Bill Text: CA AB2809 | 2015-2016 | Regular Session | Amended
Bill Title: Developmental services: regional centers.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Engrossed - Dead) 2016-11-30 - Died on Senate inactive file. [AB2809 Detail]
Download: California-2015-AB2809-Amended.html
BILL NUMBER: AB 2809 AMENDED
BILL TEXT
AMENDED IN SENATE AUGUST 16, 2016
AMENDED IN SENATE JUNE 20, 2016
AMENDED IN ASSEMBLY MAY 27, 2016
AMENDED IN ASSEMBLY MAY 4, 2016
AMENDED IN ASSEMBLY MARCH 18, 2016
INTRODUCED BY Assembly Member Rodriguez
FEBRUARY 19, 2016
An act to amend Sections 4646.5, 4648, and 4686.2
4646.5 and 4648 of the Welfare and Institutions
Code, relating to developmental services.
LEGISLATIVE COUNSEL'S DIGEST
AB 2809, as amended, Rodriguez. Developmental services: regional
centers.
Existing law, the California Early Intervention Services Act,
provides a statewide system of coordinated, comprehensive,
family-centered, multidisciplinary, and interagency programs that are
responsible for providing appropriate early intervention services
and support to all eligible infants and toddlers, as defined, and
their families and requires an eligible infant or toddler receiving
services under the act to have an individualized family service plan
(IFSP). The act requires these services to be provided pursuant to
the existing regional center system under the Lanterman Developmental
Disabilities Service Act.
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. The services and supports to be provided to a regional
center consumer are contained in an individual program plan (IPP),
developed in accordance with prescribed requirements.
This bill would require regional centers to provide certain
information information, including a
statement of services and supports purchased and information about
the appeal and complaint process, to a consumer or his or her
parents, legal guardian, conservator, or authorized representative,
or both, in threshold languages, as defined.
Existing law also requires a regional center to only purchase
applied behavioral analysis (ABA) services or intensive behavioral
intervention services when the parent or parents of minor consumers
receiving services participate in the intervention plan for the
consumers. Existing law includes completion of group instruction on
the basics of behavior intervention within the definition of "parent
participation."
This bill would prohibit a parent's or caregiver's noncompletion
of group instruction on the basics of behavior intervention from
being used to deny, delay, or reduce ABA or intensive behavioral
intervention services if the parent or caregiver demonstrates
hardship in accessing or attending group instruction classes. The
bill would require the IPP or IFSP team to review the parent's or
caregiver's demonstration of hardship every 6 months.
Vote: majority. Appropriation: no. Fiscal committee: no.
State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 4646.5 of the Welfare and Institutions Code is
amended to read:
4646.5. (a) The planning process for the individual program plan
described in Section 4646 shall include all of the following:
(1) Gathering information and conducting assessments to determine
the life goals, capabilities and strengths, preferences, barriers,
and concerns or problems of the person with developmental
disabilities. For children with developmental disabilities, this
process should include a review of the strengths, preferences, and
needs of the child and the family unit as a whole. Assessments shall
be conducted by qualified individuals and performed in natural
environments whenever possible. Information shall be taken from the
consumer, his or her parents and other family members, his or her
friends, advocates, authorized representative, if applicable,
providers of services and supports, and other agencies. The
assessment process shall reflect awareness of, and sensitivity to,
the lifestyle and cultural background of the consumer and the family.
(2) A statement of goals, based on the needs, preferences, and
life choices of the individual with developmental disabilities, and a
statement of specific, time-limited objectives for implementing the
person's goals and addressing his or her needs. These objectives
shall be stated in terms that allow measurement of progress or
monitoring of service delivery. These goals and objectives should
maximize opportunities for the consumer to develop relationships, be
part of community life in the areas of community participation,
housing, work, school, and leisure, increase control over his or her
life, acquire increasingly positive roles in community life, and
develop competencies to help accomplish these goals.
(3) When developing individual program plans for children,
regional centers shall be guided by the principles, process, and
services and support parameters set forth in Section 4685.
(4) When developing an individual program plan for a transition
age youth or working age adult, the planning team shall consider the
Employment First Policy described in Chapter 14 (commencing with
Section 4868).
