BILL ANALYSIS �
SB 555
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Date of Hearing: August 13, 2013
ASSEMBLY COMMITTEE ON HUMAN SERVICES
Mark Stone, Chair
SB 555 (Correa) - As Amended: August 5, 2013
SENATE VOTE : 36-0
SUBJECT : Developmental services: regional centers: individual
program plans and individualized family service plans
SUMMARY : Clarifies that regional centers must make every
reasonable effort to communicate with, and plan services for,
consumers and their families in the consumer's or family's
native language.
Specifically, this bill :
1)Declares the following findings:
a) California's diverse language and ethnic communities
account for about 60% of its population. The number of
people in the United States who do not speak English as
their native language has grown 140% over the past three
decades. In California, about 40% 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; and
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 individual program
plan and individualized family service plan processes and
procedures.
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1)Requires a regional center to make every reasonable effort to
communicate in a family's native language during the planning
process for the individualized family service plan (IFSP) and
to provide a copy of the IFSP in the family's native language.
2)Requires a regional center to document the family's native
language in the IFSP.
3)Requires a regional center to make every reasonable effort to
communicate in a consumer's native language or, when
appropriate, in the native language of his or her family or
representative, as specified, during the planning process for
the individual program plan (IPP) and to provide a copy of the
IPP in the identified native language.
4)Requires regional centers to document the native language of
the consumer or, when appropriate, the consumer's authorized
representative, as specified, in the IPP.
5)Defines every reasonable effort, for purposes of ensuring
compliance with requirements of Part C of the federal
Individuals with Disabilities Education Act (IDEA), including
its implementing regulations, as all effort necessary to meet
the regional center requirements with respect to use of a
family's native language during the IFSP planning process,
unless it is clearly not feasible to do so.
6)Further defines every reasonable effort, for purposes of
ensuring compliance with Government Code Sections 11135
through 11139.5, including implementing regulations, as all
effort necessary to meet a regional center's requirements with
respect to use of a family's or a consumer's native language
during consumer intake and assessment, and during the IFSP or
IPP planning processes, unless it has been determined that
such effort would place undue hardship on the regional center.
7)Defines "native language" as the language normally used or the
preferred language identified by the individual and, when
appropriate, his or her parent, legal guardian or conservator,
or authorized representative.
EXISTING LAW
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1)Establishes an entitlement to services for individuals with
developmental disabilities under the Lanterman Developmental
Disabilities Services Act (Lanterman Act). (WIC 4500 et seq.)
2)Grants all individuals with developmental disabilities, among
all other rights and responsibilities established for any
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 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 those 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 4620 et seq.)
4)Requires public and private agencies serving regional center
consumers under the Lanterman Act to provide consumers
relevant information in an understandable form to aid them in
making decisions about their own day-to-day lives. (WIC
4502.1)
5)Requires the development of an IPP for each regional center
consumer, which specifies services to be provided to the
consumer, based on his or her individualized needs
determination and preferences, 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)
6)Requires the IPP planning processes to 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; and
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c) Statewide training and review of the IPP plan creation,
as specified. (WIC 4646.5)
1)Enacts, through federal law, the Early Intervention Program
for Infants and Toddlers with Disabilities of 1986 under the
Individuals with Disabilities Education Act (IDEA), and
requires DDS, regional centers and local education agencies to
provide early intervention services to infants and toddlers
with developmental delays, as specified. (20 U.S.C. Sec. 1400
et seq., GOV 95000 et seq.)
2)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.
(GOV 95020)
3)Authorizes regional centers to solicit an individual or agency
through a request for proposals or other means to provide
needed services or supports not presently available and
provided it is necessary to expand the availability of needed
services of good quality. (WIC 4648(e)(1))
4)Requires all regional centers to conduct casefinding
activities, including notification of the availability of
services in English and such other languages as may be
appropriate to the catchment area, outreach services in areas
with a high incidence of developmental disabilities, and
identification of persons who may need services. (WIC 4641)
5)Requires a regional center to provide initial intake and
assessment services to any person believed to have a
developmental disability, as specified, and identifies
guidelines and timelines for the intake and assessment
process. (WIC 4642 et seq.)
