BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  SB 1377
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          Date of Hearing:   June 19, 2012

                           ASSEMBLY COMMITTEE ON JUDICIARY
                                  Mike Feuer, Chair
                   SB 1377 (Corbett) - As Amended:  April 19, 2012

                                  PROPOSED CONSENT

           SENATE VOTE  :   37-0
           
          SUBJECT  :  PROTECTION AND ADVOCACY AGENCIES

           KEY ISSUE  :  SHOULD THE RIGHTS OF A PROTECTION AND ADVOCACY 
          AGENCY TO REVIEW REPORTS OF ABUSE AND NEGLECT OF INDIVIDUALS 
          WITH DEVELOPMENT AND MENTAL HEALTH DISABILITIES BE CLARIFIED?

           FISCAL EFFECT  :  As currently in print this bill is keyed fiscal.

                                      SYNOPSIS

          Existing federal and state law provides for the designation of a 
          protection and advocacy (P&A) agency in each state, charged with 
          protecting and advocating for the rights of persons with 
          disabilities, as defined.  Existing law authorizes P&A agencies 
          to investigate any incident of abuse or neglect, and to review 
          all relevant records of any facility or program service 
          recipient, and provides that all information and records 
          obtained in the course of providing intake, assessment and 
          services, as specified, to persons with developmental 
          disabilities or mental health disorders shall be confidential 
          and disclosed only as enumerated.  This non-controversial bill 
          would specify that the P&A agency's authority to access 
          information and records of persons with disabilities, as 
          otherwise specified, shall include access to specified 
          unredacted records.  

           SUMMARY  :  Clarifies the role and information available to the 
          state-designated protection and advocacy agency.  Specifically, 
           this bill  :   

          1)Provides that the authority of the P&A agency shall include 
            access to the following unredacted records: a citation report, 
            licensing report, survey report, plan of correction, or 
            statement of deficiency prepared by a department responsible 
            for issuing a license or certificate to a program, facility, 








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            or service serving an individual with a disability, and 
            provides that the information obtained in those records is 
            subject to the confidentiality requirements of Section 4903(f) 
            of the Welfare and Institutions Code. 

          2)Adds to the enumerated exceptions of existing law that the 
            information and records otherwise subject to certain 
            confidentiality requirements shall also be disclosed to the 
            P&A agency to the extent that the information is contained in 
            an unredacted version of any of the following: a citation 
            report, licensing report, survey report, plan of correction, 
            or statement of deficiency prepared by an authorized licensing 
            personnel or authorized representatives described, as 
            specified.

          3)Deletes obsolete and inapplicable references.
           
           EXISTING LAW  :    

          1)Pursuant to federal law, mandates the creation and maintenance 
            of a protection and advocacy system in each state, for the 
            purpose of investigating allegations of abuse or neglect of 
            several classes of disabled persons: the developmentally 
            disabled, the mentally ill, and other disabled persons that 
            qualify for the services provided by the system.  (PADD Act, 
            42 U.S.C. Sec. 15041 et seq.; PAIMI Act, 42 U.S.C. Sec. 10801 
            et seq.; and PAIR Act, 29 U.S.C. Sec. 794e.)  

          2)Provides that an independent private, nonprofit corporation 
            designated by the Governor, shall act as the P&A agency for 
            the state, and requires that agency meet all requirements of 
            federal law applicable to P&A systems for people with 
            disabilities.  (Welf. & Inst. Code Sec. 4901.) 

          3)Defines "disability" as a developmental disability, as defined 
            in the federal PADD Act, a mental illness, as defined in the 
            federal PAIMI Act, or a disability as defined under the 
            federal Americans with Disabilities Act of 1990, or as defined 
            under the California Fair Employment and Housing Act.  (Welf. 
            & Inst. Code Sec. 4900(a)(d).)

          4)Specifies the authorities of the P&A agency, pursuant to its 
            federal mandate, including the authority to investigate any 
            incident of abuse or neglect of any person with a disability 
            if the incident is reported to the P&A agency or if the P&A 








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            determines there is probable cause to believe the abuse or 
            neglect occurred.  Among other things, existing law provides 
            that this investigatory authority shall include reasonable 
            access to a facility or program and authority to examine all 
            relevant records and interview any facility or program service 
            recipient, employee, or other person who might have knowledge 
            of the alleged abuse or neglect.  (Welf. & Inst. Code Sec. 
            4902(a)(1).)   

          5)Requires that the P&A agency have access to the records of a 
            person with disabilities where specified circumstances exist.  
            (Welf. & Inst. Code Sec. 4903(a).)  

          6)Provides that the P&A agency shall have access to various 
            individual records, whether written or in another medium, 
            draft or final, including, but not limited to, handwritten 
            notes, electronic files, photographs, videotapes, or 
            audiotapes.  Such individual records include, but are not 
            limited to, specified records relating to the provision of 
            services, reports of investigations of specified claims 
            including their supporting documents, as well as any discharge 
            records.  (Welf. & Inst. Code Sec. 4903(b)(1)-(3).)  

