BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                     AB 176


                                                                    Page  1





          Date of Hearing:  April 21, 2015 


                            ASSEMBLY COMMITTEE ON HEALTH


                                  Rob Bonta, Chair


          AB 176  
          (Bonta) - As Amended April 14, 2015


          SUBJECT:  Data collection.


          SUMMARY:  Requires specified state agencies to report and  
          publish data using collection and tabulation categories, for  
          Native Hawaiian, Asian, and Pacific Islander groups (API),  
          whenever they collect demographic data, as specified.   
          Specifically, this bill:


          1)Requires the Board of Governors (BOG) of the California  
            Community Colleges (CCC), the Trustees of the California State  
            University (CSU), and the Regents of the University of  
            California (UC), whenever said entities collect demographic  
            data as to the ancestry or ethnic origin of students for a  
            report that includes student admission, enrollment,  
            completion, or graduation rates, to use specified collection  
            and tabulation categories for Native Hawaiian, and other API  
            groups.

          2)Requires the Department of Public Health (DPH), Department of  
            Health Care Services (DHCS), and Department Managed Health  
            Care (DMHC) to use additional collection and tabulation  
            categories for Native Hawaiian (NH), Asian, and Pacific  
            Islander (API) groups whenever said entities collect  
            demographic data.








                                                                     AB 176


                                                                    Page  2








          3)Requires the BOG, CCC, CSU, and UC to collect and publish  
            specified data, in compliance with the Family Educational  
            Rights and Privacy Act, and requires these entities to observe  
            criteria for ensuring statistical significance of data  
            collected and published.



          4)Requires DPH, DHCS, and DMHC whenever they collect patient  
            demographic data on level of health care coverage, amount of  
            health care coverage, rates for major diseases, leading causes  
            of death per demographic, subcategories for leading causes of  
            death in California overall, pregnancy rates, and housing  
            numbers, each must use the following separate collection  
            categories and tabulations, in addition to the categories  
            required by existing law:



             a)   Major Asian groups, including, but not limited to,  
               Bangladeshi, Hmong, Indonesian, Malaysian, Pakistani, Sri  
               Lankan, Taiwanese, and Thai; and,

             b)   Major Native Hawaiian and other Pacific Islander groups,  
               including, but not limited to, Fijian and Tongan.



          5)Requires DPH, DHCS, and DMHC to make any data collected  
            publicly available, except for personal identifying  
            information by posting the data on the Internet Website of the  
            agency on or before July 1, 2012, and annually thereafter.   
            Requires DPH, DHCS, and DMHC to update their data collection  
            to reflect the additional Asian groups and additional Native  
            Hawaiian and API groups as they are reported by the U.S.  
            Census Bureau within 18 months after a decennial U.S. Census  








                                                                     AB 176


                                                                    Page  3





            is released to the public.
          


          EXISTING LAW:  


          1)Requires state agencies, boards, and commissions that directly  
            or by contract collect demographic data as to the ancestry or  
            ethnic origin of Californians to use separate collection  
            categories and tabulations for each major API group,  
            including, but not limited to, Chinese, Japanese, Filipino,  
            Korean, Vietnamese, Asian Indian, Laotian, Cambodian,  
            Hawaiian, Guamanian, and Samoan.


          2)Requires the Department of Industrial Relations (DIR) and the  
            Department of Fair Employment and Housing (DFEH) to collect  
            and tabulate data for additional major Asian groups.


          FISCAL EFFECT:  This bill has not yet been analyzed by a fiscal  
          committee.


          COMMENTS:  


          1)PURPOSE OF THIS BILL.  The author states many of the  
            communities within the API population face similar challenges  
            in California, such as language barriers and immigration;  
            however, they differ on many issues.  The author asserts this  
            is most evident with respect to education and public health,  
            where the outcomes of some of the largest NH and API groups  
            within the aggregate population raise the average outcome of  
            the greater NH and API population as a whole.  The author  
            points to data from a 2013 report done by the Asian American  
            Center for Advancing Justice, which demonstrates that 14% of  
            Asian Americans are uninsured; disaggregated data shows that  








                                                                     AB 176


                                                                    Page  4





            Korean, Tongan, and Thai have uninsured rates higher than 22%  
            whereas only 8% to 10% of Japanese and Asian Indian  
            populations are uninsured.  The author contends that the lack  
            of disaggregated data for the NH and API community within the  
            public health sector is limiting the state's ability to  
            provide the best health care to this population.  The author  
            concludes that this bill will enable the state and public to  
            identify trends that are typically unseen through aggregate  
            data, and ensure that the state is adequately meeting the  
            health needs of its residents.

          2)BACKGROUND.



             a)   Aggregate vs. disaggregated data.  Data aggregation is  
               any process in which information is gathered and expressed  
               in a collective or summary form, for purposes such as  
               statistical analysis.  A common aggregation purpose is to  
               get more information about particular groups based on  
               specific variables such as age, profession, or income where  
               the data are aggregated to preserve the confidentiality of  
               individuals.  Disaggregated data are data that have been  
               extrapolated from aggregated data and divided and broken  
               down into smaller information units.  Disaggregating data  
               is another critical step to gaining increased knowledge  
               from collective or aggregated information.  Fully  
               disaggregating data helps to expose hidden trends, and can  
               enable the identification of vulnerable populations.

             b)   Need for disaggregated data.  According to the 2010 U.S.  
               Census, there are currently over 4.8 million Californians  
               of Asian descent.  NH and API subgroups represent over 50  
               ethnic backgrounds and speak over 100 different languages,  
               thus language and cultural barriers pose health care  
               problems for many individuals within these subgroups.  A  
               2010 study by the Asian and Pacific Islander American  
               Health Forum demonstrated that different NH and API  
               subgroups have varying health care problems.  Data from the  








