California-2023-AB1147-Introduced

CALIFORNIA LEGISLATURE— 2023–2024 REGULAR SESSION

Assembly Bill

No. 1147

Introduced by Assembly Member Addis

February 16, 2023

An act to amend Sections 4519.5, 4571, 4622, 4626.5, 4642, 4643, 4646, 4646.4, 4646.5, 4647, 4659, 4685.8, 4726, and 4731 of, and to add Sections 4519.20, 4629.1, and 4639.76 to, the Welfare and Institutions Code, relating to developmental services.

LEGISLATIVE COUNSEL'S DIGEST

AB 1147, as introduced, Addis. Disability Equity and Accountability Act of 2023.

The Lanterman Developmental Disabilities Services Act makes the State Department of Developmental Services responsible for providing various services and supports to individuals with developmental disabilities, and for ensuring the appropriateness and quality of those services and supports. Pursuant to that law, the department contracts with regional centers to provide services and supports to persons with developmental disabilities.

This bill would enact the Disability Equity and Accountability of 2023, which would make various changes to the act for purposes including gathering relevant data and providing increased oversight of regional center operations and performance. The bill would require an evaluation of regional center performance by the department, which would be implemented using a common set of performance measures. The bill would require the assessments to use performance measures in 7 specific domains: community integration, employment, equity in access, case management, client and family choice, experience and satisfaction, human and civil rights, and health and safety. The bill would require the department to establish standards for theses performance measures, as specified, by July 1, 2024.

The bill would require the department, as part of its planning process for the planning and development of a uniform, statewide data automation system, to develop a charter for approval by the Secretary of the California Health and Human Services Agency and the Department of Technology. The bill would require the charter development process to include the participation and input of program consumers and families, researchers and quality and outcome evaluators, regional centers, and service providers. The bill would require the charter to include specified components, including, but not limited to, an impact statement, project guiding principles, and program goals, including maximizing the performance and business processes for the delivery of intellectual or developmental disabilities (IDD) system services to regional center consumers.

Existing law requires the department, in consultation with stakeholders, to identify a valid and reliable quality assurance instrument that assesses consumer and family satisfaction, provision of services in a linguistically and competent manner, and personal outcomes, as specified.

This bill would require the department by March 1, 2024, to submit a report to the Legislature describing the extent to which the requirements of this section have not been met, including the surveying of all consumers, including those who have not purchased services, and providing specific steps and the schedule by which these requirements will be met.

Existing law requires regional centers to conduct client assessments, and requires those assessments to be performed within 120 days following intake, and within no more than 60 days following initial intake if delay would expose the client to unnecessary risk to their health and safety, as specified.

This bill would revise those timeframes to require an assessment to be completed within 60 days of intake, and within 30 days of intake for at-risk clients.

Existing law declares the intent of the Legislature to ensure that the individual program plan (IPP) and provision of services and supports by the regional center system is centered on the individual and the family of the individual with developmental disabilities and takes into account the needs and preferences of the individual and the family, as prescribed.

This bill also would declare the intent of the Legislature for the IPP to be developed consistent with the federal Affordable Care Act, as specified, requiring community-based long-term services and supports be person-centered and self-directed, and ensuring that goals in any plan allow for innovation and nontraditional services service delivery. The bill would revise existing complaint procedures for consumers and their representatives, including requiring complaints to be made to the Director of Developmental Services, and requiring the director to issue a written administrative decision within 30 days of receiving the complaint, and send a copy of the decision to the complainant, the director of the subject regional center or state-operated facility, and the service provider, as prescribed.

The bill would revise the criteria applicable to regional center governing boards with which the state contracts, including with respect to terms, the composition of nominating committees, and training. The bill would require the department to establish and adopt a grievance procedure for governing board members, as specified. The bill also would make regional centers subject to requirements of the California Public Records Act.

Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NO

The people of the State of California do enact as follows:

SECTION 1.

This act shall be known, and may be cited, as the Disability Equity and Accountability Act of 2023.

SEC. 2.

(a) The Legislature finds and declares as follows:

(1) Recent reports and hearings by the California State Auditor, the Little Hoover Commission, and advocacy organizations have found that California’s service system for the over 400,000 children and adults with intellectual and developmental disabilities through the Lanterman Act, as overseen by the State Department of Developmental Services, which contracts with 21 regional centers, is failing in significant ways to deliver critical, adequate, and timely services to individuals and families. The result is that individuals and families, particularly those of color, are unable to timely access services and supports, resulting in barriers to their living independent, productive, and integrated lives in their communities.

(2) California’s developmental disability service system is plagued with racial, ethnic, and geographic disparities that can dramatically impact the essential services received by children and adults with developmental disabilities. Systemic inequities and discrimination within California’s 21 regional centers broaden the gap between inclusive possibilities and segregated limitations. Data show Latinos are most negatively impacted by these disparities, but people who are clients of the lowest-performing regional centers are also significantly affected.

(3) California spends nearly $13,000,000,000 annually on the administration and delivery of developmental services, but lacks a transparent, common, integrated, and coordinated model for the delivery and measurement of services throughout the 21 regional centers, resulting in poor outcomes, poor satisfaction levels by consumer and families, and disparate levels of available services and performance expectations.

(4) The delivery of services through 21 separate private nonprofit regional centers with separate boards, funding, and delivery models was originally intended to ensure that the delivery of services could be more effectively delivered through nonstate entities. However, with the subsequent caseload and budget growth since the enactment of the Lanterman Act, local administration has become more disparate and less accountable. Boards of directors are untrained and are not providing the oversight needed of the regional centers. Stronger state oversight of regional centers by the State Department of Developmental Services is essential to ensure that services are equitably delivered, performance and outcomes are uniformly measured and reported, and the system is transparent and accountable to individuals and families.

(5) The department’s system lacks a statewide automated technology system for the delivery of services to persons with intellectual and developmental disabilities and, as a result, the current program is constrained by disparate automation systems, inadequate documentation, the lack of open system architecture, insufficient data to support administration of the system, and the lack of data to support program improvements for improving the quality of life outcomes through new service delivery methods.

(6) Statewide uniformity of service delivery practices and procedures is essential to an effective program and to support necessary oversight and research for ongoing program improvements.

(7) The department’s technical infrastructure is over 40 years old. The lack of a statewide automation system does not meet current program needs and significantly contributes to the racial and geographic disparities in the delivery of services. California currently lacks clear and consistent service delivery outcomes for individuals with intellectual and developmental disabilities that sets high expectations for their quality of life, and must develop a system for measuring and quantifying the value of service delivery outcomes.

(8) A previous effort to develop an intellectual and developmental disabilities (IDD) program technology system failed. As a result, the department and regional centers maintain a patchwork of at least three case management and fiscal systems that are not integrated and six legacy case management automation systems that lack integration, have dissimilar data sources, and are technically outdated.

(9) In the 2021–22 annual budget the Legislature appropriated $6,000,000 to the State Department of Developmental Services for planning purposes related to the implementation of a uniform fiscal system and consumer electronic records management system. The department has not developed a vision or scope for a proposed system development approach.

(b) Therefore, it is the intent of the Legislature in enacting this act to do all of the following:

(1) Ensure that racial, ethnic, and geographic service disparities be systemically addressed and eliminated and that all people, regardless of their race or ethnicity or where they live, receive equitable access to services within the regional center system.

(2) Ensure that all regional centers offer and provide a consistent and common set of services and that the services are delivered in a timely way.

(3) Ensure that the delivery of all services and supports comply with federal law and guidance and are responsive to the needs and choices of beneficiaries receiving home- and community-based services, are person-centered and strengths-based, have high expectations for interdependence, self-direction, and competitive integrated employment, provide support coordination to assist with a community supported life, and achieve a more consistent and coordinated approach to the administration of policies and procedures across the state.

(4) Provide the department with new tools for holding regional centers and service providers accountable through the development of a standardized and coordinated set of performance measures and related standards that establish targets and standards above which a regional center may receive incentives for improved performance, and a separate set of standards that require corrective action.

(5) Improve regional center governance by establishing new standards and procedures for regional center governing boards to ensure they can more effectively represent the communities they serve by providing them with greater independence and protection from regional center retaliation.

(6) Require the State Department of Developmental Services to develop a written project charter for the planning and development of a uniform statewide automation system that serves as a foundation document for the system development, which includes project guiding principles, scope, strategies and approach, and project governance, in order to provide transparency to the Legislature and the public on the system development as has been used with other statewide system development.

SEC. 3.

Section 4519.5 of the Welfare and Institutions Code is amended to read:

4519.5.

(a) The department and the regional centers shall annually collaborate to compile data in a uniform manner relating to purchase of service authorization, utilization, and expenditure by each regional center with respect to all of the following:

(1) The age of the consumer, categorized by the following:

(A) Birth to two years of age, inclusive.

(B) Three to 21 years of age, inclusive.

(2) Race or ethnicity of the consumer.

(3) Preferred language spoken by the consumer, and other related details, as feasible.

(4) Disability detail, in accordance with the categories established by subdivision (a) of Section 4512, and, if applicable, a category specifying that the disability is unknown.

(5) Residence type, subcategorized by age, race or ethnicity, and preferred language.

(6) Number of instances when the written copy of the individual program plan was provided at the request of the consumer and, when appropriate, the consumer’s parents, legal guardian or conservator, or authorized representative, in a language other than a threshold language, as defined by paragraph (3) of subdivision (a) of Section 1810.410 of Title 9 of the California Code of Regulations, if that written copy was provided more than 60 days after the request.

(7) Number of instances when the written copy of the individual program plan was provided at the request of the consumer and, when appropriate, the consumer’s parents, legal guardian or conservator, or authorized representative, in a threshold language, as defined by paragraph (3) of subdivision (a) of Section 1810.410 of Title 9 of the California Code of Regulations, if that written copy was provided more than 45 days after the request, in violation of paragraph (5) of subdivision (a) of Section 4646.5.

(8) Beginning with data for the fiscal year of 2023–24, the numbers, percentages, and total and per capita expenditure and authorization amounts, by age, as applicable, according to race or ethnicity and preferred language, for all combined residence types and for consumers living in the family home, regarding the following service types:

(A) Camping and associated travel expenses.

(B) Social recreation activities.

(D) Nonmedical therapies, including, but not limited to, specialized recreation, art, dance, and music.

(b) The data reported pursuant to subdivision (a) shall also include the number and percentage of individuals, categorized by age, race or ethnicity, and disability, and by residence type, as set forth in paragraph (5) of subdivision (a), who have been determined to be eligible for regional center services, but are not receiving purchase of service funds.

(c) By March 31, 2013, each regional center shall post the data described in this section that are specific to the regional center on its website. Commencing on December 31, 2013, each regional center shall annually post these data by December 31. Each regional center shall maintain all previous years’ data on its website.

(d) By March 31, 2013, the department shall post the information described in this section on a statewide basis on its website. Commencing December 31, 2013, the department shall annually post this information by December 31. The department shall maintain all previous years’ data on its website. The department shall also post notice of any regional center stakeholder meetings on its website.

