BILL NUMBER: AB 1518 CHAPTERED 10/10/99 CHAPTER 919 FILED WITH SECRETARY OF STATE OCTOBER 10, 1999 APPROVED BY GOVERNOR OCTOBER 9, 1999 PASSED THE ASSEMBLY SEPTEMBER 7, 1999 PASSED THE SENATE SEPTEMBER 2, 1999 AMENDED IN SENATE JULY 7, 1999 AMENDED IN ASSEMBLY MAY 13, 1999 AMENDED IN ASSEMBLY APRIL 27, 1999 AMENDED IN ASSEMBLY APRIL 13, 1999 INTRODUCED BY Assembly Member Soto (Coauthors: Assembly Members Aroner, Bock, and Longville) FEBRUARY 26, 1999 An act to add Sections 11325.9, 11325.91, 11325.93, and 11325.95 to the Welfare and Institutions Code, relating to public social services. LEGISLATIVE COUNSEL'S DIGEST AB 1518, Soto. CalWORKs: multidisciplinary services teams. Existing law provides for the California Work Opportunity and Responsibility to Kids (CalWORKs) program, under which each county provides cash assistance and other benefits to qualified low-income families. Each county is required to pay a share of the cost of both aid grant and administrative costs for the CalWORKs program. This bill would require the State Department of Social Services to develop 3-year pilot projects in Alameda County, San Bernardino County, and Ventura County, at the option of each county, to create an integrated and coordinated case management system for the delivery of services to families receiving CalWORKs benefits, through the use of multidisciplinary service teams, as defined. The teams would be permitted to share information for the purpose of ensuring the provision of appropriate health, educational, substance abuse, social, and other services. The bill would require the department to prepare a report, for submission to the Legislature by April 1, 2002, on the impact of this pilot program. THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS: SECTION 1. The Legislature finds and declares all of the following: (a) Some long-term welfare dependent families face multiple barriers to employment, including serious problems with substance abuse, domestic violence, mental illness, and child abuse or neglect. (b) These hard-to-serve families may need intensive interventions and treatment from a variety of service providers from different disciplines over a period of time. (c) Local county welfare departments need to be able to develop coordinated and integrated case management services with multiple providers, such as therapists, school truant officers, public health nurses, probation officers, child welfare workers, and substance abuse counselors. (d) Communication between providers is essential to avoid conflicting case plans, prevent duplications in services, and ensure the family's timely access to needed services. (e) However, most of the programs that provide sensitive services to families have strict confidentiality standards that appropriately protect a family's right to privacy. (f) Operating under these restrictive confidentiality rules often means that service providers work in isolation, exposing vulnerable families to conflicting schedules and demands. SEC. 2. Section 11325.9 is added to the Welfare and Institutions Code, to read: 11325.9. (a) The department shall develop three-year pilot projects in Alameda County, San Bernardino County, and Ventura County, at the option of each county, to create an integrated and coordinated case management system for delivery of services to CalWORKs families who face multiple barriers to employment. This pilot program shall permit the exchange of information and records between members of a multidisciplinary services team for the purpose of coordinating services relevant to the prevention, identification, and treatment of the family's barriers to employment. Information shared between members of the multidisciplinary services team shall be maintained in a manner to ensure maximum protection of the family' s privacy. Information shall not be shared between the team or otherwise disclosed, except as otherwise authorized by law, once an individual and his or her family no longer receive CalWORKs benefits or services. (b) For purposes of this section and Sections 11325.91 to 11325.96, inclusive: (1) "Multidisciplinary service team" or "team" means a team of two or more persons trained and qualified to provide one or more of the services listed in paragraph (2) who are assigned the responsibility, within an integrated welfare system, for identifying the educational, health, and social service needs of a member of an assistance unit, and for developing a plan to address those needs. Team members may include any of the following: (A) Representatives of public employment services agencies under contract with the CalWORKs program. (B) Psychiatrists, psychologists, or other trained counseling personnel involved in mental health treatment. (C) Providers of substance abuse treatment. (D) Medical personnel with sufficient training to provide health services. (E) Any public or private school teacher, administrative officer, supervisor of child welfare and attendance, or certificated public personnel employee. (F) Representatives of a domestic violence shelter. (G) Probation officers. (H) Social workers with experience or training in child abuse or abuse of elder or dependent adults. (I) Representatives from public housing agencies. (J) Other team members may be added if necessary and if approved by the client if the team member agrees to abide by the confidentiality requirements in Section 11325.93. (2) "Integrated welfare system" means programs established by the state or by the pilot project county governments to provide two or more of the following services to households in which recipients of benefits under this chapter reside: (A) Child welfare services. (B) Employment services. (C) Health care services. (D) Mental health services. (E) Substance abuse prevention and treatment. (F) Child abuse prevention, identification, and treatment. (G) Elder or dependent adult abuse prevention, identification, and treatment. (H) Public housing services. (I) Domestic violence counseling services. (J) Juvenile probation services. However, representatives of juvenile probation may provide information to other team members, but may not receive information, records, or copies of records, from other team members. (K) Educational services for children and adults. (L) Nutrition services. (M) Child care and development services. (N) Learning disability evaluation. (3) "Targeted population" means long-term welfare-dependent families with multiple barriers to employment, including, but not limited to, substance abuse, mental illness, child abuse and neglect, and