Purchase of Services Expenditure by Diagnosis, Ethnicity, Language, Residence and Age FY 2013-2014 Regional Center of the East Bay Public Meetings.

Purchase of Services Expenditure by Diagnosis, Ethnicity, Language, Residence and Age

FY 2013-2014

Regional Center of the East BayPublic Meetings

Why?

• Changes to the Lanterman Act – W & I Code 4519.5 • Changes in the populations in both our community and in the state.

• Diagnosis• Age• Ethnicity• Language• Residence

• Look at current trends and changes to understand and be responsive to meet both existing and emerging needs

• Identify how to meet the needs of our consumers and families in a way that is responsive to diverse cultural and linguistic needs

• Share information and hold a discussion with our community about the data and what is needed to reduce any disparities

Welfare and Institutions CodeSection 4519.5

• (a) The department and the regional centers shall annually collaborate to compile data in a uniform manner relating to purchase of service authorization, utilization, and expenditure by each regional center with respect to all of the following:

• (1) The age of consumer, categorized by the following:• (A) Birth to age two, inclusive. • (B) Three to 21, inclusive. • (C) Twenty–two and older. • (2) Race or ethnicity of the consumer. • (3) Primary language spoken by the consumer, and other related details, as feasible. • (4) Disability detail, in accordance with the categories established by subdivision (a) of

Section 4512, and, if applicable, a category specifying that the disability is unknown. • (5) Residence type, subcategorized by age, race or ethnicity, and primary language. • (b) The data reported pursuant to subdivision (a) shall also include the number and

percentage of individuals, categorized by age, race or ethnicity, and disability, and by residence type, as set forth in paragraph (5) of subdivision (a), who have been determined to be eligible for regional center services but are not receiving purchase of service funds.

Public Meetings and Data• …..Commencing on December 31, 2013, each regional center shall annually post this data by

December 31. Each regional center shall maintain all previous years’ data on its Internet Web site.

• (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 any meetings held pursuant to Section 4660. The regional center shall provide participants of these meetings with the data and any associated information, and shall 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 required by Sections 11135 to 11139.7, inclusive, of the Government Code and implementing regulations. Regional centers shall inform the department of the scheduling of those public meetings 30 days prior to the meeting. Notice of the meetings shall also be posted on the regional center’s Internet Web site 30 days prior to the meeting and shall be sent to individual stakeholders and groups representing underserved communities in a timely manner. Each regional center shall, in holding the meetings required by this subdivision, consider the language needs of the community and shall schedule the meetings at times and locations designed to result in a high turnout by the public and underserved communities.

Reports• (f) (1) Each regional center shall annually report to the department

regarding its implementation of the requirements of this section. The report shall include, but shall 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 described in this section 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.

• (2) Each regional center and the department shall annually post the reports required by paragraph (1) on its Internet Web site by August 31.

4519.6. The department and the regional centers shall annually collaborate to determine the most appropriate methods to collect and compile meaningful data in a uniform manner, as specified in Section 4519.5, related to the payment of copayments, coinsurance, and deductibles by each regional center. (Amended by Stats. 2014, Ch. 30, Sec. 14. (SB 856) Effective June 20, 2014.)

The RCEB and our Community

• One of 21 regional centers in California• Serves Alameda and Contra Costa County• Currently (March, 2015) 17, 270 consumers who

are status 1, 2 or 8.• The data in our report reflects 18,766 consumers

It reflects consumers who were served by RCEB at any time in the 2013/2014 fiscal year. Some of those consumers may have moved out of our area or into our area at any time during the year.

POS Expenditures

• Report shows cost of services that have been paid for by the regional center– Doesn’t include services coordinated through a

generic resource such as Medicare, Medi-Cal, private insurance, SSI

– Doesn’t include Services provided through contract such as Transportation

– Utilization doesn’t include services provided but not paid for due to late bills

Other Factors

• These expenditures and number include more than our average number of consumers as anyone who spent part of the year here is included

• Clients with multiple diagnoses are counted more than once.

• Some slides include information on authorized expenditures and some on utilization

RCEB Population By Ethnicity 2013/14

Asian13%

Black18%

Filipino4%

Hispanic22%

Polynesian0%

Other12%

Native American0%

White30%

Alameda/Contra Costa County Population By Ethnicity

African Amer.; 11%

Caucasion; 59%

Latino; 24%

Asian; 23%

Pacific Islander; 3% American Indian; 1% Other; 5%

African Amer.

