BILL ANALYSIS                                                                                                                                                                                                    �          1





                SENATE ENERGY, UTILITIES AND COMMUNICATIONS COMMITTEE
                                 ALEX PADILLA, CHAIR
          

          AB 136 -  Beall                                   Hearing Date:  
          June 21, 2011              A
          As Amended:         June 14, 2011            FISCAL       B
                                                                        
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                                      DESCRIPTION
           
           Current law  requires the California Public Utilities Commission 
          (CPUC) to design and implement a universal service program to 
          provide a telecommunications device or dual-party relay system 
          to enable persons who are deaf or hearing impaired to use the 
          telecommunications network at no charge additional to the basic 
          exchange rate.

           Current law  requires the CPUC to design and implement a program 
          to provide specialized or supplemental telephone communications 
          equipment to subscribers who are disabled at no charge 
          additional to the basic exchange rate.

           Current law  requires the CPUC to recover the costs of the deaf 
          and disabled universal service program through a customer 
          surcharge of not more than one-half of 1 percent of charges for 
          intrastate telephone service, effective until January 1, 2014.

           Current law  requires that persons eligible for these programs be 
          certified as deaf or hearing impaired by a licensed physician 
          and surgeon, audiologist, licensed hearing aid dispenser, or 
          physician assistant, or certified as disabled with a visual or 
          medical need for specialized telecommunications equipment by a 
          licensed optometrist, physician and surgeon, physician assistant 
          or a qualified state or federal agency, as determined by the 
          CPUC.

           Current law  authorizes the CPUC to expand the deaf and disabled 
          program consistent with evolving telecommunications technology 
          in order to meet the access needs of individuals with functional 
          limitations on hearing, vision, movement, manipulation and 











          interpretation of information. 

           This bill  requires the CPUC to expand the deaf and disabled 
          program to include assistance to individuals with speech 
          disabilities that impair access to and use of the telephone 
          network and ensure funding for speech-generating devices, 
          accessories, and mounting systems and specialized 
          telecommunications equipment, including infrared telephones, 
          speaker phones, and telephone interface devices.

           This bill  requires the CPUC to ensure that eligibility for 
          speech-generating devices is limited to state residents who are 
          certified as speech impaired by a licensed physician, licensed 
          speech-language pathologist, or qualified state or federal 
          agency.

           This bill  requires the CPUC to provide appropriate 
          speech-generating equipment consistent with the recommendation 
          of a licensed speech-language pathologist and with the economy, 
          efficiency, and quality of equipment available for purchase in 
          the state.

           Current law  requires the CPUC to submit an annual report to the 
          Legislature on the deaf and disabled program with an evaluation 
          of options for controlling program expenses, including 
          establishing a means test for qualifying for the program.

                                      BACKGROUND
           
          Current Deaf and Disabled Program - The deaf and disabled 
          program is one of several universal service programs designed to 
          ensure that affordable telecommunications service is 
          ubiquitously available to all members of society.  Under this 
          program, the CPUC provides deaf and disabled Californians with a 
          "telecommunications device" or "specialized telecommunications 
          equipment" and relay services that enable communications via 
          telephone.  Program services and equipment are provided to 
          eligible persons by vendors under contract with the CPUC.  The 
          CPUC also conducts pilot programs with new technologies, 
          including a current pilot involving wireless phones for the 
          hearing impaired.

          Devices for Speech Disabilities - According to the author, 
          devices currently provided through the deaf and disabled program 










          do not enable persons with severe speech disabilities to utilize 
          the telephone.  However, new technologies have resulted in 
          speech-generating devices that enable telephone communication.  
          DynaVox, a major provider of these devices and supporter of this 
          bill, estimates that statewide demand for these devices is about 
          1,000 to 1,250 per year.  Estimates of the cost per device range 
          from $7,000 to $11,000.

          Devices Covered by Insurance - Because speech-generating devices 
          enable communication generally, they are considered durable 
          medical equipment and may be covered by public and private 
          insurance. DynaVox claims the devices are covered by Medi-Cal, 
          Medi-Care and most private insurance companies.  Disability 
          Rights California, on the other hand, claims that this 
          specialized equipment is cost-prohibitive and not always covered 
          by insurance or Medi-Cal.  

          Request for CPUC Pilot - In response to a request to conduct a 
          pilot on speech-generating devices, the CPUC determined that 
          these devices do not fit within the parameters of the deaf and 
          disabled program because they are primarily medical equipment 
          rather than telecommunications devices.  According to the CPUC, 
          its research revealed that, while all the speech generating 
          devices it examined facilitated speech communication, only a 
          subset of those devices had a telecommunications component, and 
          none of them were designed solely for use as a 
          telecommunications device.  Moreover, the CPUC claims that 
          speech-generating devices are customized to each user, making 
          competitive procurement as required by state contracting 
          procedures a complicated and lengthy process. 

