BILL ANALYSIS Ó
AB 1231
Page 1
GOVERNOR'S VETO
AB 1231 (V. Manuel Pérez)
As Amended September 5, 2013
2/3 vote
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|ASSEMBLY: |74-0 |(May 23, 2013) |SENATE: |39-0 |(September 9, |
| | | | | |2013) |
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|ASSEMBLY: |78-0 |(September 10, | | | |
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Original Committee Reference: HUM. S.
SUMMARY : Requires the Department of Developmental Services
(DDS) to inform all regional centers that appropriate health
care services and dentistry services may be provided to regional
center consumers through the use of telehealth. Specifically,
this bill :
1)States the intent of the Legislature to do all of the
following:
a) Improve access to treatments and intervention services,
including dental health care services, for consumers of
regional center services and their families in underserved
populations.
b) Provide more cost-effective treatments and intervention
services for consumers of regional center services and
their families.
c) Maximize the effectiveness of the interpersonal and
face-to-face interactions that are utilized for the
treatment of consumers of regional center services.
d) Continue maintenance and support of the existing service
AB 1231
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workforce for consumers of regional center services.
e) Utilize telehealth to improve services for consumers of
regional center services.
1)Requires DDS to do the following:
a) Inform all regional centers that any appropriate health
care service and dentistry services may be provided to
regional center consumers through the use of telehealth;
b) Request regional centers to consider the use of
telehealth services for inclusion in training programs for
parents of consumers, as specified; and
c) Provide technical assistance to regional centers
regarding the use of telehealth to meet the health and
dental care needs of consumers through the use of existing
resources, and in partnership with other organizations,
resources, and stakeholders.
1)Authorizes DDS to implement appropriate vendorization subcodes
for services provided through telehealth.
2)Provides that services provided through telehealth shall be
accessed on a voluntary basis and shall be immediately
discontinued at the request of the consumer or the consumer's
representative, as specified. Further allows a consumer to
immediately return to the services prescribed in his or her
individual program plan (IPP) that were in place prior to the
implementation of the telehealth service.
3)Provides that a provider of telehealth services shall be
responsible for all expenses and costs related to the
equipment, transmission, storage, infrastructure, and other
expenses related to telehealth.
4)Establishes a sunset date of January 1, 2019, for the
provisions included in this bill, as specified.
The Senate amendments :
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1)Delete legislative findings related to autism spectrum
disorders (ASD) and behavioral health treatment.
2)Delete explicit mention of ASD within provisions stating
legislative intent.
3)Delete all references to teledentistry and instead provide for
the use of telehealth to provide dentistry services.
4)Delete provisions related to behavioral health treatment.
5)Delete provisions establishing a 12-month provisional period
during which a consumer may discontinue the use of telehealth
and may return to his or her preexisting services.
6)Delete the requirement for DDS to request that regional
centers include a consideration of telehealth in each IPP and
individualized family service plan (IFSP).
7)Delete the requirement for DDS to provide information to the
Legislature pertaining to the effectiveness and
appropriateness of providing telehealth services through the
IPP and IFSP processes.
FISCAL EFFECT : Unknown. This bill, as amended, has not been
heard by a fiscal committee.
COMMENTS : This bill is part of a package that arose from a
hearing in 2012 by the Senate Select Committee on Autism and
Related Disorders that focused on disparities in available
services and service delivery in underserved communities. As a
result of the hearing, the Select Committee convened a taskforce
to address disparities in the allocation of regional center
resources across different racial and socio-economic groups. In
order to reach underserved communities as effectively and
efficiently as possible, the report recommends alternatives to
customary service provision, such as the use of center-based
therapy, home and community-based therapy and the use of
telehealth/telemedicine for parent training and direct service
delivery.
AB 1231
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Background : The Lanterman Developmental Disabilities Services
Act (Lanterman Act) (Welfare and Institutions Code (WIC) 4500 et
seq.) guides the provision of services and supports for
Californians with developmental disabilities. Each individual
under the Lanterman Act, typically referred to as a "consumer,"
is legally entitled to treatment and habilitation services and
supports in the least restrictive environment. Lanterman Act
services are designed to enable all consumers to live more
independent and productive lives in the community.
The term "developmental disability" means a disability that
originates before an individual attains 18 years of age, is
expected to continue, indefinitely, and constitutes a
substantial disability for that individual. It includes
intellectual disabilities, cerebral palsy, epilepsy, and autism
spectrum disorders. Other developmental disabilities are those
disabling conditions similar to an intellectual disability that
require treatment and management similar to that required by
individuals with an intellectual disability.
Direct responsibility for implementation of the Lanterman Act
service system is shared by the Department of Developmental
Services (DDS) and 21 regional centers, which are private
nonprofit entities, established pursuant to the Lanterman Act,
that contract with DDS to carry out many of the state's
responsibilities under the Lanterman Act. The principal roles
of regional centers include intake and assessment,
individualized program plan development, case management, and
securing services through generic agencies (e.g., school
districts, In-Home Supportive Services) or by purchasing
services provided by vendors. The regional center caseload
includes roughly 260,000 consumers who receive services such as
residential placements, supported living services, respite care,
transportation, day treatment programs, work support programs,
and various social and therapeutic activities. Approximately
1,400 consumers reside at one of California's four Developmental
Centers-and one state-operated, specialized community
facility-that provide 24-hour habilitation and medical and
social treatment services.
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Services provided to people with developmental disabilities are
determined through an individual planning process. Under this
process, planning teams-which include, among others, the
consumer, his or her legally authorized representative, and one
or more regional center representatives-jointly prepare an IPP
based on the consumer's needs and choices. The Lanterman Act
requires that the IPP promote community integration and maximize
opportunities for each consumer to develop relationships, be
part of community life, increase control over his or her life,
and acquire increasingly positive roles in the community. The
IPP must give the highest preference to those services and
supports that allow minors to live with their families and
adults to live as independently as possible in the community.
Telehealth : The Telehealth Advancement Act (Act) of 2011 was
established in AB 415 (Logue), Chapter 547, Statutes of 2011.
One of the primary goals of telehealth under the Act is to
expand health care consumers' access to convenient and quality
care in an effort to maintain or improve the physical and
economic health of medically underserved communities.
Telehealth is meant to enhance the overall health care delivery
system while saving money, preserving health-related jobs, and
increasing meaningful and positive interactions between patients
and providers.
Need for the bill : A prior version of this bill (SB 764
(Steinberg) of 2012) was vetoed by the Governor, who stated the
goals of the bill could already be accomplished under current
law. However, while the Lanterman Act grants regional centers
the authority to use innovative service delivery mechanisms, and
there is nothing in statute precluding regional centers from
promoting service delivery through the use of telehealth, the
author has noted that providers have perceived reluctance on the
part of regional centers to integrate telehealth into their
treatment models without explicit authorization from DDS. This
bill is, in part, intended to clarify scope and process for
regional centers, which the author hopes will result in an
increased willingness to seek appropriate and desired services
for regional center consumers through the use of telehealth.
GOVERNOR'S VETO MESSAGE :
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"This bill would require the Department of Developmental
Services to inform regional centers that any appropriate health
care service, including dentistry, may be provided through
telehealth. The bill would additionally require the department
to ask regional centers to consider using telehealth in their
parent training programs and provide technical assistance on
telehealth.
"Everything required by this bill either can be done, or is
already being done, under existing law."
Analysis Prepared by : Myesha Jackson / HUM. S. / (916)
319-2089
FN: 0002893