BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                    AB 2083


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          Date of Hearing:  April 19, 2016
          Consultant:           Matt Dean


                         ASSEMBLY COMMITTEE ON PUBLIC SAFETY


                       Reginald Byron Jones-Sawyer, Sr., Chair





          AB  
                      2083 (Chu) - As Introduced  February 17, 2016




          SUMMARY:  Allows agencies, at the request of an interagency  
          child death review team, to disclose otherwise confidential  
          information.  Specifically, this bill:  

          1)Allows, but does not require, agencies to disclose, orally or  
            in writing, otherwise confidential information to an  
            interagency child death review team, but does not require  
            those agencies to disclose any requested confidential  
            information.  This information may include the following:


             a)   Medical information, as provided;
             b)   Mental health information, as provided;


             c)   Information from child abuse reports and investigations,  
               except the identity of the person making the report which  
               shall not be disclosed;


             d)   State summary criminal history information, as defined;










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             e)   Criminal offender record information, as defined;


             f)   Local summary criminal history information, as defined;


             g)   Information pertaining to reports by health  
               practitioners of persons suffering from physical injuries  
               inflicted by means of a firearm or of persons suffering  
               physical injury where the injury is a result of assaultive  
               or abusive conduct; and


             h)   Records of in-home supportive services, unless  
               disclosure is prohibited by federal law.


          2)States that agencies and individuals receiving these requests  
            may rely on the request to release the information sought in  
            the request.
          EXISTING LAW:  

          1)Allows counties to establish interagency child death review  
            teams to assist local agencies in identifying and reviewing  
            suspicious child deaths and facilitating communication among  
            persons who perform autopsies and the various persons and  
            agencies involved in child abuse or neglect cases, but does  
            not require counties to establish child death review teams.   
            (Pen. Code, § 11174.32.)

          2)States that interagency child death teams have been used  
            successfully to ensure that incidents of child abuse or  
            neglect are recognized and other siblings and non-offending  
            family members receive the appropriate services in cases where  
            a child has expired.  (Pen. Code, § 11174.32(a).)

          3)States that each county may develop a protocol that may be  
            used as a guideline by persons performing autopsies on  
            children to assist coroners and other persons who perform  
            autopsies in the identification of child abuse or neglect, in  
            the determination of whether child abuse or neglect  
            contributed to death or whether child abuse or neglect had  








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            occurred prior to but was not the actual cause of death, and  
            in the proper written reporting procedures for child abuse or  
            neglect, including the designation of the cause and mode of  
            death.  (Pen. Code, § 11174.32(b).)

          4)States that in developing an interagency child death team and  
            an autopsy protocol, each county, working in consultation with  
            local members of the California State Coroner's Association  
            and county child abuse prevention coordinating councils, may  
            solicit suggestions and final comments from persons,  
            including, but not limited to, the following:

             a)   Experts in the field of forensic pathology;

             b)   Pediatricians with expertise in child abuse;

             c)   Coroners and medical examiners;

             d)   Criminologists;

             e)   District attorneys;

             f)   Child protective services staff;

             g)   Law enforcement personnel;

             h)   Representatives of local agencies which are involved  
               with child abuse or neglect reporting;

             i)   County health department staff who deals with children's  
               health issues; and

             j)   Local professional associations of persons described in  
               paragraphs (1) to (9), inclusive.  (Pen. Code, §  
               11174.32(c).) 

          5)Clarifies that records exempt from disclosure to third parties  
            pursuant to state or federal law shall remain exempt from  
            disclosure when they are in the possession of a child death  
            review team.  (Pen. Code, § 11174.32(d).)

          6)Requires each child death review team to make available to the  








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            public findings, conclusions and recommendations of the team,  
            including aggregate statistical data on the incidences and  
            causes of child deaths.  The team is required to withhold the  
            child's last name unless certain exceptions apply.  (Pen.  
            Code, § 11174.32(e).)

          7)Defines "local summary criminal history information" as "the  
            master record of information compiled by any local criminal  
            justice agency pertaining to the identification and criminal  
            history of any person, such as name, date of birth, physical  
            description, dates of arrests, arresting agencies and booking  
            numbers, charges, dispositions, and similar data about the  
            person."  (Pen. Code, § 13300, subd. (a)(1).)

