BILL ANALYSIS �
SENATE JUDICIARY COMMITTEE
Senator Noreen Evans, Chair
2013-2014 Regular Session
SB 528 (Yee)
As Amended April 15, 2013
Hearing Date: April 23, 2013
Fiscal: Yes
Urgency: No
NR
SUBJECT
Dependents: care and treatment: minor and nonminor dependent
parents
DESCRIPTION
This bill would require a social worker to ensure that a
dependent child age 12 years or older has received specified
reproductive health information, and has been informed of his or
her right to consent to specified medical and mental health
treatment. This bill would clarify that existing law which
authorizes a social worker or court to make specified medical
care decisions for a dependent minor shall not be construed to
limit the right of the minor to consent to specified treatment.
This bill would also require child welfare agencies to ensure
pregnant and parenting dependents have access to case workers
with specialized training, and that case plans are developed
through a process which includes specified adults involved in
the dependent's care. This bill would also add parenting minor
and nonminor dependents to the list of families prioritized for
subsidized state and federal child development services.
Finally, this bill would establish the intent of the Legislature
to track information related to the number of parenting minor
and nonminor dependents, and make that information publicly
available, as specified.
BACKGROUND
AB 12 (Beall and Bass, Chapter 559, Statutes of 2010), the
California Fostering Connections to Success Act (Act),
(more)
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authorized the juvenile courts to exercise jurisdiction over and
extend foster benefits to nonminor dependents between the ages
of 18 to 21 if they meet specified criteria. Thus, eligible
nonminor foster youth are now able to continue receiving support
from the dependency system as they transition into adulthood.
However, as California has expanded foster care to serve older
youth, concerns related to reproductive health have become even
more urgent.
A 2009 Time article described why concerns are rising:
A study at the University of Chicago found that nearly half
of girls who had spent time in the foster-care system had
been pregnant at least once by the time they were 19 years
old. Even more troubling, unplanned pregnancy had already
become a pattern for many of the young women - close to
one-quarter had experienced multiple pregnancies in their
teens. ?
The stats shouldn't come as a surprise to anyone who knows
the risk factors for teen pregnancy. A report released the
week of July 20 by the National Campaign to Prevent Teen
and Unplanned Pregnancy found that almost half of the
500,000 or so kids in foster care had sex for the first
time before age 16, compared with 30 percent of their peers
not in foster care. They're also more likely to have
experienced forced sex and less likely to use
contraception.
Perhaps the most important asset teenagers need to avoid
early parenthood is a strong relationship with parents or
other adults in their lives. But these are precisely the
kinds of bonds that many foster teens lack. "You're so busy
being transferred from home to home," says Alixes Rosado,
who has been in foster care in Connecticut since he was 6
years old. "You don't have a lot of stable connections."
The 20-year-old estimates that he has worked with a
different social worker every year for the past 10. "And
not a single one talked about sex." (Amy Sullivan, Teen
Pregnancy: An Epidemic in Foster Care, July 22, 2009, Time
.)
In 2008, Los Angeles County embarked on a new project to aid
pregnant and parenting dependents. The Pregnant and Parenting
Teen conference (PPT) is an entirely voluntary program in which
pregnant or parenting dependents are connected with a variety of
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resources from the child welfare system as well as other benefit
systems. The PPT is a "team based" approach, where a number of
supportive adults, including the dependent and a resource
specialist or social worker, work to create a plan for the
dependent with a focus on healthy parenting and identifying
appropriate resources. The program has been successful in Los
Angeles, with an estimated 95 percent of eligible youth
participating.
This bill would take a comprehensive approach to addressing many
of the issues which have become more pressing with California's
expansion of foster care to eligible nonminors. Among other
provisions, this bill would require social workers to ensure
that dependents over the age of 12 have received specified
reproductive health information, and have been informed of
medical and mental health consent rights. This bill would also
clarify that existing law permitting the court and social
workers to authorize specified medical care for a dependent
child shall not be construed to limit the medical consent rights
of the minor. Similar to PPT, this bill would require child
welfare agencies to ensure pregnant and parenting dependents
have access to case workers with specialized training, and that
case plans are developed through a team decision-making process.
This bill would also provide that it is the intent of the
Legislature to ensure that accurate data related to parenting
minor and nonminor dependents is collected, and that the data is
available to the public on a quarterly basis.
