BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 302 
                                                                  Page  1

          Date of Hearing:   April 1, 2009

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                Kevin De Leon, Chair

                 AB 302 (Beall) - As Introduced:   February 17, 2009

          Policy Committee:                              Human Services  
          Vote:        5-2

          Urgency:     No                   State Mandated Local Program:  
          No     Reimbursable:              No

           SUMMARY  

          This bill requires the Department of Developmental Services  
          (DDS) to conduct annual analysis to be published in the  
          aggregate and for each of the 21 Regional Centers (RC) to  
          determine: 

          1)The proportion of RC-eligible individuals by ethnicity, age,  
            and primary language who have no purchase of services (POS)  
            expenditures. 

          2)The average annual per capita POS expenditures for consumers  
            by residence type, service category, ethnicity, age, and  
            primary language.  

           FISCAL EFFECT  

          1)One-time cost of $200,000 GF and on-going costs of $100,000 GF  
            to conduct statewide and RC-specific analysis and post it  
            online. This bill requires the analysis of eligible but  
            unserved consumers. It is not clear that this population is  
            easily identified, therefore actual costs may be higher. 

          2)This bill is designed to highlight inequities in POS spending  
            and reduce differences between ethnic and racial groups. If  
            this research is effective, cost pressures are created to  
            increase entitlement services under the Lanterman Act. The  
            2009-10 POS budget is $2.8 billion. A one-percent increase in  
            this budget is $280 million (66% GF). 

           COMMENTS  









                                                                  AB 302 
                                                                  Page  2

           1)Rationale  . This bill requires DDS to publish annual reports  
            regarding POS expenditures and services by a number of  
            demographic variables, including primary language and  
            ethnicity. The author indicates several reports over the past  
            15 year have shown significant differences in expenditures for  
            consumers of different racial groups. For example, a recently  
            published report by researchers at the University of  
            California, San Francisco concluded that African-American,  
            Asian, and Latino consumers had annual POS expenditures 10%  
            and 25% lower than their Caucasian counterparts. Research  
            indicates such differences may reflect service access, demand,  
            and discrimination. 

           2)Many Codes within Purchase of Services  . POS for consumers by  
            RCs fall into 10 major service categories and total $2.5  
            billion (all funds) in 2008-09. The 10 categories are 1)  
            community care facilities, 2) medical facilities, 3) day  
            programs, 4) habilitation services, 5) transportation, 6)  
            support services, 7) in-home respite, 8) out-of-home respite,  
            9) health care, and 10) miscellaneous services. Within the 10  
            major service categories, about 190 different and more  
            specific service expenditure codes are authorized by DDS and  
            used by the RCs to classify purchase of service expenditures  
            for entry into the central POS database. 

           3)Is More Study Needed  ? Numerous studies on the actual or  
            suspected inequities in POS expenditures have been conducted  
            since the early 1990s through the present day. Although  
            findings have varied, many of the studies have confirmed  
            questions of access and equity for a number of subpopulations.  
            It is unclear how this bill will further answer the subsequent  
            questions about solutions, including increased funding, to  
            reduce disparities and improve quality for RC consumers. 

           4)Related Legislation  . AB 1535 (Bass) in 2005 addressed similar  
            research and equity issues as this bill. AB 1535 was amended  
            to address a different subject. 


           Analysis Prepared by  :    Mary Ader / APPR. / (916) 319-2081