Bill Text: CA SB468 | 2013-2014 | Regular Session | Amended

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Developmental services: statewide Self-Determination

Spectrum: Slight Partisan Bill (Democrat 3-1)

Status: (Passed) 2013-10-09 - Chaptered by Secretary of State. Chapter 683, Statutes of 2013. [SB468 Detail]

Download: California-2013-SB468-Amended.html

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BILL NUMBER: SB 468	AMENDED
	BILL TEXT

	AMENDED IN ASSEMBLY  AUGUST 6, 2013
	AMENDED IN SENATE  MAY 28, 2013
	AMENDED IN SENATE  APRIL 25, 2013
	AMENDED IN SENATE  APRIL 15, 2013

INTRODUCED BY   Senators Emmerson and Beall
   (Coauthor: Assembly Member  Blumenfield  
Mitchell  )

                        FEBRUARY 21, 2013

   An act to add Section 4685.8 to the Welfare and Institutions Code,
relating to developmental services.


	LEGISLATIVE COUNSEL'S DIGEST


   SB 468, as amended, Emmerson. Developmental services: statewide
Self-Determination Program.
   Under existing law, the Lanterman Developmental Disabilities
Services Act, the State Department of Developmental Services
contracts with regional centers to provide services and supports to
individuals with developmental disabilities. Under existing law, the
regional centers purchase needed services and supports for
individuals with developmental disabilities through approved service
providers, or arrange for their provision through other publicly
funded agencies. The services and supports to be provided to a
regional center consumer are contained in an individual program plan
(IPP), developed in accordance with prescribed requirements. Existing
law establishes, contingent upon approval of a federal waiver, the
Self-Directed Services Program, and requires the program to be
available in every regional center catchment area to provide
participants, within an individual budget, greater control over
needed services and supports.
   This bill would require the department, contingent upon approval
of federal funding, to establish and implement a state
Self-Determination Program, as defined, that would be available in
every regional center catchment area to provide participants and
their families, within an individual budget  amount  ,
increased flexibility and choice, and greater control over decisions,
resources, and needed and desired services and supports to implement
their IPP, in accordance with prescribed requirements. The statewide
program would be phased in over 3 years, initially serving up to
2,500 regional center consumers, and thereafter would be available on
a voluntary basis to all  eligible  regional center
consumers. The bill would require the department to, among other
things, apply for federal funding for the program by December 31,
2014.
   This bill would provide that program participants receive an
individual budget  amount  , as prescribed, to be used for
the purchase of services and supports necessary to implement the
participant's IPP. The bill would require program participants to
agree to, among other things, manage self-determination services 
and supports  within the individual budget amount. The
individual budget amount would be available to the participant each
year for the purchase of services and supports under the program
until a new individual budget  amount  has been determined.
The bill would, among other things, require each regional center to
be responsible for implementing the program as a term of its
contract, and to establish a local  voluntary  advisory
committee to provide oversight of the project.  The bill would
require the State Council on Developmental Disabilities to form a
volunteer statewide committee to, among other things, identify
self-determination best practices.  The bill would require the
State Council on Developmental Disabilities to issue to the
Legislature a report regarding the status of the program and
recommendations to the program, as specified, and would require the
department, beginning January 10, 2016, to provide to the appropriate
policy and fiscal committees of the Legislature prescribed
information relating to the program.
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  The Legislature finds and declares all of the
following:
   (a) In 1998, the Legislature expanded the Lanterman Developmental
Disabilities Services Act to include a self-determination pilot
 program   project  . That pilot 
program   project  was continued by the Legislature
in 2002 and 2003. However, the pilot  program  
project  was only available at five regional centers and the
number of individuals served by the  local 
self-determination pilot program   programs
 remains small, about 200 regional center consumers.
