CALIFORNIA ASSOCIATION OF MARRIAGE AND FAMILY THERAPISTS June 3-4, 2017 Board of Directors Meeting Hyatt Regency La Jolla 3777 La Jolla Village Drive San Diego, CA 92122 Syros Room
PUBLIC BOARD BOOK
About this Public Packet:
At the June, 2014, Board meeting, the Board voted for staff and President to split the Board meeting materials into a public and a Board-only packet and post the public packet on the CAMFT website in the members-only section when it is available.
The packet contains only materials deemed to be NON-SENSITIVE. Documents that contain member names (including member proposals) have been shared only with the Board to protect privacy. (Note: Proposal forms now include an opt-in box to allow for the member to choose to have his/her proposal made public through this vehicle.) In addition, all draft minutes and draft financial reports have been shared only with the Board as these materials are not in final form. Closed session materials and any materials that include competitively valuable updates have been shared only with the Board.
Welcome ...... page 1 Agenda ...... page 7 Orientation ...... page 63 Policies/Procedures/Positions ...... page 70 Committee Actions/Nominations ...... page 81 Finance ...... page 289 Proposed Projects ...... page 303 Executive Director Report ...... page 316 Legislative/Advocacy Update ...... page 332
ADHERENCE TO POLICY ON ANTI-TRUST COMPLIANCE - 1A
Page 1 of 521 ADHERENCE TO POLICY ON ANTI-TRUST COMPLIANCE - 1A
Page 2 of 521 ACKNOWLEDGMENT OF STRATEGIC PLAN – 1B
CAMFT Strategic Plan APPROVED MARCH 19, 2016
Vision (Objective of the organization)
Through leadership, education, and advocacy, CAMFT and its members strive to be exemplary professional resources for mental health professionals and people seeking their services.
Mission (Fundamental reason for being)
CAMFT exists for the advancement of the Marriage and Family Therapist profession in California by strengthening qualifications, and maintaining high standards of professional ethics and accountability, in order to enhance recognition and utilization of the profession. CAMFT strives to anticipate and meet the professional needs of its members and to create a vibrant Marriage and Family Therapist community.
Values (Guiding principles that dictate behavior and action)
Integrity Accountability Transparency Inclusiveness Collaboration
Page 3 of 521 ACKNOWLEDGMENT OF STRATEGIC PLAN – 1B
Goals and Objectives
Goal I Professionalism CAMFT will maintain and promote all legal and ethical standards of professionalism, competence, accountability, and inclusiveness.
Objectives:
1.1 CAMFT will develop and uphold ethical standards consistent with the evolving profession.
1.2 CAMFT will develop and advocate for legal standards consistent with the evolving profession.
1.3 CAMFT will create, deliver, and promote quality professional development opportunities consistent with current research and best practices.
1.4 Interaction between the Board of Directors, staff, and members will be collaborative.
1.5 In addition to the investment goals of safety, liquidity, and return on investment, CAMFT will attempt to have investments that are believed to have a positive social, economic, and environmental impact.
Goal II Governance The Board of Directors will govern in accordance with the California Corporations Code, CAMFT Bylaws, and CAMFT policies.
Objectives:
2.1 The Board will govern in a collaborative, professional, ethical, and deliberative manner.
2.2 The Board will develop policies and initiatives, for the staff to implement, that ensure an effective operation.
2.3 The Board will be cognizant of CAMFT’s history as it plans for the future.
2.4 The Board is accountable to this Strategic Plan. Page 4 of 521 ACKNOWLEDGMENT OF STRATEGIC PLAN – 1B
Goal III Advocacy CAMFT will advocate for the advancement of Marriage and Family Therapists in accordance with CAMFT’s Vision, Mission, and Values.
Objectives:
3.1 CAMFT will champion and invest in the future of the Marriage and Family Therapist profession.
3.2 CAMFT will seek parity with other licensed mental health professionals and will promote increased utilization of Marriage and Family Therapists in the public and private sectors.
3.3 CAMFT will coordinate and collaborate with other mental health organizations and stakeholders for common goals.
3.4 CAMFT will advocate in the legislative and regulatory process at the local, state, and federal levels.
3.5 CAMFT will promote member participation in governmental and advocacy efforts that impact the profession.
3.6 CAMFT will educate and galvanize members to contribute financially to support government and advocacy efforts of the organization through contributions to the CAMFT Political Action Committees (PACs).
Goal IV Public Outreach CAMFT will promote Marriage and Family Therapists.
Objectives:
4.1 CAMFT will increase the recognition, credibility, professional visibility, and need for Marriage and Family Therapists through professional branding, public relations, social media and marketing.
Page 5 of 521 ACKNOWLEDGMENT OF STRATEGIC PLAN – 1B
4.2 CAMFT will increase public awareness that Marriage and Family Therapists are not only relationship experts, but also diagnose and treat a variety of mental health issues.
4.3 CAMFT will reach out to chapters in efforts to disseminate marketing initiatives.
Goal V Membership CAMFT will cultivate a participatory and growing membership.
Objectives:
5.1 CAMFT will strive to maintain and increase its membership.
5.2 CAMFT will encourage member participation in activities, such as chapter meetings, Annual Conference, and other CAMFT-sponsored initiatives.
5.3 CAMFT will take strive to understand the demographics and perspectives of the membership.
5.4 CAMFT will strive to increase diversity within its membership.
Goal VI Volunteer Leadership CAMFT will promote collaboration, accountability, dedication, and commitment in its leaders.
Objectives:
6.1 CAMFT will recruit, and promote the benefits of and need for, competent and active volunteer leaders.
6.2 CAMFT will strive to have volunteer leaders who identify with and/or are proactive, sensitive, and responsive to the needs of a diverse population.
6.3 CAMFT will provide opportunities for training and development for volunteer leaders.
Page 6 of 521 APPROVAL OF AGENDA – 2A
POSTED 5/10/17 UPDATED 5/17/17 CALIFORNIA ASSOCIATION OF MARRIAGE AND FAMILY THERAPISTS
Hyatt Regency La Jolla 3777 La Jolla Village Drive San Diego, CA 92122 June 3-4, 2017
CAMFT’s Mission: CAMFT exists for the advancement of the Marriage and Family Therapist profession in California by strengthening qualifications, and maintaining high standards of professional ethics and accountability, in order to enhance recognition and utilization of the profession. CAMFT strives to anticipate and meet the professional needs of its members and to create a vibrant marriage and family therapist community.
Times are approximate. We would appreciate attendees refraining from wearing perfumes/fragrances to keep the meeting accessible for those with environmental illnesses or allergies. Thank you.
SATURDAY, JUNE 3, 2017 8:30 - 8:35 AM 1. Welcome/Introductions and Call to Order A. Adherence to Policy on Anti-Trust Compliance B. Acknowledgment of Strategic Plan
8:35-8:40 AM 2. Approval of Consent Agenda—Any item can be pulled from the Consent Agenda for discussion at the request of any Board Member A. Approval of Agenda
Page 7 of 521 APPROVAL OF AGENDA – 2A
B. Approval of Minutes of March 25-26 and April 21 Board meeting; March 29 and April 28 unanimous written consent C. Analytics i. CAMFT Website ii. CounselingCalifornia.com iii. CAMFT Community D. Member Reports i. Approval of New Members ii. Membership Summary iii. Drop Survey Results E. Certified Supervisor Program Report F. “Behind the Scenes” (includes school, chapter, and agency presentations by staff and Board) G. Committee Reports i. Executive Committee ii Political Action Committee iii. Finance Committee iv. Legislative Committee v Elections Committee vi. Personnel Committee vii. Prelicensed Committee viii. Special Interest Groups Task Force ix. External Management Audit Task Force
8:40-9:10 AM 3. Member Forum - (30 min maximum) This is an opportunity for CAMFT members in attendance to present concerns or topics for possible future agenda items. Each member is limited to three minutes and the maximum time allotted for total member comments is 30 minutes. Speakers shall place their names on the sign- up sheet available just prior to the beginning of the meeting. To permit Board Members to engage in a thorough and open discussion, observers of Board Meetings and individuals making presentations to the CAMFT Board of Directors shall not transmit or record information by any electronic means during any CAMFT Board Meeting. In accordance with the CAMFT Policy on Anti-Trust Compliance, comments which border on areas of anti-trust sensitivity will be not be permitted.
9:10-9:15 AM 4. Appointment of Parliamentarian
Page 8 of 521 APPROVAL OF AGENDA – 2A
9:15:10-9:30AM 5. Orientation (15 min) Note: New Board Members will receive an in-depth orientation on Friday, June 2 at the CAMFT office. This orientation is a brief refresher for all Directors and Officers.
9:30 – 10:10 AM 6. Policies/Procedures/Positions - (40 min) A. Policy on Dues-Extended Payment Option (edits) B. Policy on Nominating Committee Charge, Composition, and Restrictions (edits) C New Logo for CAMFT (discussion) D. Board Code of Conduct (discussion)
10:10-10:25 AM BREAK
10:25 -11:00 AM 7. Committee Actions/Nominations – (35 min) A. Legislative Committee B. Connects Task Force C. Scope of Practice Task Force D. Chapter Task Force E. Nominating Committee Description (edits) F. Public Outreach Committee (dissolution discussion) G. Ad Hoc Search Committee Nomination H. CAMFT 2017-2018 Committee Nominations
11:00 – 11:20 AM 8. Finance (20 min) A. Financial Reports—April, 2017 B. CAMFT Fund Balances— April, 2017 C. PAC Fund Balances— April, 2017 D. CAMFT-EF Fund Balance— April, 2017
11:20-12:00 PM 9. Proposed Projects (40 min) A. Support FBI Cyber Criminal Division of Los Angeles Office investigation
Page 9 of 521 APPROVAL OF AGENDA – 2A
B. Vote of Members Whether to Discontinue Publishing Disciplinary Actions Taken by BBS C. Roll Call Votes for all Board actions
12:00-1:00 PM LUNCH
1:00-1:30 PM 10. Executive Director Report (30 min) A. CAMFT Staff/Operations Report B. External Groups Update C. The Therapist D. Marketing and Public Relations Report E. Continuing Education Provider Approval Program Report F. Chapter Relations Report i. Chapter Agreement non-compliance G. Professional Development Report
1:30-2:30 11. CLOSED SESSION – Personnel Issue
SUNDAY, JUNE 4, 2017
8:30-9:30 AM 12. Legislative/Advocacy Update (60 min) A. BBS B. State Legislation/Advocacy i. Bianka M. v. Superior Court C. Federal Legislation/Advocacy i. Immigration Review of Marco Antonio Lera-Vasquez D. Legislative Committee Recommendations E. 2017 Sacramento/DC Lobby Days update
9:30-9:45 AM 13. Open Forum (15 min)
Page 10 of 521 APPROVAL OF AGENDA – 2A
This is an opportunity for Board members to engage in discussion of Board process; limited to 15 minutes.
9:45-10:00 AM 14. Suggestions for Future Agenda (15 minutes) This is an opportunity for Board members to suggest items for the President and Executive Director to consider for a future meeting’s agenda; limited to 15 minutes.
10:00 – 10:30 AM 15. Vision Session (30 minutes) Group creative thinking about emerging trends and topics relevant to CAMFT and the profession.
10:30 AM ADJOURN
Page 11 of 521 ANALYTICS – 2C
www.camft.org - January 1, 2017 – May 8, 2017
Sessions 71,593 Sessions – The total number of sessions within the date range. A Users 42,954 Session is the period time a user is actively within the website. All Page Views 330,540 usage date is associated with a session. Avg. Time on Site 4:62 New Visitor 39,118 Users – Those who have had at least one session within the Returning Visitor 32,475 selected data range. Includes both new and returning users. 1 Day Active User 839 7 Day Active Users 4,574 Pageviews - The total number pages viewed. Repeated views of a 14 Day Active Users 8,594 single page are counted. 30 Day Active Users 15,710 1 Day Active User - The number of unique users who had at least one session within the last day of the active date range.
7 Day Active Users -The number of unique users who had at least one session within a 7-day period. The 7 day period includes the last day in the active date range.
14 Day Active Users -The number of unique users who had at least one session within a 14-day period. The 14 day period includes the last day in the active date range.
30 Day Active Users -The number of unique users who had at least one session within a 30-day period. The 30 day period includes the last day in the active date range.
Browser & Operating Systems for CAMFT.org Browsers Visits New Visits 1. Safari 38,340 20,707 2. Chrome 19,290 10,736 3. Internet Explorer 5,408 2,666 4. Firefox 3,963 2,190 5. Edge 3,490 1,913 6. Safari (in-app) 743 613 7. Android Webview 109 80
Page 23 of 521 ANALYTICS – 2C
Device Info for Visits New % New Visits camft.org Sessions
1 Desktop 41,867 21,292
2 Mobile 25,309 15,438
3 Tablet 4,417 2,388
Mobile Device Info for % New Sessions New Users camft.org Sessions
1. Apple iPhone 22,046 60.53% 13,345
2. Apple iPad 4,169 53.56% 2,233
3. Microsoft Xbox One 205 56.10% 115
4. No set 186 74.19% 138
5. Samsung Galaxy S7 Edge 172 25.00% 43
6. Apple iPhone 6 125 88.00% 110
7. Samsung SM-G030V Galaxy S7 123 64.23% 79
8. Apple iPhone 6s 121 88.43% 107
9. Samsung Galaxy S5 119 49.58% 59
10. Samsung Galaxy S6 89 65.17% 58
Frequency & Recency for camft.org
Count of Visits Visits Pageviews Once 39,118 166,799 2 times 10,582 51,270 3 times 5,180 25,727 4 times 3,072 14,942 5 times 2,053 9,674 6 times 1,464 7,347 7 times 1,142 5,391
8 times 870 4,246 9-14 times 2,795 13,600 15-25 times 1,698 8,756 26-50 times 1,367 7,076
51-100 times 990 5,535 Page 24 of 521 ANALYTICS – 2C
Top 25 Viewed Pages on camft.org Title Pageviews Unique Pageviews
1 Home Page 42,438 32,958
2 Shopping Cart 12,448 5,493
3 Member Sign-in 10,746 9,431
4 Member Account Page 10,186 8,820
5 Renewal Beginning Page 7,739 5,563
6 Office Space – View Ads 4,511 3,562
7 Job Board 3,568 2,658
8 Membership Index 3,304 2,473
9 Resources Index 2,671 2,150
10 CAMFT Staff 2,539 2,296
11 Order Confirmation 2,459 2,118
12 Join CAMFT 2,276 1,745
13 Classified Ads landing page 1,923 1,574
14 2017 Annual Conference Workshops 1,799 9144
15 Annual Conference – Workshops 1,678 1,314
16 Educational Opportunities 1,605 1,178
17 2017 Annual Conference Overview 1,585 1,359
18 2017 Annual Conference Registration Fees 1,468 1,128
19 Legal Forms Index 1,398 583
20 About CAMFT 1,332 1,092
21 Attorney Article – Landlord Tenant Commercial Lease 1,324 1,275 FAQ – Cathy Atkins
22 Join Now – Pre-licensed 1,310 374
23 2017 Annual Conference Agenda 1,258 694
24 Student Liability Insurance 1,228 743
25 About CEPA 1,227 961
Page 25 of 521 ANALYTICS – 2C
CounselingCalifornia.com
Visits January 1, 2017 – May 8, 2017 Sessions 32,172 Sessions – The total number of sessions within the date Users 25,502 range. A Session is the period time a user is actively Pageviews 97,850 within the website. All usage date is associated with a Avg. Time on Site 2:08 session. New Visitor 25,233 Users – Those who have had at least one session within Returning Visitor 6,939 the selected data range. Includes both new and 1 Day Active Users 198 returning users. Pageviews - The total number pages viewed. Repeated 7 Day Active Users 1,134 views of a single page are counted.
14 Day Active Users 2,731 1 Day Active User - The number of unique users who had at least one session within the last day of the 30 Day Active Users 6,978 active date range.
7 Day Active Users -The number of unique users who had at least one session within a 7-day period. The 7 day period includes the last day in the active date range.
14 Day Active Users -The number of unique users who had at least one session within a 14-day period. The 14 day period includes the last day in the active date range. 30 Day Active Users -The number of unique users who had at least one session within a 30-day period. The 30 day period includes the last day in the active date range.