(5) A schedule of the type and amount of services and supports to
be purchased by the regional center or obtained from generic agencies
or other resources in order to achieve the individual program plan
goals and objectives, and identification of the provider or providers
of service responsible for attaining each objective, including, but
not limited to, vendors, contracted providers, generic service
agencies, and natural supports. The individual program plan shall
specify the approximate scheduled start date for services and
supports and shall contain timelines for actions necessary to begin
services and supports, including generic services. In addition to the
requirements of subdivision (h) of Section 4646, each regional
center shall offer, and upon request provide, a written copy of the
individual program plan to the consumer, and, when appropriate, his
or her parents, legal guardian or conservator, or authorized
representative within 45 days of their request in a threshold
language, as defined by paragraph (3) of subdivision (a) of Section
1810.410 of Title 9 of the California Code of Regulations.
(6) At the beginning of each individual program plan meeting, the
regional center shall provide a consumer and, when appropriate, his
or her parents, legal guardian, conservator, or authorized
representative information about the appeal and complaint process in
threshold languages, as defined in paragraph (3) of subdivision (a)
of Section 1810.410 of Title 9 of the California Code of Regulations,
as appropriate. This paragraph is in addition to, and independent
of, any other rights, remedies, or procedures under any other law and
shall not be construed to alter, limit, or negate any other rights,
remedies, or procedures provided for by law.
(7) When agreed to by the consumer, the parents, legally appointed
guardian, or authorized representative of a minor consumer, or the
legally appointed conservator of an adult consumer or the authorized
representative, including those appointed pursuant to subdivision (a)
of Section 4541, subdivision (b) of Section 4701.6, and subdivision
(e) of Section 4705, a review of the general health status of the
adult or child, including medical, dental, and mental health needs,
shall be conducted. This review shall include a discussion of current
medications, any observed side effects, and the date of the last
review of the medication. Service providers shall cooperate with the
planning team to provide any information necessary to complete the
health status review. If any concerns are noted during the review,
referrals shall be made to regional center clinicians or to the
consumer's physician, as appropriate. Documentation of health status
and referrals shall be made in the consumer's record by the service
coordinator.
(8) (A) The development of a transportation access plan for a
consumer when all of the following conditions are met:
(i) The regional center is purchasing private, specialized
transportation services or services from a residential, day, or other
provider, excluding vouchered service providers, to transport the
consumer to and from day or work services.
(ii) The planning team has determined that a consumer's community
integration and participation could be safe and enhanced through the
use of public transportation services.
(iii) The planning team has determined that generic transportation
services are available and accessible.
(B) To maximize independence and community integration and
participation, the transportation access plan shall identify the
services and supports necessary to assist the consumer in accessing
public transportation and shall comply with Section 4648.35. These
services and supports may include, but are not limited to, mobility
training services and the use of transportation aides. Regional
centers are encouraged to coordinate with local public transportation
agencies.
(9) A schedule of regular periodic review and reevaluation to
ascertain that planned services have been provided, that objectives
have been fulfilled within the times specified, and that consumers
and families are satisfied with the individual program plan and its
implementation.
(b) For all active cases, individual program plans shall be
reviewed and modified by the planning team, through the process
described in Section 4646, as necessary, in response to the person's
achievement or changing needs, and no less often than once every
three years. If the consumer or, where appropriate, the consumer's
parents, legal guardian, authorized representative, or conservator
requests an individual program plan review, the individual program
shall be reviewed within 30 days after the request is submitted.
(c) (1) The department, with the participation of representatives
of a statewide consumer organization, the Association of Regional
Center Agencies, an organized labor organization representing service
coordination staff, and the state council shall prepare training
material and a standard format and instructions for the preparation
of individual program plans, which embody an approach centered on the
person and family.
(2) Each regional center shall use the training materials and
format prepared by the department pursuant to paragraph (1).
(3) The department shall biennially review a random sample of
individual program plans at each regional center to ensure that these
plans are being developed and modified in compliance with Section
4646 and this section.
SEC. 2. Section 4648 of the Welfare and Institutions Code is
amended to read:
4648. In order to achieve the stated objectives of a consumer's
individual program plan, the regional center shall conduct
activities, including, but not limited to, all of the following:
(a) Securing needed services and supports.
(1) It is the intent of the Legislature that services and supports
assist individuals with developmental disabilities in achieving the
greatest self-sufficiency possible and in exercising personal
choices. The regional center shall secure services and supports that
meet the needs of the consumer, as determined in the consumer's
individual program plan, and within the context of the individual
program plan, the planning team shall give highest preference to
those services and supports which would allow minors with
developmental disabilities to live with their families, adult persons
with developmental disabilities to live as independently as possible
in the community, and that allow all consumers to interact with
persons without disabilities in positive, meaningful ways.
