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HomeMy WebLinkAbout2016-03-08 - AGENDA REPORTS - ASSEMBLY BILL 1565 (2)0 Agenda Item: 3 CITY OF SANTA CLARITA Q) AGENDA REPORT CONSENT CALENDAR i, CITY MANAGER APPROVAL: 1 j=� DATE: March 8, 2016 SUBJECT: STATE LEGISLATION: ASSEMBLY BILL 1565 (LACKEY) AND ASSEMBLY BILLx2 1 (THURMOND) DEPARTMENT: City Manager's Office PRESENTER: Matthew Levesque RECOMMENDED ACTION City Council adopt the City Council Legislative Committee's recommendation to support Assembly Bill 1565 (Lackey) and Assembly Billx2 1 (Thurmond) and transmit position statements to Assembly Member Lackey, Assembly Member Thurmond, Santa Clarita's state legislative delegation, appropriate legislative committees, Governor Brown, and the League of California Cities. BACKGROUND Assembly Billx2 1 (ABx2 1) was introduced during the Second Extraordinary Session on Public Health and Developmental Services in the State Legislature on July 2, 2015, and amended into its current form on February 22, 2016, by Assembly Member Tony Thurmond (D -15 - Richmond). The bill contains many of the components of Assembly Bill 1565 by Assembly Member Tom Lackey (R -36 -Palmdale), which the City Council Legislative Committee has recommended a position of support to the full City Council. ABx2 1 seeks to expand upon the level and variety of services offered for individuals with developmental disabilities. Existing state policies related to developmental services are largely shaped by the Lanterman Developmental Disabilities Services Act (Statue 1977 Chapter 1252), which requires the State Department of Developmental Services (DDS) to contract with regional centers to provide services and support to individuals with developmental disabilities. Under existing law, regional centers purchase the services necessary for individuals with developmental disabilities through approved service providers or arrange for those services through other publicly funded agencies. The Lanterman Act also establishes specified rates and wages to be paid to certain service providers and the rates to be paid for certain developmental services, which are determined by either the DDS or between regional centers and service providers. Page 1 PacketPg. 20 If enacted, ABx2 1 would implement targeted rate increases to the community-based developmental services system within DDS by $287 million effective July 1, 2016. More specifically, the bill would appropriate increased funding toward rates and wages for developmental services providers and offer financial incentives for integrated employment opportunities for individuals with disabilities to encourage placement and retention in the workforce. DDS would also be required to complete a rate study to address the sustainability and quality of community-based services for individuals with disabilities by March 1, 2019. ABx2 1 differs from AB 1565 in terms of the total funding increase the bill proposes for developmental services funding. ABx2 1 proposes between 5 percent and 7.5 percent increases to various elements of developmental services funding, whereas AB 1565 proposes a 10 percent across the board increase. The City Council Legislative Committee met on February 16, 2016, and recommends that the City Council adopt a "support" position on AB 1565. After the Legislative Committee meeting Assembly Member Lackey's office informed City staff that a substantial number of provisions of AB 1565 have been amended into ABx2 1. On February 29, 2016, ABx2 1 was passed by the State Assembly 78-0 (supported by Assembly Members Tom Lackey and Scott Wilk) and Senate 40-0 (supported by Senators Fran Pavley and Sharon Runner) and was sent to Governor Brown for signature. ALTERNATIVE ACTION 1. Adopt an "oppose" position on ABx2 1 2. Take no position on ABx2 1 3. Refer ABx2 1 back to the Legislative Committee 4. Other direction as determined by the City Council FISCAL IMPACT No additional resources, beyond those contained within the adopted FY 2015/16 City budget, are required for implementation of the recommended action. ATTACHMENTS Assembly Bill 1565 Assembly Billx2 1 Page 2 Packet Pg. 21 CALIFORNIA LEGISLATURE -2015-16 REGULAR SESSION ASSEMBLY BILL No. 1565 Introduced by Assembly Member Lackey (Principal coauthors: Assembly Members Baker, Chavez, Grove, Linder, Patterson, and Wilk) (Principal coauthor: Senator Stone) (Coauthors: Assembly Members Achadjian, Bigelow, Maienschein, and Mayes) January 4, 2016 An act to amend Sections 4629.7, 4681.1, 4681.6, 4689.8, 4691.9, and 4860 of, and to add Sections 4519.8, 4681.2, 4690.7, 4793, and 4794 to, the Welfare and Institutions Code, relating to developmental services, and declaring the urgency thereof, to take effect immediately. LEGISLATIVE COUNSEL'S DIGEST AB 1565, as introduced, Lackey. Developmental services: funding. The Lanterman Developmental Disabilities Services Act requires the State Department of Developmental Services to contract with regional centers to provide services and supports to individuals with developmental disabilities. Under existing law, the regional centers purchase needed services for individuals with developmental disabilities through approved service providers or arrange for those services through other publicly funded agencies. This bill would require the department to submit a plan to the Legislature by August 1, 2017, to ensure the sustainability, quality, and transparency of community-based services for individuals with developmental disabilities. The bill would require the department to regularly consult with stakeholders in developing the plan and would require the plan to address specified topics, including, among others, 99 3.a Packet Pg. 22 co co N 7 AB 1565 —2— recommendations for a comprehensive approach to funding regional center operations in a sustainable and transparent manner that enables regional centers to deliver high-quality services to consumers. Existing law requires that contracts or agreements between regional centers and service providers in which the rates between the regional center and the service provider are determined through negotiations to ensure that not more than 15% of regional center funds be spent on administrative costs, as described. This bill would instead provide that the percentage of the funds that may be spent on administrative costs varies depending on the total value, annually, of the payments received by a service provider from all regional centers. Existing law establishes specified rates to be paid to certain service providers and the rates to be paid for certain developmental services. Existing law requires that rates to be paid to other developmental service providers either be set by the department or negotiated between the regional center and the service provider. Existing law prohibits certain provider rate increases, but authorizes increases to those rates as necessary to adjust employee wages to meet the state minimum wage law. This bill would increase the rates established by existing law, as specified, and would require an increase to the rates set by the department and the rates negotiated between regional centers and service providers, as specified. The bill would also require the department, when setting rates for community care facilities serving people with developmental disabilities, to ensure that the rates permit the viability of those facilities by establishing different rates for each facility size, as determined by the number of beds available, that reflect reasonable differences in the cost structure of facilities with differing numbers of beds. The bill would require the department to adopt emergency regulations implementing that provision. Existing law requires each regional center to submit, on or before August 1 of each year, to the department and the State Council on Developmental Disabilities a program budget plan for the subsequent budget year. Existing law provides that, to the extent feasible, all funds appropriated for developmental disabilities programs be allocated to those programs by August 1 of each year and designates the department as the agency responsible for the processing, audit, and payment of funds made available to regional centers. 99 3.a Packet Pg. 23 —3— AB 1565 This bill would require the department to increase the funding paid to a regional center for the regional center's operating budget, beginning July 1, 2016, by 10% above the amount the regional center otherwise would have received under the department's core staffing formula, and, beginning July 1, 2017, by 10% above the amount the regional center otherwise would have received under the department's core staffing formula, plus a percentage equal to the percentage of any increase in the California Consumer Price Index since July 1, 2016. The bill would also require the department to increase the funding provided to a regional center to enable the regional center and the regional center's purchase -of -service vendors to fund certain costs related to minimum wage requirements. This bill would declare that it is to take effect immediately as an urgency statute. Vote: 2/3. Appropriation: no. Fiscal committee: yes. State -mandated local program: no. The people of the State of California do enact as follows: 1 SECTION 1. (a) The Legislature finds and declares all of the 2 following: 3 (1) California's vision to promote fulfilling lives for persons 4 with developmental disabilities launched in 1969 with the passage 5 of the Lanterman Developmental Disabilities Services Act, 6 authored by Assembly Member Frank Lanterman and signed by 7 Governor Ronald Reagan. However, the Lanterman Act's vision 8 is now threatened by neglect of the community service system and 9 wasteful spending on outdated state institutions. 10 (2) The current funding system for regional center operations 11 and for community-based services is inadequate and outdated. The 12 funding currently provided has not kept pace with the cost of 13 delivering high-quality services. Funding formulas and ratesetting 14 methods are archaic and ill-suited to promote an effective and 15 efficient community system that delivers high-quality services to 16 consumers. 17 (3) The result of inadequate funding for community services 18 and onerous requirements on providers can be seen in the decline 19 of the number of vendors serving the community. As documented 20 in the January 2015 Fact Book issued by the State Department of 21 Developmental Services, the number of vendors declined by 30 99 3.a Packet Pg. 24 AB 1565 —4- 1 percent from 2009-10 to 2013-14, inclusive, despite an increase 2 of 12 percent in the number of consumers served in the community. 3 The Association of Regional Center Agencies also reports that 435 4 licensed residential homes and 57 day and work programs have 5 closed since July 2011. 6 (4) California must recommit itself to vibrant and sustainable 7 community services that maximize opportunities for persons with 8 developmental disabilities to thrive in their own neighborhoods. 9 (5) It is imperative that the Legislature take action to ensure the 10 viability of the community service system by paying sustainable 11 reimbursement rates, streamlining requirements for community 12 service providers, and fairly funding the regional center system to 13 administer services. 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 (b) Accordingly, it is the intent of the Legislature to enact short-term increases in reimbursement rates for community services providers while undertaking a stakeholder process with specific deadlines to develop and implement long-term reforms to accomplish these goals. It is also the intent of the Legislature to establish requirements for greater regional center transparency with respect to rates paid to vendors and the amount and type of services provided to consumers across the spectrum of regional center services. It is further the intent of the Legislature that the provisions added by this act only remain in place until a revised, comprehensive rate system that provides adequate and transparent funding for community-based services, including supported employment, is implemented. SEC. 2. Section 4519.8 is added to the Welfare and Institutions Code, immediately following Section 4519.7, to read: 4519.8. (a) The department shall submit a plan to the Legislature to ensure the sustainability, quality, and transparency of community-based services for individuals with developmental disabilities. The department shall regularly consult with stakeholders in developing the plan. The department shall submit the plan to the Legislature by August 1, 2017. The plan shall include, but not be limited to, all of the following: (1) An assessment of the effectiveness of the methods used to pay each category of community service provider. This assessment shall include consideration of the following factors for each category of service provider: 99 3.a Packet Pg. 25 M N —5— AB 1565 1 (A) Whether the current method of ratesetting for a service 2 category is ensuring an adequate supply of providers in that 3 category, including, but not limited to, whether there is a sufficient 4 supply of providers to enable a consumer to have a choice of 5 providers. 6 (B) A comparison of the likely fiscal effects of using the 7 following methodologies for each service provider category: 8 (i) Negotiated rates, which may be limited to regional medians 9 or other limits. 