BILL ANALYSIS                                                                                                                                                                                                    







                      SENATE COMMITTEE ON PUBLIC SAFETY
                             Senator Mark Leno, Chair                A
                             2009-2010 Regular Session               B

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          AB 2229 (Brownley)                                         9
          As Amended April 29, 2010 
          Hearing date:  June 29, 2010
          Welfare and Institutions Code
          AA:mc

                               CHILD ABUSE AND NEGLECT:

                               MULTIDISCIPLINARY TEAMS

                                           

                                       HISTORY

          Source:   Los Angeles County District Attorney (on behalf of the  
          Inter-Agency                                                 
          Council on Child Abuse and Neglect)

          Prior Legislation:SB 1681 (Mello) - Ch. 594, Stats. 1994
                           SB 219 (Petris) - Ch. 1441, Stats. 1989
                         AB 1049 (Bader) - Ch. 353, Stats. 1987

          Support: Los Angeles County Sheriff's Department

          Opposition:American Civil Liberties Union (unless amended)

          Assembly Floor Vote:  Ayes  76 - Noes  0

          (NOTE:  Amendments to this bill are described in Comment #1  
          below.)
          

                                         KEY ISSUE




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          SHOULD A SECOND STATUTE AUTHORIZING COUNTIES TO ESTABLISH CHILD  
          ABUSE INVESTIGATION AND PREVENTION MULTIDISCIPLINARY PERSONNEL  
          TEAMS BE ESTABLISHED, ALLOWING TEAMS OF 2 OR MORE MEMBERS, AS  
          SPECIFIED?


                                       PURPOSE

          The purpose of this bill is to enact a new section authorizing  
          counties to establish child abuse investigation and prevention  
          multidisciplinary personnel teams with 2 or more members, as  
          specified. 

          Mandated Child Abuse and Neglect Reporting; Child Abuse Central  
          Index 
          
          Current law  establishes the Child Abuse and Neglect Reporting  
          Act ("CANRA"), which generally is intended to protect children  
          from abuse and neglect.  (Penal Code  11164.)

           Under current law  the term "child abuse or neglect" for the  
          purposes of CANRA "includes physical injury or death inflicted  
          by other than accidental means upon a child by another person,  
          sexual abuse . . . , neglect . . . , the willful harming or  
          injuring of a child or the endangering of the person or health  
          of a child, . . . and unlawful corporal punishment or injury . .  
          . .   'Child
          abuse or neglect' does not include a mutual affray between  
          minors.  'Child abuse or neglect' does not include an injury  
          caused by reasonable and necessary force used by a peace officer  
          acting within the course and scope of his or her employment as a  
          peace officer."  (Penal Code  11165.6.)

           Current law  provides that, "(a)ny mandated reporter who has  
          knowledge of or who reasonably suspects that a child is  
          suffering serious emotional damage or is at a substantial risk  
          of suffering serious emotional damage, evidenced by states of  
          being or behavior, including, but not limited to, severe  
          anxiety, depression, withdrawal, or untoward aggressive behavior  




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          toward self or others, may make a report to an agency," as  
          specified.  (Penal Code  11166.05.)

           Current law  generally provides for the content of reports made  
          pursuant to these provisions, and expressly provides that  
          "(i)nformation relevant to the incident of child abuse or  
          neglect
          may be given to an investigator from an agency that is  
          investigating the known or suspected case of child abuse or  
          neglect."  (Penal Code  11167(b).)
           
          Current law  requires that "reports of suspected child abuse or  
          neglect shall be made by mandated reporters . . . to any police  
          department or sheriff's department, not including a school  
          district police or security department, county probation  
          department, if designated by the county
          to receive mandated reports, or the county welfare department,"  
          as specified.  (Penal Code  11165.9.)

           Current law  generally requires agencies receiving child abuse or  
          neglect reports to forward to
          the Department of Justice a report in writing of every case it  
          investigates of known or suspected child abuse or severe neglect  
          which is determined not to be unfounded, as specified.  (Penal  
          Code  11169.)

           Current law  requires the Department of Justice to maintain the  
          "Child Abuse Central Index," which is an index of all reports of  
          child abuse and severe neglect submitted pursuant to these  
          provisions as "a repository of reports," as specified.  (Penal  
          Code  11170.)

          Multidisciplinary Personnel Teams
           
          Current law  includes legislative intent that "child abuse and  
          neglect prevention and intervention programs be encouraged by  
          the funding of agencies addressing needs of children at high  
          risk of abuse or neglect and their families."  (WIC  18960(a).)  
            Current law  includes "multidisciplinary team services" under  
          programs eligible for funding provided under these provisions.   




