# Presentation: 024469

##  			   TM 

**Handout**
***Panel Main Topic: State Policy Approaches for Addressing and Treating Individuals with an FASD***
***Date/Time: May 11, 2006 10:00 AM – 11:30 AM***
- Building FASD State Systems Meeting
- May 9-11, 2006
- Hyatt at Fisherman’s Wharf
- San Francisco, California
**Steven Bruce, Executive Director**
**PEOPLE WITH DISABILITIES FOUNDATION**
- 507 Polk Street, 2nd Floor
- San Francisco, CA 94102
- Telephone : 415-931-3070
- Fax: 415-931-2828
- _[www.pwdf.org](http://www.pwdf.org/)_
- Equality for People with Psychiatric and Physical Disabilities through Advocacy, Education and Public Awarenes

## State Policy Approaches for Addressing and Treating Individuals with an FASDMay 11, 2006 10:00 AM-11:30 AMSan Francisco, CA

**Contact information**
- 1) National Organization of Social Security Claimants’ Representatives (NOSSCR)
- Englewood Cliffs, NJ
- 1-800-431-2804
- 2) Social Security Administration
- From 7 a.m. to 7 p.m., Monday through Friday:
- 1-800-772-1213
- 3) Local Legal Aid
- 4) Local Lawyer Refferal Service, State Bar or Local County Bar

## State Policy Approaches for Addressing and Treating Individuals with an FASDMay 11, 2006 10:00 AM-11:30 AMSan Francisco, CA

- Social Security

## State Policy Approaches for Addressing and Treating Individuals with an FASDMay 11, 2006 10:00 AM-11:30 AMSan Francisco, CA

**Selected Social Security Administration Regulations 20 CFR 404**
**As of April 13, 2006**
- ADULT RULES (See below for children’s rules)
**10.00 Impairments That Affect Multiple Body Systems**
-       ....
- C. How Do We Evaluate Other Impairments That Affect Multiple Body Systems? ...
- 2. There are many other impairments that can cause deviation from, or interruption of, the normal function of the body or interfere with development;  for example, congenital anomalies, chromosomal disorders, dysmorphic syndromes, metabolic disorders, and perinatal infectious diseases. In these impairments, the degree of deviation or interruption may vary widely from individual to individual.  Therefore, the resulting functional limitations and the progression of those limitations also vary widely.  For this reason, we evaluate the specific effects of these impairments on you under the listing criteria in any affected body system(s) on an individual case basis.  Examples of such impairments include triple X syndrome (XXX syndrome), fragile X syndrome, phenylketonuria (PKU), caudal regression syndrome, and fetal alcohol syndrome....
**11.00 Neurological**
-      ....
- 11.02 Epilepsy--convulsive epilepsy, (grand mal or psychomotor), documented by detailed description of a typical seizure pattern, including all associated phenomena;  occurring more frequently than once a month in spite of at least 3 months of prescribed treatment.
- A. Daytime episodes (loss of consciousness and convulsive seizures) or

## State Policy Approaches for Addressing and Treating Individuals with an FASDMay 11, 2006 10:00 AM-11:30 AMSan Francisco, CA

- B. Nocturnal episodes manifesting residuals which interfere significantly with activity during the day....
- 11.07 Cerebral palsy.  With:
- A. IQ of 70 or less;  or
- B. Abnormal behavior patterns, such as destructiveness or emotional instability;  or
- C. Significant interference in communication due to speech, hearing, or visual defect;  or
- D. Disorganization of motor function as described in 11.04B....
**12.00 Mental Disorders**
- 12.02 Organic Mental Disorders:  Psychological or behavioral abnormalities associated with a dysfunction of the brain.  History and physical examination or laboratory tests demonstrate the presence of a specific organic factor judged to be etiologically related to the abnormal mental state and loss of previously acquired functional abilities.
- The required level of severity for these disorders is met when the requirements in both A and B are satisfied, or when the requirements in C are satisfied.
- A. Demonstration of a loss of specific cognitive abilities or affective changes and the medically documented persistence of at least one of the following:
- 1. Disorientation to time and place;  or
- 2. Memory impairment, either short-term (inability to learn new information), intermediate, or long-term (inability to remember information that was known sometime in the past);  or

