Judge: James C. Chalfant, Case: 20STCP04289, Date: 2022-08-23 Tentative Ruling
Case Number: 20STCP04289 Hearing Date: August 23, 2022 Dept: 85
Stephanie Litwin, on
behalf of Jonathan Litwin v. Nancy Bargmann, et al., 20STCP04289
Tentative decision on petition
for writ of mandate: denied
Petitioner
Stepanie Litwin (“Mother”), as conservator and guardian ad litem for Johnathan
Litwin (“Johnathan”), applies for administrative mandamus compelling Respondents
Zacchary Morazzini (“Morazzini”), Director and Chief Administrative Law Judge
(“ALJ”) of the Office of Administrative Hearings (“OAH”), and Nancy Bargmann
(“Bargmann”), Director of the Department of Social Services (“DSS”), to set
aside the decision upholding Real Party-in-Interest Eastern Los Angeles
Regional Center’s (“Regional Center”) denial of Johnathan’s request to increase
his Adaptive Skills Training (“AST”) hours from 75 to 125 at Progressive Resources
(“Progressive”).
The
court has read and considered the moving papers, opposition, and reply, and renders
the following tentative decision.
A. Statement of the Case
1. Petition
Petitioner
Mother, as guardian ad litem for Jonathan Litwin (“Jonathan”), filed
this Petition on December 30, 2020 against Respondents Bargmann, in her
official capacity as Director of DDS, and Morazzini, in his official capacity
as Director and Chief ALJ of OAH. The
Petition alleges two causes of action for writ of administrative mandamus as
follows.
Jonathan
is a client of Regional Center diagnosed with Level 3 autism who was receiving
75 monthly hours of programming from Regional Center’s vendor,
Progressive. He requested an additional
50 monthly hours. On December 18, 2019, Regional
Center issued a Notice of Proposed Action denying the request.
Johnathan filed a request for hearing on February 11, 2020. Following a hearing in July and August 2020, OAH
issued a decision on September 28, 2020 upholding the denial.
Petitioner
Jonathan[1] seeks
a writ of administrative mandate setting aside the September 28, 2020 decision
denying the request to increase his monthly service hours from 75 to 125, as
well as reasonable attorney’s fees and costs.
2.
Course of Proceedings
On
January 14, 2021, the court rejected Mother’s application to be appointed as Jonathan’s
guardian ad litem. On February 3,
2021, the court granted Mother’s renewed application.
On
May 5, 2021, Jonathan served Real Party Regional Center with the Petition.
On
May 6, 2021, Jonathan served Respondent DSS with the Petition. DDS filed a Notice of Appearance and
Statement of No Position regarding the merits of the Petition, objecting only
to any claim against it for attorney’s fees.
On
May 13, 2021, Jonathan served Respondent OAH with the Petition. OAH subsequently filed a notice of non-appearance
as did Respondent Morazinni.
On
August 2, 2021, Regional Center filed its Answer.
On
June 14, 2022, the court granted Regional Center’s motion to augment the record
with the Declaration of Jessica Acosta Barba and an email from Una K. Hayes-Shepard
(“Shepard”). In granting Regional Center’s
motion, the court denied Jonathan’s purported motion to augment contained in
his opposition, indicating that he would have to make a noticed motion if he
wished to augment the record.
B. Standard of Review
CCP
section 1094.5 is the administrative mandamus provision which structures the
procedure for judicial review of adjudicatory decisions rendered by
administrative agencies. Topanga
Ass’n for a Scenic Community v. County of Los Angeles, (“Topanga”)
(1974) 11 Cal.3d 506, 514-15.
CCP
section 1094.5 does not in its face specify which cases are subject to
independent review, leaving that issue to the courts. Fukuda v. City of Angels, (1999)20
Cal.4th 805, 811. In cases reviewing
decisions which affect a vested, fundamental right the trial court exercises
independent judgment on the evidence. Bixby v. Pierno, (1971) 4 Cal.3d
130, 143. See CCP §1094.5(c). Although Litwin cites the substantial
evidence test (Pet. Op. Br. at 2), in administrative mandamus actions to review
decisions affecting developmental services, the trial court exercises
independent judgment on the evidence. Mason
v. Office of Admin. Hearings, (“Mason”) (2001) 89 Cal.App.4th 1119,
1130.
Under
the independent judgment test, “the trial court not only examines the
administrative record for errors of law but also exercises its independent
judgment upon the evidence disclosed in a limited trial de novo.” Id. at 143. The court must draw its own reasonable
inferences from the evidence and make its own credibility determinations. Morrison v. Housing Authority of the City
of Los Angeles Board of Commissioners, (2003) 107 Cal.App.4th 860,
868. In short, the court substitutes its
judgment for the agency’s regarding the basic facts of what happened, when,
why, and the credibility of witnesses. Guymon
v. Board of Accountancy, (1976) 55 Cal.App.3d 1010, 1013-16.
However,
“[i]n exercising its independent judgment, a trial court must afford a strong
presumption of correctness concerning the administrative findings, and the
party challenging the administrative decision bears the burden of convincing
the court that the administrative findings are contrary to the weight of the
evidence.” Fukuda, supra,
20 Cal.4th at 817. Unless it can be
demonstrated by petitioner that the agency’s actions are not grounded upon any
reasonable basis in law or any substantial basis in fact, the courts should not
interfere with the agency’s discretion or substitute their wisdom for that of
the agency. Bixby, supra,
4 Cal.3d 130, 150-151; Bank of America v. State Water Resources Control
Board, (1974) 42 Cal.App.3d 198, 208.
The
agency’s decision must be based on a preponderance of the evidence presented at
the hearing. Board of Medical Quality
Assurance v. Superior Court, (1977) 73 Cal.App.3d 860, 862. The hearing officer is only required to issue
findings that give enough explanation so that parties may determine whether,
and upon what basis, to review the decision. Topanga, supra, 11
Cal.3d 506, 514-15. Implicit in section
1094.5 is a requirement that the agency set forth findings to bridge the
analytic gap between the raw evidence and ultimate decision or order. Id. at 115.
An
agency is presumed to have regularly performed its official duties (Evid. Code
§664), and the petitioner therefore has the burden of proof. Steele v. Los Angeles County Civil Service
Commission, (1958) 166 Cal.App.2d 129, 137.
“[T]he burden of proof falls upon the party attacking the administrative
decision to demonstrate wherein the proceedings were unfair, in excess of
jurisdiction or showed prejudicial abuse of discretion. Afford v. Pierno, (1972) 27 Cal.App.3d
682, 691.
C. Lanterman Act
The Lanterman Developmental Disabilities Act, W&I Code[2] §§
4500-4845 (“Lanterman Act”) is a comprehensive statutory scheme intended by the
Legislature “to provide a ‘pattern of facilities and services . . .
sufficiently complete to meet the needs of each person with developmental
disabilities, regardless of age or degree of handicap, and each stage of
life.” Association for Retarded
Citizens-California v. Dept. of Developmental Services, (“Association”)
(1985) 38 Cal.3d 384, 388 (quoting §4501).
“Such services include locating developmentally disabled persons,
assessing their needs, and selecting and providing services to meet disabled
persons’ needs on an individual basis.” Id.
at 388 (citing §§ 4641-43, 4646, 4647).
To
implement the scheme of statutory rights of developmentally disabled persons
and the corresponding obligations of the state towards them, the Legislature
has fashioned a system in which both state agencies and private entities have
functions. DSS, a state agency, “has
jurisdiction over the execution of the laws relating to the care; custody, and
treatment of developmentally disabled persons.” §4416.
