BILL ANALYSIS Ó
SB 291
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SENATE THIRD READING
SB
291 (Lara)
As Amended September 4, 2015
Majority vote
SENATE VOTE: 36-1
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|Committee |Votes|Ayes |Noes |
| | | | |
| | | | |
| | | | |
|----------------+-----+-----------------------+---------------------|
|Health |18-0 |Bonta, Maienschein, | |
| | |Bonilla, Burke, | |
| | |Chávez, Chiu, Gomez, | |
| | |Gonzalez, Roger | |
| | |Hernández, Lackey, | |
| | |Nazarian, Patterson, | |
| | |Rodriguez, Santiago, | |
| | |Steinorth, Thurmond, | |
| | |Waldron, Wood | |
| | | | |
|----------------+-----+-----------------------+---------------------|
|Appropriations |17-0 |Gomez, Bigelow, Bloom, | |
| | |Bonta, Calderon, | |
| | |Chang, Daly, Eggman, | |
| | |Gallagher, Eduardo | |
| | |Garcia, Holden, Jones, | |
| | |Quirk, Rendon, Wagner, | |
SB 291
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| | |Weber, Wood | |
| | | | |
| | | | |
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SUMMARY: Amends the definition of vulnerable communities to
include individuals who have experienced trauma related to
genocide; requires the Department of Health Care Services (DHCS)
to include stakeholders in vulnerable communities, as defined,
in its decision making process, to promote effective and
efficient quality mental health services; and, requires the
Office of Health Equity (OHE) to include representatives from
vulnerable communities amongst the stakeholders they seek input
from when developing and updating their strategic plan on
eliminating health disparities.
FISCAL EFFECT: According to the Assembly Appropriations
Committee, negligible state fiscal impact.
COMMENTS: According to the author, in the last decade, the
Legislature has sought to expand access to mental health care.
OHE and DHCS, among other state and local entities, have been
charged with carrying out various mental health initiatives.
Yet barriers to mental health care remain and community and
non-profit organizations that serve individuals suffering from
trauma related to genocide struggle to access programs and
services administered by these departments. The author states,
in particular the Cambodian-American population still suffers
from the effects of the Cambodian Genocide that occurred between
1975 to 1979 and their mental health challenges are
multigenerational, extending beyond the elders who were refugees
to the youth who are United States born citizens. The author
concludes, in the interest of continuing the state's goal
towards advancing mental health care access, this bill will
improve institutional access for Californians who have
experienced with trauma related to genocide by improving
SB 291
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stakeholder engagement, service delivery, and ultimately access
to mental health services.
Health disparities. According to the federal Centers for
Disease Control and Prevention, health disparities are
preventable differences in the burden of disease, injury,
violence, or opportunities to achieve optimal health that are
experienced by socially disadvantaged populations. Populations
can be defined by factors such as race or ethnicity, gender,
education or income, disability, geographic location (e.g.,
rural or urban), or sexual orientation. Health disparities are
inequitable and are directly related to the historical and
current unequal distribution of social, political, economic, and
environmental resources.
Disparities in data collection. According to a 2010 Asian and
Pacific Islander American Health Forum Report, in California,
data available for Asian Americans (AA) and Native
Hawaiians/Pacific Islanders (NHPI) lag far behind data on other
racial/ethnic groups. In addition, aggregated AA and NHPI data
fail to capture the diversity and differences across subgroups.
For example, in the 1980s and 1990s, aggregated AA and NHPI data
showed that the group had the lowest incidence of breast cancer
across races and ethnicities, which helped lead to a belief that
Asian women had significantly lower rates of breast cancer.
However, subsequent studies showed that Native Hawaiian women
had a very high incidence of breast cancer, second only to white
women, whereas Korean women had a very low incidence. The high
risk for Native Hawaiians was hidden by the aggregation of data.
Asian subpopulations also have varying socioeconomic statuses,
which is an important predictor of health access. The Asian &
Pacific Islander American Health Forum stated in the report that
support for new primary data collection and longitudinal studies
are needed to fully capture the diverse social and health assets
and needs faced by all the AA and NHPI communities.
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DHCS efforts. In March of this year the Senate and Assembly
Health Committees held a joint hearing regarding health
disparities in California. At that time DHCS informed the
Senate and Assembly Health Committees that it will soon stratify
quality measures by demographic factors. Their goal is to focus
quality improvement efforts to eliminate heath disparities and
improve quality overall. DHCS is in the process of identifying
initial measures to conduct this analysis.
Another demographic analysis currently conducted by DHCS is the
use of managed care plan grievances and appeals data. DHCS is
able to determine if an over-prevalence of grievances and/or
appeals exists among a specific demographic group. DHCS has
previously collected race and/or ethnicity data when conducting
the Consumer Assessment of Healthcare Providers and Systems
(CAHPS) survey. This survey is a measure of Medi-Cal
beneficiary satisfaction. DHCS reports they will continue to
conduct this analysis by race and/or ethnicity and use the CAHPS
survey to collect additional demographic factors.
Families in Good Health (FGH) supports this bill stating, in the
last 20 years or so there has been a tremendous amount of
research done on how trauma and stress affects brain development
and physical and mental health. FGH notes the Cambodian
community with its own unique challenges is lumped together, if
recognized at all, under the Asian and Pacific Islander (API)
category by state departments, and this aggregation of identity
does not reveal the real health conditions of the Cambodians in
California.
The California Immigrant Policy Center supports this bill
because it will improve institutional access for community and
non-profit organizations that service individuals who suffer
from trauma related to genocide.
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There is no opposition to this bill.
Analysis Prepared by:
Lara Flynn / HEALTH / (916) 319-2097 FN:
0002089