BILL ANALYSIS                                                                                                                                                                                                    �



                                                                            



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                                    THIRD READING


          Bill No:  SB 208
          Author:   Lara (D)
          Amended:  5/28/13
          Vote:     21

           
           SENATE HUMAN SERVICES COMMITTEE  :  6-0, 4/9/13
          AYES:  Yee, Berryhill, Emmerson, Evans, Liu, Wright

           SENATE APPROPRIATIONS COMMITTEE  :  7-0, 5/23/13
          AYES:  De Le�n, Walters, Gaines, Hill, Lara, Padilla, Steinberg


           SUBJECT  :    Developmental services:  request for proposals

           SOURCE  :     Author


           DIGEST  :    This bill requires a request for proposals (RFP) that  
          is prepared by the Department of Developmental Services (DDS) or  
          by a regional center and that relates to consumer programs or  
          services and supports, to include a section on issues of equity  
          and diversity, as specified.

           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  
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            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 and to  
            coordinate services and supports best suited to them  
            throughout their lifetime.

          3.Establishes an Individual Program Plan (IPP) 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 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.

          This bill:

          1.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.

          2.Requires that an RFP that is prepared by DDS or a regional  
            center and that relates to consumer programs or services and  
            supports shall include a section on issues of equity and  
            diversity.

          3.Requires 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; and

             C.   Any additional information that the applicant deems  
               relevant to issues of equity and diversity.


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          1.Exempts from this requirement all contracts entered into  
            before January 1, 2014.

           Background
           
           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.  In 2001, the Office of  
          Minority Health released a report which identified adoption of  
          Culturally and Linguistically Appropriate Services 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. 

           Comments
           
          According to the Senate Human Services Committee, this bill is  
          part of a package that arose from a hearing in 2012 by the  
          Senate Select Committee on Autism and Related Disorders that  
          focused on disparities in services in underserved communities. 

          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.  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.

          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  

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          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 of  
          providing equity and diversity to consumers who are from  
          potentially underserved communities.

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes    
          Local:  No

          According to the Senate Appropriations Committee, minor costs to  
          the regional centers.  (General Fund)

           SUPPORT  :   (Verified  5/28/13)

          Autism Society of Los Angeles
          Disability Rights California
          Special Needs Network, Inc.

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           ARGUMENTS IN SUPPORT  :    According to the author, despite  
          significant cultural and linguistic diversity among the  
          populations served by DDS and the regional centers, the RFP  
          process does not currently assess the capacity of providers to  
          provide services and supports in a culturally and linguistically  
          competent manner. According to the author, SB 208 ensures  
          consumers receive developmental services and supports that are  
          culturally and linguistically appropriate.

          Disability Rights California, a non-profit advocacy organization  
          mandated to advance the human and legal rights of people with  
          disabilities, states in support that given the unique needs of  
          culturally and ethnic diverse populations in California that  
          this is a critical piece of legislation. 


          JL:AL:nl  5/28/13   Senate Floor Analyses 

                           SUPPORT/OPPOSITION:  SEE ABOVE

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