Device Info for Visits New CounselingCalifornia.com Sessions
1 Mobile 16,038 12,567
2 Desktop 14,621 11,487
3 Tablet 1,513 1,179
Page 26 of 521 ANALYTICS – 2C
Browser & Operating Systems
Browser Sessions New Users
Chrome 15,842 12,456
Safari 12,315 9,769
Internet Explorer 1,689 1,246
Firefox 1,438 1,113
Edge 410 313
Android Webviews 125 95
Opera 116 37
Safari (in-app) 80 71
Android Browser 67 52
Amazon Silk 33 27
Frequency & Recency for CounselingCalifornia.com
Count of Visits Sessions Pageviews
Once 25,233 74,720 2 times 3,745 11,446 3 times 1,169 3,197 4 times 509 2,085 5 times 271 825 6 times 173 1,074 7 times 113 851 8 times 92 337 9-14 times 278 1,379 15-25 times 183 507 26-50 times 142 336 51-100 times 163 605
Top Ten Most Visited Pages CounselingCalifornia.com
Count of Visits Pageviews Unique Pageviews
Home Page 19,421 15,932 Advance Search 18,598 3,523 Mental Health Matters/Mood Stress 4,165 3,777 How to Choose a Therapist 712 620 About Us 513 456 Mental Health Matters 444 395 What is a MFT 373 325 Mood Stress/Anxiety 362 306 Mood Stress/Panic Disorder 247 213 FAQs About Therapy 242 217
Page 27 of 521 ANALYTICS – 2C
Top 25 Searched Therapists CounselingCalifornia.com
Therapist Pageviews Unique Pageviews
1. Vicki Marlow 72 67
2 Barbara Gibson-Paul 43 36
3 Dina DeSanctis 41 29
4 Jeanette Abney 32 24
5 Starr Kelton-Locke 28 27
6 Malena Puentes 27 25
7 Margo Doxakis-Stein 27 21
8 Cheryl Berman 26 25
9 Barbara Grossman 24 24
10 Cindi Teichert 24 8
11 Sally Levy Albert 24 21
12 Rosemary Jalovaara 22 21
13 Arlene Dunn 21 18
14 Barbara Down 21 20
15 Kathy Wolfe 19 15
16 Marrisa Lepore 19 17
17 Tracey Fitzgerald-Donahue 18 18
18 Benita Young 17 16
19 Bernie Carter 17 13
20 Jason Nigl 17 14
21 Laura Hughes Poppink 17 16
22 Nikki Nachum 17 17
23 Sophie Bryan 17 15
24 Christina Bennett 16 10
25 Lorrin McCormick 16 15
Page 28 of 521 ANALYTICS – 2C
Social Networking Sites CAMFT Community Jan Feb Mar April May June July Aug Sept Oct Nov Forums 64 60 74 108 17 Engaged 647 578 576 601 518 Users Total Page 14,534 9,511 9,085 9,148 2,074 Visits
Members with profile pages on LinkedIn Facebook Counseling California CAMFT CounselingCA 2017 2016 2017 2016 2017 2016 2017 2016 January 6,118 9,312 8,112 7,112 6,002 1,413 1,308 February 7,953 6,264 9,380 8,465 7,303 6,064 1,581 1,373 March 8,312 6,295 9,498 8,516 7,489 6,195 1,583 1,389 April 8,460 6,160 9,560 8,590 7,512 6,385 1,589 1,425 May 8,502 6,095 9,812 8,612 7,585 6,427 1,594 1,439 June July August September October November
Page 29 of 521 MEMBER REPORTS - 2D
Board Report for June 2017 From February 28, 2017 / March 2017 / April 2017 / May 10, 2017 Information was collected 5/10/2017
Total Member Count for years 2010 2011 2012 2013 2014 2015 2016 5/10/2017
Total Membership 29,900 30,470 30,834 31,064 31,530 31,910 31,900 31,773 Clinical 17,163 17,477 17,766 18,083 18,030 18,459 18,609 18,963 Associate 978 996 999 929 1,025 1,042 1,077 1,108 Prelicensed 11,055 11,257 11,269 11,191 11,510 11,365 11,050 10,492 Life 337 353 382 415 456 491 566 593 Emeritus 367 387 418 446 509 553 598 617
The figures at the end of 2015 reflect the membership count after drops had been made / previous years the count was before drops were made.
Membership Retention Rate 2010 2011 2012 2013 2014 2015 2016 2/28/2017 ‐ 5/10/2017 The dates are as of 5/10/2017 86% 85% 86% 89% 87% 87% 88% 83%
Overall feeling about Association services of dropped members 2010 2011 2012 2013 2014 2015 2016 2/28/2017 - 5/10/2017 Excellent 55% 49% 57% 60% 60% 49% 49% 63% Good 37% 38% 35% 39% 39% 39% 44% 29% Fair 5% 10% 7% 1% 1% 10% 7% 5% Poor 2% 2% 1% 0% 0% 2% 0% 2% N/A 1% 0% 0% 0% 0% 0% 0% 0% Excellent + Good 92% 87% 92% 99% 99% 88% 93% 92%
Top 4 Reasons For Dropping
Currently Not Practicing 24% Retirement 24% Financial 20% Other 14%
Legal Calls Year to Date 2009 2010 2011 2012 2013 2014 2015 2/28/2017 ‐ 5/10/2017 21,567 22,894 23,943 23,683 22,465 21,932 22,679 4,910
Information was collected 5/10/2017
Total Incoming Calls 02/28/2017 ‐ 05/10/2017 11,919
Page 39 of 521 MEMBER REPORTS - 2D CAMFT Membership Membership Growth Board of Directors Meeting June 2017
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 Clinical 15,968 16,582 16,645 16,935 17,163 17,477 17,766 18,083 17,962 18,459 18,710 18,963 Prelicensed 10,874 11,310 11,150 11,335 11,055 11,257 11,269 11,191 11,486 11,365 11,281 10,492 Associate 871 938 959 987 978 996 999 929 1,015 1,042 1,082 1,108 Life 328 298 300 309 337 353 382 415 449 491 557 593 Emeritus 232 269 270 299 367 387 418 446 507 553 591 617
TOTAL 28,273 29,397 29,324 29,865 29,900 30,470 30,834 31,064 31,419 31,910 32,221 31,773
35,000
-
30,000
25,000
20,000
15,000
10,000
5,000 123456789101112 Series1 28,273 29,397 29,324 29,865 29,900 30,470 30,834 31,064 31,419 31,910 32,221 31,773 Series2 0.00% 3.82% -0.25% 1.81% 0.12% 1.87% 1.18% 0.74% 1.13% 1.54% 0.97% -1.41%
Page 40 of 521 MEMBER REPORTS - 2D
Reason Total Percentage Clinical Prelicensed Associate Active in another Association 1 2% 0 0 1 Currently Not Practicing 12 24% 9 3 0 Financial 10 20% 4 6 0 Retirement 12 24% 11 1 0 Moved 4 8% 2 1 1 Unable to Participate 2 4% 1 1 0 Change in Profession 1 2% 0 1 0 Other 7 14% 3 4 0 NA 00%000
Total 49 100% 30 17 2
Total Percentage Clinical Prelicensed Associate Overall feeling about Association's services: Excellent 26 63% 16 8 2 Good 12 29% 5 7 0 Fair 2 5% 1 1 0 Poor 1 2% 1 0 0 NA 00%000
Total 41 100% 23 16 2
The Therapist is: Highly Informative 20 53% 11 7 2 Some Value 18 47% 11 7 0 No Value 0 0% 0 0 0 NA 00%000
Total 38 100% 22 14 2
Did you ever request information about the Association? Yes 25 63% 17 7 1 No 15 38% 6 8 1 NA 00%000
Total 40 100% 23 15 2
Was the answer prompt? Yes 22 65% 16 5 1 No 13%100 NA 11 32% 5 6 0
Total 34 100% 22 11 1
Do you believe the association is working for the profession as it should? Yes 30 86% 16 12 2 No 4 11% 3 1 0 Not Sure 1 3% 1 0 0 NA 00%000
Total 35 100% 20 13 2
Will you consider rejoining at a later date? Yes 25 68% 13 12 0 No 12 32% 9 2 1 NA 00%000
Total 37 100% 22 14 1
Page 41 of 521 MEMBER REPORTS - 2D
Drop Survey Comments Surveys February 28, 2017– May 10, 2017
Reasons for not renewing membership: I've decided to retire and let my license go. Keep up the good work. I am out of the country for 3 1/2 months, and maybe spending a year or two in monasteries. Not Practicing and license is inactive. Did not Make use of benefits and we are overpriced. Fees too high Husband passed away BBS did not accept hours Retirement X 5 Pregnancy I am retired and not planning to practice in the near future.
The Therapist is: Good
Was the answer prompt for Legal calls? Less-than satisfactory service today from the CAMFT legal team. The legal team was very helpful and provided the answers that I needed
How do you feel the Association could do better? Lower prices
Will you consider rejoining at a later date? I will be out of the country for a while, and when ready to rejoin I know where to find you….thanks
Additional Comments: I have greatly appreciated CAMFT and how you all have worked so diligently on our mutual goals. Offer scholarships for CG members dues Great discount using the CAMFT benefit program – Office Depot. Thank you for all you do to support our profession. Be less partisan politically Fees to high I called CAMFT and renewed my membership in less than 5 minutes. This was a good service.
Page 42 of 521 CERTIFIED SUPERVISOR PROGRAM REPORT – 2E
June 2017 Board Meeting CAMFT Certified Supervisor Program
Category Total Participants (PART, CON/PA) 57 CAMFT Certified Supervisors (CS) 244
Grand Total: 301
Category Total Change in Numbers from March 2017 Participants (PART, CON/PA) +3 CAMFT Certified Supervisors (CS) -5 Participants Pending CS Approval 0
TOTAL Number of Certified Supervisors Who Have Renewed in 2017: 12 TOTAL Number of Individuals Who Have Become Certified in 2017: 0 TOTAL Number of Individuals Who Have Applied in 2017: 5
May 9, 2017 Prepared by Rene Clement Page 1 of 1
Page 43 of 521 BEHIND THE SCENES - 2F
BEHIND THE SCENES February 2017
CAMFT Staff participated in 8 meetings with California Coalition for Mental Health Parity Committee Workgroup, Executive Director of California Psychological Association, Executive Officer of BBS, BBS Policy and Advocacy Committee, Irregulars, Department of Managed Health Care Stakeholders, Department of Managed Health Care Consumer Provider Plan Agency Workgroup, and the Inland Empire MFT Consortium. It is critical for CAMFT to have a place at the table with other mental health professionals and regulatory bodies. These meetings will always be a high priority.
CAMFT Legal Staff responded to over 1,890 calls from members with questions on legal, ethical and licensure issues. Access to this expert, legal guidance is one of the most beneficial and popular member benefits.
Over 6,900 people visited the CounselingCalifornia.com website with 5,695 of those being unique visitors. There were hits to 3,010 different therapist profiles and 20,913 total page views. The newly re-designed CounselingCalifornia.com marketing tool is available to all members for the purpose of promoting services to the public. Create your profile now.
CAMFT Board participated in 3 Chapter meetings: Los Angeles, Redwood Empire, and Southwest Riverside County. CAMFT Staff made presentations at 1 Chapter meeting: Southwest Riverside County. Chapter meetings are a prime opportunity for CAMFT leadership and staff to hear directly from members and exchange ideas for serving members. Click here to connect with your local chapter.
CAMFT Staff presented Law and Ethics seminars at 2 Chapters: Yolo-Solano and Inland Empire. The law and ethics seminar is a valuable training tool that gets consistently positive response from MFTs and other participants.
The CAMFT Leadership Conference was held on February 24 & 25, 2017 in Irvine, CA. There were over 100 chapter volunteers in attendance representing 25 of the 29 active chapters of CAMFT. The Board also participated in this event. The Chapter Leadership Conference is hosted each year by CAMFT to provide education and networking opportunities to individuals volunteering within local CAMFT chapters.
CAMFT hosted a “CAMFT Connects” meeting focusing on “Building a Successful Practice” in Irvine, CA. More than 60 members participated. CAMFT Connects provides an opportunity for members to connect with CAMFT leadership and provide input for CAMFT’s direction
The CAMFT 2018 Annual Conference & Continuing Education Planning, Audit, Crisis Response Education and Resource, and Executive Committees, Connects and Grassroots Task Forces, and the Educational Foundation Board of Directors met. If you are interested in serving on a Committee, please contact [email protected]. Committee appointments are made by the President of the Board of Directors. Click here for a list of Committees.
Tell your therapist friends that they can enjoy these same benefits by joining our dynamic and influential organization!
Page 44 of 521 BEHIND THE SCENES - 2F
BEHIND THE SCENES March 2017
CAMFT Staff participated in 11 meetings with Department of Health Care Services Medi-Cal Management Care Advisory Group, California Coalition for Mental Health, California Coalition for Mental Health Parity Committee, MFT Leadership Collaborative, Irregulars, and Consortium meetings in Central Valley, Imperial County, Los Angeles, Orange County, Sacramento and San Diego. It is critical for CAMFT to have a place at the table with other mental health professionals and regulatory bodies. These meetings will always be a high priority.
CAMFT Legal Staff responded to over 2,150 calls from members with questions on legal, ethical and licensure issues. Access to this expert, legal guidance is one of the most beneficial and popular member benefits.
Over 8,390 people visited the CounselingCalifornia.com website with 6,874 of those being unique visitors. There were hits to 1,196 different therapist profiles and 30,928 total page views. The newly re-designed CounselingCalifornia.com marketing tool is available to all members for the purpose of promoting services to the public. Create your profile now.
CAMFT Staff testified before 2 Assembly Committees: Assembly Health Committee in support of AB 191 and Assembly Budget Subcommittee in support of removing delayed implementation of AB 1863.
CAMFT Staff submitted 3 advocacy letters to: California Senate Health Committee, urging Committee members to vote “Aye” on SB 374 (Newman), which would require health insurers to comply with the federal Mental Health Parity & Addiction Equity Act of 2008 California Assembly Health Committee, urging Committee members to vote “Aye” on AB 191 (Wood), which would authorize LMFTs as a second signatory to extend involuntary commitments House Speaker Paul Ryan, House Minority Leader Nancy Pelosi, and California U.S. Representatives, urging each to ensure access to and coverage of mental health care in the American Health Care Act CAMFT consistently interacts with key legislators and agencies to reinforce how proposed legislation, regulation, or other actions may be beneficial or harmful to LMFTs and MFT Interns and Trainees. Advocacy is a cornerstone of CAMFT’s commitment to members.
CAMFT Board, Staff and Members met with 13 legislative offices, for State Assembly Members Arambula, Brough, Burke, Maienschein, McCarty, Obernolte, Quirk-Silva, Rodriguez, Rubio, Salas, Santiago, Stone, and Waldron. CAMFT consistently interacts with key legislators to reinforce how proposed legislation, regulation, or other actions may be beneficial or harmful to LMFTs and MFT Interns and Trainees. Advocacy is a cornerstone of CAMFT’s commitment to members.
CAMFT Staff and lobbyists attended 1 reception for State Assembly Speaker Rendon and 1 caucus for Assembly Members Aguiar-Curry, Caballero, Friedman, Limon, Quirk-Silva, Reyes, and Rubio. The goal of the CAMFT PAC is to ensure that Marriage and Family Therapist-friendly candidates and incumbents from both political parties get elected to the California legislature. We support candidates who have demonstrated an understanding and willingness to fight for the issues most important to Marriage and Family Therapists. Click here to donate to the CAMFT PAC!
Page 45 of 521 BEHIND THE SCENES - 2F
CAMFT Staff made presentations at 1 Chapter and 1 school: Delta Stockton and University of Phoenix. CAMFT Board participated in 2 Chapter meetings: Redwood Empire and Santa Barbara. Chapter meetings are a prime opportunity for CAMFT leadership and staff to hear directly from members and exchange ideas for serving members. Click here to connect with your local chapter.
CAMFT Staff presented Law and Ethics seminars at 1 Chapter, 1 school, and 1 agency: San Diego, Hope International University, and Penny Lane Center. The law and ethics seminar is a valuable training tool that gets consistently positive response from MFTs and other participants.
The CAMFT Connects Task Force, and Ethics, Executive, Finance, Insurance and Healthcare Reform, and Political Action Committees met. If you are interested in serving on a Committee, please contact [email protected]. Committee appointments are made by the President of the Board of Directors. Click here for a list of Committees.
The CAMFT Board of Directors met on March 25-26, 2017, in Sacramento. The Board hosted a reception for the Sacramento Valley and Yolo-Solano Chapters board members. The Board will meet again on June 3-4, 2017, in La Jolla, CA. For Board meeting dates, highlights, and minutes, click here.
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Page 46 of 521 BEHIND THE SCENES - 2F
BEHIND THE SCENES April 2017
CAMFT Staff participated in 6 meetings with Department of Health Care Services, Medi-Cal Children’s Health Advisory Panel, Irregulars, AAMFT, BBS Executive Officer, and BBS Policy & Advocacy Committee. It is critical for CAMFT to have a place at the table with other mental health professionals and regulatory bodies. These meetings will always be a high priority.
CAMFT Legal Staff responded to over 1,840 calls from members with questions on legal, ethical and licensure issues. Access to this expert, legal guidance is one of the most beneficial and popular member benefits.
Over 9,380 people visited the CounselingCalifornia.com website with 7,414 of those being unique visitors. There were hits to 1,646 different therapist profiles and 24,418 total page views. The newly re-designed CounselingCalifornia.com marketing tool is available to all members for the purpose of promoting services to the public. Create your profile now.
CAMFT Staff testified before 1 Assembly Committee: Assembly Budget Subcommittee in support of removing delayed implementation of AB 1863.
CAMFT Staff submitted 11 advocacy letters to: Assembly Member Jose Medina in support of AB 93 which would increase the quality of supervision to pre-licensees. Assembly Member Joaquin Arambula in support of AB 470 which would create a performance outcome system for specialty mental health services for Medi-Cal beneficiaries in underserved communities. Assembly Member Brian Maienschein in support of AB 516 which would provide for additional protection of those with mental disorders and developmental disabilities from sexual assault and abuse. Assembly Member Reginald Jones-Sawyer in support of AB 575 which would add substance use disorder counselors to the list of providers required to report elder abuse and neglect under California law. Assembly Member Patrick O’Donnell in support of AB 834 which would establish he Office of School- Based Health Programs (OSBH). Assembly Member Adrin Nazarian in support of AB 1188 which would increase licensing fees for those regulated by the BBS and other regulatory boards for the purpose of enhancing the Licensed Mental Health Service Provider Education Program. State Senators Toni Atkins and Scott Wiener in support of SB 179 which would ease barriers for people applying for a change in gender on their state issued identity documents. State Senator Jim Beall in support of SB 191 which would promote partnerships between counties and school districts in an effort to reduce barriers to mental health access for children and families. State Senator Robert Hertzberg in support of SB 237 which would authorize an arresting officer to release an arrested person from custody without taking him/her to court if the person is delivered to a specified facility for the purpose of mental health evaluation and treatment and no further criminal proceedings are desirable. State Senator Holly Mitchell in support of SB 323 which would authorize Federally Qualified Health Centers and Rural Health Clinics to provide specialty mental health services to Medi-Cal beneficiaries as part of a mental health plan’s provider network. State Senator Ricardo Lara, asking him to co-sponsor SB 374 which would require all health care policies that cover mental health and substance use disorder benefits to comply with the federal Mental Health Parity & Addiction Equity Act of 2008
Page 47 of 521 BEHIND THE SCENES - 2F
CAMFT consistently interacts with key legislators and agencies to reinforce how proposed legislation, regulation, or other actions may be beneficial or harmful to LMFTs and MFT Interns and Trainees. Advocacy is a cornerstone of CAMFT’s commitment to members.
