BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                            



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          |SENATE RULES COMMITTEE            |                        SB 367|
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                                    THIRD READING


          Bill No:  SB 367
          Author:   Block (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, 05/23/13
          AYES: De León, Walters, Gaines, Hill, Lara, Padilla, Steinberg


            SUBJECT  :    Developmental services:  regional centers:   
                      cultural and linguistic competency

           SOURCE  :     Author


           DIGEST  :    This bill requires that training and support to board  
          members of the regional center includes issues relating to  
          linguistic and cultural competency, and requires each regional  
          center to post on its Internet Web site information regarding  
          the training and support provided.  This bill requires the  
          performance review of the director to include an evaluation of  
          the director's performance in providing regional center services  
          that are linguistically and culturally appropriate.

           ANALYSIS  :    

          Existing law:

           1. Requires the Lanterman Developmental Disabilities Services  
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             Act, the Department of Developmental Services (DDS) to  
             contract with regional centers to provide support and  
             services to individuals with developmental disabilities. 

           2. Requires the governing board of the regional center to  
             satisfy specified requirements, including annually reviewing  
             the performance of the director of the regional center, and  
             providing necessary training and support to board members.

           3. Requires the state to contract only with agencies, the  
             governing boards of which conform to all of the following  
             criteria:

              A.    The governing board shall be composed of individuals  
                with demonstrated interest in, or knowledge of,  
                developmental disabilities.

              B.    The membership of the governing board shall include  
                persons with legal, management, public relations, and  
                developmental disability program skills.

              C.    The membership of the governing board shall include  
                representatives of the various categories of disability to  
                be served by the regional center.

              D.    The governing board shall reflect the geographic and  
                ethnic characteristics of the area to be served by the  
                regional center.

              E.    A minimum of 50% of the members of the governing board  
                shall be persons with developmental disabilities or their  
                parents or legal guardians.  No less than 25% of the  
                members of the governing board shall be persons with  
                developmental disabilities.

              F.    Members of the governing board shall not be permitted  
                to serve more than seven years within each eight-year  
                period.

              G.    The regional center shall provide necessary training  
                and support to these board members to facilitate their  
                understanding and participation

          This bill:

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          1. Requires the regional center to provide necessary training  
             and support to these board members to facilitate their  
             understanding and participation, including issues relating to  
             linguistic and cultural competency.

          2. Requires each regional center to post on its Internet Web  
             site information regarding the training and support provided  
             to board members.

          3. Requires this performance review to include an evaluation of  
             the director's performance in providing regional center  
             services that are linguistically and culturally appropriate.

           Background
           
           Regional Centers  .  Regional Centers are part of a system of care  
          overseen by the 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. 

          Historically, the regional centers have been praised for  
          providing services that are tailored to local needs and  
          responsive to individuals in communities, and criticized for  
          their inconsistency across the state.  While DDS sets some  
          common standards, there are variations among regional centers in  
          access to services across the regional center system.

           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.   
          The hearing was prompted by a series of articles in the Los  
          Angeles Times in 2011, which explored the different experiences  
          that families of children with autism had in accessing services.  
           The articles looked at variations in services among families  
          with different ethnic backgrounds, socio-economic status,  
          geography and other factors, including differences in practices  

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          at various regional centers.

          As a result of that hearing, Senate President pro Tempore  
          Darrell Steinberg created a 20-member 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.

          The task force also noted that DDS and regional centers should  
          build more effective community-based partnerships with health  
          and other providers that already serve consumers in underserved  
          communities.  Some examples from the report include the  
          promotoras community health model in Latino communities,  
          faith-based groups and other grass-roots organizations.  These  
          providers could serve as ambassadors for families who might not  
          otherwise seek or obtain services. (p 22-23)

           Access to health care services  .  The United States 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 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. 

             "The CLAS standards ? provide a common understanding and  
             consistent definitions of culturally and linguistically  
             appropriate services in health care. They offer a practical  
             framework for the implementation of services and  
             organizational structures that can help health care  

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             organizations and providers be responsive to the cultural and  
             linguistic issues presented by diverse populations."

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

          According to the Senate Appropriations Committee:

             The regional centers indicate that they will need additional  
             staff to identify barriers to utilization of services and  
             work with outside groups to reduce disparities in service  
             utilization.  The regional centers indicate that the total  
             cost to undertake these activities is likely to be about  
             $800,000 per year (General Fund).

             To the extent that there are barriers to the utilization of  
             services and the regional centers are successful in reducing  
             or eliminating such barriers to utilization, there could be  
             increased demand for regional center services.  The extent of  
             this impact is unknown.

           SUPPORT  :   (Verified  5/23/13)

          Center for Autism and Related Disorders

           ARGUMENTS IN SUPPORT  :    The Center for Autism and Related  
          Disorders (CARD) writes:

            The executive director and founder of CARD, Doreen  
            Granpeesheh, Ph.D., BCBA-D, was part of the Senate taskforce  
            that identified the need for regional center programs that  
            consider the cultural and linguistic diversity that  
            characterizes California.  The work of this task-force  
            culminated in the identification of several important goals,  
            one of which would be met through the passage and  
            implementation of SB 367.

            The Centers for Disease Control estimates autism prevalence at  
            1 in every 88 children, with recent data indicating that  
            prevalence may be as high as 1 in every 50 children.   
            Two-thirds of all new regional center consumers are diagnosed  
            with ASD.  The cost to the State decreases significantly when  
            diagnosis is made early, and individuals receive early  
            intensive intervention.

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          RM:k  5/28/13   Senate Floor Analyses 

                           SUPPORT/OPPOSITION:  SEE ABOVE

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