BILL ANALYSIS                                                                                                                                                                                                    




                                                                  AB 2322
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          Date of Hearing:   May 11, 2010

                        ASSEMBLY COMMITTEE ON HUMAN SERVICES
                                Jim Beall, Jr., Chair
                AB 2322 (Feuer and Bass) - As Amended:  April 29, 2010
           
          SUBJECT  :  Abuse of children, elder, or dependent persons:  
          confidentiality.

           SUMMARY  :  Provides eligibility for California Work Opportunities  
          and Responsibility to Kids (CalWORKs) case managers to  
          participate on a child abuse multidisciplinary personnel team;  
          and would broaden the scope of information that can be included  
          in county multidisciplinary personnel team databases to include  
          information regarding nonrelatives living in a child's home and  
          information about the convictions of members of a child's  
          household.  Specifically,  this bill:  

          1)Clarifies that child abuse multidisciplinary personnel teams  
            (MDTs), as defined in Section 18951 of the Welfare and  
            Institutions Code (WIC), may share confidential information  
            and records when engaged in the "management" of cases of child  
            abuse  or  neglect. 

          2)Adds CalWORKs case managers responsible for case planning and  
            coordination for children and families in need of both child  
            welfare services and CalWORKs programs, to the personnel  
            eligible to participate in an MDT.

          3)Provides that confidential information related to families in  
            need of child welfare services may be shared among members of  
            an MDT and included in an MDT computerized database, and  
            directs counties with an MDT database to develop standards for  
            "in need of child welfare services."
           
          4)Permits information regarding any person residing in a child's  
            home, including individuals not considered part of the child's  
            family, to be shared by MDTs and stored in an MDT database,  
            relative to child abuse and neglect investigations or child  
            welfare services.

          5)Adds information about convictions related to crimes against  
            children for family members and others living in the child's  
            home to the information that may be shared by members of an  
            MDT.  









                                                                  AB 2322
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           EXISTING LAW  

          1)Establishes the child welfare services (CWS) system intended  
            to protect all children, comprised of a continuum of public  
            social services, including services to prevent, treat, and  
            care for children who have been, or are at risk for abuse,  
            neglect, homelessness, delinquency or exploitation.  WIC  
            Sections 16500 and 16501.

          2)Defines a child abuse MDT multidisciplinary personnel team as  
            any team of three or more people trained in the prevention,  
            identification, and treatment of child abuse and neglect cases  
            and who are qualified to provide a broad range of child  
            abuse-related services to include, but not be limited to:

             a)   Psychiatrists, psychologists, marriage and family  
               therapists, 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 experience or training in child  
               abuse prevention; and

             e)   Any public or private school teacher, administrative  
               officer, supervisor of child welfare attendance, or  
               certified pupil personnel employee. WIC Section 18951 (d).

          3)Authorizes, notwithstanding existing information  
            confidentiality protections, any person trained and qualified  
            to serve on an MDT formed pursuant to WIC Sec. 18951 (d) to be  
            deemed a part of the team as necessary, for the purposes of a  
            particular case, provided the reasons for deeming the person a  
            member of the team are specified in writing.  WIC 18964.

          4)Permits members of an MDT, as defined in Section 18951, to  
            exchange confidential information and writings during team  
            meetings, provided the information disclosed:

               a)     Is relevant to the prevention, identification or  
                 treatment of child abuse;










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               b)     Relates to incidents of child abuse;

               c)     Is kept confidential; and

               d)     Is not admissible in any criminal, civil, or  
                 juvenile court proceeding. WIC 830.

          5)Authorizes counties to establish a computerized data base to  
            allow provider agencies to share confidential information  
            related to families at risk for child abuse or neglect through  
            the formation of MDTs aimed at preventing, identifying,  
            managing, or treating child abuse or neglect.  WIC 18961.5.

          6)Restricts information related to a child or family identified  
            as at risk for child abuse or neglect and entered into the  
            database to:

             a)   The name, address, telephone number, and date and  
               birthplace for family members;

             b)   The case number assigned to the case by each provider  
               agency;

             c)   Contact information for the provider agency employee  
               assigned to the case; and

             d)   The date(s) of contact between the provider agency and  
               family. WIC 18961.5.

           FISCAL EFFECT  :  Unknown.
























                                                                  AB 2322
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           COMMENTS :

           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 over 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.  Currently, all 58  
          California counties operate child abuse MDTs, and counties often  
          operate multiple MDTs at once.

