BILL ANALYSIS �
SB 416
Page 1
SENATE THIRD READING
SB 416 (Kehoe)
As Amended August 26, 2011
Majority vote
SENATE VOTE :25-14
HEALTH 13-4 APPROPRIATIONS 12-5
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|Ayes:|Monning, Ammiano, Atkins, |Ayes:|Fuentes, Blumenfield, |
| |Bonilla, Eng, Gordon, | |Bradford, Charles |
| |Hayashi, | |Calderon, Campos, Davis, |
| |Roger Hern�ndez, Bonnie | |Gatto, Hall, Hill, Lara, |
| |Lowenthal, Mitchell, Pan, | |Mitchell, Solorio |
| |V. Manuel P�rez, Williams | | |
| | | | |
|-----+--------------------------+-----+--------------------------|
|Nays:|Garrick, Nestande, Silva, |Nays:|Harkey, Donnelly, |
| |Smyth | |Nielsen, Norby, Wagner |
| | | | |
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SUMMARY : Requires, not later than January 1, 2015, appropriate,
voluntary, demographic, self-identification questions related to
sexual orientation, gender identity, gender expression, to
domestic partnership and gender of one's spouse to be included
in the California Health Interview Survey (CHIS) and the
Behavioral Risk Factor Surveillance System (BRFSS).
FISCAL EFFECT : According to the Assembly Appropriations
Committee:
1)Annual General Fund (GF) costs in the range of $7,000 to
$20,000 to include additional questions on the BRFSS.
2)Unknown annual ongoing costs, at least $50,000, and
potentially exceeding $180,000 per two-year cycle (50% GF/50%
federal), to include additional survey questions on CHIS.
3)Actual costs will depend on the number of people receiving the
questions, amount of time it takes to ask and answer the
questions, and whether some of the questions would be included
regardless of this bill. The first two factors relate to a
lack of a well-validated and generally accepted set of
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telephone survey questions. Some of the questions, such as a
question on sexual orientation, would likely be included in
both surveys even in the absence of this bill; the inclusion
of other questions, even those that were included in 2009
surveys, is less certain. Additionally, gender identity and
expression are complex constructs and may take additional time
to clarify if people are unfamiliar with what is being asked,
which could further increase costs beyond the estimates
presented here.
COMMENTS : According to the sponsors, Equality California
(EQCA), data relating to California's Lesbian, Gay, Bisexual,
and Transgender (LGBT) population is not being currently
collected in a consistent manner by the state or federal
government. EQCA contends that a growing body of research has
documented that LGBT people differ from the general population
in terms of income, poverty rates, public benefit program
participation, mental health, physical health, victimization,
and employment discrimination. EQCA points out that the state
currently administers a number of statewide surveys that collect
important information about Californians. Specifically,
according to EQCA, CHIS, the nation's largest state health
survey gives a detailed picture of the health and healthcare
needs of California's large and diverse population, and the
BRFSS, a federal survey administered by the state, has tracked
health conditions and risk behaviors in the United States since
1984. The sponsors point out that although these and other
studies collect demographic information such as race/ethnic
identity, age, family size, health and safety information, and
other data, they do not include questions about LGBT people in a
manner that allows for uniform compilation and reporting.
CHIS is conducted by UCLA, Center for Health Policy Research in
collaboration with the Department of Public Health (DPH) and
Department of Health Care Services (DHCS) every two years. CHIS
conducts random-dial telephone interviews with up to 50,000 or
more California households in 44 geographic areas in California
and claims to be the nation's largest state health survey. It
is funded by a variety of public agencies and private
organizations such as DPH, DHCS, California Children and
Families Commission, the California HealthCare Foundation, and
the California Endowment. The persons included in CHIS are a
statistically representative sample of the entire state's
diverse population. According to CHIS, the survey covers dozens
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of essential health topics, from asthma, diabetes, and obesity
to immigrant health and the number of Californians with health
insurance. Many core questions are repeated in each survey in
order to measure significant shifts over time. New questions
are also added each survey year to address emerging concerns
that are important for planning and policy development. In
2009, CHIS included questions in the category of "Respondent
Characteristics" that asked about sexual orientation, registered
domestic partner, and the gender of the spouse.
The BRFSS is a state-based system of health surveys that
generate information about health risk behaviors, clinical
preventive practices, and health care access and use primarily
related to chronic diseases and injury. Conducted by the 50
state health departments as well as those in the District of
Columbia, Puerto Rico, Guam, and the U.S. Virgin Islands with
support from the Centers for Disease Control and Prevention
(CDC), BRFSS provides state-specific information about issues
such as asthma, diabetes, health care access, alcohol use,
hypertension, obesity, cancer screening, nutrition and physical
activity, tobacco use, and more. According to the CDC, it is
the world's largest, on-going telephone health survey system,
tracking health conditions and risk behaviors in the United
States yearly since 1984. Federal, state, and local health
officials and researchers use this information to track health
risks, identify emerging problems, prevent disease, and improve
treatment.
The BRFSS questionnaire is developed each year by CDC in
collaboration with participating state agencies. Wherever
possible questions are selected from previously conducted
national surveys for comparability. The questionnaire has three
components. The first component consists of a core set of
questions that are administered by all states participating in
the BRFSS collection effort. Many of the core questions have
remained fixed from year to year, although revisions are made to
the core annually. Changes are implemented at the beginning of
each interviewing year. From 1992-1999 CDC implemented a
"rotating core" strategy, allowing some core questions to appear
on the questionnaire in alternate years only. The second
component of the questionnaire consists of a series of topical
modules developed by the CDC. States have the option of adding
as many modules as they wish to the core questionnaire each
year. California has used several of the CDC modules, although
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the same modules have not been used consistently across all
years of the survey. The final component of the questionnaire
consists of questions designed and administered by individual
states to address issues of local concern. These have been
revised annually in California to address the needs of as many
programs as possible. BRFSS includes a California specific
question to determine whether California will yield results
consistent with other research that has shown sexual minority
community members have important health risk factors, such as
smoking. As with CHIS, the author's intent is to ensure that
questions include gender identity and gender expression in a
manner that is most likely to elicit uniform, useful, and
accurate information. In addition, the BRFSS question on
marital status does not ask the gender of the spouse or partner
and will therefore not provide data that can be compared using
this distinction.
Analysis Prepared by : Marjorie Swartz / HEALTH / (916)
319-2097
FN: 0002254