Bill Text: CA AB1461 | 2013-2014 | Regular Session | Amended
Bill Title: Developmental services.
Spectrum: Partisan Bill (Democrat 16-0)
Status: (Engrossed - Dead) 2014-06-26 - Ordered to inactive file at the request of Senator Corbett. [AB1461 Detail]
Download: California-2013-AB1461-Amended.html
BILL NUMBER: AB 1461 AMENDED
BILL TEXT
AMENDED IN SENATE JUNE 12, 2014
INTRODUCED BY Committee on Budget (Skinner (Chair), Bloom, Campos,
Chesbro, Dababneh, Daly, Dickinson, Gordon, Jones-Sawyer, Mullin,
Muratsuchi, Nazarian, Rodriguez, Stone, Ting, and Weber)
JANUARY 9, 2014
An act relating to the Budget Act of 2014.
An act to amend Section 854.1 of, and to amend, repeal, and add
Section 95014 of, the Government Code, to amend Sections 1502 and
1524 of, to add Article 9.7 (commencing with Section 1567.80) to
Chapter 3 of Division 2 of, and to add and repeal Article 9.5
(commencing with Section 1567.61) of Chapter 3 of Division 2 of, the
Health and Safety Code, and to amend Sections 4418.25, 4418.7,
4474.2, 4474.3, 4514, 4519.6, 4648, 4659.1, 4681.6, 4691.6, 4691.9,
6504.5, and 6509 of, to amend, repeal, and add Section 7505 of, to
add Section 4436 to, to add Article 8 (commencing with Section 4698)
to Chapter 6 of Division 4.5 of, and to add and repeal Article 3.6
(commencing with Section 4684.80) of Chapter 6 of Division
4.5 of, the Welfare and Institutions Code, relating to developmental
services, and making an appropriation therefor, to take effect
immediately, bill related to the budget.
LEGISLATIVE COUNSEL'S DIGEST
AB 1461, as amended, Committee on Budget. Budget Act of
2014. Developmental services.
(1) Existing law, the California Community Care Facilities Act,
provides for the licensing and regulation of community care
facilities, as defined, by the State Department of Social Services. A
violation of the act is a misdemeanor.
This bill would license as a community care facility an enhanced
behavioral supports home, which is a facility certified by the State
Department of Developmental Services and licensed by the State
Department of Social Services as an adult residential facility or a
group home, with a maximum of 4 clients, that provides 24-hour
nonmedical care to individuals with developmental disabilities who
require enhanced behavioral supports, staffing, and supervision in a
homelike setting, and that is eligible for federal Medicaid funding.
The bill would require the State Department of Developmental Services
to establish a pilot program, until January 1, 2020, for the
operation of up to 6 enhanced behavioral supports homes, as
specified, each fiscal year in which the pilot program is in effect
and to the extent funding is available. The bill would require an
enhanced behavioral supports home to be certified by the State
Department of Developmental Services, and its plan of operation
approved by both the State Department of Developmental Services and
the State Department of Social Services prior to being licensed as a
community care facility.
This bill would also include within the definition of a community
care facility a community crisis home. The bill would define a
community crisis home as a facility that has a maximum of 8 clients,
conforms to certain federal regulations, is eligible for federal
Medicaid home and community-based services funding, is certified by
the State Department of Developmental Services, and is licensed by
the State Department of Social Services as an adult residential
facility. A community crisis home would provide 24-hour nonmedical
care to individuals with developmental disabilities receiving
regional center service, in need of crisis intervention services, and
who would otherwise be at risk of admission to the acute crisis
center at Fairview Developmental Center or Sonoma Developmental
Center, an out-of-state placement, a general acute hospital, an acute
psychiatric hospital, or an institution for mental disease.
This bill would require the State Department of Developmental
Services, using community placement plan funds, to establish a
community-based residential option consisting of community crisis
homes, as specified. The bill would authorize the State Department of
Developmental Services to issue a certificate of program approval to
a qualified community crisis home. The bill would also require a
community crisis home to have been issued a certificate of program
approval by the State Department of Developmental Services, and its
plan of operation to have been approved by both the State Department
of Developmental Services and the State Department of Social
Services, prior to licensure by the State Department of Social
Services as a community care facility. The bill would prohibit either
the certificate or the license from being issued until the
publication of emergency regulations by the State Department of
Developmental Services, as provided.
By expanding the definition of a community care facility, this
bill would change the definition of an existing crime, creating a
state-mandated local program.
(2) Existing law establishes the State Department of Developmental
Services and sets forth its powers and duties, including, but not
limited to, the administration of state developmental centers and the
administration and oversight of community programs providing
services to consumers with developmental disabilities and their
families.
This bill would require the department to evaluate enhanced
behavioral supports homes, community crisis homes, and the acute
crisis centers at the Fairview Developmental Center and the Sonoma
Developmental Center, and to provide the evaluations to the budget
committees and appropriate policy committees of the Legislature, as
specified. The bill would require the evaluation for each facility to
include specified information, including, but not limited to,
comparative summary information regarding the characteristics of the
persons served and their immediate past residential settings.
(3) Existing law specifies procedures for the commitment of
persons with developmental disabilities to the department for
purposes of placement and treatment, including, among others, that a
written report be submitted to the court containing a specified
evaluation of the person alleged to have a developmental disability.
Existing law requires that treatment, services, and supports be
provided in natural community settings to the maximum extent
possible, and authorizes the department to contract with regional
centers to provide services and supports to individuals with
developmental disabilities.
Under existing law, those services and supports are contained in
an individual program plan, developed in accordance with prescribed
requirements. Existing law also requires the department to establish
a statewide specialized resource service to reduce reliance on
out-of-state placements and developmental centers and mental health
facilities for which federal funding is not available. Existing law
requires regional centers to complete, and update annually as part of
the individual program planning process for as long as the consumer
resides in the developmental center, a comprehensive assessment of
specified consumers residing in a developmental centers, and requires
that this assessment be provided to the individual program planning
team in order to assist the planning team in determining the least
restrictive environment for the consumer. Under existing law, the
regional center is required to also provide, to the extent
appropriate, relevant information from the statewide specialized
resource service to the individual program planning team. Existing
law requires that the clients' rights advocate for the regional
center be notified of each individual program plan meeting that
includes discussion of the results of the assessment, and authorizes
the advocate to participate in the meeting unless the consumer
objects on his or her own behalf.
This bill would additionally require the regional center to
provide the comprehensive assessment, or updated assessment, and
relevant information from the statewide specialized resource service
to the clients' rights advocate for the regional center and the
superior court with jurisdiction over the consumer's placement at the
developmental center, including the consumer's attorney of record
and other parties known to the regional center, as specified. The
bill would require the comprehensive assessment, or updated
assessment, to be provided to the court as part of the report
described above in specified circumstances. The bill would also
require the regional center to provide a copy of the most recent
comprehensive assessment or updated assessment to notify the clients'
rights advocate of the time, date, and location of each individual
program plan meeting that includes discussion of the results of the
comprehensive assessment and updates to that assessment as soon as
practicable following the completion of the comprehensive assessment
or update and not less than 30 calendar days prior to the meeting.
(4) Existing law requires the confidentiality of all information
and records obtained in the course of providing intake, assessment,
and services pursuant to specified provisions of existing law to
persons with developmental disabilities and authorizes disclosure in
certain cases, including to the courts and designated parties as part
of a regional center report or assessment in compliance with
specified statutory or regulatory requirements.
This bill would authorize a regional center to, when a
comprehensive assessment has been conducted or updated pursuant to
specified provisions of existing law, provide the assessment to the
regional center clients' rights advocate.
(5) Existing law requires a regional center to immediately notify
the appropriate regional resource development project, the consumer,
and the consumer's parents, legal guardian, or conservator if the
regional center determines, or is informed by the consumer's parents,
legal guardian, conservator, or authorized representative that the
community placement of a consumer is at risk of failing, and that
admittance to a state developmental center is a likelihood, or the
regional center is notified by a court of a potential admission to a
developmental center.
This bill would additionally require the regional center to notify
the clients' rights advocate for the regional center in the
circumstances described above.
(6) Existing law generally prohibits a regional center from
purchasing new residential services from institutions for mental
disease, including in emergencies when a regional center cannot
locate alternate services to meet the consumer's needs. Existing law
requires a regional center, as soon as possible within 30 days of
admission due to an emergency, to complete an assessment and convene
an individual program plan meeting immediately following the
assessment, to determine the services and supports needed for
stabilization and to develop a plan to transition the consumer from
the facility to the community. Existing law requires the clients'
rights advocate to be notified of each admission and individual
program planning meeting pursuant these provisions and authorizes the
clients' rights advocate to participate in all individual program
planning meetings unless the consumer objects on his or her own
behalf.
This bill would require the notification to the clients' rights
advocate described above to be provided as soon as practicable, but
not less than 7 calendar days prior to the meeting, and require the
notification to include the date, time and location of the meeting.
(7) Existing law, the California Early Intervention Services Act,
provides a statewide system of coordinated, comprehensive,
family-centered, multidisciplinary, and interagency programs that are
responsible for providing appropriate early intervention services
and support to all eligible infants and toddlers, as defined, and
their families. The act requires these services to be provided
pursuant to the existing regional center system under the Lanterman
Developmental Disabilities Service Act, and further requires the
regional centers to comply with that act and its implementing
regulations, as specified.
This bill would, beginning January 1, 2015, revise the definition
of an eligible infant or toddler for purposes of eligibility for
services.
(8) Existing law authorizes a regional center to pay any
applicable copayment or coinsurance for a service or support required
by a consumer's individual program plan if the service is paid for
by the health care service plan or health insurance policy of the
consumer or his or her parent, guardian, or caregiver and, among
other conditions, the family or the consumer, as applicable, has an
annual gross income that does not exceed 400% of the federal poverty
level. Existing law prohibits a regional center from paying health
care service plan or health insurance policy deductibles.
This bill would delete that prohibition against payment of
deductibles and would authorize a regional center to pay any
applicable deductible for a service or support required by a consumer'
s individual program plan if the support or service is paid for by
the health care service plan or health insurance policy of the
consumer or his or her parent, guardian, or caregiver, and other
specified conditions are satisfied.
(9) Existing law requires the department and regional centers to
annually collaborate to determine the most appropriate methods to
collect and compile meaningful data in a uniform manner, as
specified, related to the payment of copayments and coinsurance by
each regional center.
This bill would also require the department and regional centers
to include in that collaboration the most appropriate methods to
collect and compile meaningful data in a uniform manner related to
the payment of deductibles by each regional center.
(10) Existing law prohibits the admission of a person to a
developmental center except under certain circumstances, including
when the person is experiencing an acute crisis and is committed by a
court to the Fairview Developmental Center.
This bill, commencing January 1, 2015, would additionally
authorize the admission of a person to the acute crisis center at
Sonoma Developmental Center upon commitment by a court due to an
acute crisis. The bill would require the acute crisis center at the
Fairview Developmental Center and the acute crisis center at the
Sonoma Developmental Center to each consist of a unit that is
distinct from other residential units in the developmental center and
to each serve no more than 5 residents. The bill would authorize
crisis center residents to participate in day, work, and recreation
programs, and other developmental center facility activities, outside
of the acute crisis unit, when the individual program plan
identifies it is appropriate and consistent with the individual's
treatment plan. The bill would further require the acute crisis
centers to assist the consumer with transitioning back to his or her
residence, as specified.
(11) Existing law details a process for the transition of an
individual from a developmental center to a community living
arrangement, including a requirement that the department provide
followup services to help ensure a smooth transition to the
community. Under existing law, whenever the State Department of
Developmental Services proposes the closure of a developmental
center, the department is required to submit a detailed plan to the
Legislature by a specified date that includes a description of the
services that will no longer be provided by the center and potential
job opportunities for developmental center employees and other
efforts made to mitigate the effect of the closure on employees.
Existing law authorizes the department to operate a facility, provide
employees to assist in the operation of a facility, or provide other
necessary services if the department determines that the activity
will assist in meeting the goal of the orderly closures of specified
developmental centers and requires the department to annually prepare
a report on the use of the department's employees in this regard.
Existing law makes specified public contracting conflict-of-interest
provisions inapplicable to those employees.
This bill would expand those provisions to authorize the
department to operate a facility, provide employees to assist in the
operation of a facility, or provide other necessary services and
supports if the department determines that the activity will assist
in meeting the goal of successfully transitioning developmental
center residents to community living or deflecting the admission of
individuals with developmental disabilities to a developmental
center, an institution for mental disease, an out-of-state placement,
a general acute care hospital, or an acute psychiatric hospital. The
bill would require the department to annually prepare a report on
the use of the department's employees in this regard, and would
exempt those employees from specified public contracting
conflict-of-interest provisions. The bill would also require the
report to include specified recommendations.
(12) Existing law sets forth the rules relating to the liability
of governmental agencies for tort injury caused by the action or
omission of its officers or employees, including the operation of
mental institutions or medical facilities. Existing law defines a
mental institution or medical facility for purposes of those
provisions to include a facility where a public employee provides
services relating to the closure of specified developmental centers.
This bill would expand the definition of a "mental institution" or
"medical facility" for purposes of those provisions to include a
facility where a public employee provides services and supports to
individuals transitioning from a developmental center to the
community or to individuals at risk of admission to a developmental
center, an institution for mental disease, an out-of-state placement,
a general acute care hospital, or an acute psychiatric hospital.
(13) Existing law requires the department to enter into contracts
with private nonprofit corporations to operate regional centers that
provide community services and support for consumers and their
families, including, but not limited to, residential placement.
Existing law sets forth the department's and the regional center's
authority to negotiate provider rates, and sets forth certain
limitations. Existing law authorizes prescribed provider rate
increases and prohibits others.
Existing law, commencing July 1, 2014, increases the state minimum
wage to no less than $9 per hour.
This bill would, notwithstanding existing law, authorize
adjustment in prescribed provider rates commencing July 1, 2014, as
necessary to adjust employee wages to meet the new state minimum wage
law.
The bill would, commencing January 1, 2015, require an increase of
the in-home respite service agency rate schedule and the rates for
personal assistance and supported living services by 5.82%, subject
to funding being specifically appropriated for these purposes, as
specified.
(14) The Budget Act of 2011 appropriated $2,289,463,000 to the
State Department of Developmental Services for regional centers,
payable from the General Fund.
This bill would, notwithstanding any other law, provide that this
appropriation is available for liquidation of encumbrances through
June 30, 2015. The bill would also reappropriate the unencumbered
balance of $13,048,000 of that appropriation for the purposes
provided for in the appropriation and make that amount available for
encumbrance or expenditure until June 30, 2015, and for liquidation
through June 30, 2017.
(15)The California Constitution requires the state to reimburse
local agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
This bill would provide that no reimbursement is required by this
act for a specified reason.
(16) This bill would declare that it is to take effect immediately
as a bill providing for appropriations related to the Budget Bill.
This bill would express the intent of the Legislature to enact
statutory changes relating to the Budget Act of 2014.
Vote: majority. Appropriation: no yes
. Fiscal committee: no yes .
State-mandated local program: no yes .
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 854.1 of the
Government Code is amended to read:
854.1. (a) It is the intent of the Legislature to ensure
continuity of care for clients of Agnews Developmental
Center individuals with developmental disabilities
transitioning from a developmental center to the community and
Lanterman Developmental Center. to prevent
the unnecessary institutionalization and hospitalization of these
individuals.
(b) In the effort to achieve these goals, it is the intent of the
Legislature to seek and implement recommendations that include all of
the following services to retain Agnews and Lanterman
developmental center staff as employees:
(1) Crisis management teams that provide behavioral, medical, and
dental treatment, training, and technical assistance.
(2) Specialized services, including adaptive equipment design and
fabrication, and medical, dental, psychological, and assessment
services.
(3) Staff support in community homes to assist individuals with
behavioral or psychiatric needs.
(c) As used in this chapter, the terms "mental institution" or
"medical facility" also include a developmental services facility.
For the purposes of this chapter "developmental services facility"
means any facility or place where a public employee provides
services and supports to individuals transitioning from a
developmental services relating center
to the closure community or to individuals
with developmental disabilities at risk of Agnews
Developmental Center admission to a developmental
center, an institution for mental disease, an out-of-state placement,
a general acute care hospital, or Lanterman
Developmental Center. an acute psychiatric hospital.
SEC. 2. Section 95014 of the Government
Code is amended to read:
95014. (a) The term "eligible infant or toddler" for the purposes
of this title means infants and toddlers from birth through two
years of age, for whom a need for early intervention services, as
specified in the federal Individuals with Disabilities Education Act
(20 U.S.C. Sec. 1431 et seq.) and applicable regulations, is
documented by means of assessment and evaluation as required in
Sections 95016 and 95018 and who meet one of the following criteria:
(1) Infants and toddlers with a developmental delay in one or more
of the following five areas: cognitive development; physical and
motor development, including vision and hearing; communication
development; social or emotional development; or adaptive
development. Developmentally delayed infants and toddlers are those
who are determined to have a significant difference between the
expected level of development for their age and their current level
of functioning. This determination shall be made by qualified
personnel who are recognized by, or part of, a multidisciplinary
team, including the parents. A significant difference is defined as a
33-percent delay in one developmental area before 24 months of age,
or, at 24 months of age or older, either a delay of 50 percent in one
developmental area or a 33-percent delay in two or more
developmental areas. The age for use in determination of eligibility
for the Early Intervention Program shall be the age of the infant or
toddler on the date of the initial referral to the Early Intervention
Program.
(2) Infants and toddlers with established risk conditions, who are
infants and toddlers with conditions of known etiology or conditions
with established harmful developmental consequences. The conditions
shall be diagnosed by a qualified personnel recognized by, or part
of, a multidisciplinary team, including the parents. The condition
shall be certified as having a high probability of leading to
developmental delay if the delay is not evident at the time of
diagnosis.