   (b) As reflected in the State Department of Developmental Services
2002 Report to the Legislature, the pilot  program 
 project  remains an innovative, cost effective, and
successful way of providing services to regional center consumers and
their families. The findings in the report show that
self-determination pilot  program   project
 participants were happy and experienced more freedom and
responsibility in controlling the direction of their services and
life choices, and the  program   project 
was cost neutral in the aggregate. The report also found that good
self-determination requires intensive person-centered planning,
collaboration, and follow-along services and supports.
   (c) Most other states have self-directed or self-determination
services as a model for providing services. Many California consumers
and families have asked for a statewide expansion of the pilot
 program   project  believing it will do
the following: increase innovative and effective services, eliminate
bureaucracy, and increase choices for consumers and parents, thereby
allowing them to increase their control of services and supports by
easily navigating increasingly complex service systems. 
   (d) Consumers in traditionally underserved linguistic, cultural,
socioeconomomic, and ethnic communities have unique challenges in
accessing needed regional center services that have been impacted by
service limitations imposed as a response to California's recent
budget shortfalls. This is particularly true for consumers living at
home with a parent or guardian. The Self-Determination Program offers
increased service flexibility, which will promote access to needed
services for these consumers and their families.  
   (d) 
    (e)  The intent of this act is to allow for voluntary
participation in the Self-Determination Program while ensuring that
the program is available to all consumers regardless of geographic
location, economic or educational background, or race or ethnicity,
and ensuring a consistent statewide method of administration and
comparable services. To ensure these outcomes are achieved, it is the
intent of the Legislature that the State Department of Developmental
Services and local advisory boards be responsible for oversight and
monitoring of funds used for the Self-Determination Program and the
achievement of consumer outcomes. 
   (e) 
    (f)  In addition, the intent of this act is that the
Self-Determination Program be phased in over a three-year period and
that the program will continue to be available to all consumers as an
option after the initial phase-in period ends.
  SEC. 2.  Section 4685.8 is added to the Welfare and Institutions
Code, to read:
   4685.8.  (a) The department shall implement a statewide
Self-Determination Program. The Self-Determination Program shall be
available in every regional center catchment area to provide
participants and their families, within an individual budget 
amount  , increased flexibility and choice, and greater control
over decisions, resources, and needed and desired services and
supports to implement their IPP. The statewide Self-Determination
Program shall be phased in over three years, initially serving up to
2,500 regional center consumers,  inclusive of the remaining
participants in the self-determination pilot project authorized
pursuant   to Section 13 of Chapter 1043 of the Statutes of
1998, as amended,  and thereafter shall be available on a
voluntary basis to all regional center consumers  who are
eligible for the Self-Determination Program  .  The program
shall be available to individuals who reflect the disability, ethnic,
and geographic diversity of the state. 
   (b) The department in establishing the statewide program shall
ensure the following: 
   (1) Participants in the program reflect the disability, ethnic,
and geographic diversity of the state.  
   (2) 
    (   1)  The program is cost neutral in the
aggregate. 
   (3) 
    (   2)  A statewide method of administration
and determining comparable services. 
   (4) 
    (   3)  Oversight of expenditure of
self-determined funds and the achievement of consumer outcomes over
time. 
   (5) 
    (   4)  Increased consumer and family control
over which services  and supports  best meet their needs and
the IPP objectives.  A participant's unique support system may
include the purchase of existing service offerings from service
providers or local businesses,   hiring his or her own
support workers, or negotiating unique service arrangements with
local community resources.  
   (6) 
    (   5)  Comprehensive person-centered planning,
including an individual budget and services that are outcome based.

