically submit to the Department of Justice fingerprint images and related information required by the Department of Justice of nonvendored providers of services and supports, as specified in paragraph (1), for purposes of obtaining information as to the existence and content of a record of state or federal convictions and state or federal arrests and also information as to the existence and content of a record of state or federal arrests for which the Department of Justice establishes that the person is free on bail or on their own recognizance pending trial or appeal.
(4) When received, the Department of Justice shall forward to the Federal Bureau of Investigation requests for federal summary criminal history information received pursuant to this section. The Department of Justice shall review the information returned from the Federal Bureau of Investigation and compile and disseminate a response to the department.
(5) The Department of Justice shall provide a state or federal response to the department pursuant to paragraph (1) of subdivision (p) of Section 11105 of the Penal Code.
(6) The department shall request from the Department of Justice subsequent notification service, as provided pursuant to Section 11105.2 of the Penal Code, for persons described in paragraph (1).
(7) The Department of Justice shall charge a fee sufficient to cover the cost of processing the request described in this subdivision.
(8) The fingerprints of any provider of services and supports who is required to obtain a criminal background check shall be submitted to the Department of Justice prior to employment. The costs of the fingerprints and the financial management service’s administrative cost authorized by the department shall be paid by the services and supports provider or the provider’s employing agency. Any administrative costs incurred by the department pursuant to this subdivision shall be offset by the funds specified in subdivision (g).
(9) If the criminal record information report shows a criminal history, the department shall take the steps specified in Section 4689.2. The department may prohibit a provider of services and supports from becoming employed, or continuing to be employed, based on the criminal background check, as authorized in Section 4689.6. The provider of services and supports who has been denied employment shall have the rights set forth in Section 4689.6.
(10) The department may utilize a current department-issued criminal record clearance to enable a provider to serve more than one participant, as long as the criminal record clearance has been processed through the department and no subsequent arrest notifications have been received relative to the cleared applicant.
(11) Consistent with subdivision (h) of Section 4689.2, the participant or financial management service that denies or terminates employment based on written notification from the department shall not incur civil liability or unemployment insurance liability.
(w) To ensure the effective implementation of the Self-Determination Program and facilitate the sharing of best practices and training materials commencing with the implementation of the Self-Determination Program, local and statewide advisory committees shall be established as follows:
(1) Each regional center shall establish a local volunteer advisory committee to provide oversight of the Self-Determination Program and identify a regional center liaison to the committee. The regional center and the State Council on Developmental Disabilities shall each appoint one-half of the membership of the committee. The committee shall consist of the regional center clients’ rights advocate, consumers, family members, and other advocates, and community leaders, including a representative from a family resource center. A majority of the committee shall be consumers and their family members. The committee shall reflect the multicultural diversity and geographic profile of the catchment area. The committee shall review the development and ongoing progress of the Self-Determination Program, including whether the program advances the principles of self-determination and is operating consistent with the requirements of this section, and may make ongoing recommendations for improvement to the regional center and the department. Annually, the regional center shall confirm, in writing, that the committee meets the requirements specified in this paragraph and provide the department with the name of the staff liaison and the names of the committee members, the positions they fill on the committee, and which entity appointed them to the committee.
(2) The State Council on Developmental Disabilities shall form a volunteer committee, to be known as the Statewide Self-Determination Advisory Committee, comprised of the chairs of the 21 local advisory committees or their designees. The council shall convene the Statewide Self-Determination Advisory Committee twice annually, or more frequently in the sole discretion of the council. The Statewide Self-Determination Advisory Committee shall meet by teleconference or other means established by the council to identify self-determination best practices, effective consumer and family training materials, implementation concerns, systemic issues, ways to enhance the program, and recommendations regarding the most effective method for participants to learn of individuals who are available to provide services and supports. The council shall synthesize information received from the Statewide Self-Determination Advisory Committee, local advisory committees, and other sources, share the information with consumers, families, regional centers, and the department, and make recommendations, as appropriate, to increase the program’s effectiveness in furthering the principles of self-determination.
(x) The department shall annually provide the following information to the appropriate policy and fiscal committees of the Legislature:
(1) Number and characteristics of participants, by regional center, including the number of participants who entered the program upon movement from a developmental center.
(2) Types and amount of services and supports purchased under the Self-Determination Program, by regional center.
(3) Range and average of individual budgets, by regional center, including adjustments to the budget to address the adjustments permitted in clause (ii) of subparagraph (A) of paragraph (1) of subdivision (m).
(4) The number and outcome of appeals concerning individual budgets, by regional center.
(5) The number and outcome of fair hearing appeals, by regional center.
(6) The number of participants who voluntarily withdraw from the Self-Determination Program and a summary of the reasons why, by regional center.
(7) The number of participants who are subsequently determined to no longer be eligible for the Self-Determination Program and a summary of the reasons why, by regional center.
(y) (1) The State Council on Developmental Disabilities shall issue an interim report to the Legislature, in compliance with Section 9795 of the Government Code, no later than June 30, 2021, on the status of the Self-Determination Program authorized by this section, barriers to its implementation, and recommendations to enhance the effectiveness of the program. The interim report shall provide an update to the program’s status, each regional center’s cap on participation and progress toward that cap, the most recent statewide and per-regional-center participant count, and the historical trend in the statewide participation count since the start of the program. The department shall assist in providing available information to the council in order to facilitate the timely issuance of the report.
(2) The council, in collaboration with the protection and advocacy agency identified in Section 4900 and the federally funded University Centers for Excellence in Developmental Disabilities Education, Research, and Service, may work with regional centers to survey participants regarding participant satisfaction under the Self-Determination Program and, when data is available, the traditional service delivery system, including the proportion of participants who report that their choices and decisions are respected and supported and who report that they are able to recruit and hire qualified service providers, and to identify barriers to participation and recommendations for improvement.
(3) The council, in collaboration with the protection and advocacy agency identified in Section 4900 and the federally funded University Centers for Excellence in Developmental Disabilities Education, Research, and Service, shall issue a report to the Legislature, in compliance with Section 9795 of the Government Code, by June 30, 2023, on the status of the Self-Determination Program authorized by this section, and provide recommendations to enhance the effectiveness of the program. This review shall include the program’s effectiveness in furthering the principles of self-determination, including all of the following:
(A) Freedom, which includes the ability of adults with developmental disabilities to exercise the same rights as all citizens to establish, with freely chosen supporters, family and friends, where they want to live, with whom they want to live, how their time will be occupied, and who supports them; and for families to have the freedom to receive unbiased assistance of their own choosing when developing a plan and to select all personnel and supports to further the life goals of a minor child.
(B) Authority, which includes the ability of a person with a disability, or family, to control a certain sum of dollars in order to purchase services and supports of their choosing.
(C) Support, which includes the ability to arrange resources and personnel, both formal and informal, that will assist a person with a disability to live a life in the community that is rich in community participation and contributions.
(D) Responsibility, which includes the ability of participants to take responsibility for decisions in their own lives and to be accountable for the use of public dollars, and to accept a valued role in their community through, for example, competitive employment, organizational affiliations, spiritual development, and general caring of others in their community.
(E) Confirmation, which includes confirmation of the critical role of participants and their families in making decisions in their own lives and designing and operating the system that they rely on.
SEC. 17.
Section 4726 of the Welfare and Institutions Code is amended to read:
4726.
Notwithstanding Section 5328, any exemption to the California Public Records Act (Division 10 (commencing with Section 7920.000) of Title 1 of the Government Code), or any other law that authorizes, but does not require, an entity to withhold all or part of a record on the basis of its confidentiality, access to records regarding an applicant for, or recipient of, services shall be provided, upon request, to the applicant, recipient, or their authorized representative, including the person appointed as a developmental services decisionmaker pursuant to Section 319, 361, or 726, for purposes, including, but not limited to, the appeal process under this chapter, unless disclosure of the record is expressly prohibited by law.
SEC. 18.
Section 4731 of the Welfare and Institutions Code is amended to read:
4731.
(a) Each consumer or any representative acting on behalf of any consumer or consumers, who believes that any right to which a consumer is entitled has been abused, punitively withheld, or improperly or unreasonably denied by a regional center, state-operated facility, or service provider, may pursue a complaint as provided in this section.
(b) Initial referral of any complaint taken pursuant to this section shall be to the director of the regional center from which the consumer receives case management services. If the consumer resides in a state-operated facility, the complaint shall be made to the director of the state-operated facility. The director shall, within 20 working days of receiving a complaint, investigate the complaint and send a written proposed resolution to the complainant and, if applicable, to the service provider. The written proposed resolution shall include a telephone number and mailing address for referring the proposed resolution in accordance with subdivision (c).
(b) (c) Any complaint made pursuant to this section shall be made to If the complainant is not satisfied with the proposed resolution, the complainant may refer the complaint, in writing, to the Director of Developmental Services. Services within 15 working days of receipt of the proposed resolution. The director, within 30 days of receiving a complaint, shall issue a written administrative decision and send a copy of the decision to the complainant, the director of the regional center or state-operated facility, and the service provider, if applicable. If there is no referral to the department, the proposed resolution shall become effective on the 20th working day following receipt by the complainant.
(c) (d) The department, on a quarterly basis, shall department shall annually compile the number of complaints filed, by each regional center and state-operated facility, the subject matter of each complaint, and a summary of each decision, and post the compilation on its internet website at the end of each quarter. Copies of any decision included in the compilation shall be made available within 10 days, with all individually identifiable information redacted, to any person upon request.
(d) (e) This section shall not be used to resolve disputes concerning the nature, scope, or amount of services and supports that should be included in an individual program plan, for which there is an appeals procedure established in this division, or disputes regarding rates or audit appeals for which there is an appeals procedure established in regulations. Those disputes shall be resolved through the appeals procedure established by this division or in regulations.
(e) (f) All consumers or, if appropriate, their authorized representative, shall be notified in writing in their preferred language of the right to file a complaint pursuant to this section when they apply for services from a regional center or a state-operated facility, and at each regularly scheduled planning meeting.
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ASSEMBLY THIRD READING
ATR Bill Id:AB 1147
Author:(Addis and Garcia)
As Amended Ver:May 19, 2023
Majority vote
SUMMARY
Deletes, revises, and adds requirements for the Department of Developmental Services (DDS) and the regional centers that coordinate services for the eligible population, to include process standardization, data and reporting requirements, and timelines for accessing services.
Major Provisions
- Provides that DDS must require all of the following of regional centers:
- The use, when reporting data by race and ethnicity, of consistent classifications of race and ethnicity, based on categories current in use by the United States Census Bureau;
- Confirmation of the race and ethnicity identification of each consumer at the time of the annual review of the consumer's individual program plan (IPP);
- When reporting by residence types, separate presentation of data for those in independent living services and those in supported living services; and,
- Consistent standards and requirements for regional center internet websites, using the same placement and language for all information required by these provisions, including that data be posted in a machine-readable format
- Requires, as part of DDS' planning process for the planning and development of a uniform statewide data automation system, DSS, in consultation with stakeholders to develop, by March 1, 2024, a project charter to be approved by the Secretary of the California Health and Human Services Agency and the Department of Technology. The charter development process shall include the participation and input of program consumers and families, researchers, quality and outcome evaluators, regional centers, and service providers.
- Requires, by March 1, 2024, DDS to submit a report to the policy and budget subcommittees of the Legislature describing the extent to which the requirements of this section have not been met, including the surveying of all consumers, including those with no purchase of services, and providing specific steps and the schedule by which these requirements will be met.
- To provide uniformity, consistency, and cost-effectiveness in the delivery of services by regional centers throughout the state, requires the department, by January 1, 2025, to establish a common set of services and supports, including supported living services, that every regional center in the state must make available to consumers in negotiating, developing, or amending the IPP as required by existing law; and requires the common set of services and supports to be prominently posted on each regional center's internet website.
- Requires DDS to develop the common set of services and supports in consultation with the Association of Regional Center Agencies, consumers and their families, advocacy organizations, and service providers.
- Requires, in each contract with a regional center, DDS to require the common set of services and supports developed pursuant to this section to be available to consumers in the development of an IPP.
- Requires that notwithstanding any other law, the evaluation of regional center performance must be implemented using a common set of performance measures specified in the bill, which must be administered by DDS.
- Provides, notwithstanding any exemption, that a regional center with which DDS maintains a contract must be subject to the California Public Records Act.
- Requires the standardized information packet required under existing law to be provided to any person seeking services from a regional center, to also including the following:
- Information about appeals procedures; and,
- Information on the Self-Determination Program, including the eligibility requirements.
