BILL ANALYSIS SENATE HUMAN SERVICES COMMITTEE Senator Carol Liu, Chair BILL NO: AB 2229 A AUTHOR: Brownley B VERSION: April 29, 2010 HEARING DATE: June 22, 2010 2 FISCAL: Public Safety/Appropriations 2 2 CONSULTANT: 9 Park SUBJECT Mandated child abuse reporting SUMMARY Establishes time-limited authority for counties to create two-person multidisciplinary personnel teams (MDT) engaged in the investigation of suspected child abuse or neglect, as specified. ABSTRACT Existing law: 1.Authorizes members of a multidisciplinary personnel team engaged in the prevention, identification, and treatment of child abuse to disclose and exchange information and writings to and with one another relating to any incidents of child abuse that may also be part of a juvenile court record or otherwise designated as confidential under state law if the member of the team having that information reasonably believes it is generally relevant to the prevention, identification or treatment of child abuse. Continued--- STAFF ANALYSIS OF ASSEMBLY BILL 2229 (Brownley) Page 2 2.Defines "multidisciplinary personnel" as any team of three or more persons who are trained in the prevention, identification, and treatment of child abuse and neglect cases and who are qualified to provide a broad range of services related to child abuse. The team may include but not be limited to: a. Psychiatrists, psychologists, or other trained counseling personnel; b. Police officers or other law enforcement agents; c. Medical personnel with sufficient training to provide health services; d. Social workers with training or experience in child abuse prevention; and, e. Any public or private school teacher, administrative officer, supervisor of child welfare and attendance, or certificated pupil personnel employee. 3.Provides that any county may establish a computerized data base system within that county to allow provider agencies, as defined, to share specified identifying information regarding families at risk for child abuse and neglect, for the purposes of forming multidisciplinary personnel teams. This bill: 1.Allows a county to establish, notwithstanding any other provision of law, a child abuse investigation and prevention multidisciplinary personnel team within that county to allow provider agencies, as defined, to share confidential information in order to investigate reports of suspected child abuse or neglect, or for the purposes of making a child welfare services referral or detention determination. 2.Defines "child abuse investigation and prevention multidisciplinary personnel team," related to the STAFF ANALYSIS OF ASSEMBLY BILL 2229 (Brownley) Page 3 provisions below, to mean any team of two or more persons (current law defines as three or more persons) who are trained in the prevention, identification, or treatment of child abuse and neglect cases and who are qualified to provide a broad range of services related to child abuse. Allows this team to include, but not be limited to, the same persons that are included in a three-person MDT, pursuant to current law. (See list above.) 3.Defines "provider agency" to mean any governmental or other agency that has as one of its purposes the prevention, identification, management, or treatment of child abuse or neglect. Specifies provider agencies to include, but not be limited to, the following entities or service agencies (identical to current law specifying three-person MDTs): social services; children's services; health services; mental health services; probation; law enforcement; and schools. 4.Allows members of a child abuse investigation and prevention multidisciplinary personnel team to disclose and exchange with one another information and writings, as specified, during the 48-hour period following a report of suspected child abuse or neglect, notwithstanding any other provision of law. Provides that any discussion relative to the disclosure or exchange of the information or writings during a team meeting is confidential and, notwithstanding any other provision of law, testimony concerning that discussion is not admissible in any criminal, civil, or juvenile court proceeding. 5.Allows disclosure and exchange of information pursuant to the above to occur telephonically and electronically if there is adequate verification of the identity of the child abuse investigation and prevention multidisciplinary personnel who are involved in that disclosure or exchange of information. 6.Prohibits the disclosure and exchange of information to be made to anyone other than members of the child abuse STAFF ANALYSIS OF ASSEMBLY BILL 2229 (Brownley) Page 4 investigation and prevention multidisciplinary personnel team, and those qualified to receive information, as specified. 