   (7) 
    (   6)  Consumer and family training to ensure
understanding of the  principles of self-determination, the 
planning  process   process,  and  the
 management of budgets, services, and staff. 
   (8) 
   (   7)  Choice of independent facilitators who
can assist with the person-centered planning process and  choice
of  financial management services providers  vendored by
regional centers  who can assist with payments and provide
employee-related services. 
   (9) 
    (   8)  Innovation that will more effectively
allow consumers to achieve their goals.
   (c) For purposes of this section, the following definitions shall
apply:
   (1) "Financial management services" means services or functions
that assist the participant to manage and direct the distribution of
funds contained in the individual budget, and ensure that the
participant has the financial resources to implement his or her IPP
throughout the year. These may include, but are not limited to, bill
paying services and activities that facilitate the employment of
service and support workers by the participant, including, but not
limited to, fiscal accounting, tax withholding,  compliance with
relevant state and federal employment laws,  and expenditure
reports.  The department shall establish   The
financial management services provider shall meet the requirements of
Sections 58884, 58886, and 58887 of Title 17 of the California Code
of Regulations and other specific qualifications  that
shall be required of a financial management services provider
  established by the department  .  The costs
of financial management services shall be paid by the participant out
of his or her individual budget. 
   (2) "Independent facilitator" means a 
conflict-of-interest-free  person, selected and directed by the
participant, who may assist the participant in making informed
decisions about the individual budget, and in locating, accessing,
and coordinating services  and supports  consistent with the
participant's IPP. He or she is available to assist in identifying
immediate and long-term needs, developing options to meet those
needs,  leading or participating   leading,
participating, or advocating on behalf of the participant  in
the person-centered planning process and development of the IPP, and
obtaining identified services and supports.  The costs of the
independent facilitator shall be paid by the participant out of his
or her individual budget. An independent facilitator shall receive
training in the principles of self-determination and the
responsibilities described in this paragraph at his or her own cost.

   (3) "Individual  budget"   budget amount
  "  means the amount of funding available to the
participant for the purchase of services and supports necessary to
implement the IPP. The individual budget  amount  shall be
 constructed   determined  using a fair,
equitable, and transparent methodology.
   (4) "IPP" means individual program  plan  
plan, as described in Section 4646  .
   (5) "Participant" means an individual, and when appropriate, his
or her parents, legal guardian or conservator, or authorized
representative, who has been deemed eligible for, and has voluntarily
agreed to participate in, the Self-Determination Program.
   (6) "Self-determination" means a voluntary delivery system
consisting of a defined and comprehensive mix of services and
supports, selected and directed by a participant through
person-centered planning, in order to meet all or some of the
objectives in his or her IPP. Self-determination services and
supports are designed to assist the participant to achieve personally
defined outcomes in community settings that promote inclusion. The
Self-Determination Program shall only fund services and supports that
 are approved by  the federal Centers for Medicare
and Medicaid Services  has determined are eligible for federal
financial participation  .
   (d) Participation in the Self-Determination Program is fully
voluntary. A consumer may choose to participate in, and may choose to
leave, the Self-Determination Program at any time. A regional center
may not require or prohibit participation in the Self-Determination
Program as a condition of eligibility for, or the delivery of,
services and supports otherwise available under this division.
Participation in the Self-Determination Program shall be available to
any regional center consumer who meets the following eligibility
requirements:
   (1) The participant is three years of age or older.
   (2) The participant has a developmental disability, as defined in
Section 4512.
   (3) The participant does not live in a licensed long-term health
care facility, as defined in paragraph (44) of subdivision (a) of
Section 54302 of Title 17 of the California Code of Regulations. An
individual, and when appropriate his or her parent, legal guardian or
conservator, or authorized representative, who is not eligible to
participate in the Self-Determination Program pursuant to this
paragraph may request that the regional center provide
person-centered planning services in order to make arrangements for
transition to the Self-Determination  Program  
Program, provided that he or she is eligible for the California
Community Transitions Project  . In that case, the regional
center shall initiate person-centered planning services within 60
days of that request.
   (4) The participant agrees to all of the following terms and
conditions:
   (A) The participant shall receive an orientation to the
Self-Determination Program prior to  enrollment 
 enrollment, which includes the principles of self-determination,
the role of the   independent facilitator and the financial
management services provider, person-centered planning, and
development of a budget  .
   (B) The participant shall agree to utilize the services and
supports available within the Self-Determination Program only when
generic services and supports  cannot be accessed 
 are not available  .
   (C) The participant shall only  use  
purchase  services and supports necessary to implement his or
her IPP and shall agree to comply with any and all other terms and
conditions for participation in the Self-Determination Program
described in this section.
   (D) The participant shall manage Self-Determination Program
services and supports within the individual budget amount.
   (E) The participant shall utilize the services of  the
  a  conflict-of-interest-free financial management
services provider of his or her own choosing  and who is
vendored by a regional center  .
   (F) The participant may utilize the services of a
conflict-of-interest-free independent facilitator of his or her own
choosing for the purpose of providing services and functions as
described in paragraph (2) of subdivision (c).  The financial
management services provider shall determine that the independent
facilitator is adequately trained and otherwise qualified. 
 If the participant elects not to use an independent facilitator,
he or she may use a regional center service coordinator of his or
her choosing to provide the services and functions described in
paragraph (2) of subdivision (c). 
   (e) A participant who is not Medi-Cal eligible may participate in
the Self-Determination Program and receive self-determination
services and supports if all other program eligibility requirements
are met  and the services and supports are otherwise eligible for
federal financial participation  .
   (f) An individual receiving services and supports under the
self-determination  projects   pilot programs
 authorized pursuant to Section 13 of Chapter 1043 of the
Statutes of 1998, as amended, may elect to continue to receive
self-determination services and supports pursuant to this 
section. An individual who participates in the Self-Determination
Program may elect to continue to receive self-determination services
and supports if he or she transfers to another regional center
catchment area.   section or the regional center shall
provide for the participant's transition from the self-determination
pilot   program to other services and supports. This
transition shall include the development of a new IPP that reflects
the services and supports necessary to meet the individual's needs.
The regional center shall ensure that there is no gap in services and
supports during the transition period. 
    (g)     The additional federal financial
participation funds generated by individuals participating in the
  Self-Determination Program pursuant to this section shall
be used to offset the administrative costs of the program, including,
but not limited to, training for consumers, family members, and
regional center staff, caseload ratio improvement, and costs
associated with the participant's initial person-centered planning
meeting and development of the participant's initial budget amount.
 
