BILL ANALYSIS AB 2322 Page A 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 Page B 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; AB 2322 Page C 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 Page D 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 Page E 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 Page F 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. AB 2322 Page G 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 AB 2322 Page H 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 Page I 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