(b) Regional centers and local educational agencies shall be
responsible for ensuring that eligible infants and toddlers are
served as follows:
(1) The State Department of Developmental Services and regional
centers shall be responsible for the provision of appropriate early
intervention services that are required for California's
participation in Part C of the federal Individuals with Disabilities
Education Act (20 U.S.C. Sec. 1431 et seq.) for all infants eligible
under Section 95014, except for those infants with solely a visual,
hearing, or severe orthopedic impairment, or any combination of those
impairments, who meet the criteria in Sections 56026 and 56026.5 of
the Education Code, and in Section 3030(a), (b), (d), or (e) of, and
Section 3031 of, Title 5 of the California Code of Regulations.
(2) The State Department of Education and local educational
agencies shall be responsible for the provision of appropriate early
intervention services in accordance with Part C of the federal
Individuals with Disabilities Education Act (20 U.S.C. Sec. 1431 et
seq.) for infants with solely a visual, hearing, or severe orthopedic
impairment, or any combination of those impairments, who meet the
criteria in Sections 56026 and 56026.5 of the Education Code, and in
Section 3030(a), (b), (d), or (e) of, and Section 3031 of, Title 5 of
the California Code of Regulations, and who are not eligible for
services under the Lanterman Developmental Disabilities Services Act
(Division 4.5 (commencing with Section 4500) of the Welfare and
Institutions Code).
(c) For infants and toddlers and their families who are eligible
to receive services from both a regional center and a local
educational agency, the regional center shall be the agency
responsible for providing or purchasing appropriate early
intervention services that are beyond the mandated responsibilities
of local educational agencies and that are required for California's
participation in Part C of the federal Individuals with Disabilities
Education Act (20 U.S.C. Sec. 1431 et seq.). The local educational
agency shall provide special education services up to its funded
program capacity as established annually by the State Department of
Education in consultation with the State Department of Developmental
Services and the Department of Finance.
(d) No agency or multidisciplinary team, including any agency
listed in Section 95012, shall presume or determine eligibility,
including eligibility for medical services, for any other agency.
However, regional centers and local educational agencies shall
coordinate intake, evaluation, assessment, and individualized family
service plans for infants and toddlers and their families who are
served by an agency.
(e) Upon termination of the program pursuant to Section 95003, the
State Department of Developmental Services shall be responsible for
the payment of services pursuant to this title.
(f) This section shall remain in effect only until January 1,
2015, and as of that date is repealed, unless a later enacted
statute, that is enacted before January 1, 2015, deletes or extends
that date.
SEC. 3. Section 95014 is added to the
Government Code , to read:
95014. (a) The term "eligible infant or toddler" for the purposes
of this title means infants and toddlers from birth through two
years of age, for whom a need for early intervention services, as
specified in the federal Individuals with Disabilities Education Act
(20 U.S.C. Sec. 1431 et seq.) and applicable regulations, is
documented by means of assessment and evaluation as required in
Sections 95016 and 95018 and who meet one of the following criteria:
(1) Infants and toddlers with a developmental delay in one or more
of the following five areas: cognitive development; physical and
motor development, including vision and hearing; communication
development; social or emotional development; or adaptive
development. Developmentally delayed infants and toddlers are those
who are determined to have a significant difference between the
expected level of development for their age and their current level
of functioning. This determination shall be made by qualified
personnel who are recognized by, or part of, a multidisciplinary
team, including the parents. A significant difference is defined as a
33-percent delay in one or more developmental areas.
(2) Infants and toddlers with established risk conditions, who are
infants and toddlers with conditions of known etiology or conditions
with established harmful developmental consequences. The conditions
shall be diagnosed by a qualified personnel recognized by, or part
of, a multidisciplinary team, including the parents. The condition
shall be certified as having a high probability of leading to
developmental delay if the delay is not evident at the time of
diagnosis.
(3) Infants and toddlers who are at high risk of having
substantial developmental disability due to a combination of
biomedical risk factors, the presence of which are diagnosed by
qualified personnel recognized by, or part of, a multidisciplinary
team, including the parents.
(b) Regional centers and local educational agencies shall be
responsible for ensuring that eligible infants and toddlers are
served as follows:
(1) The State Department of Developmental Services and regional
centers shall be responsible for the provision of appropriate early
intervention services that are required for California's
participation in Part C of the federal Individuals with Disabilities
Education Act (20 U.S.C. Sec. 1431 et seq.) for all infants eligible
under Section 95014, except for those infants with solely a visual,
hearing, or severe orthopedic impairment, or any combination of
those impairments, who meet the criteria in Sections 56026 and
56026.5 of the Education Code, and in Section 3030(a), (b), (d), or
(e) of, and Section 3031 of, Title 5 of the California Code of
Regulations.
(2) The State Department of Education and local educational
agencies shall be responsible for the provision of appropriate early
intervention services in accordance with Part C of the federal
Individuals with Disabilities Education Act (20 U.S.C. Sec. 1431 et
seq.) for infants with solely a visual, hearing, or severe orthopedic
impairment, or any combination of those impairments, who meet the
criteria in Sections 56026 and 56026.5 of the Education Code, and in
Section 3030(a), (b), (d), or (e) of, and Section 3031 of, Title 5 of
the California Code of Regulations, and who are not eligible for
services under the Lanterman Developmental Disabilities Services Act
(Division 4.5 (commencing with Section 4500) of the Welfare and
Institutions Code).
(c) For infants and toddlers and their families who are eligible
to receive services from both a regional center and a local
educational agency, the regional center shall be the agency
responsible for providing or purchasing appropriate early
intervention services that are beyond the mandated responsibilities
of local educational agencies and that are required for California's
participation in Part C of the federal Individuals with Disabilities
Education Act (20 U.S.C. Sec. 1431 et seq.). The local educational
agency shall provide special education services up to its funded
program capacity as established annually by the State Department of
Education in consultation with the State Department of Developmental
Services and the Department of Finance.
(d) No agency or multidisciplinary team, including any agency
listed in Section 95012, shall presume or determine eligibility,
including eligibility for medical services, for any other agency.
However, regional centers and local educational agencies shall
coordinate intake, evaluation, assessment, and individualized family
service plans for infants and toddlers and their families who are
served by an agency.
(e) Upon termination of the program pursuant to Section 95003, the
State Department of Developmental Services shall be responsible for
the payment of services pursuant to this title.
(f) This section shall become operative on January 1, 2015.
SEC. 4. Section 1502 of the Health and
Safety Code is amended to read:
1502. As used in this chapter:
(a) "Community care facility" means any facility, place, or
building that is maintained and operated to provide nonmedical
residential care, day treatment, adult day care, or foster family
agency services for children, adults, or children and adults,
including, but not limited to, the physically handicapped, mentally
impaired, incompetent persons, and abused or neglected children, and
includes the following:
(1) "Residential facility" means any family home, group care
facility, or similar facility determined by the director, for 24-hour
nonmedical care of persons in need of personal services,
supervision, or assistance essential for sustaining the activities of
daily living or for the protection of the individual.
(2) "Adult day program" means any community-based facility or
program that provides care to persons 18 years of age or older in
need of personal services, supervision, or assistance essential for
sustaining the activities of daily living or for the protection of
these individuals on less than a 24-hour basis.
(3) "Therapeutic day services facility" means any facility that
provides nonmedical care, counseling, educational or vocational
support, or social rehabilitation services on less than a 24-hour
basis to persons under 18 years of age who would otherwise be placed
in foster care or who are returning to families from foster care.
Program standards for these facilities shall be developed by the
department, pursuant to Section 1530, in consultation with
therapeutic day services and foster care providers.
(4) "Foster family agency" means any organization engaged in the
recruiting, certifying, and training of, and providing professional
support to, foster parents, or in finding homes or other places for
placement of children for temporary or permanent care who require
that level of care as an alternative to a group home. Private foster
family agencies shall be organized and operated on a nonprofit basis.
(5) "Foster family home" means any residential facility providing
24-hour care for six or fewer foster children that is owned, leased,
or rented and is the residence of the foster parent or parents,
including their family, in whose care the foster children have been
placed. The placement may be by a public or private child placement
agency or by a court order, or by voluntary placement by a parent,
parents, or guardian. It also means a foster family home described in
Section 1505.2.
(6) "Small family home" means any residential facility, in the
licensee's family residence, that provides 24-hour care for six or
fewer foster children who have mental disorders or developmental or
physical disabilities and who require special care and supervision as
a result of their disabilities. A small family home may accept
children with special health care needs, pursuant to subdivision (a)
of Section 17710 of the Welfare and Institutions Code. In addition to
placing children with special health care needs, the department may
approve placement of children without special health care needs, up
to the licensed capacity.
(7) "Social rehabilitation facility" means any residential
facility that provides social rehabilitation services for no longer
than 18 months in a group setting to adults recovering from mental
illness who temporarily need assistance, guidance, or counseling.
Program components shall be subject to program standards pursuant to
Article 1 (commencing with Section 5670) of Chapter 2.5 of Part 2 of
Division 5 of the Welfare and Institutions Code.
(8) "Community treatment facility" means any residential facility
that provides mental health treatment services to children in a group
setting and that has the capacity to provide secure containment.
Program components shall be subject to program standards developed
and enforced by the State Department of Health Care Services pursuant
to Section 4094 of the Welfare and Institutions Code.
Nothing in this section shall be construed to prohibit or
discourage placement of persons who have mental or physical
disabilities into any category of community care facility that meets
the needs of the individual placed, if the placement is consistent
with the licensing regulations of the department.
(9) "Full-service adoption agency" means any licensed entity
engaged in the business of providing adoption services, that does all
of the following:
(A) Assumes care, custody, and control of a child through
relinquishment of the child to the agency or involuntary termination
of parental rights to the child.
(B) Assesses the birth parents, prospective adoptive parents, or
child.
(C) Places children for adoption.
(D) Supervises adoptive placements.
Private full-service adoption agencies shall be organized and
operated on a nonprofit basis. As a condition of licensure to provide
intercountry adoption services, a full-service adoption agency shall
be accredited and in good standing according to Part 96 of Title 22
of the Code of Federal Regulations, or supervised by an accredited
primary provider, or acting as an exempted provider, in compliance
with Subpart F (commencing with Section 96.29) of Part 96 of Title 22
of the Code of Federal Regulations.
(10) "Noncustodial adoption agency" means any licensed entity
engaged in the business of providing adoption services, that does all
of the following:
(A) Assesses the prospective adoptive parents.
(B) Cooperatively matches children freed for adoption, who are
under the care, custody, and control of a licensed adoption agency,
for adoption, with assessed and approved adoptive applicants.
(C) Cooperatively supervises adoptive placements with a
full-service adoptive agency, but does not disrupt a placement or
remove a child from a placement.
Private noncustodial adoption agencies shall be organized and
operated on a nonprofit basis. As a condition of licensure to provide
intercountry adoption services, a noncustodial adoption agency shall
be accredited and in good standing according to Part 96 of Title 22
of the Code of Federal Regulations, or supervised by an accredited
primary provider, or acting as an exempted provider, in compliance
with Subpart F (commencing with Section 96.29) of Part 96 of Title 22
of the Code of Federal Regulations.
(11) "Transitional shelter care facility" means any group care
facility that provides for 24-hour nonmedical care of persons in need
of personal services, supervision, or assistance essential for
sustaining the activities of daily living or for the protection of
the individual. Program components shall be subject to program
standards developed by the State Department of Social Services
pursuant to Section 1502.3.
(12) "Transitional housing placement provider" means an
organization licensed by the department pursuant to Section 1559.110
and Section 16522.1 of the Welfare and Institutions Code to provide
transitional housing to foster children at least 16 years of age and
not more than 18 years of age, and nonminor dependents, as defined in
subdivision (v) of Section 11400 of the Welfare and Institutions
Code, to promote their transition to adulthood. A transitional
housing placement provider shall be privately operated and organized
on a nonprofit basis.
(13) "Group home" means a residential facility that provides
24-hour care and supervision to children, delivered at least in part
by staff employed by the licensee in a structured environment. The
care and supervision provided by a group home shall be nonmedical,
except as otherwise permitted by law.
(14) "Runaway and homeless youth shelter" means a group home
licensed by the department to operate a program pursuant to Section
1502.35 to provide voluntary, short-term, shelter and personal
services to runaway youth or homeless youth, as defined in paragraph
(2) of subdivision (a) of Section 1502.35.
(15) "Enhanced behavioral supports home" means a facility
certified by the State Department of Developmental Services pursuant
to Article 3.6 (commencing with Section 4684.80) of Chapter 6 of
Division 4.5 of the Welfare and Institutions Code, and licensed by
the State Department of Social Services as an adult residential
facility or a group home that provides 24-hour nonmedical care to
individuals with developmental disabilities who require enhanced
behavioral supports, staffing, and supervision in a homelike setting.
An enhanced behavioral supports home shall have a maximum capacity
of four consumers, shall conform to Section 441.530(a)(1) of Title 42
of the Code of Federal Regulations, and shall be eligible for
federal Medicaid home-and community-based services funding.
(16) "Community crisis home" means a facility certified by the
State Department of Developmental Services pursuant to Article 8
(commencing with Section 4698) of Chapter 6 of Division 4.5 of the
Welfare and Institutions Code, and licensed by the State Department
of Social Services pursuant to Article 9.7 (commencing with Section
1567.80), as an adult residential facility, providing 24-hour
nonmedical care to individuals with developmental disabilities
receiving regional center service, in need of crisis intervention
services, and who would otherwise be at risk of admission to the
acute crisis center at Fairview Developmental Center, Sonoma
Developmental Center, an acute general hospital, acute psychiatric
hospital, an institution for mental disease, as described in Part 5
(commencing with Section 5900) of Division 5 of the Welfare and
Institutions Code, or an out-of-state placement. A community crisis
home shall have a maximum capacity of eight consumers, as defined in
subdivision (a) of Section 1567.80, shall conform to Section 441.530
(a)(1) of Title 42 of the Code of Federal Regulations, and shall be
eligible for federal Medicaid home and community-based services
funding.
(b) "Department" or "state department" means the State Department
of Social Services.
(c) "Director" means the Director of Social Services.
SEC. 5. Section 1524 of the Health and
Safety Code is amended to read:
1524. A license shall be forfeited by operation of law when one
of the following occurs:
(a) The licensee sells or otherwise transfers the facility or
facility property, except when change of ownership applies to
transferring of stock when the facility is owned by a corporation,
and when the transfer of stock does not constitute a majority change
of ownership.
(b) The licensee surrenders the license to the department.
(c) (1) The licensee moves a facility from one location to
another. The department shall develop regulations to ensure that the
facilities are not charged a full licensing fee and do not have to
complete the entire application process when applying for a license
for the new location.
(2) This subdivision shall not apply to a licensed foster family
home, a home certified by a licensed foster family agency, or a home
approved pursuant to Sections 309, 361.4, and 361.45 of the Welfare
and Institutions Code. When a foster family home licensee, certified
home parent, or a person approved to care for children pursuant to
Sections 309, 361.4, and 361.45 of the Welfare and Institutions Code
moves to a new location, the existing license, certification, or
approval may be transferred to the new location. All caregivers to
whom this paragraph applies shall be required to meet all applicable
licensing laws and regulations at the new location.
(d) The licensee is convicted of an offense specified in Section
220, 243.4, or 264.1, or paragraph (1) of Section 273a, Section 273d,
288, or 289 of the Penal Code, or is convicted of another crime
specified in subdivision (c) of Section 667.5 of the Penal Code.
(e) The licensee dies. If an adult relative notifies the
department of his or her desire to continue operation of the facility
and submits an application, the department shall expedite the
application. The department shall promulgate regulations for
expediting applications submitted pursuant to this subdivision.
(f) The licensee abandons the facility.
(g) When the certification issued by the State Department of
Developmental Services to a licensee of an Adult Residential Facility
for Persons with Special Health Care Needs, licensed pursuant to
Article 9 (commencing with Section 1567.50), is rescinded.
(h) When the certification issued by the State Department of
Developmental Services to a licensee of an enhanced behavioral
supports home, licensed pursuant to Article 9.5 (commencing with
Section 1567.61), is rescinded.
(i) When the certificate of program approval issued by the State
Department of Developmental Services, pursuant to Article 8
(commencing with Section 4698) of Chapter 6 of Division 4.5 of the
Welfare and Institutions Code, to a licensee of a community crisis
home, licensed pursuant to Article 9.7 (commencing with Section
1567.80), is rescinded.
SEC. 6. Article 9.5 (commencing with Section
1567.61) is added to Chapter 3 of Division 2 of the Health
and Safety Code , to read:
Article 9.5. Enhanced Behavioral Supports Homes
1567.61. As used in this article the following terms apply:
(a) "Consumer" or "client" means an individual who has been
determined by a regional center to meet the eligibility criteria of
Section 4512 of the Welfare and Institutions Code and applicable
regulations and for whom the regional center has accepted
responsibility.
(b) "Individual
behavior supports plan" means the plan that identifies and documents
the behavior and intensive support and service needs of a consumer
and details the strategies to be employed and services to be provided
to address those needs, and includes the entity responsible for
providing those services and timelines for when each identified
individual behavior support will commence.
(c) "Individual behavior supports team" means those individuals
who develop, monitor, and revise the individual behavior supports
plan for consumers residing in an enhanced behavioral supports home,
pursuant to subdivision (d) of Section 4684.80 of the Welfare and
Institutions Code.
1567.62. (a) Each enhanced behavioral supports home shall be
licensed as an adult residential facility or a group home and
certified by the State Department of Developmental Services.