10 (ii) Rates established through regulations on either a statewide 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 or regionally adjusted basis. (iii) Alternate rate methodologies that may use combinations of negotiated or regulatory rates on either a statewide or regionally adjusted basis. (2) An evaluation of the appropriateness of the number and type of service codes for regional center services, including, but not limited to, recommendations for making service codes more reflective of the level and type of services provided and for reducing the number and type of services that are billed with a service code of "Miscellaneous." (3) Recommendations for a comprehensive purchase -of -services rate structure that would ensure a sustainable, high-quality, and transparent community services system. (4) An assessment of the adequacy of the number and locations of regional centers for providing timely service to consumers. This assessment shall consider, at a minimum, all of the following factors: (A) The waiting time for consumers to obtain appointments with regional center personnel. (B) The distance consumers must travel for in-person meetings with regional center personnel. (C) The type and frequency of interactions between consumers and regional center personnel that can be accommodated remotely through electronic means, including, but not limited to, electronic mail, video conferencing, or telehealth. (D) Whether the number of consumers and the geographic size of the catchment area served by each regional center are reasonable for delivering high-quality service to consumers and their families. (E) Whether additional regional centers or regional center locations are necessary to address any identified deficiencies in 99 3.a Packet Pg. 26 M N AB 1565 1 access to regional center personnel, or whether technology -enabled 2 means of access or other solutions are warranted. 3 (5) Recommendations for a comprehensive approach to funding 4 regional center operations in a sustainable and transparent manner 5 that enables regional centers to deliver high-quality services to 6 their consumers, including, but not limited to, recommendations 7 and estimated costs for increasing the number of regional centers 8 or altering catchment areas. 9 (b) The report submitted to the Legislature pursuant to 10 subdivision (a) shall be submitted in compliance with Section 9795 11 of the Government Code. 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 SEC. 3. Section 4629.7 of the Welfare and Institutions Code is amended to read: 4629.7. (a) Notwithstanding any other-previ4on--e€ law, all regional center contracts or agreements with service providers in which rates are determined through negotiations between the regional center and the service provider shall expressly require that not more than admit-=-`__`:_ _ eosts. For the amount of funds specified in paragraphs (1) to (3), inclusive, be spent on administrative costs. (1) For service providers who receive payments from one or more regional centers totaling two million dollars ($2,000,000) or more annually from those regional centers, 15 percent of regional center funds. (2) For service providers who receive payments from one or more regional centers totaling less than two million dollars ($2,000,000), but more than five hundred thousand dollars ($500,000), annually from those regional centers, 20 percent of regional center funds. (3) For service providers who receive payments from one or more regional centers totaling five hundred thousand dollars ($500, 000) or less annually from those regional centers, 25 percent of regional center funds. (b) For purposes of this subdivision, direct service expenditures are those costs immediately associated with the services to consumers being offered by the provider. Funds spent on direct services shall not include any administrative costs. Administrative costs include, but are not limited to, any of the following: (1) Salaries, wages, and employee benefits for managerial personnel whose primary purpose is the administrative management 99 3.a Packet Pg. 27 M N —7— AB 1565 1 of the entity, including, but not limited to, directors and chief 2 executive officers. 3 (2) Salaries, wages, and benefits of employees who perform 4 administrative functions, including, but not limited to, payroll 5 management, personnel functions, accounting, budgeting, and 6 facility management. 7 (3) Facility and occupancy costs, directly associated with 8 administrative functions. 9 (4) Maintenance and repair. 10 (5) Data processing and computer support services. 11 (6) Contract and procurement activities, except those provided 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 by a direct service employee. (7) Training directly associated with administrative functions. (8) Travel directly associated with administrative functions. (9) Licenses directly associated with administrative functions. (10) Taxes. (11) Interest. (12) Property insurance. (13) Personal liability insurance directly associated with administrative functions. (14) Depreciation. (15) General expenses, including, but not limited to, communication costs and supplies directly associated with administrative functions. (c) Notwithstanding any other-previ4on- € law, all contracts between the department and the regional centers shall require that not more than 15 percent of all funds appropriated through the regional center's operations budget shall be spent on administrative costs. For purposes of this subdivision, "direct services" includes, but is not limited to, service coordination, assessment and diagnosis, monitoring of consumer services, quality assurance, and clinical services. Funds spent on direct services shall not include any administrative costs. For purposes of this subdivision, administrative costs include, but are not limited to, any of the following: (1) Salaries, wages, and employee benefits for managerial personnel whose primary purpose is the administrative management of the regional center, including, but not limited to, directors and chief executive officers. 99 3.a Packet Pg. 28 M N AB 1565 1 (2) Salaries, wages, and benefits of employees who perform 2 administrative functions, including, but not limited to, payroll 3 management, personnel functions, accounting, budgeting, auditing, 4 and facility management. 5 (3) Facility and occupancy costs, directly associated with 6 administrative functions. 7 (4) Maintenance and repair. 8 (5) Data processing and computer support services. 9 (6) Contract and procurement activities, except those performed 10 by direct service employees. 11 (7) Training directly associated with administrative functions. 12 (8) Travel directly associated with administrative functions. 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 (9) Licenses directly associated with administrative functions. (10) Taxes. (11) Interest. (12) Property insurance. (13) Personal liability insurance directly associated with administrative functions. (14) Depreciation. (15) General expenses, including, but not limited to, communication costs and supplies directly associated with administrative functions. (d) Consistent with-s�rr{fr, subdivisions (a) and (b), service providers and contractors, upon request, shall provide regional centers with access to any books, documents, papers, computerized data, source documents, consumer records, or other records pertaining to the service providers' and contractors' negotiated rates. SEC. 4. Section 4681.1 of the Welfare and Institutions Code is amended to read: 4681.1. (a) The department shall adopt regulations that specify rates for community care facilities serving persons with developmental disabilities. The implementation of the regulations shall be contingent upon an appropriation in the annual Budget Act for this purpose. These rates shall be calculated on the basis of a cost model designed by the department that ensures that aggregate facility payments support the provision of services to each person in accordance with his or her individual program plan and applicable program requirements. The cost model shall reflect 99 3.a Packet Pg. 29 M N —9— AB 1565 1 cost elements that shall include, but are not limited to, all of the 2 following: 3 (1) "Basic living needs" include utilities, furnishings, food, 4 supplies, incidental transportation, housekeeping, personal care 5 items, and other items necessary to ensure a quality environment 6 for persons with developmental disabilities. The amount identified 7 for the basic living needs element of the rate shall be calculated 8 as the average projected cost of these items in an economically 9 and efficiently operated community care facility. 10 (2) "Direct care" includes salaries, wages, benefits, and other 11 expenses necessary to supervise or support the person's functioning 12 in the areas of self-care and daily living skills, physical 13 coordination mobility, and behavioral self-control, choice making, 14 and integration. The amount identified for direct care shall be 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 calculated as the average projected cost of providing the level of service required to meet each person's functional needs in an economically and efficiently operated community care facility. The direct care portion of the rate shall reflect specific service levels defined by the department on the basis of relative resident need and the individual program plan. (3) "Special services" include specialized training, treatment, supervision, or other services that a person's individual program plan requires to be provided by the residential facility in addition to the direct care provided under paragraph (2). The amount identified for special services shall be calculated for each individual based on the additional services specified in the person's individual program plan and the prevailing rates paid for similar services in the area The special services portion of the rate shall reflect a negotiated agreement between the facility and the regional center in accordance with Section 4648. (4) "Indirect costs" include managerial personnel, facility operation, maintenance and repair, other nondirect care, employee benefits, contracts, training, travel, licenses, taxes, interest, insurance, depreciation, and general administrative expenses. The amount identified for indirect costs shall be calculated as the average projected cost for these expenses in an economically and efficiently operated community care facility. (5) "Property costs" include mortgages, leases, rent, taxes, capital or leasehold improvements, depreciation, and other expenses related to the physical structure. The amount identified 99 3.a Packet Pg. 30 M N AB 1565 —10- 1 for property costs shall be based on the fair rental value of a model 2 facility that is adequately designed, constructed, and maintained 3 to meet the needs of persons with developmental disabilities. The 4 amount identified for property costs shall be calculated as the 5 average projected fair rental value of an economically and 6 efficiently operated community care facility. 7 (b) The cost model shall take into account factors that include, 8 but are not limited to, all of the following: 9 (1) Facility size, as defined by the department on the basis of 10 the number of facility beds licensed by the State Department of 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 Social Services and vendorized by the regional center. (2) Specific geographic areas, as defined by the department on the basis of cost of living and other pertinent economic indicators. (3) Common levels of direct care, as defined by the department on the basis of services specific to an identifiable group of persons as determined through the individual program plan. (4) Positive outcomes, as defined by the department on the basis of increased integration, independence, and productivity at the aggregate facility and individual consumer level. (5) Owner -operated and staff -operated reimbursement, which shall not differ for facilities that are required to comply with the same program requirements. (c) The rates established for individual community care facilities serving persons with developmental disabilities shall reflect all of the model cost elements and rate development factors described in this section. The cost model design shall include a process for updating the cost model elements that address variables, including, but not limited to, all of the following: (1) Economic trends in California. (2) New state or federal program requirements. (3) Changes in the state or federal minimum wage. (4) Increases in fees, taxes, or other business costs. (5) Increases in federal supplemental security income/state supplementary program for the aged, blind, and disabled payments. (d) Rates established for persons with developmental disabilities who are also dually diagnosed with a mental health disorder may be fixed at a higher rate. The department shall work with the State Department of Health Care Services to establish criteria upon which higher rates may be fixed pursuant to this subdivision. The higher rate for persons with developmental disabilities who are 99 3.a Packet Pg. 31 —11— AB 1565 1 also dually diagnosed with a mental health disorder may be paid 2 when requested by the director of the regional center and approved 3 by the Director of Developmental Services. 