BILL ANALYSIS �
SB 367
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Date of Hearing: August 13, 2013
ASSEMBLY COMMITTEE ON HUMAN SERVICES
Mark Stone, Chair
SB 367 (Block) - As Amended: May 28, 2013
SENATE VOTE : 38-0
SUBJECT : Developmental services: regional centers: cultural
and linguistic competency
SUMMARY : Includes issues related to cultural and linguistic
competency in regional center governing board training
requirements.
Specifically, this bill :
1)Adds issues relating to linguistic and cultural competency to
the training and support a regional center is required to
provide to its governing board members.
2)Requires each regional center to post information regarding
the training and support provided to governing board members
on its Internet Web site.
3)Requires a governing board's annual performance review of the
regional center director to include an evaluation of the
director's performance in providing regional center services
that are linguistically and culturally appropriate.
EXISTING LAW
1)Establishes an entitlement to services for individuals with
developmental disabilities under the Lanterman Developmental
Disabilities Services Act (Lanterman Act). (WIC 4500 et seq.)
2)Grants all individuals with developmental disabilities, among
all other rights and responsibilities established for any
individual by the United States Constitution and laws and the
California Constitution and laws, the right to treatment and
habilitation services and supports in the least restrictive
environment. (WIC 4502)
3)Establishes a system of 21 nonprofit regional centers
throughout the state to identify needs and coordinate services
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for eligible individuals with developmental disabilities, and
requires the Department of Developmental Services (DDS) to
contract with the regional centers to provide case management
services and arrange for or purchase services that meet the
needs of individuals with developmental disabilities, as
defined. (WIC 4620 et seq.)
4)Requires the governing board of each regional center to meet
specified criteria, including that board members must be
individuals with demonstrated interest in, or knowledge of,
developmental disabilities; each board must reflect the
geographic and ethnic characteristics of the regional center
catchment area; and at least 25% of board membership must be
persons with developmental disabilities. (WIC 4622)
5)Requires the governing board of each regional center to
annually submit detailed documentation to DDS demonstrating
that the composition of the board meets the criteria
established in WIC 4622. (WIC 4622.5)
6)Sets forth specific requirements and annual performance
objectives for contracts between DDS and regional centers.
(WIC 4629)
7)Provides that each contract between DDS and a regional center
must include a requirement that the regional center adopt,
maintain, and post on its Internet Web site a board-approved
policy regarding transparency and access to public
information, and requires that policy to provide, at a
minimum, information regarding requests for proposals, service
provider rates, documentation related to establishment of
negotiated rates, audits, and other forms, as specified. (WIC
4629.5)
8)Creates a process by which regional centers may "vendorize"
service providers, thereby providing a path to contract for
services with that provider. (WIC 4648 (a)(3))
FISCAL EFFECT : According to the Senate Appropriations
Committee, this bill will result in minor costs to the regional
centers to provide additional training (General Fund).
COMMENTS : This bill is part of a package of legislation that
was developed as a result of a 2012 hearing of the Senate Select
Committee on Autism & Related Disorders focused on disparities
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in services provided to underserved communities. It seeks to
address inconsistencies in consumer access to services and
supports, as well as regional center spending on consumers, by
ensuring regional center governing boards and regional center
directors are sensitive to the linguistic and cultural needs of
the consumers served in their respective catchment areas.
Background : The Lanterman Act guides the provision of services
and supports for Californians with developmental disabilities.
Each individual under the Act, typically referred to as a
"consumer," is legally entitled to treatment and habilitation
services and supports in the least restrictive environment.
Lanterman Act services are designed to enable all consumers to
live more independent and productive lives in the community.
