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

FY 2012-2013

Regional Center of the East BayMarch 24, 2014 Public Meeting

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

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

• Identify ways to meet the needs of our diverse populations in a way that is responsive to individuals and cultures

• Share information and meet with our community regarding the data

Welfare and Institutions Code 4519.5• 4 5 1 9 . 5 . ( a ) T h e d e p a r t m e n t a n d t h e r e g i o n a l c e n t e r s s h a l l a n n u a l l y

c o l l a b o r a t e t o c o m p i l e d a t a r e l a t i n g t o p u r c h a s e o f s e r v i c e a u t h o r i z a t i o n , u t i l i z a t i o n , a n d e x p e n d i t u r e b y e a c h r e g i o n a l c e n t e r w i t h r e s p e c t t o a l l o f t h e f o l l o w i n g :

• ( 1 ) T h e a g e o f c o n s u m e r , c a t e g o r i z e d b y t h e f o l l o w i n g :

( A ) B i r t h t o a g e t w o , i n c l u s i v e

( B ) T h r e e t o 2 1 , i n c l u s i v e .

( C ) T w e n t y t w o a n d o l d e r .

• ( 2 ) R a c e o r e t h n i c i t y o f t h e c o n s u m e r .

• ( 3 ) P r i m a r y l a n g u a g e s p o k e n b y t h e c o n s u m e r , a n d o t h e r r e l a t e d d e t a i l s , a s f e a s i b l e .

• ( 4 ) D i s a b i l i t y d e t a i l , i n a c c o r d a n c e w i t h t h e c a t e g o r i e s e s t a b l i s h e d b y s u b d i v i s i o n ( a ) o f S e c t i o n 4 5 1 2 , a n d , i f a p p l i c a b l e , a c a t e g o r y s p e c i f y i n g t h a t t h e d i s a b i l i t y i s u n k n o w n

• ( b ) T h e d a t a r e p o r t e d p u r s u a n t t o s u b d i v i s i o n ( a ) s h a l l a l s o i n c l u d e t h e n u m b e r a n d p e r c e n t a g e o f i n d i v i d u a l s c a t e g o r i z e d b y a g e , r a c e o r e t h n i c i t y , a n d d i s a b i l i t y , w h o h a v e b e e n d e t e r m i n e d t o b e e l i g i b l e f o r r e g i o n a l c e n t e r s e r v i c e s b u t a r e n o t r e c e i v i n g p u r c h a s e o f s e r v i c e f u n d s .

(c) By March 31,2013, each regional center shall post the data described in this section that is specific to the regional center on its Internet Website. Commencing on December 31, 2013, each regional center shall annuallypost this data by December 31.

(d) By March 31, 2013,the department shall post the information described in this section on a statewide basis on its Internet Website. Commencing December 31,2013,the department shall annually post this information by December 31. The department shall also post notice of any regional center stakeholder meetings 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 a public meeting regarding the data. Regional centers shall inform the department of the scheduling of those public meetings 30 days prior to the meeting. Notice of the meetings 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.

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 and coinsurance by each regional center. (Added by Stats. 2013, Ch. 25, Sec. 4. (AB 89) Effective June 27, 2013.)

The RCEB and our Community

• One of 21 regional centers in California• Serves Alameda and Contra Costa County• Currently ( March, 2013) , 16, 723 consumers

who are status 1, 2 or 8.• The data in our report reflects 18, 357 consumers

It reflects consumers who were served by RCEB at any time in the 2012-2013 fiscal year. Some of those consumers may have moved out of our area or into our area at any time during the year.

RCEB Population By Ethnicity

Asian12%

Filipino4%

Hispanic21%

Polynesian0%

Native Amer-ican0%Other Ethnicity/Race

12%

White31%

African American18%

Asian

Filipino

Hispanic

Polynesian

Native American

Other Ethnicity/Race

White

African American

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 Alameda and Contra Costa

African Amer.; 11%

Caucasion; 59%Latino; 24%

Asian; 23%

Pacific Is-lander; 3%

American Indian; 1% Other; 5%

African Amer.

