BILL ANALYSIS
AB 2229
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Date of Hearing: April 27, 2010
ASSEMBLY COMMITTEE ON HUMAN SERVICES
Jim Beall, Jr., Chair
AB 2229 (Brownley) - As Amended: April 15, 2010
SUBJECT : Mandated child abuse reporting.
SUMMARY : Creates a new category of child abuse
multidisciplinary personnel team, comprised of two or more
persons, and permits communication of confidential information
by team members as specified. Specifically, this bill :
1)Defines a "multidisciplinary personnel team" (MDT) as a team
of two or more people trained and qualified to identify and
treat child abuse, created for the purpose of investigating a
report of suspected child abuse filed by a mandated reporter.
Provides the team may include, but shall not be limited to,
all of the following:
a) Psychiatrists, psychologists, marriage and family
therapists, or other trained counseling personnel;
b) Police officers or other law enforcement agents;
c) Medical personnel with sufficient training to provide
health services;
d) Social service workers with experience or training in
child abuse prevention; and
e) Any public or private school teacher, administrative
officer, supervisor of child welfare attendance or
certified pupil personnel employee.
2)Allows for the members of the MDT, as defined above, to
exchange confidential information and writings during team
meetings provided the information disclosed:
a) Is relevant to the prevention, identification or
treatment of child abuse;
b) Relates to incidents of child abuse;
c) Is kept confidential; and,
d) Is not admissible in any criminal, civil, or juvenile
court proceeding.
3)Deletes the reference to existing child abuse MDTs in allowing
for the exchange of confidential information and writing
between team members as provided above.
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4)Allows for disclosures and exchange of information to occur by
phone or electronically, provided there is adequate
verification of the identity of the MDT members involved.
5)Adds the MDT described above to an existing provision allowing
for the creation of a computerized database within a county
for the sharing of child abuse MDT information.
EXISTING LAW
1)Defines a child abuse multidisciplinary personnel team as any
team of three or more people trained in the prevention,
identification, and treatment of child abuse and neglect cases
and who are qualified to provide a broad range of child
abuse-related services to include, but not be limited to:
a) Psychiatrists, psychologists, marriage and family
therapists, or other trained counseling personnel;
b) Police officers or other law enforcement agents;
c) Medical personnel with sufficient training to provide
health services;
d) Social workers with experience or training in child
abuse prevention; and,
e) Any public or private school teacher, administrative
officer, supervisor of child welfare attendance, or
certified pupil personnel employee. Welfare and
Institutions Code (WIC) Section 18951 (d).
2)Allows, notwithstanding existing information confidentiality
protections, any person trained and qualified to serve on an
MDT formed pursuant to WIC Sec. 18951 (d) to be deemed a part
of the team as necessary, for the purposes of a particular
case, provided the reasons for deeming the person a member of
the team are specified in writing. WIC 18964.
3)Allows for members of an MDT, as defined in Section 18951, to
exchange confidential information and writings during team
meetings, provided the information disclosed:
a) Is relevant to the prevention, identification or
treatment of child abuse;
b) Relates to incidents of child abuse;
c) Is kept confidential; and,
d) Is not admissible in any criminal, civil, or juvenile
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court proceeding. WIC 830.
4)Provides members of an MDT as defined in WIC Section 18951 may
exchange confidential applications and records related to
federal grants-in-aid received by the state for an individual,
if that information is believed to be relevant to the
prevention, identification or treatment of child abuse to
other team members; and provides that all related discussions
or exchange of information are kept confidential, and are not
admissible in court. WIC 10850.1.
5)Allows for confidential and identifying information regarding
a child or family at risk for child abuse or neglect to be
stored in a computerized database, established by a county,
for the purpose of forming an MDT for the prevention,
identification, management, or treatment of child abuse. WIC
18961.5.
FISCAL EFFECT : Unknown
COMMENTS :
Confidentiality: Existing state and federal laws prohibit most
county health and human services programs and educational
entities from sharing confidential patient, recipient, and
student information without the express consent of the
individual, or in the case of minors, the parent or guardian.
These laws seek to safeguard the constitutional right to
privacy, and to ensure that individuals are comfortable sharing
the personal information necessary to the provision of services.
Confidential information may be shared in rare cases among
government agencies although written permission is often
required, and civil and criminal penalties may apply if the
information is unlawfully disclosed.
Specifically, with regard to juvenile court records, Section
827.9 of the Welfare and Institutions Code reaffirms the
Legislature's commitment to the confidentiality of records and
information gathered by law enforcement agencies in the process
of taking a minor into custody or detention. WIC Section 827.9
also acknowledges that confidentiality is necessary to protect
minors from being denied opportunity and further rehabilitative
efforts within the juvenile justice system, and to prevent the
lifelong stigma associated with having a juvenile police record.