4 (e) By January 1, 2001, the department shall prepare proposed 5 regulations to implement the changes outlined in this section. The 6 department may use a private firm to assist in the development of 7 these changes and shall confer with consumers, providers, and 8 other interested parties concerning the proposed regulations. By 9 May 15, 2001, and each year thereafter, the department shall 10 provide the Legislature with annual community care facility rates 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 including any draft amendments to the regulations as required. By July 1, 2001, and each year thereafter, contingent upon an appropriation in the annual Budget Act for this purpose, the department shall adopt emergency regulations that establish the annual rates for community care facilities serving persons with developmental disabilities for each fiscal year. (f) During the first year of operation under the revised rate model, individual facilities shall be held harmless for any reduction in aggregate facility payments caused solely by the change in reimbursement methodology. (g) (1) The department shall ensure that rates established for community care facilities serving persons with developmental disabilities permit the viability of those facilities, including, but not limited to, four -bed facilities, by establishing different rates for each facility size, as determined by the number of beds available, that reflect reasonable differences in the cost structure offacilities with differing numbers of beds. (2) The department shall adopt emergency regulations, within 30 days of the effective date of the amendments adding this subdivision, to implement this subdivision. The adoption, amendment, repeal, or readoption of a regulation authorized by this paragraph is deemed to be necessary for the immediate preservation of the public peace, health and safety, or general welfare, for purposes of Sections 11346.1 and 11349.6 of the Government Code, and the department is hereby exempted from the requirement that it describe specific facts showing the need for immediate action. SEC. 5. Section 4681.2 is added to the Welfare and Institutions Code, to read: 99 3.a Packet Pg. 32 M N 7 AB 1565 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 —12- 4681.2. (a) Notwithstanding any other law, commencing July 1, 2016, the department shall increase the rates set for community care facilities serving persons with developmental disabilities by 10 percent above the levels that otherwise would have been in effect as of July 1, 2016. Commencing July 1, 2017, except as specified in subdivision (b), the department shall increase those rates by a percentage equal to the percentage of any increase in the California Consumer Price Index since July 1, 2016. (b) The rate increase described in subdivision (a) that is required to commence July 1, 2017, shall only be made if the Budget Act of 2017 does not implement alternative rate increases or rate reforms based on the plan required by Section 4519.8. (c) The funding increases authorized in this section shall only be made if the increase would not result in a reduction to the amount of federal matching funds available for these services. SEC. 6. Section 4681.6 of the Welfare and Institutions Code is amended to read: 4681.6. (a) Notwithstanding any other-lave-�, law, commencing July 1, 2008: (1) A regional center shall not pay an existing residential service provider, for services where for which rates are determined through a negotiation between the regional center and the provider, a rate higher than the rate in effect on June 30, 2008, unless the increase is required by a contract between the regional center and the vendor that is in effect on June 30, 2008, or the regional center demonstrates that the approval is necessary to protect the consumer's health or safety and the department has granted prior written authorization. (2) A regional center shall not negotiate a rate with a new residential service provider, for services where for which rates are determined through -ft negotiation between the regional center and the provider, that is higher than the regional center's median rate for the same service code and unit of service, or the statewide median rate for the same service code and unit of service, whichever is lower. The unit of service designation shall conform with an existing regional center designation or, if none exists, a designation used to calculate the statewide median rate for the same service. The regional center shall annually certify to the department its median rate for each negotiated rate service code, by designated unit of service. This certification shall be subject to 99 3.a Packet Pg. 33 —13— AB 1565 1 verification through the department's biennial fiscal audit of the 2 regional center. 3 (b) Notwithstanding subdivision (a), commencing July 1, 2014, 4 regional centers may negotiate a rate adjustment with residential 5 service providers regarding rates that are otherwise restricted 6 pursuant to subdivision (a), if the adjustment is necessary in order 7 to pay employees no less than the minimum wage as established 8 by Section 1182.12 of the Labor Code, as amended by Chapter 9 351 of the Statutes of 2013, and only for the purpose of adjusting 10 payroll costs associated with the minimum wage increase. The 11 rate adjustment shall be specific to the unit of service designation 12 that is affected by the increased minimum wage, shall be specific 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 to payroll costs associated with any increase necessary to adjust employee pay only to the extent necessary to bring pay into compliance with the increased state minimum wage, and shall not be used as a general wage enhancement for employees paid above the minimum wage. Regional centers shall maintain documentation on the process to determine, and the rationale for granting, any rate adjustment associated with the minimum wage increase. (c) (1) Notwithstanding subdivision (a), commencing July 1, 2016, regional centers shall increase the rates paid to residential service providers, for services for which rates are determined through negotiation between the regional center and the provider, by 10 percent above the levels that otherwise would have been in effect on July 1, 2016 Commencing July 1, 2017, except as specified in paragraph (2), the regional centers shall increase those rates by a percentage equal to the percentage of any increase in the California Consumer Price Index since July 1, 2016 99 3.a Packet Pg. 34 AB 1565 —14- 1 14- 1 (2) The rate increase described in paragraph(]) that is required 2 to commence July 1, 2017, shall only be made if the Budget Act 3 of 2017 does not implement alternative rate increases or rate 4 reforms based on the plan required by Section 4519.8. 5 (3) The funding increases authorized in this subdivision shall 6 only be made if the increase would not result in a reduction to the 7 amount of federal matching funds available for these services. 8 (d) For purposes of this section, "residential service provider" 9 includes Adult Residential Facilities for Persons with Special 10 Health Care Needs, as described in Section 4684.50. 11 (e) This section shall not apply to those services for which rates 12 are determined by the State Department of Health Care Services, 13 or the State Department of Developmental Services, or are usual 14 and customary. 15 SEC. 7. Section 4689.8 of the Welfare and Institutions Code 16 is amended to read: 17 4689.8. (a) Notwithstanding any other 18 regulation, law, commencing July 1, 2008: 19 (a) No 20 (1) A regional center -may shall not pay an existing supported 21 living service provider, for services where for which rates are 22 determined through -ft negotiation between the regional center and 23 the provider, a rate higher than the rate in effect on June 30, 2008, 24 unless the increase is required by a contract between the regional 25 center and the vendor that is in effect on June 30, 2008, or the 26 regional center demonstrates that the approval is necessary to 27 protect the consumer's health or safety and the department has 28 granted prior written authorization. 29 (b) No 30 (2) A regional center -ray shall not negotiate a rate with a new 31 supported living service provider, for services where for which 32 rates are determined through negotiation between the regional 33 center and the provider, that is higher than the regional center's 34 median rate for the same service code and unit of service, or the 35 statewide median rate for the same service code and unit of service, 36 whichever is lower. The unit of service designation shall conform 37 with an existing regional center designation or, if none exists, a 38 designation used to calculate the statewide median rate for the 39 same service. The regional center shall annually certify to the State 40 Department of Developmental Services its median rate for each 99 3.a Packet Pg. 35 M N —15— AB 1565 1 negotiated rate service code, by designated unit of service. This 2 certification shall be subject to verification through the 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 department's biennial fiscal audit of the regional center. (b) (1) Notwithstanding subdivision (a), commencing July 1, 2016, regional centers shall increase the rates paid to supported living service providers, for services for which rates are determined through negotiation between the regional center and the provider, by 10 percent above the levels that otherwise would have been in effect on July 1, 2016 Commencing July 1, 2017, except as specified in paragraph (2), the regional centers shall increase those rates by a percentage equal to the percentage of any increase in the California Consumer Price Index since July 1, 2016 (2) The rate increase described in paragraph (1) that is required to commence July 1, 2017, shall only be made if the Budget Act of 2017 does not implement alternative rate increases or rate reforms based on the plan required by Section 4519.8. (3) The funding increases authorized in this subdivision shall only be made if the increase would not result in a reduction to the amount of federal matching funds available for these services. SEC. 8. Section 4690.7 is added to the Welfare and Institutions Code, to read: 4690.7. (a) Notwithstanding any other law, commencing July 1, 2016, the department shall increase the rates set for nonresidential service providers by 10 percent above the levels that otherwise would have been in effect on July 1, 2016. Commencing July 1, 2017, except as specified in subdivision (b), the department shall increase those rates by a percentage equal to the percentage of any increase in the California Consumer Price Index since July 1, 2016. (b) The rate increase described in subdivision (a) that is required to commence July 1, 2017, shall only be made if the Budget Act of 2017 does not implement alternative rate increases or rate reforms based on the plan required by Section 4519.8. (c) The funding increases authorized in this section shall only be made if the increase would not result in a reduction to the amount of federal matching funds available for these services. SEC. 9. Section 4691.9 of the Welfare and Institutions Code is amended to read: 4691.9. (a) Notwithstanding any other-lave-�, law, commencing July 1, 2008: 99 3.a Packet Pg. 36 M N AB 1565 —16- 1 (1) A regional center shall not pay an existing service provider, 2 for services where rates are determined through a negotiation 3 between the regional center and the provider, a rate higher than 4 the rate in effect on June 30, 2008, unless the increase is required 5 by a contract between the regional center and the vendor that is in 6 effect on June 30, 2008, or the regional center demonstrates that 7 the approval is necessary to protect the consumer's health or safety 8 and the department has granted prior written authorization. 9 (2) A regional center shall not negotiate a rate with a new service 10 provider, for services where rates are determined through a 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 negotiation between the regional center and the provider, that is higher than the regional center's median rate for the same service code and unit of service, or the statewide median rate for the same service code and unit of service, whichever is lower. The unit of service designation shall conform with an existing regional center designation or, if none exists, a designation used to calculate the statewide median rate for the same service. The regional center shall annually certify to the State Department of Developmental Services its median rate for each negotiated rate service code, by designated unit of service. This certification shall be subject to verification through the department's biennial fiscal audit of the regional center. (b) Notwithstanding subdivision (a), commencing July 1, 2014, regional centers may negotiate a rate adjustment with providers regarding rates if the adjustment is necessary in order to pay employees no less than the minimum wage as established by Section 1182.12 of the Labor Code, as amended by Chapter 351 of the Statutes of 2013, and only for the purpose of adjusting payroll costs associated with the minimum wage increase. The rate adjustment shall be specific to the unit of service designation that is affected by the increased minimum wage, shall be specific to payroll costs associated with any increase necessary to adjust employee pay only to the extent necessary to bring pay into compliance with the increased state minimum wage, and shall not be used as a general wage enhancement for employees paid above the increased minimum wage. Regional centers shall maintain documentation on the process to determine, and the rationale for granting, any rate adjustment associated with the minimum wage increase. 99 3.a Packet Pg. 37 M N —17— AB 1565 1 (c) Notwithstanding any othe law or regulatioit, law, 2 commencing January 1, 2015, rates for personal assistance and 3 supported living services in effect on December 31, 2014, shall 4 be increased by 5.82 percent, subject to funds specifically 5 appropriated for this increase for costs due to changes in federal 6 regulations implementing the federal Fair Labor Standards Act of 7 1938 (29 U.S.C. Sec. 201 et seq.). The increase shall be applied 8 as a percentage, and the percentage shall be the same for all 9 applicable providers. As used in this subdivision, both of the 10 following definitions shall apply: 11 (1) "Personal assistance" is limited only to those services 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 provided by vendors classified by the regional center as personal assistance providers, pursuant to the miscellaneous services provisions contained in Title 17 of the California Code of Regulations. (2) "Supported living services" are limited only to those services defined as supported living services in Title 17 of the California Code of Regulations. (d) (1) Notwithstanding subdivision (a), commencing July 1, 2016, regional centers shall increase the rates paid to service providers, for services for which rates are determined through negotiation between the regional center and the provider, by 10 percent above the levels that otherwise would have been in effect on July 1, 2016 Commencing July 1, 2017, except as specified in paragraph (2), the regional centers shall increase those rates by a percentage equal to the percentage of any increase in the California Consumer Price Index since July 1, 2016 99 3.a Packet Pg. 38 M M N 7 AB 1565 1 (2) The rate increase described in paragraph(]) that is required 2 to commence July 1, 2017, shall only be made if the Budget Act 3 of 2017 does not implement alternative rate increases or rate 4 reforms based on the plan required by Section 4519.8. 