BILL ANALYSIS �
SENATE COMMITTEE ON HEALTH
Senator Ed Hernandez, O.D., Chair
BILL NO: AB 1790
AUTHOR: Dickinson
AMENDED: June 11, 2014
HEARING DATE: June 25, 2014
CONSULTANT: Diaz
SUBJECT : Foster children: mental health services.
SUMMARY : Requires the Department of Social Services to convene
a stakeholder group, as specified, to identify barriers to
mental health services by mental health professionals with
specified training. Requires the stakeholder group, on or before
September 30, 2015, to make specific, non-binding
recommendations to specified groups to address the identified
barriers.
Existing law:
1.Establishes the Department of Social Services (DSS) to serve,
aid, and protect needy and vulnerable children and adults in
ways that strengthen and preserve families, encourage personal
responsibility, and foster independence.
2.Requires a foster child whose adoption is final, who is
receiving or is eligible for Adoption Assistance Program
assistance, including Medi-Cal, and whose foster care court
supervision has been terminated, to 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.
This bill:
1.Requires DSS to convene a stakeholder group to identify
barriers to the provision of mental health services by mental
health professionals with specialized clinical training in
adoption or permanency issues to foster youth receiving
services from the Adoption Assistance Program. Requires the
stakeholder group to include at least all of the following
individuals:
a. Adoptive parents;
b. Former foster youth;
c. Representatives from the mental health and
child welfare fields, including an association
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AB 1790 | Page 2
representing county mental health departments;
d. Representatives from mental health and social
work graduate degree-granting postsecondary education
institutions; and,
e. Representatives from relevant state and local
agencies.
2.Requires the stakeholder group, on or before September 30,
2015, to make specific recommendations for voluntary measures
available to state and local government agencies and private
entities, as appropriate, to address those barriers.
3.Requires DSS to collect existing research and professional
literature pertinent to the need for specialized clinical
training in adoption and permanency issues. Requires DSS to
distribute the information to the stakeholder group and to
coordinate with, and endeavor not to duplicate, existing
local, state, or national initiatives.
4.Prohibits any recommendation made to be construed to be
binding on any state or local government agency or private
entity.
FISCAL EFFECT : According to the Assembly Appropriations
Committee, minor staff costs, less than $100,000, to DSS to
convene a stakeholder panel.
PRIOR VOTES :
Assembly Health: 17- 1
Assembly Appropriations:17- 0
Assembly Floor: 78- 0
COMMENTS :
1.Author's statement. According to the author, this bill
improves the stability of adoptive and guardianship families
by increasing the pool of adoption/permanency competent mental
health professionals. Without the support of clinicians with
specialized clinical adoption training and experience,
children adopted from foster care are at unnecessary risk for
disruption from their new families. The consequence is return
of children to foster care, suffering one more devastating
loss in a litany of preventable losses. Despite the increase
in the numbers of children in foster care achieving permanence
through adoption and guardianship, placement into a stable and
motivated family is not sufficient to compensate for
psychosocial problems related to prior trauma and chronic
AB 1790 | Page
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maltreatment. Adoption and guardianship bring with them unique
issues, which if not understood by the clinician, can result
in ineffective or even damaging treatment. Because adoption
issues are not typically included in the education of
psychologists and marriage and family therapists, these issues
are given relatively limited attention in the training of
graduate-level social workers. Most clinicians are unaware of
the impact of the unique issues facing these families. Rather
than getting the help needed, many adoptive parents and
guardians are misunderstood or even blamed for a child's
problems, leaving the family in greater crisis.
2.Background. In May 2011 a coalition of child welfare
organizations participated in a Congressional hearing on the
need for post-adoption services and recommended policy
reforms. One of the recommendations to come out of that
hearing was to ensure that services offered to adoptive
families embrace best practices and are provided by
adoption-competent professionals.
An August 2013 document published by the Donaldson Adoption
Institute, "A Need to Know: Enhancing Adoption Competence
among Mental Health Professionals," states that issues related
to adoption can require counseling and other services from a
variety of professionals, including child welfare specialists,
mental health practitioners, physicians, educational advisors,
and teachers; however, adoptive parents and adopted
individuals (as children and adults), and birth relatives
often encounter barriers to obtain assistance. The document
cites a study in which 81 percent of 485 respondents reported
having worked with one or more mental health professionals. Of
those people, about 25 percent believed the professionals were
adoption-competent, while 26 percent thought none of the
professionals knew about adoption issues. Some respondents
reported experiences that damaged their families, citing a
lack of sensitivity or having knowledge of issues such as
attachment, trauma, loss, and the use of appropriate language.
According to an article published on the Psychiatric News Web
site on May 24, 2014, American Psychiatric Association CEO and
Medical Director Saul Levin testified in Congress and stated
that children in foster care systems experience high rates of
mental illness and require a broad spectrum of mental health
services. According to the National Survey of Child and
Adolescent Well-Being, upwards of three-fourths of children
AB 1790 | Page 4
entering foster care exhibit behavior or social competency
problems that warrant mental health care. Dr. Levin also
stated that the shortage of child and adolescent psychiatrists
is a major obstacle to the promotion of sound mental health
among youth in foster care.
3.Support. The sponsor and supporters argue that a large body
of research confirms the need for adoption competency in
mental health professionals accepting adoptive and guardian
families as clients. They further argue that children adopted
from foster care bring histories of trauma and loss into their
new families, and providing mental health services to these
families by professionals who do not have training and
experience in adoption competency can and has caused
unintentional harm.
SUPPORT AND OPPOSITION :
Support: Mission Focused Solutions (sponsor)
American Academy of Pediatrics, California
California Alliance of Child and Family Services
Children Now
One individual
Oppose: None received.
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