BILL ANALYSIS                                                                                                                                                                                                    Ó






                                  SENATE HUMAN
                               SERVICES COMMITTEE
                            Senator Carol Liu, Chair


          BILL NO:       SB 764                                      
          S
          AUTHOR:        Steinberg                                   
          B
          VERSION:       January 4, 2012
          HEARING DATE:  January 10, 2012                            
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          FISCAL:        Appropriations                              
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          CONSULTANT:    Sara Rogers                                 

                                        

                                     SUBJECT
                                         
               Developmental Services: Autism TeleHealth Program

                                     SUMMARY  

          Requires the Department of Developmental Services to 
          establish the telehealth systems program for the purpose of 
          expanding the provision of applied behavioral analysis 
          (ABA) or intensive behavioral intervention (IBI) services 
          by regional centers or vendors through the use of 
          telehealth systems (THS).  Requires the Department to 
          implement vendorization codes and/or sub codes for relevant 
          THS services and programs.

                                     ABSTRACT  

          Current law

          1.Enacts the Telehealth Advancement Act of 2011 and repeals 
            the Telemedicine Development Act of 1996.  Defines 
            telehealth as a mode of delivering health care and public 
            health services facilitating the diagnosis, consultation, 
            treatment, education, care management and self-management 
            while the patient is at an originating site and the 
            health care provider is at a distant site.
                                                         Continued---



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          2.Enacts the Lanterman Developmental Disabilities Service 
            Act under the Department of Developmental Services (DDS) 
            affirming a variety of rights and responsibilities for 
            persons with developmental disabilities, including the 
            right to treatment and habilitation services and supports 
            in the least restrictive environment.

          3.Establishes regional centers (RC), a network of nonprofit 
            private corporations that operate under contract with DDS 
            to provide or direct the provision of services and 
            supports identified in a client individual program plan.

          4.Enacts the California Early Intervention Services Act of 
            1993 establishing a statewide system of family-centered 
            interagency programs responsible for providing 
            appropriate early intervention services and support to 
            all eligible infants and toddlers and their families, 
            also known as "Early Start."

          5.Enacts, through federal law, the Early Intervention 
            Program for Infants and Toddlers with Disabilities of 
            1986 under the Individuals with Disabilities Education 
            Act (IDEA).

          6.Prohibits health care service plans, health insurers, and 
            the Medi-Cal program from requiring in-person contact to 
            occur between a health provider and a patient before 
            payment is made for covered services appropriately 
            provided through telehealth, subject to the terms and 
            conditions of plan contract or the reimbursement policies 
            adopted by the Department of Health Care Services.

          This bill

          1.Requires the Department of Developmental Services to 
            establish the telehealth systems program.  

           2.Authorizes a provider vendorized with a regional center 
            to provide applied behavioral analysis (ABA) services or 
            intensive behavioral intervention (IBI) services to 
            provide such services through telehealth systems (THS), 
            subject to approval by a regional center.  
                 
           3.Authorizes a regional center to purchase ABA or IBI 




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            services through the use of THS if the provider can 
            demonstrate that the provided services are beneficial for 
            the consumer and are in compliance with existing ABA and 
            IBI program requirements, privacy and confidentiality 
            standards, state and federal requirements and federal 
            funding participation guidelines.  
                 
           4.Requires regional centers to consider the use of THS in 
            implementation of parent training for autism related ABA 
            or behavior intervention as part of the regional centers 
            family support services.  
                 
           5.Requires the department to implement vendorization codes 
            or subcodes for all applicable THS services and programs.  
                 
           6.States that a provider shall be responsible for all 
            expenses and costs related to the THS.  
                 
           7.Defines telehealth systems as a mode of delivering 
            services and information that utilizes technologies to 
            enable evaluation, consultation, and treatment of 
            individuals and the provision of supports, 
            self-management and other appropriate services, including 
            synchronous and asynchronous interactions to individuals 
            being served by regional centers regardless of the 
            location of the providers or individuals.  
           


                                  FISCAL IMPACT
                                         
          This bill has not been analyzed by a fiscal committee. 

                            BACKGROUND AND DISCUSSION
                                         

          Purpose of the bill
          According to the author, this bill is intended to enhance 
          and promote the use of telehealth for the diagnosis and 
          treatment of Autism Spectrum Disorders (ASD) by DDS and RCs 
          and support the provision of services in the most competent 
          and cost effective manner possible.  The author notes that 
          there are currently over 53,000 ASD consumers receiving 
          services through RCs and that remote and underserved 
          communities in particular lack sufficient access to 




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          programs and providers to serve these consumers.  The 
          author states that telehealth applications have been 
          established as highly effective in providing access to 
          services, especially in rural and underserved communities.

          The author further asserts that the goals and objectives of 
          SB 764 are consistent with the DDS ASD initiative that has 
          emphasized the use of innovative methods and technology to 
          promote best practices in the assessment, diagnosis, 
          treatment, education and training for individuals with ASD 
          and their families.

          The author states that, as amended, SB 764 is intended to 
          ensure that the proposed telehealth services comply with 
          all existing requirements of the Lanterman Act; comply with 
          all existing privacy and confidentiality requirements and 
          regulations; and also comply with all relevant federal and 
          state requirements.