This bill unanimously passed out of Senate Human Services
Committee on April 9, 2013. If approved by the Senate Judiciary
Committee, this bill will be heard by the Senate Committee on
Education.
CHANGES TO EXISTING LAW
Existing law establishes the Foster Care Bill of Rights to
clearly enumerate the rights of children placed in foster care.
(Welf. & Inst. Code Sec. 16001.9)
Existing law authorizes minors, 12 years of age and older, to
consent to specified health care and determine whether to keep
it private, including sexual and reproductive health services,
drug treatment, and mental health treatment or counseling
services if, in the opinion of the attending professional
person, the minor is mature enough to participate intelligently
in the mental health treatment or counseling services. (Health
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& Saf. Code Secs. 123115, 124260; Civ. Code Sec. 56.11(c)(1);
Fam. Code Secs. 6924-6929.)
Existing law provides that a minor may consent to medical or
dental care if that minor is over the age of 15, living separate
and apart from his or her parents whether with or without his or
her parents' consent, and managing his or her own financial
affairs. (Fam. Code Sec. 6922 (c).)
Existing law authorizes a social worker who is responsible for,
or supervising the care of, a child to authorize medical,
surgical, dental or other remedial care, upon recommendation by
an attending physician, surgeon, or dentist, as specified.
(Welf. & Inst. Code Sec. 369.)
Existing law authorizes the juvenile court to make an order
authorizing the performance of necessary medical, surgical,
dental or other remedial care for a child for whom a petition
has been filed, as specified. (Welf. & Inst. Code Sec. 369.)
Existing law states the intent of the Legislature to support the
preservation of families headed by minor parents and nonminor
dependent parents, and provides that such families shall be
provided with access to existing services for which they may be
eligible, as specified. (Welf. & Inst. Code Sec. 16002.5.)
Existing law requires the Superintendent of Public Instruction
to adopt rules and regulations related to the eligibility,
enrollment, and priority of services needed in the
implementation of state subsidized child care and child
development services. (Ed. Code Sec. 8263.)
Existing law requires, in order to be eligible for such
services, a family must be a current aid recipient, income
eligible, homeless, a recipient of child protective services, or
at risk of being abused or neglected, and a family must need the
services for one of the following reasons:
the child is a recipient of child protective services, is
being, or is at risk of being, neglected, abused or exploited;
and
the parents are engaged in vocational training, employed or
seeking employment, seeking permanent housing, or are
incapacitated. (Ed. Code Sec. 8263.)
This bill would include parenting foster youth or parenting
nonminor dependents in the list of family categories receiving
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priority for subsidized child care or child development
services.
This bill would clarify that existing law establishing the
ability of the court or a social worker to consent to specified
medical care on behalf of a foster youth shall not limit the
rights of a dependent child to consent to medical care.
This bill would require the social worker of a dependent child
over the age of 12 to ensure the child is informed of his or her
right to consent to and receive specified medical services.
This bill would state that foster children have the right to
have access to age-appropriate information about reproductive
health care, the prevention of unplanned pregnancy, and the
prevention of sexually transmitted infections for children 12
years of age or older.
This bill would require social workers to ensure that all
dependent children are provided with age-appropriate and
medically accurate information about sexual development,
reproductive health, and the prevention of unplanned pregnancy
and sexually transmitted diseases on an ongoing basis.
This bill would require child welfare agencies to ensure that
minor parents and nonminor dependent parents have access to
social workers or resource specialists who have received
training on the needs of teenaged parents and on available
resources, and to update the case plan of a minor or nonminor
within 60 days of the agency being informed of a pregnancy. The
case plans for pregnant minor or nonminor dependents would need
to be informed by a specialized conference of specified
individuals, including a specially trained social worker or
resource specialist.
This bill would provide that participation in the specialized
conference shall be voluntary on the part of the foster youth or
nonminor dependent and assistance in identifying and accessing
resources shall not be dependent on participation in the
conference.
This bill would require child welfare agencies, local
educational agencies and child care resource and referral
agencies to make coordinated efforts to ensure that minor
parents and nonminor dependent parents who have not completed
high school have access to school programs that provide onsite
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or coordinated child care and that minor dependent parents are
given priority for subsidized child care.
This bill would state the intent of the Legislature to ensure
that the following information is available to the public on a
quarterly basis: the number of parenting minor and nonminor
dependent parents and their children, total number of children,
their age, their ethnic group, their placement type, and their
time in care.
