BILL NUMBER: SB 383 AMENDED
BILL TEXT
AMENDED IN SENATE MARCH 31, 2009
INTRODUCED BY Senator Liu
FEBRUARY 26, 2009
An act to add Section 4643.4 to Article 9
(commencing with Section 4699) to Chapter 6 of Division 4.5 of
the Welfare and Institutions Code, relating to autism.
LEGISLATIVE COUNSEL'S DIGEST
SB 383, as amended, Liu. Autism Spectrum Disorders :
screening.
Existing law, the Lanterman Developmental Disabilities Services
Act, requires the State Department of Developmental Services to
contract with regional centers for the provision of various services
and supports to persons with developmental disabilities, including
Autism Spectrum Disorders (ASD).
Existing law, the California Early Start Intervention Services
Act, commonly known as the Early Start program, provides various
early intervention services for infants and toddlers who have
disabilities or who are at risk of having disabilities to enhance
their development and to minimize the potential for developmental
delays.
This bill would require the State Department of Developmental
Services to partner with at least one regional center to implement a
2-year Autism Spectrum Disorders Early Screening, Intervention, and
Treatment Pilot Program in at least 3 key geographic areas. The pilot
program would establish best practices for early screening,
diagnosis, referral, and treatment for children with ASD.
The bill would require the department, no later than July 1, 2011,
to report to the Legislature and the Governor on the pilot program.
The bill would prohibit state general funds to be used to prepare the
report and to fund the pilot program in any fiscal year of the pilot
program's operation. The department would be required to seek
federal funding for the pilot program.
Under existing law, the State Department of Developmental Services
contracts with private nonprofit entities, known as regional
centers, to provide or purchase services and supports for persons
with developmental disabilities, including Autism Spectrum Disorders
(ASD). Existing law requires the department to develop and publish
evaluation and diagnostic procedures for the diagnosis of autism
spectrum disorders and to train regional center clinical staff in the
utilization of those procedures.
This bill would require the department, not later than October 1,
2011, to provide recommendations for a system of universal screening
for infants, and rescreening of children at 2 years of age, as
specified, and would require the department to seek existing or new
federal funding for this purpose.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. The Legislature finds and declares the
following:
(a) The diagnosis of Autistic Disorder, Asperger's Disorder, and
Pervasive Developmental Disorder Not Otherwise Specified all fall
under the clinical umbrella term Autism Spectrum Disorders (ASD).
(b) The number of children diagnosed with ASD has grown
dramatically in recent years and is a serious public health crisis
that must be addressed. According to the federal Centers for Disease
Control and Prevention, ASD can now be diagnosed in one of every 150
children and can occur in all ethnic, racial, and socioeconomic
groups.
(c) Autism Spectrum Disorders are complex neurological
developmental disorders with onset in early childhood that result in
substantial impairment in social interaction and communication and in
the presence of unusual behaviors and interests.
(d) Recent reports and studies have called attention to
significant gaps in programs and services for individuals with ASD.
Late identification and referral for intervention of young children
with ASD, insufficient preparation and reimbursement of health care
professionals, and inadequate collaboration between medical, home,
and other systems of care that are important in comprehensive
intervention are just a few challenges facing children with ASD and
their families.
(e) While it is now accepted and supported by research that early
screening, diagnosis, and intervention, as well as timely access to
services, can improve outcomes and help children with ASD function at
higher levels, significant barriers exist to achieving these goals.
SEC. 2. Article 9 (comme ncing with
Section 4699) is added to Chapter 6 of Division 4.5 of the
Welfare and Institutions Code , to read:
Article 9. The Autism Spectrum Disorders Early Screening,
Intervention, and Treatment Pilot Program
4699. (a) As used in this article, "ASD" means Autism Spectrum
Disorders.
(b) The State Department of Developmental Services shall partner
with one or more regional centers to implement a two-year pilot
program in at least three key geographic areas around the state for
the purpose of providing integrated and seamless services and systems
of care for children with ASD who are deemed eligible for services
and supports by regional centers.
(c) The goals of the pilot program include all of the following:
(1) Identify solutions to improve early developmental screening
protocols and coordination of referral, diagnostic, and treatment
services for children with ASD between birth and five years of age,
inclusive.
(2) Develop a comprehensive model of best practices for early
identification of children with ASD or other developmental delays and
effective referral and coordinated followup care, focusing
particularly on culturally, linguistically, and geographically
diverse or underserved populations.
4699.1. (a) In order to achieve the goals of the pilot program,
the department may consult with the following entities, as well as
other interested stakeholders that the department deems necessary:
(1) The State Department of Public Health.