6)Requires state agencies, as specified, that are directly
involved with providing information or rendering services to a
substantial number of members of the public who are
non-English speaking to employ a sufficient number of
qualified bilingual persons in public contact positions to
ensure provision of information and services to the public, in
the language of the non-English speaking persons. (GOV 7292)
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7)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)
8)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)
9)Prohibits discrimination against individuals in protected
classes, including national origin and ethnic group
identification, for purposes of providing full and equal
access to benefits or programs that are operated or funded by
the state. (GOV 11135 et seq.)
FISCAL EFFECT : According to the Senate Appropriations
Committee, this bill will likely result in costs of $1 million
to $2 million per year for the regional centers to provide
translation services (General Fund) for initial intake and
assessment meetings and translation of certain documents.
COMMENTS : This bill is part of a package of legislation
intended to address disparities in the provision of regional
center services to underserved communities. The author of this
bill seeks to ensure access to culturally and linguistically
competent services and supports by clarifying the current
requirement that regional centers communicate with consumers and
their families in their native languages when planning and
establishing services.
Background : The Lanterman Act guides the provision of services
and supports for Californians with developmental disabilities.
Each individual under the 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.
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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. This
does not include conditions that are solely psychiatric or
physical in nature, and the conditions must occur before age 18,
result in a substantial disability, be likely to continue
indefinitely, and involve brain damage or dysfunction. Examples
of conditions might include intracranial neoplasms, degenerative
brain disease or brain damage associated with accidents.
Direct responsibility for implementation of the Lanterman Act
service system is shared by the Department of Developmental
Services and 21 regional centers, which are private nonprofit
entities, established pursuant to the Lanterman Act, that
contract with DDS to carry out many of the state's
responsibilities under the Act. The principal roles of regional
centers include intake and assessment, individualized program
plan development, case management, and securing services through
generic agencies or purchasing services provided by vendors.
Regional centers also share primary responsibility with local
education agencies (LEAs) for the provision of early
intervention services under the California Early Intervention
Services Act through Early Start. In this shared role, LEAs
provide services for children with low-incidence disabilities
(e.g.: blindness, deafness, hard of hearing, orthopedic
impairments).
Services provided to people with developmental disabilities are
determined through an individual planning process. 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. For infants and toddlers under 3 years of age, the
plan generated is an individualized family service plan (IFSP),
which similarly dictates the services to be provided to a child
to meet his or her developmental and early intervention needs.
The Lanterman Act requires that the planning process for
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developmental services promotes community integration and
maximizes 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.
Regional centers serve roughly 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
programs. Approximately 1,500 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. 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.
Need for the bill : 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 disparities
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 is clearly an unfair
situation given that all children who are determined to need
regional center services based on their assessment 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 don't
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
Select Committee on Autism and Related Disorders held an
informational hearing in April 2012 to discuss questions
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surrounding equal access to regional center services for
consumers with autism spectrum disorders. The Select Committee
then formed a 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. A report titled "A Preliminary Report by the Taskforce
on Equity and Diversity for Regional Center Autism Services" was
published on March 18, 2013, identifying a number of
recommendations for changes to current practice within the
developmental services system. Among them were recommendations
to conduct IPP and IFSP meetings in the consumer or family's
preferred language and to provide consumers and family members
with the IPP or IFSP document and related documents in the
consumer or family's preferred language.
Current language and communication requirements : Existing laws
and regulations prohibit discrimination against people with
disabilities with respect to their receipt of public services
and establish circumstances under which regional centers are
required to provide information to consumers and family members
in languages other than English. More specifically, state
regulations require the use of an interpreter or translator
during IPP meetings if all members of the planning team-which
includes the consumer-don't speak the same language, and state
law requires that information exchanged by members of the
planning team be done so in a way that is understandable to the
consumer and his or her family. State law further requires that
the final IPP be prepared in a form that is understandable to
the consumer and family.