          8)States that "local summary criminal history information" does  
            not refer to records and data compiled by criminal justice  
            agencies other than that local agency, nor does it refer to  
            records of complaints to or investigations conducted by, or  
            records of intelligence information or security procedures of,  
            the local agency.  (Pen. Code, § 13300, subd. (a)(2).)

          9)Requires a local criminal justice agency to furnish local  
            summary criminal history information to any of the following  
            when needed in the course of their duties:  the courts,
          peace officers, district attorneys, prosecuting city attorneys,  
            probation and parole officers, public defender or attorney of  
            record in a criminal case or in a case involving a certificate  
            of rehabilitation, any city or county district office when  
            needed in fulfilling employment, certification or licensing  
            duties, the subject of the local summary criminal history  
            information; managing or supervising correction officers of a  
            county jail, local child support agencies, county child  
            welfare agencies, humane officers, and other expressly  
            authorized by statute, as specified.  (Pen. Code, § 13300,  
            subd. (b).)

          10)Permits a local criminal justice agency to furnish local  
            summary criminal history information to the following, upon a  
            showing of compelling need, to other specified entities,  
            including a public utility which operates a nuclear energy  
            facility, a peace officer from another country,  public  
            officers other than peace officers of the United States, a  








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            public utility when access is needed to assist in employing  
            person who will be entering private residences.  (Pen. Code, §  
            13300, subd. (c).)

          11)States that it is not a violation to disseminate statistical  
            or research information obtained from a record, provided that  
            the identity of the subject of the record is not disclosed.   
            (Pen. Code, §§ 13300, subd. (h), and 13305.)
           
          12)States that an employee of a local criminal justice agency  
            who knowingly furnishes a record or information obtained from  
            a record to a person who is not authorized by law to receive  
            the record or information is guilty of a misdemeanor.  (Pen.  
            Code, § 13302.)

          13)Punishes as a misdemeanor any person authorized by law to  
            receive a record or information obtained from a record who  
            knowingly furnishes the record or information to a person who  
            is not authorized by law to receive the record or information.  
             (Pen. Code, § 13303.)

          14)Requires the DOJ to furnish state summary criminal history  
            information to specified entities, if needed in the course of  
            their duties, provided that when information is furnished to  
            assist an agency, officer, or official of state or local  
            government, a public utility, or any other entity in  
            fulfilling employment, certification, or licensing duties,  
            specified restrictions listed in the Labor Code are followed.   
            (Pen. Code, § 11105, subd. (b).)

          15)Allows the DOJ to furnish state summary criminal history  
            information to specified entities and, when specifically  
            authorized, federal-level criminal history information, upon a  
            showing of a compelling need, provided that when information  
            is furnished to assist an agency, officer, or official of  
            state or local government, a public utility, or any other  
            entity in fulfilling employment, certification, or licensing  
            duties, specified restrictions listed in the Labor Code are  
            followed.  (Pen. Code, § 11105, subd. (c).)

          16)Allows DOJ to charge a fee to reimburse department costs, and  
            a surcharge to fund system maintenance and improvements,  








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            whenever state summary criminal history information is  
            furnished as the result of an application and is to be used  
            for employment, licensing, or certification purposes.  Allows,  
            notwithstanding any other law, any person or entity required  
            to pay a fee to DOJ for information received under this  
            provision to charge the applicant a fee sufficient to  
            reimburse the person or entity for this expense.  (Pen. Code,  
            § 11105, subd. (e).)

          17)Authorizes, notwithstanding any other law, a human resource  
            agency or an employer to request from DOJ records of all  
            convictions or any arrest pending adjudication involving the  
            offenses specified of a person who applies for a license,  
            employment, or volunteer position, in which he or she would  
            have supervisory or disciplinary power over a minor or any  
            person under his or her care.  Requires DOJ to furnish the  
            information to the requesting employer and also send a copy of  
            the information to the applicant.  (Pen. Code, § 11105.3,  
            subd. (a).)

          18)Punishes as a misdemeanor any person authorized by law to  
            receive a record or information obtained from a record who  
            knowingly furnishes the record or information to a person who  
            is not authorized by law to receive the record or information.  
             (Pen. Code, § 11142.)