COMMENT
1.Stated need for the bill:
According to the author,
Currently, young parents in the foster care system face both
the challenges of being in foster care as well as the
challenges of being a young, usually single, parent. Studies
of both groups have found that they will experience higher
than average rates of poverty, unemployment and low
educational attainment. While this has long been the case, the
issue of parenting youth in foster care has become more
pressing with the implementation of extended foster care in
California.
Research from the University of Chicago suggests that
extending foster care to age 21 will roughly double the
incidence of parenting youth in foster care. Given this, it is
important that California's foster care system adapt itself to
meet the real needs of parenting youth and their children.
Doing so provides an important opportunity both to better
serve parenting foster youth and meet the needs of their
children in their first, most critical years of life.
2.Connecting parenting dependents to existing resources
According to the author, parenting dependents face an uphill
battle. "Parenting foster youth experience disproportionate
rates of poverty and low-educational attainment. Educationally,
they are 34 percent less likely to have a GED or high school
diploma by age 21 than non-parenting foster youth and 43 percent
less likely than the general population of 21 year-olds. A full
48 percent of teen parents live below the poverty line, a rate
which increases to 50 percent by the time their child reaches
their third birthday. ? Children of parenting foster youth
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experience a rate of maltreatment and child welfare involvement
that is five times greater than children of same-age foster
youth. According to an analysis conducted in Illinois, one in
ten children of parenting foster youth will be placed into
foster care themselves."
Accordingly, this bill would take a comprehensive approach to
connecting pregnant and parenting dependents with resources,
hopefully giving them the opportunity to become economically
stable and improve the health and well-being of their young
children.
a. Specialized conferences for pregnant and parenting youth
This bill would require counties to ensure that minor
parents and nonminor dependent parents have access to
social workers or resource specialists who have received
training on the needs of teenaged parents, and are able to
direct dependents to the resources and programs available
them. This bill would also require the county agency to
update the case plans for pregnant and parenting dependents
within 60 calendar days of being informed of the pregnancy.
When updating these case plans, this bill would require
child welfare agencies to hold a specialized conference to
inform the case plan.
These provisions are largely based on the pregnant and
parenting teen conferences (PPT) that have been utilized in
Los Angeles County (see Background). These specialized
conferences must include a social worker or a resource
specialist trained in the needs of pregnant or parenting
dependents, but could also include family members, other
supportive adults, a public health nurse, or other
personnel from public or private sectors with a
comprehensive knowledge of available maternal and child
resources, including public benefit programs. The
conferences would be voluntary for a pregnant or parenting
dependent, but would give the dependent an opportunity to
develop a birth plan for the child and related issues, such
as how the birth of the child will affect foster care
placement, education, and childcare. The requirement that
the social worker or resource specialists identify
resources, however, is mandatory. Thus, pregnant and
parenting dependents that choose not to participate in the
conference will still have a centralized list of resources
which may be available to them.
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b. Subsidized child care
This bill would provide that pregnant or parenting
dependents would be added to the list of individuals
eligible for federal and state subsidized child development
services. In support of this bill, the Children's Advocacy
Institute writes, "parenting and pregnant youth in foster
care are 200 percent more likely to drop out of high school
than to graduate, leaving them without the means to achieve
economic stability. One key reason for this is a lack of
reliable, affordable child care. SB 528 will prioritize
foster youth who are parents for subsidized child care,
thereby allowing foster youth to complete their education
and get one step closer to achieving economic stability for
themselves and their children."
To participate in extended foster care, a youth must
fulfill one of the following requirements: be completing
high school or an equivalent program; be enrolled in
college, community college or a vocational education
program; be participating in a program designed to remove
barriers to employment; be employed at least 80 hours per
month; or, be unable to do one of these requirements
because of a medical condition.
Extending benefits to eligible dependents until the age of
21 has had unintended consequences for nonminor dependent
parents. For example, while parenting minor dependents may
be eligible for subsidized childcare under particular
programs, such as Cal-Learn, and adult parents are eligible
under programs such as CAL-WORKS, currently, there are no
specific child care programs or services directed toward
parenting nonminor dependents which allow them to meet the
above requirements while simultaneously caring for their
child. Thus, parenting nonminor dependents may be forced to
exit extended foster care or lose their child.
