BILL ANALYSIS                                                                                                                                                                                                    �







                      SENATE COMMITTEE ON PUBLIC SAFETY
                            Senator Loni Hancock, Chair              S
                             2011-2012 Regular Session               B

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          SB 678 (Negrete McLeod)                                     
          As Amended April 25, 2011 
          Hearing date:  May 3, 2011
          Penal Code
          SM:mc

                     COMMUNITY CORRECTIONS MULTIDISCIPLINARY TEAMS  

                                       HISTORY

          Source:  Chief Probation Officers of California

          Prior Legislation: SB 731 (Ashburn) - 2009, never set for 
          hearing in Senate Public Safety

          Support: California Mental Health Directors Association; 
                   California Probation, Parole and Correctional 
                   Association; California State Association of Counties

          Opposition:American Civil Liberties Union; California Public 
          Defenders Association


                                      KEY ISSUES
           
          SHOULD COUNTIES BE AUTHORIZED TO CONVENE "COMMUNITY CORRECTIONS 
          MULTIDISCIPLINARY TEAMS," AS DEFINED, FOR PURPOSES OF PROVIDING 
          EVIDENCE-BASED PRACTICES, AS DEFINED, AND SUPERVISION? 

          SHOULD EVERY MEMBER OF A COMMUNITY CORRECTIONS MULTIDISCIPLINARY 
          TEAM WHO RECEIVES NONPRIVILEGED INFORMATION, AS DEFINED, OR 
          WRITINGS BE UNDER THE SAME PRIVACY AND CONFIDENTIALITY 
          OBLIGATIONS AND SUBJECT TO THE SAME PENALTIES FOR VIOLATING 




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          THOSE OBLIGATIONS AS THE PERSON DISCLOSING OR PROVIDING THE 
          INFORMATION OR WRITINGS?

                                                                (CONTINUED)



          SHOULD THE INFORMATION OBTAINED BE REQUIRED TO BE MAINTAINED IN A 
          MANNER THAT ENSURES THE PROTECTION OF CONFIDENTIALITY?

          SHOULD IT BE SPECIFIED THAT THESE PROVISIONS SHALL NOT BE CONSTRUED 
          TO INDEPENDENTLY AUTHORIZE ACCESS TO, OR POSSESSION OF, INFORMATION 
          FROM LOCAL, STATE, OR FEDERAL INFORMATION SYSTEMS OR DATABASES THAT 
          MULTIDISCIPLINARY TEAM MEMBERS ARE AUTHORIZED TO ACCESS OR POSSESS 
          IN THE COURSE OF THEIR DUTIES?



                                       PURPOSE

          The purpose of this bill is to (1) authorize counties to convene 
          "community corrections multidisciplinary teams," as defined, for 
          purposes of providing evidence-based practices, as defined, and 
          supervision; (2) require that every member of a community 
          corrections multidisciplinary team who receives nonprivileged 
          information, as defined, or writings be under the same privacy 
          and confidentiality obligations and subject to the same 
          penalties for violating those obligations as the person 
          disclosing or providing the information or writings; (3) require 
          that the information obtained be maintained in a manner that 
          ensures the protection of confidentiality; and (4) require that 
          its provisions not be construed to independently authorize 
          access to, or possession of, information from local, state, or 
          federal information systems or databases that multidisciplinary 
          team members are authorized to access or possess in the course 
          of their duties.
           
          Current law  creates multidisciplinary teams to provide treatment 
          plans for juvenile wards of the court who are seriously 
          emotionally disturbed, have a serious mental disorder, or have a 




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          developmental disability.  (Welfare and Institutions Code (WIC) 
          � 713.)

           Current law  creates multidisciplinary teams to provide services 
          to seriously emotionally disturbed and special needs children 
          and other county family and children's services programs, as 
          specified.  (WIC � 18986.40, et seq.)

           Current law  creates multidisciplinary teams who are trained in 
          the prevention, identification, management, or treatment of 
          abuse of elderly or dependent adults.  (WIC � 15610.55, et seq.)

           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.  
          (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 



















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          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 
          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 
          ---------------------------
          <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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          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  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 
          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.) 





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           This bill  would authorize counties to convene "community 
          corrections multidisciplinary teams" for purposes of providing 
          evidence-based practices and supervision.

           This bill  would provide that every member of a community 
          corrections multidisciplinary team who receives nonprivileged 
          information or writings shall be under the same privacy and 
          confidentiality obligations and subject to the same penalties 
          for violating those obligations as the person disclosing or 
          providing the information or writings.  The information obtained 
          shall be maintained in a manner that ensures the protection of 
          confidentiality.

           This bill  defines, "nonprivileged information" as any 
          information not subject to a privilege pursuant to Division 8 
          (commencing with Section 900) of the Evidence Code.

           This bill  defines, "community corrections" as the placement of 
          persons convicted of a felony offense under probation 
          supervision, with conditions imposed by a court for a specified 
          period.

           This bill  defines, "multidisciplinary team" as any team of three 
          or more persons, the members of which are engaged in providing 
          community corrections supervision, treatment, and services.  The 
          team may include, but is not limited to:

                 Probation officers.
                 Police officers, sheriffs' deputies, and other law 
               enforcement officers.
                 Social workers.
                 Health and mental health providers.
                 Substance abuse treatment providers.
                 Education professionals.
                 Employment coordinators.
                 Representatives from community-based organizations with 
               experience in successfully providing rehabilitative 
               services.

           This bill  defines "evidence-based practices" as supervision 




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          policies, procedures, programs, and practices demonstrated by 
          scientific research to reduce recidivism among individuals under 
          probation, parole or postrelease supervision.

           This bill  states that its provisions shall not be construed to 
          independently authorize access to, or possession of, information 
          from local, state, or federal information systems or databases 
          that multidisciplinary team members are authorized to access or 
          possess in the course of their duties.


                    RECEIVERSHIP/OVERCROWDING CRISIS AGGRAVATION
          
          For the last several years, severe overcrowding in California's 
          prisons has been the focus of evolving and expensive litigation. 
           As these cases have progressed, prison conditions have 
          continued to be assailed, and the scrutiny of the federal courts 
          over California's prisons has intensified.  

          On June 30, 2005, in a class action lawsuit filed four years 
          earlier, the United States District Court for the Northern 
          District of California established a Receivership to take 
          control of the delivery of medical services to all California 
          state prisoners confined by the California Department of 
          Corrections and Rehabilitation ("CDCR").  In December of 2006, 
          plaintiffs in two federal lawsuits against CDCR sought a 
          court-ordered limit on the prison population pursuant to the 
          federal Prison Litigation Reform Act.  On January 12, 2010, a 
          three-judge federal panel issued an order requiring California 
          to reduce its inmate population to 137.5 percent of design 
          capacity -- a reduction at that time of roughly 40,000 inmates 
          -- within two years.  The court stayed implementation of its 
          ruling pending the state's appeal to the U.S. Supreme Court.  

          On Monday, June 14, 2010, the U.S. Supreme Court agreed to hear 
          the state's appeal of this order and, on Tuesday, November 30, 
          2010, the Court heard oral arguments.  A decision is expected as 
          early as this spring.  

          In response to the unresolved prison capacity crisis, in early 




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          2007 the Senate Committee on Public Safety began holding 
          legislative proposals which could further exacerbate prison 
          overcrowding through new or expanded felony prosecutions.     

           This bill  does not appear to aggravate the prison overcrowding 
          crisis described above.

                                      COMMENTS

          1.  Need for This Bill  

          A fact sheet provided by the author's office describes the 
          following purposes for this bill:

                     Clarify - The probation officer's authority to 
                 develop and implement community corrections programs 
                 that incorporate MDT teams.  (Current state 
                 authorizes juvenile justice, child abuse and mental 
                 health MDT's, but does address MDTs adult 
                 probationers.)     
                     Ensure that members of a probation MDT can be 
                 held to the same level of confidentiality and to the 
                 same level of consequences for failure to maintain 
                 confidentiality as probation employees are.  For 
                 example, not disclose to unauthorized persons an 
                 offender's status as a probationer, without the 
                 permission of the probationer.
                     Ensure that if employees of probation who come 
                 into possession of confidential information from 
                 other participants in the MDT the probation 
                 employees can be held the same level of 
                 confidentiality as the original processor of that 
                 information.  For example: confidential information 
                 contained in an Addiction Severity assessment 
                 administer by a substance abuse provider.
                     As to the consent issue, Court opinions have 
                 consistently found a grant of adult probation 
                 requiring the consent of the offender.  Once a 
                 person accept adult probation, the probation officer 
                 has the authority to determine level and type of 




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                 supervision consistent with the court ordered 
                 conditions of probation.  Probationers have the 
                 right to challenge the level and type of supervision 
                 based on whether it is consistent with the 
                 conditions of probation.  In addition probationers 
                 have certain confidentiality rights, the most basic 
                 being the confidentiality of his/her status as a 
                 probationer. Therefore, probation obtains both the 
                 consent of the probationer to participated programs, 
                 as well as consents from probationer for release of 
                 information from treatment providers.  This 
                 legislation is intended to preserve those rights.

          2.  Multidisciplinary Teams in Other Contexts  

          Current law grants authority, and in some cases mandates 
          creation of, multidisciplinary teams (MDTs) to tackle complex 
          social issues.  These include in the areas of prevention of 
          elder abuse (WIC � 15610.55, et seq.), child abuse (WIC � 
          18961(a)(4)), juvenile wards of the court with serious mental 
          illness (Welfare and Institutions Code � 713), and support for 
          emotionally disturbed children and their families (WIC � 
          18986.40, et seq.).  The concept and purpose of 
          multidisciplinary teams is to gather the collective knowledge 
          and input of several experts specializing in different aspects 
          of a social problem and pool their knowledge and skills to 
          formulate a comprehensive and coordinated response to assisting 
          a particularly vulnerable population.

          Clearly, at the core of this enterprise is the sharing of 
          pertinent information.  The statutory provisions listed above 
          have established specific, highly detailed, rules and parameters 
          for the sharing of information by MDT members in their specific 
          context, each of whom may have access to information that the 
          other members of the team may not legally be permitted to obtain 
          or possess.  Under what conditions information may be shared and 
          for what purposes are issues at the heart of the MDT approach.

          A recent report by the California Endowment on the use of MDTs 
          in juvenile probation cases addressed the prerequisites that may 




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          be necessary to allow information sharing between juvenile MDT 
          members:

               Even if MOUs are established with providers 
               participating in MDTs to share information, 
               confidentiality issues including youths' Health 
               Insurance Portability and Accountability Act (HIPPA) 
               rights, Family Educational Rights and Privacy (FERPA), 
               their right to consent to services, juvenile court 
               confidentiality rights, and parental rights still 
               exist.  In Los Angeles County, consent from youth and 
               parents is needed first to open the doors for 
               cross-systems information sharing. Other counties 
               established standing court orders to facilitate the 
               sharing of information.  (Multidisciplinary Teams, 
               California Endowment, December 2010, on file with the 
               Committee.)

          The sponsors of this bill have informed Committee staff that the 
          Los Angeles County Probation Department has had lengthy 
          negotiations with the Los Angeles Public Defender's Office over 
          what sort of waivers their clients might be willing to sign in 
          order to participate in an MDT.  Despite the parties devoting a 
          great deal of time to these negotiations, staff was informed 
          that they could not reach agreement on the nature and scope of 
          any such waivers.  It is not clear to what extent this bill is 
          intended to or would resolve those issues.

          3.  What This Bill Would Do  

          As noted above, MDTs have been utilized in other contexts 
          involving the protection of specifically identified vulnerable 
          groups such as elders, small children or youths with severe 
          mental disorders.  This bill would expressly authorize counties 
          to create "community corrections multidisciplinary teams," which 
          could be utilized in any or all criminal cases in which a person 
          is convicted of a felony and granted probation.  These MDTs 
          would be authorized for the purposes of providing 
          "evidence-based practices and supervision."  Members may wish to 
          consider whether there is research demonstrating that this is a 




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          successful approach when applied to supervising felony 
          probationers?  If so, what does the research demonstrate are the 
          essential elements of a successful MDT program?  For example, 
          who are the essential members of an MDT?  

          SB 678 does not specify the composition of a "community 
          corrections MDT" other than to say it would have at least three 
          members and that they be "engaged in providing community 
          corrections supervision, treatment, and services."  The bill 
          states that the MDT might include probation officers, police 
          officers, sheriffs' deputies, and other law enforcement 
          officers, social workers, health and mental health providers, 
          substance abuse treatment providers, education professionals, 
          employment coordinators, and representatives from 
          community-based organizations with experience in successfully 
          providing rehabilitative services.  However, the bill does not 
          require that any of these people be included.  

          The bill does not address several specifics as to how a 
          community corrections MDT would function.  For example, it is 
          not specified whether participation by a probationer would be 
          voluntary.  Could some or all probationers be required to 
          participate on threat on having their probation revoked if they 
          refused?  If a probationer's consent is not required before an 
          MDT meeting takes place including his or her probation officer, 
          a police officer and the probationer's therapist, could that 
          potentially interfere with the probationer's willingness to 
          confide in the therapist?  If the probationer's therapist 
          refuses to participate in the MDT, could that be grounds to 
          revoke probation?  

          IS USE OF MULTIDISCIPLINARY TEAMS IN SUPERVISING FELONY 
          PROBATIONERS AN EVIDENCE-BASED APPROACH?

          IF SO, WHAT DOES THE RESEARCH SHOW ARE THE ESSENTIAL ELEMENTS OF 
          A SUCCESSFUL COMMUNITY CORRECTIONS MULTIDISCIPLINARY TEAM?

          DOES THIS BILL INCORPORATE THE ELEMENTS OF ANY RESEARCH IN THIS 
          AREA?





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          ARE THE DETAILS OF HOW COMMUNITY CORRECTIONS MULTIDISCIPLINARY 
          TEAM WOULD BE UTILIZED SUFFICIENTLY SPECIFIED?  

          WOULD PARTICIPATION BE VOLUNTARY ON THE PART OF THE PROBATIONER? 
           IF NOT, WHAT PRIVACY RIGHTS MIGHT THE PROBATIONER BE REQUIRED 
          TO WAIVE TO AVOID HAVING HIS OR HER PROBATION REVOKED?

          This bill addresses the issue of information sharing by 
          providing that every member of the MDT who receives 
           nonprivileged  information or writings shall be "under the same 
          privacy and confidentiality obligations and subject to the same 
          penalties for violating those obligations as the person 
          disclosing or providing the information or writings and that the 
          information obtained shall be maintained in a manner that 
          ensures the protection of confidentiality."  This does not 
          address the issue of how the team members could use any 
           privileged  information that is revealed either deliberately or 
          inadvertently.  For example, if a team member is a mental health 
          care provider and reveals to the other team members a 
          confidential communication that he or she received from the 
          probationer, that would be a disclosure of privileged 
          information.  The bill does not appear to place any restrictions 
          on what the other team members could do with that information.  

          If, for example, the probationer admits to his psychiatrist 
          confidentially that he had a relapse and had used illegal drugs, 
          and the psychiatrist divulges this privileged information at an 
          MDT meeting, while the psychiatrist might be violating various 
          confidentiality laws and might be liable to the probationer for 
          violating his confidentiality, there would appear to be no 
          restriction on the probation officer using that information to 
          have the probationer sent to jail.  Under these circumstances, 
          requiring a probationer to take part in an MDT could have the 
          unintended effect of inhibiting the relationship between the 
          probationer and their therapist.  There would also appear to be 
          no evidence-based rationale for allowing such breaches of 
          confidentiality to be used against the probationer in a court 
          proceeding.






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          4.  Suggested Amendment  

          Members might wish to consider whether the bill should be 
          amended to include the following language:

               "Information obtained in connection with a community 
               corrections MDT shall not be admissible in any 
               criminal, civil, or juvenile court proceeding."  

          SHOULD THIS AMENDMENT BE TAKEN?
































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          5.  Argument in Support  

          The California Mental Health Directors Association state:

               County mental health departments in many counties 
               actively participate in local multidisciplinary teams 
               and other collaborative efforts for serving local 
               criminal justice populations, a significant number of 
               whom have serious mental health disorders.  As the 
               devolution of responsibility for criminal justice and 
               other health and human services continues to move from 
               the state to the counties, it will be increasingly 
               critical that multidisciplinary team members have the 
               authorization to share information with one another in 
               order to ensure that service providers can meet the 
               holistic needs of probationers in a timely and 
               effective manner.

          6.  Argument in Opposition  

          The American Civil Liberties Union states:

               Current law already permits community corrections 
               personnel access to confidential information about the 
               student or family with either the consent of the 
               individual or where authorized under the terms of 
               probation.  The California Constitution provides that 
               all people have inalienable rights, including the 
               right to pursue and obtain privacy. (Cal.Const. art. 
               I, sec.1).  In addition, California's Confidentiality 
               of Medical Information Act (CMIA) (California Civil 
               Code Section 56.10 (a)) and the federal Health 
               Insurance Portability and Accountability Act of 1996 
               (HIPAA) generally prohibit health care providers from 
               disclosing medical information about patients or 
               subscribers without first obtaining authorization.  
               And, the California Department of Justice carefully 
               guards the confidentiality of criminal justice 
               databases. 




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               SB 678 would allow health and mental health providers, 
               social workers, and probation officers among others to 
               communicate confidential "non privileged" information 
               about a probationer or his or her family without first 
               obtaining consent.  California only allows seizures 
               that interfere with fundamental privacy rights with a 
               showing of compelling interest. White v. Davis, 13 
               Cal. 3d 757, 775 (1974)  (holding the privacy right 
               prohibits the disclosure of personal information 
               unless justified by a compelling interest), Hill v. 
               National Collegiate Athletic Assn., 7 Cal. 4th 1, 34 
               (1994) (holding a "compelling interest must be present 
               to overcome the vital privacy interest").  

               In addition, the Court has held that California 
               Constitution requires that there be no other less 
               intrusive means of serving the party's interest before 
               medical records can be discovered.  American Academy 
               of Pediatrics v. Lungren, 16 Cal. 4th 307, 341 (1997) 
               (discovery of private medical records is allowed only 
               if the discovering party's interest "cannot be served 
               by alternative means less intrusive on fundamental 
               rights").

               While we have asked for evidence of the "need" for 
               this legislation, we have not been provided that 
               information.  Nor have we been provided with 
               information that this community corrections approach 
               actually works and that it is necessary to share 
               individual's private information without their 
               consent.  We are concerned that the goal of 
               rehabilitation will actually be undermined by the 
               non-consensual sharing of participant's information. 


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