BILL ANALYSIS Ó
SENATE HUMAN
SERVICES COMMITTEE
Senator Leland Y. Yee, Chair
BILL NO: SB 208
S
AUTHOR: Lara
B
VERSION: March 14, 2013
HEARING DATE: April 9, 2013
2
FISCAL: Yes
0
8
CONSULTANT: Mareva Brown
SUBJECT
Developmental services: request for proposals
SUMMARY
This bill requires that a request for proposal that is
prepared by the Department of Developmental Services (DDS)
or a regional center that relates to consumer programs, or
services and supports, must include a section on issues of
equity and diversity, as specified. Establishes the Equity
and Diversity in Developmental Services Act.
ABSTRACT
Existing law
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
Continued---
STAFF ANALYSIS OF SENATE BILL 208 (Lara)
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the community. (WIC 4500, et al)
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)
Establishes an Individual Program Plan 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. (WIC
4512)
Creates a process by which service providers may
"vendorize" service providers, thereby providing a
path to contract for services with that provider. (WIC
4648 (a) (3))
Requires DDS, in cooperation with the regional
centers, to ensure that all providers of services and
supports are informed about their responsibility to
comply with conditions of any contract between the
department or regional center and the provider. (WIC
4648.1 (c))
This bill
1) Makes various legislative findings and declarations
about the numbers of children diagnosed with autism,
the role of DDS and the regional centers in providing
services to individuals with developmental
disabilities and California's diverse population.
2) Makes legislative findings that services provided
to regional center consumers should be provided in a
linguistically and culturally competent manner that
promotes equity and diversity for all Californians.
3) Enacts the Equity and Diversity in Developmental
Services Act.
4) Requires, under the act, that a request for
proposals (RFP) that is prepared by DDS or a regional
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center and that relates to consumer programs or
services and supports shall include a section on
issues of equity and diversity.
5) Requires, under the act, that the section on equity
and diversity include a request for information that
includes at a minimum:
a. A statement outlining the applicant's
plan to serve diverse populations.
b. Examples of the applicant's commitment to
addressing the needs of diverse populations.
c. Any additional information that the
applicant deems relevant to issues of equity and
diversity, including hiring bilingual staff,
location of the program site, outreach strategies
for underserved communities, and training and
other materials in various languages and that are
provided in a manner that is linguistically and
culturally competent.
6) Exempts from this requirement all contracts entered
into on or before January 1, 2014.
FISCAL IMPACT
This bill has not been analyzed by a fiscal committee.
BACKGROUND AND DISCUSSION
Purpose of the bill
This bill is part of a package that arose from a hearing in
2012 by the Senate Select Committee on Autism & Related
Disorders that focused on disparities in services in
underserved communities.
The author states that despite significant cultural and
linguistic diversity among the populations served by DDS
and the regional centers, the request for proposal process
does not currently assess the capacity of providers to
STAFF ANALYSIS OF SENATE BILL 208 (Lara)
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provide services and supports in a culturally and
linguistically competent manner. According to the author,
SB 208 will ensure consumers receive developmental services
and supports that are culturally and linguistically
appropriate.
Specifically, this bill adds a section to all new RFPs
prepared by DDS and all regional centers that are
associated with consumer programs, supports, or other
services which includes:
A statement outlining the applicant's plan to serve
diverse populations.
Examples of the applicant's commitment to
addressing the needs of diverse populations, and
Any additional information that the applicant deems
relevant to issues of equity and diversity.
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 autism spectrum disorders
(ASD). The hearing was prompted by a series of articles in
2011 in the Los Angeles Times, which explored the
differences that families of children with autism had in
accessing services. "Warrior Parents Fare Best in Securing
Autism Services" states that people of color, low income,
and socio-economically disadvantaged communities receive
fewer services compared to their white counterparts, and
found that DDS spent an average of $11,723 per child on
whites; $11,063 on Asians; $7,634 on Latinos, and $6,593 on
blacks.
A key point of the article was that parents who fought
more for their children gained more services. Often, these
parents are wealthier, more sophisticated in navigating
bureaucratic systems, fluent in English, and able to devote
significant time to providing for their children. In
contrast, the author states, parents who work multiple
jobs, single parents, immigrants, those who can't speak
English, and those who have multiple children don't have
the time and/or ability to fight for the services that
their children are legally entitled to receive.