Cau-casion

Latino

Asian

Pacific Is-lander

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

RCEB Consumers By Age

0 to 2 years, inclusive

15%

3 years to 21 years, inclusive

43%

22 years and older

42%

0 to 2 years, inclusive

3 years to 21 years, inclusive

22 years and older

RCEB Consumers by Diagnosis

Autism

Intellectual Disability

Cerebral Palsy

Epilepsy

Category 5

No diagnosis

18%

37%

10%

10%

11%

14%

Diagnoses By Age

Overall Age 0 through 2 3 through 21 Years 22 +0%

20%

40%

60%

80%

100%

No diagnosisCategory 5EpilepsyCerebral PalsyIntellectual DisabilityAutism

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

Living Arrangements

Home of Parent/Guardian74%

ILS/SLS10%

CCF/ICF14%

Family/Foster Home Agency1%

Other1%

Living Arrangements By Ethnicity

Asian

African American

Filipino

Hispanic

Multicultural

Native American

Other

Polynesian

White

89%

64%

87%

88%

73%

55%

85%

92%

57%

7%

14%

10%

7%

9%

21%

7%

6%

25%

3%

17%

2%

4%

4%

14%

6%

0%

16%

1%

5%

1%

2%

15%

10%

2%

2%

2%

Home Parent/Guardian CCF/ICF ILS/SLS OTHER

Asian

African American

Filipino

Hispanic

Multicultural

Native American

Other

Polynesian

White

89%

64%

87%

88%

73%

55%

85%

92%

57%

7%

14%

10%

7%

9%

21%

7%

6%

25%

3%

17%

2%

4%

4%

14%

6%

0%

16%

1%

5%

1%

2%

15%

10%

2%

2%

2%

Home Parent/Guardian CCF/ICF ILS/SLS OTHER

Overall Living Arrangements By Age

Ages 0-2, inclusive Ages 3-21, inclusive Ages 22+0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Other

FosterHome/Family Home Agency

CCF/ICF

ILS/SLS

Home of Parent/Guardian

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

Ages and Ethnicities

Asian Afican American Filipino Hispanic Native American Other Polynesian White

19%8% 9%

25%

10%

20%21%

9%

49%

8%

51%

50%

24%

20%43%

34%

32%

54%

40%

25%

66%

26% 36%

57%

Under 3 years Ages 3- 21 years, inclusive Ages 22+

Authorized Expenditures- Ethnicity and Age

Asian

Africa

n American

Filipino

Hispanic

Native American

Other

Polynesian

White

$-

$10,000.00

$20,000.00

$30,000.00

$40,000.00

OverallUnder 33 thru 2122+

Utilization of Services By Age

Overall Under 3 3 thru 21 22+

81%

66% 71%

86%

Asian African American

Filipino Hispanic Native American

Other Polynesian White

76.80%83.20% 79.90% 76.60%

88.80%

76.50%67.40%

83.40%

Utilization By Ethnicity

Authorizations By Ethnicity

Asian African American Filipino Hispanic Native American Other Polynesian White

$12,699.00

$19,996.00

$14,384.00

$11,315.00

$20,975.00

$13,981.00

$7,669.00

$24,976.00

Service Authorization As a Percentage of the Population

POS $ Authorized By Ethnicity Ethnic Groups % of RCEB Population

Asian9%

African American21%

Fil-ipino3%Hispanic

14%

Native American0%

Other10%Poly

ne-sian0%

White43%

Asian12%

Fil-ipino4%

Hispanic21%

Poly-nesian

0%Native Amer-ican0%

Other Ethnicity/Race

12%

White31%

African

Amer-ican18%

Utilization By Language

ASL

Cantonese

English

Spanish

Tagalog

Vietnamese

Mandarin

65.00% 70.00% 75.00% 80.00% 85.00% 90.00%

Authorizations By Language

ASL Cantonese English Spanish Tagalog Vietnamese Mandarin $-

$5,000.00

$10,000.00

$15,000.00

$20,000.00

$25,000.00

$30,000.00

$35,000.00

Chart Title

Series1

POS Authorizations

% POS Authorizations % RCEB Consumers

Asian12%

Fil-ipino4%

Hispanic21%

Poly-nesian

0%Native Amer-ican0%

Other Ethnicity/Race

12%

White31%

African

Amer-ican18%

Asian9%

African American21%

Fil-ipino3%Hispanic

14%

Native American0%

Other10%Poly

ne-sian0%

White43%

By Diagnosis Authorized Expenditures 22+

Autism ID Cerebral Palsy Epilepsy CAT 5 Other0

5000

10000

15000

20000

25000

30000

35000

40000

Authorizations By Diagnosis

Autism ID Cerebral Palsy

Epilepsy CAT 5 Other

$16,022.00

$23,437.00

$20,221.00 $21,815.00

$13,311.00

$7,193.00

No Services

Overall 0 through 2 3 through 21 22 +0%

10%

20%

30%

40%

50%

60%

70%

Chart Title

Asian African American Filipino HispanicNative American Other Polynesian White

Overall No Services

Asian African American Filipino Hispanic Native American Other Polynesian White

25%

21%

31%

26% 27%24%

41%

18%

NO POS 3-21

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

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

3 through 21

3 through 21

NO Purchase of Service-22+

Asian

African American

Filipino

Hispanic

Native American

Other

Polynesian

White

0.00% 5.00% 10.00% 15.00% 20.00% 25.00% 30.00% 35.00% 40.00% 45.00%

22 +

22 +

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

• 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

Since the last report…

• Diversity and Equity Committee established by the Board

Three sub committees• Diversity and Equity Webpage• Training ( both for families and staff)• Support Groups

• Questions regarding differences between persons receiving case management through delegate agencies and through RCEB. Data provided today.

Delegate Case Management

Number Auth Amount Paid Amount

RCEB 3887 $13,934.61 $10,849.29

Delegation 1700 $13,491.00 $10,652.26

Summary

• The data 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.