BILL ANALYSIS �
SENATE HUMAN
SERVICES COMMITTEE
Senator Carol Liu, Chair
BILL NO: SB 1445
S
AUTHOR: Evans
B
VERSION: March 25, 2014
HEARING DATE: April 8, 2014
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FISCAL: Yes
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CONSULTANT: Mareva Brown
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SUBJECT
Developmental services: regional centers: individual
program plans: telehealth
SUMMARY
This bill includes telehealth services and supports among
the services and supports authorized to be included as part
of an individual program plan (IPP).
ABSTRACT
Existing Law:
1) Establishes the Lanterman Developmental
Disabilities Services Act, which declares California's
responsibility for providing an array of services and
supports to meet the needs of each person with
developmental disabilities in the least restrictive
environment, regardless of age or degree of
disability, and to support their integration into the
mainstream life of the community. (WIC 4500 et seq.)
Continued---
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2) Establishes a system of nonprofit Regional Centers
(RCs) to provide fixed points of contact in the
community for all persons with developmental
disabilities and their families, to coordinate
services and supports best suited to them throughout
their lifetime. (WIC 4620)
3) Establishes the IPP and defines that planning
process as the vehicle to ensure that services and
supports are customized to meet the needs of consumers
who are served by regional centers. (WIC 4512)
4) Defines permissible services and supports to be
listed in the IPP to include diagnosis, evaluation,
treatment, personal care, day care, domiciliary care,
special living arrangements, physical, occupational,
and speech therapy, training, education, supported and
sheltered employment, mental health services,
recreation, counseling of the individual with a
developmental disability and of his or her family,
protective and other social and sociolegal services,
information and referral services, follow-along
services, adaptive equipment and supplies, advocacy
assistance, including self-advocacy training,
facilitation and peer advocates, assessment,
assistance in locating a home, child care, behavior
training and behavior modification programs, camping,
community integration services, community support,
daily living skills training, emergency and crisis
intervention, facilitating circles of support,
habilitation, homemaker services, infant stimulation
programs, paid roommates, paid neighbors, respite,
short-term out-of-home care, social skills training,
specialized medical and dental care, supported living
arrangements, technical and financial assistance,
travel training, training for parents of children with
developmental disabilities, training for parents with
developmental disabilities, vouchers, and
transportation services necessary to ensure delivery
of services to persons with developmental
disabilities. (WIC 4512 (b))
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5) Creates the Telehealth Advancement Act of 2011 and
defines "Telehealth" as the mode of delivering health
care services and public health via information and
communication technologies to facilitate the
diagnosis, consultation, treatment, education, care
management, and self-management of a patient's health
care while the patient is at the originating site and
the health care provider is at a distant site. (BPC
2290.5)
This bill:
1) Adds telehealth services and support, as defined in
BPC 2290.5, to the lengthy list of permissible
services and supports listed in WIC 4512 (b) (see #4
above).
FISCAL IMPACT
This bill has not been analyzed by a fiscal committee.
BACKGROUND AND DISCUSSION
Purpose of the bill
The author states that despite the implication in law that
permits regional centers to integrate telehealth into their
service models for individuals with developmental
disabilities, many regional centers have been reluctant to
use the treatment model. SB 1445 is intended to clarify
that existing services and supports may be provided through
telehealth by regional centers under the provisions of the
Lanterman Act.
Regional Centers
In California, 21 nonprofit regional centers are part of a
system of care that delivers services and supports to
individuals with developmental disabilities. The regional
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centers are overseen by the California Department of
Developmental Services (DDS). With a proposed budget of
$5.2 billion for community-based services in 2014-2015, DDS
is responsible for coordinating care and providing services
for more than 265,000 people who receive services and
supports to live in their communities, as well as 1,300
people who reside in developmental centers.
A developmental disability is defined in statute as a
substantial disability that originates before the age of 18
and continues, or can be expected to continue,
indefinitely, such as intellectual disabilities, cerebral
palsy, epilepsy, and autism. Disabling conditions found to
be closely related to an intellectual disability or that
require treatment similar to that required for individuals
with an intellectual disability also qualify.