Regional
centers are established and operate under the provisions of the Lanterman Act. §4500 et
seq. Each regional center is a
separate non-profit corporation that has a contract with DSS to assess
individuals for eligibility and to provide services to those eligible and
residing in a particular geographical area known as a “catchment area.” §§ 4416, 4620, 4621, 4640(a).
Regional centers serve those with a “developmental
disability” as that term is defined by law.
§4512(a) & (l). A
“developmental disability” is a condition that exists prior to the age of 18
years old, is expected to continue indefinitely, and is a substantial
disability for the individual. §4512(a). Autism is included in the definition of
“developmental disability.” §4512(a).
DSS’s regulations further define a “developmental
disability” as a disability attributable to mental retardation (now
intellectual disability), cerebral palsy, epilepsy, autism, or disabling
conditions found to be closely related to mental retardation or to require
treatment similar to that required for individuals with mental retardation. 17 CCR §54000(a). The developmental disability shall (1)
originate before age 18, (2) be likely to continue indefinitely, (3) constitute
a substantial disability. 17 CCR
§54000(b). The Lanterman Act defines a
“substantial disability” as the existence of significant functional limitations
in three or more of the following areas: (1) self-care; (2) receptive and
expressive language; (3) learning; (4) mobility; (5) self-direction; (6)
capacity for independent living; and (7) economic self-sufficiency. §4512(l)(1).
Excluded from the definition of “developmental disability” are
conditions that are solely psychiatric disorders, solely learning disabilities,
or disabilities that are solely physical in nature. 17 CCR §54000(c).
The purchase of needed services for developmentally disabled
individuals is one of the obligations the Lanterman Act imposes on the regional
centers. “Under the statutory scheme,
the regional centers provide services to developmentally disabled persons and
determine the manner in which those services are to be rendered.” Association, supra, 3 Cal.3d at
389. To determine whether an individual
believed to have a developmental disability is eligible for services, a
regional center conducts an initial intake and an assessment to determine if
the individual has a developmental disability.
§§ 4642-43.
Each
eligible individual has a regional center service coordinator assigned to them
and an individual program plan (“IPP”). §§
4646, 4646.5, 4647(a). The IPP is developed
through a process of individualized needs determination. §4646(b).
The IPP includes agreed-upon goals and objectives and services and
supports, whether from generic resources or funded by the regional center,
needed to assist the individual in attaining those goals and objectives. §§ 4646-48. The IPP and provision of services and supports
is intended to be centered on the individual and the family and “takes[] into
account the needs and preferences of the individual and the family, if appropriate,
as well as promoting community integration, independent, productive, and normal
lives, and stable and healthy environments.” §4646(a). The services should “be effective in meeting
the goals stated in the individual program plan, reflect the preferences and
choices of the consumer, and reflect the cost-effective use of public resources.”
Ibid.
The
IPP includes 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.” §4646.5(a)(8). A review must occur, as necessary, “in
response to the person’s achievement or changing needs, and no less often than
once every three years.” §4646.5(b). An
individual or authorized representative can ask for an IPP meeting at any time
and one must be held within 30 days. Ibid.
The Lanterman Act contains limitations for regional center
funding of services. See §§ 4646.4, 4646.5(a)(4), 4648(a)(8),
4659. Regional centers do not provide
direct services, but instead use service providers that meet certain
qualifications to be “vendored” by a regional center to provide particular
services. §4648(a)(3)-(6). A service or support provided by an agency or
individual shall not be continued unless the consumer or, if appropriate, the
consumer’s parents, legal guardian, or conservator, or authorized
representative is satisfied and the regional center and the consumer or, if
appropriate, the consumer’s parents or legal guardian or conservator agree that
planned services and supports have been provided, and reasonable progress
toward objectives have been made. §4648(a)(7).
If
there is a dispute over services funded by the regional center, the regional
center consumer is entitled to an administrative appeal known as a “fair
hearing.” §§ 4710-14.
D. Statement of Facts[3]
1. Background
Jonathan was born on
October 30, 1995. He was 26 years old as
of the fair hearing. AR 1413. Jonathan has autism spectrum disorder, and according
his IPP, he demonstrates aggression and emotional outbursts while having tantrums. AR 1419.
Although he can repeat words back to people to greet them, he is non-verbal
and communicates mostly through sounds and gestures. AR 1419.
Johnathan lives with his
parents and siblings. AR 1415. Mother is Jonathan’s limited conservator with
the ability to fix his residence, access confidential records and papers,
consent or withhold consent to his marriage to or registered domestic
partnership with another, control his right to contract, consent or withhold
consent to medical treatment, control his social and sexual contracts and
relationships, and make decisions as to his education. AR 31, 33.
Regional Center provides
Jonathan with in-home/community individual service skills training, respite
services, personal assistance, counseling, and autism special psychiatry
services. AR 725-26, 1414. Jonathan has a Medicaid waiver compelling the
federal government to pay half the cost of services to the state’s
government. AR 83.
2. Post-High School Services
Until aging out at 22
years old, Jonathan attended the Buena Park Speech and Language program (“Buena
Park”). AR 397, 846.
On November 29,
2017, while Jonathan still attended Buena Park, clinical psychologist Randi
Bienstock (“Bienstock”) evaluated him.
AR 396. Bienstock’s report listed
the range of services Jonathan received: specialized academic instruction in a
non-public school setting, intensive individual services, speech therapy, counseling
and guidance, work experience and vocational training, transition services, and
transportation. AR 397. Before he entered the Buena Park program, Jonathan’s
parents had observed that he had regressed in some known skills such as bladder
control during high school, and they questioned whether he received adequate
support. AR 397. However, they were pleased at the level of
support and services Buena Park provided.
AR 397.
A month after he left Buena
Park in December 2017 – and after a year of searching for a new program –
Jonathan started at REACH, a community
integration program, five days a week.
AR 397, 846-47. His parents
wanted Jonathan to have 1:1 support at all times and that staff are trained in
the use of facilitated communication. AR
397. After seven months at REACH, Jonathan’s
aggressive behavior and incidents of elopement compelled REACH to conclude it
could not provide a safe program for him. AR 752.
According to Jonathan’s clinical psychologist Rodric Rhodes (“Rhodes”), Jonathan’s
more aggressive behavior coincided with a change in the direct service provider
who worked with him. AR 922, 928-29.
After Jonathan left
REACH, Regional Center Service Coordinator Venessa Grande (“Grande”) increased his
personal assistance hours to 60 to support his family in the interim period before
a day program could be found. AR 384,
767-68. Personal assistance services
provide the beneficiary with assistance with completing tasks at home and in
the community. AR 746-47. Grande also increased Jonathan’s hours of AST
at Progressive. He had been receiving
five hours a month of AST from Progressive to assist in developing appropriate
behaviors, social skills, and safety skills while out in the community. AR 689.
Grande increased Jonathan’s Progressive hours to 75. AR 965.
On October 24, 2019,
Grande and Mother met for Jonathan’s IPP.
AR 1415. The IPP noted that Jonathan
exhibits aggressive behaviors such as emotional outbursts and non-compliance
when he cannot communicate his needs, which he best does with a computer. AR 1416.
He requires varying levels of support to initiate his communication, with
assistant helping him from his forearm to his shoulder. AR 1415.
Regional Center
identified Choices as an option for community activity support, but he never
attended it. AR 755.
Regional Center also
identified Real Connections as a candidate and offered 50 monthly hours to
Johnathan. AR 74, 965. Jonathan received Real Connections service beginning
in December 2019, but they ended a month later in January 2020 due to its inability
to support his aggressive and destructive behavior. See AR 692.
In a March 23, 2020
report, Progressive noted that it had attempted to introduce Jonathan to group
setting and had observed him independently attempt to communicate with peers. AR 320, 328.
He had also stopped, turned towards the specialist with whom he works,
and pointed at an item with which he wanted to engage. AR 328.