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          (WIC  18961(a)(4).)
           
          Current law  provides that "'Multidisciplinary personnel' means  
          any team of three or more
          persons who are trained in the prevention, identification, and  
          treatment of child abuse and neglect<1> cases and who are  
          qualified to provide a broad range of services related to child  
          abuse. The team may include but not be limited to:

             (1)   Psychiatrists, psychologists, marriage and family  
               therapists, or other trained counseling personnel.
             (2)   Police officers or other law enforcement agents.
             (3)   Medical personnel with sufficient training to provide  
               health services.
             (4)   Social workers with experience or training in child  
               abuse prevention.
             (5)   Any public or private school teacher, administrative  
               officer, supervisor of child welfare and attendance, or  
               certificated pupil personnel employee."  (WIC  18951(d).)
           
          Current law  provides that "members of a multidisciplinary  
          personnel team engaged in the prevention, identification, and  
          ---------------------------
          <1>  "Child abuse" in this context is defined as follows:   
          "Child abuse" "means a situation in which a child suffers from  
          any one or more of the following:  (1) Serious physical injury  
          inflicted upon the child by other than accidental means.  (2)  
          Harm by reason of intentional neglect or malnutrition or sexual  
          abuse.  (3) Going without necessary and basic physical care.   
          (4) Willful mental injury, negligent treatment, or maltreatment  
          of a child under the age of 18 years by a person who is  
          responsible for the child's welfare under circumstances that  
          indicate that the child's health or welfare is harmed or  
          threatened thereby, as determined in accordance with regulations  
          prescribed by the Director of Social Services.  (5) Any  
          condition that results in the violation of the rights or  
          physical, mental, or moral welfare of a child or jeopardizes the  
          child's present or future health, opportunity for normal  
          development or capacity for independence."  (WIC  830,  
          cross-referencing WIC  18951.)




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          treatment of child abuse may disclose and exchange information  
          and writings to and with one another relating to any incidents  
          of child abuse that may also be a part of a juvenile court  
          record or otherwise designated as confidential under state law  
          if the member of the team having that information or writing  
          reasonably believes it is generally relevant to the prevention,  
          identification, or treatment of child abuse.  All discussions  
          relative to the disclosure or exchange of any such information  
          or writings during team meetings are confidential and,  
          notwithstanding any other provision of law, testimony concerning  
          any such discussion is not admissible in any criminal, civil, or  
          juvenile court proceeding."  (WIC  830.)  As used in this  
          section, "multidisciplinary personnel team" means any team of  
          three or more persons, as specified in Section 18951, the  
          members of which are trained in the prevention, identification,  
          and treatment of child abuse and are qualified to provide a  
          broad range of services related to child abuse.  (Id.)

           Current law  generally provides for the limited inspection of  
          juvenile court case files, as specified.  (WIC  827.)

           Current law  provides that, with respect to applications and  
          records concerning any form of public social services for which  
          grants-in-aid, "the activities of a multidisciplinary personnel  
          team engaged in the prevention, identification, and treatment of  
          child abuse or the abuse of elder or dependent persons are  
          activities performed in the administration of public social  
          services, and a member of the team may disclose and exchange any  
          information or writing that also is kept or maintained in  
          connection with any program of public social services or  
          otherwise designated as
          confidential under state law which he or she reasonably believes  
          is relevant to the prevention, identification, or treatment of  
          child abuse or the abuse of elder or dependent persons to other  
          members of the team.  All discussions relative to the disclosure  
          or exchange of any such information or writing during team  
          meetings are confidential and, notwithstanding any other  
          provision of law, testimony concerning any such discussion is  
          not admissible in any criminal,
          civil, or juvenile court proceeding."  (WIC  10850.1.)  "As  




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          used in this section, 'multidisciplinary personnel team' means  
          any team of three or more persons, as specified . . . , the  
          members of which are trained in the prevention, identification,  
          and treatment of child abuse or the abuse of elder or dependent  
          persons and are qualified to provide a broad range of services  
          related to child abuse or the abuse of elder or dependent  
          persons."  (Id.) 


