BILL NUMBER: SB 163	AMENDED
	BILL TEXT

	AMENDED IN SENATE  APRIL 25, 2013
	AMENDED IN SENATE  APRIL 8, 2013

INTRODUCED BY   Senator Hueso

                        FEBRUARY 1, 2013

   An act to add Section 4659.1 to the Welfare and Institutions Code,
relating to developmental services.


	LEGISLATIVE COUNSEL'S DIGEST


   SB 163, as amended, Hueso. Developmental services: health
insurance payments.
   Under existing law, the Lanterman Developmental Disabilities
Services Act, the State Department of Developmental Services is
authorized to contract with regional centers to provide services and
supports to individuals with developmental disabilities, including,
but not limited to, autism. The services and supports to be provided
to a regional center consumer are contained in an individual program
plan (IPP) or individualized family services plan (IFSP) developed in
accordance with prescribed requirements.
   This bill would require a regional center to pay any applicable
copayment, coinsurance,  and   or 
deductible imposed by a health insurance policy or health care
service plan for a service or support required by a consumer's IPP or
IFSP, as specified. This bill would prohibit a regional center from
imposing on the consumer or his or her family a share of cost for, or
income requirements relating to, those payments, and from seeking
reimbursement for those payments. This bill would require  a
regional center   the department  to establish
appropriate application and documentation forms to implement those
provisions.
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  Section 4659.1 is added to the Welfare and Institutions
Code, to read:
   4659.1.  (a) If a service or support provided pursuant to a
consumer's individual program plan under this division or
individualized family service plan pursuant to the California Early
Intervention Services Act (Title 14 (commencing with Section 95000)
of the Government Code) is paid for, in whole or in part, by the
consumer's or his or her parents' private health insurance policy or
health care service plan, the regional center shall pay any
applicable copayment, coinsurance, or deductible associated with the
service or support for which the consumer and his or her family are
responsible.
   (b) The regional center shall not impose on the consumer or his or
her family a share of cost for, or income requirements relating to,
payments made pursuant to subdivision (a), and shall not seek
reimbursement for any payments made pursuant to subdivision (a).
   (c) The regional center may pay the family or provide direct
reimbursement to the provider, or to the health insurer or health
care service plan, for the payments required under subdivision (a).
   (d) A consumer and his or her family shall provide appropriate
documentation to affirm that the payments required under subdivision
(a) are for services that have been established under the consumer's
individual program plan or individualized family service plan.
   (e) The  regional center    
department  shall establish appropriate application and
documentation forms to implement this section.