(2) The State Department of Health Care Services.
(3) The State Department of Mental Health.
(4) The Department of Managed Health Care.
(5) University Centers for Excellence in Developmental
Disabilities.
(6) The State Council on Developmental Disabilities.
(7) The Association of Regional Center Agencies.
(8) The University of California.
(9) The American Academy of Pediatrics.
(10) The California Academy of Family Physicians.
(11) Local volunteers, including, but not limited to:
(A) Regional center staff.
(B) Health care professionals.
(C) Representatives from public and private health insurance
companies.
(b) The pilot program shall do all of the following:
(1) Establish innovative, collaborative, integrated, and seamless
methods, instruments, and systems of care between primary care
providers and regional centers for the early identification and
assessment of children with ASD from birth to five years of age,
inclusive.
(2) Test the use of innovative methods to increase early screening
for ASD, including, but not limited to, the use of parent-completed
screening tools, more screening in community settings, and the use of
Web-based tools and those that are compatible with electronic
medical records.
(3) Determine how the use of telehealth and telemedicine
strategies for professional development, outreach, and training for
primary care physicians, residents in pediatrics and family practice,
and medical students, as well as for clinical consultation, improves
access to care in rural sites.
(4) Establish incentives for continuing medical education and
other professional training and development and practice improvement
to assist physician offices with implementation of universal early
development screening, including, but not limited to, selecting,
obtaining, and utilizing appropriate and validated screening tools
and increasing knowledge of referral protocols and treatment options.
(c) In consultation with the State Department of Public Health and
the State Department of Health Care Services, the department may
test the following methods for the purpose of meeting the goals of
the pilot program, as deemed appropriate by the department:
(1) Implementation of the medical home model to improve
coordination among physicians, families, regional centers, and other
entities, as it relates to the evaluation screening, referral, and
coordination of care and treatment for children with ASD.
(2) Use of adequate payment and reimbursement strategies that will
facilitate and provide incentives for routine screening and
facilitate collaborative, coordinated, ongoing care to families
within the context of a medical home.
(d) The department and the advisory committee may partner with
existing public, private, state, or national initiatives to share
information and to avoid duplication of efforts and shall build upon
the work and recommendations in recent reports and published models.
(e) The Legislature recognizes that the regional center system
serves individuals who are deemed eligible pursuant to subdivision
(a) of Section 95014 of the Government Code and subdivisions (a) and
(l) of Section 4512. Nothing in this article is intended to change
existing eligibility requirements for receiving regional center
services.
4699.3. (a) No later than July 1, 2011, the department shall
provide to the Legislature and the Governor a report on the pilot
program. The report shall make recommendations for legislative,
regulatory, or fiscal initiatives that would further the goal of
early identification and treatment of ASD and other developmental
delays.
(b) The report shall specifically address all of the following:
(1) The change in referral numbers and patterns from baseline
historical trends after training in, and implementation of,
screening, referral, and assessment protocols.
(2) The planning and resource allocation required at the state and
federal levels to build capacity in, and ensure access to, the
regional center system and Early Start programs to prepare for the
influx of autistic children and families that will result from
routine screening.
(3) Accessibility and diagnostic evaluation and intervention
resources for children identified with ASD.
(4) The fiscal impact on health care professionals and regional
centers of increased screenings and referrals.
(5) Changes in practice patterns for participating physicians,
including residents establishing new practices, and other health care
professionals.
(6) Cost-effectiveness of routine early screening, referral, and
intervention conducted in a coordinated fashion using the medical
home model.
(7) The impact on families in an environment of universal,
widespread developmental screening, including the impact of false
positives on parent-child interaction.
(8) Other factors as the department and the advisory committee
deem appropriate.
(c) The preparation of the report shall be funded through federal,
state, or private funds secured for the purposes of this section.
State general funds shall not be used to prepare the report.
4699.4. State general funds shall not be used to fund the pilot
program in any fiscal year of the pilot program's operation. The
department shall seek federal funding to cover the pilot program.
SECTION 1. Section 4643.4 is added to the
Welfare and Institutions Code, to read:
4643.4. (a) The department shall provide recommendations for a
system of universal screening for infants, and rescreening of
children at two years of age, the age at which some conditions,
including autism spectrum disorders, begin to manifest. These
screenings shall be safe, secure, and available to every Californian
who wants them.
(b) The department shall seek existing and new federal funds to
accomplish the goal descibed in subdivision (a), to the extent that
this goal can be achieved without statutory changes.
(c) Not later than October 1, 2011, the department shall submit
the recommendations required pursuant to subdivision (a) to the
Legislature and the Governor.