Today's Law As Amended

Add To My Favorites | print page

AB-1244 Developmental services: Self-Determination Program.(2011-2012)



SECTION 1.

 Section 4677 of the Welfare and Institutions Code is amended to read:

4677.
 (a) (1) All parental fees collected by or for regional centers shall be remitted to the State Treasury to be deposited in the Developmental Disabilities Program Development Fund, which is hereby created in the State Treasury  and hereinafter called the Program Development Fund. The purpose of the Program Development Fund shall be to provide resources needed to initiate new programs, and to expand or convert existing programs. Within the context of, and consistent with, approved priorities for program development in the state plan, program development funds shall promote integrated residential, work, instructional, social, civic, volunteer, and recreational services and supports that increase opportunities for self-determination and maximize maximum  independence of persons with developmental disabilities. Notwithstanding any other provision of  law or regulation,  regulation to the contrary,  commencing July 1, 2009, parental fees remitted to the State Treasury shall be deposited in accordance with Section 4784.
(2) An  In no event shall an  allocation from the Program Development Fund shall not  be granted for more than 24 months.
(b) (1) The State Council on Developmental Disabilities shall, at least once every five years, request from all regional centers information on the types and amounts of services and supports needed, but currently unavailable.
(2) The state council shall work collaboratively with the department and the Association of Regional Center Agencies to develop standardized forms and protocols that shall be used by all regional centers and the state council  area boards  in collecting and reporting this information. In addition to identifying services and supports that are needed, but currently unavailable, the forms and protocols shall also solicit input and suggestions on alternative and innovative service delivery models that would address consumer needs.
(3) In addition to the information provided pursuant to paragraph (2), the state council may utilize information from other sources, including, but not limited to, public hearings, quality assurance assessments conducted pursuant to Section 4571, regional center reports on alternative service delivery submitted to the department pursuant to Section 4669.2, and the annual report on self-directed  Self-Determination Program  services produced pursuant to Section 4685.7. 4689.94. 
(4) The department shall provide additional information, as requested by the state council.
(5) Based on the information provided by the regional centers and other agencies, the state council shall develop an assessment of the need for new, expanded, or converted community services and supports, support,  and make that assessment available to the public. The assessment shall include a discussion of the type and amount of services and supports necessary but currently unavailable including the impact on consumers with common characteristics, including, but not limited to, disability, specified geographic regions, age, and ethnicity, who  face distinct challenges. The assessment shall highlight alternative and innovative service delivery models identified through their assessment process.
(6) This needs assessment shall be conducted at least once every five years and updated annually. The assessment shall be included in the state plan and shall be provided to the department and to the appropriate committees of the Legislature. The assessment and annual updates shall be made available to the public. The state council,  State Council on Developmental Disabilities,  in consultation with the department, shall make a recommendation to the Department of Finance as to the level of funding for program development to be included in the Governor’s Budget, based upon this needs assessment.
(c) Parental fee schedules shall be evaluated pursuant to Section 4784 and adjusted annually, as needed, by the department, with the approval of the state council. The July 1, 2009, parental fee adjustment shall be exempt from this approval requirement. Fees for out-of-home care shall bear an equitable relationship to the cost of the care and the ability of the family to pay.
(c) (d)  In addition to parental fees and General Fund appropriations, the Program Development Fund may be augmented by federal funds available to the state for program development purposes, when these funds are allotted to the Program Development Fund in the state plan. The Program Development Fund is available, upon appropriation by the Legislature,  hereby appropriated  to the department, and subject to any  allocations that may be made in the annual Budget Act. These funds shall not  In no event shall any of these funds  revert to the General Fund.
(d) (e)  Notwithstanding any other requirement of this section, and to the extent appropriated for this purpose in the annual Budget Act, the  The  department may allocate funds from the Program Development Fund for the purpose of funding projects approved pursuant to Section 4679. any legal purpose, provided that requests for proposals and allocations are approved by the state council in consultation with the department, and are consistent with the priorities for program development in the state plan. Allocations from the Program Development Fund shall take into consideration the following factors: 
(1) The future fiscal impact of the allocations on other state-supported services and supports for persons with developmental disabilities.
(2) The information on priority services and supports needed, but currently unavailable, submitted by the regional centers.
Consistent with the level of need as determined in the state plan, excess parental fees may be used for purposes other than programs specified in subdivision (a) only when specifically appropriated to the State Department of Developmental Services for those purposes.
(e) (f)  The  Under no circumstances shall the  deposit of federal moneys into the Program Development Fund shall not  be construed as requiring the State Department of Developmental Services to comply with a definition of “developmental disabilities” and “services for persons with developmental disabilities” other than as specified in subdivisions (a) and (b) of Section 4512 for the purposes of determining eligibility for developmental services or for allocating parental fees and state general funds deposited in the Program Development Fund.

SEC. 2.

 Section 4678 of the Welfare and Institutions Code is amended to read:

4678.
 (a) The State Council on Developmental Disabilities, in implementing subdivision (b) of Section 4677, and with the support of the State Department of Developmental Services, shall convene a stakeholder workgroup on alternative and expanded options for nonresidential services and supports. The workgroup shall include persons with developmental disabilities, family members, providers, and other system stakeholders. The workgroup shall develop recommendations on how to best achieve all of the following:
(1) The development and expansion of community-based models that provide an array of nonresidential options, including, but not limited to, participation in integrated instructive, social, civic, volunteer, and recreational activities.
(2) The development and expansion of community-based work activities, including, but not limited to, customized employment development, integrated job training, and employer-provided job coaching.
(3) The expansion of work opportunities in the public sector.
(4) The increased utilization of existing models, including, but not limited to, self-directed  Self-Determination Program  services, vouchers, family teaching models, existing habilitation, and supported work vendors to facilitate access to nontraditional community-based nonresidential activities.
(5) Strategies to promote and duplicate successful and innovative models developed in California and in other states.
(6) The identification of, and strategies to address, statutory, regulatory, licensing, vendor-related, funding funding,  and other types of barriers to achieving the goals identified in this act, including strategies to improve individualization of services and supports by increased flexibility in design, staffing, and compensation.
(b) By May 1, 2007, the State Council on Developmental Disabilities shall submit recommendations from the workgroup to the Governor and appropriate committees of the Legislature and may, thereafter, incorporate subsequent recommendations into its state plan developed pursuant to Section 4561.