           This bill  would enact a new, separate section of law authorizing  
          counties to "establish a child abuse investigation and  
          prevention multidisciplinary personnel team within that county  
          to allow provider agencies to share confidential information in  
          order to investigate reports of suspected child abuse or neglect  
          made pursuant to Section 11166 or 11166.05 of the Penal Code, or  
          for the purposes of making a child welfare services referral or  
          detention determination," with the following features and  
          requirements:



          Definitions



           This bill  would provide the following definitions for purposes  
          of this new section:

           

          (1) "Child abuse investigation and prevention multidisciplinary  
          personnel team" means any team of two or more persons who are  
          trained in the prevention, identification, or treatment of child  
          abuse and neglect cases and who are qualified to provide a broad  
          range of services related to child abuse.  The team may include,  
          but shall not be limited to:

               (A) Psychiatrists, psychologists, marriage and family  
          therapists, or other trained counseling personnel.





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               (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.

               (E) Any public or private school teacher, administrative  
          officer, supervisor of child welfare attendance, or certified  
          pupil personnel employee.



          (2) "Provider agency" means any governmental or other agency  
          that has as one of its purposes the prevention, identification,  
          management, or treatment of child abuse or neglect.  The  
          provider agencies serving children and their families that may  
          share information under this section shall include, but not be  
          limited to, the following entities or service agencies:

               (A) Social services.

               (B) Children's services.

               (C) Health services.

               (D) Mental health services.

               (E) Probation.

               (F) Law enforcement.

               (G) Schools."



          Information Disclosure






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           This bill  would provide that "during the 48-hour period  
          following a report of suspected child abuse or neglect,<2>  
          members of a child abuse investigation and prevention  
          multidisciplinary personnel team engaged in the prevention,  
          identification, and treatment of child abuse may disclose to and  
          exchange with one another information and writings that relate  
          to any incident of child abuse that may also be designated as  
          confidential under state law if the member of the team having  
          that information or writing reasonably believes it is generally  
          relevant to the prevention, identification, or treatment of  
          child abuse.  Any discussion relative to the disclosure or  
          exchange of the information or writings during a team meeting is  
          confidential and, notwithstanding any other provision of law,  
          testimony concerning that discussion is not admissible in any  
          criminal, civil, or juvenile court proceeding."



           This bill  would provide that this disclosure and exchange of  
          information "may occur telephonically and electronically if  
          there is adequate verification of the identity of the child  
          abuse investigation and prevention multidisciplinary personnel  
          who are involved in that disclosure or exchange of information."



           This bill  would provide that this disclosure and exchange of  
          information "shall not be made to anyone other than members of  
          the child abuse investigation and prevention multidisciplinary  
          personnel team," except those acting as team members, as  
          specified.



           This bill  would authorize persons qualified by the child abuse  
          investigation and prevention multidisciplinary personnel team to  
          ---------------------------
          <2>  See Comment 2, below.  This 48-hour requirement will be  
          deleted from the bill in author's amendments pursuant to  
          agreement agreed upon in the Senate Human Services. 



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          designate persons qualified as described above to be a member of  
          the team for a particular case.  A person so designated as a  
          team member would be authorized to receive and disclose relevant  
          information and records, subject to confidentiality provisions,  
          as specified.



           This bill  would require that the "sharing of information  
          permitted by this bill "shall be governed by memoranda of  
          understanding among the participating service providers or  
          provider agencies. These memoranda shall specify the types of  
          information that may be shared, and the process to be used to  
          ensure that current confidentiality requirements," as specified.



           This bill  would require that every "member of the child abuse  
          investigation and prevention multidisciplinary personnel team  
          who receives information or records regarding children and  
          families in his or her capacity as a member of the team 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."



           This bill  would specify that its provisions "shall not be  
          construed to restrict guarantees of confidentiality provided  
          under federal law."



           This bill  would provide that information "and records  
          communicated or provided to the team members by all providers  
          and agencies, as well as information and records created in the  
          course of a child abuse or neglect investigation, shall be  




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          deemed private and confidential and shall be protected from  
          discovery and disclosure by all applicable statutory and common  
          law protections. Existing civil and criminal penalties shall  
          apply to the inappropriate disclosure of information held by the  
          team members."



          Sunset



           This bill  would provide that this new section would sunset on  
          January 1, 2014.
           
           Information Sharing
           
          Current law  authorizes any county to establish a computerized  
          data base system within that county to allow any governmental or  
          other agency which has as one of its purposes the prevention,  
          identification, management, or treatment of child abuse or  
          neglect to share identifying information regarding families at  
          risk for child abuse or neglect, for the purpose of forming  
          multidisciplinary personnel teams for the prevention,  
          identification, management, or treatment of child abuse, as  
          specified.  (WIC  18961.5.)