(e) Within three months of compiling the data with the department, and annually thereafter, each regional center shall meet with stakeholders in one or more public meetings regarding the data. The meeting or meetings shall be held separately from any meetings held pursuant to Section 4660. The regional center shall provide participants of these meetings with the data and any associated information related to improvements in the provision of developmental services to underserved communities and shall conduct a discussion of the data and the associated information in a manner that is culturally and linguistically appropriate for that community, including providing alternative communication services, as required by Sections 11135 to 11139.7, inclusive, of the Government Code and implementing regulations. Regional centers shall inform the department of the scheduling of those public meetings 30 days prior to the meeting. Notice of the meetings shall also be posted on the regional center’s website 30 days prior to the meeting and shall be sent to individual stakeholders and groups representing underserved communities in a timely manner. Each regional center shall, in holding the meetings required by this subdivision, consider the language needs of the community and shall schedule the meetings at times and locations designed to result in a high turnout by the public and underserved communities.

(f) (1) Each regional center shall annually report to the department regarding its implementation of the requirements of this section. The report shall include, but shall not be limited to, all of the following:

(A) Actions the regional center took to improve public attendance and participation at stakeholder meetings, including, but not limited to, attendance and participation by underserved communities.

(B) Copies of minutes from the meeting and attendee comments.

(C) Whether the data described in this section indicate a need to reduce disparities in the purchase of services among consumers in the regional center’s catchment area. If the data do indicate that need, the regional center’s recommendations and plan to promote equity, and reduce disparities, in the purchase of services.

(2) Each regional center and the department shall annually post the reports required by paragraph (1) on its website by August 31.

(g) (1) The department shall consult with stakeholders, including consumers and families that reflect the ethnic and language diversity of regional center consumers, regional centers, advocates, providers, family resource centers, the protection and advocacy agency described in Section 4901, and those entities designated as University Centers for Excellence in Developmental Disabilities Education, Research, and Service pursuant to Section 15061 of Title 42 of the United States Code, to achieve the following objectives:

(A) Review the data compiled pursuant to subdivision (a).

(B) Identify barriers to equitable access to services and supports among consumers and develop recommendations to help reduce disparities in purchase of service expenditures.

(C) Encourage the development and expansion of culturally appropriate services, service delivery, and service coordination.

(D) Identify best practices to reduce disparity and promote equity.

(2) The department shall report the status of its efforts to satisfy the requirements of paragraph (1) during the 2016–17 legislative budget subcommittee hearing process.

(h) (1) Subject to available funding, the department shall allocate funding to regional centers or community-based organizations with department oversight to assist with implementation of the recommendations and plans developed pursuant to subdivisions (f) and (g). Activities funded through these allocations may include, but are not limited to, pay differentials supporting direct care bilingual staff of community-based service providers, parent or caregiver education programs, cultural competency training for regional center staff, outreach to underserved populations, or additional culturally appropriate service types or service delivery models.

(2) Each regional center shall consult with stakeholders regarding activities that may be effective in addressing disparities in the receipt of regional center services and the regional center’s proposed requests for the funding specified in paragraph (1). Each regional center shall identify the stakeholders it consulted with and include information on how it incorporated the input of stakeholders into its requests.

(3) A community-based organization may submit a request for grant funding pursuant to this subdivision. The organization shall submit the request concurrently to the regional center of the jurisdiction in which the organization is located and to the department. The regional center shall provide the department with input regarding the request prior to the department’s final determination on the request.

(4) The department shall review requests for funding within 45 days from the deadline specified in the department’s guidance to regional centers and community-based organizations.

(5) Each regional center and community-based organization receiving funding shall report annually to the department, in a manner determined by the department, on how the funding allocations were used and shall include recommendations of priorities for activities that may be effective in addressing disparities, based on the consultation with stakeholders.

(6) The department shall post the following information on its website:

(A) By September 1 of any year in which grant funding is available and has not been allocated, a structure for the grant program, including all of the following information:

(i) How community-based organizations reflecting groups that are disadvantaged by disparities in the purchase of services will be invited to participate in the grant program.

(ii) How statewide strategies were considered.

(iii) How the department will ensure grant funds are not used for activities that regional centers are otherwise required by statute or regulation to conduct.

(iv) How funded activities will be evaluated.

(B) By October 1 of any year in which grant funding is available and has not been allocated, the final invitation for requests for funding or another mechanism through which requests for funding are solicited.

(C) By January 1 of any year in which grant funding has been allocated, a list of grant recipients, funding level per grant, and a description of the funded project.

(D) By May 1 of any year in which the information is available, evaluation results from prior grants. To ensure the department complies with this subparagraph, regional centers and community-based organizations receiving funding shall provide the department, by March 1 of the same year, with an evaluation of funded activities and the effectiveness of those activities in reducing disparities in the purchase of services, to the extent information is available.

(i) On or before December 31, 2021, the department shall contract with an entity or entities with demonstrated experience in quantitative and qualitative data evaluation to design and conduct an independent evaluation of the efforts to promote equity and reduce disparities pursuant to subdivision (h).

(j) For the purposes of this section, the department shall require all of the following:
(1) The use by the department and regional centers, when reporting data by race and ethnicity, of consistent classifications of race and ethnicity, based on categories current in use by the United States Census Bureau.
(2) Confirmation of the race and ethnicity identification of each consumer at the time of the annual review of the consumer’s individual program plan (IPP).
(3) When reporting by residence types, separate presentation of data for those in independent living services and those in supported living services.
(4) Consistent standards and requirements for regional center internet websites, using the same placement and language for all information required by this division, including that data be posted in a machine-readable format.

SEC. 4.

Section 4519.20 is added to the Welfare and Institutions Code, to read:

4519.20.

As part of the department’s planning process for the planning and development of a uniform statewide data automation system, the department, in consultation with stakeholders shall develop, by _____, a project charter that shall be approved by the Secretary of the California Health and Human Services Agency and the Department of Technology. The charter development process shall include the participation and input of program consumers and families, researchers and quality and outcome evaluators, regional centers, and service providers. The project charter shall include all of the following:

(a) An impact statement on the primary entities and individuals impacted by the system development.

(b) Project guiding principles that are foundational to the project approach to be used throughout the planning, development, implementation, and maintenance of the system.

(1) Worker effectiveness and accountability that are constrained by the lack of timely, adequate, and accurate data, the lack of uniformity, and the current system’s limited functionality.

(2) Service delivery that is constrained by the lack of timely, adequate, accurate and accessible data, the lack of clear understandable communication of information, lack of uniformity, and the system’s limited functionality.

(3) Current system maintainability that is constrained by disparate systems, inadequate documentation, the lack of open system architecture, and business changes.

(4) Disparate systems, complex business rules, the number of locations and variability of local system delivery, and changes in the way of doing business.

(5) Limited access of researchers and program evaluators to the set of person-level data that they need to assess program effectiveness.

(d) Program goals, which shall include all of the following:

(1) Maximizing the performance and the business processes for the delivery of intellectual or developmental disability (IDD) system services to consumers at the regional centers.

(2) Improving data quality, privacy, confidentiality, and integration of all data sources at an individual level.

(3) Enabling data-driven decisionmaking and performance measures for the effective administration of the program.

(4) Improving the business processes administered by the department to support regional center service delivery.

(5) Supporting access to individual level data to support program evaluation and other research.

(e) Technology goals that recognize that a statewide system solution not only meets requirements, but also ensures effective transition, while minimizing disruption to existing services.

(f) Project strategies and approaches for development and implementation.

(g) Project governance.

(h) Technology that can readily be enhanced and modernized for the expected system life. In selecting the new system, consideration shall be given to the extent to which the candidate systems employ open architectures and standards and the future ability of the selected system to provide enhancements that will improve long-term effectiveness of program management of the statewide service delivery system.

SEC. 5.

Section 4571 of the Welfare and Institutions Code is amended to read:

4571.

(a) It is the intent of the Legislature to ensure the well-being of consumers, taking into account their informed and expressed choices. It is further the intent of the Legislature to support the satisfaction and success of consumers through the delivery of quality services and supports. Evaluation of the services that consumers receive is a key aspect to the service system. Utilizing the information that consumers and their families provide about those services in a reliable and meaningful way is also critical to enable the department to assess the performance of the state’s developmental services system and to improve services for consumers in the future. To that end, the State Department of Developmental Services, on or before January 1, 2010, shall implement an improved, unified quality assessment system, in accordance with this section.

(b) The department, in consultation with stakeholders, shall identify a valid and reliable quality assurance instrument that assesses consumer and family satisfaction, provision of services in a linguistically and culturally competent manner, and personal outcomes. The instrument shall do all of the following:

(1) Provide nationally validated, benchmarked, consistent, reliable, and measurable data for the department’s Quality Management System.

(2) Enable the department and regional centers to compare the performance of California’s developmental services system against other states’ developmental services systems and to assess quality and performance among all of the regional centers.

(3) Include outcome-based measures such as health, safety, well-being, relationships, interactions with people who do not have a disability, employment, quality of life, integration, choice, service, and consumer satisfaction.

(4) Include outcome-based measures to evaluate the linguistic and cultural competency of regional center services that are provided to consumers across their lifetimes.

(c) To the extent that funding is available, the instrument identified in subdivision (b) may be expanded to collect additional data requested by the State Council on Developmental Disabilities.

(d) (1) The department shall contract with an independent agency or organization to implement, by January 1, 2010, the quality assurance instrument described in subdivision (b). The contractor shall be experienced in all of the following:

(A) Designing valid quality assurance instruments for developmental service systems.

(B) Tracking outcome-based measures such as health, safety, well-being, relationships, interactions with people who do not have a disability, employment, quality of life, integration, choice, service, and consumer satisfaction.

(D) Data analysis and report preparation.

(E) Assessments of the services received by consumers who are moved from developmental centers to the community, given the Legislature’s historic recognition of a special obligation to ensure the well-being of these persons.

(F) Issues related to linguistic and cultural competency.

(2) Notwithstanding any other law, the contract and any amendments pursuant to this section shall be exempt from all of the following:

(A) The personal services contracting requirements of Article 4 (commencing with Section 19130) of Chapter 5 of Part 2 of Division 5 of Title 2 of the Government Code.

(B) The Public Contract Code, the State Contracting Manual, and the State Administration Manual.

(D) The approval of the Department of Technology.

(3) The exemptions specified in paragraph (2) shall remain in effect until there is more than one available assessment that meets the criteria in subdivision (b) from an organization that also meets the criteria in this subdivision.

(e) The department, in consultation with the contractor described in subdivision (d), shall establish the methodology by which the quality assurance instrument shall be administered, including, but not limited to, how often and to whom the quality assurance will be administered, and the design of a stratified, random sample among the entire population of consumers served by regional centers. The contractor shall provide aggregate information for all regional centers and the state as a whole. At the request of a consumer or the family member of a consumer, the survey shall be conducted in the primary language of the consumer or family member surveyed.

(f) The department shall contract with the state council to collect data for the quality assurance instrument described in subdivision (b). If, during the data collection process, the state council identifies any suspected violation of the legal, civil, or service rights of a consumer, or if it determines that the health and welfare of a consumer is at risk, that information shall be provided immediately to the regional center providing case management services to the consumer. At the request of the consumer or family, when appropriate, a copy of the completed survey shall be provided to the regional center providing case management services to improve the consumer’s quality of services through the individual planning process.

