BILL ANALYSIS SENATE HEALTH AND HUMAN SERVICES COMMITTEE ANALYSIS Senator Deborah V. Ortiz, Chair BILL NO: AB 688 A AUTHOR: John Campbell B AMENDED: May 14, 2001 HEARING DATE: June 27, 2001 6 FISCAL: Appropriations 8 8 CONSULTANT: McCarthy / ak SUBJECT Developmental disabilities SUMMARY This bill requires the Department of Developmental Services to develop and implement, by January 1, 2003, uniform based evaluation protocols and guidelines to determine eligibility for regional center services, as specified. ABSTRACT Existing law: 1.Establishes the Lanterman Developmental Disabilities Services Act, under which an eligible individual with developmental disabilities is entitled to services and supports to meet his or her needs. 2.Provides for the regional centers system, under which the Department of Developmental Services (DDS) contracts with 21 private non-profit agencies to provide assessment, eligibility determination, case coordination, and other services and support in community-based settings. 3.Specifies that the conditions that must exist for an Continued--- STAFF ANALYSIS OF ASSEMBLY BILL 688 (John Campbell) Page 2 individual to be determined eligible for DSS services must originate before the age of 18 and continue, or be expected to continue, indefinitely and constitute a "substantial" disability for the individual. 4.Specifies the disorders that an individual must have to be eligible for DDS services as: a) mental retardation, b) cerebral palsey, c) autism, d) epilepsy, and e) conditions that require treatment similar to that required for mental retardation. 5.Specifies that handicapping conditions that are solely physical in nature do not qualify an individual for services under the Act. This bill: 1.Requires DDS to develop and implement, by January 1, 2003, uniform functionally based evaluation protocols and guidelines to determine eligibility for regional center services. 2.Requires the new DDS protocols to address autism and disorders not specifically listed as a disorder potentially qualifying an individual for DDS services, including familial dysautonomia, that require treatments similar to those disabilities that are listed as qualifying disorders. 3.Requires DDS to develop by July 1, 2002, a training program on the new protocols for regional center staff. 4.Requires DDS to implement the new protocols by January 1, 2003 and make the protocols and guidelines available to the public during development of the protocols. FISCAL IMPACT According to the Assembly Appropriations Committee analysis, there would be minor, absorbable costs to DDS to develop and implement eligibility protocols that include familial dysautonomia. Of an estimated 17 to 20 people with the disease, 15 are already receiving regional center services. DDS also indicates the cost of developing and implementing evaluation protocols and guidelines could be done within existing DDS resources. No estimate is Continued--- STAFF ANALYSIS OF ASSEMBLY BILL 688 (John Campbell) Page 3 available of any training program costs. BACKGROUND AND DISCUSSION 1.Familial dysautonomia This bill is sponsored by the parents of a son with familial dysautonomia (FD), which is a rare genetic disorder that seriously impairs the functioning of the autonomic and sensory nervous systems. FD affects Jewish families in which both parents carry a particular gene, and affects fewer than 20 persons in California. Half of FD patients survive to age 30. Affected individuals can experience impairment of heartbeat; inability to regulate body temperature and blood pressure; insensitivity to pain, heat and cold; inadequate tear production, resulting in infections, corneal abrasions, and scarring; and serious gastrointestinal problems. It is present from birth and poses severe physical, emotional, and developmental problems as the child ages. According to information submitted to this Committee by the author, experts indicate the severity of the disorder varies greatly from patient to patient, and varies with a particular individual's age. Learning disabilities are frequent, but mental retardation is not common in the disorder. According to the sponsors, there is inconsistency from one regional center to another in determination of eligibility for children with FD. Most have received regional center services, while some have been denied. The sponsors argue that these children require treatment similar to that required by children with mental retardation or other developmental disabilities listed in statute. Under current law, only conditions that require treatment similar to that required for mental retardation qualify an individual for regional center services under the "fifth category", as described in 4) on page 1 of this analysis. Based on information submitted to this Committee by the author, in 2000 the state of New York enacted legislation adding familial dysautonomia to the list of disorders covered under that state's definition of a developmental disability. (That state's statutory definition of eligible developmental disorders differs from Continued--- STAFF ANALYSIS OF ASSEMBLY BILL 688 (John Campbell) Page 4 California's in several ways, for example, by including neurological impairment as a separate category of eligibility, and also including dyslexia resulting from a covered disorder as a category of eligibility.) 2.Evaluation protocols and eligibility guidelines This bill also is intended to address the issue of inconsistency among regional centers by requiring DDS to develop and implement protocols for use by regional centers in determining eligibility. The protocols would include not only mental retardation, autism, cerebral palsy and epilepsy, but also disorders that, while not specifically named, require treatment similar to these disorders. The sponsors' son has been determined to be eligible for services by the local regional center under the "requiring similar treatment" to mental retardation category, but the family fears that as their son grows and develops, one day talking and eating by himself, the evaluation may not continue to be supported, even though he will still suffer pervasive developmental challenges and require substantial support. The family also fears that if it ever moves, another regional center may have a different opinion than their current center. 