BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                            



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          |SENATE RULES COMMITTEE            |                        SB 158|
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                                    THIRD READING


          Bill No:  SB 158
          Author:   Correa (D), et al.
          Amended:  5/28/13
          Vote:     21

           
           SENATE HUMAN SERVICES COMMITTEE  :  5-0, 4/9/13
          AYES:  Yee, Berryhill, Emmerson, Evans, Wright
          NO VOTE RECORDED:  Liu

           SENATE APPROPRIATIONS COMMITTEE  :  7-0, 5/23/13
          AYES:  De León, Walters, Gaines, Hill, Lara, Padilla, Steinberg


           SUBJECT  :    Autism services:  demonstration program

           SOURCE  :     Author


           DIGEST  :    This bill establishes, until January 1, 2019, a  
          demonstration program, the Regional Center Excellence in  
          Community Autism Partnerships (RE CAP), coordinated by a  
          University of California (UC) or California State University  
          (CSU) campus which defines underserved communities in regional  
          center (RC) catchment areas and establishes guidelines to assist  
          individuals with autism spectrum disorders (ASD), as specified. 

           ANALYSIS  :    

          Existing Law:

          1. Establishes the Lanterman Developmental Disabilities Services  
             Act, which states that California is responsible for  
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             providing an array of services and supports sufficient to  
             meet the needs and choices of each person with developmental  
             disabilities, regardless of age or degree of disability, and  
             at each stage of life and to support their integration into  
             the mainstream life of the community. 

          2. Defines a "developmental disability" as a disability that  
             originates before an individual attains age 18 years,  
             continues, or can be expected to continue, indefinitely, and  
             constitutes a substantial disability for that individual.   
             This term also includes autism. 

          3. Establishes in California law that the Department of  
             Developmental Services (DDS) contracts with private  
             non-profit RCs to provide supports in order for the state to  
             carry out many of its responsibilities to provide fixed  
             points of contact in the community for persons with  
             developmental disabilities and their families, to the end  
             that these persons may have access to the services and  
             supports best suited to them throughout their lifetime. 

          4. Establishes an Individual Program Plan and defines that  
             planning process as the vehicle to ensure that services and  
             supports are customized to meet the needs of consumers who  
             are served by RCs. 

          5. Requires that any individual who is believed to have a  
             developmental disability is eligible for intake and  
             assessment services, and sets guidelines and timelines for  
             performing those services. 

          6. Requires DDS to develop evaluation and diagnostic procedures  
             for ASD, as specified. 

          This bill:

          1. Permits the establishment of a demonstration program, known  
             as RE CAP, and requires it to provide improved services,  
             supports, interventions, and other resources to assist  
             individuals with ASD, and their families, who are RC  
             consumers and reside in underserved communities.

          2. Permits DDS to contract with a UC or CSU campus to serve as a  
             coordinating center to develop the RE CAP program. 

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          3. Permits the coordination center to establish guidelines, best  
             practices, and technical assistance by which participating  
             RCs are required to implement measures in underserved  
             communities to accomplish any of the following goals and  
             objectives in a linguistically and culturally competent  
             manner:

              A.    Promote awareness and reduce the stigma associated  
                with ASD.

              B.    Improve the early screening for ASD.

              C.    Improve the diagnosis and assessment of ASD.

              D.    Increase access to evidence-based interventions and  
                treatments for ASD.

          4. Requires participation of the RCs to be on a voluntary basis.  


          5. Requires funding for the RE CAP program to be from existing  
             RC resources in combination with additional resources  
             provided by foundations, federal funding, and other sources  
             and as allocated by the coordinating center for each of the  
             RE CAP programs.  Prohibits additional state funds to be  
             allocated to the coordinating center for these purposes.

          6. Sunsets the program on January 1, 2019. 

           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 services in underserved  
          communities. 

           Access to health care services  .  The United States Department of  
          Health and Human Services Office of Minority Health has issued  
          14 standards for health organizations to ensure Culturally and  
          Linguistically Appropriate Services (CLAS).  In 2001, the Office  
          of Minority Health released a report which identified adoption  
          of CLAS standards as a way to correct inequities that currently  
          exist in the provision of health services, and to make these  

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          services more responsive to the individual needs of all  
          patients/consumers.  
           
