CA AB 143

Quick answers

Description

(1) Existing law, the Lanterman Developmental Disabilities Services Act, requires the State Department of Developmental Services to contract with regional centers for the provision of services and supports for persons with developmental disabilities and their families. Under existing law, the services and supports are contained in an individual program plan (IPP) , as specified. Existing law requires the department to implement a statewide Self-Determination Program, available in every regional center catchment area to provide participants and their families, within an individual budget, with increased flexibility and choice, and greater control over decisions, resources, and needed and desired services and supports to implement their IPP. Existing law prescribes the process for allocating funds to, and within, the participant's individual budget. This bill would make various changes to the Self-Determination Program, including, among others, establishing the participants' individual budget generally based on the services authorized instead of being based on purchase of service expenditures, requiring a regional center to certify that participants' spending plans satisfy certain criteria, and requiring the department to establish statewide standardized processes and procedures for the program, with community input, no later than March 1, 2027. (2) Under existing law, contracts between the department and regional centers require regional centers to maintain specified service coordinator-to-consumer ratios and have expertise in certain topics in order to serve consumers. Existing law requires the department, through contracts, to require regional centers to implement implicit bias training, as specified. Existing law authorizes the training to be procured by the department or by a regional center that has obtained prior approval by the department. This bill would make the departmental training requirements subject to an appropriation by the Legislature for that purpose. The bill would also state the intent of the Legislature that regional centers continue to implement the implicit bias training to the extent they are able to, in the absence of a state appropriation. (3) Existing law required the department, between April 1, 2022, and January 1, 2025, to incrementally implement rate reform to increase rates paid to developmental service providers. Existing law requires, in conjunction with the rate reform, the department to implement a quality incentive program that includes the development of a quality incentive payment structure for providers meeting quality measures or benchmarks, or both. This bill would require, beginning in the 2026–27 fiscal year, a provider to be compliant with electronic visit verification, home- and community-based services rules, and applicable annual fiscal reviews and audit requirements as a condition of eligibility for the quality incentive program. Existing law requires the department to implement a hold harmless policy, as specified, for providers whose rates exceed rate model recommendations, to freeze a provider's existing rates until June 30, 2026, and to subsequently adjust the provider's rates to equal the rates for other providers in the provider's service category and region. Existing law requires the department, beginning January 1, 2025, to implement a similar hold harmless policy for providers whose rates in effect on January 1, 2023, exceed 90% of the rate model. This bill would shift the expiration date of the rate freezes to February 28, 2026. Existing law requires that regional centers receive specialized funding allocations to facilitate applications for payments authorized to protect the health and safety of consumers, as specified, for non-English-speaking individuals served. This bill would make that requirement subject to an appropriation by the Legislature. (4) Existing law requires the department to assess a monthly fee to parents of children under 18 years of age who are receiving 24-hour out-of-home care services through a regional center or who are residents of a state hospital when the family's gross income is above 200% of the federal poverty level, as specified. This bill would repeal those provisions relating to the monthly parental fee. The bill would also make technical, conforming changes. (5) Existing law requires a regional center consumer to be referred to a provider of habilitation services if they are determined to be in need of habilitation services, among other factors. Existing law authorizes a regional center to vendor a new work activity or supported employment program after determining the capacity of the program to deliver effective services and assessing the ability of the program to comply with the requirements of CARF, the Rehabilitation Accreditation Commission, as defined. Existing law also defines additional terms relating to habilitation services, including group services to mean job coaching in a group supported employment placement at a job coach-to-consumer ratio of not less than 1 to 3 nor more than 1 to 8 where services to a minimum of 3 consumers are funded by specified entities. This bill would update the definition of CARF to mean the Commission on Accreditation of Rehabilitation Facilities. The bill would also update the definition of group service to include a coach-to-consumer ratio of not less than 1 to 2 instead of 1 to 3 and would also instead require a minimum of 2 consumers to be funded by specified entities. Existing law authorizes regional centers to purchase habilitation services only from providers who are accredited community nonprofit agencies that provide work activity services or supported employment services, or both, and that have been vendored according to the provisions listed above. This bill would remove the requirement that the providers be accredited community nonprofit agencies that provide work activity services or supported employment services, or both. Existing law sets the hourly rate for supported employment services provided to consumers receiving individualized services and for group services at $36.57 and requires job coaching hours for group services to be allocated on a prorated basis between a regional center and the Department of Rehabilitation when consumers are served in the same group. Existing law also requires that a new work activity program receive the statewide average rate, as determined by the department. This bill would remove the hourly rate for both supported employment services and group services and would instead require the department to set a rate and post the rate to its internet website. The bill would also remove the requirements that job coaching hours for group services be allocated on a prorated basis and that a new work activity program receive the statewide average rate, and would instead require that the program receive the rate posted on the department's internet website. (6) Existing law authorizes a consumer to choose a tailored day service or vouchered community-based training service, in lieu of, or in conjunction with, any other regional center vendored day program, look-alike day program, supported employment program, or work activity program. Existing law requires the hourly rate for the tailored day service option to be calculated in a specified manner. Existing law requires that hourly rate to remain in effect pending the department's review, as specified, and requires the review to be completed by June 30, 2024. This bill would end use of the above-described calculation methodologies on June 30, 2025, and, commencing on July 1, 2025, would require the hourly rate for the tailored day service option for vendored programs to be set by the department and posted on its internet website. (7) Existing law requires the Secretary of California Health and Human Services, in coordination with the department, to lead the development and implementation of the Master Plan for Developmental Services for the state. Existing law requires the secretary to solicit input through the Master Plan for Developmental Services Committee and submit to the Governor and the Legislature an initial report summarizing the recommended components of the master plan, as specified. Existing law requires the secretary and the Director of Developmental Services to work with other state agencies, as necessary, to identify policies, efficiencies, and strategies necessary to implement the master plan. Existing law requires the secretary to annually submit master plan implementation updates to the Governor and the Legislature, as specified. This bill would require the Master Plan for Developmental Services Committee to meet at least 2 times each year, as specified, and would set forth the information to be included in the initial report and recommendation updates, including, among other things, a narrative summary of the master plan committee meetings. (8) This bill would appropriate $2,789,000 from the General Fund to the State Department of Developmental Services for project planning activities at regional centers associated with the Life Outcomes Improvement System. Under the bill, these funds would be available for encumbrance or expenditure through June 30, 2026. (9) This bill would declare that it is to take effect immediately as a bill providing for appropriations related to the Budget Bill.