BILL ANALYSIS                                                                                                                                                                                                    �



                                                                            



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                                    THIRD READING


          Bill No:  SB 1093
          Author:   Liu (D)
          Amended:  5/27/14
          Vote:     21

           
           SENATE HUMAN SERVICES COMMITTEE  :  4-0, 4/22/14
          AYES:  Liu, Berryhill, DeSaulnier, Hancock
          NO VOTE RECORDED:  Wyland

           SENATE APPROPRIATIONS COMMITTEE  :  7-0, 5/23/14
          AYES:  De Le�n, Walters, Gaines, Hill, Lara, Padilla, Steinberg


            SUBJECT  :    Developmental services:  regional centers:   
                      culturally and 
                       linguistically competent services

           SOURCE  :     Disability Rights


           DIGEST  :    This bill requires that independent living skills  
          services be available to all adult consumers of regional  
          centers, as specified.  This bill requires regional centers to  
          hold the annual stakeholder meetings regarding data that  
          includes residency type, race or ethnicity, and primary  
          language, separately from any meetings of its board of directors  
          and to schedule the meetings at times and locations designed to  
          result in a high turnout by the public and underserved  
          communities, as specified.  This bill also requires each  
          regional center to annually report to the Department of Social  
          Services (DSS) specified information regarding its  
          implementation of these provisions and requires the reports to  
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          be posted on DSS's and each regional center's Internet Web site  
          by August 31 of each year.

           
          ANALYSIS  :    

          Existing law:

          1. Establishes DDS to administer the Lanterman Developmental  
             Disabilities Act, which entitles individuals with  
             developmental disabilities to community services and  
             supports. 

          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. 

          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 Internet Web site annually, as  
             specified. 

          4. Requires regional centers, within three months of the release  
             of data, to conduct public meetings with stakeholders about  
             the data and to inform DDS and public of the meetings 30 days  
             prior to holding them. 

          5. Requires that, within the scope of a five-year contractual  
             agreement, DDS to provide oversight of the regional centers  
             by requiring specified activities and establishing annual  
             performance objectives.  

          6. Establishes steps for DDS to ensure contract compliance,  
             including incentives for regional centers that meet or exceed  

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             performance standards, levels of probationary status for  
             regional centers that do not, and other specified actions. 

          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 Internet Web site 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 within three months of  
             the data's annual release to requiring "one or more public  
             meetings."  

          5. Requires that the regional centers' public meetings to  
             discuss the data be held separately from any other board  
             meetings, as defined.

          6. Requires the regional center to provide participants of these  
             meetings with the data and any associated information, and to  
             conduct a discussion of the data and the associated  
             information in a manner that is culturally and linguistically  
             appropriate for that community, including providing  
             alternative communication services, as defined.

          7. 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. 


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          8. Adds to required contents of regional center annual  
             performance contracts the development of culturally and  
             linguistically appropriate services and supports.

          9. Requires each regional center to annually report to DSS  
             regarding its implementation of the requirements of the above  
             provisions and requires the report to include, but not be  
             limited to, all of the following:

             A.    Actions the regional center took to improve public  
                attendance and participation at stakeholder meetings,  
                including, but not limited to, attendance and  
                participation by underserved communities.

             B.    Copies of minutes from the meeting and attendee  
                comments.

             C.    Whether the data indicates a need to reduce  
                disparities in the purchase of services among consumers  
                in the regional center's catchment area. If the data  
                does indicate that need, the regional center's  
                recommendations and plan to promote equity, and reduce  
                disparities, in the purchase of services.

          10.Requires each regional center and DSS to annually post the  
             above report on its Internet Web site by August 31.

          11.When a regional center is placed on probation, requires the  
             clients' rights advocacy contractor, as defined, to be  
             provided with copies of the correction plan, timeline and  
             other documents, in addition to providing these documents to  
             the local area boards.

          12.Requires independent living skills services to be available  
             to all adult consumers who live in the home of a parent,  
             relative, or other person, or who live independently.

           Background
           
           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  

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          communities, as well as approximately 1,300 people who reside in  
          developmental centers.  A developmental disability is defined in  
          statute as a substantial 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 Autism and Related  
          Disorders Select Committee 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.  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 Senate Autism and Related Disorders 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.  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.   
          This bill addresses both of these recommendations.

           Prior Legislation
           
          SB 158 (Correa, 2013), would have established a pilot project  
          coordinated by a major university to identify underserved  

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          communities in regional center catchment areas and improve  
          Autism identification and services in those communities.  This  
          bill vetoed by Governor Brown.

          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 Internet Web site 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 as specified, requires  
          the native language to 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.

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes    
          Local:  No


          According to the Senate Appropriations Committee:



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             Unknown, but likely minor costs to provide additional  
             independent living skills services (General Fund and federal  
             funds).  This bill specifically provides that independent  
             living skills services shall be available to adult consumers  
             who live in the home of a parent, family member, or others.   
             Under existing law, such consumers are already eligible for  
             those services.  Putting an explicit authorization in statute  
             might increase awareness of, and demand for, such services.   
             However, because those services are already allowed, such an  
             increase in demand may not be large and may be offset by  
             reductions in other services to those consumers.

             Minor administrative costs to the regional centers to  
             collect and report additional data and engage in additional  
             stakeholder outreach (General Fund).

           SUPPORT  :   (Verified  5/27/14)

          Disability Rights California (source)
          ACLU
          Public Counsel
          Special Needs Network

           ARGUMENTS IN SUPPORT  :    There is a significant purchase of  
          service gap across racial and ethnic groups, according to the  
          author's office, who also argues that some culturally based  
          choices, such as multi-generational living arrangement, may  
          result in consumers receiving fewer services.  The author's  
          office 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.


          JL:d  5/27/14   Senate Floor Analyses 

                           SUPPORT/OPPOSITION:  SEE ABOVE

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