          MDTs operate, not just to investigate possible child abuse and  
          neglect but also 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 U.S. Department of Justice (DOJ) Office of Juvenile  
          Justice and Delinquency Prevention<1>, elements of a successful  
          MDT include confidentiality policies in line with legislative  
          mandates, agency policies and professional practices, and the  
          best interests of the child; conflict resolution practices; and  
          periodic self-analysis and outside evaluation to ensure the team  
          continues to achieve its intended purpose.

          Under existing state law, counties may form computerized  
          databases for the purpose of allowing specified provider  
          agencies to share identifying information regarding families at  
          risk for child abuse or neglect in order to form MDTs to  
          prevent, identify, manage and treat child abuse. According to  
          the Department of Social Services (DSS) and the County Welfare  
          Director's Association (CWDA), Los Angeles County (LA County)  
          has the only known computerized MDT database provided pursuant  
          to WIC Section 18961.5.

           Confidentiality  : Existing state and federal laws prohibit most  
          county health 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.   
          These laws seek to safeguard the constitutional right to  
          ---------------------------
          <1> Ells, Mark.  "Forming a Multidisciplinary Team to  
          Investigate Child Abuse."  Washington, D.C.  U.S. Department of  
          Justice, Office of Justice Programs Office of Juvenile Justice  
          and Delinquency Prevention.  Second printing March 2000.








                                                                  AB 2322
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          privacy, and to ensure that individuals are comfortable sharing  
          the personal information necessary to the provision of services.  
           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.

           Federal law  provides exceptions to confidentiality protections  
          for child abuse or neglect reports and records under the Child  
          Abuse Prevention and Treatment Act (CAPTA) (42 U.S.C. 5101 et  
          seq.), which requires federal, state, or local government  
          agencies to share confidential information in order to fulfill  
          their legal responsibilities to protect children from abuse and  
          neglect.

           This bill  seeks to clarify and expand on existing MDT laws, to  
          allow for greater interagency communication and improved  
          response to families at risk for child abuse or neglect  
          following several high-profile cases of child deaths stemming  
          from child abuse or neglect in Los Angeles County in recent  
          years.   

          According to the author:   

                LA County's Department of Child and Family Services  
               (DCFS) and the LA County Board of Supervisors are  
               taking several steps, through staff training, policy  
               changes, and through legislation, to address the  
               problem of several county departments knowing about  
               problems in a child's home, but not sharing  
               information with one another to make decisions that  
               protect the child.  Child Social Workers [CSWs] use a  
               pointer-system database to help them figure out which  
               departments/agencies have had contact with children,  
               but the database has some shortcomings and CSWs do not  
               always know whether or not they are able to share  
               information.

          The author goes on to detail problems with existing law,  
          including, an underutilized database and lack of clarity  
          among several statutes.   In recent months, according to  
          the author, Los Angles County has required social workers  
          to consult its database, the Family Child Index (FCI).  

           The County of Los Angeles  , one of the co-sponsors of this  









                                                                  AB 2322
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          bill, defines the FCI as follows: "Family and Children's  
          Index serves as a "pointer" system to direct authorized  
          users of a participating agency to other County agencies  
          who have had contact with the family subject to the initial  
          inquiry.  Once users are pointed to other agencies, WIC  
          189561.5 requires that confidential, substantive  
          information about a family must be shred through the  
          formation of Multi-Disciplinary Teams (MDTs), unless some  
          other legally permissible way to share that information  
          already exists."<2>  Currently, DCFS, the District  
          Attorney, Public Health, Mental Health, Probation, Public  
          Social Services, and Sheriff participate in the FCI.  In  
          addition, LA County intends to expand FCI participation to  
          at least two non-county agencies such as schools or private  
          hospitals.  

          With regard to the inclusion of CalWORKs case managers to  
          the eligible MDT team members, precedent for the inclusion  
          of CalWORKs case managers in case coordination was  
          established by AB 1518 (Soto), Chapter 919, Statutes of  
          1999, and continued with private, foundation funding and  
          federal grant funding under the "Linkages Project."  The  
          purpose of the Linkages coordination model is to draw on  
          the resources available through both the CWS system as well  
          as CalWORKs to help individuals become more successful in  
          meeting the goals of both programs.  According to DSS, the  
          Linkages model is currently being utilized in 33 counties  
          across California.  This bill would clarify that those  
          CalWORKs case managers engaged in case planning and  
          coordination for families who crossover between CWS and the  
          CalWORKs program, may participate as members of an MDT.

