BILL ANALYSIS                                                                                                                                                                                                    






                        SENATE HEALTH AND HUMAN SERVICES
                               COMMITTEE ANALYSIS
                        Senator Deborah V. Ortiz, Chair


          BILL NO:       AB 1191                                      
          A
          AUTHOR:        Longville                                    
          B
          AMENDED:       April 19, 2001
          HEARING DATE:  June 27, 2001                                
          1
          FISCAL:        Appropriations                               
          1
                                                                      
          9
          CONSULTANT:                                                 
          1
          McCarthy / ak
                                        

                                     SUBJECT
                                         
                           Developmental disabilities

                                     SUMMARY  

          Establishes a process for resolving disputes between  
          regional centers and local public agencies.

                                     ABSTRACT  

          Existing law:
          1.Establishes the Lanterman Developmental Disabilities  
            Services Act, under which the Department of Developmental  
            Services (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.   
            Some of the services are sought from another  
            publicly-funded agency.

          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;  
            however, the regional center is the payer of last resort  
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            for services the regional center has determined necessary  
            for an individual.

          3.Requires that regional centers develop an individualized  
            program plan (IPP) to be developed for every child over  
            the age of 36 months who is determined by a regional  
            center to be eligible for DDS system services.  Requires  
            the IPP to identify the services and supports to be  
            purchased by the regional center or obtained from other  
            agencies.

          4.Establishes the California Early Intervention Services  
            Act (Early Start Program), in addition to regular  
            development disabilities (DD) system service, 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 are at  
            risk of developing a disability.  Eligibility for Early  
            Start is broader than eligibility for regular DD system  
            services.  

          5.Requires regional centers to share primary responsibility  
            for provision of Early Start early intervention services  
            with local education agencies.  Requires that the  
            regional centers develop an individualized family service  
            plan (IFSP) for each child in Early Start, delineating  
            the child's levels of development, desired outcomes,  
            services to be provided, and methods to be used to  
            determine the child's progress.

          This bill:
          1.Establishes a dispute resolution process that applies to  
            disputes regarding which local agency is responsible for  
            delivering or paying for a specific type, duration, or  
            frequency of service contained in either an Early Start  
            IFSP or a regular DD System 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 state fair  
            hearing process or a proceeding under the California  
            Early Intervention Act, or for which a consumer has  
            requested mediation or a fair hearing.
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          3.Specifies that the provisions of the bill do not modify  
            the mandated responsibility of a regional center or local  
            education agency to fund services identified in the Early  
            Start IFSP, and do not modify the responsibilities of a  
            regional center under the Lanterman Developmental  
            Services Act (regular DD system).

          4.Authorizes a regional center to submit to another local  
            agency (e.g., local education agency, county health  
            department, county mental health department) a written  
            notification of the failure to provide a service, and a  
            request for dispute resolution, to the agency that the  
            regional center believes is responsible for providing the  
            service. Requires the regional center also to provide  
            written notification of this request to the consumer's  
            parent, legal guardian, or authorized representative.

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

          6.Upon receipt of the written notification, requires the  
            local agency to meet with the regional center and resolve  
            the dispute within 15 calendar 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.

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

          8.Requires OAH to review the dispute and issue a binding  
            written decision within 30 calendar days of receipt of  
            the case, specifying the type, frequency and duration of  
            the disputed service to be provided, as specified in the  
            IFSP or IPP developed by the regional center, and which  
            entity is responsible for the service.
          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.

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          10.Permits the local agency and the regional center to  
            arrange for the provision of services in the child's IFSP  
            or IPP on an interim basis, until the dispute is  
            resolved.

          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 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.

                                  FISCAL IMPACT  

          According to the Assembly Appropriations Committee  
          analysis, there would be minor costs of about $123,000  
          General Fund annually for DDS to pay for the Office of  
          Administrative Hearing (OAH) services.  This assumes 70  
          cases a year will require OAH review and decision, at a  
          cost of $1,750 per case.  (However, there may be other  
          costs to other local county agencies, especially local  
          education agencies, related to their participation in the  
          dispute resolution process.)

                            BACKGROUND AND DISCUSSION  

          Early Start Program - ages 0-3
          DDS and the regional centers administer early intervention  
          services for children who are developmentally delayed or at  
          risk of developmental disability.  However, the regional  
          centers are required to share program responsibility with  
          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  
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          Services) and  programs administered by county mental  
          health departments. It is not uncommon for disagreements to  
          occur among these various agencies regarding which agency  
          is responsible for paying for a particular service. When  
          such disagreements arise, the result is that the child may  
          go without the service until the agencies resolve their  
          differences or one of the agencies agrees to provide it.   
          Such disagreements can cause stress on families, interfere  
          with the provision of early intervention services, and,  
          regional centers believe, cause regional centers to absorb  
          more costs.