Finally, this section points out that certain circumstances
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require the release of juvenile police records to specified
persons and entities, and examples are enumerated in subsequent
Sections of the Welfare and Institutions Code.
The California Child Welfare Council (CWC) formed by AB 2216
(Bass), Chapter 384, Statutes of 2006, is a state advisory body
tasked with "considering recommendations to improve child and
youth outcomes through increased collaboration and coordination
among the programs, services and processes administered by the
multiple agencies and courts that serve children and youth in
California's child welfare system."
Acknowledging the importance of data sharing, the CWC formed a
Data Linkage and Information Sharing Committee, which issued a
set of recommendations, approved by the Council, to: 1) issue a
policy statement supporting data linkages and sharing; 2)
perform an inventory of existing data sharing practices; and 3)
issue policy briefs on laws related to information sharing in
the areas of health, education, and substance abuse. The Data
Linkage and Information Sharing Committee is expected to
finalize related briefs and policy recommendations by 2011.
While the CWC supports the need to better coordinate data and
services across agencies and providers, it also acknowledges the
barriers associated with opening up systems of information:
Sharing these data among agencies and departments is
no easy task. The data systems currently in use in
the courts, child welfare, education, health, juvenile
justice, and other areas were independently developed
without anticipating the technological advances that
now allow for massive amounts of information to be
compiled and exchanged. In addition, each type of
data maintained for foster children - placement,
health, education, mental health, substance abuse, and
court records - is subject to its own complex set of
privacy laws and regulations that make sharing data
difficult even when the technology is in place to link
systems.
Further complicating matters, as the CWC Data Linkage and
Information Sharing Committee noted, are varying legal
interpretations of the laws and regulations related to sharing
child welfare information. Federal law does, however, provide
for exceptions to federal confidentiality protections under the
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Child Abuse Prevention and Treatment Act (42 U.S.C. 5101 et
seq.), which allow federal, state, or local government agencies
to share confidential information in order to fulfill their
legal responsibilities to protect children from abuse and
neglect.
Child abuse multidisciplinary personnel teams:
Multidisciplinary teams have been authorized in California to
allow for a coordinated interagency response to elder and child
abuse cases for over twenty years. MDTs, formed and operated at
the county level are afforded the ability to share confidential
information among team members for the purposes of preventing,
identifying, or treating child abuse. According to the U.S.
Department of Justice (DOJ) Office of Juvenile Justice and
Delinquency Prevention's guide, "Forming a Multidisciplinary
Team to Investigate Child Abuse,"<1> MDTs are an effective tool
for conducting a timely and objective investigation while
causing as little added trauma to children and families. And
MDTs operate, not just to investigate possible child abuse and
neglect, but to facilitate coordination among the different
agencies and entities participating on the team so that
decisions can be made through team decision-making. According
to the DOJ, elements of a successful MDT include confidentiality
policies in line with legislative mandates, agency policies and
professional practices, and the best interests of the child;
conflict resolution practices; and periodic self-analysis and
outside evaluation to ensure the team continues to achieve its
intended purpose.
According to the author, the Legislature first authorized the
use of MDTs for both child abuse and elder abuse with the
passage of AB 1049 (Bader), Chapter 353, Statutes of 1987.
Currently, all 58 California counties operate child abuse MDTs,
and counties often operate multiple MDTs at once.
Need for this bill: This bill, sponsored by the Los Angeles
County District Attorney, seeks to remedy the problem faced by
members of an MDT investigating a potential case of child abuse
who are time-limited in making detention determinations, and
face barriers accessing necessary information from other members
of the MDT because current law requires discussions among three
---------------------------
<1> Ells, Mark. "Forming a Multidisciplinary Team to
Investigate Child Abuse." Washington, D.C. U.S. Department of
Justice, Office of Justice Programs Office of Juvenile Justice
and Delinquency Prevention. Second printing March 2000.
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or more MDT members, and is unclear regarding telephonic and
electronic communications. According to the author,
Existing law provides for the formation of a child
abuse MDT comprised of three individuals who are
trained in the prevention, treatment and
identification of child abuse. The benefit and
purpose of forming a child abuse MDT is that
information that would otherwise be confidential may
be shared within the confines of the team.
Unfortunately nurses, social workers, and law
enforcement personnel complain that valuable time is
lost in responding to an emergency child abuse problem
while a third party is sought to complete the team and
allow for the information to be shared. Additionally,
the existing statute is silent as to telephonic and
electronic communication as an acceptable mode for the
sharing of information upon the proper verification of
the recipient's status as a team member?