- Requires an IPP, including all assessments to be developed through a process of individualized needs determination and person-centered service planning developed pursuant to, and consistent with the Affordable Care Act (ACA), federal regulation implementing the ACA, and federal guidance issued by the Centers for Medicare and Medicaid Services (CMS) on June 6, 2014, requiring community-based, long-term services and supports to be person-centered, strengths-based, and self-directed. Further, requires that the individual must lead the service planning process to the greatest extent possible.
- Following the IPP intake and assessment, the plan must be completed within 50 days of the completion of the assessment.
- Requires, as part of the initial IPP meeting and each annual review required by law, the consumer or, if appropriate, their parents, legal guardian, conservator, or authorized representative, to be provided by the service coordinator oral and written information about the Self-Determination Program. The information must include each of the provisions as specified. Each IPP must include a provision stating that the consumer or authorized representative was informed about the availability of the Self-Determination Program. If the consumer chooses not to participate in the program, the IPP must include an explanation of the reason or reasons for that decision, or, if the consumer is ineligible for the program, the reason or reasons for that ineligibility.
- Requires, if the consumer is interested in participating in the program or wants additional information or assistance, the service coordinator, within five days of expressing the interest, to provide the consumer a date for the Self-Determination Program orientation, training resources, dates of local volunteer Self-Determination Program advisory committee meetings, and other information to assist the consumer in participating in the program.
- Requires, at the conclusion of an IPP meeting, an authorized representative of the regional center to provide to the consumer, in written or electronic format, a list of agreed-upon services and supports, and, if known, the projected start date, the frequency and duration of the services and supports, and the provider.
- Requires, for all active cases, IPPs to be reviewed and modified by the planning team, in response to the person's achievement or changing needs, and no less often than once every 12 months, rather than once every three years, as required by existing law.
- Permits a regional center to request a consumer or family member to pursue a service or source of funding from specified entities, if the request is documented with specificity in the IPP or individualized family plan and the plan contains detailed instructions for the consumer or family pursuing the service. Further, the IPP or individualized family plan must also specify the ways in which the regional center will initially assist the consumer or family to apply for and pursue the service or source of funding and specify that it will provide additional assistance when requested by the consumer or family.
- Requires the regional center to purchase the service when the entity denies the service.
- Prohibits a consumer, or their family, to be required to appeal an entity's denial of the requested service for the regional center a verification that an administrative appeal is being pursued to purchase that service pursuant to this subdivision. The regional center may file an appeal on behalf of the consumer, but the appeal cannot delay the payment of the requested service by the regional center as specified.
- Specifies this bill does not prohibit a consumer or their family, where appropriate, from filing a formal appeal of an entity's denial of the service at issue, or a regional center from seeking reimbursement from the entity it believes is responsible for providing the service and from requesting assistance with filing the appeal or from utilizing assistance from other advocacy organizations.
- Requires DDS, to provide uniformity, consistency, and cost-effectiveness, to reduce barriers, and to increase the number of service providers throughout the state, to comprehensively review the current processes for vendorizing providers for the delivery of services and supports to regional center consumers and revise those processes to streamline the process and create a uniform statewide vendorization process. Further, requires DDS to develop the revised processes, in consultation with the Association of Regional Center Agencies, consumers and their families, advocacy organizations, and service providers.
- Requires each regional center, as a part of implementing the Self-Determination Program to ensure that each individual plan includes the specified information.
- Deletes and recasts the current initial regional center complaint process and replaces the process.
- Requires DDS, on a quarterly basis, to compile the number of complaints filed, by each regional center and state-operated facility, as specified.
COMMENTS
For a detailed description of this bill and background see the Assembly Human Services Committee's analysis.
Recent and ongoing oversight discussions: California State Auditor and the Little Hoover Commission. In June 2022, the California State Auditor found a number of deficiencies in the developmental disabilities system that negatively impact services, particularly for people of color. The audit of three regional centers, which collectively serve more than 65,000 consumers, found that they have neither sufficient staff nor funding. The audit found regional centers struggles with a number of issues due to inaction from DDS. The key findings include: regional centers have insufficient staffing because DDS has not ensured adequate funding was received, regional centers are not monitoring vendors appropriately, DDS and regional centers are failing to monitor access to convenient services, and DDS does not provide adequate oversight on consumer complaints with regional centers. The State Auditor made the following recommendations to DDS:
- Work with regional centers as necessary to update the core staffing formula so that it aligns with actual regional center staffing costs.
- Provide vendor monitoring training so that regional centers understand the statutory requirements for vendor monitoring.
- Establish standards for measuring how convenient it is for consumers to access services.
- Ensure that regional centers provide statutorily required information to consumers about how to file a consumer rights complaint.
- Issue guidance to regional centers and develop best practices to ensure that regional centers complete complaint investigations within statutory deadlines."
The Little Hoover Commission held a series of public meetings in the fall of 2022 to discuss the disparities plaguing California's Developmental Disabilities System and is scheduled to release a study in spring 2023. At one of the public meetings in the fall of 2022, comments from regional centers, DDS, and advocates were made discussing problems and possible steps forward. DDS' director, in their written testimony posted on The Little Hoover's Website, committed to:
- Develop a Strategic Plan;
- Host meetings with regional center representatives to hear directly from individuals and families;
- Direct regional centers to develop community engagement plans;
- Work with the Association of Regional Center Agencies (ARCA) to develop and implement standardized intake standards;
- Work with community partners to identify and implement assessment tools and process used in determining early start eligibility;
- Work with ARCA to establish a streamlined and standardized vendorization process; and,
- Continue to build capacity for data fluency, prioritize data integrity, usefulness and transparency.
Equity Implications: Individuals living with developmental disabilities rely on services from regional centers to live independently and effectively integrate into the community. As outlined above, regional centers are severely underperforming for years which is having an adverse effect on the population who relies on these services. While some of the issues can be traced back to cost saving measures implemented during the Great Recession, the impact has been profound on the community. There is clear inequity between different race and ethnicities as well geographically that is not improving despite grants issued over the last seven years. Although unclear the best way to achieve equity, the spending data shows a clear inequity on services provided. For almost a decade, heightened attention has been given to disparities in regional center spending and service provision; data from DDS indicate that, statewide, per capita spending for services for a Latino consumer was $12,152 in 2021 compared to $28,143 for a White consumer. In 2015, statewide data showed that Latino consumers utilize services for which they are authorized at a lower rate (76.6%) than White consumers (82.7%).
According to the Author
"Regional centers play a critical role in California's developmental disability system by providing assessments, determining eligibility, and coordinating the services for those with intellectual and developmental disabilities. Despite California's network of centers that serve nearly 400,000 individuals, numerous issues plague the system, including a lack of transparency, accountability, and disparities in the services provided. Not only has this undermined confidence in California's developmental disability system, but it has failed to serve the Californians that need these services most. [This bill], the Disability Equity & Accountability Act, enacts several reforms to help ensure that all people, regardless of their race or ethnicity or where they live, receive equitable access to services within the regional center system and that all regional centers offer and provide a consistent and common set of services and that the services are delivered in a timely way. It is time that we provide accountability, transparency, and fairness to Californians with disabilities and their families."
Arguments in Support
Supporters state, "[This bill] proposes key reforms to the Lanterman Act. These reforms are designed to strengthen the ability of the Department of Developmental Services (DDS) to provide effective oversight of the state's 21 regional centers, address racial, ethnic, and geographic disparities, improve outcomes for people with intellectual and developmental disabilities (I/DD), provide greater transparency, and increase confidence and trust in California's developmental disability service system"
Arguments in Opposition
No opposition on file.
FISCAL COMMENTS
According to the Assembly Appropriations Committee on May 18, 2023, Ongoing General Fund (GF) costs of an unknown amount, likely in the millions to low-tens of millions of dollars to fund the changes in the bill. DDS was unable to provide a fiscal estimate at the time of this writing. According to the Association of Regional Center Agencies (ARCA) estimated regional center costs to comply with the CPRA are likely in the low-hundreds of thousands of dollars annually per regional center.
The author is also pursuing this proposal in the state budget process.
VOTES
ASM JUDICIARY: 11-0-0
YES: Maienschein, Essayli, Connolly, Dixon, Haney, Kalra, Pacheco, Papan, Reyes, Robert Rivas, Sanchez
ASM HUMAN SERVICES: 7-0-1
YES: Jackson, Sanchez, Alanis, Arambula, Bryan, Calderon, Garcia
ABS, ABST OR NV: Bonta
ASM APPROPRIATIONS: 11-0-5
YES: Holden, Bryan, Calderon, Wendy Carrillo, Mike Fong, Hart, Lowenthal, Papan, Pellerin, Weber, Ortega
ABS, ABST OR NV: Megan Dahle, Dixon, Mathis, Robert Rivas, Sanchez
UPDATED
VERSION: May 19, 2023
CONSULTANT: Alexandria Smith / HUM. S. / (916) 319-2089 FN: 0000967
Date of Hearing: May 17, 2023
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Chris Holden, Chair
ABPCA Bill Id:AB 1147
Author:(Addis) – As Amended Ver:April 11, 2023
Policy Committee: | Judiciary | Vote: | 11 - 0 |
Human Services | 7 - 0 | ||
|
|
Urgency: No State Mandated Local Program: No Reimbursable: No
SUMMARY:
This bill makes substantial changes to the Lanterman Developmental Disabilities Act (Lanterman Act) affecting the Department of Development Services (DDS) and regional centers to improve process standardization, strengthen data and reporting requirements and provide timelines for accessing services. This bill also makes regional centers subject to the provisions of the California Public Records Act (CPRA).
Specifically, this bill:
- Creates the following:
- Standardized Individual Program Planning (IPP): Adopts standardized planning criteria to ensure that people with developmental disabilities receive equitable case management regardless of their race, ethnicity, spoken language, or geographic location.
- Timely Access to Services and Programs: Adopts mandatory timelines, including for the start of services after referral to a provider agency; the reporting of necessary assessments and the resulting authorization of services; and the response of regional center staff to all calls and emails from clients.
- Availability of Services for All Persons Served by Regional Centers: Establishes a minimum set of specific services, including supported living services that all regional centers must provide.
- Coordinate Statewide Performance Measures: Provides DDS with new tools for holding regional centers and service providers accountable through a standardized set of performance measures.
- Improve Regional Center Governance: Establishes new procedures for governing boards to ensure they can more effectively represent the communities.
- Prevent Conflicts of Interest Within Regional Centers: Develops an anti-nepotism policy for regional center senior staff.
- New Information Technology System: Ensures that the records system integrate performance standards and metrics to address racial and ethnic disparities, support evidence-based research and improve accountability.
- Racial/Ethnic Reporting: Requires DDS and regional centers to collect standardized racial and ethnicity data aligned with federal census data categories.
- Provides that a regional center with which DDS maintains a contract is subject to the CPRA.
- Provides that notwithstanding any exemption to the CPRA, or any other law that authorizes, but does not require, an entity to withhold a record on the basis of its confidentially, access to records regarding an applicant for, or recipient of, services must be provided to the applicant, recipient, or to their authorized representative, including the person appointed as a developmental services decisionmaker, upon request, for purposes including, but not limited to, the appeal process under the Act, unless disclosure of the record is prohibited by law.
FISCAL EFFECT:
Ongoing General Fund (GF) costs of an unknown amount, potentially in the high-tens of millions of dollars, or more, to fund the changes in the bill. DDS was unable to provide a fiscal estimate at the time of this writing. The author has requested $75 million in the state budget for this proposal.
The Association of Regional Center Agencies (ARCA) provides a GF cost estimate in the mid-hundreds of millions of dollars based on a detailed cost estimate that includes both regional center staff and purchase of services costs. According to ARCA’s analysis, estimated regional center costs to comply with the CPRA are approximately $467,000 annually per regional center.
COMMENTS:
- Purpose. According to the author:
Despite California’s network of centers that serve nearly 400,000 individuals, numerous issues plague the system, including a lack of transparency, accountability, and disparities in the services provided. Not only has this undermined confidence in California’s developmental disability system, but it has failed to serve the Californians that need these services most. [This bill], the Disability Equity & Accountability Act, enacts several reforms to help ensure that all people, regardless of their race or ethnicity or where they live, receive equitable access to services within the regional center system and that all regional centers offer and provide a consistent and common set of services and that the services are delivered in a timely way.
