BILL ANALYSIS                                                                                                                                                                                                    �




                   Senate Appropriations Committee Fiscal Summary
                            Senator Kevin de Le�n, Chair


          SB 321 (Price) - Developmental services: regional centers:  
          performance contracts.
          
          Amended: April 2, 2013          Policy Vote: Human Services 4-0
          Urgency: No                     Mandate: No
          Hearing Date: May 23, 2013      Consultant: Brendan McCarthy
          
          SUSPENSE FILE.
          
          
          Bill Summary: SB 321 would require the Department of  
          Developmental Services to establish contract performance  
          guidelines for regional centers, relating to cultural and  
          linguistic competency.

          Fiscal Impact: 
              One-time costs likely between $100,000 and $200,000 for the  
              Department of Developmental Services to adopt or update  
              regulations (General Fund).

              Ongoing costs for the regional centers in the hundreds of  
              thousands per year (General Fund). Under the bill, each  
              regional center would have to evaluate the cultural and  
              linguistic competency of the regional center, its contracted  
              vendors, and the needs of the communities the regional  
              center serves. The amount of staff time required will likely  
              vary between regional centers, but in the aggregate is  
              likely to be in the hundreds of thousands per year.

              Unknown impact on the utilization of services by regional  
              center consumers. If regional centers find that there are  
              significant disparities in the provision of services and  
              develop strategies to reduce those disparities, there could  
              be increased demand for services. The extent of this General  
              Fund impact is unknown. 

          Background: The Department of Developmental Services is  
          responsible for coordinating care and services for about 250,000  
          people with developmental disabilities. The vast majority of  
          these people are served by 21 regional centers, which are  
          non-profit entities that contract with the state. The regional  
          centers, in turn, contract with a variety of vendors to provide  








          SB 321 (Price)
          Page 1


          direct services to the developmentally disabled.

          In April 2012, the Senate Select Committee on Autism and Related  
          Disorders held an informational hearing to investigate equal  
          access to regional center services for consumers with autism  
          spectrum disorders. Following the hearing, a Taskforce on Equity  
          and Diversity for Regional Center Autism Services was  
          established to study and make recommendations to ensure that  
          consumers of regional center services receive appropriate  
          services, regardless of race, ethnicity, or other socio-economic  
          factors. Based on the deliberations of the taskforce, staff of  
          the Select Committee compiled recommendations and findings of  
          the taskforce into a draft report.

          The 2012-13 developmental services trailer bill (AB 1472,  
          Chapter 25 of 2012) requires the Department and the regional  
          centers to collect and analyze data on the utilization of  
          services by consumers with respect to age, race, language  
          spoken, and disability.

          Proposed Law: SB 321 would require the Department of  
          Developmental Services to establish contract performance  
          guidelines for regional centers, relating to cultural and  
          linguistic competency.

          Under the bill, performance contracts between the Department and  
          the regional centers would require regional centers to provide a  
          variety of information about regional center services and  
          operations to the public in appropriate languages and to  
          consider the linguistic and ethnic diversity of its community  
          when conducting focus groups or surveys.

          The bill requires the Department to develop contract guidelines  
          relating to cultural and linguistic competency. After 2014, the  
          Department would be required to include in a regional center's  
          performance contract areas that require improvement.

          Related Legislation: 
              SB 158 (Correa) would establish a pilot project to identify  
              underserved communities and improve autism identification  
              and service delivery. That bill is on this committee's  
              Suspense File.
              SB 208 (Lara) would require any request for proposal that  
              is prepared by the Department of Developmental Services or a  








          SB 321 (Price)
          Page 2


              regional center to include a section relating to issues of  
              equity and diversity. That bill is on this committee's  
              Suspense File.
              SB 319 (Price) would require the Department of  
              Developmental Services to ensure that regional centers  
              report certain information on the services they provide in a  
              uniform manner. The bill would require the regional centers  
              to report on whether there are disparities in the provision  
              of services and plans to reduce disparities. That bill will  
              be heard in this committee.
              SB 367 (Block) would require regional centers to establish  
              a process to review cultural and linguistic competence. That  
              bill is on this committee's Suspense File.
              SB 555 (Correa) would require communications between a  
              regional center and a consumer and his/her family to be in  
              the consumer's native language. That bill will be heard in  
              this committee.
              AB 1232 (V. M. Perez) would require an existing Department  
              of Developmental Services quality assurance tool to assess  
              the provision of services in a culturally and linguistically  
              appropriate manner. That bill is in the Assembly Human  
              Services Committee.

          Staff Comments: The Administrative Procedure Act (beginning at  
          Section 11340 of the Government Code) prohibits state agencies  
          from issuing or enforcing any rule, regulation, order, or  
          standard of general application unless it has been issued as a  
          regulation under the Administrative Procedure Act. In order to  
          clarify the requirements of this bill, the Department will most  
          likely have to adopt implementing regulations.
          

          According to the Select Committee on Autism and Related  
          Disorders, there are indications of disparities in the provision  
          of services to racial and ethnic minorities - both in the larger  
          healthcare system and within the state's regional center system.  
          This implies that there may be significant unmet needs for  
          services for racial and ethnic minorities with developmental  
          disabilities. Under California law, services and supports for  
          the developmentally disabled are entitlements and the regional  
          centers are required to provide services and supports for  
          eligible individuals.

          The bill requires regional centers to analyze the utilization of  








          SB 321 (Price)
          Page 3


          services, determine whether there are any disparities in  
          utilization, and make recommendations to reduce disparities. 

          To the extent that this bill compels regional centers to reduce  
          disparities in the provision of services, the bill will likely  
          result in overall increase in the demand for services. At this  
          time, the unmet need for services and the fiscal implications of  
          meeting that need are unknown, but could be significant.