## State Policy Approaches for Addressing and Treating Individuals with an FASDMay 11, 2006 10:00 AM-11:30 AMSan Francisco, CA

- 3. Perceptual or thinking disturbances (e.g., hallucinations, delusions);  or
- 4. Change in personality;  or
- 5. Disturbance in mood;  or
- 6. Emotional lability (e.g., explosive temper outbursts, sudden crying, etc.) and impairment in impulse control;  or
- 7. Loss of measured intellectual ability of at least 15 I.Q. points from premorbid levels or overall impairment index clearly within the severely impaired range on neuropsychological testing, e.g., the Luria-Nebraska, Halstead-Reitan, etc.;
- AND
- B. Resulting in at least two of the following:
- 1. Marked restriction of activities of daily living;  or
- 2. Marked difficulties in maintaining social functioning;  or
- 3. Marked difficulties in maintaining concentration, persistence, or pace;  or
- 4. Repeated episodes of decompensation, each of extended duration;
- Or
- C. Medically documented history of a chronic organic mental disorder of at least 2 years' duration that has caused more than a minimal limitation of ability to do basic work activities, with symptoms or signs currently attenuated by medication or psychosocial support, and one of the following:
- 1. Repeated episodes of decompensation, each of extended duration;  or

## State Policy Approaches for Addressing and Treating Individuals with an FASDMay 11, 2006 10:00 AM-11:30 AMSan Francisco, CA

- 2. A residual disease process that has resulted in such marginal adjustment that even a minimal increase in mental demands or change in the environment would be predicted to cause the individual to decompensate;  or
- 3. Current history of 1 or more years' inability to function outside a highly supportive living arrangement, with an indication of continued need for such an arrangement.
- 12.07 Somatoform Disorders:  Physical symptoms for which there are no demonstrable organic findings or known physiological mechanisms.
- The required level of severity for these disorders is met when the requirements in both A and B are satisfied.
- A. Medically documented by evidence of one of the following:
- 1. A history of multiple physical symptoms of several years duration, beginning before age 30, that have caused the individual to take medicine frequently, see a physician often and alter life patterns significantly;  or
- 2. Persistent nonorganic disturbance of one of the following:
- a. Vision;  or
- b. Speech;  or
- c. Hearing;  or
- d. Use of a limb;  or
- e. Movement and its control (e.g., coordination disturbance, psychogenic seizures, akinesia, dyskinesia;  or
- f. Sensation (e.g., diminished or heightened).

## State Policy Approaches for Addressing and Treating Individuals with an FASDMay 11, 2006 10:00 AM-11:30 AMSan Francisco, CA

- 3. Unrealistic interpretation of physical signs or sensations associated with the preoccupation or belief that one has a serious disease or injury;
- And
- B. Resulting in at least two of the following:
- 1. Marked restriction of activities of daily living;  or
- 2. Marked difficulties in maintaining social functioning;  or
- 3. Marked difficulties in maintaining concentration, persistence, or pace;  or
- 4. Repeated episodes of decompensation, each of extended duration.
**CHILD’S DISABILTY LISTINGS**
**111.00 Neurological ....**
- 111.02 Major motor seizure disorder.
- A. Convulsive epilepsy.  In a child with an established diagnosis of epilepsy, the occurrence of more than one major motor seizure per month despite at least three months of prescribed treatment.  With:
- 1. Daytime episodes (loss of consciousness and convulsive seizures);  or
- 2. Nocturnal episodes manifesting residuals which interfere with activity during the day.
- B. Convulsive epilepsy syndrome.  In a child with an established diagnosis of epilepsy, the occurrence of at least one major motor seizure in the year prior to application despite at least three months of prescribed treatment.