   (g) 
    (   h)  If at any time during participation in
the Self-Determination Program a regional center determines that a
participant is no longer eligible to continue in, or a participant
voluntarily chooses to exit, the Self-Determination Program, the
regional center shall provide for the participant's transition from
the Self-Determination Program to other services and supports. This
transition shall include the development of a new IPP that reflects
the services and supports necessary to meet the individual's needs.
The regional center shall ensure that there is no gap in services and
supports during the transition period. 
   (h) 
    (   i)  An individual determined to be
ineligible for or who voluntarily exits the Self-Determination
Program shall be permitted to return to the Self-Determination
Program upon meeting all applicable eligibility criteria and upon
approval of the participant's  IPP   planning
 team, as described in subdivision (j) of Section 4512.  An
individual who has voluntarily exited the Self-Determination Program
may not return to the program for at least 12 months.  
   (j) An individual who participates in the Self-Determination
Program may elect to continue to receive self-determination services
and supports if he or she transfers to another regional center
catchment area.  
   (i) 
    (   k)  The IPP team shall utilize the
person-centered planning process to develop the IPP for a
participant. The IPP shall detail the goals and objectives of the
participant that are to be met through the purchase of
participant-selected services and supports. The IPP team shall
determine the individual budget  amount  to ensure the
budget  amount  assists the participant to achieve the
outcomes set forth in his or her IPP and ensures his or her health
and safety. The completed individual budget  amount  shall
be attached to the IPP. 
   (j) 
    (   l   )  The participant shall
implement his or her IPP, including choosing  and purchasing
 the services and supports allowable under this section
necessary to implement the plan. A participant is exempt from
 Section 4783, the Family Cost Participation Program, and
  the  cost control  restrictions,
including, but not limited to,   restrictions regarding
the  purchases of services and supports pursuant to Sections
 4648.35, 4648.5, and 4659, subparagraph (B) of paragraph (3)
of subdivision (c) of Section 4685, Sections 4648.55, 4686.2,
4686.5, and 4689, and purchase of services best practices enacted
pursuant to Section 4620.3   4648.5 and 4686.5  . A
regional center shall not prohibit the purchase of any service or
support that is otherwise allowable under this section. 
   (k) 
    (   m)  A participant shall have all the rights
established in  Sections 4646 to 4646.6, inclusive, and 
Chapter 7 (commencing with Section 4700). 
   (l) The department, in consultation with stakeholders, shall
develop a methodology for individual budgets that ensures the budgets
are computed in a fair, transparent, and equitable manner and are
based on consumer characteristics and needs, and a method for
adjusting individual budgets to address a participant's unanticipated
needs. In developing this methodology, the department shall ensure
that budgets of all participants are cost neutral in the aggregate
within each regional center.  
   (m) The IPP team, using the methodology developed in subdivision
(l), shall determine the individual budget for the participant. That
individual budget amount shall be available to the participant each
year for the purchase of program services and supports until a new
individual budget has been determined. An individual budget shall be
calculated no more than once in a 12-month period, unless revised to
reflect the unanticipated needs of the participant. The individual
budget shall be distributed among uniform budget categories developed
by the department in consultation with stakeholders.  
   (n) (1) During the first two years of the Self-Determination
Program, the individual budget amount shall equal 98 percent of the
annual purchase of service costs for the individual. The annual costs
shall reflect the average annual costs for the previous two fiscal
years for the individual. In addition, the IPP team may adjust the
individual budget amount to address a change in the participant's
circumstances.  
   (2) Prior to the end of the second year of the Self-Determination
Program, the department, in consultation with stakeholders, shall
develop one or more additional methodologies for individual budget
amounts that are computed in a fair, transparent, and equitable
manner and are based on consumer characteristics and needs, and that
include a method for adjusting individual budget amounts to address a
participant's change in circumstances.  
   (o) The IPP team, using any of the methodologies developed in
subdivision (n), shall determine the individual budget amount for the
participant. That individual budget amount shall be available to the
participant each year for the purchase of program services and
supports until a new individual budget amount has been determined. An
individual budget amount shall be calculated no more than once in a
12-month period, unless revised to address a participant's change in
circumstances. The IPP team shall annually ascertain from the
participant whether there are any circumstances that require a change
to the annual individual budget amount. The individual budget amount
shall be distributed among uniform budget categories developed by
the department in consultation with stakeholders and in accordance
with the timing of the expenditures anticipated in the IPP. 

