BILL ANALYSIS �
SENATE HUMAN
SERVICES COMMITTEE
Senator Leland Y. Yee, Chair
BILL NO: AB 1171
A
AUTHOR: Levine
B
VERSION: June 18, 2013
HEARING DATE: June 25, 2013
1
FISCAL: Yes
1
7
CONSULTANT: Sara Rogers
1
SUBJECT
Child welfare services: electronic records
SUMMARY
Authorizes a three year pilot program in three counties to
provide foster youth, age 16 and older, with access to an
online electronic record keeping repository of personal
documents and records that are provided to foster youth
upon their transition to independence. Additionally, this
bill requires the Department of Social Services, in
coordination with the three counties, to submit a report to
the Legislature no later than December 1, 2016.
ABSTRACT
Existing Law
1.Establishes the California Fostering Connections to
Success Act, which corresponds with the federal Fostering
Connections to Success Act that provided an option for
states to receive federal financial participation for
federally-eligible nonminor dependents of the juvenile
Continued---
STAFF ANALYSIS OF ASSEMBLY BILL 1171 (Levine)
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court who are between the ages of 18 and 21 and who
satisfy certain conditions. (WIC 11403, AB 12, 2010 and
P.L. 110-351)
2.Permits a court to terminate its dependency, delinquency,
or transitional jurisdiction over a nonminor dependent
between the time the nonminor reaches the age of majority
and 21 years of age. (WIC 303)
3.Requires that at the last review hearing to be held
before a dependent minor attains 18 years of age, the
report provided by the county welfare department shall
describe efforts made toward completing specified items
under WIC 391. Prohibits a dependency court from
terminating jurisdiction over a nonminor until a hearing
is conducted, as specified. (WIC 366.31 and WIC 391)
4.At any termination hearing, requires a county welfare
department to submit a report that verifies that the
following information has been provided to the nonminor
(WIC 391):
Written information about the nonminor's dependency
case, including family history, Indian heritage,
available family photographs (except as specified),
whereabouts of siblings under the jurisdiction of the
juvenile court (except as specified) and information
on how to access their case file.
Essential personal documents including the social
security card, a certified copy of the birth
certificate, the health and education summary (as
specified), driver's license or identification card,
any applicable death certificates for the nonminor's
parents, proof of citizenship, an advance health care
directive, forms used to resume dependency and the
written 90 day transition plan.
A letter containing information about the nonminor
STAFF ANALYSIS OF ASSEMBLY BILL 1171 (Levine)
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including their name and date of birth, the dates
during which the nonminor was a foster youth.
Referrals to transitional housing, assistance in
obtaining employment or other financial support,
assistance in applying to college or to a vocational
education program, assistance in maintaining
relationships with individuals who are important to
the nonminor, assistance in accessing the Independent
Living Aftercare Program, and other information.
1.Under federal law, pursuant to Title IV E of the Social
Security Act, provides funding to states to implement a
Statewide Automated Child Welfare Information System
(SACWIS) for the purpose of establishing a unified case
management automation tool used by all child welfare
social workers responsible for case management
activities. (45 CFR 1355.50 and 45 CFR 95.621)
2.Establishes the Child Welfare Services/Case Management
System (CWS/CMS) as California's SACWIS system to
establish a unified case management automation tool used
by all child welfare social workers responsible for case
management activities. (WIC 16501.5)
3.Pursuant to the Budget Act of 2011-2012, indefinitely
suspends the Child Welfare Services Web (CWS/Web) Project
and requires the Department of Social Services, in
consultation with the Office of Systems Integration,
stakeholders, legislative staff and counties to evaluate
and determine the best approach to upgrade the CWS/CMS
system in order to support and enhance the effectiveness
of child welfare system. (AB 106, Committee on Budget.
Human Services. Chapter 32, Statutes of 2011)
4.Establishes the California Longitudinal Pupil Achievement
Data System (CALPADS) to provide for the retention and
analysis of longitudinal pupil achievement data pursuant
to federal requirements under the No Child Left Behind
Act of 2001. (20 U.S.C. Sec. 6301 et seq. and EDC 60900)
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5.Establishes the California Office of Health Information
Integrity (CalOHII) to provide oversight and review of
state compliance with implementation of Health Insurance
Portability and Accountability Act (HIPAA) regulations,
and provide policy guidance and support to ensure that
health information can be shared with the patient, the
patient's providers and other key stakeholders in
accordance with state and federal law. (HSC 130300 et
seq.)
