BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                  SB 764
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          SENATE THIRD READING
          SB 764 (Steinberg)
          As Amended  August 20, 2012
          Majority vote 

           SENATE VOTE  :24-13  
           
           HUMAN SERVICES      4-2         APPROPRIATIONS      12-0        
           
           ----------------------------------------------------------------- 
          |Ayes:|Beall, Ammiano, Hall,     |Ayes:|Gatto, Blumenfield,       |
          |     |Portantino                |     |Bradford, Charles         |
          |     |                          |     |Calderon, Campos, Davis,  |
          |     |                          |     |Fuentes, Hall, Hill,      |
          |     |                          |     |Cedillo, Mitchell,        |
          |     |                          |     |Solorio                   |
          |     |                          |     |                          |
          |-----+--------------------------+-----+--------------------------|
          |Nays:|Jones, Grove              |     |                          |
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           SUMMARY  :  Establishes a pilot program for the provision of 
          treatment and intervention services through the use of 
          telehealth.  Specifically,  this bill  :   

          1)States legislative intent to do all of the following:

             a)   Improve access to treatment and intervention services 
               for individuals with autism spectrum disorders (ASDs) or 
               other developmental disabilities and their families in 
               underserved populations;

             b)   Provide more cost-effective treatments and intervention 
               services for individuals with ASDs or other developmental 
               disabilities and their families;

             c)   Maximize the effectiveness of the interpersonal and 
               face-to-face interactions that are utilized for the 
               treatment of individuals with ASDs or other developmental 
               disabilities; and,

             d)   Continue maintenance and support of the existing service 
               workforce for individuals with ASDs or other developmental 
               disabilities.








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          2)Provides that, to improve access to services for consumers and 
            family members, including those from underserved communities, 
            and to facilitate better and cost-effective services, 
            individual program planning (IPP) teams shall consider 
            telehealth, whenever applicable.

          3)Requires that telehealth be considered for parent trainings, 
            including group trainings for parents on behavioral 
            intervention techniques.

          4)Requires the Department of Developmental Services (DDS) to 
            implement appropriate vendorization subcodes for telehealth 
            services and programs.

          5)Requires telehealth providers to maintain the privacy and 
            security of all confidential consumer information.

          6)Provides that the provision of a service through the use of 
            telehealth is voluntary and may be discontinued at the request 
            of the consumer or, as appropriate, the consumer's authorized 
            legal representative at any time.  Requires the regional 
            center, upon receiving a request to discontinue telehealth, to 
            convene an IPP review to determine alternative, appropriate 
            means for providing the service.

          7)Defines "telehealth" as that term defined in the Business and 
            Professions Code.

           FISCAL EFFECT  :  According to the Assembly Appropriations 
          Committee, cost associated with this legislation should be minor 
          and absorbable within existing resources.

           COMMENTS  :  According to the author, this bill is intended to 
          promote and encourage the use of Tele-Health and Tele-Medicine 
          applications for the diagnosis and treatment of ASD by DDS and 
          regional centers; to improve access for the appropriate 
          evaluation and treatment of ASD by regional centers to 
          underserved communities; and, to provide services for the 
          appropriate evaluation and treatment of ASD by regional centers 
          in the most competent and cost-effective manner possible.

          The author notes that there has been a twelve fold increase in the 
          diagnosis of ASD during the past decade.  ASDs are increasing at an 








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          average annual rate of 17%, and two-thirds of all new consumers who 
          are entering the regional center system are now diagnosed with ASD.  
          The cost to DDS and the regional centers for the evaluation, 
          diagnosis, assessment, and treatment of ASD, the author says, is 
          significantly higher than the costs for services and programs 
          provided for other developmental disorders.  According to the 
          author, because there are currently over 51,000 ASD consumers who 
          are receiving services from DDS and regional centers, the number of 
          programs and service providers available for these consumers are 
          diminishing, especially in geographically remote communities and in 
          underserved populations.  The author points out that there are 
          currently innovative approaches and applications that are being used 
          extensively in the area of Tele-Health and Tele-Medicine.  Autism 
          experts and healthcare professionals, the author says, have 
          recommended that these applications and systems be used for the 
          evaluation and treatment of ASD.

          On April 12, 2012, the Senate Select Committee on Autism & Related 
          Disorders held an informational hearing, Ensuring Fair & Equal 
          Access to Regional Center Services for Autism Spectrum Disorders.  
          Testimony addressed disparities, including racial and ethnic 
          disparities, in access to regional center services, often based on 
          where in the state the consumer lives.  Access issues exist 
          particularly within low-income communities or rural areas where 
          services may not exist, or where other barriers, such as inadequate 
          transportation, are common.  It was clear from testimony at the 
          Select Committee hearing that these disparities and access issues do 
          not exist only for regional center consumers with ASD.

          Nothing prevents the use of telehealth for regional center consumers 
          under current law.  As described in the Existing Law section, above, 
          the Lanterman Act includes numerous references to the use of 
          innovative and economical service mechanisms and methods of 
          achieving IPP objectives.  Because it can increase access to needed 
          services by means of an innovative and cost-effective service 
          mechanism, telehealth is certainly consistent with the intent of the 
          Lanterman Act and not precluded by the current statute when 
          identified as the preferred means of achieving a consumer's IPP 
          objectives.  This bill would require consideration of telehealth, 
          when appropriate, for purposes of increasing access to services for 
          people with ASD and other developmental disabilities and their 
          families in underserved populations.  This bill would make it clear, 
          however, that consumers and family members may choose to have 
          services provided in-person rather than through telehealth.  








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           Analysis Prepared by  :    Chris Reefe / HUM. S. / (916) 319-2089 
          FN: 0005085