SECTIONS 4353-4359 - California Statutes

WELFARE AND INSTITUTIONS CODE

SECTION 4353-4359

4353. The Legislature finds and declares all of the following:
(a) There is a large population of persons who have suffered
traumatic head injuries resulting in significant functional
impairment.
(b) Approximately 80 percent of these injuries have occurred as a
direct result of motor vehicle accidents.
(c) There is a lack of awareness of the problems associated with
head injury resulting in a significant lack of services for persons
with head injuries, including, but not limited to, in-home and
out-of-home services, respite care, placement programs, counseling,
cognitive rehabilitation, transitional living, and vocational
rehabilitation services.
(d) Although there are currently a number of different programs
attempting to meet the needs of the persons with head injuries, there
is no clearly defined ultimate responsibility vested in any single
state agency. Nothing in this section shall be construed to mandate
services for persons with acquired traumatic injury through county
and city programs.
(e) There is no programmatic coordination among agencies to
facilitate the provision of a continuing range of services
appropriate for persons with traumatic head injuries.
(f) There is a serious gap in postacute care services resulting in
incomplete recovery of functional potential.
(g) Due to the problems referred to in this section, the state is
not adequately meeting the needs of persons with head injuries
enabling them to return to work and to lead productive lives.

4354. For purposes of this chapter, the following definitions shall
apply:
(a) "Acquired traumatic brain injury" is an injury that is
sustained after birth from an external force to the brain or any of
its parts, resulting in cognitive, psychological, neurological, or
anatomical changes in brain functions.
(b) "Department" means the State Department of Rehabilitation.
(c) "Director" means the Director of Rehabilitation.
(d) (1) "Vocational supportive services" means a method of
providing vocational rehabilitation and related services that may
include prevocational and educational services to individuals who are
unserved or underserved by existing vocational rehabilitation
services.
(2) "Extended supported employment services" means ongoing support
services and other appropriate services that are needed to support
and maintain an individual with an acquired traumatic brain injury in
supported employment following that individual's transition from
support provided as a vocational rehabilitation service, including
job coaching, by the department, as defined in paragraphs (1) and (5)
of subdivision (a) of Section 19150.
(e) The following four characteristics distinguish "vocational
supportive services" from traditional methods of providing vocational
rehabilitation and day activity services:
(1) Service recipients appear to lack the potential for unassisted
competitive employment.
(2) Ongoing training, supervision, and support services must be
provided.
(3) The opportunity is designed to provide the same benefits that
other persons receive from work, including an adequate income level,
quality of working life, security, and mobility.
(4) There is flexibility in the provision of support which is
necessary to enable the person to function effectively at the
worksite.
(f) "Community reintegration services" means services as needed by
consumers, designed to develop, maintain, increase, or maximize
independent functioning, with the goal of living in the community and
participating in community life. These services may include, but are
not limited to, providing, or arranging for access to, housing,
transportation, medical care, rehabilitative therapies, day programs,
chemical dependency recovery programs, personal assistance, and
education.
(g) "Fund" means the Traumatic Brain Injury Fund.
(h) "Supported living services" means a range of appropriate
supervision, support, and training in the consumer's place of
residence, designed to maximize independence.
(i) "Functional assessment" means measuring the level or degree of
independence, amount of assistance required, and speed and safety
considerations for a variety of categories, including activities of
daily living, mobility, communication skills, psychosocial
adjustment, and cognitive function.
(j) "Residence" means the place where a consumer makes his or her
home, that may include, but is not limited to, a house or apartment
where the consumer lives independently, assistive living
arrangements, congregate housing, group homes, residential care
facilities, transitional living programs, and nursing facilities.
(k) "Community rehabilitation program" shall have the same meaning
as contained in subdivision (5) of Section 705 of Title 29 of the
United States Code.

4354.5. The Legislature finds and declares all of the following:
(a) Traumatic brain injuries have a long-term impact on the
survivors, their families, caregivers, and support systems.
(b) Long-term care consumers experience great differences in
service levels, eligibility criteria, and service availability,
resulting in inappropriate and expensive care that fails to be
responsive to their needs.
(c) To the maximum extent feasible, the department shall pursue
all available sources of federal financial participation, including,
but not limited to, the Medicaid home and community-based services
waiver program (42 U.S.C. Sec. 1396n(c)) and Part J of Subchapter II
of the Public Health Service Act (42 U.S.C. Sec. 280b et seq.).
(d) If new sources of funding are secured which will permit
expanding the existing Traumatic Brain Injury Program, the department
shall fund an array of appropriate services and assistance to adults
18 years of age and older with traumatic brain injuries in those
areas of the state with the greatest need.
(e) Implementation of this chapter shall be consistent with the
state's public policy strategy to design a coordinated services
delivery system pursuant to Article 4.05 (commencing with Section
14139.05) of Chapter 7 of Part 3 of Division 9.