(g) The department, in consultation with stakeholders, shall annually review the data collected from and the findings of the quality assurance instrument described in subdivision (b) and accept recommendations regarding additional or different criteria for the quality assurance instrument in order to assess the performance of the state’s developmental services system and improve services for consumers.

(h) (1) Each regional center shall annually present data collected from, and the findings of, the quality assurance instrument described in subdivision (b) for that regional center, at a public meeting of its governing board in order to assess the comparative performance of the regional center and identify needed improvements in services for consumers, including, but not limited to, case management services. Notice of this meeting shall also be posted on the regional center’s internet website at least 30 days prior to the meeting and shall be sent to regional center consumers and families and individual stakeholders at least 30 days prior to the meeting. The governing board shall provide a sufficient public comment period so members of the public may provide comments. Each regional center, in holding the meeting required by this subdivision, shall ensure that the meeting and meeting materials provide language access, as required by state and federal law.

(2) All regional center-specific reports generated by the department pursuant to this subdivision shall be made publicly available on the regional center’s internet website in a machine-readable format, but shall not contain any personal identifying information about any person assessed.

(3) Within 60 days following its annual presentation, each regional center shall submit a report to the department regarding its implementation of the requirements of this section. The report shall include, but shall not be limited to, both of the following:

(A) Copies of the presentation described in paragraph (1), minutes from the meeting, and attendee comments.

(B) The regional center’s recommendations and plans to use the information to address regional center priorities, strategic directions to improve specific areas of performance, or both.

(i) All reports generated pursuant to this section shall be made publicly available, but shall not contain any personal identifying information about any person assessed.

(j) All data collected pursuant to subdivision (c) shall be provided to the state council, but shall not contain personal identifying information about the persons being surveyed.

(k) Implementation of this section shall be subject to an annual appropriation of funds in the Budget Act for this purpose.

(l) By March 1, 2024, the department shall submit a report to the policy and budget subcommittees of the Legislature describing the extent to which the requirements of this section have not been met, including the surveying of all consumers, including those with no purchase of services, and providing specific steps and the schedule by which these requirements will be met.

SEC. 6.

Section 4622 of the Welfare and Institutions Code is amended to read:

4622.

The state shall contract only with agencies, the governing boards of which conform to all of the following criteria:

(a) The governing board shall be composed of individuals with demonstrated interest in, or knowledge of, developmental disabilities.

(b) The membership of the governing board shall include persons with legal, management or board governance, financial, and developmental disability program expertise. Board governance expertise may not be acquired solely by serving on a regional center board. The governing board of the regional center shall include members with financial expertise and members with management or board governance expertise by August 15, 2020.

(c) The membership of the governing board shall include representatives of the various categories of disability to be served by the regional center.

(d) The governing board shall reflect the geographic and ethnic characteristics of the area to be served by the regional center.

(e) A minimum of 50 percent of the members of the governing board shall be persons with developmental disabilities or their parents or legal guardians. No less than 25 percent of the members of the governing board shall be persons with developmental disabilities.

(f) (1) Members of the governing board shall not be permitted to serve more than ~~seven years within each eight-year period.~~ a six-year term, and may return to the board for a subsequent term after five years. The members of each regional center governing board nominating committee shall be comprised of current board members and members of the community, and should be representative of the community served in the regional center’s catchment area.

(2) The board nominating committee shall solicit interests and nominations from the broader community through outreach. The committee shall interview candidates for the board and make recommendations to the governing board for election. During the meeting at which the board elects new members, a candidate may be nominated by a board member with a second by another board member for the open positions. A regional center executive director shall be prohibited from any involvement in the recruitment or election of governing board members.

(g) (1) The ~~regional center~~ department shall provide necessary training and support to these board members to facilitate their understanding and participation, including issues relating to linguistic and cultural competency. The training shall be developed with community input, including persons served and family members. Ongoing support by the department shall include surveying board members about their ability to meaningfully participate in, and understand the subjects and votes at, board meetings. If board members report that they are unable to meaningfully participate, the department shall work with the regional center and the board member to ensure adequate and appropriate accommodations are provided.

(2) As part of its monitoring responsibility, the department shall review and approve the method by which training and support are provided to board members to ensure maximum understanding and participation by board members.

(3) Each regional center shall post on its internet website information regarding the training and support provided to board members.

(h) The governing board may appoint a consumers’ advisory committee composed of persons with developmental disabilities representing the various categories of disability served by the regional center.

(i) The governing board shall appoint an advisory committee composed of a wide variety of persons representing the various categories of providers from which the regional center purchases client services. The advisory committee shall provide advice, guidance, recommendations, and technical assistance to the regional center board in order to assist the regional center in carrying out its mandated functions. The advisory committee shall designate one of its members to serve as a member of the regional center board.

(j) (1) The governing board shall annually review the performance of the director of the regional center. The department shall establish guidelines for governing boards to measure executive director performance, including with respect to issues of equity and diversity.

(2) The governing board shall annually review the performance of the regional center in providing services that are linguistically and culturally appropriate and may provide recommendations to the director of the regional center based on the results of that review.

(k) No A member of the board who is an employee or member of the governing board of a provider from which the regional center purchases client services shall not do any of the following:

(1) Serve as an officer of the board.

(2) Vote on any fiscal matter affecting the purchase of services from any regional center provider.

(3) Vote on any issue other than as described in paragraph (2), in which the member has a financial interest, as defined in Section 87103 of the Government Code, and determined by the regional center board. The member shall provide a list of the member’s financial interests, as defined in Section 87103, to the regional center board.

~~Nothing in this section shall prevent the appointment to a regional center governing board of a person who meets the criteria for more than one of the categories listed above.~~
(l) The department shall establish, and each board shall adopt, an antiretaliation policy for board members that requires department approval for any reduction in services for consumer board members or the family member of family board members.
(m) The department shall establish and adopt a grievance procedure whereby a governing board member who has concerns, complaints, or questions may contact a specific executive at the department.
(n) This section does not prevent the appointment to a regional center governing board of a person who meets the criteria for more than one of the categories listed above.

SEC. 7.

Section 4626.5 of the Welfare and Institutions Code is amended to read:

4626.5.

Each regional center shall submit a conflict-of-interest policy to the department by July 1, 2011, and shall post the policy on its ~~Internet Web site~~ internet website by August 1, 2011. The policy shall do, or comply with, all of the following:

(a) Contain the elements of this section and be consistent with applicable law.

(b) Define conflicts of interest.

(d) Facilitate disclosure of information to identify conflicts of interest.

(e) Require candidates for nomination, election, or appointment to a regional center board, and applicants for regional center director to disclose any potential or present conflicts of interest prior to being appointed, elected, or confirmed for hire by the regional center or the regional center governing board.

(f) Require the regional center and its governing board to regularly and consistently monitor and enforce compliance with its conflict-of-interest policy.

(g) Prohibit a regional center employee from accepting a gift or gifts from a service provider, consumer, or consumer’s family member valued over ten dollars ($10) per year.
(h) Establish a policy prohibiting regional center senior staff from hiring relatives at the center or any ancillary foundation and organization. The policy shall be included in the regional center contract and shall be included in training of the governing board.

SEC. 8.

Section 4629.1 is added to the Welfare and Institutions Code, to read:

4629.1.

(a) Notwithstanding any other law, the evaluation of regional center performance shall be implemented using a common set of performance measures, which shall be administered by the department. This includes the performance requirements under the regional center contracts pursuant to Section 4629, the performance incentives established under Section 4620.5, and the quality assessment instrument required under Section 4571. These measures shall be annually reported and made available to the public through posting of the measures results in machine-readable formats.

(b) By July 1, 2024, the department shall establish standards for each measure above, for which a regional center may receive rewards for good performance, and a separate set of minimal standards, below which the regional center is subject to each level of probation required under Section 4629. The department shall establish the process for assessing corrective action undertaken by a regional center and the process by which a regional center may end its probation status.

(c) The performance measures shall encompass the domains and the associated measures as itemized in subdivision (d). Additional measures may be adopted by the department as needed. Modification of the domain and measures shall be accomplished through a process of consultation that includes the engagement of stakeholders in a manner consistent with that required by subdivision (b) of Section 4620.5. The measures may be amended as reporting mechanisms mature as the department develops new information technology capabilities.

(d) The performance measures for purposes of this section shall be organized under seven domains, as follows:

(1) Community integration, including all of the following:

(A) The percentage of consumers who report spending their days primarily with people without disabilities who are not paid to be with them.

(B) The percentage of consumers who report they feel part of their communities, participate in community activities, know their neighbors, and have friends.

(D) The percentage of adult consumers living in licensed group homes, intermediate care facilities, or other institutional settings.

(E) The percentage of adult consumers living in their own homes with independent living services.

(F) The percentage of adult consumers living in their own homes with supported living services.

(G) The percentage of adult consumers seeking affordable and accessible housing.

(H) The percentage of adult consumers that have secured housing outside of their family home, if desired.

(2) Employment, including all of the following:

(A) The percentage of adult consumers in competitive integrated employment and the length of time in the job.

(B) The percentage of employed adult consumers reporting increased wages and opportunities for advancement.

(C) The percentage of employed adult consumers reporting satisfaction with their jobs with the ability to learn new skills and interact with coworkers.

(D) The average per capita annual wages of employed adult consumers.

(E) The percentage of participants in the paid internship program that led to permanent employment.

(F) The average hourly wage for competitive, integrated employment.

(G) The average number of hours per week in competitive, integrated employment.

(H) The percentage of adult consumers in competitive integrated employment, by race and ethnicity.

(3) Equity in service access, including all of the following:

(A) Per capita spending, by race and ethnicity.

(B) Per capita spending, by primary language.

(D) Access to Early Start services by race and ethnicity.

(E) Per capita spending on adult consumers, by residence type and by race and ethnicity.

(F) Per capita spending on adult consumers, by residence type and regional center.

(G) The percentage of consumers with no purchase of services, by regional center.

(H) The percentage of consumers with no purchase of services, by race and ethnicity.

(4) Case management, including all of the following:

(A) Timeliness of intake for eligibility.

(B) Timeliness of initiation of services for Early Start.

(D) Timeliness of delivery of IPP services after authorization.

(E) Share of consumers reporting that the regional center service coordinator assisted them in attaining generic resources.

(F) Responsiveness of service coordinator.

(G) Consumer or family directs their own person-centered planning process.

(H) Timeliness of translated IPPs and other documents.

(5) Consumer and family choice, experience, and satisfaction, including all of the following:

(A) Overall satisfaction and happiness.

(B) Service coordinator cultural competency.

(D) Access to approved services.

(E) Access to services provided by individuals who speak the consumer’s language.

(F) Consumers report they are treated with dignity and respect.

(G) Access to the Self-Determination Program.

(H) The ability to select their services and providers from among a range of choices.

(I) The ability to select the place where they live, with whom they live, and who supports them.

(J) The percentage of consumers who report having a way to communicate and express choices and decisions.

(K) The percentage of consumers or families who report that they understand the information provided to them by their regional center.

(L) The percentage of consumers or families reporting they feel comfortable in their interactions with the regional center, and if they are aware they can change their service coordinator.

(6) Human and civil rights, including all of the following:

(A) The number of special incident reports, and number of incidents of seclusion and restraint or other types of abuse by regional center.