CAMFT Board, Staff and Members met with 15 legislative offices, for U.S. Representatives Tony Cardenas, Ken Calvert, Anna Eshoo, Ted Lieu, Doris Matsui, Kevin McCarthy, Jerry McNerney, Devin Nunes, Ed Royce, Raul Ruiz, Linda Sanchez, Jackie Speier, Mimi Walters, and US Senators Dianne Feinstein and Kamala Harris. CAMFT consistently interacts with key legislators to reinforce how proposed legislation, regulation, or other actions may be beneficial or harmful to LMFTs and MFT Interns and Trainees. Advocacy is a cornerstone of CAMFT’s commitment to members.
CAMFT Board attended 1 open house for Assembly Member Monique Limon and 1 town hall for US Representative Salud Carbajal. CAMFT Staff and lobbyists attended 3 receptions for US Representatives Mimi Walters and Mike Thompson, and State Senator Toni Atkins. The goal of the CAMFT PAC is to ensure that Marriage and Family Therapist-friendly candidates and incumbents from both political parties get elected to the California legislature. We support candidates who have demonstrated an understanding and willingness to fight for the issues most important to Marriage and Family Therapists. Click here to donate to the CAMFT PAC!
CAMFT Board participated in 1 Chapter meeting: Santa Barbara. Chapter meetings are a prime opportunity for CAMFT leadership and staff to hear directly from members and exchange ideas for serving members. Click here to connect with your local chapter.
CAMFT Staff presented Law and Ethics seminars at 2 Chapters and 1 school: Central Coast and Ventura County, and Azusa Pacific University. CAMFT Staff presented 1 Law and Ethics seminar at CAMFT headquarters. The law and ethics seminar is a valuable training tool that gets consistently positive response from MFTs and other participants.
The CAMFT Executive and Legislative Committees met. If you are interested in serving on a Committee, please contact [email protected]. Committee appointments are made by the President of the Board of Directors. Click here for a list of Committees.
The CAMFT Board of Directors met on April 21, 2017, via conference call. The Board will meet again on June 3- 4, 2017, in La Jolla, CA. For Board meeting dates, highlights, and minutes, click here.
Tell your therapist friends that they can enjoy these same benefits by joining our dynamic and influential organization!
Page 48 of 521 ORIENTATION - 5
FIDUCIARY DUTIES
Business Judgment Rule: Directors generally protected from personal liability IF they act in GOOD FAITH, and in manner REASONABLY believed to be in corporation’s best interest, with INDEPENDENT and INFORMED judgement, as an ORDINARILY PRUDENT person in a like position would use under similar circumstances.
Boards carry out their fiduciary duty by protecting not only financial assets, but also human resource assets (i.e. staff, members), physical assets, and the reputation and image of the association.
Duty of Care:
Be reasonably informed about activities and goals of association Attend meetings Good Faith o Make decisions with best interests of Assn in mind . Free from outside pressures or personal opinions . Utilize input and information from staff . Get outside evaluations on complex issues when necessary
Duty of Loyalty:
Expected to act for Association AS A WHOLE o Not personal benefit or special interests of subset of Association Once vote taken, support Board decisions o Even if personal views differ o Publically versus personally/not representing the Board o Fine line Board speaks with one voice Do not disclose confidential information of Association o Even if not marked “confidential”, use best judgment on whether should not be released
Avoid Conflict of Interest:
2012 CAMFT Policy: “Conflict of interest” as “a transaction or relationship which presents or may present a conflict between a Board Member’s obligations to CAMFT and the Board
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Member’s personal, business or other interests.”
Conflicts Financial o Self dealing Personal o Active in non-profit with opposing public policy matters (opposition position on piece of legislation) Procedure:
Disclose o Even if not sure, better to err on side of caution o Better to do before meeting to Pres as FYI Board Discussion o Should person abstain from discussion o Should person abstain from vote o Will conflict cause legal or public relations problem for Assn o **Not all conflicts are harmful or need to be avoided, but must be disclosed
Adherence to Applicable Laws/Rules
CA Corp Code Association Bylaws General Laws: o Insurance Coverage o Preserving Tax Status Anti-Trust Laws o Laws apply to competitors . CAMFT members are competitors; CAMFT made up of competitors o Avoid restrictions on members dealing w/ non-members o Boycotting plans to influence rates o Don’t limit access to information developed by association if could harm non- member ability to practice o Surveying members on income needs to be over 3 months old before conveying o Do not facilitate or allow member conversation about price fixing or boycotting (interfere with free market) o **Whole memo that goes into anti-trust analysis in detail if interested
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ROBERTS RULES OF ORDER PROCEDURES
Procedures in Small Boardsi Notes
1) Members may raise a hand instead of standing when While RONR calls for members to wait seeking to obtain the floor, and may remain seated until the floor has been yielded before while making motions or speaking. seeking to be recognized by the chair, the CAMFT Board does not wait until the floor has been yielded but instead quietly raise their hand while others are speaking and the president keeps a running list of those wishing to obtain the floor. This provides for expediency while assuring respect to the speaker.
2) Motion need not be seconded. Obtaining a second to indicate there is interest in discussion is good form.
3) There is no limit to the number of times a member can speak to a debatable question.* Appeals, however, are debatable under the regular rules—that is, each member can speak only once in debate, while the chair can speak twice.
*However, motions to close or limit debate, including motions to limit the number of times a member can speak on a question, are in order even in meetings of a small board.
4) Informal discussion of a subject is permitted while no motion is pending.
5) When a proposal is perfectly clear to all present, a vote If an item is going to have a formal vote can be taken without a motion having been introduced. instead of being approved by unanimous Unless agreed to by unanimous consent, however, all consent, a formal motion is advised.
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proposed actions must be approved by vote under the same rules as in a larger meeting, except that a vote can be taken initially by a show of hands, which is often a better method in small meetings.
6) The chairperson need not rise while putting questions to a vote.
7) If the chairperson is a member, s/he may, without If there is a point of order involving the leaving the chair, speak in informal discussions and in chair’s discussion, the point of order will debate, and vote on all questions.** be ruled on by the next person in the order of succession, i.e. president-elect, etc. **Informal discussion may be initiated by the chairperson which in effect, enables the chairperson to submit his or her own proposals without formally making a motion (although s/he has the right to make a motion if s/he wishes.
CAMFT Commonly Used Motions/Procedures Notes
8) Motion and second: Member who has the floor makes a motion, someone seconds the motion, chair restates the motion, the group then owns the motion.
9) Amend the Motion: Modifies the wording, and within limits, a. Motion to amend must be seconded. the meaning of the main motion. Must b. Motion to amend must state exactly the wording be germane to the current question. to be amended. c. Majority vote to determine whether to amend the One way of dealing with a motion that is Motion (not a vote on the motion’s substance unclear, needing amendment, is to itself). simply vote it down and reintroduce a d. Secondary amendments acceptable but not new motion. tertiary (a second motion can be made on the motion, but not a third amendment). e. Can amend from one word to the whole paragraph i. Insert word(s) ii. Strike Out word(s) iii. Strike out and insert word(s), or Substitute paragraphs
10) Request Permission to Withdraw or Modify a Motion: Can only be made by the maker of the motion and is voted on by the group; Can
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be withdrawn by unanimous consent (no need for official vote.)
11) Table: Set aside the motion without setting a timeframe to resume consideration.
Can be taken up again when the majority so decides. Not meant to kill a motion, just to be used if something else needs to be immediately addressed.
Use “Take From the Table” to begin debate again.
If goal is to kill a motion more appropriate to use “Postpone Indefinitely.”
12) Postpone to a Certain Time: Need to name the time (i.e. 3pm, or next meeting).
Should not be postponed past the next quarterly meeting.
13) Call the Question (Previous Question): "The previous question is moved [or demanded, or called for] on [specify the motions on which the previous question is demanded].”
Closes debate, stops amendments.
Requires two-thirds vote to pass.
If passes, closes debate and amendments, and proceed to vote of the previous question.
14) Refer to committee: Sending a question to a committee to be redrafted or further studied before it is voted on.
15) Add an item to the Agenda: This adds an item to the agenda after the agenda has already been approved.
Item can be taken up in the moment by suspending the rules with 2/3 vote. “I move to suspend the rules that interfere
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with the introduction at this time of a motion to _____”
Change to agenda via 2/3 vote of the Board, majority vote of entire membership, or unanimous consent.
16) Parliamentary Request: A question directed to the chair to obtain information on parliamentary procedure. In order while another has the floor.
The chair’s response is an opinion, not a ruling.
If the question can wait until the floor is yielded the chair can defer until then.
17) Point of order: Call attention to the chair of a violation of the rules of order.
If there is a point of order involving the chair’s discussion, the point of order will be ruled on by the next person in the order of succession, i.e. president-elect, etc.
18) Request for information: A request to the chair, or through the chair to another member, for information relevant to the business at hand but not related to parliamentary procedure.
In order while another has the floor. If turns are timed, time is taken from person who has the floor so they need to agree to the request for information.
Not to be used to debate a point, only to obtain pertinent information in the moment that cannot wait.
19) Reconsider a Motion: Reconsider a question already voted on.
Can only be taken up in the same meeting.
Can only be moved by someone who voted on the winning side.
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20) Suspend the Rules: Not amendable or debatable; 2/3 vote.
No need to name the rule you are suspending, just describe what you want to be able to do. “I move to suspend the rules to read and allow the newspaper to be read out loud.”
i Pages 487-488 RONR (#1-#7)
Page 69 of 521 POLICY ON DUES-EXTENDED PAYMENT OPTION – 6A
MEMORANDUM
To: Board of Directors
From: Jill Epstein
Date: May 9, 2017
RE: Extended Payment Plan for New Applicants and Renewing Members
Issues:
1) If a new applicant pays dues on an extended payment plan, when does his/her membership begin? 2) If a renewing member pays on an extended payment plan, when does his/her renewed membership begin?
Discussion Issue 1
According to the CAMFT Bylaws, an applicant is not admitted into the membership unless he or she pays dues in accordance with the dues schedule of the association. Pursuant to Article IV, Section C, Admission to Membership, membership in any category shall be upon a 1) majority vote of the Board of Directors ; 2) all members shall pay dues in accordance with the dues schedule of the Association; and 3) shall abide by the Bylaws and the CAMFT Code of Ethics.
Therefore, an applicant who pays on an extended payment plan as established by the Board has not been admitted to membership until full membership dues are paid in accordance with the dues schedule (Clinical Members is $175 a year; Pre-licensed Members is $90 a year; Associate Members is $125 a year). The Board can structure the extended payment plan for new applicants as it sees fit, but membership would not begin until dues are paid in full.
Recommendation
The Board may consider offering an installment plan for new applicants if they pay their dues in full within a limited time frame. Staff recommends offering the new applicant to pay membership dues in four monthly installments over a six-month period. The Board may allow the applicant to enjoy member benefits, as a courtesy during this period. However, admission into membership would not confer until full payment has been received by or before the end of the six-month period. If the applicant does not pay within this time period, the applicant will forfeit all monies paid and will no longer be eligible for member benefits. Staff recommends the Board adopt the following language in a revised Extended Payment Option Policy:
1 Page 70 of 521 POLICY ON DUES-EXTENDED PAYMENT OPTION – 6A
New Applicants
When a new applicant for membership chooses the Extended Payment Option, he or she shall have the option of paying his or her membership dues in four (4) installments over a six- (6) month period. CAMFT membership does not confer until dues are paid in full by or before the end of the six-(6) month period. As a courtesy, member benefits shall be offered to the applicant during this period. Applicants who do not pay in full by or before the end of the six- (6) month period shall forfeit all monies paid toward dues to that point and he or she shall no longer be eligible for any member benefits that were offered as a courtesy.
Discussion Issue 2
According to Article VIII, Section C, if a member chooses to continue their membership, renewal dues are required to be paid on the first day of the member’s designated anniversary month. The designated anniversary month would fall on the same month in which the application and the required fees were initially submitted to CAMFT the previous year. Any renewing member whose dues are in default on the first day of the sixth month following that member's designated anniversary month shall automatically be dropped from membership in the Association, after notice has been provided (see also Article IV, Section E.2. Termination).
Additionally, pursuant to Article IV, Section D, each member in good standing1, except if otherwise exempt by these Bylaws, must pay, within the time and on the conditions set forth in these Bylaws, or where appropriate, as established by the Board of Directors, such fees, dues and assessments as are fixed from time to time by the Board of Directors. The dues schedule as established by the Board is as follows: Clinical Members is $175 a year; Pre-licensed Members is $90 a year; Associate Members is $125 a year.
Therefore, only upon payment of the dues in full either by the first day of the member’s designated anniversary month or payment in full by the first day of the sixth-month following the designated anniversary month will the member have his or her membership with CAMFT renewed for another year. During this time, the renewing member is still considered a CAMFT member who enjoys the rights and privileges offered by CAMFT, however, his or her membership will only continue after the six-month grace period upon payment of dues as established by the Bylaws or as set by the Board.
1 The Bylaws do not define “good standing.” The 2016 Bylaws Committee proposed an amendment to the Bylaws that would define a member in good standing as a member who meets the qualifications of membership, pursuant to Section B of Article IV; is current in payment of dues, pursuant to Section E of Article IV; and is not suspended, pursuant to Section F of Article IV. This bylaw amendment has not put been forward to the membership to date.
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Recommendation
The Board may consider offering an installment plan for renewing members that corresponds with the six-month grace period for paying membership dues currently authorized by the Bylaws. Staff recommends offering a renewing member to pay renewal membership dues in four monthly installments over a six-month period. This corresponds with Article VIII, Section C, which offers a six-month grace period for members who have not paid their membership dues on the first day of the member’s designated anniversary month.
Staff recommends the Board adopt the following language in a revised Extended Payment Option Policy:
Renewing Members
When a renewing member chooses the Extended Payment Option, he or she shall have the option of paying his or her membership dues in four (4) monthly installments over a six- (6) month period. The first installment shall be due in the first month following the member’s designated anniversary month and shall be paid in full before or by the first day of the sixth month following the member’s designated anniversary month. If dues are not paid in full by the first day of the sixth month following the member’s designated anniversary month, he or she shall forfeit all monies paid toward dues to that point and he or she shall be dropped from membership pursuant to CAMFT Bylaws, Article IV., Section E.2.).
3 Page 72 of 521 POLICY ON DUES-EXTENDED PAYMENT OPTION - 6A
Dues - Extended Payment Option (New Applications) Policy
Date: March 24, 1983 Accepted: March 25, 1983 Revised: March 13, 2015 New Date
Clinical member applicantsAll applicants for CAMFT membership and renewing members shall have the option of paying their initial membership dues as per current policy or in up to four (4) installments over a four- (4) month period.on an “Extended Payment Option” pursuant to this policy. Applicants and renewing members who choose the Eextended Ppayment Ooption shall include the application feebe charged an administrative fee, as established by the Board of Directors or its designee, which shall be due with and the initial monthly installment along with their application.payment.
When applicants choose this option and their dues are not paid in full within a six- (6) month period from the date of application, they shall forfeit all monies paid toward dues to that point and they will be dropped from membership.
New Applicants
When a new applicant for membership chooses the Extended Payment Option, he or she shall have the option of paying his or her membership dues in four (4) installments over a six-(6) month period. CAMFT membership does not confer until dues are paid in full by or before the end of the six-(6) month period. As a courtesy, member benefits shall be offered to the applicant during this period. Applicants who do not pay in full by or before the end of the six-(6) month period shall forfeit all monies paid toward dues to that point and he or she shall no longer be eligible for any member benefits that were offered as a courtesy.
Renewing Members
When a renewing member chooses the Extended Payment Option, he or she shall have the option of paying his or her membership dues in four (4) installments over a six-(6) month period. The first installment shall be due in the first month following the member’s designated anniversary month and shall be paid in full before or by the first day of the sixth month following the member’s designated anniversary month. If dues are not paid in full by the first day of the sixth month following the member’s designated anniversary month, he or she shall forfeit all monies paid toward dues to that point and he or she shall be dropped from membership pursuant to CAMFT Bylaws, Article IV, Section E.2.
Page 73 of 521 POLICY ON NOMINATING COMMITTEE CHARGE – 6B
MEMORANDUM
TO: Board of Directors
FROM: Jill Epstein, Executive Director
DATE: May 9, 2017
RE: Nominating Committee Limitations
The following motions were approved by the Board at the March 25-26, 2017, Board meeting: Motion (5) – Widhalm: Nominating Committee members are precluded from serving as references for candidates’ applications. APPROVED; Strom ABSTAINED
Motion (6) – Perlmutter: Nominating Committee members are precluded from endorsing any candidate in the CAMFT election. APPROVED; Strom ABSTAINED
The Policy on Nominating Committee Charge, Composition, and Restrictions and the Nominating Committee description were edited to include these limitations.
