Bill Text: CA AB1610 | 2017-2018 | Regular Session | Amended
Bill Title: Developmental services: regional centers.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Failed) 2018-02-01 - From committee: Filed with the Chief Clerk pursuant to Joint Rule 56. [AB1610 Detail]
Download: California-2017-AB1610-Amended.html
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Amended
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April 18, 2017 |
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Amended
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March 27, 2017 |
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Amended
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March 20, 2017 |
CALIFORNIA LEGISLATURE—
2017–2018 REGULAR SESSION
| Assembly Bill | No. 1610 |
| Introduced by Assembly Member Ridley-Thomas |
February 17, 2017 |
An act to amend Sections 95020 and 95021 of the Government Code, and to amend Sections 4502.1, 4646.5, 4659, and 4686.2 of, to add Sections 4646.45 and 4648.7 to, and to repeal Sections 4648.5, 4648.6, and 4686.5 of, the Welfare and Institutions Code, relating to developmental services.
LEGISLATIVE COUNSEL'S DIGEST
AB 1610, as amended, Ridley-Thomas.
Developmental services: regional centers.
(1) Existing law, the California Early Intervention Services Act, provides a statewide system of coordinated, comprehensive, family-centered, multidisciplinary, and interagency programs that are responsible for providing appropriate early intervention services and supports to all eligible infants and toddlers, as defined, and their families and requires an eligible infant or toddler receiving services under the act to have an individualized family service plan. The act requires these services to be provided pursuant to the existing regional center system under the Lanterman Developmental Disabilities Services Act.
Under existing law, the Lanterman Developmental Disabilities Services Act, the State Department of Developmental Services is responsible for providing various services and supports to individuals with
developmental disabilities, and for ensuring the appropriateness and quality of those services and supports. Under existing law, the department contracts with regional centers to provide services and supports to persons with developmental disabilities. The services and supports to be provided to a regional center consumer are contained in an individual program plan, developed in accordance with prescribed requirements.
This bill would require regional centers to provide certain information to a consumer during the individual program plan process and to an infant’s or toddler’s parents, legal guardian, conservator, or authorized representative at the initial individualized family service plan meeting and annually thereafter.
(2) Existing law requires each service identified on the individualized family service plan to be designated as an early intervention service, another service that the eligible
infant or toddler or his or her family may receive from other state programs, or a referral to a nonrequired service that may be provided to an eligible infant or toddler or his or her family. With the exception of durable medical equipment, existing law prohibits a regional center from purchasing nonrequired services but authorizes a regional center to refer a family to a nonrequired service, as specified. Under existing law, the granting or denial of nonrequired services by a public or private agency is not subject to appeal.
This bill would additionally make an exception for respite services and other family support services to the prohibition on the purchase of nonrequired services. The bill would also make the granting or denial of durable medical equipment, respite services, and other family support services subject to appeal.
(3) Existing law states the right of individuals with developmental
disabilities to make choices in their own lives requires that public or private agencies receiving state funds for the purpose of serving those persons respect the choices made by consumers or, if appropriate, their parents, legal guardian, or conservator.
This bill would make the requirement that public or private agencies receiving state funds respect the choices made by consumers, as described above, specifically applicable to choices made by an authorized representative of a consumer, if appropriate. The bill would also require a regional center to provide information in a manner that is culturally and linguistically appropriate for the consumer or, when appropriate, the consumer’s parents, legal guardian, conservator, or authorized representative, as specified.
(4) Existing law requires the department, in consultation with stakeholders, to develop an alternative service delivery model that
provides an Individual Choice Budget for obtaining quality services and supports that provides choice and flexibility within a finite budget that, in the aggregate, reduces regional center purchase of service expenditures, reduces reliance on the General Fund, and maximizes federal financial participation. Existing law prohibits a regional center from purchasing specified services, including, among others, nonmedical therapies or social recreation activities, except as specified, and places certain restrictions on the purchase of respite services by a regional center, pending implementation of the Individual Choice Budget.