(b) A certificate of program approval issued by the State
Department of Developmental Services shall be a condition of
licensure for the enhanced behavioral supports home by the State
Department of Social Services.
(c) An enhanced behavioral supports home shall not be licensed by
the State Department of Social Services until the certificate of
program approval, granted by the State Department of Developmental
Services, has been received.
(d) Placements of dual agency clients into enhanced behavioral
supports homes that are licensed as group homes shall be subject to
the limitations on the duration of the placement set forth in
Sections 319.2 and 319.3 of, and subparagraph (A) of paragraph (8)
and subparagraph (A) of paragraph (9) of subdivision (e) of Section
361.2 of, the Welfare and Institutions Code.
(e) For the purpose of this article, dual agency clients are
foster children in temporary custody of the child welfare agency
under Section 319 of the Welfare and Institutions Code or under the
jurisdiction of the juvenile court pursuant to Section 300, 450, 601,
or 602 of the Welfare and Institutions Code who are also either a
consumer of regional center services, or who are receiving services
under the California Early Intervention Services Act (Title 14 (the
age of commencing with Section 45000) of the Government Code) but who
are under three years of age and have not yet been determined to
have a developmental disability.
(f) The State Department of Social Services shall not be
responsible for any of the following:
(1) Developing and approving a consumer's individual behavior
supports plan in conjunction with the consumer's individual behavior
supports team.
(2) (A) Oversight of any services that may be provided by a
licensed health professional or licensed mental health professional
to a consumer.
(B) Services provided by a licensed health or licensed mental
health professional means services that may only be provided under
the authority of the licensed health service provider's or licensed
mental health service provider's professional license.
(g) Subdivision (f) shall not limit the State Department of Social
Services' ability to enforce Chapter 3 (commencing with Section
1500), and applicable regulations.
1567.63. The license applicant shall submit a facility program
plan to the State Department of Developmental Services for approval
and submit the approved plan to the State Department of Social
Services as part of the facility plan of operation. The plan of
operation shall be approved by the State Department of Social
Services prior to licensure.
1567.64. The State Department of Social Services shall adopt
regulations to address, at a minimum, staffing structure, staff
qualifications, and training. Training requirements shall include a
minimum of 16 hours of emergency intervention training. "Emergency
intervention training" means the techniques the licensee will use to
prevent injury to, and maintain safety for, consumers who are a
danger to themselves or others and shall emphasize positive
behavioral supports and techniques that are alternatives to physical
restraints.
1567.65. If the State Department of Social Services determines
that urgent action is necessary to protect a consumer residing in an
enhanced behavioral supports home from physical or mental abuse,
abandonment, or any other substantial threat to their health and
safety, the State Department of Social Services shall notify the
State Department of Developmental Services. The State Department of
Developmental Services may request that the regional center or
centers take action within 24 hours, which may include, as
appropriate, the removal of a consumer from the enhanced behavioral
supports home or obtaining alternative or additional services. When
possible, an individual program plan (IPP) meeting shall be convened
to determine the appropriate action pursuant to this section. In any
case, an IPP meeting shall be convened within 30 days following an
action pursuant to this section.
1567.66. An enhanced behavioral supports home employing secured
perimeters shall comply with Section 1531.15 and applicable
regulations.
1567.67. (a) The State Department of Social Services shall revoke
the enhanced behavioral supports home's facility license if the
State Department of Developmental Services has decertified an
enhanced behavioral supports home program certification pursuant to
Article 3.6 (commencing with Section 4684.80) of Chapter 6 of
Division 4.5 of the Welfare and Institutions Code.
(b) The State Department of Developmental Services and regional
centers shall, for purposes of assisting in licensing, provide the
State Department of Social Services with all available documentation
and evidentiary support that was submitted to the State Department of
Developmental Services in connection with certification by an
applicant for licensure under this article.
1567.68. (a) A license shall not be issued pursuant to this
article before emergency regulations for this article filed by the
State Department of Developmental Services have been published.
(b) Emergency regulations to implement this article may be adopted
by the director of the State Department of Social Services in
accordance with the Administrative Procedure Act (Chapter 3.5
(commencing with Section 11340) of Part 1 of Division 3 of Title 2 of
the Government Code). These regulations shall be developed in
consultation with system stakeholders. The initial adoption of the
emergency regulations and one readoption of the initial regulations
shall be deemed to be an emergency and necessary for the immediate
preservation of the public peace, health, safety, or general welfare.
Initial emergency regulations and the first readoption of those
emergency regulations shall be exempt from review by the Office of
Administrative Law. The emergency regulations authorized by this
section shall be submitted to the Office of Administrative Law for
filing with the Secretary of State and shall remain in effect for no
more than 180 days.
(c) The adoption, initial amendment, repeal, or readoption of a
regulation authorized by this section is deemed to be an emergency
and necessary for the immediate preservation of the public peace,
health, safety, or general welfare for purposes of Sections 11346.1
and 11349.6 of the Government Code, and the State Department of
Social Services is hereby exempted from the requirement that it
describe specific facts showing the need for immediate action. A
certificate of compliance for these implementing regulations shall be
filed within 24 months following the adoption of the first emergency
regulations filed pursuant to this section. The emergency
regulations may be readopted and remain in effect until approval of
the certificate of compliance.
1567.69. Nothing in this article shall interfere with the
authority of the State Department of Social Services to temporarily
suspend or revoke the license of an enhanced behavioral supports home
pursuant to Section 1550 of the Health and Safety Code.
1567.70. This article shall remain in effect only until January
1, 2020, and as of that date is repealed, unless a later enacted
statute, that is enacted before January 1, 2020, deletes or extends
that date.
SEC. 7. Article 9.7 (commencing with Section
1567.80) is added to Chapter 3 of Division 2 of the Health
and Safety Code , to read:
Article 9.7. Community Crisis Home Licensure
1567.80. For the purposes of this article, the following
definitions apply:
(a) "Consumer" or "client" means an individual who has been
determined by a regional center to meet the eligibility criteria of
Section 4512 of the Welfare and Institutions Code and applicable
regulations, and for whom the regional center has accepted
responsibility.
(b) "Individual behavior support plan" means the plan that
identifies and documents the behavioral and intensive support and
service needs of a consumer and details the strategies to be
employed, and services to be provided, to address those needs, and
includes the entity responsible for providing those services and
timelines for when each identified individual behavioral support will
commence.
1567.81. (a) (1) Each community crisis home shall be licensed as
an adult residential facility, pursuant to this article, and
certified by the State Department of Developmental Services, pursuant
to Article 8 (commencing with Section 4698) of Chapter 6 of Division
4.5 of the Welfare and Institutions Code.
(2) Notwithstanding whether a community crisis home is licensed
for more than six consumers, subdivisions (a) and (b) of Section
1524.5 shall apply.
(b) A certificate of program approval issued by the State
Department of Developmental Services, pursuant to Article 8
(commencing with Section 4698) of Chapter 6 of Division 4.5 of the
Welfare and Institutions Code, shall be a condition of licensure for
the community crisis home by the State Department of Social Services.
(c) A community crisis home shall not be licensed by the State
Department of Social Services until the certificate of program
approval, issued by the State Department of Developmental Services,
has been received.
(d) The State Department of Social Services shall not be
responsible for any of the following:
(1) Developing and approving a consumer's individual behavior
support plan in conjunction with the consumer's individual behavior
support team.
(2) Oversight of any services that may be provided by a licensed
health or licensed mental health professional to a consumer.
"Services provided by a licensed health or licensed mental health
professional" means services that may only be provided under the
authority of the licensed health or licensed mental health service
provider's professional license.
(e) Subdivision (d) does not limit the State Department of Social
Services' ability to enforce this chapter and applicable regulations.
1567.82. The State Department of Social Services' regulations
shall address at least both of the following:
(a) Staffing structure, staff qualifications, and training.
(b) Training requirements shall include a minimum of 16 hours of
emergency intervention training. "Emergency intervention training"
shall include the techniques the licensee will use to prevent injury
and maintain safety regarding consumers who are a danger to self or
others and shall emphasize positive behavioral supports and
techniques that are alternatives to physical restraints.
1567.83. (a) When the State Department of Social Services
determines that urgent action is necessary to protect consumers
residing in a community crisis home from physical or mental abuse,
abandonment, or any other substantial threat to their health and
safety, the State Department of Social Services shall notify the
State Department of Developmental Services. The State Department of
Developmental Services may request that the regional center or
centers take action within 24 hours, which may include, as
appropriate, the removal of a consumer from the community crisis home
or obtaining alternative or additional services. When possible, an
individual program plan (IPP) meeting shall be convened to determine
the appropriate action pursuant to this section. In any case, an IPP
meeting shall be convened within 30 days following an action pursuant
to this section.
(b) Nothing in this article shall interfere with the authority of
the State Department of Social Services to temporarily suspend or
revoke the license of a community crisis home pursuant to Section
1550.
1567.84. The licensee shall submit the facility program plan
approved by the State Department of Developmental Services, pursuant
to Section 4698 of the Welfare and Institutions Code, to the State
Department of Social Services as part of the facility plan of
operation. The plan of operation shall be approved by the State
Department of Social Services prior to licensure.
1567.85. If applicable, a community crisis home shall be in
compliance with Section 1531.15 and the applicable regulations.
1567.86. (a) The State Department of Social Services shall revoke
the community crisis home's facility license if the State Department
of Developmental Services has rescinded a community crisis home's
certificate of program approval.
(b) The State Department of Developmental Services and regional
centers shall provide the State Department of Social Services all
available documentation and evidentiary support necessary for the
licensing and administration of community crisis homes and
enforcement of this article and the applicable regulations.
1567.87. (a) A license shall not be issued pursuant to this
article until the publication in Title 17 of the California Code of
Regulations of emergency regulations filed by the State Department of
Developmental Services pursuant to Section 4698.1 of the Welfare and
Institutions Code.
(b) Emergency regulations to implement this article may be adopted
by the Director of Social Services in accordance with the
Administrative Procedure Act (Chapter 3.5 (commencing with Section
11340) of Part 1 of Division 3 of Title 2 of the Government Code).
These emergency regulations shall be developed in consultation with
system stakeholders. The initial adoption of the emergency
regulations and one readoption of the initial regulations shall be
deemed to be an emergency and necessary for the immediate
preservation of the public peace, health and safety, or general
welfare. Initial emergency regulations and the first readoption of
those emergency regulations shall be exempt from review by the Office
of Administrative Law. The emergency regulations authorized by this
section shall be submitted to the Office of Administrative Law for
filing with the Secretary of State and shall remain in effect for no
more than 180 days.
(c) The adoption, amendment, repeal, or readoption of a regulation
authorized by this section is deemed to be an emergency and
necessary for the immediate preservation of the public peace, health
and safety, or general welfare for purposes of Sections 11346.1 and
11349.6 of the Government Code, and the State Department of Social
Services is hereby exempted from the requirement that it describe
specific facts showing the need for immediate action. A certificate
of compliance for these implementing regulations shall be filed
within 24 months following the adoption of the first emergency
regulations filed pursuant to this section. The emergency regulations
may be readopted and remain in effect until approval of the
certificate of compliance.
SEC. 8. Section 4418.25 of the Welfare
and Institutions Code is amended to read:
4418.25. (a) The department shall establish policies and
procedures for the development of an annual community placement plan
by regional centers. The community placement plan shall be based upon
an individual program plan process as referred to in subdivision (a)
of Section 4418.3 and shall be linked to the development of the
annual state budget. The department's policies shall address
statewide priorities, plan requirements, and the statutory roles of
regional centers, developmental centers, and regional resource
development projects in the process of assessing consumers for
community living and in the development of community resources.
(b) (1) To reduce reliance on developmental centers and mental
health facilities, including institutions for mental disease as
described in Part 5 (commencing with Section 5900) of Division 5, for
which federal funding is not available, and out-of-state placements,
the department shall establish a statewide specialized resource
service that does all of the following:
(A) Tracks the availability of specialty residential beds and
services.
(B) Tracks the availability of specialty clinical services.
(C) Coordinates the need for specialty services and supports in
conjunction with regional centers.
(D) Identifies, subject to federal reimbursement, developmental
center services and supports that can be made available to consumers
residing in the community, when no other community resource has been
identified.
(2) By September 1, 2012, regional centers shall provide the
department with information about all specialty resources developed
with the use of community placement plan funds and shall make these
resources available to other regional centers.
(3) When allocating funding for community placement plans,
priority shall be given to the development of needed statewide
specialty services and supports, including regional community crisis
homes.
(4) If approved by the director, funding may be allocated to
facilities that meet the criteria of Sections 1267.75 and 1531.15 of
the Health and Safety Code.
(5) The department shall not provide community placement plan
funds to develop programs that are ineligible for federal funding
participation unless approved by the director.
(c) (1) The community placement plan shall provide for dedicated
funding for comprehensive assessments of developmental center
residents, for identified costs of moving individuals from
developmental centers to the community, and for deflection of
individuals from developmental center admission. The plans shall,
where appropriate, include budget requests for regional center
operations, assessments, resource development, and ongoing placement
costs. These budget requests are intended to provide supplemental
funding to regional centers. The plan is not intended to limit the
department's or regional centers' responsibility to otherwise conduct
assessments and individualized program planning, and to provide
needed services and supports in the least restrictive, most
integrated setting in accord with the Lanterman Developmental
Disabilities Services Act (Division 4.5 (commencing with Section
4500)).
(2) (A) Regional centers shall complete a comprehensive assessment
of any consumer residing in a developmental center on July 1, 2012,
who meets both of the following criteria:
(i) The consumer is not committed pursuant to Section 1370.1 of
the Penal Code.
(ii) The consumer has not had such an assessment in the prior two
years.
(B) The assessment shall include input from the regional center,
the consumer, and, when appropriate, the consumer's family, legal
guardian, conservator, or authorized representative, and shall
identify the types of community-based services and supports available
to the consumer that would enable the consumer to move to a
community setting. Necessary services and supports not currently
available in the community setting shall be considered for
development pursuant to community placement planning and funding.
(C) Regional centers shall specify in the annual community
placement plan how they will complete the required assessment and the
timeframe for completing the assessment for each consumer. Initial
assessments pursuant to this paragraph for individuals residing in a
developmental center on July 1, 2012, shall be completed by December
31, 2015, unless a regional center demonstrates to the department
that an extension of time is necessary and the department grants such
an extension.
(D) The assessment completed in the prior two years, or the
assessment completed pursuant to the requirements of this section,
including any updates pursuant to subparagraph (E), shall be provided
to both of the following:
(i) The individual program planning team and clients' rights
advocate for the regional center in order to assist the planning team
in determining the least restrictive environment for the consumer.
(ii) The superior court with jurisdiction over the consumer's
placement at the developmental center, including the consumer's
attorney of record and other parties known to the regional center.
For judicial proceedings pursuant to Article 2 (commencing with
Section 6500) of Chapter 2 of Part 2 of Division 6, the comprehensive
assessment shall be included in the regional center's written report
required by Section 6504.5. For all other proceedings, the regional
center shall provide the comprehensive assessment to the court and
parties to the case at least 14 days in advance of any regularly
scheduled judicial review. This clause shall not apply to consumers
committed pursuant to Section 1370.1 of the Penal Code.
(D)
(E) The assessment completed
assessments described in the prior two years, or the
assessment completed pursuant to the requirements of this section
subparagraph (D) shall be provided to
the individual program planning team in order to assist the planning
team in determining the least restrictive environment for the
consumer. These assessments shall be updated annually as
part of the individual program planning process for as long as the
consumer resides in the developmental center. To the extent
appropriate, the regional center shall also provide relevant
information from the statewide specialized resource service.
For The regional center shall notify the clients'
rights advocate for the regional center of the time, date, and
location of each individual program plan meeting that includes
discussion of the results of the assessment, the clients'
rights advocate for the comprehensive assessment and
updates to that assessment. The regional center shall
be notified provide this notice as soon as practicable
fo llowing the completion of the meeting
comprehensive assessment or update and not
less than 30 calendar days prior to the meeting. The clients' rights
advocate may participate in the meeting unless the consumer
objects on his or her own behalf.
(d) The department shall review, negotiate, and approve regional
center community placement plans for feasibility and reasonableness,
including recognition of each regional centers' current developmental
center population and their corresponding placement level, as well
as each regional centers' need to develop new and innovative service
models. The department shall hold regional centers accountable for
the development and implementation of their approved plans. The
regional centers shall report, as required by the department, on the
outcomes of their plans. The department shall make aggregate
performance data for each regional center available, upon request, as
well as data on admissions to, and placements from, each
developmental center.
(e) Funds allocated by the department to a regional center for a
community placement plan developed under this section shall be
controlled through the regional center contract to ensure that the
funds are expended for the purposes allocated. Funds allocated for
community placement plans that are not used for that purpose may be
transferred to Item 4300-003-0001 for expenditure in the state
developmental centers if their population exceeds the budgeted level.
Any unspent funds shall revert to the General Fund.
(f) Commencing May 1, 2013, and then on April 1, 2014, and on
April 1 annually thereafter, the department shall provide to the
fiscal and appropriate policy committees of the Legislature
information on efforts to serve consumers with challenging service
needs, including, but not limited to, all of the following:
(1) For
each regional center, the number of consumers admitted to each
developmental center, including the legal basis for the admissions.
(2) For each regional center, the number of consumers described in
paragraph (2) of subdivision (a) of Section 7505 who were admitted
to Fairview Developmental Center by court order pursuant to Article 2
(commencing with Section 6500) of Chapter 2 of Part 2 of Division 6,
and the number and lengths of stay of consumers, including those who
have transitioned back to a community living arrangement.
