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Written on August 8, 2018 Catherine Atkins, JD Deputy Executive Director
The California legislative session for 2018 is almost over, nearing the end of a two-year legislative cycle. Hundreds of bills have been introduced, reviewed and assessed by CAMFT to determine the impact on CAMFT members and the profession. This article provides a brief overview on CAMFT’s legislative priorities/outcomes for 2018. For more information on what bills CAMFT is sponsoring or taking a position, we encourage members to review CAMFT’s Legislative Action Center.
CAMFT Legislation for 2018 AB 2088 (Santiago)—Minor’s Records: This bill would permit all patients, not just adult patients, to addend (not amend/change) their records upon finding a mistake or error. Under current law, minors age 12 or older can consent for their own treatment, with a few exceptions. Minors also have the right to inspect their treatment records. This bill would give minors the ability to add an addendum up to 250 words in length to their records when they believe the record is incomplete or inaccurate. This right to addend a treatment record is important given that these records may be subject to disclosure and have the potential to impact the patients’ lives and their ability to pursue various endeavors. This bill is on the Governor’s desk.
Other 2018 State Legislation AB 93 (Medina)—Supervision Requirements: This bill, sponsored by the Board of Behavioral Sciences (BBS), revises and recasts some LMFT supervised experience requirements. To address changing and evolving supervised experience and supervisor relationships, the BBS formed a special committee in 2014, to examine supervision requirements. Through that Committee, and relying on fruitful stakeholder participation, came SB 620 (2015) and AB 93.
Some of the more notable changes in AB 93 include:
CAMFT participated in all stakeholder meetings and has taken a position of support on this legislation. CAMFT will be releasing a detailed article about the changes to supervision through AB 93 once the law is signed by the Governor.
AB 1779 (Nazarian)—SOCE with a Minor: Existing law prohibits mental health providers from performing sexual orientation change efforts (SOCE) with a patient under 18 years of age. Existing law provides that any sexual orientation change efforts attempted on a patient under 18 years of age by a mental health provider shall be considered unprofessional conduct and shall subject the provider to discipline by the provider’s licensing entity. This bill would additionally prohibit a mental health provider from engaging in SOCE with a patient, regardless of age, under a conservatorship or a guardianship. In line with prior positions on the issue of SOCE with minor patients, CAMFT has taken a position of support on this legislation.
AB 1968 (Low)—5150s and Gun Possession: This bill prohibits an individual from owning a firearm if the person is taken into custody, assessed, and admitted to a designated facility because he or she is a danger to himself/herself or others because of a mental health disorder, more than once within a one-year period. The prohibition is also subject to the right to challenge the prohibition at periodic court hearings. The California Psychiatric Association has taken a position of oppose, whereas the California Psychological Association has taken a position of support. After substantial review and discussion, the CAMFT Board of Directors voted to support AB 1968 as a protective measure of suicidal patients.
AB 2022 (Chu)—Mental Health within K-12 School System: The purpose of this bill is to increase mental health services geared towards children and youth. The original goal of this bill was to place paid mental health professionals onto the campus, both providing timely services for children as well as breaking down stigma surrounding mental health generally. After moving through the legislature, the bill has been turned into a research vehicle to supply future data to the legislature to craft appropriate measures to address mental health issues within the K-12 school system. CAMFT has taken a position of support on this bill.
AB 2138 (Low)—DCA Licensees: Existing law provides that a health care provider shall not be denied a license under the BBS solely on the basis that the person has been convicted of a felony if he or she has obtained a certificate of rehabilitation, the conviction has been dismissed, or that the person has been convicted of a misdemeanor if he or she met certain requirements of rehabilitation developed by the board. This bill would instead prohibit a person from being denied a license solely on the basis that he or she has been convicted of a nonviolent crime and would make conforming changes. The BBS has expressed concerns about this bill, specifically consumer protection. CAMFT took a watch position on this legislation.
AB 2498 (Eggman)—School Health Care and Social Worker Pilot Program: This bill provides grant funding in certain K-12 school districts, as a pilot program, to fund mental health services. However, the pilot program is only aimed at social workers with a credential under the Department of Education or Licensed Clinical Social Workers. While CAMFT generally supports any additional funding of mental health services to children in California, there is concern that the program is only aimed at credentialed staff or LCSWs. This could lead to disenfranchisement of other mental health professionals, as well as limit the access to qualified mental health professionals. The bill did not make it out of Committee.
AB 2608 (Stone)—BBS Licensees and Grants: This bill increases the licensing fee (by $10) for those regulated by the BBS to fund grants to repay educational loans for licensees who had grown up through the foster care system. While the intent of the bill has merit, CAMFT has concerns that it is unfair to provide preferential treatment to one group over another in accessing the grant funds (for example, licensees with disabilities). CAMFT has taken a position of oppose on this legislation.
AB 2943 (Low)—SOCE and Unlawful Practices: This bill would include, as an unlawful practice prohibited under the Consumer Legal Remedies Act, advertising, offering to engage in, or engaging in sexual orientation change efforts with any individual. CAMFT has worked with the author to amend language into the bill clarifying that this prohibition does not include sexual orientation-neutral interventions to promote healthy sexual and romantic relationships. After reviewing and discussing member proposals on AB 2943, the CAMFT Board of Directors voted to support this legislation.
