4850-4867

WELFARE AND INSTITUTIONS CODE
SECTION 4850-4867




4850.  (a) The Legislature reaffirms its intent that habilitation
services for adults with developmental disabilities should be planned
and provided as a part of a continuum and that habilitation services
should be available to enable persons with developmental
disabilities to approximate the pattern of everyday living available
to nondisabled people of the same age.
   (b) The Legislature further intends that habilitation services
shall be provided to adults with developmental disabilities as
specified in this chapter in order to guarantee the rights stated in
Section 4502.



4850.1.  Notwithstanding Section 19050.9 of the Government Code,
beginning July 1, 2004, the State Department of Developmental
Services shall succeed to all functions and responsibilities of the
Department of Rehabilitation with respect to the administration of
the Habilitation Services Program established pursuant to former
Chapter 4.5 (commencing with Section 19350) of Part 2 of Division 10.



4850.2.  (a) Except as otherwise specifically provided, this chapter
shall only apply to those habilitation services purchased by the
regional centers.
   (b) Nothing in this section shall be construed to abridge the
rights stated in Section 4502.



4851.  The definitions contained in this chapter shall govern the
construction of this chapter, with respect to habilitation services
provided through the regional center, and unless the context requires
otherwise, the following terms shall have the following meanings:
   (a) "Habilitation services" means community-based services
purchased or provided for adults with developmental disabilities,
including services provided under the Work Activity Program and the
Supported Employment Program, to prepare and maintain them at their
highest level of vocational functioning, or to prepare them for
referral to vocational rehabilitation services.
   (b) "Individual program plan" means the overall plan developed by
a regional center pursuant to Section 4646.
   (c) "Individual habilitation service plan" means the service plan
developed by the habilitation service vendor to meet employment goals
in the individual program plan.
   (d) "Department" means the State Department of Developmental
Services.
   (e) "Work activity program" includes, but is not limited to,
sheltered workshops or work activity centers, or community-based work
activity programs certified pursuant to subdivision (f) or
accredited by CARF, the Rehabilitation Accreditation Commission.
   (f) "Certification" means certification procedures developed by
the Department of Rehabilitation.
   (g) "Work activity program day" means the period of time during
which a Work Activity Program provides services to consumers.
   (h) "Full day of service" means, for purposes of billing, a day in
which the consumer attends a minimum of the declared and approved
work activity program day, less 30 minutes, excluding the lunch
period.
   (i) "Half day of service" means, for purposes of billing, any day
in which the consumer's attendance does not meet the criteria for
billing for a full day of service as defined in subdivision (g), and
the consumer attends the work activity program not less than two
hours, excluding the lunch period.
   (j) "Supported employment program" means a program that meets the
requirements of subdivisions (n) to (s), inclusive.
   (k) "Consumer" means any adult who receives services purchased
under this chapter.
   (l) "Accreditation" means a determination of compliance with the
set of standards appropriate to the delivery of services by a work
activity program or supported employment program, developed by CARF,
the Rehabilitation Accreditation Commission, and applied by the
commission or the department.
   (m) "CARF" means CARF the Rehabilitation Accreditation Commission.
   (n) "Supported employment" means paid work that is integrated in
the community for individuals with developmental disabilities.
   (o) "Integrated work" means the engagement of an employee with a
disability in work in a setting typically found in the community in
which individuals interact with individuals without disabilities
other than those who are providing services to those individuals, to
the same extent that individuals without disabilities in comparable
positions interact with other persons.
   (p) "Supported employment placement" means the employment of an
individual with a developmental disability by an employer in the
community, directly or through contract with a supported employment
program. This includes provision of ongoing support services
necessary for the individual to retain employment.
   (q) "Allowable supported employment services" means the services
approved in the individual program plan and specified in the
individual habilitation service plan for the purpose of achieving
supported employment as an outcome, and may include any of the
following:
   (1) Job development, to the extent authorized by the regional
center.
   (2) Program staff time for conducting job analysis of supported
employment opportunities for a specific consumer.
   (3) Program staff time for the direct supervision or training of a
consumer or consumers while they engage in integrated work unless
other arrangements for consumer supervision, including, but not
limited to, employer supervision reimbursed by the supported
employment program, are approved by the regional center.
   (4) Community-based training in adaptive functional and social
skills necessary to ensure job adjustment and retention.
   (5) Counseling with a consumer's significant other to ensure
support of a consumer in job adjustment.
   (6) Advocacy or intervention on behalf of a consumer to resolve
problems affecting the consumer's work adjustment or retention.
   (7) Ongoing support services needed to ensure the consumer's
retention of the job.
   (r) "Group services" means job coaching in a group supported
employment placement at a job coach-to-consumer ratio of not less
than one-to-three nor more than one-to-eight where services to a
minimum of three consumers are funded by the regional center or the
Department of Rehabilitation. For consumers receiving group services,
ongoing support services shall be limited to job coaching and shall
be provided at the worksite.
   (s) "Individualized services" means job coaching and other
supported employment services for regional center-funded consumers in
a supported employment placement at a job coach-to-consumer ratio of
one-to-one, and that decrease over time until stabilization is
achieved. Individualized services may be provided on or off the
jobsite.