5 (3) The funding increases authorized in this subdivision shall 6 only be made if the increase would not result in a reduction to the 7 amount of federal matching funds available for these services. 8 (e) This section shall not apply to those services for which rates 9 are determined by the State Department of Health Care Services, 10 or the State Department of Developmental Services, or are usual 11 and customary. 12 SEC. 10. Section 4793 is added to the Welfare and Institutions 13 Code, to read: 14 4793. (a) The department shall increase the funding provided 15 to a regional center for the regional center's operating budget as 16 follows: 17 (1) Beginning July 1, 2016, increase the amount paid under the 18 core staffing formula by 10 percent. 19 (2) Beginning July 1, 2017, increase the amount paid under the 20 core staffing formula by 10 percent, plus a percentage equal to the 21 percentage of any increase in the California Consumer Price Index 22 since July 1, 2016. 23 (b) The rate increase described in paragraph (2) of subdivision 24 (a) that is required to commence July 1, 2017, shall only be made 25 if the Budget Act of 2017 does not implement alternative rate 26 increases or regional center funding reforms based on the plan 27 required by Section 4519.8. 28 (c) The funding increases authorized in this section shall only 29 be made if the increase would not result in a reduction to the 30 amount of federal matching funds available for these services. 31 SEC. 11. Section 4794 is added to the Welfare and Institutions 32 Code, to read: 33 4794. (a) The department shall increase the funding provided 34 to a regional center to enable the regional center and regional 35 center's purchase -of -service vendors to fund all of the following 36 costs associated with minimum wage requirements: 37 (1) The costs necessary to comply with a statewide minimum 38 wage requirement. 99 3.a Packet Pg. 39 M N 7 —19— AB 1565 1 (2) The costs necessary to comply with minimum wage 2 requirements enacted by local governments that exceed the 3 statewide minimum wage. 4 (3) The costs necessary to increase compensation for exempt, 5 salaried employees to comply with wage orders issued by the 6 Industrial Welfare Commission or any other state regulatory 7 agency. 8 (4) Any other wage adjustments that vendors are required to 9 make in response to minimum wage increases mandated by state 10 or federal statutes, regulations, or other authorities. 11 (b) The funding increases required by this section shall be in 12 addition to the funding increases required by Sections 4681.2, 13 4681.6, 4689.8, 4690.7, 4691.9, 4793, and 4860, as those sections 14 were added or amended by the act that added this section. 15 SEC. 12. Section 4860 of the Welfare and Institutions Code is 16 amended to read: 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 4860. (a) (1) The -Except as provided in subdivision (J), the hourly rate for supported employment services provided to consumers receiving individualized services shall beery thirty-four dollars and-eigf*y-twa twenty four cents). ($34.24). (2) Job coach hours spent in travel to consumer worksites may be reimbursable for individualized services only when the job coach travels from the vendor's headquarters to the consumer's worksite or from one consumer's worksite to another, and only when the travel is one way. (b) T+,e--Except as provided in subdivision (J), the hourly rate for group services shall be4hirty thirty-four dollars and -eighty-two twenty four cents ($30-82), ($34.24) regardless of the number of consumers served in the group. Consumers in a group shall be scheduled to start and end work at the same time, unless an exception that takes into consideration the consumer's compensated work schedule is approved in advance by the regional center. The department, in consultation with stakeholders, shall adopt regulations to define the appropriate grounds for granting these exceptions. When the number of consumers in a supported employment placement group drops to fewer than the minimum required in subdivision (r) of Section 4851, the regional center may terminate funding for the group services in that group, unless, within 90 days, the program provider adds one or more regional 99 3.a Packet Pg. 40 M N AB 1565 —20- 1 centers, or Department of Rehabilitation -funded supported 2 employment consumers to the group. 3 (c) Job coaching hours for group services shall be allocated on 4 a prorated basis between a regional center and the Department of 5 Rehabilitation when regional center and Department of 6 Rehabilitation consumers are served in the same group. 7 (d) When Section 4855 applies, fees shall be authorized for the 8 following: 9 (1) A four -hundred -dollar 10 ($400) fee shall be paid to the program provider upon intake of a 11 consumer into a supported employment program. No fee shall be 12 paid if that consumer completed a supported employment intake 13 process with that same supported employment program within the 14 previous 12 months. 15 (2) An 16 eight -hundred -dollar ($800) fee shall be paid upon placement of 17 a consumer in an integrated job, except that no fee shall be paid 18 if that consumer is placed with another consumer or consumers 19 assigned to the same job coach during the same hours of 20 employment. 21 (3) An 22 eight -hundred -dollar ($800) fee shall be paid after a 90 -day 23 retention of a consumer in a job, except that no fee shall be paid 24 if that consumer has been placed with another consumer or 25 consumers, assigned to the same job coach during the same hours 26 of employment. 27 (e) Notwithstanding paragraph (4) of subdivision (a) of Section 28 4648, the regional center shall pay the supported employment 29 program rates established by this section. 30 (J) (1) Commencing July 1, 2017, the rates established by 31 subdivisions (a) and (b) shall be thirty-seven dollars and sixty-six 32 cents ($37.66). 33 (2) The rate increase described in paragraph (1), shall only be 34 made if the Budget Act of 2017 does not implement alternative 35 rate increases or regional center funding reforms based on the 36 plan required by Section 4519.8. 37 SEC. 13. The Legislature declares that the changes made by 38 this act are not intended to result in the substantial impairment of 39 any contract. To the extent any contract would be substantially 40 impaired as a result of the application of any change made by this 99 3.a Packet Pg. 41 M N —21— AB 1565 1 act, it is the intent of the Legislature that the change apply only to 2 contracts renewed or entered into on or after the effective date of 3 this act. 4 SEC. 14. This act is an urgency statute necessary for the 5 immediate preservation of the public peace, health, or safety within 6 the meaning of Article IV of the Constitution and shall go into 7 immediate effect. The facts constituting the necessity are: 8 In order to ensure that the necessary increases in the rates paid 9 for services provided to persons with developmental disabilities 10 and in the hourly rates for supported employment services provided 11 to consumers receiving individualized services take effect as soon 12 as possible, it is necessary that this act take immediate effect. O 99 3.a Packet Pg. 42 Proposed Conference Report No. 1 February 22, 2016 AMENDED IN SENATE SEPTEMBER 3, 2015 CALIFORNIA LEGISLATURE -2015-16 SECOND EXTRAORDINARY SESSION ASSEMBLY BILL No. 1 Introduced by Assembly Menthet Bonta Assembly Member Thurmond, Senator Beall, Assembly Member Banta, Assembly Member Maienschein, and Senator Cannella (Coauthors: Assembly Members Alejo, Atkins, Baker, Bigelow, Bloom, Bonilla, Brown, Burke, Calderon, Campos, Chau, Chiu, Chu, Cooley, Cooper, Dababneh, Dahle, Daly, Dodd, Eggman, Frazier, Gallagher, Cristina Garcia, Eduardo Garcia, Gatto, Gipson, Gomez, Gonzalez, Gordon, Gray, Roger Hernkndez, Holden, Irwin, Jones, Jones -Sawyer, Levine, Linder, Lopez, Low, Mathis, Mayes, McCarty, Medina, Mullin, Nazarian, O'Donnell, Olsen, Quirk, Rendon, Ridley-Thomas, Rodriguez, Salas, Santiago, Mark Stone, Ting, Waldron, Weber, Williams, and Wood) (Coauthors: Senators Allen, Block, De Leon, Galgiani, Glazer, Hall, Hancock, Hernandez, Hertzberg, Hill, Hueso, Jackson, Lara, Leno, Leyva, Liu, McGuire, Mendoza, Mitchell, Monning, Pan, Pavley, Roth, Wieckowski, and Wolk) July 2, 2015 An actrelafing to soeittl serviees. to amend Sections 4519.5, 4639.5, 4652.5, 4689.8, 4690.5, 4691.6, 4691.9, and 4860 of, and to add Sections 4519.8, 4691.10, 4691.11, 4870, 14105.075, and 14105.195 to, the Welfare and Institutions Code, relating to human services financing, and making an appropriation therefor. ❑2 97 3.b Packet Pg. 43 AB 1 —2— LEGISLATIVE COUNSEL'S DIGEST AB 1, as amended, Berta Thurmond. Developmental services: Medi -Cal: funding. The Lanterman Developmental Disabilities Services Act requires the State Department ofDevelopmental Services to contract with regional centers to provide services and supports to individuals with developmental disabilities. Under existing law, regional centers purchase needed services for individuals with developmental disabilities through approved service providers or arrange for those services through other publicly funded agencies. Existing law establishes specified rates and wages to be paid to certain service providers and the rates to be paid for certain developmental services. Existing law requires that rates to be paid to other developmental service providers either be set by the department or negotiated between the regional center and the service provider. Existing law establishes the Medi -Cal program, administered by the State Department of Health Care Services, under which basic health care services are provided to qualified low-income persons. The Medi -Cal program is, in part, governed and funded by federal Medicaid Program provisions. Existing law requires, except as otherwise provided, Medi -Cal provider payments to be reduced, as specified. This bill would appropriate a specified sum to the State Department ofDevelopmental Services to, commencing July 1, 2016, among other things, increase rates and wages for certain developmental services providers and fund incentive payments for competitive integrated employment opportunities and internships for individuals with developmental disabilities. The bill would require the department to submit a rate study to specified committees of the Legislature on or before March 1, 2019, regarding community-based services for individuals with developmental disabilities. The bill would require each regional center to report specified information to the department regarding increased funding for regional center operations. The bill would, for dates of service on or after August 1, 2016, increase the payment rates for intermediate care facilities and skilled nursing facilities that provide services to developmentally disabled individuals under the Medi -Cal program, as specified. The bill would also prohibit the State Department of Health Care Services from seeking to retroactively implement certain Medi -Cal provider payment reductions and limitations with regards to ❑2 97 3.b Packet Pg. 44 CO N r N X CO a a E w m m Y E t v R —3— AB 1 reimbursements for services provided by skilled nursing facilities that are distinct parts of general acute care hospitals for dates of service on or after June 1, 2011, and on or before September 30, 2013, and from seeking to recoup overpayments, as specified. Existing law requires the department and regional centers to annually collaborate to compile specified data relating to purchase of service authorization, utilization, and expenditure by each regional center. Existing law requires each regional center to annually report to the department regarding the regional center's implementation of these requirements, including whether the data indicates a need to reduce disparities in the purchase ofservices among consumers in the regional center's catchment area and the regional center's recommendations and plan to promote equity, and reduce disparities, in the purchase of services. Existing law requires the department to consult with specified stakeholders to review the data, develop recommendations to help reduce disparities in purchase of service expenditures, and encourage development and expansion of culturally appropriate services, among other things, and to report the status of its efforts during the 2016-17 legislative budget subcommittee hearing process. The bill would also require the department, subject to available funding, to allocate funding to regional centers to assist in implementing specified recommendations and plans, including the recommendations and plans of the regional centers to promote equity, and reduce disparities, in the purchase of services. Existing law requires an entity that receives payments between $250, 000 and $500, 000 per year from one or more regional centers to obtain either an independent audit or an independent review report of its financial statements, and requires an entity that receives payments that are equal to or more than $500,000 per year to obtain an independent audit. This bill would instead require an entity that receives payments between $500,000 and $2,000,000 from one or more regional centers to obtain an independent review report of its financial statements, and would authorize these entities to apply for, and require the regional center to grant, a 2 -year exemption from this requirement ifthe regional center does not find issues in the independent review report that have an impact on regional center services. The bill would require an entity that receives payments from one or more regional centers that are equal to or more than $2, 000, 000 to obtain an independent audit and would authorize these entities to apply for, and require the regional center to ❑2 97 3.b Packet Pg. 45 CO CO N N x Ca a Z E W m m Y c w E t v R AB 1 —4— grant, a 2 -year exemption from the audit requirement if the audit resulted in an unmodified opinion, an unmodified opinion with additional communication, or a qualified opinion with issues that are not material. The bill would require a regional center to annually report to the State Department of Developmental Services any exemptions granted pursuant to these provisions. eeitters to provide sefviees and suppofts to individuals with other publiely funded agetteies. thaf establishes ftniding gottrees mid meeliallignis in order to pro -fide Provided idd+ _ _g _ _1 Vote: ftt&jff4tr2/3. Appropriation: eyes. Fiscal committee: rfa yes. State -mandated local program: no. The people of the State of California do enact as follows: 1 SECTION 1. Section 4519.5 of the Welfare and Institutions 2 Code is amended to read: 3 4519.5. (a) The department and the regional centers shall 4 annually collaborate to compile data in a uniform manner relating 5 to purchase of service authorization, utilization, and expenditure 6 by each regional center with respect to all of the following: 7 (1) The age of the consumer, categorized by the following: 8 (A) Birth to age two, two years of age, inclusive. 