(B) The percentage of consumers reporting they have a private space, if they live out of their family home.

(D) The percentage of adult consumers who are conserved.

(7) Health and safety, including all of the following:

(A) Hospitalization and mortality rates among regional center consumers.

(B) The percentage of consumers receiving regular preventative care, vaccinations, and cancer screenings.

SEC. 9.

Section 4639.76 is added to the Welfare and Institutions Code, to read:

4639.76.

A regional center with which the department maintains a contract pursuant to Section 4629 shall be subject to the California Public Records Act (Chapter 1 (commencing with Section 7920.000) of Division 10 of Title 1 of the Government Code).

SEC. 10.

Section 4642 of the Welfare and Institutions Code is amended to read:

4642.

(a) (1) Any person believed to have a developmental disability, and any person believed to have a high risk of parenting ~~a developmentally disabled infant~~ an infant with a developmental disability shall be eligible for initial intake and assessment services in the regional centers. In addition, any infant having a high risk of becoming developmentally disabled may be eligible for initial intake and assessment services in the regional centers. For purposes of this section, “high-risk infant” means a child less than 36 months of age whose genetic, medical, or environmental history is predictive of a substantially greater risk for developmental disability than that for the general population. The department, in consultation with the State Department of Public Health, shall develop specific risk and service criteria for the high-risk infant program on or before July 1, 1983. These criteria may be modified in subsequent years based on analysis of actual clinical experience.

(2) Initial intake shall be performed within 15 working days following request for assistance. Initial intake shall include, but need not be limited to, information and advice about the nature and availability of services provided by the regional center and by other agencies in the community, including guardianship, conservatorship, income maintenance, mental health, housing, education, work activity and vocational training, medical, dental, recreational, and other services or programs that may be useful to persons with developmental disabilities or their families. Intake shall also include a decision to provide assessment.

(3) (A) The department shall create, with input from stakeholders, standardized information packets to be provided to any person seeking services from a regional center. There shall be one information packet related to services provided under the California Early Intervention Services Act and another information packet related to services provided under the Lanterman Developmental Disabilities Services Act. The information packets shall be translated to provide language access, as required by state and federal law, shall be available in alternative formats and alternative modes of communication, as required by federal law, and shall include, at a minimum, all of the following:

(i) An overview of the regional center system.

(ii) A resource guide for consumers and their families.

(iii) Consumer ~~rights.~~ rights, including the appeals procedures specified in Chapter 7 (commencing with Section 4700).

(iv) Contact information for the regional center, the department, the office of clients’ rights advocacy, and the protection and advocacy agency specified in Division 4.7 (commencing with Section 4900).

(v) Information on the Self-Determination Program, including the eligibility requirements specified in subdivision (d) of Section 4685.8.

(B) Each regional center shall distribute the information packets at intake, upon transfer to receiving services under the Lanterman Developmental Disabilities Services Act, and upon request. Each regional center shall begin distributing the information packets within 60 days following the department providing the information packets and issuing directives regarding the distribution of the information packets. In addition to, and not in lieu of, this requirement, each regional center shall post the full content of the most updated information packet on its internet website.

(b) A regional center shall communicate with the consumer and the consumer’s family pursuant to this section in their native language, including providing alternative communication services and alternative formats, as required by state and federal law.

SEC. 11.

Section 4643 of the Welfare and Institutions Code is amended to read:

4643.

(a) If assessment is needed, the ~~assessment shall be performed within 120 days~~ regional center shall require the assessment to be completed within 60 days following initial intake. Assessment shall be ~~performed~~ commenced as soon as ~~possible~~ possible, and in no event more than 60 30 days following initial intake ~~where~~ when any delay would expose the client to unnecessary risk to ~~his or her~~ their health and safety or to significant further delay in mental or physical development, or the client would be at imminent risk of placement in a more restrictive environment. Assessment may include collection and review of available historical diagnostic data, provision or procurement of necessary tests and evaluations, and summarization of developmental levels and service needs and is conditional upon receipt of the release of information specified in subdivision (b).

(b) In determining if an individual meets the definition of developmental disability contained in subdivision (a) of Section 4512, the regional center may consider evaluations and tests, including, but not limited to, intelligence tests, adaptive functioning tests, neurological and neuropsychological tests, diagnostic tests performed by a physician, psychiatric tests, and other tests or evaluations that have been performed by, and are available from, other sources.

(c) At the time of assessment, the individual, or, where appropriate, the parents, legal guardian, or conservator, shall provide copies of any health benefit cards under which the consumer is eligible to receive health benefits, including, but not limited to, private health insurance, a health care service plan, Medi-Cal, Medicare, and TRICARE. If the individual, or where appropriate, the parents, legal guardians, or conservators, have no such benefits, the regional center shall not use that fact to negatively impact the services that the individual may or may not receive from the regional center.

(d) A regional center shall communicate with the consumer and ~~his or her~~ the consumer’s family pursuant to this section in their ~~native~~ preferred language, including providing alternative communication services, as required by Sections 11135 to 11139.7, inclusive, of the Government Code and implementing regulations.

SEC. 12.

Section 4646 of the Welfare and Institutions Code is amended to read:

4646.

(a) It is the intent of the Legislature to ensure that the individual program plan and provision of services and supports by the regional center system is centered on the individual and the family of the individual with developmental disabilities and takes into account the needs and preferences of the individual and the family, if appropriate, as well as promoting community integration, independent, productive, and normal lives, and stable and healthy environments. It is the further intent of the Legislature ~~to ensure~~ that individual program plans shall be developed consistent with the federal Affordable Care Act and the regulations and federal guidance adopted pursuant to the act requiring that community-based long-term services and supports be person-centered and self-directed. It is the further intent of the Legislature to ensure that goals in any plan allow for innovation and nontraditional service delivery and not be limited by the lack of easily identified services or supports, the provision of services to consumers and their families be effective in meeting the goals stated in the individual program plan, reflect the preferences and choices of the consumer, and reflect the cost-effective use of public resources.

(b) ~~The~~ (1) Notwithstanding any other law, the individual program plan is shall be developed through a process of individualized needs ~~determination.~~ determination and person-centered service planning developed pursuant to, and consistent with, Section 2402(a) of the federal Affordable Care Act (Pub. L. 111-148) and amendments thereto, Section 441.725 of Title 42 of the Code of Federal Regulations, and federal guidance issued by the Centers for Medicaid and Medicare Services on June 6, 2014, requiring community-based, long-term services and supports to be person-centered, strengths-based, and self-directed. The individual with developmental disabilities and, if appropriate, the individual’s parents, legal guardian or conservator, or authorized representative, shall have the opportunity to actively participate in the development of the plan. The individual shall lead the service planning process to the greatest extent possible.

(c) An individual program plan shall be developed for any person who, following intake and assessment, is found to be eligible for regional center services. ~~These plans shall be completed within 60 days of the completion of the assessment.~~ A final assessment agreement shall be completed and provided to the consumer within 30 days of an intake unless there is good cause for the regional center to exceed the 30-day time period, but in no event shall the assessment be completed any later than 60 days from the intake unless the consumer or, if appropriate, the parents, legal guardian, conservator, or authorized representative request additional time pursuant to subdivision (h). If a completed assessment recommends the delivery of services, those services shall be provided within seven days of the receipt of the assessment by the regional center. At the time of intake, the regional center shall inform the consumer and, if appropriate, the consumer’s parents, legal guardian or conservator, or authorized representative, of the services available through the state council and the protection and advocacy agency designated by the Governor pursuant to federal law, and shall provide the address and telephone numbers of those agencies.

(d) (1) As part of the initial individual program plan meeting and each annual review required by subdivision (b) of Section 4646.5, the consumer or, if appropriate, their parents, legal guardian, conservator, or authorized representative, shall be provided by the service coordinator oral and written information about the Self-Determination Program. The information shall include each of the provisions specified in subdivision (d) of Section 4685. Each individual program plan shall include a provision stating that the consumer or authorized representative was informed about the availability of the Self-Determination Program. If the consumer chooses not to participate in the program, the individual program plan shall include an explanation of the reason or reasons for that decision, or, if the consumer is ineligible for the program, the reason or reasons for that ineligibility.
(2) If the consumer is interested in participating in the program or wants additional information or assistance, the service coordinator, within five days of expressing the interest, shall provide the consumer a date for the Self-Determination Program orientation, training resources, dates of local volunteer Self-Determination Program advisory committee meetings, and other information to assist the consumer in participating in the program.
~~(d)~~

(e) Individual program plans shall be prepared jointly by the planning team. Decisions concerning the consumer’s goals, objectives, and services and supports that will be included in the consumer’s individual program plan and purchased by the regional center or obtained from generic agencies shall be made by agreement between the regional center representative and the consumer or, if appropriate, the parents, legal guardian, conservator, or authorized representative at the program plan meeting.

~~(e)~~

(f) Regional centers shall comply with the request of a consumer or, if appropriate, the request of the consumer’s parents, legal guardian, conservator, or authorized representative, that a designated representative receive written notice of all meetings to develop or revise the individual program plan and of all notices sent to the consumer pursuant to Section 4710. The designated representative may be a parent or family member.

~~(f)~~

(g) Notwithstanding any other law, ~~until June 30, 2023,~~ a meeting regarding the provision of services and supports by the regional center, including a meeting to develop or revise the individual program plan, shall be held by remote electronic communications if requested by the consumer or, if appropriate, if requested by the consumer’s parents, legal guardian, conservator, or authorized representative.

~~(g)~~

(h) At the conclusion of an individual program plan meeting, an authorized representative of the regional center shall provide to the consumer, in written or electronic format, a list of the agreed-upon services and ~~supports, and, if known, the projected~~ supports and the start date, the frequency and duration of the services and supports, and the ~~provider.~~ provider, and a summary page written in plain language. The identified services and supports specified in an individual program plan referred to a provider shall begin on the date specified in the plan. In the event the services or supports are not started by the provider within 45 days of the specified start date, a referral shall be made within 14 days to another provider for delivery of the specified services and supports. The authorized representative of the regional center shall sign the list of agreed-upon services and supports at that time. The consumer, or if appropriate, the consumer’s parent, legal guardian, conservator, or authorized representative shall sign the list of agreed-upon services and supports prior to its implementation. The consumer, or if appropriate, the consumer’s parent, legal guardian, conservator, or authorized representative, may elect to delay receipt of the list of agreed-upon services and supports pending final agreement, as described in subdivision (h). If the consumer, or if appropriate, the consumer’s parent, legal guardian, conservator, or authorized representative, elects to delay the receipt of the list of agreed-upon services and supports for 15 days, the list shall be provided in the preferred language of the consumer, or of the consumer’s parent, legal guardian, or authorized representative.

~~(h)~~

(i) If a final agreement regarding the services and supports to be provided to the consumer cannot be reached at a program plan meeting, then a subsequent program plan meeting shall be convened within 15 days, or later at the request of the consumer or, if appropriate, the parents, legal guardian, conservator, or authorized representative or if agreed to by the planning team. The list of the agreed-upon services and supports described in subdivision ~~(g)~~ (h) and signed by the authorized representative of the regional center shall be provided, in writing or electronically, at the conclusion of the subsequent program plan meeting, and shall be provided in the preferred language of the consumer, or of the consumer’s parent, legal guardian, conservator, or authorized representative. Additional program plan meetings may be held with the agreement of the regional center representative and the consumer or, if appropriate, the parents, legal guardian, conservator, or authorized representative.