## State Policy Approaches for Addressing and Treating Individuals with an FASDMay 11, 2006 10:00 AM-11:30 AMSan Francisco, CA

- And one of the following:
- 1. IQ of 70 or less;  or
- 2. Significant interference with communication due to speech, hearing, or visual defect;  or
- 3. Significant mental disorder;  or
- 4. Where significant adverse effects of medication interfere with major daily activities.
- 111.06 Motor dysfunction (due to any neurological disorder).  Persistent disorganization or deficit of motor function for age involving two extremities, which (despite prescribed therapy) interferes with age-appropriate major daily activities and results in disruption of:
- A. Fine and gross movements;  or
- B. Gait and station....
- 111.07 Cerebral Palsy.  With:
- A. Motor dysfunction meeting the requirements of 101.02 or 111.06;  or
- B. Less severe motor dysfunction (but more than slight) and one of the following:
- 1. IQ of 70 or less;  or
- 2. Seizure disorder, with at least one major motor seizure in the year prior to application;  or
- 3. Significant interference with communication due to speech, hearing or visual defect;  or
- 4. Significant emotional disorder.

## State Policy Approaches for Addressing and Treating Individuals with an FASDMay 11, 2006 10:00 AM-11:30 AMSan Francisco, CA

**112.00 Mental Disorders **
**     ...****.**
- 112.02 Organic Mental Disorders:  Abnormalities in perception, cognition, affect, or behavior associated with dysfunction of the brain.  The history and physical examination or laboratory tests, including psychological or neuropsychological tests, demonstrate or support the presence of an organic factor judged to be etiologically related to the abnormal mental state and associated deficit or loss of specific cognitive abilities, or affective changes, or loss of previously acquired functional abilities.
- 	The required level of severity for these disorders is met when the requirements in both A and B are satisfied.
- A. Medically documented persistence of at least one of the following:
- 1. Developmental arrest, delay or regression;  or
- 2. Disorientation to time and place;  or
- 3. Memory impairment, either short-term (inability to learn new information), intermediate, or long-term (inability to remember information that was known sometime in the past);  or
- 4. Perceptual or thinking disturbance (e.g., hallucinations, delusions, illusions, or paranoid thinking);  or
- 5. Disturbance in personality (e.g., apathy, hostility);  or
- 6. Disturbance in mood (e.g., mania, depression);  or
- 7. Emotional lability (e.g., sudden crying);  or
- 8. Impairment of impulse control (e.g., disinhibited social behavior, explosive temper outbursts);  or

## State Policy Approaches for Addressing and Treating Individuals with an FASDMay 11, 2006 10:00 AM-11:30 AMSan Francisco, CA

- 9. Impairment of cognitive function, as measured by clinically timely standardized psychological testing;  or
- 10. Disturbance of concentration, attention, or judgment;
- And
- B. Select the appropriate age group to evaluate the severity of the impairment:
- 1. For older infants and toddlers (age 1 to attainment of age 3), resulting in at least one of the following:
- a. Gross or fine motor development at a level generally acquired by children no more than one-half the child's chronological age, documented by:
- (1) An appropriate standardized test;  or
- (2) Other medical findings (see 112.00C);  or
- b. Cognitive/communicative function at a level generally acquired by children no more than one-half the child's chronological age, documented by:
- (1) An appropriate standardized test;  or
- (2) Other medical findings of equivalent cognitive/communicative abnormality, such as the inability to use simple verbal or nonverbal behavior to communicate basic needs or concepts;  or
- c. Social function at a level generally acquired by children no more than one-half the child's chronological age, documented by:
- (1) An appropriate standardized test;  or
- (2) Other medical findings of an equivalent abnormality of social functioning, exemplified by

## State Policy Approaches for Addressing and Treating Individuals with an FASDMay 11, 2006 10:00 AM-11:30 AMSan Francisco, CA

