Today's Law As Amended


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AB-641 Developmental services: integrated competitive employment.(2019-2020)



As Amends the Law Today


SECTION 1.

 Section 4688.21 of the Welfare and Institutions Code is amended to read:

4688.21.
 (a) The Legislature places a high priority on opportunities for adults with developmental disabilities to choose and customize day services to meet their individualized needs; needs,  have opportunities to further the development and support or maintenance  of employment and volunteer activities; activities,  direct their services; services,  pursue postsecondary education; establish and support paid internship program opportunities; and  education, and  increase their ability to lead integrated and inclusive lives. To further these goals, a consumer may choose a tailored day service or vouchered community-based training service, in lieu of, or in conjunction with,  of  any other regional center vendored day program, look-alike day program, supported employment program, or work activity program.
(b) (1) A tailored day service shall do both of the following:
(b) (A)  (1) Include  A tailored day service shall include    an individualized service design, as determined through the individual program plan (IPP), and developed through a person-centered planning process that reflects and maximizes individual preferences and goals, and approved by the regional center.  (IPP) and approved by the regional center, that maximizes the consumer’s individualized choices and needs.  This service design may include, but may not be limited to, the following:
(A) (i)  Fewer days or hours than in the program’s approved day program, look-alike day program, supported employment program, or work activity program design.
(B) (ii)  Flexibility in the duration, location, including by remote electronic communications,  duration  and intensity of services to meet the consumer’s individualized needs.
(C) (B)  Prioritize  Encourage opportunities to further  the development or support maintenance  of competitive, integrated  employment, volunteer activities, or pursuit of postsecondary education; establish and support paid internship program opportunities;  maximize consumer direction of the service; and increase the consumer’s ability to lead an integrated and inclusive life.
(2) The type and amount of tailored day service shall be determined through the IPP process, pursuant to Section 4646. The IPP shall contain, but not be limited to, both of  the following:
(A) A detailed description of the consumer’s individualized choices and needs and how these choices and needs will be met.
(B) The type and amount of services and staffing needed to meet the consumer’s individualized choices and needs, and unique health and safety and other needs.
(3) The staffing requirements set forth in Section 55756 56756  of Title 17 of the California Code of Regulations and subdivision (r) of Section 4851 of this code shall not apply to a tailored day service.
(4) Commencing July 1, 2022, for  For currently  vendored programs wishing to offer a tailored day service option, the hourly rate for the  regional center shall vendor a  tailored day service option shall be calculated using a base rate, defined as twice the amount of the rate model or models for “Community-Based Day, Community Only, 1:2.” The calculation of the rate shall be as follows: upon negotiating a rate and maximum units of service design that includes, but is not limited to, the following: 
(A) Effective July 1, 2022, the hourly rate shall equal 80 percent of the base  A daily or hourly rate and maximum units of service design that does not exceed the equivalent cost of four days per week of the vendor’s current rate, if the vendor has a daily day program  rate.
(B) The rate established in subparagraph (A) shall remain in effect pending the department’s review, in coordination with stakeholders, of implementation of this section, as amended by the act that added this paragraph. The review, to be completed by June 30, 2024, shall include development of recommendations that may include, but not be limited to, modifying the scope of the service or establishing a rate model specific to the service. The department shall provide an update to the Legislature on the status of the review no later than January 10, 2024.
(5) The hold harmless policy defined in subdivision (d) of Section 4519.10 shall apply for vendored programs offering a tailored day service as of June 30, 2022, with an hourly rate that exceeds the rate calculated in paragraph (4).
(6) Tailored day services shall not be delivered on the same day as any other regional center vendored day program, look-alike day program, supported employment program, or work activity program unless all of the following apply:
(A) A consumer has a plan identified in their individual program plan for transitioning from a work activity program to competitive integrated employment, paid internship, or postsecondary education.
(B) The transition plan is developed through a person-centered planning process that reflects and maximizes individual preferences and goals.
(C) The duration of the delivery of tailored day services on the same day or days as a work activity program or supported employment services is no longer than six months.
(7) (B)  The total monthly hours of tailored day services shall A rate and maximum units of service design that does  not exceed the number of days in the month tailored day services are authorized, multiplied by four. equivalent cost of four-fifths of the hours of the vendor’s current rate, if the vendor has an hourly rate. 
(8) (5)  The regional center shall ensure that the vendor is capable of complying with, and will comply with, the consumer’s IPP, individual choice, and health and safety needs.
(6) For new programs wishing to offer a tailored day service option, the regional center shall vendor a tailored day service option upon negotiating a rate and maximum units of service design. The rate paid to the new vendor shall not exceed four-fifths of the temporary payment rate or the median rate, whichever is applicable.