4852.  A consumer shall be referred to a provider of habilitation
services under this chapter when all of the following apply:
   (a) The individual is an adult who has been diagnosed as having a
developmental disability.
   (b) The individual is determined to be in need of and has chosen
habilitation services through the individual program planning process
pursuant to Section 4646.


4853.  (a) When a referral for habilitation services pursuant to
Section 4852 has been made and if the individual is placed in a work
activity program, he or she shall be deemed presumptively eligible
for a period not to exceed 90 days.
   (b) During the period of presumptive eligibility, the work
activity program shall submit a work skills evaluation report to the
regional center. The work skills evaluation report shall reflect the
performance of the consumer in all of the following areas:
   (1) Appropriate behavior to safely conduct himself or herself in a
work setting.
   (2) Adequate attention span to reach a productivity level in paid
work.
   (3) Ability to understand and act on simple instructions within a
reasonable length of time.
   (4) Ability to communicate basic needs and understand basic
receptive language.
   (5) Attendance level.
   (c) During the period of presumptive eligibility, the individual
program plan planning team shall, pursuant to Section 4646, utilize
the work skills evaluation report to determine the appropriateness of
the referral.



4854.  In developing the individual habilitation service plan
pursuant to Section 4853, the habilitation service provider shall
develop specific and measurable objectives to determine whether the
consumer demonstrates ability to reach or maintain individual
employment goals in all of the following areas:
   (a) Participation in paid work for a specified period of time.
   (b) Obtaining or sustaining a specified productivity rate.
   (c) Obtaining or sustaining a specified attendance level.
   (d) Demonstration of appropriate behavior for a work setting.




4854.1.  The individual program plan planning team, shall, pursuant
to Section 4646, meet, when it is necessary to review any of the
following:
   (a) The appropriateness of job placement.
   (b) The appropriateness of the services available at the Work
Activity Program or Supported Employment Program.
   (c) The individual habilitation service plan.



4855.  When an individual who is eligible for habilitation services
under this chapter is referred to the Department of Rehabilitation
for vocational rehabilitation services, including supported
employment services, and is placed on a Department of Rehabilitation
waiting list for vocational rehabilitation as a result of the
Department of Rehabilitation's order of selection regulations, the
regional center shall authorize appropriate services for the
individual pursuant to this chapter as needed until services can be
provided by the vocational rehabilitation program.



4856.  (a) The regional center shall monitor, evaluate, and audit
habilitation services providers for program effectiveness, using
performance criteria that include, but are not limited to, all of the
following:
   (1) Service quality.
   (2) Protections for individuals receiving services.
   (3) Compliance with applicable CARF standards.
   (b) (1) The regional center may impose immediate sanctions on
providers of work activity programs and supported employment programs
for noncompliance with accreditation or services standards contained
in regulations adopted by the department, and for safety violations
which pose a threat to consumers of habilitation services.
   (2) Sanctions include, but are not limited to, the following:
   (A) A moratorium on new referrals.
   (B) Imposition of a corrective plan as specified in regulations.
   (C) Removal of consumers from a service area where dangerous
conditions or abusive conditions exist.
   (D) Termination of vendorization.
   (c) A moratorium on new referrals may be the first formal sanction
to be taken except in instances where consumers are at imminent risk
of abuse or other harm. When the regional center determines a
moratorium on new referrals to be the first formal sanction, a
corrective action plan shall be developed. The moratorium shall be
lifted only when the conditions cited are corrected per a corrective
action plan.
   (d) A corrective action plan is a formal sanction, that may be
imposed either simultaneously with a moratorium on new referrals, or
as a single sanction in circumstances that do not require a
moratorium, as determined by the regional center. Noncompliance with
the conditions and timelines of the corrective action plan shall
result in termination of vendorization.
   (e) Removal of consumers from a program shall only take place
where dangerous or abusive conditions are present, or upon
termination of vendorization. In instances of removal for health and
safety reasons, when the corrections are made by the program, as
determined by the regional center, consumers may return, at their
option.
   (f) Any provider sanctioned under subparagraph (B) or (C) of
paragraph (2) of subdivision (b) may request an administrative review
as specified in Section 4648.1.
   (g) Any provider sanctioned under subparagraph (D) of paragraph
(2) of subdivision (b) shall have a right to a formal review by the
Office of Administrative Hearings under Chapter 4 (commencing with
Section 11370) of Part 1 of Division 3 of Title 2 of the Government
Code.
   (h) Effective July 1, 2004, if a habilitation services provider is
under sanction under former Section 19354.5, the provider shall
complete the requirements of the corrective action plan or any other
terms or conditions imposed upon it as part of the sanctions. At the
end of the term of the corrective action plan or other compliance
requirements, the services provider shall be evaluated by the
regional center based upon the requirements in this section.