(2) In implementing individual program plans, regional centers,
through the planning team, shall first consider services and supports
in natural community, home, work, and recreational settings.
Services and supports shall be flexible and individually tailored to
the consumer and, where appropriate, his or her family.
(3) A regional center may, pursuant to vendorization or a
contract, purchase services or supports for a consumer from any
individual or agency that the regional center and consumer or, when
appropriate, his or her parents, legal guardian, or conservator, or
authorized representatives, determines will best accomplish all or
any part of that consumer's program plan.
(A) Vendorization or contracting is the process for
identification, selection, and utilization of service vendors or
contractors, based on the qualifications and other requirements
necessary in order to provide the service.
(B) A regional center may reimburse an individual or agency for
services or supports provided to a regional center consumer if the
individual or agency has a rate of payment for vendored or contracted
services established by the department, pursuant to this division,
and is providing services pursuant to an emergency vendorization or
has completed the vendorization procedures or has entered into a
contract with the regional center and continues to comply with the
vendorization or contracting requirements. The director shall adopt
regulations governing the vendorization process to be utilized by the
department, regional centers, vendors, and the individual or agency
requesting vendorization.
(C) Regulations shall include, but not be limited to: the vendor
application process, and the basis for accepting or denying an
application; the qualification and requirements for each category of
services that may be provided to a regional center consumer through a
vendor; requirements for emergency vendorization; procedures for
termination of vendorization; and the procedure for an individual or
an agency to appeal any vendorization decision made by the department
or regional center.
(D) A regional center may vendorize a licensed facility for
exclusive services to persons with developmental disabilities at a
capacity equal to or less than the facility's licensed capacity. A
facility already licensed on January 1, 1999, shall continue to be
vendorized at their full licensed capacity until the facility agrees
to vendorization at a reduced capacity.
(E) Effective July 1, 2009, notwithstanding any other law or
regulation, a regional center shall not newly vendor a State
Department of Social Services licensed 24-hour residential care
facility with a licensed capacity of 16 or more beds, unless the
facility qualifies for receipt of federal funds under the Medicaid
Program.
(4) Notwithstanding subparagraph (B) of paragraph (3), a regional
center may contract or issue a voucher for services and supports
provided to a consumer or family at a cost not to exceed the maximum
rate of payment for that service or support established by the
department. If a rate has not been established by the department, the
regional center may, for an interim period, contract for a specified
service or support with, and establish a rate of payment for, any
provider of the service or support necessary to implement a consumer'
s individual program plan. Contracts may be negotiated for a period
of up to three years, with annual review and subject to the
availability of funds.
(5) In order to ensure the maximum flexibility and availability of
appropriate services and supports for persons with developmental
disabilities, the department shall establish and maintain an
equitable system of payment to providers of services and supports
identified as necessary to the implementation of a consumer's
individual program plan. The system of payment shall include a
provision for a rate to ensure that the provider can meet the special
needs of consumers and provide quality services and supports in the
least restrictive setting as required by law.
(6) The regional center and the consumer, or when appropriate, his
or her parents, legal guardian, conservator, or authorized
representative, including those appointed pursuant to subdivision (a)
of Section 4541, subdivision (b) of Section 4701.6, or subdivision
(e) of Section 4705, shall, pursuant to the individual program plan,
consider all of the following when selecting a provider of consumer
services and supports:
(A) A provider's ability to deliver quality services or supports
that can accomplish all or part of the consumer's individual program
plan.
(B) A provider's success in achieving the objectives set forth in
the individual program plan.
(C) Where appropriate, the existence of licensing, accreditation,
or professional certification.
(D) The cost of providing services or supports of comparable
quality by different providers, if available, shall be reviewed, and
the least costly available provider of comparable service, including
the cost of transportation, who is able to accomplish all or part of
the consumer's individual program plan, consistent with the
particular needs of the consumer and family as identified in the
individual program plan, shall be selected. In determining the least
costly provider, the availability of federal financial participation
shall be considered. The consumer shall not be required to use the
least costly provider if it will result in the consumer moving from
an existing provider of services or supports to more restrictive or
less integrated services or supports.
