BILL NUMBER: SB 319 AMENDED
BILL TEXT
AMENDED IN SENATE MARCH 26, 2015
INTRODUCED BY Senator Beall
( Principal coauthor: Senator
Mitchell )
( Principal coauthor: Assembly Member
Chiu )
(Coauthor: Senator Monning)
( Coauthor: Assembly Member
Gatto )
FEBRUARY 23, 2015
An act to amend Section 56.103 of the Civil Code, and to
amend Sections 5328.04 and 16501.3 of the Welfare and
Institutions Code, relating to child welfare services.
LEGISLATIVE COUNSEL'S DIGEST
SB 319, as amended, Beall. Child welfare services: public health
nursing.
Existing law requires the State Department of Social Services to
establish a program of public health nursing in the child welfare
services program, and requires counties to use the services of the
foster care public health nurse under this program. Existing law
requires the foster care public health nurse to perform specified
duties, including participating in medical care planning and
coordinating for a child in foster care. Existing law also requires a
county to establish a community child health and disability
prevention program to provide early and periodic assessments of the
health status of children in the county.
This bill would require a county to provide the services of a
foster care public health nurse to children in foster care by
contracting with the community child health and disability prevention
program established in that county. The bill would require a foster
care public health nurse to monitor and oversee
each child in foster care who is administered one or more
psychotropic medications, as specified. The bill would give
the foster care public health nurse access to the child's medical,
dental, and mental health care information in order to fulfill these
duties. By imposing these additional duties on foster care
public health nurses, this bill would impose a state-mandated local
program.
The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
This bill would provide that, if the Commission on State Mandates
determines that the bill contains costs mandated by the state,
reimbursement for those costs shall be made pursuant to these
statutory provisions.
Existing law restricts the disclosure of medical and mental health
information by providers of health care and mental health care
services, but authorizes disclosure of this information to county
social workers, probation officers, or any other person who is
legally authorized to have custody and care of a minor who is in
temporary custody or subject to the jurisdiction of the juvenile
court, for the purpose of coordinating medical treatment and health
care, mental health, and developmental disability services for the
minor.
This bill would authorize the disclosure of this health care and
mental health care information to a foster care public health nurse,
as specified.
The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
This bill would provide that no reimbursement is required by this
act for a specified reason.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: yes.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 56.103 of the Civil
Code is amended to read:
56.103. (a) A provider of health care may disclose medical
information to a county social worker, a probation officer, a
foster care public health nurse acting pursuant to Section 16501.3 of
the Welfare and Institutions Code, or any other person who is
legally authorized to have custody or care of a minor for the purpose
of coordinating health care services and medical treatment provided
to the minor , including, but not limited to, the sharing of
information related to screenings, assessments, and laboratory tests
necessary to monitor the administration of psychotropic medications
.
(b) For purposes of this section, health care services and medical
treatment includes one or more providers of health care providing,
coordinating, or managing health care and related services,
including, but not limited to, a provider of health care coordinating
health care with a third party, consultation between providers of
health care and medical treatment relating to a minor, or a provider
of health care referring a minor for health care services to another
provider of health care.
(c) For purposes of this section, a county social worker, a
probation officer, foster care public health nurse, or any
other person who is legally authorized to have custody or care of a
minor shall be considered a third party who may receive any of the
following:
(1) Medical information described in Sections 56.05 and 56.10.
(2) Protected health information described in Section 160.103 of
Title 45 of the Code of Federal Regulations.
(d) Medical information disclosed to a county social worker,
probation officer, foster care public health nurse, or any
other person who is legally authorized to have custody or care of a
minor shall not be further disclosed by the recipient unless the
disclosure is for the purpose of coordinating health care services
and medical treatment of the minor and the disclosure is authorized
by law. Medical information disclosed pursuant to this section may
not be admitted into evidence in any criminal or delinquency
proceeding against the minor. Nothing in this subdivision shall
prohibit identical evidence from being admissible in a criminal
proceeding if that evidence is derived solely from lawful means other
than this section and is permitted by law.
(e) (1) Notwithstanding Section 56.104, if a provider of health
care determines that the disclosure of medical information concerning
the diagnosis and treatment of a mental health condition of a minor
is reasonably necessary for the purpose of assisting in coordinating
the treatment and care of the minor, that information may be
disclosed to a county social worker, probation officer, foster
care public health nurse, or any other person who is legally
authorized to have custody or care of the minor. The information
shall not be further disclosed by the recipient unless the disclosure
is for the purpose of coordinating mental health services and
treatment of the minor and the disclosure is authorized by law.
