BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 1191
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          Date of Hearing:   April 3, 2001

                        ASSEMBLY COMMITTEE ON HUMAN SERVICES 
                                 Dion Aroner, Chair
               AB 1191 (Longville) - As Introduced:  February 23, 2001
           
          SUBJECT  :   Regional centers for persons with developmental  
          disabilities: inter-agency dispute resolution

           SUMMARY  : Establishes a process for resolving disputes between  
          regional centers and local public agencies.  Specifically,  this  
          bill  :  

          1)Applies to disputes regarding which agency is responsible for  
            delivering or paying for a specific type, duration, or  
            frequency of service contained in an individualized family  
            service plan (IFSP) or individualized program plan (IPP) of a  
            child, aged 0 - 5.

          2)Prohibits the dispute resolution process from being used to  
            determine eligibility for a service, resolve disputes between  
            a consumer and a regional center, or take up issues that have  
            been decided through a proceeding under the California Early  
            Intervention Act.

          3)Authorizes a regional center to submit a written notification  
            of the failure to provide a service and a request for dispute  
            resolution to the local agency that the regional center  
            believes is responsible for providing the service.

          4)Permits the regional center to withdraw its request for  
            dispute resolution at any time during the process.

          5)Upon receipt of the written notification, requires the local  
            agency to meet with the regional center and resolve the  
            dispute within 15 days. If the dispute is resolved, requires  
            the agency to mail a written copy of the resolution to the  
            parent, guardian, or authorized representative within 10  
            calendar days of the meeting.

          6)If the dispute cannot be resolved within 10 calendar days,  
            requires the parties to submit their contentions to the Office  
            of Administrative Hearings (OAH).

          7)Requires OAH to review the dispute and issue a binding written  








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            decision within 30 calendar days of receipt of the case,  
            specifying the type, frequency and duration of the disputed  
            service to be provided and which entity is responsible. 

          8)Permits OAH to award reimbursement retroactively to the  
            prevailing party for services provided.

          9)Requires OAH to send a written copy of the resolution to the  
            parent, guardian, or authorized representative, the Director  
            of Developmental Services, and the regional center or local  
            agency involved in the dispute resolution process. 

          10)Permits the local public agency or the regional center to  
            continue to provide services until the dispute is resolved, or  
            to provide services under an alternative agreement.

          11)Once the dispute resolution process is completed, requires  
            the agency determined to be responsible for the service to  
            reimburse the agency that provided the service, if one did.

          12)Specifies that nothing in the inter-agency dispute resolution  
            process shall prevent a consumer from filing for a due process  
            hearing or pursuing a remedy through a civil action.

          13)Requires the Department of Developmental Services (DDS) to  
            pay for the services of the OAH.

          14)Specifies that no resolution reached through this process  
            shall set a precedent for the resolution of any other matter.

          15)Sunsets the program December 31, 2004.

           EXISTING LAW  

          1)Establishes the Lanterman Developmental Disabilities Services  
            Act, under which the DDS contracts with 21 private non-profit  
            regional centers to provide case management services and  
            arrange for, or purchase, other services that meet the needs  
            of individuals with developmental disabilities. 

          2)Prohibits regional centers from using funds to supplant the  
            budget of any agency that has a legal responsibility and is  
            funded to provide services to the general public, thereby  
            establishing the regional center as the payer of last resort  
            for specific services. 








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          3)Establishes the California Early Intervention Services Act and  
            Early Start Program, funded through Part C of the federal  
            Individuals with Disabilities Education Act (IDEA), to promote  
            a coordinated family service system for children from birth to  
            36 months who have a developmental delay or an established  
            risk condition. Requires regional centers to share primary  
            responsibility for provision of early intervention services  
            with local education agencies.  Requires an IFSP to be  
            developed for each eligible child, delineating the child's  
            levels of development, desired outcomes, services to be  
            provided, and methods to be used to determine the child's  
            progress.