- serious inability to achieve age-appropriate autonomy as manifested by excessive clinging or extreme separation anxiety;  or
- d. Attainment of development or function generally acquired by children no more than two-thirds of the child's chronological age in two or more areas covered by a., b., or c., as measured by an appropriate standardized test or other appropriate medical findings.
- 2. For children (age 3 to attainment of age 18), resulting in at least two of the following:
- a. Marked impairment in age-appropriate cognitive/communicative function, documented by medical findings (including consideration of historical and other information from parents or other individuals who have knowledge of the child, when such information is needed and available) and including, if necessary, the results of appropriate standardized psychological tests, or for children under age 6, by appropriate tests of language and communication;  or
- b. Marked impairment in age-appropriate social functioning, documented by history and medical findings (including consideration of information from parents or other individuals who have knowledge of the child, when such information is needed and available) and including, if necessary, the results of appropriate standardized tests;  or
- c. Marked impairment in age-appropriate personal functioning, documented by history and medical findings (including consideration of information from parents or other individuals who have knowledge of the child, when such information is needed and available) and including, if necessary, appropriate standardized tests;  or
- d. Marked difficulties in maintaining concentration, persistence, or pace.
- 	**     ...****.**

## State Policy Approaches for Addressing and Treating Individuals with an FASDMay 11, 2006 10:00 AM-11:30 AMSan Francisco, CA

- 112.04 Mood Disorders:  Characterized by a disturbance of mood (referring to a prolonged emotion that colors the whole psychic life, generally involving either depression or elation), accompanied by a full or partial manic or depressive syndrome.
- 	The required level of severity for these disorders is met when the requirements in both A and B are satisfied.
- A. Medically documented persistence, either continuous or intermittent, of one of the following:
- 1. Major depressive syndrome, characterized by at least five of the following, which must include either depressed or irritable mood or markedly diminished interest or pleasure:
- a. Depressed or irritable mood;  or
- b. Markedly diminished interest or pleasure in almost all activities;  or
- c. Appetite or weight increase or decrease, or failure to make expected weight gains;  or
- d. Sleep disturbance;  or
- e. Psychomotor agitation or retardation;  or
- f. Fatigue or loss of energy;  or
- g. Feelings of worthlessness or guilt;  or
- h. Difficulty thinking or concentrating;  or
- i. Suicidal thoughts or acts;  or
- j. Hallucinations, delusions, or paranoid thinking;
- Or

## State Policy Approaches for Addressing and Treating Individuals with an FASDMay 11, 2006 10:00 AM-11:30 AMSan Francisco, CA

- 2. Manic syndrome, characterized by elevated, expansive, or irritable mood, and at least three of the following:
- a. Increased activity or psychomotor agitation;  or
- b. Increased talkativeness or pressure of speech;  or
- c. Flight of ideas or subjectively experienced racing thoughts;  or
- d. Inflated self-esteem or grandiosity;  or
- e. Decreased need for sleep;  or
- f. Easy distractibility;  or
- g. Involvement in activities that have a high potential of painful consequences which are not recognized;  or
- h. Hallucinations, delusions, or paranoid thinking;
- Or
- 3. Bipolar or cyclothymic syndrome with a history of episodic periods manifested by the full symptomatic picture of both manic and depressive syndromes (and currently or most recently characterized by the full or partial symptomatic picture of either or both syndromes);
- And
- B. For older infants and toddlers (age 1 to attainment of age 3), resulting in at least one of the appropriate age-group criteria in paragraph B1 of 112.02; or, for children (age 3 to attainment of age 18), resulting in at least two of the appropriate age-group criteria in paragraph B2 of 112.02.
- 112.05 Mental Retardation:  Characterized by significantly subaverage general intellectual functioning with deficits in adaptive functioning.