   (n) 
    (   p)  Annually, participants may transfer up
to  20   10  percent of the funds
originally distributed to any budget category set forth in
subdivision  (m)   ,   (o)
 to another budget category or categories. Transfers in excess
of  20   10  percent of the original amount
allocated to any budget category may be made upon the approval of
the regional center or the participant's IPP team. Regional centers
or the IPP team may only deny a transfer if necessary to protect the
health and safety of the participant. 
   (o) 
    (   q)  Consistent with the implementation date
of the IPP, the IPP team shall annually ascertain from the
participant whether there are any circumstances that require a change
to the annual individual budget  amount  . Based on that
review, the IPP team shall calculate a new individual budget 
amount  consistent with the methodology identified in
subdivision  (l)   (   n)  .

   (p) 
    (   r)  On or before December 31, 2014, the
department shall apply for federal Medicaid funding for the
Self-Determination Program by applying for a state plan amendment, an
amendment to a current home- and community-based waiver for
individuals with developmental disabilities, for a new waiver, or by
seeking to maximize federal financial participation through other
means. Contingent upon approval of federal funding, the
Self-Determination Program shall be established. The department shall
adopt regulations to implement the procedures set forth in this
section. 
   (q) 
    (   s)  The department, in consultation with
stakeholders, shall develop informational materials about the
Self-Determination Program. The department shall ensure that regional
centers are trained in the principles of self-determination, the
mechanics of the Self-Determination Program, and the rights of
consumers and families as candidates for, and participants in, the
Self-Determination Program. 
   (r) 
    (   t)  Each regional center shall be
responsible for implementing the Self-Determination Program as a term
of its contract under Section 4629. As part of implementing the
program, the regional center shall do all of the following:
   (1) Contract with local  consumer  or family-run 
consumer  organizations to conduct outreach  and
training  through local meetings or forums to 
provide regional center  consumers and their families
 with   to provide  information about the
Self-Determination Program and to help ensure that the program is
available to a diverse group of participants, with special outreach
to underserved communities. 
   (2) Collaborate with the local consumer or family-run
organizations identified in paragraph (1) to jointly conduct training
about the Self-Determination Program.  
   (2) 
    (3)  Advance funds to a financial management services
provider to facilitate participation in the Self-Determination
Program,  as determined necessary by a participant's IPP
team.   when the participant's IPP team determines it is
necessary to enable participation in the Self-Determination Program.
The regional center shall not, at any one time, advance more than 15
percent of the budget amount.  
   (s) 
    (   u)  The financial management services
provider shall provide the  participant, or his or her
authorized representative,   participant  and the
regional center service coordinator with a monthly individual budget
statement that describes the amount of funds allocated by budget
category, the amount spent in the previous 30-day period, and the
amount of funding that remains available under the participant's
individual budget  amount  . 
   (t) 
    (   v)  Only the financial management services
provider is required to apply for vendorization in accordance with
Subchapter 2 (commencing with Section 54300) of Chapter 3 of Title 17
of the California Code of Regulations, for the Self-Determination
Program. All other service providers shall have applicable state
licenses, certifications, or other state required documentation, but
are exempt from the vendorization requirements set forth in Title 17
of the California Code of Regulations  when serving participants
in the Self-Determination Program, and shall not be on the federal
debarment list  .  The financial management services
provider shall ensure and document that all service providers meet
specified requirements for any service that may be delivered to the