Progressive planned to have Jonathan type with peers during
communication workshops and receive and send non-verbal cues. AR 328.
4. The Request to Increase Progressive
Hours
Mother requested that Regional
Center increase Jonathan’s AST hours at Progressive from 75 to 125 hours per
month, an increase of 50 hours and an average of about six hours per day for a
five-day week. AR 434. Jonathan’s parents planned to use the
additional hours for Jonathan to (1) attend a cooking class and shop for the
necessary ingredients to increase self-reliance; (2) exercise at the gym three
times per week; and (3) use public transportation with staff support. AR 434.
Regional Center reviewed
Jonathan’s quarterly progress reports, which showed skills levels in the respective
goals as follows: (1) 3.8, 3.5, and 3.5 after the second quarter of 2017; (2)
4.0, 3.6, and 3.7 in August 2018; (3) 4.3, 3.8, and 3.8 at the end of 2019,
along with 2.2, 2.3, 1.0, 2.1, and 2.0 in newly added goals; and (4) 4.4, 3.9,
3.9, 2.4, 2.3, 1.5, 2.1, and 2.0 after the first quarter of 2020 – all out of
10. AR 408-11, 415-17, 422-28, 437-43. Each report also included a description of
the interactions and observations underlying those scores. See, e.g., AR 1479-85.
Regional Center denied
the request. On February 13, 2020, Mother
filed a fair hearing request for the denial of the additional 50 hours from Progressive. AR 11.
At the informal
meeting required prior to the administrative hearing, Regional Center offered funding
with Progressive which would begin at the requested 125 hours per month for
three months but be reduced by ten hours each subsequent month while Jonathan
transitioned to another program. AR
772-73, 787-88. The offer did not
resolve the issue.
5. The Hearing
OAH held the hearing on
July 14 and August 13, 2020. As
evidence, Regional Center attached Progressive’s comprehensive AST program
design manual, which includes the training requirements for the staff. AR 1487, 1497. The design manual states that Progressive
staff is well-versed in research on a variety of disciplines and theories and
undergoes substantive hands-on training, often in addition to a university degree. AR 1497.
Relevant testimony
is as follows.
a. Grande
When Jonathan joined
REACH, the staff spent over a month finding and training a staff member to work
one-on-one with him. AR 752. Its one-on-one support structure and ability
to take Jonathan out to mingle with the community made its program ideal. AR 752.
However, after seven months, his aggressive behavior and incidents of
elopement compelled REACH to conclude it could not provide a safe program for
him. AR 752.
Regional Center provided
60 hours per month at Progressive after Jonathan left REACH. In making this determination, Regional Center
considered Mother’s work schedule, Jonathan’s program availability, and the
hours of support that Progressive provided.
AR 742.
After Jonathan left
REACH, Mother wanted a program that would provide facilitated communication for
him. AR 755. One option, Choices, is not a day program but
it provides community support. AR
755. Jonathan never attended it. AR 755.
He attended another alternative, Real Connections, for less than a
week. AR 755.
Progressive is not a
day program, but rather an AST which focuses on teaching skills to a
recipient. AR 743. A day program provides support through
personal assistance to help a recipient finish tasks at home or access the
community. AR 743, 747. If Jonathan attended Progressive for six
hours per day, it would appear as a day program. AR 743.
Mother told Grande that at-home Personal assistance for Jonathan is
mostly just supervision and Grande was not sure if it helped him finish
activities at home. AR 747.
Grande objected to
increasing Jonathan’s AST hours at Progressive to 125 hours because it is a
skills training service and is not meant to be a day program service. AR 764.
b. Lilia Ortega
In preparing the Notice
of Action in response to Mother’s request for additional AST hours, Regional
Center employee Lilia Ortega (“Ortega”) detailed the alternative services available
to meet Jonathan’s needs – a combination of Personal assistance, AST, and other
community services. AR 772. Ortega proposed that Regional Center initially
pay for three months of 125 hours each of AST through Progressive, then reduce
the payment by ten hours per month until the current 75 hours per month was
reached. AR 773. The goal was to find a more suitable service
in between Mother’s request and the current hours. AR 773.
Another option was
to combine services from different providers – cross-training – but Ortega did
not know of any agencies who could do that.
AR 801.
AST services like
Progressive are meant to be hourly, time limited, skill building, and
transitory – phased out as the recipient masters the skills taught. AR 776, 800.
Providing these supports with extensive hours creates more dependence
than independence. AR 800.
Regional Center
monitors skills development through the quarterly reports on set goals. A score of eight means the recipient is ready
to transition. AR 777-79. Jonathan’s goals included increasing his
communication, increasing his ability to co-regulate with various environments,
and increase his independence and ability to complete tasks. AR 778.
Based on the quarterly reports, Jonathan has shown minimal improvement. AR 783-84.
This suggests that he may need to try something different than the
current plan. AR 783-84, 800. The base 75 hours are not in dispute in this
appeal – only the use of an additional 50 to turn Progressive’s AST into a day
program. AR 798-799.
c. Brittany Berg
As a Regional Center
Speech language consultant, Brittany Berg (“Berg”) helps determine eligibility,
works with agencies that need help purchasing equipment for the programs, and
coordinates with program supervisors. AR
807.
Facilitated
communication is an alternative form of communication for use with individuals
with limited speech capacity. AR
808. It refers to a situation where another
person helps the individual through physical or emotional support, such as
through contact with the shoulders or hands.
AR 808. The American Speech
Language Hearing Association and other groups have discredited this technique
on the ground that facilitated communication compromises the veracity of the
message transmitted; it communicates what the facilitator wants to communicate
and not the speaker. AR 810, 812, 852.
d. Bienstock
Bienstock is Regional
Center’s consulting psychologist. See
AR 817. He evaluates recipient
eligibility based on psychological evaluations.
AR 817. Because facilitated
communication is not evidence-based, he informed Jonathan’s parents that
evaluations based on it are not valid.
AR 822-23. The primary concern is
that it can make the subject appear capable of doing things that he or she cannot,
resulting in decreased support approval.
AR 824.
Because Bienstock could
not use facilitated communication and had no direct measurement of Jonathan’s academic
performance, he was unable to assess Jonathan’s cognitive ability to his
unresponsiveness and lack of records. AR
821. He found that Jonathan needed substantial support regarding social
communication and restrictive repetitive behavior, including impulsive
behaviors that could pose a safety risk.
AR 825.
e. Mother
Jonathan, who is 24,
lives with her. AR 831. His pediatrician, Ricki Robinson M.D. (“Robinson”),
diagnosed Jonathan with autism at 30 months.
Mother considers it severe, likely level three. AR 831-32.
The family tried helping him from a young age, starting with ABA therapy
from ages three to seven for 35 to 40 hours a week. AR 831.
During this time, Jonathan relied on one-word communication and picture
exchange communication where pictures were all over the house for him to grab
and show others that’s what he wanted to talk about. AR 832-33.
Even this was imperfect; his poor motor skills often made him grab the
wrong picture. AR 833.
When Jonathan was seven,
Robinson recommended that he work with a speech therapist, Darleen Hanson
(“Hanson”), who introduced his parents to facilitated communication. AR 832.
The resulting improvement was amazing, beyond the results of the
treatment Jonathan underwent with UCLA at the time. AR 834-35.
Before he was eight,
the family consulted with Hanson and decided to move to Whittier so that Jonathan
could attend public schools that have experience working with autistic
kids. AR 837. At the time, getting a stranger to help with facilitated
communication required training and practice, and Jonathan’s siblings were
never the right age to do so. By the
time his younger sister was ready, he was old enough to hurt her. AR 839.
Facilitated communication is a lot of work. AR 839.