(3) Outcome data related to the assessment process set forth in
Section 4418.7, including the number of consumers who received
assessments pursuant to Section 4418.7 and the outcomes of the
assessments. Each regional center, commencing March 1, 2013, and then
on February 1, 2014, and on February 1 annually thereafter, shall
provide the department with information on alternative community
services and supports provided to those consumers who were able to
remain in the community following the assessments, and the unmet
service needs that resulted in any consumers being admitted to
Fairview Developmental Center.
(4) Progress in the development of needed statewide specialty
services and supports, including regional community crisis options,
as provided in paragraph (3) of subdivision (b). Each regional center
shall provide the department with a report containing the
information described in this paragraph commencing March 1, 2013, and
then on February 1, 2014, and on February 1 annually thereafter.
(5) Progress in reducing reliance on mental health facilities
ineligible for federal Medicaid funding, and out-of-state placements.
(6) Information on the utilization of facilities serving consumers
with challenging service needs that utilize delayed egress devices
and secured perimeters, pursuant to Section 1267.75 or 1531.15 of the
Health and Safety Code, including the number of admissions, reasons
for admissions, and lengths of stay of consumers, including those who
have transitioned to less restrictive living arrangements.
(7) If applicable, any recommendations regarding additional rate
exceptions or modifications beyond those allowed for under existing
law that the department identifies as necessary to meet the needs of
consumers with challenging service needs.
(g) Each regional center, commencing March 1, 2013, and then on
February 1, 2014, and on February 1 annually thereafter, shall
provide information to the department regarding the facilities
described in paragraph (6) of subdivision (f), including, but not
limited to, the number of admissions, reasons for admissions, and
lengths of stay of consumers, including those who have transitioned
to less restrictive living arrangements.
SEC. 9. Section 4418.7 of the Welfare
and Institutions Code is amended to read:
4418.7. (a) (1) If the regional center
determines, or is informed by the consumer's parents, legal guardian,
conservator, or authorized representative that the community
placement of a consumer is at risk of failing, and that admittance to
a state developmental center is a likelihood, or the regional center
is notified by a court of a potential admission to a developmental
center consistent with Section 7505, the regional center shall
immediately notify the appropriate regional resource development
project, the consumer, and the consumer's parents,
legal guardian, or conservator. conservator,
and the regional center clients' rights advocate.
(2) For purposes of this section, notification to the clients'
rights advocate for the consumer's regional center shall include a
copy of the most recent comprehensive assessment or updated
assessment, and the time, date, and location of an individual program
plan meeting held pursuant to subdivision (b). The regional center
shall provide this notice as soon as practicable but not less than 7
calendar days prior to the meeting.
(b) In these cases, the regional resource development project
shall immediately arrange for an assessment of the situation,
including, visiting the consumer, if appropriate, determining
barriers to successful integration, and recommending the most
appropriate means necessary to assist the consumer to remain in the
community. The regional center shall request assistance from the
statewide specialized resource service pursuant to Section 4418.25 as
necessary in order to determine the most appropriate means necessary
to assist the consumer to remain in the community and shall provide
the information obtained from the statewide specialized resource
service to the regional resource developmental project. If, based on
the assessment, the regional resource development project determines
that additional or different services and supports are necessary, the
department shall ensure that the regional center provides those
services and supports on an emergency basis. An individual program
plan meeting, including the regional resource development project's
representative, shall be convened as soon as possible to review the
emergency services and supports and determine the consumer's ongoing
needs for services and supports. The regional resource development
project shall follow up with the regional center as to the success of
the recommended interventions until the consumer's living
arrangement is stable.
(c) (1) If the regional resource development project determines,
based on the assessment conducted pursuant to subdivision (b), that
the consumer referred to the regional resource development project by
the court cannot be safely served in the developmental center, the
department shall notify the court in writing.
(2) (A) If the regional resource development project, in
consultation with the regional center, the consumer, and the consumer'
s parents, legal guardian, or conservator, when appropriate,
determines that admittance to a state developmental center is
necessary due to an acute crisis, as defined in paragraph (1) of
subdivision (d), the regional center shall immediately pursue the
obtainment of a court order for short-term admission and crisis
stabilization.
(B) (i) The regional resource development project, in consultation
with the regional center, the consumer, and, when appropriate, the
consumer's parents, legal guardian, conservator, or authorized
representative, shall not make a determination that admittance to a
state developmental center is necessary due to an acute crisis as
defined in paragraph (1) of subdivision (d) unless the determination
includes a regional center report detailing all considered
community-based services and supports
supports, including a community crisis home certified pursuant to
Article 8 (commencing with Section 4698) of Chapter 6 of Division
4.5, and an explanation of why those options could not meet the
consumer's needs at the time of such a determination.
(ii) For purposes of complying with clause (i), the regional
center shall not be required to consider out-of-state placements or
mental health facilities, including institutions for mental disease,
as described in Part 5 (commencing with Section 5900) of Division 5,
that are ineligible for federal Medicaid funding.
(d) (1) For purposes of this section, an "acute crisis" means a
situation in which the consumer meets the criteria of Section 6500
and, as a result of the consumer's behavior, all of the following are
met:
(A) There is imminent risk for substantial harm to self or others.
(B) The service and support needs of the consumer cannot be met in
the community, including with supplemental services as set forth in
subparagraph (E) of paragraph (9) of subdivision (a) of Section 4648
and emergency and crisis intervention services as set forth in
paragraph (10) of subdivision (a) of Section 4648.
(C) Due to serious and potentially life-threatening conditions,
the consumer requires a more restrictive environment for crisis
stabilization.
(2) For purposes of paragraph (1), out-of-state placements or
mental health facilities and other facilities, including institutions
for mental disease, as described in Part 5 (commencing with Section
5900) of Division 5, for which federal Medicaid funding is not
available, shall not be deemed to be supplemental services or
emergency and crisis intervention services.
(e) When an admission occurs due to an acute crisis, all of the
following shall apply:
(1) As soon as possible following admission to a developmental
center, a comprehensive assessment shall be completed by the regional
center in coordination with the developmental center. The
comprehensive assessment shall include the identification of the
services and supports needed for crisis stabilization and the
timeline for identifying or developing the services and supports
needed to transition the consumer back to the community. The regional
center shall immediately submit a copy of the comprehensive
assessment to the committing court. Immediately following the
assessment, and not later than 30 days following admission, the
regional center and the developmental center shall jointly convene an
individual program plan meeting to determine the services and
supports needed for crisis stabilization and to develop a plan to
transition the consumer into community living pursuant to Section
4418.3. The clients' rights advocate for the regional center shall be
notified of the admission and the individual program plan meeting
and may participate in the individual program plan meeting unless the
consumer objects on his or her own behalf.
(2) If transition is not expected within 90 days of admission, an
individual program plan meeting shall be held to discuss the status
of transition and to determine if the consumer is still in need of
crisis stabilization. If crisis services continue to be necessary,
the regional center shall submit to the department an updated
transition plan and a request for an extension of stay at the
developmental center of up to 90 days.
(3) (A) A consumer shall reside in the developmental center no
longer than six months before being placed into a community living
arrangement pursuant to Section 4418.3, unless, prior to the end of
the six months, all of the following have occurred:
(i) The regional center has conducted an additional comprehensive
assessment based on information provided by the regional center, and
the department determines that the consumer continues to be in an
acute crisis.
(ii) The individual program planning team has developed a plan
that identifies the specific services and supports necessary to
transition the consumer into the community, and the plan includes a
timeline to obtain or develop those services and supports.
(iii) The committing court has reviewed and, if appropriate,
extended the commitment.
(B) The clients' rights advocate for the regional center shall be
notified of the proposed extension pursuant to clause (iii) of
subparagraph (A) and the individual program plan meeting to consider
the extension, and may participate in the individual program plan
meeting unless the consumer objects on his or her own behalf.
(C) (i) In no event shall a consumer's placement at the
developmental center exceed one year unless both of the following
occur:
(I) The regional center demonstrates significant progress toward
implementing the plan specified in clause (ii) of subparagraph (A)
identifying the specific services and supports necessary to
transition the consumer into the community.
(II) Extraordinary circumstances exist beyond the regional center'
s control that have prevented the regional center from obtaining
those services and supports within the timeline based on the plan.
(ii) If both of the circumstances described in subclauses (I) and
(II) exist, the regional center may request, and the committing court
may grant, an additional extension of the commitment, not to exceed
30 days.
(D) Consumers placed in the community after admission to a
developmental center pursuant to this section shall be considered to
have moved from a developmental center for purposes of Section
4640.6.
(f) The department shall collect data on the outcomes of efforts
to assist at-risk consumers to remain in the community. The
department shall make aggregate data on the implementation of the
requirements of this section available, upon request.
(g) (1) Notwithstanding any other law or
regulation, commencing July 1, 2012, and until December 31,
2014, Fairview Developmental Center shall be the only
developmental center authorized to admit a consumer pursuant to a
court order for an acute crisis as described in this section.
(2) Commencing January 1, 2015, admissions to a developmental
center pursuant to a court order for an acute crisis as described in
this section shall be limited to the acute crisis center at the
Fairview Developmental Center and the acute crisis center at the
Sonoma Developmental Center.
(h) The acute crisis center at the Fairview Developmental Center
and the acute crisis center at the Sonoma Developmental Center shall
each consist of one unit that is distinct from other residential
units at the developmental center and shall each serve no more than
five consumers. Crisis center residents may participate in day, work,
and recreation programs, and other developmental center facility
activities, outside of the acute crisis unit, when the individual
program plan identifies it is appropriate and consistent with the
individual's treatment plan. The acute crisis centers shall assist
the consumer with transitioning back to his or her prior residence,
or an alternative community-based residential setting, within the
timeframe described in this section.
SEC. 10. Section 4436 is added to the
Welfare and Institutions Code , to read:
4436. (a) In order to provide the information necessary to assess
the impact of implementing the recommendations of the report
submitted by the California Health and Human Services Agency,
pursuant to Section 14 of Chapter 25 of the Statutes of 2013, the
State Department of Developmental Services shall evaluate enhanced
behavioral supports homes, established pursuant to Article 3.6
(commencing with Section 4684.80) of Chapter 6 of Division 4.5,
community crisis homes, established pursuant to Article 8 (commencing
with Section 4698) of Chapter 6 of Division 4.5, and the acute
crisis centers at the Fairview Developmental Center and the Sonoma
Developmental Center, as described in subdivision (h) of Section
4418.7.
(b) The evaluation for enhanced behavioral supports homes and
community crisis homes shall include information, by regional center
catchment area, regarding the number of homes approved, the number of
homes opened, the number of beds, the number of placements in a home
from outside the regional center catchment area, comparative summary
information regarding the characteristics of the persons served in
these homes, immediate past residential settings, vacancy rates, and
the established fixed facility rates and individual rates.
(c) The evaluation for community crisis homes and the acute crisis
centers at the Fairview Developmental Center and the Sonoma
Developmental Center shall include comparative information regarding
characteristics of the persons served, immediate past residential
settings, staffing requirements, the average monthly occupancy, the
average length of time to secure placement into the home or center,
the average length of stay, the regional center of origin for
placements, the number of placements from outside the regional center
of origin, the number of individuals with multiple stays, the number
of residents whose discharge was delayed due to the unavailability
of a residential placement, and the per capita and total cost for
each home or center.
(d) The evaluation for enhanced behavioral supports homes shall
also include the number of beds in the homes utilizing delayed egress
devices in combination with secured perimeters, the extent to which
the statewide limit established in regulation on the total number of
beds permitted in homes with delayed egress devices in combination
with secured perimeters is exceeded, the number of residents
requiring out-of-home crisis intervention services, the nature of the
services provided, and the ability of residents to return to the
same home after temporary placement in another facility.
(e) (1) Notwithstanding Section 10231.5 of the Government Code,
the department shall provide the evaluations of enhanced behavioral
supports homes and community crisis homes to the budget committees
and appropriate policy committees of the Legislature annually,
commencing on January 10 of the year after the first enhanced
behavioral supports home or community crisis home is opened and
services have commenced.
(2) Notwithstanding Section 10231.5 of the Government Code, the
department shall provide the evaluations for the acute crisis centers
at the following facilities to the budget committees and appropriate
policy committees of the Legislature annually:
(A) The Fairview Developmental Center, commencing on January 10,
2015.
(B) The Sonoma Developmental Center, commencing on January 10,
2016.
SEC. 11. Section 4474.2 of the Welfare
and Institutions Code is amended to read:
4474.2. (a) Notwithstanding any law to
other law, the contrary, the department may
operate any facility, provide its employees to assist in the
operation of any facility, or provide other necessary services and
supports if, in the discretion of the department, it determines that
the activity will assist in meeting the goal of successfully
transitioning developmental center residents to community living or
deflecting the orderly closures
admission of Agnews Developmental Center and Lanterman
Developmental Center. individuals with developmental
disabilities to a developmental center, an institution for mental
disease, an out-of-state placement, a general acute care hospital, or
an acute psychiatric hospital. The department may contract
with any entity for the use of the department's employees to provide
services and supports in furtherance of the
orderly closures of Agnews Developmental Center and Lanterman
Developmental Center. this goal.
(b) The department shall prepare a report on the use of the
department's employees in providing services in the community
pursuant to assist in the orderly closures of Agnews
Developmental Center and Lanterman Developmental Center.
this section. The report shall include data on the number
and classification of state employees working in the community
program. The report shall include recommendations on whether the
program should be continued or ways in which the program
may be improved. Notwithstanding Section 10231.5 of the Government
Code, the report shall be submitted with the Governor's
proposed budget for the 2012-13 2015-16
fiscal year to the fiscal committees of both houses of the
Legislature and annually thereafter.
SEC. 12. Section 4474.3 of the Welfare
and Institutions Code is amended to read:
4474.3. The provisions of Section 10411 of the Public Contract
Code shall not apply to any person who, in connection with
the closures of Agnews Developmental Center or Lanterman
Developmental Center, provides developmental services.
who provides developmental services and supports to individuals
transitioning from a developmental center to community living or to
individuals with developmental disabilities at risk of admission to a
developmental center, an institution for mental disease, an
out-of-state placement, a general acute care hospital, or an acute
psychiatric hospital, pursuant to Section 4474.2.
SEC. 13. Section 4514 of the Welfare
and Institutions Code is amended to read:
4514. All information and records obtained in the course of
providing intake, assessment, and services under Division 4.1
(commencing with Section 4400), Division 4.5 (commencing with Section
4500), Division 6 (commencing with Section 6000), or Division 7
(commencing with Section 7100) to persons with developmental
disabilities shall be confidential. Information and records obtained
in the course of providing similar services to either voluntary or
involuntary recipients prior to 1969 shall also be confidential.
Information and records shall be disclosed only in any of the
following cases:
(a) In communications between qualified professional persons,
whether employed by a regional center or state developmental center,
or not, in the provision of intake, assessment, and services or
appropriate referrals. The consent of the person with a developmental
disability, or his or her guardian or conservator, shall be obtained
before information or records may be disclosed by regional center or
state developmental center personnel to a professional not employed
by the regional center or state developmental center, or a program
not vendored by a regional center or state developmental center.
(b) When the person with a developmental disability, who has the
capacity to give informed consent, designates individuals to whom
information or records may be released, except that nothing
in this chapter shall not be construed to compel
a physician and surgeon, psychologist, social worker, marriage and
family therapist, professional clinical counselor, nurse, attorney,
or other professional to reveal information that has been given to
him or her in confidence by a family member of the person unless a
valid release has been executed by that family member.
(c) To the extent necessary for a claim, or for a claim or
application to be made on behalf of a person with a developmental
disability for aid, insurance, government benefit, or medical
assistance to which he or she may be entitled.
(d) If the person with a developmental disability is a minor,
dependent ward, or conservatee, and his or her parent, guardian,
conservator, limited conservator with access to confidential records,
or authorized representative, designates, in writing, persons to
whom records or information may be disclosed, except that
nothing in this chapter shall not be construed
to compel a physician and surgeon, psychologist, social worker,
marriage and family therapist, professional clinical counselor,
nurse, attorney, or other professional to reveal information that has
been given to him or her in confidence by a family member of the
person unless a valid release has been executed by that family
member.
(e) For research, provided that if
the Director of Developmental Services designates by regulation rules
for the conduct of research and requires the research to be first
reviewed by the appropriate institutional review board or boards.
These rules shall include, but need not be limited to, the
requirement that all researchers shall sign an oath of
confidentiality as follows:
"" ____________________________
Date
As a condition of doing research concerning persons with
developmental disabilities who have received services from ____ (fill
in the facility, agency or person), I, ____, agree to obtain the
prior informed consent of persons who have received services to the
maximum degree possible as determined by the appropriate
institutional review board or boards for protection of human subjects
reviewing my research, or the person's parent, guardian, or
conservator, and I further agree not to divulge any information
obtained in the course of the research to unauthorized persons, and
not to publish or otherwise make public any information regarding
persons who have received services so those persons who received
services are identifiable.
I recognize that the unauthorized release of confidential
information may make me subject to a civil action under provisions of
the Welfare and Institutions Code.
________________________''
Signed
(f) To the courts, as necessary to the administration of justice.
(g) To governmental law enforcement agencies as needed for the
protection of federal and state elective constitutional officers and
their families.
(h) To the Senate Committee on Rules or the Assembly Committee on
Rules for the purposes of legislative investigation authorized by the
committee.
(i) To the courts and designated parties as part of a regional
center report or assessment in compliance with a statutory or
regulatory requirement, including, but not limited to, Section 1827.5
of the Probate Code, Sections 1001.22 and 1370.1 of the Penal Code,
and Section 6502 of the Welfare and Institutions Code.