          Autism 
          Autism is defined as a group of neural development 
          disorders linked to atypical biology and chemistry in the 
          brain and generally appearing within the first three years 
          of life.   Autism is further characterized by delayed, 
          impaired or otherwise atypical verbal and social 
          communication skills, sensitivity to sensory stimulation, 
          atypical behaviors and body movements, and sensitivity to 
          changes in routines.
          
          According to the Centers for Disease Control and Prevention 
          (CDC), the average total ASD prevalence in 2006 (children 
          born in 1998) was 9.0 per 1,000 children, translating to 
          one in 110 children.  ASD prevalence was found to be 4 to 5 
          times higher for boys than for girls.

          In 2007, the California Department of Developmental 
          Services (DDS) reported serving 38,000 individuals with 
          autism reflecting an annual increase of 13.4 percent since 
          2002, and that, of California children born during 
          1990-1997, more than 11,000 are enrolled with DDS to 
          receive services for autism.

          Public services for children and adults with autism
          The Lanterman Developmental Disabilities Service Act 
          administered by the Department of Developmental Services 




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          (DDS) affirms a variety of rights and responsibilities for 
          persons with developmental disabilities, including the 
          right to treatment and habilitation services and supports 
          in the least restrictive environment.  Prior to enactment 
          of the Lanterman Act the majority of children with autism 
          were placed in state funded institutions for life at higher 
          average and overall cost to the state.

          State law requires the Department of Developmental Services 
          and Regional Centers, as their contracted local 
          administrator, to provide a variety of services and 
          supports necessary to prevent institutionalization and to 
          assist families caring for their children at home.  
          Provided services include diagnosis and eligibility 
          assessment services as well as family support or 
          community/independent living services in accordance with an 
          individual program plan (IPP) or an individualized family 
          service plan (IFSP).  Regional centers are permitted to 
          purchase Applied Behavior Analysis or Intensive Behavior 
          Intervention services if the service provider uses 
          evidence-based practices and the services promote positive 
          social behaviors and help address issues with learning and 
          social interactions.

          DDS additionally administers the Early Start program in 
          California which provides a broad scope of behavioral 
          intervention and family support services to infants and 
          toddlers under the age of 3 who are 'developmentally 
          delayed' or have an 'established risk' or are 'at high 
          risk' of a developmental delay.

          Telehealth as a treatment modality for autism 
          Many studies indicate that early diagnosis and intervention 
          is critical for children with ASD, offering significant 
          opportunities to improve quality of life for these children 
          and their families over the short and long term.

          Recent studies have evaluated the effectiveness and 
          efficiency of behavioral intervention treatments, 
          functional communication training and functional analysis 
          training for parents conducted through telehealth, 
          including both synchronous (simultaneous exchange of 
          information) and asynchronous (information exchange occurs 
          over a period of time) modalities.  These studies have 
          demonstrated that telehealth can result in increased 




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          efficiency, cost savings and comparable treatment outcomes.

          Related/prior legislation
          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.
          
          ABx4 9, Chapter 9, Statutes of 2009-10, Fourth 
          Extraordinary Session among other provisions, required the 
          least costly available provider of comparable service, 
          including transportation costs, who is able to accomplish 
          all or parts of the consumer's IPP, consistent with  the 
          needs of the consumer and family as identified in the IPP, 
          to be selected to deliver services to the consumer.

          Statutorily defined ABA and IBI treatments and established 
          a variety of standards and restrictions for vendors 
          providing applied behavioral analysis (ABA) services or 
          intensive behavioral intervention services, or both.

          SB 1665 (M. Thompson), Chapter 864, Statutes of 1996 
          enacted the "Telemedicine Development Act of 1996" imposing 
          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.

                                         
                             COMMENTS AND QUESTIONS

           1.A previous Senate Health Committee analysis of an earlier 
            version of this bill noted that a number of terms and 
            conditions used in this bill are also defined in AB 415 
            (Chapter 547, 2011).  Health Committee staff recommended 
            this bill use terms that are consistent with that law.  
            Currently, the definitions of the terms continue to 
            differ.  Staff notes that differences between ABA/IBI 
            services in comparison to traditional medical services 
            may necessitate some variance between the definitions; 
            however staff recommends the author consider bringing the 
            two definitions into closer alignment.




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            (d) For purposes of this section, "telehealth systems" 
            means  a  the mode of delivering services  and  via 
            information  that utilizes  and communication technologies 
            to  enable  facilitate diagnosis, evaluation, consultation, 
             and  treatment, education, care management, supports, and 
            self-management  and other appropriate services, including 
            synchronous and a synchronous interactions to individuals 
            who are within the purview and responsibility of the 
            regional center  regardless of the location of the 
            providers or  individuals  consumers.  Telehealth includes 
            synchronous interactions and asynchronous store and 
            forward transfers.

          2.Creation of a new program.  This bill calls for the 
            creation of the telehealth systems program; however, the 
            substantive effect of the bill makes changes addressing 
            the administration of existing programs.  Staff 
            recommends the author consider amending or deleting this 
            provision.




                                    POSITIONS  

          Support:       Behavioral Intervention Association (BIA)
                         Capitol Autism Services
                         The Children's Partnership

          Oppose:   None received






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