6.Permits the Department of Health Care Services to enter
into nonexclusive contracts providing for claims
administration and payment to health care providers for
Medi-Cal. Through this authority, the Department has
entered into contract for the management of the
California Medicaid Management Information System. (WIC
14104.3 (a))
This bill
1.Requires the Department of Social Services to implement
and oversee a three-county pilot program to provide
foster youth who are age 16 or older with access to an
online electronic recordkeeping repository of specified
documents.
2.Provides that the documents to be included in the
electronic recordkeeping repository include the
following:
Medical or health records, as specified.
A copy of the youth's birth certificate.
A copy of the youth's social security card.
A letter documenting the child's status as a
ward or dependent of the court.
Special immigrant juvenile status, if
applicable.
Educational records, including a copy of the
STAFF ANALYSIS OF ASSEMBLY BILL 1171 (Levine)
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youth's high school transcript and diploma or
equivalency certificate.
A copy of the youth's driver's license or
identification card.
Background and contact information for siblings
and other family members, as appropriate.
An application to seal juvenile court records.
A copy of the youth's transitional independent
living case plan, if applicable.
1.Provides that the electronic recordkeeping repository
shall allow foster youth to view, download, upload and
transmit specified documents.
2.Requires "necessary efforts" to be taken to provide for
the security of a repository, including online security
protocols, as determined by DSS.
3.Requires the department, in coordination with the three
participating counties, to submit a report to the
Assembly and Senate Human Services Committees no later
than December 16, 2016.
4.Sunsets the provisions of this bill as of January 1,
2019.
5.Provides that the provisions of this bill shall be
implemented only if the Department of Finance makes a
written determination that there are sufficient funds
available from sources other than the General Fund for
this purpose.
FISCAL IMPACT
The Assembly Appropriations Committee states that costs
associated with this legislation would likely be in excess
STAFF ANALYSIS OF ASSEMBLY BILL 1171 (Levine)
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of $500,000 (GF) for workload associated with DSS
developing an electronic depository for the required
documents and for developing, administering, and evaluating
the pilot project.
BACKGROUND AND DISCUSSION
According to the author, approximately 4,500 youth age out
of the foster care system each year in California. The
author states that important documents that are required to
be provided to transitioning youth as part of the youth's
Transitional Independent Living Plan (TILP) are generally
shared only in paper form. According to the author, this
presents a challenge to ensuring that the documents are in
their most current form and are readily available to the
youth when needed.
The sponsors state that these records are essential to a
foster youth's successful transition to adulthood and to
applying for employment, housing, or financial aid to
attend college. Additionally, the sponsors write that
foster youth often experience more complex medical
conditions requiring coordination and continuity of care to
ensure the best possible health outcomes.
The author and sponsors state that this bill is the first
step in developing a statewide strategy for providing all
youth in foster care with timely, complete and accurate
records to assist them in their transition to successful
adulthood.
Foster Youth Health and Education Passport
Existing law requires a foster youth's case plan to include
a summary of the health and education information or
records, including mental health information or records, of
the child. This information is maintained in a health and
education passport (HEP) that includes the following
information:<1>
-------------------------
<1> Welfare and Institutions Code Section 16010.
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Names and addresses of the child's health,
dental, education providers and educational liaison;
Grade level performance, school records, and
educational performance including credits earned
toward graduation;
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;
Number of school transfers the child has
already experienced;
Immunization and allergy records;
Known medical problems, current medications,
past health problems, and hospitalizations;
Known mental health conditions, current
medications, and relevant mental health history;
Any other relevant mental health, dental,
health, and education information concerning the
child determined to be appropriate by the Director
of Social Services.
Although this comprehensive collection of information is a
critical tool used by social workers, foster caretakers,
and educational providers to provide services to foster
youth who may frequently move between placements and
schools, the lack of an electronic system to maintain and
share this information has led to major implementation
challenges. Health records are often not updated in a
timely manner, caretakers often do not receive the HEP, and
the information is frequently inaccurate and incomplete.
Existing law, pursuant to AB 490 (Chapter 862, Statutes of
2003), requires local agencies to work together to ensure
that school placements for foster youth are stable, that
foster youth are placed in the least restrictive
educational program, and that students in foster care have
access to the same academic resources, services, and
extracurricular and enrichment activities that are
available to all pupils. The bill authorized county placing
agencies to access student records without parental consent
if it is for the purpose of fulfilling the requirements of
a health and education summary, fulfilling educational case
management requirements, or to assist with the timely
transfer or enrollment of a student. However despite these
improvements, significant challenges to implementation have
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persisted throughout the state.
