BILL ANALYSIS                                                                                                                                                                                                    



                                                                    AB 1726


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          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  








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               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:  











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          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  








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               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  








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               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.











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          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  








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               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










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          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








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          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










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          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










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          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








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          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










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          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