(2) As used in this subdivision, "medical information" does not
include psychotherapy notes as defined in Section 164.501 of Title 45
of the Code of Federal Regulations.
(f) The disclosure of information pursuant to this section is not
intended to limit the disclosure of information when that disclosure
is otherwise required by law.
(g) For purposes of this section, "minor" means a minor taken into
temporary custody or as to who a petition has been filed with the
court, or who has been adjudged to be a dependent child or ward of
the juvenile court pursuant to Section 300 or 601 of the Welfare and
Institutions Code.
(h) (1) Except as described in paragraph (1) of subdivision (e),
nothing in this section shall be construed to limit or otherwise
affect existing privacy protections provided for in state or federal
law.
(2) Nothing in this section shall be construed to expand the
authority of a social worker, probation officer, foster care
public health nurse, or custodial caregiver beyond the
authority provided under existing law to a parent or a patient
representative regarding access to medical information.
SEC. 2. Section 5328.04 of the Welfare
and Institutions Code is amended to read:
5328.04. (a) Notwithstanding Section 5328, information and
records made confidential under that section may be disclosed to a
county social worker, a probation officer, a foster care public
health nurse acting pursuant to Section 16501.3
, or any other person who is legally authorized to have
custody or care of a minor, for the purpose of coordinating health
care services and medical treatment, as defined in subdivision (b) of
Section 56.103 of the Civil Code, mental health services, or
services for developmental disabilities, for the minor.
(b) Information disclosed under subdivision (a) shall not be
further disclosed by the recipient unless the disclosure is for the
purpose of coordinating health care services and medical treatment,
or mental health or developmental disability services, for the minor
and only to a person who would otherwise be able to obtain the
information under subdivision (a) or any other provision of law.
(c) Information disclosed pursuant to this section shall not be
admitted into evidence in any criminal or delinquency proceeding
against the minor. Nothing in this subdivision shall prohibit
identical evidence from being admissible in a criminal proceeding if
that evidence is derived solely from lawful means other than this
section and is permitted by law.
(d) Nothing in this section shall be construed to compel a
physician and surgeon, licensed psychologist, social worker with a
master's degree in social work, licensed marriage and family
therapist, licensed professional clinical counselor, nurse, attorney,
or other professional person to reveal information, including notes,
that has been given to him or her in confidence by the minor or
members of the minor's family.
(e) The disclosure of information pursuant to this section is not
intended to limit disclosure of information when that disclosure is
otherwise required by law.
(f) Nothing in this section shall be construed to expand the
authority of a social worker, probation officer, foster care
public health nurse, or custodial caregiver beyond the
authority provided under existing law to a parent or a patient
representative regarding access to confidential information.
(g) As used in this section, "minor" means a minor taken into
temporary custody or for whom a petition has been filed with the
court, or who has been adjudged a dependent child or ward of juvenile
court pursuant to Section 300 or 601.
(h) Information and records that may be disclosed pursuant to this
section do not include psychotherapy notes, as defined in Section
164.501 of Title 45 of the Code of Federal Regulations.
SECTION 1. SEC. 3. Section 16501.3
of the Welfare and Institutions Code is amended to read:
16501.3. (a) The State Department of Social Services shall
establish and maintain a program of public health nursing in the
child welfare services program that meets the federal requirements
for the provision of healthcare health care
to minor and nonminor dependents in foster care consistent with
Section 30026.5 of the Government Code. The purpose of the public
health nursing program shall be to promote and protect
enhance the physical, mental, dental, and
developmental well-being of children in the child welfare system.
(b) Under this program, counties shall provide the services of a
foster care public health nurse to children in foster care by
contracting with the community child health and disability prevention
program established in that county pursuant to Section 124040 of the
Health and Safety Code. The foster care public health nurse and the
child's social worker shall consult and ,
collaborate , and share information in a timely manner
to ensure that the child's physical, mental, dental, and
developmental needs are met. The foster care public health nurse
shall serve as a liaison with health care professionals and other
providers of health-related services. In order to fulfill these
duties, the foster care public health nurse shall have access to the
child's medical, dental, and mental health care information.
(c) The duties of a foster care public health nurse shall include,
but need not be limited to, the following:
(1) Documenting that each child in foster care receives initial
and followup health screenings that meet reasonable standards of
medical practice.
(2) Collecting health information and other relevant data on each
foster child as available, receiving all collected information to
determine appropriate referral and services, and expediting referrals
to providers in the community for early intervention services,
specialty services, dental care, mental health services, and other
health-related services necessary for the child.