This bill would repeal the provisions relating to the Individual Choice Budget and the prohibitions and restrictions on the purchase of the above-described services. The bill would require the department, by March 31, 2018, to convene a task force to develop a purchase of services budget and allocation methodology based on consumer needs. The bill
would require the task force to include the department and specified representatives, including, among others, representatives of consumers and families, as specified, regional centers, and providers. The bill would require the task force to submit a report of its recommendations on implementing the methodology to the Legislature by August 31, 2018.
(5) Existing law generally prohibits, beginning July 1, 2009, a regional center from purchasing medical or dental services for a consumer 3 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 of the denial by the consumer or family does not have merit. Existing law authorizes a regional center to pay for medical or dental services during certain periods, including, among others, while coverage is being pursued, but before a denial is made.
This bill would instead require a regional center to pay for medical or dental services identified as necessary to implement the consumer’s individual program plan during those periods.
(6) Existing law also requires a regional center to only purchase applied behavioral analysis (ABA) services or intensive behavioral intervention services when the parent or parents of minor consumers receiving services participate in the intervention plan for the consumers.
This bill would instead require a regional center, to the extent feasible, to facilitate a parent’s or caregiver’s participation in ABA or intensive behavioral intervention services for a minor consumer receiving those services through the provision of additional services and supports, accommodations, or both. The bill would prohibit a parent’s or caregiver’s failure to participate in ABA or intensive
behavioral intervention services from being used to deny, delay, or reduce the provision of those services.
Digest Key
Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NOBill Text
The people of the State of California do enact as follows:
SECTION 1.
Section 95020 of the Government Code is amended to read:95020.
(a) An eligible infant or toddler shall have an individualized family service plan. The individualized family service plan shall be used in place of an individualized education program required pursuant to Sections 4646 and 4646.5 of the Welfare and Institutions Code, the individualized program plan required pursuant to Section 56340 of the Education Code, or any other applicable service plan.(b) For an infant or toddler who has been evaluated for the first time, a meeting to share the results of the evaluation, to determine eligibility and, for children who are eligible, to develop the initial individualized family service plan shall be conducted within 45 calendar days of receipt of
the written referral. Evaluation results and determination of eligibility may be shared in a meeting with the family prior to the individualized family service plan. Written parent consent to evaluate and assess shall be obtained within the 45-day timeline. A regional center, local educational agency, or the designee of one of those entities shall initiate and conduct this meeting. Families shall be afforded the opportunity to participate in all decisions regarding eligibility and services. During intake and assessment, but no later than the individualized family service plan meeting, 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, when 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.
(c) (1) Parents shall be fully informed of their rights, including the right to invite another person, including a family member or an advocate or peer parent, or any or all of them, to accompany them to any or all individualized family service plan meetings. With parental consent, a referral shall be made to the local family resource center or network.
(2) At the beginning of During the
initial individualized family service plan meeting and at least annually thereafter at the beginning of during an individualized family service plan meeting or at a biannual review of the individualized family service plan, the regional center shall provide the infant’s or toddler’s parents, legal guardian, conservator, or authorized representative written information about the appeal procedure established under Chapter 7 (commencing with Section 4700) of Division 4.5 of the Welfare and Institutions Code and the complaint process described in Section 52170 of Title 17 of the California Code of Regulations.
(d) The individualized family service plan shall be in writing and
shall address all of the following:
(1) A statement of the infant’s or toddler’s present levels of physical development including vision, hearing, and health status, cognitive development, communication development, social and emotional development, and adaptive developments.
(2) With the concurrence of the family, a statement of the family’s concerns, priorities, and resources related to meeting the special developmental needs of the eligible infant or toddler.
(3) A statement of the major outcomes expected to be achieved for the infant or toddler and family where services for the family are related to meeting the special developmental needs of the eligible infant or toddler.
(4) The criteria, procedures, and timelines used to determine the degree to which progress toward achieving the outcomes is being made and whether modifications or revisions are necessary.