9 (B) Three tom 21 years of age inclusive. 10 (C) Twenty-two years of age and older. ❑2 97 3.b Packet Pg. 46 N X Fa a M E d N N Q C O Y R N d J Y R N M M N r —5— AB 1 1 (2) Race or ethnicity of the consumer. 2 (3) Primary language spoken by the consumer, and other related 3 details, as feasible. 4 (4) Disability detail, in accordance with the categories 5 established by subdivision (a) of Section 4512, and, if applicable, 6 a category specifying that the disability is unknown. 7 (5) Residence type, subcategorized by age, race or ethnicity, 8 and primary language. 9 (6) Number of instances when the written copy of the individual 10 program plan was provided at the request of the consumer and, 11 when appropriate, his or her parents, legal guardian or conservator, 12 or authorized representative, in a language other than a threshold 13 language, as defined by paragraph (3) of subdivision (a) of Section 14 1810.410 of Title 9 of the California Code of Regulations, if that 15 written copy was provided more than 60 days after the request. 16 (b) The data reported pursuant to subdivision (a) shall also 17 include the number and percentage of individuals, categorized by 18 age, race or ethnicity, and disability, and by residence type, as set 19 forth in paragraph (5) of subdivision (a), who have been determined 20 to be eligible for regional center services but are not receiving 21 purchase of service funds. 22 (c) By March 31, 2013, each regional center shall post the data 23 described in this section that is specific to the regional center on 24 its Internet Web site. Commencing on December 31, 2013, each 25 regional center shall annually post this data by December 31. Each 26 regional center shall maintain all previous years' data on its Internet 27 Web site. 28 (d) By March 31, 2013, the department shall post the information 29 described in this section on a statewide basis on its Internet Web 30 site. Commencing December 31, 2013, the department shall 31 annually post this information by December 31. The department 32 shall maintain all previous years' data on its Internet Web site. 33 The department shall also post notice of any regional center 34 stakeholder meetings on its Internet Web site. 35 (e) Within three months of compiling the data with the 36 department, and annually thereafter, each regional center shall 37 meet with stakeholders in one or more public meetings regarding 38 the data. The meeting or meetings shall be held separately from 39 any meetings held pursuant to Section 4660. The regional center 40 shall provide participants of these meetings with the data and any ❑2 97 3.b Packet Pg. 47 AB 1 1 associated information, and shall conduct a discussion of the data 2 and the associated information in a manner that is culturally and 3 linguistically appropriate for that community, including providing 4 alternative communication services, as required by Sections 11135 5 to 11139.7, inclusive, of the Government Code and implementing 6 regulations. Regional centers shall inform the department of the 7 scheduling of those public meetings 30 days prior to the meeting. 8 Notice of the meetings shall also be posted on the regional center's 9 Internet Web site 30 days prior to the meeting and shall be sent to 10 individual stakeholders and groups representing underserved 11 communities in a timely manner. Each regional center shall, in 12 holding the meetings required by this subdivision, consider the 13 language needs of the community and shall schedule the meetings 14 at times and locations designed to result in a high turnout by the 15 public and underserved communities. 16 (f) (1) Each regional center shall annually report to the 17 department regarding its implementation of the requirements of 18 this section. The report shall include, but shall not be limited to, 19 all of the following: 20 (A) Actions the regional center took to improve public 21 attendance and participation at stakeholder meetings, including, 22 but not limited to, attendance and participation by underserved 23 communities. 24 (B) Copies of minutes from the meeting and attendee comments. 25 (C) Whether the data described in this section indicates a need 26 to reduce disparities in the purchase of services among consumers 27 in the regional center's catchment area If the data does indicate 28 that need, the regional center's recommendations and plan to 29 promote equity, and reduce disparities, in the purchase of services. 30 (2) Each regional center and the department shall annually post 31 the reports required by paragraph (1) on its Internet Web site by 32 August 31. 33 (g) (1) The department shall consult with stakeholders, 34 including consumers and families that reflect the ethnic and 35 language diversity of regional center consumers, regional centers, 36 advocates, providers, the protection and advocacy agency described 37 in Section 4901, and those entities designated as University Centers 38 for Excellence in Developmental Disabilities Education, Research, 39 and Service pursuant to Section 15061 of Title 42 of the United 40 States Code, to achieve the following objectives: ❑2 97 3.b Packet Pg. 48 N X Fa a B E w m m c 0 Y R N w J Y R N M M N —7— AB 1 1 (A) Review the data compiled pursuant to subdivision (a). 2 (B) Identify barriers to equitable access to services and supports 3 among consumers and develop recommendations to help reduce 4 disparities in purchase of service expenditures. 5 (C) Encourage the development and expansion of culturally 6 appropriate services, service delivery, and service coordination. 7 (D) Identify best practices to reduce disparity and promote 8 equity. 9 (2) The department shall reportthe status of its efforts to satisfy 10 the requirements of paragraph (1) during the 2016-17 legislative 11 budget subcommittee hearing process. 12 (h) Subject to available funding, the department shall allocate 13 funding to regional centers to assist with implementation of the 14 recommendations and plans developed pursuant to subdivisions 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 (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. SEC. 2. Section 4519.8 is added to the Welfare and Institutions Code, to read: 4519.8. On or before March 1, 2019, the department shall submit a rate study to the appropriate fiscal and policy committees of the Legislature addressing the sustainability, quality, and transparency of community-based services for individuals with developmental disabilities. The department shall consult with stakeholders, through the developmental services task force process, in developing the study. The study shall include, but not be limited to, all of thefollowing: (a) An assessment of the effectiveness of the methods used to pay each category ofcommunity service provider. This assessment shall include consideration of the following factors for each category of service provider: (1) Whether the current method of ratesetting for a service category provides an adequate supply ofproviders in that category, including, but not limited to, whether there is a sufficient supply ofproviders to enable consumers throughout the state to have a choice ofproviders, depending upon the nature of the service. ❑2 97 3.b Packet Pg. 49 N L( Fa a B E w m m c 0 Y R N w J Y R N M M N AB 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 0 (2) A comparison of the estimated fiscal effects of alternative rate methodologies for each service provider category. (3) How different rate methodologies can incentivize outcomes for consumers. (b) An evaluation of the number and type of service codes for regional center services, including, but not limited to, recommendations for simplifying and making service codes more reflective of the level and types of services provided. SEC. 3. Section 4639.5 of the Welfare and Institutions Code is amended to read: 4639.5. (a) By December 1 of each year, each regional center shall provide a listing to the State Department of Developmental Services a complete current salary schedule for all personnel classifications used by the regional center. The information shall be provided in a format prescribed by the department. The department shall provide this information to the public upon request. From February 1, 2009, to June 30, 2010, inclusive, the requirements of this subdivision shall not apply. (b) By December 1 of each year, each regional center shall report information to the State Department of De-velopmenta+ Seff iees department on all prior fiscal year expenditures from the regional center operations budget for all administrative services, including managerial, consultant, accounting, personnel, labor relations, and legal services, whether procured under a written contract or otherwise. Expenditures for the maintenance, repair, or purchase of equipment or property shall not be required to be reported for purposes of this subdivision. The report shall be prepared in a format prescribed by the department and shall include, at a minimum, for each recipient the amount of funds expended, the type of service, and purpose of the expenditure. The department shall provide this information to the public upon request. Regional centers shall not be required to prepare or submit the report required by this subdivision in 2009. (c) Beginning July I, 2016, and to the extent funds are appropriated in the annual Budget Act for this purpose, the department shall allocate thirty-one million one hundred thousand dollars ($31,100,000), plus any associated matching funds, to provide a salary increase, benefit increase, or both, excluding unfunded retirement liabilities, for regional center operations. Of this amount, twenty-nine million seven hundred thousand dollars 97 3.b Packet Pg. 50 CO CO N N L( m a B E W m m Y c w E t v R AB 1 1 ($29,700, 000) shall be used for salary, benefit increases, or both, 2 for regional center staff, and shall not supplant funding currently 3 scheduled to be used for this purpose. These funds shall not be 4 used to provide salary or benefit increases to regional center 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 0 executive staffor for unfunded retirement liabilities. The remaining one million four hundred thousand dollars ($1,400,000) shall be used for an increase for administrative costs, consistent with those specified in subdivision (b) of Section 4629.7, for both regional centers and clients' rights advocates contracts pursuant to subdivision (b) of Section 4433. Regional centers shall maintain documentation, subject to audit, on how this funding was allocated. (d) By March 10, 2017, and again by October 1, 2017, and in a formatprescribed by the department, each regional center shall report the following information to the department: (1) The total amountprovided to staffforpurposes ofsubdivision (c). (2) The position titles ofstaffreceiving the increase and amounts of increases by title. (3) The number of service coordinators receiving the increase. (4) Data on staff turnover. (5) The classification of expenditures and amount for each of the administrative costs outlined in subdivision (b) of Section 4629.7. (6) The allocation methodology used by a regional center to distribute the funding. (7) Any other information determined by the department. (e) In its 2017-18MayRevisionfiscal estimate, the department shall describe the implementation of the increase provided in subdivision (c), including, but not limited to, the data described in subdivision (d), aggregated by regional center and statewide, and the impact of the increase on caseload ratios. (f) Any regional center that fails to report the information required by subdivision (d) to the department shall forfeit the increases described in subdivision (c). SEC. 4. Section 4652.5 of the Welfare and Institutions Code is amended to read: 4652.5. (a) (1) An entity-reeeiairtg that receives payments from one or more regional centers shall contract with an independent accounting firm for tm to obtain an independent audit or independent review report of its financial statements relating 97 3.b Packet Pg. 51 N X Fa a B E w m m c 0 Y R N w J Y R N M M N AB 1 —10- 1 to payments made by regional centers, subject tom both of the 2 following: 3 (A)*Rteit--If the amount received from the regional center or 4 regional centers during the entity's fiscal year is more than or equal 5 to, five hundred 6 thousand dollars ($500, 000), but less than `- '---- red 4--------' 7 dtwo million dollars ($2,000,000), the entity 8 shall obtain an independent review report of 9 its financial statements for the period. Consistent with Subchapter 10 21 (commencing with Section 58800) of Chapter 3 ofDivision 2 11 of Title 17 of the California Code of Regulations, this subdivision 12 shall also apply to work activity program providers receiving less 13 than . five hundred 14 thousand dollars ($500, 000). 