(9) (7)  Effective July 1, 2011, and prior to the time of development, review, or modification of a consumer’s IPP, regional centers shall provide information about tailored day service to eligible adult consumers. A consumer may request information about tailored day services from the regional center at any time and may request an IPP meeting to secure those services.
(c) (1) Notwithstanding subdivision (a), a consumer in a supported employment program or work activity program who has the stated goal of integrated competitive employment in their IPP may request to use tailored day services in conjunction with their existing program to achieve that goal, if both of the following criteria are met:
(A) The type, amount, and provider of tailored day service allowed under this subdivision shall be determined through the IPP process, pursuant to Section 4646.
(B) The IPP shall contain, but not be limited to, both of the following:
(i) A detailed description of the consumer’s individualized choices and needs detailing how these choices and needs will be met to achieve integrated competitive employment.
(ii) The type and amount of services and staffing needed to meet the consumer’s individualized choices and needs, and unique health and safety and other needs to gain integrated competitive employment.
(2) The following are the maximum hours of tailored day services that may be authorized in conjunction with existing services under this subdivision:
(A) For individuals currently receiving work activity program services, the IPP may authorize up to 75 hours of service per calendar quarter, the authorized hours shall be reduced from the individual’s work activity program hours, and the work activity program shall conform to the hourly billing process described in Section 4863.
(B) For individuals receiving group supported employment services, the IPP may authorize up to five hours a month of tailored day services in addition to the job coaching supports they receive on the job.
(c) (d)  (1) A vouchered community-based training service is defined as a consumer-directed service that assists the consumer in the development of skills required for competitive integrated employment, the paid internship program,  community integrated employment or  participation in volunteer activities, or any combination of these,  both,  and the assistance necessary for the consumer to secure employment, a paid internship,  employment  or volunteer positions or pursue secondary education.
(2) Implementation of vouchered community-based training service is contingent upon the approval of the federal Centers for Medicare and Medicaid Services.
(3) Vouchered community-based training service shall be provided in natural environments in the community, separate from the consumer’s residence.
(4) A consumer, parent, or conservator vendored as a vouchered community-based training service shall utilize the services of a financial management services (FMS) entity. The regional center shall provide information about available financial management services and shall assist the consumer in selecting a FMS vendor to act as coemployer.
(5) A parent or conservator shall not be the direct support worker employed by the vouchered community-based training service vendor.
(6) If the direct support worker is required to transport the consumer, the vouchered community-based training service vendor shall verify that the direct support worker can transport the consumer safely and has a valid California driver’s license and proof of insurance.
(7) The rate for vouchered community-based training service shall be the most recent rate posted on the department’s public internet website.  not exceed fourteen dollars and ninety-nine cents ($14.99) per hour.  The rate includes employer-related taxes and all transportation needed to implement the service, except as described in paragraph (8). The rate does not include the cost of the FMS.
(8) A consumer vendored as a vouchered community-based training service shall also be eligible for a regional center-funded bus pass, if appropriate and needed.
(9) Vouchered community-based training service shall be limited to a maximum of 150 hours per quarter. The services to be provided and the service hours shall be documented in the consumer’s IPP.
(10) A direct support worker of vouchered community-based training service shall be an adult who possesses the skill, training, and experience necessary to provide services in accordance with the IPP.
(11) Effective July 1, 2011, and prior to the time of development, review, or modification of a consumer’s IPP, regional centers shall provide information about vouchered community-based training service to eligible adult consumers. A consumer may request information about vouchered community-based training service from the regional center at any time and may request an IPP meeting to secure those services. 
(12) The type and amount of vouchered community-based training service shall be determined through the IPP process pursuant to Section 4646. The IPP shall contain, but not be limited to, the following:
(A) A detailed description of the consumer’s individualized choices and needs and how these choices and needs will be met.
(B) The type and amount of services and staffing needed to meet the consumer’s individualized choices and unique health and safety and other needs.
(d) (e)  The department may adopt emergency regulations for tailored day service or vouchered community-based training service. The adoption, amendment, repeal, or readoption of a regulation authorized by this subdivision is deemed to be necessary for the immediate preservation of the public peace, health and safety, or general welfare, for purposes of Sections 11346.1 and 11349.6 of the Government Code, and the department is hereby exempted from the requirement that it describe specific facts showing the need for immediate action. A certificate of compliance for these implementing regulations shall be filed within 24 months following the adoption of the first emergency regulations filed pursuant to this subdivision.

