BILL ANALYSIS
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THIRD READING
Bill No: AB 398
Author: Monning (D), et al
Amended: 7/23/09 in Senate
Vote: 21
SENATE HUMAN SERVICES COMMITTEE : 4-1, 6/23/09
AYES: Liu, Maldonado, Alquist, Yee
NOES: Runner
SENATE HEALTH COMMITTEE : 10-0, 7/15/09
AYES: Alquist, Strickland, Aanestad, Cedillo, Cox,
DeSaulnier, Leno, Negrete McLeod, Pavley, Wolk
NO VOTE RECORDED: Maldonado
SENATE APPROPRIATIONS COMMITTEE : 9-0, 8/17/09
AYES: Kehoe, Cox, Corbett, Denham, Hancock, Leno, Price,
Walters, Yee
NO VOTE RECORDED: Oropeza, Runner, Wolk, Wyland
ASSEMBLY FLOOR : 77-0, 5/21/09 (Consent) - See last page
for vote
SUBJECT : Acquired brain trauma: administration
SOURCE : California Foundation for Independent Living
Centers
Traumatic Brain Injury Services of California
DIGEST : This bill transfers the administrative duties
and oversight of the California traumatic brain injury
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program from the Department of Mental Health to the
Department of Rehabilitation, and extends the program's
sunset date from July 1, 2012 to July 1, 2019.
ANALYSIS : Existing law:
1. Establishes the traumatic brain injury program within
the State Department of Mental Health (DMH) and
requires the department to designate project sites for
a system of post-acute continuum-of-care models for
adults with traumatic brain injury.
2. Sunsets the program on July 1, 2012.
3. Requires DMH to ensure the project sites provide or
coordinate services to clients, including supported
living, community reintegration services, vocational
supportive services, and information, referral, and
assistance in identifying, accessing, utilizing, and
coordinating all services needed by individuals with
traumatic brain injury and their families.
4. Establishes the state penalty fund as a depository
for assessments on specified fines, penalties, and
forfeitures imposed and collected by the courts for
specified offenses; provides for distribution of money
in the fund.
5. Establishes the traumatic brain injury fund, which
receives a monthly transfer of 0.66 percent of the
state penalty fund, and which pays for the traumatic
brain injury program.
6. Directs the Department of Health Care Services, by
March 15, 2009, to submit a home- and community-based
services waiver application to the federal Centers for
Medicare and Medicaid Services to serve at least 100
adults, who have an acquired traumatic brain injury,
utilizing rehabilitative therapies in lieu of a
nursing facility or an intermediate care facility for
persons with developmental disabilities.
This bill:
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1. Transfers the administration of the Traumatic Brain
Injury Program from DMH to the Department of
Rehabilitation (DOR).
2. Defines community rehabilitation program, by citing
federal law, to mean a program that provides directly,
or facilitates the provision of, vocational
rehabilitation services to individuals with
disabilities, and that provides, singly or in
combination, for an individual with a disability to
enable the individual to maximize opportunities for
employment, including career advancement; and, includes,
but is not limited to medical, psychiatric,
psychological, social, and vocational services that are
provided under one management, as well as other
additional services.
3. Directs DOR to use any new funds to provide an array of
services to adults with traumatic brain injuries, in
areas of the state with the greatest need.
4. Requires DOR, by January 1, 2012, to determine
requirements related to service delivery, data
collection, and other aspects of program administration
that service providers must meet.
5. Requires DOR, by January 1, 2013, to determine the level
of funding necessary for a service provider to serve its
designated area, determine the number of sites that
current funding can support, and solicit applications to
provide services.
6. Requires DOR to meet periodically with the Traumatic
Brain Injury Program service providers to discuss
performance standards and data collection, eligibility
requirements, refinement of the continuum of care, and,
if approved by the federal government, implementation of
a Medicaid waiver.
7. Directs DOR to monitor and evaluate the performance of
service providers.
