BILL ANALYSIS Ó
Senate Appropriations Committee Fiscal Summary
Senator Kevin de León, Chair
SB 909 (Pavley) - Children in temporary custody: health
screenings.
Amended: May 12, 2014 Policy Vote: HS 5-0, JUD 7-0
Urgency: No Mandate: No
Hearing Date: May 19, 2014 Consultant: Jolie Onodera
This bill meets the criteria for referral to the Suspense File.
Bill Summary: SB 909 would allow social workers to authorize
noninvasive initial medical, dental, and mental health
screenings of a child in temporary custody, without parental
consent or court order, if reasonable attempts to notify the
parent are made. This bill would add "mental health care" as
defined, to the list of services that may be authorized under
specified circumstances for a child who is a dependent of the
juvenile court, is in temporary custody, or for whom a
dependency petition has been filed.
Fiscal Impact:
Potential increase in Medi-Cal costs (Federal/State) for
mental health care services, including assessments,
treatment, and counseling, to dependents of the juvenile
court, children in temporary custody, and children for whom
a dependency petition has been filed.
Potential increase in Medi-Cal costs (Federal/State) for
additional medical and dental screenings for children in
temporary custody that may not have been administered under
existing law.
Potential cost savings in social worker time and court
workload to the extent the authorization provided to social
workers reduces the need to seek court orders to authorize
medical, dental, and mental health screenings that otherwise
would have been required.
Background: Under existing law, for a child who has been placed
in temporary custody, a social worker is required to obtain
either the consent of a parent or permission from the court to
authorize medical, surgical, dental, or other remedial care,
except in emergency situations, which if not immediately
diagnosed and treated, would lead to serious disability or
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death.
A child is placed in the temporary custody after a complaint of
suspected child abuse or neglect is investigated and validated
by a county welfare social worker. The social worker is required
to immediately file a petition with the juvenile court, and a
detention hearing must be held within three judicial days of the
petition being filed to determine whether the child should
remain in custody or be returned to his or her parent(s).
While a social worker is allowed to authorize medical, surgical,
dental, or other remedial care for a dependent child that has
been placed by the court under the custody or supervision of a
social worker if it appears there is no parent or guardian
capable of authorizing or willing to authorize care, social
workers currently do not have similar authority over children
being held in temporary custody.
As noted in the Senate Judiciary Committee analysis: "Temporary
loss of custody of a child does not eliminate all rights of a
parent. Generally, until a parent's rights have been limited or
terminated by the court, parental consent is necessary for
medical treatment. A parent's rights will not be altered until
the court has ruled on the allegations of abuse, and determined
that a child does in fact come within the jurisdiction of the
dependency court."
Existing law provides for medical, surgical, dental, or other
remedial care to be authorized under specified circumstances for
a child in temporary custody, a dependent child, or a child for
whom a petition has been filed. This bill would add "mental
health care" to the list of services authorized to be provided
to these populations of children.
Proposed Law: This bill would allow social workers to authorize
noninvasive initial medical, dental, and mental health
screenings of a child in temporary custody, without parental
consent or court order if reasonable attempts to notify the
parent are made. Specifically, this bill:
Provides that whenever a child is taken into temporary
custody, the social worker may authorize a noninvasive
initial medical, dental, and mental health screening of the
child, prior to the detention hearing for the following
purposes:
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o To determine whether the child has an urgent
medical, dental, or mental health need that requires
immediate attention.
o To determine whether the child poses a health
risk to other persons.
o To determine an appropriate placement to meet
the child's medical and mental health care needs
identified in the initial health screening.
Requires the social worker to make reasonable attempts
to notify the parent of the child that the child will be
undergoing a noninvasive initial medical, dental, and
mental health screening.
Requires a social worker to provide the parent with a
reasonable opportunity to object to this screening, and if
the parent objects, the screening may be conducted only
upon the order of the court.
Provides that for the purposes of this measure a
noninvasive initial medical, dental, or mental health
screening shall be limited to a review of available health
and developmental history, a standard review of systems, a
measurement of the child's height, weight, and head
circumference with percentiles, a taking of vital signs,
and a physical examination by a physician or pediatric
nurse practitioner to identify signs of acute and chronic
illness. Provides for clothing requirements for physical
examinations of children over three years old.
Adds "mental health care," as defined, to the care that
may be authorized for a child who is a dependent of the
juvenile court, is in temporary custody, or for whom a
dependency petition has been filed.
Defines "mental health care," as the provision of mental
health services, including assessment, treatment, or
counseling, on an outpatient basis.
Specifies that nothing in the bill authorizes a child to
receive psychotropic medication without the consent of the
child's parent or guardian, or the court.
Includes uncodified legislative findings and
declarations.
Related Legislation: AB 506 (Mitchell) Chapter 153/2013
authorized a social worker to consent to HIV testing for infants
less than 12 months of age if in temporary custody of the
juvenile court or if the subject of a dependency petition filed
with the court.
SB 909 (Pavley)
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SB 913 (Pavley) Chapter 256/2011 permitted a chief probation
officer to provide consent to medical examinations and
non-emergency medical care for youth detained in county juvenile
facilities.
Staff Comments: By allowing social workers to authorize
noninvasive initial medical, dental, and mental health
screenings of a child in temporary custody, as specified, and
adding "mental health care" to the list of services that can be
authorized by social workers to provide to dependent children,
children in temporary custody, and children for whom a
dependency petition has been filed, this bill could result in
increased ongoing costs to the Medi-Cal program to provide
services to these children that may not otherwise have been
provided under existing law.
Under state and federal law, the Department of Health Care
Services (DHCS) operates the Medi-Cal program, which provides
health care coverage to pregnant women, children, and their
parents with low incomes, as well as blind, disabled, and
certain other populations. Generally, the federal government
provides a 50 percent match for state expenditures. For children
from families with slightly higher income, the federal match is
65 percent.
While it is unknown how many children would be provided these
services, to the extent Medi-Cal services in excess of $100,000
($50,000 General Fund) are provided annually would meet the
Suspense File threshold of this Committee.
This bill is not projected to result in significant new workload
for county social workers, as existing duties include social
worker efforts to locate a parent. Rather, to the extent the
provisions of this bill serve to reduce the need for social
workers to seek court orders to authorize treatment, could not
only save social worker time, but could also result in reduced
court workload to hear and process these orders.
To the extent the provision of initial medical, dental, and
mental health screenings to children during the brief period of
temporary custody serves to successfully identify and treat
children prior to situations escalating to a critical level,
this bill could result in potential future cost savings in
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averted medical, dental, and mental health care services that
would be required in the future.