Page 74 of 521 POLICY ON NOMINATING COMMITTEE CHARGE - 6B
POLICY ON NOMINATING COMMITTEE CHARGE. AND COMPOSITION, AND RESTRICTIONS
Date: August 20, 2014 Accepted: September 20, 2014 Proposed: June 3, 2017
In recruiting and selecting a slate, the Nominating Committee shall take into account the geographical, ethnic, gender, and professional composition of the membership. The Committee shall also conduct an analysis of the current Board’s areas of strength, weakness, and need to help identify key skill sets or backgrounds that would complement the current Board and benefit CAMFT. In selecting nominees for President-Elect, the Committee shall, in addition to the above, give consideration to prior CAMFT Board, Chapter and/or Committee service. The Committee shall identify the best candidate(s) for each office.
Past President is to serve as chair of Nominating Committee. If Past President cannot serve, the President shall choose a member of the Board to serve in the role of Nominating Committee chair.
Committee members are precluded from endorsing any candidate or serving as a reference for any candidate in the year the member is serving on the Nominating Committee.
Page 75 of 521 NEW LOGO FOR CAMFT – 6C
MEMORANDUM
TO: Board of Directors
FROM: Jill Epstein, Executive Director
DATE: May 10, 2017
RE: CAMFT Logo
BACKGROUND: The CAMFT logo has been virtually unchanged in CAMFT’s 53-year history. Newsletters from the 1970s and 1980s reflect the two rings, though one was white and one was black. Based on archived materials, the rings became white and the background became maroon by the 1990s. That logo and color scheme remain in effect.
A question on the recent Demographic Survey asked members if they want to see CAMFT’s logo/graphic identity updated. As of May 9, results are as follows: (Note: Updated figures will be reported to the Board in June as the survey will close on May 18.) Clinical Survey: 1366 people responded Yes – 152 No – 176 No Opinion - 1,038
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Pre-Licensed Survey: 849 people responded Yes – 134 No – 85 No Opinion -630
DISCUSSION: The Board will discuss this feedback and determine whether a Task Force should be created to explore and recommend new options for a CAMFT logo and color scheme.
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Page 79 of 521 BOARD CODE OF CONDUCT – 6D
MEMORANDUM
TO: Board of Directors
FROM: Jill Epstein, Executive Director
DATE: May 10, 2017
RE: Board Code of Conduct
BACKGROUND: Currently, Board members sign the following documents after being elected by the CAMFT membership: Confidentiality Acknowledgement, Conflict of Interest, Consent to Electronic Transmission, and Policy on Antitrust Compliance. At the March, 2017, Board meeting, a Board member requested a future agenda item on guidance on how Board members should conduct themselves in public arenas and how this intersects with First Amendment rights.
ISSUE: Many for profit and not for profit organizations have Board members sign a Code of Conduct. This document is typically designed to reflect how the organization expects its Board members to meet the highest professional and personal standards in their actions, their use of authority, and their interactions with others in the community. A Code of Conduct could make Board members accountable and helps avoid potential problems.
DISCUSSION: Does the CAMFT Board want staff to work with Outside Counsel to develop a Board Code of Conduct?
Page 80 of 521 LEGISLATIVE COMMITTEE - 7A
To: Jill Epstein, Executive Director; Board of Directors From: Cathy Atkins, Deputy Executive Director Date: May 12, 2017 RE: Legislative Committee –Sunset Period
Background:
At the March 2015 Board meeting, the Board voted to create a Legislative Committee for the purpose of assisting CAMFT to review and recommend legislative priorities and positions. Included within the Committee description was a sunset provision of June 1, 2017.
The Committee commenced in July 2015. The Committee met in summer 2015 and 2016 for the purpose of selecting CAMFT’s legislative priorities and concepts to sponsor for the following year. The Committee also met in winter/spring of 2016 and 2017 for the purpose of reviewing legislation to assist in determining CAMFT’s positions on bills of interest.
Discussion:
The Legislative Committee will sunset unless the Board votes to continue the Committee moving forward. It is the recommendation of staff to allow the Committee to continue, with the following discussion points to determine within the description/purpose:
1. Given the incredible workload within a short turn-around timeframe, it is difficult to obtain a quorum for this Committee. Please consider the pros and cons of reducing the size of the Committee (flexibility and availability versus increased clinical input).
2. Currently the Committee reviews hundreds of bills to assist CAMFT in determining CAMFT position—many of these bills being loosely tangential to the MFT profession (for example, bills that CAMFT would like to be knowledgeable about but that have no direct effect on membership or mental health generally). The Committee (and staff) spend excessive amounts of time reviewing tangential bills (all of which are “watch”), when they could be focusing on legislation more directly germane to the membership and/or mental health generally. It is the recommendation of staff to limit the Committee’s focus on legislation that is controversial, complicated and/or has a large scale impact on the membership or mental health, in general.
The staff requests the Board to consider the following amendments to the Legislative Committee description, including administrative changes to meeting schedule:
Page 81 of 521 LEGISLATIVE COMMITTEE - 7A
Legislative Committee
Purpose/Function: The Committee analyzes legislative proposals for possible CAMFT sponsorship and makes recommendations to the Board. The Legislative Committee also reviews state and federal bills as they arise, and makes recommendations to the Executive Director on CAMFT position. Committee recommendations on bills determined by the Executive Director to be controversial will also be reviewed by the Board.
Composition: The Legislative Committee shall consist of up to six (6) members, a majority of whom shall be clinical members. No more than one (1) Board member shall serve on this Committee. Diversity in committee composition is desired.
All Committee members shall have been members of the Association for at least two (2) years prior to appointment. All Committee members shall have prior experience with local, state or federal politics or legislative advocacy. In making appointments, the President shall give consideration to: special competence; geographic distribution; and, political party affiliations. A chair of the Committee shall be selected by the Committee.
Term: Committee members are appointed and serve with the approval of the Board of Directors for a two (2) year term. A member may serve as Chair for one (1) term.
This Committee will sunset two (2) years after its creation, on June 1, 2017. The Board of Directors at that time will determine if its continuance is necessary and beneficial to the Association. If the Committee continues after June 1, 2017, half of the incumbent members will continue for an additional year. A Committee member may serve a maximum of three (3) consecutive terms.
Responsibilities: Analyze proposals submitted for possible CAMFT sponsored bills, and provide recommendation to the Board of Directors Review/analyze/recommend position to the Executive Director on legislation that is controversial, complicated and/or has large scale impact on CAMFT membership or the mental health field approximately 100-150 state pieces of legislation of interest; identify relevant constituents for input Maintain high awareness of state and federal legislative efforts that could affect LMFTs and/or all psychotherapists. Strong familiarity with goals of CAMFT’s Strategic Plan (Advocacy Section) Respond to emails and phone calls in a timely manner Mandatory attendance at meetings including, but not limited to: o One (1) full day meeting, during the summer months, to assist in the development of the upcoming year’s state legislative proposals; o One (1) to Two (2) separate half full day meetings, approximately two to five three (2- 53) weeks after the late February state bill introduction deadline to discuss CAMFT positions;
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o Via conference call or email, as it is deemed necessary on any material changes to legislation or CAMFT’s positions, or as requested by the Executive Director or Legislative Staff. Decisions on legislation/positions will be made based on a majority of the Legislative Committee who vote via email or phone by the stated deadline. If a quorum cannot be reached and urgent decisions are required on legislation/positions, the Committee delegates authority to the Executive Director and President and/or Committee Chair to make a decision on behalf of the Committee. Committee members are required to sign: Committee Member Participation Agreement, Conflict of Interest Policy, Anti-Trust Compliance Policy, and Consent to Electronic Transmission.
Page 83 of 521 SCOPE OF PRACTICE TASK FORCE – 7C
MEMORANDUM
TO: Board of Directors
FROM: Jill Epstein, Executive Director
DATE: May 2, 2017
RE: Scope of Practice Task Force
In September, 2016, the Board voted to convene a Task Force of the President, Legislative Committee Chair and up to two others to help formulate which groups should be included in a focus group on the scope of practice issue. This Task Force will brainstorm on setting an agenda and determining the composition of a formal focus group, ideally representing a variety of business practices, to do a holistic review of the practice of marriage and family therapy in 2017 vs. the MFT of the 1980s. The focus group’s review would assess the risks and benefits and potentially lend itself to the creation of a new scope, with comments from the full membership, to be submitted for legislation in several years.
Given other priorities, the appointments to and convening of this Task Force has been postponed, at the request of the President, until later in 2017.
Page 84 of 521 CHAPTER TASK FORCE – 7D
MEMORANDUM
TO: Board of Directors
FROM: Jill Epstein, Executive Director
DATE: May 9, 2017
RE: Board Task Force on Chapter Issues
At the March 25-26 Board meeting, the Board discussed how CAMFT can better support chapters. The Board approved the following motion:
Motion (13) – Trailer: Establish a Board Task Force to look into Chapter issues.
The Task Force was to be comprised of Patricia Ravitz, Jonathan Flier, Chris Trailer, Curt Widhalm, Howard Leavitt, and Bob Dalzell. However, the Task Force is not convening until summer, 2017. Howard Levitt and Bob Dalzell will no longer be on the Board so the Board needs to discuss possible replacements or needs to amend the motion so it is not a Board Task Force.
Page 85 of 521 NOMINATING COMMITTEE DESCRIPTION – 7E
MEMORANDUM
TO: Board of Directors
FROM: Jill Epstein, Executive Director
DATE: May 9, 2017
RE: Nominating Committee Limitations
The following motions were approved by the Board at the March 25-26, 2017, Board meeting: Motion (5) – Widhalm: Nominating Committee members are precluded from serving as references for candidates’ applications. APPROVED; Strom ABSTAINED
Motion (6) – Perlmutter: Nominating Committee members are precluded from endorsing any candidate in the CAMFT election. APPROVED; Strom ABSTAINED
The Policy on Nominating Committee Charge, Composition, and Restrictions and the Nominating Committee description were edited to include these limitations.
Page 86 of 521 NOMINATING COMMITTEE DESCRIPTON - 7E
Nominating Committee Updated June, 2016 Proposed Edits June, 2017
Purpose/Function: To select nominees for a slate of candidates for the Board of Directors based upon candidate data and interview.
Composition: The Nominating Committee shall be comprised of a total of five (5) members, including the Past President as Chair and four (4) clinical members of the Association, none of whom shall be eligible for nomination by the Nominating Committee and none except the Past President shall currently be serving on the Board of Directors or the Ethics Committee. Diversity in committee composition is desired.
Term: Committee members are appointed by and serve at the pleasure of the CAMFT Board of Directors for a term of one (1) year.
Meetings: The Committee shall hold two (2) face-to-face meetings per year to interview candidates, one (1) in Southern California and one (1) in Northern California. The Committee communicates as necessary via email.
Responsibilities: Committee shall put out a call for prospective nominees to all members of the Association at least one hundred and fifty (150) days before the date of Board elections. This period shall close on the last Friday of the fifth month preceding the date of election. Conduct interviews with prospective nominees and prepare a final slate of nominees. Inform all nominees of the duties of the offices for which they have been nominated, secure their consent to serve, and request from them pertinent information, in writing, about their educational and professional background and their activities within the Association. Review and evaluate applications or petitions from candidates and prepare and submit, in accordance with the Association's bylaws, nominations for officers and members of the Board of Directors for election each year. 1) The committee will select a slate of nominees for the following positions for even years: President-Elect, Chief Financial Officer, and three (3) Board Directors-At-Large. 2) The committee will select the following positions for odd years: President-Elect, Secretary, three (3) Board Directors-At-Large and one (1) Board Director-At-Large elected by Pre-Licensed members. In making final selections for the nominee slate, the Committee shall give due consideration to: 1) Ensuring a diverse slate in terms of geographic, ethnic, and gender characteristics of nominees 2) Nominee's experience within the profession and Association 3) Nominee's chapter and community involvement 4) In selecting nominees for President-Elect, give consideration to prior CAMFT Board, chapter and/or committee service. Send a slate and a “nominating ballot” to all voting members in accordance with the bylaws of the Association and in cooperation with the Elections Committee.
Page 87 of 521 NOMINATING COMMITTEE DESCRIPTON - 7E
Committee members are precluded from endorsing any candidate or serving as a reference in the year the member is serving on the Nominating Committee. Committee members are required to sign: Committee Member Participation Agreement, Conflict of Interest Policy, Anti-Trust Compliance Policy, and Consent to Electronic Transmission.
Page 88 of 521 PUBLIC OUTREACH COMMITTEE – 7F
MEMORANDUM
TO: Board of Directors
FROM: Jill Epstein, Executive Director
DATE: May 11, 2017
RE: Public Outreach Committee
BACKGROUND: The Public Outreach Committee was conceived to help create the public messaging of a marketing campaign around the benefits of mental health therapy to Californians and their families, and brainstorm new advertising vehicles and strategies to promote a better understanding and recognition of Licensed Marriage Family Therapists.
ISSUE: Now that the re-branded Counseling California website has launched, with a new public relations firm under contract, is there an ongoing need for a Public Outreach Committee or should staff and outside vendors address public outreach going forward?
Page 89 of 521 PUBLIC OUTREACH COMMITTEE – 7F
Public Outreach Committee Updated June, 2016
Purpose/Function of the Committee: The purpose of the committee is to help create the public messaging of a marketing campaign around the benefits of mental health therapy to Californians and their families, and brainstorm new advertising vehicles and strategies to promote a better understanding and recognition of Licensed Marriage Family Therapists.
Composition of Committee: The Public Outreach Committee shall be comprised up to six (6) members, including up to two (2) Board members. Diversity in committee composition is desired.
Term: Committee members are appointed by and serve at the pleasure of the CAMFT Board of Directors for a term of one (1) year. A member may serve as Chair for up to two (2) years, if re-appointed.
Meetings: The Public Outreach Committee will meet as needed. One (1) meeting may be in person. Other meetings will be held via tele/video conference and via electronic transmission.
Responsibilities: Assist with messaging and content Committee members are required to sign: Committee Member Participation Agreement, Conflict of Interest Policy, Anti-Trust Compliance Policy, and Consent to Electronic Transmission.
Page 90 of 521 AD HOC SEARCH COMMITTEE NOMINATION – 7G
MEMORANDUM
TO: Board of Directors
FROM: Jill Epstein, Executive Director
DATE: May 10, 2017
RE: Search Committee
At the April 21, 2017, Board meeting, a motion was approved that authorized and directed the current and incoming Board Presidents to form a Search Committee authorized to take those steps necessary to find a new Executive Director for CAMFT.
The President and President-Elect selected the following people to serve on the Committee: President Bob Casanova, Co-Chair Director at Large Curt Widhalm Director at Large Danah Williams Past President Patricia Ravitz, Co-Chair Susan Read-Weil (2007-2008 Director-At-Large; 2010 Search Committee)
Page 91 of 521 FINANCIAL REPORT – 8A
MEMORANDUM
DATE: 5/9/2017
TO: CAMFT Board of Directors
FROM: Ron Hynum, Managing Director, Finance & Operations
RE: April 2017 Financial results
Balance Sheet Narrative Note # 1. Checking Account and Credit Card Clearing variance is normal fluctuation of funds. 2. Variances in Investments reflect the transfer of $400,000 from operating accounts in April, the $504,113 proceeds from sale of Sacramento Property in April and gains on our investments year to date. 3. Variances in Deposit Held by Others reflects the return of rental deposit for Sacramento Property. 4. Variance in Prepaid Expense is due to prepayment of vendor contracts that will be expensed over the year or coming years. 5. Variances in Fixed Assets Furniture, and Building reflect the removal of the Sacramento Property and furnishings due to its recent sale 6. Variance in Accumulated Depreciation reflect the reduction of accumulated depreciation due to the sale of the Sacramento Property. 7. Variance in Accounts Payable is normal and reflects the invoices that were outstanding at that particular period of time, all of which have since been paid. 8. Variance in Accrued Expenses is the result of accruals for 2016 invoices received after the close of the year, those invoices, once received, were booked as an expense in 2017 and the release of this accrual offsets that expense, creating a net -0- effect for 2017. 9. Variance in Accrued Employee Retirement and Accrued 401(k) CAMFT portion reflect the payment to employee retirement funds in early January. 10. Variance in Deferred Income reflect the application of Advertising and Sponsorships dollars paid in 2016 for 2017 advertising and events.
Revenue & Expense Statement Narrative Note # 11. Dues revenue is ahead of plan, and is also higher than this time last year because the dues increase that had only just gone into effect in April, 2016, 12. Registration revenue for Annual Conference is behind plan, but similar to 2016 Annual Conference revenue at this same time, last year. Overall, the conference is expected to post revenue of approximately $136,000, thanks to the registrations received after April 30. 13. Sponsorship revenue is slightly behind plan, but staff continues to solicit sponsors and exhibitors for upcoming live events and staff believes this gap will close as potential Annual Conference sponsors and exhibitor funds are booked in May. 14. Rent variance will exist for all of 2017 since the Board decision to sell the Sacramento property occurred after the budget (which included rental revenue) had been approved. 15. Miscellaneous Income variance is the return of tenants deposit (see note 3 above, as well) 16. Vacation Expense variance is due to timing of fewer staff utilizing vacation to date.
