BILL ANALYSIS                                                                                                                                                                                                    

                                                                     AB 918

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          918 (Mark Stone)

          As Amended  August 26, 2015

          Majority vote

          |ASSEMBLY:  | 77-0 | (June 2,      |SENATE: |40-0  | (August 31,     |
          |           |      |2015)          |        |      |2015)            |
          |           |      |               |        |      |                 |
          |           |      |               |        |      |                 |

          Original Committee Reference:  HEALTH

          SUMMARY:  Requires the Secretary of California Health and Human  
          Services to establish a system of mandatory, consistent, timely,  
          and publicly accessible data collection related to data on  
          seclusion and restraint in community facilities serving aged and  
          developmentally disabled persons, as specified.  Requires the  
          Department of Developmental Services (DDS) to publish on its Web  
          page the number of incidents of physical and chemical restraint  
          in community facilities, as specified.  Requires community  
          facilities to report every death or serious injury of a person  
          in seclusion or in physical or chemical restraint no later than  
          the close of business day following the death or serious injury.

          The Senate amendments define "regional center vendor" as an  
          agency, individual, or service provider that a regional center  
          has approved to provide vendored or contracted services; specify  
          that acute psychiatric hospitals must also meet the requirements  
          of this bill, and; clarify that institutions for mental diseases  


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          that are regional center vendors meet the definition of an acute  
          psychiatric hospital.

          FISCAL EFFECT:  According to the Senate Appropriations  
          Committee, pursuant to Senate Rule 28.8, negligible state costs.

          COMMENTS:  According to the author, while existing law protects  
          individuals with developmental disorders in developmental  
          centers (DCs) from unreported use of seclusions and restraint,  
          the populations in these facilities are changing.  State  
          facilities are beginning to close and more people are living in  
          community facilities.  The author states that this move can be  
          heralded as an important and beneficial move for those with  
          developmental disabilities, but it also leaves them vulnerable  
          to the use of seclusion and behavioral restraint as tactics to  
          control behavior. 

          The author also states that the Legislature has made findings  
          and declarations indicating that the use of seclusions and  
          restraints is not a treatment nor does it positively change  
          behavior.  When the state first implemented reporting and  
          publishing requirements, most individuals were living in DCs.   
          However, now California is moving individuals to community  
          facilities, where no such requirement exists.  According to the  
          author, California must protect these vulnerable individuals,  
          give consumers more information when choosing a facility, and  
          allow the government and the designated protection and advocacy  
          agency, Disability Rights California (DRC), the ability to  
          compare the use of seclusion and restraint across facilities. 

          1)DCs.  California provides services and support to individuals  
            with developmental disabilities in two ways.  The vast  
            majorities of people live in their families' homes or other  
            community settings and receive state-funded services that are  
            coordinated by one of 21 non-profit corporations known as  
            regional centers.  More than 99% of DDS consumers receive  
            services in this way under the Community Services Program.  A  
            smaller number of individuals, or less than 1% of the DDS  


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            caseload, live in three state-operated DCs and one  
            state-operated community facility.  DDS operates three DCs:   
            Fairview (Orange County); Porterville (Tulare County); and,  
            Sonoma (Sonoma County).  Among other services, Porterville  
            also provides secure treatment services.  A fourth DC,  
            Lanterman, transitioned its last resident into community  
            living on December 23, 2014.  Services at all facilities  
            involve the provision of active treatment through residential  
            and day programs on a 24-hour basis, including appropriate  
            medical and dental care, health maintenance activities, and  
            assistance with activities of daily living, training,  
            education, and employment.
          2)Population Transitions.  During a period of recent budget  
            deficits, the Legislature enacted numerous DDS budget  
            reductions and cost savings measures to yield General Fund  
            savings.  The 2012-13 budget imposed a moratorium on  
            admissions to DCs except for individuals involved in the  
            criminal justice system, and consumers in an acute crisis  
            needing short-term stabilization.  The high costs to maintain  
            and staff these facilities, coupled with an emphasis on  
            transitioning individuals back into their community, have led  
            to the closure and/or restructuring of many DCs.  The  
            moratorium on DC admission as well as the need for the  
            availability of services in the community have led to a shift  
            in spending from the DCs to the community services programs.   
            The 2015-16 Budget reflects this change, as the budget for DCs  
            has decreased and the Community Services budget has increased.

          DRC, the sponsors of the bill, write in support of this bill  
          that residents in DCs are moving from large state facilities and  
          into smaller community facilities.  Family members and advocates  
          are concerned about the unknown and unreported use of behavioral  
          restraint and seclusion; dangerous practices that often result  
          in serious injuries, even death.  The concern continues to grow  
          as individuals with behavioral challenges migrate from DCs where  
          there is public reporting and accountability to isolated  
          community settings where there is no public accountability  
          regarding as to the use of seclusion and behavioral restraint.   
          People with disabilities should live in the community with  
          appropriate services and supports; and there should be  
          appropriate oversight of community facilities that use dangerous  


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          restraint and seclusion practices. 

          The National Association of Social Workers (NASW) writes that  
          through previous legislation, the state has attempted to reduce  
          or eliminate the use of seclusion or behavior restraints at  
          state facilities.  Efforts have also been made to make the data  
          on the use of seclusion and restraints available to the public.   
          Currently, these laws do not apply to community facilities.   
          NASW argues this bill will require information about deaths or  
          serious injury available to the protection and advocacy agency  
          designated by the Governor. 

          There is no known opposition to this bill.

          Analysis Prepared by:                                             
                          Paula Villescaz / HEALTH / (916) 319-2097  FN: