BILL ANALYSIS Ó SB 578 Page 1 Date of Hearing: June 17, 2014 ASSEMBLY COMMITTEE ON BUSINESS, PROFESSIONS AND CONSUMER PROTECTION Susan A. Bonilla, Chair SB 578 (Wyland) - As Amended: June 9, 2014 SENATE VOTE : vote not relevant. SUBJECT : Marriage and family therapists: records retention. SUMMARY : Requires a licensed marriage and family therapist (LMFT), a licensed educational psychologist (LEP), a licensed clinical social worker (LCSW), and a licensed professional clinical counselor (LPCC) to retain a patient or client's health service record for seven years, as specified. Specifically, this bill : 1)Requires a LMFT, LEP, LCSW and an LPCC to retain a patient or client's health service record for a minimum of seven years from the date therapy is terminated. 2)Specifies that if the patient or client is a minor, the health services records must be retained for a minimum of seven years from the date the patient reaches 18 years of age. 3)States that the recordkeeping provisions only apply patient or client records whose therapy is terminated on or after January 1, 2015. 4)States that no reimbursement is required by this bill pursuant to the California Constitution because the only costs that may be incurred by a local agency or a school district will be incurred because this bill creates a new crime or infraction, eliminates a crime or infraction, changes the penalty for a crime or infraction, or changes the definition of a crime, as specified. EXISTING LAW : 1)Requires licensed providers of health services, if the licensee ceases operation, to preserve records for a minimum of seven years following discharge of the patient, except that the records of un-emancipated minors shall be kept at least one year after the minor has reached the age of 18 years, and SB 578 Page 2 in any case, not less than seven years, as specified. (Health and Safety Code Section 123145) 2)Requires a licensed psychologist to retain a patient's health service records for a minimum of seven years from the patient's discharge date and specifies that if the patient is a minor, the patient's health service records shall be retained for a minimum of seven years from the date the patient reaches 18 years of age. (Business and Profession Code Section 2919) FISCAL EFFECT : Unknown COMMENTS : 1)Purpose of this bill . This bill requires LMFTs, LEPs, LCSWs, and LPCCs to retain patient or client healthcare records for seven years, which is consistent with practices in other healthcare setting such as skilled nursing facilities, adult-day health care and mental health clinics. The retention requirement aims to curb inconsistent recordkeeping amongst private practice behavioral healthcare specialists and will help standardize record requirements across the health care spectrum. This bill is sponsored by the California Association of Marriage and Family Therapists. 2)Author's statement . According to the author, "[This bill] will establish a record retention statute for LMFTs, LPCCs, LCSWs, LEP in private practice. Both the Board of Behavioral Sciences (BBS) and the California Association of Marriage and Family Therapists (CAMFT) receive complaints and questions from California practitioners about ambiguous private practice record retention requirements. The absence of state law results in a non-standardized record retention for mental health records kept by private practices. "In the absence of specific federal [legislation], state legislation or regulation, CAMFT routinely recommends that mental health care records be kept for a minimum of seven years, using the psychologists' requirement as the standard for the profession. [This bill] will establish a seven year records retention schedule for LMFTs, LPCCs, LCSWs, and LEPs that conforms to the existing records retention schedule for those who practice in licensed clinics, nursing facilities, intermediate care facilities, adult day health care and SB 578 Page 3 skilled nursing homes. It will also codify that if the patient is a minor, the patient's health service records shall be retained for a minimum of seven years from the date the patient reaches 18 years of age." 3)Varied patient healthcare recordkeeping requirements . Currently, there is no uniform standard for patient record retention in California, especially for many in private practice. For example, physicians are not required to maintain patient medical records for a specific amount of time. However, current law requires certain healthcare facilities such as healthcare clinics, health facilities, adult day health centers and skilled nursing facilities to preserve patient records for a minimum of seven years following discharge of the patient, and the records of un-emancipated minors shall be kept at least one year after the minor has reached the age of 18 years, and in any case, not less than seven years. According to the Medical Board of California, several areas of law specify a three-year retention period, including those records pertaining to Medi-Cal patients, records of services reimbursed by Emergency Medical Services Fund and those dealing with a physician prescribing dispensing or administering a Schedule II controlled substance. In addition, optometrists are required to retain patient records for a minimum of seven years from the date the individual completes treatment, and if the patient is a minor, the records must be retained for a minimum of seven years from the date the individual completes treatment and at least until the patient reaches 19 years of age. 4)Psychologists . Current law requires licensed psychologists to retain a patient's health service records for a minimum of seven years from the patient's discharge date. The law specifies that if the patient is a minor, the patient's health service records shall be retained for a minimum of seven years from the date the patient reaches 18 years of age. The provisions of this bill for LMFTs, LEPs, LCSWs, and LPCCs are modeled after the current requirements for psychologists. 5)Arguments in support . According to the California Association of Marriage and Family Therapists, "current law does not prescribe the amount of time a therapist is required to retain client records. The absence of such a law creates confusion SB 578 Page 4 for LMFTs regarding the length of time patient records must be kept, when patient records must be destroyed, and subject LMFTs to non-standardized record retention guidelines pertaining to their profession. This law would eliminate any ambiguity by establishing a specific time period LMFTs in private practice are required to retain the records of both minor and adult patients." 6)Suggested technical amendment . As written, this bill requires LMFTs, LEPs, LCSWs, and LPCCs to retain a client or patient's health record for a minimum of seven years; however, the language does not specify if the record needs to be a written record or an electronic record. The suggested amendment will clarify that both written and electronic forms of record retention are acceptable. On page 2, line 8, after "age." insert "Health service records may be retained in both written and electronic formats." On page 2, line 17, after "age." insert "Health service records may be retained in both written and electronic formats." On page 2, line 27, after "age." insert "Health service records may be retained in both written and electronic formats." On page 3, line 10, after "age." insert "Health service records may be retained in both written and electronic formats." 7)Senate vote not relevant . This bill was voted off the Senate Floor (32-0), on May 6, 2013, as a substantially different subject. This bill, in its current form, has not been heard by a policy committee in the Senate or the Assembly. 8)Previous legislation . AB 2257 (Committee on Business and Professions) Chapter 89, Statutes of 2006, requires psychologists to maintain a patient's records for seven years from the patient's discharge date, or in the case of a minor, seven years after the minor reaches 18 years of age. AB 986 (Eng) Chapter 276, Statutes of 2007, establishes a retention period for optometrists to maintain patient records, SB 578 Page 5 allows the practice of optometry at temporary locations under certain conditions, increases the amount of fees charged for optometry licensing, and creates new fees to be paid by licensed optometrists for services provided to them by the Board of Optometry. REGISTERED SUPPORT / OPPOSITION : Support California Association of Marriage and Family Therapists (sponsor) Opposition None on file. Analysis Prepared by : Elissa Silva / B.,P. & C.P. / (916) 319-3301