SEC. 3.

 Section 4685.7 of the Welfare and Institutions Code is repealed.

4685.7.
 (a) Contingent upon approval of a federal waiver, the Self-Directed Services Program (SDS Program) is hereby established and shall be available in every regional center catchment area to provide participants, within an individual budget, greater control over needed services and supports. The Self-Directed Services Program shall be consistent with the requirements set forth in this section. In order to provide opportunities to participate in the program, the department shall adopt regulations, consistent with federal law, to implement the procedures set forth in this section.
(b) For purposes of this section, the following definitions shall apply:
(1) “Financial management services” means a service or function that assists the participant to manage and direct the distribution of funds contained in the individual budget. This may include, but is not limited to, bill paying services and activities that facilitate the employment of service workers by the participant, including, but not limited to, federal, state, and local tax withholding payments, unemployment compensation fees, setting of wages and benefits, wage settlements, fiscal accounting, and expenditure reports. The department shall establish specific qualifications which shall be required of a financial management services provider.
(2) “Supports brokerage” means a service or function that assists participants in making informed decisions about the individual budget, and assists in locating, accessing and coordinating services consistent with and reflecting a participant’s needs and preferences. The service is available to assist in identifying immediate and long-term needs, developing options to meet those needs, participating in the person-centered planning process and development of the individual program plan, and obtaining identified supports and services.
(3) “Supports broker” means a person, selected and directed by the participant, who fulfills the supports brokerage service or function and assists the participant in the SDS Program. Specific qualifications shall be established by the department and required of a supports broker provider.
(4) “Waiver” means a waiver of federal law pursuant to Section 1396n of Title 42 of the United States Code.
(5) “Independence Plus Self-Directed (IPSD) Waiver Program” or “Self-Directed Waiver Program” means a federal waiver to the state’s Medicaid plan to allow a person with developmental disabilities who needs or requires long-term supports and services, and when appropriate, the person’s family, greater opportunity to control his or her own health and well-being by utilization of self-directed services.
(6) “Self-directed services” or “SDS” means a voluntary delivery system consisting of a defined and comprehensive mix of services and supports, selected and directed by a participant, in order to meet all or some of the objectives in his or her individual program plan. Self-directed services are designed to assist the participant to achieve personally defined outcomes in inclusive community settings.
Self-directed services shall include, but are not limited to, all of the following:
(A) Home health aide services.
(B) Supported employment and prevocational services.
(C) Respite services.
(D) Supports broker functions and services.
(E) Financial management services and functions.
(F) Environmental accessibility adaptations.
(G) Skilled nursing.
(H) Transportation.
(I) Specialized medical equipment and supplies.
(J) Personal emergency response system.
(K) Integrative therapies.
(L) Vehicle adaptations.
(M) Communication support.
(N) Crises intervention.
(O) Nutritional consultation.
(P) Behavior intervention services.
(Q) Specialized therapeutic services.
(R) Family assistance and support.
(S) Housing access supports.
(T) Community living supports, including, but not limited to, socialization, personal skill development, community participation, recreation, leisure, home and personal care.
(U) Advocacy services.
(V) Individual training and education.
(W) Participant-designated goods and services.
(X) Training and education transition services.
The department shall include all of the services and supports listed in this paragraph in the IPSD Waiver Program application. Notwithstanding this paragraph, only services and supports included in an approved IPSD Waiver shall be funded through the SDS Program.
(7) “Advocacy services” means services and supports that facilitate the participant in exercising his or her legal, civil and service rights to gain access to generic services and benefits that the participant is entitled to receive. Advocacy services shall only be provided when other sources of similar assistance are not available to the participant, and when advocacy is directed towards obtaining generic services.
(8) “Individual budget” means the amount of funding available to the participant for the purchase of services and supports necessary to implement an individual program plan. The individual budget shall be constructed using a fair, equitable, and transparent methodology.
(9) “Risk pool” means an account that is available for use in addressing the unanticipated needs of participants in the SDS Program.
(10) “Participant” means an individual, and when appropriate, his or her parents, legal guardian or conservator, or authorized representative, who have been deemed eligible for, and have voluntarily agreed to participate in, the SDS Program.
(c) Participation in the SDS Program is fully voluntary. A participant may choose to participate in, and may choose to leave, the SDS Program at any time. A regional center may not require participation in the SDS Program as a condition of eligibility for, or the delivery of, services and supports otherwise available under this Division.
(d) The department shall develop informational materials about the SDS Program. The department shall ensure that regional centers are trained in the principles of SDS, the mechanics of the SDS Program and the rights of consumers and families as candidates for, and participants, in the SDS Program. Regional centers shall conduct local meetings or forums to provide regional center consumers and families with information about the SDS Program. All consumers and families who express an interest in participating in the SDS program shall receive an in-depth orientation, conducted by the regional center, prior to enrollment in the program.
(e) Prior to enrollment in the SDS Program, and based on the methodologies described below, an individual, and when appropriate, his or her parents, legal guardian or conservator, or authorized representative, shall be provided in writing two individual budget amounts. If the individual, and when appropriate his parents, legal guardian or conservator, or authorized representative, elects to become a participant in the SDS Program, he or she shall choose which of the two budget amounts provided will be used to implement their individual program plan.
(1) The methodologies and formulae for determining the two individual budget amounts shall be detailed in departmental regulations, as follows:
(A) One individual budget amount shall equal 90 percent of the annual purchase of services costs for the individual. The annual costs shall reflect the average annual costs for the previous two fiscal years for the individual.
(B) One individual budget amount shall equal 90 percent of the annual per capita purchase of service costs for the previous two fiscal years for consumers with similar characteristics, who do not receive services through the SDS Program, based on factors including, but not limited to, age, type of residence, type of disability and ability, functional skills, and whether the individual is in transition. This budget methodology shall be constructed using data available on the State Department of Developmental Services information system.
(2) Once a participant has selected an individual budget amount, that individual budget amount shall be available to the participant each year for the purchase of self-directed services until a new individual budget amount has been determined. An individual budget amount shall be calculated no more than once in a 12-month period.
(3) As determined by the participant, the individual budget shall be distributed among the following budget categories in order to implement the IPP:
(A) Community Living.
(B) Health and Clinical Services.
(C) Employment.
