BILL ANALYSIS                                                                                                                                                                                                    Ó

          |SENATE RULES COMMITTEE            |                        AB 796|
          |Office of Senate Floor Analyses   |                              |
          |(916) 651-1520    Fax: (916)      |                              |
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                                   THIRD READING 

          Bill No:  AB 796
          Author:   Nazarian (D), et al.
          Amended:  8/16/16 in Senate
          Vote:     21 

           SENATE HEALTH COMMITTEE:  6-2, 6/15/16
           AYES:  Hernandez, Hall, Monning, Pan, Roth, Wolk
           NOES:  Nguyen, Nielsen
           NO VOTE RECORDED:  Mitchell

           SENATE HUMAN SERVICES COMMITTEE:  5-0, 6/28/16
           AYES:  McGuire, Berryhill, Hancock, Liu, Nguyen

           AYES: Lara, Beall, Hill, McGuire, Mendoza
           NO VOTE RECORDED: Bates, Nielsen

           ASSEMBLY FLOOR:  75-0, 1/25/16 - See last page for vote

           SUBJECT:   Health care coverage:  autism and pervasive  
                     developmental disorders

          SOURCE:    DIR/Floortime Coalition of California 
          DIGEST:   This bill eliminates the sunset date on the health  
          insurance mandate to cover behavioral health treatment for  
          pervasive developmental disorder or autism.

          Existing law:

          1)Establishes the Department of Managed Health Care (DMHC) to  
            regulate health plans under the Knox-Keene Health Care  


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            Services Plan Act of 1975; the California Department of  
            Insurance (CDI) to regulate health insurers under; and, the  
            California Health Benefit Exchange (Exchange) to compare and  
            make available through selective contracting health insurance  
            for individual and small business purchasers as authorized  
            under the federal Patient Protection and Affordable Care Act  

          2)Establishes as California's essential health benefits (EHBs)  
            benchmark the Kaiser Small Group Health Maintenance  
            Organization plan, existing California mandates, and 10 ACA  
            mandated benefits, which include mental health and substance  
            use disorder services, including behavioral health treatment.

          3)Requires every health plan contract that provides hospital,  
            medical, or surgical coverage and health insurance policy to  
            also provide coverage for behavioral health treatment for  
            pervasive developmental disorder or autism no later than July  
            1, 2012.  Requires the coverage to be provided in the same  
            manner and to be subject to the same requirements as provided  
            in California's mental health parity law.

          4)Establishes a definition for "qualified autism service  
            professional" which includes a requirement that the individual  
            is a behavioral service provider approved as a vendor by a  
            California regional center to provide services as an Associate  
            Behavior Analyst, Behavior Analyst, Behavior Management  
            Assistant, Behavior Management Consultant, or Behavior  
            Management Program as defined in existing law and regulations;  
            and a definition for "qualified autism service  
            paraprofessional" which includes a requirement to meet  
            criteria set forth in different section of existing law and  

          5)Exempts from 3) above a specialized health plan or health  
            insurance policy that does not deliver mental health or  
            behavioral health services to enrollees, or an accident only,  
            specified disease, hospital indemnity, or Medicare supplement  
            policy, a health plan contract or health insurance policy  
            under Medi-Cal or Healthy Families program, and a health care  
            benefit plan or contract pursuant to the Public Employees'  
            Retirement System (CalPERS).


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          6)Sunsets the provisions above on January 1, 2017.

          7)Establishes a system of nonprofit Regional Centers, overseen  
            by the State Department of Developmental Services (DDS), 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.

          8)Defines in state regulations, for purposes of regional center  
            vendorization, Behavior Management Assistant, Behavior  
            Management Consultant, Behavior Analyst and Associate Behavior  
            Analyst and requires education or experience in applied  
            behavioral analysis, as specified.

            This bill deletes the January 1, 2017 sunset date. 