          This bill, sponsored by the Association of Regional Center  
          Agencies (ARCA), is nearly identical to one introduced last  
          year by the Assembly Human Services Committee, AB 2918.  AB  
          2918 passed out of the Assembly, but failed passage in the  
          Senate Appropriations Committee.  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 another local 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.

          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 responsibility for 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.

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

                              QUESTIONS AND COMMENTS
          
          1.Initiation of dispute resolution process
            AB 1191 allows only the regional center to initiate the  
            dispute resolution process outlined in the bill.  This  
            provision could result in a one-sided process, in which  
            regional centers can start the process to require other  
            local agencies to provide services to a regional center  
            client, but does not provide a process for other local  
            agencies to require the regional centers to provide  
            services to a child not currently being served by a  
            regional center.  For example, if a county mental health  
            agency is serving a young child and believes the child  
            qualifies for, and should be receiving services through,  
            the local regional center, no remedy is available to the  
            mental health agency through the proposed dispute  
            resolution process.   Should this bill be amended to  
            allow other local agencies to also initiate the dispute  
            resolution process required by this bill? 
          
          2.IFSP and IPP required services
            The regional centers develop for each eligible consumer  
            an Early Start IFSP or a regular DD system IPP;  these  
            are the service plans that describe the type, frequency  
            and duration of services the child needs.  Other local  
            agencies may not have been involved in determining the  
            contents of a child's IFSP or IPP and, thus, may disagree  
            with the regional center regarding the type, duration and  
            frequency of services outlined in those service plans,  
            but still be expected to provide those services by the  
            regional center.  Also, as the other local agencies have  
            different eligibility criteria under state and federal  
            law, there may be different opinions as to the child's  
            eligibility for services.  For example, mental health  
            services provided by county mental health are generally  
            limited to children who meet the criteria of "severely  
            emotionally disturbed" (SED);  if a child's IPP requires  
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            mental health services, but the county mental health  
            department does not agree the particular child meets the  
            SED criteria, a dispute may arise regarding payment for  
            mental health services.  This bill requires that the  
            decision of OAH must "specify the type, frequency, and  
            duration of the service or services to be provided as  
            specified in the consumer's individualized program plan  
            [IPP] or individualized family service plan [IFSP]".   
            Thus, the bill requires the OAH to accept the regional  
            center plan for services and only focus on which local  
            agency should pay for it.

            At the state level, state agencies have developed  
            memoranda of understanding regarding how to resolve these  
            disputes.  The author may want to consider an amendment  
            to require that the four major local agencies involved,  
            the local education agencies, county health and county  
            mental health and the regional centers develop similar  
            memoranda of understanding. 
          
          3.Technical amendment
            This bill requires a technical amendment to insure  
            notification of the OAH decision is required to be  
            provided to any local agency involved, in addition to the  
            regional center. 
          
          4.Interim payment
            Protection and Advocacy, Inc. opposed this bill on the  
            basis that it appeared to weaken requirements in current  
            law that regional centers must provide and pay for  
            services that are specified in a child's service plan  
            until or unless another local agency provides them.  This  
            bill states that regional centers and other public  
            agencies may enter into written agreements regarding  
            which local agency shall provide the services on an  
            interim basis.  Protection and Advocacy requested more  
            explicit language in the bill that, after submitting a  
            request for dispute resolution, a regional center is  
            still legally responsible, as payor of last resort, for  
            provision of the services pending the outcome of the  
            dispute resolution process.  The author believes that  
            recent amendments to the bill have eliminated PAI's  
            concerns.  

                                  PRIOR ACTIONS
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           Assembly Floor:          75 - 0  Pass on Consent
          Assembly Appropriations: 21 - 0  Do Pass to Consent
          Assembly Human Services:   6 - 0  Do Pass to Consent









































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                                    POSITIONS  

          Support:       Association of Regional Center Agencies  
          (sponsor)
                         Alta California Regional Center
                         Developmental Disabilities Area Board 10
                         San Gabriel/Pomona
                         Tri-Counties Association for the  
          Developmentally disabled, Inc.

          Oppose:   Protection and Advocacy, Inc. (opposition may be  
          withdrawn due 
                           to recent amendments)






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