BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 1171
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          Date of Hearing:   April 30, 2013

                        ASSEMBLY COMMITTEE ON HUMAN SERVICES
                                  Mark Stone, Chair
                 AB 1171 (Levine) - As Introduced:  February 22, 2013
           
          SUBJECT  :  Child Welfare Services: Electronic Records

           SUMMARY :  Establishes a three-county pilot for the provision of  
          electronic access to records for foster youth.  Specifically,  
           this bill  :   

          1)Establishes a pilot program in three counties to provide a  
            foster youth who is 16 years of age or older, upon his or her  
            request, the ability to establish an online electronic  
            repository for his or her records, which shall include but not  
            be limited to:

             a)   Medical or health records;

             b)   Certified copy of his or her birth certificate;

             c)   Social security card;

             d)   Letter proving the child or nonminor dependent was a  
               ward or dependent of the court;

             e)   Special immigrant juvenile status, if applicable;

             f)   School records;

             g)   Driver's license, as described in Section 12500 of the  
               Vehicle Code, or identification card, as described in  
               Section 13000 of the Vehicle Code;

             h)   Background and contact information of siblings and other  
               family members; and

             i)   Application to seal juvenile court records.

          2)Requires the California Department of Social Services (DSS) to  
            select the three counties upon their agreement to participate.

          3)Requires implementation of the pilot on January 1, 2014.









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           EXISTING LAW   

          1)Requires a foster youth's case plan to include a summary of  
            health and education information or records, including mental  
            health information of the child in the form of a health and  
            education passport (Passport). 

          2)Requires the Passport to include, but not be limited to the  
            following information:

             a)   Names and addresses of the child's health, dental, and  
               education providers;

             b)   The child's grade level performance;

             c)   The child's school record;

             d)   Assurances that the child's placement in foster care  
               takes into account proximity to the school in which the  
               child is enrolled at the time of placement;

             e)   The number of school transfers the child has already  
               experienced;

             f)   The child's educational progress, as demonstrated by  
               factors, including, but not limited to, academic  
               proficiency scores;

             g)   Credits earned toward graduation;

             h)   A record of the child's immunizations and allergies;

             i)   The child's known medical problems;

             j)   The child's current medications, past health problems,  
               and hospitalizations;

             aa)  A record of the child's relevant mental health history;

             bb)  The child's known mental health condition and  
               medications; and

             cc)  Any other relevant mental health, dental, health, and  
               education information concerning the child determined to be  
               appropriate by the Director of DSS.








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          3)Requires the information contained in the Passport to be  
            included in the California Child Welfare Services (CWS) Case  
            Management System (CMS).

          4)Under federal and state law, provides for specific privacy  
            protections for children in foster care and for pupils  
            enrolled in the public education system.

           FISCAL EFFECT  :  Unknown

           COMMENTS  :    

           Foster Youth Health and Education Passport
           The purpose of the passport is primarily to ensure that a foster  
          youth's caseworker has immediate access to important and  
          necessary educational and health records in order to help  
          support and provide for positive outcomes for the foster youth  
          assigned to them.  It provides for a vast array of information  
          relating to educational records, school enrollment, contact  
          information for teachers and medical physicians, and any other  
          relevant medical records, including mental health information  
          and prescribed medication. 

          The passport has become a critical and important informational  
          tool for social workers, as it allows for current and up-to-date  
          information to be readily accessible to ensure they can provide  
          for the needs of their foster youth in a timely manner.   
          However, one of its drawbacks is its limitation of access for a  
          foster youth.  Oftentimes when foster youth emancipate from the  
          CWS system, they are not provided access to all of the  
          information they would otherwise need, such as health and  
          educational records.  Whereas many children's parents maintain  
          their child's health and educational records and provide  
          guidance as to how and when to utilize these records, foster  
          youth do not have that regular parental support.  Rather, they  
          are faced with having to act as both parent and child when it  
          comes to these records.  This can be a formidable and daunting  
          task, especially when many foster youth do not have a regular  
          home or safe space in which to maintain their records.  Upon  
          emancipation, many foster youth are provided hard copy documents  
          of records, which overtime can be lost without a central place  
          to store them. 

           Need for the bill  








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          Writing to express the need for the bill, the author states:

               Approximately 4,500 youth age out of the foster care system  
               each year in California.  For youth transitioning out of  
               the foster care system, a social worker will work with them  
               to develop their Transitional Independent Living Plan  
               (TILP).  This plan is designed to describe the youth's  
               current level of functioning, establish emancipation goals,  
               progress towards achieving those goals, the programs and  
               services needed, and individuals assisting the youth.  The  
               TILP is reviewed, updated and approved every six months  
               prior to emancipation by the social worker/probation  
               officer and the youth. 

               One of the specific goals of the TILP is to help youth  
               obtain important documents, including, but not limited to a  
               certified birth certificate, a social security card, and  
               health/immunization records.

               Currently, these important documents are handed over to a  
               foster youth dependent upon emancipation.  However, these  
               records are generally shared only in paper form.  As such,  
               it is a challenge to ensure that the documents contain the  
               most current information and [are] readily available when  
               care providers need [them] to help make informed care  
               decisions.