(E) The consumer's choice of providers, or, when appropriate, the
consumer's parent's, legal guardian's, authorized representative's,
or conservator's choice of providers.
(7) No service or support provided by any agency or individual
shall be continued unless the consumer or, when appropriate, his or
her parents, legal guardian, or conservator, or authorized
representative, including those appointed pursuant to subdivision (a)
of Section 4541, subdivision (b) of Section 4701.6, or subdivision
(e) of Section 4705, is satisfied and the regional center and the
consumer or, when appropriate, the person's parents or legal guardian
or conservator agree that planned services and supports have been
provided, and reasonable progress toward objectives have been made.
(8) Regional center funds shall not be used to supplant the budget
of any agency that has a legal responsibility to serve all members
of the general public and is receiving public funds for providing
those services.
(9) (A) A regional center may, directly or through an agency
acting on behalf of the center, provide placement in, purchase of, or
follow-along services to persons with developmental disabilities in,
appropriate community living arrangements, including, but not
limited to, support service for consumers in homes they own or lease,
foster family placements, health care facilities, and licensed
community care facilities. In considering appropriate placement
alternatives for children with developmental disabilities, approval
by the child's parent or guardian shall be obtained before placement
is made.
(B) Effective July 1, 2012, notwithstanding any other law or
regulation, a regional center shall not purchase residential services
from a State Department of Social Services licensed 24-hour
residential care facility with a licensed capacity of 16 or more
beds. This prohibition on regional center purchase of residential
services shall not apply to any of the following:
(i) A residential facility with a licensed capacity of 16 or more
beds that has been approved to participate in the department's Home
and Community Based Services Waiver or another existing waiver
program or certified to participate in the Medi-Cal program.
(ii) A residential facility service provider that has a written
agreement and specific plan prior to July 1, 2012, with the vendoring
regional center to downsize the existing facility by transitioning
its residential services to living arrangements of 15 beds or less or
restructure the large facility to meet federal Medicaid eligibility
requirements on or before June 30, 2013.
(iii) A residential facility licensed as a mental health
rehabilitation center by the State Department of Health Care Services
or successor agency under any of the following circumstances:
(I) The facility is eligible for Medicaid reimbursement.
(II) The facility has a department-approved plan in place by June
30, 2013, to transition to a program structure eligible for federal
Medicaid funding, and this transition will be completed by June 30,
2014. The department may grant an extension for the date by which the
transition will be completed if the facility demonstrates that it
has made significant progress toward transition, and states with
specificity the timeframe by which the transition will be completed
and the specified steps that will be taken to accomplish the
transition. A regional center may pay for the costs of care and
treatment of a consumer residing in the facility on June 30, 2012,
until June 30, 2013, inclusive, and, if the facility has a
department-approved plan in place by June 30, 2013, may continue to
pay the costs under this subparagraph until June 30, 2014, or until
the end of any period during which the department has granted an
extension.
(III) There is an emergency circumstance in which the regional
center determines that it cannot locate alternate federally eligible
services to meet the consumer's needs. Under such an emergency
circumstance, an assessment shall be completed by the regional center
as soon as possible and within 30 days of admission. An individual
program plan meeting shall be convened immediately following the
assessment to determine the services and supports needed for
stabilization and to develop a plan to transition the consumer from
the facility into the community. If transition is not expected within
90 days of admission, an individual program plan meeting shall be
held to discuss the status of transition and to determine if the
consumer is still in need of placement in the facility. Commencing
October 1, 2012, this determination shall be made after also
considering resource options identified by the statewide specialized
resource service. If it is determined that emergency services
continue to be necessary, the regional center shall submit an updated
transition plan that can cover a period of up to 90 days. In no
event shall placements under these emergency circumstances exceed 180
days.
(C) (i) Effective July 1, 2012, notwithstanding any other law or
regulation, a regional center shall not purchase new residential
services from, or place a consumer in, institutions for mental
disease, as described in Part 5 (commencing with Section 5900) of
Division 5, for which federal Medicaid funding is not available.
Effective July 1, 2013, this prohibition applies regardless of the
availability of federal funding.
(ii) The prohibition described in clause (i) shall not apply to
emergencies, as determined by the regional center, when a regional
center cannot locate alternate services to meet the consumer's needs.
