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.