7.Allows the child abuse investigation and prevention multidisciplinary personnel team to designate persons to be a member of the team for a particular case, as specified, and allows a person designated as a team member to receive and disclose relevant information and records, subject to the confidentiality provisions specified in the bill. 8.Requires the sharing of the information above to be governed by memoranda of understanding among the participating service providers or provider agencies, and requires the memoranda to specify the types of information that may be shared, and the process to be used to ensure that current confidentiality requirements of the bill are met. 9.Requires every member of the child abuse investigation and prevention multidisciplinary personnel team who receives information or records regarding children and families in his or her capacity as a member of the team to be under the same privacy and confidentiality obligations and subject to the same confidentiality penalties as the person disclosing or providing the information or records. Requires the information or records obtained to be maintained in a manner that ensures the maximum protection of privacy and confidentiality rights. Provides that this section shall not be construed to restrict guarantees of confidentiality provided under federal law. 10.Provides that the information and records communicated or provided to the team members by all providers and agencies, as well as information and records created in the course of a child abuse or neglect investigation, shall be deemed private and confidential and shall be protected from discovery and disclosure by all applicable statutory and common law protections. Provides that STAFF ANALYSIS OF ASSEMBLY BILL 2229 (Brownley) Page 5 existing civil and criminal penalties shall apply to the inappropriate disclosure of information held by the team members. 11.Specifies that the sharing of a computerized data base system that a county is authorized to establish related to child abuse and neglect be available for the purpose of the child abuse investigation and prevention multidisciplinary personnel team established pursuant to these provisions, in addition to the multidisciplinary personnel team authorized in current law. 12.Repeals the provisions above on January 1, 2014. FISCAL IMPACT According to the Assembly Appropriations Committee, minor nonreimbursable local costs to the extent counties opt to form these teams. BACKGROUND AND DISCUSSION Author's statement The author states that existing law provides for the formation of a child abuse MDT comprised of three individuals who are trained in the prevention, treatment and identification of child abuse; however, existing law regarding elder abuse MDTs require only two members. The author also states that nurses, social workers, and law enforcement personnel report losing valuable time in responding to an emergency child abuse problem while a third party is sought to complete the team and allow for the information to be shared. The author also points out that existing statute is silent as to telephonic and electronic communication as an acceptable mode for the sharing of information. The author notes that, because there is a significant amount of confusion among members of child abuse MDTs regarding their legal ability to communicate, it is necessary to clarify the law to specifically permit telephonic and electronic STAFF ANALYSIS OF ASSEMBLY BILL 2229 (Brownley) Page 6 communication among team members upon the proper verification of the recipient's status as a team member. The author notes that by bringing the law regarding child abuse MDTs into line with existing law regarding elder abuse MDTs, the bill will enhance the treatment and prevention of child abuse by streamlining the ability of qualified personnel to aid victims and ensure that no time is lost in responding to an emergency child abuse problem. Child abuse multidisciplinary personnel teams Multidisciplinary teams have been authorized in California to allow for a coordinated interagency response to elder and child abuse cases for more than twenty years. MDTs, formed and operated at the county level are afforded the ability to share confidential information among team members for the purposes of preventing, identifying, or treating child abuse. According to the U.S. Department of Justice Office of Juvenile Justice and Delinquency Prevention's guide, "Forming a Multidisciplinary Team to Investigate Child Abuse," MDTs are an effective tool for conducting a timely and objective investigation while causing as little added trauma to children and families. Additionally, MDTs operate, not just to investigate possible child abuse and neglect, but to facilitate coordination among the different agencies and entities participating on the team so that decisions can be made through team decision-making. According to the author, the Legislature first authorized the use of MDTs for both child abuse and elder abuse with the passage of AB 1049 (Bader), Chapter 353, Statutes of 1987. At that time, MDTs were a relatively new concept, which primarily existed as pilot projects in certain counties. In 1994, however, a comprehensive overhaul of the elder abuse statutes was proposed by SB 1681 (Mello). SB 1681 reduced from three to two the number of members necessary to form an elder abuse MDT. Since that time, the law regarding MDTs in elder abuse and child abuse cases has no longer been consistent. Currently, all 58 California counties operate child abuse MDTs, and counties often operate multiple MDTs at once. Confidentiality Existing state and federal laws prohibit most county health STAFF ANALYSIS OF ASSEMBLY BILL 2229 (Brownley) Page 7 and human services programs and educational entities from sharing confidential patient, recipient, and student information without the express consent of the individual, or in the case of minors, the parent or guardian. Confidential information may be shared in rare cases among government agencies although written permission is often required, and civil and criminal penalties