Amended in Assembly May 23, 2014

Amended in Assembly April 24, 2014

Amended in Assembly April 9, 2014

Amended in Assembly March 25, 2014

California Legislature—2013–14 Regular Session

Assembly Bill No. 1790

Introduced by Assembly Member Dickinson

February 18, 2014

An act to amend Section 16125 of the Welfare and Institutions Code, relating to foster children.

LEGISLATIVE COUNSEL’S DIGEST

AB 1790, as amended, Dickinson. Foster children: mental health services.

Existing law provides for the Adoption Assistance Program, administered by the State Department of Social Services, which provides for the payment by the department and counties of cash assistance to eligible families that adopt eligible children, and bases the amount of the payment on the needs of the child and the circumstances of the family. Under existing law, the department, county adoption agency, or licensed adoption agency is required, among other duties, to provide the prospective adoptive family with information on the availability of mental health services through the Medi-Cal program or other programs. Existing law provides that a foster child whose adoption has become final and who is receiving or is eligible to receive Adoption Assistance Program assistance, including Medi-Cal, and whose foster care court supervision has been terminated, shall be provided medically necessary specialty mental health services by the local mental health plan in the county of residence of his or her adoptive parents, as specified.

This bill would begin delete require the county mental health plan to take steps to increase the pool of specialty mental health providers who meet specified training or experience criteria and are available to meet the needs of children formerly in foster care who have been adopted or placed with a guardian. The bill would end delete require the State Department of Social Services to convene a stakeholder group to begin delete recommend strategies and facilitate the development of processes relating to the education and training of these specialty mental health providers, and to consult with the State Department of Health Care Services to ensure that these provisions are implemented in compliance with state and federal requirements governing the Medi-Cal program. end delete begin insert identify barriers to the provision of mental health services by mental health professionals with specialized clinical training in adoption or permanency issues to children receiving those medically necessary specialty mental health services end insert begin insert . The bill would authorize the stakeholder group to make specific recommendations for voluntary measures to address those barriers, but would provide that those recommendations are not binding on any state or local government agency or private entity. The bill would require the stakeholder group to coordinate with, and endeavor not to duplicate, existing local, state, or national initiatives. end insert

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To the extent that it would impose new duties on counties in connection with the provision of mental health services, this bill would impose a state-mandated local program.

end delete begin delete

The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

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This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to these statutory provisions.

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Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program:  begin delete yes end delete begin insert no end insert .

The people of the State of California do enact as follows:

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SECTION 1.  

(a) The Legislature finds and declares all of the
following:

(1) Despite the increase in the number of children achieving
permanence through adoption, placement of a child into a stable
and motivated family is not considered sufficient to compensate
for psychosocial problems related to prior trauma and chronic
maltreatment. As the number of adopted children with significant
developmental and emotional issues surrounding their adoption
experience has grown, the need has increased for child welfare
professionals and clinicians with an in-depth understanding of
adoption issues and the skills to work effectively with adoptive
persons and their families.

(2) Many textbooks for counseling professionals have limited
coverage of adoption. As a result, most mental health practitioners
and many child welfare professionals lack knowledge about
adoption and the issues that are unique to adoptive families. Many
mental health professionals, for example, are unaware of the
potential impact of adoption on clients. Given the absence of
education on adoption issues, it is not surprising that many
counselors report feeling unprepared to deal with adoption related
issues in their practice.

(3) The interest in developing specialized clinical training in
adoption has evolved over two decades as a result of the high
demand for postadoption services by families and the lack of local
mental health and post permanency supports that address the needs
of adoptive families.

(4) Adoption competence begins with a solid foundation of
knowledge and clinical skills gained through an approved graduate
program in psychiatry, psychology, social work, marriage and
family therapy, or counseling. Meeting the needs of individuals
and families touched by adoption also requires specialized training
in assessment, diagnosis, and intervention. At each phase of the
clinical process, therapists must be attuned to the complex array
of historical and contemporary factors impacting the lives of their
clients and, specifically, to the ways in which the adoption
experience can influence their identity, relationships, and
development.

(b) It is the intent of the Legislature in enacting this act to
increase stability of adoptive and guardianship families by
increasing the pool of adoption and permanency competent mental
health professionals.

