BILL ANALYSIS �
SENATE HUMAN
SERVICES COMMITTEE
Senator Carol Liu, Chair
BILL NO: SB 1093
S
AUTHOR: Liu
B
VERSION: April 10, 2014
HEARING DATE: April 22, 2014
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FISCAL: Yes
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CONSULTANT: Mareva Brown
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SUBJECT
Developmental services: regional centers: culturally and
linguistically competent services
SUMMARY
This bill adds to required data that is compiled annually
including the number and percentage of individuals who have
been determined to be eligible for regional center
services, but are not receiving them and requires the
Department of Developmental Services (DDS) and each
regional center to maintain previous years' data on their
web sites. The bill requires that regional centers hold
required stakeholder meetings to discuss the data
separately from meetings of the board of directors, as
specified. It requires that the development of culturally
and linguistically appropriate services and supports be
included in annual regional center performance objectives,
as specified. Additionally, this bill requires that
independent living skills services be available to all
adult consumers who live in the home of a parent, relative,
other person, or who live independently.
ABSTRACT
Existing law :
Continued---
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1)Establishes DDS to administer the Lanterman Developmental
Disabilities Act, which entitles individuals with
developmental disabilities to community services and
supports. (WIC 4500)
2)Requires DDS to contract with private non-profit regional
centers to provide fixed points of contact in the
community for persons with developmental disabilities and
their families, so that these persons may have access to
the services and supports best suited to them throughout
their lifetime. (WIC 4620)
3)Requires DDS and regional centers to annually collaborate
to compile data in a uniform manner relating to purchase
of service authorization, utilization and expenditure by
each regional center and by specified demographics
including: age, race and ethnicity, primary language
spoken by the consumer, detail on disabilities, and
others. The requirement includes identifying data for
individuals who have been determined to be eligible for
regional center services who are not receiving purchase
of services funds. DDS is required to post this data on
its website annually, as specified. (WIC 4519.5 (a) et
seq.)
4)Requires regional centers, within three months of the
release of data, to conduct public meetings with
stakeholders about the data and to inform the department
and public of the meetings 30 days prior to holding them.
(WIC 4519.5 (e))
5)Requires the regional centers to secure appropriate
services and supports, as identified in an Individual
Program Plan (IPP), and to give the highest preference to
those services and supports which would allow minors to
live with their families and adults to live as
independently as possible within the community, as
specified. (WIC 4648)
6)Requires that, within the scope of a five-year
contractual agreement, DDS shall provide oversight of the
regional centers by requiring specified activities and
establishing annual performance objectives. These
objectives must include specific measurable goals
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including assisting consumers to achieve life quality
outcomes, achieving meaningful progress and developing
services and supports necessary to meet identified needs.
(WIC 4629 (a-c))
7)Establishes steps for DDS to ensure contract compliance,
including incentives for regional centers that meet or
exceed performance standards, levels of probationary
status for regional centers that do not, and other
specified actions. (WIC 4629 (d)(2))
8)Requires that a regional center conduct specified
activities in order to achieve the stated objectives in
an individuals IPP, including securing services and
supports that meet the needs of the consumer, giving
highest preference to those services and supports that
allow minors to live with their families, adults to live
as independently as possible in the community and
consumers to interact with persons without disabilities
in positive, meaningful ways. (WIC 4648)
This bill :
1) Adds to required purchase of service authorization
and utilization data collected annually by DDS and
regional centers the collection of data by residence
type, subcategorized by age, race or ethnicity, and
primary language.
2) Adds to required annual reporting of data on
individuals who have been determined eligible for
regional center services but do not receive services,
specifically requiring the reporting of data on these
individuals by residence type, as defined.
3) Adds to the requirement that DDS and regional
centers post such data on their websites annually, a
requirement that DDS and the regional centers maintain
all previous years' data on its Internet web site.
4) Increases the requirement for regional centers to
meet with stakeholders once in a public meeting once
within three months of the data's annual release to
requiring "one or more public meetings."
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5) Requires that the regional centers' public meetings
to discuss the data be held separately from board
meetings, and that the report and associated public
discussion be provided in an understandable form.