15 (B)*Atett--If the amount received from the regional center or 16 regional centers during the entity's fiscal year is equal to or more 17 than two million dollars 18 ($2, 000, 000), the entity shall obtain an independent audit of its 19 financial statements for the period. 20 (2) This requirement does not apply to payments made using 21 usual and customary rates, as defined by Title 17 of the California 22 Code of Regulations, for services provided by regional centers. 23 (3) This requirement does not apply to state and local 24 governmental agencies, the University of California, or the 25 California State University. 26 (b) An entity subject to subdivision (a) shall provide copies of 27 the independent audit or independent review report required by 28 subdivision (a), and accompanying management letters, to the 29 vendoring regional center within 30 attdit or review.nine months of the end of the fiscal year for the 31 entity. 32 (c) Regional centers reeeiving that receive the audit or review 33 reports required by subdivision (b) shall review and require 34 resolution by the entity for issues identified in the report that have 35 an impact on regional center services. Regional centers shall take 36 appropriate action, up to termination of vendorization, for lack of 37 adequate resolution of issues. 38 (d) Regional centers shall notify the department of all qualified 39 opinion reports or reports noting significant issues that directly or ❑2 97 3.b Packet Pg. 52 N X Fa a B E w m m c 0 Y R N w J Y R N M M N —11— AB 1 1 indirectly impact regional center services within 30 days after 2 receipt. Notification shall include a plan for resolution of issues. 3 (e) For purposes of this section, an independent review of 4 financial statements must shall be performed by an independent 5 accounting firm and shall cover, at a minimum, all of the following: 6 (1) An inquiry as to the entity's accounting principles and 7 practices and methods used in applying them. 8 (2) An inquiry as to the entity's procedures for recording, 9 classifying, and summarizing transactions and accumulating 10 information. 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 0 (3) Analytical procedures designed to identify relationships or items that appear to be unusual. (4) An inquiry about budgetary actions taken at meetings of the board of directors or other comparable meetings. (5) An inquiry about whether the financial statements have been properly prepared in conformity with generally accepted accounting principles and whether any events subsequent to the date of the financial statements would have a material effect on the statements under review. (6) Working papers prepared in connection with a review of financial statements describing the items covered as well as any unusual items, including their disposition. (f) For purposes of this section, an independent review report shall cover, at a minimum, all of the following: (1) Certification that the review was performed in accordance with standards established by the American Institute of Certified Public Accountants. (2) Certification that the statements are the representations of management. (3) Certification that the review consisted of inquiries and analytical procedures that are lesser in scope than those of an audit. (4) Certification that the accountant is not aware of any material modifications that need to be made to the statements for them to be in conformity with generally accepted accounting principles. (g) The department shall not consider a request for adjustments to rates submitted in accordance with Title 17 of the California Code of Regulations by an entity receiving payments from one or more regional centers solely to fund either anticipated or unanticipated changes required to comply with this section. 97 3.b Packet Pg. 53 N X Fa a Z E w m m c 0 Y R N w J Y R N M M N AB —12- 1 (h) (1) An entity required to obtain an independent review 2 report of its financial statement pursuant to subparagraph (A) of 3 paragraph (1) of subdivision (a) may apply to the regional center 4 for, and the regional center shall grant, a two-year exemption from 5 the independent review report requirement if the regional center 6 does not find issues in the prior year's independent review report 7 that have an impact on regional center services. 8 (2) An entity required to obtain an independent audit of its 9 financial statements pursuant to subparagraph (B) of paragraph 10 (1) of subdivision (a) may apply to the regional center for an 11 exemptionfrom the independent audit requirement, subject to both 12 of the following conditions: 13 (A) If the independent audit for the prior year resulted in an 14 unmodified opinion or an unmodified opinion with additional 15 communication, the regional center shall grant the entity a 16 two-year exemption. 17 (B) If the independent audit for the prior year resulted in a 18 qualified opinion and the issues are not material, the regional 19 center shall grant the entity a two-year exemption. The entity and 20 the regional center shall continue to address issues raised in this 21 independent audit, regardless ofwhether the exemption is granted. 22 (3) A regional center shall annually report to the department 23 any exemptions granted pursuant to this subdivision. 24 SEC. 5. Section 4689.8 of the Welfare and Institutions Code 25 is amended to read: 26 4689.8. Notwithstanding any other—previ4err4 law or 27 regulation, commencing July 1, 2008: 28 (a) No regional center may pay an existing supported living 29 service provider, for services where rates are determined through 30 a negotiation between the regional center and the provider, a rate 31 higher than the rate in effect on June 30, 2008, unless the increase 32 is required by a contract between the regional center and the vendor 33 that is in effect on June 30, 2008, or the regional center 34 demonstrates that the approval is necessary to protect the 35 consumer's health or safety and the department has granted prior 36 written authorization. 37 (b) No regional center may negotiate a rate with anew supported 38 living service provider, for services where rates are determined 39 through a negotiation between the regional center and the provider, 40 that is higher than the regional center's median rate for the same ❑2 97 3.b Packet Pg. 54 N L( Fa a Z E w m m c 0 Y R N w J Y R N M M N —13— AB 1 service code and unit of service, or the statewide median rate for 2 the same service code and unit of service, whichever is lower. The 3 unit of service designation shall conform with an existing regional 4 center designation or, if none exists, a designation used to calculate 5 the statewide median rate for the same service. The regional center 6 shall annually certify to the State Department of Developmental 7 Services its median rate for each negotiated rate service code, by 8 designated unit of service. This certification shall be subject to 9 verification through the department's biennial fiscal audit of the 10 regional center. 11 (c) Notwithstanding any other law or regulation, commencing 12 July 1, 2016, and to the extent funds are appropriated in the annual 13 BudgetAct for this purpose, the rates in effect on June 30, 2016, 14 for supported living services, as defined in Subchapter 19 of 15 Chapter 3 of Division 2 of Title 17 of the California Code of 16 Regulations, shall be increased by 5 percent. The increase shall 17 be applied as a percentage, and the percentage shall be the same 18 for all providers. 19 SEC. 6. Section 4690.5 of the Welfare and Institutions Code 20 is amended to read: 21 4690.5. Notwithstanding any other-1%revi4on--e€ law or 22 regulation, commencing July 1, 2006, 2016, and to the extent funds 23 are appropriated in the annual Budget Act for this purpose, the 24 rate for family member -provided respite services authorized by 25 the department and in operation June 30, 2996, 2016, shall be 26 increased by 27 for t4iis itterease in t4te Budget,ket of 2 5 percent. The increase 28 shall be applied as a percentage, and the percentage shall be the 29 same for all providers. 30 SEC. 7. Section 4691.6 of the Welfare and Institutions Code 31 is amended to read: 32 4691.6. (a) Notwithstanding any other law or regulation, 33 commencing July 1, 2006, the community-based day program, 34 work activity program, and in-home respite service agency rate 35 schedules authorized by the department and in operation June 30, 36 2006, shall be increased by 3 percent, subject to funds specifically 37 appropriated for this increase in the Budget Act of 2006. The 38 increase shall be applied as a percentage, and the percentage shall 39 be the same for all providers. Any subsequent increase shall be ❑2 97 3.b Packet Pg. 55 N L( Fa a M E w m m c 0 Y R N w J Y R N M M N AB 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 0 —14— governed by subdivisions (b), (c), (d), (e), (f), (g), (h), (i), (k), and (l), and Section 4691.9. (b) Notwithstanding any other law or regulation, the department shall not establish any permanent payment rate for a community-based day program or in-home respite service agency provider that has a temporary payment rate in effect on June 30, 2008, if the permanent payment rate would be greater than the temporary payment rate in effect on or after June 30, 2008, unless the regional center demonstrates to the department that the permanent payment rate is necessary to protect the consumers' health or safety. (c) Notwithstanding any other law or regulation, neither the department nor any regional center shall approve any program design modification or revendorization for a community-based day program or in-home respite service agency provider that would result in an increase in the rate to be paid to the vendor from the rate that is in effect on or after June 30, 2008, unless the regional center demonstrates that the program design modification or revendorization is necessary to protect the consumers' health or safety and the department has granted prior written authorization. (d) Notwithstanding any other law or regulation, the department shall not approve an anticipated rate adjustment for a community-based day program or in-home respite service agency provider that would result in an increase in the rate to be paid to the vendor from the rate that is in effect on or after June 30, 2008, unless the regional center demonstrates that the anticipated rate adjustment is necessary to protect the consumers' health or safety. (e) Notwithstanding any other law or regulation, except as set forth in subdivisions (f) and (i), the department shall not approve any rate adjustment for a work activity program that would result in an increase in the rate to be paid to the vendor from the rate that is in effect on or after June 30, 2008, unless the regional center demonstrates that the rate adjustment is necessary to protect the consumers' health and safety and the department has granted prior written authorization. (f) Notwithstanding any other law or regulation, commencing July 1, 2014, the department may approve rate adjustments for a work activity program that demonstrates to the department that the rate adjustment is necessary in order to pay employees who, prior to July 1, 2014, were being compensated at a wage that is 97 3.b Packet Pg. 56 CO CO N N x Ca a Z E W m m Y c w E t v R _15— AB 1 1 less than the minimum wage established on and after July 1, 2014, 2 by Section 1182.12 of the Labor Code, as amended by Chapter 3 351 of the Statutes of 2013. The rate adjustment pursuant to this 4 subdivision shall be specific to payroll costs associated with any 5 increase necessary to adjust employee pay only to the extent 6 necessary to bring pay into compliance with the increased state 7 minimum wage, and shall not constitute a general wage 8 enhancement for employees paid above the increased minimum 9 wage. 10 (g) Notwithstanding any other law or regulation, commencing 11 July 1, 2014, community-based day program and in-home respite 12 services agency providers with temporary payment rates set by 13 the department may seek unanticipated rate adjustments from the 14 department due to the impacts of the increased minimum wage as 15 established by Section 1182.12 of the Labor Code, as amended by 16 Chapter 351 of the Statutes of 2013. The rate adjustment shall be 17 specific to payroll costs associated with any increase necessary to 18 adjust employee pay only to the extent necessary to bring pay into 19 compliance with the increased state minimum wage, and shall not 20 constitute a general wage enhancement for employees paid above 21 the increased minimum wage. 22 (h) Notwithstanding any other law or regulation, commencing 23 January 1, 2015, the in-home respite service agency rate schedule 24 authorized by the department and in operation December 31, 2014, 25 shall be increased by 5.82 percent, subject to funds specifically 26 appropriated for this increase for costs due to changes in federal 27 regulations implementing the federal Fair Labor Standards Act of 28 1938 (29 U.S.C. Sec. 201 et seq.). The increase shall be applied 29 as a percentage, and the percentage shall be the same for all 30 applicable providers. 31 (i) Notwithstanding any other law or regulation, commencing 32 July 1, 2015, the department may approve rate adjustments for a 33 work activity program that demonstrates to the department that 34 the rate adjustment is necessary to implement Article 1.5 35 (commencing with Section 245) of Chapter 1 of Part 1 of Division 36 2 of the Labor Code, as added by Chapter 317 of the Statutes of 37 2014. The rate adjustment may be applied only if a minimum of 38 24 hours or three days of paid sick leave per year was not a benefit 39 provided to employees as of June 30, 2015, and shall be specific 40 to payroll costs associated with any increase necessary to ❑2 97 3.b Packet Pg. 57 N X Fa a Z E w m m c 0 Y R N w J Y R N M M N 3.b AB 1 —16- 1 16- 1 compensate an employee up to a maximum of 24 hours or three 2 days of paid sick leave in each year of employment. 