BILL ANALYSIS                                                                                                                                                                                                    Ó






                                                                     ACR 77


                                                                     Page A


          ASSEMBLY THIRD READING


          ACR  
          77 (Mark Stone)


          As Amended  June 24, 2015


          Majority vote


           ------------------------------------------------------------------ 
          |Committee       |Votes|Ayes                  |Noes                |
          |                |     |                      |                    |
          |                |     |                      |                    |
          |                |     |                      |                    |
          |----------------+-----+----------------------+--------------------|
          |Human Services  |7-0  |Chu, Mayes, Calderon, |                    |
          |                |     |Lopez, Maienschein,   |                    |
          |                |     |Mark Stone, Thurmond  |                    |
          |                |     |                      |                    |
          |                |     |                      |                    |
           ------------------------------------------------------------------ 


          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  











                                                                     ACR 77


                                                                     Page B


               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  
               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.













                                                                     ACR 77


                                                                     Page C


          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  
            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 United States Code Section  
            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.  (Government Code Section 95000 et seq.)


          3)Establishes that an infant or toddler under age three who is  











                                                                     ACR 77


                                                                     Page D


            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.   
            (Government Code Section 95020)


          4)Establishes an entitlement to services for individuals with  
            developmental disabilities under the Lanterman Developmental  
            Disabilities Services Act (Lanterman Act).  (Welfare and  
            Institutions Code (WIC) Section 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 Section 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 Section  
            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.   
            (Health and Safety Code Section 130100 et seq.)













                                                                     ACR 77


                                                                     Page E


          FISCAL EFFECT:  Unknown.  This resolution is keyed non-fiscal by  
          the Legislative Counsel.


          COMMENTS:  


          Child development:  There are a number of factors that can  
          contribute to health risks and developmental delays for  
          children.  These factors often include:


          1)Prematurity or low birth weight;
          2)Difficulties seeing or hearing;


          3)Prenatal exposure or other types of exposure to drugs,  
            alcohol, or tobacco;


          4)Poor nutrition or difficulties eating (a lack of nutritious  
            foods, proteins, vitamins, or iron in a child's diet);


          5)Exposure to lead-based paint (through eating, licking, or  
            sucking on lead-base painted doors, floors, furniture, toys,  
            or other objects); and


          6)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 ASD.  Other  











                                                                     ACR 77


                                                                     Page F


          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.  


          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:


          1)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);


          2)They have an established risk condition of known etiology,  











                                                                     ACR 77


                                                                     Page G


            with a high probability of resulting in a developmental delay;  
            or


          3)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.  













                                                                     ACR 77


                                                                     Page H


          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  
          greatest cost effectiveness."




          Analysis Prepared by:                                             
                          Myesha Jackson / HUM. S. / (916) 319-2089  FN:  
          0001149

          ---------------------------


          <1>


           "Building an Early Identification System in CA: The Need for  
          Action" First 5 Association of California;  
           www.first5association.org 










                                                                     ACR 77


                                                                     Page I