Today's Law As Amended


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AB-823 Developmental services.(2019-2020)



As Amends the Law Today


SECTION 1.

 Section 4640.6 of the Welfare and Institutions Code is amended to read:

4640.6.
 (a) In approving regional center contracts, the department shall ensure that regional center staffing patterns demonstrate that direct service coordination are is  the highest priority.
(b) Contracts between the department and regional centers shall require that regional centers implement an emergency response system that ensures that a regional center staff person will respond to a consumer, or individual acting on behalf of a consumer, within two hours of the time an emergency call is placed. This emergency response system shall be operational 24 hours per day, 365 days per year.
(c) Contracts between the department and regional centers shall require regional centers to have service coordinator-to-consumer ratios, as follows:
(1) An average service coordinator-to-consumer ratio of 1 to 62 for all consumers who have not moved from the developmental centers to the community since April 14, 1993. In no case shall a service coordinator for these consumers have an assigned caseload in excess of 79 consumers for more than 60 days.
(2) An average service coordinator-to-consumer ratio of 1 to 45 for all consumers who have moved from a developmental center to the community since April 14, 1993. In no case shall a service coordinator for these consumers have an assigned caseload in excess of 59 consumers for more than 60 days.
(3) Commencing January 1, 2004, the following coordinator-to-consumer ratios shall apply:
(A) All consumers three years of age and younger and for consumers enrolled in the Home and Community-based Services Waiver program for persons with developmental disabilities, an average service coordinator-to-consumer ratio of 1 to 62.
(B) All consumers who have moved from a developmental center to the community since April 14, 1993, and have lived continuously in the community for at least 12 months, an average service coordinator-to-consumer ratio of 1 to 62.
(C) All consumers who have not moved from the developmental centers to the community since April 14, 1993, and who are not described in subparagraph (A), an average service coordinator-to-consumer ratio of 1 to 66.
(4) (A) Notwithstanding paragraphs (1) to (3), inclusive, an average service coordinator-to-consumer ratio of 1 to 25 for all consumers with complex needs.
(B) The coordinator-to-consumer ratio specified in this paragraph shall not be authorized for a consumer for more than 12 months after the consumer is no longer receiving the services described in clause (i) or (ii) of subparagraph (C), after the consumer is no longer placed in a facility described in clause (iii), (iv), (v), (vi), (vii), or (viii) of subparagraph (C), or after the department has made the determination described in clause (ix) of subparagraph (C), unless an extension is granted. An extension shall be based on a new and complete comprehensive assessment of the consumer’s needs. An extension may be granted one time, and shall not exceed six months.
(C) For the purposes of this paragraph, a “consumer with complex needs” means a consumer who is any of the following:
(i) Receiving regional center-funded mobile crisis services by a department-approved vendor, or has received those services within the past six months.
(ii) Receiving state-operated crisis assessment stabilization team services, or has received those services within the past six months.
(iii) Placed in a community crisis home, as defined in Section 4698.
(iv) Placed in an acute crisis home operated by the department, pursuant to Section 4418.7.
(v) Placed in a locked psychiatric setting or has been placed in a locked psychiatric setting in the past six months.
(vi) Placed in an institution for mental disease, as described in Part 5 (commencing with Section 5900) of Division 5.
(vii) Placed out of state as a result of appropriate services being unavailable within the state, pursuant to Section 4519.
(viii) Placed in a county jail and eligible for diversion pursuant to Chapter 2.8 (commencing with Section 1001.20) of Title 6 of Part 2 of the Penal Code or found incompetent to stand trial as described in Section 1370.1 of the Penal Code.
(ix) A person the department has determined cannot be safely served in a developmental center, as described in Section 6510.5.
(5) For purposes of paragraph (3), service coordinators may have a mixed caseload of consumers three years of age and younger, consumers enrolled in the Home and Community-based Services Waiver program for persons with developmental disabilities, and other consumers if the overall average caseload is weighted proportionately to ensure that overall regional center average service coordinator-to-consumer ratios as specified in paragraph (3) are met. For purposes of paragraph (3), in no case shall a service coordinator have an assigned caseload in excess of 84 for more than 60 days.
(d) For purposes of this section, “service coordinator” means a regional center employee whose primary responsibility includes preparing, implementing, and monitoring consumers’ individual program plans, securing and coordinating consumer services and supports, and providing placement and monitoring activities.
(e) In order to ensure that caseload ratios are maintained pursuant to this section, each regional center shall provide service coordinator caseload data to the department, annually for each fiscal year. The data shall be submitted in the format, including the content, prescribed by the department. Within 30 days of receipt of data submitted pursuant to this subdivision, the department shall make a summary of the data available to the public upon request. The department shall verify the accuracy of the data when conducting regional center fiscal audits. Data submitted by regional centers pursuant to this subdivision shall:
(1) Only include data on service coordinator positions as defined in subdivision (d). Regional centers shall identify the number of positions that perform service coordinator duties on less than a full-time basis. Staffing ratios reported pursuant to this subdivision shall reflect the appropriate proportionality of these staff to consumers served.
(2) Be reported separately for service coordinators whose caseload includes any of the following:
(A) Consumers who are three years of age and older and who have not moved from the developmental center to the community since April 14, 1993.
(B) Consumers who have moved from a developmental center to the community since April 14, 1993.
(C) Consumers who are younger than three years of age.
(D) Consumers enrolled in the Home and Community-based Services Waiver program.
(3) Not include positions that are vacant for more than 60 days or new positions established within 60 days of the reporting month that are still vacant.
(4) For purposes of calculating caseload ratios for consumers enrolled in the Home and Community-based Services Waiver program, vacancies shall not be included in the calculations.
(f) The department shall provide technical assistance and require a plan of correction for any regional center that, for two consecutive reporting periods, fails to maintain service coordinator caseload ratios required by this section or otherwise demonstrates an inability to maintain appropriate staffing patterns pursuant to this section. Plans of correction shall be developed following input from the state council, local organizations representing consumers, family members, regional center employees, including recognized labor organizations, and service providers, and other interested parties.
(g) Contracts between the department and regional center shall require the regional center to have, or contract for, all of the following areas:
(1) Criminal justice expertise to assist the regional center in providing services and support to consumers involved in the criminal justice system as a victim, defendant, inmate, or parolee.
(2) Special education expertise to assist the regional center in providing advocacy and support to families seeking appropriate educational services from a school district.
(3) Family support expertise to assist the regional center in maximizing the effectiveness of support and services provided to families.
(4) Housing expertise to assist the regional center in accessing affordable housing for consumers in independent or supportive living arrangements.
(5) Community integration expertise to assist consumers and families in accessing integrated services and supports and improved opportunities to participate in community life.
(6) Quality assurance expertise, to assist the regional center to provide the necessary coordination and cooperation with the state council, in conducting quality-of-life assessments and coordinating the regional center quality assurance efforts.
(7) Each regional center shall employ at least one  At least one employee who is a  consumer advocate who is a person with developmental disabilities.
(8) Mobile crisis services to assist consumers in remaining in, or returning to, the community.
(8) (9)  Other staffing arrangements related to the delivery of services that the department determines are necessary to ensure maximum cost-effectiveness and to ensure that the service needs of consumers and families are met.
(h) Any regional center proposing a staffing arrangement that substantially deviates from the requirements of this section shall request a waiver from the department. Prior to granting a waiver, the department shall require a detailed staffing proposal, including, but not limited to, how the proposed staffing arrangement will benefit consumers and families served, and shall demonstrate clear and convincing support for the proposed staffing arrangement from constituencies served and impacted, that include, but are not limited to, consumers, families, providers, advocates, and recognized labor organizations. In addition, the regional center shall submit to the department any written opposition to the proposal from organizations or individuals, including, but not limited to, consumers, families, providers, and advocates, including recognized labor organizations. The department may grant waivers to regional centers that sufficiently demonstrate that the proposed staffing arrangement is in the best interest of consumers and families served, complies with the requirements of this chapter, and does not violate any contractual requirements. A waiver shall be approved by the department for up to 12 months, at which time a regional center may submit a new request pursuant to this subdivision.
(i) From February 1, 2009, to June 30, 2010, inclusive, the following shall not apply:
(1) The service coordinator-to-consumer ratio requirements of paragraph (1), and subparagraph (C) of paragraph (3), of subdivision (c).
(2) The requirements of subdivision (e). The regional centers shall, instead, maintain sufficient service coordinator caseload data to document compliance with the service coordinator-to-consumer ratio requirements in effect pursuant to this section.
(3) The requirements of paragraphs (1) to (6), inclusive, of subdivision (g).
(j) From July 1, 2010, until June 30, 2013, the following shall not apply:
(1) The service coordinator-to-consumer ratio requirements of paragraph (1), and subparagraph (C) of paragraph (3), of subdivision (c).
(2) The requirements of paragraphs (1) to (6), inclusive, of subdivision (g).
(k) (1) Any contract between the department and a regional center entered into on and after January 1, 2003, shall require that all employment contracts entered into with regional center staff or contractors be available to the public for review, upon request. For purposes of this subdivision, an employment contract or portion thereof may not be deemed confidential nor unavailable for public review.
(2) Notwithstanding paragraph (1), the social security number of the contracting party may not be disclosed.
(3) The term of the employment contract between the regional center and an employee or contractor shall not exceed the term of the state’s contract with the regional center.