AB 3087 (Kalra)—Health Care in California: This bill establishes the Health Care Cost, Quality, and Equity Commission (Commission), in an attempt to control in-state health care costs and set the amounts accepted as payment by health plans, hospitals, physicians, physician groups, and other healthcare providers. This bill has been opposed by numerous health provider groups, hospitals, and health care plan groups. Some of the concerns raised have been the loss of health care provider positions, lack of attention to Medi-Cal services, likely lowering of provider rates, administrative complexities, and loss of revenue in the billions to hospitals. CAMFT has taken a position of oppose on this legislation.
SB 399 (Portafino)—Applied Behavioral Analysis: This bill makes changes to the mandate on health plans and health insurers to cover behavioral health treatment for pervasive developmental disorder or autism, such as prohibits a health plan or insurer from denying or reducing coverage for medically necessary services. This bill also broadens the eligibility criteria to become a qualified autism service professional and paraprofessional. Although CAMFT is generally in support of increased access to care, the bill as currently written limits the opportunities pre-licensees have when working with the ABA population. CAMFT has taken an oppose unless amended position on this bill until pre-licensees are included.
SB 968 (Pan)—Mental Health Counselors and Colleges: This bill requires the California State University (CSU), Board of Trustees, Board of Governors (BOG) of the California Community College (CCC) and requests the Regents of University of California (UC) to have one full-time equivalent mental health counselor per 1,000 students enrolled at each of their respective campuses. CAMFT is supportive of the intent and merits of hiring additional mental health professionals at the college level, however CAMFT needs to ensure that this bill moves forward in a manner that does not put pre-licensees jobs on the college campuses in jeopardy. Because recent amendments to the bill have included funding requirements, CAMFT has taken a position of watch until CAMFT is ensured that no unintentional consequences arise.
SB 974 (Lara)—Health for All: This bill extends eligibility for fullscope Medi-Cal benefits, including mental health care, to individuals of all ages who are otherwise eligible for those benefits but for their immigration status. CAMFT supports increasing access to mental health care services, and accordingly has taken a position of support.
WET Funding The 2014-2019 Mental Health Services Act (MHSA) Workforce Education and Training (WET) plan was put into place this year without monies being earmarked for MFTs in 2019. This is very concerning because the reasoning behind the removal of MFTs from the list of eligible providers was due to a misunderstanding that MFTs could work with the seriously mental ill population. CAMFT is working to attempt a clean-up remedy for 2019, but also beginning the process of ensuring that the next five-year plan (2020-2025) appropriately contains MFTs within the eligible provider group.
Medicare: CAMFT has obtained bi-partisan co-authors in both the House and Senate (Sen. Barrasso (R-WY), Sen. Stabenow (D-WY), Rep. Thompson (D-CA), and Rep. Katko (R-NY)). HR 3032 has been introduced in the House, and S 1879 in the Senate.
HR 3032 has 73 co-sponsors, including 15 from California—this is the highest number of co-sponsors to date. CAMFT, with our coalition partners, is working to increase the number of co-sponsors with the goal of trying to get 100 by the year’s end. It is possible that over the next five months there will be another round of opioid related bills, which could contain our Medicare bill. If 2018 does not result in passage of CAMFT’s Medicare bill, we would start 2019 with the introduction of a similar bill with a likely 73 co-sponsors to start. Depending on the make-up of the House post-November elections, the priorities related to health-care could change and CAMFT will have a clearer picture of the 2019 landscape at that time.
S 1879 has 12 co-sponsors, and neither Senators Feinstein nor Harris have signed on to date.
Veterans Affairs: In May 2018, the Department of Veteran Affairs (VA) finally released their new employment standards for LMFT hiring. As background, signed into law in 2016, was the removal of the requirement that LMFTs must be graduates of COAMFTE-accredited programs in order to work at the VA. A committee consisting of five LMFTs employed through the VA, and a psychologist, began drafting the employment standards for LMFT hiring in early 2017. After review of the standards, CAMFT remains very concerned given the substantial limitation for promotion of LMFTs within the VA without a COAMFTE-accredited degree. CAMFT is currently strategizing next steps within Congress and the VA. In the meantime, CAMFT encourages LMFTs interested in working within the VA to seek out and apply for positions within the VA (including those only for LCSWs/LPCCs). To learn more about jobs within the VA, we encourage members to visit usajobs.gov.
Department of Homeland Security (DHS): Over the last year, CAMFT has become aware of the difficulties deportation and asylum defendants have had when utilizing MFTs as the therapist attesting to mental health status—the difficulties resulting from the DHS arguing that MFTs are not able to provide testimony related to diagnosis (arguing it is outside the scope of practice). CAMFT has reached out to DHS to advocate against this misinformation; as well as provided individual defendants, and their attorneys, amicus briefs and letters to the court to provide education and background on MFT’s ability to treat and diagnose. CAMFT is hopeful its advocacy to the DHS will result in a reversal of their standard legal argument against the usage of MFTs within deportation and asylum hearings.
Catherine L. Atkins, JD, is a staff attorney and the Deputy Executive Director at CAMFT. Cathy is available to answer members’ questions regarding legal, ethical, and licensure issues.