(j) To the attorney for the person with a developmental disability
in any and all proceedings upon presentation of a release of
information signed by the person, except that when the person lacks
the capacity to give informed consent, the regional center or state
developmental center director or designee, upon satisfying himself or
herself of the identity of the attorney, and of the fact that the
attorney represents the person, shall release all information and
records relating to the person except that nothing in
this article shall not be construed to compel a
physician and surgeon, psychologist, social worker, marriage and
family therapist, professional clinical counselor, nurse, attorney,
or other professional to reveal information that has been given to
him or her in confidence by a family member of the person unless a
valid release has been executed by that family member.
(k) Upon written consent by a person with a developmental
disability previously or presently receiving services from a regional
center or state developmental center, the
director of the regional center or state
developmental center, or his or her designee, may release any
information, except information that has been given in confidence by
members of the family of the person with developmental disabilities,
requested by a probation officer charged with the evaluation of the
person after his or her conviction of a crime if the regional center
or state developmental center director or designee determines that
the information is relevant to the evaluation. The consent shall only
be operative until sentence is passed on the crime of which the
person was convicted. The confidential information released pursuant
to this subdivision shall be transmitted to the court separately from
the probation report and shall not be placed in the probation
report. The confidential information shall remain confidential except
for purposes of sentencing. After sentencing, the confidential
information shall be sealed.
( l ) Between persons who are trained and qualified to
serve on "multidisciplinary personnel" teams pursuant to subdivision
(d) of Section 18951. The information and records sought to be
disclosed shall be relevant to the prevention, identification,
management, or treatment of an abused child and his or her parents
pursuant to Chapter 11 (commencing with Section 18950) of Part 6 of
Division 9.
(m) When a person with a developmental disability dies from any
cause, natural or otherwise, while hospitalized in a state
developmental center, the State Department of Developmental Services,
the physician and surgeon in charge of the client, or the
professional in charge of the facility or his or her designee, shall
release information and records to the coroner. The State Department
of Developmental Services, the physician and surgeon in charge of the
client, or the professional in charge of the facility or his or her
designee, shall not release any notes, summaries, transcripts, tapes,
or records of conversations between the resident and health
professional personnel of the hospital relating to the personal life
of the resident that is not related to the diagnosis and treatment of
the resident's physical condition. Any information released to the
coroner pursuant to this section shall remain confidential and shall
be sealed and shall not be made part of the public record.
(n) To authorized licensing personnel who are employed by, or who
are authorized representatives of, the State Department of Public
Health, and who are licensed or registered health professionals, and
to authorized legal staff or special investigators who are peace
officers who are employed by, or who are authorized representatives
of, the State Department of Social Services, as necessary to the
performance of their duties to inspect, license, and investigate
health facilities and community care facilities, and to ensure that
the standards of care and services provided in these facilities are
adequate and appropriate and to ascertain compliance with the rules
and regulations to which the facility is subject. The confidential
information shall remain confidential except for purposes of
inspection, licensing, or investigation pursuant to Chapter 2
(commencing with Section 1250) and Chapter 3 (commencing with Section
1500) of Division 2 of the Health and Safety Code, or a criminal,
civil, or administrative proceeding in relation thereto. The
confidential information may be used by the State Department of
Public Health or the State Department of Social Services in a
criminal, civil, or administrative proceeding. The confidential
information shall be available only to the judge or hearing officer
and to the parties to the case. Names which
that are confidential shall be listed in attachments separate
to the general pleadings. The confidential information shall be
sealed after the conclusion of the criminal, civil, or administrative
hearings, and shall not subsequently be released except in
accordance with this subdivision. If the confidential information
does not result in a criminal, civil, or administrative proceeding,
it shall be sealed after the State Department of Public Health or the
State Department of Social Services decides that no further action
will be taken in the matter of suspected licensing violations. Except
as otherwise provided in this subdivision, confidential information
in the possession of the State Department of Public Health or the
State Department of Social Services shall not contain the name of the
person with a developmental disability.
(o) To any board which that licenses
and certifies professionals in the fields of mental health and
developmental disabilities pursuant to state law, when the Director
of Developmental Services has reasonable cause to believe that there
has occurred a violation of any provision of law subject to the
jurisdiction of a board and the records are relevant to the
violation. The information shall be sealed after a decision is
reached in the matter of the suspected violation, and shall not
subsequently be released except in accordance with this subdivision.
Confidential information in the possession of the board shall not
contain the name of the person with a developmental disability.
(p) (1) To governmental law enforcement
agencies by the director of a regional center or state developmental
center, or his or her designee, when (1) the person with a
developmental disability has been reported lost or missing or (2)
there is probable cause to believe that a person with a developmental
disability has committed, or has been the victim of, murder,
manslaughter, mayhem, aggravated mayhem, kidnapping, robbery,
carjacking, assault with the intent to commit a felony, arson,
extortion, rape, forcible sodomy, forcible oral copulation, assault
or battery, or unlawful possession of a weapon, as provided in any
provision listed in Section 16590 of the Penal Code.
(2) This subdivision shall be limited solely
to information directly relating to the factual circumstances of the
commission of the enumerated offenses and shall not include any
information relating to the mental state of the patient or the
circumstances of his or her treatment unless relevant to the crime
involved.
(3) This subdivision shall not be construed
as an exception to, or in any other way affecting, the provisions of
Article 7 (commencing with Section 1010) of Chapter 4 of Division 8
of the Evidence Code, or Chapter 11 (commencing with Section 15600)
and Chapter 13 (commencing with Section 15750) of Part 3 of Division
9.
(q) To the Division of Juvenile Facilities and Department of
Corrections and Rehabilitation or any component thereof, as necessary
to the administration of justice.
(r) To an agency mandated to investigate a report of abuse filed
pursuant to either Section 11164 of the Penal Code or Section 15630
of the Welfare and Institutions Code for the purposes of either a
mandated or voluntary report or when those agencies request
information in the course of conducting their investigation.
(s) When a person with developmental disabilities, or the parent,
guardian, or conservator of a person with developmental disabilities
who lacks capacity to consent, fails to grant or deny a request by a
regional center or state developmental center to release information
or records relating to the person with developmental disabilities
within a reasonable period of time, the director of the regional or
developmental center, or his or her designee, may release information
or records on behalf of that person provided both of the following
conditions are met:
(1) Release of the information or records is deemed necessary to
protect the person's health, safety, or welfare.
(2) The person, or the person's parent, guardian, or conservator,
has been advised annually in writing of the policy of the regional
center or state developmental center for release of confidential
client information or records when the person with developmental
disabilities, or the person's parent, guardian, or conservator, fails
to respond to a request for release of the information or records
within a reasonable period of time. A statement of policy contained
in the client's individual program plan shall be deemed to comply
with the notice requirement of this paragraph.
(t) (1) When an employee is served with a notice of adverse
action, as defined in Section 19570 of the Government Code, the
following information and records may be released:
(A) All information and records that the appointing authority
relied upon in issuing the notice of adverse action.
(B) All other information and records that are relevant to the
adverse action, or that would constitute relevant evidence as defined
in Section 210 of the Evidence Code.
(C) The information described in subparagraphs (A) and (B) may be
released only if both of the following conditions are met:
(i) The appointing authority has provided written notice to the
consumer and the consumer's legal representative or, if the consumer
has no legal representative or if the legal representative is a state
agency, to the clients' rights advocate, and the consumer, the
consumer's legal representative, or the clients' rights advocate has
not objected in writing to the appointing authority within five
business days of receipt of the notice, or the appointing authority,
upon review of the objection has determined that the circumstances on
which the adverse action is based are egregious or threaten the
health, safety, or life of the consumer or other consumers and
without the information the adverse action could not be taken.
(ii) The appointing authority, the person against whom the adverse
action has been taken, and the person's representative, if any, have
entered into a stipulation that does all of the following:
(I) Prohibits the parties from disclosing or using the information
or records for any purpose other than the proceedings for which the
information or records were requested or provided.
(II) Requires the employee and the employee's legal representative
to return to the appointing authority all records provided to them
under this subdivision, including, but not limited to, all records
and documents or copies thereof that are no longer in the possession
of the employee or the employee's legal representative because they
were from any source containing confidential information protected by
this section, and all copies of those records and documents, within
10 days of the date that the adverse action becomes final except for
the actual records and documents submitted to the administrative
tribunal as a component of an appeal from the adverse action.
(III) Requires the parties to submit the stipulation to the
administrative tribunal with jurisdiction over the adverse action at
the earliest possible opportunity.
(2) For the purposes of this subdivision, the State Personnel
Board may, prior to any appeal from adverse action being filed with
it, issue a protective order, upon application by the appointing
authority, for the limited purpose of prohibiting the parties from
disclosing or using information or records for any purpose other than
the proceeding for which the information or records were requested
or provided, and to require the employee or the employee's legal
representative to return to the appointing authority all records
provided to them under this subdivision, including, but not limited
to, all records and documents from any source containing confidential
information protected by this section, and all copies of those
records and documents, within 10 days of the date that the adverse
action becomes final, except for the actual records and documents
that are no longer in the possession of the employee or the employee'
s legal representatives because they were submitted to the
administrative tribunal as a component of an appeal from the adverse
action.
(3) Individual identifiers, including, but not limited to, names,
social security numbers, and hospital numbers, that are not necessary
for the prosecution or defense of the adverse action, shall not be
disclosed.
(4) All records, documents, or other materials containing
confidential information protected by this section that have been
submitted or otherwise disclosed to the administrative agency or
other person as a component of an appeal from an adverse action
shall, upon proper motion by the appointing authority to the
administrative tribunal, be placed under administrative seal and
shall not, thereafter, be subject to disclosure to any person or
entity except upon the issuance of an order of a court of competent
jurisdiction.
(5) For purposes of this subdivision, an adverse action becomes
final when the employee fails to answer within the time specified in
Section 19575 of the Government Code, or, after filing an answer,
withdraws the appeal, or, upon exhaustion of the administrative
appeal or of the judicial review remedies as otherwise provided by
law.
(u) To the person appointed as the developmental services
decisionmaker for a minor, dependent, or ward pursuant to Section
319, 361, or 726.
(v) To a protection and advocacy agency established pursuant to
Section 4901, to the extent that the information is incorporated
within any of the following:
(1) An unredacted facility evaluation report form or an unredacted
complaint investigation report form of the State Department of
Social Services. This information shall remain confidential and
subject to the confidentiality requirements of subdivision (f) of
Section 4903.
(2) An unredacted citation report, unredacted licensing report,
unredacted survey report, unredacted plan of correction, or
unredacted statement of deficiency of the State Department of Public
Health, prepared by authorized licensing personnel or authorized
representatives described in subdivision (n). This information shall
remain confidential and subject to the confidentiality requirements
of subdivision (f) of Section 4903.
(w) When a comprehensive assessment is conducted or updated
pursuant to Section 4418.25, 4418.7, or 4648, a regional center is
authorized to provide the assessment to the regional center clients'
rights advocate, who provides service pursuant to Section 4433.
SEC. 14. Section 4519.6 of the Welfare
and Institutions Code is amended to read:
4519.6. The department and the regional centers shall annually
collaborate to determine the most appropriate methods to collect and
compile meaningful data in a uniform manner, as specified in Section
4519.5, related to the payment of copayments
copayments, coinsurance, and coinsurance
deductibles by each regional center.
SEC. 15. Section 4648 of the Welfare
and Institutions Code is amended to read:
4648. In order to achieve the stated objectives of a consumer's
individual program plan, the regional center shall conduct
activities, including, but not limited to, all of the following:
(a) Securing needed services and supports.
(1) It is the intent of the Legislature that services and supports
assist individuals with developmental disabilities in achieving the
greatest self-sufficiency possible and in exercising personal
choices. The regional center shall secure services and supports that
meet the needs of the consumer, as determined in the consumer's
individual program plan, and within the context of the individual
program plan, the planning team shall give highest preference to
those services and supports which would allow minors with
developmental disabilities to live with their families, adult persons
with developmental disabilities to live as independently as possible
in the community, and that allow all consumers to interact with
persons without disabilities in positive, meaningful ways.
(2) In implementing individual program plans, regional centers,
through the planning team, shall first consider services and supports
in natural community, home, work, and recreational settings.
Services and supports shall be flexible and individually tailored to
the consumer and, where appropriate, his or her family.
(3) A regional center may, pursuant to vendorization or a
contract, purchase services or supports for a consumer from any
individual or agency which the regional center and consumer or, where
appropriate, his or her parents, legal guardian, or conservator, or
authorized representatives, determines will best accomplish all or
any part of that consumer's program plan.
(A) Vendorization or contracting is the process for
identification, selection, and utilization of service vendors or
contractors, based on the qualifications and other requirements
necessary in order to provide the service.
(B) A regional center may reimburse an individual or agency for
services or supports provided to a regional center consumer if the
individual or agency has a rate of payment for vendored or contracted
services established by the department, pursuant to this division,
and is providing services pursuant to an emergency vendorization or
has completed the vendorization procedures or has entered into a
contract with the regional center and continues to comply with the
vendorization or contracting requirements. The director shall adopt
regulations governing the vendorization process to be utilized by the
department, regional centers, vendors and the individual or agency
requesting vendorization.
(C) Regulations shall include, but not be limited to: the vendor
application process, and the basis for accepting or denying an
application; the qualification and requirements for each category of
services that may be provided to a regional center consumer through a
vendor; requirements for emergency vendorization; procedures for
termination of vendorization; the procedure for an individual or an
agency to appeal any vendorization decision made by the department or
regional center.
(D) A regional center may vendorize a licensed facility for
exclusive services to persons with developmental disabilities at a
capacity equal to or less than the facility's licensed capacity. A
facility already licensed on January 1, 1999, shall continue to be
vendorized at their full licensed capacity until the facility agrees
to vendorization at a reduced capacity.
(E) Effective July 1, 2009, notwithstanding any other provision of
law or regulation to the contrary, a regional center shall not newly
vendor a State Department of Social Services licensed 24-hour
residential care facility with a licensed capacity of 16 or more
beds, unless the facility qualifies for receipt of federal funds
under the Medicaid Program.
(4) Notwithstanding subparagraph (B) of paragraph (3), a regional
center may contract or issue a voucher for services and supports
provided to a consumer or family at a cost not to exceed the maximum
rate of payment for that service or support established by the
department. If a rate has not been established by the department, the
regional center may, for an interim period, contract for a specified
service or support with, and establish a rate of payment for, any
provider of the service or support necessary to implement a consumer'
s individual program plan. Contracts may be negotiated for a period
of up to three years, with annual review and subject to the
availability of funds.
(5) In order to ensure the maximum flexibility and availability of
appropriate services and supports for persons with developmental
disabilities, the department shall establish and maintain an
equitable system of payment to providers of services and supports
identified as necessary to the implementation of a consumers'
individual program plan. The system of payment shall include
provision for a rate to ensure that the provider can meet the special
needs of consumers and provide quality services and supports in the
least restrictive setting as required by law.
(6) The regional center and the consumer, or where appropriate,
his or her parents, legal guardian, conservator, or authorized
representative, including those appointed pursuant to subdivision (d)
of Section 4548, subdivision (b) of Section 4701.6, or subdivision
(e) of Section 4705, shall, pursuant to the individual program plan,
consider all of the following when selecting a provider of consumer
services and supports:
(A) A provider's ability to deliver quality services or supports
which can accomplish all or part of the consumer's individual program
plan.
(B) A provider's success in achieving the objectives set forth in
the individual program plan.
(C) Where appropriate, the existence of licensing, accreditation,
or professional certification.
(D) The cost of providing services or supports of comparable
quality by different providers, if available, shall be reviewed, and
the least costly available provider of comparable service, including
the cost of transportation, who is able to accomplish all or part of
the consumer's individual program plan, consistent with the
particular needs of the consumer and family as identified in the
individual program plan, shall be selected. In determining the least
costly provider, the availability of federal financial participation
shall be considered. The consumer shall not be required to use the
least costly provider if it will result in the consumer moving from
an existing provider of services or supports to more restrictive or
less integrated services or supports.
(E) The consumer's choice of providers, or, where appropriate, the
consumer's parent's, legal guardian's, authorized representative's,
or conservator's choice of providers.
(7) No service or support provided by any agency or individual
shall be continued unless the consumer or, where appropriate, his or
her parents, legal guardian, or conservator, or authorized
representative, including those appointed pursuant to subdivision (d)
of Section 4548, subdivision (b) of Section 4701.6, or subdivision
(e) of Section 4705, is satisfied and the regional center and the
consumer or, when appropriate, the person's parents or legal guardian
or conservator agree that planned services and supports have been
provided, and reasonable progress toward objectives have been made.
(8) Regional center funds shall not be used to supplant the budget
of any agency that has a legal responsibility to serve all members
of the general public and is receiving public funds for providing
those services.
(9) (A) A regional center may, directly or through an agency
acting on behalf of the center, provide placement in, purchase of, or
follow-along services to persons with developmental disabilities in,
appropriate community living arrangements, including, but not
limited to, support service for consumers in homes they own or lease,
foster family placements, health care facilities, and licensed
community care facilities. In considering appropriate placement
alternatives for children with developmental disabilities, approval
by the child's parent or guardian shall be obtained before placement
is made.
(B) Effective July 1, 2012, notwithstanding any other law or
regulation to the contrary, a regional center shall not purchase
residential services from a State Department of Social Services
licensed 24-hour residential care facility with a licensed capacity
of 16 or more beds. This prohibition on regional center purchase of
residential services shall not apply to any of the following:
(i) A residential facility with a licensed capacity of 16 or more
beds that has been approved to participate in the department's Home
and Community Based Services Waiver or another existing waiver
program or certified to participate in the Medi-Cal program.
(ii) A residential facility service provider that has a written
agreement and specific plan prior to July 1, 2012, with the vendoring
regional center to downsize the existing facility by transitioning
its residential services to living arrangements of 15 beds or less or
restructure the large facility to meet federal Medicaid eligibility
requirements on or before June 30, 2013.