Arguments in support : While current law, regulations, and the
DDS Manual of Policies and Procedures set forth standards for
regional centers to communicate with consumers and their family
members in a language they can understand, supporters of this
legislation assert that consumers and their families continue to
find adequate and appropriate services to be inaccessible due to
linguistic and cultural barriers. The Lanterman Act requires
consumer and family voice and choice to be represented in a
consumer's IPP or IFSP planning process and in the written IPP
or IFSP document that will guide services. This bill seeks to
ensure that consumers and their family members are able to
understand and fully participate in the regional center service
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planning process by clarifying that regional centers have an
obligation to make every reasonable effort to communicate with
consumers and their family members in their native language.
According to the author, "Consumers and family members who are
limited English proficient have a right to a planning process
for regional center services that is linguistically and
culturally appropriate. Regional centers must make every effort
to ensure that the intake process, the planning process for the
IPP and the IFSP, and the IPP and IFSP meeting be provided in
the consumer's and family's native language. To address
disparities in the regional center system requires that having
IPP and IFSP planning process and meeting in the language the
consumer and family speaks and understands. Effective
communication and health literacy is essential to promoting
quality of life, health development, and health behaviors across
all groups and life stages. Service planning in a culturally
and linguistically competent manner can assist in achieving
health equity."
Arguments in opposition : In opposition to this bill, the
Association of Regional Center Agencies (ARCA) asserts that
implementation of this bill would be costly. ARCA states,
"Currently, centers often have the fortune of having staff who
are bilingual - with the caveat that the ability to speak a
language does not always indicate a fluency in the written word.
In other cases, meetings can be functionally conducted in
English. And where neither of those options exists, there are,
at times, individuals outside of the nuclear family who
volunteer their time to help the family. In all circumstances,
the focus is on ensuring that the needs of the client and family
are met, and their comfort respected?Regional centers fund
formal language assistance when the aforementioned options are
unavailable. But ARCA enquiries of regional centers found this
is in no way a standard practice?The translation mandate is
therefore neither a minor nor absorbable cost. Conservatively,
such a sweeping change in procedure is anticipated to require
tens of millions of dollars annually."
RECOMMENDED AMENDMENTS
The August 5, 2013 version of the bill includes amendments that
require regional centers to make every reasonable effort to
provide certain information to consumers and their families,
both spoken and written, in their native languages. Current law
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and regulations, which are referenced in provisions defining
every reasonable effort in this bill, already provide a hardship
exemption in cases where it is not feasible for the
communication and translation requirements to be met, thereby
making the addition of a new reasonable effort standard
redundant and confusing. In order to clarify the language and
ensure that it matches the true intent and meaning of current
law and regulations, committee staff recommends the following
amendments (in mock-up form):
1)Page 3, beginning in line 3:
3 (c) To address any disparities in the regional center
system, it
4 is the intent of the Legislature that the State Department
of
5 Developmental Services and regional centers ensure that all
6 consumers and their families receive culturally and
linguistically
7 competent information, including written documents, about
the
8 individual program plan and individualized family service
plan
9 processes and procedures and that regional centers comply
with Part C of the federal Individuals with Disabilities
Education Act (20 U.S.C. Sec. 1400 et seq.) and implementing
regulations, and Government Code Section 11135-11139.7 and
implementing regulations.
2)Page 10, beginning in line 17 through page 11, line 2:
17 (g) (1) A regional center shall make every reasonable
effort to
18 communicate and provide written materials in the family's
native language during the assessment, evaluation, and planning
19 process for the individualized family service plan,
including during
20 the individualized family service plan meeting , as
required by Part C of the federal Individuals with
Disabilities Education Act (20 U.S.C. Sec. 1400 et seq.) and
implementing regulations, and as required by Government Code
Sections 11135-11139.7 and implementing regulations,
including the provision of alternative communication services
as provided in Title 22 California Code of Regulations
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Sections 98210-98211.
21 (2) A regional center shall make every reasonable
effort to
22 provide a copy of the individualized family service plan in
the
23 family's native language.
24 (3) (2) The family's native language shall be documented
in the
25 individualized family service plan.
