BILL ANALYSIS Ó
SENATE HUMAN
SERVICES COMMITTEE
Senator Leland Y. Yee, Chair
BILL NO: AB 1232
A
AUTHOR: V. Manuel Perez
B
VERSION: February 22, 2013
HEARING DATE: June 11, 2013
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FISCAL: Yes
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CONSULTANT: Mareva Brown
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SUBJECT
Developmental services: quality assessment system
SUMMARY
This bill would require that any quality assurance
instrument used by the Department of Developmental Services
(DDS) to assess the provision of services within the system
to also assess whether services are being provided in a
linguistically and culturally competent manner. It requires
that an outcome-based measure on issues of equity and
diversity be included. This bill also would require the
department's quality assurance contractor to be experienced
in issues relating to linguistic and cultural competency.
ABSTRACT
Existing law :
1) Establishes the Lanterman Developmental
Disabilities Services Act, which states
that California is responsible for providing an array
of services and supports sufficiently complete to meet
the needs and choices of each person with
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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. (WIC 4500, et al)
2) Establishes a system of nonprofit Regional Centers
to provide fixed points of contact in the community
for all persons with developmental disabilities and
their families, to coordinate services and supports
best suited to them throughout their lifetime. (WIC
4620)
3) Requires that DDS implement an improved, unified
quality assessment system and identify, with
stakeholders, a valid and reliable quality assurance
instrument to assess consumer and family satisfaction,
provision of services and personal outcomes, as
specified. (WIC 4571)
4) Requires DDS to contract with an independent agency
or organization to implement by January 1, 2010, the
quality assurance instrument and defines
qualifications that the contractor must have, as
specified. (WIC 4751 (d))
5) Requires DDS, in consultation with the contractor,
to establish the methodology by which the quality
assurance instrument is administered, as specified,
and to provide aggregate information for all regional
centers and the state as a whole. (WIC 4751 (e))
6) Requires that this survey be conducted in the
primary language of the consumer or family member
surveyed, upon request of the consumer or family
member. (WIC 4751 (e))
This bill:
1) Makes various findings and declarations about the
individual program plan (IPP) and individual family
service plan (IFSP), including:
a. That the Lanterman Act requires active
participation of the consumer and family member
to create and implement the plans;
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b. That the planning and services must be
provided in a linguistically and culturally
competent manner;
c. That existing law requires DDS to
establish a quality assessment system to provide
evaluation and oversight for regional center
services;
d. That DDS has an established contractual
relationship with the National Core Indicators to
meet those statutory requirements, with an annual
expenditure of more than $3.2 million in the
budget year;
e. That the current quality assessment
system does not require evaluation or oversight
on issues of equity and diversity to ensure that
regional center services are provide in
linguistically and culturally competent manner.
2) Requires that the existing process for DDS and
stakeholders to identify a valid and reliable quality
assurance assessment instrument also include an
assessment about whether services are provided in a
linguistically and culturally competent manner.
3) Requires that the assessment instrument include
outcome-based measures on issues of equity and
diversity to evaluate the linguistic and cultural
competency of regional center services that are
provided to consumers across their lifetime.
4) Requires that the contracted agency or organization
that is to implement the quality assurance instrument
be experienced in issues related to linguistic and
cultural competency, in addition to other statutory
requirements.
FISCAL IMPACT
An Assembly Appropriations committee analysis concluded
costs associated with this bill should be minor and
absorbable within existing DDS resources.
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BACKGROUND AND DISCUSSION
Purpose of the bill
The author states that AB 1232 will add cultural competency
outcome measures to existing oversight requirements of
regional center services to ensure that all Californians
have the appropriate access to state-funded services. The
author notes that the prevalence of autism spectrum
disorder (ASD) has increased dramatically since the 1980s.
Recent studies have underscored that early intervention
therapy may "rewire the brain" for some children with ASD,
thereby resulting in significant improvements.
This bill, and others introduced in this session, result
from a 2013 report by the Senate Select Committee on Autism
and Related Disorders, which found that many families, due
to issues of equity and diversity, lack access to vital
services, including those for ASD.
Senate Hearing
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 ASD. The hearing was prompted
by a series of articles in the Los Angeles Times published
in late 2011, which explored the differences that families
of children with autism had in accessing services. The
articles looked at variations in services among families
with different ethnic backgrounds, geography and other
factors, including differences in practices at various
regional centers.
