BILL ANALYSIS                                                                                                                                                                                                    






                                  SENATE HUMAN
                               SERVICES COMMITTEE
                            Senator Carol Liu, Chair


          BILL NO:       AB 2322                                      
          A
          AUTHOR:        Feuer                                        
          B
          VERSION:       As proposed to be amended
          HEARING DATE:  June 30, 2010                                
          2
          FISCAL:        Appropriations, Urgency 2/3rds required      
          3
                                                                      
          2
          CONSULTANT:                                                 
          2
          Hailey
                                        

                                     SUBJECT
                                         
                Abuse of children, elder, or dependent persons:  
                                confidentiality


                                     SUMMARY  

          Broadens the scope of information available -- through a  
          computerized database system -- to county personnel who  
          work in child welfare services; and, authorizes case  
          managers from the California Work Opportunities and  
          Responsibility to Kids (CalWORKs) program to participate in  
          multidisciplinary personnel teams formed to prevent,  
          identify, manage, or treat child abuse or neglect.


                                     ABSTRACT  

           Current law
           1)  Defines "child abuse" as a situation in which a child  
          suffers from:
                 serious physical injury inflicted by other than  
               accidental means,
                 harm caused by intentional neglect or malnutrition  
                                                         Continued---



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               or sexual abuse,
                 the absence of basic physical care,
                 willful mental injury or negligent treatment or  
               maltreatment, or
                 any condition which results in the violation of  
               rights or welfare or jeopardizes present or future  
               health, normal development, or capacity for  
               independence.  [WIC 18951(e)]

          2)  Defines a child abuse multidisciplinary personnel team  
          (MDT) 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 such as mental health  
          professionals, law enforcement personnel, social workers,  
          and teachers.  [Welfare and Institutions Code (WIC) Section  
          18951(d)]

          3)  Permits members of an MDT, as defined in Section 18951,  
          to exchange confidential information and writings during  
          team meetings, provided the information is relevant to the  
          prevention, identification or treatment of child abuse and  
          is kept confidential.  (WIC Section 830)

          4)  Permits members of an MDT to exchange confidential  
          information that includes information about voluntary and  
          involuntary mental health services if the information and  
          records are relevant to the prevention, identification,  
          management, or treatment of an abused child and that  
          child's parents.  (WIC 5328)

          5)  Allows psychotherapists to release information to law  
          enforcement agencies if a patient presents a serious danger  
          of violence to a reasonably foreseeable victim or victims.   
          (WIC 5328)

          6)  Authorizes each county to establish a computerized  
          database to allow provider agencies, MDTs, and child  
          welfare workers to access a county database designed to  
          "point" these professionals toward other departments in  
          county government that have information about the household  
          in question.  (WIC Section 18961.5)

          7)  Specifies the identifying information in the database  
          as:




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                 the name, address, telephone number, and date and  
               place of birth of family members,
                 the number assigned to the case by each provider  
               agency,
                 the name and telephone number of each employee  
               assigned to the case from each provider agency, and
                 the date or dates of contact between each provider  
               agency and a family member.

          8)  Requires that the information in the system be entered  
          by and disclosed to designated employees, and the heads of  
          provider agencies shall establish a system by which  
          unauthorized personnel cannot access the data contained in  
          the system.

          9)  Defines "provider agencies" for the purposes of the  
          computerized database as any governmental or other agency  
          which has as one of its purposes the prevention,  
          identification, management or treatment of child abuse or  
          neglect -- agencies including but not limited those  
          providing social services, children's services, health  
          services, mental health services, probation, law  
          enforcement, or education.

          10)  Requires each county to develop its own standards for  
          defining "at risk" establishing a computerized database  
          system for sharing information among MDT members.

          11)  Establishes the CalWORKs program to provide welfare to  
          work services and benefit payments to qualifying households  
          with children.

           This bill
           1)  Establishes consistency in statutory references to  
          members of child abuse multidisciplinary personnel teams  
          (MDTs), to the teams themselves, and to the information  
          shared among team members: members are engaged in and  
          information is relevant to the prevention, identification,  
          management or treatment of child abuse or neglect.

          2)  Adds that access to the computerized database can be  
          for those providing child welfare services, and defines  
          those as "services that are directed at preventing child  
          abuse or neglect."





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          3)  Allows psychotherapists to release information to  
          county child welfare agencies if a patient presents a  
          serious danger of violence to a reasonably foreseeable  
          victim or victims.

          4)  Adds CalWORKs case managers responsible for case  
          planning and coordination for children and families in need  
          of both child welfare services and CalWORKs programs, to  
          the personnel authorized to participate on an MDT.

          5)  Requires the CalWORKs case manager to get the informed  
          written consent of the family receiving cross program case  
          planning and coordination in order to share confidential  
          information regarding the child and family as a member of  
          an MDT.

          6)  Allows counties to enter into the database information  
          about a person living in the child's home who are not a  
          family member.

          7)  Allows counties to enter into the database convictions  
          of family members and persons living in the child's home  
          for crimes that involved a child as a victim.

          8)  Stipulates that information related to convictions  
          shall be accessible only to those entities currently  
          entitled to obtain criminal history records; requires  
          counties to install system controls to ensure that this  
          limited access is maintained.

          9)  Allows conviction information to be discussed among MDT  
          members.

          10)  Stipulates that any person knowingly and intentionally  
          violating the confidentiality provisions of the subdivision  
          shall be subject to the penalties set forth in respective  
          statutes governing the confidentiality of the records  
          maintained by the agencies providing the information.

          11)  Requires each county that establishes a computerized  
          database system to develop its own standards for  
          determining whether a child or family is in need of child  
          welfare services and requires each provider agency to  
          develop protocols for applying the county's standards  
          consistently.




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          12)  Requires each county that establishes a computerized  
          database system to install system controls to monitor  
          system use and to detect any violations of the system  
          controls.

          13)  Adds an urgency clause.


                                  FISCAL IMPACT  

          According to the Assembly Appropriations Committee, costs  
          would be minor and absorbable.

                                         
                           BACKGROUND AND DISCUSSION 

          This bill adds to the information contained in computerized  
          databases that each county can establish to assist provider  
          agencies (as defined), multidisciplinary personnel teams  
          (MDTs), and social workers in their provision of child  
          welfare services and child abuse prevention, investigation,  
          and treatment.  The bill adds information regarding  
          unrelated persons who may live in the household of a child  
          receiving child welfare services or who is at risk of abuse  
          or neglect; and, by adding information to the database  
          about convictions for crimes against a child.

          In addition, the bill adds CalWORKs case managers, with a  
          family's permission, to these child welfare and child abuse  
          MDTs.

          Third, the bill adds consistency to the various code  
          sections dealing with MDTs and with the computerized  
          databases.

           Child abuse multidisciplinary personnel teams  
          For about 20 years, California law has authorized  
          multidisciplinary teams (MDTs) to allow a coordinated  
          interagency response to child abuse cases.  MDTs, formed  
          and operated at the county level, can share confidential  
          information among team members for the purposes of  
          preventing, identifying, or treating child abuse.   
          Currently, all 58 California counties operate child abuse  
          MDTs.




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           Adding CalWORKs case managers to MDTs
           In approximately 30 California counties, case managers in  
          the CalWORKs program join colleagues providing child  
          welfare services for the purpose of case planning and  
          coordination.  These coordinated efforts are called the  
          "linkages project."  This bill will allow CalWORKs case  
          managers to be part of MDTs working on the prevention,  
          investigation, management, or treatment of child abuse.   
          These CalWORKs case managers participate on a child welfare  
          MDT with the informed written consent of the family  
          involved.

           Computerized databases  
          Under existing law, counties may establish computerized  
          databases so that provider agencies, MDTs, and child  
          welfare service professionals can share identifying  
          information regarding families receiving child welfare  
          services and children at risk of abuse or neglect.

          At this time, Los Angeles County is the only California  
          county operating a computerized database for its provider  
          agencies, MDTs, and child welfare services personnel.  This  
          computerized database in Los Angeles County is called the  
          family child index.  It is a "pointer" system, telling  
          authorized users if another participating agency has had  
          contacts with a family.  For example, a social worker  
          investigating an abuse case after providing emergency  
          response should be able to discover if the district  
          attorney's office, the sheriff's department, or another  
          county agency such as social services or health services  
          has had contact with the child or a member of the child's  
          family.  The database includes the name and phone number of  
          a person in each of those departments whom the social  
          worker can contact for more information.  Those contact  
          persons constitute the team that can share information.

          According to the author, Los Angles County now requires its  
          child welfare workers to consult the family child index.

           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,  




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          or in the case of minors, the parent or guardian.  These  
          laws safeguard individuals' right to privacy.  Statutes  
          sometimes allow confidential information to be shared among  
          government agencies although written permission is often  
          required, and civil and criminal penalties may apply if the  
          information is unlawfully disclosed.

          Federal law provides exceptions to confidentiality  
          protections for child abuse or neglect reports and records  
          under the Child Abuse Prevention and Treatment Act (42  
          U.S.C. 5101 et seq.), which requires federal, state, or  
          local government agencies to  share confidential  
          information in order to fulfill their legal  
          responsibilities to protect children from abuse and  
          neglect.

          Conviction data in Los Angeles County  
          The County of Los Angeles has identified 52 felonies for  
          which they will make conviction data available through the  
          family child index, the computerized database established  
          pursuant to WIC Section 18961.5.  This conviction  
          information will be available to provider agencies, MDTs,  
          and child welfare professionals.  According to the office  
          of the Los Angeles District Attorney, data on some of these  
          convictions go back to 1991.

          In the past three years, approximately 5,000 defendants  
          have been found guilty of one or more of these crimes.  In  
          2007, 1536 defendants convicted; in 2008, 1733 defendants  
          convicted; and, in 2009, 1740 defendants convicted.  The  
          average number of convicted defendants per month for the  
          past three years is 140.

          If the bill becomes law and allows conviction information  
          to be shared between a district attorney's office and  
          multidisciplinary personnel teams, a district attorney's  
          office can set up a special file into which information  
          about convictions for crimes against children would be  
          placed for 50 years.  Those allowed by law will have access  
          to that conviction information through the family child  
          index.

           Related legislation and a potential conflict  
          AB 2229 (Brownley), which passed out of the committee on  
          June 22 and is sponsored by the Los Angeles County District  




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          Attorney, also makes changes in the composition of MDTs and  
          the information available to them.

           Arguments in support
           The County Welfare Directors Association supports the bill  
          in general and specifically argues for allowing CalWORKs  
          case managers to participate on MDTs: such participation  
          will improve cross-program planning and coordination.  The  
          County of Los Angeles supports the clarification of  
          circumstances under which information can be shared among  
          multidisciplinary team members.  It also argues that timely  
          access to information about unrelated persons living in a  
          child's home and conviction information about those persons  
          and family members will assist multidisciplinary personnel  
          teams when making determinations about children's safety.

           Arguments in opposition
           Because the bill adds information about convictions to the  
          database, the American Civil Liberties Union recommends:
                 Requiring notice and the opportunity to correct to  
               individuals about whom conviction information is being  
               used by provider agencies, MDTs, and child welfare  
               personnel in making determinations about children's  
               placement.

           Previous Assembly votes
           Floor          77-0
          Appropriations16-0
          Human Services  6-0


                             COMMENTS AND QUESTIONS
          
           Providing notice and an opportunity to correct
           As noted above in the "arguments in opposition," the  
          inclusion of conviction information in the county database  
          raises objections from the American Civil Liberties Union.   
          The ACLU's recommends an amendment to give individuals an  
          opportunity to correct the record when conviction  
          information is incorrectly associated with them.  The ACLU  
          believes that fairness demands that an individual has the  
          opportunity to correct a record that may be shared across a  
          range of county departments and schools.  Per this bill,  
          conviction data from a district attorney's office is  
          matched to information in a computerized database that  




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          includes one or more of these identifiers: name, address,  
          phone number, date of birth, and place of birth.

          Los Angeles County provided the committee with an estimate  
          of the cost of providing notice to any individual against  
          whom conviction information is matched and that information  
          is used by provider agencies, MDTs, or child welfare  
          workers.  Los Angeles estimates that about 100 individuals  
          each month would have conviction information matched to  
          them; to provide them notice and an opportunity to correct  
          would cost the county between $150,000 and $250,000 per  
          year provide notice.  (This is in the range of $130 to $210  
          per individual receiving notice).  In addition, one time  
          only costs during the first year, of technical enhancements  
          to the family child index and training costs would cost  
          between $150,000 and $270,000.  The county believes these  
          costs are prohibitive when weighed against the added  
          protections of providing notice.

          Supervisors from the Los Angeles County Department of  
          Children and Family Services believe that it is in the  
          interests of children and families to be sure that any  
          conviction information is correctly matched to the  
          household under investigation.  For these supervisors, the  
          importance of accurate information means that, on the  
          natural, social workers and other members of MDTs will take  
          steps to minimize mistaken identity - without the  
          administrative requirement that notice be provided.
          The ACLU recognizes the cost burden of general notice, and,  
          as an alternative, recommends that social workers be  
          required to inform individuals that conviction information  
          is being used in decisions about the child and family.   
          This disclosure would be made at the first face-to-face  
          between a children's-services worker and the child's parent  
          or parents.  If the individual in question believes the  
          matching of conviction data to himself or herself is in  
          error, he or she would be provided a way to correct that  
          information.  This would eliminate costs of mailing but  
          would ensure that the individual in question knows that the  
          county believes that he or she matches conviction  
          information for a crime against a child - and ensures that  
          social workers pursue due diligence in checking the  
          validity of the match of individual with conviction  
          information.





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           Conviction information and Los Angeles County: suggested  
          amendment
           Los Angeles County is the only county in the state using a  
          computerized database per WIC 18916.5.  Portions of AB 2322  
          that amend the provisions of this code section are based on  
          Los Angeles County's 18 years of experience with this  
          database.  Given that experience and expertise, the bill  
          could be amended to provide that conviction information be  
          added to the computerized database only in Los Angeles  
          County.  Any other county that establishes a similar  
          database - and the committee is not aware of any counties  
          that are working on such a project - would not include  
          conviction information in that database.


                                    POSITIONS  

          Support:       County Welfare Directors Association  
          (sponsor)
                         Los Angeles County Board of Supervisors  
          (sponsor)
                         Service Employees International Union  
          (sponsor)
                         Los Angeles County Sheriff's Department
                         State Public Affairs Committee of the Junior  
                    Leagues of California

          Oppose:   American Civil Liberties Union (unless amended)




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