26 (4) (A) To ensure compliance with Part C of the
federal
27 Individuals with Disabilities Education Act (20 U.S.C. Sec.
1400
28 et seq.) and implementing regulations, "every reasonable
effort"
29 shall mean all effort necessary to achieve the stated
requirements
30 of this subdivision, unless it is clearly not feasible to
do so.
31 (B) To ensure compliance with Sections 11135 to
11139.5,
32 inclusive, and implementing regulations, for any
requirement other
33 than the requirements under Part C of the federal
Individuals with
34 Disabilities Education Act and implementing regulations,
"every
35 reasonable effort" shall mean all effort necessary to
achieve the
36 stated requirements of this subdivision, unless it is
determined that
37 the effort would place an undue hardship on the regional
center
38 pursuant to Sections 11135 to 11139.5, inclusive, and
implementing
39 regulations. This subdivision shall not limit the procedural
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1 safeguards provided under Part C of the federal Individuals
with
2 Disabilities Education Act and implementing regulations.
3)Page 14, beginning in line 19:
19 (n) To ensure compliance with Sections 11135 to
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11139.5,
20 inclusive, of the Government Code and implementing
regulations,
21 "every reasonable effort" means all effort necessary to
achieve
22 the stated requirements of the applicable provisions of
this division,
23 unless it is determined that the effort would place an
undue
24 hardship on the regional center pursuant to Sections 11135
to
25 11139.5, inclusive, of the Government Code and implementing
26 regulations. This subdivision shall not limit the rights
established
27 in Chapter 7 (commencing with Section 4700).
4)Page 15, beginning in line 15:
15 (b) Unless it is clearly not feasible to do so, a A
regional center
16 shall make every reasonable effort to communicate with the
17 consumer and his or her family pursuant to this section in
their
18 native language, including through the provision of
alternative communication services, as required by Government
Code Sections 11135-11139.7 and implementing regulations.
5)Page 16, beginning in line 11:
11 (d) Unless it is clearly not feasible to do so, a A
regional center
12 shall make every reasonable effort to communicate with the
13 consumer and his or her family pursuant to this section in
their
14 native language, including through the provision of
alternative communication services, as required by Government
Code Sections 11135-11139.7 and implementing regulations.
6)Page 18, beginning in line 6:
6 (h) (1) Unless it is clearly not feasible to do so, a
A regional
7 center shall make every reasonable effort to communicate in
the
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8 consumer's native language, or, when appropriate, the native
9 language of his or her family, legal guardian, conservator,
or
10 authorized representative, during the planning process for
the
11 individual program plan, including during the program plan
12 meeting, including through the provision of alternative
communication services, as required by Government Code Section
11135-11139.7 and implementing regulations.
13 (2) Unless it is clearly not feasible to do so, a A
regional center
14 shall make every reasonable effort to provide alternative
communication services, including the provision of a copy of the
15 individual program plan in the native language of the
consumer
16 or his or her family, legal guardian, conservator, or
authorized
17 representative, or both, as required by Government Code
Sections 11135-11139.7 and implementing regulations.
PENDING RELATED LEGISLATION
SB 158 (Correa) authorizes the establishment of the Regional
Center Excellence in Community Autism Partnerships (RE CAP)
pilot program to improve regional center services, supports,
interventions, and other resources to assist regional center
consumers with ASD living in underserved 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 367 (Block) includes issues related to cultural and
linguistic competency in regional center governing board
operations.
AB 1232 (V. Manuel Perez) requires 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.
REGISTERED SUPPORT / OPPOSITION :
Support
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American Civil Liberties Union
Area 4 Developmental Disabilities Board
California State PTA
Center for Autism and Related Disorders (CARD)
Chinese Parents Association of the Disabled
Disability Rights California
Fuerza, Inc.
Japanese Speaking Parents Association of Children with
Challenges
Loving Your Disabled Child
Public Counsel
The ARC and United Cerebral Palsy California Collaboration
Vietnamese Parents with Disabled Children Association, Inc.
Opposition
Association of Regional Center Agencies (ARCA)
Analysis Prepared by : Myesha Jackson / HUM. S. / (916)
319-2089