BILL ANALYSIS �
SB 208
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Date of Hearing: July 2, 2013
ASSEMBLY COMMITTEE ON HUMAN SERVICES
Mark Stone, Chair
SB 208 (Lara) - As Amended: May 28, 2013
SENATE VOTE : 39-0
SUBJECT : Developmental services: request for proposals
SUMMARY : Establishes requirements related to cultural and
linguistic competency for requests for proposals submitted by
regional centers.
Specifically, this bill :
1)Makes a number of legislative findings related to the needs of
regional center consumers, as specified, and declares 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 a request for proposals prepared by a regional center
for consumer services and supports to include a section on
issues of equity and diversity that requests, at least, all of
the following information:
a) A statement outlining the applicant's plan to serve
diverse populations, including those that are culturally
and linguistically diverse;
b) Examples of the applicant's commitment to addressing the
needs of those diverse populations; and
c) Additional information that the applicant deems relevant
to issues of equity and diversity.
1)Provides that this statute shall not alter any contracts
entered into prior to January 1, 2014.
EXISTING LAW
1)Establishes an entitlement to services for individuals with
developmental disabilities under the Lanterman Developmental
Disabilities Services Act (Lanterman Act). (WIC 4500 et seq.)
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2)Grants all individuals with developmental disabilities, among
all other rights and responsibilities established for any
individual by the United States Constitution and laws and the
California Constitution and laws, the right to treatment and
habilitation services and supports in the least restrictive
environment. (WIC 4502)
3)Establishes a system of 21 nonprofit regional centers
throughout the state to identify needs and coordinate services
for eligible individuals with developmental disabilities and
requires the Department of Developmental Services (DDS) to
contract with those regional centers to provide case
management services and arrange for or purchase services that
meet the needs of individuals with developmental disabilities,
as defined. (WIC 4620 et seq.)
4)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 an individualized needs
determination. (WIC 4512)
5)Creates a process by which regional centers may "vendorize"
service providers, thereby providing a path to contract for
services with that provider. (WIC 4648 (a)(3))
6)Authorizes regional centers to solicit an individual or agency
through a request for proposals or other means to provide
needed services or supports not presently available and
provided it is necessary to expand the availability of needed
services of good quality. (WIC 4648(e)(1))
7)Requires regional centers to provide the consumer, his or her
parent, legal guardian, or other appropriate authorized
representative, as specified, at least annually, a statement
of service and supports the regional center purchased for the
purpose of ensuring that the services are delivered. (WIC
4648(h))
8)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 regional center and the provider
or the provider and DDS. (WIC 4648.1 (c))
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FISCAL EFFECT : According to the Senate Appropriations
Committee's May 23, 2013 analysis, implementation of this bill
may result in minor costs to the regional centers (General
Fund).
COMMENTS : This bill is part of a package of legislation that
was developed as a result of a 2012 hearing of the Senate Select
Committee on Autism & Related Disorders focused on disparities
in services in underserved communities. It seeks to address
disparities in consumer access to services and supports, as well
as regional center spending on consumers, by prompting service
providers within the regional center system to indicate their
capacity for and commitment to equitably serving diverse
populations.
Background : The Lanterman Act guides the provision of services
and supports for Californians with developmental disabilities.
Each individual under the 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.
The term "developmental disability" means a disability that
originates before an individual attains 18 years of age, is
expected to continue indefinitely, and constitutes a substantial
disability for that individual. It includes intellectual
disabilities, cerebral palsy, epilepsy, and autism spectrum
disorders (ASD). Other developmental disabilities are those
disabling conditions similar to an intellectual disability that
require treatment (i.e., care and management) similar to that
required by individuals with intellectual disabilities. This
does not include conditions that are solely psychiatric or
physical in nature, and the conditions must occur before age 18,
result in a substantial disability, be likely to continue
indefinitely, and involve brain damage or dysfunction. Examples
of conditions might include intracranial neoplasms, degenerative
brain disease or brain damage associated with accidents.
Regional centers : The Department of Developmental Services
(DDS) contracts with 21 regional centers throughout the state,
which are private nonprofit entities, to carry out many of the
state's responsibilities under the Lanterman Act. The regional
center caseload is comprised of 260,000 consumers who receive
services such as residential placements, supported living
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services, respite care, transportation, day treatment programs,
work support programs, and various social and therapeutic
activities. While most individuals receive treatment and
services in the community, 1,600 consumers reside at one of
California's four Developmental Centers-and one state-operated,
specialized community facility-which provide 24-hour
habilitation and medical and social treatment services.