In middle school,
Jonathan’s frustration made him more aggressive such that it was too dangerous for
Mother to continue typing with him. AR
966. Only Rod Rhodes (“Rhodes”) can do
so now, although Mother hopes that someday she can go back to typing with
Jonathan herself. AR 967.
When Jonathan first
received 75 monthly hours with Progressive, the plan was to spend an additional
50 with Real Connections. AR 965. Jonathan first started with Real Connections
in January 2020 after months of assessment and waiting for staffing
capacity. AR 1998-99. Real Connections proved to be poorly prepared
for him compared to REACH. AR 965. After spending only three hours a day with Jonathan
and returning early each time, the staff member reported that Jonathan was too
aggressive and refused to work with him.
AR 2000.
Real Connections used facilitated
communications on the forearm with Jonathan and for years before. AR 965-66. Mother questioned why Regional Center
challenges the practice now even though Progressive has been providing it since
he was seven and Jonathan attended many facilitative communication conferences at
Regional Center’s expense. AR 966, 973.
Jonathan’s peers are
receiving full-day programming, and Jonathan should not be denied that on the
basis that he is too aggressive. AR
2004. Having too much downtime makes him
more likely to fall asleep during the day and stay awake at night. AR 2005.
His parents have to sleep in separate rooms to keep watch over him, and they
are sleep deprived when trying to work and care for the other children. AR 2005.
f. Robinson
Robinson is a pediatrician. In 1998, Jonathan was one of the first
patients in Robinson’s then-fledgling practice.
AR 871. Jonathan needs support,
but not a residential program, for ten hours a day. AR 1917.
If left to his own devices, he will pick his favorite things to do and
stay with them – not an ideal situation.
AR 1912.
In 2019, Robinson
received reports from Progressive that Jonathan could go out to eat, shop at
malls, communicate why he went where he did, and think about how to use money –
all things Robinson wants Jonathan to learn to do on a regular basis. AR 1915.
g. Rhodes
Rhodes is Jonathan’s
therapist with whom he has weekly therapy sessions. AR 405.
Augmentative communication uses tools such as picture boards and cards
to support the sensory motor system of the individual. AR 882, 1918.
Facilitative communication is a means of prompting language from an
autistic person. AR 882. The person gives input to the recipient at
their wrist, arm, or elbow. AR 882. It is a useful alternative to using the
spoken word to prompt a child with autism to speak, which did not work with
Jonathan because he could only say single words at a time. AR 882, 1918.
Admittedly, the results are still anecdotal rather than scientific
evidence after 25 years. AR 898-99. However, this is just because psychologists
struggle to obtain the funding for evidence-based work to prove it. AR 899.
Since starting AST at
Progressive, Jonathan’s sleep patterns have improved and his aggressive
behavior indicating stress decreased. AR
936-37. His aggressiveness decreased
gradually in the months prior to the hearing.
AR 937-38. While he was calm when
he spent the day alone at home without human interaction, that is not helpful
for community participation. AR 938.
h. Shepard
Shepard is the executive director of Progressive,
which serves individuals with developmental disabilities from as young as three
years old, including AST for autistic patients like Jonathan. AR 985-86.
Progressive’s staff must
typically have at least a bachelor’s degree, although many have master’s
degrees and Progressive does hire those without a degree who meet other
criteria. AR 986. Those without a bachelors’ degree receive
three extra months of training before they receive their own caseload. AR 2023.
Progressive trains its
staff to use a transdisciplinary approach, which allows a professional to draw
from areas outside of its expertise when meeting with clients whose mental
health issues have caused other issues.
AR 989. The community Progressive
serves – not just those with autism – benefit from such an approach. AR 2029.
The intensive nature of the training also means that Progressive needs
to have staff trained to anticipate staff turnover. AR 997.
Each employee also receives training specific to each new case. AR 998.
Courtney Wakeham was
responsible for both training of other staff and Jonathan’s case. AR 997. Jonathan currently receives 2:1 support, with
plans to transition to 1:1. AR 1030. When he goes into the community, Jonathan
suffers from sensory overload and is trying to prevent that from triggering a
fight-or-flight response from his compromised motor primary system – a common
problem for those with autism spectrum disorder. AR 2040-41.
One hour a week spent in
the community can improve Jonathan’s condition, but it will not suffice. AR 1025.
At the same time, Progressive does not intend to keep Jonathan in an
individual program forever. AR 1025. Jonathan needs to spend some time
receiving one-on-one AST training before increasing community time to the full
2.5 hours per week; how much training will be required is unclear. AR
1028.
When Jonathan is not
busy, he sleeps during the day and stays awake at night while he becomes more
aggressive. AR 999. An increase in AST time from 75 to 125 hours
would allow him to work on skills for longer and build his stamina but take
breaks in between. AR 999. Additionally, to the extent that Jonathan’s
and the family’s well-being affect each other, an increase in hours would give
his family a break and time to live their lives so they can focus on him when
necessary. AR 1002.
Although this time
commitment would mean that Progressive doubles as a day program, it has before
and is willing to here unless Jonathan finds a suitable day program. AR 1027-28.
Shepard is not sure for how long this will be necessary, but more than a
year. AR 1027.
6. Post-Hearing Brief
On August 20, 2020, Regional
Center submitted its written closing argument to answer questions posed by the ALJ. AR 74.
The brief identified the costs of each program as $79.70 per day for
REACH, $52.40 per hour for Real Connections, $33.09 per hour for CHOICESS, and
$150.80 an hour for Progressive. AR 74.
7. The Decision
On September 28, 2020, the
ALJ issued a decision denying Jonathan’s claim.
AR 707. The ALJ framed Mother’s position
as that an increase from 75 hours to 125 hours per month of AST at Progressive is
necessary for Jonathan’s progress in adopting to a daily routine that leads to
an independent and normal life. AR
687. Regional Center’s objection to Mother’s
request for 50 more AST hours was based on a concern that Progressive’s program
was not an effective means of ensuring that Jonathan learns how to interact
positively with members of the community.
AR 688.
The ALJ discussed
Jonathan’s background, including Mother’s report in his IPP that he had tantrums
daily when told to do something he does not want to or otherwise unable to
communicate. AR 688. Progressive is not a behavior management
agency that could adequately address these behaviors. AR 689.
Mother declined behavior management services, stating that she is
satisfied with his progress in Progressive.
AR 689.
Jonathan was
approved for services at REACH at 130 hours per month but was terminated in
July 2018. AR 690-91. Following the termination, Grande researched
other programs, but they were limited because Mother wanted an agency that
would support facilitated communication and Jonathan’s aggressive
behaviors. AR 691. Mother did not want an agency that would
treat behavior management and was satisfied with Progressive. AR 691.
Regional Center increased Progressive’s AST support to 25 hours as a
temporary support program. AR 691.
In June 2019,
Jonathan was referred to Real Connections and Regional Center funded an
additional 50 hours of service through Progressive while services through Real
Connections was pending. AR 692. Those services began in December 2019 but
were terminated a month later because of Jonathan’s aggressive and destructive
behavior. AR 692.
Jonathan has been
receiving AST services from Progressive since he was seven years old. AR 692.
The progress reports during the period from 2017 through 2020 show little
improvement (AR 692-96, 699) but Shepard testified that Jonathan is far more
capable of doing things than he was in 2018.
AR 697. According to a
Progressive supervisor, an additional 50 hours would allow Jonathan to engage
in a variety of tasks at which he excels.
AR 697. When he limited to a
meeting for a short time per day, he is not getting “fluid participation” in
the program. AR 697.
According to
Regional Center, the purpose of an adult day program is to provide the
recipient with support that allows him or her independence and access to the
community. AR 698. In contrast, AST provides the recipient with
training on different behavior modification techniques. AR 698.