~~(i)~~

(j) An authorized representative of the regional center and the consumer or, if appropriate, the consumer’s parent, legal guardian, conservator, or authorized representative shall sign the individual program plan and the list of the agreed-upon services and supports prior to its implementation. If the consumer or, if appropriate, the consumer’s parent, legal guardian, conservator, or authorized representative, does not agree with all components of the individual program plan, the consumer may indicate that disagreement on the plan. Disagreement with specific plan components shall not prohibit the implementation of services and supports agreed to by the consumer or, if appropriate, the consumer’s parent, legal guardian, conservator, or authorized representative. If the consumer or, if appropriate, the consumer’s parent, legal guardian, conservator, or authorized representative, does not agree with the plan in whole or in part, the consumer shall be sent written notice of their appeal rights, as required by Sections 4701 and 4710.

~~(j)~~

(k) (1) A regional center shall communicate in the consumer’s preferred language, or, if appropriate, the preferred language of the consumer’s family, legal guardian, conservator, or authorized representative, during the planning process for the individual program plan, including during the program plan meeting, and including providing alternative communication services, as required by Sections 11135 to 11139.8, inclusive, of the Government Code and implementing regulations.

(2) A regional center shall provide alternative communication services, including providing copies of the list of services and supports, and the individual program plan in the preferred language of the consumer or the consumer’s family, legal guardian, conservator, or authorized representative, or both, as required by Sections 11135 to 11139.8, inclusive, of the Government Code and implementing regulations.

(3) The preferred language of the consumer or the consumer’s family, legal guardian, conservator, or authorized representative, or both, shall be documented in the individual program plan.

SEC. 13.

Section 4646.4 of the Welfare and Institutions Code is amended to read:

4646.4.

(a) Regional centers shall ensure, at the time of development, scheduled review, or modification of a consumer’s individual program plan developed pursuant to Sections 4646 and 4646.5, or of an individualized family service plan pursuant to Section 95020 of the Government Code, the establishment of an internal process. This internal process shall ensure adherence with federal and state law and regulation, and if purchasing services and supports, shall ensure all of the following:

(1) Conformance with the regional center’s purchase of service policies, as approved by the department pursuant to subdivision (d) of Section 4434.

(2) Utilization of generic services and supports if appropriate. The individualized family service planning team for infants and toddlers eligible under Section 95014 of the Government Code and the individual program plan team pursuant to Section 4646 may determine that a medical service identified in the individualized family service plan is not available through the family’s private health insurance policy or health care service plan and therefore, in compliance with the timely provision of service requirements contained in Part 303 (commencing with Section 303.1) of Title 34 of the Code of Federal Regulations, service provided by a generic agency, as defined by subdivision (g) of Section 4659.5, or a service or source of funding contained in Section 4659 identified in the individualized family service plan or individual program plan is not available, and, therefore, will be funded by the regional center.

(3) Utilization of other services and sources of funding as contained in Section 4659.

(4) Consideration of the family’s responsibility for providing similar services and supports for a minor child without disabilities in identifying the consumer’s service and support needs as provided in the least restrictive and most appropriate setting. In this determination, regional centers shall take into account the consumer’s need for extraordinary care, services, supports and supervision, and the need for timely access to this care.

(5) Commencing October 1, 2022, consideration of information obtained from the consumer and, if appropriate, the parents, legal guardian, conservator, or authorized representative about the consumer’s need for the services, barriers to service access, and other information.

(b) At the time of development, scheduled review, or modification of a consumer’s individual program plan developed pursuant to Sections 4646 and 4646.5, or of an individualized family service plan pursuant to Section 95020 of the Government Code, the consumer, or, if appropriate, the parents, legal guardian, or conservator, shall provide copies of their health benefit cards under which the consumer is eligible to receive health benefits, including, but not limited to, private health insurance, a health care service plan, Medi-Cal, Medicare, and TRICARE. If the individual, or, if appropriate, the parents, legal guardians, or conservators, do not have health benefits, the regional center shall not use that fact to negatively impact the services that the individual may or may not receive from the regional center.

(d) Final decisions regarding the individualized family service plan shall be made pursuant to Section 95020 of the Government Code.

SEC. 14.

Section 4646.5 of the Welfare and Institutions Code is amended to read:

4646.5.

(a) The planning process for the individual program plan described in Section 4646 shall include all of the following:

(1) Gathering information and conducting assessments to determine the life goals, capabilities and strengths, preferences, barriers, and concerns or problems of the person with developmental disabilities. For children with developmental disabilities, this process should include a review of the strengths, preferences, and needs of the child and the family unit as a whole. Assessments shall be conducted by qualified individuals and performed in natural environments whenever possible. Information shall be taken from the consumer, the consumer’s parents and other family members, the consumer’s friends, advocates, authorized representative, if applicable, providers of services and supports, and other agencies. The assessment process shall reflect awareness of, and sensitivity to, the lifestyle and cultural background of the consumer and the family.

(2) A statement of goals, based on the needs, preferences, and life choices of the individual with developmental disabilities, and a statement of specific, time-limited objectives for implementing the person’s goals and addressing the person’s needs. These objectives shall be stated in terms that allow measurement of progress or monitoring of service delivery. These goals and objectives should maximize opportunities for the consumer to develop relationships, be part of community life in the areas of community participation, housing, work, school, and leisure, increase control over the consumer’s life, acquire increasingly positive roles in community life, and develop competencies to help accomplish these goals.

(3) In developing individual program plans for children, regional centers shall be guided by the principles, process, and services and support parameters set forth in Section 4685.

(4) In developing an individual program plan for a transition age youth or working age adult, the planning team shall consider the Employment First Policy described in Chapter 14 (commencing with Section 4868).

(5) A schedule of the type and amount of services and supports to be purchased by the regional center or obtained from generic agencies or other resources in order to achieve the individual program plan goals and objectives, and identification of the provider or providers of service responsible for attaining each objective, including, but not limited to, vendors, contracted providers, generic service agencies, and natural supports. The individual program plan shall specify the approximate scheduled start date for services and supports and shall contain timelines for actions necessary to begin services and supports, including generic services. In addition to the requirements of subdivision (h) of Section 4646, each regional center shall offer, and upon request provide, a written copy of the individual program plan to the consumer, and, if appropriate, the consumer’s parents, legal guardian or conservator, or authorized representative within 45 days of their request in a threshold language, as defined by paragraph (3) of subdivision (a) of Section 1810.410 of Title 9 of the California Code of Regulations.

(6) If agreed to by the consumer, the parents, legally appointed guardian, or authorized representative of a minor consumer, or the legally appointed conservator of an adult consumer or the authorized representative, including those appointed pursuant to subdivision (a) of Section 4541, subdivision (b) of Section 4701.6, and subdivision (e) of Section 4705, a review of the general health status of the adult or child, including medical, dental, and mental health needs, shall be conducted. This review shall include a discussion of current medications, any observed side effects, and the date of the last review of the medication. Service providers shall cooperate with the planning team to provide any information necessary to complete the health status review. If any concerns are noted during the review, referrals shall be made to regional center clinicians or to the consumer’s physician, as appropriate. Documentation of health status and referrals shall be made in the consumer’s record by the service coordinator.

(7) (A) The development of a transportation access plan for a consumer when all of the following conditions are met:

(i) The regional center is purchasing private, specialized transportation services or services from a residential, day, or other provider, excluding vouchered service providers, to transport the consumer to and from day or work services.

(ii) The planning team has determined that a consumer’s community integration and participation could be safe and enhanced through the use of public transportation services.

(iii) The planning team has determined that generic transportation services are available and accessible.

(B) To maximize independence and community integration and participation, the transportation access plan shall identify the services and supports necessary to assist the consumer in accessing public transportation and shall comply with Section 4648.35. These services and supports may include, but are not limited to, mobility training services and the use of transportation aides. Regional centers are encouraged to coordinate with local public transportation agencies.

(8) A schedule of regular periodic review and reevaluation to ascertain that planned services have been provided, that objectives have been fulfilled within the times specified, and that consumers and families are satisfied with the individual program plan and its implementation.

(b) For all active cases, individual program plans shall be reviewed and modified by the planning team, through the process described in Section 4646, as necessary, in response to the person’s achievement or changing needs, and no less often than once every ~~three years.~~ 12 months. If the consumer or, if appropriate, the consumer’s parents, legal guardian, authorized representative, or conservator requests an individual program plan review, the individual program plan shall be reviewed within 30 days after the request is submitted, or no later than 7 days after the request is submitted if necessary for the consumer’s health and safety or to maintain the consumer in their home.

(c) (1) The department, with the participation of representatives of a statewide consumer organization, the Association of Regional Center Agencies, an organized labor organization representing service coordination staff, and the state council shall prepare training material and a standard format and instructions for the preparation of individual program plans, which embody ~~an approach centered on the person and family.~~ a person-centered planning process consistent with federal law, regulations and guidance.

~~(2)Each regional center shall use the training materials and format prepared by the department pursuant to paragraph (1).~~
(2) The department shall require each regional center to use, for all new and modified individual program plans, the training materials and the standard format plan prepared by the department pursuant to paragraph (1) by no later than March 1, 2024.

(3) The department shall biennially review a random sample of individual program plans at each regional center to ensure that these plans are being developed and modified in compliance with Section 4646 and this section.

SEC. 15.

Section 4647 of the Welfare and Institutions Code is amended to read:

4647.

(a) Pursuant to Section 4640.7, service coordination shall include those activities necessary to implement an individual program plan, including, but not limited to, participation in the individual program plan process; assurance that the planning team considers all appropriate options for meeting each individual program plan objective; securing, through purchasing or by obtaining from generic agencies or other resources, services and supports specified in the person’s individual program plan; coordination of service and support programs; collection and dissemination of information; and monitoring implementation of the plan to ascertain that objectives have been fulfilled and to assist in revising the plan as ~~necessary.~~ necessary, and ensuring service coordinators are accessible to consumers and their representatives by telephone and other electronic means, which shall include responding to consumer inquiries within 48 hours of the inquiry.

(b) The regional center shall ~~assign~~ ensure that every consumer has a service coordinator who shall be responsible for implementing, overseeing, and monitoring each individual program plan. The service coordinator may be an employee of the regional center or may be a qualified individual or employee of an agency with whom the regional center has contracted to provide service coordination services, or persons described in Section 4647.2. The regional center shall provide the consumer or, where appropriate, ~~his or her~~ the consumer’s parents, legal guardian, or conservator or authorized representative, with written notification of any temporary or permanent change in the assigned service coordinator within 10 business days. ~~No person shall~~ A person shall not continue to serve as a service coordinator for any individual program plan unless there is agreement by all parties that the person should continue to serve as service coordinator.

(c) Where appropriate, a consumer or the consumer’s parents or other family members, legal guardian, or conservator, may perform all or part of the duties of the service coordinator described in this section if the regional center director agrees and it is feasible.

