BILL ANALYSIS �
SB 528
Page 1
Date of Hearing: June 25, 2013
ASSEMBLY COMMITTEE ON JUDICIARY
Bob Wieckowski, Chair
SB 528 (Yee) - As Amended: June 20, 2013
As Proposed to be Amended
SENATE VOTE : 34-2
SUBJECT : DEPENDENT CHILDREN AND PARENTS: CARE AND TREATMENT
KEY ISSUE : IN ORDER TO BETTER ASSIST OLDER FOSTER YOUTH,
PARTICULAR NONMINOR DEPENDENTS AGE 18-21, SHOULD THE LAWS ON
MEDICAL CONSENT FOR FOSTER YOUTH AND ON PROVISION OF
AGE-APPROPRIATE REPRODUCTIVE HEALTH INFORMATION BE CLARIFIED,
AND SHOULD CHILDREN OF FOSTER YOUTH RECEIVE PRIORITY ENROLLMENT
IN CHILD CARE?
FISCAL EFFECT : As currently in print this bill is keyed fiscal.
SYNOPSIS
AB 12 (Beall and Bass, 2012) authorized the juvenile court 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. This bill, sponsored by the Alliance for Children's
Rights, the Children's Law Center of California, the John Burton
Foundation and Public Counsel, and supported by over 75 other
organizations, seeks to better address the health and welfare of
minor and nonminor foster youth, including those who have become
parents. First, this bill authorizes social workers to provide
foster youth with access to age-appropriate, medically accurate
information about sexual development, reproductive health, and
prevention of unplanned pregnancies and sexually transmitted
diseases. This bill clarifies that a dependent youth's right to
consent to certain medical care, including treatment for sexual
assault, medical treatment for care or prevention of pregnancy,
mental health treatment, or treatment for drug or alcohol abuse,
is not limited because a court or social worker is authorized to
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consent to medical care for the youth. This bill also
authorizes a social worker to inform dependents who are 12 or
older of this right. Finally, this bill adds minor and nonminor
dependent parents to the list of families prioritized for
subsidized state and federal child development services. This
bill is opposed by the California Right to Life Committee. It
passed out of the Assembly Human Services Committee on a 6-1
vote.
SUMMARY : Provides additional considerations for foster children
and nonminor dependents with respect to access to medical care
and child care. Specifically, this bill :
1)Clarifies that a social worker's or court's authority to
consent to medical care for a child in the foster care system
is not to be construed to limit the child's right to consent
to, among other things, the diagnosis and treatment of sexual
assault, medical care regarding the prevention or treatment of
pregnancy, including contraception, abortion, and prenatal
care, treatment of infectious, contagious, or communicable
diseases, mental health treatment, and treatment for alcohol
and drug abuse. Authorizes a social worker to inform a
dependent over the age of 12 of his or her right to consent to
and receive those health care services, as specified.
2)Authorizes social workers to provide dependent children with
access to age-appropriate, medically accurate information
about sexual development, reproductive health, prevention of
unplanned pregnancies and sexually transmitted infections.
3)Adds to the Foster Youth Bill of Rights the right of a minor
or nonminor in foster care to have access to medically
accurate, age-appropriate information about reproductive
health, the prevention of unplanned pregnancy, and the
prevention and treatment of sexually transmitted infections at
12 years of age or older.
4)States the intent of the Legislature to ensure that complete
and accurate data on parenting minor and nonminor dependents
and their children are collected, and that the Department of
Social Services shall ensure that specified information is
publicly available on a quarterly basis by county about
parenting minor and nonminor dependents and their children.
5)Permits child welfare agencies to provide dependents and
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nonminor dependents with access to social workers or resource
specialists who are trained on the needs of parenting
teenagers and available resources.
6)Encourages child welfare agencies to update a dependent's or
nonminor dependent's case plan with specified pregnant and
parenting information in collaboration with specified
individuals within 60 days of being notified that a dependent
or nonminor dependent has become pregnant. Permits child
welfare agencies, when updating the case plan, to hold a
specialized conference to assist pregnant or parenting foster
youth and nonminor dependents, and to inform the case plan.