- The Lanterman Act. The Lanterman Act, enacted in 1969, provides entitlement to services and supports for an individual age three and older who has a qualifying developmental disability, including autism, epilepsy, cerebral palsy, intellectual disabilities, and other conditions closely related to intellectual disabilities that require similar treatment. To qualify, an individual must have a substantial disability that began before the age of 18 and is expected to be life-long. There are no income‑related eligibility criteria. As of December 2022, DDS, the entity responsible for carrying out the Lanterman Act, serves about 330,000 Lanterman‑eligible individuals and another 2,900 children ages three and four who are provisionally eligible.
DDS oversees the coordination and delivery of services for individuals with developmental disabilities through a statewide network of 21 community-based, non-profit agencies known as regional centers. Regional centers provide assessments, determine eligibility for services, and offer case management services. Regional centers also develop, purchase, and coordinate the services in each person’s Individual Program Plan. The 21 regional centers serve approximately 370,000 consumers.
Problems Plague Developmental Disability System. Despite California’s network of centers that serves nearly 400,000 individuals, numerous issues plague the system according to a number of recent reports. These issues include a lack of transparency, accountability, consistency, and equity in the services they help to provide.
In June 2022, the California State Auditor found a number of deficiencies in the developmental disabilities system that negatively impact services, particularly for people of color. The audit of three regional centers, which collectively serve more than 65,000 consumers, found they have neither sufficient staff nor funding.
The Little Hoover Commission held four public hearings on the regional center system in the fall of 2022 to identify the underlying causes of disparities, analyze the current state efforts to address them, and consider how state government can improve the consistency and timeliness of service delivery. The Commission’s report and recommendations are expected in early 2023.
In November 2021, a coalition of disability rights advocates released a report that found people with disabilities and their families, especially people of color, encounter numerous barriers in their attempts to enforce their rights under the Lanterman Act. Among the report’s major findings were that 90% of all survey respondents reported at least one problem with the IPP process, with the most common complaint being that no one authorized to make a decision on behalf of the regional center attended their IPP; the informal dispute resolution process does not encourage swift and equitable solution to disagreements; belief that the fair hearing system magnifies systemic inequalities and is inaccessible, opaque, and biased; 72% of fair hearings are withdrawn, likely showing that many individuals and families give up because of the complexities of the process and the inability to hire a lawyer; and people served win, or partially win, fewer than 5% of cases filed.
This bill seeks to address and prevent inequities in the crucial services provided by regional centers by enacting significant reforms at regional centers to ensure proper equity, accountability, and transparency for underserved Californians. Named the Disability Equity and Accountability Act, the bill enacts several reforms to help ensure that all people, regardless of their race or ethnicity or where they live, receive equitable access to services within the regional center system and that all regional centers offer and provide a consistent and common set of services and that the services are delivered in a timely way.
CPRA Provision. The bill would make records of regional centers subject to the CPRA, notwithstanding the fact that regional centers are private non-profit entities. A regional center does not meet the definition of “public agency” and therefore would not otherwise be subject to the CPRA under state law. According to the Assembly Judiciary Committee analysis of this bill, such a provision—making a non-profit entity subject to the CPRA—is not unprecedented in the law. Charter schools, nonprofit public benefit corporations that operate charter schools in California are subject to the CPRA.
- Related Legislation. AB 649 (Wilson) permits regional centers to purchase services that would otherwise be available from other means when a consumer or a consumer’s representative chooses not to pursue coverage despite eligibility. AB 649 is pending in this committee.
Analysis Prepared by: Jennifer Swenson / APPR. / (916) 319-2081
Date of Hearing: April 18, 2023
ASSEMBLY COMMITTEE ON HUMAN SERVICES
Corey A. Jackson, Chair
ABPCA Bill Id:AB 1147 (
Author:Addis) – As Amended Ver:April 11, 2023
SUBJECT: Disability Equity and Accountability Act of 2023
SUMMARY: Deletes, revises, and adds requirements for the Department of Developmental Services (DDS) and the regional centers that coordinate services for the eligible population, to include process standardization, data and reporting requirements, and timelines for accessing services. Specifically, this bill:
- On behalf of the Legislature finds and declares as follows:
- Recent reports and hearings by the California State Auditor, the Little Hoover Commission, and advocacy organizations have found that California’s service system for the over 400,000 children and adults with intellectual or developmental disabilities (IDDs) through the Lanterman Developmental Disabilities Act (Lanterman Act), as overseen by DDS, which contracts with 21 regional centers, is failing in significant ways to deliver critical, adequate, and timely services to individuals and families. The result is that individuals and families, particularly those of color, are unable to access timely services and supports, resulting in barriers to their ability to live independent, productive, and integrated lives in their communities;
- California’s developmental disability service system is plagued with racial, ethnic, and geographic disparities that can dramatically impact the essential services received by children and adults with developmental disabilities. Systemic inequities and discrimination within California’s 21 regional centers broaden the gap between inclusive possibilities and segregated limitations. Data show Latinos are most negatively impacted by these disparities, but people who are clients of the lowest-performing regional centers are also significantly affected;
- California spends nearly $13 billion annually on the administration and delivery of developmental services, but lacks a transparent, common, integrated, and coordinated model for the delivery and measurement of services throughout the 21 regional centers, resulting in poor outcomes, poor satisfaction levels by consumers and families, and disparate levels of available services and performance expectations;
- The delivery of services through 21 separate private nonprofit regional centers with separate boards, funding, and delivery models was originally intended to ensure that the delivery of services could be more effectively delivered through nonstate entities. However, with the subsequent caseload and budget growth since the enactment of the Lanterman Act, local administration has become more disparate and less accountable. Boards of directors are untrained and are not providing the oversight needed of the regional centers. Stronger state oversight of regional centers by DDS is essential to ensure that services are equitably delivered, performance and outcomes are uniformly measured and reported, and the system is transparent and accountable to individuals and families;
- DDS’ system lacks a statewide automated technology system for the delivery of services to persons with IDDs and, as a result, the current program is constrained by disparate automation systems, inadequate documentation, the lack of open system architecture, insufficient data to support administration of the system, and the lack of data to support program improvements for improving the quality of life outcomes through new service delivery methods;
- Statewide uniformity of service delivery practices and procedures is essential to an effective program and to support necessary oversight and research for ongoing program improvements;
- DDS’ technical infrastructure is over 40 years old. The lack of a statewide automation system does not meet current program needs and significantly contributes to the racial and geographic disparities in the delivery of services. California currently lacks clear and consistent service delivery outcomes for individuals with IDDs that sets high expectations for their quality of life, and must develop a system for measuring and quantifying the value of service delivery outcomes;
- A previous effort to develop an IDD program technology system failed. As a result, DDS and regional centers maintain a patchwork of at least three case management and fiscal systems that are not integrated and six legacy case management automation systems that lack integration, have dissimilar data sources, and are technically outdated; and,
- In the 2021-22 annual budget the Legislature appropriated $6 million to DDS for planning purposes related to the implementation of a uniform fiscal system and consumer electronic records management system. DDS has not developed a vision or scope for a proposed system development approach.
- States legislative intent that enacting the bill to do all of the following:
- Ensure that racial, ethnic, and geographic service disparities be systemically addressed and eliminated and that all people, regardless of their race or ethnicity or where they live, receive equitable access to services within the regional center system;
- Ensure that all regional centers offer and provide a consistent and common set of services and that the services are delivered in a timely way;
- Ensure that the delivery of all services and supports comply with federal law and guidance and are responsive to the needs and choices of beneficiaries receiving home- and community-based services, are person centered and strengths based, have high expectations for interdependence, self-direction, and competitive, integrated employment, provide support coordination to assist with a community-supported life, and achieve a more consistent and coordinated approach to the administration of policies and procedures across the state;
- Provide DDS with new tools for holding regional centers and service providers accountable through the development of a standardized and coordinated set of performance measures and related standards that establish targets and standards above which a regional center may receive incentives for improved performance, and a separate set of standards that require corrective action;
- Improve regional center governance by establishing new standards and procedures for regional center governing boards to ensure they can more effectively represent the communities they serve by providing them with greater independence and protection from regional center retaliation; and,
- Require DDS to develop a written project charter for the planning and development of a uniform statewide automation system that serves as a foundation document for the system development, which includes project guiding principles, scope, strategies and approach, and project governance, in order to provide transparency to the Legislature and the public on the system development as has been used with other statewide system development.
- Provides that DDS must require all of the following of regional centers:
- The use, when reporting data by race and ethnicity, of consistent classifications of race and ethnicity, based on categories current in use by the United States Census Bureau;
- Confirmation of the race and ethnicity identification of each consumer at the time of the annual review of the consumer’s individual program plan (IPP);
- When reporting by residence types, separate presentation of data for those in independent living services and those in supported living services; and,
- Consistent standards and requirements for regional center internet websites, using the same placement and language for all information required by these provisions, including that data be posted in a machine-readable format
- Requires, as part of DDS’ planning process for the planning and development of a uniform statewide data automation system, the department, in consultation with stakeholders to develop, by March 1, 2024, a project charter that shall be approved by the Secretary of the California Health and Human Services Agency and the Department of Technology. The charter development process shall include the participation and input of program consumers and families, researchers and quality and outcome evaluators, regional centers, and service providers.
- Requires the project charter described in 4) to include all of the following:
- An impact statement on the primary entities and individuals impacted by the system development;
- Project guiding principles that are foundational to the project approach to be used throughout the planning, development, implementation, and maintenance of the system;
- Project scope that addresses business problems required to be solved by the system, including all of the following:
- Worker effectiveness and accountability that are constrained by the lack of timely, adequate, and accurate data, the lack of uniformity, and the current system’s limited functionality;
- Service delivery that is constrained by the lack of timely, adequate, accurate, and accessible data, the lack of clear understandable communication of information, lack of uniformity, and the system’s limited functionality;
- Current system maintainability that is constrained by disparate systems, inadequate documentation, the lack of open system architecture, and business changes;
- Disparate systems, complex business rules, the number of locations and variability of local system delivery, and changes in the way of doing business; and,
- Limited access of researchers and program evaluators to the set of person-level data that they need to assess program effectiveness.
- Program goals, which must include all of the following:
- Maximizing the performance and the business processes for the delivery of IDD system services to consumers at the regional centers;
- Improving data quality, privacy, confidentiality, and integration of all data sources at an individual level;
- Enabling data-driven decisionmaking and performance measures for the effective administration of the program;
- Improving the business processes administered by DDS to support regional center service delivery; and,
- Supporting access to individual-level data to support program evaluation and other research.
- Technology goals that recognize that a statewide system solution not only meets requirements, but also ensures effective transition, while minimizing disruption to existing services;
- Project strategies and approaches for development and implementation;
- Project governance; and,
- Technology that can readily be enhanced and modernized for the expected system life. In selecting the new system, consideration will be given to the extent to which the candidate systems employ open architectures and standards and the future ability of the selected system to provide enhancements that will improve long-term effectiveness of program management of the statewide service delivery system.
- Requires, by March 1, 2024, DDS to submit a report to the policy and budget subcommittees of the Legislature describing the extent to which the requirements of this section have not been met, including the surveying of all consumers, including those with no purchase of services, and providing specific steps and the schedule by which these requirements will be met.
- To provide uniformity, consistency, and cost-effectiveness in the delivery of services by regional centers throughout the state, requires the department, by January 1, 2025, to establish a common set of services and supports, including supported living services, that every regional center in the state must make available to consumers in negotiating, developing, or amending the IPP as required by existing law; and requires the common set of services and supports to be prominently posted on each regional center’s internet website.
- Requires DDS to develop the common set of services and supports in consultation with the Association of Regional Center Agencies, consumers and their families, advocacy organizations, and service providers.
- Requires, in each contract with a regional center, DDS to require the common set of services and supports developed pursuant to this section to be available to consumers in the development of an IPP. Clarifies that by enacting 7) – 9), it is the intent of the Legislature the provisions not be construed to control or interfere with the discretion of the individual program planning team to determine the needs and services appropriate for each person with a developmental disability who is entitled to services.
- Enacts the following reforms regarding membership of each regional center’s governing board:
- Specifies that members of the governing board may not serve more than a six-year term, and may return to the board for a subsequent term after five years. The members of each regional center governing board nominating committee must comprise current board members and members of the community, and should be representative of the community served in the regional center’s catchment area;
- The board nominating committee must solicit interests and nominations from the broader community through outreach. The committee must interview candidates for the board and make recommendations to the governing board for election. During the meeting at which the board elects new members, a candidate may be nominated by a board member with a second by another board member for the open positions. A regional center executive director must be prohibited from any involvement in the recruitment or election of governing board members.