Ortega testified that Jonathan already has a high level of AST hours and
an increase to 125 hours per month would duplicate a day program, which
Progressive is not. AR 698. Additionally, high AST hours can result in
dependency. AR 698. AST is a skill building service and should
decrease, not increase, as skills are acquired.
AR 699.
Robinson believes that
Jonathan’s communication abilities can be fully accessed through facilitated
communication, although she acknowledged that it is not an accepted
modality. AR 699. Rhodes testified that he has provided weekly
psychotherapy to Jonathan since 2008 and the lack of a full-time day service
program has resulted in negative consequences for Johnathan. AR 700.
Jonathan’s aggressive is a form of communication and that aggression has
gradually decreased since Progressive has been providing extra hours. AR 700.
He recommends a full-time program of approximately 30 hours per
week. AR 700.
Mother testified
about her difficulties in obtaining adult day services and her interactions
with REACH and Real Connections. AR 701. Jonathan has been using facilitated
communication in a variety of therapies and now types with Rhodes in which Mother
can have good conversations with him. AR
702. She feels that he is being denied a
full day program because he is too aggressive, but he is less aggressive with
proper supports. AR 702.
The ALJ noted that the
individual requesting services or government benefits has the burden of proving
eligibility. AR 703. Although an IPP must reflect the needs and
preferences of the consumer, a regional center need not provide all the services
a consumer requests. AR 704. Services must be cost effective (§4512,
4646(a)) and regional centers must control costs as afar and possible to share
resources with many consumers. AR
704. A regional center is not required
to meet a consumer’s every possible need or desire, in part because it must
meet the needs of many disabled persons and their families. AR 705.
A regional center has discretion in determined which services it should
purchase to best accomplish the IPP’s goals.
Williams v. Macomber, (1990) 226 Cal.App.3d 225, 233. AR 705.
The ALJ relied on section 4689(e) to provide that a regional center
should monitor and ensure quality of services and whether they are having the
desired effect. AR 705.
The fact that Jonathan
has been without a day program since July 2018 does not on its own merit
increasing his AST hours from 75 to 125 per month. AR 706.
Mother’s insistence on a program that uses facilitated communication – a
non-evidence-based treatment modality-- as well as Jonathan’s aggressive
behavior, was partially responsible for the lack of a day program, despite Regional
Center’s best efforts to find one. AR
706. Regional Center had been providing
Jonathan with temporary increased AST hours as well as personal assistance
while it tried to find a vendor who would do both. AR 706.
The progress reports
show that Progressive had not helped Jonathan make much progress towards the
three goals identified from June 1, 2017 thereafter or the five added at the
end of August 2018. AR 706-07. Robinson testified that the right program could
help Jonathan change, and Jonathan’s minimal progress with Progressive showed
that it was not the right program. AR
706-07.
Mother did not meet
her burden to establish that 50 additional AST hours are necessary or
appropriate. AR 707.
8. The Augmented Administrative
Record
On October 18, 2021, Progressive’s owner and CEO Shepard sent an
email to various employees of Regional Center.
Barba Decl., ¶3, Ex. 2. The two
letters attached to this email announced that Progressive was terminating all
services and permanently closing on November 30, 2021. Barba Decl., ¶3, Ex. 2. As a result, Progressive no longer provides
services to Regional Center clients.
Barba Decl., ¶4.
On May 17, 2022, Regional Center’s counsel learned of Progressive’s
closure and informed Jonathan’s counsel.
Ocheltree Decl., ¶¶ 4-5. On May
19, 2022, Jonathan’s counsel replied that Jonathan would not request dismissal
of the Petition. Ocheltree Decl., ¶5.
E. Analysis
Petitioner
Jonathan seeks to set aside the ALJ’s decision affirming Regional Center’s
denial of Mother’s request to increase his Progressive AST hours from 75 to 125
hours per month.
1.
Jonathan’s Procedural Failures
a. Full and Fair Statement of Facts
Jonathan’s opening brief does not present a full and fair
statement of facts with citations to the Administrative Record as required by
the court’s order at the trial setting conference and LASC 3.231(i)(2). Under the heading “Factual, Legal and Procedural
Background”, Jonathan includes few facts and only two citations to the Record. Pet. Op. Br. at 3-4. Under the heading “Respondent’s Reasoning
Does Not Rise To The Level of Competent And Measured Inquiry Into the Current
Case,” Jonathan includes only three citations to the Record. Pet. Op. Br. at 4-5. Under the heading “Respondent Lacks Facts to
Support Claim that Petitioner Failed to Meet His Burden”, Jonathan includes a
total of nine citations to the Record.
Pet. Op. Br. at 5-7. Finally,
under the heading “Respondent Contravenes Statutory Protection and Judicial
Interpretation of Case Law”, he includes a total of 12 citations to the Record. Some of these citations are either incorrect
or to immaterial parts of the Record.
Nowhere
does Jonathan present a full and fair statement of facts supported by adequate
citations to the Administrative Record. When
a petitioner challenges an administrative decision as unsupported by the record
as a whole, it is the petitioner’s burden to demonstrate that the
administrative record does not contain sufficient evidence to support the
agency’s decision. State Water
Resources Control Board Cases, (2006) 136 Cal.App.4th 674, 749. The petitioner is obligated to lay out the
evidence favorable to the other side and show why it is lacking and the
"[f]ailure to do so is fatal" to any substantial evidence challenge
and "is deemed a concession that the evidence supports the findings
Defend the Bay v. City of Irvine,
(2004) 11928 Cal.App.4th 1261, 1266. The
reviewing court should "not independently review the record to make up for
appellant's failure to carry his burden."
Ibid. A recitation of only
the part of the evidence that supports the petitioner’s position is not the
“demonstration” contemplated by this rule.
According, if a petitioner contends that some issue of fact is not
sustained, he is required to set forth in his brief all the material evidence
on the point and note merely his own evidence.
Unless this is done, the error is deemed to be waived. Id. (quoting Foreman & Clark
Corp. v. Fallon, (1971) 3 Cal.3d 875, 881).
Jonathan’s
failure to fully present and cite to the facts as required means that he has
waived any claim that the evidence does not support the ALJ’s findings. The Petition must be denied for this reason.
b.
Improper Attempt to Augment the Record
On June 14, 2022, the court granted Regional Center’s motion
to augment the Administrative Record with a declaration and an email. In doing so, the court denied Jonathan’s effort
in his opposition to augment the Record with additional evidence, indicating
that he would have to make a noticed motion if he also wished to augment the Record.
Jonathan never made a noticed motion to augment. Instead, his reply includes an attempt to
revive the motion to augment. Reply at
1-3. Even if that were considered as a
properly noticed motion, the reply does not include the evidence Jonathan wants
to add to the record. No declarations or
exhibits are attached to the reply.[4]
Jonathan’s failure to make a separate noticed motion as
directed with appropriate notice under CCP section 1005 means that it must
again be summarily denied. In any event,
the mootness discussion post demonstrates that the request would be
ineffectual.
2.
The Case Is Moot
“Although a case may originally present an existing
controversy, if before decision it has, through the acts of the parties or
other cause, occurring after commencement of the action, lost that essential
character, it becomes a moot case or question which will not be considered by
the court.” Wilson v. Los Angeles
County Civil Service Com., (1952) 112 Cal.App.2d 450, 453; Colony Cove Props., LLC v. City of Carson,
(2010) 187 Cal.App.4th 1487, 1509.
"The pivotal question in determining if a case is moot is []
whether the court can grant the plaintiff any effectual relief." Giles
v. Horn, (2002) 100 Cal.App.4th 206, 227 (claim that county failed to make required
findings to approve contracts rendered moot by contract extensions which were
the operative agreements); Eye Dog Foundation v. State Bd. of Guide Dogs
for the Blind, (“Eye Dog Foundation”) (1967) 67 Cal. 2d 536,
541.