8. Requires service providers to furnish uniform data to
DOR as necessary to monitor and evaluate the program.
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9. Requires that providers continuing to participate in the
program after July 1, 2013, be in compliance with
requirements that DOR establishes pursuant to this act.
10.Requires grants awarded to service providers to be
subject to open competition every three years unless DOR
elects to extend a grant up to two additional years.
11.Provides a new date of March 15, 2011 for DHCS to submit
a Medicaid waiver application for the services of
persons with a traumatic brain injury.
12.Clarifies that funds deposited in the Traumatic Brain
Injury Fund may be matched by federal vocational
rehabilitation services funds to the extent the matching
funds are consistent with the policies and priorities of
the department and permitted by other state and federal
laws.
13.Extends the sunset date for the program from July 1,
2012 to July 1, 2019.
Background
Traumatic brain injury results from a blow or jolt to the
head or a penetrating head injury that disrupts the normal
function of the brain. According to the federal Centers
for Disease Control and Prevention, the leading causes are
falls, motor vehicle-traffic crashes, and assaults.
Symptoms include post-traumatic stress disorder, chronic
fatigue, memory loss, poor attention and concentration,
sleep deprivation, loss of balance, confusion, and
sensitivity to light and sound.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: No
According to the Senate Appropriations Committee:
Fiscal Impact (in thousands)
Major Provisions 2009-10 2010-11
2011-12 Fund
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DOR administration $50 $100
$100Special*
of Traumatic Brain
Injury Program
* Traumatic Brain Injury Fund
SUPPORT : (Verified 8/19/09)
California Foundation for Independent Living Centers
(co-source)
Traumatic Brain Injury Services of California (co-source)
American Federation of State, County and Municipal
Employees
Association of California Caregiver Resource Centers
Betty Clooney Foundation
California Association for Adult Day Services
California Brain Injury Association
California Ski and Snowboard Safety Organization
Central Coast Center for Independent Living
Disabilities Rights California
Making Headway Center for Brain Injury Recovery
Mercy's Coordinated Care Project
San Francisco Traumatic Brain Injury Network
St. Jude Brain Injury Network
The California Disabled Veteran Business Alliance
ARGUMENTS IN SUPPORT : Supporters of this bill believe
that DOR has the proven capacity and expertise to
administer the existing physical and vocational
rehabilitation, peer counseling, job referral, and other
specialized programs and services that persons with
traumatic brain injury need to achieve independent living.
They point out that DOR administers the state's independent
living centers, which are designed to maximize options for
independence for persons with disabilities. Several of the
current project sites as well as the Disabled Veterans
Business Alliance state that DOR's focus on rehabilitation
makes it a better fit for the needs of persons with
traumatic brain injury.
ASSEMBLY FLOOR :
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AYES: Adams, Ammiano, Anderson, Arambula, Beall, Bill
Berryhill, Tom Berryhill, Blakeslee, Block, Blumenfield,
Brownley, Buchanan, Caballero, Charles Calderon, Carter,
Chesbro, Conway, Cook, Coto, Davis, De La Torre, De Leon,
DeVore, Duvall, Emmerson, Eng, Evans, Feuer, Fletcher,
Fong, Fuller, Furutani, Gaines, Galgiani, Garrick,
Gilmore, Hagman, Hall, Harkey, Hayashi, Hernandez, Hill,
Huber, Huffman, Jeffries, Jones, Knight, Krekorian, Lieu,
Logue, Bonnie Lowenthal, Ma, Mendoza, Miller, Monning,
Nestande, Niello, Nielsen, John A. Perez, V. Manuel
Perez, Portantino, Price, Ruskin, Salas, Silva, Skinner,
Smyth, Solorio, Audra Strickland, Swanson, Torlakson,
Torres, Torrico, Tran, Villines, Yamada, Bass
NO VOTE RECORDED: Fuentes, Nava, Saldana
CTW/JJA:nl 8/19/09 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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