SECTION 1.SEC. 2.

 Section 4850.3 of the Welfare and Institutions Code is amended to read:

4850.3.
 (a) The Legislature intends that in  In  order to increase effectiveness and opportunity to gain meaningful integrated competitive employment opportunities, pursuant to paragraph (1) of subdivision (a) of Section 4869, habilitation services shall also provide community-based vocational development services to enhance community employment readiness, develop social skills necessary for successful community employment, and build a network of community and employment opportunities for individuals with developmental disabilities.
(b) (1)  The department shall conduct a four-year demonstration project, pursuant to paragraph (1) of subdivision (a) of Section 4869, to determine whether community-based vocational development services increase integrated competitive employment outcomes and reduce purchase of service costs for working age adults. For purposes of this section, “community-based vocational development services” means all of the following: 
(1) (A)  For purposes of this section,“community-based vocational development services” means (A) services  Services  provided to enhance community employment readiness, which readiness that  may include the use of discovery and job exploration opportunities, (B) social skill development services necessary to obtain and maintain community employment, (C) services to use internship, apprenticeship, and volunteer opportunities to provide community-based vocational development skills development opportunities, (D) services to access and participate in postsecondary education or career technical education, and (E) building a network of community and employment  opportunities.
(B) Social skill development services necessary to obtain and maintain community employment.
(C) Services to use internship, apprenticeship, and volunteer opportunities to provide community-based vocational development skills development opportunities.
(D) Services to access and participate in postsecondary education or career technical education.
(E) Building a network of community and employment opportunities.
(2) If community-based vocational development services are determined to be a necessary step to achieve a supported  an integrated competitive  employment outcome, a plan shall be developed through the IPP process  and may include, but is not limited to, all of the following:
(A) An inventory of potential employment interests.
(B) Preferences for types of work environments or situations.
(C) Identification of any training or education needed for the consumer’s desired job.
(D) Opportunities to explore jobs or self-employment as a means to meet the consumer’s desired employment outcome.
(E) Identification of any personal or family networks the consumer may use to achieve his or her  their  desired employment outcomes.
(3) The habilitation service provider and the regional center shall review the plan developed pursuant to paragraph (2) semiannually to document progress towards objectives, additional barriers, and other changes that impact the consumer’s desired employment outcome.
(4) The hourly rate for community-based vocational development services, for the purposes of this section, shall be  is  forty dollars ($40) per hour for a maximum of 75 hours per calendar quarter for all services identified and provided in the community-based vocational development plan as developed pursuant to paragraphs (2) and (3). Prior to the implementation of community-based vocational development services, the department shall secure federal Medicaid funding for this service.
(5) Hours of participation in community-based vocational development services may be provided in lieu of hours of participation in other community-based day program services, as determined by the consumer’s individual program planning team, for up to two years. Community-based vocational development services may be authorized for an additional two years, if the consumer’s individual program planning team determines and documents at each semiannual review that the consumer is making significant progress toward the habilitation services objectives. A consumer’s participation in community-based vocational development services shall not exceed a total of four years.
(c) The department shall select up to five volunteer regional centers that reflect the geographic diversity of California to participate in the demonstration project.
(d) The department shall publish a notice on the department’s Internet Web site when the demonstration project has been implemented.
(e) (1) After conclusion of the demonstration project, the department shall review the effectiveness of the demonstration project and make determinations whether community-based vocational development services (A) increase employment outcomes, (B) reduce purchase of service costs, and (C) may be implemented on a statewide basis.
(2) The department shall notify the appropriate fiscal and policy committees of both houses of the Legislature of the determinations made pursuant to this subdivision.
(f) (b)  This section shall be implemented only to the extent that federal financial participation is available and any necessary federal approvals have been obtained.
(g) This section shall remain in effect only until January 1, 2025, and as of that date is repealed, unless a later enacted statute, that is enacted before January 1, 2025, deletes or extends that date.