(5) (A) A statement of the specific early intervention services necessary to meet the unique needs of the infant or toddler as identified in paragraph (3), including, but not limited to, the frequency, intensity, location, duration, and method of delivering the services, and ways of providing services in natural generic environments, including group training for parents on behavioral intervention techniques in lieu of some or all of the in-home parent training component of the behavior intervention services, and purchase of neighborhood preschool services and needed qualified personnel in lieu of infant development programs.
(B) Effective July 1, 2009, at the time of development, review, or modification of an infant’s or toddler’s individualized family service plan, the regional center shall consider both of the following:
(i) The use of group training for parents on behavior intervention techniques, in lieu of some or all of the in-home parent training component of the behavior intervention services.
(ii) The purchase of neighborhood preschool services and needed qualified personnel, in lieu of infant development programs.
(6) A statement of the agency responsible for providing the identified services.
(7) The name of
the service coordinator who shall be responsible for facilitating implementation of the plan and coordinating with other agencies and persons.
(8) The steps to be taken to ensure transition of the infant or toddler upon reaching three years of age to other appropriate services. These may include, as appropriate, special education or other services offered in natural environments.
(9) The projected dates for the initiation of services in paragraph
(5) and the anticipated duration of those services.
(e) Each service identified on the individualized family service plan shall be designated as one of three types:
(1) An early intervention service, as defined in subsection (4) of Section 1432 of Title 20 of the United States Code, and applicable regulations, that is provided or purchased through the regional center, local educational agency, or other participating agency. The State Department of Health Care Services and the State Department of Social Services shall provide services in accordance with state and federal law and applicable regulations, and up to the level of funding as appropriated by the Legislature. Early intervention services identified on an individualized family service plan that exceed the
funding, statutory, and regulatory requirements of these departments shall be provided or purchased by regional centers or local educational agencies under subdivisions (b) and (c) of Section 95014. The State Department of Health Care Services and the State Department of Social Services shall not be required to provide early intervention services over their existing funding, statutory, and regulatory requirements.
(2) Another service, other than those specified in paragraph (1), that the eligible infant or toddler or his or her family may receive from other state programs, subject to the eligibility standards of those programs.
(3) A referral to a nonrequired service that may be provided to an eligible infant or toddler or his or her family. Nonrequired services are those services
that are not defined as early intervention services or do not relate to meeting the special developmental needs of an eligible infant or toddler related to the disability, but that may be helpful to the family. With the exception of durable medical equipment, respite services, or other family support services, regional centers shall not purchase nonrequired services, but may refer a family to a nonrequired service that may be available to an eligible infant or toddler or his or her family. The granting or denial of nonrequired services, with the exception of durable medical equipment, respite services, or other family support services, by a public or private agency is not subject to appeal under this title.
(f) An annual review, and other periodic reviews, of the individualized family service plan for an infant or toddler and the infant’s
or toddler’s family shall be conducted to determine the degree of progress that is being made in achieving the outcomes specified in the plan and whether modification or revision of the outcomes or services is necessary. The frequency, participants, purpose, and required processes for annual and periodic reviews shall be consistent with the statutes and regulations under Part C of the federal Individuals with Disabilities Education Act (20 U.S.C. Sec. 1400 et seq.) and this title, and shall be specified in regulations adopted pursuant to Section 95028. At the time of the review, 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 parents, legal guardian, or conservator have
no such benefit cards, 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.
(g) (1) A regional center shall communicate and provide written materials in the family’s native language during the assessment, evaluation, and planning process for the individualized family service plan, as required by Part C of the federal Individuals with Disabilities Education Act (20 U.S.C. Sec. 1400 et seq.) and implementing regulations, and as required by Sections 11135 to 11139.7, inclusive, and implementing regulations, including providing alternative communication services pursuant to Sections 98210 to 98211, inclusive, of Title 22 of the California Code of Regulations.
(2) The
family’s native language shall be documented in the individualized family service plan.
SEC. 2.
Section 95021 of the Government Code is amended to read:95021.
(a) Notwithstanding any law or regulation to the contrary, any vendor who provides applied behavioral analysis (ABA) services or intensive behavioral intervention services, or both, as defined in subdivision (d), shall:(1) Conduct a behavioral assessment of each infant or toddler to whom the vendor provides these services.