participant.  
   (u) 
   (w)   (1)    A participant may request,
at no charge to the participant or the regional center, criminal
history background checks for persons seeking employment as a
provider of services and supports  and providing direct care
services and supports  to the  participant.

    (1)     Criminal
  participant.   The criminal  history
record checks pursuant to this subdivision shall be performed and
administered as described in subdivision (b)  and
subdivisions (d) to (h), inclusive, of Section 4689.2, and Sections
4689.4 to 4689.6, inclusive, and shall apply to vendorization of
providers and hiring of employees to provide services and supports
for family home agencies and family homes. 
    (2)     The 
 of Section 4689.2. The  department may enter into a written
agreement with the Department of Justice to implement this
subdivision. 
   (2) Upon receipt of information relating to the criminal history
background check, the department shall do one of the following: 

   (A) Advise the participant that the person seeking employment
declined to allow any information to be reported.  
   (B) With the consent of the person who is seeking employment,
provide the participant with a copy of the criminal history
background check.  
     (x) To ensure the effective implementation of the
Self-Determination Program and facilitate the sharing of best
practices and training materials commencing with the implementation
of the Self-Determination Program, local and statewide advisory
committees shall be established as follows:  
   (v) 
    (   1)  Each regional center shall establish a
local  volunteer  advisory committee to provide oversight of
the Self-Determination Program. The regional center  ,
  and the  area board  , and the Office of
Clients' Rights Advocacy of Disability Rights California 
shall each appoint  one-third   one-half 
of the membership of the committee  , which   .
The committee  shall consist of  the regional center clients'
rights advocate,  consumers, family members,  clients'
rights advocates  and other advocates, and community
leaders. A majority of the committee shall be consumers and their
family members. The committee shall reflect the multicultural
diversity and geographic profile of the catchment area. The committee
shall review the development and ongoing progress of the
Self-Determination Program, including whether the program 
advances the principles of self-determination and  is operating
consistent with the requirements of this section, and may make
ongoing recommendations for improvement to the regional center and
the department. 
   (w)  
   (2) The State Council on Developmental Disabilities shall form a
volunteer committee, to be known as the Statewide Self-Determination
Advisory Committee, comprised of the chairs of the 21 local advisory
committees or their designees. The council shall convene the
Statewide Self-Determination Advisory Committee at least semiannually
by teleconference or other means established by the council, to
identify self-determination best practices, effective consumer and
family training materials, implementation concerns, systemic issues,
and ways to enhance the program. The council shall synthesize
information received from the Statewide Self-Determination Advisory
Committee, local advisory committees, and other sources, shall share
the information with consumers, families, regional centers and the
department, and shall make recommendations, as appropriate, to
increase the program's effectiveness in furthering the principles of
self-determination. 
    (   y)  Commencing January 10, 2016, the
department shall annually provide the following information to the
appropriate policy and fiscal committees of the Legislature:
   (1) Number and characteristics of participants, by regional
center.
   (2) Types and ranking of services and supports purchased under the
Self-Determination Program, by regional center.
   (3) Range and average of individual  budgets 
 budget amounts  , by regional center, including adjustments
to the budget  amounts  to address unanticipated 
need   change in circumstances  . 
   (4) Information regarding participant satisfaction under the
Self-Determination Program and, when data is available, the
traditional service delivery system, by regional center. 