(d) If ~~any~~ a person described in subdivision (c) is designated as the service coordinator, that person shall not deviate from the agreed-upon program plan and shall provide any reasonable information and reports required by the regional center director.

(e) If any a person described in subdivision (c) is designated as the service coordinator, the regional center shall provide ongoing information and support as necessary, to assist the person to perform all or part of the duties of service coordinator.

SEC. 16.

Section 4659 of the Welfare and Institutions Code is amended to read:

4659.

(a) Except as otherwise provided in subdivision ~~(b)~~ (b), (d), or (e), the regional center shall identify and pursue all possible sources of funding for consumers receiving regional center services. These sources shall include, but not be limited to, both of the following:

(1) Governmental or other entities or programs required to provide or pay the cost of providing services, including Medi-Cal, Medicare, the Civilian Health and Medical Program for Uniform Services, school districts, and federal supplemental security income and the state supplementary program.

(2) Private entities, to the maximum extent they are liable for the cost of services, aid, insurance, or medical assistance to the consumer.

(b) Any revenues collected by a regional center pursuant to this section shall be applied against the cost of services prior to use of regional center funds for those services. This revenue shall not result in a reduction in the regional center’s purchase of services budget, except as it relates to federal supplemental security income and the state supplementary program.

(c) Effective July 1, 2009, notwithstanding any other law or regulation, regional centers shall not purchase any service that would otherwise be available from Medi-Cal, Medicare, the Civilian Health and Medical Program for Uniform Services, In-Home Support Services, California Children’s Services, private insurance, or a health care service plan when a consumer or a family meets the criteria of this coverage but chooses not to pursue that ~~coverage.~~ coverage after being advised of the provisions of subdivision (d). If, on July 1, 2009, a regional center is purchasing that service as part of a consumer’s individual program plan (IPP), the prohibition shall take effect on October 1, 2009.

(d)(1)Effective July 1, 2009, notwithstanding any other law or regulation, a regional center shall not purchase medical or dental services for a consumer three years of age or older unless the regional center is provided with documentation of a Medi-Cal, private insurance, or a health care service plan denial and the regional center determines that an appeal by the consumer or family of the denial does not have merit. If, on July 1, 2009, a regional center is purchasing the service as part of a consumer’s IPP, this provision shall take effect on August 1, 2009. Regional centers may pay for medical or dental services during the following periods:
~~(A)While coverage is being pursued, but before a denial is made.~~
~~(B)Pending a final administrative decision on the administrative appeal if the family has provided to the regional center a verification that an administrative appeal is being pursued.~~
~~(C)Until the commencement of services by Medi-Cal, private insurance, or a health care service plan.~~
~~(2)When necessary, the consumer or family may receive assistance from the regional center, the Clients’ Rights Advocate funded by the department, or the state council in pursuing these appeals.~~
(d) (1) Notwithstanding Section 4646.4, a regional center may request a consumer or family member to pursue a service or source of funding from an entity described in subdivision (a) or (c) of this section, or pursuant to subdivision (g) of Section 4659.5, if the request is documented with specificity in the individual program plan or individualized family plan and the plan contains detailed instructions for the consumer or family pursuing the service. The individual program plan or individualized family plan shall also specify the ways in which the regional center will initially assist the consumer or family to apply for and pursue the service or source of funding and specify that it will provide additional assistance when requested by the consumer or family.
(2) The regional center shall purchase the service when either of the following occurs:
(A) The entity denies the service.
(B) The entity does not provide the requested service within 45 days from the date of the request, or 15 days after the statutory or regulatory time limit, if any, for the entity to make an initial decision, whichever is shorter.
(3) A consumer, or their family, shall not be required to appeal an entity’s denial of the requested service for the regional center to purchase that service pursuant to this subdivision. The regional center may file an appeal on behalf of the consumer, but the appeal shall not delay the payment of the requested service by the regional center as specified in subparagraph (B) of paragraph (2).
(4) This section does not prohibit a consumer or their family, where appropriate, from filing a formal appeal of an entity’s denial of the service at issue, or a regional center from seeking reimbursement from the entity it believes is responsible for providing the service and from requesting assistance with filing the appeal or from utilizing assistance from other advocacy organizations.

(e) This section shall not impose any additional liability on the parents of children with developmental disabilities, or to restrict eligibility for, or deny services to, any individual who qualifies for regional center services but is unable to pay.

(f) In order to best utilize generic resources, federally funded programs, and private insurance programs for individuals with developmental disabilities, the department and regional centers shall engage in the following activities:

(1) Within existing resources, the department shall provide training to regional centers, no less than once every two years, in the availability and requirements of generic, federally funded and private programs available to persons with developmental disabilities, including, but not limited to, eligibility requirements, the application process and covered services, and the appeal process.

(2) Regional centers shall disseminate information and training to all service coordinators regarding the availability and requirements of generic, federally funded, and private insurance programs on the local level.

SEC. 17.

Section 4685.8 of the Welfare and Institutions Code is amended to read:

4685.8.

(a) The department shall implement a statewide Self-Determination Program. The Self-Determination Program shall be available in every regional center catchment area to provide participants and their families, within an individual budget, increased flexibility and choice, and greater control over decisions, resources, and needed and desired services and supports to implement their IPP. As of July 1, 2021, the program shall begin to be available on a voluntary basis to all regional center consumers who are eligible for the Self-Determination Program.

(b) The department, in establishing the statewide program, shall do both of the following:

(1) Set targets and benchmarks as set forth in paragraph (1) of subdivision (r).

(2) Address all of the following:

(A) Oversight of expenditure of self-determined funds and the achievement of participant outcomes over time.

(B) Increased participant control over which services and supports best meet the participant’s needs and the IPP objectives. A participant’s unique support system may include the purchase of existing service offerings from service providers or local businesses, hiring their own support workers, or negotiating unique service arrangements with local community resources.

(D) Consumer and family training to ensure understanding of the principles of self-determination, the planning process, and the management of budgets, services, and staff.

(E) Choice of independent facilitators, who meet standards and certification requirements established by the department, and who can assist with the functions specified in paragraph (2) of subdivision (c).

(F) Choice of financial management services providers who meet standards and certification requirements established by the department, and who can carry out the functions specified in paragraph (1) of subdivision (c).

(G) Innovation that will more effectively allow participants to achieve their goals.

(H) Long-term sustainability of the Self-Determination Program by doing all of the following:

(i) Requiring IPP teams, when developing the individual budget, to determine the services, supports and goods necessary for each consumer based on the needs and preferences of the consumer, and when appropriate the consumer’s family, and the effectiveness of each option in meeting the goals specified in the IPP, and the cost effectiveness of each option, as specified in subparagraph (D) of paragraph (6) of subdivision (a) of Section 4648.

(ii) The department may review final individual budgets that are at or above a spending threshold determined by the department of all individual budgets and use information from its review in the aggregate to develop additional program guidance and verify compliance with federal and state laws and other requirements.

(1) “Financial management services” means services or functions that assist the participant to manage and direct the distribution of funds contained in the individual budget, and ensure that the participant has the financial resources to implement their IPP throughout the year. These may include bill paying services and activities that facilitate the employment of service and support workers by the participant, including, but not limited to, fiscal accounting, tax withholding, compliance with relevant state and federal employment laws, assisting the participant in verifying provider qualifications, including criminal background checks, and expenditure reports. The financial management services provider shall meet the applicable requirements of Title 17 of the California Code of Regulations and other specific qualifications or certifications established by the department.

(2) “Independent facilitator” means a person, selected and directed by the participant, who is not otherwise providing services to the participant pursuant to their IPP and is not employed by a person providing services to the participant. The independent facilitator may assist the participant in making informed decisions about the individual budget, and in locating, accessing, and coordinating services and supports consistent with the participant’s IPP. The independent facilitator is available to assist in identifying immediate and long-term needs, developing options to meet those needs, leading, participating, or advocating on behalf of the participant in the person-centered planning process and development of the IPP, and obtaining identified services and supports. The cost of the independent facilitator, if any, shall be paid by the participant out of the participant’s individual budget. An independent facilitator shall receive training in the principles of self-determination, the person-centered planning process, and the other responsibilities described in this paragraph at the independent facilitator’s own cost. The independent facilitator shall meet standards and certification requirements established by the department.

(3) “Individual budget” means the amount of regional center purchase of service funding available to the participant for the purchase of services and supports necessary to implement the IPP. The individual budget shall be determined using a fair, equitable, and transparent methodology.

(4) “IPP” means individual program plan, as described in Section 4646.

(5) “Participant” means an individual, and when appropriate, the participant’s parents, legal guardian or conservator, or authorized representative, who has been deemed eligible for, and has voluntarily agreed to participate in, the Self-Determination Program.

(6) “Self-determination” means a voluntary delivery system consisting of a defined and comprehensive mix of services and supports, selected and directed by a participant through person-centered planning, in order to meet the objectives in their IPP. Self-determination services and supports are designed to assist the participant to achieve personally defined outcomes in community settings that promote inclusion. The Self-Determination Program shall only fund services and supports provided pursuant to this division that the federal Centers for Medicare and Medicaid Services determines are eligible for federal financial participation.

(7) “Spending Plan” means the plan the participant develops to use their available individual budget funds to purchase goods, services, and supports necessary to implement their individual program plan (IPP). The spending plan shall identify the cost of each good, service, and support that will be purchased with regional center funds. The total amount of the spending plan cannot exceed the amount of the individual budget. A copy of the spending plan shall be attached to the participant’s IPP.

(d) Participation in the Self-Determination Program is fully voluntary. A participant may choose to participate in, and may choose to leave, the Self-Determination Program at any time. A regional center shall not require or prohibit participation in the Self-Determination Program as a condition of eligibility for, or the delivery of, services and supports otherwise available under this division. Participation in the Self-Determination Program shall be available to any regional center consumer who meets the following eligibility requirements:

(1) The participant has a developmental disability, as defined in Section 4512, and is receiving services pursuant to this division.

(2) The consumer does not live in a licensed long-term health care facility, as defined in paragraph (44) of subdivision (a) of Section 54302 of Title 17 of the California Code of Regulations. An individual, and when appropriate the individual’s parent, legal guardian or conservator, or authorized representative, who is not eligible to participate in the Self-Determination Program pursuant to this paragraph may request that the regional center provide person-centered planning services in order to make arrangements for transition to the Self-Determination Program, provided that the individual is reasonably expected to transition to the community within 90 days. In that case, the regional center shall initiate person-centered planning services within 60 days of that request.

(3) The participant agrees to all of the following terms and conditions:

(A) The participant shall receive an orientation that meets the standards set or developed by the department to the Self-Determination Program prior to enrollment, which includes the principles of self-determination, the role of the independent facilitator and the financial management services provider, person-centered planning, and development of a budget.

(B) The participant shall utilize the services and supports available within the Self-Determination Program only when generic services and supports are not available.

(C) The participant shall only purchase services and supports necessary to implement their IPP and shall comply with any and all other terms and conditions for participation in the Self-Determination Program described in this section.

(D) The participant shall manage Self-Determination Program services and supports within the participant’s individual budget.

(E) The participant shall utilize the services of a financial management services provider of their own choosing and who is vendored by a regional center and who meets the qualifications in paragraph (1) of subdivision (c).