This bill would address this issue by adding pregnant and
parenting dependents, regardless of age, to the list
individuals eligible for federal and state subsidized child
development services.
3.Guarantees dependents access to critical health information
This bill would require social workers to ensure that all
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dependent children are provided with age-appropriate, medically
accurate information about sexual development, reproductive
health, and prevention of unplanned pregnancies and sexually
transmitted diseases on an ongoing basis.
Regarding the need of dependents to receive accurate information
about medical and health care, the Public Health Institute wrote
in a 2009 report:
Children and youth in foster care are often characterized by
the absence of a dependable family or social network, an
intense need for affection, the desire to possess something of
their own that they do not have to share, exposure to sexual
abuse, exposure to other types of violence, and limited skills
in identifying and accessing resources to support themselves
now and in the future?.
Youth in foster care tend to change schools frequently due to
changes in foster placements and thus may experience lapses in
school attendance, falling behind not only in academic
subjects, but also missing the sex education sometimes
delivered in traditional schools. Foster and former foster
youth are therefore less likely to have had access to sex
education classes, despite their increased risk for unintended
pregnancy, HIV, and other STDs. (Public Health Institute, Sex
Education and Reproductive Health Needs of Foster and
Transitioning Youth in Three California Counties (March 2,
2009) p. 4.)
The author argues that there is "a lack of clarity about who is
responsible for educating youth in the foster care about
reproductive health, which has resulted in higher than average
rates of unintended pregnancy and sexually transmitted diseases
among youth in foster care." This assertion makes sense: if
discussing reproductive health with their own children is
something many parents dread, discussing these issues with a
foster child with whom they do not have a close relationship may
be even more difficult for foster parents. Additionally, only
about a third of social workers reported that they regularly
provide information related to reproductive health with
dependents under their charge. (Public Health Institute, Sex
Education and Reproductive Health Needs of Foster and
Transitioning Youth in Three California Counties (March 2, 2009)
p. 16.)
This bill would ensure that dependent youth receive
age-appropriate health information by requiring the each social
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worker to ensure that dependents under his or her charge receive
specified information on an ongoing basis. This represents a
flexible approach where social workers do not necessarily need
to be the person having sensitive conversations with dependents,
but merely need to ensure that the dependents have received the
information. Thus, the information may come from a foster
parent with whom the dependent has a close relationship, a
registered nurse, a counselor, or the social worker herself.
4.Clarify existing law regarding minor's ability to consent to
specified health care treatment
Under existing law, at least two parties may make specified
medical decisions for a dependent child 12 years of age or
older. First, existing law permits a social worker or the
juvenile court responsible for a child taken into temporary
custody to authorize specified medical care upon recommendation
by an attending physician, and permits a social worker
supervising the care of a dependent child to authorize medical
care, as specified. (Welf. & Inst. Code Sec. 369.)
Existing law also permits minors, 12 years of age and older, to
consent to specified health care and determine whether to keep
it confidential, including sexual and reproductive health
services, drug treatment, and mental health treatment or
counseling services if, in the opinion of the attending
professional person, the minor is mature enough to participate
intelligently in the mental health treatment or counseling
services. (Fam. Code Secs. 6924-6929.)
This bill would clarify that a dependent minor's right to
consent to specified medical or mental health care is not
impaired because a court or social worker has authorized medical
care. This bill would also require the social worker to inform
the dependent of this right. Thus, while this provision does
not substantially change current law, it will arguably ensure
that dependents are informed of existing rights to consent to
medical treatment.
5.Complete and accurate data collection regarding parenting
dependents and their children
This bill would state the intent of the Legislature to ensure
that complete and accurate data on parenting minor and nonminor
dependents and their children by county is collected, and made
available on a quarterly basis. This bill would specify that
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information be collected regarding the total number of parenting
minor and nonminor dependents, the number of their children,
their age, their ethnic group, their placement type, and their
time in care.
Arguably, the above information is crucial in order for the
Legislature or counties to adequately address the needs of
dependents in foster care. In support of this bill, the John
Burton Foundation writes, "currently we cannot answer the most
basic questions [about parenting youth and their children] such
as how many parenting youth are in foster care or how many of
their children have been removed and placed into foster care.
This information is vital if we are to understand how to target
limited resources to prevent unintended pregnancies, support
young parents, and prevent maltreatment of the children of
parenting foster youth."
