BILL ANALYSIS Ó
AB 1231
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CONCURRENCE IN SENATE AMENDMENTS
AB 1231 (V. Manuel Pérez)
As Amended September 5, 2013
Majority vote
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|ASSEMBLY: |74-0 |(May 23, 2013) |SENATE: |39-0 |(September 9, |
| | | | | |2013) |
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Original Committee Reference: HUM. S.
SUMMARY : Requires the Department of Developmental Services (DDS) to
inform all regional centers that appropriate health care services
and dentistry services may be provided to regional center consumers
through the use of telehealth. Specifically, this bill :
1)States the intent of the Legislature to do all of the following:
a) Improve access to treatments and intervention services,
including dental health care services, for consumers of
regional center services and their families in underserved
populations.
b) Provide more cost-effective treatments and intervention
services for consumers of regional center services and their
families.
c) Maximize the effectiveness of the interpersonal and
face-to-face interactions that are utilized for the treatment
of consumers of regional center services.
d) Continue maintenance and support of the existing service
workforce for consumers of regional center services.
e) Utilize telehealth to improve services for consumers of
regional center services.
1)Requires DDS to do the following:
a) Inform all regional centers that any appropriate health care
service and dentistry services may be provided to regional
center consumers through the use of telehealth;
b) Request regional centers to consider the use of telehealth
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services for inclusion in training programs for parents of
consumers, as specified; and
c) Provide technical assistance to regional centers regarding
the use of telehealth to meet the health and dental care needs
of consumers through the use of existing resources, and in
partnership with other organizations, resources, and
stakeholders.
1)Authorizes DDS to implement appropriate vendorization subcodes for
services provided through telehealth.
2)Provides that services provided through telehealth shall be
accessed on a voluntary basis and shall be immediately
discontinued at the request of the consumer or the consumer's
representative, as specified. Further allows a consumer to
immediately return to the services prescribed in his or her
individual program plan (IPP) that were in place prior to the
implementation of the telehealth service.
3)Provides that a provider of telehealth services shall be
responsible for all expenses and costs related to the equipment,
transmission, storage, infrastructure, and other expenses related
to telehealth.
4)Establishes a sunset date of January 1, 2019, for the provisions
included in this bill, as specified.
The Senate amendments :
1)Delete legislative findings related to autism spectrum disorders
(ASD) and behavioral health treatment.
2)Delete explicit mention of ASD within provisions stating
legislative intent.
3)Delete all references to teledentistry and instead provide for the
use of telehealth to provide dentistry services.
4)Delete provisions related to behavioral health treatment.
5)Delete provisions establishing a 12-month provisional period
during which a consumer may discontinue the use of telehealth and
may return to his or her preexisting services.
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6)Delete the requirement for DDS to request that regional centers
include a consideration of telehealth in each IPP and
individualized family service plan (IFSP).
7)Delete the requirement for DDS to provide information to the
Legislature pertaining to the effectiveness and appropriateness of
providing telehealth services through the IPP and IFSP processes.
FISCAL EFFECT : Unknown. This bill, as amended, has not been heard
by a fiscal committee.
COMMENTS : This bill is part of a package that arose from a hearing
in 2012 by the Senate Select Committee on Autism and Related
Disorders that focused on disparities in available services and
service delivery in underserved communities. As a result of the
hearing, the Select Committee convened a taskforce to address
disparities in the allocation of regional center resources across
different racial and socio-economic groups. In order to reach
underserved communities as effectively and efficiently as possible,
the report recommends alternatives to customary service provision,
such as the use of center-based therapy, home and community-based
therapy and the use of telehealth/telemedicine for parent training
and direct service delivery.
Background : The Lanterman Developmental Disabilities Services Act
(Lanterman Act) (Welfare and Institutions Code (WIC) 4500 et seq.)
guides the provision of services and supports for Californians with
developmental disabilities. Each individual under the Lanterman
Act, typically referred to as a "consumer," is legally entitled to
treatment and habilitation services and supports in the least
restrictive environment. Lanterman Act services are designed to
enable all consumers to live more independent and productive lives
in the community.
The term "developmental disability" means a disability that
originates before an individual attains 18 years of age, is expected
to continue, indefinitely, and constitutes a substantial disability
for that individual. It includes intellectual disabilities,
cerebral palsy, epilepsy, and autism spectrum disorders. Other
developmental disabilities are those disabling conditions similar to
an intellectual disability that require treatment and management
similar to that required by individuals with an intellectual
disability.
Direct responsibility for implementation of the Lanterman Act
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service system is shared by the Department of Developmental Services
(DDS) and 21 regional centers, which are private nonprofit entities,
established pursuant to the Lanterman Act, that contract with DDS to
carry out many of the state's responsibilities under the Lanterman
Act. The principal roles of regional centers include intake and
assessment, individualized program plan development, case
management, and securing services through generic agencies (e.g.,
school districts, In-Home Supportive Services) or by purchasing
services provided by vendors. The regional center caseload includes
roughly 260,000 consumers who receive services such as residential
placements, supported living services, respite care, transportation,
day treatment programs, work support programs, and various social
and therapeutic activities. Approximately 1,400 consumers reside at
one of California's four Developmental Centers-and one
state-operated, specialized community facility-that provide 24-hour
habilitation and medical and social treatment services.
Services provided to people with developmental disabilities are
determined through an individual planning process. Under this
process, planning teams-which include, among others, the consumer,
his or her legally authorized representative, and one or more
regional center representatives-jointly prepare an IPP based on the
consumer's needs and choices. The Lanterman Act requires that the
IPP promote community integration and maximize opportunities for
each consumer to develop relationships, be part of community life,
increase control over his or her life, and acquire increasingly
positive roles in the community. The IPP must give the highest
preference to those services and supports that allow minors to live
with their families and adults to live as independently as possible
in the community.
Telehealth : The Telehealth Advancement Act (Act) of 2011 was
established in AB 415 (Logue), Chapter 547, Statutes of 2011. One
of the primary goals of telehealth under the Act is to expand health
care consumers' access to convenient and quality care in an effort
to maintain or improve the physical and economic health of medically
underserved communities. Telehealth is meant to enhance the overall
health care delivery system while saving money, preserving
health-related jobs, and increasing meaningful and positive
interactions between patients and providers.
Need for the bill : A prior version of this bill (SB 764 (Steinberg)
of 2012) was vetoed by the Governor, who stated the goals of the
bill could already be accomplished under current law. However,
while the Lanterman Act grants regional centers the authority to use
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innovative service delivery mechanisms, and there is nothing in
statute precluding regional centers from promoting service delivery
through the use of telehealth, the author has noted that providers
have perceived reluctance on the part of regional centers to
integrate telehealth into their treatment models without explicit
authorization from DDS. This bill is, in part, intended to clarify
scope and process for regional centers, which the author hopes will
result in an increased willingness to seek appropriate and desired
services for regional center consumers through the use of
telehealth.
Analysis Prepared by : Myesha Jackson / HUM. S. / (916) 319-2089
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