3 0) Notwithstanding any other law or regulation, commencing 4 July 1, 2015, community-based day program and in-home respite 5 services agency providers with temporary payment rates set by 6 the department may seek unanticipated rate adjustments from the 7 department if the adjustment is necessary to implement Article 1.5 8 (commencing with Section 245) of Chapter 1 of Part 1 of Division 9 2 of the Labor Code, as added by Chapter 317 of the Statutes of 10 2014. The rate adjustment may be applied only if a minimum of 11 24 hours or three days of paid sick leave per year was not a benefit 12 provided to employees as of June 30, 2015, and shall be specific 13 to payroll costs associated with any increase necessary to N 14 compensate an employee up to a maximum of 24 hours or three x 15 days of paid sick leave in each year of employment. m 16 (k) Notwithstanding any other law or regulation, commencing 17 July 1, 2016, and to the extent funds are appropriated in the annual w 18 Budget Act for this purpose, the in-home respite service agency 19 rate schedule authorized by the department and in operation June 20 30, 2016, shall be increased by 5 percent. The increase shall be c 21 applied as a percentage, and the percentage shall be the same for R 22 all providers. A 23 (l) Notwithstanding any other law or regulation, commencing 24 July 1, 2016, and to the extent funds are appropriated in the annual w 25 Budget Act for this purpose, the independent living service rate .2 26 schedule authorized by the department and in operation June 30, 27 2016, shall be increased by 5 percent. The increase shall be applied 28 as a percentage, and the percentage shall be the same for all 29 providers. 30 SEC. 8. Section 4691.9 of the Welfare and Institutions Code x 31 is amended to read: m 32 4691.9. (a) Notwithstanding any other law or regulation, a 33 commencing July 1, 2008: E 34 (1) A regional center shall not pay an existing service provider, 35 for services where rates are determined through a negotiation 36 between the regional center and the provider, a rate higher than 37 the rate in effect on June 30, 2008, unless the increase is required 38 by a contract between the regional center and the vendor that is in 39 effect on June 30, 2008, or the regional center demonstrates that ❑2 97 Packet Pg. 58 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 —17— AB the approval is necessary to protect the consumer's health or safety and the department has granted prior written authorization. (2) A regional center shall not negotiate arate with anew service provider, for services where rates are determined through a negotiation between the regional center and the provider, that is higher than the regional center's median rate for the same service code and unit of service, or the statewide median rate for the same service code and unit of service, whichever is lower. The unit of service designation shall conform with an existing regional center designation or, if none exists, a designation used to calculate the statewide median rate for the same service. The regional center shall annually certify to the State Department of Developmental Services its median rate for each negotiated rate service code, by designated unit of service. This certification shall be subject to verification through the department's biennial fiscal audit of the regional center. (b) Notwithstanding subdivision (a), commencing July 1, 2014, regional centers may negotiate a rate adjustment with providers regarding rates if the adjustment is necessary in order to pay employees no less than the minimum wage as established by Section 1182.12 of the Labor Code, as amended by Chapter 351 of the Statutes of 2013, and only for the purpose of adjusting payroll costs associated with the minimum wage increase. The rate adjustment shall be specific to the unit of service designation that is affected by the increased minimum wage, shall be specific to payroll costs associated with any increase necessary to adjust employee pay only to the extent necessary to bring pay into compliance with the increased state minimum wage, and shall not be used as a general wage enhancement for employees paid above the increased minimum wage. Regional centers shall maintain documentation on the process to determine, and the rationale for granting, any rate adjustment associated with the minimum wage increase. (c) Notwithstanding any other law or regulation, commencing January 1, 2015, rates for personal assistance and supported living services in effect on December 31, 2014, shall be increased by 5.82 percent, subject to funds specifically appropriated for this increase for costs due to changes in federal regulations implementing the federal Fair Labor Standards Act of 1938 (29 U.S.C. Sec. 201 et seq.). The increase shall be applied as a ❑2 97 3.b Packet Pg. 59 co co N N L( m a Z E W m m Y c w E t v R AB 1 1 percentage, and the percentage shall be the same for all applicable 2 providers. As used in this subdivision, both of the following 3 definitions shall apply: 4 (1) "Personal assistance" is limited only to those services 5 provided by vendors classified by the regional center as personal 6 assistance providers, pursuant to the miscellaneous services 7 provisions contained in Title 17 of the California Code of 8 Regulations. 9 (2) "Supported living services" are limited only to those services 10 defined as supported living services in Title 17 of the California 11 Code of Regulations. 12 (d) Notwithstanding subdivision (a), commencing July 1, 2015, 13 regional centers may negotiate a rate adjustment with existing 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 0 service providers for services for which rates are determined through negotiation between the regional center and the provider, if the adjustment is necessary to implement Article 1.5 (commencing with Section 245) of Chapter 1 of Part 1 of Division 2 of the Labor Code, as added by Chapter 317 of the Statutes of 2014. The rate adjustment may be applied only if a minimum of 24 hours or three days of paid sick leave per year was not a benefit provided to employees as of June 30, 2015, and shall be specific to payroll costs associated with any increase necessary to compensate an employee up to a maximum of 24 hours or three days of paid sick leave in each year of employment. (e) Notwithstanding any other law or regulation, commencing July 1, 2016, and to the extent funds are appropriated in the annual Budget Act for this purpose, rates for transportation services in effect on June 30, 2016, shall be increased by 5 percent. The increase shall be applied as a percentage to existing rates, and the percentage shall be the same for all applicable providers. (f) This section shall not apply to those services for which rates are determined by the State Department of Health Care Services, or the State Department of Developmental Services, or are usual and customary. SEC. 9. Section 4691.10 is added to the Welfare and Institutions Code, to read: 4691.10. (a) (I) Notwithstanding any other law or regulation, and to the extent funds are appropriated in the annual BudgetAct for this purpose, the department shall provide a rate increase for 97 3.b Packet Pg. 60 N L( Fa a B E w m m c 0 Y R N w J Y R N M M N —19— AB 1 1 the purpose of enhancing wages and benefits for staff who spend 2 a minimum of 75 percent of their time providing direct services to 3 consumers. The department shall not allocate more than one 4 hundred sixty-nine million five hundred thousand dollars 5 ($169,500, 000) of the amount appropriated in the act that added 6 this section for this purpose, plus any associated matching funds. 7 The rate increase shall only apply to services for which rates are 8 set by the department or through negotiations between the regional 9 centers and service providers, and to the rates paid for supported 10 employment services, as specified in subdivisions (a) and (b) of 11 Section 4860, and vouchered community-based services, as 12 specified in paragraph (7) of subdivision (c) of Section 4688.21. 13 This section shall not apply to those services for which rates are 14 determined by other entities, including, but not limited to, the State 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 Department of Health Care Services or the State Department of Social Services, or are usual and customary. (2) For the purposes of this subdivision, "direct services" are services, supports, care, supervision, or assistance provided by staff directly to a consumer to address the consumer's needs, as identified in the individual program plan, and include staff's participation in training and other activities directly related to providing services to consumers, as well as program preparation functions as defined in Section 54302 of Title 17 of the California Code of Regulations. State employees participating in the Community State Staff Program are ineligible for the wage increase described in this section. (b) The rate increase specified in subdivision (a) shall be implemented in the following manner: (1) With regional center participation, the department shall conduct a survey of random sample ofservice providers in each service category eligible for the rate increase. The survey shall request information regarding all of the following and shall be returned to the regional center and department by April 15, 2016: (A) Number of employees who spend a minimum of 75 percent oftheir time providing direct services to consumers and their total salary, wage, and benefit costs. (B) Administrative costs as specified in subdivision (b) of Section 4629.7, including the number ofemployees and total salary, wage, and benefit costs associated with those administrative costs. ❑2 97 3.b Packet Pg. 61 N X Fa a B E w m m c 0 Y R N w J Y R N M M N AB 1 —20- 1 (C) Any other staff and their total salary, wage, and benefit 2 costs that are not included in either subparagraph (A) or (B). 3 (D) Any other costs to the provider, other than the costs 4 described in subparagraphs (A) to (C), inclusive. 5 (E) Any additional information, as requested by the department, 6 to assist in the determination of rate increases. 7 (2) The vendoring regional center shall certify that, to the best 8 of its knowledge, the survey results accurately reflect the services 9 provided by each surveyed service provider. The results from the 10 survey shall be used by the department to determine the rate 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 0 increase to be applied, by service category. The rate increase shall be the same for all eligible providers in each service category and is intended to provide comparable increases across service categories for staff providing direct services as described in subdivision (a). (3) By July 1, 2016, utilizing the data derived from paragraph (1), the department shall do both of the following: (A) For those service providers whose rates are set by the department, notify those providers and the associated regional centers of the amount by which the rates are to be increased. (B) For those service providers whose rates are set by negotiation with the regional center, notify the regional center of the amount by which the rates are to be increased. (4) With regional center participation, the department shall conduct a survey, in a format determined by the department, ofall providers who received the rate increase described in subdivision (a). Providers shall submit the completed survey to the department by October 1, 2017. The survey shall request information on how the rate increase was used by providers and shall include, but is not limited to, the following: (A) Number of employees and their salary, wage, and benefit costs, and increases provided as a result of this subdivision. (B) Percentage of time each employee spends providing direct services. (C) Administrative expenses, consistent with subdivision (b) of Section 4629.7. (D) Any additional information as determined by the department. (c) Providers granted a rate increase pursuant to this section shall maintain documentation, subject to audit by the department or regional center, that the rate increase was used solely to 97 3.b Packet Pg. 62 N LC Fa a Z E W m m c 0 Y R N w J Y R N M M N —21— AB 1 1 increase wages, salaries, and benefits of eligible staff members 2 spending a minimum of 75 percent of their time providing direct 3 services to consumers. 4 (d) The rate increases calculated by the department pursuant 5 to this section shall be effective July 1, 2016, and implemented as 6 described in subdivision (b). 7 (e) Any provider that fails to report the information required 8 byparagraph (4) of subdivision (b) to the department by October 9 1, 2017, shall forfeit the increases described in subdivision (a). 10 (J) In its 2017-18MayRevision fiscal estimate, the department 11 shall describe the implementation of the increases provided 12 pursuant to this section. 