Telehealth
The Telehealth Advancement Act of 2011 (AB 415 (Logue)
Chapter 547, Statutes of 2011) defines "Telehealth" as the
mode of delivering health care services and public health
via information and communication technologies to
facilitate the diagnosis, consultation, treatment,
education, care management, and self-management of a
patient's health care while the patient is at the
originating site and the health care provider is at a
distant site. The bill's stated intent was to provide
better access to primary care and specialty providers to
patients in medically underserved rural and urban areas,
and to ensure a continuum of care in those areas.
Telehealth was defined as s tool to create parity in those
areas and to create new models of care as part of a
multi-faceted approach to health care.
A 2008 report, "Meeting the Health Care Needs of
California's Children: the Role of Telemedicine," by the
Children's Partnership, stated that "Quality health care no
longer requires a health care provider and patient to be in
the same room at the same time. With the advancement of
information and communications technology, children and
adults can receive high-quality health care from a distance
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through telemedicine. In fact, telemedicine is rapidly
becoming a viable solution to meeting the health care needs
of patients in rural and other underserved areas."
California was one of the first states to adopt legislation
to define and support the role of telemedicine in health
care delivery. In 1996, California adopted the Telemedicine
Development Act of 1996, identifying telemedicine as a
legitimate means of providing health care. Current statute
prohibits a health care service plan from requiring that
in-person contact occur between a health care provider and
a patient before payment is made for a covered service
appropriately provided through telehealth.
Related legislation
AB 1231 (V. Manuel Perez, 2013) would have required DDS to
inform all regional centers that any appropriate health
care service and dentistry may be provided through the use
of telehealth, as defined, to consumers of regional center
services. The bill was vetoed by the governor who stated
the bill's goals were permissible under current law.
SB 764 (Steinberg, 2012) would have required each regional
center's IPP team to consider the use of telehealth,
whenever applicable, to improve access to intervention and
therapeutic services for consumers and family members. This
bill was vetoed by the governor who stated the bill's goals
could be accomplished under current law.
AB 415 (Logue), Chapter 547, Statutes of 2011, established
the Telehealth Advancement Act of 2011 and stated
legislative intent to use telehealth to expand consumers'
access to convenient and quality care.
Comments :
Twice in the last two years, Governor Brown has vetoed
similar bills that sought to require the state to inform
regional centers about their ability to use telehealth
services, when appropriate. In both cases, the governor
noted that telehealth services are currently permissible
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under California law. This bill seeks a different approach
by simply adding telehealth to the list of authorized
regional center services within the Lanterman Act. In the
author's proposed version of the bill, telehealth is listed
prior to other fundamental services and supports in the
list of permissible items.
Staff recommends amending the bill to move telehealth to a
place on the list commensurate with similar services, as
follows:
WIC 4512 (b)
? Services and supports listed in the individual
program plan may include, but are not limited to,
telehealth services and support, as defined in Section
2290.5 of the Business and Professions Code,
diagnosis, evaluation, treatment, personal care, day
care, domiciliary care, special living arrangements,
physical, occupational, and speech therapy, training,
education, supported and sheltered employment, mental
health services, recreation, counseling of the
individual with a developmental disability and of his
or her family, protective and other social and
sociolegal services, information and referral
services, follow-along services, adaptive equipment
and supplies, advocacy assistance, including
self-advocacy training, facilitation and peer
advocates, assessment, assistance in locating a home,
child care, behavior training and behavior
modification programs, camping, community integration
services, community support, daily living skills
training, emergency and crisis intervention,
facilitating circles of support, habilitation,
homemaker services, infant stimulation programs, paid
roommates, paid neighbors, respite, short-term
out-of-home care, social skills training, specialized
medical and dental care, including telehealth services
and support, as defined in Section 2290.5 of the
Business and Professions Code, supported living
arrangements, technical and financial assistance,
travel training, training for parents of children with
developmental disabilities, training for parents with
developmental disabilities, vouchers, and
transportation services necessary to ensure delivery
of services to persons with developmental
STAFF ANALYSIS OF SENATE BILL 1445 (Evans) Page
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disabilities. Nothing in this subdivision is intended
to expand or authorize a new or different service or
support for any consumer unless that service or
support is contained in his or her individual program
plan.
POSITIONS
Support: Center for Autism and Related Disorders
Special Needs Network
Oppose: None received.
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