6) Requires that each regional center, in holding the
required meetings, consider the language needs of the
community and requires that regional centers schedule
the meetings at times and locations designed to result
in a high turnout by the public and underserved
communities.
7) Adds to required contents of regional center annual
performance contracts the development of culturally
and linguistically appropriate services and supports.
8) Permits DDS to require each regional center to
develop and implement a plan with specific and
measurable objectives that include activities and
timelines that will lead to an increase in the
utilization of services by consumers impacted by
identified purchase of service disparities identified
by the data, as well as data compiled on the payment
of coinsurance and copayments by each regional center.
9) In developing that plan, requires a regional center
to use a public process, as defined, and to consider
stakeholder input from the State Council on
Developmental Disabilities, the Office of Clients'
Rights Advocacy, and the protection and advocacy
agency, as well as input gathered from public meetings
held to discuss the data.
10) When a regional center is placed on probation,
requires the Office of Clients' Rights Advocacy be
provided with copies of the correction plan, timeline
and other documents, in addition to providing these
documents to the local area boards.
FISCAL IMPACT
This bill has not been analyzed by fiscal committee.
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BACKGROUND AND DISCUSSION
Purpose of the bill :
There is a significant purchase of service gap across
racial and ethnic groups, according to the author, who also
argues that some culturally based choices, such as
multi-generational living arrangement, may result in
consumers receiving fewer services. The author states that
while recently passed legislation requires reporting of
data, it does not do enough to illuminate the cause of the
racial disparities that exist in the system. This bill
clarifies that all adult consumers are entitled to
independent living skills services even if they choose to
live at home, and requires DDS to include data on residence
type in the reporting of services utilized. This bill also
requires DDS and regional centers to post past years' data
on their websites as well as current data.
In 2012 the Senate Select Committee on Autism & Related
Disorders held a hearing that focused on disparities in
services in underserved communities. A package of bills
followed in 2013, and the resulting statute now requires
among other things, that a consumer's IPP process be
conducted in their native language. Regional centers board
members must now receive training in and monitor their
regional centers' provision of services that are culturally
and linguistically competent. Quality assurance
measurements now must include measures of cultural and
linguistic competency. However, a number of elements of the
package either were removed or were not successfully
passed. Many of those are included in this bill, including
the requirement that cultural and linguistic competence be
an element of a regional center's performance contract.
Regional Centers
California's 21 nonprofit regional centers are part of a
system of care for individuals with developmental
disabilities that is overseen by DDS. DDS is responsible
for coordinating care and providing services for more than
265,000 people who receive services and supports to live in
their communities, as well as approximately 1,300 people
who reside in developmental centers. A developmental
disability is defined in statute as a substantial
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disability that originates before the age of 18 and
continues, or can be expected to continue, indefinitely,
such as intellectual disabilities, cerebral palsy,
epilepsy, and autism.
Senate hearing
In April 2012, prompted by a series of articles in The Los
Angeles Times, the Senate Select Committee on Autism and
Related Disorders held an informational hearing to examine
the question of whether consumers across the state received
equal access to regional center services for consumers with
autism spectrum disorders (ASD). The articles, entitled
"Warrior Parents Fare Best in Securing Autism Services,"
reported that people of color, low income, and
socio-economically disadvantaged communities received fewer
services compared to their white counterparts, and found
that DDS spent an average of $11,723 per child on whites;
$11,063 on Asians; $7,634 on Latinos, and $6,593 on blacks.
The articles also noted that while the average amount spent
for services on autistic children was $9,751 per case
statewide, it ranged from an average of $1,991 per child at
the regional center in South Los Angeles to $18,356 in
Orange County.
An outcome of the select committee's hearing was a
20-member taskforce, appointed by Senate President pro
Tempore Darrell Steinberg, which was charged with
recommending ways to ensure that consumers receive
appropriate and timely supports regardless of race,
ethnicity, educational background and other socio-economic
factors. A 119-page report published on March 18, 2013,
identified 19 recommended changes. Among them was the
recommendation that DDS continue to explore opportunities
that ensure consistent methods of seeking and obtaining
information related to equity and diversity performance (p
42). The taskforce additionally recommended that DDS
establish measurements within the regional centers'
existing annual performance contracts to inform the state
about whether a regional center's provision of services is
equitable. (p. 62). This bill addresses both of these
recommendations.