Page 289 of 521 FINANCIAL REPORT – 8A
17. Advertising variance is due in part to timing of planned campaigns, and delayed receipt of bills from new PR agency. 18. Outside Services variance is due in part to delayed receipt of bills from new PR agency, and timing of receipt of invoices for Annual Conference, also includes $15,000 paid to investment advisors for 1st quarter 2017 positive results on portfolio(we’ve not paid any fees for the investment management since 2014). 19. Printing TCT variance is result of additional pages needed for Annual Conference information printed in magazine. 20. Printing fees are lower than budgeted due to a reduction in annual ballot printing costs and timing of Annual Conference invoices. 21. Audio-Visual variance due to a later deposit required for Annual Conference services than planned. 22. Travel Air, Meals and Lodging variances are due in part to timing of receipt of invoices related to DC fly-in. 23. Lobbyist variance is due to renegotiation of Federal Lobbyist contract (after budget had been approved, resulting in lower than budgeted monthly fees), and timing of State lobbyist invoices. 24. Operational revenue is at plan, while expenses were ~$256,000 less than plan, resulting in an overall net operational revenue of $483,542 or a variance from budget of ~$259,284. As noted, many expenses that were budgeted for this period had not been recorded as of April 30, 2017, so true net operational revenue is less than $483,542 (though still ahead of plan).
Non-Operational Revenue The first four months results of our portfolio show a net gain of $206,561. The Gain on Disposal of Fixed Assets reflects the net gain on the sale of Sacramento property. The Reserve fund balance as of 4/30/2017 is $7,281,856.77. Per CAMFT’s reserve policy this total is ~$680,000 above the minimum 15 months of operating expenses or $6,597,655.
Net Excess/Deficit YTD is $858,842 which is $573,084 better than plan.
Page 290 of 521 CAMFT FUND BALANCES - 8B
As of 4/30/2017 12/31/2016 Balance Sheet Change Note Narrative
Assets Checking 490,828.38 541,087.96 (50,260) 1 Credit Card Clearing 82,309.75 44,193.50 38,116 1 Money Market Acct 250,157.43 250,085.92 72 Petty Cash 300.00 300.00 0 Investments Securities 7,281,856.77 6,186,602.75 1,095,254 2 Accounts Receivable - iIMIS 4,019.41 2,601.61 1,418 Deposit held by Others 950.00 3,500.00 (2,550) 3 Inventory 12,006.79 9,420.61 2,586 Prepaid Expense 122,527.21 118,906.43 3,621 4 Fixed Assets-Furniture 92,204.64 103,917.87 (11,713) 5 Fixed Assets-Hardware 66,277.01 66,277.01 0 Fixed Assets-Software 966,838.84 966,838.84 0 Fixed Assets-Auto 15,629.39 15,629.39 0 Building 604,335.30 1,045,513.65 (441,178) 5 Capital Improvements 175,350.30 175,350.30 0 Land 221,387.88 221,387.88 0 Accum Depr- Fixed Assets (1,252,012.71) (1,267,808.43) 15,796 6 Total Assets 9,134,966.39 8,483,805.29 651,161.10
Liabilities Accounts Payable 40,372.94 81,836.67 (41,464) 7 Accrued Expenses 0.00 5,986.74 (5,987) 8 Sales Tax Payable 36.00 0.00 36 Accrued Vacation 109,938.19 101,572.05 8,366 Accrued Employee Retirement 60,267.04 163,864.08 (103,597) 9 Accrued 401(k) CAMFT Portion 18,080.22 52,537.08 (34,457) 9 Section 125 FSA (57.67) 0.00 (58) 401k Witholding Payable 0.00 0.00 0 Health Insurance Witheld Payable 0.00 0.00 0 Deferred Income 23,209.21 51,255.37 (28,046) 10 Due to Foundation 6,870.00 5,630.00 1,240 Due to PAC 9,065.00 13,725.00 (4,660) Due to PAC/FPAC-Reception Funds 840.00 0.00 840 Total Liabilities 268,620.93 476,406.99 (207,786.06)
Net Assets Beginning Net Assets Net Assets 7,413,569.58 6,577,684.09 Prior Period Adjustments 593,933.72 593,933.72 Total Beginning Net Assets 8,007,503.30 7,171,617.81 Net Income (Loss) 858,842.16 835,885.49 Total Net Assets 8,866,345.46 8,007,503.30
Total Liabilities & Net Assets 9,134,966.39 8,483,910.29
Page 291 of 521 Page 1 CAMFT FUND BALANCES - 8B
Current Period Current Period Total Budget 4/30/2017 Budget Budget 2017 Variance Revenue & Expense Prior Year Statement 4/30/2016 Narrative Note
Revenue Member Dues 1,348,628 1,478,082 1,406,140 71,942 11 4,175,985 Registration 128,943 128,861 181,666 (52,805) 12 247,280 Other Cont. Ed. Revenue 31,584 38,567 29,803 8,764 92,638 Sponsorship 96,671 98,931 106,546 (7,615) 13 134,546 Publications 88,238 73,500 78,900 (5,400) 151,500 CE Approval Revenue 37,700 59,200 55,800 3,400 155,300 Products 4,230 1,226 3,850 (2,624) 10,950 Royalties 138,460 140,500 147,650 (7,150) 310,100 Rent 12,981 6,600 8,800 (2,200) 14 17,600 Miscellaneous Income 500 (3,473) 0 (3,473) 15 0 Total Revenue 1,887,935 2,021,994 2,019,155 2,839 5,295,899
Expense Salaries Fixed 334,101 351,564 367,785 16,221 1,103,355 Salaries Hourly 224,814 248,040 245,733 (2,307) 737,199 Cost of Goods Sold 2,663 960 2,025 1,065 5,875 Payroll Taxes 55,082 53,720 53,848 128 161,544 Medical Insurance 47,015 43,793 50,000 6,207 150,000 Vacation Expense 40,626 18,735 36,874 18,139 16 110,622 Employee Benefits 250 100 800 700 3,050 Employee Retirement 74,725 78,699 79,757 1,058 239,272 Worker's Comp Insurance 3,131 5,858 7,575 1,717 18,175 Accounting 20,714 20,881 22,500 1,619 39,600 Bank & Credit Card Fees 31,078 30,609 31,475 866 92,725 Advertising 41,030 2,575 18,200 15,625 17 50,400 Dues 4,663 3,258 6,265 3,007 12,295 Publications 18 218 390 172 1,020 Building Maintenance 7,686 14,877 12,900 (1,977) 34,500 Equipment Lease 19,313 19,662 20,850 1,188 63,850 Computer Maintenance 57,120 54,436 56,400 1,964 169,800 Property Insurance 4,780 4,512 5,500 988 17,800 D & O insurance 3,977 3,977 4,600 623 13,800 Student Insurance 2,460 3,186 2,500 (686) 8,000 Office Supplies 18,552 10,591 16,932 6,340 35,457 Legal 2,945 21,757 12,800 (8,957) 38,400 Outside Services 98,251 79,925 133,891 53,966 18 367,774 Postage 52,657 56,829 60,132 3,303 176,567 Professional Development 2,340 4,912 6,952 2,040 18,941 Professional Development- 608 2,917 1,500 (1,417) 4,000 ExecDir Research Data Base 11,342 10,956 11,860 904 35,580 Direct Mail Handling 13,443 14,229 16,652 2,423 45,046 Printing TCT 67,750 70,671 64,000 (6,671) 19 192,000 Printing 19,161 23,145 36,621 13,476 20 75,450 Presenters 3,000 1,000 5,000 4,000 55,750 Audio-Visual 1,526 5,143 17,105 11,962 21 45,273 Tax & Licenses 7,405 9,772 11,850 2,078 24,870 Telephone 11,064 11,583 12,000 417 36,000 Utilities 10,356 6,653 11,600 4,947 38,300 Travel Air 27,318 18,364 38,975 20,611 22 94,966 Travel Auto 11,790 8,055 14,976 6,921 45,313 Meals 30,475 39,213 51,302 12,089 22 249,824 Lodging 31,267 22,346 47,122 24,776 22 131,881 Meeting Room 915 1,131 5,150 4,019 11,850 Lobbyist 95,660 59,600 92,500 32,900 23 222,000 Depreciation 100,000 100,000 100,000 0 300,000 Total Expense 1,593,071 1,538,452 1,794,898 256,445 5,278,124 Page 292 of 521 Page 1 Excess (Deficit) Operational Revenue 294,864 483,542 224,258 259,284CAMFT 24 FUND BALANCES17,775 - 8B over Expenses
Non-Operational Revenue Dividends 49,799 59,363 50,000 9,363 158,000 Interest 0 82 11,500 (11,418) 36,000 Gain (Loss) on Investments (18,676) (4,958) 0 (4,958) 0 Gain (Loss) Disposal of Fixed Assets 168,739 168,739 Unrealized Gains (Losses) 92,454 152,074 0 152,074 0 Total Non-Operational Revenue 123,577 375,300 61,500 313,800 194,000
Net Excess [Deficit] 418,441 858,842 285,758 573,084 211,775
Page 293 of 521 Page 2 CAMFT FUND BALANCES - 8B
2017 Functional Allocation MEMBERS LEGAL BOARD LOBBYISTS CONF/MTNGS PUBL CHAPTERS ADMIN Total
Expenses Salaries Fixed 5000 0 0 0 0 0 0 0 351,564 351,564 Salaries Hourly 5001 0 0 0 0 0 0 0 248,040 248,040 Cost of Goods Sold 5050 960 0 0 0 0 0 0 0 960 Payroll Taxes 5100 0 0 0 0 0 0 0 53,720 53,720 Medical Insurance 5105 0 0 0 0 0 0 0 43,793 43,793 Vacation Expense 5110 0 0 0 0 0 0 0 18,735 18,735 Employee Benefits 5115 0 0 0 0 0 0 0 100 100 Employee Retirement 5120 0 0 0 0 0 0 0 78,699 78,699 Worker's Comp Insurance 5125 0 0 0 0 0 0 0 5,858 5,858 Accounting 5130 0 0 0 6,381 0 0 0 14,500 20,881 Bank & Credit Card Fees 5135 30,328 0 0 0 0 0 0 15,619 45,947 Advertising 5136 2,575 0 0 0 0 0 0 0 2,575 Dues 5150 450 2,008 0 0 0 0 0 800 3,258 Publications 5151 0 203 0 0 0 0 0 16 218 Building Maintenance 5152 0 0 0 0 0 0 0 14,877 14,877 Equipment Lease 5154 0 0 0 0 0 0 0 19,662 19,662 Computer Maintenance 5157 0 0 0 0 0 0 0 54,436 54,436 Property Insurance 5160 0 0 0 0 0 0 0 4,512 4,512 D & O insurance 5161 0 0 3,977 0 0 0 0 0 3,977 Student Insurance 5162 3,186 0 0 0 0 0 0 0 3,186 Office Supplies 5165 0 0 347 0 2,686 0 0 7,559 10,591 Legal 5169 0 0 20,825 0 0 0 0 931 21,757 Outside Services 5170 36,709 0 3,509 4,641 600 4,029 3,240 11,859 64,587 Postage 5175 4,484 0 12,124 337 9,150 24,359 109 6,265 56,829 Professional Development 5180 (44) 1,848 0 0 0 1,000 0 2,109 4,912 Professional Development-ExecDir 5181 0 0 0 0 0 0 0 2,917 2,917 Research Data Base 5182 8,889 2,067 0 0 0 0 0 0 10,956 Direct Mail Handling 5184 1,048 0 4,515 0 2,243 6,423 0 0 14,229 Printing TCT 5185 0 0 0 0 0 70,671 0 0 70,671 Printing 5190 4,026 0 8,659 0 8,810 0 0 1,652 23,145 Presenters 5191 0 0 0 0 0 0 1,000 0 1,000 Audio-Visual 5193 0 0 832 0 0 0 4,311 0 5,143 Tax & Licenses 5195 0 0 0 0 0 0 0 9,772 9,772 Telephone 5200 0 0 0 0 0 0 0 11,583 11,583 Utilities 5205 0 0 0 0 0 0 0 6,653 6,653 Travel Air 5210 820 0 5,472 7,262 1,733 417 2,660 0 18,364 Travel Auto 5211 773 28 3,003 1,802 46 0 2,201 203 8,055 Meals 5212 184 163 19,894 2,030 989 95 15,172 686 39,213 Lodging 5215 108 0 12,944 772 1,152 866 6,503 0 22,346 Meeting Room 5216 0 0 1,131 0 0 0 0 0 1,131 Lobbyist 5220 0 0 0 59,600 0 0 0 0 59,600 Depreciation 5230 0 0 0 0 0 0 0 100,000 100,000 Total Expenses 94,496 6,317 97,232 82,825 27,409 107,860 35,196 1,087,120 1,538,452 % 6.14 0.41 6.32 5.38 1.78 7.01 2.29 70.66 100.00
Page 294 of 521 CAMFT FUND BALANCES - 8B Schedule of Investments & Securities as of4/30/2017
Percent Asset Name Quantity Price Date Price Market Value Invested Fixed: 80.00 % Dunham Floating Rate Bond Fd Cl N 172,990.62 4/28/2017 $9.75 $1,686,658.50 24.00% Dunham Corp/Govt Bond Fd Cls N 49,066.43 4/28/2017 $13.75 $674,663.40 9.60% Dunham Mthly Distribution Fd Cls N 52,543.88 4/28/2017 $36.38 $1,911,546.32 27.20% Dunham High‐Yield Bond Fd Cls N 110,721.57 4/28/2017 $9.14 $1,011,995.10 14.40% Dunham International Opp Bd Fd Cl N 37,439.70 4/28/2017 $9.01 $337,331.70 4.80% Equity: 20.00 % Dunham Dynamic Macro Fd Cl N 14,430.69 4/28/2017 $9.74 $140,554.88 2.00% Dunham Appreciation & Incm Fd Cls N 5,173.80 4/28/2017 $8.15 $42,166.45 0.60% Dunham Large Cap Value Fd Cls N 15,863.98 4/28/2017 $13.29 $210,832.31 3.00% Dunham Focused Lg Cap Grwth Fd Cl N 11,965.51 4/28/2017 $17.62 $210,832.30 3.00% Dunham International Stock Fd Cls N 22,438.52 4/28/2017 $15.66 $351,387.19 5.00% Dunham Real Estate Stock Fd Cls N 6,343.55 4/28/2017 $15.51 $98,388.41 1.40% Dunham Small Cap Value Fd Cls N 5,111.09 4/28/2017 $16.50 $84,332.94 1.20% Dunham Emerging Mkts Stock Fd Cls N 12,347.43 4/28/2017 $13.66 $168,665.85 2.40% Dunham Small Cap Growth Fd Cls N 5,561.81 4/28/2017 $17.69 $98,388.42 1.40%
Cash: $0.00 0.00% Total: $7,027,743.77 Total:
Total a/o 2/28/2017 $6,342,223.40
Page 295 of 521 PAC FUND BALANCES - 8C
Page 296 of 521 PAC FUND BALANCES - 8C
Page 297 of 521 PAC FUND BALANCES - 8C
Page 298 of 521 PAC FUND BALANCES - 8C
Page 299 of 521 CAMFT-EF FUND BALANCE - 8D
CAMFT Education Foundation Statement of Revenues & Expenses as of 4/30/2017
Unrestricted Temp Actual This Restricted Current Year Period This Period Actual
Revenue Contributions 4000 2,795.00 20,912.75 Temp Restr Contributions 4001 4,000.00 0.00 Interest Earned 4150 0.00 0.00 Dividends 4160 146.90 589.35 Gain/Loss on Investments 4165 (26.70) (66.70) Unrealized Gains/Losses 4170 367.31 1,525.71 Total Revenue 3,282.51 4,000.00 22,961.11 Expenditures Scholarships Expense 5000 2,500.00 2,500.00 Accounting 6000 705.04 705.04 Licenses & Fees 6030 0.00 0.00 Total Expenditures 3,205.04 0.00 3,205.04 Excess (Deficit) 77.47 4,000.00 19,756.07
Page 300 of 521 CAMFT-EF FUND BALANCE - 8D
CAFMT Education Foundation Balance Sheet as of 4/30/2017 Current Year
Assets Current Assets Cash & Cash Equivalents Cash in Bank 1000 43,096.25 Investments 1600 64,272.11 Total Cash & Cash Equivalents 107,368.36 Accounts Receivable Due from Association 1500 6,795.00 Total Accounts Receivable 6,795.00 Total Current Assets 114,163.36
Total Assets 114,163.36
Net Assets Beginning Net Assets Net Assets 94,407.29 Current YTD Net Income 19,756.07 Total Current YTD Net Income 19,756.07 Total Net Assets 114,163.36
Total Liabilities and Net Assets 114,163.36
Page 301 of 521 CAMFT-EF FUND BALANCE - 8D
Investments as of 4/30/2017 Market Percent Asset Name Quantity Price Date Price Value Invested Fixed: 79.90 % Dunham Floating Rate Bond Fd Cl N 1,578.65 4/28/2017 $9.75 $15,391.82 23.95% Dunham Corp/Govt Bond Fd Cls N 447.165 4/28/2017 $13.75 $6,148.52 9.57% Dunham Mthly Distribution Fd Cls N 479.907 4/28/2017 $36.38 $17,459.02 27.16% Dunham High‐Yield Bond Fd Cls N 1,016.00 4/28/2017 $9.14 $9,286.20 14.45% Dunham International Opp Bd Fd Cl N 340.381 4/28/2017 $9.01 $3,066.83 4.77% Equity: 20.10 % Dunham Dynamic Macro Fd Cl N 132.517 4/28/2017 $9.74 $1,290.72 2.01% Dunham Appreciation & Incm Fd Cls N 46.9 4/28/2017 $8.15 $382.24 0.59% Dunham Large Cap Value Fd Cls N 143.685 4/28/2017 $13.29 $1,909.57 2.97%
Dunham Focused Lg Cap Grwth Fd Cl N 112.013 4/28/2017 $17.62 $1,973.67 3.07%
Dunham International Stock Fd Cls N 208.408 4/28/2017 $15.66 $3,263.67 5.08% Dunham Real Estate Stock Fd Cls N 56.03 4/28/2017 $15.51 $869.03 1.35% Dunham Small Cap Value Fd Cls N 46.7 4/28/2017 $16.50 $770.55 1.20% Dunham Emerging Mkts Stock Fd Cls N 113.335 4/28/2017 $13.66 $1,548.16 2.41% Dunham Small Cap Growth Fd Cls N 51.564 4/28/2017 $17.69 $912.17 1.42%
Cash: $0.00 0.00% Total: $64,272.17
Total a/o 1/31/2017 $63,212.04
Page 302 of 521 PROPOSED PROJECT-SUPPORT FBI CYBER INVESTIGATION - 9A
PROPOSED PROJECT OR ACTIVITY
Date of proposal: 4/20/2017 Person, chapter or committee submitting proposal: Curt Widhalm, LMFT & Nicholas Stauth, LMFT What is the problem, as you perceive it, that the proposed project or activity will connect: The website https://recoveryexperts.com/, and specifically https://recoveryexperts.com/nicholas-stauth-11880 came up in 2016. The website appears to be stripped from a database of old Psychology Today accounts, as evidenced by the phone number listed on the profile for Nicholas is identical to the unique phone number that Psychology Today has assigned him during the time that he has an active profile with Psychology Today.