As soon as possible within 30 days of admission due to an emergency,
an assessment shall be completed by the regional center. An
individual program plan meeting shall be convened immediately
following the assessment, to determine the services and supports
needed for stabilization and to develop a plan to transition the
consumer from the facility to the community. If transition is not
expected within 90 days of admission, an emergency program plan
meeting shall be held to discuss the status of the transition and to
determine if the consumer is still in need of placement in the
facility. If emergency services continue to be necessary, the
regional center shall submit an updated transition plan to the
department for an extension of up to 90 days. Placement shall not
exceed 180 days.
(iii) To the extent feasible, prior to any admission, the regional
center shall consider resource options identified by the statewide
specialized resource service established pursuant to subdivision (b)
of Section 4418.25.
(iv) The clients' rights advocate shall be notified of each
admission and individual program plan meeting pursuant to this
subparagraph and may participate in all individual program plan
meetings unless the consumer objects on his or her own behalf. For
purposes of this clause, notification to the clients' rights advocate
shall include a copy of the most recent comprehensive assessment or
updated assessment and the time, date, and location of the meeting,
and shall be provided as soon as practicable, but not less than seven
calendar days prior to the meeting.
(v) If a consumer is placed in an institution for mental disease
by another entity, the institution for mental disease shall inform
the regional center of the placement within five days of the date the
consumer is admitted. If an individual's records indicate that he or
she is a regional center consumer, the institution for mental
disease shall make every effort to contact the local regional center
or department to determine which regional center to provide notice.
As soon as possible within 30 days of admission to an institution for
mental disease due to an emergency pursuant to clause (ii), or
within 30 days of notification of admission to an institution for
mental disease by an entity other than a regional center, an
assessment shall be completed by the regional center.
(vi) Regional centers shall complete a comprehensive assessment of
any consumer residing in an institution for mental disease as of
July 1, 2012, for which federal Medicaid funding is not available,
and for any consumer residing in an institution for mental disease as
of July 1, 2013, without regard to federal funding. The
comprehensive assessment shall be completed prior to the consumer's
next scheduled individual program plan meeting and shall include
identification of the services and supports needed and the timeline
for identifying or developing those services needed to transition the
consumer back to the community. Effective October 1, 2012, the
regional center shall also consider resource options identified by
the statewide specialized resource service. For each individual
program plan meeting convened pursuant to this subparagraph, the
clients' rights advocate for the regional center shall be notified of
the meeting and may participate in the meeting unless the consumer
objects on his or her own behalf. For purposes of this clause,
notification to the clients' rights advocate shall include the time,
date, and location of the meeting, and shall be provided as soon as
practicable, but not less than seven calendar days prior to the
meeting.
(D) A person with developmental disabilities placed by the
regional center in a community living arrangement shall have the
rights specified in this division. These rights shall be brought to
the person's attention by any means necessary to reasonably
communicate these rights to each resident, provided that, at a
minimum, the Director of Developmental Services prepare, provide, and
require to be clearly posted in all residential facilities and day
programs a poster using simplified language and pictures that is
designed to be more understandable by persons with intellectual
disabilities and that the rights information shall also be available
through the regional center to each residential facility and day
program in alternative formats, including, but not limited to, other
languages, braille, and audiotapes, when necessary to meet the
communication needs of consumers.
(E) Consumers are eligible to receive supplemental services
including, but not limited to, additional staffing, pursuant to the
process described in subdivision (d) of Section 4646. Necessary
additional staffing that is not specifically included in the rates
paid to the service provider may be purchased by the regional center
if the additional staff are in excess of the amount required by
regulation and the individual's planning team determines the
additional services are consistent with the provisions of the
individual program plan. Additional staff should be periodically
reviewed by the planning team for consistency with the individual
program plan objectives in order to determine if continued use of the
additional staff is necessary and appropriate and if the service is
producing outcomes consistent with the individual program plan.
Regional centers shall monitor programs to ensure that the additional
staff is being provided and utilized appropriately.
(10) Emergency and crisis intervention services including, but not
limited to, mental health services and behavior modification
services, may be provided, as needed, to maintain persons with
developmental disabilities in the living arrangement of their own
choice. Crisis services shall first be provided without disrupting a
person's living arrangement. If crisis intervention services are
unsuccessful, emergency housing shall be available in the person's
home community. If dislocation cannot be avoided, every effort shall
be made to return the person to his or her living arrangement of
choice, with all necessary supports, as soon as possible.