domestic violence. SEC. 3. Section 11325.91 is added to the Welfare and Institutions Code, to read: 11325.91. Notwithstanding any other provision of law, for purposes of Section 10850, a team engaged in any activity permitted pursuant to Section 11325.93 shall be deemed to be engaged in the administration of public social services. SEC. 4. Section 11325.93 is added to the Welfare and Institutions Code, to read: 11325.93. (a) Team members may disclose to one another information about, and view records on, members of an assistance unit to the extent permitted by this section, for CalWORKs clients in the targeted population. In the operation of the pilot projects authorized by Section 11325.9, information disclosed or records viewed by team members shall be limited to relevant information or records necessary to formulate an integrated services plan or to deliver services to children and families. All information or documents, or copies of documents, to be disclosed by team members shall be necessary to the prevention, identification, and treatment of a parent's or guardian's barriers to employment. (b) If team members require records held by other team members, copies may be provided subject to the limitations of subdivision (c). Requests for copies shall be limited to the records necessary to formulate an integrated services plan, or to deliver services to children and their families. (c) (1) Team members who receive information or records pertaining to a member of an assistance unit shall be allowed to establish and maintain a common computer data base for the purpose of planning and delivering services. The data base may contain demographic data and data on the level of individual involvement with an assistance unit member. The data base shall be for the use and disclosure only within the program, except by properly authorized consent of the CalWORKs recipient. A memorandum of understanding shall be established that specifies what types of information may be shared and for what purposes. (2) Juvenile probation services shall be involved in the integrated welfare system for the limited purpose of providing information that directly affects the parent's or guardian's ability to participate in employment training or employment. (3) Part 2.6 (commencing with Section 56) of Division 1 of the Civil Code, shall apply to the programs or services providing integrated services. Programs or services that seek access to an individual's medical information, including mental health and drug treatment records, shall be required to obtain informed authorization from the individual or from the custodial parent or guardian if the individual is a minor, unless a minor is authorized to give consent. Medical information shall not be disclosed to any individual who is not authorized to have that information pursuant to the authorization. Medical information shall not be disclosed for any purpose not authorized by the authorization. A client shall have access to his or her medical information and the right to correct any inaccurate information. (4) The pilot program may authorize use of information contained in the data base for bona fide evaluation and research purposes, unless otherwise prohibited by law. No information disclosed under this paragraph shall permit identification of the CalWORKs recipient or his or her family members. (5) The release of copies of records protected by evidentiary privileges, as defined in Chapter 4 (commencing with Section 930) of Division 8 of the Evidence Code, may take place only after the team has received a form permitting release of records on the assistance unit member, which is signed by the member or the member's custodial parent or guardian if the member is a minor. This paragraph shall not be construed to waive any right of privilege contained in the Evidence Code, except in compliance with Section 912 of that code. (d) The sharing of information permitted under subdivisions (a), (b), and (c) shall be governed by memoranda of understanding among the agencies represented on the team. These memoranda shall specify the types of information that may be shared without a signed release form, in accordance with subdivision (c), and the process to be used to ensure that current confidentiality requirements, as described in subdivision (e), are met. (e) Every team member shall be under the same privacy and confidentiality obligations and subject to the same confidentiality penalties as the person disclosing or providing the information or records. The information or records obtained shall be maintained in a manner that ensures the maximum protection of privacy and confidentiality rights. (f) This section shall not be construed to restrict guarantees of confidentiality provided under federal law. (g) Nothing in this section shall be construed to affect the authority of a health care provider to disclose medical information pursuant to paragraph (1) of subdivision (c) of Section 56.10 of the Civil Code. (h) Information and records communicated or provided to the pilot programs by all providers, programs, and agencies, as well as information and records created by the program in the course of serving CalWORKs recipients and their families, shall be deemed private and confidential, and shall be protected from discovery and disclosure by all applicable statutory and common-law protections. Civil and criminal penalties shall apply to the inappropriate disclosure of information held by the pilot programs. This section shall not affect the authority of a health care provider to disclose medical information pursuant to paragraph (1) of subdivision (c) of Section 56.10 of the Civil Code. SEC. 5. Section 11325.95 is added to the Welfare and Institutions Code, to read: 11325.95. The department shall prepare a report, for submission to the Legislature on or before April 1, 2002, on the outcomes of the pilot program established pursuant to Sections 11325.9 to 11325.93, inclusive, improving coordinated case management, assisting hard-to-serve CalWORKs families in alleviating multiple barriers to employment, and integrating service delivery within the multidisciplinary services team structure. The department shall also include in the report an analysis of the impact that record and information sharing has on CalWORKs recipients and their families, whether this information sharing pilot program results in increased employment rates of hard-to-serve parents, and whether there are any adverse consequences to recipients resulting from information sharing among agencies.