Related legislation
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SB 158 (Correa) 2013, would have established a pilot
project coordinated by a major university to identify
underserved communities in regional center catchment areas
and improve Autism identification and services in those
communities. It was vetoed by the Governor.
SB 208 (Lara) Chapter 656, Statutes of 2013, 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 319 (Price) 2013, would have required DDS to ensure that
the regional centers collect, analyze, and report data in a
way that allows for comparisons across regional centers,
and require regional centers to identify plans to reduce
disparities. This bill died in the Senate Appropriations
committee.
SB 321 (Price) 2013, would have required DDS to establish
performance contract guidelines and measures relating to
issues of cultural and linguistic competency.
SB 367 (Block) Chapter 682, Statutes of 2013, requires
regional centers to include issues related to cultural and
linguistic competency in governing board training
requirements, to post such training on their websites and
to annually review the regional center's provision of
services in a culturally and linguistically competent way.
SB 555 (Correa) Chapter 685, Statutes of 2013, requires a
regional center to communicate and provide written
materials in a consumer or family's native language during
the IPP and IFSP processes and to require that the native
language be documented.
AB 1232 (V. Manuel Perez) Chapter 679, Statutes of 2013,
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.
Comments :
1.Language of the bill requires that the regional centers
provide a "report" to the public "in an understandable
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form." Staff recommends clarifying both of these terms.
The author has worked out the language below with staff.
Staff recommends clarifying the intent of language in the
following sentence, as follows.
4519.5. (e) Within three months of compiling the data
with the department, and annually thereafter, each
regional center shall meet with stakeholders in one or
more public meetings regarding the data. The meeting or
meetings shall be held separately from a any meeting s
held pursuant to Section 4660 . and The regional center
shall provide particpants of these meetings with the
report data and any associated information and conduct a
discussion of the data and associated information in an
understandable form a manner that is culturally and
linguistically appropriate for that community, including
providing alternative communication services, as required
by Sections 11135 to 11139.7, inclusive, of the
Government Code and implementing regulations.
2.This bill requires input be sought from the Office of
Clients' Rights Advocacy in developing a plan to increase
use of services by consumers impacted by purchase of
services disparities. It also requires DDS to provide
various documents to the Office of Clients' Rights
Advocacy when a regional center is placed on probation.
This office is the currently contracted agency described
in WIC 4433 to provide advocacy for consumers; however,
it is not named in statute. Staff and the author agree to
replacing the name of the office in this bill with a
description of the contracted agency, should the contract
change in the future or the office be renamed.
Staff recommends the following clarifying amendments:
4629.(c) (1)(3) In addition to the performance objectives
developed pursuant to this section, the department shall
require each regional center to develop and implement a
plan with specific and measurable objectives that include
activities and timelines that will lead to an increase in
the utilization of services by consumers impacted by the
purchase of service disparities identified pursuant to
Sections 4519.5 and 4519.6. In developing that plan, a
regional center shall utilize the public process
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described in subparagraph (B) of paragraph (1), and shall
consider stakeholder input from the State Council on
Developmental Disabilities, the Office of Clients' Rights
Advocacy , the clients' rights advocacy contractor
identified in WIC 4433, and the protection and advocacy
agency described in Section 4901, and input gathered from
meetings held pursuant to subdivision (e) of Section
4519.5.
4629 (d) (2) Levels of probationary status for regional
centers that do not meet, or are at risk of not meeting,
performance standards. The department shall require that
corrective action be taken by any regional center which
is placed on probation. Corrective action may include,
but is not limited to, mandated consultation with
designated representatives of the Association of Regional
Center Agencies or a management team designated by the
department, or both. The department shall establish the
specific timeline for the implementation of corrective
action and monitor its implementation. When a regional
center is placed on probation, the department shall
provide the appropriate area board and the Office of
Clients' Rights Advocacy clients' rights advocacy
contractor identified in WIC 4433 with a copy of the
correction plan, timeline, and any other action taken by
the department relating to the probationary status of the
regional center.
POSITIONS
Support: Disability Rights California (sponsor)
Public Counsel
Special Needs Network
Oppose: None received
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