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
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            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
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            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  








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            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,  








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            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