Requires the specialized conference to include the pregnant or
parenting minor or nonminor dependent, family members and
other supportive adults, and the specially trained social
worker or resource specialist. Permits the specialized
conference to include other individuals, as specified.
Clarifies that participation in the specialized conference is
voluntary on the part of the foster youth or nonminor
dependent and assistance in identifying and accessing
resources is not dependent on participation in the conference.
7)Permits child welfare agencies, local educational agencies,
and child care resource and referral agencies to make
reasonable and 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
or coordinated child care, and that minor dependent parents
are given priority for subsidized child care. Adds parenting
minor and nonminor dependents to the list of families eligible
for federal and state subsidized child care.
EXISTING LAW :
1)Allows a juvenile court to adjudicate a minor a dependent of
the court if the child has been neglected or abused. (Welfare
& Institutions Code Section 300. Unless stated otherwise, all
further statutory references are to that code.)
2)Establishes the California Fostering Connections to Success
Act of 2010, which, among other provisions, provides for the
extension of transitional foster care to eligible youth up to
age 21, as specified. (AB 12 (Beall), Chap. 559, Stats. 2010;
Section 303.)
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3)Establishes the Foster Care Bill of Rights to clearly
enumerate the rights of children placed in foster care.
(Section 16001.9.)
4)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 & Safety Code Section 124260; Civil Code
Section 56.11(c)(1); Family Code Sections 6924-29.)
5)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.
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 dependency petition has
been filed, as specified. (Section 369.)
6)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 will be
provided with access to existing services for which they may
be eligible, as specified. (Section 16002.5.)
7)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.
(Education Code Section 8263.)
COMMENTS : AB 12 (Beall and Bass), Chap. 559, Stats. 2010, known
as the California Fostering Connections to Success Act,
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, issues related to reproductive health and parenting have
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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 . . . 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, Time (July 22,
2009.)
This bill addresses many of the issues which have become more
pressing with California's expansion of foster care to eligible
nonminors. Among other provisions, this bill authorizes social
workers to provide foster youth specified reproductive health
information. This bill also clarifies that existing law
permitting the court and social workers to authorize specified
medical care for a dependent child is not to be construed to
limit the medical consent rights of the child. This bill also
allows 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
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decision-making process. This bill adds parenting minor and
nonminor dependents to the list of individuals eligible for
federal and state subsidized child development services and
provides priority enrollment for those families. Finally, this
bill states the intent of the Legislature to ensure that
accurate data related to parenting minor and nonminor dependents
are collected, and that the data are available to the public on
a quarterly basis.
In support of the bill, the author writes:
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.
Helps Provide Foster Youth Access to Critical Health
Information : This bill authorizes social workers to provide
foster youth with age-appropriate, medically accurate
information about sexual development, reproductive health, and
prevention of unplanned pregnancies and sexually transmitted
diseases. On the importance of foster youth receiving 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
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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. (Wendy Constantine, et al.,
Sex Education and Reproductive Health Needs of Foster and
Transitioning Youth in Three California Counties 4 (Public
Health Institute, March 2009).)
Clarifies Existing Law Regarding Minor's Ability to Consent to
Specified Health Care Treatment : Under current 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.
Current law also permits minors, 12 years of age and older, to
consent to specified health care and to 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.
This bill clarifies that a dependent youth's right to consent to
specified medical or mental health care, specifically including
treatment for sexual assault, medical treatment for care or
prevention of pregnancy, mental health treatment or treatment
for drug or alcohol abuse, is not limited because a court or
social worker is authorized to consent to medical care. This
bill also authorizes the social worker to inform the dependent
who is 12 or older of this right. Thus, while this provision
does not change current law, it will help ensure that dependents
are informed of important existing rights to consent to medical
treatment.
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Requires Complete and Accurate Data Collection on Parenting
Dependents and Their Children : This bill states the intent of
the Legislature to ensure that complete and accurate data on
parenting minor and nonminor dependents and their children is
collected, and made available on a quarterly basis. The bill
specifies that 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.
This information is important for the Legislature and counties
to first understand the needs of parenting foster youth and then
to better address those needs. In support of the 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."
