BILL ANALYSIS �
SENATE HUMAN
SERVICES COMMITTEE
Senator Carol Liu, Chair
BILL NO: SB 683
S
AUTHOR: Correa
B
VERSION: January 4, 2012
HEARING DATE: January 10, 2012
6
FISCAL: Appropriations
8
3
CONSULTANT: Mareva Brown
SUBJECT
Early intervention services: assessments.
SUMMARY
Directs the Secretary of the Health and Human Services
Agency and the Superintendent of Public Instruction to
require use of an electronic integrated assessment
instrument for all providers of children's health, mental
health and developmental disability services, or to create
a process to consolidate multiple agencies' assessments.
ABSTRACT
Current law
1. Establishes various programs to assess and provide
health, education, and therapeutic services to persons
who have or may have a disability.
2. Provides for the administration of these programs
through local education agencies, county offices of
education, county departments of health and mental
health, regional centers, and other state and local
government entities.
Continued---
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3. Requires the Superintendent of Public Instruction
and various departments within the Health and Human
Services agency to assess children who are receiving
services in order to create a specific plan for each
child and to evaluate progress within that plan.
This bill
1. Requires that the Secretary of the California
Health and Human Services Agency and the
Superintendent of Public Instruction together adopt
a goal of finding ways to consolidate assessments
and attendant paperwork.
2. Requires use of an interagency electronic
integrated assessment instrument by all authorized,
qualified personnel of the state and local agencies
that provide services, treating therapists,
physicians, service providers, governmental
employees, nonpublic agencies and other qualified
private health practitioners and education
professionals.
3. Directs users of the electronic integrated
assessment instrument to ensure that authorization
for access to the child's medical records in the
instrument is with the consent of parents or legal
guardians, or by the adult consumer, and conforms
with federal Health Insurance Portability and
Accountability Act laws.
4. Directs the Secretary of Health and Human
Services and the Superintendent of Public
Instruction to implement a process to:
a. Complete a comprehensive assessment
at least annually to meet the needs of every
agency that is required to conduct an
assessment.
b. Ensure the comprehensive assessment
is completed by a qualified health practitioner
or education professional of each relevant
discipline.
c. Ensure the assessment findings are
input and stored in the electronic integrated
assessment instrument for access by all
authorized persons.
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5. Requires the Secretary of the Health and Human
Services Agency and the Superintendent of Public
Instruction to coordinate all agencies responsible
for providing services to children with disabilities
in utilizing the electronic instrument and to
prorate each share of the costs of the special needs
assessment among the governmental and private
agencies responsible for the assessments in
accordance with the agency's percentage of
responsibility for the assessment, and any
applicable private insurance carriers of the child.
6. Allow assessments to be limited, at the
discretion of the parent, to no more than one annual
interagency assessment per relevant discipline, in
lieu of requiring a duplication of assessments
within the same discipline.
7. Creates a Special Children's Electronic
Integrated Assessment Instrument Fund in the state
Treasury to collect federal funds and private
donations and makes them available to be used in
creating and funding the assessment tool. This
includes any interest and dividends earned from
money in the fund.
8. Directs that no state funds be used to create
the electronic integrated assessment instrument.
9. Prohibits money from being expended from the
fund until the Director of Finance determines that
there is sufficient money to develop the tool, to
ensure that all relevant providers are prepared to
use it, as specified, and that the tool is compliant
with privacy laws.
FISCAL IMPACT
This bill has not been analyzed by a fiscal committee.
BACKGROUND AND DISCUSSION
Author's statement
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Multiple assessments can be a burden to both the child and
parents who must find the time and resources to travel to
several different locations each year for these multiple
assessments. This potential duplication can also result in
unnecessary expenditures by the state.
The goal of this bill is to find ways to reduce the burden
on these children and their families by avoiding
duplication between the agencies involved in caring for
these children, which may provide more resources for
services for these children.
Discussion
Children who live with multiple disabilities may have an
individual education plan with their local school district
or county office of education; an individual program plan
with a Regional Center; receive services from California
Children's Services; receive therapy from the county mental
health department; receive county supports from in-home
supportive services; receive other therapeutic services,
such as speech and language therapy, through their local
education agency or county office, or through private
providers contracted by the Regional Center. Many children
have a combination of these services. Additionally, some
children have partial coverage for services through
Medicaid or private health care insurance.
For each of these services, there are initial and periodic
assessments to ensure eligibility for services and to
evaluate the effectiveness of those services, therapies,
and educational programs. Each program provides these
assessments on their own calendar and at their own
locations, with parents being responsible to make and keep
appointments. The author argues that these many
assessments, located around the county or sometimes in a
neighboring county, can be a burden on families, causing
lost time at work and lost time in educational and
therapeutic programs - as well as the challenges and
frustrations of arranging transportation or using public
transportation.
In addition to the challenges of making and completing
multiple appointments in various locations, parents report
to the author that these assessments often cover the same
topics as others conducted by a different service
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organization.
Prior legislation
This bill is similar to SB 472, which was held in Senate
Appropriations committee in 2011. SB 472 would have
directed the Superintendent of Public Instruction and the
Secretary of the Health and Human Services Agency to find
ways to consolidate the assessments and attendant paperwork
of children with disabilities who receive services from
more than one agency. It directed these entities to either
develop an integrated assessment instrument that could be
performed in one place at one time each year and would
serve the assessment needs of all service agencies, or to
develop a process to conduct multiple assessments in one
place and time. SB 472 required that this integration
process be focused on infants and toddlers participating in
the Department of Developmental Services' Early
Intervention Services Act. SB 683 includes all children
with disabilities.
COMMENT AND QUESTIONS
Is one instrument a feasible possibility?
Because the range of disabilities and of therapies is
broad, some professionals question the possibility that one
assessment instrument is feasible. Physical therapists,
occupational therapists, psychologists, speech and language
therapists, physicians, mental health providers, and
teachers may each be responsible for one part of a child's
individual program plan or individual education plan. It is
not known how many children receive services provided by
all these agencies or a combination of agencies. The
assessments vary based upon age, needs and county of
residents. They have significantly different goals, and
most require some unique expertise to evaluate consumers
and create a plan for them. Therefore, each of these
entities may need to do an assessment of the child that is
unique, in part, although it may also contain information
common to other assessments. Staff recommends the following
amendment:
For elements of the assessment that require unique
professional expertise to evaluate a child's needs and
progress, that portion of the electronic integrated
assessment instrument shall be submitted by a provider with
expertise in providing or overseeing those services.
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Do the superintendent and secretary have access to persons
with experience providing direct service?
Neither the office of the Superintendent of Public
Instruction nor the programs within the several departments
that report to the Secretary of Health and Human Services
provide direct services. As each evaluation is intended for
a specific purpose and is intended for use by direct
providers, staff recommends the following amendment:
The Superintendent of Public Instruction and Secretary of
the Health and Human Services Agency shall consult or
involve representatives of counties, local education
agencies, providers of regional center services, regional
center case managers and other relevant organizations in
creating the electronic integrated assessment instrument.
POSITIONS
Support: Arc of California (sponsor)
United Cerebral Palsy (sponsor)
Oppose: None received.
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