(2) Design an intervention plan that shall include the service type, number of hours, and parent participation recommended to achieve the goals and objectives of the infant or toddler, as set forth in his or her individualized family service plan (IFSP). The intervention
plan shall also set forth the frequency at which the progress of the infant or toddler shall be evaluated and reported.
(3) Provide a copy of the intervention plan to the regional center for review and consideration by the planning team members.
(b) Notwithstanding any law or regulation to the contrary, regional centers shall:
(1) Only purchase ABA services or intensive behavioral intervention services that reflect evidence-based practices, promote positive social behaviors, and ameliorate behaviors that interfere with learning and social interactions.
(2) (A) To the extent feasible, facilitate a parent’s or caregiver’s participation in ABA or
intensive behavioral intervention services for an infant or toddler consumer receiving those services through the provision of additional services and supports, accommodations, or both.
(B) A parent’s or caregiver’s failure to participate in ABA or intensive behavioral intervention services shall not be used to deny, delay, or reduce the provision of those services.
(3) Not purchase either ABA or intensive behavioral intervention services for purposes of providing respite, day care, or school services.
(4) Discontinue purchasing ABA or intensive behavioral intervention services for an infant or toddler when his or her treatment goals and objectives, as described under subdivision (a), are achieved. ABA or intensive
behavioral intervention services shall not be discontinued until the goals and objectives are reviewed and updated as required in paragraph (5) and shall be discontinued only if those updated treatment goals and objectives do not require ABA or intensive behavioral intervention services.
(5) For each infant or toddler, evaluate the vendor’s intervention plan and number of service hours for ABA or intensive behavioral intervention no less than every six months, consistent with evidence-based practices. If necessary, the intervention plan’s treatment goals and objectives shall be updated and revised.
(6) Not reimburse a parent for participating in a behavioral services treatment program.
(c) For infants and toddlers
receiving ABA or behavioral intervention services on July 1, 2009, as part of their IFSP, subdivision (b) shall apply on August 1, 2009.
(d) For purposes of this section the following definitions shall apply:
(1) “Applied behavioral analysis” means the design, implementation, and evaluation of systematic instructional and environmental modifications to promote positive social behaviors and reduce or ameliorate behaviors that interfere with learning and social interaction.
(2) “Intensive behavioral intervention” means any form of applied behavioral analysis that is comprehensive, designed to address all domains of functioning, and provided in multiple settings for no more than 40 hours per week, across all settings, depending
on the individual’s needs and progress. Interventions can be delivered in a one-to-one ratio or small group format, as appropriate.
(3) “Evidence-based practice” means a decisionmaking process that integrates the best available scientifically rigorous research, clinical expertise, and individual’s characteristics. Evidence-based practice is an approach to treatment rather than a specific treatment. Evidence-based practice promotes the collection, interpretation, integration, and continuous evaluation of valid, important, and applicable individual- or family-reported, clinically-observed, and research-supported evidence. The best available evidence, matched to infant or toddler circumstances and preferences, is applied to ensure the quality of clinical judgments and facilitates the most cost-effective care.
(4) “Parent” has the same meaning as defined in paragraph (15) of subdivision (b) of Section 52000 of Title 17 of the California Code of Regulations.
(5) “Parent participation” shall include, but shall not be limited to, the following meanings:
(A) Completion of group instruction on the basics of behavior
intervention.
(B) Implementation of intervention strategies according to the intervention plan.
(C) If needed, collection of data on behavioral strategies and submission of those data to the provider for incorporation into progress reports.
(D) Participation in any needed clinical meetings.
(E) Purchase of suggested behavior modification materials or community involvement if a reward system is used.
SEC. 3.
Section 4502.1 of the Welfare and Institutions Code is amended to read:4502.1.