          4)Requires an IPP to be developed for every child over the age  
            of 36 months who is eligible for regional center services.   
            Requires the IPP to identify the services and supports to be  
            purchased by the regional center or obtained from other  
            agencies.

           FISCAL EFFECT  :   Unknown

           COMMENTS  :   

          1)Responsibility for early intervention services for children  
            who are developmentally delayed or at risk of developmental  
            disability is shared by regional centers, local school  
            districts and, if the child has health care needs, programs  
            administered by the Department of Health Services, including  
            Medi-Cal and California Children's Services. It is not  
            uncommon for disagreements to occur among these various  
            agencies regarding which is responsible for a particular  
            service. When such disagreements arise, the result is that the  
            child often goes without the service until the agencies  
            resolve their differences or one of the agencies simply agrees  
            to provide it.  Not only does this cause undue stress on  
            families, but it also interferes with the provision of  
            essential early intervention services.

          2)This bill, sponsored by the Association of Regional Center  
            Agencies (ARCA), is nearly identical to one introduced last  
            year by the Human Services Committee, AB 2918.  AB 2918 passed  
            out of the Assembly Human Services Committee, 6-0, but failed  
            passage in the Senate Appropriations Committee. (Its failure  
            in the Senate Appropriations Committee was due to legislative  








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            deadlines, not cost; DDS had estimated the cost of AB 2918 to  
            be no greater than $123,000.)  According to ARCA, the bill was  
            re-introduced this year because the need still exists.  
            Families often face great frustration when a regional center  
            refers it to an agency for services, but the agency is  
            reluctant to provide them. This bill is intended to assure a  
            timely resolution of inter-agency disputes, and encourage  
            services to be provided while the resolution process is  
            underway.  

          3)In its 1999 monitoring report of California's Early Start  
            program, the federal Office of Special Education Programs  
            (OSEP) found, that "[p]rovision of early intervention services  
            to some children and families is inappropriately delayed  
            because the State lacks a reimbursement procedure to ensure  
            that needed services can begin in a timely manner without  
            disputes about agency fiscal responsibility."  The Continuous  
            Improvement Plan, submitted in response by DDS to OSEP,  
            includes training for regional center service coordinators and  
            other staff, instructions that the "payer of last resort" has  
            an obligation to purchase services specified in the IFSP, and  
            negotiations with the Department of Education and the  
            Department of Health Services to develop reimbursement  
            agreements.  Subsequent to the OSEP report, DDS has developed  
            memoranda of understanding with the Departments of Health  
            Services, Education, Mental Health, and Alcohol and Drug  
            Programs, specifying procedures for resolving disputes at the  
            state level.  

            Nonetheless, according to ARCA, at the local level the impasse  
            over who is the responsible agency continues to occur. This  
            bill, ARCA argues, will definitively resolve local disputes.  
            Because it establishes a statutory process and includes the  
            OAH, ARCA believes it will be more enforceable than the  
            current memoranda of understanding among state departments. 

          4)Protection and Advocacy Inc. (PAI), a federally-funded  
            non-profit organization that advocates for persons with  
            disabilities, opposes the bill on the grounds that it fails to  
            ensure the delivery of services during the pendency of the  
            interagency dispute resolution. PAI argues that the Lanterman  
            Act specifies that the regional centers' mandate to pursue  
            non-regional center sources of funding may not impose any  
            additional liability on the parents of, or deny services to,  
            consumers with developmental disabilities. PAI requests an  








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            amendment that would state the IFSP and IPP services "shall"  
            (versus "may") be provided until the dispute resolution  
            process is completed.


















































                                                                  AB 1191
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           REGISTERED SUPPORT / OPPOSITION  :   

           Support  

          Association of Regional Center Agencies (sponsor)

           Opposition  

          Protection and Advocacy, Inc.
           
          Analysis Prepared by  :    Sherry Novick / HUM. S. / (916)  
          319-2247