Additionally, advances in information exchanges for foster
care have largely pertained to the exchange of information
between agencies, and have not been linked to the provision
of information to transitioning foster youth, information
that is required to be provided to youth pursuant to WIC
391 (see above).
Electronic Information Exchange for Foster Care
A study published by the California Children's Partnership,
a sponsor of this bill, notes that the Fostering
Connections to Success and Increasing Adoptions Act of
2008, which expanded foster care eligibility to Title IV-E
eligible foster youth up to age 21, specifically mandates
interagency information-sharing for the purposes of
assisting governmental entities in fulfilling their duties
to protect and provide adequate services to children in the
child welfare system.<2>
The study notes that many existing data systems related to
health care, child welfare, and education information are
being redesigned and updated to reflect technological
advancements and opportunities for improved functionality.
The report recommends the development of a statewide data
system that would enable some of the following
technological capabilities:
Enable and control online access to information
through User Ids and passwords that provide varying
degrees of access to users.
Permit both providers and youth to retrieve
-----------------------
<2> Gluckman, S. Electronic Information Exchange for
Children in Foster Care. The Children's Partnership.
February 2010.
http://www.childrenspartnership.org/storage/documents/Public
ations/RoadMapFinal.pdf
STAFF ANALYSIS OF ASSEMBLY BILL 1171 (Levine)
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information from a variety of existing databases.
Store and track longitudinal data from a variety of
databases over multiple points in time to provide a
comprehensive history of conditions and services
received.
Provide reminders and alerts regarding gaps in
care, upcoming appointments and court dates, and
interacting medications or treatments.
Permit providers to communicate to coordinate care.
Generate forms and reports and facilitate
referrals.
Authors of the study write that, "much of the data that
will be accessed is already collected and stored in
state-level department databases or is accessible through
state-level portals/hubs/networks." The study lays out two
potential models for the statewide system discussing
technical design elements of each model and their
advantages or limitations.
Child Welfare Services/Case Management System (CWS/CMS)
DSS oversees CWS/CMS, California's centralized statewide
computer system, which automates the functions of county
child welfare offices. The system allows county caseworkers
to open and track child welfare cases, enables case workers
to record and update assessments, create and maintain case
plans, and manage the placement of children in the
appropriate foster homes or facilities. Additionally, the
system collects data for state, county, and federal
reporting.
Though currently delayed pursuant to the Budget Act of
2011-2012, the state is actively working on plans to
modernize the CWS/CMS system. Recently, DSS completed a
statutorily mandated evaluation to determine the best
approach to upgrade the CWS/CMS system and is currently
seeking stakeholder input on potential functionality
changes to the system. A component of the new system is to
move toward integration of multiple existing data sources
to improve efficiency for social workers.
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California Longitudinal Pupil Achievement System (CALPADS)
Overseen by the California Department of Education (CDE),
CALPADS was created pursuant to federal requirements under
the No Child Left Behind Act of 2001 (20 U.S.C. Sec. 6301
et seq.), and has been operational since 2009. CDE
describes the system as the foundation of California's K-12
education data system, comprising student demographic,
program participation, grade level, enrollment, course
enrollment and completion, discipline, and statewide
assessment data.
Pursuant to Education Code Section 60900, Local educational
agencies are required to retain the following information:
All demographic data collected from the STAR
Program test, high school exit examination, and
English language development tests.
Pupil achievement data from assessments
administered pursuant to the STAR Program, high school
exit examination, and English language development
testing programs.
A unique pupil identification number, which shall
be retained by each local educational agency and used
to ensure the accuracy of information on the header
sheets of the STAR Program tests, high school exit
examination, and the English language development
test.
All data necessary to compile reports required by
the federal No Child Left Behind Act of 2001 (20
U.S.C. Sec. 6301 et seq.), including, but not limited
to, dropout and graduation rates.
Privacy law pertaining to educational information is
governed by the Family Education Rights and Privacy Act
(FERPA) (20 U.S.C. � 1232g; 34 CFR Part 99), which until
recently only permitted disclosure of certain information
to child welfare caseworkers with parental or student
consent, with some limited exceptions. FERPA has frequently
been cited as a legal barrier to sharing educational
information of foster youth with the child welfare system
and other caretakers. However, pursuant to the federal
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Uninterrupted Scholars Act of 2013 (P.L. 112-278), AB 643
(Stone, 2013) will allow child welfare caseworkers to
access transcripts and report cards for foster youth while
maintaining important privacy protections.