Caucasion

Latino

Asian

Pacific Islander

American Indian

Other

Ethnicity

RCEB 2012/13 RCEB 2013/14

Asian12% Fil-

ipino4%His-

panic21%Polyne-sian0%

Na-tive

Amer-ican0%

Other Eth-nicity/Race

12%

White31%

African

Amer-ican18%

Asian

Filipino

Hispanic

Polynesian

Native Amer-ican

Other Ethnic-ity/Race

White

African Amer-ican

Asian13%

Black18%

Filipino4%Hispanic

22%Poly-

nesian0%

Other12%

Native Amer-ican0%

White30%

Ethnicity RCEB/General Population

RCEB 2013/14 Alameda and Contra CostaAfrican Amer.; 11%

Caucasion; 59%Latino; 24%

Asian; 23%

Pacific Islander; 3%American Indian; 1%Other; 5%

African Amer.Cau-casionLatinoAsianPacific Is-landerAmer-ican IndianOther

Asian13%

Black18%

Filipino4%Hispanic

22%Poly-

nesian0%

Other12%

Native Amer-ican0%

White30%

RCEB Ethnicity Ages 22-99

Asian9%

Black24%

Filipino4%

Hispanic13%

Polynesian0%

Other8%Native American

0%

White41%

Ethnicity Ages 3-21

Asian15%

Black16%

Filipino5%

Hispanic25%

Polynesian0%

Other15%

Native American0%

White24%

Younger Versus Older

Asian15%

Black16%

Fil-ipino

5%

Hispanic25%

Poly-nesian

0%

Other15%

Native Amer-ican0%

White24%

Asian9%

Black24%

Fil-ipin

o4%

His-pani

c13%

Polynesian0%

Other8%

Na-tive Ame

ri-can0%

White41%

Ethnicity By Age

Under 3 years Ages 3- 21 years, inclusive

Ages 22+0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

WhitePolynesianOtherNative AmericanHispanicFilipinoAfican AmericanAsian

RCEB Primary Languages

English73%

Spanish280515%

Cantonese2%

Tagalog1%

Vietnamese1%

Mandarin1%

Other Asian2%

ASL1%

other3%

Language By Age

Language

0 through 2

Age 3 through21

Ages 22+

0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1

EnglishSpanishCantoneseTagalogVietnameseMandarinOther AsianASLALL OTHER

Overall Living Arrangements

75%

10%

13%1% 1%

Parent/Guardian ILS/SLSCCF/ICF Family Home/Foster HomeOther

Residence Type By Ethnicity(13/14)

Asian

Black

Filipino

Hispanic

Polynesian

Other

Native American

White

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Parent/GuardianILS/SLsFoster Home/FHANFOtherICFCCF

Ages 22 Plus By Residence

Asian Black Filipino Hispanic Polynesian Other Native American White

71

580

18132

1

95

6871

CCFICFOtherNFFoster Home/FHAILS/SLsParent/Guardian

Ages 3 through21 Years

Asian Black Filipino Hispanic Polynesian Other Native American White0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

CCFICFOtherNFFoster Home/FHAILS/SLsParent/Guardian

Expenditures By Living Arrangement

CCF

FHA

ILS/SLS

ICF

NF

Home Parent or Guardian

Foster Home

Other

$- $10,000.00 $20,000.00 $30,000.00 $40,000.00 $50,000.00 $60,000.00

Per Capita Expenditures

Diagnosis By Age

Overall 3 years to 21 Age 22 and older0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

OtherCategory 5Cerebral PalsyIntellectual DisabilityEpilepsyAutism

Expenditures By Diagnosis and Age

Birth thru2 3to21 22plus $-

$5,000.00

$10,000.00

$15,000.00

$20,000.00

$25,000.00

$30,000.00

$35,000.00

AutismIntellectual DisabilityCerebral PalsyEpilepsyCAT5Other

Authorizations By Diagnosis

Autism ID Cerebral Palsy

Epilepsy CAT 5 Other

$15,394.00

$24,106.00

$20,221.00 $21,815.00

$13,311.00

$7,193.00

Expenditures By Diagnosis

Autism Intellectual Disability Cerebral Palsy Epilepsy CAT5 Other $-

$5,000.00

$10,000.00

$15,000.00

$20,000.00

$25,000.00

By Diagnosis Authorized Expenditures 22+

Autism ID Cerebral Palsy Epilepsy CAT 5 Other0

5000

10000

15000

20000

25000

30000

POS AUTHORIZATIONS 2013/2014

RCEB Population By Ethnicity Authorizations By Ethnicity

Asian13%

Black18%

Filipino4%Hispanic

22%Poly-

nesian0%

Other12%

Native Amer-ican0%

White30%

Chart Title

Asian10%

Black16%

Filipino11%

Hispanic9%Polynesian

5%

Other11%

Native American19%

White20%

Expenditures By Age and Language

Mandarin Cantonese Japanese Vietnamese Korean Laotian Cambodian Other Mien Tagalog Asian $-

