BILL ANALYSIS                                                                                                                                                                                                    



                                                                  SB 367
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          SENATE THIRD READING
          SB 367 (Block)
          As Amended  August 15, 2013
          Majority vote 

           SENATE VOTE  :38-0  
           
           HUMAN SERVICES      7-0                                         
           
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          |Ayes:|Stone, Maienschein,       |     |                          |
          |     |Ammiano,                  |     |                          |
          |     |Ian Calderon, Garcia,     |     |                          |
          |     |Grove, Hall               |     |                          |
          |-----+--------------------------+-----+--------------------------|
          |     |                          |     |                          |
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           SUMMARY  :  Includes issues related to cultural and linguistic  
          competency in regional center governing board training  
          requirements.  Specifically,  this bill  :

          1)Adds issues relating to linguistic and cultural competency to  
            the training and support a regional center is required to  
            provide to its governing board members.

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

          3)Requires a regional center governing board to annually review  
            the performance of the regional center in providing services  
            that are linguistically and culturally appropriate and allows  
            the board to provide recommendations to the regional center  
            director based on the results of that review.

           EXISTING LAW  :

          1)Establishes an entitlement to services for individuals with  
            developmental disabilities under the Lanterman Developmental  
            Disabilities Services Act (Lanterman Act).  (Welfare and  
            Institutions Code (WIC) Section 4500 et seq.)

          2)Grants all individuals with developmental disabilities, among  
            all other rights and responsibilities established for any  








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            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 Section 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 the 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 Section 4620 et seq.)

          4)Requires the governing board of each regional center to meet  
            specified criteria, including that board members must be  
            individuals with demonstrated interest in, or knowledge of,  
            developmental disabilities; each board must reflect the  
            geographic and ethnic characteristics of the regional center  
            catchment area; and at least 25% of board membership must be  
            persons with developmental disabilities.  (WIC Section 4622)

          5)Requires the governing board of each regional center to  
            annually submit detailed documentation to DDS demonstrating  
            that the composition of the board meets the criteria  
            established in WIC 4622.  (WIC Section 4622.5)

          6)Sets forth specific requirements and annual performance  
            objectives for contracts between DDS and regional centers.   
            (WIC Section 4629) 

          7)Provides that each contract between DDS and a regional center  
            must include a requirement that the regional center adopt,  
            maintain, and post on its Internet Web site a board-approved  
            policy regarding transparency and access to public  
            information, and requires that policy to provide, at a  
            minimum, information regarding requests for proposals, service  
            provider rates, documentation related to establishment of  
            negotiated rates, audits, and other forms, as specified.  (WIC  
            Section 4629.5)

           FISCAL EFFECT  :  None.  This bill is keyed non-fiscal by the  
          Legislative Counsel.









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           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 and Related Disorders focused on disparities  
          in services provided to underserved communities.  It seeks to  
          address inconsistencies in consumer access to services and  
          supports, as well as regional center spending on consumers, by  
          ensuring regional centers and their governing boards are  
          sensitive to the linguistic and cultural needs of the consumers  
          served in their respective catchment areas.

           Background  :  The Lanterman Act guides the provision of services  
          and supports for Californians with developmental disabilities.   
          Each individual under the Lanterman 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.  

          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  
          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.   








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          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.  

           Need for the bill  :  According to the author, "Regional centers  
          serve the most diverse state in the country. Every regional  
          center has different challenges in serving these communities. It  
          is critical that they understand the barriers that communities  
          have in getting these services. SB 367 seeks to increase the  
          training the board of directors receives related to these  
          barriers, with the goal of increasing services to the most  
          underserved people in the state.  Furthermore, SB 367 requires  
          directors to be evaluated on their performance in providing  
          services to these communities to increase transparency and  
          accountability, and to better understand the barriers that  
          families face in receiving services from regional centers."

          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 inequalities in access to  
          developmental services among families from different regions and  
          demographic groups.  Among the conclusions 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 creates a number of disparities within the  
          regional center system, as all children who are determined to  
          need regional center services based on their assessments 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 do not 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  








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          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.  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," identified a number of recommendations for changes to  
          current practice within the developmental services system.   
          Among them was a specific recommendation for regional centers to  
          implement self-assessments in order to evaluate their own  
          performance in areas of equity, diversity and cultural  
          competency, as well as recommendations for the boards of  
          directors of regional centers to receive ongoing training on  
          issues of cultural and linguistic competency.

          July 2013 consumer characteristic data from the Department of  
          Developmental Services shows that 37% of the individuals served  
          by the regional centers are identified as White, whereas 35% are  
          identified as Hispanic, just over 6% identify as Asian, 2.4%  
          identify as Filipino, and nearly 10% identify as Black or  
          African American.  While assumptions about the languages spoken  
          by regional center consumers cannot necessarily be made based on  
          this data, the ethnic and cultural diversity represented in the  
          caseload supports the notion that all aspects of the regional  
          center operations and service delivery systems should be  
          linguistically and culturally sensitive and equitable.


           Analysis Prepared by  :    Myesha Jackson / HUM. S. / (916)  
          319-2089 


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