BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 2204
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          Date of Hearing:   March 23, 2010

                        ASSEMBLY COMMITTEE ON HUMAN SERVICES
                                Jim Beall, Jr., Chair
                    AB 2204 (Beall) - As Amended:  March 15, 2010
           
          SUBJECT  :  Developmental services:  stakeholder groups

           SUMMARY  :  Requires the Department of Developmental Services  
          (DDS) to take into account the state's ethnic, geographic, and  
          socioeconomic diversity when convening or consulting with  
          stakeholder groups under the Lanterman Developmental  
          Disabilities Services Act (Lanterman Act).  Specifically,  this  
          bill  :  

          1)Requires that, in convening stakeholder organizations or  
            groups pursuant to the Lanterman Act, DDS take into account  
            the state's ethnic, geographic, and socioeconomic diversity  
            and use best efforts to include stakeholder groups that,  
            collectively, reflect the interests of the state's diverse  
            population.

          2)Requires that, in preparing reports to the Legislature  
            required under the Lanterman Act related to activities that  
            involve stakeholder groups, DDS include a description of how  
            it considered diversity in convening the stakeholders.

          3)Makes non-substantive changes to the definition of  
            "stakeholder organizations."

           EXISTING LAW  

          1)Establishes, under the 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)Establishes DDS as the state department responsible for  
            overall administration of the requirements Lanterman Act.

          3)Defines "stakeholder organizations" as statewide organizations  
            representing the interests of consumers, family members, and  
            service providers, and statewide advocacy organizations.









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          4)Requires that, when convening any task force or advisory  
            group, DDS make its best effort to ensure representation by  
            consumers and family members representing California's  
            multicultural diversity.

           FISCAL EFFECT  :  Unknown

           COMMENTS  :  According to the author, "[I]t is important that all  
          segments of California's diverse population have a voice into  
          policy decisions related to the provision of services to people  
          with developmental disabilities under the Lanterman Act.  This  
          means that DDS should consider diversity--cultural, ethnic,  
          language, geographic, and socioeconomic--when it is required to  
          convene stakeholder groups or to consult with stakeholders on  
          issues related to the budget or policies impacting the  
          availability and delivery of services to regional center  
          consumers throughout the state."

          Like the population of the state as a whole, the population of  
          those served by regional centers is quite diverse, not only  
          racially and culturally but also geographically and  
          socioeconomically.  In terms of ethnicity, for example, whites  
          comprised 46.8% of the regional center consumer population in  
          December 1997 but only 39.7% of the population in December 2007.  
           Latinos, on the other hand, went from 25.9% of the regional  
          center population in December 1997 to 33.2% in December 2007.   
           DDS Fact Book  , 11th Edition (October 2008), p. 9.  DDS has  
          recognized that "[i]t is essential that DDS take actions to  
          ensure services are provided in a culturally competent manner,  
          and choices in services are available to meet the needs and  
          preferences of such a diverse population."   Working Toward a  
          Better Future for Persons with Developmental Disabilities and  
          Their Families:  Strategic Plan 2003-2008,  " p. 10.

          The need to ensure diversity in stakeholder discussions is  
          supported, in part, by studies conducted since the early 1990s  
          that have examined regional centers' expenditures of  
          purchase-of-service (POS) dollars as a function of a 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, released in August of 2003, showed some  








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          significant disparities, though not to the extent of the earlier  
          studies.

          Most recently, however, the results of independent statistical  
          studies using DDS data were published by researchers at the  
          University of California, San Francisco--Charlene Harrington and  
          Taewoon Kang.  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, C. & Kang, T.,  Disparities in service  
          utilization and expenditures for individuals with developmental  
          disabilities  , Disability & Health Journal, 1:184, 190 (2008).

          Thus, while the results of the POS have been varied and open to  
          interpretation, the studies, overall, show that ethnicity does  
          have a statistically significant relationship to service  
          expenditures, even with the legitimate cost factors controlled  
          for.   Purchase of Service Study II: Final Report Summary  , DDS,  
          Report to the Legislature (December 2003).  Based on survey data  
          of consumers and family members, as opposed to data on dollars  
          spent, the 2003 DDS study reported several significant ethnic  
          differences in such measures as receipt of services, the need  
          for additional resources, and satisfaction with supports.   
          Results showed, for example, that consumers from all identified  
          minority groups had higher reported levels of need for  
          additional resources than did white consumers.  Id. at 7-8.   
          Latinos reported significantly greater unmet needs.  Id. at  
          9-10.

          The author of this bill contends that, if nothing else, these  
          data show that there is at least the perception of many regional  
          center consumers and family members that services are not being  
          provided and needs are not being met, equitably.  Explicit  
          recognition in the Lanterman Act that diversity must be  
          considered in convening stakeholder groups is one step in  
          ensuring that all segments of the state's diverse population are  
          included in discussions of fiscal and policy issues affecting  
          the delivery of services to all Californians with developmental  
          disabilities.  








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          There are several provisions in the Lanterman Act directing DDS  
          to convene or consult with stakeholder organizations or groups.   
          Recently, for example, one of the 2009-10 Budget trailer bills  
          (ABX4 9 (Evans)) required DDS to consult with stakeholders on a  
          number of initiatives, including development of an alternative  
          service delivery model providing for an Individual Choice  
          Budget.  ABX4 9 also required an ongoing stakeholder review  
          process, and report to the Assembly and Senate Budget  
          Committees, on implementation of cost containment measures and  
          their effect on the developmental disabilities services system.

          This bill requires only that, in convening stakeholder groups,  
          DDS take into account the state's ethnic, geographic, and  
          socioeconomic diversity and use best efforts to include  
          stakeholder groups that, collectively, reflect the interests of  
          the state's diverse population.  If a Legislative report is  
          required as part of an activity involving stakeholders, DDS  
          would be required to describe how stakeholder diversity was  
          taken into account.

          In support of this bill, The Arc of California says that "[w]e  
          must expand [the] consultation process to include better  
          representation of California's enormously diverse population."   
          Disability Rights California states that by requiring the state  
          to take the state's diversity into account "this bill will  
          ensure that diverse views are represented and will help to  
          reduce unintended disparate results."

           REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           
          The Arc of California
          Disability Rights California
          USC University Center for Excellence in Developmental  
          Disabilities (UCEDD)

           Opposition 
           
          None on file
           
          Analysis Prepared by  :    Eric Gelber / HUM. S. / (916) 319-2089