BILL NUMBER: AB 1790INTRODUCED BILL TEXT 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 introduced, 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 require the county mental health plan to prioritize referrals of pre- and postadoptive or guardianship families to specialty mental health services providers who are adoption and permanency competent, as described, and requires the county mental health plan to attempt to ensure that an adequate number of adoption and permanency competent specialty mental health providers are available to meet the needs of the children. 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. 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. 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. Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: yes. THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS: 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) Adoption issues are not typically included in the education of psychologists and marriage and family therapists, and these issues are given relatively limited attention in the training of graduate level social workers. 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. SEC. 2. 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. (d) The county mental health plan shall prioritize referrals of pre- and postadoptive or guardianship families to specialty mental health services providers who are adoption and permanency competent. (1) A mental health professional shall be considered adoption and permanency competent if the following requirements are met: (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 adoption and permanency competency training from an evidence-informed curriculum that shows empirical support for the impact of training on recipients' knowledge and adoption practice. Topics covered in the curricula 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 pre- 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) A family-based, strength-based, and evidence-based approach to working with adoptive families and birth families. (D) A developmental and systemic approach to understanding and working with adoptive and birth families. (E) Demonstrated knowledge, clinical skills, and experience in treating individuals with a history of abuse, neglect, or trauma. (F) Demonstrated knowledge, clinical skills, and experience in working with adoptive families and birth families. (2) County mental health plans shall attempt to ensure that an adequate number of adoption and permanency competent specialty mental health providers are available to meet the needs of children formerly in foster care who have been adopted or are with guardianship families. 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.