California Medicaid Management Information System
Pursuant to its authority under WIC Section 14104.3, the
Department of Health Care Services has recently entered
into a ten-year contract with Affiliated Computer Services,
Inc. to provide for the management of the California
Medicaid Management Information System (CA-MMIS). In its
request for proposal, the Department stated its intent for
the selected contractor to both manage the existing legacy
system as well as propose a replacement system with new
functionalities including health information exchange.<3>
California Court Case Management System (CCMS)
Last year, following a decade of planning to implement a
statewide court case management tool projected to cost $2
billion, the Judicial Council voted to abandon CCMS as a
statewide technology project following a critical report
form the state auditor. Instead, the council directed court
efforts toward finding other ways to use the CCMS
technology and the state's investment in the software
system, as well as to develop new strategies to assist
courts with failing case management systems.
Currently, court management systems containing data such as
court dates, case initiation, name and contact information
for the primary attorney, case plan and case management
information is held and managed at the county court level.
San Diego Foster Youth-Student Information Exchange System
-------------------------
<3>
http://www.dhcs.ca.gov/provgovpart/rfa_rfp/Documents/IFBcamm
isRFPmain.pdf
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San Diego County has been a national leader in developing
an electronic information exchange system for foster care.
Specifically, the Foster Youth-Student Information System
(FY-SIS) is a secured, web-based system that stores health,
education and placement information for more than 5000
wards and dependents of San Diego County. The system
includes immunization records, medical information,
transcripts, assessment scores, and child welfare
information and can be accessed by group homes, children's
attorneys, schools, probation agencies, the juvenile court
and child welfare services. The system currently does not
include a component for youth to access their own records.
COMMENTS
Implementation of the pilot project envisioned in this bill
is intended to occur at the county level, rather than at
the state level, in light of the wide range of existing
resources and level of stakeholder collaboration found in
various counties that may participate in the pilot. The
practical role of the DSS in this context is to provide
technical support and guidance to ensure that developed
systems provide maximum opportunity to align with the
existing CWS/CMS system and with the system that is
currently being developed. Should the bill move forward,
staff recommends the author consider amending the bill to
reflect the appropriate role of DSS in this regard.
Additionally, there are many state-level agencies that may
provide critical guidance in the development of systems
envisioned under this bill. The author may wish to consider
the creation of a multi-agency workgroup that includes
entities such as the Department of Education, the Judicial
Council, the Department of Health Care Services, the Office
of Systems Integration, and the California Office of Health
Information Integrity. Many of these agencies are currently
redesigning data systems that would inform the systems
envisioned in this bill, and these agencies may help to
ensure that any county efforts comply with federal and
state requirements.
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Related/Prior Legislation
SB 343 (Yee, 2013) revises and recasts current law which
specifies the documents and information required to be
provided to a dependent youth prior to terminating
dependency. This bill is in Assembly Judiciary Committee.
AB 643 (Stone, 2013) allows child welfare caseworkers to
access transcripts and report cards for foster youth while
maintaining important privacy protections. This bill is on
the Senate Floor.
AB 791 (Ammiano, Chapter 59, Statutes of 2012) required the
court, when denying or terminating reunification services
with a parent or guardian, to order that a dependent
child's caregiver be provided with the child's birth
certificate, or, when appropriate, if the child is 16 years
of age or older, that the child receive his or her birth
certificate.
AB 2310 (Maze, Chapter 131, Statutes of 2008) required that
the county welfare department provide emancipating youth
with specified documents before the court terminates
jurisdiction over the child, including the youth's birth
certificate.
AB 686 (Aroner, Chapter 911, Statutes of 2000) required the
county welfare department, prior to the dependency court's
termination of jurisdiction over a child who has reached
the age of 18, to submit a report verifying that specified
documents, including the child's birth certificate, have
been provided to the child.
PRIOR VOTES
Assembly Floor: 76-0
Assembly Appropriations: 16-0
Assembly Human Services: 5-1
POSITIONS
Support: Aspiranet (Co-Sponsor)
The Children's Partnership (Co-Sponsor)
California Alliance of Child and Family Services
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California Council of Community Mental Health
Agencies
Exec Committee of the Family Law Section of the
State Bar (FLEXCOM)
John Burton Foundation for Children Without Homes
Mental Health America of California (MHAC)
National Association of Social Workers,
California Chapter (NASW-CA)
Oppose:None received
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