           In support of this bill, CWDA  writes: 

               Increasing attention has recently been paid to the  
               cross-program needs of families and children.  In some  
               cases, multiple agencies are providing services to  
               children or their parents, but not all of the agencies  
               know the others' involvement.  If a database could be  
               developed to allow authorized agency staff to  
               determine that another service provider already is  
               ----------------------
          <2> William T. Fujioka, Chief Executive Officer.  "Status Report  
          on the Implementation of the County's Family and Children's  
          Index Recommendations," Memo to Los Angeles County Board of  
          Supervisors.  March 9, 2010.








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               assisting a family, it can help in the investigation  
               of child abuse and neglect reports as well as allow  
               for better coordination of services to these families.  
                The hope is to better prevent child abuse and neglect  
               from occurring and more effectively respond to these  
               issues when they do arise?

               The 32 counties participating in Linkages report that  
               inclusion of the CalWORKs staff on the  
               multidisciplinary team would greatly enhance their  
               capacity to coordinate case management for these  
               families.  The law defining multidisciplinary teams  
               currently does not include these staff. 

           The American Civil Liberties Union opposes this bill unless  
          it is amended to  : restrict access to conviction records  
          only to those entities currently entitled to obtain  
          criminal history records; require notice to individuals in  
          the database that information is being held about him or  
          her, and to allow for correction of inaccuracies in the  
          information; require destruction of data after specified  
          time periods; specify the level of security protections and  
          to include precautions against the deliberate abuse or  
          misuse of information; require monitoring of the system to  
          detect possible violations of the security of the system;  
          and to establish a legal remedy for individuals, should  
          their information be wrongfully accessed or deliberately  
          misused.

           Concerns and Recommended Amendments:  
           
          1)Staff recommends the author amend the bill to delete  
            added references to "in need of child welfare services"  
            and "the provision of child welfare services" in WIC  
            Sections 830, 5328, and 18961.5.  Unlike the "at risk for  
            child abuse or neglect" language in existing law, the  
            designation to be determined by counties related to "in  
            need of child welfare services" is much broader, and  
            could encompass families with no indication of possible  
            or past child abuse or neglect.  State law defines child  
            welfare services broadly to encompass services to  
            homeless children and juvenile delinquents, irrespective  
            of child abuse and neglect.  CAPTA, on the other hand,  
            sets forth exemptions to federal privacy protections for  
            agencies fulfilling their legal obligations to protect a  









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            child from child abuse or neglect, as well as for other  
            entities or classes of individuals authorized by statute  
            to receive information pursuant to a legitimate State  
            purpose.  Each of these exemptions specifically applies  
            to the confidentiality of child abuse and neglect records  
            or reports.

          2)Staff also recommends the author limit access to  
            information regarding convictions to law enforcement and  
            child welfare services personnel, as personnel within  
            these agencies would have sufficient justification to  
            access that information.  Current law allows for a  
            variety of agencies, for example schools or hospitals, to  
            view general information regarding a contact with a  
            family at risk for child abuse or neglect.  This  
            information is not detailed, and although names of family  
            members may be included, does not encompass other  
            private, confidential types of information.   

          Urgency  :  The Committee voted unanimously to approve adding  
          an urgency clause to this bill at the April 27, 2010  
          hearing.  Most bills take effect on January 1 of the year  
          following the bill's passage, unless otherwise specified.   
          An urgency clause is a section of a bill specifying that a  
          bill is to take effect immediately upon signature of the  
          Governor, due to a measure affecting the public peace,  
          health, or safety.  Adding an urgency clause to this bill  
          will result in this bill requiring a two-thirds vote in  
          each house.  
           
           Prior and Related Legislation:
           AB 2229 (Brownley) of the current session is sponsored by  
          the Los Angeles County District Attorney and seeks to  
          create a new child abuse investigation multidisciplinary  
          team to allow two or more persons to share confidential  
          information electronically and by phone within the first 48  
          hours of a report of possible child abuse or neglect.

          AB 1518 (Soto) Chapter 919, Statutes of 1999 established a  
          three-year, three county pilot in Alameda, San Bernardino  
          and Ventura counties to create an integrated coordinated  
          case management system for CalWORKs families with multiple  
          barriers to employment through MDTs.

           REGISTERED SUPPORT / OPPOSITION :   









                                                                  AB 2322
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           Support 
           
          County Welfare Directors Association of CA (CWDA) (co-sponsor)
          Los Angeles County Board of Supervisors (co-sponsor)
          Service Employees International Union (co-sponsor)
          Los Angeles County Sheriff's Department

           Opposition 
           
          None on file.
           
          Analysis Prepared by  :    Michelle Doty Cabrera / HUM. S. / (916)  
          319-2089