(11) Among other service and support options, planning teams shall
consider the use of paid roommates or neighbors, personal
assistance, technical and financial assistance, and all other service
and support options which would result in greater self-sufficiency
for the consumer and cost-effectiveness to the state.
(12) When facilitation as specified in an individual program plan
requires the services of an individual, the facilitator shall be of
the consumer's choosing.
(13) The community support may be provided to assist individuals
with developmental disabilities to fully participate in community and
civic life, including, but not limited to, programs, services, work
opportunities, business, and
activities available to persons without disabilities. This
facilitation shall include, but not be limited to, any of the
following:
(A) Outreach and education to programs and services within the
community.
(B) Direct support to individuals that would enable them to more
fully participate in their community.
(C) Developing unpaid natural supports when possible.
(14) When feasible and recommended by the individual program
planning team, for purposes of facilitating better and cost-effective
services for consumers or family members, technology, including
telecommunication technology, may be used in conjunction with other
services and supports. Technology in lieu of a consumer's in-person
appearances at judicial proceedings or administrative due process
hearings may be used only if the consumer or, when appropriate, the
consumer's parent, legal guardian, conservator, or authorized
representative, gives informed consent. Technology may be used in
lieu of, or in conjunction with, in-person training for providers, as
appropriate.
(15) Other services and supports may be provided as set forth in
Sections 4685, 4686, 4687, 4688, and 4689, when necessary.
(16) Notwithstanding any other law or regulation, effective July
1, 2009, regional centers shall not purchase experimental treatments,
therapeutic services, or devices that have not been clinically
determined or scientifically proven to be effective or safe or for
which risks and complications are unknown. Experimental treatments or
therapeutic services include experimental medical or nutritional
therapy when the use of the product for that purpose is not a general
physician practice. For regional center consumers receiving these
services as part of their individual program plan (IPP) or
individualized family service plan (IFSP) on July 1, 2009, this
prohibition shall apply on August 1, 2009.
(b) (1) Advocacy for, and protection of, the civil, legal, and
service rights of persons with developmental disabilities as
established in this division.
(2) Whenever the advocacy efforts of a regional center to secure
or protect the civil, legal, or service rights of any of its
consumers prove ineffective, the regional center or the person with
developmental disabilities or his or her parents, legal guardian, or
other representative may request advocacy assistance from the state
council.
(c) The regional center may assist consumers and families
directly, or through a provider, in identifying and building circles
of support within the community.
(d) In order to increase the quality of community services and
protect consumers, the regional center shall, when appropriate, take
either of the following actions:
(1) Identify services and supports that are ineffective or of poor
quality and provide or secure consultation, training, or technical
assistance services for any agency or individual provider to assist
that agency or individual provider in upgrading the quality of
services or supports.
(2) Identify providers of services or supports that may not be in
compliance with local, state, and federal statutes and regulations
and notify the appropriate licensing or regulatory authority to
investigate the possible noncompliance.
(e) When necessary to expand the availability of needed services
of good quality, a regional center may take actions that include, but
are not limited to, the following:
(1) Soliciting an individual or agency by requests for proposals
or other means, to provide needed services or supports not presently
available.
(2) Requesting funds from the Program Development Fund, pursuant
to Section 4677, or community placement plan funds designated from
that fund, to reimburse the startup costs needed to initiate a new
program of services and supports.
(3) Using creative and innovative service delivery models,
including, but not limited to, natural supports.
(f) Except in emergency situations, a regional center shall not
provide direct treatment and therapeutic services, but shall utilize
appropriate public and private community agencies and service
providers to obtain those services for its consumers.
(g) When there are identified gaps in the system of services and
supports or when there are identified consumers for whom no provider
will provide services and supports contained in his or her individual
program plan, the department may provide the services and supports
directly.
(h) (1) At least annually, regional centers shall provide the
consumer, his or her parents, legal guardian, conservator, or
authorized representative a statement of services and supports the
regional center purchased for the purpose of ensuring that they are
delivered. The statement shall include the type, unit, month, and
cost of services and supports purchased.
(2) Upon request of the consumer, or his or her legal guardian,
the regional center shall make the statement described in paragraph
(1) available in threshold languages, as defined in paragraph (3) of
subdivision (a) of Section 1810.410 of Title 9 of the California Code
of Regulations, as appropriate, to the consumer or his or her
parents, legal guardian, conservator, or authorized representative,
or both. This paragraph is in addition to, and independent of, any
other rights, remedies, or procedures under any other law and shall
not be construed to alter, limit, or negate any other rights,
remedies, or procedures provided for by law.