- Revises the training program that DDS is required to provide to board members to require that the training is be developed with community input, including persons served and family members. Ongoing support by DDS must include surveying board members about their ability to meaningfully participate in, and understand the subjects and votes at, board meetings. If board members report that they are unable to meaningfully participate, DDS must work with the regional center and the board member to ensure adequate and appropriate accommodations are provided.
- Requires DDS to establish guidelines for governing boards to measure executive director performance, including with respect to issues of equity and diversity.
- Requires DDS to establish, and each board must adopt, an anti-retaliation policy for board members that requires department approval for any reduction in services for consumer board members or the family member of family board members.
- Requires DDS to establish and adopt a grievance procedure whereby a governing board member who has concerns, complaints, or questions may contact a specific executive at the department.
- Requires a conflict of interest policy for board members to do the following (in addition to requirements of existing law):
- Prohibit a regional center employee from accepting a gift or gifts from a service provider, consumer, or consumer’s family member valued over $10 per year; and,
- Establish a policy prohibiting regional center senior staff from hiring relatives at the center or any ancillary foundation and organization. The policy must be included in the regional center contract and must be included in training of the governing board.
- Requires that notwithstanding any other law, the evaluation of regional center performance must be implemented using a common set of performance measures specified in the bill, which must be administered by DDS.
- Provides, notwithstanding any exemption, that a regional center with which DDS maintains a contract must be subject to the California Public Records Act.
- Defines “request for assistance” for purposes or eligibility for initial intake and assessment for services in a regional center, to include any initial contact or inquiry from an individual, or a person acting on their behalf, on the nature of services or supports available or provided by the regional center, and the individual’s eligibility to receive them.
- Requires the standardized information packet required under existing law to be provided to any person seeking services from a regional center, to also including the following:
- Information about appeals procedures; and,
- Information on the Self-Determination Program, including the eligibility requirements.
- Requires, if assessment is needed, the regional center to require the assessment to be completed within 60 days following initial intake. Assessment must be commenced as soon as possible, and in no event more than 30 days following initial intake when any delay would expose the client to unnecessary risk to their health and safety or to significant further delay in mental or physical development, or the client would be at imminent risk of placement in a more restrictive environment.
- States legislative intent that an IPP must be developed consistent with the federal Affordable Care Act (ACA) and the regulations and federal guidance adopted pursuant to the ACA requiring that community-based long-term services and supports be person-centered and self-directed. Further, states legislative intent to ensure that goals in any plan allow for innovation and nontraditional service delivery and not be limited by the lack of easily identified services or supports.
- Requires an IPP, including all assessments to be developed through a process of individualized needs determination and person-centered service planning developed pursuant to, and consistent with the ACA, federal regulation implementing the ACA, and federal guidance issued by the Centers for Medicare and Medicaid Services (CMS) on June 6, 2014, requiring community-based, long-term services and supports to be person-centered, strengths-based, and self-directed. Further, requires that the individual must lead the service planning process to the greatest extent possible.
- Requires an initial assessment agreement to be completed and provided to the consumer within 30 days of an intake unless there is good cause for the regional center to exceed the 30-day time period, but in no event can the assessment be completed any later than 60 days from the intake. If the assessment is not completed within the 30- or 60-day time period, as applicable, the regional center must provide the consumer with an adequate notice of action, and must notify DDS of the reason for not meeting the deadline. At the time of intake, the regional center must inform the consumer and, if appropriate, the consumer’s parents, legal guardian or conservator, or authorized representative, of the services available through the state council and the protection and advocacy agency designated by the Governor pursuant to federal law, and shall provide the address and telephone numbers of those agencies.
- Requires, as part of the initial IPP meeting and each annual review required by law, the consumer or, if appropriate, their parents, legal guardian, conservator, or authorized representative, to be provided by the service coordinator oral and written information about the Self-Determination Program. The information must include each of the provisions as specified. Each IPP must include a provision stating that the consumer or authorized representative was informed about the availability of the Self-Determination Program. If the consumer chooses not to participate in the program, the IPP must include an explanation of the reason or reasons for that decision, or, if the consumer is ineligible for the program, the reason or reasons for that ineligibility.
- Requires, if the consumer is interested in participating in the program or wants additional information or assistance, the service coordinator, within five days of expressing the interest, to provide the consumer a date for the Self-Determination Program orientation, training resources, dates of local volunteer Self-Determination Program advisory committee meetings, and other information to assist the consumer in participating in the program.
- Requires, at the conclusion of an IPP meeting, an authorized representative of the regional center to provide to the consumer, in written or electronic format, a summary page written in plain language. The identified services and supports specified in an IPP referred to a provider must begin on the date specified in the plan. In the event the services or supports are not started by the provider within 45 days of the specified start date, a referral must be made within 14 days to another provider for delivery of the specified services and supports.
- Allows the individualized family service planning team for infants and toddlers eligible and the IPP team to determine that a service provided by a generic agency identified in the individualized family service plan or IPP is not available, and, therefore, will be funded by the regional center.
- Requires, for all active cases, IPPs to be reviewed and modified by the planning team, in response to the person’s achievement or changing needs, and no less often than once every 12 months, rather than once every three years, as required by existing law.
- Requires the department to require each regional center to use, for all new and modified IPPs, the training materials and the standard format plan prepared by DDS pursuant to the bill’s requirements by no later than March 1, 2024.
- Provides that if any services or supports that require an assessment are requested by a consumer at any time after an IPP is in place, and for as long as the individual remains eligible for services, the assessment must be completed, at no cost to the consumer, within 30 days from the date of request.
- Provides that if the assessment recommends services or supports, the services or supports shall be authorized by the regional center within seven days and the consumer must be referred to a provider within seven days from the date of the authorization. If the services or supports are not commenced by the provider within 45 days of the referral, a referral must be made to another provider within seven days for the specified services and supports.
- Provides that a consumer is entitled to an adequate notice of action and the appeal procedures specified in the law if the regional center does not comply with the deadlines specified in 30) and 31).
- Requires service coordinators to be accessible to consumers and their representative by telephone and other electronic means, and respond to consumer inquiries within two business days of the inquiry.
- Requires regional centers to ensure that every consumer has a service coordinator and provide written notice of any temporary change in the assigned service coordinator.
- Requires regional centers to advise consumers of 37) -39) before prohibiting from purchasing of any service that would otherwise be available from Medi-Cal, Medicare, the Civilian Health and Medical Program for Uniform Services, In-Home Support Supportive Services (IHSS), California Children’s Services, private insurance, or a health care service plan when a consumer or a family meets the criteria of this coverage.
- Removes the existing requirement that regional centers must not purchase any service that would otherwise be available from Medi-Cal, Medicare, the Civilian Health and Medical Program for Uniform Services, IHSS, 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, and replaces it with 37).
- Permits a regional center to request a consumer or family member to pursue a service or source of funding from specified entities, if the request is documented with specificity in the IPP or individualized family plan and the plan contains detailed instructions for the consumer or family pursuing the service. Further, the IPP or individualized family plan must also specify the ways in which the regional center will initially assist the consumer or family to apply for and pursue the service or source of funding and specify that it will provide additional assistance when requested by the consumer or family.
- Requires the regional center to purchase the service when either of the following occurs:
- The entity denies the service; or,
- The entity does not provide the requested service within 45 days from the date of the request, or 15 days after the statutory or regulatory time limit, if any, for the entity to make an initial decision, whichever is shorter.
- Prohibits a consumer, or their family, to be required to appeal an entity’s denial of the requested service for the regional center a verification that an administrative appeal is being pursued to purchase that service pursuant to this subdivision. The regional center may file an appeal on behalf of the consumer, but the appeal cannot delay the payment of the requested service by the regional center as specified in 36) b) above.
- Specifies this bill does not prohibit a consumer or their family, where appropriate, from filing a formal appeal of an entity’s denial of the service at issue, or a regional center from seeking reimbursement from the entity it believes is responsible for providing the service and from requesting assistance with filing the appeal or from utilizing assistance from other advocacy organizations.
- Requires DDS, to provide uniformity, consistency, and cost-effectiveness, to reduce barriers, and to increase the number of service providers throughout the state, to comprehensively review the current processes for vendorizing providers for the delivery of services and supports to regional center consumers and revise those processes to streamline the process and create a uniform statewide vendorization process. Further, requires DDS to develop the revised processes, in consultation with the Association of Regional Center Agencies, consumers and their families, advocacy organizations, and service providers.
- States legislative intent to ensure that a service provider vendored in one regional center is automatically, without additional requirements, eligible to provide services in all regional centers; and 35) - 41) cannot be construed to control or interfere with the discretion of the individual program planning team to determine the needs and services appropriate for each person with a developmental disability who is entitled to services in this bill.
- Requires DDS, no later than March 1, 2024, and on March 1 annually thereafter, to submit a report to the Legislature and post on its internet website the following data, statewide and for each regional center, broken down by qualifying disability category, race or ethnicity, and age categories 0–21 years of age, 22–64 years of age, and 65 years of age and over:
- The number of consumers for whom health and safety waivers have been requested;
- The number of consumers for whom health and safety waivers have been granted;
- The number of days elapsed between the date on which the department received the health and safety waiver request worksheet from the service provider and the date the service provider was notified of the outcome; and,
- The percentage of health and safety waiver requests that are due to behavioral challenges.
- Requires DDS to post on its internet website brief summaries, with any individual identifying information redacted, of the health and safety risks and challenges, and the service changes that are necessary to protect the health and safety, of the affected consumer or consumers, contained in each health and safety waiver request worksheet received by DDS.
- Requires each regional center, as a part of implementing the Self-Determination Program to ensure that each individual plan includes the information required in 24).
- Deletes the current initial regional center complaint process.
- Requires any complaint made pursuant to Welfare and Institutions Code Section (WIC) 4731 to be made to the director of DDS. Further, requires the director within 30 days of receiving a complaint, to issue a written administrative decision and send a copy of the decision to the complainant, the director of the regional center or state-operated facility, and the service provider, if applicable.
- Requires DDS, on a quarterly basis, to compile the number of complaints filed, by each regional center and state-operated facility, the subject matter of each complaint, and a summary of each decision and post the compilation on its internet website at the end of each quarter. Copies of any decision included in the compilation to be made available within 10 days, with all individually identifiable information redacted, to any person upon request.
EXISTING LAW:
- Establishes the Lanterman Developmental Disabilities Act (Lanterman 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, at each stage of life, and to support their integration into the mainstream life of the community. (WIC 4500 et seq.)
- Establishes a system of nonprofit regional centers, overseen by DDS, to provide fixed points of contact in the community for all persons with developmental disabilities and their families and to coordinate services and supports best suited to them throughout their lifetime. (WIC 4620)
- Provides the Director of DDS the authority to issue directives to regional centers when necessary to protect a consumer’s health, safety, welfare, or when needed to ensure that regional centers comply with the Act or other state or federal law. (WIC 4639.6)
- Establishes an IPP as the process to ensure that services and supports are customized to meet the needs of consumers who are served by regional centers for the purpose of alleviating a developmental disability or toward the social, personal, physical, or economic habilitation or rehabilitation of an individual with a developmental disability, or toward the achievement and maintenance of independent, productive, and normal lives. (WIC 4512(b))
- Requires decisions concerning the consumer’s goals, objectives, and services and supports included in their IPP to be made by agreement between the regional center representative and the consumer or, when appropriate, the consumer’s parents, legal guardian, conservator, or authorized representative, at the program plan meeting. (WIC 4646(d))
- Requires the IPP planning processes to include:
- A statement of the individual’s goals and objectives, a schedule of the type and nature of services to be provided and other information and considerations, as specified;
- Review and modification, as necessary, by the regional center’s planning team no less frequently than every three years; and,
- Statewide training and review of the IPP plan creation, as specified. (WIC 4646.5)
- Provides the dispute process when a regional center believes that a generic agency is legally obligated to fund or provide services described in an IPP for children under age six. (WIC 4659.5)
- Makes all information and records obtained in the course of providing services under the Lanterman Act, to either voluntary or involuntary recipients of services confidential. (WIC 5328(a))
- Provides that the people have the right of access to information concerning the conduct of the people’s business and, therefore, the writings of public officials and agencies are be open to public scrutiny. Specifies that any law or rule that limits the public right of access shall be adopted with findings demonstrating the interest protected by the limitation. (California Constitution, art. I, Section 3)
FISCAL EFFECT: Unknown, this bill has not been analyzed by a fiscal committee.