(D) Training and Education.
(E) Environment and Medical Supports.
(F) Transportation.
(4) Annually, participants may transfer up to 10 percent of the funds originally distributed to any budget category set forth in paragraph (3), to another budget category or categories. Transfers in excess of 10 percent of the original amount allocated to any budget category may be made upon the approval of the regional center. Regional centers may only deny a transfer if necessary to protect the health and safety of the participant.
(5) The regional center shall annually ascertain from the participant whether there are any circumstances that require a change to the annual individual budget amount. The department shall detail in regulations the process by which this annual review shall be achieved.
(6) A regional center’s calculation of an individual budget amount may be appealed to the executive director of the regional center, or his or her designee, within 30 days after receipt of the budget amount. The executive director shall issue a written decision within 10 working days. The decision of the executive director may be appealed to the Director of Developmental Services, or his or her designee, within 15 days of receipt of the written decision. The decision of the department is final.
(f) The department shall establish a risk pool fund to meet the unanticipated needs of participants in the SDS Program. The fund shall be administered by the department. Notwithstanding Section 13340 of the Government Code, all moneys in the fund shall be continuously appropriated to the department, without regard to fiscal years, for the purpose of funding services and supports pursuant to this subdivision.
(1) The risk pool shall be funded at the equivalent of 5 percent of the historic annual purchase of service costs for consumers participating in the SDS Program.
(2) The risk pool shall be allocated by the department to regional centers through a process specified by the department.
(3) The risk pool may be used only in the event of substantial change in a participant’s service and support needs that were not known at the time the individual budget was set, including an urgent need to relocate a residence, and catastrophic injury or illness.
(4) The risk pool may be accessed by a participant more than once in a lifetime.
(g) In the first year of the SDS Program, the department shall provide for establishment of savings to the General Fund equivalent to 5 percent of the historic annual purchase of service costs for SDS program participants. In subsequent fiscal years, the department shall annually provide for establishment of savings to the General Fund equivalent to 5 percent of the annual purchase of services costs for SDS Program participants, averaged over the prior two fiscal years.
(h) A regional center may advance funds to a financial management services entity pursuant to SDS Program regulations to facilitate development of a participant’s individual budget and transition into the SDS Program.
(i) Participation in the SDS Program shall be available to any regional center consumer who meets the following eligibility requirements.
(1) The participant is three years of age or older.
(2) The participant has a developmental disability, as defined in Section 4512.
(3) The participant does not live in a licensed long-term health care facility, as defined in paragraph (44) of subdivision (a) of Section 54302 of Title 17 of the California Code of Regulations, or a residential facility, as defined in paragraph (55) of subdivision (a) of Section 54302 of Title 17 of the California Code of Regulations, or receive day program or habilitation services, as defined in paragraph (16) or (34) of subdivision (a) of Section 54302 of Title 17 of the California Code of Regulations, respectively. An individual, and when appropriate, his or her parent, legal guardian or conservator, or authorized representative, who is not eligible to participate in the SDS Program pursuant to this paragraph, may request that the regional center provide person-centered planning services in order to make arrangements for transition to the SDS Program. In that case, the regional center shall initiate person-centered planning services within 60 days of a request.
(4) The participant agrees to all of the following terms and conditions:
(A) The participant shall undergo an in-depth orientation to the SDS Program prior to enrollment.
(B) The participant shall agree to utilize the services and supports available within the SDS Program only when generic services cannot be accessed, and except for Medi-Cal state plan benefits when applicable.
(C) The participant shall consent to use only services necessary to implement his or her individual program plan as described in the IPSD Waiver Program, and as defined in paragraph (6) of subdivision (b), as an available service in the SDS Program, and shall agree to comply with any and all other terms and conditions for participation in the SDS Program described in this section.
(D) The participant shall manage self-directed services within the individual budget amount, chosen pursuant to subdivision (e).
(E) The participant shall utilize the services of a financial management services entity of his or her own choosing. A financial management services provider may either be hired or designated by the participant. A designated financial management services provider shall perform services on a nonpaid basis. An individual or a parent of an individual in the SDS Program shall provide financial management services only as a designated provider and only if the capacity to fulfill the roles and responsibilities as described in the financial management services provider qualifications can be demonstrated to the regional center.
(F) The participant shall utilize the services of a supports broker of his or her own choosing for the purpose of providing services and functions as described in paragraphs (2) and (3) of subdivision (b). A supports broker may either be hired or designated by the participant. A designated supports broker shall perform support brokerage services on a nonpaid basis. An individual or a parent of an individual in the SDS Program shall provide supports brokerage services or his or her designated representative shall provide the services only as a designated provider and only if the capacity to fulfill the role and responsibilities as described in the supports broker provider qualifications can be demonstrated to the financial management services entity.
(j) A participant who is not Medi-Cal eligible may participate in the SDS Program without IPSD Waiver Program enrollment and receive self-directed services if all other IPSD Waiver Program eligibility requirements are met.
(k) The planning team, established pursuant to subdivision (j) of Section 4512, shall utilize the person-centered planning process to develop the Individual Program Plan (IPP) for an SDS participant. The IPP shall detail the goals and objectives of the participant that are to be met through the purchase of participant selected services and supports.
(l) The participant shall implement his or her IPP, including choosing the services and supports allowable under this section necessary to implement the plan. A regional center may not prohibit the purchase of any service or support that is otherwise allowable under this section.
(m) An adult may designate an authorized representative to effect the implementation. The representative shall meet all of the following requirements:
(1) He or she shall demonstrate knowledge and understanding of the participant’s needs and preferences.
(2) He or she shall be willing and able to comply with SDS Program requirements.
(3) He or she shall be at least 18 years of age.
(4) He or she shall be approved by the participant to act in the capacity of a representative.
(n) The participant, or his or her authorized representative and the regional center case manager shall receive a monthly budget statement that describes the amount of funds allocated by budget category, the amount spent in the previous 30-day period, and the amount of funding that remains available under the participant’s individual budget.
(o) If at any time during participation in the SDS Program a regional center determines that an individual is no longer eligible to continue based on the criteria described in subdivision (i), or a participant voluntarily chooses to exit the SDS Program, the regional center shall provide for the participant’s transition from the SDS Program to other services and supports. This shall include the development of a new individual program plan that reflects the services and supports necessary to meet the individual’s needs. The regional center shall ensure that there is no gap in services and supports during the transition period.
