BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 302
                                                                  Page  1


          ASSEMBLY THIRD READING
          AB 302 (Beall)
          As Amended  June 1, 2009
          Majority vote 

           HUMAN SERVICES      5-2         APPROPRIATIONS      12-5        
           
           -------------------------------------------------------------------- 
          |Ayes:|Beall, Ammiano, Hall,     |Ayes:|De Leon, Ammiano, Charles    |
          |     |Portantino, Torres        |     |Calderon, Davis, Fuentes,    |
          |     |                          |     |Hall, John A. Perez, Price,  |
          |     |                          |     |Skinner, Solorio, Torlakson, |
          |     |                          |     |Krekorian                    |
          |     |                          |     |                             |
          |-----+--------------------------+-----+-----------------------------|
          |Nays:|Tom Berryhill, Logue      |Nays:|Nielsen, Duvall, Harkey,     |
          |     |                          |     |Miller,                      |
          |     |                          |     |Audra Strickland             |
           -------------------------------------------------------------------- 

           SUMMARY  :  Requires the Department of Developmental Services  
          (DDS), using existing data, to determine how purchase-of-service  
          (POS) funds are spent based on consumer ethnicity and primary  
          language.  Specifically,  this bill  :

          1)Requires DDS, as part of its responsibility to monitor  
            regional centers and to assist in determining whether POS  
            funds are being spent equitably among the state's  
            linguistically and ethnically diverse population, to use  
            existing data, from the client master file, the client  
            development evaluation report file, and the  
            purchase-of-service file, to determine the following:

             a)   The number and percentage of individuals, by ethnicity  
               and age and by primary language and age, who are eligible  
               for regional center services but are not receiving any  
               services using POS funds; and,

             b)   The average annual per capita POS expenditures for  
               individuals receiving services using POS funds, overall, by  
               residence type, and by service category, with details by  
               ethnicity and age and by primary language and age.

          2)Requires DDS to annually update these POS data, for the state  








                                                                  AB 302
                                                                  Page  2


            as a whole and separately for each regional center, and post  
            the data on its Internet Web site.

           EXISTING LAW  : 

          1)Establishes, under the Lanterman Developmental Disabilities  
            Services Act (Lanterman Act), 21 nonprofit regional centers,  
            which contract with DDS to provide case management services,  
            conduct assessments, and develop and implement an individual  
            program plan (IPP) for each person determined to be eligible  
            for regional center services under the Lanterman Act.

          2)Requires that, in order to achieve the stated objectives of a  
            consumer's IPP, the regional center secure needed services and  
            supports, either from an agency that receives public funds to  
            serve all members of the general public or by purchasing the  
            service or support from a provider using funds allocated to  
            the regional center's POS budget.

          3)Provides that DDS, through appropriate and regular monitoring  
            activities, is responsible for ensuring that regional centers  
            meet their statutory, regulatory, and contractual obligations,  
            and provide services and supports in compliance with the  
            principles of the Lanterman Act.

           FISCAL EFFECT  :  According to the Assembly Appropriations  
          Committee, one-time GF costs of $50,000 to $80,000 to use  
          current data sets to quantify statewide and [regional center]  
          specific conclusions and post results online. On-going GF costs  
          of $30,000 to $50,000.

           COMMENTS  :  In its letter supporting AB 302, the USC University  
          Center on Excellence in Developmental Disabilities says that  
          "[r]esearch in many fields over the past 10-15 years, has  
          documented racial disparities in access to services and service  
          outcomes in health care, mental health, education, foster care,  
          childcare, and corrections, to name but a few.  While there are  
          differences across ethnic groups, there is solid evidence that  
          people of color receive fewer services and have poorer outcomes  
          than their white counterparts, regardless of the service  
          system." 

          Several studies conducted since the early 1990s have examined  
          regional centers' expenditures of POS dollars as a function of a  








                                                                  AB 302
                                                                  Page  3


          number of variables, including client ethnicity.  Language  
          contained in a trailer bill to the budget of 1998 required DDS  
          to analyze the POS expenditures and factors that lead to  
          variance among various race and ethnic groups.  The data  
          produced were criticized by some as not having sufficient  
          control factors; so, the decision was made to alter the  
          methodology and conduct another study.  The second study was  
          released in August of 2003.  Most recently, the results of  
          independent statistical studies using DDS data were published in  
          2008 by researchers at the University of California, San  
          Francisco--Charlene Harrington and Taewoon Kang.  

          While the results have been varied and open to interpretation,  
          the studies overall show that the per capita expenditure of POS  
          dollars is higher for white clients than for other racial and  
          ethnic groups.  The Harrington and Kang studies found that, even  
          when controlling for client needs, all racial and ethnic groups  
          (Asian/Pacific Islanders, African Americans, Hispanics) were  
          23-31% less likely to receive any services than were whites.   
          For those who received services, even when client need is taken  
          into account, annual per-person expenditures for non-white  
          racial and ethnic groups were significantly lower than for  
          whites:  Hispanics received $3,190 less, Asian/Pacific Islanders  
          received $2,560 less, and African Americans received $1,320  
          less.

          Harrington and Kang note that any number or combination of  
          factors might explain these disparities, "including client and  
          family attitudinal and belief systems, language skills,  
          immigration status, provider race/ethnicity, and lack of  
          knowledge of the system.  [Regional center] staff assessment and  
          case management procedures or cultural competence as well as  
          [regional center] and/or provider discrimination could be other  
          factors."  Harrington, C. & Kang, T.,  Disparities in service  
          utilization and expenditures for individuals with developmental  
          disabilities  , Disability & Health Journal, 1:184, 193 (2008).

          A 2005 bill (AB 1535 (Bass)) likewise would have required the  
          posting of information on POS disparities on DDS's website.   
          Unlike this bill, however, AB 1535 would also have required more  
          complex and detailed analyses and reports.  AB 1535 was  
          eventually amended to address an entirely different subject  
          matter.









                                                                  AB 302
                                                                  Page  4


          This bill requires that, using existing data, DDS annually  
          merely post specified aggregate POS information on its Web site,  
          based on age, ethnicity and primary language.  DDS already posts  
          demographic and statistical data on its Web site in an annual  
          Fact Book and could include the information required by this  
          bill.  The author points out that this bill makes no assumptions  
          about the reasons for identified POS disparities based on  
          race/ethnicity or other factors.  In fact, as the author notes,  
          "[t]he extent of the disparities and the underlying reasons may,  
          in fact, vary by regional center."  But, for stakeholders to  
          have informed discussions of these issues at the regional center  
          and state level, it is necessary to start with current data.   
          According to the author, "[t]he requirement that the data be  
          made public and regularly updated will enable informed  
          discussions to be held, appropriate strategies to be developed  
          and implemented, and changes to be assessed over time."

           
          Analysis Prepared by  :    Eric Gelber / HUM. S. / (916) 319-2089 


                                                                FN: 0001343