4857.  The regional center shall purchase habilitation services
pursuant to the individual program plan. Habilitation services shall
continue as long as satisfactory progress is being made toward
achieving the objectives of the individual habilitation service plan
or as long as these services are determined by the regional center to
be necessary to maintain the individual at their highest level of
vocational functioning, or to prepare the individual for referral to
vocational rehabilitation services.



4857.1.  Regional centers may purchase habilitation services only
from providers who are accredited community nonprofit agencies that
provide work activity services or supported employment services, or
both, and that have been vendored as described in Section 4861 and
regulations promulgated pursuant thereto. Habilitation services
providers who, on July 1, 2004, are providing services to consumers
shall be deemed to be an approved vendor.



4858.  (a) Each work activity program vendor shall, at a minimum,
annually review the status of consumers participating in their
program to determine whether these individuals would benefit from
vocational rehabilitation services, including supported employment.
   (b) If it is determined that the consumer would benefit from
vocational rehabilitation services, the work activity program vendor
shall, in conjunction with the regional center and in accordance with
the individual program plan process, refer the consumer to the
Department of Rehabilitation.


4859.  (a) The department shall adopt regulations to establish rates
for work activity program services subject to the approval of the
Department of Finance. The regulations shall provide for an equitable
and cost-effective ratesetting procedure in which each specific
allowable service, activity, and provider administrative cost
comprising an overall habilitation service, as determined by the
department, reflects the reasonable cost of service. Reasonable costs
shall be determined biennially by the department, subject to audit
at the discretion of the department.
   (b) The department shall adopt the existing work activity program
rates as of July 1, 2004, that shall remain in effect until the next
ratesetting year.
   (c) Notwithstanding paragraph (4) of subdivision (a) of Section
4648, the regional center shall pay the work activity program rates
established by the department.



4860.  (a) (1) The hourly rate for supported employment services
provided to consumers receiving individualized services shall be
thirty dollars and eighty-two cents ($30.82).
   (2) Job coach hours spent in travel to consumer worksites may be
reimbursable for individualized services only when the job coach
travels from the vendor's headquarters to the consumer's worksite or
from one consumer's worksite to another, and only when the travel is
one way.
   (b) The hourly rate for group services shall be thirty dollars and
eighty-two cents ($30.82), regardless of the number of consumers
served in the group. Consumers in a group shall be scheduled to start
and end work at the same time, unless an exception that takes into
consideration the consumer's compensated work schedule is approved in
advance by the regional center. The department, in consultation with
stakeholders, shall adopt regulations to define the appropriate
grounds for granting these exceptions. When the number of consumers
in a supported employment placement group drops to fewer than the
minimum required in subdivision (r) of Section 4851, the regional
center may terminate funding for the group services in that group,
unless, within 90 days, the program provider adds one or more
regional centers, or Department of Rehabilitation-funded supported
employment consumers to the group.
   (c) Job coaching hours for group services shall be allocated on a
prorated basis between a regional center and the Department of
Rehabilitation when regional center and Department of Rehabilitation
consumers are served in the same group.
   (d) When Section 4855 applies, fees shall be authorized for the
following:
   (1) A three-hundred-sixty-dollar ($360) fee shall be paid to the
program provider upon intake of a consumer into a supported
employment program. No fee shall be paid if that consumer completed a
supported employment intake process with that same supported
employment program within the previous 12 months.
   (2) A seven-hundred-twenty-dollar ($720) fee shall be paid upon
placement of a consumer in an integrated job, except that no fee
shall be paid if that consumer is placed with another consumer or
consumers assigned to the same job coach during the same hours of
employment.
   (3) A seven-hundred-twenty-dollar ($720) fee shall be paid after a
90-day retention of a consumer in a job, except that no fee shall be
paid if that consumer has been placed with another consumer or
consumers, assigned to the same job coach during the same hours of
employment.
   (e) Notwithstanding paragraph (4) of subdivision (a) of Section
4648, the regional center shall pay the supported employment program
rates established by this section.