COMMENTS: This bill is seeking major reforms that will impact delivery of developmental services. These reforms impact IPPs, timeliness for access to services and programs, standardizing services in all regional centers, governance and oversight of regional centers by DDS, and new data reporting for increased transparency.
Background: Lanterman Developmental Disabilities Act originally was passed in 1969. The Lanterman Act provides entitlement to services and supports for individuals ages three and older who have a qualifying developmental disability. Qualifying disabilities include autism, epilepsy, cerebral palsy, intellectual disabilities, and other conditions closely related to intellectual disabilities that require similar treatment. To qualify, an individual must have a disability that is substantial that began before the age of 18 and is expected to be life-long. There are no income‑related eligibility criteria. As of December 2022, DDS serves about 330,000 Lanterman‑eligible individuals and another 2,900 children ages three and four who are provisionally eligible.
Recent and ongoing oversight discussions: California State Auditor and the Little Hoover Commission. In June 2022, the California State Auditor found a number of deficiencies in the developmental disabilities system that negatively impact services, particularly for people of color. The audit of three regional centers, which collectively serve more than 65,000 consumers, found that they have neither sufficient staff nor funding. The audit found regional centers struggles with a number of issues due to inaction from DDS. The key findings include: regional centers have insufficient staffing because DDS has not ensured adequate funding was received, regional centers are not monitoring vendors appropriately, DDS and regional centers are failing to monitor access to convenient services, and DDS does not provide adequate oversight on consumer complaints with regional centers. The State Auditor made the following recommendations to DDS:
- Work with regional centers as necessary to update the core staffing formula so that it aligns with actual regional center staffing costs.
- Provide vendor monitoring training so that regional centers understand the statutory requirements for vendor monitoring.
- Establish standards for measuring how convenient it is for consumers to access services.
- Ensure that regional centers provide statutorily required information to consumers about how to file a consumer rights complaint.
- Issue guidance to regional centers and develop best practices to ensure that regional centers complete complaint investigations within statutory deadlines.”
The Little Hoover Commission held a series of public meetings in the fall of 2022 to discuss the disparities plaguing California’s Developmental Disabilities System and is scheduled to release a study in spring 2023. At one of the public meetings in the fall of 2022, comments from regional centers, DDS, and advocates were made discussing problems and possible steps forward. DDS’ director, in their written testimony posted on The Little Hoover’s Website, committed to:
- Develop a Strategic Plan;
- Host meetings with regional center representatives to hear directly from individuals and families;
- Direct regional centers to develop community engagement plans;
- Work with ARCA to develop and implement standardized intake standards;
- Work with community partners to identify and implement assessment tools and process used in determining early start eligibility;
- Work with ARCA to establish a streamlined and standardized vendorization process; and,
- Continue to build capacity for data fluency, prioritize data integrity, usefulness and transparency.
The study will “assess the extent of current disparities in service access within the state, identify the underlying causes of these disparities and the current state efforts to address them, and consider how state government can improve the consistency and timeliness of service delivery for the individuals and their families who rely on the state’s developmental services programs.”
Regional center governance and structure. Direct responsibility for implementation of the Lanterman Act’s service system is shared by DDS and a statewide network of 21 regional centers, which are private, community-based nonprofit entities, that contract with DDS to carry out many of the state’s responsibilities. Regional centers are governed by a Board of Directors (Board) who are a part of the community, receive services, or a representative of someone who receives services from the regional center. The Board is responsible for hiring (and firing) the Executive Director who is tasked with the day-to-day management of the regional center. DDS establishes contracts with regional centers that include specific, measurable, performance objectives. Every year, DDS reviews each regional center’s performance data for compliance with their contracts and posts them on their website.
DDS highlighted provisions added to contracts with regional centers in written testimony to The Little Hoover Committee. The following are recent changes and are the most pertinent to this bill:
- Added language requiring regional centers to review and provide, at minimum, annual training to all board members regarding the board’s approved Whistleblower Policy and Conflict of Interest Policy;
- Added language requiring that either a board-approved policy or bylaws must describe: the roles and responsibilities of the board in setting policy and overall governance and the executive director in day-to-day operations; and the selection, training and monitoring of facilitators who will support board members to ensure maximum understanding and participation in carrying out their roles and responsibilities; and,
- Added language requiring regional centers to report: caseload ratio data by October 10th, and, monthly, specified information for whom the Director of DDS is conservator and conservatorship responsibilities have been delegated to the regional center.
Because regional centers are private nonprofits, DDS has limited ability, but not none, to take corrective action. If DDS finds that a regional center is not complying with its contractual obligations, DDS may issue a letter of noncompliance and establish a corrective action plan for the regional center. If the regional center cannot comply with the corrective action plan, DDS has the power to terminate the regional center’s contract. In accordance with specific provisions of the Lanterman Act, DDS can directly operate a regional center for 120 days while it contracts with a new Board to operate the regional center.
When there is a complaint that a regional center, developmental center, or a provider has violated or improperly withheld a right, current law allows the consumer or any representative acting on their behalf to file a complaint with the regional center’s director. The regional center’s director must investigate and provide a written response within 20 working days. A complainant can then appeal within 25 more working days to DDS and DDS then has 45 days to respond. There is no appeal process after it has reached the DDS level.
The State Auditor found that each regional center they examined exceeded this required timeline and DDS has not taken action to remedy this problem as of June 2022. Two out of the three regional centers examined also failed to notify consumers of their rights to file complaints.
This bill makes a number of changes to regional center governance and operations in an effort, according to proponents of this measure, to increase transparency and accountability as well as encourage equity gaps to shrink disparities. This bill revises the standards and procedures for regional center governance such as more limits on board members’ terms of service, a more open board nominating process, and more standardized training for board members to be conducted by DDS instead of the regional center. This bill also requires that complaints are made to DDS and a decision must be issued within 30 days instead of the current 45 days. DDS would also have to post, on a quarterly basis, all complaints received on their internet website with redacted personal information.
Regional center services. The 21 regional centers serve approximately 370,000 consumers, providing services such as: Information and referral; assessment and diagnosis; counseling; lifelong individualized planning and service coordination; purchase of necessary services included in the IPP; resource development; outreach; assistance in finding and using community and other resources; advocacy for the protection of legal, civil and service rights; early intervention services for at risk infants and their families; genetic counseling; family support; planning, placement, and monitoring for 24-hour out-of-home care; training and educational opportunities for individuals and families; and, community education about developmental disabilities. Regional centers services vary at each location. One location might offer one program and the next might offer what they consider an alternative or nothing comparable. Geographically, regional centers’ spending also varies. For continuity of care, it makes it difficult for eligible consumers to move from one regional center to another. It is unclear why the services vary so widely.
This bill requires DDS to establish a uniform set of services for all regional centers to provide uniformity, consistency and cost-effective delivery of services.
Vendorization process. Service providers must be vendored by a regional center before they can provide and be reimbursed for services. DDS and regional centers use the term “vendorization” to describe the entire approval process involved in preparing to provide services to regional center consumers. Typically, this process also often involves obtaining licenses or approvals from other state and local agencies prior to becoming a vendor, but starts at the regional center.
According to DDS, vendorization is the process for identification, selection, and utilization of service providers based on the qualifications and other requirements necessary in order to provide the services. The vendorization process allows regional centers to verify, prior to the provision of services to consumers, that an applicant meets all of the requirements and standards specified in regulations. Applicants who meet the specified requirements and standards are assigned a service code and a unique vendor identification number.
Service providers are vendored by the regional center in whose catchment area the service is located, known as the vendoring regional center. The vendoring regional center is responsible for ensuring that the applicant meets licensing and Title 17 requirements for vendorization, determining the appropriate vendor category for the service to be provided, and approving or disapproving vendorization based upon their review of the documentation submitted by the applicant.
Once a potential service provider has obtained all necessary licenses, submitted a complete application and all necessary documentation to the vendoring regional center, the regional center has 45 days to approve or disapprove vendorization.
DDS reported at The Little Hoover Commission public meetings that stakeholders have expressed frustration with the difference in how services are provided between regional centers. DDS also reported the department has already undertaken standardization efforts.
This bill will require DDS and stakeholders to review the current vendorization process and create streamlined uniform processes for all regional centers. Further, the bill states legislative intent that if approved by one regional center, then the vendor should be considered approved by all other regional centers.
Payer of Last Resort. Under the Lanterman Act, regional centers are considered the “payer of last resort,” meaning, individuals and families must first exhaust all other “generic resources” available to them as outlined in existing law above, including funds from state and federal programs and private insurance before regional centers will purchase a requested service. Regional centers are tasked with coordinating services which may be service providers or vendors or within the regional center or might be with other public entities such as school districts and transportation agencies, and from other state and federal programs. Further, enacted as a cost saving measure during the Great Recession, in order to get services paid for by the regional center, consumers must prove denial and provide proof that an administrative appeal was being pursued. Because of these rules, consumers report significant hurdles to accessing services in a timely manner.
This bill significantly revises the current requirements around payer of last resort and purchasing of generic services by only permitting a regional center to request the consumer seek services through state and federal programs or private insurance if it is documented in the IPP with detailed instruction on pursuing the service. Further, this bill would require that the regional center would have to provide the services if this request was denied or if the entity does not provide the requested service within 45 days from the date of the request, or 15 days after the statutory or regulatory time limit.
Individual Program Plan. IPPs are guiding services provided to people with developmental disabilities and are outlined in a person-centered IPP, which is developed by a series of planning discussions and interactions with the IPP team—including, among other individuals, the consumer, their legally authorized representative, and one or more regional center representatives—and is based on the consumer’s needs and choices. The team helps determines a “preferred future” by identifying a preferred place to live, favorite people with whom to socialize, and preferred types of daily activities, including preferred jobs.
The Lanterman Act requires that the IPP promote community integration and maximize opportunities for each consumer to develop relationships, be part of community life, increase control over their life, and acquire increasingly positive roles in the community. The IPP must give the highest preference to those services and supports that allow minors to live with their families and adults to live as independently as possible in the community.
The recommendations set forth in each IPP are the foundation for each individual’s care as it guides services received, eligibility for services, and can help assist in the quality of life for that individual. Each regional center operates independently as described above. As such, the development of each IPP varies in forms and specific processes used; however, the general guiding steps are similar and are as follows: Once an individual or their representative contacts a regional center there is an initial basic intake and then the family will wait up to 60 days for an assessment. Preceding the diagnosis and eligibility determination, an IPP meeting will take place to determine services needed and desired. The IPP can take multiple meetings or discussions until a plan is settled on. Federal law dictates that this plan is to be renewed annually, and should be determined by the guiding rules stated above. However, families can request an IPP meeting at any time.
In November 2021, a coalition of disability rights advocates released a report titled, Unfair Hearings: How People with Intellectual & Developmental Disabilities Lack Access to Justice in California and the report found that 90% of all survey respondents reported at least one problem with the IPP process, with the most common complaint being that no one authorized to make a decision on behalf of the regional center attended their IPP; the informal dispute resolution process does not encourage swift and equitable solution to disagreements; belief that the fair hearing system magnifies systemic inequalities and is inaccessible, opaque, and biased; 72% of fair hearings are withdrawn, likely showing that many individuals and families give up because of the complexities of the process and the inability to hire a lawyer; and people served win, or partially win, fewer than 5% of cases filed.
This bill would standardize the IPP format among all regional centers. This bill also would require assessments to be done within 30 days of the request, or 60 days within good cause, and services must be authorized within seven days of service recommendation. If the regional center will not meet this timeline, then they must provide notice to the consumer and DDS. Further, this bill would require the regional center to make a referral within seven days.
History of the Self-Determination Program. The concept of facilitating a way for individuals with developmental disabilities to choose their own services and supports, rather than be prescribed a list of customized services began in the mid-1990s. According to a 2007 Robert Wood Johnson Foundation report, the growing move toward de-institutionalization and the home and community-based waivers associated with that move allowed states to serve more people. However, most states did not have the resources to meet the long-term care needs of everyone who sought help.
The foundation created a “Self-Determination for Persons with Developmental Disabilities Program” in 1996 to help 18 states implement a more cost-effective system, while simultaneously giving consumers and their families more choice in determining the services they receive. The program – inspired by the success of a 1993 self-determination grant that the foundation gave to the state of New Hampshire – authorized grant funding of up to $5 million nationwide. While each program was unique, they had common tenets including person-centered planning, an independent support broker, individual budgets and a designated fiscal intermediary.
