BILL ANALYSIS Ó
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Date of Hearing: June 30, 2015
ASSEMBLY COMMITTEE ON HUMAN SERVICES
Kansen Chu, Chair
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(Mark Stone) - As Amended June 24, 2015
SUBJECT: California Early Intervention Services Act.
SUMMARY:
Specifically, this bill:
1)Makes a number of findings and declarations related to
children's development, including the following:
a) The period between a child's birth and third birthday is
a time of intense and ongoing development;
b) Adversity during a child's early years can impair
development, and children exposed to maltreatment and
additional risk factors face an increased likelihood of one
or more delays in their cognitive, language, or emotional
development;
c) Unaddressed developmental delays and disabilities result
in persistently impaired learning and health outcomes for
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children;
d) Nationally, one in every 68 children was affected by
autism spectrum disorder (ASD) in 2014, and one in four
children in California has a moderate or higher risk for a
developmental delay;
e) Latino and African American children are more likely to
experience barriers in accessing early identification and
intervention services;
f) The American Academy of Pediatrics and other experts
recommend routine, regular, and formalized developmental
and behavioral screening for all infants and toddlers in
order to identify children in need of supports and
services;
g) Nearly 75% of children in California with special health
care needs under three years of age do not receive early
intervention services they could benefit from; and
h) A system of universal development and behavioral
screenings should work hand in hand with a robust early
intervention system.
2)Resolves that every child in California deserves periodic
formal assessment of his or her development for the purposes
of introducing supports and services if needed, and that those
supports and services should be easily accessible and
responsive to a child's needs.
3)Resolves that the Legislature leverage existing efforts and
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statutes to ensure an accountable, results-oriented, and
coordinated statewide network of resources, services, systems,
and strong local infrastructures, and that the Legislature
invest sufficiently in comprehensive health and early
intervention services and supports, built upon existing
efforts, in order to ensure that they meet the health and
learning needs of California's diverse child population.
EXISTING LAW:
1)Enacts, through federal law, Part C of the Individuals with
Disabilities Education Act (IDEA), to provide funding to and
encourage states to expand opportunities and provide
intervention services to children under three years of age
with developmental delays. (20 U.S.C. § 1431 et seq.)
2)Establishes the Early Intervention Services Act (Early Start
Program), under which the Department of Developmental Services
(DDS) and regional centers, in collaboration with the
Department of Education and local education agencies, provide
services for infants and toddlers who have disabilities or who
are at risk of having disabilities, including ASD, in order to
enhance their development and to minimize the potential for
developmental delays. (GOV 95000 et seq.)
3)Establishes that an infant or toddler under age 3 who is
eligible for early intervention services shall have an
individualized family service plan (IFSP) to direct services,
as specified, and defines the types of services, supports and
staffing that should be considered when creating the plan.
(GOV 95020)
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4)Establishes an entitlement to services for individuals with
developmental disabilities under the Lanterman Developmental
Disabilities Services Act (Lanterman Act). (WIC 4500 et seq.)
5)Establishes a system of 21 nonprofit regional centers
throughout the state to identify needs and coordinate services
for eligible individuals with developmental disabilities and
requires DDS to contract with regional centers to provide case
management services and arrange for or purchase services that
meet the needs of individuals with developmental disabilities,
as defined. (WIC 4620 et seq.)
6)Requires a regional center to provide initial intake and
assessment services to any person believed to have a
developmental disability and any person believed to have a
high risk of parenting an infant with a developmental
disability, as specified, and identifies guidelines and
timelines for the intake and assessment process. (WIC 4642 et
seq.)
7)Creates the First 5 Commission through the voter-approved
California Children and Families First Act of 1998
(Proposition 10) and authorizes the creation of First 5 county
commissions to promote and develop early childhood development
programs funded by revenues from a tax on tobacco products.
(HSC 130100 et seq.)
FISCAL EFFECT: Unknown.
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COMMENTS:
Child development: There are a number of factors that can
contribute to health risks and developmental delays for
children. These factors often include:
a) Prematurity or low birth weight;
b) Difficulties seeing or hearing;
c) Prenatal exposure or other types of exposure to drugs,
alcohol, or tobacco;
d) Poor nutrition or difficulties eating (a lack of
nutritious foods, proteins, vitamins, or iron in a child's
diet);
e) Exposure to lead-based paint (through eating, licking,
or sucking on lead-base painted doors, floors, furniture,
toys, or other objects); and
f) Abuse or neglect.
Services: The Lanterman Act guides the provision of services
and supports for Californians with developmental disabilities.
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
disability, cerebral palsy, epilepsy, and autism spectrum
disorders (ASD). Other developmental disabilities are those
disabling conditions similar to an intellectual disability that
require treatment (i.e., care and management) similar to that
required by individuals with intellectual disability.