4861.  The regional center may vendor new work activity or supported
employment programs, after determining the capacity of the program
to deliver effective services, and assessing the ability of the
program to comply with CARF requirements.
   (a) Programs that receive the regional center's approval to
provide supported employment services shall receive rates in
accordance with Section 4860.
   (b) A new work activity program shall receive the statewide
average rate, as determined by the department. As soon as the new
work activity program has a historical period of not less than three
months that is representative of the cost per consumer, as determined
by the department, the department shall set the rate in accordance
with Section 4859.
   (c) The regional center may purchase services from new work
activity programs and supported employment programs, even though the
program in not yet accredited by CARF, if all of the following apply:
   (1) The vendor can demonstrate that the program is in compliance
with certification standards established by the Department of
Rehabilitation, to allow a period for becoming CARF accredited.
   (2) (A) The program commits, in writing, to apply for
accreditation by CARF within three years of the approval to purchase
services by the regional center.
   (B) CARF shall accredit a program within four years after the
program has been vendored.
   (d) The regional center may approve or disapprove proposals
submitted by new or existing vendors based on all of the following
criteria to the extent that it is federally permissible:
   (1) The need for a work activity or supported employment program.
   (2) The capacity of the vendor to deliver work activity or
supported employment services effectively.
   (3) The ability of the vendor to comply with the requirements of
this section.
   (4) The ability of the vendor to achieve integrated paid work for
consumers served in supported employment.



4862.  (a) The length of a work activity program day shall not be
less than five hours, excluding the lunch period.
   (b) (1) Except as provided in paragraph (2), the length of a work
activity program day shall not be reduced from the length of the work
activity program day in the historical period that was the basis for
the approved habilitation services rate.
   (2) (A) A work activity program may, upon consultation with, and
prior written approval from, the regional center, change the length
of a work activity program day.
   (B) If the regional center approves a reduction in the work
activity program day pursuant to subparagraph (A), the department may
change the work activity program rate.
   (c) (1) A work activity program may change the length of a work
activity program day for a specific consumer in order to meet the
needs of that consumer, if the regional center, upon the
recommendation of the individual program planning team, approves the
change.
   (2) The work activity program shall specify in writing to the
regional center the reasons for any proposed change in a work
activity program day on an individual basis.



4863.  (a) In accordance with regulations adopted by the department,
and if agreed upon by the work activity program and the regional
center, hourly billing shall be permitted, provided that it does not
increase the regional center's costs when used in lieu of full-day or
half-day billing. A work activity program shall be required to
submit a request for the hourly billing option to the regional center
not less than 60 days prior to the program's proposed implementation
of this billing option.
   (b) If a work activity program and the regional center elect to
utilize hourly billing, the hourly billing process shall be required
to be used for a minimum of one year.
   (c) When the hourly billing process is being used, the definitions
contained in subdivisions (h) and (i) of Section 4851 shall not
apply.



4864.  The department shall authorize payment for absences in work
activity programs and supported employment programs that are directly
consequent to a declaration of a State of Emergency by the Governor.
If the department authorizes payment for absences due to a state of
emergency, the vendor shall bill only for absences in excess of the
average number of absences experienced by the vendor during the
12-month period prior to the month in which the disaster occurred.



4865.  At the request of the Department of Rehabilitation, a work
activity or supported employment program or both shall release
accreditation and state licensing reports and consumer special
incident reports as required by law or regulations in instances of
suspected abuse.



4865.1.  (a) A regional center shall continue to pay the rate in
effect as of June 30, 2004, for a supported employment placement
group composed of a coach-to-client ratio of 1:3 when the provider
submits to the State Department of Developmental Services and the
regional center, by July 30, 2004, documentation that all of the
following conditions apply:
   (1) The group was established prior to July 1, 2002.
   (2) The group was at the 1:3 ratio on May 1, 2004.
   (3) The employer will only accommodate a group of three.
   (b) In consultation with the regional center, the State Department
of Developmental Services shall determine whether the requirements
of this section have been met. The department's decision shall be
final.
   (c) Groups paid under this section shall meet the requirements of
subdivision (r) of Section 4851 by July 1, 2005, or be subject to
termination of funding pursuant to subdivision (b) of Section 4860.



4866.  The department may promulgate emergency regulations to carry
out the provisions of this chapter. If the Department of
Developmental Services promulgates emergency regulations, the
adoption of the regulations shall be deemed necessary for the
immediate preservation of the public peace, health and safety, or
general welfare for purposes of subdivision (b) of Section 11346.1 of
the Government Code.



4867.  Nothing in this chapter shall be interpreted to mean that
work activity programs or supported employment programs cannot serve
consumers who are funded by agencies other than regional centers,
including, but not limited to, the Department of Rehabilitation.