The state's efforts to provide a self-determination option to consumers in the developmental services system began with what were intended to be three-year pilot projects launched at five regional centers in January 1999, and was subsequently reauthorized by the Legislature through 2004. A subsequent report to the Legislature showed that the participants were happy and had experienced more freedom and responsibility in controlling the direction of their services and their life choices. The report also indicated that good self-determination practices required intensive person-centered planning, collaboration, and follow-along support.
The 2005-06 Budget Act included a new Self-Directed Services Program, which was intended to expand the original pilot program statewide, contingent upon approval of a federal waiver for self-directed services. The waiver application was submitted in 2008, but was subsequently stalled when CMS invoked rules that would have required a redesign of the state's payment structure for developmental services; DDS would have had to assume responsibility for paying providers directly rather than allowing the regional centers to serve as fiscal intermediaries. Consequently, CMS never approved the Self-Directed Services waiver, and the program was never implemented. With the renewal of California's principal Home and Community Based Services (HCBS) waiver in 2012, CMS redefined DDS as an Organized Health Care System, thereby allowing the state to continue to pay approved service providers through the regional centers rather than requiring direct payment from DDS.
As part of the 2009-10 Budget Act, which included the suspension of various non-medical regional center services, the Legislature approved the development of an “Individual Choice Budget”; another attempt to provide individual consumers and their families increased flexibility in access to services, including those that had been suspended. Although DDS convened a budget advisory group to discuss what the Individual Choice Budget would entail, it was never implemented, as DDS was not able to certify that the Individual Choice Budget would result in the savings target proposed in the law.
The Self-Determination Program Today. After a long history of working toward a Self-Determination Program, in 2013, SB 468 (Emmerson), Chapter 683, Statutes of 2013, was enacted and established a statewide “Self-Determination Program” for individuals with developmental disabilities contingent upon funding.
SB 468 established five principles of self-determination: 1) Freedom, which includes the ability of adults with developmental disabilities to exercise the same rights as all citizens; to establish, with freely chosen supporters, family and friends, where they want to live, with whom they want to live, how their time will be occupied, and who supports them; and, for families, to have the freedom to receive unbiased assistance of their own choosing when developing a plan and to select all personnel and supports to further the life goals of a minor child; 2) Authority, which includes the ability of a person with a disability or family, to control a certain sum of dollars in order to purchase services and supports of their choosing; 3) Support, which includes the ability to arrange resources and personnel, both formal and informal, that will assist a person with a disability to live a life in their community that is rich in community participation and contributions; 4) Responsibility, which includes the ability of participants to take responsibility for decisions in their own lives and to be accountable for the use of public dollars, and to accept a valued role in their community through, for example, competitive employment, organizational affiliations, spiritual development, and general caring of others in their community; and 5) Confirmation, which includes confirmation of the critical role of participants and their families in making decisions in their own lives and designing and operating the system that they rely on.
Any eligible regional center consumer is eligible to participate in the program on a voluntary basis and can register through their regional center. Regional center individuals who would like to participate in the Self-Determination Program are required to attend a Self-Determination Program Orientation session. After the IPP is developed which can be in consultation with the regional center coordinator or an independent facilitator, an individual then must request a budget meeting where a 12-month budget is determined and a spending plan based on the IPP needs and goals. Then, a financial management service and payer model is selected. The individual or their representative can then begin hiring service providers.
In 2018, CMS approved the Self-Determination Program waiver and 2,500 individuals were selected in 2018, and then a second set of participants again one year later were selected. The 2020-21 Annual Budget included $4.4 million total funds ($3.1 million General Fund) ongoing to support administration of the Self-Determination Program. As of July 1, 2021, the Self-Determination Program is available to all eligible individuals receiving services from a regional center. While enrollment has steadily increased since the full rollout, the enrollment broken down into racial and ethnicity demographics are not proportionate.
The 2021-22 Budget provided money to establish the following to increase service access and equity, and reduce disparities:
- An Office of the Self-Determination Program Ombudsperson within the department to provide information and assist regional center consumers and their families in understanding their rights under the self-determination program;
- Participant Choice Specialists to provide timely transition to program participation and access to regional center staff; and,
- Enhanced Transition Support Services for individuals and their families who need greater assistance in transitioning to the Self-Determination Program.
- An Office of the Self-Determination Program Ombudsperson within the department to provide information and assist regional center consumers and their families in understanding their rights under the self-determination program;
The Legislative Analyst Office (LAO)’s 2023-24 Budget report on DDS reports that “white consumers comprise a plurality of [Self-Determination Program] participants (45 percent), despite making up only 30 percent of all DDS consumers. By comparison, Latino consumers comprise only 23 percent of [Self-Determination Program] participants, but 40 percent of all DDS consumers.”
This bill builds upon past the Self-Determination Program efforts by requiring regional centers to inform individuals about the Self-Determination Program during request for assistance and then again during the IPP meetings. This bill will also require documentation from coordinators indicating if the individual is interested and if they are not interested, a reason for not wanting to participate. Furthermore, the regional center must provide information within five days of a consumer requesting information about the Self-Determination Program.
Ongoing racial disparities in developmental services. There is a longstanding documentation about disparities in the amount of spending on services amongst racial/ethnic groups. According to DDS, within the regional center system, 24% of individuals served speak a language other than English and 72% of all consumers served by DDS are non-white; however, studies consistently find that communities of color are less likely to receive regional center services, and receive lower than average per capita purchase of service compared to White individuals. Several DDS initiatives are currently underway; these initiatives have the goal of improving language access, in addition to reducing disparities within the developmental services system more broadly.
Beginning in 2011-12, state law required all regional centers to annually publish data on the amount spent on services for consumers disaggregated by the race/ethnicity of these consumers. These data consistently have shown large disparities in the average amounts spent among these groups. In particular, spending for Hispanic/Latino consumers is about half that for White consumers on average. Since 2016-17, the state has invested $11 million annually for equity grants. In 2021-22, DDS was required to contract with a research entity to evaluate the effectiveness of the plan; this research has not been published yet. The existing and available data has not shown much change. In some instances, it has even gotten worse. The Inland Empire Regional Center reported that in “Fiscal year 2021/2022 data shows that disparity gaps increased across all clients regardless of ethnicity, age, or diagnosis.”
In the same 2023-23 budget report by the LAO, the LAO points out that one possible reason the ongoing $11 million per budget year might not be moving the needle is because there is not an understanding of what is causing the disparities. The LAO writes, “Although the Administration has pointed to some factors which explain a share of the overall disparities (most notably, that Latino/Hispanic consumers are more likely than white consumers to live with their parents and thus consume fewer residential services), to date, no attempt has been made to document comprehensively the drivers of disparities and to quantify their likely effects.”
This bill adds more reporting-specific requirements. Under this bill, DDS must submit an annual report with statewide and regional center data, broken down by qualifying disability category, race or ethnicity, and age categories with the number of consumers for whom health and safety waivers have been requested, and granted. As well as the number of days elapsed between the date on which DDS received the health and safety waiver request worksheet from the service provider and the date the service provider was notified of the outcome.
Author’s Statement: According to the Author, “Regional centers play a critical role in California’s developmental disability system by providing assessments, determining eligibility, and coordinating the services for those with intellectual and developmental disabilities. Despite California’s network of centers that serve nearly 400,000 individuals, numerous issues plague the system, including a lack of transparency, accountability, and disparities in the services provided. Not only has this undermined confidence in California’s developmental disability system, but it has failed to serve the Californians that need these services most. [This bill], the Disability Equity & Accountability Act, enacts several reforms to help ensure that all people, regardless of their race or ethnicity or where they live, receive equitable access to services within the regional center system and that all regional centers offer and provide a consistent and common set of services and that the services are delivered in a timely way. It is time that we provide accountability, transparency, and fairness to Californians with disabilities and their families.”
Equity Implications: Individuals living with developmental disabilities rely on services from regional centers to live independently and effectively integrate into the community. As outlined above, regional centers are severely underperforming for years which is having an adverse effect on the population who relies on these services. While some of the issues can be traced back to cost saving measures implemented during the Great Recession, the impact has been profound on the community. There is clear inequity between different race and ethnicities as well geographically that is not improving despite grants issued over the last seven years. Regional centers have a duty to offer equitable services and close the gap.
Although unclear the best way to achieve equity, the spending data shows a clear inequity on services provided. For almost a decade, heightened attention has been given to disparities in regional center spending and service provision; data from DDS indicate that, statewide, per capita spending for services for a Latino consumer was $12,152 in 2021 compared to $28,143 for a White consumer. In 2015, statewide data showed that Latino consumers utilize services for which they are authorized at a lower rate (76.6%) than White consumers (82.7%).
Policy Considerations: This bill makes a number of sweeping changes and reforms to the developmental services system through DDS and the regional centers by trying to address transparency and oversight, close the equity gap, improve overall timeliness of access, and consistency of services. Over the past few years and after multiple calls for oversight, DDS began implementing changes to address issues raised at oversight hearings as described above. Many of the changes, but not all, DDS is currently undergoing is noted above. The changes include undergoing initiatives to standardize data collection, IPP forms and processes, and vendorization. These efforts are ongoing and in some cases in the middle of policy changes using technological systems and data collection. This bill might cause some of these efforts to halt and in some cases, force projects to begin at phase 1 despite similar desired objectives from DDS and stakeholders. Should this measure move forward, the author should continue to work with this committee, interested stakeholders, and DDS to determine how to best combine the efforts of this bill with current ongoing efforts so the laudable goals of this bill are not inadvertently and unnecessarily slowed down. It is in the best interest of the consumers of developmental services for all interested parties to work on a reform that can implemented quickly, efficiently, and with the best results.
Double referral: This bill pass out of the Assembly Judiciary Committee on April 11, 2023, with an 11-0 vote.
RELATED AND PRIOR LEGISLATION:
AB 649 (Wilson) of the current legislative session, would permit regional centers to purchase services that would otherwise be available from other specified means when a consumer or a consumer’s representative chooses not to pursue coverage despite eligibility. AB 649 is pending before this Committee and is set to be heard on April 18, 2023.
AB 1957 (Wilson), Chapter 314, Statutes of 2022, added additional data points to the set of data that DDS and regional centers must report. These additional data mostly relate to services that were cut during the pandemic and recently restored, including social recreation, camping, educational services, and nonmedical therapies such as art, dance, and music. AB 1957 also added untimely translations of an IPP in a threshold language to be included in the set of data.
AB 1 X2 (Thurmond), Chapter 3, Statutes of 2016, authorized the Service Access and Equity grant program through which $11 million in ongoing General Fund resources for DDS was provided to assist regional centers in reducing purchase of service disparities.
SB 468 (Emmerson), Chapter 683, Statutes of 2013, see comments above.
AB 1244 (Chesbro) of 2011, would have created a self-determination program to provide individuals with a single, capitated funding allocation they may use to purchase services that support goals identified in their IPP. AB 1244 failed passage in the Senate Human Services Committee.
AB 9 X4 (Evans), Chapter 9, Statutes of 2009, 4th Extraordinary Session, created an option for the individual choice budget, which allowed for the purchase of otherwise suspended services but required savings of $35.1 million. AB 9 X4 has not been implemented.
AB 131 (Committee on Budget), Chapter 80 Statutes of 2005, established a self-directed services option statewide, contingent upon approval of a federal waiver. A waiver was never obtained, and it has not been implemented.
SB 1038 (Thompson), Chapter 1043, Statutes of 1998, authorized the creation of pilot projects for self-determination at three regional centers. Two other regional centers also created independent self-determination pilots under an alternative service delivery model, bringing to five the number of regional centers engaged in the pilot.
REGISTERED SUPPORT / OPPOSITION:
Support
Disability Voices United (UNREG) (Sponsor)
Autism Support Community
Disability Rights California
Down Syndrome Association of Santa Barbara County
Integrated Community Collaborative
Parents Helping Parents
Pragnya
326 Private Citizens
Opposition
None on file
Analysis Prepared by: Alexandria Smith / HUM. S. / (916) 319-2089
Date of Hearing: April 11, 2023
ASSEMBLY COMMITTEE ON JUDICIARY
Brian Maienschein, Chair
ABPCA Bill Id:AB 1147
Author:(Addis) – As Amended Ver:March 27, 2023
PROPOSED CONSENT (As Proposed to be Amended, with Amendments to be taken in the Assembly Committee on Human Services)
SUBJECT: Disability Equity and Accountability Act of 2023
KEY ISSUES:
- SHOULD REGIONAL CENTERS, WHICH ARE FUNDED BY THE PUBLIC, OPERATE AS QUASI-GOVERNMENTAL AGENCIES, AND PERFORM UNIQUELY GOVERNMENT FUNCTIONS, BE SUBJECT TO THE CALIFORNIA PUBLIC RECORDS ACT?
