BILL ANALYSIS Ó
SENATE COMMITTEE ON APPROPRIATIONS
Senator Ricardo Lara, Chair
2015 - 2016 Regular Session
AB 959 (Chiu) - Lesbian, Gay, Bisexual, and Transgender
Disparities Reduction Act
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|Version: July 7, 2015 |Policy Vote: G.O. 12 - 1 |
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|Urgency: No |Mandate: No |
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|Hearing Date: August 17, 2015 |Consultant: Mark McKenzie |
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This bill meets the criteria for referral to the Suspense File.
Bill
Summary: AB 959 would require the Department of Health Care
Services (DHCS), the Department of Public Health (DPH), the
Department of Social Services (DSS), and the Department of Aging
(CDA) to collect voluntary self-identification information on
sexual orientation and gender identity, beginning no later than
January 1, 2017, when collecting demographic data.
Fiscal
Impact:
DHCS: This department indicates costs to implement the bill
would be "indeterminate." DHCS is currently engaged in
dialogue with the federal Centers for Medicare and Medicaid
Services (CMS) regarding the placement of sexual orientation
and gender identity information on the paper and online single
streamline application (SSApp). If CMS approves these
efforts, costs to update the SSApp would not be attributable
to this bill, but these costs would be accelerated as a result
AB 959 (Chiu) Page 1 of
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of the bill. In addition, staff estimates that DHCS could
incur significant costs to modify various other databases and
eligibility systems to provide for the collection of this
information. (General Fund, federal funds, and/or special
funds).
DPH: DPH administers two programs that would be impacted by
the bill.
o Under its Center for Health Statistics and
Information (CHSI), DPH estimates one-time costs of
approximately $165,000 (General Fund) to make programming
changes to Birth and Death Registration systems. Ongoing
costs for CHSI-related activities would be minor and
absorbable.
o Under its Genetic Disease Screening Program (GDSP),
DPH estimates one-time programming costs of approximately
$160,000 (General Fund) to update the Screening
Information System. There would also be ongoing costs of
approximately $105,000 (General Fund) related to printing
an enlarged form, but only some of these ongoing costs
can be attributed to this bill. (see staff comments)
DSS: Unknown costs to DSS. The department was unable to
provide information for purposes of this analysis. Staff
estimates that there could be significant one-time costs to
the extent that county welfare department information
technology systems would need programming changes to provide
for the collection of sexual orientation and gender identity
information. (General Fund)
CDA: The CDA indicates minor and absorbable costs to implement
the bill, but was unable to provide information about whether
specified information technology systems related to federal
aging programs have current functionality for collecting
demographic information on sexual orientation and gender
identity. There could be significant costs if these systems
would need to be updated to allow for this functionality.
(General Fund and/or federal funds)
Background: Existing law requires a state agency, board, or commission
that directly, or by contract, collects demographic data as to
the ancestry or ethnic origin of Californians, to use separate
collection categories and tabulations for each major Asian group
AB 959 (Chiu) Page 2 of
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and each major Pacific Islander group. This data is required to
be made available to the public in accordance with state and
federal law, except for personal identifying information, which
shall be deemed confidential.
Proposed Law:
AB 959 would enact the Lesbian, Gay, Bisexual, and Transgender
Disparities Reduction Act, requiring DHCS, DPH, DSS, and CDA to
collect voluntary self-identification information pertaining to
sexual orientation and gender identity in the course of
collecting demographic data directly or by contract. These
departments must also report the data collected, and the method
used to collect the data, and make the data available to the
public, excluding any personal identifying information, in
accordance with federal law. The data collected may only be
used for demographic analysis, coordination of care, quality
improvement of services, conducting approved research,
fulfilling reporting requirements, and guiding policy or funding
decisions.
Related
Legislation: SB 280 (Lieu and Lara), which was held on this
Committee's Suspense File last year, would have authorized the
application form for insurance affordability programs to include
questions on sexual orientation and gender identity, and would
have required the application to include voluntary questions
regarding specified demographic information, including sexual
orientation and gender identity or expression, as of January 1,
2016.
AB 1208 (Pan), which was vetoed by Governor Brown in 2013,
contained similar provisions to SB 280. The veto message
included the following statement:
We don't need to mandate these requirements in law. The
Department of Health Care Services and Covered California
already have the authority to modify these types of
questions on the form, and they can work constructively
with stakeholders to decide what is necessary to change for
2015 and beyond.
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Staff
Comments:
Department of Health Care Services : DHCS indicates that there
will be "indeterminate General Fund costs" to implement this
bill. In order to collect and report additional information on
sexual orientation and gender identity, DHCS would need to
modify the paper and online SSApp as well as various databases
and eligibility systems, including the Medi-Cal Eligibility Data
System, Medi-Cal Management Information System/Decision Support
System and the Statewide Automated Welfare System. DHCS is
currently in discussion with the federal CMS regarding the
placement of sexual orientation and gender identity information
for the SSApp. If these efforts are approved by CMS, DHCS will
incur costs that would not be attributable to this bill. These
costs would be associated with the bill if CMS does not approve
the changes. In addition, staff estimates that DHCS could incur
significant costs to update the various other database and
eligibility systems noted above, although DHCS was unable to
provide information regarding these other systems.
Department of Public Health : The CHSI, within DPH and through
the State Registrar, is responsible for registering each live
birth, fetal death, death, and marriage that occurs in
California, and for providing certified copies of vital records
to the public. Current law requires the State Registrar to
permanently preserve vital records in a systematic manner, and
to prepare and maintain a comprehensive and continuous index of
all registered certificates. This bill would require DPH to
make one-time programming changes to the Birth and Death
Registration systems at a cost of about $165,000. Any ongoing
costs to develop new worksheets and forms required for entering
information into the database would be minor and absorbable.
DPH, through the Genetic Disease Screening Program (GDSP),
produces the results of the statewide Newborn Screening Program,
which provides testing for nearly all babies born in the state,
and the Prenatal Screening Program, an optional program which is
offered to pregnant women who are in prenatal care before the
twentieth week of gestation. DPH indicates the bill would
require programming changes to the Screening Information System
at a one-time cost of approximately $160,000. In addition, DPH
notes that it would incur ongoing costs of approximately
AB 959 (Chiu) Page 4 of
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$105,000 annually in printing costs related to larger forms
required to accommodate additional fields for sexual orientation
and gender identity, as well as additional races and
ethnicities. Only some of these ongoing costs would be related
to this bill.
Department of Social Services : The department was unable to
provide information for purposes of this analysis. Staff
estimates the bill could result in significant costs to update
county welfare department information technology systems (known
as SAWS) and to reprint paper applications to provide for the
collection of sexual orientation and gender identity
information.
Department of Aging : CDA indicates that it collects and reports
demographic information from 33 local Area Agencies on Aging
(AAA) that use National Aging Programs Information System, and
each AAA has its own management information system unique to its
service area. It is unclear whether these systems currently
provide functionality for collection of demographic information
on sexual orientation and gender identity. Staff estimates that
the bill could result in significant costs to either update
those systems to provide necessary functionality, or to create
stand-alone methods for collecting this data, to the extent
existing systems do not provide for collecting this information.
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