          19)Prohibits a provider of health care, health care service  
            plan, or contractor from disclosing medical information  
            regarding a patient of the provider of health care or an  
            enrollee or subscriber of a health care service plan without  
            first obtaining an authorization, except as provided. (Civ.  
            Code, § 56.10, subd. (a).)

          20)Requires a provider of health care, health care service plan,  
            or contractor to disclose medical information regarding a  
            patient of the provider of health care or an enrollee or  
            subscriber of a health care service plan if the disclosure is  
            compelled by any of the following:

             a)   By a court pursuant to an order of that court;

             b)   By a board, commission, or administrative agency for  








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               purposes of adjudication pursuant to its lawful authority;

             c)   By a party to a proceeding before a court or  
               administrative agency pursuant to a subpoena, subpoena  
               duces tecum, notice to appear served pursuant to Section  
               1987 of the Code of Civil Procedure, or any provision  
               authorizing discovery in a proceeding before a court or  
               administrative agency;

             d)   By a board, commission, or administrative agency  
               pursuant to an investigative subpoena issued under Article  
               2 (commencing with Section 11180) of Chapter 2 of Part 1 of  
               Division 3 of Title 2 of the Government Code;

             e)   By an arbitrator or arbitration panel, when arbitration  
               is lawfully requested by either party, pursuant to a  
               subpoena duces tecum issued under Section 1282.6 of the  
               Code of Civil Procedure, or another provision authorizing  
               discovery in a proceeding before an arbitrator or  
               arbitration panel;

             f)   By a search warrant lawfully issued to a governmental  
               law enforcement agency;

             g)   By the patient or the patient's representative;

             h)   By a coroner, when requested in the course of an  
               investigation by the coroner's office for the purpose of  
               identifying the decedent or locating next of kin, or when  
               investigating deaths that may involve public health  
               concerns, organ or tissue donation, child abuse, elder  
               abuse, suicides, poisonings, accidents, sudden infant  
               deaths, suspicious deaths, unknown deaths, or criminal  
               deaths, or upon notification of, or investigation of,  
               imminent deaths that may involve organ or tissue donation  
               pursuant to Section 7151.15 of the Health and Safety Code,  
               or when otherwise authorized by the decedent's  
               representative. Medical information requested by the  
               coroner under this paragraph shall be limited to  
               information regarding the patient who is the decedent and  
               who is the subject of the investigation or who is the  
               prospective donor and shall be disclosed to the coroner  








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               without delay upon request, or

             i)   When otherwise specifically required by law.  (Civ.  
               Code, § 56.10, subd. (b).)

          21)Allows a provider of health care, health care service plan,  
            or contractor to disclose medical information regarding a  
            patient of the provider of health care or an enrollee or  
            subscriber of a health care service plan to authorized  
            individuals or entities for research, billing, treatment and  
            other purposes, as specified.  (Civ. Code, § 56.10, subd.  
            (c).) 

          22)Limits the disclosure of mental health information, as  
            specified.  (Welf. & Inst. Code, § 5328.)

          23)Limits the disclosure of information from child abuse reports  
            and investigations, as specified.  (Pen. Code, § 11167.5.)

          24)Limits the disclosure of information pertaining to reports by  
            health practitioners of persons suffering from physical  
            injuries inflicted by means of a firearm or of persons  
            suffering physical injury where the injury is a result of  
            assaultive or abusive conduct.  (Pen. Code, § 11163.2.)

          25)Limits the disclosure of records of in-home supportive  
            services, as specified.  (Welf. & Inst. Code, § 10850.)

          26)States that a Health Insurance Portability and Accountability  
            Act of 1996  (HIPPA) covered entity may use or disclose health  
            information as follows:

             a)   To the individual for treatment, payment or health care  
               operations;

             b)   Incident to a use or disclosure otherwise permitted if  
               it is the minimum necessary to accomplish the purpose of  
               the use or disclosure; 

             c)   Pursuant to an authorization or agreement by the  
               individual;









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             d)   Under circumstances set out in the rule for which  
               neither authorization nor agreement is required.  (42  
               U.S.C. §§ 201 et seq.; 45 C.F.R. §§ 164 et seq.)  