The website lists many therapists from around the country without their knowledge as recovery and treatment records. Many of the listed therapists are not, which puts the therapists in a legal and ethical gray area. Further, it lists a "Recovery Experts Rating", which appears in search engine results, and lists almost every therapist as a 4.5/10, a very poor rating. The rating is not based on client or patient reviews, and the seemingly only way to rate it is to join the website and pay a monthly fee ranging from $49-$179 . Such information is deceptive to the public and misrepresents therapists.
Proposed project or activity: An investigation by the Cyber Crimes Division of the Los Angeles Office of the FBI has already been started. Bryan Willett has expressed that the efforts behind the investigation are likely to be proportional to the enthusiasm and numbers of individuals behind the project. If CAMFT were to put their support behind the investigation and be in contact with the investigating officers, it would further the speed and priority of the investigation. Rationale or reason for project or activity: Attempts to contact the website by phone, email, and through their webpage are not returned or lead to disconnected numbers. When our members are unable to represent themselves in a positive or accurate manner, the larger resources of the organization can help to dissuade the incorrect information. CAMFT's Strategic plan has a goal of Public Outreach to emphasize Marriage & Family Therapists credibility and ability to provide a variety of services.
Fiscal implications of project: Some staff time in contact with investigating agents, possibly some staff time in speaking with members affected by this type of scheme.
Would you be willing to make a presentation to the Board meeting regarding your proposal if requested? Yes ✔ No
Do you want your proposal to be included in the public board packet? Yes No
CHECKLIST FOR PROPOSING A PROJECT/ACTIVITY
When proposing a project or activity for Board action, the following should be considered. When presenting the project or activity to the Board, you can anticipate the Board asking these questions: ( ) Recommended action for Association/Foundation: ( ) Explanation of recommendation: ( ) What purposes will this proposal serve?
( ) How does this proposal coincide with Pageeither 303current of or521 long-range CAMFT/CAMFT-EF Bylaws and Strategic Plan? ( ) Who will benefit from or be served by this project? PROPOSED PROJECT-SUPPORT FBI CYBER INVESTIGATION - 9A ( ) How will this project be accomplished? ( ) How will CAMFT/CAMFT-EF resources be utilized? What are the costs? Actual cost? Staff? Space? Is this project currently within the budget? ( ) What are the policy issues to be addressed by the Board of Directors? ( ) What are the implementation concerns of staff? ( ) What are the anticipated results? ( ) What are the anticipated problem? ( ) What is your expected likelihood of success for this project? ( ) Do the anticipated results exceed the value of resources that will be utilized? ( ) Are the methods suggested for this project the best methods to achieve the anticipated results? ( ) What is your anticipated sequence of events? ( ) What are the anticipated time-frame and completion dates for this proposed project?
Page 304 of 521 VOTE OF MEMBERS WHETHER TO DISCONTINUE PUBLISHING DISCIPLINARY ACTIONS TAKEN BY BBS - 9B
Page 305 of 521 VOTE OF MEMBERS WHETHER TO DISCONTINUE PUBLISHING DISCIPLINARY ACTIONS TAKEN BY BBS - 9B
Page 306 of 521 VOTE OF MEMBERS WHETHER TO DISCONTINUE PUBLISHING DISCIPLINARY ACTIONS TAKEN BY BBS - 9B
Page 307 of 521 VOTE OF MEMBERS WHETHER TO DISCONTINUE PUBLISHING DISCIPLINARY ACTIONS TAKEN BY BBS - 9B
Page 308 of 521 VOTE OF MEMBERS WHETHER TO DISCONTINUE PUBLISHING DISCIPLINARY ACTIONS TAKEN BY BBS - 9B
Page 309 of 521 VOTE OF MEMBERS WHETHER TO DISCONTINUE PUBLISHING DISCIPLINARY ACTIONS TAKEN BY BBS - 9B
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Publication of BBS and BOP Disciplinary Actions in The Therapist Policy
Date: September 17, 1987 Accepted: September 18, 1987 Revised: October 2, 1993 Revised: June 7, 1997 Updated: June 6, 2005
The results of disciplinary action taken by the Board of Behavioral Sciences against any person regulated by the board and the results of disciplinary action taken by the Board of Psychology (BOP) against any person regulated by the board shall be published in The Therapist. The information published shall be the information provided by the BBS and the BOP in making public the results of their action and/or to such other information as shall be a matter of public record or information. Publication of the information shall be made at the earliest time possible following receipt of the information from the BBS and the BOP.
Public Reprovals by the BBS and BOP will be printed with individual names omitted.
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PROPOSED PROJECT OR ACTIVITY
Date of proposal: ___5/11/17______Person, chapter or committee submitting proposal: ______Adele Brookman, MFT Amy Klatzkin, MFT Barbara Petterson, MFT Betty Michaud, MA, MFT Carolyn McAleavy, MFT Caryn Gottfried, MFT Claire-Elizabeth DeSophia, MFT Dana Locke, MFT Dana J. Schwartz, MFT Dawn Keller, MFT Dino Di Donato, MFT Don L. Mathews MFT Elayne Savage, PhD, MFT Fred Morrison, MFT Gerry Fagoaga, MFT Jim Moyers, MFT Jürgen Braungardt, MFT Lucy Garcia, MFT Lynn Wiese, MFT Maria Shufeldt, MFT Margaret Petersen, MFT Maurine Poppers, MFT Nickie Amerius-Sargeant, MFT Nina Sprecher, MFT Penny Fellbrich, MFT Phyllis Galanis, MFT Phyllis Shulman, Ph.D., MFT Renee Beck, MFT Sally Reese, MFT Sarah Jolley. MFT Sherry M Freeman, MFT Steven Brody, MFT Steven Kessler, MFT Vanita Kunert, MFT Vera Gassner, MFT, SEP * * indicates not a member of CAMFT Yvonne Mansell, MFT
What is the problem, as you perceive it, that the proposed project or activity will connect correct:
Without complete information on how each board member has voted on past motions, the membership cannot cast informed votes to re-elect or replace that member, so the Board is not accountable to the membership and CAMFT is not structurally a democracy.
Proposed project or activity:
We ask that you pass a motion making it standard Board policy to disclose to the membership how each Page 312 of 521 board member votes on each motion, regardless of whether the motion ultimately fails or is approved. We ask that the vote record for each motion appear in the minutes of each Board meeting, next to the listing of FAILED or APPROVED for that motion, in a standard format,ROLL CALL such VOTES as "In FOR favor: ALL BOARD name, ACTIONS name, - 9C name. Opposed: name, name, name."
Rational or reason for project or activity:
We propose this change in policy to make CAMFT more transparent and accountable to the membership.
Fiscal implications of project:
None
Would you be willing to make a presentation to the Board meeting regarding your proposal if requested?
Yes X No
Do you want your proposal to be included in the public board packet?
Yes X No
CHECKLIST FOR PROPOSING A PROJECT/ACTIVITY
When proposing a project or activity for Board action, the following should be considered. When presenting the project or activity to the Board, you can anticipate the Board asking these questions: ( ) Recommended action for Association/Foundation: ( ) Explanation of recommendation: ( ) What purposes will this proposal serve? ( ) How does this proposal coincide with either current or long-range CAMFT/CAMFT-EF Bylaws and Strategic Plan? ( ) Who will benefit from or be served by this project? ( ) How will this project be accomplished? ( ) How will CAMFT/CAMFT-EF resources be utilized? What are the costs? Actual cost? Staff? Space? Is this project currently within the budget? ( ) What are the policy issues to be addressed by the Board of Directors? ( ) What are the implementation concerns of staff? ( ) What are the anticipated results? ( ) What are the anticipated problem? ( ) What is your expected likelihood of success for this project? ( ) Do the anticipated results exceed the value of resources that will be utilized? ( ) Are the methods suggested for this project the best methods to achieve the anticipated results? ( ) What is your anticipated sequence of events? ( ) What are the anticipated time-frame and completion dates for this proposed project?
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From: Steven Kessler Sent: Thursday, May 11, 2017 10:41 AM To: Board
Dear Board Members,
We, the undersigned, ask that you pass a motion making it standard Board policy to disclose to the membership how each board member votes on each motion, regardless of whether the motion ultimately fails or is approved. We ask that the vote record for each motion appear in the minutes of each Board meeting, next to the listing of FAILED or APPROVED for that motion, in a standard format, such as "In favor: name, name, name. Opposed: name, name, name."
We believe this is necessary because, without complete information on how each board member has voted on past motions, the membership cannot cast informed votes to re-elect or replace that member, so the Board is not accountable to the membership and CAMFT is not structurally a democracy. We propose this change in policy to make CAMFT more transparent and accountable to the membership.
We anticipate that this change in how votes are recorded and reported to the membership will not have any significant fiscal impact on CAMFT.
Thank you for considering this proposal. We look forward to your response.
Signed, Adele Brookman, MFT Amy Klatzkin, MFT Barbara Petterson, MFT Betty Michaud, MA, MFT Carolyn McAleavy, MFT Caryn Gottfried, MFT Claire-Elizabeth DeSophia, MFT Dana Locke, MFT Dana J. Schwartz, MFT Dawn Keller, MFT Dino Di Donato, MFT Don L. Mathews MFT Elayne Savage, PhD, MFT Fred Morrison, MFT Gerry Fagoaga, MFT Jim Moyers, MFT Jürgen Braungardt, MFT Lucy Garcia, MFT Lynn Wiese, MFT Maria Shufeldt, MFT Margaret Petersen, MFT
Page 314 of 521 ROLL CALL VOTES FOR ALL BOARD ACTIONS - 9C ROLL CALL VOTES FOR ALL BOARD ACTIONS – 9C
Maurine Poppers, MFT Nickie Amerius-Sargeant, MFT Nina Sprecher, MFT Penny Fellbrich, MFT Phyllis Galanis, MFT Phyllis Shulman, Ph.D., MFT Renee Beck, MFT Sally Reese, MFT Sarah Jolley. MFT Sherry M Freeman, MFT Steven Brody, MFT Steven Kessler, MFT Vanita Kunert, MFT Vera Gassner, MFT, SEP * Yvonne Mansell, MFT
* indicates non-member
Page 315 of 521 CAMFT STAFF/OPERATIONS REPORT – 10A
MEMORANDUM
TO: Board of Directors
FROM: Jill Epstein, Executive Director
DATE: May 11, 2017
RE: Staff/Operations Update
Sacramento Property Ron Hynum and I managed the sale of the Sacramento property, yielding a sale price of $542,000. Escrow documents were signed by both me and Patricia Ravitz and the property closed on April 17, 2017. Details about the sale are provided in the Finance section of the Board book.
San Diego Property CAMFT’s longtime tenant in the San Diego headquarters announced his intention to move to new space, effective June 1, 2017. While this will result in a loss of revenue, it affords CAMFT the opportunity to grow into that space.
Employee Updates Staff celebrated the following milestone anniversaries since the last Board meeting: Dave Jensen – 15 years with CAMFT
Sara Jasper, Staff Attorney, will be on maternity leave beginning in June. The Legal Team and I have discussed coverage for Sara’s responsibilities while she is gone.
Page 316 of 521 EXTERNAL GROUPS UPDATE – 10B
MEMORANDUM
TO: Board of Directors
FROM: Jill Epstein, Executive Director
DATE: May 11, 2017
RE: Executive Director Activity Update
Between March 26 and June 2, I will have taken 9 trips and participated in the following meetings/events:
1. Professional Organizations Met with and regularly conferred with Executive Officer of BBS Met with regularly conferred with Executive Director of AAMFT Attended one Irregulars meeting Attended one CA Coalition of Mental Health meetings
2. Advocacy Executed CAMFT Sacramento Lobby Day Executed CAMFT DC Lobby Days Attended BBS Board meeting Initiated and participated in monthly call with David Connolly and AAMFT Attended PAC fundraiser for Senator Leyva Attended Assembly Budget Subcommittee Meeting for AB 1865 Met with and regularly conferred with Political Solutions Regularly conferred with David Connolly
3. CAMFT Committee Meetings Staffed PAC Committee meeting Staffed Board meeting Staffed Connects Task Force meeting Staffed Legislative Committee meeting Staffed External Management Audit Task Force
4. Miscellaneous Staffed Annual Conference; Presented Executive Director report at Annual Membership Meeting and facilitated Educators’ Luncheon Staffed Counseling California exhibit at Mental Health Matters Day Met with incoming Board membersPage Nanci 317 Finley,of 521 Kristy Labardee, and Jan Mellinger. MARKETING AND PUBLIC RELATIONS REPORT – 10D
Memorandum
To: Jill Epstein, Executive Director CAMFT Board of Directors
From: Eileen Schuster, Managing Director of Marketing and Communications
Re: Marketing and Public Relations
Date: May 17, 2017
Exhibiting The CAMFT team is scheduled to be at the following exhibiting events: May 24: Mental Health Matters Day June 1-4: West Coast Symposium of Addictive Disorder (WCSAD) December 13-17: Evolution of Psychotherapy Conference
Social Media The CAMFT Facebook and Twitter accounts continue to share postings featuring news, events, and updates. Facebook “page likes” increased to a total of 7,601. CAMFT’s Twitter page has 1,828 “Followers.”
CAMFT’s social media shared highlights of the Grassroots Advocacy Team’s visit to Sacramento and Washington with the hashtag #MedicareNeedsMFTs. Unfortunately, Facebook no longer reports the reach of a hashtag. Approximately 120 public postings were found by the hashtag. There could be more, but a user’s privacy setting may prohibit it from being found in a general search. Approximately 219 tweets and retweets (101 original tweets) were found with the hashtag.
The Counseling California Facebook and Twitter accountsare experiencing an uptick of engagement with “likes” and “shares.” Counseling California Facebook “page likes” increased to a total of 1,597. The Counseling California Twitter page has 1,828 “Followers.”
New Search Feature on Counseling California Visitors on the Counseling California site can now search for therapists by city.
Public Relations CAMFT’s public relations firm developed a radio interview campaign to highlight May as Mental Health Awareness Month. A press release and opinion editorial was created and distributed for a variety of media outlets. The campaign included ten radio station interviews in selected markets and occurred during the morning drive time hours. CAMFT President Patricia Ravitz was the spokesperson for all of the interviews. Talking points addressed the value of talk therapy, expertise of marriage and family therapists, and promotion of Counseling California.
Radio stations: KTIP-AM FRESNO - KGX-AM-FM PALM SPRINGS
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KJMB-FM LOS ANGELES KVTA-AM SANTA BARBARA KVON-AM SAN FRANCISCO - KCBQ-AM SAN DIEGO KMET-AM LOS ANGELES - KEST-AM SAN FRANCISCO KPFK-FM LOS ANGELES - KZYX-FM SAN FRANCISCO - KLIV-AM SAN JOSE - KNSJ-FM SAN DIEGO KJLH-FM LOS ANGELES - KDYA-AM SAN FRANCISCO - KSAC-AM SACRAMENTO JEFFERSON PUBLIC RADIO REGIONAL KAHI-AM SACRAMENTO KHSU-FM - KHSR-FM - KHSF-FM - KHSG-FM EUREKA
President Patricia Ravitz also did a television interview with Jeffrey Schaub of KPIX-TV KBCW-TV SAN FRANCISCO and KSTW-TV SEATTLE regarding the therapeutic value of emotional support animals.
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Update Memo: Outreach Coordinator June 2017
CHAPTER RELATIONS
CAMFT Leadership Conference 2018 & CAMFT Connects Survey
In an effort to facilitate planning efforts for the 2018 CAMFT Leadership Conference, a survey was sent to the chapter leader attendees to solicit feedback about the 2017 conference. Survey questions focused on the efficacy and success of continued desirability of concurrently holding the leadership conference and CAMFT Connects events.