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Non-English speaking families also are less likely to seek
regional center services and tend to be more comfortable
going to health clinics or providers who are culturally and
linguistically sensitive to their own race/ethnicity.
Often times, families of individuals who are eligible for
regional center services are engaged with community-based
organizations, which provide services and support to
communities with cultural and linguistic barriers as well
as socio-economic barriers.
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 also noted that in 2010, the system
served 16,367 autistic children between the 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
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. Among those
recommendations were:
That DDS should establish performance
contract outcome measures to provide oversight on
issues of equity and diversity
That cultural competency best practices
and community outreach should utilize specific
examples of effective regional center programs
One example of a best practice that was highlighted in the
report was Regional Center of the East Bay's practice of
requiring a section in each new RFP that addresses issues
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of providing equity and diversity to consumers who are from
potentially underserved communities. (p. 68)
Regional Centers
Regional Centers are part of a system of care overseen by
the Department of Developmental Services (DDS). With a
proposed budget of $4.3 billion for community-based
services in 2013-2014, DDS is responsible for coordinating
care and providing services for more than 250,000 people
with developmental disabilities who receive services and
supports to live in their communities, as well as
approximately 1,560 people who resided in developmental
centers as of March 6, 2013. California's 21 regional
centers are non-profit organizations that provide local
services and supports to individuals through contracts with
DDS. Services for consumers are determined through an
individual program plan, and those services are provided
through contracts with the regional centers.
Access to Health Care Services
The U.S. Department of Health and Human Services Office of
Minority Health has issued 14 standards for health
organizations to ensure Culturally and Linguistically
Appropriate Services (CLAS). In 2001, the Office of
Minority Health released a report<1> which identified
adoption of CLAS standards as a way to correct inequities
that currently exist in the provision of health services,
and to make these services more responsive to the
individual needs of all patients/consumers.
Standards are intended to be inclusive of all cultures and
not limited to any particular population group or sets of
groups. However, they are especially designed to address
the needs of racial, ethnic, and linguistic population
groups that experience unequal access to health services.
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<1>
http://minorityhealth.hhs.gov/assets/pdf/checked/executive.p
df
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<2>
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 include:
SB 158 (Correa) would establish a pilot project coordinated
by a major university to identify underserved communities
in regional center catchment areas and improve Autism
identification and services in those communities.
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.
SB 555 (Correa) would require that communication about
assessment, individual program plans and other critical
documents and processes be done in a consumer or family
member's native language and other culturally and
linguistically competent manners.
AB 1232 (V. Manuel Perez) would require the existing DDS
quality assurance instrument to assess the provision of
services in a linguistically and culturally competent
manner and include an outcome-based measure on issues of
equity and diversity.
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<2> US Department of Health and Human Services, Office of
Minority Health, "National Standards for Culturally and
Linguistically Appropriate Services in Health Care," March
2001, page ix.
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Comments
Although the focus of the news articles and the legislative
hearing involved inequities in care among families whose
children have ASD, the language of this bill does not
directly address autism services. Including cultural and
linguistic competency standards in all department- or
regional center-issued RFPs would affect consumers who have
many different developmental disabilities. Therefore, the
legislative findings related specifically to ASD are not
necessary here.
Staff recommends the following amendment:
The people of the State of California do enact as follows:
SECTION 1. The Legislature hereby finds and declares the
following:
(a) Recent and emerging evidence in the number of children
diagnosed with autism spectrum disorders (ASDs) in
California and in the United States indicates that ASDs
have reached a level of public health crisis that must be
addressed.
(b) (a) The State Department of Developmental Services and
the regional center system provide treatment, habilitation,
and other services to Californians with developmental
disabilities so that they may lead more independent,
productive, and integrated lives.
(c) (b) California, where diverse communities account for
about 60 percent of the population, is now a "majority
minority" state.
(d) (c) The Lanterman Developmental Disabilities Services
Act requires that a person who receives services from a
regional center must have programs, services, and supports
that are "person centered" and that are based on the
specific assessment and needs of each consumer.
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(e) (d) Therefore, services provided to regional center
consumers should be provided in a linguistically and
culturally competent manner that promotes equity and
diversity for all Californians.
POSITIONS
Support: None received
Oppose: None received
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