BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 1113
                                                                  Page  1

          Date of Hearing:   April 14, 2009

                   ASSEMBLY COMMITTEE ON BUSINESS AND PROFESSIONS
                                 Mary Hayashi, Chair
               AB 1113 (Lowenthal) - As Introduced:  February 27, 2009
           
          SUBJECT  :   Prisoners: professional mental health providers:  
          marriage and family therapists.

           SUMMARY  :   Allows a person to gain qualifying experience for  
          licensure as a marriage and family therapist (MFT) in a state  
          correctional facility.

           EXISTING LAW  requires any person employed or under contract to  
          provide mental health diagnostic or treatment or other mental  
          health services in the state correctional system to be a  
          physician and surgeon, psychologist, or other health  
          professional, licensed to practice in this state, except as  
          specified.  This licensure requirement may be waived in order  
          for a person to gain qualifying experience for licensure as a  
          psychologist or clinical social worker in this state.

           FISCAL EFFECT  :   Unknown

           COMMENTS  :   

           Purpose of the bill  .  According to the author's office, "The  
          California Department of Corrections and Rehabilitation (CDCR)  
          is currently suffering from a severe shortage of mental health  
          clinician applicants to fill its vacancies in mental health  
          programs throughout the state.  If these positions cannot be  
          filled, the mental health needs of the persons incarcerated will  
          not be met, which will deter rehabilitation and likely lead to  
          repeated offenses when their periods of incarceration have been  
          completed.  Marriage and family therapists currently provide  
          mental health services in state facilities, and this is  
          explicitly authorized in Health and Safety Code Section 1277.   
          Unfortunately, while Penal Code Section 5068.5 allows  
          psychologist and clinical social worker interns to gain  
          qualifying experience in the correctional system, the law  
          currently does not allow MFT interns to gain such qualifying  
          experience.  AB 2652 would amend Section 5068.5 to provide  
          specifically for a waiver of the licensure requirement for MFT  
          interns in correctional facilities.









                                                                  AB 1113
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          "CDCR recognizes the nearly identical training and  
          qualifications of MFTs and Clinical Social Workers and would  
          like to be able to use MFTs to help address the current shortage  
          of mental health professionals serving in the correctional  
          system.  It is important to note that it would not compel CDCR  
          to use any particular discipline.  The bill merely provides for  
          greater choice among a greater array of possible mental health  
          professionals."

           Background  .  CDCR has employed social workers for decades within  
          various program areas.  In the development of the Mental Health  
          Services Delivery System in the mid 1990s, the number of social  
          workers (among other mental health clinicians) employed within  
          CDCR was increased due to the recognition of the significant  
          percentage of seriously mentally ill inmates within the prison  
          system. 

          With the burgeoning inmate population increasing the number of  
          mentally ill inmates in the system, the mental health program  
          has proportionately increased its clinical position numbers as  
          well.  Concurrently, CDCR is under court order to improve  
          services to its mentally ill inmates. Part of the order requires  
          CDCR to decrease its clinicians' vacancy rate.  Due to several  
          factors, including insufficient pay, poor working conditions and  
          lack of appropriate candidates, the vacancy rate for these  
          clinical slots is high.

          Currently, the CDCR does not have any employment classifications  
          that include MFTs.  The CDCR has proposed the establishment of a  
          new class, Mental Health Therapist, Correctional Facility for  
          which an MFT licensee would qualify.  This proposal is currently  
          pending before the California State Personnel Board. 

           Support  .  The California Association of Marriage and Family  
          Therapists (CAMFT) states in support, "Marriage and family  
          therapist registered interns (MFT Interns) have education and  
          experience requirements substantially equivalent to clinical  
          social work associates and are equally capable of providing the  
          mental health services necessary within correctional settings.

          "Permitting MFT interns to be employed within the CDCR would  
          help reduce the mental health professional shortage currently at  
          issue." 

           Opposition  .  The California Psychological Association (CPA)  








                                                                  AB 1113
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          states in opposition, "With nearly 20% of the prison population  
          in the mental health program designed for individuals with  
          severe mental illness, the CDCR needs trained clinicians who  
          possess the training and skill sets to assist these individuals.  
           CPA does not believe that the skills, training, and education  
          of an MFT make for a good fit within the prison system.

          "The scope of practice for an MFT is to assist individuals to  
          have healthier interpersonal relationships within their  
          families.  This bill, in effect, is requesting a significant  
          scope of expansion for MFTs to work with individuals with severe  
          mental illness without any increase in training and educational  
          standards to accommodate the expansion.

          "CPA is also concerned that the training of these individuals  
          will not be effective as there will not be a position for an MFT  
          in CDCR once they are licensed.  There is currently no  
          state-approved position for an MFT in state service.  Training  
          an individual in a position in a Department for a job that will  
          not exist is a poor use of state resources."

          Local 2620 of the American Federation of State, County, and  
          Municipal Employees (Local 2620 AFSCME) writes in opposition,  
          "We do not believe it is in the best interest of the public or  
          for the prisoners to receive mental health treatment from MFTs  
          who do not have the appropriate educational background or  
          training to work with this highly volatile population.   
          Additionally, if AB 1113 were enacted, another task of  
          supervising workers would be placed on an already overburdened  
          staff that have extremely high caseloads."

           Previous legislation  .  AB 2652 (Anderson) of 2008 was an  
          identical bill that died in Assembly Appropriations.

           REGISTERED SUPPORT / OPPOSITION  :   

           Support 
          
          California Association of Marriage and Family Therapists  
          (sponsor)
          American Association for Marriage and Family Therapy -  
          California Division
          California Council of Community Mental Health Agencies
          Mental Health Association in California









                                                                  AB 1113
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           Opposition 
           
          California Psychological Association 
          Local 2620 of the American Federation of State, County, and  
          Municipal Employees
           
          Analysis Prepared by  :    Whitney Clark / B. & P. / (916)  
          319-3301