                                                                     AB 176


                                                                    Page  5





               report revealed NH and Filipino adults have some of the  
               highest rates of obesity and diabetes in the state, whereas  
               Korean adults suffer from the highest rates of serious  
               psychological stress in the state.  The report also showed  
               Tongans and Koreans have some of the highest uninsured  
               rates in the state



          3)SUPPORT.  Supporters of this bill state the lack of  
            disaggregated data collection by public health state agencies  
            undermines efforts to increase awareness of public health  
            intiatives and increase preventive care.  Supporters contend  
            this bill is necessary to ensure that limited public health  
            resources are effectively utilized on the populations that  
            need them most.  Supporters conclude that disaggregated data  
            will also be useful to organizations within the public which  
            examine the optimal public health support services are  
            necessary to best assist the community.

          4)CONCERNS.  DPH has expressed concern that the additional  
            collection and tabulation categories may lead to a small  
            enough sample size that information may be personally  
            identifiable.  DPH is seeking clarification that data  
            reporting would be statewide rather than on a countywide  
            basis.  DPH also raises concerns about whether third party  
            data - data used by DPH, but not collected by it - would be  
            covered in the bill provisions.





            DMHC states they deal primarily with insurance and medical  
            complaints, and infrequently collect demographic data.  DMHC  
            contends that any data gathered is on a scale small enough to  
            be statistically insignificant and possibly personally  
            identifiable.  DMHC is concerned that the provisions of this  
            bill would apply in the case that DMHC expands collection of  








                                                                     AB 176


                                                                    Page  6





            demographic data.


            


          5)POLICY CONSIDERATIONS.  Some supporters of the bill have  
            advocated for inclusion of the Iu Mien ethnic group as one of  
            the additional major Asian groups specified for collection and  
            tabulation by the departments.  According to Lao Family  
            Community Development, there are approximately 50 thousand Iu  
            Mien in the entire U.S.  This bill mandates that DPH, DHCS,  
            and DMHC update their collection and tabulation categories  
            with any new categories provided with the release of a  
            decennial census.  Iu Mien have yet to be included as a  
            distinct category in the U.S. Census, but would be covered by  
            the bill provisions in the case that the group is in the  
            future. 
            


            This bill currently requires the higher education authorities  
            to collect data in a manner that complies with federal privacy  
            law and is statistically significant.  The current language  
            does not contain such requirements for the public health  
            authorities within this bill.  The Committee may suggest to  
            the author amendments later in the legislative process to  
            safeguard the privacy of individuals and ensure statistical  
            significance of the data collected.



          6)PRIOR LEGISLATION:

             a)   AB 1088 (Eng), Chapter 689, Statutes of 2011, requires  
               DIR and DFEH to collect and tabulate data for additional  
               major Asian groups.

             b)   AB 1737 (Eng) of 2010, would have required certain state  








                                                                     AB 176


                                                                    Page  7





               agencies to use additional separate collection categories  
               and tabulations for major Native Hawaiian and API groups.   
               AB 1737 was held on the suspense file of the Assembly  
               Appropriations Committee.
             
             c)   AB 295 (Lieu) of 2007 would have required various state  
               entities to report collected demographic data according to  
               each major API group and make that data available to the  
               public to the extent that disclosure did not violate  
               confidentiality.  AB 295 was vetoed by the Governor.

             d)   AB 2420 (Lieu) of 2006 would have expanded from 11 to 23  
               the ancestry or ethnic origin collection categories  
               required to be collected by any state agency, board,  
               commission, California Community Colleges, or the  
               California State University.  Also, would have required the  
               above entities to collect, tabulate, report, and make  
               available to the public any data collected on the groups.   
               AB 2420 was held on the Senate Appropriations Committee  
               Suspense File.

          7)DOUBLE REFERRAL.  This bill is double referred, it was heard  
            in the Assembly Higher Education Committee on April 7, 2015  
            and passed out on a vote of 12-1.

          REGISTERED SUPPORT / OPPOSITION:




          Support


          Alliance for Boys and Men of Color
          Asian Pacific American Labor Alliance - Alameda Chapter
          Asian Pacific American Labor Alliance
          California Black Health Network
          California Commission on Asian and Pacific Islander American  
          Affairs








                                                                     AB 176


                                                                    Page  8





          California Immigrant Policy Center
          California Pan-Ethnic Health Network
          California State University
          Cambodian Association of America
          Families in Good Health
          Fresno Interdenominational Refugee Ministries
          Healthy House Within a MATCH Coalition
          Hmong National Development, Inc.
          Iu Mien Community Services
          Khmer Girls in Action
          Khmer Parent Association
          Lao Family Community Empowerment, Inc.
          Los Angeles Community College District
          National Commission on AAPI Research in Education
          National Council of Asian Pacific Islanders
          OCA - Asian Pacific American Advocates
          OCA - Greater Los Angeles
          Pasadena Community College District
          Project Prevention Coalition
          Service Employees International Union California


          Southeast Asia Resource Action Center
          Stone Soup Fresno
          United Cambodian Community
          University of Southern California Student Coalition for Asian  
          Pacific Empowerment
          West Coast Asian Pacific Islander Student Union 
          Young Invincibles
          54 Individuals


          Opposition


          None on file.











                                                                     AB 176


                                                                    Page  9






          Analysis Prepared by:Rylan Gervase / HEALTH / (916) 319-2097