(1) Upon determination of ineligibility pursuant to this subdivision, the regional center shall inform the participant in writing of his or her ineligibility, the reason for the determination of ineligibility and shall provide a written notice of the fair hearing rights, as required by Section 4701.
(2) An individual determined ineligible, or who voluntarily exits the SDS Program, shall be permitted to return to the SDS Program upon meeting all applicable eligibility criteria and after a minimum of 12 months time has elapsed.
(p) A participant in the SDS Program shall have all the rights established in Chapter 7 (commencing with Section 4700), except as provided under paragraph (6) of subdivision (e).
(q) Only a financial management services provider is required to apply for vendorization in accordance with Subchapter 2 (commencing with Section 54300) of Chapter 3 of Title 17 of the California Code of Regulations, for the SDS Program. All other service providers shall have applicable state licenses, certifications, or other state required documentation, but are exempt from the vendorization requirements set forth in Title 17 of the California Code of Regulations. The financial management services entity shall ensure and document that all service providers meet specified requirements for any service that may be delivered to the participant.
(r) A participant in the SDS Program may request, at no charge to the participant or the regional center, criminal history background checks for persons seeking employment as a service provider and providing direct care services to the participant.
(1) Criminal history records checks pursuant to this subdivision shall be performed and administered as described in subdivision (b) and subdivisions (d) to (h), inclusive, of Section 4689.2, and Sections 4689.4 to 4689.6, inclusive, and shall apply to vendorization of providers and hiring of employees to provide services for family home agencies and family homes.
(2) The department may enter into a written agreement with the Department of Justice to implement this subdivision.
(s) A participant enrolled in the SDS Program pursuant to this section and utilizing an individual budget for services and supports is exempt from Section 4783 and from the Family Cost Participation Program.
(t) Notwithstanding any provision of law, an individual receiving services and supports under the self-determination projects established pursuant to Section 4685.5 may elect to continue to receive self-determination services within his or her current scope and existing procedures and parameters. Participation in a self-determination project pursuant to Section 4685.5 may only be terminated upon a participant’s voluntary election and qualification to receive services under another delivery system.
(u) Each regional center shall be responsible for implementing an SDS Program as a term of its contract under Section 4629.
(v) Commencing January 10, 2008, the department shall annually provide the following information to the policy and fiscal committees of the Legislature:
(1) Number and characteristics of participants, by regional center.
(2) Types and ranking of services and supports purchased under the SDS Program, by regional center.
(3) Range and average of individual budgets, by regional center.
(4) Utilization of the risk pool, including range and average individual budget augmentations and type of service, by regional centers.
(5) Information regarding consumer satisfaction under the SDS Program and, when data is available, the traditional service delivery system, by regional center.
(6) The proportion of participants who report that their choices and decisions are respected and supported.
(7) The proportion of participants who report they are able to recruit and hire qualified service providers.
(8) The number and outcome of individual budget appeals, by regional center.
(9) The number and outcome of fair hearing appeals, by regional center.
(10) The number of participants who voluntarily withdraw from participation in the SDS Program and a summary of the reasons why, by regional center.
(11) The number of participants who are subsequently determined to no longer be eligible for the SDS Program and a summary of the reasons why, by regional center.
(12) Identification of barriers to participation and recommendations for program improvements.
(13) A comparison of average annual expenditures for individuals with similar characteristics not participating in the SDS Program.

SEC. 4.

 Article 4.5 (commencing with Section 4689.90) is added to Chapter 6 of Division 4.5 of the Welfare and Institutions Code, to read:

Article  4.5. Self-Determination Program
4689.90.
 For the purposes of this section, the following definitions shall apply:
(a) “Advocacy services” means services and supports that facilitate the participant in exercising his or her legal, civil, and service rights to gain access to generic services and benefits that the participant is entitled to receive. Advocacy services shall be provided only when other sources of similar assistance are not available to the participant, and when advocacy is directed toward obtaining generic services.
(b) “Financial management service” means a conflict-of-interest free service or function that assists the participant to manage and direct the distribution of funds contained in the individual allocation. This may include, but is not limited to, (1) bill paying services and activities that facilitate the employment of service workers by the participant, including, but not limited to, federal, state, and local tax withholding payments, (2) unemployment compensation fees, (3) providing benefits, including workers’ compensation and health insurance benefits, to the extent that they are or become available to SD support workers, (4) fiscal accounting, and (5) expenditure reports. The financial management service shall provide to the department workforce and expenditure information as required in this article. The department shall establish specific qualifications which shall be required of a financial management services provider and contract with one entity to provide financial management services statewide.
(c) “Individual allocation” means the amount of funding available to the participant for the purchase of services and supports necessary to implement an individual program plan (IPP). The individual allocation shall be constructed using a fair, equitable, and transparent methodology.
(d) “Individual budget” means an individually created and designed expenditure plan, developed by the participant, for purchases to be made within the individual allocation to achieve the core quality outcomes relevant to the participant and meet the participant’s IPP goals.
(e) “Participant” means an individual, and when appropriate, his or her parents, legal guardian or conservator, or authorized representative, who has been deemed eligible for, and has voluntarily agreed to participate in, the Self-Determination Program.
(f) “Public Employment Relations Board” or “board” means the board established pursuant to Article 2 (commencing with Section 3541) of Chapter 10.7 of Division 4 of Title 1 of the Government Code.
(g) “Risk pool” means an account that is available for use in addressing the unanticipated needs of participants in the Self-Determination Program.
(h) “Self-Determination Program” or “SD Program” means a voluntary delivery system consisting of a defined and comprehensive mix of services and supports, selected and directed by a participant, in order to meet all or some of the objectives in his or her IPP. Self-determination services and supports are designed to assist the participant to achieve personally defined outcomes in inclusive community settings. Self-determination services and supports shall include, but are not limited to, all of the following:
(1) Home health aide services.
(2) Employment and self-employment supports, including individual placement-supported employment.
(3) Respite services.
(4) Supports broker functions and services.
(5) Financial management services and functions.
(6) Environmental accessibility adaptations.
(7) Skilled nursing.
(8) Transportation.
(9) Specialized medical equipment and supplies.
(10) Personal emergency response system.
(11) Integrative therapies.
(12) Vehicle adaptations.