           This bill  would revise this section to include a cross-reference  
          to the new code section proposed by this bill.
                                          


              RECEIVERSHIP/OVERCROWDING CRISIS AGGRAVATION IMPLICATIONS
          
          The severe prison overcrowding problem California has  
          experienced for the last several years has not been solved.  In  
          December of 2006 plaintiffs in two federal lawsuits against the  
          Department of Corrections and Rehabilitation sought a  
          court-ordered limit on the prison population pursuant to the  
          federal Prison Litigation Reform Act.  On January 12, 2010, a  




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          federal three-judge panel issued an order requiring the state to  
          reduce its inmate population to 137.5 percent of design capacity  
          -- a reduction of roughly 40,000 inmates -- within two years.   
          In a prior, related 184-page Opinion and Order dated August 4,  
          2009, that court stated in part:

               "California's correctional system is in a tailspin,"  
               the state's independent oversight agency has reported.  
               . . .  (Jan. 2007 Little Hoover Commission Report,  
               "Solving California's Corrections Crisis: Time Is  
               Running Out").  Tough-on-crime politics have increased  
               the population of California's prisons dramatically  
               while making necessary reforms impossible. . . .  As a  
               result, the state's prisons have become places "of  
               extreme peril to the safety of persons" they house, .  
               . .  (Governor Schwarzenegger's Oct. 4, 2006 Prison  
               Overcrowding State of Emergency Declaration), while  
               contributing little to the safety of California's  
               residents, . . . .   California "spends more on  
               corrections than most countries in the world," but the  
               state "reaps fewer public safety benefits." . . .  .   
               Although California's existing prison system serves  
               neither the public nor the inmates well, the state has  
               for years been unable or unwilling to implement the  
               reforms necessary to reverse its continuing  
               deterioration.  (Some citations omitted.)

               . . .

               The massive 750% increase in the California prison  
               population since the mid-1970s is the result of  
               political decisions made over three decades, including  
               the shift to inflexible determinate sentencing and the  
               passage of harsh mandatory minimum and three-strikes  
               laws, as well as the state's counterproductive parole  
               system.  Unfortunately, as California's prison  
               population has grown, California's political  
               decision-makers have failed to provide the resources  
               and facilities required to meet the additional need  
               for space and for other necessities of prison  




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               existence.  Likewise, although state-appointed experts  
               have repeatedly provided numerous methods by which the  
               state could safely reduce its prison population, their  
               recommendations have been ignored, underfunded, or  
               postponed indefinitely.  The convergence of  
               tough-on-crime policies and an unwillingness to expend  
               the necessary funds to support the population growth  
               has brought California's prisons to the breaking  
               point.  The state of emergency declared by Governor  
               Schwarzenegger almost three years ago continues to  
               this day, California's prisons remain severely  
               overcrowded, and inmates in the California prison  
               system continue to languish without constitutionally  
               adequate medical and mental health care.<3>

          The court stayed implementation of its January 12, 2010, ruling  
          pending the state's appeal of the decision to the U.S. Supreme  
          Court.  On Monday, June 14, 2010, the U.S. Supreme Court agreed  
          to hear the state's appeal in this case.   

           This bill  would not aggravate the prison overcrowding crisis  
          described above.


                                      COMMENTS

          1.  Amendments

           To comply with a commitment to the Senate Committee on Human  
          Services, this bill will be amended in this Committee to delete  
          the 48-hour requirement, described above.

          2.  Stated Need for This Bill
          ---------------------------
          <3>  Three Judge Court Opinion and Order, Coleman v.  
                                          Schwarzenegger, Plata v. Schwarzenegger, in the United States  
          District Courts for the Eastern District of California and the  
          Northern District of California United States District Court  
          composed of three judges pursuant to Section 2284, Title 28  
          United States Code (August 4, 2009).




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           The author states:

            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.

            In 1987, the Legislature enacted AB 1049 (Bader) which first  
            authorized the use of MDTs in both child abuse and elder abuse  
            cases to exchange confidential information.  At that time,  
            MDTs were a relatively new concept, which primarily existed as  
            pilot projects in certain counties.  In 1994, however there  
            was a comprehensive overhaul of the elder abuse statutes  
            proposed by SB 1681 (Mello).  SB 1681 reduced from three to  
            two the number of members necessary to form an elder abuse  
            MDT.  By 1994, the change from three to two members was no  
            longer considered controversial because there was no  
            discussion of this change in the legislative history of SB  
            1681.  However, since that time the law regarding MDTs in  
            elder abuse and child abuse cases has no longer been  
            consistent.

