BILL ANALYSIS Ó AB 1726 Page 1 Date of Hearing: April 12, 2016 ASSEMBLY COMMITTEE ON HEALTH Jim Wood, Chair AB 1726 (Bonta) - As Amended March 1, 2016 SUBJECT: Data collection. SUMMARY: Requires specified entities, when collecting demographic data on ancestry or ethnic origin, to disaggregate those data for specified Native Hawaiian (NH) and Asian and Pacific Islander (API) groups. Specifically, this bill: 1)Requires the following entities, on or after July 1, 2017, when collecting demographic data on ancestry or ethnic origin to collect and tabulate data for additional major Asian groups and additional major NH and other API, as specified: a) The Department of Public Health and the Department of Health Care Services for a report that includes the type and amount of health care coverage, the rates for major diseases, leading causes death per demographic, subcategories of leading causes of death in California overall, pregnancy rates, or housing numbers; and, b) The Board of Governors of the California Community Colleges (CCC), the Trustees of the California State University (CSU), or the Regents of the University of AB 1726 Page 2 California (UC), whenever the entity collects demographic data as to the ancestry or ethnic origin of students for a report that includes student admission, enrollment, completion, or graduation rates. Requires these entities to comply with the federal Family Educational Rights and Privacy Act, as specified. 2)Exempts demographic data of graduate or professional schools of UC, and applies the requirements of this bill to the UC only if the Regents of the UC, by resolution, make it applicable. 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: AB 1726 Page 3 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 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 AB 1726 Page 4 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 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. c) Data collection at CCC, CSU and UC. According to the Assembly Higher Education Committee analysis of this bill, the CCC collects information on 11 different API communities on its application CCC Apply. It is unclear how the data is reported or if it is published for public access. As of 2009, the CSU application was modified to provide applicants with over 50 different API categories from which to self-identify. Additionally, the existing practices of the UC on data collection exceed what is required in this measure. d) Joint Informational Hearing. On March 11, 2015, the California Senate and Assembly Committees on Health held a joint information hearing to examine health disparities in California. Testimony provided by the Southeast Asia AB 1726 Page 5 Resource Action Center illustrated how the lack of disaggregated data masks disparities within the API community. For example, 24% of Hmong and Cambodian Americans have diabetes, but there are no data regarding the number of Hmong and Cambodian Americans that are served by California's Heart Disease and Prevention Unit. Among recommendations was disaggregating data for DHCS. The Committees also heard that the federal Office of Minority Health has issued guidelines for the collection of more granular and disaggregated categories for race and ethnicity, and accordingly, California should take administrative steps to standardize demographic data categories for race and ethnicity in order to reduce health disparities. 3)SUPPORT. The California Pan-Ethnic Health Network states that data disaggregation within the API American communities is imperative for uncovering the social, economic, and educational disparities inherent not only but in all ethnic populations. The California Young Democrats Asian and Pacific Islander Caucus state that API's are the fastest growing and most ethnically diverse population in California, and as such it is important that policymakers fully understand the disparities that exist within this populations so that no API ethnic community is overlooked. SEIU California states that disaggregation of API demographic data will illuminate important health care disparities and higher education achievement gap that policymakers will need to address in future years. 