BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | SB 1445|
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UNFINISHED BUSINESS
Bill No: SB 1445
Author: Evans (D)
Amended: 8/7/14
Vote: 21
SENATE HUMAN SERVICES COMMITTEE : 5-0, 4/8/14
AYES: Liu, Berryhill, DeSaulnier, Hancock, Wyland
SENATE APPROPRIATIONS COMMITTEE : 7-0, 5/23/14
AYES: De León, Walters, Gaines, Hill, Lara, Padilla, Steinberg
SENATE FLOOR : 37-0, 5/28/14
AYES: Anderson, Beall, Berryhill, Block, Cannella, Corbett,
Correa, De León, DeSaulnier, Evans, Fuller, Gaines, Galgiani,
Hancock, Hernandez, Hill, Hueso, Huff, Jackson, Knight, Lara,
Leno, Lieu, Liu, Mitchell, Monning, Morrell, Nielsen, Padilla,
Pavley, Roth, Steinberg, Torres, Vidak, Walters, Wolk, Wyland
NO VOTE RECORDED: Calderon, Wright, Yee
ASSEMBLY FLOOR : 77-0, 8/7/14 (Consent) - See last page for vote
SUBJECT : Developmental services: regional centers:
individual program
plans: telehealth
SOURCE : Author
DIGEST : This bill includes telehealth services and supports
among the services and supports authorized to be included as
part of an individual program plan (IPP).
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Assembly Amendments make a technical change.
ANALYSIS : Existing law:
1.Establishes the Lanterman Developmental Disabilities Services
Act, which declares California's responsibility for providing
an array of services and supports to meet the needs of each
person with developmental disabilities in the least
restrictive environment, regardless of age or degree of
disability, and to support their integration into the
mainstream life of the community.
2.Establishes a system of nonprofit regional centers (RCs) to
provide fixed points of contact in the community for all
persons with developmental disabilities and their families, to
coordinate services and supports best suited to them
throughout their lifetime.
3.Establishes the IPP 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 regional
centers.
4.Defines permissible services and supports to be listed in the
IPP, which includes diagnosis, evaluation, treatment, personal
care, day care, domiciliary care, special living arrangements,
physical, occupational, and speech therapy.
5.Creates the Telehealth Advancement Act of 2011 and defines
"telehealth" as the mode of delivering health care services
and public health via information and communication
technologies to facilitate the diagnosis, consultation,
treatment, education, care management, and self-management of
a patient's health care while the patient is at the
originating site and the health care provider is at a distant
site.
This bill adds telehealth services and support, as defined, to
the existing list of permissible services and supports listed as
part of an IPP.
Comments
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Telehealth . The Telehealth Advancement Act of 2011 (AB 415,
Logue, Chapter 547, Statutes of 2011) defines "telehealth" as
the mode of delivering health care services and public health
via information and communication technologies to facilitate the
diagnosis, consultation, treatment, education, care management,
and self-management of a patient's health care while the patient
is at the originating site and the health care provider is at a
distant site. The bill's stated intent was to provide better
access to primary care and specialty providers to patients in
medically underserved rural and urban areas, and to ensure a
continuum of care in those areas. Telehealth was defined as a
tool to create parity in those areas and to create new models of
care as part of a multi-faceted approach to health care.
A 2008 report, "Meeting the Health Care Needs of California's
Children: the Role of Telemedicine," by the Children's
Partnership, stated that "Quality health care no longer requires
a health care provider and patient to be in the same room at the
same time. With the advancement of information and
communications technology, children and adults can receive
high-quality health care from a distance through telemedicine.
In fact, telemedicine is rapidly becoming a viable solution to
meeting the health care needs of patients in rural and other
underserved areas."
California was one of the first states to adopt legislation to
define and support the role of telemedicine in health care
delivery. In 1996, California adopted the Telemedicine
Development Act of 1996, identifying telemedicine as a
legitimate means of providing health care. Current statute
prohibits a health care service plan from requiring that
in-person contact occur between a health care provider and a
patient before payment is made for a covered service
appropriately provided through telehealth.