13 SEC. 10. Section 4691.11 is added to the Welfare and 14 Institutions Code, to read: 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 0 4691.11. Notwithstanding any other law or regulation, and to the extent funds are appropriated in the annual BudgetAct for this purpose, the department shall allocate no more than nine million nine hundred thousand dollars ($9,900, 000) plus any associated matching funds for the purpose of administrative expenses for service providers. The department shall provide a rate increase for the purpose of administrative expenses that shall apply only to providers for which rates are set by the department or through negotiations between the regional centers and service providers, and to the rates paid for supported employment services, as specified in subdivisions (a) and (b) of Section 4860, and vouchered community-based services, as specified in paragraph (7) of subdivision (c) of Section 4688.21. This increase shall be determined using the information collected pursuant to subdivision (b) of Section 4691.10. This increase shall be consistent for providers within each service category and is intended to provide comparable increases for administrative expenses across service categories. This section shall not apply to those services for which rates are determined by other entities, including, but not limited to, the State Department of Health Care Services or the State Department of Social Services, or are usual and customary. SEC. 11. Section 4860 of the Welfare and Institutions Code is amended to read: 4860. (a) (1) The hourly rate for supported employment services provided to consumers receiving individualized services . is thirty-four 97 3.b Packet Pg. 63 N X Fa a Z E w m m c 0 Y R N w J Y R N M M N AB 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 0 —22— dollars and twenty-four cents ($34.24). The rate shall be adjusted by the department pursuant to subdivision (a) of Sections 4691.10 and 4691.11. (2) Job coach hours spent in travel to consumer worksites may be reimbursable for individualized services only when the job coach travels from the vendor's headquarters to the consumer's worksite or from one consumer's worksite to another, and only when the travel is one way. (b) The hourly rate for group services eighty two eents , is thirty-four dollars and twenty four cents ($34.24), regardless of the number of consumers served in the group. Consumers in a group shall be scheduled to start and end work at the same time, unless an exception that takes into consideration the consumer's compensated work schedule is approved in advance by the regional center. The department, in consultation with stakeholders, shall adopt regulations to define the appropriate grounds for granting these exceptions. When the number of consumers in a supported employment placement group drops to fewer than the minimum required in subdivision (r) of Section 4851, the regional center may terminate funding for the group services in that group, unless, within 90 days, the program provider adds one or more regional centers, or Department of Rehabilitation -funded supported employment consumers to the group. The rate shall be adjusted by the department pursuant to subdivision (a) of Sections 4691.10 and 4691.11. (c) Job coaching hours for group services shall be allocated on a prorated basis between a regional center and the Department of Rehabilitation when regional center and Department of Rehabilitation consumers are served in the same group. (d) When Section 4855 applies, fees shall be authorized for the following: (1) A three -hundred -sixty -dollar ($360) fee shall be paid to the program provider upon intake of a consumer into a supported employment program. No fee shall be paid if that consumer completed a supported employment intake process with that same supported employment program within the previous 12 months. (2) A seven -hundred -twenty -dollar ($720) fee shall be paid upon placement of a consumer in an integrated job, except that no fee shall be paid if that consumer is placed with another consumer 97 3.b Packet Pg. 64 CO CO N N L( m a Z E W m m Y c w E t v R —23— AB 1 1 or consumers assigned to the same job coach during the same hours 2 of employment. 3 (3) A seven -hundred -twenty -dollar ($720) fee shall be paid after 4 a 90 -day retention of a consumer in a j ob, except that no fee shall 5 be paid if that consumer has been placed with another consumer 6 or consumers, assigned to the same job coach during the same 7 hours of employment. 8 (e) Notwithstanding paragraph (4) of subdivision (a) of Section 9 4648, the regional center shall pay the supported employment 10 program rates established by this section. 11 (J) The department, with regional center participation, shall 12 conduct an annual survey ofproviders, in a format determined by 13 the department, to collect the following information: 14 (1) The number of employment placements in the previous 12 15 months. 16 (2) Types of employment in which consumers are placed. 17 (3) The cost components ofthe rates in subdivisions (a) and (b), 18 including, but not limited to, the amount used for hourly wages of 19 job coaches, administration, and placement search costs. 20 (4) The number of hours each consumer works and the 21 consumer's hourly wage. 22 (5) Any other information determined by the department. 23 (g) In its 2017-18MayRevision fiscal estimate, the department 24 shall describe the results of the survey described in subdivision 25 (j). 26 SEC. 12. Section 4870 is added to the Welfare and Institutions 27 Code, to read: 28 4870. (a) To encourage competitive integrated employment 29 opportunities statewide for individuals with developmental 30 disabilities, the department shall establish guidelines and oversee 31 a program, to the extent funds are appropriated in the annual 32 Budget Act for this purpose, to increase paid internship 33 opportunities for individuals with developmental disabilities that 34 produce outcomes consistent with the individual program plan. 35 The department shall consult with the State Council on 36 Developmental Disabilities, regional centers, employers, supported 37 employmentprovider organizations, and clients'rights advocates, 38 to establish a program that shall be administered by community 39 service providers and that meets all of the following criteria: ❑2 97 3.b Packet Pg. 65 N X Fa a M E w m m c 0 Y R N w J Y R N M M N AB 1 —24- 1 (1) Payments for internships shall not exceed ten thousand four 2 hundred dollars ($10,400) per year for each individual placed in 3 an internship. 4 (2) Placements shall be made into competitive, integrated work 5 environments. 6 (3) Placements shall be made into internships that develop skills 7 that will facilitate paid employment opportunities in the future. 8 (4) Regional centers shall increase awareness of these 9 internships to consumers outside ofcurrent employmentprograms 10 through outreach to consumers once the program is implemented, 11 as well as during the individual program plan process. 12 (b) The department shall require annual reporting by regional 13 centers and vendors that ensures program accountability and 14 achievement ofprogram goals. This shall include, but is not limited 15 to, all of the following: 16 (1) The number ofinterns placed who might not otherwise have 17 achieved the placement absent this internship program. 18 (2) Types of employment in which interns are placed. 19 (3) Length of internships. 20 (4) Demographic information of interns. 21 (5) Amount of each intern placement payment. 22 (6) Employment-related supports provided by another agency 23 or individual to the intern. 24 (7) Number of interns who subsequently entered paid 25 employment, including salary and benefit information. 26 (8) Any additional information, as determined by the department. 27 (c) The department shall include in its annual May Revision 28 fiscal estimate a description of the implementation of the program, 29 including, but not limited to, a description of the stakeholder 30 consultation, the data described in subdivision (b), aggregated by 31 regional center and statewide, and any recommendations for 32 program changes that may be necessary or desirable to maximize 33 program effectiveness and accountability. 34 (d) Consistent with the individual program plan, the program 35 shall increase sustained and appropriate competitive integrated 36 employment placements by providers of supported employment 37 services, as defined in subdivision (p) of Section 4851, as follows: 38 (1) A payment of one thousand dollars ($1, 000) to the supported 39 employment services provider for initial placements made on or 40 after July 1, 2016, in competitive integrated employment, as defined ❑2 97 3.b Packet Pg. 66 N X Fa a Z E w m m c 0 Y R N w J Y R N M M N —25— AB 1 1 in subdivision (o) of Section 4851 and subdivision (d) of Section 2 4868. 3 (2) An additional payment of one thousand two hundred fifty 4 dollars ($1,250) to the supported employment services provider 5 for an individual described in paragraph (1) who remains in 6 competitive integrated employment for six consecutive months. 7 (3) An additional payment ofone thousand five hundred dollars 8 ($1,500) to the supported employment services provider for an 9 individual described in paragraphs (1) and (2) who remains in 10 competitive integrated employment for 12 consecutive months. 11 (e) Regional centers shall annually report to the department 12 the payments for placements pursuant to subdivision (d). The 13 information shall be reported in a format determined by the 14 department, and shall include the number ofindividuals placed in 15 internships or other employment as described in this section each 16 year. 17 SEC. 13. Section 14105.075 is added to the Welfare and 18 Institutions Code, to read: 19 14105.075. (a) Notwithstanding any other law, for dates of 20 service on or after August 1, 2016, payments to intermediate care 21 facilities for the developmentally disabled that are licensed 22 pursuantto subdivision (e), (g), or (h) ofSection 1250 oftheHealth 23 and Safety Code, and to facilities providing continuous skilled 24 nursing care to developmentally disabled individuals pursuant to 25 the pilot project established by Section 14132.20, as determined 26 by the applicable methodology for setting reimbursement rates for 27 those facilities, shall be the reimbursement rates that were 28 applicable to those facilities in the 2008 09 rate year, increased 29 by 3.7 percent. Payments to the facilities pursuant to this section 30 shall also include the projected cost of complying with new state 31 or federal mandates to the extent applicable to the reimbursement 32 methodology associated with the type offacility. 33 (b) The director shall seek any necessary federal approvals to 34 implement this section. This section shall not be implemented until 35 the necessary federal approval is obtained, and only to the extent 36 federal financial participation is available. If, and only to the 37 extent, federal approval is obtained to implement this section, the 38 payments resulting from the application of subdivision (a) shall 39 be implemented retroactively to August 1, 2016, or any later ❑2 97 3.b Packet Pg. 67 N X Fa a B E w m m c 0 Y R N w J Y R N M M N AB 1 —26- 1 effective date identified in the federal approval that is obtained, 2 as applicable. 3 SEC. 14. Section 14105.195 is added to the Welfare and 4 Institutions Code, to read: 5 14105.195. (a) Notwithstanding Sections 14105.191 and 6 14105.192, the department shall not seek to retroactively implement 7 the reductions and limitations to the reimbursement for services 8 provided by skilled nursing facilities that are distinct parts of 9 general acute care hospitals set forth in Sections 14105.191 and 10 14105.192 for dates of service on or after June 1, 2011, and on or 11 before September 30, 2013. For purposes of this section, "distinct 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 0 part" has the same meaning as defined in Section 72041 of Title 22 of the California Code ofRegulations. (b) The department shall not seek to recoup any overpayments from skilled nursing facilities that are distinct parts of general acute care hospitals resulting from the reductions and limitations to the reimbursement for these facilities pursuant to Sections 14105.191 and 14105.192 for dates of service on or after June 1, 2011, and on or before September 30, 2013. (c) Notwithstanding Chapter 3.5 (commencing with Section 11340) ofPart I ofDivision 3 of Title 2 of the Government Code, the department may implement this section by means of provider bulletins or notices, policy letters, or other similar instructions, without taking regulatory action. SEC. 15. (a) The sum of two hundred eighty-seven million dollars ($287,000,000) is hereby appropriated from the General Fund to the State Department ofDevelopmental Services to provide all of the following, effective July 1, 2016: (1) Twenty-nine million seven hundred thousand dollars ($29,700, 000) for regional centers for staff, in an allocation to be determined by the department. (2) One million four hundred thousand dollars ($1,400, 000) for regional centers for administrative costs, in an allocation to be determined by the department. This amount includes an amount to be allocated by the departmentfor regional center clients'rights advocates contracts pursuant to subdivision (b) of Section 4433. (3) Nine million nine hundred thousand dollars ($9,900,000) for administrative costs for service providers, in an allocation to be determined by the department. 97 3.b Packet Pg. 68 N X Fa a B E w m m c 0 Y R N w J Y R N M M N —27— AB 1 1 (4) One hundred sixty-nine million five hundred thousand dollars 2 ($169,500,000) for a rate increase for staff providing direct 3 services employed by a community-based provider organization, 4 in a manner to be determined by the department. 5 (5) A 5 -percent rate increase for supported and independent 6 living services. 7 (6) Twenty million dollars ($20,000,000) for competitive 8 integrated employment incentive payments. 9 (7) A 5 -percent rate increase for in-home and out -of -home 10 respite services. 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 (8) A 5 -percent increase for transportation services. (9) A three -dollar -and forty -two -cent ($3.42) per hour rate increase for supported employment providers. (10) Eleven million dollars ($11,000,000) for bilingual staff at regional centers and implementing plans and recommendations to address disparities. (b) These funds shall be available for encumbrance until June 30, 2017, and available for expenditure until June 30, 2019. SEC. 16. The increases in rates and payments provided for in this act shall be effective July 1, 2016, and August 1, 2016, as expressly provided in this act, unless otherwise provided in this act. SEGTION 1. It is the itttettt of the f7egislature to etitwt O 0 97 3.b Packet Pg. 69 N X Fa a Z E W m m c 0 Y R N w J Y R N M M N