(13) Communication support, including interpretive or translation services.
(14) Crises intervention.
(15) Nutritional consultation.
(16) Behavior intervention services.
(17) Specialized therapeutic services.
(18) Family assistance and support.
(19) Housing access supports.
(20) Community living supports, including, but not limited to, socialization, personal skill development, community participation, recreation, and leisure.
(21) In-home and personal care supports.
(22) Advocacy services.
(23) Individual training and education, including, but not limited to, adult education and support to attend community college.
(24) Participant-designated goods and services.
(25) Training and education transition services.
(i) “Self-determination support worker” or “SD support worker” means a person who has been selected and employed by a participant for an average of at least 25 hours per month over a two-month period to provide the relevant SD services and supports described in subdivision (h), but does not include licensed professionals and workers providing services purchased from agencies or other organizations where the worker is solely under the employ of those organizations.
(j) “Supports broker” means a person, selected and directed by the participant, who fulfills the supports brokerage service or function and assists the participant in the SD Program.
(k) “Supports brokerage” means a conflict-of-interest free service or function that assists participants in making informed decisions about how to develop their budget from the individual allocation, assists in locating, accessing, and coordinating services consistent with and reflecting a participant’s needs and preferences and negotiating with providers. A supports brokerage service is available to assist in identifying immediate and long-term needs, developing options to meet those needs, participating in the person-centered planning process and development of the IPP, and obtaining identified services and supports.
4689.91.
 (a) (1) Contingent upon approval of federal Medicaid matching funding, the Self-Determination Program is hereby established and shall be available in every regional center catchment area to enable individuals with developmental disabilities to exercise their rights to make choices in their own lives and access services and supports as described in subdivision (j) of Section 4502. The program shall give participants greater control over, increased flexibility and choice over, and the ability to access, a wide range of needed and desired services and supports, including, but not limited to, hiring their own workers and purchasing needed items. The SD Program shall be consistent with the requirements set forth in this section.
(2) SD Program participants shall be provided with a capitated individual funding allocation computed in a fair, transparent, and equitable manner, based on consumer characteristics and needs. The allocation shall be used for the purchase of services and supports necessary to implement the participant’s individual program plan (IPP).
(b) The SD Program shall be designed to promote, and shall be evaluated against, core quality outcomes for the participants, including, but not limited to, all of the following:
(1) Participants’ welfare, health, and safety.
(2) Participants living in a place called home, including living with family, friends, or on one’s own; adult participants’ living arrangements are under their own control.
(3) Participants having meaningful participation and membership in their own community.
(4) Participants maintaining reciprocal long-term relationships, including relationships that assist the participant to live a healthy, included life.
(5) Participants of working age generating private income, through typical jobs in regular employment settings or through self-employment.
(6) Participants having access to or control over transportation.
(7) Participants having access to a defined and comprehensive mix of services and supports that are selected and directed by a participant.
(8) Participants controlling and achieving personally defined outcomes in inclusive community settings.
(c) Participation in the SD Program is fully voluntary. A participant may choose to participate in, and may choose to leave, the SD Program at any time. A regional center may not require participation in the SD Program as a condition of eligibility for, or the delivery of, services and supports otherwise available under this division. Participation in the SD Program shall be available to any regional center consumer who meets the following eligibility requirements:
(1) The participant is three years of age or older.
(2) The participant and, when appropriate, his or her parents, legal guardian, conservator, or authorized representative, agrees to all of the following terms and conditions:
(A) The participant shall agree to utilize the services and supports available within the SD Program only when generic services cannot be accessed, and except for Medi-Cal state plan benefits when applicable.
(B) The participant shall consent to use only services necessary to implement his or her IPP, as an available service in the SD Program, and shall agree to comply with any and all other terms and conditions for participation in the SD Program described in this section.
(C) The participant shall manage SD Program services within the individual allocation amount.
(D) The participant shall utilize the services of the conflict of interest free financial management services entity.
(E) The participant shall utilize the services of a supports broker of his or her own choosing for the purpose of providing services and functions as described in subdivisions (j) and (k) of Section 4689.90. A supports broker may either be hired or designated by the participant. A designated supports broker shall perform support brokerage services on a nonpaid basis. An individual or a parent of an individual in the SD Program shall provide supports brokerage services only as an unpaid designated provider.
(3) A participant who is not Medi-Cal eligible may participate in the SD Program and receive SD Program services if all other program eligibility requirements are met.
(d) An adult may designate an authorized representative to participate in the program on his or her behalf. The representative shall meet all of the following requirements:
(1) He or she shall demonstrate knowledge and understanding of the participant’s needs and preferences.
(2) He or she shall be willing and able to comply with SD Program requirements.
(3) He or she shall be at least 18 years of age.
(4) He or she shall be approved by the participant to act in the capacity of a representative.
(e) Notwithstanding any provision of law, an individual receiving services and supports under the self-determination pilot projects originally established pursuant to Section 13 of Chapter 80 of the Statutes of 1998, as amended, may elect to continue to receive self-determination services within his or her current scope and existing procedures and parameters. Participation in self-determination projects originally authorized pursuant to Section 13 of Chapter 80 of the Statutes of 1998, as amended, may only be terminated upon a participant’s voluntary election and qualification to receive services under another delivery system.
(f) The SD Program shall be phased in during the first year in the five regional centers with self-determination pilot projects that were originally authorized by Section 13 of Chapter 80 of the Statutes of 1998, as amended. In the second year, each regional center shall be responsible for implementing an SD Program as a term of its contract under Section 4629.
4689.92.
 (a) The department shall develop informational materials about the SD Program. The department shall ensure that regional centers are trained in the principles of the SD Program, the mechanics of the SD Program, and the rights of consumers and families as candidates for, and participants in, the SD Program. Regional centers shall conduct local meetings or forums to provide regional center consumers and families with information about the SD Program. Regional centers shall make available to consumers and families who express an interest in participating in the SD Program a timely in-depth orientation; however, enrollment in the SD Program shall not be delayed or conditioned on the orientation.
(b) Prior to enrollment in the SD Program, and based on the methodology described in this subdivision, an individual and, when appropriate, his or her parents, legal guardian, conservator, or authorized representative shall be provided, in writing, two individual allocation amounts. The individual and, when appropriate, his or her parents, legal guardian, conservator, or authorized representative may then choose which of the two individual allocation amounts would be provided for developing his or her individual budget to implement his or her IPP. The individual and, when appropriate, his or her parents, legal guardian,conservator, or authorized representative may then elect to participate in the SD Program.