Because there is a significant amount of confusion
among members of child abuse MDTs regarding their
legal ability to communicate by the prospect of civil
liability, our office and ICAN believes it is
necessary to clarify the law to specifically permit
telephonic and electronic communication among team
members upon the proper verification of the
recipient's status as a team member?
The work of child abuse MDTs is very time sensitive
because county Children's Protective Service agencies
only have 48 hours from the time an incident of
potential child abuse is reported to make a
determination on whether or not to file a petition
under California Welfare and Institutions Code Section
300. Because of this short time line it is critical
that information needed by a Children's Protective
Service agent that may be in the possession of an
agency represented on the child abuse MDT be shared.
By bringing the law regarding child abuse MDTs into
line with existing law regarding elder abuse MDTs,
which only require two members, AB 2229 will enhance
the treatment and prevention of child abuse by
streamlining the ability of qualified personnel to aid
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victims by promptly sharing relevant information, and
save time and resources by eliminating the need for a
redundant third person consulted merely to satisfy the
statute.
Comments/Suggested Amendments: This bill seeks to reduce the
number of individuals required to form a child abuse MDT from
three or more persons, to two or more persons, and to explicitly
allow for electronic and telephonic communications. Although
there is some precedent with the integrated children's service
program MDTs for a two or more person MDT for children, the
integrated children's service program sets forth much more
stringent confidentiality protections for the children and
families involved than what is proposed in this bill. Families
knowingly participate in the program, and give written consent
for confidential information to be shared. They may opt out of
the information sharing as well, and still receive services.
Finally, information sharing among service providers and
agencies is governed by memoranda of understanding.
This bill would amend WIC Section 830 to create a new MDT
category closely mirroring the existing MDT statute set forth in
WIC Section 18951. However, Section 830 of the Welfare and
Institutions Code falls under Article 22, which sets forth laws
governing the storage, destruction, and confidentiality of
juvenile court records, and applies to existing child abuse
MDTs. The problem with deleting the reference to existing child
abuse MDTs, as proposed in this bill, is the confidentiality
waivers provided by WIC Section 830 would no longer be afforded
to the existing category of MDTs, and only to the newly created
category. Furthermore, the new category of MDT does not provide
the same privacy protections related to other child abuse MDTs.
Staff recommends the author consider amending this bill to
create a new "child abuse investigation and prevention" MDT
limited to the period of time following a report of possible
child abuse or neglect during which the suspected child abuse or
neglect is being investigated, and the child welfare services
determination is being assessed, and to sunset those provisions.
Adding a sunset to this bill will allow for the review of
existing practices and policy recommendations that will be put
forward by the CWC Data Linkage and Information Sharing
Committee.
To facilitate expedited communication and coordination among
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child abuse investigation and prevention MDT members, telephonic
and electronic communications would be permitted, but
participating agencies would be required to have agreements in
place to ensure the confidentiality of the information shared
pursuant to this section.
By limiting the time afforded for electronic or telephonic
communication among the child abuse investigation and prevention
MDT members to the 48 hours following a report of suspected
child abuse or neglect, the author's goals of facilitating a
timely assessment, and response to the allegation will be
achieved. Existing child abuse MDTs may continue to serve the
family following the initial assessment period, pursuant to
existing law.
Related and prior legislation:
AB 2322 (Feuer) this session is sponsored by Los Angeles County,
and seeks to make several modifications to existing MDT
statutes, including specifying the inclusion of CalWORKs social
workers in MDTs and allowing for information regarding
convictions related to crimes against children, and information
regarding nonrelative members of a household to be shared and
tracked in a computerized database for the purposes of the MDT.
Pending hearing in Assembly Human Services Committee.
AB 2028 (Hernandez) from this session provides exceptions to the
Confidentiality of Medical Information Act and authorizes a
health care provider or health care service plan to disclose
information related to an incident of child abuse or neglect to
an investigator or licensing agency, including information
related to the patient's participation in outpatient
psychotherapy without a prior written request, provided the
information is relevant to the incident of child abuse or
neglect. Awaiting hearing in Assembly Appropriations Committee
AB 1049 (Bader) Chapter 353, Statutes of 1987 added Sections 830
and 10850.1 to the WIC pertaining to information sharing among
child abuse MDTs.
SECOND COMMITTEE OF REFERENCE . This bill was previously heard
in the Assembly Public Safety Committee on April 13, 2010, and
was approved on a 7-0 vote.
REGISTERED SUPPORT / OPPOSITION :
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Support
None on file.
Opposition
California Medical Association (CMA) (prior version)
Analysis Prepared by : Michelle Doty Cabrera / HUM. S. / (916)
319-2089