          1)Author's statement.  According to the author, this bill would  
            ensure that children diagnosed with autism continue to have  
            access to medically necessary treatments to increase their  
            quality of life and functional independence by removing the  
            2017 sunset on the requirement for health plans and insurers  
            to provide behavioral health treatments to children with  

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

          According to the Senate Committee on Appropriations:

          1)One-time costs of about $50,000 and ongoing costs of $15,000  
            per year to review health plan filings for compliance with the  
            requirements of the bill and to undertake any necessary  
            enforcement actions by DMHC (Managed Care Fund).


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          2)Likely costs of less than $100,000 per year for review of  
            health insurance plan filings and enforcement actions by CDI  
            (Insurance Fund).
          3)No state costs are anticipated due to the elimination of the  
            existing sunset on the benefit mandate. Current law exempts  
            Medi-Cal managed care plans and CalPERS coverage from the  
            benefit mandate. This bill does not eliminate those  
            While existing law specifically mandates coverage for  
            behavioral health treatment, separate federal and state mental  
            health parity requirements and requirements for the provision  
            of essential health benefits implicitly require coverage for  
            behavioral health treatment for autism and related disorders.  
            Therefore, elimination of the statutory sunset will not  
            materially impact coverage for behavioral health treatment.  
            Nor will eliminating the sunset require the state to pay for  
            the costs to subsidize coverage for behavioral health  
            treatment coverage for subsidized Covered California plans.

           SUPPORT:  (Verified8/10/16)

          DIR/Floortime Coalition of California (source)
          Association of Regional Center Agencies
          Occupational Therapy Association of California
          Several hundred individuals

          OPPOSITION:   (Verified8/10/16)

          Department of Developmental Disabilities 

          ARGUMENTS IN SUPPORT:     The DIR Floortime Coalition of  
          California writes that as supporters of SB 946, they are  
          familiar with the intent of the legislation.  The DMHC was  
          tasked with convening a task force to provide recommendations  
          concerning the legislation, and they unanimously adopted the  


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          guiding principle that behavioral health interventions should be  
          highly individualized and that the choice of treatment should be  
          grounded in scientific evidence, clinical practice guidelines,  
          and/or evidence-based practice.  (This support argument is based  
          on a prior version of this bill.)

          ARGUMENTS IN OPPOSITION:     DDS writes in opposition that it  
          recognizes that timely and effective behavioral health treatment  
          reduces the lifelong costs associated with providing services to  
          individuals with Autism Spectrum Disorders (ASD) and that  
          conversely, the absence of effective interventions, or use of  
          ineffective or harmful treatment modalities, can inhibit  
          meaningful progress. The determination of effectiveness of  
          treatment modalities must be based on sound, scientifically  
          validated principles and supported by empirical data.  Several  
          well-established sources of information already exist regarding  
          evidence-based practices for ASD.  (This opposition argument is  
          based on a prior version of this bill.)

          ASSEMBLY FLOOR:  75-0, 1/25/16
          AYES:  Achadjian, Alejo, Travis Allen, Baker, Bigelow, Bloom,  
            Bonilla, Bonta, Brough, Brown, Burke, Calderon, Campos, Chang,  
            Chau, Chávez, Chiu, Chu, Cooley, Cooper, Dahle, Daly, Dodd,  
            Eggman, Frazier, Beth Gaines, Gallagher, Cristina Garcia,  
            Gatto, Gipson, Gomez, Gonzalez, Gordon, Gray, Grove, Hadley,  
            Harper, Roger Hernández, Holden, Irwin, Jones, Jones-Sawyer,  
            Kim, Lackey, Levine, Linder, Lopez, Low, Maienschein, Mathis,  
            Mayes, McCarty, Medina, Mullin, Nazarian, Obernolte,  
            O'Donnell, Olsen, Patterson, Quirk, Rendon, Ridley-Thomas,  
            Rodriguez, Salas, Santiago, Steinorth, Mark Stone, Thurmond,  
            Ting, Wagner, Waldron, Weber, Williams, Wood, Atkins
          NO VOTE RECORDED:  Dababneh, Eduardo Garcia, Melendez, Wilk

          Prepared by:Teri Boughton / HEALTH / (916) 651-4111
          8/16/16 17:38:44

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