(1) The methodologies and formulae for determining the two individual allocation amounts shall be computed in a fair, transparent, and equitable manner. The methodologies shall specify the mechanism by which a consumer’s individual allocation shall be adjusted to allow for increases in the base compensation package established in Section 4689.93. The department shall meet with the Self-Determination Program Advisory Committee, established pursuant to Section 4689.94, to receive their input on developing the methodologies.
(2) The methodologies and formulae for determining the two individual allocation amounts shall be as follows:
(A) One individual allocation amount shall equal 90 percent of the annual purchase of services costs for the individual. The annual costs shall reflect the average annual costs for the individual for the previous two fiscal years.
(B) One individual allocation amount shall equal 90 percent of the annual per capita purchase of service costs for the previous fiscal year for consumers with similar characteristics, who do not receive services through the SD Program. The allocation methodology shall be constructed using data available on the State Department of Developmental Services’ information system, including, but not limited to, age, type of residence, type of disability and ability, functional skills, support needs, and whether the individual is in transition. Until the first full year of historical data is available, the department shall adjust the allocation to estimate the impact of service reductions resulting from the Budget Act of 2011.
(3) The allocation methodology shall provide for additional necessary resources when a participant is transitioning from a family home or a congregate setting to living independently.
(4) Once an individual and, when appropriate, his or her parents, legal guardian, conservator, or authorized representative, has elected to become an SD Program participant, his or her individual allocation amount shall be available to the participant each year for the purchase of SD Program services until a new individual allocation amount has been determined pursuant to paragraph (9) of subdivision (c). An individual allocation amount shall be calculated no more than once in a 12-month period.
(5) A regional center’s calculation of an individual allocation amount may be appealed to the executive director of the regional center, or his or her designee, within 30 days after receiving the statement of the allocation amount. The executive director of the regional center shall issue a written decision within 10 working days. The decision of the executive director may be appealed to the Director of Developmental Services, or his or her designee, within 15 days of receipt of the written decision. The decision of the department is final.
(c) Once an individual and, when appropriate, his or her parents, legal guardian, conservator, or authorized representative, has elected to become an SD Program participant and his or her individual allocation amount has been determined, the following shall occur:
(1) A regional center shall advance funds to the financial management services entity to support a participant’s hiring of a supports broker to assist with person-centered planning, budget development, and the Individual Program Plan, pursuant to paragraphs (2), (3), and (6). These funds shall be independent of the allocation computed pursuant to subdivision (b).
(2) The participant and, when appropriate, his or her parents, legal guardian, conservator, or authorized representative, with the assistance of the service broker and other members of his or her circle of support, if appropriate, shall develop a person-centered plan and individual budget within the amount of the individual allocation. The plan and budget shall be designed to assist the participant to achieve the relevant core quality outcomes specified in paragraphs (1) to (8), inclusive, of subdivision (b) of Section 4689.91.
(3) The individual budget shall enable participants to achieve personally defined outcomes in inclusive community settings, using services and supports selected and directed by the participant. The individual budget shall distribute the allocation, including expenditures for services and supports, among the following categories based on the core quality outcomes specified in paragraphs (1) to (6), inclusive, of subdivision (b) of Section 4689.91:
(A) Welfare, health, and safety.
(B) Supports for living in a place called home.
(C) Meaningful participation and membership in the community including, but not limited to, socialization, recreational, and educational opportunities.
(D) Developing and maintaining long-term relationships.
(E) Generating income, supports for employment, or self-employment.
(F) Transportation.
(4) A participant may not use any portion of his or her individual allocation to purchase services from a licensed long-term health care facility, as defined in paragraph (44) of subdivision (a) of Section 54302 of Title 17 of the California Code of Regulations, or a residential facility, as defined in paragraph (55) of subdivision (a) of Section 54302 of Title 17 of the California Code of Regulations. A participant may not use his or her individual allocation to purchase complete day program or habilitation services, as defined in paragraph (16) or (34) of subdivision (a) of Section 54302 of Title 17 of the California Code of Regulations, respectively. However, a participant may use a portion of his or her individual allocation to negotiate for specific periodic or one-time services from a day program or habilitation services provider. A participant may also use a portion of his or her allocation to purchase job development and job coaching services for individual placement-supported employment.
(5) Consumers currently living in a licensed long-term health care facility, as defined in paragraph (44) of subdivision (a) of Section 54302 of Title 17 of the California Code of Regulations, or a residential facility, as defined in paragraph (55) of subdivision (a) of Section 54302 of Title 17 of the California Code of Regulations, or receiving day program or habilitation services, as defined in paragraph (16) or (34) of subdivision (a) of Section 54302 of Title 17 of the California Code of Regulations, respectively, may request that the regional center provide person-centered planning services in order to make arrangements for transition to the SD Program. In that case, within 30 days of a request, the regional center shall initiate person-centered planning services pursuant to paragraphs (1) and (2).
(6) The planning team, established pursuant to subdivision (j) of Section 4512, shall review and utilize the person-centered plan developed in paragraph (2) to develop the IPP for the participant. The IPP shall detail the goals and objectives of the participant that are to be met through the purchase of participant-selected services and supports. The planning team shall also review the individual budget to ensure the budget assists the participant to achieve the relevant core quality outcomes identified in paragraphs (1) to (8), inclusive, of subdivision (b) of Section 4689.91, ensures his or her health and safety, and implements his or her IPP goals. The completed budget shall be attached to the IPP.
(7) The participant shall implement his or her IPP, including choosing the services and supports allowable under this section necessary to implement the plan. A regional center may not prohibit the purchase of any service or support that is otherwise allowable under this section.
(8) Annually, participants may transfer up to 20 percent of the funds originally distributed to any budget category set forth in paragraph (3), to another budget category or categories. Transfers in excess of 20 percent of the original amount allocated to any budget category may be made upon the approval of the regional center. Regional centers may only deny a transfer if necessary to protect the health and safety of the participant, or if the budgeted funds fail to address the core quality outcomes pursuant to paragraph (6).
