Transcript History of SB 946 - Family Voices of California

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REGIONAL CENTER
RESPONSE TO SB 946
Amy Westling
Senior Policy Analyst
Association of Regional Center Agencies
[email protected]
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What is the function of the regional center?
•
“In the past available services lacked a continuity necessary for
the…individual to reach his fullest potential. The Lanterman Act
seeks to join fragmented services, eliminate duplicated services,
and provide services where none exist so that a parent may find
help for a child at the earliest possible moment…”
•
1971 manual on the Lanterman Act
3
When is regional center funding
available?
• “The Centers attempt to utilize services for which
the…person is eligible before purchasing these services
with Regional Center funds.”
• 1971 manual on the Lanterman Act
4
What are limitations on regional center
funding?
• Welfare and Institutions Code Section 4648 (a)(8)
• “Regional center funds shall not be used to supplant the
budget of any agency which has a legal responsibility to
serve all members of the general public and is receiving
public funds for providing those services.”
• http://law.onecle.com/california/welfare/4648.html
5
What must regional centers do before
authorizing funding for a service?
• Welfare and Institutions Code Section 4659
• (a) Except as otherwise provided in subdivision (b) or (e), the
regional center shall identify and pursue all possible sources of
funding for consumers receiving regional center services.
These sources shall include, but not be limited to, both of the
following:
(1) Governmental or other entities or programs required to
provide or pay the cost of providing services, including MediCal, Medicare, the Civilian Health and Medical Program for
Uniform Services, school districts, and federal supplemental
security income and the state supplementary program.
(2) Private entities, to the maximum extent they are liable for
the cost of services, aid, insurance, or medical assistance to
the consumer.
• http://law.onecle.com/california/welfare/4659.html
6
Who funded behavioral health treatment
prior to SB 946?
• Prior to the implementation of SB 946 the only other
widely available source of behavioral health treatment
was the education system.
• Unmet needs for behavioral health treatment were funded
by regional centers for needs not related to educational
goals.
7
What did ARCA do in preparation for SB
946?
• Consulted with the California Association of Health Plans
as well as the Departments of Managed Health Care,
Developmental Services, and Insurance regarding
anticipated implementation issues
• Consulted with various health plans to streamline the
referral process
• Raised the issue with the Legislature regarding
anticipated concerns with copayments and coinsurance
for these services
• Established a list of contacts for each regional center and
health plan to facilitate case-specific discussions
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What have regional centers done in response to SB
946?
• Provided families and existing vendors with information
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about how to access health plan funding for services
Established relationships with local health plan groups
Worked to support families and vendors through the
transition from regional center to health plan funding for
behavioral health services
Coordinated referrals for new services with health plans
Provided assistance with health plan appeals
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ONGOING
DEVELOPMENTS
Katie Hornberger (OCRA)
Amy Westling (ARCA)
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What are the remaining issues?
• Termination of the Healthy Families program
• Copayment, coinsurance, and deductible funding
• Sunset date extension
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How does the Healthy Families termination
impact services?
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In 2012 the Legislature made a decision to transition children in the Healthy
Families program into Medi-Cal in four phases in 2013.
Under regulations issued by the Department of Managed Health Care the
responsibility of Healthy Families plans to provide behavioral health
treatments for individuals with autism or PDD was clarified.
Medi-Cal does not fund behavioral health treatment for individuals with
autism or PDD.
Those transitioning from Healthy Families to Medi-Cal would lose funding
for behavioral health treatment if they are not regional center clients.
Senate Budget Subcommittee approved language that would provide
services for this group until 6/30/14, but the budget has not been finalized
yet.
12
Who funds copayments, coinsurance, and
deductibles for behavioral services?
• Both the Senate and Assembly budget subcommittees have voted to
support the position of the Administration that would allow regional
centers to fund copayments and coinsurance for those with incomes
up to 400% of the Federal Poverty Level and would prohibit the
funding of deductibles.
• There are exceptions to allow some funding of copayments and
coinsurance for those with incomes over 400% of the Federal Poverty
Level.
• This would apply to services on the IPP or IFSP in addition to
behavioral health treatment.
• The issue now goes to the budget conference committee and could
be changed there.
• http://www.leginfo.ca.gov/pub/13-14/bill/sen/sb_0101-0150/sb_126_bill_20130122_introduced.htm
• SB 163 would have required the funding of all copayments,
coinsurance, and deductibles for services on the IPP or IFSP, but the
bill did not make it through the legislative process.
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Do I need to worry about the 2014 sunset
of SB 946?
• SB 126 is making its way through the
Legislature and would extend the sunset
date of SB 946 to 2019.
• SB 126 has not received a single vote
against it to date.
• www.leginfo.ca.gov/pub/13-14/bill/sen/sb_0101-0150/sb_126_bill_20130122_introduced.htm
QUESTIONS???