Outreach
Between April 2017 and June 2017, CAMFT staff have presented at the following chapters: Delta Stockton, Santa Barbara, Santa Clara Valley.
Upcoming chapter board visits are planned for Santa Cruz and Chico. The outreach coordinator will meet with the boards of these chapters at their monthly meeting to discuss objectives for the chapter in the coming year, answer questions, and distribute chapter handbooks.
SCHOOLS/PRELICENSEES
Outreach to School
A quarterly outreach email was sent in April to faculty and program directors of MFT programs across the state to advertise school presentations and the availability of membership materials for prelicensees. A webinar presentation to students at Cal Southern and Holy Names University is planned.
COMMITTEES
The Crisis Response Education and Resources Committee will meet via teleconference on May 19, 2017. A new chairperson will be appointed after this meeting, following the stepping down of Victoria Campbell.
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EXEMPT SETTING COMMITTEE MEETING NOTICE March 24, 2017 1:30 p.m. to 3:30 p.m. Department of Consumer Affairs 1625 North Market Blvd., 1st Floor Sacramento, CA 95834
1. Purpose of Committee
The Exempt Setting Committee was appointed in November 2016. The Committee will review practice within an exempt setting to determine if consumers are receiving services consistent with the standard of care for the mental health professions. The Committee will also focus on ensuring consumer protection within an exempt setting.
The Committee’s work will focus on gathering information related to practice in an exempt setting; such as reviewing existing law, evaluating other state agencies practice and law. Further, the Committee will identify areas for improvement that are within the Board’s regulatory authority.
The Committee will hold a series of meetings to conduct an open ended inquiry gathering information and data. Stakeholders and interested parties will be given an opportunity to provide input, feedback, and express their concerns.
It is anticipated that this process will take approximately 18 months to complete, with the committee’s recommendations presented to the Board in the summer of 2018.
2. Review of Exempt Setting Definition
The Committee reviewed the definition of “exempt setting” as defined at the BBS, the Board of Psychology, as well as other state’s licensing agencies. The BBS currently defines an exempt setting to include: colleges and universities, public K-12 schools, private schools, government entities, and agencies that are classified as “charitable.” No decision was made as to any change to the definition at this time, but instead more discussion on the issue.
3. Review of Private Practice Definition
The Committee reviewed the definition of “private practice” as defined by the different licensing practice acts under the BBS, the Board of Psychology, as well as other state’s licensing agencies. There was no unified definition of “private practice” and the Committee showed interest in attempting to, at a minimum, to create a single definition for BBS licensees.
4. Review of Proper Placement Locations for Trainees
The Committee discussed where trainees are currently being placed, and what are and are not appropriate work settings.
The Committee reviewed various MFT Program’s “practicum site agreements,” as well as feedback from the programs on confusion as to appropriate worksites.
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The Committee also reviewed draft surveys for practicum sites and registrants and licensees. In addition to amending the content of the questions, the Committee added agency directors as recipients of the survey.
The Committee will review the answers to the surveys upon receipt during one of the next two Committee meetings.
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Policy and Advocacy Committee Meeting
April 21, 2017
I. Discussion and Recommendations on Bills
Assembly Bill 191 (Wood) Mental Health: Involuntary Treatment
This CAMFT-sponsored bill seeks to add licensed marriage and family therapists and licensed professional clinical counselors to the list of professionals who are authorized to be the secondary signatory to extend involuntary commitments, under certain circumstances. Currently, a physician or psychologist must be the first signer. The second person to sign an involuntary treatment certification may be another physician, another psychologist, a social worker or a registered nurse. It is not uncommon for LMFTs or LPCCs to be part of involuntary hold treatment teams, but they are currently not able to provide the second required signature. If a social worker or registered nurse is not available, this can lead to a person being held longer than authorized by law, or it can cause continuity of care issues, because the treating LMFT or LPCC is unable to sign the certification.
The Committee voted to recommend a position of Support.
CAMFT’s position on this bill is Support.
Assembly Bill 456 (Thurmond) Healing Arts: Associate Clinical Social Workers
This bill seeks to extend the Board’s “90-day rule” to applicants for registration as an associate clinical social worker (ASW). Currently, the 90-day rule allows applicants for registration as a marriage and family therapist intern or a professional clinical counselor intern to count post-degree hours of supervised experience before receiving a registration number, as long as they apply for their intern registration within 90 days of the granting of their qualifying degree.
The Committee discussed concerns about consumer protection, particularly applicants who are able to continue to provide counseling services, but have a criminal conviction that has not been reviewed by the BBS. The fingerprinting requirement is a deficiency that can be made up after a one-year period, therefore applicants who have a conviction or criminal history are providing services to clients during the period their registration application is pending. However, the Committee is hesitant to oppose the bill if applicants from the other two professions, MFT and LPCC, are able to count hours per the 90-day rule. The Committee suggested further discussion on the 90-day rule, generally.
The Committee voted to defer a recommendation to the full Board for discussion at its May meeting.
CAMFT is watching this bill.
Assembly Bill 508 (Santiago) Health Care Practitioners: Student Loans
This bill seeks to remove a healing art board’s ability to issue a citation and fine and its ability to deny an application for a license or renewal of a license due to the licensee or applicant being in default on a U.S. Department of Health and Human Services education loan. The bill is further seeking to protect the professional licenses of people who have defaulted on their federal student loan debt, arguing that by removing a person’s ability to practice their profession, they remove their ability to repay their loans
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and other bills. BBS staff indicated they have not taken any action when in receipt of this information, although they have the legal authority do so. The Committee discussed it is not within their purview to cite/fine applicants and licensees for being in default of loans.
The Committee voted to recommend a position of Support.
CAMFT does not yet have a position on this bill.
Assembly Bill 703 (Flora) Professions and Vocations: Licenses: Fee Waivers
This bill would require licensing boards within the Department of Consumer Affairs (DCA), which would include the BBS, to grant fee waivers for the application for and issuance of an initial license to a person who holds a current license in the same profession in another state and is married to or in a domestic partnership with an active duty member of the U.S. military. The BBS only charges an initial license fee. (Applicants also typically have to pay a registration application fee, registration renewal fees, and exam application fees, but these fees are not waived under this bill.) The fees that the BBS charges that would qualify for a military service waiver under this bill are as follows: LMFTs: $130 initial license fee; LEPs: $80 initial license fee; LCSWs: $100 initial license fee; LPCCs: $200 initial license fee. This change would require modifications to the BreEZe system which would be paid for by the BBS.
The Committee voted to recommend a position of Support.
CAMFT is watching this bill.
Senate Bill 27 (Morrell) Professions and Vocations: Licenses: Military Service
This bill would require licensing boards within the Department of Consumer Affairs (DCA), which would include the BBS, to grant fee waivers for the application for and issuance of an initial license to an applicant who has served as an active duty member of the California National Guard or the U.S. Armed Forces and was honorably discharged.
The Committee directed BBS staff to obtain more data on how many applicants are active duty member or honorably discharged from the California National Guard or the U.S. Armed Forces and referred to the full Board for further discussion at its May Meeting.
CAMFT is watching this bill.
Assembly Bill 767 (Quirk-Silva) Master Business License Act
This bill seeks to create a master business license system under the Governor’s Office of Business and Economic Development. It would allow a person who needs to apply for more than one business license to submit a single master application through GO-Biz, which would then distribute the application information to the various relevant licensing entities. The bill would require, among other items, that each state agency to cooperate and provide reasonable assistance to GO-Biz in implementing the Master Business License Act.
The Committee discussed the complexity of obtaining a license with the BBS. The licensing process for BBS-licenses is a unique process, including intern registration, taking the L&E exam during registration, and the clinical exam after hours have been obtained. The Committee discussed supporting the concept of the master business license system, but not for BBS-licensees.
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The Committee voted to recommend a position of Support If Amended to exclude BBS.
CAMFT does not yet have a position on this bill.
Assembly Bill 1116 (Grayson) Peer Support and Crisis Referral Services Act
This bill was amended on 4/21/2017. Existing law provides a definition of a “psychotherapist” for purposes of establishing the psychotherapist-patient privilege. This bill establishes the “Peer Support and Crisis Referral Services Act.” The bill specifies that a communication made by emergency service personnel to a crisis hotline or crisis referral service is confidential and cannot be disclosed in a civil or administrative proceeding. The bill also states that except under certain specified circumstances, a communication made by emergency service personnel to a peer support team member while receiving peer support services is confidential and cannot be disclosed in a civil or administrative proceeding. Prior to amendments, the bill included these professionals under the definition of “psychotherapists” as defined under Evidence Code 1010. The amendments remove these professionals under the definition of “psychotherapists.”
CAMFT and NASW expressed support for the concept of protecting the confidentiality of these communications, however is concerned with the unintended consequences of defining these professionals as “psychotherapists” under the law. CAMFT and NASW have met with the sponsors of this bill to discuss how to protect the confidentiality of these communications without placing these persons under the definition of “psychotherapist” in the Evidence Code.
The Committee voted for BBS staff to further review and analyze the recent amendments and to refer to the full Board for further discussion at its May meeting.
Assembly Bill 1188 (Nazarian) Health Professions Development: Loan Repayment
This bill would increase the Mental Health Practitioner Education Fund fee that licensed marriage and family therapists and licensed clinical social workers pay upon license renewal from $10 to $20. It would also require LPCCs to pay a $20 fee into the fund upon renewal, and would allow LPCCs and PCC interns to apply for the loan repayment grant if they work in a mental health professional shortage area. The BBS has requested minor amendments to change all references of “interns” to “associates” in the bill.
The Committee discussed the urgency measure of the bill, meaning the law would be effective upon the governor’s signature. BBS Staff indicated that implementing the change immediately upon the governor’s signature would be impracticable given the necessary administrative changes that would need to occur, including amendments to forms, renewal notices and the BrEZe system. BBS Staff suggested they would be comfortable implementing the required changes on July 1, 2018. The Committee discussed supporting the bill, but to request the bill be amended to include an implementation date of July 1, 2018.
The Committee voted to recommend a position of Support If Amended to include an implementation date of July 1, 2018.
CAMFT’s position on this bill is Support.
Assembly Bill 89 (Levine) Psychologists: Suicide Prevention Training
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This bill would require, beginning January 1, 2020, an applicant for licensure as a psychologist, or a licensed psychologists, upon renewal of his or her license, to demonstrate completion of at least six hours of coursework or supervised experience in suicide risk assessment and intervention. This bill is similar to AB2198 (2014), which included BBS licensees. The Governor vetoed AB2198 and asked the licensing boards to evaluate the issues raised. Per the Governor’s direction, the BBS distributed a survey to graduate programs requesting the programs to report the number of required courses covering these courses. 28 programs responded and after review of the results, the BBS found the graduate programs commonly integrate the topic of suicide assessment across a variety of courses. The BBS concluded that mandating a specific number of hours of suicide assessment coursework is unlikely to be effective in reducing suicides because degree programs are already providing coverage of the topic.
The Committee discussed the current bill’s inapplicability to BBS-licensees. BBS Staff indicated they were not concerned the bill would extend to include BBS-licensees.
The Committee voted to recommend taking a Neutral position.
CAMFT is watching this bill.
Assembly Bill 1372 (Levine) Crisis Stabilization Unit: Psychiatric Patients
This bill would allow a crisis stabilization unit that provides specialty mental health services, at its discretion, to provide medically necessary crisis stabilization services to individuals beyond the allowable treatment time of 24 hours under certain circumstances.
The Committee discussed the importance of consumers to have access to crisis stabilization services.
The Committee voted to recommend a position of Support.
CAMFT is watching this bill.
Assembly Bill 1591 (Berman) Medi-Cal: Federally Qualified Health Centers and Rural Health Centers: Licensed Professional Clinical Counselors
This bill would allow Medi-Cal reimbursement for covered mental health services provided by a licensed professional clinical counselor employed by a federally qualified health center or a rural health clinic.
The Committee voted to recommend a position of Support.
CAMFT does not yet have a position on this bill.
Senate Bill 244 (Lara) Privacy: Agencies: Personal Information
This bill would provide additional privacy protections for personal information that is submitted to state agencies from an applicant for public services or programs. Under existing law, the Department of Consumer Affairs (DCA) is required to collect from applicants an individual taxpayer ID number or their social security number. This bill requires that information collected from applicants cannot be disclosed except for licensing purposes or required by state or federal law. This bill would also prohibit information obtained by applicants to the Mental Health Practitioner Education Fund loan repayment grant from being considered public record per the Public Records Act. The information would be confidential and used for assessing eligibility or as required by state or federal law.
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The Committee voted to recommend a position of Support.
CAMFT is watching this bill.
Senate Bill 374 (Newman) Health Insurance: Discriminatory Practices: Mental Health
This CAMFT-cosponsored bill grants the Department of Insurance the authority to require that large group health insurance policies and individual or small group health insurance policies must provide all covered mental health and substance use disorder benefits in compliance with federal law. This is parallel to current authority already given to the Department of Managed Health Care for its regulation of large, individual or small group health care service plans.
The Committee voted to recommend a position of Support.
CAMFT’s position on this bill is Support.
Senate Bill 399 (Portantino) Health Care Coverage: PDD or Autism
This bill seeks to close some of the loopholes that insurance companies use to deny treatment for behavioral health treatment. It also revises the definitions of a “qualified autism service professional” and a “qualified autism service paraprofessional.”
CAMFT has not taken a position on this bill, but expressed concerns that paraprofessionals who render the services to this vulnerable population receive adequate supervision from qualified licensed professionals.
The Committee voted to recommend taking a Neutral position.
CAMFT is watching this bill.
Senate Bill 572 (Stone) Healing Arts Licenses: Violations: Grace Period
This bill would require a healing arts board to grant a licensee a 15-day grace period to correct any violations of law that do not cause irreparable harm before imposing discipline. BBS Staff is concerned that the term “irreparable harm” is not defined, which leaves it open for subjective interpretation. The BBS would have to send more cases to subject matter experts in order to determine if irreparable harm occurred. BBS Staff is also concerned the bill would create a disincentive for licensees to complete their required continuing education. If a licensee was provided with a 15-day grace period to come into compliance, some licensees may decide there is no need to complete their education unless audited. BBS Staff also expressed concerns with the vagueness of when the 15-day window to correct the violations commences. In addition, BBS Staff indicated the 15-day grace period will extend the time it takes to complete some investigations. The current performance measure for completing an investigation is 180 days. The Committee discussed and agreed with Staff’s concerns.
The Committee voted to recommend a position of Oppose.
CAMFT is watching this bill.
Senate Bill 636 (Bradford) Addiction: Treatment: Advertising: Payment
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This bill prohibits persons, including BBS-licensees, who provide counseling services in an alcoholism or drug abuse recovery and treatment program licensed by the Department of Health Care Services (DHCS), from giving or receiving any type of remuneration for patient referrals. It permits DHCS to investigate potential violations and recommend disciplinary action to the relevant licensing board. The Committee discussed whether the BBS wants to share enforcement authority/oversight of BBS-licensees with the DHCS.
The Committee discussed supporting the concept of DHCS investigating its licensed facilities and the facilities’ employees, including BBS-licensees and registrants. However, the Committee is concerned about DHCS having the authority to enforce and take disciplinary action against BBS-licensees and registrants. The Committee would rather see DHCS providing a referral to the BBS rather than making a recommendation to the BBS or taking disciplinary action through DHCS’s administrative hearings.
The Committee voted a position of Oppose Unless Amended to remove DHCS’s authority to take disciplinary action against BBS-licensees and registrants. The Committee directed staff to provide technical assistance to the author of the bill.
CAMFT is watching this bill.
II. Status of Board-Sponsored Legislation
Assembly Bill 93 (Medina) Healing Arts: Licensed Marriage and Family Therapists, Licensed Clinical Social Workers, Licensed Professional Clinical Counselors: Required Supervision and Experience
This bill represents the work of the Board’s Supervision Committee. Its amendments focus on strengthening the qualifications of supervisors, supervisor responsibilities, types of supervision that may be provided, and acceptable work settings for supervisees. The bill also strives to make the Board’s supervision requirements more consistent across its licensed professions.
This bill proposal was approved by the Board at its November 4, 2016 meeting. Minor technical amendments to the bill were approved at the Board’s March 3, 2017 meeting.
Status: AB 93 recently passed the Assembly Business and Professions Committee, and is currently in the Assembly Appropriations Committee.
Board Omnibus Bill - Proposed Technical and Non-Substantive Amendments to Business and Professions Code Sections 801, 801.1, 802, 4980.09, 4999.12.5, 4980.44, 4984.7, 4999.32, 4999.42, 4999.53, 4999.62, 4999.63, 4999.120, 4984.4, 4984.7, 4996.3, 4996.6, 4999.32, 4999.33, 4999.60, 4999.61, 4984.9, 4992.8, 4989.46, 4999.18, 4980.72, 4996.17, 4999.53; Evidence Code Section 1010(f)(o); and Penal Code Section 11165.7(a)(25) and (a)(40)
This proposal, approved by the Board at its November 4, 2016 meeting, makes minor, technical, and non-substantive amendments to add clarity and consistency to current licensing law.