The term "developmental disability" means a disability that
originates before an individual attains 18 years of age, is
expected to continue indefinitely, and constitutes a substantial
disability for that individual. It includes intellectual
disabilities, cerebral palsy, epilepsy, and autism spectrum
disorders (ASD). Other developmental disabilities are those
disabling conditions similar to an intellectual disability that
require treatment (i.e., care and management) similar to that
required by individuals with intellectual disabilities. This
does not include conditions that are solely psychiatric or
physical in nature, and the conditions must occur before age 18,
result in a substantial disability, be likely to continue
indefinitely, and involve brain damage or dysfunction. Examples
of conditions might include intracranial neoplasms, degenerative
brain disease or brain damage associated with accidents.
Regional centers : The Department of Developmental Services
(DDS) contracts with 21 regional centers throughout the state,
which are private nonprofit entities, to carry out many of the
state's responsibilities under the Lanterman Act. The regional
center caseload is comprised of 260,000 consumers who receive
services such as residential placements, supported living
services, respite care, transportation, day treatment programs,
work support programs, and various social and therapeutic
activities. While most individuals receive treatment and
services in the community, 1,600 consumers reside at one of
California's four Developmental Centers-and one state-operated,
specialized community facility-which provide 24-hour
habilitation and medical and social treatment services.
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Services provided to consumers with developmental disabilities
are determined through an individualized planning process.
Under this process, planning teams-which include, among others,
the consumer, his or her legally authorized representative, and
one or more regional center representatives-jointly prepare an
Individual Program Plan (IPP) based on the consumer's needs and
choices. The Lanterman Act requires that the IPP promote
community integration and maximize opportunities for each
consumer to develop relationships, be part of community life,
increase control over his or her life, and acquire increasingly
positive roles in the community.
Need for the bill : A four-part 2011 Los Angeles Times series
focused on autism included a report titled "Warrior Parents Fare
Best in Securing Autism Services," which addressed inequalities
in access to developmental services among families from
different regions and demographic groups. Among the conclusions
drawn based on the reporter's research, as indicated by the
title of the report, was that parents who fight harder for their
children gain more services. This creates a number of
disparities within the regional center system, as all children
who are determined to need regional center services based on
their assessments and diagnoses are entitled to such services.
Also revealed in the report was that the "fighter" parents tend
to be sophisticated, wealthier white parents who have the time
and resources needed to navigate the bureaucracy that stands
between their children and necessary services. On the other
hand, parents who work multiple jobs, for example, with
linguistic and cultural barriers that don't allow them to
navigate the system as easily, can find it nearly impossible to
get their children the effective services they need in a timely
manner.
Prompted, in part, by the Los Angeles Times series, the Senate
Select Committee on Autism and Related Disorders held an
informational hearing in April 2012 to discuss questions
surrounding equal access to regional center services for
consumers with autism spectrum disorders. An outcome of the
hearing was the creation of a 20-member Taskforce on Equity and
Diversity for Regional Center Autism Services, which was charged
with developing recommendations to ensure that consumers of
regional center services receive appropriate and timely supports
regardless of race, ethnicity, educational background and other
socio-economic factors. The report, "A Preliminary Report by
the Taskforce on Equity and Diversity for Regional Center Autism
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Services," was published on March 18, 2013, and identified a
number of recommendations for changes to current practice within
the developmental services system. Among them was a specific
recommendation for regional centers to implement
self-assessments in order to evaluate their own performance in
areas of equity, diversity and cultural competency, as well as
recommendations for the boards of directors of regional centers
to receive ongoing training on issues of cultural and linguistic
competency.
July 2013 consumer characteristic data from the Department of
Developmental Services shows that 37% of the individuals served
by the regional centers are identified as White, whereas 35% are
identified as Hispanic just over 6% identify as Asian, 2.4%
identify as Filipino, and nearly 10% identify as Black or
African American. While assumptions about the languages spoken
by regional center consumers cannot necessarily be made based on
this data, the ethnic and cultural diversity represented in the
caseload supports the notion that all aspects of the regional
center operations and service delivery systems should be
linguistically and culturally competent and equitable.