## State Policy Approaches for Addressing and Treating Individuals with an FASDMay 11, 2006 10:00 AM-11:30 AMSan Francisco, CA

- The required level of severity for this disorder is met when the requirements in A, B, C, D, E, or F are satisfied.
- For older infants and toddlers (age 1 to attainment of age 3), resulting in at least one of the appropriate age-group criteria in paragraph B1 of 112.02; or, for children (age 3 to attainment of age 18), resulting in at least two of the appropriate age-group criteria in paragraph B2 of 112.02;
- Or
- B. Mental incapacity evidenced by dependence upon others for personal needs  (grossly in excess of age-appropriate dependence) and inability to follow directions such that the use of standardized measures of intellectual functioning is precluded;
- Or
- C. A valid verbal, performance, or full scale IQ of 59 or less;
- Or
- D. A valid verbal, performance, or full scale IQ of 60 through 70 and a physical or other mental impairment imposing an additional and significant limitation of function;
- Or
- E. A valid verbal, performance, or full scale IQ of 60 through 70 and:
- 1. For older infants and toddlers (age 1 to attainment of age 3), resulting in attainment of development or function generally acquired by children no more than two-thirds of the child's chronological age in either paragraphs B1a or B1c of 112.02;  or
- 2. For children (age 3 to attainment of age 18), resulting in at least

## State Policy Approaches for Addressing and Treating Individuals with an FASDMay 11, 2006 10:00 AM-11:30 AMSan Francisco, CA

- one of paragraphs B2b or B2c or B2d of 112.02;
- Or
- F. Select the appropriate age group:
- For older infants and toddlers (age 1 to attainment of age 3), resulting in attainment of development or function generally acquired by children no more than two-thirds of the child's chronological age in paragraph B1b of 112.02, and a physical or other mental impairment imposing an additional and significant limitation of function;
- Or
- 2. For children (age 3 to attainment of age 18), resulting in the satisfaction of 112.02B2a, and a physical or other mental impairment imposing an additional and significant limitation of function....

## State Policy Approaches for Addressing and Treating Individuals with an FASDMay 11, 2006 10:00 AM-11:30 AMSan Francisco, CA

**An Illustration of Analysis of Children’s SSI Disability**
-       Substantial evidence did not support finding of non-disability for minor Supplemental Security Income (SSI) claimant diagnosed with attention deficit hyperactivity disorder (ADHD) and fetal alcohol syndrome; claimant showed marked, if not extreme, limitation in at least two domains found in regulation governing children’s “functional equivalence” to listed impairments, namely attending and completing tasks and interacting and relating with others, and medication was not effective on consistent basis. Social Security Act, §1614 (a) (3) (c) (i), as amended, 42 U.S.C.A. § 1382c (a) (3) (c) (i); 20 C.F.R. §§ 416.924 (a), 416.926a (b) (1) (ii, iii).

## State Policy Approaches for Addressing and Treating Individuals with an FASDMay 11, 2006 10:00 AM-11:30 AMSan Francisco, CA

**Comparative Analysis of **
**California Developmental Disability Benefits **
**and **
**Supplemental Security Income **
**Disability Benefits**

## State Policy Approaches for Addressing and Treating Individuals with an FASDMay 11, 2006 10:00 AM-11:30 AMSan Francisco, CA

**Supplemental Security Income Benefit Rates**
- Effective April 1, 2006, State Supplemental Income benefits will increase for consumers who are _not_ in Community Care Facilities (CCF’s/Board & Care).  These are the consumers who did not receive an increase effective 1/1/2006.   Below are the new 2006 rates for all SSI recipients receiving single benefits.*
*	**          *_*Category*_*	**                                                               **	** *_*Dollars ($)*_
**	****Aged or Disabled****	**
- 		Own Household                                                               836.00
- 		Household of Another			   636.00
- 		No Cooking Facilities                                                       920.00
**	****Disabled Minor**
- 		Living with Parent or Relative                                           722.00
- 		Household of Another                                                       510.00
**	****Blind**
- 		Own Household                                                                901.00
- 		Household of Another                                                       717.00
**	****All Individuals**
- 		Nonmedical Out-Of-Home Care (Board and Care)          1015.00
**	****	**
**	****	****This consists of the following:****	**
- 	Personal and Incidental (P & I) Residential Care Facility                     117.00
- 	Non-medical Board & Care (Not including P & I)**	****	****          **_898.00_
- 	Total Nonmedical Out-Of-Home Care (Board and Care)	        1015.00
**	****These Board and Care rates did not change for 4/06.**
- 	*Add $20 to rates above for those recipients receiving multiple benefits; i.e, SSA & SSI; VA & SSA; VA & SSI, etc.
**	****Personal and Incidental **
**	****	****Skilled Nursing Facility & Intermediate Care Facility**
**	****	**SSA recipient only**	****	****	****    **35.00
**	****	**SSI recipient only			    50.00