(3) Participating in medical care planning and coordinating for
the child. This may include, but is not limited to, assisting case
workers in arranging for comprehensive health and mental health
assessments, interpreting the results of health assessments or
evaluations for the purpose of case planning and coordination,
facilitating the acquisition of any necessary court authorizations
for procedures or medications, advocating for the health care needs
of the child and ensuring the creation of linkage among various
providers of care.
(4) Providing followup contact to assess the child's progress in
meeting treatment goals.
(5) At the request of and under the direction of a nonminor
dependent, as described in subdivision (v) of Section 11400,
assisting the nonminor dependent in accessing physical health and
mental health care, coordinating the delivery of health and mental
health care services, advocating for the health and mental health
care that meets the needs of the nonminor dependent, assisting the
nonminor dependent to make an informed
decision to begin or continue taking psychotropic medications,
decisions about his or her health care by,
at a minimum, providing educational material s, and
assisting the nonminor dependent to assume responsibility for his or
her ongoing physical and mental health care management.
(6) Monitoring and oversight of each child in
foster care who is administered one or more psychotropic medications.
This oversight monitoring shall
include the review , but is not limited to,
all of the following:
(A) The review of each request
for psychotropic medication filed pursuant to Section 369.5 to ensure
that lab tests, all required information is
provided in the application to the court.
(B) Ensuring that laboratory tests,
other screenings and measurements, evaluations, and assessments
required to meet reasonable standards of medical practice have been
completed. The foster care public health nurse shall also
ensure that all of the following occur:
(A) The
(C) Ensuring that the juvenile
court has authorized the psychotropic medication to be administered
to the child.
(B) Periodic
(D) Ensuring that periodic
followup visits with the prescribing physician, lab work, and other
measurements are scheduled and completed.
(C) The
(E) Ensuring that the child's
health and education passport, as described in Section 16010,
includes accurate documentation concerning the psychotropic
medications authorized for and administered to the child.
(D) The medication's efficacy in addressing the illness or
symptoms for which it was prescribed are documented.
(F) Assessing, monitoring, and documenting the response of the
child to the administration of psychotropic medication through review
and interpretation of the laboratory tests, reports by the child and
caregiver, and other screenings.
(E) Any
(G) Ensuring that any adverse
effects of the medication reported by the child or child's
caregiver are promptly addressed, and, if necessary, brought to the
attention of the court , the child's social worker, or both
.
(d) The services provided by foster care public health nurses
under this section shall be limited to those for which reimbursement
may be claimed under Title XIX of the federal Social Security
Act at an enhanced rate for services delivered by skilled
professional medical personnel. Notwithstanding any other law, this
section shall be implemented only if, and to the extent that, the
department determines that federal financial participation, as
provided under Title XIX of the federal Social Security Act (42
U.S.C. Sec. 1396 et seq.), is available.
(e) (1) The State Department of Health Care Services shall seek
any necessary federal approvals for child welfare agencies to
appropriately claim enhanced federal Title XIX funds for services
provided pursuant to this section.
(2) Commencing in the fiscal year immediately following the fiscal
year in which the necessary federal approval pursuant to paragraph
(1) is secured, county child welfare agencies shall provide health
care oversight and coordination services pursuant to this section,
and may accomplish this through agreements with local public health
agencies.
(f) (1) Notwithstanding Section 10101, prior to the 2011-12 fiscal
year, there shall be no required county match of the nonfederal cost
of this program.
(2) Commencing in the 2011-12 fiscal year, and each fiscal year
thereafter, funding and expenditures for programs and activities
under this section shall be in accordance with the requirements
provided in Sections 30025 and 30026.5 of the Government Code.
SEC. 2. If the Commission on State Mandates
determines that this act contains costs mandated by the state,
reimbursement to local agencies and school districts for those costs
shall be made pursuant to Part 7 (commencing with Section 17500) of
Division 4 of Title 2 of the Government Code.
SEC. 4. To the extent that this act has an overall
effect of increasing the costs already borne by a local agency for
programs or levels of service mandated by the 2011 Realignment
Legislation within the meaning of Section 36 of Article XIII of the
California Constitution, it shall apply to local agencies only to the
extent that the state provides annual funding for the cost increase.
Any new program or higher level of service provided by a local
agency pursuant to this act above the level for which funding has
been provided shall not require a subvention of funds by the state
nor otherwise be subject to Section 6 of Article XIII B of
the California Constitution.