Arguments in support : According to the author, "Regional
centers serve the most diverse state in the country. Every
regional center has different challenges in serving these
communities. It is critical that they understand the barriers
that communities have in getting these services. SB 367 seeks to
increase the training the board of directors receives related to
these barriers, with the goal of increasing services to the most
underserved people in the state. Furthermore, SB 367 requires
directors to be evaluated on their performance in providing
services to these communities to increase transparency and
accountability, and to better understand the barriers that
families face in receiving services from regional centers."
Arguments in opposition : The Association of Regional Center
Agencies has raised a number of concerns about the current
language in the bill. These include concerns about prescribing
training standards for one particular type of board of directors
out of an array of similar boards of entities that contract with
the state; a concern that and evaluation of linguistic and
cultural competency may be too subjective to attain; and they
raise a question about whether the Legislature should be
dictating internal performance review practices.
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RECOMMENDED AMENDMENTS
The May 28, 2013 amendments to this bill require the annual
review of a regional center director's performance by the
governing board to include an assessment of the director's
performance in providing services that are linguistically and
culturally appropriate. While a regional center director
oversees regional center operations and provides guidance to
regional center staff on the manner in which they should provide
services to consumers and their families, evaluating the
director's performance in this aspect of service delivery would
be subjective from one regional center to the next and may not
shed any light on whether daily interactions with consumers are
linguistically and culturally appropriate. The author may wish
to clarify the language in the bill to, instead, require the
governing board to review the regional center's overall
performance in providing linguistically and culturally
appropriate services, and allow the governing board to provide
recommendations to the regional center director based on the
results of that review.
Staff recommends the following amendments, in mock-up form
below, beginning on page 3, line 21 of the bill:
21 (j) (1) The governing board shall annually review the
performance
22 of the director of the regional center. This performance
review
23 shall include an evaluation of the director's performance in
24 providing regional center services that are linguistically
and
25 culturally appropriate.
(2) The governing board shall annually review the performance of
the regional center in providing services that are
linguistically and culturally appropriate and may provide
recommendations to the director of the regional center based on
the results of that review.
26 (k) No member of the board who is an employee or member of
27 the governing board of a provider from which the regional
center
28 purchases client services shall do any of the following:
29 (1) Serve as an officer of the board.
30 (2) Vote on any fiscal matter affecting the purchase of
services
31 from any regional center provider.
32 (3) Vote on any issue other than as described in paragraph
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(2),
33 in which the member has a financial interest, as defined in
Section
34 87103 of the Government Code, and determined by the regional
35 center board. The member shall provide a list of his or her
financial
36 interests, as defined in Section 87103, to the regional
center board.
37 Nothing in this section shall prevent the appointment to a
38 regional center governing board of a person who meets the
criteria
39 for more than one of the categories listed above.
40 This section shall become operative on July 1, 1999.
CURRENT RELATED LEGISLATION :
SB 158 (Correa) authorizes the establishment of the Regional
Center Excellence in Community Autism Partnerships (RE CAP)
pilot program to improve regional center services, supports,
interventions, and other resources to assist regional center
consumers with ASD living in underserved communities.
SB 208 (Lara) requires that a request for proposal prepared by
DDS or a regional center that relates to consumer services and
supports include a section on equity and diversity.
SB 555 (Correa) requires that communication about assessment,
individual program plans and other critical documents and
processes be done in a consumer or family member's native
language and are otherwise completed in a culturally and
linguistically competent manners.
AB 1232 (V. Manuel Perez) requires the existing DDS quality
assurance instrument to assess the provision of services in a
linguistically and culturally competent manner and include an
outcome-based measure on issues of equity and diversity.
REGISTERED SUPPORT / OPPOSITION :
Support
Autism Care and Treatment (ACT)
Autism Research Group
Center for Autism and Related Disorders (CARD)
Public Counsel's Children's Rights Project
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The Help Group
Opposition
Association of Regional Center Agencies (ARCA)
Analysis Prepared by : Myesha Jackson / HUM. S. / (916)
319-2089