## State Policy Approaches for Addressing and Treating Individuals with an FASDMay 11, 2006 10:00 AM-11:30 AMSan Francisco, CA

**California Department of Developmental Services**
**What Do Regional Developmental Center Services Cost?**
- 	There is no charge for diagnosis and assessment for eligibility. Once eligibility is determined, _most services are free regardless of age or income_ (emphasis added). There is a requirement for parents to share the cost of 24-hour out-of-home placements for children under age 18. This share depends on the parents' ability to pay. There may also be a co-payment requirement for other selected services.
- 	Regional centers are required by law to provide services in the most cost-effective way possible. They must use all other resources, including generic resources, before using any regional center funds. A generic resource is a service provided by an agency which has a legal responsibility to provide services to the general public and receives public funds for providing those services. Some generic agencies you might be referred to are the local school district, county social services department, Medi-Cal, Social Security Administration, Department of Rehabilitation and others. Other resources may include natural supports. This is help that you may get from family, friends or others at little or no cost.

## State Policy Approaches for Addressing and Treating Individuals with an FASDMay 11, 2006 10:00 AM-11:30 AMSan Francisco, CA

**DEPARTMENT OF DEVELOPMENTAL SERVICES**
**2006-07 GOVERNOR’S BUDGET HIGHLIGHTS**
***Message from the Director***
- 	The 2006-07 Governor’s Budget includes $3.8 billion ($2.4 billion General Fund) for the Department of Developmental Services (Department).  This reflects a net increase of $208.7 million ($155.6 million General Fund) over the revised 2005-06 budget.  (This funding does not include the Capital Outlay request in the budget of $2.3 million in 2005-06 and $80.3 million in 2006-07.)  In this proposed budget, the Department maintains its commitment to containing program and administrative costs while continuing to provide an expansive array of services and supports to developmentally disabled individuals and their families. **...**
- 							CLIFF ALLENBY
- 							Director
- January 10, 2006

## State Policy Approaches for Addressing and Treating Individuals with an FASDMay 11, 2006 10:00 AM-11:30 AMSan Francisco, CA

**California Definition of Developmental Disabilities**
**(The Lanterman Act, as of 2001)**
- 	The term developmental disability refers to a severe and chronic disability that is attributable to a mental or physical impairment that begins before an individual reaches adulthood. These disablities include mental retardation, cerebral palsy, epilepsy, autism, and disabling conditions closely related to mental retardation or requiring similar treatment.
**Mental Retardation **
- 	Mental Retardation is characterized by significantly subaverage general intellectual functioning (i.e., an IQ of approximately 70 or below) with concurrent deficits or impairments in adaptive functioning.
**Cerebral Palsy **
- 	Cerebral Palsy includes two types of motor dysfunction: (1) nonprogressive lesion or disorder in the brain occurring during intrauterine life or the perinatal period and characterized by paralysis, spasticity, or abnormal control of movement or posture, such as poor coordination or lack of balance, which is manifest prior to two or three years of age, and (2) other significant motor dysfunction appearing prior to age 18.
**Autism **
- 	Autism is a neurodevelopmental disorder with multiple causes or origins. It is defined as a syndrome causing gross and sustained impairment in social interaction and communication with restricted and stereotyped patterns of