                                       COMMENTS
           
              1.   Author's Purpose  .  According to the author, this bill 
               will help ensure that no one is prevented from making or 
               receiving a telephone call if technology exists to make it 
               possible.  The author claims that this bill is necessary 
               because "the CPUC has refused to make newly developed 
               technology (e.g., speech-generating devices) available to 
               people with the most severe communications disabilities."

              2.   Focus on Telecommunications Equipment  .  Ensuring that 
               persons with disabilities can utilize the 
               telecommunications network is consistent with the long-held 










               principle of universal service.  However, the language of 
               this bill requiring the CPUC to provide speech-generating 
               devices to persons with speech disabilities is both 
               extremely open-ended and overly prescriptive in the types 
               of devices included.  It mandates that a specific list of 
               devices be funded, including "accessories" and "speaker 
               phones," regardless of whether their primary purpose is for 
               daily life other than communicating on the telephone. 
               Moreover, the bill mandates the CPUC to provide "the 
               appropriate equipment consistent with the recommendation of 
               a licensed speech-language pathologist" and "consistent 
               with the economy, efficiency, and quality of equipment that 
               is available for purchase in the state." The CPUC should 
               not be bound by the recommendation of one speech-language 
               pathologist but instead have flexibility so long as the 
               device provided meets the individual's needs.  In order to 
               ensure that the deaf and disabled program remains focused 
               on providing eligible persons only telecommunications 
               equipment, the author and committee may wish to consider 
               amending the bill to require instead that the CPUC provide 
               a person certified as having a speech disability with a 
               speech-generating device that is a telecommunications 
               device or includes a telecommunications component and that 
               the CPUC, in determining the appropriate device, shall 
               consider the recommendation of a licensed speech-language 
               pathologist and ensure that the device is of high quality.

              3.   Require Insurance Coverage First  .  This bill also 
               requires the CPUC to fund speech generating devices 
               regardless of whether they are covered by public or private 
               insurance. The author and DynaVox claim that only about 130 
               to 260 people will need devices from the CPUC because 
               third-party funding from Medi-Cal, Medi-Care, or private 
               insurance is available for most users.  However, the the 
               bill does not make unavailability of third-party funding a 
               condition for getting a free device from the CPUC.  It is 
               possible that obtaining a free device from the CPUC will be 
               preferred, especially if there is a cap on the amount of 
               reimbursement for these devices from insurers. Thus, the 
               author and committee may wish to consider amending the bill 
               to authorize the CPUC, prior to providing a person 
               certified as having a speech disability with a 
               speech-generating device, to require that person to 
               demonstrate that coverage from public or private insurance 










               has been denied or is unavailable.  

              4.   Custom Devices Require Flexibility  .  Because each 
               speech-generating device is customized for the user, and 
               state contracting of individual items is burdensome, 
               requiring the CPUC to procure each device and then provide 
               it to eligible persons may not be cost-effective.  The 
               author indicates that this bill gives the CPUC flexibility 
               to either obtain and provide a device directly to an 
               eligible person or provide a cash payment or reimbursement 
               to the eligible person for obtaining the device in the 
               commercial market, whichever method is cost-effective and 
               ensures that the person obtains the device. 

              5.   Ratepayer Impact  .  Because the deaf and disabled program 
               is funded entirely by a telephone customer surcharge, any 
               expansion of the program will increase costs and ratepayer 
               impact.  It is unclear what the total cost of the 
               requirements of this bill will be.  Current law requires 
               that the CPUC's annual report on the deaf and disabled 
               program evaluate options for controlling program costs, 
               including establishing a means test for eligibility.  The 
               surcharge for the current program sunsets on January 1, 
               2014.  Thus, the author and committee may wish to consider 
               amending the bill to require that at least one annual 
               report issued prior to any reauthorization of the surcharge 
               evaluate options for controlling program costs of providing 
               speech-generating equipment.

                                    ASSEMBLY VOTES
           
          Assembly Floor                     (77-1)
          Assembly Appropriations Committee  (17-0)
          Assembly Utilities and Commerce Committee                      
          (15-0)

                                       POSITIONS
           
           Sponsor:
           
          California ALS Advocacy Committee

           Support:
           










          The Arc
          California Speech-Language-Hearing Association
          Disability Rights California
          DynaVox Technologies
          Occupational Therapy Association of California
          United Cerebral Palsy in California
          United States Society for Augmentative and Alternative 
          Communication

           Oppose:
           
          None on file


          






          Jacqueline Kinney 
          AB 136 Analysis
          Hearing Date:  June 21, 2011