          7)Lists the types of information in the possession of a program, 
            facility, or service that must be available to the agency 
            investigating instances of abuse or neglect, as specified.  
            (Welf. & Inst. Code Sec. 4903(c).)  

          8)Requires that the P&A agency be given access to the records of 
            specified individuals, and other records that are relevant to 
            conducting an investigation of potential instances of abuse or 
            neglect with respect to specified persons with disabilities 
            not later than three business days after the agency makes a 
            written request.  Existing law requires that immediate access 
            be granted not later than 24 hours after the P&A agency makes 
            a request, without consent from another party, in specified 
            circumstances, if the agency determines there is probable 
            cause to believe that the health or safety of the individual 
            is in serious and immediate jeopardy, or in a case of death of 
            an individual with a disability.  (Welf. & Inst. Code Sec. 
            4903(e).)

          9)Requires that confidential information kept or obtained by the 
            P&A agency remain confidential and prohibits that information 
            from being subject to disclosure, except that the P&A agency 








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            shall not be prevented from, among other things, issuing a 
            public report of the results of an investigation that 
            maintains the individual service recipients' confidentiality 
            or reporting the investigation results to responsible agencies 
            should an investigation reveal information warranting possible 
            sanctions or corrective action, as specified.  (Welf. & Inst. 
            Code Sec. 4903(f).)

          10)Requires the P&A agency to inform and train employees as 
            appropriate regarding the confidentiality of client records.  
            (Welf. & Inst. Code Sec. 4903(g).)  

          11)Requires that, notwithstanding the section above, information 
            and records be disclosed, as specified, to the P&A agency 
            designated by the Governor in this state to fulfill the 
            requirements and assurances of the federal PADD Act for the 
            protection and advocacy of the rights of persons with 
            developmental disabilities, as defined (42 U.S.C. Section 
            15002(8)).  (Welf. & Inst. Code Sec. 4514.3(a).)

          12)Requires that all information and records obtained in the 
            course of providing intake, assessment, and service, as 
            specified, to persons with developmental disabilities be held 
            confidential, and that information and records obtained in the 
            course of providing similar services to either voluntary or 
            involuntary recipients prior to 1969 shall also be 
            confidential, except that such information and records shall 
            be disclosed in specified cases.  (Welf. & Inst. Code Sec. 
            4514(a)-(u).)  

           COMMENTS  :  According to the author, "SB 1377 would clarify a 
          protection and advocacy agency's right to review reports of 
          abuse and neglect of individuals with development and mental 
          health disabilities without having to make a separate assertion 
          of probable cause in each case."  The author further explains 
          the need for such clarification as follows: 

            Federally mandated protection and advocacy agencies such as 
            Disability Rights California (DRC) are charged with protecting 
            and advocating for the rights of persons with disabilities. In 
            order to fulfill this function, federal law grants protection 
            and advocacy �P&A] agencies the right to access reports 
            prepared by state agencies that investigate reports of abuse, 
            neglect, injury or death of persons with disabilities and 
            perform certification or licensing reviews.  








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            In the past, the Department of Public Health (DPH) provided 
            such reports to DRC in complete and unredacted form.  However, 
            in 2009 the DPH changed this policy for two special 
            populations of vulnerable individuals with disabilities-people 
            with developmental disabilities and people with mental health 
            disabilities.  Citing state privacy laws governing the records 
            of persons with developmental disabilities (W&I Code Sec. 
            4514) and mental health disabilities (W&I Code Sec. 5328), DPH 
            began forwarding to DRC redacted records with all relevant 
            information about cases involving individuals with either a 
            developmental disability or mental health disability blacked 
            out.  Under DPH's policy, DRC upon receipt of the redacted 
            report must then submit an individual written request to 
            receive an unredacted record for the case.  For cases 
            involving people with all other disabilities, DRC continued to 
            receive reports from DPH in the usual unredacted for.  

          This extra step is unnecessary and unwarranted, supporters 
          state.  California law (W&I Code Sec. 4903) already requires the 
          P&A agencies to maintain the confidentiality of this information 
          and the right to P&A's to access this information is not in 
          dispute.  Requiring this extra layer of bureaucratic process 
          creates a significant time lag that often extends months before 
          DRC receives the unredacted report.  In some cases the wait has 
          been almost a year.  This delay can jeopardize the well-being of 
          the individuals involved.  In addition, the requirement creates 
          more administrative work and unnecessary costs for the State.