(iii) A residential facility licensed as a mental health
rehabilitation center by the State Department of Mental Health or
successor agency under any of the following circumstances:
(I) The facility is eligible for Medicaid reimbursement.
(II) The facility has a department-approved plan in place by June
30, 2013, to transition to a program structure eligible for federal
Medicaid funding, and this transition will be completed by June 30,
2014. The department may grant an extension for the date by which the
transition will be completed if the facility demonstrates that it
has made significant progress toward transition, and states with
specificity the timeframe by which the transition will be completed
and the specified steps that will be taken to accomplish the
transition. A regional center may pay for the costs of care and
treatment of a consumer residing in the facility on June 30, 2012,
until June 30, 2013, inclusive, and, if the facility has a
department-approved plan in place by June 30, 2013, may continue to
pay the costs under this subparagraph until June 30, 2014, or until
the end of any period during which the department has granted an
extension.
(III) There is an emergency circumstance in which the regional
center determines that it cannot locate alternate federally eligible
services to meet the consumer's needs. Under such an emergency
circumstance, an assessment shall be completed by the regional center
as soon as possible and within 30 days of admission. An individual
program plan meeting shall be convened immediately following the
assessment to determine the services and supports needed for
stabilization and to develop a plan to transition the consumer from
the facility into the community. If transition is not expected within
90 days of admission, an individual program plan meeting shall be
held to discuss the status of transition and to determine if the
consumer is still in need of placement in the facility. Commencing
October 1, 2012, this determination shall be made after also
considering resource options identified by the statewide specialized
resource service. If it is determined that emergency services
continue to be necessary, the regional center shall submit an updated
transition plan that can cover a period of up to 90 days. In no
event shall placements under these emergency circumstances exceed 180
days.
(C) (i) Effective July 1, 2012, notwithstanding any other law or
regulation to the contrary, a regional center shall not purchase new
residential services from, or place a consumer in, institutions for
mental disease, as described in Part 5 (commencing with Section 5900)
of Division 5, for which federal Medicaid
funding is not available. Effective July 1,
2013, this prohibition applies regardless of the availability of
federal funding.
(ii) The prohibition described in clause (i) shall not apply to
emergencies, as determined by the regional center, when a regional
center cannot locate alternate services to meet the consumer's needs.
As soon as possible within 30 days of admission due to an emergency,
an assessment shall be completed by the regional center. An
individual program plan meeting shall be convened immediately
following the assessment, to determine the services and supports
needed for stabilization and to develop a plan to transition the
consumer from the facility to the community. If transition is not
expected within 90 days of admission, an emergency program plan
meeting shall be held to discuss the status of the transition and to
determine if the consumer is still in need of placement in the
facility. If emergency services continue to be necessary, the
regional center shall submit an updated transition plan to the
department for an extension of up to 90 days. Placement shall not
exceed 180 days.
(iii) To the extent feasible, prior to any admission, the regional
center shall consider resource options identified by the statewide
specialized resource service established pursuant to subdivision (b)
of Section 4418.25.
(iv) The clients' rights advocate shall be notified of each
admission and individual program planning meeting pursuant to this
subparagraph and may participate in all individual program planning
meetings unless the consumer objects on his or her own behalf.
For purposes of this clause, notification to the clients' rights
advocate shall include a copy of the most recent comprehensive
assessment or updated assessment and the time, date, and location of
the meeting, and shall be provided as soon as practicable, but not
less than 7 calendar days prior to the meeting.
(v) Regional centers shall complete a comprehensive assessment of
any consumer residing in an institution for mental disease as of July
1, 2012, for which federal Medicaid funding is not available, and
for any consumer residing in an institution for mental disease as of
July 1, 2013, without regard to federal funding. The comprehensive
assessment shall be completed prior to the consumer's next scheduled
individual program plan meeting and shall include identification of
the services and supports needed and the timeline for identifying or
developing those services needed to transition the consumer back to
the community. Effective October 1, 2012, the regional center shall
also consider resource options identified by the statewide
specialized resource service. For each individual program plan
meeting convened pursuant to this subparagraph, the clients' rights
advocate for the regional center shall be notified of the meeting and
may participate in the meeting unless the consumer objects on his or
her own behalf. For purposes of this clause,
notification to the clients' rights advocate shall include the time,
date, and location of the meeting, and shall be provided as soon as
practicable, but not less than 7 calendar days prior to the meeting.
(D) Each person with developmental disabilities placed by the
regional center in a community living arrangement shall have the
rights specified in this division. These rights shall be brought to
the person's attention by any means necessary to reasonably
communicate these rights to each resident, provided that, at a
minimum, the Director of Developmental Services prepare, provide, and
require to be clearly posted in all residential facilities and day
programs a poster using simplified language and pictures that is
designed to be more understandable by persons with cognitive
disabilities and that the rights information shall also be available
through the regional center to each residential facility and day
program in alternative formats, including, but not limited to, other
languages, braille, and audio tapes, when necessary to meet the
communication needs of consumers.
(E) Consumers are eligible to receive supplemental services
including, but not limited to, additional staffing, pursuant to the
process described in subdivision (d) of Section 4646. Necessary
additional staffing that is not specifically included in the rates
paid to the service provider may be purchased by the regional center
if the additional staff are in excess of the amount required by
regulation and the individual's planning team determines the
additional services are consistent with the provisions of the
individual program plan. Additional staff should be periodically
reviewed by the planning team for consistency with the individual
program plan objectives in order to determine if continued use of the
additional staff is necessary and appropriate and if the service is
producing outcomes consistent with the individual program plan.
Regional centers shall monitor programs to ensure that the additional
staff is being provided and utilized appropriately.
(10) Emergency and crisis intervention services including, but not
limited to, mental health services and behavior modification
services, may be provided, as needed, to maintain persons with
developmental disabilities in the living arrangement of their own
choice. Crisis services shall first be provided without disrupting a
person's living arrangement. If crisis intervention services are
unsuccessful, emergency housing shall be available in the person's
home community. If dislocation cannot be avoided, every effort shall
be made to return the person to his or her living arrangement of
choice, with all necessary supports, as soon as possible.
(11) Among other service and support options, planning teams shall
consider the use of paid roommates or neighbors, personal
assistance, technical and financial assistance, and all other service
and support options which would result in greater self-sufficiency
for the consumer and cost-effectiveness to the state.
(12) When facilitation as specified in an individual program plan
requires the services of an individual, the facilitator shall be of
the consumer's choosing.
(13) The community support may be provided to assist individuals
with developmental disabilities to fully participate in community and
civic life, including, but not limited to, programs, services, work
opportunities, business, and activities available to persons without
disabilities. This facilitation shall include, but not be limited to,
any of the following:
(A) Outreach and education to programs and services within the
community.
(B) Direct support to individuals which would enable them to more
fully participate in their community.
(C) Developing unpaid natural supports when possible.
(14) When feasible and recommended by the individual program
planning team, for purposes of facilitating better and cost-effective
services for consumers or family members, technology, including
telecommunication technology, may be used in conjunction with other
services and supports. Technology in lieu of a consumer's in-person
appearances at judicial proceedings or administrative due process
hearings may be used only if the consumer or, when appropriate, the
consumer's parent, legal guardian, conservator, or authorized
representative, gives informed consent. Technology may be used in
lieu of, or in conjunction with, in-person training for providers, as
appropriate.
(15) Other services and supports may be provided as set forth in
Sections 4685, 4686, 4687, 4688, and 4689, when necessary.
(16) Notwithstanding any other provision of law or regulation to
the contrary, effective July 1, 2009, regional centers shall not
purchase experimental treatments, therapeutic services, or devices
that have not been clinically determined or scientifically proven to
be effective or safe or for which risks and complications are
unknown. Experimental treatments or therapeutic services include
experimental medical or nutritional therapy when the use of the
product for that purpose is not a general physician practice. For
regional center consumers receiving these services as part of their
individual program plan (IPP) or individualized family service plan
(IFSP) on July 1, 2009, this prohibition shall apply on August 1,
2009.
(b) (1) Advocacy for, and protection of, the civil, legal, and
service rights of persons with developmental disabilities as
established in this division.
(2) Whenever the advocacy efforts of a regional center to secure
or protect the civil, legal, or service rights of any of its
consumers prove ineffective, the regional center or the person with
developmental disabilities or his or her parents, legal guardian, or
other representative may request the area board to initiate action
under the provisions defining area board advocacy functions
established in this division.
(c) The regional center may assist consumers and families
directly, or through a provider, in identifying and building circles
of support within the community.
(d) In order to increase the quality of community services and
protect consumers, the regional center shall, when appropriate, take
either of the following actions:
(1) Identify services and supports that are ineffective or of poor
quality and provide or secure consultation, training, or technical
assistance services for any agency or individual provider to assist
that agency or individual provider in upgrading the quality of
services or supports.
(2) Identify providers of services or supports that may not be in
compliance with local, state, and federal statutes and regulations
and notify the appropriate licensing or regulatory authority, or
request the area board to investigate the possible noncompliance.
(e) When necessary to expand the availability of needed services
of good quality, a regional center may take actions that include, but
are not limited to, the following:
(1) Soliciting an individual or agency by requests for proposals
or other means, to provide needed services or supports not presently
available.
(2) Requesting funds from the Program Development Fund, pursuant
to Section 4677, or community placement plan funds designated from
that fund, to reimburse the startup costs needed to initiate a new
program of services and supports.
(3) Using creative and innovative service delivery models,
including, but not limited to, natural supports.
(f) Except in emergency situations, a regional center shall not
provide direct treatment and therapeutic services, but shall utilize
appropriate public and private community agencies and service
providers to obtain those services for its consumers.
(g) Where there are identified gaps in the system of services and
supports or where there are identified consumers for whom no provider
will provide services and supports contained in his or her
individual program plan, the department may provide the services and
supports directly.
(h) At least annually, regional centers shall provide the
consumer, his or her parents, legal guardian, conservator, or
authorized representative a statement of services and supports the
regional center purchased for the purpose of ensuring that they are
delivered. The statement shall include the type, unit, month, and
cost of services and supports purchased.
SEC. 16. Section 4659.1 of the Welfare
and Institutions Code is amended to read:
4659.1. (a) If a service or support provided pursuant to a
consumer's individual program plan under this division or
individualized family service plan pursuant to the California Early
Intervention Services Act (Title 14 (commencing with Section 95000)
of the Government Code) is paid for, in whole or in part, by the
health care service plan or health insurance policy of the consumer's
parent, guardian, or caregiver, the regional center may, when
necessary to ensure that the consumer receives the service or
support, pay any applicable copayment
copayment, coinsurance, or coinsurance
deductible associated with the service or support for which the
parent, guardian, or caregiver is responsible if all of the
following conditions are met:
(1) The consumer is covered by his or her parent's, guardian's, or
caregiver's health care service plan or health insurance policy.
(2) The family has an annual gross income that does not exceed 400
percent of the federal poverty level.
(3) There is no other third party having liability for the cost of
the service or support, as provided in subdivision (a) of Section
4659 and Article 2.6 (commencing with Section 4659.10).
(b) If a service or support provided to a consumer 18 years of age
or older, pursuant to his or her individual program plan, is paid
for in whole or in part by the consumer's health care service plan or
health insurance policy, the regional center may, when necessary to
ensure that the consumer receives the service or support, pay any
applicable copayment copayment, coinsurance,
or coinsurance deductible
associated with the service or support for which the consumer is
responsible if both of the following conditions are met:
(1) The consumer has an annual gross income that does not exceed
400 percent of the federal poverty level.
(2) There is no other third party having liability for the cost of
the service or support, as provided in subdivision (a) of Section
4659 and Article 2.6 (commencing with Section 4659.10).
(c) Notwithstanding paragraph (2) of subdivision (a) or paragraph
(1) of subdivision (b), a regional center may pay a
copayment copayment, coinsurance, or
coinsurance deductible associated with the
health care service plan or health insurance policy for a service or
support provided pursuant to a consumer's individual program plan or
individualized family service plan if the family's or consumer's
income exceeds 400 percent of the federal poverty level, the service
or support is necessary to successfully maintain the child at home or
the adult consumer in the least-restrictive setting, and the parents
or consumer demonstrate one or more of the following:
(1) The existence of an extraordinary event that impacts the
ability of the parent, guardian, or caregiver to meet the care and
supervision needs of the child or impacts the ability of the parent,
guardian, or caregiver, or adult consumer with a health care service
plan or health insurance policy, to pay the copayment
copayment, coinsurance, or coinsurance.
deductible.
(2) The existence of catastrophic loss that temporarily limits the
ability to pay of the parent, guardian, or caregiver, or adult
consumer with a health care service plan or health insurance policy
and creates a direct economic impact on the family or adult consumer.
For purposes of this paragraph, catastrophic loss may include, but
is not limited to, natural disasters and accidents involving major
injuries to an immediate family member.
(3) Significant unreimbursed medical costs associated with the
care of the consumer or another child who is also a regional center
consumer.
(d) The parent, guardian, or caregiver of a consumer or an adult
consumer with a health care service plan or health insurance policy
shall self-certify the family's gross annual income to the regional
center by providing copies of W-2 Wage Earners Statements, payroll
stubs, a copy of the prior year's state income tax return, or other
documents and proof of other income.
(e) The parent, guardian, or caregiver of a consumer or an adult
consumer with a health care service plan or health insurance policy
is responsible for notifying the regional center when a change in
income occurs that would result in a change in eligibility for
coverage of the health care service plan or health insurance policy
copayments copayments, coinsurance, or
coinsurance. deductibles.
(f) Documentation submitted pursuant to this section shall be
considered records obtained in the course of providing intake,
assessment, and services and shall be confidential pursuant to
Section 4514.
(g) Regional centers shall not pay health care service plan or
health insurance policy deductibles.
(h)
(g) This section shall not be implemented in a manner
that is inconsistent with the requirements of Part C of the federal
Individuals with Disabilities Education Act (20 U.S.C. Sec. 1431 et
seq.).
SEC. 17. Section 4681.6 of the Welfare
and Institutions Code is amended to read:
4681.6. (a) Notwithstanding any other
provision of law or regulation, commencing July 1,
2008:
(a)
(1) No A regional center
may shall not pay an existing
residential service provider, for services where rates are determined
through a negotiation between the regional center and the provider,
a rate higher than the rate in effect on June 30, 2008, unless the
increase is required by a contract between the regional center and
the vendor that is in effect on June 30, 2008, or the regional center
demonstrates that the approval is necessary to protect the consumer'
s health or safety and the department has granted prior written
authorization.
(b)
(2) No A regional center
may shall not negotiate a rate with a
new residential service provider, for services where rates are
determined through a negotiation between the regional center and the
provider, that is higher than the regional center's median rate for
the same service code and unit of service, or the statewide median
rate for the same service code and unit of service, whichever is
lower. The unit of service designation must
shall conform with an existing regional center designation or,
if none exists, a designation used to calculate the statewide median
rate for the same service. The regional center shall annually certify
to the department its median rate for each negotiated rate service
code, by designated unit of service. This certification will
shall be subject to verification through the
department's biennial fiscal audit of the regional center.
(b) Notwithstanding subdivision (a), commencing July 1, 2014,
regional centers may negotiate a rate adjustment with residential
service providers regarding rates that are otherwise restricted
pursuant to subdivision (a), if the adjustment is necessary in order
to pay employees no less than the minimum wage as established by
Section 1182.12 of the Labor Code, as amended by Chapter 351 of the
Statutes of 2013, and only for the purpose of adjusting payroll costs
associated with the minimum wage increase. The rate adjustment shall
be specific to the unit of service designation that is affected by
the increased minimum wage, shall be specific to payroll costs
associated with any increase necessary to adjust employee pay only to
the extent necessary to bring pay into compliance with the increased
state minimum wage, and shall not be used as a general wage
enhancement for employees paid above the minimum wage. Regional
centers shall maintain documentation on the process to determine, and
the rationale for granting, any rate adjustment associated with the
minimum wage increase.
(c) For purposes of this section, "residential service provider"
includes Adult Residential Facilities for Persons with Special Health
Care Needs, as described in Section 4684.50.
(d) This section shall not apply to those services for which rates
are determined by the State Department of Health Care Services, or
the State Department of Developmental Services, or are usual and
customary.
SEC. 18. Article 3.6 (commencing with Section
4684.80) is added to Chapter 6 of Division 4.5 of the
Welfare and Institutions Code , to read:
Article 3.6. Enhanced Behavioral Supports Homes
4684.80. (a) "Enhanced behavioral supports home" means a facility
certified by the State Department of Developmental Services and
licensed by the State Department of Social Services pursuant to
Section 1567.62 of the Health and Safety Code as an adult residential
facility or a group home that provides 24-hour nonmedical care to
individuals with developmental disabilities who require enhanced
behavioral supports, staffing, and supervision in a homelike setting.
An enhanced behavioral supports home shall have a maximum capacity
of four consumers, shall conform to Section 441.530(a)(1) of Title 42
of the Code of Federal Regulations, and shall be eligible for
federal Medicaid home- and community-based services funding.
(b) "Enhanced behavioral services and supports" means additional
staffing supervision, facility characteristics, or other services and
supports to address a consumer's challenging behaviors, which are
beyond what is typically available in other community facilities
licensed as an adult residential facility or a group home to serve
individuals in a community setting rather than an institution.
(c) "Individual behavior supports plan" means the plan that
identifies and documents the behavior and intensive support and
service needs of a consumer and details the strategies to be employed
and services to be provided to address those needs, and includes the
entity responsible for providing those services and timelines for
when each identified individual behavior support will commence.
