BILL NUMBER: SB 319 ENROLLED
BILL TEXT
PASSED THE SENATE SEPTEMBER 10, 2015
PASSED THE ASSEMBLY SEPTEMBER 8, 2015
AMENDED IN ASSEMBLY SEPTEMBER 3, 2015
AMENDED IN ASSEMBLY AUGUST 28, 2015
AMENDED IN ASSEMBLY JULY 7, 2015
AMENDED IN SENATE JUNE 2, 2015
AMENDED IN SENATE MARCH 26, 2015
INTRODUCED BY Senator Beall
(Principal coauthor: Senator Mitchell)
(Principal coauthor: Assembly Member Chiu)
(Coauthor: Senator Monning)
(Coauthors: Assembly Members Gatto, Gipson, and Lopez)
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, 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.
This bill would authorize a foster care public health nurse, as
part of his or her requirement to participate in medical care
planning and coordinating for a child, to monitor and oversee the
child's use of psychotropic medications. The bill would also require
a foster care public health nurse to assist a nonminor dependent to
make informed decisions about his or her health care. By imposing
this additional duty on foster care public health nurses, this bill
would impose a state-mandated local program.
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.
This bill would incorporate changes to Section 16501.3 of the
Welfare and Institutions Code proposed by both this bill and SB 238,
which would become operative only if both bills are enacted and
become effective on or before January 1, 2016, and this bill is
chaptered last.
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.
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 whom 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 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.
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 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 enhance the physical, mental, dental, and developmental
well-being of children in the child welfare system.
(b) Under this program, counties shall use the services of a
foster care public health nurse. The foster care public health nurse
shall work with the appropriate child welfare services workers to
coordinate health care services and serve as a liaison with health
care professionals and other providers of health-related services.
This shall include coordination with county mental health plans and
local health jurisdictions, as appropriate. 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, in a
manner that is consistent with all relevant privacy requirements.
(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, monitoring and oversight of
psychotropic 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 informed decisions about his or her health
care by, at a minimum, providing educational materials, and
assisting the nonminor dependent to assume responsibility for his or
her ongoing physical and mental health care management.
(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. 3.5. 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 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 enhance the physical, mental, dental, and developmental
well-being of children in the child welfare system.
(b) Under this program, counties shall use the services of a
foster care public health nurse. The foster care public health nurse
shall work with the appropriate child welfare services workers to
coordinate health care services and serve as a liaison with health
care professionals and other providers of health-related services.
This shall include coordination with county mental health plans and
local health jurisdictions, as appropriate. 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, in a
manner that is consistent with all relevant privacy requirements.
(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, monitoring and oversight of
psychotropic 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 informed decisions about his or her health
care by, at a minimum, providing educational materials, and
assisting the nonminor dependent to assume responsibility for his or
her ongoing physical and mental health care management.
(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.
(g) Public health nurses shall receive training developed pursuant
to subdivision (d) of Section 16501.4.
SEC. 4. Section 3.5 of this bill incorporates amendments to
Section 16501.3 of the Welfare and Institutions Code proposed by both
this bill and Senate Bill 238. It shall only become operative if (1)
both bills are enacted and become effective on or before January 1,
2016, (2) each bill amends Section 16501.3 of the Welfare and
Institutions Code, and (3) this bill is enacted after Senate Bill
238, in which case Section 3 of this bill shall not become operative.
SEC. 5. 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.