          Writing in support of AB 1171, Aspiranet states:

               Currently foster youth are only provided with paper copies  
               of these (health records, birth certificates, social  
               security card, etc.) important records; and unfortunately,  
               often times these documents are lost or stolen.  Without  
               access to any of these documents, youth will have a hard  
               time applying for jobs, accessing public assistance, and  
               securing housing.

               Foster youth also tend to have greater and more complex  
               health care needs than other children and account for a  
               disproportionate share of public health spending.  Under  
               the Federal Health Information Technology for Economic and  
               Clinical Health (HITECH) Act, individuals have a right to  
               access and obtain a copy of their health information from  
               health care providers and health plans.  Some individuals  
               may choose to store and manage their health information  








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               using a personal health record, which have the potential  
               for one to have their complete medical history all in one  
               place.  Electronic access to these records would help  
               minimize barriers to accessing necessary health care  
               services for this population. 
















































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           RECOMMENDED AMENDMENTS  

          The current language in the bill lacks specificity on how the  
          pilot will be administered, its standards, and how long it will  
          last.  Specifically, the bill should be amended to address the  
          following issues:

               1)     Specify the organization necessary to oversee the  
                 pilot; 

               2)     Clarify how long the pilot should last;

               3)     Include an evaluation of the pilot with a  
                 recommendation to the Legislature as to whether it should  
                 continue, be expanded, or be made permanent for all  
                 counties;

               4)     Address access and security requirements to protect  
                 the privacy of the emancipated foster youth; and

               5)     Provide assurances for the safety and security of  
                 the records.

          Specifically, staff recommends the following amendments:

          Amend the bill to read:

               16521.6. (a)  No later than July 1, 2014, the department  
               shall implement and oversee a three county pilot for a  
               period of three years to provide foster youth who are 16  
               years of age or older, upon their request, or upon the  
               foster youth's emancipation from dependency or probation,  
               with access to a singular online electronic recordkeeping  
               repository of necessary documents for purposes of assisting  
               the foster youth in maintaining and having access to those  
               documents and to assist in the youth's transition to  
               adulthood  .   When a child is 16 years of age or older, or  
               when he or she makes the request,  

                (b) The online electronic recordkeeping repository should  
               have the capacity to allow the youth to view, download,  
               upload, and transmit, as appropriate, key documents to  
               assist the youth or nonminor in maintaining documents.









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               (c)   a   A  social worker or other representative of the county  
               welfare department or a probation officer or other  
               representative of the probation department, as appropriate,  
                or another authorized representative as designated by the  
               county or the court  shall assist the child or nonminor  
               dependent with establishing and obtaining electronic copies  
               of his or her records  , including, but not limited to:   for  
               the purposes of this pilot.

               (d) Documents included in this online electronic  
               recordkeeping repository shall include, but not be limited  
               to:  

                    (1) Medical or health records  , including an up-to-date  
                    Summary of Care record with diagnoses, allergies, test  
                    results, immunizations, and medications as permitted  
                    by the Health Insurance Portability and Accountability  
                    Act  .

                    (2)  Certified copy   Copy  of his or her  certified  birth  
                    certificate.

                    (3)  Copy of his or her  Social security card.

                    (4) Letter proving the child or nonminor dependent was  
                    a ward or dependent of the court.

                    (5) Special immigrant juvenile status, if applicable.

                    (6)  School   Educational  records  , as permitted by state  
                    pupil privacy laws and the federal Family Educational  
                    Rights and Privacy Act, which shall include a copy of  
                    his or her official high school transcript and high  
                    school diploma or certificate of high school  
                    equivalency, if applicable  .

                    (7)  Copy of his or her driver's   Driver's  license, as  
                    described in Section 12500 of the Vehicle Code, or  
                    identification card, as described in Section 13000 of  
                    the Vehicle Code.

                    (8) Background and contact information of siblings and  
                    other family members  , as appropriate, and as permitted  
                    by court order pursuant to federal and state law  .









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                    (9) Application to seal juvenile court records.

                     (10) Copy of his or her Transitional Independent  
                    Living Plan and Agreement, if applicable.

                    (11) Any additional records as needed as determined by  
                    the Director.

               (e) Access to the repository shall be limited to the foster  
               youth and the person designated pursuant to subdivision  
               (c).

               (f) Any necessary efforts to provide for the security of  
               the repository, including online security protocols, shall  
               be taken to protect the privacy of the foster youth as  
               determined by the Director.

               (g) The department, in coordination with the three  
               participating counties, shall submit a report to the  
               Assembly and Senate Human Services Committee no later than  
               December 1, 2018 evaluating the pilot and provide  
               recommendations as to whether it should be extended,  
               expanded, or made permanent.  

                (h) This section shall become inoperative on July 1, 2017,  
               and as of January 1, 2019, is repealed, unless a later  
               enacted statute, that is enacted before January 1, 2019,  
               deletes or extends the dates on which it becomes  
               inoperative and is repealed.

                 (b) This section shall be a pilot program in three counties  
               that agree to participate, as determined by the State  
               Department of Social Services, beginning on January 1,  
               2014.



















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           REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           
          Aspiranet
          California Alliance of Child and Family Services
          California Council of Community Mental Health Agencies
          Children's Partnership
          Family Law Section of the State Bar
          Mental Health America of California (MHAC)
          National Association of Social Workers, California Chapter  
          (NASW-CA)

           Opposition 
           
          None on file
           
          Analysis Prepared by  :    Chris Reefe / HUM. S. / (916) 319-2089