## State Policy Approaches for Addressing and Treating Individuals with an FASDMay 11, 2006 10:00 AM-11:30 AMSan Francisco, CA

**California Definition of Developmental Disabilities**
**                    ****(The Lanterman Act, as of 2001)            **Cont’d
- 	behavior, interests, and activities that appear prior to the age of three. Specific symptoms may include impaired
- 	awareness of others, lack of social or emotional reciprocity, failure to develop peer relationships appropriate to developmental level, delay or absence of spoken language and abnormal nonverbal communication, stereotyped and repetitive language, idiosyncratic language, impaired imaginative play, insistence on sameness (e.g., nonfunctional routines or rituals), and stereotyped and repetitive motor mannerisms.
**Epilepsy **
- 	Epilepsy is defined as recurrent, unprovoked seizures.
**Other Developmental Disabilities **
- 	Other Developmental Disabilities are those handicapping conditions similar to mental retardation that require treatment (i.e., care and management) similar to that required by individuals with mental retardation. This does not include handicapping conditions that are solely psychiatric or physical in nature. The handicapping conditions must occur before age 18, result in a substantial handicap, be likely to continue indefinitely, and involve brain damage or dysfunction. Examples of conditions might include intracranial neoplasms, degenerative brain disease or brain damage associated with accidents.

## State Policy Approaches for Addressing and Treating Individuals with an FASDMay 11, 2006 10:00 AM-11:30 AMSan Francisco, CA

**California Developmental Disabilities Eligibility Criteria**
**(The Lanterman Act, as of 2001)**
- 	To be eligible for services funded by the California Department of Developmental Services, individuals must have a developmental disability as defined in _[Section 4512](http://www.dds.cahwnet.gov/Statutes/WICSectionView.cfm?Section=4500-4519.7.htm&anchor=4512#4512)__[ of the ](http://www.dds.cahwnet.gov/Statutes/WICSectionView.cfm?Section=4500-4519.7.htm&anchor=4512#4512)__[California Welfare and Institutions Code](http://www.dds.cahwnet.gov/Statutes/WICSectionView.cfm?Section=4500-4519.7.htm&anchor=4512#4512)_. Section 4512 defines developmental disability as:
- 	"a disability which originates before an individual attains age 18, continues, or can be expected to continue, indefinitely, and constitutes a substantial disability for that individual. As defined by the Director of Developmental Services, in consultation with the Superintendent of Public Instruction, this term shall include mental retardation, cerebral palsy, epilepsy, and autism. This term shall also include disabling conditions found to be closely related to mental retardation or to require treatment similar to that required for mentally retarded individuals, but shall not include other handicapping conditions that are solely physical in nature."
- 	Infants and toddlers (age 0 to 36 months) who are at risk of becoming developmentally disabled or who have a developmental delay may also qualify for services. The criteria for determining the eligibility of infants and toddlers is specified in *Section 95014* of the *California Government Code*:
- 	The term "eligible infant or toddler" for the purposes of this title means infants and toddlers from birth through two years of age, for whom a need for early intervention services, as specified in the Individuals with Disabilities Education Act (20 U.S.C. Sec. 1471 et seq.) and applicable regulations, is documented by means of assessment and evaluation as

## State Policy Approaches for Addressing and Treating Individuals with an FASDMay 11, 2006 10:00 AM-11:30 AMSan Francisco, CA

