BILL ANALYSIS                                                                                                                                                                                                    Ó


          |SENATE RULES COMMITTEE            |                       AB 1232|
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                                    THIRD READING

          Bill No:  AB 1232
          Author:   V. Manuel Pérez (D)
          Amended:  8/22/13 in Senate
          Vote:     21

           SENATE HUMAN SERVICES COMMITTEE  :  6-0, 6/11/13
          AYES:  Yee, Berryhill, Emmerson, Evans, Liu, Wright
          SENATE APPROPRIATIONS COMMITTEE  :  Senate Rule 28.8

           ASSEMBLY FLOOR  :  73-0, 5/09/13 - See last page for vote

           SUBJECT  :    Developmental services:  quality assessment system

           SOURCE  :     ACT (Autism Care and Treatment) Today!
                      Fiesta Educativa, Inc.

           DIGEST  :    This bill requires 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.  This bill  
          requires outcome-based measures to evaluate the linguistic and  
          cultural competency of regional center services and for DDS's  
          quality assurance contractor to be experienced in issues related  
          to linguistic and cultural competency.

           Senate Floor Amendments  of 8/22/13 remove language requiring  
          measurement of outcomes of "equity and diversity" within a  
          section that requires regional centers to measure services are  


                                                                    AB 1232

          provided "in a culturally and linguistically competent manner."

           ANALYSIS  :    

          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 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.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  

          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.

          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.

          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.

          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.

          This bill:



                                                                    AB 1232

          1.Finds and declares that, although existing law requires DDS to  
            establish a quality assessment system to provide evaluation  
            and oversight for regional center services, the existing  
            quality assessment system does not require evaluation or  
            oversight to ensure that regional center services are provided  
            in a linguistically and culturally competent manner.

          2.Requires DDS and stakeholders to identify a valid and reliable  
            quality assurance assessment instrument that assesses consumer  
            and family satisfaction provision of services in a  
            linguistically and culturally competent manner, and personal  

          3.Requires that the assessment instrument include outcome-based  
            measures 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.

          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.



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          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' Internet Web site.  Associated with each  
          indicator is a source from which the data is collected.  Sources  
          of information include consumer 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.).

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes    
          Local:  No
          SUPPORT  :   (Verified  8/23/13)

          ACT (Autism Care and Treatment) Today! (co-source)
          Fiesta Educativa, Inc. (co-source)
          Autism Research Group
          Autism Society of Los Angeles
          Center for Autism and Related Disorders
          Disability Rights California
          Special Needs Network
          State Council on Developmental Disabilities

          ARGUMENTS IN SUPPORT  :    The author states:

               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.

           ASSEMBLY FLOOR  :  73-0, 5/9/13
          AYES:  Achadjian, Alejo, Allen, Ammiano, Atkins, Bigelow, Bloom,  



                                                                    AB 1232

            Blumenfield, Bocanegra, Bonilla, Bonta, Bradford, Brown,  
            Buchanan, Ian Calderon, Campos, Chau, Chávez, Chesbro, Cooley,  
            Dahle, Daly, Dickinson, Eggman, Fong, Fox, Frazier, Beth  
            Gaines, Garcia, Gatto, Gomez, Gordon, Gorell, Gray, Grove,  
            Hagman, Hall, Harkey, Roger Hernández, Jones, Jones-Sawyer,  
            Levine, Linder, Lowenthal, Maienschein, Medina, Melendez,  
            Mitchell, Morrell, Mullin, Muratsuchi, Nazarian, Nestande,  
            Olsen, Pan, Patterson, Perea, V. Manuel Pérez, Quirk,  
            Quirk-Silva, Rendon, Salas, Skinner, Stone, Ting, Torres,  
            Wagner, Weber, Wieckowski, Wilk, Williams, Yamada, John A.  
          NO VOTE RECORDED:  Conway, Donnelly, Holden, Logue, Mansoor,  
            Waldron, Vacancy

          JL:ej  8/29/13   Senate Floor Analyses 

                           SUPPORT/OPPOSITION:  SEE ABOVE