BILL ANALYSIS                                                                                                                                                                                                    Ó



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          ASSEMBLY THIRD READING
          AB 1232 (V. Manuel Pérez)
          As Introduced  February 22, 2013
          Majority vote 

           HUMAN SERVICES      7-0         APPROPRIATIONS      16-0        
           
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          |Ayes:|Stone, Maienschein,       |Ayes:|Gatto, Harkey, Bigelow,   |
          |     |Ammiano,                  |     |Bocanegra, Bradford, Ian  |
          |     |Ian Calderon, Garcia,     |     |Calderon, Campos, Eggman, |
          |     |Grove, Hall               |     |Gomez, Hall, Holden,      |
          |     |                          |     |Linder, Pan, Quirk,       |
          |     |                          |     |Wagner, Weber             |
          |-----+--------------------------+-----+--------------------------|
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           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 legislative findings related to the provision of  
            services to regional center consumers.

          2)Changes the scope of the existing quality assurance instrument  
            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.

          3)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.

          4)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  








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            Act (Lanterman Act), under which 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)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.
           
           3)Requires all regional centers to notify consumers and families  
            of the availability of services in English and 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. 

          4)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. 

          5) 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% or more of the  
            people served by any local office or facility of a state  
            agency.

          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.

          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  








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            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  :  According to the Assembly Appropriations  
          Committee, costs associated with this legislation should be  
          minor and absorbable within existing DDS resources.

           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 of the hearing was a 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,  








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          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.  Both of these recommendations are reflected in this  
          legislation. 

          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  
          (SCDD) 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.

           Background  :  The Lanterman Developmental Disabilities Services  
          Act (Welfare & Institutions Code Section 4500 et seq.) guides  
          the provision of services and supports for Californians with  
          developmental disabilities.  Each individual under the Lanterman  
          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  
          service system is shared by the 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).   








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          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 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  :  AB 9 (Evans), Chapter 9,  
          Chapter 9, Statutes of 2009-10 Fourth Extraordinary Session, 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 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.  SCDD uses the NCI instrument to collect the data for  








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          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.  
           
           
          Analysis Prepared by  :    Myesha Jackson / HUM. S. / (916)  
          319-2089 


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