4)OPPOSITION. Opponents such as the Dublin Chinese Association, No Tower in Schools and the Silicon Valley Chinese Association indicate that the stratified data to be collected by government agencies and state universities may easily be manipulated to advance race-based public policies that are unlawful. AB 1726 Page 6 5)PREVIOUS LEGISLATION. a) AB 176 (Bonta) of 2015 was substantially similar to this bill and would have required the same entities under this bill, in addition to, the Department of Managed Health Care (DMHC) to collect and tabulate specified demographic data. AB 176 was vetoed by Governor Brown who indicated: "To be sure, there is value in understanding data on race, ethnicity, gender and other aspects of identity. On a broad level, these demographic data can signal important changes in society. On a practical level, they can help elucidate how our laws and programs can be shaped to reflect a changing population. Despite this utility, I am wary of the ever growing desire to stratify. Dividing people into ethnic or other subcategories may yield more information, but not necessarily greater wisdom about what actions should follow. To focus just on ethnic identity may not be enough. CSU, community colleges, and UC already provide many ways in which to self-identify, including choosing among several ethnic identities. In the case of CSU, there are 50 choices for API applicants alone. Codifying the collection and reporting of at least 12 API groups several years into the future appears unnecessary, or at least premature." b) AB 1088 (Eng), Chapter 689, Statutes of 2011, requires DIR and DFEH to collect and tabulate data for additional major Asian groups. c) AB 1737 (Eng) of 2010, would have required certain state agencies to use additional separate collection categories and tabulations for major NH and API groups. AB 1737 was held on the suspense file of the Assembly Appropriations AB 1726 Page 7 Committee. d) 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. e) 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, CCCs, or the CSU. 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. 6)DOUBLE REFERRAL. This bill is double referred; it was heard in the Assembly Higher Education Committee on March 15, 2016 and passed out on a vote of 10-2. 7)POLICY COMMENT. With the exception of the DMHC, this bill is substantially similar to the provisions of AB 176 which was vetoed by the Governor last year. The Committee may wish to inquire from the author how he plans to address the Governor's veto message. REGISTERED SUPPORT / OPPOSITION: Support AB 1726 Page 8 Asian & Pacific Islander American Health Forum (cosponsor) Empowering Pacific Islander Communities (cosponsor) Southeast Asia Resource Action Center (cosponsor) Abriendo Puertas/Opening Doors Alliance for Boys and Men of Color American Cancer Society Cancer Action Network American Civil Liberties Union Asian Pacific American Labor Alliance - Alameda Chapter Asian American Cancer Support Network Asian Americans Advancing Justice - California Asian Americans for Community Involvement Asian Law Alliance Asian Pacific American Labor Alliance - Sacramento Chapter Asian Pacific Islander Obesity Prevention Alliance AB 1726 Page 9 Asian Pacific Partners for Empowerment, Advocacy and Leadership Asian Pacific Policy & Planning Council Banteay Srei Brightline California Asian Pacific Islander Budget Partnership California Immigrant Policy Center California Pan-Ethnic Health Network California Young Democrats Asian and Pacific Islander Caucus Campaign for College Opportunity Canal Alliance Chinatown Public Health Center Chinese for Affirmative Action Community Health Partnership East Bay Asian Youth Center Fresno Interdenominational Refugee Ministries AB 1726 Page 10 Global Refugee Awareness Healing Center Graduate Academic Achievement and Advocacy Program Health House Within a MATCH Coalition Hmong Innovating Politics Inland Empire - Immigrant Youth Coalition Khmer Girls in Action Khmer Parent Association Korean Churches for Community Development Korean Resource Center Leadership Education for Asian Pacifics, Inc. Lu-Mien Community Services Multicultural Council of America National Asian Pacific American Women's Forum AB 1726 Page 11 National Association of Social Workers - California Chapter National Council of Asian Pacific Americans National Pacific Islander Education Network Native Hawaiian and Pacific Islander Alliance OCA - Asian Pacific Advocates OCA - Greater Los Angeles OCA - San Mateo OCA - Silicon Valley OCA- San Francisco Bay OCA-East Bay PALS for Health PolicyLink Refugee & Immigration Ministries - Christian Church (Disciples of Christ) in the U.S. and Canada SEIU California AB 1726 Page 12 Services, Immigrant Rights, and Education Network Services, Immigrant Rights, and Education Network Southeast Asian Assistance Center Stone Soup Fresno The Cambodian Family Community Center TOFA, Inc. United Cambodian Community Urban Stratagies Council Vietnamese Youth Development Center Opposition AB 1726 Page 13 Dublin Chinese Association No Tower in Schools San Diego Asian Americans for Equality San Ramon Chinese Association Silicon Valley Chinese Association Small Hand Big Hand Two individuals Analysis Prepared by:Rosielyn Pulmano / HEALTH / (916) 319-2097