Bill Text

Bill Information


PDF |Add To My Favorites |Track Bill | print page

AB-2634 Developmental services: dental services.(2019-2020)

SHARE THIS:share this bill in Facebookshare this bill in Twitter
Date Published: 02/20/2020 02:00 PM
AB2634:v99#DOCUMENT


CALIFORNIA LEGISLATURE— 2019–2020 REGULAR SESSION

Assembly Bill
No. 2634


Introduced by Assembly Member Lackey

February 20, 2020


An act to amend Section 4640.6 of the Welfare and Institutions Code, relating to developmental services.


LEGISLATIVE COUNSEL'S DIGEST


AB 2634, as introduced, Lackey. Developmental services: dental services.
Under existing law, the Lanterman Developmental Disabilities Services Act, the State Department of Developmental Services is responsible for providing various services and supports to individuals with developmental disabilities, and for ensuring the appropriateness and quality of those services and supports. Under existing law, the department contracts with regional centers to provide services and supports to persons with developmental disabilities. Existing law requires the department to ensure that regional center staffing patterns demonstrate that direct service coordination is the highest priority, and requires a regional center contract to include specified staffing levels and expertise, including criminal justice and special education expertise.
This bill would, by December 31, 2021, require a contract between the department and a regional center to require the regional center to have, or contract for, a full-time dental coordinator, or equivalent thereof, to serve consumers. The bill would require the department to establish uniform expectations and performance outcomes for the dental-coordinator position, and to fund this position at each regional center.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: NO  

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


SECTION 1.

 The Legislature finds and declares all of the following:
(a) Access to appropriate dental services is a major challenge for individuals with developmental disabilities who are consumers that are served by regional centers.
(b) Many consumers receive their dental services under the Medi-Cal program. Those consumers struggle to perform adequate oral hygiene. Moreover, it is difficult to locate dental providers who are willing and able to serve this population.
(c) Dental coordinators hired by regional centers work with local dental providers to improve access to dental care and assist consumers in overcoming fears about seeing a dentist.
(d) Regional center dental coordinators play an important role in maintaining and improving the oral health of consumers who are served by regional centers.

SEC. 2.

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

4640.6.
 (a) In approving any regional center contracts, contract, the department shall ensure that regional center staffing patterns demonstrate that direct service coordination are is the highest priority.
(b) Contracts A contract between the department and regional centers a regional center shall require that regional centers a regional center 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 A contract between the department and regional centers a regional center shall require regional centers a regional center 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 a service coordinator 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 shall not 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 submitted data, 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 A consumer who is three years of age and older and who have has not moved from the developmental center to the community since April 14, 1993.
(B) Consumers who have A consumer who has moved from a developmental center to the community since April 14, 1993.
(C) Consumers who are A consumer who is younger than three years of age.
(D) Consumers A consumer 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 A plan 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 A contract 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 their 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 At least one consumer advocate who is a person with developmental disabilities.
(8) (A) By December 31, 2021, a full-time dental coordinator, or equivalent thereof, to serve consumers.
(B) The department shall establish uniform expectations and performance outcomes for the dental coordinator position, and shall fund this position at each regional center.

(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 their 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 Before 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 shall neither be confidential nor unavailable for public review.
(2) Notwithstanding paragraph (1), the social security number of the contracting party may shall 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.