BILL ANALYSIS �
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|SENATE RULES COMMITTEE | SB 416|
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UNFINISHED BUSINESS
Bill No: SB 416
Author: Kehoe (D)
Amended: 8/26/11
Vote: 21
SENATE GOVERNMENTAL ORG. COMMITTEE : 7-5, 3/22/11
AYES: Wright, Calderon, Corbett, De Le�n, Evans, Padilla,
Yee
NOES: Anderson, Berryhill, Cannella, Strickland, Wyland
NO VOTE RECORDED: Hernandez
SENATE APPROPRIATIONS COMMITTEE : 6-2, 5/26/11
AYES: Kehoe, Alquist, Lieu, Pavley, Price, Steinberg
NOES: Walters, Runner
NO VOTE RECORDED: Emmerson
SENATE FLOOR : 25-14, 6/1/11
AYES: Alquist, Calderon, Corbett, Correa, De Le�n,
DeSaulnier, Evans, Hancock, Hernandez, Kehoe, Leno, Lieu,
Liu, Lowenthal, Negrete McLeod, Padilla, Pavley, Price,
Rubio, Simitian, Steinberg, Vargas, Wolk, Wright, Yee
NOES: Anderson, Berryhill, Blakeslee, Cannella, Dutton,
Emmerson, Fuller, Gaines, Harman, Huff, La Malfa,
Strickland, Walters, Wyland
NO VOTE RECORDED: Runner
ASSEMBLY FLOOR : 53-26, 9/8/11 - See last page for vote
SUBJECT : Health: survey
SOURCE : Equality California
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DIGEST : This bill requires, not later than January 1,
2015, the Department of Public Health and the Department of
Health Care Services to collaborate with the University of
California, to include specified information related to
gender into the California Health Interview Survey. This
bill requires, no later than January 1, 2015, the above
departments to collaborate with the California state
coordinator for the Behavioral Risk Factor Surveillance
System to include specified information related to gender
into the system.
Assembly Amendments (1) change the date of January 1, 2013,
to not later than January 1, 2015; and (2) requires the
state department to collaborate with the University of
California Regents instead of University of California, Los
Angeles.
ANALYSIS : Existing law creates the Department of Public
Health and requires it to carry out various duties related
to public health programs. Existing law creates the State
department of Health Care Services and requires it to carry
out various duties related to health purchasing programs.
This bill requires, not later than January 1, 2015, the
Department of Public Health and the Department of Health
Care Services to collaborate with the University of
California, to include specified information related to
gender into the California Health Interview Survey (CHIS).
This bill requires, no later than January 1, 2015, 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.
Comments
According to the sponsors, Equality California, 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. Equality California (EQCA) contends that a
growing body of research has documented that LGBT people
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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 University of California, Los Angeles,
Center for Health Policy Research in collaboration with the
Department of Public Health 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 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
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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 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
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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.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: No
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; and (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 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.
SUPPORT : (Verified 9/8/11)
Equality California (source)
American Civil Liberties Union
BIENESTAR Human Services, Inc.
California Communities United Institute
California NOW
California Pan-Ethnic Health Network
City of Los Angeles
Gay-Straight Alliance Network
Los Angeles Gay and Lesbian Center
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Mental Health America of Northern California
National Association of Social Workers - California Chapter
Openhouse
Planned Parenthood
The Trevor Project
Transgender Law Center
ARGUMENTS IN SUPPORT : Proponents state that, "In an
environment of limited resources, it is critically
important that the State of California collect information
that allows those limited resources to be focused on doing
the most good at the lowest cost."
ASSEMBLY FLOOR : 53-26, 9/8/11
AYES: Alejo, Allen, Ammiano, Atkins, Beall, Block,
Blumenfield, Bonilla, Bradford, Brownley, Buchanan,
Butler, Charles Calderon, Campos, Carter, Cedillo,
Chesbro, Davis, Dickinson, Eng, Feuer, Fletcher, Fong,
Fuentes, Furutani, Galgiani, Gatto, Gordon, Hall,
Hayashi, Roger Hern�ndez, Hill, Huber, Hueso, Huffman,
Lara, Bonnie Lowenthal, Ma, Mendoza, Mitchell, Monning,
Pan, Perea, V. Manuel P�rez, Portantino, Skinner,
Solorio, Swanson, Torres, Wieckowski, Williams, Yamada,
John A. P�rez
NOES: Achadjian, Bill Berryhill, Conway, Cook, Donnelly,
Beth Gaines, Garrick, Grove, Hagman, Halderman, Harkey,
Jeffries, Jones, Knight, Logue, Mansoor, Miller, Morrell,
Nestande, Nielsen, Norby, Olsen, Silva, Smyth, Valadao,
Wagner
NO VOTE RECORDED: Gorell
PQ:do 9/9/11 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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