(a) The right of individuals with developmental disabilities to make choices in their own lives requires that all public or private agencies receiving state funds for the purpose of serving persons with developmental disabilities, including, but not limited to, regional centers, shall respect the choices made by consumers or, if appropriate, their parents, legal guardian, conservator, or authorized representative. Those public or private agencies shall provide consumers with opportunities to exercise decisionmaking skills in any aspect of day-to-day living and shall provide consumers with relevant information in an understandable form to aid the consumer in making his or her choice.(b) A regional center shall provide information in a manner that is culturally and linguistically appropriate for the consumer, or, when appropriate, the consumer’s parents, legal guardian, conservator, or authorized representative, including providing alternative communication services, as required by Article 9.5 (commencing with Section 11135) of Chapter 1 of Part 1 of Division 3 of Title 2 of the Government Code and the regulations implementing that article.
SEC. 4.
Section 4646.45 is added to the Welfare and Institutions Code, immediately following Section 4646.4, to read:4646.45.
At the time of development of the initial individual program plan, as described in subdivision (c) of Section 4646, and at least annually thereafter(a) The exception described in subdivision (d) of Section 4648.35.
(b) The exemption described in subdivision (d) of Section 4648.55.
SEC. 5.
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, his or her parents and other family members,
his or her 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 his or her 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 his or her life, acquire increasingly positive roles in community life, and develop competencies to help accomplish these goals.
(3) When 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) When 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, when appropriate, his or her 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) At the time of development of the initial individual program plan, as described in subdivision (c) of Section 4646, and at least annually thereafter at the beginning of an individual program plan meeting or at an annual review of the individual program plan, the regional center shall provide a consumer and, when appropriate, his or her parents, legal guardian, conservator, or authorized representative a list of services provided purchased by the regional center and written information about the appeal procedure established under Chapter 7 (commencing with Section 4700) and the complaint process described in Section 4731.
(7) At the end of the individual program plan meeting, the regional center shall provide a consumer and, when appropriate, his or her parents, legal guardian, conservator, or authorized representative a written list of agreed-upon services and supports, including the amount and anticipated start date, and a list of any requested services and supports for which final agreement has not yet been reached and for which there will be a subsequent program plan meeting pursuant to subdivision (f) of Section 4646.
(8) When 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.
(9) (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.
(10) 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. If the consumer or, where appropriate, the consumer’s parents, legal guardian, authorized representative, or conservator requests an individual program plan review, the individual program shall be reviewed within 30 days after the request is submitted.
(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.
(2) Each regional center shall use the training materials and format prepared by the department pursuant to paragraph (1).
(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. 6.
Section 4648.5 of the Welfare and Institutions Code is repealed.SEC. 7.
Section 4648.6 of the Welfare and Institutions Code is repealed.SEC. 8.
Section 4648.7 is added to the Welfare and Institutions Code, to read:4648.7.
(a) By March 31, 2018, the department shall convene a task force to develop a purchase of services budget and allocation methodology based on consumer needs.(b) The task force shall include the department and stakeholders, including representatives of all of the following:
(1) Consumers and families that reflect the ethnic and language diversity of regional center consumers.
(2) Regional centers.
(3) Advocates.
(4) Providers.
(5) The protection and advocacy agency, as defined in Section 4900.
(6) The State Council on Developmental Disabilities, as described in Section 4520.
(c) (1) (A) The task force shall submit a report of its recommendations on implementing the methodology described in subdivision (a) to the Legislature by August 31, 2018.
(B) A report submitted pursuant to subparagraph (A) shall be submitted in compliance with Section 9795 of the Government Code.
(2) The requirement for submitting a report imposed under paragraph (1) is
inoperative on January 1, 2022, pursuant to Section 10231.5 of the Government Code.
SEC. 9.
Section 4659 of the Welfare and Institutions Code is amended to read:4659.
(a) Except as otherwise provided in subdivision (b) 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. 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. At the time of development of the initial individual program plan, as described in subdivision (c) of Section 4646, and at least annually thereafter at the beginning of during an individual program plan meeting or at an annual review of the individual program plan, the regional center shall provide a written description of the denial documentation consumers and families are required to provide pursuant to this paragraph. In order to ensure that there are no gaps in the provision of services and supports, regional centers shall pay for medical or dental services identified, pursuant to subdivision (d) of Section 4646 and paragraph (5) of subdivision (a) of Section 4646.5, as necessary to implement the
consumer’s individual program plan 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.
