BILL ANALYSIS
Senate Appropriations Committee Fiscal Summary
Senator Christine Kehoe, Chair
383 (Liu)
Hearing Date: 4/27/2009 Amended: 4/16/2009
Consultant: Katie Johnson Policy Vote: Human Services 3-1
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BILL SUMMARY: SB 383 would require the Department of
Developmental Services (DDS) to partner with a regional center
to create a 2-year Autism Spectrum Disorders (ASD) Early
Screening, Intervention, and Treatment Pilot Program that would
establish best practices for early screening, diagnosis,
referral, and treatment for children with ASD.
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Fiscal Impact (in thousands)
Major Provisions 2009-10 2010-11 2011-12 Fund
DDS Pilot Program $550
$1,100 $1,100 Federal
DDS Pilot Program Report $0 $0 up to
$100 Federal/
Special/
Private
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STAFF COMMENTS: This bill meets the criteria for referral to
the Suspense File.
Existing law, the Lanterman Developmental Disabilities Services
Act, requires the DDS to contract with regional centers for the
provision of various services and supports to persons with
developmental disabilities, including ASD.
Existing law, the California Early Start Intervention Services
Act, otherwise known as the Early Start program, provides early
intervention services for infants and toddlers who have or are
at risk for disabilities.
This bill is nearly identical to SB 527 (Steinberg, 2008). The
substantial difference between the two bills is that in SB 527,
the bill stipulated that the pilot program would be funded by
California Children and Families Commission funds, whereas this
bill would require the DDS to seek federal funding for the pilot
program. SB 527 was vetoed by the Governor with the veto message
stating, "...the provisions of this bill can be accomplished
administratively with funding from private, non-state general
fund sources. In addition, given our state's ongoing fiscal
challenges, it is not the time to be enacting new programs in
statute. I would encourage the author and sponsors to work
directly with entities willing to fund this type of program." It
appears that this bill does not address SB 527's veto message.
Staff notes that this bill is similar to the current duties and
programmatic activities of the DDS. In addition, the DDS plans
to publish updated guidelines on intervention and treatment of
children with ASD in the summer of 2009. As part of the
2009-2010 Budget Act and the Governor's Special Session, the DDS
was required to reduce its budget by $100 million General Fund,
to cut regional centers' expenditures for consumer services by 3
percent for a savings of about $40.4 million ($24.1 million
General Fund), and to
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SB 383 (Liu)
cut regional centers' operations budget by 3 percent for a
savings of $6.6 million ($4.6 General Fund). Due to limited
funding, efforts should be made to avoid a duplication of duties
among current DDS services and those provided by this pilot
program.
This bill would require DDS to partner with one or more regional
centers to implement a two-year pilot program, in at least three
geographic areas around the state with the goals of 1)
identifying solutions to improve early developmental screening
protocols and coordination of referral, diagnostic, and
treatment for services for children with ASD between the ages of
birth and 5 years, and 2) developing best practices for early
identification, effective referral, and coordinated follow-up
care for children with ASD or other developmental delays with a
focus on culturally, linguistically, and geographically diverse
or underserved populations.
This bill would provide that the DDS could consult with a
variety of national, state, and community stakeholders to
achieve the program goals and to share information, to build
upon the work of recent recommendations and published models,
and to avoid duplication of efforts.
This bill would also permit the DDS, in consultation with the
Department of Public Health (DPH) and the Department of Health
Care Services (DHCS), to test a medical home model and the use
of adequate payment and reimbursement strategies that would
facilitate and provide incentives for routine screening and
collaborative care. If the DDS were to exercise this option when
implementing the pilot program, there could be significant costs
of a few million dollars to the DDS, the DPH, and the DHCS. For
example, approximately 300 children, on average, aged 0 - 4 are
served at each regional center. For the purposes of this
analysis, if it were to cost $5,000 per child to test this
medical home model and implement these payment and reimbursement
strategies at the 3 pilot project regional centers, it could
cost $4.5 million annually.
This bill would require the DDS to submit a report on the pilot
program, as specified, to the Legislature and the Governor no
later than July 1, 2012, and would require that the report would
be funded not through the state General Fund, but through
federal, other state, or private funds. The cost of the report
is unknown, but could constitute General Fund pressure of at
least $100,000 if the non-General Fund moneys were unavailable
upon the passage of this bill.
This bill would require the DDS to seek federal funding to
provide for the pilot program and would stipulate that General
Fund moneys may not be used to implement this bill. If federal
funding were unavailable, DDS would be unable to establish this
pilot program.
The total cost of the pilot program could exceed $1.1 million
annually in federal funds. If this pilot program were to be
expanded statewide to all 21 regional centers at a cost of
$150,000 per site, the costs are estimated to be at least $3
million annually. Existing federal law, the American
Reinvestment and Recovery Act (ARRA), provides a total of $1.1
billion for an expansion of the Early Head Start Program in the
form of competitive grants. These grants may be a possible
funding source for this pilot program.