Regional center response to sb 946

1. Regional center response to sb 946 Amy Westling Senior Policy Analyst Association of Regional Center Agencies Awestling@arcanet.org

2. 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 Medi-Cal, 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

8. What have regional centers done in response to SB 946? • Provided families and existing vendors with information 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

9. 9 Ongoing developments Katie Hornberger (OCRA) Amy Westling (ARCA)

10. What are the remaining issues? • Termination of the Healthy Families program • Copayment, coinsurance, and deductible funding • Sunset date extension

11. How does the Healthy Families termination impact services? • 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.

13. 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

14. Questions???