(d) "Individual behavior supports team" means those individuals
who develop, monitor, and revise the individual behavior supports
plan for consumers residing in an enhanced behavioral supports home.
The team shall, at a minimum, be composed of all of the following
individuals:
(1) Regional center service coordinator and other regional center
representatives, as necessary.
(2) Consumer and, where appropriate, his or her conservator or
authorized representative.
(3) Service provider's board-certified behavior analyst or
qualified behavior modification professional.
(4) Enhanced behavioral supports home administrator.
(5) Regional center clients' rights advocate, unless the consumer
objects on his or her own behalf to participation by the clients'
rights advocate.
(6) Others deemed necessary by the consumer, or his or her
conservator or authorized representative, for developing a
comprehensive and effective individual behavior supports plan.
4684.81. (a) The department shall implement a pilot project using
community placement plan funds, as appropriated in the State
Department of Developmental Services' annual budget, to test the
effectiveness of providing enhanced behavioral supports in homelike
community settings. The enhanced behavioral supports homes shall be
for purposes of providing intensive behavioral services and supports
to adults and children with developmental disabilities who need
intensive services and supports due to challenging behaviors that
cannot be managed in a community setting without the availability of
enhanced behavioral services and supports, and who are at risk of
institutionalization or out-of-state placement, or are transitioning
to the community from a developmental center, other state-operated
residential facility, institution for mental disease, or out-of-state
placement.
(b) An enhanced behavioral supports home may only be established
in an adult residential facility or a group home approved through a
regional center community placement plan pursuant to Section 4418.25.
(c) No more than six enhanced behavioral supports homes may be
approved by the State Department of Developmental Services each
fiscal year in which the pilot program is in effect and to the extent
funding is available for this purpose, each for no more than four
individuals with developmental disabilities. The homes shall be
located throughout the state, as determined by the State Department
of Developmental Services, based on regional center requests.
(d) Each enhanced behavioral supports home shall be licensed as an
adult residential facility or a group home pursuant to the
California Community Care Facilities Act (Chapter 3 (commencing with
Section 1500) of Division 2 of the Health and Safety Code) and
certified by the State Department of Developmental Services, shall
exceed the minimum requirements for a Residential Facility Service
Level 4-i pursuant to Sections 56004 and 56013 of Title 17 of the
California Code of Regulations, and shall meet all applicable
statutory and regulatory requirements applicable to a facility
licensed as an adult residential facility or a group home for
facility licensing, seclusion, and restraint, including Division 1.5
(commencing with Section 1180) of the Health and Safety Code, and the
use of behavior modification interventions, subject to any
additional requirements applicable to enhanced behavioral supports
homes established by statute or by regulation promulgated pursuant to
this article and Article 9.5 (commencing with Section 1567.61) of
Chapter 3 of Division 2 of the Health and Safety Code.
(e) A regional center shall not place a consumer in an enhanced
behavioral supports home unless the program is certified by the State
Department of Developmental Services and the facility is licensed by
the State Department of Social Services.
(f) The State Department of Developmental Services shall be
responsible for granting the certificate of program approval for an
enhanced behavioral supports home.
(g) The State Department of Developmental Services may, pursuant
to Section 4684.85, decertify any enhanced behavioral supports home
that does not comply with program requirements. Upon decertification
of an enhanced behavioral supports home, the State Department of
Developmental Services shall report the decertification to
the State Department of Social
Services. The State Department of Social Services shall revoke the
license of the enhanced behavioral supports home that has been
decertified pursuant to Section 1550 of the Health and Safety Code.
(h) If the State Department of Developmental Services determines
that urgent action is necessary to protect a consumer residing in an
enhanced behavioral supports home from physical or mental abuse,
abandonment, or any other substantial threat to the consumer's health
and safety, the State Department of Developmental Services may
request that the regional center or centers remove the consumer from
the enhanced behavioral supports home or direct the regional center
or centers to obtain alternative or additional services for the
consumers within 24 hours of that determination. When possible, an
individual program plan (IPP) meeting shall be convened to determine
the appropriate action pursuant to this section. In any case, an IPP
meeting shall be convened within 30 days following an action pursuant
to this section.
(i) Enhanced behavioral supports homes shall have a facility
program plan approved by the State Department of Developmental
Services.
(1) The facility program plan approved by the State Department of
Developmental Services shall be submitted to the State Department of
Social Services for inclusion in the facility plan of operation.
(2) The vendoring regional center and each consumer's regional
center shall have joint responsibility for monitoring and evaluating
the services provided in the enhanced behavioral supports home.
Monitoring shall include at least quarterly, or more frequently if
specified in the consumer's individual program plan, face-to-face,
onsite case management visits with each consumer by his or her
regional center and at least quarterly quality assurance visits by
the vendoring regional center. The State Department of Developmental
Services shall monitor and ensure the regional centers' compliance
with their monitoring responsibilities.
(j) The State Department of Developmental Services shall establish
by regulation a rate methodology for enhanced behavioral supports
homes that includes a fixed facility component for residential
services and an individualized services and supports component based
on each consumer's needs as determined through the individual program
plan process, which may include assistance with transitioning to a
less restrictive community residential setting.
(k) (1) The established facility rate for a full month of service,
as defined in regulations adopted pursuant to this article, shall be
paid based on the licensed capacity of the facility once the
facility reaches maximum capacity, despite the temporary absence of
one or more consumers from the facility or subsequent temporary
vacancies created by consumers moving from the facility. Prior to the
facility reaching licensed capacity, the facility rate shall be
prorated based on the number of consumers residing in the facility.
When a consumer is temporarily absent from the facility, including
when a consumer is in need for inpatient care in a health facility,
as defined in subdivision (a), (b), or (c) of Section 1250 of the
Health and Safety Code, the regional center may, based on consumer
need, continue to fund individual services, in addition to paying the
facility rate. Individual consumer services funded by the regional
center during a consumer's absence from the facility shall be
approved by the regional center director and shall only be approved
in 14-day increments. The regional center shall maintain
documentation of the need for these services and the regional center
director's approval.
(2) An enhanced behavioral supports home using delayed egress
devices, in compliance with Section 1531.1 of the Health and Safety
Code, may utilize secured perimeters, in compliance with Section
1531.15 of the Health and Safety Code and applicable regulations. No
more than two enhanced behavioral supports homes using delayed egress
devices in combination with secured perimeters may be certified by
the State Department of Developmental Services during the first year
of the pilot program, one in northern California and one in southern
California, and no more than one additional home using delayed egress
devices in combination with a secured perimeter may be certified by
the State Department of Developmental Services in each subsequent
year of the pilot program. No more than six enhanced behavioral
supports homes that use delayed egress devices in combination with a
secured perimeter shall be certified during the pilot program.
Enhanced behavioral supports homes shall not be counted for purposes
of the statewide limit established in regulations on the total number
of beds permitted in homes with delayed egress devices in
combination with secured perimeters pursuant to subdivision (k) of
Section 1531.15 of the Health and Safety Code. The department shall
make reasonable efforts to include enhanced behavioral supports homes
within the statewide limit.
4684.82. The vendoring regional center shall, before placing any
consumer into an enhanced behavioral supports home, ensure that the
home has a license issued by the State Department of Social Services
for not more than four individuals with developmental disabilities,
is certified by the State Department of Developmental Services, and
has a contract with the regional center that meets the contracting
requirements established by the State Department of Developmental
Services through regulations promulgated pursuant to this article.
Under no circumstances shall the contract extend beyond the stated
termination date, which shall not be longer than January 1, 2020.
4684.83. The enhanced behavioral supports home provider shall be
responsible for coordinating the development and updating of each
consumer's individual behavior supports plan with the consumer's
individual behavior supports team. The initial individual behavior
supports plan shall be developed within one week of the consumer's
admission to the enhanced behavioral supports home.
4684.84. (a) The regional center shall have responsibility for
monitoring and evaluating the implementation of the consumer's
individual behavior supports plan objectives.
(b) A regional center qualified behavior modification professional
shall visit, with or without notice, the consumer, in person, at
least monthly in the enhanced behavioral supports home, or more
frequently if specified in the consumer's individual behavior
supports plan. At least four of these visits, annually, shall be
unannounced.
(c) The State Department of Developmental Services shall monitor
and ensure the regional centers' compliance with the requirements of
this article. The monitoring shall include onsite visits to all the
enhanced behavioral supports homes at least every six months for the
duration of the pilot project.
(d) The State Department of Developmental Services shall conduct a
review of the pilot project in consultation with stakeholders. The
review shall be completed and the results of the review shall be
shared in writing with the State Department of Social Services no
later than September 1, 2018.
4684.85. (a) In addition to any other contract termination
provisions, a regional center may terminate its contract with an
enhanced behavioral supports home when the regional center determines
that the home is unable to maintain substantial compliance with
state laws, regulations, or its contract with the regional center, or
the home demonstrates an inability to ensure the health and safety
of the consumers.
(b) The enhanced behavioral supports home may appeal a regional
center's decision to terminate its contract by sending to the
executive director of the contracting regional center a detailed
statement containing the reasons and facts demonstrating why the
termination is inappropriate. The appeal shall be received by the
regional center within 10 working days from the date of the letter
terminating the contract. The executive director shall respond with
his or her decision within 10 working days of the date of receipt of
the appeal from the enhanced behavioral supports home. The executive
director shall submit his or her decision to the State Department of
Developmental Services and the State Department of Social Services on
the same date that it is signed. The decision of the executive
director shall be the final administrative decision.
(c) The Director of Developmental Services may rescind an enhanced
behavioral supports home program certification when, in his or her
sole discretion, an enhanced behavioral supports home does not
maintain substantial compliance with an applicable statute,
regulation, or ordinance, or cannot ensure the health and safety of
the consumers. The decision of the Director of Developmental Services
shall be the final administrative decision. The Director of
Developmental Services shall transmit his or her decision whether to
rescind an enhanced behavioral supports home program certification to
the State Department of Social Services and the regional center with
his or her recommendation as to whether to revoke the enhanced
behavioral supports home's residential care facility license, for
which the State Department of Social Services shall revoke the
license of the enhanced behavioral supports home pursuant to Section
1550 of the Health and Safety Code.
(d) The State Department of Developmental Services and regional
centers shall, for purposes of assisting in licensing, provide the
State Department of Social Services with all available documentation
and evidentiary support that was submitted to the State Department of
Developmental Services in connection with certification by an
applicant for licensure under this article.
4684.86. (a) A certification for an enhanced behavioral supports
home shall not be issued before emergency regulations filed by the
State Department of Developmental Services pursuant to this article
have been published. These regulations shall be developed in
consultation with stakeholders, including the State Department of
Social Services, consumer advocates, and regional centers. The
regulations shall address at least the following:
(1) Program standards, including program design requirements,
staffing structure, staff qualifications, and training. Training
requirements shall include:
(A) A minimum of 16 hours of emergency intervention training,
which shall include the techniques the licensee will use to prevent
injury and maintain safety regarding consumers who are a danger to
self or others and shall emphasize positive behavioral supports and
techniques that are alternatives to physical restraints.
(B) Additional training for direct care staff to address the
specialized needs of the consumers, including training in emergency
interventions.
(2) Requirements and timelines for the development and updating of
consumers' individual behavior supports plans.
(3) Admission and continued stay requirements.
(4) Requirements for ensuring that appropriate services and
supports are provided at the time of admission to meet the consumer's
immediate needs pending development of the consumer's individual
behavior supports plan.
(5) The rate methodology.
(6) Consumer rights and protections.
(b) The adoption, initial amendment, repeal, or readoption of a
regulation authorized by this section is deemed to be an emergency
and necessary for the immediate preservation of the public peace,
health, safety, or general welfare for purposes of Sections 11346.1
and 11349.6 of the Government Code, and the department is hereby
exempted from the requirement that it describe specific facts showing
the need for immediate action. These regulations shall be developed
in consultation with system stakeholders. A certificate of compliance
for these implementing regulations shall be filed within 24 months
following the adoption of the first emergency regulations filed
pursuant to this section. The emergency regulations may be readopted
and remain in effect until approval of the certificate of compliance.
4684.87. This article shall remain in effect only until January
1, 2020, and as of that date is repealed, unless a later enacted
statute, that is enacted before January 1, 2020, deletes or extends
that date.
SEC. 19. Section 4691.6 of the Welfare
and Institutions Code is amended to read:
4691.6. (a) Notwithstanding any other provision of
law or regulation, commencing July 1, 2006, the
community-based day program, work activity program, and in-home
respite service agency rate schedules authorized by the department
and in operation June 30, 2006, shall be increased by 3 percent,
subject to funds specifically appropriated for this increase in the
Budget Act of 2006. The increase shall be applied as a percentage,
and the percentage shall be the same for all providers. Any
subsequent increase shall be governed by subdivisions (b), (c), (d),
(e), (f), (g), and (e) (h),
and Section 4691.9.
(b) Notwithstanding any other provision of law
or regulation, the department may shall
not establish any permanent payment rate for a community-based day
program or in-home respite service agency provider that has a
temporary payment rate in effect on June 30, 2008, if the permanent
payment rate would be greater than the temporary payment rate in
effect on or after June 30, 2008, unless the regional center
demonstrates to the department that the permanent payment rate is
necessary to protect the consumers' health or safety.
(c) Notwithstanding any other provision of law
or regulation, neither the department nor any regional center
may shall approve any program design
modification or revendorization for a community-based day program or
in-home respite service agency provider that would result in an
increase in the rate to be paid to the vendor from the rate that is
in effect on or after June 30, 2008, unless the regional center
demonstrates that the program design modification or revendorization
is necessary to protect the consumers' health or safety and the
department has granted prior written authorization.
(d) Notwithstanding any other provision of law
or regulation, the department may shall
not approve an anticipated rate adjustment for a community-based day
program or in-home respite service agency provider that would result
in an increase in the rate to be paid to the vendor from the rate
that is in effect on or after June 30, 2008, unless the regional
center demonstrates that the anticipated rate adjustment is necessary
to protect the consumers' health or safety.
(e) Notwithstanding any other provision of law
or regulation, except as set forth in subdivision (f), the
department may shall not approve any
rate adjustment for a work activity program that would result in an
increase in the rate to be paid to the vendor from the rate that is
in effect on or after June 30, 2008, unless the regional center
demonstrates that the rate adjustment is necessary to protect the
consumers' health and safety and the department has granted prior
written authorization.
(f) Notwithstanding any other law or regulation, commencing July
1, 2014, the department may approve rate adjustments for a work
activity program that demonstrates to the department that the rate
adjustment is necessary in order to pay employees who, prior to July
1, 2014, were being compensated at a wage that is less than the
minimum wage established on and after July 1, 2014, by Section
1182.12 of the Labor Code, as amended by Chapter 351 of the Statutes
of 2013. The rate adjustment pursuant to this subdivision shall be
specific to payroll costs associated with any increase necessary to
adjust employee pay only to the extent necessary to bring pay into
compliance with the increased state minimum wage, and shall not
constitute a general wage enhancement for employees paid above the
increased minimum wage.
(g) Notwithstanding any other law or regulation, commencing July
1, 2014, community-based day program and in-home respite services
agency providers with temporary payment rates set by the department
may seek unanticipated rate adjustments from the department due to
the impacts of the increased minimum wage as established by Section
1182.12 of the Labor Code, as amended by Chapter 351 of the Statutes
of 2013. The rate adjustment shall be specific to payroll costs
associated with any increase necessary to adjust employee pay only to
the extent necessary to bring pay into compliance with the increased
state minimum wage, and shall not constitute a general wage
enhancement for employees paid above the increased minimum wage.
(h) Notwithstanding any other law or regulation, commencing
January 1, 2015, the in-home respite service agency rate schedule
authorized by the department and in operation December 31, 2014,
shall be increased by 5.82 percent, subject to funds specifically
appropriated for this increase for costs due to changes in federal
regulations implementing the federal Fair Labor Standards Act of 1938
(29 U.S.C. Sec. 201 et seq.). The increase shall be applied as a
percentage, and the percentage shall be the same for all applicable
providers.
SEC. 20. Section 4691.9 of the Welfare
and Institutions Code is amended to read:
4691.9. (a) Notwithstanding any other
provision of law or regulation, commencing July 1,
2008:
(a)
(1) No A regional center
shall not pay an existing service provider, for services
where rates are determined through a negotiation between the regional
center and the provider, a rate higher than the rate in effect on
June 30, 2008, unless the increase is required by a contract between
the regional center and the vendor that is in effect on June 30,
2008, or the regional center demonstrates that the approval is
necessary to protect the consumer's health or safety and the
department has granted prior written authorization.
(b)
(2) No A regional center
may shall not negotiate a rate with a
new service provider, for services where rates are determined through
a negotiation between the regional center and the provider, that is
higher than the regional center's median rate for the same service
code and unit of service, or the statewide median rate for the same
service code and unit of service, whichever is lower. The unit of
service designation must shall conform
with an existing regional center designation or, if none exists, a
designation used to calculate the statewide median rate for the same
service. The regional center shall annually certify to the State
Department of Developmental Services its median rate for each
negotiated rate service code, by designated unit of service. This
certification will shall be subject to
verification through the department's biennial fiscal audit of the
regional center.
(b) Notwithstanding subdivision (a), commencing July 1, 2014,
regional centers may negotiate a rate adjustment with providers
regarding rates if the adjustment is necessary in order to pay
employees no less than the minimum wage as established by Section
1182.12 of the Labor Code, as amended by Chapter 351 of the Statutes
of 2013, and only for the purpose of adjusting payroll costs
associated with the minimum wage increase. The rate adjustment shall
be specific to the unit of service designation that is affected by
the increased minimum wage, shall be specific to payroll costs
associated with any increase necessary to adjust employee pay only to
the extent necessary to bring pay into compliance with the increased
state minimum wage, and shall not be used as a general wage
enhancement for employees paid above the increased minimum wage.