3.DDS response According to DDS, hundreds of conditions and syndromes exist that meet eligibility requirements for regional center services, even though they are not listed in statute, while some that are listed may not be severe enough to result in eligibility for particular individuals. The key in determining eligibility is the "substantial disability" standard and an individual's need for "treatment similar to that required for mental retardation." Other attempts have been made over the years to expand the list of diagnoses in the law, but DDS has opposed an expansion on the basis that it would be impossible to list every condition and, regardless, a regional center would still have to assess each case individually to make a final eligibility determination. In the case of FD, because the manifestations of the condition vary from person to person and over time within one person, as the Continued--- STAFF ANALYSIS OF ASSEMBLY BILL 688 (John Campbell) Page 5 experts describe, an individualized assessment would be necessary whether or not the condition was listed in law. DDS also points out that if a regional center's determination is disputed, existing law provides a fair hearing process to appeal it. Subsequent to the introduction of this bill, the sponsor met with DDS senior staff to discuss the experience of the families affected by FD and ways to promote consistency among regional centers in addressing their needs. As a result of that meeting, DDS has agreed to: review pertinent genetic and medical information regarding FD to assess the likelihood that it would be considered eligible for regional center services; prepare a summary of FD characteristics as they relate to regional center eligibility; use the summary as the basis of a discussion at the next regional center physicians meeting of the need for uniform protocol for determining eligibility, and recommendations for such procedures; and review the recommendations from the regional center eligibility task force for a protocol that more uniformly assesses the "similar treatment" category. Assessments have a subjective component, and families often disagree with the regional center when eligibility is denied or services are limited. AB 1800 (Ortiz), introduced in the 1999-2000 Legislative session, was intended to address one aspect of this issue through requiring regional centers to consider diagnoses by specialists not employed by the regional centers. That bill was held in the Assembly Appropriations Committee, due to the Administration's cost concerns. In regard to AB 688, regional centers assert they are attempting to improve their ability to follow eligibility determination standards closely and maintain internally consistent practices. The Association of Regional Center Agencies (ARCA) has on-going committees that work with DDS to address these issues. In regard to FD, DDS staff argue that increased funding for regional center-based clinical teams in the last several years, upgraded training, and increasing knowledge of rare syndromes that affect the population will help in this regard. Continued--- STAFF ANALYSIS OF ASSEMBLY BILL 688 (John Campbell) Page 6 1.Opposition arguments The Inland Regional Center opposes provisions of the bill requiring functionally based evaluations. The Center states that such evaluations ignore eligibility evaluations based on diagnoses and standardized intelligence eligibility criteria for the DDS regional center system, increasing cost. (However, according to ARCA, most other states use a functionally based assessment, based on degree of the individual impairment.) Continued--- QUESTIONS AND COMMENTS 1.Background This bill highlights the contentious issue of which disorders qualify for services for DDS regional center services, which provides ongoing, non-means tested services on an entitlement basis to those whose disabilities are listed in the statutory definition and whose disability is substantial. According to DDS, there are a number of disorders that, in individual cases, result in a degree and type of disability similar to that of the disorders listed in existing law; to some extent, the determination of eligibility in regard to these cases is a judgement call on the part of the regional center staff. However, if the individual is not mentally retarded but is substantially disabled in other ways, there may be no way to qualify the individual for services under existing law. 2.Other stakeholders/Legislative review AB 688 would require DDS to develop and implement evaluation protocols and guidelines to determine eligibility, as described. The bill requires DDS to consult only with the Association of Regional Center Agencies. As such eligibility determinations involve significant policy issues, should the bill be amended to require that other stakeholders knowledgeable about childhood disabilities be consulted in the development of the protocols, as well as interested parent groups? Also, as these eligibility policy issues are of significant interest to the Legislature, should DDS be required to submit the proposed protocols to the legislature for review and adoption, prior to implementation by DDS? This would allow the legislature the opportunity to have input into the new protocols for eligibility determination. 3.Author's amendment As the budget for FY 2001-2001, soon to be enacted by the Legislature, is expected to include a requirement for a study of the definition of autism under the regional center system, the sponsor has proposed an amendment to Continued--- STAFF ANALYSIS OF ASSEMBLY BILL 688 (John Campbell) Page 8 delete autism as a disorder specifically included as a disorder to be addressed in AB 688. The sponsor's intent is to avoid duplication of DDS reviews of eligibility for specific disorders. 4.Related legislation Pending legislation, AB 1693 (Assembly Human Services Committee), requires a mechanism be developed for temporary rate adjustments for regional centers in high cost areas of the state as well as rural areas, where competition to recruit and retain staff is an issue. AB 1693 bill passed this Committee on June 20, 2001. PRIOR ACTIONS Assembly Floor: 74 - 0 Pass on Consent Assembly Appropriations: 21 - 0 Do Pass to Consent Assembly Human Services: 6 - 0 Do Pass as Amended POSITIONS Support: Area XI Developmental Disabilities Board American Academy of Pediatrics Children's Hospital of Orange County Familial Dysautonomia Hope, Inc. Temple Beth Sholom 4 Individuals Oppose: Inland Regional Center -- END --