A court should not dismiss a case as moot if a substantial issue
remains. Terry v. Civil Serv. Comm’n, (1952)
108 Cal. App. 2d 861. A case is
not moot where, despite the happening of a subsequent event, there remain
material questions for the court’s determination that impact a party’s future
and contingent legal rights. Eye Dog
Foundation, supra, 67 Cal.3d at 541.
In other words, a case is moot only where the disposition of the case is
“a matter of indifference to the parties” -- where disposition of the case will
neither benefit the plaintiff nor harm the defendant. Turner v. Markham, (1909) 156 Cal.
68, 69.
Jonathan’s Petition is about the ALJ’s denial of an increase
in his hours at Progressive, not some general increase in hours at any
vendor. Mother’s fair hearing request
explicitly stated that Jonathan seeks “an approval of the hours requested (125
hours/month) with Progressive....” AR 11 (emphasis added.) The ALJ stated that the issue was “[w]hether
the service agency should increase funding for services provided to [Jonathan]
by Progressive... from 75 hours to 125 hours.” AR 685 (emphasis added). The evidence presented at the administrative
hearing, and the ALJ’s decision, concerned Regional Center’s denial of an increase
in funding of AST services with Progressive in part because Jonathan needs a day program for community
support, Progressive provides skills training, and Progressive had not helped
Jonathan make much progress towards his IPP goals. AR 706-07.
Finally, Jonathan’s Petition for the court to issue a writ
ordering the ALJ to set aside the final decision and increase the hours at Progressive
from 75 hours to 125 hours. Pet., p. 7.
As Regional Center argues, this issue is moot. On or about May 17, 2022, Regional Center’s
counsel learned that Progressive’s owners retired and the business closed on November
30, 2021. Ocheltree Decl., ¶ 4; Acosta
Barbra Decl., Ex. 2. Progressive stopped
providing services to individuals served by Regional Center on that date. Acosta Barba Decl., ¶4. Opp. at 1-2.
Thus, the court cannot order the relief Jonathan seeks. That is, the court cannot order the ALJ to
set aside his decision and order Regional Center to provide Jonathan with
additional hours of service at Progressive.
As stated ante, Jonathan attempts to augment the
record in his reply brief. Reply at 1-3. He criticizes Regional Center for failing to
report that his parents advocated and worked with Regional Center to vendor a
program, Connections Family Services (“Connections”), that would operate as
closely as possible to Progressive.
Reply at 1. Jonathan argues that
his lawyer was muted on Court Call at the hearing on Regional Center’s motion
to augment, and the court appears to have abused its discretion. The court knew or should have known that
Regional Center did not present all the facts, and Jonathan poses a possible
remedy of giving Jonathan a shorter period to answer the motion under CCP
section 1005(b). Reply at 1-2.
The court has no idea what Jonathan is talking about. The court heard and granted Regional Center’s
motion to augment. Jonathan tried to augment
the record as part of his opposition to Regional Center’s motion. That was improper and his request was
denied. However, he was informed that he
could make his own noticed motion to augment.
He did not do so. These facts
have nothing to do with Regional Center’s counsel’s duties to fairly present
evidence.
Jonathan contends that the information about Progressive’s
closure provided by Regional Center and his own information about a replacement
program at Connections are both valuable for the court’s decision. It is an important fact that Progressive is
closed, but it is more important that Regional Center has approved another
program. Regional Center’s argument that
the case is moot ignores the relationships among Regional Center, Connections,
the group of parents, and Jonathan.
Reply at 2.
Not so. As Regional
Center’s opposition to the motion to augment states, administrative remedies
have not been exhausted on whether Jonathan should have increased hours at
another program such as Connections. Opp.
at 5. Connections may be an approved vendor
of Regional Center, it may be comparable or better than Progressive in
providing AST hours, and it may also solve the problems that Progressive was a
training and not a daytime community support program, and that facilitated communication coupled with
Jonathan’s aggressiveness made providing him a day program difficult. Whether Connections can resolve these issues is
unknown, but the closure of Progressive does not permit Jonathan to avoid an
administrative hearing on these issues.[5] The case must be dismissed as moot.[6]
3. The ALJ’s Decision Is Supported by the Weight of
the Evidence
If arguendo Jonathan’s procedural failure did not
require dismissal and the case is not moot, the ALJ’s decision is supported by
the weight of the evidence.
a. The 1991 Opinion Letter
Regional Center
contends that a 1991 opinion from Regional Center’s lawyer to its director in
the Record is privileged. The letter states
that the term “entitlement” in the Lanterman Act means that developmentally
disabled individuals are entitled to the development of an IPP which meets all
of their needs and to the provision of all services to meet those needs. AR 100-05.
The letter cites the California Supreme Court’s assertion that the
legislative intent of the Lanterman Act is to assist the disabled “in achieving
their maximum developmental potential.”
AR 103 (citing Conservatorship of Valerie H., (1985) 40 Cal.3d
143, 159).
Jonathan argues that this letter is evidence “suggesting
that regional center staff have difficulty understanding the legislative intent
expressed in Welf. & Inst. Code §4501.” Pet. Op. Br. at 8. Regional Center argues that the letter is
protected by the attorney-client privilege (Evid. Code §§ 952, 954) and
Jonathan’s counsel had an ethical duty not to maintain or use a copy of the
document. See Clark v.
Superior Court, (2011) 196 Cal.App.4th 37, 48. A non-lawyer, Jacob Romero (“Romero”),
represented Regional Center at Jonathan’s hearing whereas Jonathan was
represented by legal counsel. Romero could not be expected to object to the
letter as protected by attorney-client privilege. When asked by the ALJ if he objected to any of
Jonathan’s exhibits, Romero confusingly stated that he would like OAH to take
judicial notice of three exhibits that included the letter because “they don’t
appear to be directly relevant or actual documentary evidence”. AR 720.
The court need not decide whether Jonathan’s counsel
breached his ethical obligation in presenting this very old letter because the
court does not know how and when he obtained it and, more important, the ALJ
did not receive the letter into evidence.
AR 100, 1948. Hence, the court
has not considered it.
b. The ALJ’s Gaffe
Jonathan notes that the ALJ cited section 4689(e) to support
his findings. AR 705-06. This provision applies to Supportive Living
Services (“SLS”) for adults with disabilities living in homes that they own or
lease, and not developmentally disabled persons living with their parents. It does not apply to training programs such
as AST. This substantial gaffe brings a
question to the fore. Does the ALJ not
know the difference between an adult with autism living by himself and living
with his parents? Jonathan acknowledges
that this gaffe may not necessarily be material, but it brings into question the
ALJ’s competent grasp of the subject matter and what is important in making decisions
regarding regional center clients. Pet.
Op. Br. at 7-8; Reply at 3-4.
As
Regional Center points out and Jonathan admits, the ALJ’s error of law is not
material. The ALJ cited the SLS statute,
which applies to adults with developmental disabilities living in their own
home or apartment (§4689) even though Jonathan does not receive SLS. But the quoted provision (§4689(e)) pertains
to the regional center’s obligation to assure the quality of SLS provided to
the recipient and that the services are consistent with the individual’s IPP. §4689(e).
The
Lanterman Act elsewhere requires that the regional center may (1) purchase
services or supports that it and the consumer determine will best accomplish
the IPP (§4648(a)(3)), (2) consider the provider’s ability to deliver the
quality services or supports that can accomplish the objectives of the
consumer’s IPP (§4648(a)(6)), (3) monitor services and supports with or without
notice (§4648.1), and (4) not continue a service or support unless the consumer
is satisfied and the regional center and the consumer agree that the services
or supports have been provided and that reasonable progress toward objectives has
been made (§4648 (a)(7)). See Opp.
at 12. These obligations are similar to
those referred to by the ALJ, and the error was not significant.
c.
