BILL ANALYSIS �
SENATE HUMAN
SERVICES COMMITTEE
Senator Leland Y. Yee, Chair
BILL NO: SB 319
S
AUTHOR: Price
B
VERSION: April 2, 2013
HEARING DATE: April 9, 2013
3
FISCAL: Yes
1
9
CONSULTANT: Mareva Brown
SUBJECT
Developmental services: regional centers: data compilation
SUMMARY
This bill requires the Department of Developmental Services
(DDS) to ensure that the regional centers collect, analyze,
and report disability detail using uniform methodology and
procedures that allow for comparisons across regional
centers; requires regional centers to post on its Internet
Web site an annual report relating to whether the data
indicates specified disparities and plans to reduce those
disparities, as specified.
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 sufficient to meet the needs
and choices of each person with developmental
disabilities, regardless of age or degree of
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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) 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.
(WIC 4512)
4) Requires DDS and regional centers to annually
collaborate to compile data relating to purchase of
service authorization, utilization, and expenditure by
each regional center including the consumer's age,
race or ethnicity, primary language spoken and
disability, as specified. (WIC 4519.5)
5) Requires each regional center to post this data on
its website beginning on December 31, 2013. (WIC
4519.5 (c))
6) Requires each Regional Center to enter into a
five-year contract with DDS with continued funding
contingent upon meeting specified annual performance
objectives. (WIC 4269, et seq.)
7) Specifies that each DDS contract with a regional
center must include the requirement that regional
centers post on their internet websites reports,
audits and other information, as specified. (WIC
4629.5)
This bill
1) Requires that data on disability be collected,
analyzed and reported using uniform methodology and
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procedures that allow for comparisons across regional
centers.
2) In addition to existing data that is required to be
posted on its Internet Web site, adds a the
requirement that regional centers develop and post an
annual report on whether the data described in this
section indicates a need to reduce disparities among
consumers in the purchase of services within the
regional center's catchment area. The report also must
address whether there are disparities between
consumers of the regional center and consumers of
other regional centers, and if so, the regional
center's recommendations and plans to reduce the
disparities.
3) Requires DDS to include in its contracts with each
regional center a requirement that annual reports on
disparities be posted on the regional center's
website, as specified.
FISCAL IMPACT
This bill has not been analyzed by a fiscal committee.
BACKGROUND AND DISCUSSION
Purpose of the bill
This bill is one of a package that resulted from an April
2012 Senate hearing on cultural competency within the
Regional Center system, and a subsequent report
recommending changes.
The author states that SB 319 will address the need to
track data collected as a result of 2012 trailer bill
language.
Language was added in 2012 to require DDS and regional
centers to compile data about what services were
authorized, purchased, utilized and expended for consumers
in each regional center including the consumer's age, race
or ethnicity, primary language spoken and disability, among
other items. This bill would require the regional centers
to analyze that data for evidence of disparities either
within the regional center or among the regional center and
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other regional centers. If disparities do exist, the bill
requires regional centers to recommend a way to reduce
them.
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 series 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 article 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.
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
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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
20-member Taskforce on Equity and Diversity for Regional
Center Autism Services, appointed by Senate President pro
Tempore Darrell Steinberg. The group 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 based on the work of five subcommittees.
Among those recommendations was that DDS should establish
performance contract outcome measures to provide oversight
on issues of equity and diversity. The report contains a
section specifically address the need to strengthen
guidance around how data that is collected on consumer's
demographics will be used to identify and address
disparities.
"The section (WIC 4519.5) does not address the manner
by which these data will be analyzed, nor are there
criteria by which potential factors related to
disparities and inequities in the provision of
services can be identified and analyzed. Thus, the
manner by which these data will be utilized to
identify inequities in regional center services, as
well as to highlight those regional centers that are
successfully implementing appropriate best practices
that are culturally and linguistically appropriate,
remain to be determined.
There is also a lack of specificity by which regional
center outcomes on equity and diversity can be
compared on a statewide basis and methodologies. ?
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Broadly speaking, efforts to engage DDS need to be
clear as to oversight responsibilities an whether they
will seek data to identify and address gaps in
regional center services." (P. 41)
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.
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 208 (Lara) requires that a request for proposal prepared
by DDS or a regional center that relates to consumer
services and supports include a section on equity and
diversity.
SB 319 (Price) Requires DDS to ensure that the regional
centers collect, analyze, and report data in a way that
-------------------------
<1>
http://minorityhealth.hhs.gov/assets/pdf/checked/executive.p
df
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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.
POSITIONS
Support: >
Oppose: >
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