Prior Legislation
AB 1231 (V. Manuel Perez, 2013) would have required the
Department of Developmental Services (DDS) to inform all RCs
that any appropriate health care service and dentistry may be
provided through the use of telehealth, as defined, to consumers
of RC services. This bill was vetoed by Governor Brown who
stated the bill's goals were permissible under current law.
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SB 764 (Steinberg, 2012) would have required each RC's IPP team
to consider the use of telehealth, whenever applicable, to
improve access to intervention and therapeutic services for
consumers and family members. This bill was vetoed by Governor
Brown who stated the bill's goals could be accomplished under
current law.
AB 415 (Logue, Chapter 547, Statutes of 2011) established the
Telehealth Advancement Act of 2011 and states legislative intent
to use telehealth to expand consumers' access to convenient and
quality care.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: No
According to the Senate Appropriations Committee:
Minor costs to provide technical assistance to regional
centers by the Department of Developmental Services (General
Fund).
Unknown impact on the use of services by regional center
consumers (General Fund and federal funds). To the extent
that the bill results in regional center consumers using
telehealth services, there could be both increased
utilization of services and reduced costs for current
services. To date, there has been limited use of telehealth
in the regional center system, so predicting utilization
impacts is difficult.
There may be circumstances where greater knowledge of the
availability of telehealth services by consumers and their
families increases the utilization services. For example, in
rural areas of the state there may be limited numbers of
providers for certain services. For services that are
recurring or of long duration (such as behavioral health
services), greater access to providers in other areas of the
state through telehealth may increase the demand for those
services by consumers from rural areas.
On the other hand, services provided through telehealth may
be less expensive than services provided in person. In such
cases, greater use of telehealth may reduce costs to the
regional centers.
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SUPPORT : (Verified 8/7/14)
ACT TODAY
Alta California Regional Center
Association of Regional Center Agencies
Autism Research Group
Behavioral Intervention for Autism
Bethesda Lutheran Communities
California Association for Behavior Analysis
Center for Autism and Related Disorders
Central Valley Regional Center Inc.
Institute for Behavioral Training
Regional Center of Orange County
Southern California Consortium for Behavior Analysis
Special Needs Network
Westside Regional Center
ARGUMENTS IN SUPPORT : The author states that despite the
implication in law that permits regional centers to integrate
telehealth into their service models for individuals with
developmental disabilities, many RCs have been reluctant to use
the treatment model. This bill is intended to clarify that
existing services and supports may be provided through
telehealth by RCs under the provisions of the Lanterman Act.
ASSEMBLY FLOOR : 77-0, 8/7/14
AYES: Achadjian, Alejo, Allen, Ammiano, Bigelow, Bloom,
Bocanegra, Bonta, Bradford, Brown, Buchanan, Ian Calderon,
Campos, Chau, Chávez, Chesbro, Conway, Cooley, Dababneh,
Dahle, Daly, Dickinson, Donnelly, Eggman, Fong, Frazier, Beth
Gaines, Garcia, Gatto, Gomez, Gonzalez, Gordon, Gorell, Gray,
Grove, Hagman, Hall, Harkey, Roger Hernández, Holden, Jones,
Jones-Sawyer, Levine, Linder, Logue, Lowenthal, Maienschein,
Mansoor, Medina, Melendez, Mullin, Muratsuchi, Nazarian,
Nestande, Olsen, Pan, Patterson, Perea, John A. Pérez, V.
Manuel Pérez, Quirk, Quirk-Silva, Rendon, Ridley-Thomas,
Rodriguez, Salas, Skinner, Stone, Ting, Wagner, Waldron,
Weber, Wieckowski, Wilk, Williams, Yamada, Atkins
NO VOTE RECORDED: Bonilla, Fox, Vacancy
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JL:nl 8/8/14 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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