BILL ANALYSIS �
SENATE HUMAN
SERVICES COMMITTEE
Senator Leland Y. Yee, Chair
BILL NO: SB 555
S
AUTHOR: Correa
B
VERSION: April 1, 2013
HEARING DATE: April 9, 2013
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FISCAL: Yes
5
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CONSULTANT: Mareva Brown
SUBJECT
Developmental services: regional centers:
individual program plans and individualized family service
plans
SUMMARY
This bill would require that an individual program plan
(IPP) or an individualized family service plan (IFSP) be
designed to meet the cultural preferences, values, and
lifestyle of the consumer and the consumer's family, and be
provided in their native language, as defined; requires the
Department of Developmental Services (DDS) and the regional
centers to ensure that consumers and their families receive
culturally and linguistically competent information,
including written documents, about the IPP and the IFSP, as
specified; requires each regional center to make this
information available to the public in appropriate
languages, and on the DDS and regional center Internet Web
sites. This bill also would require all communication with
the consumer and his or her family, pursuant to intake or
assessment, to be in their native language.
ABSTRACT
Continued---
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Existing law
1) Establishes the Lanterman Developmental
Disabilities Services Act, which states
that California is responsible for providing an array
of services and supports sufficiently complete to meet
the needs and choices of each person with
developmental disabilities, regardless of age or
degree of disability, and at each stage of life and to
support their integration into the mainstream life of
the community. (WIC 4500, et seq.)
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, and to coordinate services and
supports best suited to them throughout their
lifetime. (WIC 4620)
3) Establishes that an infant or toddler under age 3
who is eligible for regional center services shall
have an individualized family service plan (IFSP) to
direct services, as specified, and defines the types
of services, supports and staffing that should be
considered when creating the plan. (WIC 95020)
4) Defines various terms used in Welfare and
Institutions Code relating to individuals served in
the Developmental Disabilities system, and the
services provided. (WIC 4512)
5) Requires all regional centers to notify consumers
and families of the availability of services in
English and such other languages as may be appropriate
to the service area, provide outreach services in
areas with a high incidence of developmental
disabilities, and identify persons who may need
services. (WIC 4641)
6) Identifies specific guidelines and timelines for
conducting an assessment of an individual who is
identified as potentially needing services and
supports. (WIC 4642)
7) Establishes an individual program plan (IPP) and
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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)
8) Requires that the planning processes to create an
IPP include:
a. A statement of the individual's goals and
objectives, a schedule of the type and nature of
services to be provided and other information and
considerations, as specified.
b. Review and modification, as necessary, by
the regional center's planning team no less
frequently than every three years.
c. Statewide training and review of the IPP
plan creation, as specified. (WIC 4646.5)
9) Requires that, in order to achieve the goals and
objectives in an individual's IPP, a regional center
must provide numerous services and supports, as
specified. (WIC 4648)
10) Requires that every state agency which serves a
substantial number of non-English-speaking people and
which provides materials in English explaining
services shall also provide the same type of materials
in any non-English language spoken by a substantial
number of the public served by the agency, as
specified. (GOV 7295.2)
11) Defines a "substantial number of
non-English-speaking people" as members of a group who
either do not speak English, or who are unable to
effectively communicate in English because it is not
their native language, and who comprise 5 percent or
more of the people served by any local office or
facility of a state agency. (GOV 7296.2)
12) Establishes legislative intent that the preferred
objective for children who have developmental
disabilities is to remain at home with their families
and defines regional center goals toward that
objective. (WIC 4685)
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This bill
1) Declares the following legislative findings:
a. California's diverse language and ethnic
communities account for about 60 percent of its
population. The number of people in the United
States who do not speak English as their native
language has grown 140 percent over the past
three decades. In California, about 40 percent of
Californians speak a language other than English
at home, and the number of individuals whose
first language is not English is rapidly growing.
b. Health disparities can result in
significant health, social, and economic
consequences. Culturally and linguistically
competent health care services can assist in
achieving health equity. Health literacy plays a
central role in promoting quality of life, health
development, and health behaviors across all
groups and life stages.
c. To address any disparities in the
regional center system, it is the intent of the
Legislature that the State Department of
Developmental Services and regional centers
ensure that all consumers and their families
receive culturally and linguistically competent
information, including written documents, about
the IPP and IFSP processes and procedures. It is
also the intent of the Legislature that each
regional center make available culturally and
linguistically competent information to
individuals living in its geographic catchment
area about regional center services, processes,
and procedures.