          27)Holds that HIPPA regulations preempt any contrary provision  
            of state law unless the state law provides greater privacy  
            protection for an individual whose health information is  
            protected.  (42 U.S.C. §§ 201 et seq.; 45 C.F.R. §§ 160 et  
            seq; See In re Estate of Broderick (2005) 125 P.3d 564.)

          FISCAL EFFECT:  Unknown

          
          COMMENTS:  

          1)Author's Statement:  According to the author, "Interagency  
            child death review teams have been used successfully to ensure  
            that incidents of child abuse or neglect are recognized and  
            other siblings and non-offending family members receive the  
            appropriate services in cases involving the death of a child.   
            Actions by child death review teams may include identification  
            of emerging trends and safety concerns in other types of child  
            deaths in order to inform and address needs for prevention  
            efforts.  Disclosures of this information, which in some  
            instances in prohibited by current law, would help improve the  
            child death review team's investigation and detection of child  
            abuse and neglect as well as help identify trends to reduce  
            the incidents of child death." 

          2)Background on Child Death Review Teams: The primary purpose of  
            child death review teams is to prevent future child deaths.   
            At the county level, these teams produce educational materials  
            so that the more common causes of child death can be  
            prevented.  For example, according to the author, in  
            Sacramento "The Sacramento County Child Death Review Team,  
            which reviews the deaths of every child that dies in  
            Sacramento County, has used the report's findings in order to  
            create public awareness campaigns. The recommendations have  
            translated to the Shaken Baby Syndrome Prevention Campaign,  
            the Infant Safe Sleep Campaign, and the Drowning Prevention  
            Campaign to reduce preventable deaths."  However, each  
            county's experience is different.  This is where statewide  








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            child death review can help prevent counties from duplicating  
            efforts. 

          The statewide child death review council is responsible for  
            collecting data and information from the counties and turning  
            it into reports to the public and Legislature.  Part of the  
            statutory scheme that created child death review teams  
            included creation of the Child Death Review Council "to  
            coordinate and integrate state and local efforts to address  
            fatal child abuse or neglect, and to create a body of  
            information to prevent child deaths."  (Penal Code Section  
            11174.34(a)(1).)  The Child Death Review Council is required  
            to "[a]nalyze and interpret state and local data on child  
            death in an annual report to be submitted to local child death  
            review teams with copies to the Governor and the Legislature,  
            no later than July 1 each year.  Copies of the report shall  
            also be distributed to California public officials who deal  
            with child abuse issues and to those agencies responsible for  
            child death investigation in each county.  The report shall  
            contain, but not be limited to, information provided by state  
            agencies and the county child death review teams for the  
            preceding year."  (Penal Code Section 11174.34(d)(1).)   
            Therefore, a report analyzing the data collected by each local  
            child death review team is currently a public document.   
            Requiring each local child death review team to also make  
            public its own data appears to be consistent with the overall  
            objectives of the teams, i.e., creating a body of information  
            on the causes of child deaths to help prevent such tragedies.   
            Increased transparency may also enhance the public's trust in  
            local child death review.

          3)Argument in Support:  According to the Santa Clara Board of  
            Supervisors, "As you are aware, counties are authorized in  
            statute to form a Child Death Review Team (CDRT).  The statute  
            suggests that membership may include, but is not limited to,  
            the coroner, district attorney, child protective services, and  
            law enforcement.  The Santa Clara County CDRT is a  
            multidisciplinary team comprised of representatives from a  
            number of County agencies as well as community organizations.   
            Through a process of interagency collaboration and discussion,  
            it reviews the circumstances surrounding instances of  
            unexpected child death within the County that are reported to  








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            the Medical Examiner/Coroner's Office.  The purpose of the  
            reviews is to discover ways to improve children's lives, and  
            to prevent serious childhood injury and deaths in the future.   
            The CDRT may identify emerging trends and safety problems to  
            help increase public awareness of risks to children in the  
            community.

          "A CDRT review may include discussion of medical information for  
            the purposes of identifying and reviewing instances of child  
            abuse and neglect, which is permitted under the Health  
            Insurance Portability and Accountability Act (HIPPA).  State  
            law, however, provides greater protection to public mental  
            health services and prevents staff from the County's  
            Behavioral Health Department from disclosing information  
            contained in mental health records.  While California's other  
            death review statutes related to elder death review teams and  
            domestic violence review teams allow mental health information  
            to be shared, the corresponding child death review statute is  
            silent on this topic.