          In 2011, the U.S. Department of Health and Human Services'  
          Interagency Autism Coordinating Committee included research on  
          disparities among its top objectives.  Specifically, the  
          Committee recommended conducting at least three studies  
          nationally to identify reasons for the health disparities in  
          accessing early screening and diagnosis services, including  
          identification of barriers to implementation of and access to  
          screening, diagnosis, referral, and early intervention services  
          among diverse populations, as defined by socioeconomic status,  
          race, ethnicity, and gender of the child. 

           Autism  .  ASD are complex neurological disorders that have an  
          onset in infancy and can cause mild to severe difficulties in  
          childhood development.  Among the challenges of ASD are language  
          delays, communication problems, limited social skills and  
          repetitive or other unusual behaviors.  Nationally, ASD affects  
          an estimated one in 88 children and is present across all  
          racial, ethnic and socioeconomic backgrounds. 

           Prior Legislation
           
          SCR 51 (Perata, Chapter 124, Statues of 2005) established the  
          Legislative Blue Ribbon Commission on Autism which identifies  
          gaps in programs and services related to the education and  
          treatment of children, adolescents, transitional youth, and  
          adults with ASD, provides recommendations for a comprehensive  
          and integrated continuum of programs and services, and provides  
          a report to the Governor and to the Legislature.

          AB 1872 (Coto, 2008) would have established the California  
          Autism Spectrum Disorder Clearinghouse administered by DDS to  
          provide evidence-based and recommended information and practices  
          regarding the education of pupils with ASD, including, but not  
          limited to, information about and examples of instructional  
          strategies, fiscal management practices, and organizational  
          structures supporting quality service delivery.  The bill was  
          vetoed by Governor Schwarzenegger.

          SB 527 (Steinberg, 2008) would have required the DDS to partner  
          with at least one RC to implement a two-year ASD Early  
          Screening, Intervention, and Treatment Pilot Program in at least  

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          three key geographic areas.  The Pilot Program would have  
          established best practices for early screening, diagnosis,  
          referral, and treatment for children with ASD.  The bill was  
          vetoed by Governor Schwarzenegger. 

          SB 1475 (Torlakson, 2008) would have required DDS to establish a  
          two-year pilot project to, among other things, provide methods,  
          instruments, and systems of care between RCs and school  
          districts for the early identification and assessment of  
          children with ASD from birth to five years of age.  The bill was  
          vetoed by Governor Schwarzenegger.

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes    
          Local:  No

          According to the Senate Appropriations Committee:

             Likely one-time costs in the hundreds of thousands for DDS  
             and the contracting campus to develop program criteria,  
             guidelines and best practices to and negotiate a contract  
             (General Fund).

             Likely ongoing program oversight costs in the hundreds of  
             thousands per year for DDS and the contracting campus  
             (General Fund).

             Potential program oversight costs in the hundreds of  
             thousands to low millions to participating RCs, depending on  
             how many RCs participate in the demonstration program  
             (General Fund).

             Unknown costs to the RCs to undertake required activities  
             such as promoting awareness of ASD, improving screening,  
             increasing access to services, and other activities.  Because  
             these activities are broadly defined in this bill, the total  
             cost to undertake them is unknown.  Costs could be in the  
             millions depending on how the program is developed (General  
             Fund).

           SUPPORT  :   (Verified  5/23/13)

          Autism Speaks
          Center for Autism and Related Disorders
          Health Access

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          Special Needs Network


           ARGUMENTS IN SUPPORT  :    According to the author's office, this  
          bill will highlight California's commitment and leadership to  
          individuals with ASD and their families by establishing landmark  
          programs throughout the state that will promote best practices  
          for the appropriate screening, assessment, and treatment of ASD  
          for individuals and communities that are currently underserved.


          JL:k  5/28/13   Senate Floor Analyses 

                           SUPPORT/OPPOSITION:  SEE ABOVE

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