BILL ANALYSIS �
Senate Appropriations Committee Fiscal Summary
Senator Christine Kehoe, Chair
SB 416 (Kehoe)
Hearing Date: 5/23/2011 Amended: 5/17/2011
Consultant: Bob Franzoia Policy Vote: G O 7-5
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BILL SUMMARY: SB 416 would require the Department of Public
Health (DPH) and the Department of Health Care Services (DCHS)
to collaborate with the University of California, to include
specified information related to gender into the California
Health Interview Survey (CHIS). This bill would require the
above departments to collaborate with the California state
coordinator for the Behavioral Risk Factor Surveillance System
(BRFSS) to include specified information related to gender into
the system.
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Fiscal Impact (in thousands)
Major Provisions 2011-12 2012-13 2013-14 Fund
Health care survey data
collection
- CHIS Up to $50 Up to $100 Up to $100General
- BRFSS Up to $14 Up to $21 Up to $21 General/
Federal
Increased service Unknown, major cost pressure General/
delivery Federal
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STAFF COMMENTS: This bill meets the criteria for referral to the
Suspense File.
A report brief from the Institute of Medicine of the National
Academies noted that when conducting research on lesbian, gay,
bisexual, and transgender (LGBT) populations, researchers face a
number of challenges in understanding the health needs of LGBT
populations, including a lack of data.
Such disparities exist in many areas. A 2008 Disparities in
Service Utilization and Expenditures for Individuals with
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Developmental Disabilities study as published in the Disability
& Health Journal identified a receipt of regional center
services disparity among ethnic groups after controlling for
need and other factors. For example, Latinos received $3,190 and
African Americans received $1,080 fewer in services when
compared to white consumers. However, the study acknowledges
that other factors could explain the disparities, including
client and family attitudes and beliefs, language skills, and
lack of knowledge of the system.
The CHIS and the BRFSS are telephone surveys. Both collect data
on sexual orientation. Neither collects data on gender identity
or gender expression. If the CHIS and the BRFSS include any
question about marital status, this bill would require the
departments to include questions about registered domestic
partnership status and about the gender of the spouse or
partner.
DPH and DHCS pay for "time" in the CHIS, and have had
approximately six minutes of survey time in the past. This
survey can represent upward of 200 questions and can last 30
minutes or longer. The cost of $100,000 is an estimate of the
work to develop and introduce a new question on gender identity
and expression. It does not represent cost per question,
instead includes research, development and testing which are not
applicable to existing questions. Gender questions are
multi-faceted in that it can sometimes be difficult to determine
exactly what is to be measured, for example, behavior, desire,
or identity, which can be presented independently or in any
combination of questions. DPH and DHCS provided $1,695,000 in
2010-2011 which represents approximately 18 percent of overall
funding for CHIS.
The BRFSS is federally funded through the Center for Disease
Control and also receives various state funds from state
programs that add state-specific questions to the survey. This
survey has core questions. Preliminary information indicates
that if the question is acceptable (sexual orientation), then
only one question would need to be added. However, if the
question is not accepted as a core question, then two questions
would need to be added.
While the cost of taking California's diversity into
consideration when conducting surveys has a relatively minor
cost, there would be major General Fund and federal fund cost
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pressure, as noted above, to increase the amount spent per
consumer to create purchase of service parity between this group
and other groups.