$5,000.00

$10,000.00

$15,000.00

$20,000.00

$25,000.00

$30,000.00

$5,890

$8,836 $8,591

$4,986 $6,181

$13,470

$499

$6,334

$4,731

$6,970 $6,328

$25,772

$13,770

$25,772

$7,006

$21,237

$8,487

$5,163

$14,276

$9,436

$14,257

$17,567

Expenditures by Age Language Ethnicity

English Hispanic Spanish Asian Mandarin Cantonese Vietnamese Tagalog $-

$5,000.00

$10,000.00

$15,000.00

$20,000.00

$25,000.00

$30,000.00

$6,352 $5,383 $5,121

$6,238 $5,890

$8,836

$4,986

$6,970

$28,235

$20,415

$18,039 $17,567

$25,772

$13,770

$7,006

$14,257 Overall0to23to2122 plus

Authorized Per Capita

0 to 2

3 to 21

22 to 99

0

5000

10000

15000

20000

25000

30000

35000

40000

6664 8985

21058

91879227

29715

64507565

24163

8728

8667

27453

7647 9206

36890

Asian

Black

Filipino

Hispanic

Polynesian

Other

Native American

White

Authorized Per Capita

Asian Black Filipino Hispanic Polynesian Other Native American White0

5000

10000

15000

20000

25000

30000

35000

40000

21058

29715

21364

24163

9931

27453

31859

36890

0 to 23 to 2122 to 99Overall

Utilization Percentages

Asian Black Filipino Hispanic Polynesian Other Native American White0

10

20

30

40

50

60

70

80

90

0 to 23 to 2122 to 99AllAges

Overall No Purchase

Asian Black Filipino Hispanic Polynesian Other Native American White0.00%

5.00%

10.00%

15.00%

20.00%

25.00%

30.00%

35.00%

40.00%

26.90%

20.40%

31.90%

25.90%

39.00%

25.00%

22.70%

18.30%

No Purchase Kids

Asian Black Filipino Hispanic Polynesian Other Native American White0%

10%

20%

30%

40%

50%

60%

36.00%38.30%

43.20%41.60%

56.00%

38.70%

53.80%

38.60%

No Purchase of Service Adults

AsianBlack

FilipinoHispanic

PolynesianOther

Native AmericanWhite

0.00%

5.00%

10.00%

15.00%

20.00%

25.00%

30.00%

35.00%

40.00%

Chart Title

Insurance

Asian Black Filipino Hispanic Polynesian Other Native American White0

5

10

15

20

25

30

OverallUnder 33to2122Plus

Insurance By Diagnosis

89%

5% 1%5%

1%

Autism ID EpilepsyCat5 CP Other

Ongoing Efforts

• Utilization of two delegate agencies to insure the availability of case managers with are bilingual to serve individuals who are monolingual in either Spanish or an Asian language

• RCEB employs staff who are bilingual in Spanish, Farsi and ASL.

• Support of Multicultural and Bilingual events in the community for family support and education

• RCEB ‘s performance contract has historically contained optional local public policy objectives to support family conferences that support our culturally diverse community

Steps Taken

• Diversity and Equity Committee established by the Board

Meets Monthly

Subcommittees

Web Design

Support Groups

Training Needs

Summary

• The data only reflects the authorization outcomes of IPP/IFSP meetings. It doesn’t show what other resources were utilized including education, employment, insurance, and Medi-Cal.

• The data doesn’t tell us about unmet needs• We do know there are limited resources in certain

geographic areas as well as limited resources with certain linguistic/cultural capacities

• Data raises many more questions that need exploration.

Summary

• Age and Living Arrangement Have the Largest Impact on Expenditures

• Our population is ethnically somewhat different from the Alameda and Contra Costa census data however we need to explore why this is and look at specific age demographics in our counties. Who are we not reaching and why?

• The ethnic diversity of our younger consumers is much greater than for older consumers.

Summary

Our data doesn’t provide information on family socioeconomic or educational status. Poverty , parents working multiple jobs, frequent moves can all impact the ability to access services.

Your Input

What Do You Think?

• What regional center services do you need/want that are not available to you or your family member?

• What would make a difference?

• What are your unmet needs?