**California Developmental Disabilities Eligibility Criteria**
**                ****(The Lanterman Act, as of 2001)                Cont’d**
- 	required in Sections 95016 and 95018 and who meet one of the following criteria:
- 	(1) Infants and toddlers with a developmental delay in one or more of the following five areas: cognitive development; physical and motor development, including vision and hearing; communication development; social or emotional development; or adaptive development. Developmentally delayed infants and toddlers are those who are determined to have a significant difference between the expected level of development for their age and their current level of functioning. This determination shall be made by qualified personnel who are recognized by, or part of, a multidisciplinary team, including the parents.
- 	(2) Infants and toddlers with established risk conditions, who are infants and toddlers with conditions of known etiology or conditions with established harmful developmental consequences. The conditions shall be diagnosed by a qualified personnel recognized by, or part of, a multidisciplinary team, including the parents. The condition shall be certified as having a high probability of leading to developmental delay if the delay is not evident at the time of diagnosis.
- 	(3) Infants and toddlers who are at high risk of having substantial developmental disability due to a combination of biomedical risk factors, the presence of which is diagnosed by qualified clinicians recognized by, or part of, a multidisciplinary team, including the parents.

## State Policy Approaches for Addressing and Treating Individuals with an FASDMay 11, 2006 10:00 AM-11:30 AMSan Francisco, CA

**California Department of Developmental Services**
**Services Available From Regional Centers**
- 	Regional centers help coordinate the services and supports that are needed because of a developmental disability. This is called case management or service coordination. A case manager or service coordinator will be assigned to help develop a plan for services, tell you where services are available, and help you get the services. The following are some of the services and supports provided by the regional centers:
- Information and referral
- Assessment and diagnosis
- Counseling
- Lifelong individualized planning and service coordination
- Purchase of necessary services included in the individual program plan
- Resource development
- Outreach
- Assistance in finding and using community and other resources
- Advocacy for the protection of legal, civil and service rights
- Early intervention services for at risk infants and their families
- Genetic counseling
- Family support
- Planning, placement, and monitoring for 24-hour out-of-home care
- Training and educational opportunities for individuals and families
- Community education about developmental disabilities

## State Policy Approaches for Addressing and Treating Individuals with an FASDMay 11, 2006 10:00 AM-11:30 AMSan Francisco, CA

**California Comparison of Average by Age Group for Persons with Autism and Persons without Autism**
- 	A comparison by age group of the rates of growth of the per capita POS dollars between FY 2002/03 and FY 2003/04 shows the largest increase (4.7%) in the “3 through 21” age group for persons with autism and the largest increase (4.0%) in the “42 through 62” age group for persons without autism.  The average per capita dollars spent on individuals without autism in the “3 through 21” age group actually decreased (-0.7%) between FY 2002/03 and FY 2003/04.  For persons with autism, the average per capita dollars spent for persons in the age group “62 & Up” decreased (-3.2%) between FY 2002/03 and FY 2003/04.
- Note: Only persons with status codes 1 or 2 on the CMF in June 2004 were included in the tables and graph above.  Also, individuals under age three were excluded because children under age three seldom have a CDER, the data source used to identify persons with autism.

| Age Group | Total Persons - Autism | Autism - Dollars | Autism - Persons w. POS | Avg $s per Person |
| --- | --- | --- | --- | --- |
| 3 through 21 | 20,750 | $137,303,715  | 16,415 | $8,365  |
| 22 through 41 | 2,971 | $77,928,763  | 2,630 | $29,631  |
| 42 through 61 | 849 | $26,787,895  | 767 | $34,926  |
| 62 & Up | 32 | $1,104,765  | 31 | $35,638  |
| Autism - All Ages | 24,602 | $243,125,138  | 19,843 | $12,252  |

| Age Group | Total Persons - No Autism | No Autism - Dollars | No Autism - Persons w. POS | Avg $s per Person |
| --- | --- | --- | --- | --- |
| 3 through 21 | 69,419 | $275,076,469  | 47,436 | $5,799  |
| 22 through 41 | 46,608 | $644,276,130  | 38,373 | $16,790  |
| 42 through 61 | 27,530 | $449,552,670  | 24,161 | $18,607  |
| 62 & Up | 4,301 | $72,836,143  | 3,679 | $19,798  |
| No Autism - All Ages | 147,858 | $1,441,741,413  | 113,649 | $12,686  |