Connecting Parenting Dependents to Existing Resources :
According to the author, parenting foster youth face a large,
uphill battle. Recognizing that, in 2008, Los Angeles County
embarked on a project to aid pregnant and parenting dependents.
The Pregnant and Parenting Teen conference (PPT) is a voluntary
program in which pregnant or parenting dependents are connected
with a variety of 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 a
resource specialist or social worker, as well as the youth, work
to create a plan for the youth 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.
Building on the program, this bill helps connect pregnant and
parenting minor and nonminor dependents with resources,
hopefully providing them the opportunity to become economically
stable and improve the health and well-being of their young
children.
Specialized conferences for pregnant and parenting youth: This
bill allows child welfare agencies to provide minor parents and
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nonminor dependent parents with 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 also
encourages 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 allows 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 that have been utilized in Los Angeles County.
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 youth 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.
Subsidized child care: This bill adds parenting minor and
nonminor dependents to the list of individuals eligible for
federal and state subsidized child development services and
provides priority enrollment for those families. 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."
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
CalWORKS, currently, there are no specific child care programs
or services directed toward parenting nonminor dependents which
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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 addresses this issue by adding pregnant and parenting
dependents, regardless of age, to the list individuals eligible
for federal and state subsidized child development services.
ARGUMENTS IN OPPOSITION : In opposition to this bill, California
ProLife Council argues that the bill "would force state agencies
and workers to create ways for minor parents and non-minor
dependents to receive abortions. Many of these children have
been abused, neglected and now will have state agencies make
items like abortion their focus rather than the needs of those
they are charged with."
In response the author states that the bill does not expand
medical services that are already available to foster youth, but
it is aimed to "prevent unintended pregnancies and awareness
about the consequences of engaging in sexual behavior."
Prior Legislation : AB 499 (Atkins), Chap. 652, Stats. 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), Chap. 503, Stats. 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.
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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.
REGISTERED SUPPORT / OPPOSITION :
Support
The Alliance for Children's Rights (co-sponsor)
Children's Law Center of California (co-sponsor)
John Burton Foundation (co-sponsor)
Public Counsel (co-sponsor)
A Better Way
Abode Services
ACLU
Alameda County Office of Education
Alternative Family Services
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 Alternative Payment Program Association
California Attorneys for Criminal Justice
California Coalition for Youth
California Federation of Teachers
California Latinas for Reproductive Justice
California Public Defenders Association
California State PTA
California Women's Law Center
Casa de Amparo
Children's Advocacy Institute
Citizens for Choice
Coalition For Youth
Alameda County Court Appointed Special Advocates
Covenant House California
Crittenton Services for Children and Families
Dependency Legal Group of San Diego
East Bay Children's Law Offices
EMQ Families First
Every Child Foundation
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Family Care Network, INC.
Feminist Majority
First Place for Youth
Five Acres
Fred Finch Center
Gavilan College, EOPS
Goldman School of Public Policy, UC Berkeley
Hillsides
Home Start
Housing California
Justice Policy Institute
Imperial Valley Regional Occupational Program
InVision Shelter Network
Larkin Street Youth Services
League of Women Voters of California
Legal Services for Children
LIFETIME
Moorpark College
Mountain Circle Family Services
National Association for the Education of Homeless Children and
Youth
National Association of Social Workers - California Chapter
(NASW)
National Center for Youth Law
National Council of Jewish Women
National Foster Parent Association
New Alternatives
NYC Children's Services, Theresa Moser, Attorney
Oakland Unified School District, Lydell K Willis
OPTIMIST Youth Homes & Family Services
Peacock Acres
Promesa Behavioral Health
Redwood Children's Services
Seneca Family Agencies
Social Advocates for Youth
Stars Community Services
Stars Behavioral Health Group
St. Anne's
Transition Age Foster Youth, Santa Cruz County
Twigs to Trees Inc.
UCSF Research Director, Janet Malvin, Ph.D.
University of Southern California School of Social Work
West Coast Children's Clinic
Western Center on Law & Poverty
Youth and Family Programs
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Youth and Family Services YMCA, Santa Barbara
YWCA Santa Monica
Many individuals
Opposition
California ProLife Council
Analysis Prepared by : Leora Gershenzon / JUD. / (916) 319-2334