BILL ANALYSIS �
SB 1445
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Date of Hearing: June 17, 2014
ASSEMBLY COMMITTEE ON HUMAN SERVICES
Mark Stone, Chair
SB 1445 (Evans) - As Amended: April 10, 2014
SENATE VOTE : 37-0
SUBJECT : Developmental services: regional centers: individual
program plans: telehealth.
SUMMARY : Clarifies that services and supports provided to
regional center consumers under the Lanterman Act can be
provided through the use of telehealth.
EXISTING LAW
1)Establishes an entitlement to services for individuals with
developmental disabilities under the Lanterman Developmental
Disabilities Services Act (Lanterman Act). (WIC 4500 et seq.)
2)Grants all individuals with developmental disabilities, among
all other rights and responsibilities established for any
individual by the United States Constitution and laws and the
California Constitution and laws, the right to treatment and
habilitation services and supports in the least restrictive
environment. (WIC 4502)
3)Establishes a system of 21 nonprofit regional centers
throughout the state to identify needs and coordinate services
for eligible individuals with developmental disabilities and
requires the Department of Developmental Services (DDS) to
contract with regional centers to provide case management
services and arrange for or purchase services that meet the
needs of individuals with developmental disabilities, as
defined. (WIC 4620 et seq.)
4)Requires the development of an individual program plan (IPP)
for each regional center consumer, which specifies services to
be provided to the consumer, based on his or her
individualized needs determination and preferences, 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)
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5)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))
6)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)
FISCAL EFFECT : According to the Senate Appropriations
Committee, this bill will result in minor costs (General Fund)
for DDS to provide technical assistance to regional centers, and
will have an unknown impact on the use of services by regional
center consumers (General Fund and federal funds).
COMMENTS : This bill seeks to clarify that existing services and
supports included in the Lanterman Act can be provided through
the use of telehealth.
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Background : The Lanterman Act (WIC � 4500 et seq.) guides the
provision of services and supports for Californians with
developmental disabilities. "Developmental disabilities" are
those that originate before an individual attains 18 years of
age, are expected to continue indefinitely, and constitute a
substantial disability for the individual. These include
intellectual disabilities, cerebral palsy, epilepsy, and autism
spectrum disorders (ASD). Other developmental disabilities are
those disabling conditions similar to an intellectual disability
that require treatment similar to that required by individuals
with an intellectual disability. 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.
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 Act. The principal roles of regional
centers include intake and assessment, individualized program
plan development, case management, and securing services through
generic agencies or purchasing services provided by vendors.
Regional centers also share primary responsibility with local
education agencies for provision of early intervention services
under the California Early Intervention Services Act.
The 21 regional centers throughout the state serve 270,000
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 1,300 consumers
reside at one of California's four Developmental Centers-and one
state-operated, specialized community facility-which provide
24-hour habilitation and medical and social treatment services.
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
Individual Program Plan (IPP) based on the consumer's needs and
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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 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.
The use of telehealth gives individuals with developmental
disabilities who may not otherwise be able to receive care in a
regular office setting-due to distance or discomfort, for
example-the opportunity to interact with care professionals
while they're in their own homes, schools, or other comfortable
and familiar settings. Allowing local health providers to
interact with other health providers in another location
remotely can be useful in obtaining additional input on what
might be complex and otherwise unaddressed conditions, therefore
increasing the quality of care provided to a patient and
potentially improving long term oral health outcomes.
Need for this bill : According to the author, while current
statute does not preclude the use of telehealth for the delivery
of services to regional center consumers, some regional centers
remain reluctant to authorize the use of telehealth without
explicit authority in statute. This bill simply includes
telehealth, in an unambiguous manner, among the services that
are available to a consumer if authorized in his or her IPP.
The author states, "Telehealth is now used extensively in the
medical field and has proved to reduce costs, improve the
quality of services and increase access for rural and medically
underserved communities. Furthermore, telehealth continues to
offer individuals with developmental disabilities an opportunity
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to interface with professionals in their preferred environment
and reduces or eliminates challenges related to transportation.
[This bill] will amend the Welfare and Institutions Code to
clarify that, under the provisions of the Lanterman Act,
regional centers can provide 'telehealth services and support'
for individuals who are developmentally disabled as part of the
individual program plan."
RECOMMENDED AMENDMENTS :
As this bill is currently written, telehealth services are
exclusively tied to the provision of specialized medical and
dental care. Because it is the author's intent to apply the use
of telehealth more broadly, as appropriate, committee staff
recommends the following amendment:
1)On page 3, line 10, strike out "including"
PRIOR 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. Vetoed by the Governor.
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. Vetoed by the
Governor.
AB 415 (Logue), Chapter 547, Statutes of 2011, repealed the
Telemedicine Development Act of 1996, changing the reference
from "telemedicine" to "telehealth", revising confidentiality
and privacy standards, consent requirements, and other health
provider and insurance requirements for telehealth.
SB 1665 (M. Thompson), Chapter 864, Statutes of 1996 enacted the
Telemedicine Development Act of 1996, which imposed several
requirements governing the delivery of health care services
through telemedicine. Prohibited health insurers from requiring
face to face contact between a health care provider and patient
for covered services appropriately provided through
telemedicine.
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REGISTERED SUPPORT / OPPOSITION :
Support
ACT Today
ALTA California Regional Center
Association of Regional Center Agencies (ARCA)
Autism Research Group
Behavioral Intervention for Autism
Behavioral Training
Bethuda Lutheran Communities
California Association for Behavior Analysis (CalABA)
Center for Autism and Related Disorders (CARD)
Central Valley Regional Center
Regional Center of Orange County
Southern California Consortium for Behavior Analysis (SCCBA)
Special Needs Network (SNN)
Westside Regional Center
Opposition
None on file.
Analysis Prepared by : Myesha Jackson / HUM. S. / (916)
319-2089