           Background Regarding Role of Protection and Advocacy 
          Organizations.   The California Legislature passed SB 1088 in 
          1991 to enact this state's protection and advocacy system and 
          bring California into compliance with federal law, and in doing 
          so authorized the formation of an independent nonprofit 
          corporation, originally called the Protection and Advocacy, Inc. 
          (PAI) and now known as Disability Rights California (DRC), to 
          execute the investigatory mandate.  (SB 1088 (McCorquodale, Ch. 
          534, Stats. 1991).)  Then in 2003, the Legislature passed SB 577 
          (Keuhl, Ch. 878, Stats. 2003) to further conform to federal laws 
          and regulations governing P&A agencies, and also expanded the 
          availability of P&A services to all persons with disabilities as 
          defined under California law.  P&A agencies, as provided for by 
          these laws, are charged with providing advocacy services to 
          people with disabilities, including investigating incidents of 
          abuse or neglect and otherwise protecting their legal and civil 








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          rights.  Among other things, existing law specifies that in 
          order to fulfill its investigatory authority, the P&A agency 
          shall have access to relevant records, as specified.  (See Welf. 
          & Inst. Code Secs. 4902(a)(1), 4903(b).)  

          This bill, sponsored by DRC, would specify that certain records, 
          including citation reports, licensing reports, survey reports, 
          plans of correction, and statements of deficiencies prepared, as 
          specified, shall be provided in unredacted form.  With respect 
          to persons with developmental disabilities or mental health 
          disabilities, specifically, where existing law would prohibit 
          the disclosure of certain confidential information or records 
          subject only to limited statutory exceptions, this bill would 
          add to those enumerated exceptions that such information and 
          records shall also be disclosed to the P&A agency to the extent 
          that the information is contained in an unredacted citation 
          report, unredacted licensing report, unredacted survey report, 
          unredacted plan of correction, or unredacted statement of 
          deficiency prepared by an authorized licensing personnel or 
          authorized representatives described, as specified.  The bill 
          would also specify that information obtained in those records 
          must be kept confidential by the P&A agency pursuant to existing 
          law.    

           Timely Access To Reports Is Integral To The Intended Functions 
          Of P&A Agencies.   Existing law provides for numerous types of 
          reports that the P&A agency shall have access to under 
          subdivision (b) of Section 4903 of the Welfare and Institutions 
          Code.  This bill would require that the P&A agency have access 
          to the unredacted versions of the following records: citation 
          reports, licensing reports, survey reports, plans of correction, 
          and statements of deficiency prepared by a department 
          responsible for issuing a licensee or certificate to a program, 
          facility, or service serving an individual with a disability.   

          As explained by the sponsor of this bill, California's P&A 
          agency, Disability Rights California:  "Federally mandated 
          P&A's, such as �DRC] are charged with protecting and advocating 
          for the rights of persons with disabilities.  In order to 
          fulfill this function, federal law grants P&A's the right to 
          access reports prepared by state agencies that investigate 
          reports of abuse, neglect with disabilities and perform 
          certification or licensing reviews."  And yet, the DRC and the 
          author of this bill comment that in recent years a Department of 
          Public Health policy has created delay in DRC's timely access to 








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          unredacted citation reports, licensing reports, survey reports, 
          plans of correction, and statements of deficiencies prepared by 
          the department.  Only after the P&A agency receives a redacted 
          version and submits a specific written request will the 
          department provide the unredacted version.  On average, DRC 
          reports, it takes 32 days to get reports back from the date of 
          request to date received.  Three reports took 305 days to reach 
          DRC, while another two took 215 days.  Those wait times have 
          reportedly shortened since the DRC began working with DPH to 
          develop a standard request form.  The last 10 records requested 
          took an average of 24 days, and five of these took 45 days. 

          By specifying that these specific types of records, in 
          unredacted form, are to be provided to the agency in statute, it 
          is hoped that this bill will eliminate this relatively recent 
          practice that has resulted in substantial delays of records, 
          which are vital to the P&A agency's ability to perform its 
          investigatory duty.  

          Existing law arguably gives the P&A agency the right to access 
          these reports (Welf. & Inst. Code Secs. 4902(a), 4903(a)-(b)), 
          to the extent that the P&A agency's access to full reports is 
          obstructed by redacting information and only providing the full, 
          unredacted version upon specific written request, the addition 
          of these types of unredacted records to the existing list of 
          records in Section 4903 would add useful clarity and expedite 
          the process in the interest of these persons with disabilities 
          who are affected by delays in access to records.  

          With respect to persons with developmental disabilities or 
          mental health disabilities, this bill would specify that 
          permissible disclosures of confidential information or records 
          shall also include disclosure to the P&A agency to the extent 
          that the information is contained in specified unredacted 
          records.  The bill would provide that the confidentiality of any 
          information obtained in those reports must be maintained by the 
          P&A agency as specified under existing law.  

           REGISTERED SUPPORT / OPPOSITION  :

           Support 
           
          California Advocates for Nursing Home Reform
          California Association of Public Authorities for IHSS
          Disability Rights Education and Defense Fund, Inc.








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          The Arc and United Cerebral Palsy in California
           
           Opposition 
           
          None on file


           Analysis Prepared by :    Kevin G. Baker / JUD. / (916) 319-2334