"Though all regional centers are supposed to follow
the same criteria, average spending per child varies
widely from place to place and race to race,"
according to data obtained by The Times under the
California Public Records Act.
The articles noted that in 2010, the system served 16,367
autistic children between the critical ages of 3 and 6,
spending an average of $9,751 per case statewide. But
spending ranged from an average of $1,991 per child at the
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regional center in South Los Angeles to $18,356 at the one
in Orange County.
An outcome of the select committee's hearing was a
Taskforce on Equity and Diversity for Regional Center
Autism Services, which was charged with finding
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. A 119-page report, "A Preliminary
Report by the Taskforce on Equity and Diversity for
Regional Center Autism Services," was published on March
18, 2013, and identified 19 recommended changes to practice
within the Developmental Services system, including
incorporating cultural and linguistic competency
measurements into existing quality assessment instruments.
National Core Indicators
The National Core Indicators (NCI) is a collaboration
between the National Association of State Directors of
Developmental Disability Services and the Human Services
Research Institute. Its goal is to implement a systematic
approach to performance and outcome measurement nationwide.
Through the collaboration, participating states pool their
resources and knowledge to create performance monitoring
systems, identify common performance indicators, work out
comparable data collection strategies, and share results.
Many of the state agencies use NCI as a component within
their quality management systems.
California is among the states that contract with the NCI
(in 2012-2013 the contract was $3.2 million). DDS
established the contract in 2009 after consolidating two
other data collection efforts in order to maintain its
statutorily required data collection on consumer
satisfaction, provision of services and personal outcomes.
The NCI's current set of performance indicators includes
approximately 100 consumer, family, systemic, cost, and
health and safety outcomes which are designed to evaluate
the overall health of public developmental disabilities
agencies, according to the organizations' website.
Associated with each indicator is a source from which the
data is collected. Sources of information include consumer
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survey (e.g., empowerment and choice issues) family surveys
(e.g., satisfaction with supports), provider survey (e.g.,
staff turnover), and state systems data (e.g.,
expenditures, mortality, etc.).
Related Legislation
This bill is part of a package of legislation drafted from
recommendations in the Taskforce's report. Other bills in
this 2013 package, which were passed by the Senate Human
Services Committee, include:
SB 158 (Correa) would authorize the establishment of the
Regional Center Excellence in Community Autism Partnerships
(RE CAP) program, at a major university to advise regional
centers on a voluntary basis in improving cultural and
linguistic competency for the consumers they serve.
SB 208 (Lara) would require a request for proposals that is
prepared by a regional center for consumer services and
supports to include a section on issues of equity and
diversity, as specified.
SB 319 (Price) would require DDS to ensure that the
regional centers collect, analyze, and detail data using a
uniform methodology to allow for comparisons across
regional centers. This bill was held in the Senate
Appropriations Committee.
SB 321 (Price) would require DDS to establish performance
contract guidelines and measures for regional centers
relating to issues of cultural and linguistic competency.
This bill was held in the Senate Appropriations Committee.
SB 367 (Block) would require each regional center to post
on its Internet Web site information regarding the training
and support provided to members of the regional center's
governing board. The bill would require the performance
review of the director to include an evaluation of the
director's performance in providing regional center
services that are linguistically and culturally
appropriate.
SB 555 (Correa) would require a regional center to make
every reasonable effort to communicate in the native
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language of a consumer or his or her family during the IPP
and IFSP planning processes and to provide a copy of the
IPP and IFSP in the consumer's or family's native language.
Comments
Staff recommends deleting intent language that restates
existing law, as follows:
The Legislature finds and declares the following:
(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) While e xisting law requires the State Department of
Developmental Services to establish a quality assessment
system to provide evaluation and oversight for regional
center services , 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.
(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.
(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.
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PRIOR VOTES
Assembly Floor 73 - 0
Assembly Appropriations 16 - 0
Assembly Human Services 7 - 0
POSITIONS
Support: ACT (Autism Care and Treatment) Today!
(sponsor)
Fiesta Educativa, Inc. (sponsor)
Autism Society of Los Angeles
Center for Autism and Related Disorders
(CARD)
Disability Rights California
Special Needs Network
State Council on Developmental Disabilities
Oppose: None received
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