The Weight of the Evidence
Jonathan correctly argues that the Lanterman Act requires
that regional centers and their staff assist regional center clients and their
families in living a normal life, including the use of state funding to do so. See Pet.
Op. Br. at 3. “It is the intent of the
Legislature that regional centers assist person with developmental disability
and their families in securing those services and supports which maximize
opportunities and choices for living, working, learning, and recreating in the community.”
§4640.7. The legislative history of the
Lanterman Act shows a Senate resolution “[t]hat such opportunity for
normalization is the birthright of every citizen and a proper investment for
the good of society.” AR 93.
Jonathan
notes that he attended regular classes with special education services in
elementary school, middle school, and high school. Because of his autism, he was unable to earn
a diploma, and he ended up attending a special education transition program at
a special education center. In a
well-planned transition, a special education student who ages out of special
education at the age of 22 will move into a regional center-funded program with
no gap in services. However, Regional Center
was unable to identify a program that could meet his needs, which include
severe communication deficits and severe deficits in socialization. Pet. Op. Br. at 3.
Regional Center assisted Jonathan by funding two day
programs, REACH and Real Connections, which ultimately failed to assist him in
acquiring the ability to live, work, learn, and recreate in the community. Both
terminated him from their program because of his aggressive behaviors and
communication impairment. Regional
Center also assisted Jonathan by increasing his Progressive hours to give him the
opportunity to access the community.
However, Regional Center has cut short its investment by denying him the
additional 50 hours per month that can give him the opportunity to more forward
to a next level day program. Pet. Op.
Br. at 4.
According to Jonathan’s IPPs (AR 270, 384),[7]
Progressive is a temporary program.
Progressive’s director, Shepard, testified that Jonathan’s path at
Progressive is to move into a community group of six peers at Progressive on a
daily basis. For Petitioner to
transition from the 1:1 program, he first needs to be able to act more
independently and to be able to function with his peers. Attempts have been made to insert him into
the community group. AR 2022-42,
320-33. Pet. Op. Br. at 4.
(i).
The Need for More Hours
The ALJ noted that
Progressive’s AST program is not an adult day program that is intended for Jonathan
to become independent and participate in the community. AR 698.
Progressive is an AST program that provides the recipient with training
on different behavior modification techniques.
AR 698. Nonetheless, Mother
insisted that any service provider provide facilitated communication, thereby
limiting the number of service provider options for meeting Jonathan’s needs. Facilitated communication is not an
evidence-based program. AR 698.
Jonathan
argues that Mother wanted Progressive because it was an agency that
would accommodate both facilitated communication and his aggressive behaviors
and she was
satisfied with Progressive. Mother’s
request was based on Jonathan’s experience with facilitated communication. Mother testified that Darlene Hanson’s work
with Jonathan in a light touch on his forearm facilitated his communication and
the behavioral work that UCLA was doing “was much below” that. AR 1871.
Mother thought how frustrating it must be for Jonathan that he could not
move his body to show them the picture choices without help.. Id.
Pet. Op. Br. at 9.
Jonathan argues that the ALJ wrongly reasoned that Progressive’s
services may not be appropriate because that issue had already been
decided. Mother rejected the advice that
Jonathan needed behavioral management services to minimize his tantrum
behavior. Mother cited the poor results
of a previous behavior management program (apparently at UCLA) (AR 1871) and
testified that Progressive’s program design showed a comprehensive approach to
Jonathan’s behaviors that would achieve more durable and longer lasting
results. AR 2022-42.
Jonathan points out that section 4501 requires that “[t]he
complexities of providing services and supports to persons with developmental
disabilities requires the coordination of services... to ensure that no gaps
occur in communication or provision of services and supports....[and a]
consumer...or conservator, shall have a leadership role in services
design.” Pet. Op. Br. at 8-9. Progressive was in place, providing services,
and the real issue was whether to increase PR’s hours. Reply at 4-5.
The court agrees that Mother has a leadership role in
obtaining services for Jonathan and the fact that facilitated communication is
not evidence based is not a reason to disregard her preference. Mother was entitled to seek a day program
with facilitated communication as well as support for his aggressive
behaviors.
Mother’s
leadership role is not unlimited. The
ALJ cited section 4648 to conclude that a regional center has “discretion in
determining which services it should purchase to best accomplish all or any
part of a consumer’s IPP.” AR 1741. Regional Center’s exercise of discretion must
conform to the law. Williams v. Macomber, (1990) 226
Cal App.3d 225, 233 (regional center’s prohibition on funding day care program
violated Lanterman Act’s requirement that it consider every possible way to
keep child at home).
The ALJ did not blame the use of Progressive or suggest its
services should be discontinued. Rather,
the ALJ explained why Jonathan did not have a day program as he should and
instead was using Progressive’s AST training program. AR 706.
Mother’s insistence on a program
that uses facilitated communication – a non-evidence-based treatment modality--
as well as Jonathan’s aggressive behavior together were responsible for the
lack of a day program, despite Regional Center’s best efforts to find one. AR 706.
Regional Center had been providing Jonathan with temporary increased AST
hours at Progressive while it tried to find a vendor who would do both. AR 706.
As Jonathan agrees, the issue was not whether Jonathan
should continue with Progressive, but whether his hours should be increased to
125 per month. See Reply at
4. The ALJ did not find an adequate justification for the increase. She correctly concluded that the fact that Jonathan
was without a day program since July 2018 does not on its own merit increasing
his AST hours from 75 to 125 per month.
AR 706. There must be other
reasons for the increase.
Progressive’s
use of facilitated communication did not by itself justify increasing
Jonathan’s funding/hours. Despite
Regional Center’s evidence criticizing facilitated communication, that is not a
reason to deny Jonathan those additional hours either. “Facilitation” is defined as the use of
modified or adapted materials, special instruction or personal assistance, such
as assistance with communications, that will enable a consumer to understand
participate to the maximum extent in the decisions and choices that affect his
or her life. §4512(g). Facilitated
communication is a valid, specialized service communication that was practiced
years before the current litigation. The
fact that facilitated communication is not evidence-based does not mean it is
not useful. The evidence supports a
conclusion that facilitated communication is useful for Jonathan and his
parents.
Regional Center did not purport to disallow Progressive’s
use of facilitated communication. Instead,
Regional Center presented evidence that the additional hours of AST were
unwarranted. Ortega testified that Jonathan already has a high level of AST hours and
an increase to 125 hours per month would duplicate a day program, which
Progressive is not. AR 698. Additionally, high AST hours can result in
dependency. AR 698. AST is a skill building service and should
decrease, not increase, as skills are acquired.
AR 699.
Jonathan admits that the requested increase in hours would convert
Progressive into his day program, and he argues that actually would be appropriate.
Pet. Op. Br. at 10. His
pediatrician, Robinson, testified that
Jonathan’s communication abilities can be fully accessed through facilitated
communication. AR 699. His therapist, Rhodes, testified that the
lack of a full-time day service program has resulted in negative consequences. AR 700.
Since Progressive has been providing extra hours, Jonathan’s aggression
has gradually decreased. AR 700. Rhodes recommends a full-time program of
approximately 30 hours per week. AR 700.
Shepard testified that Jonathan is far
more capable of doing things than he was in 2018. AR 697.
An additional 50 hours would allow Jonathan to engage in a variety of
tasks at which he excels. AR 697. Finally, Mother testified that the
more staff works with Jonathan, the more he will progress. When he is at home,
left to his own devices, he regresses. AR
2004-06. Mother testified that she
feels He needs a full day program, and he is being denied one because he is too
aggressive. AR 2004.