Services provided to consumers with developmental disabilities
are determined through an individualized 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
Individual Program Plan (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.
Prior to being approved to receive funding from a regional
center for providing services to a consumer, a service provider
must become vendored by the regional center that oversees the
catchment area in which the provider is located. This
"vendorization" process includes verifying that the provider is
qualified to provide the planned services and meets all other
regulatory standards and requirements, aside from licensing
requirements, which are enforced by other departments and
agencies. There are approximately 40,000 non-parent vendors
that provide services paid for by regional centers in
California. In order to expand and improve services in their
catchment areas, regional centers submit requests for proposals
(RFPs) geared to meet changing consumer needs. By way of
example, some of the recent RFPs posted by regional centers
include requests for specialized "conscious sedation" dentists,
homes that can be converted into adult residential housing, and
other services that can meet the particular needs of consumers
who are exiting developmental centers and moving into the
community.
Need for the bill : A four-part 2011 Los Angeles Times series
focused on autism included a report titled "Warrior Parents Fare
Best in Securing Autism Services," which addressed disparities
in access to developmental services among families from
different regions and demographic groups. Among the conclusions
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drawn based on the reporter's research, as indicated by the
title of the report, was that parents who fight harder for their
children gain more services. This is clearly an unfair
situation given that all children who are determined to need
regional center services based on their assessment and diagnoses
are entitled to such services. Also revealed in the report was
that the "fighter" parents tend to be sophisticated, wealthier
white parents who have the time and resources needed to navigate
the bureaucracy that stands between their children and necessary
services. On the other hand, parents who work multiple jobs,
for example, with linguistic and cultural barriers that don't
allow them to navigate the system as easily, can find it nearly
impossible to get their children the effective services they
need in a timely manner.
Prompted, in part, by the Los Angeles Times series, the Senate
Select Committee on Autism and Related Disorders held an
informational hearing in April 2012 to discuss questions
surrounding equal access to regional center services for
consumers with autism spectrum disorders (ASD). An outcome of
the hearing was the 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, 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 was a specific
recommendation related to cultural competency within RFPs.
Specifically, the recommendation reads:
All new "Requests for Proposals" (RFPs) that are
associated with consumer programs, supports, or
other services that are relevant to issues of
equity, diversity, and cultural and linguistic
competence shall include a section to evaluate the
applicant's ability to partner with community-based
organizations on issues of equity and diversity.
The report noted that this is already standard practice for the
Regional Center of the East Bay (RCEB), which requires that all
new RFPs include a section that addresses the issues of
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providing equity and diversity to consumers who are from
potentially underserved communities.
Author's statement : "SB 208 ensures that individuals with
developmental disabilities receive services that are culturally
and linguistically appropriate. California has a rich diversity
of cultures and languages. Unfortunately, cultural and
linguistic barriers are responsible for some of the disparities
in services and spending. For example, at one regional center,
the spending on white children with autism averaged $12,794 per
child last year - compared with $9,449 for Asians, $5,094 for
blacks and $4,652 for Latinos. State law requires services to
be 'person-centered.' However, currently, there is no process
to gauge cultural and linguistic competency. SB 208 simply adds
a section in all new 'Requests for Proposals' to assess cultural
and linguistic competency."
This bill will insert considerations of equity, diversity, and
linguistic and cultural competency into everyday regional center
processes in order to make the developmental services system
better equipped to reach and provide appropriate and equitable
services to communities that have routinely been overlooked.
In support of the bill, the Special Needs Network writes, "SB
208 provides for the future by instilling awareness of diverse
populations and under-served communities directly into the RFP
process. While many other systemic concerns affecting these
communities remain, SB 208 is a bold and strong first step to
improving the delivery of services to under-served communities
of color."
RELATED LEGISLATION
SB 158 (Correa) authorizes the establishment of the Regional
Center Excellence in Community Autism Partnerships (RE CAP)
pilot program to improve regional center services, supports,
interventions, and other resources to assist regional center
consumers with ASD living in underserved communities.
SB 367 (Block) requires 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.
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SB 555 (Correa) requires 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) requires 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.
REGISTERED SUPPORT / OPPOSITION :
Support
Autism Society of Los Angeles
Special Needs Network (SNN)
The Arc and United Cerebral Palsy California Collaboration
Opposition
None on file
Analysis Prepared by : Myesha Jackson / HUM. S. / (916)
319-2089