Regional centers shall maintain documentation on the process to
determine, and the rationale for granting, any rate adjustment
associated with the minimum wage increase.
(c) Notwithstanding any other law or regulation, commencing
January 1, 2015, rates for personal assistance and supported living
services in effect on December 31, 2014, shall be increased by 5.82
percent, subject to funds specifically appropriated for this increase
for costs due to changes in federal regulations implementing the
federal Fair Labor Standards Act of 1938 (29 U.S.C. Sec. 201 et
seq.). The increase shall be applied as a percentage, and the
percentage shall be the same for all applicable providers. As used in
this subdivision, both of the following definitions shall apply:
(1) "Personal assistance" is limited only to those services
provided by vendors classified by the regional center as personal
assistance providers, pursuant to the miscellaneous services
provisions contained in Title 17 of the California Code of
Regulations.
(2) "Supported living services" are limited only to those services
defined as supported living services in Title 17 of the California
Code of Regulations.
(c)
(d) This section shall not apply to those services for
which rates are determined by the State Department of Health Care
Services, or the State Department of Developmental Services, or are
usual and customary.
SEC. 21. Article 8 (commencing with Section 4698)
is added to Chapter 6 of Division 4.5 of the Welfare and
Institutions Code , to read:
Article 8. Community Crisis Home Certification
4698. (a) (1) "Community crisis home" means a facility certified
by the State Department of Developmental Services pursuant to this
article, and licensed by the State Department of Social Services
pursuant to Article 9.7 (commencing with Section 1567.80) of Chapter
3 of Division 2 of the Health and Safety Code, as an adult
residential facility, providing 24-hour nonmedical care to
individuals with developmental disabilities receiving regional center
services and in need of crisis intervention services who would
otherwise be at risk of admission to the acute crisis center at
Fairview Developmental Center or Sonoma Developmental Center, an
out-of-state placement, a general acute hospital, an acute
psychiatric hospital, or an institution for mental disease, as
described in Part 5 (commencing with Section 5900) of Division 5. A
community crisis home shall have a maximum capacity of eight
consumers.
(2) "Consumer" or "client" means an individual who has been
determined by a regional center to meet the eligibility criteria of
Section 4512 and applicable regulations and for whom the regional
center has accepted responsibility.
(b) (1) The State Department of Developmental Services, using
Community Placement Plan funds, shall establish a community-based
residential option consisting of community crisis homes for adults
with developmental disabilities receiving regional center services
who require crisis intervention services and who would otherwise be
at risk of admission to the acute crisis center at Fairview
Developmental Center or Sonoma Developmental Center, an out-of-state
placement, a general acute hospital, an acute psychiatric hospital,
or an institution for mental disease, as described in Part 5
(commencing with Section 5900) of Division 5.
(2) The State Department of Developmental Services may issue a
certificate of program approval to a community crisis home qualified
pursuant to this article.
(c) A community crisis home shall not be licensed by the State
Department of Social Services until the certificate of program
approval, issued pursuant to this article by the State Department of
Developmental Services, has been received.
(1) A community crisis home shall be certified only if approved
through a regional center community placement plan pursuant to
Section 4418.25. Each home shall conform to Section 441.530(a)(1) of
Title 42 of the Code of Federal Regulations, and shall be eligible
for federal Medicaid home
and community-based services funding.
(2) A consumer shall not be placed in a community crisis home
unless the program is certified by the State Department of
Developmental Services, pursuant to this article, and the facility is
licensed by the State Department of Social Services, pursuant to
Article 9.7 (commencing with Section 1567.80) of Chapter 3 of
Division 2 of the Health and Safety Code.
(3) A certificate of program approval, issued pursuant to this
article by the State Department of Developmental Services, shall be a
condition of licensure for the community crisis home by the State
Department of Social Services, pursuant to Article 9.7 (commencing
with Section 1567.80) of Chapter 3 of Division 2 of the Health and
Safety Code.
(4) Community crisis homes shall exceed the minimum requirements
for a Residential Facility Service Level 4-i pursuant to Sections
56004 and 56013 of Title 17 of the California Code of regulations,
and shall meet all applicable statutory and regulatory requirements
for facility licensing, the use of behavior modification
interventions, and seclusion and restraint, including Division 1.5
(commencing with Section 1180) of the Health and Safety Code, and
that are applicable to facilities licensed as adult residential
facilities.
(d) Community crisis homes shall have a facility program plan
approved by the State Department of Developmental Services. The
facility program plan approved by the State Department of
Developmental Services shall be submitted to the State Department of
Social Services for inclusion in the facility plan of operation,
pursuant to Section 1567.84 of the Health and Safety Code.
(e) The local regional center and each consumer's regional center
shall have joint responsibility for monitoring and evaluating the
provision of services in the community crisis home. Monitoring shall
include at least monthly face-to-face, onsite case management visits
with each consumer by his or her regional center and at least
quarterly quality assurance visits by the vendoring regional center.
The State Department of Developmental Services shall monitor and
ensure the regional centers' compliance with their monitoring
responsibilities.
(f) A consumer's regional center shall also notify the clients'
rights advocate of each community crisis home admission. Unless the
consumer objects on his or her own behalf, the clients' rights
advocate may participate in developing the plan to transition the
consumer to his or her prior residence or an alternative
community-based residential setting with needed services and
supports.
(g) The State Department of Developmental Services shall establish
by regulation a rate methodology for community crisis homes that
includes a fixed facility component for residential services and an
individualized services and supports component based on each consumer'
s needs as determined through the individual program plan process,
which may include assistance with returning to the consumer's prior
living arrangement or transitioning to an alternative community
residential setting.
(h) If the State Department of Developmental Services determines
that urgent action is necessary to protect a consumer residing in a
community crisis home from physical or mental abuse, abandonment, or
any other substantial threat to the consumer's health and safety, the
State Department of Developmental Services may request that the
regional center or centers remove the consumer from the community
crisis home or direct the regional center or centers to obtain
alternative or additional services for the consumer within 24 hours
of that determination. When possible, an individual program plan
(IPP) meeting shall be convened to determine the appropriate action
pursuant to this section. In any case, an IPP meeting shall be
convened within 30 days following an action pursuant to this section.
(i) The Director of Developmental Services shall rescind a
community crisis home's certificate of program approval when, in his
or her sole discretion, a community crisis home does not maintain
substantial compliance with an applicable statute, regulation, or
ordinance, or cannot ensure the health and safety of consumers. The
decision of the Director of Developmental Services shall be the final
administrative decision. The Director of Developmental Services
shall transmit his or her decision rescinding a community crisis home'
s certificate of program approval to the State Department of Social
Services and the regional center with his or her recommendation as to
whether to revoke the community crisis home license, and the State
Department of Social Services shall revoke the license of the
community crisis home pursuant to Section 1550 of the Health and
Safety Code.
(j) The State Department of Developmental Services and regional
centers shall provide the State Department of Social Services all
available documentation and evidentiary support necessary for the
licensing and administration of community crisis homes and
enforcement of Chapter 3 (commencing with Section 1500) of Division 2
of the Health and Safety Code, and the applicable regulations.
4698.1. (a) A certificate of program approval shall not be issued
pursuant to this article until the publication in Title 17 of the
California Code of Regulations of emergency regulations filed by the
State Department of Developmental Services. These regulations shall
be developed in consultation with stakeholders, including the State
Department of Social Services, consumer advocates, and regional
centers. The regulations shall address at least all of the following:
(1) Program standards, including program design requirements,
staffing structure, staff qualifications, and training. Training
requirements shall include all of the following:
(A) A minimum of 16 hours of emergency intervention training,
which shall include the techniques the facility will use to prevent
injury and maintain safety regarding consumers who are a danger to
self or others and shall emphasize positive behavioral supports and
techniques that are alternatives to physical restraint.
(B) Additional training for direct care staff to address the
specialized needs of the consumers, including training in emergency
interventions.
(2) Requirements and timelines for the development and updating of
each consumer's individual program plan, including time-limited
objectives and a plan to transition the consumer to his or her prior
residence or an alternative community-based residential setting with
needed services and supports. In developing these regulations, the
department shall place a high priority on transitioning the consumer
to his or her prior residence, when that is the preferred objective
in the consumer's individual program plan.
(3) Procedures and requirements for identifying and providing
supplemental and ancillary staffing and supports, including
therapeutic, behavioral, and clinical services and supports, based on
individual consumer need.
(4) The rate methodology.
(5) Consumer rights and protections.
(b) The adoption, amendment, repeal, or readoption of a regulation
authorized by this section is deemed to be an emergency and
necessary for the immediate preservation of the public peace, health
and safety, or general welfare for purposes of Sections 11346.1 and
11349.6 of the Government Code, and the State Department of
Developmental Services is hereby exempted from the requirement that
it describe specific facts showing the need for immediate action.
These emergency regulations shall be developed in consultation with
system stakeholders. A certificate of compliance for these
implementing regulations shall be filed within 24 months following
the adoption of the first emergency regulations filed pursuant to
this section. The emergency regulations may be readopted and remain
in effect until approval of the certificate of compliance.
SEC. 22. Section 6504.5 of the Welfare
and Institutions Code is amended to read:
6504.5. (a) Wherever a petition is filed
pursuant to this article, the court shall appoint the director of a
regional center for the developmentally disabled established under
Division 4.5 (commencing with Section 4500), or the designee of the
director, to examine the person alleged to have a developmental
disability.
(b) Within 15 judicial days after his or her
appointment, the regional center director or designee shall submit
to the court in writing a report containing his or her evaluation of
the person alleged to have a developmental disability. If the person
is an individual described in paragraph (2) of subdivision (a) of
Section 7505, the report shall include the results of the assessment
conducted pursuant to subdivision (b) of Section 4418.7. The report
shall contain a recommendation of a facility or facilities in which
the alleged developmentally disabled person may be placed. The
report shall include any comprehensive assessment, or updated
assessment, conducted by the regional center pursuant to paragraph
(2) of subdivision (c) of Section 4418.25.
(c) The report shall include a description
of the least restrictive residential placement necessary to achieve
the purposes of treatment. In determining the least restrictive
residential placement, consideration shall be given to public safety.
If placement into or out of a developmental center is recommended,
the regional center director or designee simultaneously shall submit
the report to the executive director of the developmental center or
his or her designee. The executive director of the developmental
center or his or her designee may, within 15 days of receiving the
regional center report, submit to the court a written report
evaluating the ability of the developmental center to achieve the
purposes of treatment for this person and whether the developmental
center placement can adequately provide the security measures or
systems required to protect the public health and safety from the
potential dangers posed by the person's known behaviors.
(d) The reports prepared by the regional
center director and developmental center director, if applicable,
shall also address suitable interim placements for the person as
provided for in Section 6506.
SEC. 23. Section 6509 of the Welfare
and Institutions Code is amended to read:
6509. (a) If the court finds that the person has a
developmental disability, and is a danger to himself, herself, or to
others, the court may make an order that the person be committed to
the State Department of Developmental Services for suitable treatment
and habilitation services. Suitable treatment and habilitation
services is defined as the least restrictive residential placement
necessary to achieve the purposes of treatment. Care and treatment of
a person committed to the State Department of Developmental Services
may include placement in any of the following:
(1) Any licensed community care facility, as defined in Section
1504, or any health facility, as defined in Section 1250, other than
a developmental center or state-operated facility.
(2) The acute crisis center at Fairview Developmental
Center Center, if the person meets the
criteria for admission pursuant to paragraph (2) of subdivision (a)
of Section 7505.
(3) On or after January 1, 2015, the acute crisis center at Sonoma
Developmental Center, if the person meets the criteria for admission
pursuant to paragraph (3) of subdivision (a) of Section 7505.
(3)
(4) The secure treatment program at Porterville
Developmental Center Center, if the
person meets the criteria for admission pursuant to paragraph (3) of
subdivision (a) of Section 7505.
(4)
(5) Any other appropriate placement permitted by law.
(b) (1) The court shall hold a hearing as to the available
placement alternatives and consider the reports of the regional
center director or designee and the developmental center director or
designee submitted pursuant to Section 6504.5. After hearing all the
evidence, the court shall order that the person be committed to that
placement that the court finds to be the most appropriate and least
restrictive alternative. If the court finds that release of the
person can be made subject to conditions that the court deems proper
and adequate for the protection and safety of others and the welfare
of the person, the person shall be released subject to those
conditions.
(2) The court, however, may commit a person with a developmental
disability who is not a resident of this state under Section 4460 for
the purpose of transportation of the person to the state of his or
her legal residence pursuant to Section 4461. The State Department of
Developmental Services shall receive the person committed to it and
shall place the person in the placement ordered by the court.
(c) If the person has at any time been found mentally incompetent
pursuant to Chapter 6 (commencing with Section 1367) of Title 10 of
Part 2 of the Penal Code arising out of a complaint charging a felony
offense specified in Section 290 of the Penal Code, the court shall
order the State Department of Developmental Services to give notice
of that finding to the designated placement facility and the
appropriate law enforcement agency or agencies having local
jurisdiction at the site of the placement facility.
(d) If the State Department of Developmental Services
decides that a change in placement is necessary, it shall
notify notify, in writing
writing, the court of commitment, the district attorney,
and the attorney of record for the person
person, and the regional center of its decision
at least 15 days in advance of the proposed change in placement. The
court may hold a hearing and (1) approve or disapprove of the
change, or (2) take no action in which case the change shall be
deemed approved. At the request of the district attorney or of the
attorney for the person, a hearing shall be held.
SEC. 24. Section 7505 of the Welfare
and Institutions Code is amended to read:
7505. (a) Notwithstanding any other provision of
law, commencing July 1, 2012, the State Department of
Developmental Services shall not admit anyone to a developmental
center unless the person has been determined eligible for services
under Division 4.5 (commencing with Section 4500) and the person is:
(1) Committed by a court to Porterville Developmental Center,
secure treatment program, pursuant to Section 1370.1 of the Penal
Code.
(2) Committed by a court to Fairview Developmental Center pursuant
to Article 2 (commencing with Section 6500) of Chapter 2 of Part 2
of Division 6 due to an acute crisis, pursuant to Section 4418.7.
(3) Committed by a court to Porterville Developmental Center,
secure treatment program, pursuant to Article 2 (commencing with
Section 6500) of Chapter 2 of Part 2 of Division 6 as a result of
involvement with the criminal justice system, and the court has
determined the person is mentally incompetent to stand trial.
(4) A person described in Section 4508.
(5) A juvenile committed to Porterville Developmental Center,
secure treatment program, pursuant to Section 709.
(b) Under no circumstances shall the State Department of
Developmental Services admit a person to a developmental center after
July 1, 2012, as a result of a criminal conviction or where
when the person is competent to stand trial for
the criminal offense and the admission is ordered in lieu of trial.
(c) This section shall remain in effect only until January 1,
2015, and as of that date is repealed, unless a later enacted
statute, that is enacted before January 1, 2015, deletes or extends
that date.
SEC. 25. Section 7505 is added to the
Welfare and Institutions Code , to read:
7505. (a) Notwithstanding any other law, the State Department of
Developmental Services shall not admit anyone to a developmental
center unless the person has been determined eligible for services
under Division 4.5 (commencing with Section 4500) and the person is:
(1) Committed by a court to Porterville Developmental Center,
secure treatment program, pursuant to Section 1370.1 of the Penal
Code.
(2) Committed by a court to the acute crisis center at Fairview
Developmental Center, or the acute crisis center at Sonoma
Developmental Center, pursuant to Article 2 (commencing with Section
6500) of Chapter 2 of Part 2 of Division 6 due to an acute crisis,
pursuant to Section 4418.7.
(3) Committed by a court to Porterville Developmental Center,
secure treatment program, pursuant to Article 2 (commencing with
Section 6500) of Chapter 2 of Part 2 of Division 6 as a result of
involvement with the criminal justice system, and the court has
determined the person is mentally incompetent to stand trial.
(4) A person described in Section 4508.
(5) A juvenile committed to Porterville Developmental Center,
secure treatment program, pursuant to Section 709.
(b) Under no circumstances shall the State Department of
Developmental Services admit a person to a developmental center after
July 1, 2012, as a result of a criminal conviction or when the
person is competent to stand trial for the criminal offense and the
admission is ordered in lieu of trial.
(c) This section shall become operative on January 1, 2015.
SEC. 26. Notwithstanding any other law, Item
4300-101-0001 of Section 2.00 of the Budget Act of 2011 (Chapter 33
of the Statutes of 2011) is available for liquidation of encumbrances
through June 30, 2015. The unencumbered balance of thirteen million
forty-eight thousand dollars ($13,048,000) of the amount appropriated
by Item 4300-101-0001 of Section 2.00 of the Budget Act of 2011
(Chapter 33 of the Statutes of 2011) is reappropriated for the
purposes provided for in the appropriation and is available for
encumbrance or expenditure until June 30, 2015, and for liquidation
through June 30, 2017.
SEC. 27. No reimbursement is required by this act
pursuant to Section 6 of Article XIII B of the California
Constitution because the only costs that may be incurred by a local
agency or school district will be incurred because this act creates a
new crime or infraction, eliminates a crime or infraction, or
changes the penalty for a crime or infraction, within the meaning of
Section 17556 of the Government Code, or changes the definition of a
crime within the meaning of Section 6 of Article XIII B of the
California Constitution.
SEC. 28. This act is a bill providing for
appropriations related to the Budget Bill within the meaning of
subdivision (e) of Section 12 of Article IV of the California
Constitution, has been identified as related to the budget in the
Budget Bill, and shall take effect immediately.
SECTION 1. It is the intent of the Legislature
to enact statutory changes relating to the Budget Act of 2014.