This testimony is somewhat general, but it does support an
increase in hours. Nonetheless, it is
insufficient. When coupled with Jonathan’s
lack of success at Progressive (see post), the evidence supports a
conclusion that Mother’s choice of Progressive should remain the appropriate
program in the face of a lack of alternatives, but that an increase in hours is
not justified. This conclusion is
supported by the fact that AST is intended to teach skills and be reduced, not
increased, over time.
It is further supported by the fact that
Shepard’s opinion that hours should be increased was based on what she was told
by Mother and Rhodes, and her belief that there were no other options. See Opp. at 13.
(ii). Lack of Progress
The
ALJ concluded that Jonathan was not making reasonable progress towards his IPP
objectives in the years he was in the Progressive program. §4648(a)(7).
Jonathan has been
receiving AST services from Progressive since he was seven years old. AR 692.
The progress reports during the period from 2017 through 2020 show
little improvement (AR 692-96, 699). They
reflect that Progressive had not helped Jonathan make much progress towards the
three goals identified from June 1, 2017 thereafter or the five added at the
end of August 2018. AR 706-07. Jonathan’s minimal progress with Progressive suggests
that it is not the right program. AR
706-07.
As
Regional Center argues, none of Shepard, Rhodes or any other witness provided
objective data to support a conclusion that Jonathan made real progress in
Progressive’s AST program. Without
objective data, the ALJ could not find that progress was being made by Jonathan
that would justify an order that the hours be increased. Opp. at 13-14.
Jonathan argues that the ALJ acted arbitrarily in relying on
Jonathan’s minimal progress to bar increasing his AST hours at Progressive. The facts suggest his future growth and entry
into a group program. Jonathan’s plan is
for a one-third increase of hours that will challenge him to liberate himself from
his autism to some extent. Without the
increase in hours, he will likely remain the static world. Pet. Op. Br. at 4-5.
Jonathan
argues that the ALJ did not consider how his severe autism affects his progress. The ALJ’s reference to his lack of
progress is a failure to contrast and compare.
Regional Center has no other human with which to compare Jonathan and it
cannot make a fair judgment on his progress without such a comparison. Shepard testified about the complexity of
severe autism, the rigorous training of Progressive’s staff, how Progressive’s
interdisciplinary approach is superior to other programs, and what is needed to
work with Jonathan. AR 2022-42; see AR
1487-555. Two programs were unable to
work effectively with him while Progressive continues to do so. It is more likely than not that
Progressive’s well-disciplined, well-trained, interdisciplinary approach has
led to success for Jonathan. In contrast
to the times when he was out of program or in between programs, Jonathan is
thriving. The ALJ mentioned the terminated
programs but did not stop to ask how and why Progressive is able to maintain
Jonathan in its program. Pet. Op. Br. at
5-7; Reply at 5.
Regional Center has no plan other than to remain static and
complain about the cost of Progressive. See
AR 74, 95-98, 100-01, 1724. Regional
Center is obligated to come up with alternatives, but there were no questions
at the hearing about whether Regional Center had an alternative. The Lanterman Act contemplates that a
regional center honor the preferences of the client and family. §4501 (consumers and their families should
participate in the decisions). Pet. Op.
Br. at 6.
Jonathan
also argues that, while the ALJ stated that Progressive’s progress reports are
subjective and not objective (AR 1732), they do have an objective grid. AR1474–79. The narrative part of the progress report
reflects the complex analysis involved in in working with Jonathan. AR 1479-85.
Progressive has the understanding that the Lanterman Act wants to assist
persons with developmental disabilities in achieving their maximum development
potential. Pet. Op. Br. at 6-7.
Jonathan’s
contentions about his severe autism and its limitations on his progress are
true. The burdens of caring for him are
huge and it may be that Regional Center has no one to whom to compare him. Nonetheless, the fact is that he has made
little progress. His contention that the
grids are objective is simply wrong; the grids are a subject assessment
of progress. AR 1474-79. The evidence shows that Jonathan has made
little progress with Progressive and it may be time to adopt a different
approach. Regional Center must provide
some approach, but Mother must participate in that process of evaluating alternatives.
(iii).
Cost
The ALJ
recognized that, while the Lanterman Act’s IPP process requires a regional
center to respect a conservator’s choices, those choices are tempered by
requirements that the regional center utilize public funds in a cost-effective
manner. §§4646.5(a), 4648(a)(1), see
also 4648(a)(6). Regional Center
argues that it was not cost-effective to increase funding for Progressive’s AST
program under the circumstances presented at hearing.
Jonathan
contends that the ALJ deviated from the spirit of the Lanterman Act by stating
that the fact that Jonathan was without a program does not by itself “justify [Regional
Center] violating its obligation to exercise fiscal responsibility in providing
services to Petitioner.” AR 1742. Underlying that assertion is Regional
Center’s contention that it was being asked to spend too much of its funds on Jonathan. AR 74-75.
However, Jonathan is on a Medicaid Waiver and the cost to the state is
cut in half. AR 83. Pet. Op. Br. at 9.
Frankly,
the cost of the services for Jonathan is the least significant component of the
ALJ’s decision. If additional hours
would help Jonathan and aid his parents in reaching his IPP goals, the
additional cost would be of no moment and the court would not hesitate to order
it. However, the ALJ is correct that the
fact that Jonathan lacks a day program does not by itself justify the increased
hours. The issue for Regional Center and
the ALJ was whether the increased cost of additional hours in Progressive’s AST
program was appropriate. The court does
not conclude that the additional cost has a significant effect on the outcome.
F. Conclusion
Jonathan’s parents have a very difficult road and Regional Center is
obligated to help by listening to their desires and giving them a leadership
role in his programs. Regional Center
does have discretion, however. The
Petition must be denied because Jonathan’s Petition is moot, his papers are procedurally
defective, and the
weight of the evidence does not support the additional 50 hours of AST at
Progressive.
Regional Center’s counsel is ordered to prepare a proposed
judgment, serve it on the Petitioner’s counsel for approval as to form, wait
ten days after service for any objections, meet and confer if there are
objections, and then submit the proposed judgment along with a declaration
stating the existence/non-existence of any unresolved objections. An OSC re: judgment is set for September 27,
2022 at 1:30 p.m.
[1] Because
Mother is acting on Jonathan’s behalf as guardian ad litem, the court
will refer to Jonathan as the Petitioner.
[2]
All further statutory references are to the W&I Code unless otherwise
stated.
[3] For some
reason, Jonathan submitted two Joint Appendices. Nor are the Joint Appendices identical. There are pages cited by both Regional Center
and Jonathan that are not in either Joint Appendix. Moreover, Regional Center points out that the entire
Administrative Record is incomplete and disorganized. Opp. at 4. Most significantly, the
transcripts of two of Jonathan’s witnesses, Courtney Miller-Wakeham, a
Progressive supervisor, and Darlene Hanson are not in either the Administrative
Record or either Joint Appendix. Opp. at
4.
[4] Jonathan
apparently attempts to cure this last defect by filing and serving a motion to
augment four court days before trial.
This motion does attach evidence but provides no an explanation for its
untimeliness and does not seek to shorten time for hearing. The motion therefore is ineffectual and is
denied.
[5]
Regional Center also objects to Jonathan’s evidence as unsupported hearsay and lacking
foundation. Opp. at 4-5. The court cannot rule on these objections
because the evidence is not before it in a properly noticed motion.
[6]
Jonathan adds a discussion of the cy pres doctrine (Reply at 2-3) which
has no bearing on the issues. There is
no pot of funds that may be distributed to Jonathan cy pres.
[7]
One of the cited IPPs (AR 170) was not in the Joint Appendix.