BILL ANALYSIS Ó
AB 1232
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Date of Hearing: April 16, 2013
ASSEMBLY COMMITTEE ON HUMAN SERVICES
Mark Stone, Chair
AB 1232 (V. Manuel Pérez) - As Introduced: February 22, 2013
SUBJECT : Developmental services: quality assessment system
SUMMARY : Includes linguistic and cultural competency among the
outcomes measured with the State Department of Developmental
Services (DDS) quality assurance instrument.
Specifically, this bill :
1)Makes the following legislative findings:
a) The Lanterman Developmental Disabilities Services Act
requires that regional centers provide services to
consumers in a manner that is determined by the individual
program plan (IPP) or the individual family service plan
(IFSP);
b) The Act requires the active participation of the
consumer, and his or her family, in the planning and
implementation of the IPP and the IFSP;
c) The IPP and the IFSP and all regional center services
must be provided in a linguistically and culturally
competent manner for the consumer;
d) Existing law requires DDS to establish a quality
assessment system to provide evaluation and oversight for
regional center services;
e) The department has established a contractual
relationship with the National Core Indicators to meet
these statutory requirements with an annual expenditure of
$3,235,000 for the 2012-13 fiscal year; and
f) The current quality assessment system does not require
evaluation or oversight on issues of equity and diversity
to ensure that regional center services are provided in a
linguistically and culturally competent manner.
1)Changes the scope of the existing quality assurance instrument
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identified by DDS, which includes an assessment of the
provision of services, to include an assessment of whether
services are provided in a linguistically and culturally
competent manner.
2)Requires that the quality assurance instrument include
outcome-based measures on issues of equity and diversity to
evaluate the linguistic and cultural competency of regional
center services provided to consumers across their lifetime.
3)Requires the independent agency or organization that DDS
contracts with to implement the quality assurance assessment
to have experience with issues related to linguistic and
cultural competency.
EXISTING LAW
1)Establishes the Lanterman Developmental Disabilities Services
Act (Lanterman Act), under which the Department of
Developmental Services (DDS) is authorized to contract with
private non-profit regional centers to provide case management
services and arrange for, or purchase, services that meet the
individual needs and choices of each person with developmental
disabilities, regardless of age or degree of disability, and
at each stage of life and to support their integration into
the mainstream life of the community.
2)Grants all individuals with developmental disabilities, among
all other rights and responsibilities established for any
individual by the United States Constitution and laws and the
California Constitution and laws, the right to services and
supports in the least restrictive environment.
3)Requires the development of an Individual Program Plan (IPP)
for each regional center consumer, which specifies services to
be provided to the consumer, based on his or her
individualized needs determination and preferences, and
defines that planning process as the vehicle to ensure that
services and supports are customized to meet the needs of
consumers who are served by regional centers.
4)Requires that the planning processes to create an IPP include:
a) A statement of the individual's goals and objectives, a
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schedule of the type and nature of services to be provided
and other information and considerations, as specified;
b) Review and modification, as necessary, by the regional
center's planning team no less frequently than every three
years; and
c) Statewide training and review of the IPP plan creation,
as specified.
1)Establishes that an infant or toddler under age 3 who is
eligible for regional center services shall have an
individualized family service plan (IFSP) to direct services,
as specified, and defines the types of services, supports and
staffing that should be considered when creating the plan.
2)Requires all regional centers to notify consumers and families
of the availability of services in English and such other
languages as may be appropriate to the service area, provide
outreach services in areas with a high incidence of
developmental disabilities, and identify persons who may need
services.
3)Requires that every state agency which serves a substantial
number of non-English-speaking people and which provides
materials in English explaining services shall also provide
the same type of materials in any non-English language spoken
by a substantial number of the public served by the agency, as
specified.
4) Defines a "substantial number of non-English-speaking people"
as members of a group who either do not speak English, or who
are unable to effectively communicate in English because it is
not their native language, and who comprise 5 percent or more
of the people served by any local office or facility of a
state agency.
5)Declares that evaluation of the services consumers receive is
a key aspect to the service system.
6)Requires DDS in consultation with stakeholders, to identify a
valid and reliable quality assurance instrument that measures
consumer and family satisfaction, provision of services and
personal outcomes, as specified.
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7)Allows the quality assurance instrument to be expanded to
collect additional data requested by the State Council on
Developmental Disabilities, to the extent funding is
available.
8)Requires DDS, as of January 1, 2010, to contract with an
independent agency or organization to implement an improved,
unified quality assessment system and establishes criteria for
the contract agency or organization's required experience.
9)Requires DDS to do the following with respect to the quality
assurance instrument:
a) Establish the methodology used to administer the quality
assurance instrument;
b) Contract with the State Council on Developmental
Disabilities to collect data for the quality assurance
instrument; and
c) In consultation with stakeholders, undergo an annual
review of the quality assurance instrument data and
findings and accept recommendations regarding additional or
different criteria for the instrument to improve assessment
and services.
1)Requires reports related to the data and findings of the
quality assurance instrument to be publicly available and
subjects implementation of the instrument and process to an
annual budget appropriation.
FISCAL EFFECT : Unknown.
Background
The Lanterman Developmental Disabilities Services Act (Welfare &
Institutions Code § 4500 et seq.) guides the provision of
services and supports for Californians with developmental
disabilities. Each individual under the Act, typically referred
to as a "consumer," is legally entitled to treatment and
habilitation services and supports in the least restrictive
environment. Lanterman Act services are designed to enable all
consumers to live more independent and productive lives in the
community.