(F) The participant may utilize the services of an independent facilitator of their own choosing for the purpose of providing services and functions as described in paragraph (2) of subdivision (c). If the participant elects not to use an independent facilitator, the participant may use their regional center service coordinator to provide the services and functions described in paragraph (2) of subdivision (c).

(G) If eligible, with the assistance of the regional center, if needed, timely apply for Medi-Cal in order to maximize federal funding. The participant may consider institutional deeming in order to qualify for Medi-Cal services.

(e) A participant who is not Medi-Cal eligible may participate in the Self-Determination Program and receive self-determination services and supports if all other program eligibility requirements are met and the services and supports are otherwise eligible for federal financial participation.

(f) The additional federal financial participation funds generated by the former participants of the self-determination pilot projects authorized pursuant to Section 13 of Chapter 1043 of the Statutes of 1998, as amended, or pursuant to Article 4 (commencing with Section 4669.2) of Chapter 5, shall be used to maximize the ability of Self-Determination Program participants to direct their own lives and to ensure the department and regional centers successfully implement the program as follows:

(1) First, to offset the cost to the department for the criminal background check conducted pursuant to subdivision (v) and other administrative costs incurred by the department in implementing the Self-Determination Program.

(2) With the remaining funds, the department, in consultation with stakeholders, including a statewide self-determination advisory workgroup, shall prioritize the use of the funds to meet the needs of participants, increase service access and equity, and reduce disparities, and to implement the program, including costs associated with all of the following:

(A) Independent facilitators to assist with a participant’s initial person-centered planning meeting.

(B) Development of the participant’s initial individual budget.

(C) Joint training of consumers, family members, regional center staff, and members of the local volunteer advisory committee established pursuant to paragraph (1) of subdivision (w).

(D) Regional center operations to increase support for transition to the Self-Determination Program or for caseload ratio enhancement.

(E) To offset the costs to the regional centers in implementing the Self-Determination Program.

(F) To support the Statewide Self-Determination Advisory Committee established pursuant to paragraph (2) of subdivision (w).

(g) If at any time during participation in the Self-Determination Program a regional center determines that a participant is no longer eligible to continue in, or a participant voluntarily chooses to exit, the Self-Determination Program, the regional center shall provide for the participant’s transition from the Self-Determination Program to other services and supports. This transition shall include the development of a new IPP that reflects the services and supports necessary to meet the individual’s needs. The regional center shall ensure that there is no gap in services and supports during the transition period.

(h) An individual determined to be ineligible for or who voluntarily exits the Self-Determination Program shall be permitted to return to the Self-Determination Program upon meeting all applicable eligibility criteria and upon approval of the participant’s planning team, as described in subdivision (j) of Section 4512. An individual who has voluntarily exited the Self-Determination Program shall not return to the program for at least 12 months.

(i) An individual who participates in the Self-Determination Program may elect to continue to receive self-determination services and supports if the individual transfers to another regional center catchment area, provided that the individual remains eligible for the Self-Determination Program pursuant to subdivision (d). The balance of the participant’s individual budget shall be reallocated to the regional center to which the participant transfers.

(j) The IPP team shall utilize the person-centered planning process to develop the IPP for a participant. The IPP shall detail the goals and objectives of the participant that are to be met through the purchase of participant-selected services and supports. The IPP team shall determine the individual budget to ensure the budget assists the participant to achieve the outcomes set forth in the participant’s IPP and ensures their health and safety. The completed individual budget shall be attached to the IPP.

(k) The participant shall implement their IPP, including choosing and purchasing the services and supports allowable under this section necessary to implement the plan. A participant is exempt from the cost control restrictions regarding the purchases of services and supports pursuant to Section 4648.5. A regional center shall not prohibit the purchase of any service or support that is otherwise allowable under this section.

(l) A participant shall have all the rights established in Sections 4646 to 4646.6, inclusive, and Chapter 7 (commencing with Section 4700).

(m) (1) Except as provided in paragraph (4), the IPP team shall determine the initial and any revised individual budget for the participant using the following methodology:

(A) (i) Except as specified in clause (ii), for a participant who is a current consumer of the regional center, their individual budget shall be the total amount of the most recently available 12 months of purchase of service expenditures for the participant.

(ii) An adjustment may be made to the amount specified in clause (i) if both of the following occur:

(I) The IPP team determines that an adjustment to this amount is necessary due to a change in the participant’s circumstances, needs, or resources that would result in an increase or decrease in purchase of service expenditures, or the IPP team identifies prior needs or resources that were unaddressed in the IPP, which would have resulted in an increase or decrease in purchase of service expenditures. When adjusting the budget, the IPP team shall document the specific reason for the adjustment in the IPP.

(II) The regional center certifies on the individual budget document that regional center expenditures for the individual budget, including any adjustment, would have occurred regardless of the individual’s participation in the Self-Determination Program.

(iii) For purposes of clauses (i) and (ii), the amount of the individual budget shall not be increased to cover the cost of the independent facilitator.

(B) For a participant who is either newly eligible for regional center services or who does not have 12 months of purchase service expenditures, the participant’s individual budget shall be calculated as follows:

(i) The IPP team shall identify the services and supports needed by the participant and available resources, as required by Section 4646.

(ii) The regional center shall calculate the cost of providing the services and supports to be purchased by the regional center by using the average cost paid by the regional center for each service or support unless the regional center determines that the consumer has a unique need that requires a higher or lower cost. The IPP team also shall document the specific reason for the adjustment in the IPP. The regional center shall certify on the individual budget document that this amount would have been expended using regional center purchase of service funds regardless of the individual’s participation in the Self-Determination Program.

(iii) For purposes of clauses (i) and (ii), the amount of the individual budget shall not be increased to cover the cost of the independent facilitator.

(2) The amount of the individual budget shall be available to the participant each year for the purchase of program services and supports. An individual budget shall be calculated no more than once in a 12-month period, unless revised to reflect a change in circumstances, needs, or resources of the participant using the process specified in clause (ii) of subparagraph (A) of paragraph (1).

(3) The spending plan shall be assigned to uniform budget categories developed by the department in consultation with stakeholders and distributed according to the timing of the anticipated expenditures in the IPP and in a manner that ensures that the participant has the financial resources to implement the IPP throughout the year.

(4) The department, in consultation with stakeholders, may develop alternative methodologies for individual budgets that are computed in a fair, transparent, and equitable manner and are based on consumer characteristics and needs, and that include a method for adjusting individual budgets to address a participant’s change in circumstances or needs.

(n) Annually, participants may transfer up to 10 percent of the funds originally distributed to any budget category set forth in paragraph (3) of subdivision (m) to another budget category or categories. Transfers in excess of 10 percent of the original amount allocated to any budget category may be made upon the approval of the regional center or the participant’s IPP team.

(o) Consistent with the implementation date of the IPP, the IPP team shall annually ascertain from the participant whether there are any circumstances or needs that require a change to the annual individual budget. Based on that review, the IPP team shall calculate a new individual budget consistent with the methodology identified in subdivision (m).

(p) (1) The department, as it determines necessary, may adopt regulations to implement the procedures set forth in this section. Any regulations shall be adopted in accordance with the requirements of Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code.

(2) Notwithstanding paragraph (1) and Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, and only to the extent that all necessary federal approvals are obtained, the department, without taking any further regulatory action, shall implement, interpret, or make specific this section by means of program directives or similar instructions until the time regulations are adopted. It is the intent of the Legislature that the department be allowed this temporary authority as necessary to implement program changes only until completion of the regulatory process.

(q) The department, in consultation with stakeholders, shall develop informational materials about the Self-Determination Program. The department shall ensure that regional centers are trained in the principles of self-determination, the mechanics of the Self-Determination Program, and the rights of consumers and families as candidates for, and participants in, the Self-Determination Program.

(r) Each regional center shall be responsible for implementing the Self-Determination Program as a term of its contract under Section 4629. As part of implementing the program, the regional center shall do all of the following:

(1) Meet the Self-Determination targets approved by the department, meet benchmarks established by the department in areas including timely enrollment, diversity of consumers served, and reduction of disparities in the individual budget of participants from racial and ethnic communities, and be eligible for incentives for exceeding these targets and benchmarks once the department has established a performance incentives program.

(2) Develop and implement an outreach and training plan about the Self-Determination program for the diverse communities served by the regional center, including in congregate settings. Information shall be provided in plain language, in alternative formats and alternative modes of communication and provide language access as required by state and federal law. Obtain input from stakeholders, including consumers and families that reflect the ethnic and language diversity of the regional center’s consumers, about the effectiveness of this outreach and training and other activities that may be effective in reducing disparities in these programs.

(3) Annually report the enrollment, individual budget data, and purchase of service expenditure data for the Self-Determination Program consistent with the criteria in subdivisions (a) to (c), inclusive, of Section 4519.5.

(4) Assist eligible participants and their families in applying for Medi-Cal, in order to maximize federal funding and assist interested participants who wish to pursue institutional deeming in order to qualify for Medi-Cal services.

(5) At least annually, in addition to annual certification, conduct an additional review of all final individual budgets for participants at the regional center which are at or above a spending threshold that is specified by the department through directive consistent with federal and state requirements. This information may be used in the aggregate to provide training, program guidance, and verify compliance with state and federal requirements.

(6) Review the spending plan to verify that goods and services eligible for federal financial participation are not used to fund goods or services available through generic agencies.

(7) Contract with local consumer or family-run organizations and consult with the local volunteer advisory committee established pursuant to paragraph (1) of subdivision (w) to conduct outreach through local meetings or forums to consumers and their families to provide information about the Self-Determination Program and to help ensure that the program is available to a diverse group of participants, with special outreach to underserved communities.

(8) Collaborate with the local consumer or family-run organizations identified in paragraph (1) to jointly conduct training about the Self-Determination Program. The regional center shall consult with the local volunteer advisory committee established pursuant to paragraph (1) of subdivision (w) in planning for the training, and the local volunteer advisory committee may designate members to represent the advisory committee at the training.

(9) Train all service coordinators and fair hearing specialists in the principles of self-determination, the mechanics of the Self-Determination Program, and the rights of consumers and families. The training shall be conducted in collaboration with the local volunteer advisory committee.

(10) Provide payment to the financial management services provider for spending plan expenses through a not less than semi-monthly pay schedule.

(11) Ensure that each individual plan includes the information required by subdivision (d) of Section 4646.

(s) The financial management services provider shall provide the participant and the regional center service coordinator with a monthly individual budget statement that describes the amount of funds allocated by budget category, the amount spent in the previous 30-day period, and the amount of funding that remains available under the participant’s individual budget.

(t) Only the financial management services provider is required to apply for vendorization in accordance with Subchapter 2 (commencing with Section 54300) of Chapter 3 of Division 2 of Title 17 of the California Code of Regulations for the Self-Determination Program. All other service and support providers shall not be on the federal debarment list and shall have applicable state licenses, certifications, or other state required documentation, including documentation of any other qualifications required by the department, but are exempt from the vendorization requirements set forth in Title 17 of the California Code of Regulations when serving participants in the Self-Determination Program.

(u) The regional center shall pay the full costs of the participant’s financial management services provider.