- SHOULD APPLICANTS AND RECIPIENTS OF SERVICES FROM REGIONAL CENTERS HAVE THE RIGHT TO OBTAIN RECORDS ABOUT THEMSELVES UPON REQUEST, UNLESS DISCLOSURE IS PROHIBITED BY LAW?
SYNOPSIS
The Lanterman Developmental Disabilities Act (Act) directs the processes and structures through which individuals with developmental disabilities can access supports and services to which they are entitled. Ensuring individuals’ access to these services relies on collaboration between various institutions, including regional centers which connect consumers with services, the Department of Developmental Services (DDS), which helps develop the individual program plan (IPP) (described further below), and the Office of Administrative Hearings, which contracts with DDS to provide “fair hearings” in the event of a disagreement regarding services provided pursuant to an IPP. While the Act is intended to encourage participation in the development of IPPs and promote access to services available through DDS, there are concerns that certain communities, particularly communities of color and low-income communities, are unable to effectively advocate for access to those services.
This bill, co-sponsored by Disability Voices United and Integrated Community Collaborative, proposes many important changes to the Act. Named the Disability Equity & Accountability Act, the bill enacts several reforms to help ensure that all people, regardless of their race or ethnicity or where they live, receive equitable access to services within the regional center system and that all regional centers offer and provide a consistent and common set of services and that the services are delivered in a timely way. However, the vast majority of these provisions are outside the jurisdiction of this Committee. Therefore, the analysis focuses on those changes to the law which are within the Committee’s jurisdiction – specifically its provision that deems records of a regional center to be public records, the disclosure of which are governed by the California Public Records Act (CPRA), and another provision that refers to the bill’s CPRA provision and gives applicants and recipients of services from regional centers the right to obtain records regarding themselves.
The bill would make records of regional centers subject to the CPRA, notwithstanding the fact that regional centers are private non-profit entities, not government agencies that are subject to the CPRA under state law. Such a provision is not unprecedented in the law, and given that regional centers are quasi-governmental entities, this provision furthers both the bill’s goal of providing accountability, transparency, and fairness to Californians with disabilities and their families, as well as the Legislature’s goals of enacting the CPRA.
The author proposes minor amendments to one of these provisions, clarifying that notwithstanding any privacy laws, a consumer or their representative is entitled to obtain records regarding the consumer upon request, unless disclosure is prohibited by law. The amendments are incorporated in the Summary, below, and explained in the analysis, but will be taken in the next committee. In addition to the co-sponsors, the bill is supported by Autism Support Community and Pragnya. It has no opposition on file. Should the bill pass this Committee, it will be referred to the Assembly Committee on Human Services, the policy committee with primary jurisdiction over the bill.
SUMMARY: Seeks to address and prevent inequities in the crucial services provided by regional centers to vulnerable Californians by enacting significant reforms at regional centers to ensure proper equity, accountability, and transparency for underserved Californians; most relevant to this Committee, deems records of regional centers to be public records governed by the California Public Records Act (CPRA). Specifically, this bill:
- On behalf of the Legislature finds and declares as follows:
- Recent reports and hearings by the California State Auditor, the Little Hoover Commission, and advocacy organizations have found that California’s service system for the over 400,000 children and adults with intellectual and developmental disabilities through the Lanterman Act, as overseen by the State Department of Developmental Services, which contracts with 21 regional centers, is failing in significant ways to deliver critical, adequate, and timely services to individuals and families. The result is that individuals and families, particularly those of color, are unable to timely access services and supports, resulting in barriers to their living independent, productive, and integrated lives in their communities.
- California’s developmental disability service system is plagued with racial, ethnic, and geographic disparities that can dramatically impact the essential services received by children and adults with developmental disabilities. Systemic inequities and discrimination within California’s 21 regional centers broaden the gap between inclusive possibilities and segregated limitations. Data show Latinos are most negatively impacted by these disparities, but people who are clients of the lowest-performing regional centers are also significantly affected.
- California spends nearly $13,000,000,000 annually on the administration and delivery of developmental services, but lacks a transparent, common, integrated, and coordinated model for the delivery and measurement of services throughout the 21 regional centers, resulting in poor outcomes, poor satisfaction levels by consumers and families, and disparate levels of available services and performance expectations.
- The delivery of services through 21 separate private nonprofit regional centers with separate boards, funding, and delivery models was originally intended to ensure that the delivery of services could be more effectively delivered through nonstate entities. However, with the subsequent caseload and budget growth since the enactment of the Lanterman Act, local administration has become more disparate and less accountable. Boards of directors are untrained and are not providing the oversight needed of the regional centers. Stronger state oversight of regional centers by the State Department of Developmental Services is essential to ensure that services are equitably delivered, performance and outcomes are uniformly measured and reported, and the system is transparent and accountable to individuals and families.
- The department’s system lacks a statewide automated technology system for the delivery of services to persons with intellectual and developmental disabilities and, as a result, the current program is constrained by disparate automation systems, inadequate documentation, the lack of open system architecture, insufficient data to support administration of the system, and the lack of data to support program improvements for improving the quality of life outcomes through new service delivery methods.
- Statewide uniformity of service delivery practices and procedures is essential to an effective program and to support necessary oversight and research for ongoing program improvements.
- The department’s technical infrastructure is over 40 years old. The lack of a statewide automation system does not meet current program needs and significantly contributes to the racial and geographic disparities in the delivery of services. California currently lacks clear and consistent service delivery outcomes for individuals with intellectual and developmental disabilities that sets high expectations for their quality of life, and must develop a system for measuring and quantifying the value of service delivery outcomes.
- A previous effort to develop an intellectual and developmental disabilities (IDD) program technology system failed. As a result, the department and regional centers maintain a patchwork of at least three case management and fiscal systems that are not integrated and six legacy case management automation systems that lack integration, have dissimilar data sources, and are technically outdated.
- In the 2021–22 annual budget the Legislature appropriated $6,000,000 to the State Department of Developmental Services for planning purposes related to the implementation of a uniform fiscal system and consumer electronic records management system. The department has not developed a vision or scope for a proposed system development approach.
- States that it is the intent of the Legislature in enacting the bill to do all of the following:
- Ensure that racial, ethnic, and geographic service disparities be systemically addressed and eliminated and that all people, regardless of their race or ethnicity or where they live, receive equitable access to services within the regional center system.
- Ensure that all regional centers offer and provide a consistent and common set of services and that the services are delivered in a timely way.
- Ensure that the delivery of all services and supports comply with federal law and guidance and are responsive to the needs and choices of beneficiaries receiving home- and community-based services, are person centered and strengths based, have high expectations for interdependence, self-direction, and competitive, integrated employment, provide support coordination to assist with a community-supported life, and achieve a more consistent and coordinated approach to the administration of policies and procedures across the state.
- Provide the department with new tools for holding regional centers and service providers accountable through the development of a standardized and coordinated set of performance measures and related standards that establish targets and standards above which a regional center may receive incentives for improved performance, and a separate set of standards that require corrective action.
- Improve regional center governance by establishing new standards and procedures for regional center governing boards to ensure they can more effectively represent the communities they serve by providing them with greater independence and protection from regional center retaliation.
- Require the State Department of Developmental Services (DSS) to develop a written project charter for the planning and development of a uniform statewide automation system that serves as a foundation document for the system development, which includes project guiding principles, scope, strategies and approach, and project governance, in order to provide transparency to the Legislature and the public on the system development as has been used with other statewide system development.
- Provides that a regional center with which the department maintains a contract shall be subject to the CPRA.
- Provides that notwithstanding any section of existing law that makes information and records obtained in the course of providing services pursuant to the Lanterman Developmental Disabilities Act (Act) confidential, access to records regarding an applicant for, or recipient of, services shall be provided to the applicant, recipient, or to their authorized representative, including the person appointed as a developmental services decisionmaker, upon request, for purposes including, but not limited to, the appeal process under the Act, unless disclosure of the record is prohibited by law.
- Adopts standardized planning criteria to ensure that people with developmental disabilities receive equitable case management regardless of their race, ethnicity, spoken language, or geographic location.
- Adopts mandatory timelines, including for the start of services after referral to a provider agency; the reporting of necessary assessments and the resulting authorization of services; and the response of regional center staff to all calls and emails from clients.
- Establishes a minimum set of specific services, including supported living services that all regional centers must provide.
- Provides DDS with new tools for holding regional centers and service providers accountable through a standardized set of performance measures.
- Establishes new procedures for governing boards to ensure they can more effectively represent the communities.
- Develops an anti-nepotism policy for regional center senior staff.
- Ensures that the records system integrate performance standards and metrics to address racial and ethnic disparities, support evidence-based research and improve accountability.
- Requires DDS and regional centers to collect standardized racial and ethnicity data aligned with federal census data categories.
EXISTING LAW:
- Establishes the 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, at each stage of life, and to support their integration into the mainstream life of the community. (Welfare & Institutions Code Section 4500 et seq. Unless noted otherwise, all other references are to the Welfare and Institutions Code.)
- Establishes a system of nonprofit regional centers, overseen by DDS, to provide fixed points of contact in the community for all persons with developmental disabilities and their families and to coordinate services and supports best suited to them throughout their lifetime. (Section 4620.)
- Establishes an Individual Program Plan (IPP) as the process to ensure that services and supports are customized to meet the needs of consumers who are served by regional centers for the purpose of alleviating a developmental disability or toward the social, personal, physical, or economic habilitation or rehabilitation of an individual with a developmental disability, or toward the achievement and maintenance of independent, productive, and normal lives. (Section 4512 (b).)
- Requires decisions concerning the consumer’s goals, objectives, and services and supports included in their IPP to be made by agreement between the regional center representative and the consumer or, when appropriate, the consumer’s parents, legal guardian, conservator, or authorized representative, at the program plan meeting. (Section 4646 (d).)
- Makes all information and records obtained in the course of providing services under the Act, to either voluntary or involuntary recipients of services confidential. (Section 5328 (a).)
- Provides that the people have the right of access to information concerning the conduct of the people’s business and, therefore, the writings of public officials and agencies shall be open to public scrutiny. Specifies that any law or rule that limits the public right of access shall be adopted with findings demonstrating the interest protected by the limitation. (California Constitution, art. I, Section 3.)
- Provides that, in enacting the CPRA, the Legislature, mindful of the right of individuals to privacy, finds and declares that access to information concerning the conduct of the people’s business is a fundamental and necessary right of every person in this state. (Government Code Section 7921.000.)
- Provides that public records are open to inspection at all times during the office hours of a state or local agency and every person has a right to inspect any public record, exempted as otherwise provided; and that any reasonably segregable portion of a record shall be available for inspection by any person requesting the record after deletion of the portions that are exempted by law. (Government Code Section 7922.525.)
- Gives the public the right to obtain a copy of any public record within ten days or, in specified “unusual circumstances,” within 14 days of the ten-day period. (Government Code Section 7922.535.)
- Allows an agency to withhold from public disclosure, “Personnel, medical, or similar files, the disclosure of which would constitute an unwarranted invasion of personal privacy.” (Government Code Section 7927.700.)
- Holds in case law, that certain information supplied by individual applicants to a licensing agency may under certain circumstances entail a substantial privacy interest. For example, the records may contain intimate information concerning an applicant's own or his family's medical or psychological history. In such special cases, the confidential information may be deleted. (CBS, Inc. v. Block (1986) 42 Cal.3d 646, 655.)
- Requires a public agency to justify withholding any record by demonstrating that the record in question is exempt under express provisions of this division, or that on the facts of the particular case the public interest served by not disclosing the record clearly outweighs the public interest served by disclosure of the record. (Government Code Section 7922.000.)
- Clarifies that the CPRA does not prevent an agency from opening its records concerning the administration of the agency to public inspection, unless disclosure is otherwise prohibited by law. (Government Code Section 7921.500.)
FISCAL EFFECT: As currently in print this bill is keyed fiscal.