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begin delete SEC. 2. end delete
begin insert SECTION 1. end insert   

Section 16125 of the Welfare and Institutions
Code is amended to read:

16125.  

A foster child whose adoption has become final, who
is receiving or is eligible to receive Adoption Assistance Program
assistance, including Medi-Cal, and whose foster care court
supervision has been terminated, shall be provided medically
necessary specialty mental health services by the local mental
health plan in the county of residence of his or her adoptive parents,
pursuant to all of the following:

(a) The host county mental health plan shall be responsible for
submitting the treatment authorization request (TAR) to the mental
health plan in the county of origin.

(b) The requesting public or private service provider shall
prepare the TAR.

(c) The county of origin shall retain responsibility for
authorization and reauthorization of services utilizing an expedited
TAR process.

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(d) (1) The county mental health plan shall take steps to increase
the pool of specialty mental health providers who meet all of the
following training or experience criteria and are available to meet
the needs of children formerly in foster care who have been adopted
or placed with a guardian:

(A) The mental health professional has completed the requisite
education and obtained all necessary licenses otherwise required
by law.

(B) The mental health professional has completed a minimum
of 48 hours of training from an evidence-informed post-graduate
adoption or permanency training program, continuing education
courses, or individual workshops. Topics covered in the curricula
shall be documented and shall include, at a minimum, all of the
following:

(i) Separation, grief, and loss.

(ii) Attachment.

(iii) Trauma and brain development.

(iv) Identity formation.

(v) Openness in adoption.

(vi) Impact of prenatal or postnatal exposure to drugs and
alcohol.

(vii) Adoptive family formation, integration, and developmental
stages.

(viii) Family constellation challenges in adoption, including the
birth family and the adoptive family.

(ix) Race, ethnicity, sexual orientation, gender identity, and
cultural competence.

(x) Tools for skilled practice.

(xi) Tools for adoptive parents, including, but not limited to,
decoding behaviors, how to mitigate impacts of trauma, and
recognizing behavioral and emotional challenges in context of life
histories.

(C) The mental health professional utilizes family-based,
strength-based, and evidence-based approach to working with
adoptive families and birth families.

(D) The mental health professional utilizes developmental and
systemic approach to understanding and working with adoptive
and birth families.

(E) The mental health professional demonstrates knowledge,
clinical skills, and experience in treating individuals with a history
of abuse, neglect, or trauma.

(F) The mental health professional demonstrates knowledge,
clinical skills, and experience in working with adoptive families
and birth families.

(2)

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begin insert (d) end insert begin insert   end insert begin insert (1) end insert  The State Department of Social Services shall convene
a stakeholder group comprised of adoptive parents, representatives
from the mental health and child welfare fields, begin insert representatives
from relevant state and local agencies, end insert and others, as appropriate, begin delete to facilitate the development of a process to approve curricula and
determine criteria for trainers, and to facilitate the establishment
of a process by which mental health practitioners document
adoption and permanency training and experience that satisfies
the criteria set forth in paragraph (1). The stakeholder group shall
recommend a strategy to educate mental health professionals
working with adoptive and guardianship families about the
importance of obtaining training and experience that will increase
the pool of mental health professionals who can meet the needs of
children who were formerly in foster care and are now in adoptive
and guardianship families. The stakeholder group shall also consult
with the State Department of Health Care Services to ensure that
this subdivision is implemented in compliance with state and
federal requirements governing the Medi-Cal program. end delete begin insert to identify
barriers to the provision of mental health services by mental health
professionals with specialized clinical training in adoption or
permanency issues to children who are receiving services pursuant
to this section. The stakeholder group may make specific
recommendations for voluntary measures available to state and
local government agencies and private entities, as appropriate, to
address those barriers. The stakeholder group shall coordinate
with, and endeavor not to duplicate, existing local, state, or
national initiatives. end insert

begin insert

(2) A recommendation made pursuant to paragraph (1) shall
not be construed to be binding on any state or local government
agency or private entity.

end insert

begin delete

SEC. 3.  

If the Commission on State Mandates determines that
this act contains costs mandated by the state, reimbursement to
local agencies and school districts for those costs shall be made
pursuant to Part 7 (commencing with Section 17500) of Division
4 of Title 2 of the Government Code.

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