(v) To protect the health and safety of participants in the Self-Determination Program, the department shall require a criminal background check in accordance with all of the following:

(1) The department shall issue a program directive that identifies nonvendored providers of services and supports who shall obtain a criminal background check pursuant to this subdivision. At a minimum, these staff shall include both of the following:

(A) Individuals who provide direct personal care services to a participant.

(B) Other nonvendored providers of services and supports for whom a criminal background check is requested by a participant or the participant’s financial management service.

(2) Subject to the procedures and requirements of this subdivision, the department shall administer criminal background checks consistent with the department’s authority and the process described in Sections 4689.2 to 4689.6, inclusive.

(3) The department shall electronically submit to the Department of Justice fingerprint images and related information required by the Department of Justice of nonvendored providers of services and supports, as specified in paragraph (1), for purposes of obtaining information as to the existence and content of a record of state or federal convictions and state or federal arrests and also information as to the existence and content of a record of state or federal arrests for which the Department of Justice establishes that the person is free on bail or on their own recognizance pending trial or appeal.

(4) When received, the Department of Justice shall forward to the Federal Bureau of Investigation requests for federal summary criminal history information received pursuant to this section. The Department of Justice shall review the information returned from the Federal Bureau of Investigation and compile and disseminate a response to the department.

(5) The Department of Justice shall provide a state or federal response to the department pursuant to paragraph (1) of subdivision (p) of Section 11105 of the Penal Code.

(6) The department shall request from the Department of Justice subsequent notification service, as provided pursuant to Section 11105.2 of the Penal Code, for persons described in paragraph (1).

(7) The Department of Justice shall charge a fee sufficient to cover the cost of processing the request described in this subdivision.

(8) The fingerprints of any provider of services and supports who is required to obtain a criminal background check shall be submitted to the Department of Justice prior to employment. The costs of the fingerprints and the financial management service’s administrative cost authorized by the department shall be paid by the services and supports provider or the provider’s employing agency. Any administrative costs incurred by the department pursuant to this subdivision shall be offset by the funds specified in subdivision (g).

(9) If the criminal record information report shows a criminal history, the department shall take the steps specified in Section 4689.2. The department may prohibit a provider of services and supports from becoming employed, or continuing to be employed, based on the criminal background check, as authorized in Section 4689.6. The provider of services and supports who has been denied employment shall have the rights set forth in Section 4689.6.

(10) The department may utilize a current department-issued criminal record clearance to enable a provider to serve more than one participant, as long as the criminal record clearance has been processed through the department and no subsequent arrest notifications have been received relative to the cleared applicant.

(11) Consistent with subdivision (h) of Section 4689.2, the participant or financial management service that denies or terminates employment based on written notification from the department shall not incur civil liability or unemployment insurance liability.

(w) To ensure the effective implementation of the Self-Determination Program and facilitate the sharing of best practices and training materials commencing with the implementation of the Self-Determination Program, local and statewide advisory committees shall be established as follows:

(1) Each regional center shall establish a local volunteer advisory committee to provide oversight of the Self-Determination Program and identify a regional center liaison to the committee. The regional center and the State Council on Developmental Disabilities shall each appoint one-half of the membership of the committee. The committee shall consist of the regional center clients’ rights advocate, consumers, family members, and other advocates, and community leaders, including a representative from a family resource center. A majority of the committee shall be consumers and their family members. The committee shall reflect the multicultural diversity and geographic profile of the catchment area. The committee shall review the development and ongoing progress of the Self-Determination Program, including whether the program advances the principles of self-determination and is operating consistent with the requirements of this section, and may make ongoing recommendations for improvement to the regional center and the department. Annually, the regional center shall confirm, in writing, that the committee meets the requirements specified in this paragraph and provide the department with the name of the staff liaison and the names of the committee members, the positions they fill on the committee, and which entity appointed them to the committee.

(2) The State Council on Developmental Disabilities shall form a volunteer committee, to be known as the Statewide Self-Determination Advisory Committee, comprised of the chairs of the 21 local advisory committees or their designees. The council shall convene the Statewide Self-Determination Advisory Committee twice annually, or more frequently in the sole discretion of the council. The Statewide Self-Determination Advisory Committee shall meet by teleconference or other means established by the council to identify self-determination best practices, effective consumer and family training materials, implementation concerns, systemic issues, ways to enhance the program, and recommendations regarding the most effective method for participants to learn of individuals who are available to provide services and supports. The council shall synthesize information received from the Statewide Self-Determination Advisory Committee, local advisory committees, and other sources, share the information with consumers, families, regional centers, and the department, and make recommendations, as appropriate, to increase the program’s effectiveness in furthering the principles of self-determination.

(x) The department shall annually provide the following information to the appropriate policy and fiscal committees of the Legislature:

(1) Number and characteristics of participants, by regional center, including the number of participants who entered the program upon movement from a developmental center.

(2) Types and amount of services and supports purchased under the Self-Determination Program, by regional center.

(3) Range and average of individual budgets, by regional center, including adjustments to the budget to address the adjustments permitted in clause (ii) of subparagraph (A) of paragraph (1) of subdivision (m).

(4) The number and outcome of appeals concerning individual budgets, by regional center.

(5) The number and outcome of fair hearing appeals, by regional center.

(6) The number of participants who voluntarily withdraw from the Self-Determination Program and a summary of the reasons why, by regional center.

(7) The number of participants who are subsequently determined to no longer be eligible for the Self-Determination Program and a summary of the reasons why, by regional center.

(y) (1) The State Council on Developmental Disabilities shall issue an interim report to the Legislature, in compliance with Section 9795 of the Government Code, no later than June 30, 2021, on the status of the Self-Determination Program authorized by this section, barriers to its implementation, and recommendations to enhance the effectiveness of the program. The interim report shall provide an update to the program’s status, each regional center’s cap on participation and progress toward that cap, the most recent statewide and per-regional-center participant count, and the historical trend in the statewide participation count since the start of the program. The department shall assist in providing available information to the council in order to facilitate the timely issuance of the report.

(2) The council, in collaboration with the protection and advocacy agency identified in Section 4900 and the federally funded University Centers for Excellence in Developmental Disabilities Education, Research, and Service, may work with regional centers to survey participants regarding participant satisfaction under the Self-Determination Program and, when data is available, the traditional service delivery system, including the proportion of participants who report that their choices and decisions are respected and supported and who report that they are able to recruit and hire qualified service providers, and to identify barriers to participation and recommendations for improvement.

(3) The council, in collaboration with the protection and advocacy agency identified in Section 4900 and the federally funded University Centers for Excellence in Developmental Disabilities Education, Research, and Service, shall issue a report to the Legislature, in compliance with Section 9795 of the Government Code, by June 30, 2023, on the status of the Self-Determination Program authorized by this section, and provide recommendations to enhance the effectiveness of the program. This review shall include the program’s effectiveness in furthering the principles of self-determination, including all of the following:

(A) Freedom, which includes the ability of adults with developmental disabilities to exercise the same rights as all citizens to establish, with freely chosen supporters, family and friends, where they want to live, with whom they want to live, how their time will be occupied, and who supports them; and for families to have the freedom to receive unbiased assistance of their own choosing when developing a plan and to select all personnel and supports to further the life goals of a minor child.

(B) Authority, which includes the ability of a person with a disability, or family, to control a certain sum of dollars in order to purchase services and supports of their choosing.

(C) Support, which includes the ability to arrange resources and personnel, both formal and informal, that will assist a person with a disability to live a life in the community that is rich in community participation and contributions.

(D) Responsibility, which includes the ability of participants to take responsibility for decisions in their own lives and to be accountable for the use of public dollars, and to accept a valued role in their community through, for example, competitive employment, organizational affiliations, spiritual development, and general caring of others in their community.

(E) Confirmation, which includes confirmation of the critical role of participants and their families in making decisions in their own lives and designing and operating the system that they rely on.

SEC. 18.

Section 4726 of the Welfare and Institutions Code is amended to read:

4726.

Notwithstanding ~~Section 5328,~~ Sections 4639.76 and 5328, access to records shall be provided to an applicant for, or recipient of, services or to their authorized representative, including the person appointed as a developmental services decisionmaker pursuant to Section 319, 361, or 726, for purposes of the appeal process under this chapter.

SEC. 19.

Section 4731 of the Welfare and Institutions Code is amended to read:

4731.

(a) Each consumer or any representative acting on behalf of any consumer or consumers, who believes that any right to which a consumer is entitled has been abused, punitively withheld, or improperly or unreasonably denied by a regional center, state-operated facility, or service provider, may pursue a complaint as provided in this section.

(b)Initial referral of any complaint taken pursuant to this section shall be to the director of the regional center from which the consumer receives case management services. If the consumer resides in a state-operated facility, the complaint shall be made to the director of the state-operated facility. The director shall, within 20 working days of receiving a complaint, investigate the complaint and send a written proposed resolution to the complainant and, if applicable, to the service provider. The written proposed resolution shall include a telephone number and mailing address for referring the proposed resolution in accordance with subdivision (c).
(c)If the complainant is not satisfied with the proposed resolution, the complainant may refer the complaint, in writing, to the Director of Developmental Services within 15 working days of receipt of the proposed resolution. The director shall, within 45 days of receiving a complaint, issue a written administrative decision and send a copy of the decision to the complainant, the director of the regional center or state-operated facility, and the service provider, if applicable. If there is no referral to the department, the proposed resolution shall become effective on the 20th working day following receipt by the complainant.
(b) Any complaint made pursuant to this section shall be made to the Director of Developmental Services. The director, within 30 days of receiving a complaint, shall issue a written administrative decision and send a copy of the decision to the complainant, the director of the regional center or state-operated facility, and the service provider, if applicable.
~~(d)~~

(c) The ~~department shall annually~~ department, on a quarterly basis, shall compile the number of complaints filed, by each regional center and state-operated facility, the subject matter of each complaint, and a summary of each ~~decision. Copies shall be made available~~ decision, and post the compilation on its internet website at the end of each quarter. Copies of any decision included in the compilation shall be made available within 10 days, with all individually identifiable information redacted, to any person upon request.

~~(e)~~

(d) This section shall not be used to resolve disputes concerning the nature, scope, or amount of services and supports that should be included in an individual program plan, for which there is an appeals procedure established in this division, or disputes regarding rates or audit appeals for which there is an appeals procedure established in regulations. Those disputes shall be resolved through the appeals procedure established by this division or in regulations.

~~(f)~~

(e) All consumers or, if appropriate, their authorized representative, shall be notified in writing in their preferred language of the right to file a complaint pursuant to this section when they apply for services from a regional center or a state-operated facility, and at each regularly scheduled planning meeting.

LEGISLATIVE COUNSEL'S DIGEST

Digest Key

Bill Text

The people of the State of California do enact as follows:

SECTION 1.

SEC. 2.

SEC. 3.

4519.5.

SEC. 4.

4519.20.

SEC. 5.

4571.

SEC. 6.

4622.

SEC. 7.

4626.5.

SEC. 8.

4629.1.

SEC. 9.

4639.76.

SEC. 10.

4642.

SEC. 11.

4643.

SEC. 12.

4646.

SEC. 13.

4646.4.

SEC. 14.

4646.5.

SEC. 15.

4647.

SEC. 16.

4659.

SEC. 17.

4685.8.

SEC. 18.

4726.

SEC. 19.

4731.