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---



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          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  




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            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  




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            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  




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            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  




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          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  




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          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  




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          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  




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               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  
               determination  during 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)




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          Oppose:   None received



                                   -- END --