4355. (a) On or before January 1, 2012, the department shall
determine requirements related to service delivery, uniform data
collection, and other aspects of program administration, in addition
to those specified in Section 4357, that service providers
participating in the traumatic brain injury program must meet. This
may include, but is not limited to, the following:
(1) The department may require that service providers be approved
as community rehabilitation programs eligible to serve consumers.
(2) Upon approval of the Medicaid waiver sought pursuant to
Section 14132.992, the department may require that all service
providers do both of the following:
(A) Satisfy all applicable eligibility requirements for provision
of services under the waiver.
(B) Participate in the waiver and provide extended supported
employment services, as defined in paragraph (2) of subdivision (d)
of Section 4354.
(b) On or before January 1, 2013, the department shall do all of
the following:
(1) Determine the level of funding necessary to permit a service
provider to meet all applicable requirements and adequately serve its
designated service area.
(2) Determine the number of sites that can be supported with
available funding.
(3) Solicit applications from organizations interested in and
qualified to provide services pursuant to this chapter, and select
those best qualified to do so, with priority given to applicants that
have proven experience in providing effective services to persons
with acquired traumatic brain injuries, including, but not limited
to, supported living services, caregiver support, and family and
community education.
(c) The department shall meet periodically with traumatic brain
injury service providers for discussion of topics, including, but not
limited to, the development and implementation of performance
standards and data collection processes, eligibility requirements,
program administration, pursuit of funding, implementation of the
Medicaid waiver, if approved by the federal government, and
refinement of the traumatic brain injury continuum of care.

4356. Using data collected consistent with requirements established
pursuant to subdivision (a) of Section 4355, the department shall
monitor and evaluate the performance of service providers.

4357. (a) Service providers shall identify the needs of consumers
and deliver services designed to meet those needs.
(b) Service providers shall match not less than 20 percent of the
amount granted, with the exception of funds used for mentoring. The
required match may be cash or in-kind contributions, or a combination
of both, from the sites or any cooperating agency. In-kind
contributions may include, but shall not be limited to, staff and
volunteer services.
(c) Service providers shall provide at least 51 percent of their
services under the grant to individuals who are Medi-Cal eligible or
who have no other identified third-party funding source.
(d) (1) Service providers shall provide, directly or by
arrangement, a coordinated service model to include all of the
following:
(A) Supported living services.
(B) Community reintegration services.
(C) Vocational supportive services.
(D) Information, referral, and, as needed, assistance in
identifying, accessing, utilizing, and coordinating all services
needed by individuals with traumatic brain injury and their families.
(E) Public and professional education designed to facilitate early
identification of persons with brain injury, prompt referral of
these persons to appropriate services, and improvement of the system
of services available to them.
(2) The model shall be designed and modified with advice from
consumers and their families, and shall be accessible to the
population in need, taking into account transportation, linguistic,
and cultural factors.
(e) Service providers shall develop and utilize an individual
service plan which will allow consumers to move from intensive
medical rehabilitation or highly structured living arrangements to
increased levels of independence and employment. The goals and
priorities of each consumer shall be an integral part of his or her
service plan.
(f) Service providers shall seek all third-party reimbursements
for which consumers are eligible and shall utilize all services
otherwise available to consumers at no cost, including vocational
rehabilitation services provided by the department. However, grantees
may utilize grant dollars for the purchase of nonreimbursed services
or services otherwise unavailable to consumers.
(g) Service providers shall endeavor to serve a population that is
broadly representative with regard to race and ethnicity of the
population with traumatic brain injury in their geographical service
area, undertaking outreach activities as needed to achieve this goal.
(h) Service providers shall maintain a broad network of
relationships with local groups of brain injury survivors and
families of survivors, as well as local providers of health, social,
and vocational services to individuals with traumatic brain injury
and their families. The sites shall work cooperatively with these
groups and providers to improve and develop needed services and to
promote a well-coordinated service system, taking a leadership role
as necessary.
(i) Service providers shall furnish uniform data to the department
pursuant to subdivision (a) of Section 4355 as necessary to monitor
and evaluate the program.
(j) Service providers wishing to continue to participate in the
program after July 1, 2013, shall, by that date, be in compliance
with additional eligibility requirements established by the
department pursuant to Section 4355.

4357.1. (a) The department may make grants from the funds in the
Traumatic Brain Injury Fund, established in Section 4358, to service
providers for the purpose of carrying out the programs detailed in
this chapter.
(b) Contracts or grants awarded pursuant to this chapter,
including contracts required for administration or ancillary services
in support of programs, shall be exempt from the requirements of the
Public Contract Code and the State Administrative Manual, and from
approval by the Department of General Services.
(c) Grants awarded to service providers pursuant to this chapter
shall be subject to open competition every three years, unless the
department elects to extend one or more grants and delay competition
for those grants by a maximum of two additional years.

4358. There is hereby created in the State Treasury the Traumatic
Brain Injury Fund, the moneys in which may, upon appropriation by the
Legislature, be expended for the purposes of this chapter.

4358.5. Funds deposited into the Traumatic Brain Injury Fund
pursuant to paragraph (8) of subdivision (f) of Section 1464 of the
Penal Code may be matched by federal vocational rehabilitation
services funds for implementation of the Traumatic Brain Injury
program pursuant to this chapter. However, this matching of funds
shall occur only to the extent it is permitted by other state and
federal law, and to the extent the matching of funds would be
consistent with the policies and priorities of the department.

4359. This chapter shall remain in effect until July 1, 2019, and
as of that date is repealed, unless a later enacted statute enacted
prior to July 1, 2019, extends or deletes that date.