COMMENTS: The Lanterman Developmental Disabilities Act (Act) guides the provision of services and supports for Californians with developmental disabilities. Ensuring access to these services requires collaboration between various institutions, including regional centers which connect consumers with services; the Department of Developmental Services (DDS), which helps develop the individual program plan (IPP) (described further below); and the Office of Administrative Hearings (OAH), which contracts with DDS to provide “fair hearings” in the event of a disagreement regarding services provided pursuant to an IPP. The Act is intended to encourage participation in the development of IPPs and promote access to services available through regional centers and DDS. However, there are concerns that services are not being provided in an adequate and equitable manner. Certain communities, particularly communities of color and low-income consumers, are unable to effectively obtain and advocate for access to services they urgently need. According to the author:
Despite California’s network of centers that serve nearly 400,000 individuals, numerous issues plague the system, including a lack of transparency, accountability, and disparities in the services provided. Not only has this undermined confidence in California’s developmental disability system, but it has failed to serve the Californians that need these services most. AB 1147, the Disability Equity & Accountability Act, enacts several reforms to help ensure that all people, regardless of their race or ethnicity or where they live, receive equitable access to services within the regional center system and that all regional centers offer and provide a consistent and common set of services and that the services are delivered in a timely way. It is time that we provide accountability, transparency, and fairness to Californians with disabilities and their families.
An overview of the Lanterman Developmental Disabilities Act. The Act, among other provisions, provides that every individual seeking or obtaining services (referred to in the Act as “consumer”) and their family have a right to specified services and to live independently within their communities. The Act defines “developmental disability” as a disability that originates before a person turns 18, is expected to continue indefinitely, and is a significant disability for the individual. Disabilities contemplated by the act include, but are not limited to, epilepsy, autism, or cerebral palsy. DDS helps oversee the provision of the services guaranteed by the Act.
The aim of the Act is to center the consumer throughout the process in order to best ensure they and their families are able to elect which services best support their needs. A consumer’s Individual Program Plan (IPP) is developed with the help of an IPP planning team consisting of regional center representatives, the consumer, and any family or legally authorized representative of the consumer. The goal of the IPP is to develop a description of the consumer’s ideal living situation, including factors such as their preferred place to live, other people that they wish to interact with, their preferred work settings, and their other daily activities. Ultimately, the IPP is used as a tool to identify which of DDS’s various services and supports are most appropriate for a consumer. Services are then provided to the consumer through regional service centers. Regional centers play a critical role in California’s developmental disability system by providing assessments, determining eligibility, and coordinating the services for those with intellectual and developmental disabilities. In the event that a regional center makes a decision regarding the provision of services that a consumer or their legal representative disagrees with, the Act provides various dispute resolution processes to help mitigate the concern, including a fair hearing process.
Recent reports about the adequacy and fairness of regional center operations. Despite California’s network of centers that serve nearly 400,000 individuals, numerous issues plague the system according to a number of recent reports. These issues include a lack of transparency, accountability, consistency, and equity in the services they help to provide.
In June 2022, the California State Auditor found a number of deficiencies in the developmental disabilities system that negatively impact services, particularly for people of color. The audit of three regional centers, which collectively serve more than 65,000 consumers, found that they have neither sufficient staff nor funding. (Tilden, Michael. Department of Developmental Services; It Has Not Ensured That Regional Centers Have the Necessary Resources to Effectively Serve Californians With Intellectual and Developmental Disabilities, (June 28, 2022) Report 2021-107, available at https://www.auditor.ca.gov/pdfs/factsheets/2021-107.pdf.)
According to the Auditor, “Our audit of DDS and three regional centers highlighted the following:
- For years, most of the State's 21 regional centers have exceeded their service coordinators' maximum caseload ratios. DDS has not adequately addressed funding issues that make it difficult for regional centers to meet caseload ratios.
- DDS has not ensured that regional centers monitor vendors, and neither DDS nor the regional centers monitor whether consumers experience difficulties in accessing services.
- DDS has not provided adequate oversight of regional centers' processes for resolving consumer rights violations. Two of the three regional centers we reviewed did not consistently inform consumers about the process for filing complaints, and all three frequently took too long to investigate complaints.
- DDS should ensure that regional centers make timely decisions on applicants' eligibility for services.”
The Little Hoover Commission held four public hearings on the regional center system in the fall of 2022 to identify the underlying causes of disparities, analyze the current state efforts to address them, and consider how state government can improve the consistency and timeliness of service delivery. The Commission’s report and recommendations are expected in the first quarter of 2023.
In November 2021, a coalition of disability rights advocates released a report that found people with disabilities and their families, especially people of color, encounter numerous barriers in their attempts to enforce their rights under the Lanterman Act. (Unfair Hearings: How People with Intellectual & Developmental Disabilities Lack Access to Justice in California, Disability Rights California, Disability Voices United, Integrated Community Collaborative, Stanford Intellectual and Developmental Disabilities Law and Policy Project (November 2021) accessible at https://law.stanford.edu/publications/unfair-hearings-how-people-with-intellectual-developmental-disabilities-lack-access-to-justice-in-california/.) Among the report’s major findings were that 90% of all survey respondents reported at least one problem with the IPP process, with the most common complaint being that no one authorized to make a decision on behalf of the regional center attended their IPP; the informal dispute resolution process does not encourage swift and equitable solution to disagreements; belief that the fair hearing system magnifies systemic inequalities and is inaccessible, opaque, and biased; 72% of fair hearings are withdrawn, likely showing that many individuals and families give up because of the complexities of the process and the inability to hire a lawyer; and people served win, or partially win, fewer than 5% of cases filed. (Ibid.)
This bill seeks to address and prevent inequities in the crucial services provided by regional centers to vulnerable Californians by enacting significant reforms at regional centers to ensure proper equity, accountability, and transparency for underserved Californians. Named the Disability Equity & Accountability Act, the bill enacts several reforms to help ensure that all people, regardless of their race or ethnicity or where they live, receive equitable access to services within the regional center system and that all regional centers offer and provide a consistent and common set of services and that the services are delivered in a timely way.
Specifically, this bill creates the following:
- Standardized Individual Program Planning (IPP): Adopts standardized planning criteria to ensure that people with developmental disabilities receive equitable case management regardless of their race, ethnicity, spoken language, or geographic location.
- Timely Access to Services and Programs: Adopts mandatory timelines, including for the start of services after referral to a provider agency; the reporting of necessary assessments and the resulting authorization of services; and the response of regional center staff to all calls and emails from clients.
- Availability of Services for All Persons Served by Regional Centers: Establishes a minimum set of specific services, including supported living services that all regional centers must provide.
- Coordinate Statewide Performance Measures: Provides DDS with new tools for holding regional centers and service providers accountable through a standardized set of performance measures.
- Improve Regional Center Governance: Establishes new procedures for governing boards to ensure they can more effectively represent the communities.
- Prevent Conflicts of Interest Within Regional Centers: Develops an anti-nepotism policy for regional center senior staff.
- New Information Technology System: Ensures that the records system integrate performance standards and metrics to address racial and ethnic disparities, support evidence-based research and improve accountability.
- Racial/Ethnic Reporting: Requires DDS and regional centers to collect standardized racial and ethnicity data aligned with federal census data categories.
While these reforms are important and significant, the vast majority fall outside of this Committee’s jurisdiction. Therefore, this analysis will focus on the two issues which are under this Committee’s jurisdiction, specifically (1) its provision that deems records of regional centers to be public records pursuant to the CPRA; and (2) a provision that requires, notwithstanding the CPRA, that records of a consumer to be provided to the consumer upon request for purposes of appeal of a regional center’s decision.
CPRA Provision. The bill would make records of regional centers subject to the CPRA, notwithstanding the fact that regional centers are private non-profit entities. A regional center does not meet the definition of “public agency” (defined in Section 7920.525 (a) of the Government Code to mean, “any state or local agency”) and therefore would not otherwise be subject to the CPRA under state law. Rather, regional centers, according to DDS, are “a statewide network of 21 community-based, non-profit agencies known as regional centers.” (See DDS, Regional Centers, available at https://www.dds.ca.gov/rc/.)
Such a provision—making a non-profit entity subject to the CPRA—is not unprecedented in the law. Charter schools, nonprofit public benefit corporations that operate charter schools in California, are subject to the CPRA. (Education Code Section 47604.1 (b)(2).) In its letter of support, co-sponsor Disability Voices United points out all of the reasons why it is appropriate to do the same for regional centers:
The regional centers were created by the legislature in the Lanterman Act, they perform uniquely government functions, such as determining eligibility for services, negotiating the scope of services, and administratively implementing legislative directives. Regional centers are subject to open meetings rules and their boards of directors are laid out in detail in statute. They are wholly governmentally funded, and DDS is integrally involved with the regional centers’ activities. . . . Like charter schools, regional centers are statutorily created and are publicly funded non-profit corporations under contract to perform core governmental functions.
Given that regional centers, like charter schools, receive public funds and operate as quasi-governmental entities, the bill’s provision applying the CPRA to their records makes sense. It furthers both the bill’s goal of providing accountability, transparency, and fairness to Californians with disabilities and their families, as well as the Legislature’s goals of enacting the CPRA. In enacting the CPRA, “the Legislature, mindful of the right of individuals to privacy, finds and declares that access to information concerning the conduct of the people’s business is a fundamental and necessary right of every person in this state.” (Government Code Section 7921.000.)
Requirement for a regional center to disclose a consumer’s records to the consumer upon request “notwithstanding” the CPRA.
Section 21 of the bill in print proposes to amend Welfare & Institutions Code Section 4726 to read as follows:
4726. Notwithstanding Sections 4639.76 and 5328, access to records shall be provided to an applicant for, or recipient of, services or to their authorized representative, including the person appointed as a developmental services decisionmaker pursuant to Section 319, 361, or 726, for purposes of the appeal process under this chapter.
The new Section 4639.76 of the bill would, as discussed above, make regional centers subject to the CPRA. But under the CPRA, all regional center records will be de facto available to the public and therefore access to regional center records would be presumed to be available to any requester (unless an specific exemption in the CPRA, or another law that made the record in question confidential, applied). Therefore, while it is appropriate to “notwithstand” Section 5328 (which makes all information and records obtained in the course of providing services under the Act, confidential) it may not be necessary or appropriate to “notwithstand” the bill’s CPRA provision in a section of law that is intended to ensure that records about a consumer are provided to the consumer upon request., records shall be provided to an applicant, etc.
On the other hand, the existing law on this matter arguably should be clarified and updated to take account of the bill’s proposed CPRA provision and to ensure that all records about a consumer are provided to the consumer upon request, notwithstanding any confidentiality rules to the contrary.
In order to do so, the author proposes the following clarifying amendment to Section 21 of the bill:
4726. Notwithstanding Sections 4639.76 and Section 5328, any exemption to the California Public Records Act (Division 10 (commencing with Section 7920.000) of Title 1 of the Government Code), or any other law, access to records shall be provided to regarding an applicant for, or recipient of, services shall be provided to the applicant, recipient, or to their authorized representative, including the person appointed as a developmental services decisionmaker pursuant to Section 319, 361, or 726, upon request for purposes including, but not limited to, of the appeal process under this chapter, unless disclosure of the record is prohibited by law.
In order to accommodate the scheduling needs of the Assembly Committee on Human Services, which has primary subject matter jurisdiction over the bill and where this bill will be heard should it pass this Committee, the amendment will be taken in that committee.
ARGUMENTS IN SUPPORT: In its letter of support, co-sponsor Disability Voices United discusses the importance of the bill’s CPRA provision to increase transparency of regional center operations:
One critical component of the bill is to increase transparency of the regional centers by making them subject to California’s Public Records Act (PRA)2 (Section 10 adding WIC section 4639.76). While DDS is subject to the PRA, the 21 regional centers whose annual budget is over $13.6 billion – approximately 90% of all funding for the system – is not. Regional centers are responsible for the administration of case management and contracting for services to persons with developmental disabilities and their families,
Regional centers carry out core governmental functions and the limited statutory disclosure provisions that exist in the Lanterman Act do not provide any significant detail into the operation of regional centers and their service authorization decisions. Without that information, there is a significant gap into the transparency of regional center operations, policy and budgets that make it difficult to identify and track changes in operational policies and practices, generally, and those that disproportionally restrict services to communities of color, specifically.
Advocates and researchers have historically found it extremely difficult to get documents from the regional centers, which assert they are under no legal duty to provide that information. However, there is no reason to not apply the PRA to regional centers.
REGISTERED SUPPORT / OPPOSITION:
Support
Disability Voices United (co-sponsor)
Integrated Community Collaborative (co-sponsor)
Autism Support Community
Disability Rights California
Pragnya
Opposition
None on file
Analysis Prepared by: Alison Merrilees / JUD. / (916) 319-2334
Discussed in Hearing
57SEC
Senate Floor
1MIN
Senate Standing Committee on Appropriations
12MIN
Senate Standing Committee on Judiciary
32MIN
Senate Standing Committee on Human Services
35MIN
Assembly Standing Committee on Human Services
Bill Co-Author(s):