may apply if the information is unlawfully disclosed. California Child Welfare Council (CWC) The CWC, formed by AB 2216 (Bass), Chapter 384, Statutes of 2006, is a state advisory body tasked with considering recommendations to improve child and youth outcomes through increased collaboration and coordination among the programs, services and processes administered by the multiple agencies and courts that serve children and youth in California's child welfare system. The CWC formed a data linkage and information sharing committee, which issued a set of recommendations to: 1) issue a policy statement supporting data linkages and sharing; 2) perform an inventory of existing data sharing practices; and 3) issue policy briefs on laws related to information sharing in the areas of health, education, and substance abuse. The committee is expected to finalize related briefs and policy recommendations by 2011. Arguments in support According to the sponsor of the measure, the Los Angeles County District Attorney (on behalf of the Inter-Agency Council on Child Abuse and Neglect), the bill seeks to remedy the problem faced by members of an MDT investigating a potential case of child abuse who are time-limited in making detention determinations, and face barriers accessing necessary information from other members of the MDT because current law requires discussions among three or more MDT members, and is unclear regarding telephonic and electronic communications. Related/prior legislation AB 2322 (Feuer & Bass) of 2010, sponsored by Los Angeles County and others, seeks to make several modifications to existing MDT statutes, including specifying the inclusion of CalWORKs social workers in MDTs and allowing for STAFF ANALYSIS OF ASSEMBLY BILL 2229 (Brownley) Page 8 information regarding convictions related to crimes against children, and information regarding nonrelative members of a household to be shared and tracked in a computerized database for the purposes of the MDT. Scheduled to be heard in Senate Human Services Committee on June 22, 2010. AB 1049 (Bader) Chapter 353, Statutes of 1987, authorized the use of MDTs for both child and elder abuse. PRIOR VOTES Assembly Floor 76 - 0 Assembly Appropriations Committee 16 - 0 Assembly Human Services Committee 6 - 0 Assembly Public Safety Committee 7 - 0 COMMENTS 1.Double-referral. This bill is double-referred. Any amendments agreed to in this committee will be adopted in Senate Public Safety Committee. 2.Conflict with AB 2322 (Feuer and Bass). The author and sponsors may wish to reconcile the language of this measure to AB 2322 to avoid chaptering out issues. AB 2322 also deals with multidisciplinary personnel teams and amends the same code section authorizing the computerized database system for sharing information to provider agencies regarding families at risk for child abuse and neglect. 3.Forty-eight hour time frame for sharing information may be inadequate. Staff recommends striking the 48-hour time limitation for the two-person team to share information. While a detention determination must be made within this timeframe, there are likely to be cases when such a determination is not made within 48 hours, or cases when an immediate detention is not made and the need to share information beyond 48 hours exists. Staff recommends reiterating the purpose for which the two-or-more person MDT may share information. Page 6, lines 19-34: (c) (1) Notwithstanding Section 827 of the Welfare and STAFF ANALYSIS OF ASSEMBLY BILL 2229 (Brownley) Page 9 Institutions Code or any other provision of law, in order to investigate reports of suspected child abuse or neglect made pursuant to Section 11166 or 11166.05 of the Penal Code, or for the purposes of making a child welfare services referral or detention determinationduring the 48-hour period following a report of suspected child abuse or neglect, members of a child abuse investigation and prevention multidisciplinary personnel team engaged in the prevention, identification, and treatment of child abuse may disclose to and exchange with one another information and writings that relate to any incident of child abuse that may also be designated as confidential under state law if the member of the team having that information or writing reasonably believes it is generally relevant to the prevention, identification, or treatment of child abuse. Any discussion relative to the disclosure or exchange of the information or writings during a team meeting is confidential and, notwithstanding any other provision of law, testimony concerning that discussion is not admissible in any criminal, civil, or juvenile court proceeding. 4.Outstanding issues. The author and sponsor indicate they are continuing to work on issues raised by the American Civil Liberties Union, the Youth Law Center, this committee, and the Assembly Human Services committee. The issues are: Clarifying the purpose of the two-or-more person MDT. Establishing a preference for in-person communication versus electronic communication. Replacing the requirement to establish a memorandum of understanding agreement with a requirement to develop and distribute protocols that specify the types of information to be shared and the process to be used to ensure confidentiality. POSITIONS Support: Los Angeles County District Attorney (sponsor) STAFF ANALYSIS OF ASSEMBLY BILL 2229 (Brownley) Page 10 Oppose: None received -- END --