Direct responsibility for implementation of the Lanterman Act
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service system is shared by the Department of Developmental
Services (DDS) and 21 regional centers, which are private
nonprofit entities, established pursuant to the Lanterman Act,
that contract with DDS to carry out many of the state's
responsibilities under the Act. The principal roles of regional
centers include intake and assessment, individualized program
plan development, case management, and securing services through
generic agencies or purchasing services provided by vendors.
Regional centers also share primary responsibility with local
education agencies for provision of early intervention services
under the California Early Intervention Services Act (e.g.,
Early Start Program). The regional center caseload includes
over 250,000 consumers who receive services such as residential
placements, supported living services, respite care,
transportation, day treatment programs, work support programs,
and various social and therapeutic programs. Approximately
1,600 consumers reside at one of California's four Developmental
Centers-and one state-operated, specialized community
facility-that provide 24-hour habilitation and medical and
social treatment services. According to March DDS data that
shows the ethnic breakdown of consumers served by regional
centers, 34.87% are identified as Hispanic and 37.40% as White,
whereas 10% are identified as Black/African-American and 6.36%
are identified as Asian.
Services provided to people with developmental disabilities are
determined through an individual planning process. Under this
process, planning teams-which include, among others, the
consumer, his or her legally authorized representative, and one
or more regional center representatives-jointly prepare an
Individual Program Plan (IPP) based on the consumer's needs and
choices. The Lanterman Act requires that the IPP promote
community integration and maximize opportunities for each
consumer to develop relationships, be part of community life,
increase control over his or her life, and acquire increasingly
positive roles in the community. The IPP must give the highest
preference to those services and supports that allow minors to
live with their families and adults to live as independently as
possible in the community.
Quality Assessment Services project
ABX4 9 (Evans) Chapter 9, Statutes of 2009, was a Budget Act DDS
trailer bill and the vehicle that was used to consolidate two
data collection efforts. The Evaluation of People with
Developmental Disabilities Moving from Developmental Centers
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into the Community, and the Life Quality Assessments were
consolidated into the Quality Assessment Services project, for
which DDS uses a nationally validated instrument that allows for
the collection of statewide and regional center data needed to
assess consumer satisfaction and success. DDS established
membership with the National Core Indicators (NCI) program, of
which 33 other states' developmental services systems are
members. Using the NCI survey instruments, DDS collects data on
consumer satisfaction, provision of services, and personal
outcomes, which provide the Department with the information it
needs to evaluate the quality of the DDS service delivery
system. The State Council on Developmental Disabilities (SCDD)
uses the NCI instrument to collect the data for this project,
similar to SCDD's involvement in collecting data for the Life
Quality Assessments that were conducted prior to development of
the new quality assessment system. The data that the SCDD
gathers, including information about consumers' employment
status, perceptions of their own safety, and interactions with
their regional centers, for example, give the state the
opportunity learn a great deal about the quality of services and
the impacts they have on consumers' quality of life within the
DDS system.
COMMENTS :
The Senate Select Committee on Autism and Related Disorders held
an informational hearing on April 30, 2012, to discuss questions
surrounding equal access to regional center services for
consumers with autism spectrum disorders (ASD). An outcome
hearing was creation of a 20-member Taskforce on Equity and
Diversity for Regional Center Autism Services, which was charged
with developing recommendations to ensure that consumers of
regional center services receive appropriate and timely supports
regardless of race, ethnicity, educational background and other
socio-economic factors. The report, "A Preliminary Report by
the Taskforce on Equity and Diversity for Regional Center Autism
Services," was published on March 18, 2013, and identified a
number of recommendations for changes to current practice within
the Developmental Services system based on the work of five
subcommittees. Among them were recommendations to include
issues of equity and diversity within the quality assurance
instrument, in addition to using the instrument to measure
consumers across their lifetime, not just as adults. (P.53)
Both of these recommendations are reflected in this legislation.
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According to the author, this bill "simply stipulates that
future contracts by DDS for the quality assessment of regional
center services, already mandated by current law, must also
include outcome measures related to cultural and linguistic
competency." Current statute regarding the quality assessments
system allows the State Council on Developmental Disabilities to
expand the quality assessment instrument to collect additional
data. While the author's attempt to require cultural and
linguistic competency to be measured with respect to regional
center service delivery is not an effort put forth by the SCDD
under their statutory authority, SCDD supports the bill's goals.
RELATED LEGISLATION
SB 208 (Lara) requires that a request for proposal prepared by
DDS or a regional center that relates to consumer services and
supports include a section on equity and diversity.
SB 319 (Price) Requires DDS to ensure that the regional centers
collect, analyze, and report data in a way that allows for
comparisons across regional centers, and requires regional
centers to identify plans to reduce disparities that are
identified.
SB 321 (Price) would require DDS to establish performance
contract guidelines and measures relating to issues of cultural
and linguistic competency.
SB 367 (Block) would require Regional Centers to develop a
Regional Center Study and Planning Process for Equity and
Cultural and Linguistic Competency (RESPECT) to oversee issues
related to regional center staff and vendor cultural and
linguistic competency.
PRIOR LEGISLATION
ABX4 9 (Evans) Chapter 9, Statutes of 2009 added Section 4571 to
the Welfare and Institutions Code, which directed the Department
of Development Services (DDS) to "implement an improved,
unified, quality assessment system."
REGISTERED SUPPORT / OPPOSITION :
Support
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Fiesta Educativa, Inc.
Opposition
None on file
Analysis Prepared by : Myesha Jackson / HUM. S. / (916)
319-2089