(9) Consistent with the implementation date of the IPP, the regional center shall annually ascertain from the participant whether there are any circumstances that require a change to the annual individual allocation amount as calculated pursuant to subdivision (b). Based on that review, the regional center shall calculate a new budget amount based on the methodology described in subdivision (b). The participant may choose the new budget amount, or continue using the current amount. The IPP shall be amended to reflect any changes in the allocation.
(d) The department shall establish a risk pool fund to meet the unanticipated needs of participants in the SD Program. The fund is hereby administered by the department.
(1) The risk pool shall be funded at the equivalent of 2.5 percent of the historical annual purchase of service costs for consumers participating in the SD Program, as determined for consumers of similar characteristics pursuant to paragraph (2) of subdivision (b).
(2) The risk pool shall be allocated by the department to regional centers through a process specified by the department.
(3) The risk pool may be used only in the event of substantial change in a participant’s service and support needs that were not known at the time the individual allocation was set, including, but not limited to, an urgent need to relocate a residence or to prevent or respond to significant injury or illness.
(4) The risk pool may be accessed by a participant more than once in a lifetime.
(e) The department shall allocate 7.5 percent of the historical annual purchase of service costs for consumers participating in the SD Program, as determined for consumers of similar characteristics pursuant to paragraph (2) of subdivision (b), toward offsetting costs to the state of the SD Program with the remainder to be returned as savings to the General Fund. Program costs to the state shall include, but not be limited to, training of consumers, family members, regional centers, and service brokers, caseload ratio improvement, and service broker support for participants’ initial person-centered planning and budget plan development.
(f) The regional center service coordinator shall assist consumers and, when appropriate, their parents, legal guardian, conservator, or authorized representative, in understanding the SD Program service option, assist participants to understand their rights, responsibilities, and opportunities under the SD Program, and provide information on locating service brokers. The regional center service coordinator shall, as required by this section, determine the SD Program participant’s individual allocation amount, participate in the IPP, approve the initial individual budget and amendments to the budget, ensure plans and services are adequate to ensure the participants’ health, welfare, and safety, address the goals of the IPP and the core quality outcomes specified in paragraphs (1) to (8), inclusive, of subdivision (b) of Section 4689.91, monitor for abuse, fraud, and exploitation, monitor the quarterly budget report for rate of expenditure and consistency with the budget plan, annually ascertain from the participant whether there are any circumstances that require a change to the annual individual allocation amount, conduct quarterly visits as required by the department, and assist the participant to access the risk pool in the event of a substantial change in a participant’s service and support needs that was not known at the time the individual allocation was set. Regional centers, therefore, shall provide an average service coordinator-to-consumer ratio of 1 to 62 for all SD Program participants. To the maximum extent possible, regional centers shall assign SD Program participants to service coordinators with a designated SD Program caseload.
(g) The financial management service shall send to the participant and the regional center case manager a quarterly statement that describes the amount of allocation by budget category, the amount spent in the previous 90-day period, and the amount of funding that remains available under the participant’s individual budget.
(h) If at any time during participation in the SD Program a regional center determines that an individual is no longer eligible to continue based on the eligibility criteria described in subdivision (c) of Section 4689.91, or a participant voluntarily chooses to exit the SD Program, the regional center shall provide for the participant’s transition from the SD Program to other services and supports. This shall include the development of a new individual program plan that reflects the services and supports necessary to meet the individual’s needs. The regional center shall ensure that there is no gap in services and supports during the transition period.
(1) Upon determination of ineligibility pursuant to this subdivision, the regional center shall inform the participant in writing of his or her ineligibility, the reason for the determination of ineligibility, and shall provide a written notice of the fair hearing rights, as required by Section 4701.
(2) An individual determined to be ineligible, or who voluntarily exits the SD Program, shall be permitted to return to the SD Program upon meeting all applicable eligibility criteria and after a minimum of 12 months time has elapsed.
(i) A participant in the SD Program shall have all the rights established in Chapter 7 (commencing with Section 4700), except as provided under paragraph (5) of subdivision (b).
(j) Only the financial management service provider is required to apply for vendorization in accordance with subchapter 2 (commencing with Section 54300) of Chapter 3 of Title 17 of the California Code of Regulations, for the SD Program. All other service providers shall have applicable state licenses, certifications, or other state required documentation, but are exempt from the vendorization requirements set forth in Title 17 of the California Code of Regulations. The financial management services entity shall ensure and document that all service providers meet specified requirements for any service that may be delivered to the participant.
(k) A participant enrolled in the SD Program pursuant to this section and utilizing an individual allocation for services and supports is exempt from Section 4783, the Family Cost Participation Program, and cost control restrictions, including, but not limited to, purchases of services pursuant to Sections 4648.35, 4648.5, and 4659, subparagraph (B) of paragraph (3) of subdivision (c) of Section 4685, Sections 4686.2, 4686.5, and 4689, and purchase of service best practices enacted pursuant to Section 4620.3.
4689.93.
 (a) The Legislature finds and declares that SD Program support workers are the foundation necessary for SD Program participants to access full community participation and employment opportunities and to pursue a life of meaning in the ways that they choose.
(b) Participants shall have the right to utilize their individual allocation to employ SD support workers of their choice, hire, supervise, direct, schedule, evaluate, train, and terminate employment of SD support workers. Except for the limited purposes set forth herein, the state shall not be deemed the employer of SD support workers for any purpose.
(c) The state shall support the quality, availability, and stability of direct support workers by establishing a base compensation package to ensure decent pay standards for workers in the program. Individuals may use their allocation and private sources of funds to pay SD support workers above the base established by the state, develop job descriptions, and otherwise organize and incentivize their SD support workers.
(d) SD support workers may form, join, and participate in the activities of labor organizations of their own choosing in order to engage in collective negotiations with the department with regard to all matters specified in paragraph (4).
(1) Within 10 days of receipt of a request from a labor organization that represents SD support workers, the department shall provide the following information concerning SD support workers:
(A) Name, address, telephone number, and any unique personal identification generated by the department.
(B) Wage rates earned by each SD support worker.
(C) Hours of services provided by each SD support worker. The department shall be required to collect the information on no less than a quarterly basis from any financial management services providers that process payments for SD support workers.
(2) A labor organization that represents SD support workers may petition the board to be designated as the exclusive negotiating representative of SD support workers in the state.
(A) The only appropriate bargaining unit of SD support workers shall consist of all SD support workers in the state.