SEC. 3.SEC. 2.

 Section 4696.1 of the Welfare and Institutions Code is amended to read:

4696.1.
 (a) The Legislature finds and declares that improved cooperative efforts between regional centers and county mental health agencies are necessary in order to achieve each of the following:
(1) Increased leadership, communication, and organizational effectiveness between regional centers and county mental health agencies.
(2) Decreased costs and minimized fiscal risk in serving persons who are dually diagnosed with mental illness and developmental disabilities.
(3) Continuity of services.
(4) Improved quality of mental health outcomes for persons who are dually diagnosed.
(5) Optimized utilization of agency resources by building on the strengths of each organization.
(6) Timely resolution of conflicts.
(b) In order to achieve the outcomes specified in subdivision (a), by July 1, 1999, each regional center and county mental health agency shall develop a memorandum of understanding to do all of the following:
(1) Identify staff who will be responsible for all of the following:
(A) Coordinate service activity between the two agencies.
(B) Identify dually diagnosed consumers of mutual concern.
(C) Conduct problem resolution for those consumers serviced by both systems.
(2) Develop a general plan for crisis intervention for persons served by both systems. The plan shall include after-hours emergency response systems, interagency notification guidelines, and followup protocols.
(3) Develop a procedure by which each dually diagnosed consumer shall be the subject of a case conference conducted jointly by both regional center staff and county mental health as soon as possible after admission into a county operated or contracted acute, inpatient mental health facility. The case conference shall confirm the diagnosis and the treatment plan.
(4) Develop a procedure by which planning for dually diagnosed consumers admitted to a mental health inpatient facility shall be conducted collaboratively by both the regional center and the local mental health agency and shall commence as soon as possible or as deemed appropriate by the treatment staff. The discharge plan shall include subsequent treatment needs and the agency responsible for those services.
(5) Develop a procedure by which regional center staff and county mental health staff shall collaborate to plan and provide training to community service providers, including day programs, residential facilities, and intermediate care facilities, regarding effective services to persons who are dually diagnosed. This training shall include crisis prevention with a focus on proactively recognizing crisis and intervening effectively with consumers who are dually diagnosed.
(6) Develop a procedure by which the regional center and the county mental health agency shall work toward agreement on a consumer-by-consumer basis on the presenting diagnosis and medical necessity, as defined by regulations of the State Department of Health Care Services.
(c) The department and the State Department of Health Care Services shall collaborate to provide a statewide perspective and technical assistance to local service regions when local problem resolution mechanisms have been exhausted and state level participation has been requested by both local agencies.
(d) The director of the local regional center and the director of the county mental health agency or their designees shall meet as needed but no less than annually to do all of the following:
(1) Review the effectiveness of the interagency collaboration.
(2) Address any outstanding policy issues between the two agencies.
(3) Establish the direction and priorities for ongoing collaboration efforts between the two agencies.
(e) Copies of each memorandum of understanding shall be forwarded to the State Department of Developmental Services upon completion or whenever amended. The department shall make copies of the memorandum of understanding available to the public upon request.
(f) Each regional center shall post the memorandum of understanding described in subdivision (b) on the regional center’s internet website.
(f) (g)  By May 15 of each year, the department shall provide all of the following information to the Legislature:
(1) The status of the memorandums of understanding developed jointly by each regional center and the county mental health agency and identify any barriers to meeting the outcomes specified in this section.
(2) The availability of mobile crisis intervention services, including generic services, by regional center catchment area, including the names of vendors and rates paid.
(3) A description of each regional center’s funded emergency housing options, including the names and types of vendors, the number of beds and rates, including, but not limited to, crisis emergency group homes, crisis beds in a regular group home, crisis foster homes, motel or hotel or psychiatric facility beds, and whether each emergency housing option serves minors or adults and whether it is physically accessible.