2) Requires that ISFPs and the provision of services
and supports be designed to meet the cultural
preferences, values, and lifestyle of the infant or
toddler and his or her family, and shall be provided
in their native language.
3) Requires that a copy of the IFSP be provided in the
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family's native language.
4) Adds to the list of definitions related to the DDS
system the following: "Native language" means the
language normally used by the individual and, when
appropriate, his or her parent, legal guardian or
conservator, or authorized representative.
5) Requires DDS and the regional centers to ensure
that consumers and their families receive culturally
and linguistically competent information, including
written documents, about the IPP and IFSP, as
specified.
6) Requires that each regional center make available
to the public information about regional center
services, processes, and procedures and that they do
so under Government Code standards that specify
dissemination of materials to non-English speaking
residents, including ensuring that materials are
written in plain, straightforward language and in an
easily readable style. The materials provided by the
department and the regional centers shall also be
available on the department's and the regional
centers' Internet Web sites.
7) Adds to the list of required elements of a regional
center assessment the requirement that all
communication with the consumer and his family be
conducted in their native language.
8) Requires that the creation of an IPP plan be
designed to meet the cultural preferences, values, and
lifestyle of the individual and, when appropriate, his
or her parent, legal guardian or conservator, or
authorized representative, and shall be provided in
their native language.
9) Requires that the IPP planning process, as
specified, be conducted in a manner that meets the
cultural preferences, values, lifestyle, and native
language of the individual and, when appropriate, his
or her parent, legal guardian or conservator, or
authorized representative.
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10) Requires a regional center to ensure that IPP and
the provision of services and supports, as specified
in WIC 4648, be designed to meet the cultural
preferences, values, and lifestyle of the individual
and, when appropriate, his or her parent, legal
guardian or conservator, or authorized representative,
and are provided in their native language.
11) Expands existing legislative intent language
identifying as a priority that children live at home
and defines regional center objectives to meet that
priority the intent that a family's native language be
considered when providing supports.
FISCAL IMPACT
This bill has not been analyzed by a fiscal committee.
BACKGROUND AND DISCUSSION
Purpose of the bill
This bill is part of a package that arose from a hearing in
2012 by the Senate Select Committee on Autism & Related
Disorders that focused on disparities in services in
underserved communities.
The author states that for people with developmental
disabilities, health disparities can result in significant
health, social, and economic consequences. California's
diverse language and ethnic communities account for about
60% of its population. Ethnic disparities exist within the
regional center system. Consumers and family members who
are limited English proficient have the right to get
culturally and linguistically competent information about
the Individual Program Plan (IPP) and the Individual
Family Services Plan (IFSP) processes and procedures," the
author states.
"To address any disparities in the regional center system,
the Department and regional centers must understand the
needs of all consumers and their families in order to
provide services and supports in a culturally and
linguistically appropriate manner," the author states.
"Health literacy is essential to promoting quality of life,
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health development, and healthy behaviors across all groups
and life stages."
This bill inserts in a number of key locations in the
statute the requirement that assessment, planning for an
IPP or IFSP, and other key communication be done in the
native language or with cultural sensitivity to the
consumer and his or her family, as appropriate.
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
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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
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 them was the recommendation that DDS and regional
centers ensure that all consumers and their families
receive information, including written documents, about the
IPP and IFSP processes and information about supports in a
manner that is culturally and linguistically competent. The
taskforce made specific recommendations about where to
insert requirements for culturally and linguistically
appropriate processes, which are largely reflected in this
bill. (P. 16)
Regional Centers
Regional Centers are part of a system of care overseen by
the Department of Developmental Services (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
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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. Services for
consumers are determined through an IPP, and those services
are provided through contracts with the regional centers.
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.<2>
Related Legislation
This bill is part of a package of legislation drafted from
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<1>
http://minorityhealth.hhs.gov/assets/pdf/checked/executive.p
df
<2> US Department of Health and Human Services, Office of
Minority Health, "National Standards for Culturally and
Linguistically Appropriate Services in Health Care," March
2001,
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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
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.
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
Arguments in support
Disability Rights California, the bill's sponsor, notes
that it is the responsibility of DDS and the regional
centers to provide services and supports for consumers in a
way that is person-centered, individualized, and take into
account, the needs, preferences, and choices of the
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consumer and the family.
Support: Disability Rights California (sponsor)
Oppose: None received
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