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Sunday, May 29, 2022

Inequitable Access in California

 In The Politics of Autism, I discuss services for people with disabilities.

Regional centers are private nonprofits that contract with Califorinia's Department of Developmental Services to coordinate or provide services for people with developmental disabilities. The 21 regional centers help disabled people and their families help find and access a variety of services.

A news release from Public Counsel:

A new report from Public Counsel shows that a six-year, $66 million effort by the State of California to reduce inequitable access to developmental services for children has been largely ineffective and that inequity “continues to plague communities of color.” The report evaluates the outcomes of a disparity reduction program established by the state in 2016 to reduce inequities within California’s regional center system – a network of state-funded but independently run agencies charged with providing services to Californians with developmental disabilities.

“Our report confirms what many families and advocates have said for years – this system is broken,” said Brian Capra, the report author and senior staff attorney with Public Counsel. “While California’s efforts were well-intentioned, its piecemeal approach to reform is inadequate for fixing deep, systemic discrimination that has dogged this system for decades. Tragically, our findings indicate that many racial and ethnic disparities have only gotten worse, and the most disadvantaged families continue to get the least amount of support.”

The report’s findings include:Inequitable funding is worsening between white and Latino children at most regional centers.Disparities in service expenditures between Latino and white children have improved in four regional centers over the past six years but worsened in the other 17 regional centers.Disparities for Asian children have worsened statewide over the past six years, yet the state does not have improvement goals for this population.Without explanation, California’s Department of Developmental Services (DDS) has not assigned improvement targets for Asian children in its disparity monitoring process and has not been tracking this group’s inequitable trajectory under this process.Disparities between children of “other ethnicity” and white children are the most profound among all race/ethnicity groups and are worsening.As with Asian children, DDS has not assigned improvement targets for “other ethnicity” children in its disparity monitoring process and is not tracking this group’s worsening plight under this process.
Children with “other ethnicity” are the fastest-growing race/ethnicity group.

For 30 years, advocates and families have raised concerns about disparities in service access. An L.A. Times exposé in 2011 revealed stark racial differences in services for children with autism, prompting then State Senator Darrell Steinberg to create a Task Force on Equity and Diversity that identified dozens of recommendations for reform – many of which remain unimplemented. Public Counsel’s report calls for a joint legislative oversight hearing to thoroughly review the worsening predicament, noting that there “have been just two legislative hearings dedicated exclusively to examining funding inequities” (in 2012 and 2017), and neither consisted of a fully impaneled set of legislators from both the Senate and Assembly.

“California’s elected officials and decision-makers have been aware of these inequities for well over a decade, yet we still have a system of separate and unequal services for children with disabilities,” said Sharon Balmer Cartagena, directing attorney of Public Counsel’s Children’s Rights Project. “A family’s race, geography, and language should never influence the services a child receives from the state of California to treat developmental disabilities. Yet each year, this discrimination is allowed to persist, and it is time for a full overhaul of this system.”

The report identifies nine recommendations for addressing the system’s problems. For example, it highlights that the Department of Developmental Services (DDS) has a flawed funding methodology that perpetuates the system’s inequities: “DDS’ current budgeting formula allocates funding to regional centers not according to their consumers’ needs but on what the regional centers have previously spent.” The formula results in drastically different spending on services for children – often thousands of dollars or more annually – even between regional centers within the same city.

“Sadly, California’s regional center system still operates haphazardly with wild inconsistencies in funding,” said Capra. “DDS continues to use a convoluted funding formula that gives unequal resources to different regional centers and employs a laissez-faire approach to service delivery that allows inequities to fester. We are proposing a targeted spending plan for each regional center to provide earmarked funding to unserved and underserved groups to bring them closer to funding equity with their white peers.”

In another example of haphazard oversight, the report found that DDS has allowed regional centers to categorize their clients such that “other ethnicity” is now a predominant racial category at many regional centers, even though U.S. Census data for local population characteristics indicate otherwise. The report states there is a “burgeoning population of children of ‘other ethnicity’ who currently suffer from these inequities in relative anonymity.“

In addition to inequities in service delivery connected to race, the report found that significant gaps persist in services between English-speaking and Spanish-speaking children. While disparities in service expenditures between these groups improved in eight regional centers over the past six years, the disparities worsened in the other 13 regional centers.

In a positive finding, the report identified that service delivery for Black children improved significantly over the past six years: “This is one instance where considerable progress has been made in reducing funding disparities.”

In another positive finding, the report identified that the South Central Los Angeles Regional Center (SCLARC) made significant progress in reducing service disparities among its clients: SCLARC was “single-handedly responsible for causing a five percentage point increase in disparity reduction improvement to the statewide aggregate data for Hispanic children and an eight percentage point increase in disparity reduction improvement to the statewide aggregate data for Spanish-speaking children.” It was able to make these improvements by “more than doubling its total expenditures in the past year for its children ages 3 through 21” (from around $65 million to $137 million) while keeping the size of this group essentially unchanged.

In one of its recommendations, the report suggests that “one potential model could be a targeted spending plan that effectuates more equitable results similar to those recently achieved by SCLARC during the 2020-2021 fiscal year.”View the report here
View the report fact sheet here (ENGLISH)
View the report fact sheet here (SPANISH)