6.Opposition
In opposition to this bill California Right to Life, Inc. argues
that it is important to realize that "many of these young people
are in foster care because of physical abuse, emotional, or
mental health reasons ? [and] may be vulnerable to suggestions
by social workers an personnel that would be authorized to
educate them." Similarly, California ProLife Council argues that
this bill would force state agencies and workers to create ways
for minor parents and nonminor dependents to receive abortions.
The author writes in response:
The bill does not expand medical services that are already
available to Foster Youth. The bill addresses the immediate
needs of foster youth already parenting by helping provide
access to child care services. The Pregnant and Parenting Teen
Conference discussed in the bill is a targeted information
session that informs pregnant and parenting teens on the
services and resources available to them. This conference is
intended to inform the case plan. It will not only help the
foster youth be better prepared for their parenting situation,
but it will allow the Department of Social Services to better
assess and meet the needs of that dependent.
7.Technical amendments
The author offers the following technical and clarifying
amendments to be taken in the Senate Education Committee.
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Suggested amendments
Page 10, line 31, replace "diseases" with "infections"
Page 13, line 38, replace "minor" with "dependent"
Page 14, line 13, replace "teens" with "dependents"
Support : Advancement Project; Aspiranet; Bay Area Youth
Centers; Bill Wilson Center; Black Women for Wellness;
California Adolescent Health Collaborative; California Alliance
of Child and Family Services; California Attorneys for Criminal
Justice; California Coalition for Youth; California Federation
of Teachers; California Latinas for Reproductive Justice;
California Public Defenders Association; California Women's Law
Center; Children's Advocacy Institute; Citizens for Choice;
Crittenton Services for Children and Families; Dependency Legal
Group of San Diego; East Bay Children's Law Offices; EMQ
Families First; Every Child Foundation; Family Care Networks,
INC; Feminist Majority; First Place for Youth; Five Acres;
Gavilan College, EOPS; Goldman School of Public Policy, UC
Berkeley; Home Start; Imperial Valley Regional Occupational
Program; Larkin Street Youth Services; Legal Services for
Children; LIFETIME; Moorpark College; Mountain Circle Family
Services; National Center for Youth Law; National Council of
Jewish Women; New Alternatives, INC; Optimist Youth Homes and
Family Services; Redwood Children's Services, Inc.; Seneca
Family Agencies; St. Anne's; Twigs to Trees; WestCoast
Children's Clinic; Youth and Family Programs; six individuals
Opposition : California ProLife Council; California Right to
Life Committee
HISTORY
Source : John Burton Foundation; Alliance for Children's Rights;
Children's Law Center; Public Council
Related Pending Legislation : AB 1152 (Ammiano, 2013) would
exempt the California School Age Families Education Program
(Cal-SAFE) from any new education financing proposal that would
eliminate categorical education programs beginning with the
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2013-14 fiscal year and all subsequent fiscal years. Funding
from school districts, charter schools and county offices of
education selecting not to maintain or re-establish Cal-SAFE
programs shall be restricted to expanding existing or
establishing new Cal-SAFE programs.
Prior Legislation :
AB 499 (Atkins, Chapter 652, Statutes of 2011), authorized a
minor, who is 12 years of age or older, to consent to medical
care related to the prevention of a sexually transmitted
disease.
SB 543 (Leno, Chapter 503, Statutes of 2010), authorized a minor
who is 12 years of age or older to consent to mental health
treatment or counseling, except as specified, on an outpatient
basis, or to residential shelter services, if specified
conditions are satisfied.
SB 244 (Wright, 2009), would have required a study on the
feasibility of providing priority enrollment in high-quality
child care and development programs for children from birth to
five years of age who are in the foster care system, in relative
care or reunification, or were formerly in the foster care
system, who are at risk of abuse, neglect, or exploitation, are
homeless, or had a custodial parent who meets specified
criteria. Held in Assembly Rules.
AB 769 (Torres, 2009), would have expanded priority enrollment
in state-funded preschool programs to children who have a
biological parent who is, or who has been within the previous
six months, under the jurisdiction of the delinquency or
dependency court. AB 769 was vetoed by the Governor.
AB 270 (De La Torre, 2009) would have required courts to
continue jurisdiction over nonminors when required documents,
screenings and information were not provided or completed. This
bill died in the Assembly Appropriations Committee
Prior Vote : Senate Human Services Committee (Ayes 6, Noes 0)
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