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Regional centers are responsible for conducting intake and
assessment, individualized program plan development, case
management, and securing services through generic agencies or
purchasing services provided by vendors. Regional centers also
share primary responsibility with local education agencies
(LEAs) for the provision of early intervention services through
Early Start. In this shared role, LEAs provide services for
children with low-incidence disabilities (e.g.: blindness,
deafness, hard of hearing, orthopedic impairments), and regional
centers are required to provide or purchase appropriate early
intervention services that are required under the federal IDEA
but are beyond the mandated scope of responsibilities of LEAs.
While some delays that present themselves during infancy are
indicative of a developmental disability and trigger eligibility
for lifelong regional center services under the Lanterman Act,
other developmental delays that do not fit within the definition
of developmental disability can still lead to services and
supports for children and their families under the California
Early Intervention Services Act. Children from birth to three
years of age are eligible for early intervention services
provided they have been screened and meet at least one of the
following criteria:
a) They have a developmental delay of at least 33% in one
or more areas of either physical and motor, adaptive,
communication, social or emotional, or cognitive
development (including vision and hearing);
b) They have an established risk condition of known
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etiology, with a high probability of resulting in a
developmental delay; or
c) They can be considered to be at high risk of having a
substantial developmental disability due to a combination
of diagnosed biomedical risk factors.
Regional centers serve roughly 280,000 individuals, which
includes over 34,000 children in Early Start according to May
2015 DDS caseload data. Another 4,943 children are receiving
diagnostic and evaluation services, and 1,151 children are
considered active consumers and receive services outside of
Early Start.
The early intervention services a child receives through Early
Start are based on the developmental needs identified in his or
her individualized family service plan (IFSP). Early Start
services include: case management; family training, counseling,
and home visits; social work services; assistive technology;
audiology; health services; medical services (related to
evaluation and diagnosis); nursing services; nutrition services;
occupational therapy; physical therapy; psychological services;
special instruction; speech and language services;
transportation and related costs; and vision services.
Need for this bill: This concurrent resolution calls for a
comprehensive approach that builds on existing programs and
processes to ensure all children have access to the early
developmental interventions they need. By emphasizing the need
for timely developmental screenings, this concurrent resolution
seeks to help families address any developmental delays their
children might have as early as possible in order to avoid the
compounding effects of unaddressed needs later in their lives.
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In support of this bill, Children Now states, "Despite the fact
that developmental delays are very common, affecting as many as
1 in 6 children nationally, less than one-third (28.5%) of
California's infants and toddlers received a developmental
screening at their regular well-child health visits in 2011-12.
In fact, fewer than half of California children requiring
special education in elementary school were identified prior to
Kindergarten entry."
According to the author, "Children need access to developmental
screening tools to ensure they can access appropriate resources
and care. While most experts in the health field agree early
screening is important for the future development of children,
many children are not being properly screened. Seventy-two
percent or 1.7 million Californian children are not being
screened with recommended tools, putting them at risk for late
or no identification of developmental or behavioral delays<1>.
The problem is especially pronounced for children of color; for
instance, Latino children are diagnosed with autism an average
of 2.5 years later than white children1?.When children are not
diagnosed with developmental delays or other problems, they may
not receive the care they need and may fall further behind.
When delays are not early identified during children's first
years of life, they must wait to get the help they need when
they enroll in school. Since development is often sequential, a
developmental or behavioral delay can often cause more problems
if it is not identified and if the child does not access the
appropriate care. Without proper intervention treatment,
developmentally delayed children may experience academic and
social hardships?It has been shown that the earlier the
identification and intervention, the more beneficial to children
and families because it strengthens families' ability to support
their child's growth and development while maintaining the
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<1> "Building an Early Identification System in CA: The Need for
Action" First 5 Association of California;
www.first5association.org
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greatest cost effectiveness."
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PRIOR LEGISLATION:
ACR 155 (Bocanegra), Chapter 144, Statutes of 2014, urged the
Governor to identify evidence-based solutions to reduce
children's exposure to adverse childhood experiences, address
the impacts of those experiences, and invest in preventive
health care and mental health and wellness interventions.
SB 527 (Steinberg) 2007, would have required DDS to partner with
at least one regional center to implement an ASD early
screening, intervention and treatment pilot program to establish
best practices for early screening, diagnosis, referral and
treatment for children with ASD. As introduced, it would have
required pediatricians to routinely evaluate children ages zero
to five for behaviors resembling those identified as ASD and to
provide parents and guardians information about cognitive
impairments and information about regional centers and other
organizations that provide resources and services for children
with ASD. It was vetoed by the Governor.
REGISTERED SUPPORT / OPPOSITION:
Support
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Association of Regional Center Agencies (ARCA)
Autism Speaks
Center for Autism and Related Disorders (CARD)
Children Now
Family Resource Centers Network of CA
Fight Crime: Invest in Kids California
First 5 Association of CA
First 5 Fresno County
First 5 Monterey County
First 5 San Luis Obispo County
First 5 Santa Clara County
First 5 Santa Cruz County
Lucile Packard Children's Hospital Stanford
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ZERO TO THREE Western Office
Opposition
None on file.
Analysis Prepared by:Myesha Jackson / HUM. S. / (916) 319-2089