            According to the Elder Abuse Unit in Los Angeles County, elder  
            abuse MDTs currently exchange information telephonically, and  
            there have been no problems with either the formation of elder  
            abuse MDTs with two members or the manner of communication  
            among them.

            Because there is a significant amount of confusion among  




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            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.
               
            AB 2229 would conform the membership of child abuse  
            multidisciplinary teams with elder abuse multidisciplinary  
            teams by allowing child abuse MDTs to be formed with a minimum  
            of two rather than three members, and would permit the  
            disclosure of the information gathered by a child abuse MDT to  
            be disclosed among team members electronically and  
            telephonically 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 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 victims by promptly haring relevant  
            information, and save time and resources by eliminating the  
            need for a redundant third person consulted merely to satisfy  
            the statute.
           
           3.  What This Bill Would Do

           This bill would enact a new section authorizing counties to  
          establish child abuse investigation and prevention  
          multidisciplinary personnel teams.  As explained in detail  




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          above, current law already authorizes these teams.  The  
          authorization as provided in this bill compares to the  
          authorization provided under current law as follows:

                 The enumerated team members in this bill are identical  
               to those in current law.
                 Current law requires 3 or more team members; this bill  
               would authorize 2 or more;
                 Current law refers to these teams engaging in  
               "prevention, identification, and treatment" of child abuse;  
               this bill states a county may establish this newly-created  
               team "to allow provider agencies to share confidential  
               information in order to investigate reports of suspected  
               child abuse or neglect," made pursuant to mandated child  
               abuse or neglect reports.
                 This bill enumerates what a "provider agency" can be,  
               while current law does not appear to;
                 This bill applies a new provision that would apply  
               notwithstanding existing law regarding the limited  
               inspection of juvenile court case files with respect to the  
               teams proposed by this bill, and provide authority for  
               these teams to disclose and exchange with one another  
               information and writings relating to any incident of child  
               abuse if regarded as relevant, as specified; the sharing of  
               information under this provision would be required to be  
               governed by a memorandum of understanding among  
               participating service providers, as specified.  Current  
               teams are allowed to share information with one another  
               that may also be a part of a juvenile court record and  
               otherwise designated as confidential.
                 This bill explicitly authorizes information sharing  
               between team members telephonically or electronically,  
               something apparently not expressly addressed under current  
               law;
                 This bill would authorize teams to designate qualified  
               persons to be a member of the team for a particular case,  
               as specified.

          4.  Stand-Alone Provision





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           As drafted, this bill would provide a second stand-alone  
          statutory provision authorizing counties to create  
          multidisciplinary teams in the area of child abuse.  Members may  
          wish to discuss the purpose and need for this, and whether this  
          approach may be unnecessarily confusing.

          WHY IS IT NECESSARY TO ENACT A SECOND STATUTE AUTHORIZING  
          DISCRETIONARY MULTIDISCIPLINARY CHILD AND NEGLECT TEAMS?

          WOULD HAVING A SECOND STATUTE BE CONFUSING?


































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          5.  Authority

           This bill would provide that counties may "establish a child  
          abuse investigation and prevention multidisciplinary personnel  
          team within that county to allow provider agencies to share  
          confidential information in order to investigate reports of  
          suspected child abuse or neglect made pursuant to Section 11166  
          or 11166.05 of the Penal Code," as specified.  In current law,  
          and in some of this bill, these teams are engaged in issues  
          relating to the prevention, identification, or treatment of  
          child abuse.  Members of the Committee and the author may wish  
          to consider revising the highlighted language above to ensure  
          that these teams are not being authorized in this bill to  
          investigate reports of suspected child abuse or neglect.

          SHOULD THIS AMENDMENT BE MADE?  




          6.  Confidentiality

           This bill proposes several new provisions relating to the  
          sharing of confidential information with and by these teams.   
          Members may wish to consider the scope of these provisions,  
          especially with respect to their differences with current laws  
          providing for these teams, and discuss whether they could be  
          streamlined to address the telephonic/electronic communications  
          noted by the author.  For example, with the addition of the  
          telephonic/electronic communications authority provided by this  
          bill, members may wish to consider whether assuring adequate  
          information sharing and confidentiality could be achieved more  
          simply by adding language expressly applying the same standards  
          applicable to the existing child abuse multidisciplinary teams  
          to the new teams proposed by this bill.

          7.  Double Referral

           This bill was heard in Senate Human Services Committee on June  




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          23, 2010, where it passed (5-0).


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