   (5) The proportion of participants who report that their choices
and decisions are respected and supported.  
   (6) The proportion of participants who report that they are able
to recruit and hire qualified service providers.  
   (7) 
    (   4)  The number and outcome of individual
budget  amount  appeals, by regional center. 
   (8) 
    (  5)  The number and outcome of fair hearing
appeals, by regional center. 
   (9) 
    (   6)  The number of participants who
voluntarily withdraw from the Self-Determination Program and a
summary of the reasons why, by regional center. 
   (10) 
    (   7)  The number of participants who are
subsequently determined to no longer be eligible for the
Self-Determination Program and a summary of the reasons why, by
regional center. 
   (11) Identification of barriers to participation and
recommendations for program improvements.  
   (12) A comparison of average annual expenditures for individuals
with similar characteristics not participating in the
Self-Determination Program.  
   (x) 
    (   z)  The State Council on Developmental
Disabilities, in collaboration with the protection and advocacy
agency identified in Section 4900 and the federally funded University
Centers for Excellence in Developmental Disabilities Education,
Research, and Service,  may work with regional centers to survey
participants regarding participant satisfaction under the
Self-Determination Program, and, when data is available, the
traditional service delivery system, including the proportion of
participants who report that their choices and decisions are
respected and supported and who report that they are able to recruit
and hire qualified service providers, and to   identify
barriers to participation and recommendations for improvement. The
council  shall issue a report to the Legislature  , in
compliance with Section 9795 of the Government Code,  no later
than three years following the approval of the federal funding on the
status of the Self-Determination Program authorized by this section,
and provide recommendations to enhance the effectiveness of the
program.  This review shall include the program's effectiveness
in furthering the principles of self-determination, including all of
the following:  
   (1) Freedom, which includes the ability of adults with
developmental disabilities to exercise the same rights as all
citizens; to establish, with freely chosen supporters, family and
friends, where they want to live, with whom they want to live, how
their time will be occupied, and who supports them; and, for
families, to have the freedom to receive unbiased assistance of their
own choosing when developing a plan and to select all personnel and
supports to further the life goals of a minor child.  
   (2) Authority, which includes the ability of a person with a
disability, or family, to control a certain sum of dollars in order
to purchase services and supports of their choosing.  
   (3) Support, which includes the ability to arrange resources and
personnel, both formal and informal, that will assist a person with a
disability to live a life in his or her community that is rich in
community participation and contributions.  
   (4) Responsibility, which includes the ability of participants to
take responsibility for decisions in their own lives and to be
accountable for the use of public dollars, and to accept a valued
role in their community through, for example, competitive employment,
organizational affiliations, spiritual development, and general
caring of others in their community.  
   (5) Confirmation, which includes confirmation of the critical role
of participants and their families in making decisions in their own
lives and designing and operating the system that they rely on.