SEC. 3. Section 4686.2 of the Welfare and
Institutions Code is amended to read:
4686.2. (a) Effective July 1, 2009, notwithstanding any other law
or regulation to the contrary, any vendor who provides applied
behavioral analysis (ABA) services, or intensive behavioral
intervention services or both, as defined in subdivision (d), shall:
(1) Conduct a behavioral assessment of each consumer to whom the
vendor provides these services.
(2) Design an intervention plan that shall include the service
type, number of hours, and parent participation needed to achieve the
consumer's goals and objectives, as set forth in the consumer's
individual program plan (IPP) or individualized family service plan
(IFSP). The intervention plan shall also set forth the frequency at
which the consumer's progress shall be evaluated and reported.
(3) Provide a copy of the intervention plan to the regional center
for review and consideration by the planning team members.
(b) Effective July 1, 2009, notwithstanding any other law or
regulation to the contrary, regional centers shall:
(1) Only purchase ABA services or intensive behavioral
intervention services that reflect evidence-based practices, promote
positive social behaviors, and ameliorate behaviors that interfere
with learning and social interactions.
(2) (A) Only purchase ABA or intensive behavioral intervention
services when the parent or parents of minor consumers receiving
services participate in the intervention plan for the consumers,
given the critical nature of parent participation to the success of
the intervention plan.
(B) A parent's or caregiver's noncompletion of group instruction
on the basics of behavior intervention shall not be used to deny,
delay, or reduce ABA or intensive behavioral intervention services if
the parent or caregiver demonstrates hardship in accessing or
attending group instruction classes. The parent's or caregiver's
demonstration of hardship shall be reviewed by the IPP or IFSP team
every six months.
(3) Not purchase either ABA or intensive behavioral intervention
services for purposes of providing respite, day care, or school
services.
(4) Discontinue purchasing ABA or intensive behavioral
intervention services for a consumer when the consumer's treatment
goals and objectives, as described under subdivision (a), are
achieved. ABA or intensive behavioral intervention services shall not
be discontinued until the goals and objectives are reviewed and
updated as required in paragraph (5) and shall be discontinued only
if those updated treatment goals and objectives do not require ABA or
intensive behavioral intervention services.
(5) For each consumer, evaluate the vendor's intervention plan and
number of service hours for ABA or intensive behavioral intervention
no less than every six months, consistent with evidence-based
practices. If necessary, the intervention plan's treatment goals and
objectives shall be updated and revised.
(6) Not reimburse a parent for participating in a behavioral
services treatment program.
(c) For consumers receiving ABA or behavioral intervention
services on July 1, 2009, as part of their IPP or IFSP, subdivision
(b) shall apply on August 1, 2009.
(d) For purposes of this section the following definitions shall
apply:
(1) "Applied behavioral analysis" means the design,
implementation, and evaluation of systematic instructional and
environmental modifications to promote positive social behaviors and
reduce or ameliorate behaviors which interfere with learning and
social interaction.
(2) "Intensive behavioral intervention" means any form of applied
behavioral analysis that is comprehensive, designed to address all
domains of functioning, and provided in multiple settings for no more
than 40 hours per week, across all settings, depending on the
individual's needs and progress. Interventions can be delivered in a
one-to-one ratio or small group format, as appropriate.
(3) "Evidence-based practice" means a decisionmaking process that
integrates the best available scientifically rigorous research,
clinical expertise, and individual's characteristics. Evidence-based
practice is an approach to treatment rather than a specific
treatment. Evidence-based practice promotes the collection,
interpretation, integration, and continuous evaluation of valid,
important, and applicable individual- or family-reported,
clinically-observed, and research-supported evidence. The best
available evidence, matched to consumer circumstances and
preferences, is applied to ensure the quality of clinical judgments
and facilitates the most cost-effective care.
(4) "Parent participation" shall include, but shall not be limited
to, the following meanings:
(A) Completion of group instruction on the basics of behavior
intervention.
(B) Implementation of intervention strategies, according to the
intervention plan.
(C) If needed, collection of data on behavioral strategies and
submission of that data to the provider for incorporation into
progress reports.
(D) Participation in any needed clinical meetings.
(E) Purchase of suggested behavior modification materials or
community involvement if a reward system is used.