(B) If a labor organization that represents SD support workers petitions the board to be designated as the negotiating representative for SD support workers and provides written authorization from a majority of the total number of workers in the unit as of January of the year in which the petition is made, the board shall designate that organization as the exclusive negotiating representative for all SD support workers in the unit.
(C) If a labor organization that represents SD support workers petitions to be designated as the negotiating representative for all SD support workers in the unit and provides written authorization to serve as the negotiating representative from at least 30 percent of the workers in the unit, an election shall be held pursuant to board policies and procedures within 90 days after the day on which the petition is filed. The board shall designate the labor organization that prevails in the election the exclusive negotiating representative for all SD support workers in the unit.
(D) The board may designate a neutral third party to act on petitions filed with the board under subparagraph (B) or (C).
(E) The costs of verifying the number of SD support workers who have authorized a labor union to be their negotiating representative under subparagraph (B) shall be paid by the labor organization that petitions the board to be designated as the negotiating representative. The cost of an election held under subparagraph (C) shall be shared equally by all labor organizations placed on the ballot.
(3) The designated exclusive negotiating representative pursuant to paragraph (2) shall be the negotiating representative for all SD support workers in the unit for the purposes of this subdivision.
(A) An SD support worker may refuse to join or participate in the activities of the designated negotiating representative.
(B) The designated negotiating representative shall represent all SD support workers in the bargaining unit fairly and without discrimination and without regard to whether the workers are members of the labor organization designated as the negotiating representative.
(C) The designated negotiating representative may charge a reasonable fair share service fee to bargaining unit nonmembers, who meet the minimum hour criteria described in subdivision (i) of Section 4689.90, for representing them in negotiations, contract administration, and other activities germane to the designated negotiating representative’s role as the exclusive negotiating representative of SD support workers. The costs covered by the fair share service fee pursuant to this section may include, but are not limited to, costs associated with representing SD support workers pursuant to paragraph (4).The fair share service fee shall not exceed the annual dues paid by members of the labor organization designated as the negotiating representative of SD support workers.
(4) The designated negotiating representative of SD support workers shall negotiate with the department concerning the terms and conditions of workers’ participation in the SD Program including all of the following:
(A) The base compensation package mandated by this article, which includes, but is not limited to, wages and access to benefits, including workers’ compensation and health insurance benefits, for SD support workers.
(B) Payment procedures.
(C) Training and career development opportunities.
(D) Deduction of membership dues and fair share service fees.
(5) The designated negotiating representative of SD support workers shall not negotiate over terms and conditions of employment reserved for the participant pursuant to subdivisions (b) and (c).
(6) The designated negotiating representative of SD support workers shall not call or direct a strike or any other form of work stoppage.
(7) The board’s jurisdiction shall include all matters related to the representation of SD support workers.
(e) A participant in the SD Program may request, at no charge to the participant or the regional center, criminal history background checks for persons seeking employment as a service provider and providing direct care services to the participant.
(1) Criminal history records checks pursuant to this subdivision shall be performed and administered as described in subdivision (b) and subdivisions (d) to (h), inclusive, of Section 4689.2, and Sections 4689.4 to 4689.6, inclusive, and shall apply to vendorization of providers and hiring of employees to provide services for family home agencies and family homes.
(2) The department may enter into a written agreement with the Department of Justice to implement this subdivision.
4689.94.
 (a) The department shall establish a statewide Self-Determination Program Advisory Committee. Greater than 50 percent of the committee shall be comprised of SD Program participants and their family members representing the geographic, ethnic, and language diversity of the state. Other committee members shall include representatives from the State Council on Developmental Disabilities, Disability Rights California, a University Center for Excellence in Developmental Disabilities, regional centers, and a labor representative of regional center employees. The committee shall meet at least semiannually and participate in system oversight and advise with respect to ongoing system design and implementation and SD support worker wages, benefits, training, and career development. In addition, the committee shall meet with the department at least twice during the initial development phase of the SD Program to provide input on the methodologies for calculating individual allocations and other initial implementation issues.
(b) Notwithstanding Section 10231.5 of the Government Code, commencing January 10, 2013, the department shall annually provide the following information to the SD Program Advisory Committee and to the policy and fiscal committees of the Legislature:
(1) The number and characteristics of participants, by regional center.
(2) The range and average of individual allocations, by regional center.
(3) Utilization of the risk pool, including range and average individual allocation augmentations and type of service, by regional center.
(4) The proportion of participants who report that their choices and decisions are respected and supported.
(5) Detailed workforce metrics for SD support workers including wages, hours worked, and length of time on the job.
(6) The number and outcome of individual allocation appeals, by regional center.
(7) The number and outcome of fair hearing appeals, by regional center.
(8) The number of participants who voluntarily withdraw from participation in the SD Program and a summary of the reasons why, by regional center.
(9) The number of participants who are subsequently determined to no longer be eligible for the SD Program and a summary of the reasons why, by regional center.
(10) Identification of barriers to participation and recommendations for program improvements.
(11) A comparison of average annual expenditures for individuals with similar characteristics not participating in the SD Program.
(c) Notwithstanding Section 10231.5 of the Government Code, commencing June 30, 2015, and at three year intervals, the department shall submit an SD Program evaluation to the relevant policy committees of the Legislature and the SD Program Advisory Committee. The evaluation shall be developed in consultation with the advisory committee and shall be based on the core quality outcomes described in subdivision (b) of Section 4689.91 and also include a summary of all of the following:
(1) The types and ranking of services and supports purchased under the SD Program, by regional center.
(2) Consumer satisfaction under the SD Program and, when data is available, the traditional service delivery system, by regional center.
(3) The proportion of participants who report they are able to recruit, hire, and retain qualified service providers.
(4) The adequacy of the risk pool established pursuant to subdivision (d) of Section 4689.92.
4689.95.
 It is the intent of the Legislature that the purchase of services and supports through the SD Program be eligible for federal Medicaid match funding. The department shall take all steps necessary to ensure federal financial participation is available for all SD Program services and supports by applying for amendments to the current home- and community-based waiver for individuals with developmental disabilities or for a new waiver pursuant to Section 1396n of Title 42 of the United States Code, or by seeking to maximize federal financial participation by applying for an enhanced federal match through the federal Community First Choice Option pursuant to Section 1396n(k) of Title 42 of the United States Code.