          "AB 2083 would revise the authorizing statute for CDRTs to  
            mirror the language in the elder death review team and  
            domestic violence review team statutes to allow CDRTs to  
            discuss mental health information when conducting their review  
            of child abuse and neglect.  The ability to discuss mental  
            health information will allow for a complete review, which  
            would help improve CDRT's investigations and help identify  
            trends to reduce the incidents of child death."

          4)Argument in Opposition:  According to the California Public  
            Defenders Association, "Existing law authorizes a county to  
            establish an interagency child death review team to assist  
            local agencies in identifying and reviewing suspicious child  
            deaths and facilitating communication among persons who  
            perform autopsies and the various persons and agencies  
            involved in child abuse or neglect cases. Existing law  
            requires records that are exempt from disclosure to 3rd  
            parties pursuant to state or federal law to remain exempt from  
                                                     disclosure when they are in the possession of a child death  
            review team.










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          "This bill would authorize the voluntary disclosure of specified  
            information, including mental health records, criminal history  
            information, and child abuse reports, by an individual or  
            agency to an interagency child death review team.

          "We do not see the need for this legislation, and believe its  
            implementation may raise additional challenges and legal  
            issues.

          "First and foremost, if indeed these records are a necessary  
            part of an investigation into the death of child, then a court  
            reviewing such a request would surely grant the release of the  
            documents. 

          "Second, this bill provides no guidance to agencies who maintain  
            privileged and confidential documents regarding when such  
            documents should be released. Documents are confidential for a  
            reason- generally because they contain sensitive personal  
            information that could cause harm if released. Moreover,  
            autopsy reports are a matter of public record. Thus, if  
            privileged information was disclosed to a death review team  
            and referenced in the autopsy report, the privileged  
            information would become public record.

          "Finally, there is currently a move towards trying to reduce  
            contextual bias or the biasing of opinions based on  
            information that is considered domain irrelevant from opinions  
            of forensic scientists including medical examiners. The  
            privileged and otherwise confidential information is in many  
            cases precisely the type of domain irrelevant information that  
            should not be considered in making a determination regarding  
            manner of death."
          5)Related Legislation: AB 1737 (McCarty) would require each  
            county to establish an interagency child death review team.   
            AB 1737 is pending in the Assembly Committee on  
            Appropriations.

          6)Prior Legislation:  

             a)   SB 39 (Migden), Chapter 468, Statutes of 2007, required  
               that juvenile case files that pertain to any child who died  








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               as the result of child abuse or neglect shall be released  
               to the public, subject to certain limitations set forth in  
               the bill. SB 39 adds specified attorneys to the persons  
               allowed access to a juvenile case file.

             b)   AB 1668 (Bowen), Chapter 813, Statutes of 2006, provided  
               that interagency child death review team records that are  
               exempt from disclosure to third parties pursuant to state  
               or federal law remain exempt from disclosure when they are  
               in the possession of a child death review team; provides  
               confidentiality provisions for child death review teams;  
               and provided that each child death review team shall  
               annually make available to the public findings, conclusions  
               and recommendations of the team, including aggregate  
               statistical data on the incidences and causes of child  
               death.

             c)   SB 525 (Polanco), Chapter 1012, Statutes of 1999, added  
               more state and private entities to the members of the  
               California State Child Death Review Council, specified  
               additional duties for the council and the Department of  
               Justice in connection with gathering and tracking  
               information regarding child deaths from abuse or neglect,  
               and specified additional duties for the State Department of  
               Health Services in connection with tracking child abuse  
               information in specified state data systems.

             d)   AB 4585 (Polanco), Chapter 1580, Statutes of 1988,  
               authorized counties to establish interagency child death  
               teams and autopsy protocol.


          REGISTERED SUPPORT / OPPOSITION:

          Support
          
          Santa Clara County Board of Supervisors (Sponsor)
          County Health Executives Association of California

          Opposition
          
          California Public Defenders Association  








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          Analysis Prepared  
          by:              Matt Dean / PUB. S. / (916) 319-3744