(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. 10.
Section 4686.2 of the Welfare and Institutions Code is amended to read:4686.2.
(a) Notwithstanding any law or regulation to the contrary, any vendor who provides applied behavioral analysis (ABA) services, or intensive behavioral intervention services or both, as defined in subdivision (d), shall:(1) Conduct a behavioral assessment of each consumer to whom the vendor provides these services.
(2) Design an intervention plan that shall include the service type, number of hours, and parent participation recommended to achieve the consumer’s goals and objectives, as set forth in the consumer’s individual program plan (IPP) or individualized family service plan
(IFSP). The intervention plan shall also set forth the frequency at which the consumer’s progress shall be evaluated and reported.
(3) Provide a copy of the intervention plan to the regional center for review and consideration by the planning team members.
(b) Notwithstanding any law or regulation to the contrary, regional centers shall:
(1) Only purchase ABA services or intensive behavioral intervention services that reflect evidence-based practices, promote positive social behaviors, and ameliorate behaviors that interfere with learning and social interactions.
(2) (A) To the extent feasible, facilitate a parent’s or caregiver’s participation
in ABA or intensive behavioral intervention services for a minor consumer receiving those services through the provision of additional services and supports, accommodations, or both.
(B) A parent’s or caregiver’s failure to participate in ABA or intensive behavioral intervention services shall not be used to deny, delay, or reduce the provision of those services.
(3) Not purchase either ABA or intensive behavioral intervention services for purposes of providing respite, day care, or school services.
(4) Discontinue purchasing ABA or intensive behavioral intervention services for a consumer when the consumer’s treatment goals and objectives, as described under subdivision (a), are achieved. ABA or intensive
behavioral intervention services shall not be discontinued until the goals and objectives are reviewed and updated as required in paragraph (5) and shall be discontinued only if those updated treatment goals and objectives do not require ABA or intensive behavioral intervention services.
(5) For each consumer, evaluate the vendor’s intervention plan and number of service hours for ABA or intensive behavioral intervention no less than every six months, consistent with evidence-based practices. If necessary, the intervention plan’s treatment goals and objectives shall be updated and revised.
(6) Not reimburse a parent for participating in a behavioral services treatment program.
(c) For consumers receiving ABA or behavioral
intervention services on July 1, 2009, as part of their IPP or IFSP, subdivision (b) shall apply on August 1, 2009.
(d) For purposes of this section the following definitions shall
apply:
(1) “Applied behavioral analysis” means the design, implementation, and evaluation of systematic instructional and environmental modifications to promote positive social behaviors and reduce or ameliorate behaviors that interfere with learning and social interaction.
(2) “Intensive behavioral intervention” means any form of applied behavioral analysis that is comprehensive, designed to address all domains of functioning, and provided in multiple settings for no more than 40 hours per week, across all settings, depending on the individual’s needs and progress. Interventions can be delivered in a one-to-one ratio or small group format, as appropriate.
(3) “Evidence-based practice” means a
decisionmaking process that integrates the best available scientifically rigorous research, clinical expertise, and individual’s characteristics. Evidence-based practice is an approach to treatment rather than a specific treatment. Evidence-based practice promotes the collection, interpretation, integration, and continuous evaluation of valid, important, and applicable individual- or family-reported, clinically-observed, and research-supported evidence. The best available evidence, matched to consumer circumstances and preferences, is applied to ensure the quality of clinical judgments and facilitates the most cost-effective care.
(4) “Parent participation” shall include, but shall not be limited to, the following meanings:
(A) Completion of group instruction on the basics of
behavior intervention.
(B) Implementation of intervention strategies, according to the intervention plan.
(C) If needed, collection of data on behavioral strategies and submission of those data to the provider for incorporation into progress reports.
(D) Participation in any needed clinical meetings.
(E) Purchase of suggested behavior modification materials or community involvement if a reward system is used.
