BILL ANALYSIS                                                                                                                                                                                                    






                                  SENATE HUMAN
                               SERVICES COMMITTEE
                            Senator Carol Liu, Chair


          BILL NO:       AB 2204                                      
          A
          AUTHOR:        Beall                                        
          B
          VERSION:       April 5, 2010
          HEARING DATE:  June 22, 2010                                
          2
          FISCAL:        Appropriations                               
          2
                                                                      
          0
          CONSULTANT:                                                 
          4
          Park and Hailey
                                        

                                     SUBJECT
                                         
                   Developmental services: stakeholder groups


                                    SUMMARY  

          Requires the Department of Developmental Services (DDS) to  
          take into account the state's ethnic, sexual orientation,  
          gender identity, geographic, and socioeconomic orientation  
          diversity when convening or consulting with stakeholder  
          groups under the Lanterman Developmental Disabilities  
          Services Act (Lanterman Act).


                                     ABSTRACT  

          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.

                                                         Continued---



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          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.

          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.

          
          This bill:
          1)Requires DDS, when convening stakeholder groups pursuant  
            to the Lanterman Act, to take into account the state's  
            ethnic, sexual orientation, gender identity, geographic,  
            and socioeconomic diversity and to use best efforts to  
            include stakeholder groups that, collectively, reflect  
            the interests of the state's diverse population.

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

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


                                  FISCAL IMPACT  

          According to the Assembly Appropriations Committee, this  
          bill generates minor absorbable workload for DDS.


                            BACKGROUND AND DISCUSSION  

          Author's statement
          According to the author, "[i]t is important that all  
          segments of California's diverse population have a voice in  
          policy decisions related to the provision of services to  
          people with developmental disabilities under the Lanterman  




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          Act.  This means that DDS should consider diversity --  
          cultural, ethnic, sexual orientation, gender identity,  
          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."

          The population of those served by regional centers reflects  
          the racial, cultural, geographic, and socioeconomic  
          diversity of California.  For example, in terms of  
          ethnicity, Whites comprised 46.8 percent of the regional  
          center consumer population in December 1997 but only 39.7  
          percent of the population in December 2007.  Latinos, on  
          the other hand, went from 25.9 percent of the regional  
          center population in December 1997 to 33.2 percent 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.)

          Recent independent statistical studies using DDS data found  
          disparities in regional center spending on services related  
          to ethnicity, even when controlling for client needs.  For  
          example, all racial and ethnic groups (Asian/Pacific  
          Islanders, African Americans, and Hispanics) were 23 to 31  
          percent 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 services costing  
          $3,190 less, Asian/Pacific Islanders received services  
          costing $2,560 less, and African Americans received  
          services costing $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).]

          While the results of purchase-of-service studies have been  
          varied and open to interpretation, the studies, overall,  
          show that ethnicity does have a statistically significant  




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          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.   
          (Ibid. at pages 7-8.)  Latinos reported significantly  
          greater unmet needs.  (Ibid. at pages 9-10.)

          The author of this bill contends that, if nothing else,  
          these data show that there is at least the perception among  
          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.

          There are several provisions in the Lanterman Act directing  
          DDS to convene or consult with stakeholder organizations or  
          groups.  Recently, for example, the 2009-10 Budget trailer  
          bill related to DDS [AB 9 X4 (Evans), Chapter 9, Statutes  
          of 2009-10 Fourth Extraordinary Session] requires DDS to  
          consult with stakeholders on a number of initiatives,  
          including development of an alternative service delivery  
          model providing for an Individual Choice Budget.  AB 9 X4  
          also requires an ongoing stakeholder review process, and a  
          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 diversity in  
          designated categories 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  




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          how stakeholder diversity was taken into account.
          
          
                                   PRIOR VOTES
           
          Assembly Floor:     45 - 27
          Assembly Appropriations: 11 - 5
          Assembly Human Services:   4 - 2

                                         
                                    COMMENTS
           
           Clarifying stakeholder group membership
           If the Legislature desires DDS to assemble stakeholder  
          groups whose members - not just whose organizations --  
          reflect California's diversity, then an amendment is in  
          order on page 5, lines 23-24: "  include   convene  stakeholder  
          groups that, collectively, reflect  the interests of  the  
          state's diverse population."

          Even with a clarifying amendment, an implementation  
          strategy should include the department's inviting  
          organizations that are regional, that have an ethnic basis,  
          or that by their charter have low-income persons or gay,  
          lesbian, and transgender individuals in positions of  
          leadership. 
           

                                    POSITIONS  

          Support:       American Federation of State, County and  
          Municipal Employees
                         Disability Rights California
                         State Council on Developmental Disabilities
                         The Arc of California

          Oppose:   None received



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