BILL ANALYSIS Ó Senate Appropriations Committee Fiscal Summary Senator Kevin de León, Chair SB 1093 (Liu) - Developmental services: regional centers: culturally and linguistically competent services. Amended: April 24, 2014 Policy Vote: Human Services 4-0 Urgency: No Mandate: No Hearing Date: May 5, 2014 Consultant: Brendan McCarthy This bill meets the criteria for referral to the Suspense File. Bill Summary: SB 1093 would require regional centers to develop and implement plans to increase utilization of services by consumers impacted by disparities in service utilization. The bill would specify that independent living skills services are available to adult consumers living with family or elsewhere in the community. The bill would make a variety of changes to the existing reporting requirements on regional centers and the Department of Developmental Services. Fiscal Impact: Potential cost increases in the hundreds of millions per year due to increased utilization of services, to the extent the bill results in regional centers providing additional services to consumers (General Fund and federal funds). According to information provided by the Association of Regional Center Agencies, the average per capita cost for services and supports provided to regional center consumers varies significantly between ethnic groups. The bill requires regional centers to develop and implement plans that will lead to an increase in the utilization of services by consumers impacted by disparities in the provision of services identified under existing reporting requirements on the regional centers. By requiring regional centers to increase the utilization of services by groups of consumers, the bill is likely to significantly increase the utilization of services and the costs to the state for those services. Unknown, but likely minor costs to provide additional independent living skills services (General Fund and federal funds). The bill specifically provides that independent living skills services shall be available to adult consumers SB 1093 (Liu) Page 1 who live in the home of a parent, family member, or others. Under current law, such consumers are already eligible for those services. Putting an explicit authorization in statute might increase awareness of, and demand for, such services. However, because those services are already allowed, such an increase in demand may not be large and may be offset by reductions in other services to those consumers. Minor administrative costs to the regional centers to collect and report additional data and engage in additional stakeholder outreach (General Fund). 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 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. Proposed Law: SB 1093 would require regional centers to develop and implement plans to increase utilization of services by consumers impacted by disparities in service utilization. The bill would specify that independent living skills services are available to adult consumers living with family or elsewhere in the community. The bill would also make a variety of changes to the requirements for regional centers and the Department to collect and report data on the provision of services. SB 1093 (Liu) Page 2 Related Legislation: SB 158 (Correa, 2013) would have established 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. That bill was vetoed by the Governor. SB 208 (Lara, Statutes of 2013) 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, 2013) would have required DDS to ensure that the regional centers collect, analyze, and report data in a way that allows for comparisons across regional centers, and require regional centers to identify plans to reduce disparities. That bill was held on this committee's Suspense File. SB 321 (Price, 2013) would have required DDS to establish performance contract guidelines and measures relating to issues of cultural and linguistic competency. That bill was held on this committee's Suspense File. SB 367 (Block, Statutes of 2013) requires regional centers to include issues related to cultural and linguistic competency in governing board training requirements, to post such training on their websites and to annually review the regional center's provision of services in a culturally and linguistically competent way. SB 555 (Correa, Statutes of 2013) requires a regional center to communicate and provide written materials in a consumer or family's native language during the IPP and IFSP processes and to require that the native language be documented. AB 1232 (V. Manuel Perez, Statutes of 2013) 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. Staff Comments: In recent years, the state has negotiated a Home and Community-Based Services for the Developmentally Disabled Waiver (the "Waiver") which allows the Department to receive federal matching funds for services provided to some regional center consumers. The purpose of this Waiver is to use state and federal funds to allow consumers to remain in the community, rather than being institutionalized. In some cases, the state SB 1093 (Liu) Page 3 could use such funding to pay for a portion of the costs to provide additional services and supports that would occur under the bill.