One proposed amendment item was rejected by the Senate Business, Professions, and Economic Development Committee as being too substantive. The Committee has indicated that all other amendments the Board requested were accepted. The rejected proposal was as
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follows: Proposal to Amend BPC Sections 801, 801.1, and 802 – Judgment and Settlement Reporting Amounts
Currently, healing arts licensees must report all judgments or settlements for negligence claims in excess of a certain dollar amount to his or her licensing board. For some boards, this amount is $3,000. For the Board’s LMFT, LCSW, and LPCC licensees, this reporting amount is $10,000. However, there is a reference error in law. The law states Board licensees subject to “Chapter 14 (commencing with Section 4990)” are subject to this reporting requirement. While Chapter 14 refers to LCSW statute, section 4990 is a reference to the beginning of the Board’s general provisions. This error needs to be corrected. In addition, LEPs are not included in the list of licensees that are subject to the $10,000 reporting requirement. Instead, they are subject to the $3,000 reporting requirement. The Board’s Enforcement Unit notes that there is no known reason why the reporting threshold should be any different for LEPs, and such a difference for only one Board license type is arbitrary and potentially confusing for staff and licensees.
Additionally, BPC Section 801.1(b) refers to the Board as the “Board of Behavioral Science Examiners.” This language was amended to reference the “Board of Behavioral Sciences.”
BBS Staff indicated the Committee may consider making a recommendation next year to propose amendments to BPC 801, 801.1 and 802 to correct the reference error to Chapter 14.
Status: The Senate Business, Professions, and Economic Development Committee indicates that it plans to amend the Board’s requested omnibus bill items into SB 800.
III. Status of Board Rulemaking Proposals
English as a Second Language: Additional Examination Time: Add Title 16. California Code of Regulations Section 1805.2
This proposal would allow the Board to grant time-and-a-half (1.5x) on a Board-administered examination to an English as a second language (ESL) applicant, if the applicant meets specific criteria demonstrating limited English proficiency.
The final proposal was approved by the Board at its meeting in November 2015. It was published in the California Regulatory Notice Register on January 1, 2016. The 45-day public comment period has ended, and the public hearing was held on February 15, 2016. Upon review by the Office of Administrative Law (OAL), staff was notified wording changes that would be necessary for approval. The proposed changes were approved by the Board in March 2017, and a 15-day public comment period was held. The revised language and documents are currently being prepared for approval by the Department of Consumer Affairs (DCA) and OAL.
Application Processing Times and Registrant Advertising: Amend Title 16. California Code of Regulations, Sections 1805.1 and 1811
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(Chapter 489, Statutes of 2016) which changes the term “intern” to “associate” effective January 1, 2018, and makes several technical changes. This proposal would also amend the regulation that sets forth minimum and maximum application processing time frames.
The final proposal was approved by the Board at its meeting in November 2016. The proposal is currently in the new “initial review phase” process required by DCA. The initial review phase is expected to be completed in the next few weeks, at which time the proposal will be submitted to OAL for publishing in the California Regulatory Notice Register to initiate the 45-day public comment period.
Contact Information; Application Requirements; Incapacitated Supervisors: Amend Title 16. California Code of Regulations, Sections 1804, 1805 and 1820.7; Add Section 1815.8
This proposal would: Require all registrants and licensees to provide and maintain a current, confidential telephone number and email address with the Board. Codify the Board’s current practice of requiring applicants for registration or licensure to provide the Board with a public mailing address, and ask applicants for a confidential telephone number and email address. Codify the Board’s current practice of requiring applicants to provide documentation that demonstrates compliance with legal mandates, such as official transcripts; to submit a current photograph; and for examination candidates to sign a security agreement. Require certain applications and forms to be signed under penalty of perjury. Provide standard procedures for cases where a registrant’s supervisor dies or is incapacitated before the completed hours of experience have been signed off.
The final proposal was approved by the Board at its meeting in March 2017, and is being prepared for in the new “initial review phase” process required by DCA, which can take up to four months. Upon completion of the DCA review, the proposal will be submitted to OAL for publishing to initiate the 45- day public comment period.
Suggestions for Future Agenda Items
AAMFT-CA requested to bring to the May Board Meeting a discussion of AB387 Minimum Wage and a discussion of “Post-Traumatic Street Disorder.”
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BBS Policy and Advocacy Committee Minutes May 12, 2017
Written by Jill Epstein
1. Election of Officers A Chair and a Vice Chair must be elected prior to June 1 of each year. The Board elected Deborah Brown to serve as 2017-2018 Chair and Patricia Lock-Dawson to serve as 2017-2018 Vice Chair.
2. Presentation Regarding Treatment and Needs of Transyouth Dr. Johanna Olson-Kennedy presented on the treatment of transyouth. She reviewed the DSM description for Gender Dysphoria in Children, Adolescents and Adults and expressed her frustration over the criteria. She noted that parental support is such a critical part of the process for transyouth and reviewed the treatment and medical interventions of transgender adolescents.
When thinking of curriculum, Dr. Olson recommended to create safe places for transexperiences. She also pleaded with providers not to list transgender as a specialty unless the provider has the competency; instead just list LGB as specialty.
3. Presentation Regarding MFT Trainees Paying for Their Supervision Dr. Ben Caldwell presented his concerns with the trend for practicum sites to charge trainees for supervision. He noted that the charges are potentially exploitive. His recommendation is to prohibit direct payments from trainees to their sites for training or supervision required as part of practicum and/or to draft legislation to define that entering into or participating in a exploitive relationship with an supervisee constitutes unprofessional conduct. Dr. Caldwell argued that the sites should be working to eliminate barriers to participation.
While universities charge training fees, these are disclosing to incoming and prospective students at the beginning of the program.
The Board was sympathetic to the costs to businesses who take on trainees and expressed interest in discussing alternatives to prohibiting fees or legislation. At the same time, the Board also acknowledged the importance of protecting trainees from exploitation. The Board directed staff to research options and data to address this issue, including academic institutions in the discussions. The data and research will be presented at the fall, 2017, meeting.
4. Executive Officer Report The Board’s budget for Fiscal Year (FY) 2016/2017 is $12,377,000. FY 2016/2017 expenditures received as of March 31, 2017 total $8,141,192 or 66% of the Board’s budget. As of March 31, 2017, the Board had collected $7,949,205 in total revenue.
The Board is currently processing all MFT intern and exam applications in under 30 days.
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The Board provided 2016 year-end and 2017 examination statistics and pass rate by school. LMFT Law and Ethics exam had a 65% pass rate in 2017 through March 31 and the LMFT Clinical exam had a 54% pass rate in 2017 through March 31. CAMFT and AAMFT-CA inquired why the LMFT Clinical exam pass rate had dropped from 71% and 73% in the past two quarters. BBS responded that they have confidence in the exam process, though they are watching these scores, and OPES is making sure exam questions are appropriate. The Board was questioned whether the quarter’s exams can be re-considered. BBS reported that OPES regularly evaluates questions on exams and questions are removed and/or not scored. It was unlikely to be able to retro-actively re-consider all exams in the quarter.
In March, 2017, the Exam Unit began Subject Matter Expert recruitment in order to expand the pool of experts. To date, 217 applications were submitted.
A total of 52 LMFT licensees were audited for continuing education. Of this number, 25% failed the audit. All licensees who fail the Continuing Education Audit are referred to the Board’s Enforcement Unit for issuance of a citation and fine. The top reasons for licensees failing the continuing education audits continue to be: failure to complete the law and ethics coursework, failure to complete the required number of continuing education units within the renewal period, and completing continuing education courses from unapproved providers.
The BBS noted that they will help licensees become aware of which providers are approved by listing links on the BBS website to each BBS Approval Agencies’ approved providers. The BBS website upgrade is expected to be completed in July and the goal is to have these links posted shortly thereafter.
5. Policy and Advocacy Committee Recommendations Assembly Bill 191 (Wood) Mental Health: Involuntary Treatment This CAMFT-sponsored bill seeks to add licensed marriage and family therapists and licensed professional clinical counselors to the list of professionals who are authorized to be the secondary signatory to extend involuntary commitments, under certain circumstances. Currently, a physician or psychologist must be the first signer. The second person to sign an involuntary treatment certification may be another physician, another psychologist, a social worker or a registered nurse. It is not uncommon for LMFTs or LPCCs to be part of involuntary hold treatment teams, but they are currently not able to provide the second required signature. If a social worker or registered nurse is not available, this can lead to a person being held longer than authorized by law, or it can cause continuity of care issues, because the treating LMFT or LPCC is unable to sign the certification. CAMFT addressed the issues raised by the CA Psychological Association in their letter of opposition. The Committee voted to recommend a position of Support. The Board voted to support. CAMFT’s position on this bill is Support.
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Assembly Bill 456 (Thurmond) Healing Arts: Associate Clinical Social Workers This bill seeks to extend the Board’s “90-day rule” to applicants for registration as an associate clinical social worker (ASW). Currently, the 90-day rule allows applicants for registration as a marriage and family therapist intern or a professional clinical counselor intern to count post- degree hours of supervised experience before receiving a registration number, as long as they apply for their intern registration within 90 days of the granting of their qualifying degree. The Committee voted to defer a recommendation to the full Board for discussion at its May meeting. The Board heard about the consumer protection concerns raised by the Policy and Advocacy Committee regarding applicants who have a criminal convictions unknown to the BBS at the time of application and can continue to provide counseling services during the period their registration application is pending. However, the BBS staff is unable to identify any significant enforcement cases involving the 90-day rule. In fact, most trainees have already been fingerprinted since it is required by most agencies. The Board discussed the option of legislation that would reduce the timeframe an applicant can gain hours under the 90-day rule. Current law allows up to one year to remediate any application deficiencies (this may include coursework, transcripts, syllabi, or documents requested by the Board’s enforcement unit) before the application is abandoned. If the Board determines that one year of an applicant counting hours under the 90-day rule is excessive, it could then pursue legislation allowing a shorter timeframe for remediating conviction-related deficiencies .for all three license types The Board reviewed past discussions on this issue from 2012 and indicated that there are no major examples of enforcement issues. The Board members expressed comfort knowing that public safety is not endangered. The Board voted to support this bill. CAMFT is watching this bill. Assembly Bill 508 (Santiago) Health Care Practitioners: Student Loans This bill seeks to remove a healing art board’s ability to issue a citation and fine and its ability to deny an application for a license or renewal of a license due to the licensee or applicant being in default on a U.S. Department of Health and Human Services education loan. The bill is further seeking to protect the professional licenses of people who have defaulted on their federal student loan debt, arguing that by removing a person’s ability to practice their profession, they remove their ability to repay their loans and other bills. BBS staff indicated they have not taken any action when in receipt of this information, although they have the legal authority do so. The Committee discussed it is not within their purview to cite/fine applicants and licensees for being in default of loans nor did the Board wish to penalize low-income licensees. The Committee voted to recommend a position of Support. The Board voted to support. CAMFT does not yet have a position on this bill.
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Assembly Bill 703 (Flora) Professions and Vocations: Licenses: Fee Waivers This bill would require licensing boards within the Department of Consumer Affairs (DCA), which would include the BBS, to grant fee waivers for the application for and issuance of an initial license to a person who holds a current license in the same profession in another state and is married to or in a domestic partnership with an active duty member of the U.S. military. The BBS only charges an initial license fee. (Applicants also typically have to pay a registration application fee, registration renewal fees, and exam application fees, but these fees are not waived under this bill.) The fees that the BBS charges that would qualify for a military service waiver under this bill are as follows: LMFTs: $130 initial license fee; LEPs: $80 initial license fee; LCSWs: $100 initial license fee; LPCCs: $200 initial license fee. This change would require modifications to the BreEZe system which would be paid for by the BBS. This bill is now a two-year bill and will be re-visited in 2018. Assembly Bill 767 (Quirk-Silva) Master Business License Act This bill seeks to create a master business license system under the Governor’s Office of Business and Economic Development. It would allow a person who needs to apply for more than one business license to submit a single master application through GO-Biz, which would then distribute the application information to the various relevant licensing entities. The bill would require, among other items, that each state agency to cooperate and provide reasonable assistance to GO-Biz in implementing the Master Business License Act. The Committee discussed the complexity of obtaining a license with the BBS. The licensing process for BBS-licenses is a unique process, including intern registration, taking the L&E exam during registration, and the clinical exam after hours have been obtained. The Committee discussed supporting the concept of the master business license system, but not for BBS- licensees. The Committee voted to recommend a position of Support If Amended to exclude BBS. The Board voted to support if amended to remove BBS licensees from the bill. CAMFT does not yet have a position on this bill. Assembly Bill 1116 (Grayson) Peer Support and Crisis Referral Services Act This bill was amended on 4/21/2017. Existing law provides a definition of a “psychotherapist” for purposes of establishing the psychotherapist-patient privilege. This bill establishes the “Peer Support and Crisis Referral Services Act.” The bill specifies that a communication made by emergency service personnel to a crisis hotline or crisis referral service is confidential and cannot be disclosed in a civil or administrative proceeding. The bill also states that except under certain specified circumstances, a communication made by emergency service personnel to a peer support team member while receiving peer support services is confidential and cannot be disclosed in a civil or administrative proceeding. Prior to amendments, the bill included these professionals under the definition of “psychotherapists” as defined under
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Evidence Code 1010. The amendments remove these professionals under the definition of “psychotherapists.” At the Policy and Advocacy Committee meeting, CAMFT and NASW expressed support for the concept of protecting the confidentiality of these communications, however is concerned with the unintended consequences of defining these professionals as “psychotherapists” under the law. CAMFT and NASW met with the sponsors of this bill to discuss how to protect the confidentiality of these communications without placing these persons under the definition of “psychotherapist” in the Evidence Code. The Committee voted for BBS staff to further review and analyze the recent amendments and to refer to the full Board for further discussion at its May meeting. The Board heard about the amendments and voted to support. CAMFT does not yet have a position on this bill. Assembly Bill 1188 (Nazarian) Health Professions Development: Loan Repayment This bill would increase the Mental Health Practitioner Education Fund fee that licensed marriage and family therapists and licensed clinical social workers pay upon license renewal from $10 to $20. It would also require LPCCs to pay a $20 fee into the fund upon renewal, and would allow LPCCs and PCC interns to apply for the loan repayment grant if they work in a mental health professional shortage area. The BBS has requested minor amendments to change all references of “interns” to “associates” in the bill. The Committee discussed the urgency measure of the bill, meaning the law would be effective upon the governor’s signature. BBS Staff indicated that implementing the change immediately upon the governor’s signature would be impracticable given the necessary administrative changes that would need to occur, including amendments to forms, renewal notices and the BreEZe system. BBS Staff suggested they would be comfortable implementing the required changes on July 1, 2018. The Committee discussed supporting the bill, but to request the bill be amended to include an implementation date of July 1, 2018. The Committee voted to recommend a position of Support If Amended to include an implementation date of July 1, 2018. The Board voted to support. CAMFT’s position on this bill is Support. Assembly Bill 89 (Levine) Psychologists: Suicide Prevention Training This bill would require, beginning January 1, 2020, an applicant for licensure as a psychologist, or a licensed psychologists, upon renewal of his or her license, to demonstrate completion of at least six hours of coursework or supervised experience in suicide risk assessment and intervention. This bill is similar to AB2198 (2014), which included BBS licensees. The Governor vetoed AB2198 and asked the licensing boards to evaluate the issues raised. Per the
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Governor’s direction, the BBS distributed a survey to graduate programs requesting the programs to report the number of required courses covering these courses. Twenty-eight (28) programs responded and after review of the results, the BBS found the graduate programs commonly integrate the topic of suicide assessment across a variety of courses. The BBS concluded that mandating a specific number of hours of suicide assessment coursework is unlikely to be effective in reducing suicides because degree programs are already providing coverage of the topic. The Committee discussed the current bill’s inapplicability to BBS-licensees. BBS Staff indicated they were not concerned the bill would extend to include BBS-licensees. The Committee voted to recommend taking a neutral position. The Board voted to take a neutral position. CAMFT is watching this bill. Assembly Bill 1372 (Levine) Crisis Stabilization Unit: Psychiatric Patients This bill would allow a crisis stabilization unit that provides specialty mental health services, at its discretion, to provide medically necessary crisis stabilization services to individuals beyond the allowable treatment time of 24 hours under certain circumstances. The Committee discussed the importance of consumers to have access to crisis stabilization services. The Committee voted to recommend a position of Support. The Board voted to Support this bill. CAMFT is watching this bill. Assembly Bill 1591 (Berman) Medi-Cal: Federally Qualified Health Centers and Rural Health Centers: Licensed Professional Clinical Counselors This bill would allow Medi-Cal reimbursement for covered mental health services provided by a licensed professional clinical counselor employed by a federally qualified health center or a rural health clinic. The Committee voted to recommend a position of Support. The Board voted to Support. CAMFT does not yet have a position on this bill. Senate Bill 27 (Morrell) Professions and Vocations: Licenses: Military Service This bill would require licensing boards within the Department of Consumer Affairs (DCA), which would include the BBS, to grant fee waivers for the application for and issuance of an initial license to an applicant who has served as an active duty member of the California National Guard or the U.S. Armed Forces and was honorably discharged. The Committee directed BBS staff to obtain more data on how many applicants are active duty
Page 347 of 521 BBS – 12A member or honorably discharged from the California National Guard or the U.S. Armed Forces and referred to the full Board for further discussion at its May Meeting. The Board reviewed figures gauging how many applicants would be eligible for a fee waiver. In 2016, 103 applicants would have been eligible for a fee waiver, totaling $24,300 in waived fees. The Board voted to Support this bill. CAMFT is watching this bill. Senate Bill 244 (Lara) Privacy: Agencies: Personal Information This bill would provide additional privacy protections for personal information that is submitted to state agencies from an applicant for public services or programs. Under existing law, the Department of Consumer Affairs (DCA) is required to collect from applicants an individual taxpayer ID number or their social security number. This bill requires that information collected from applicants cannot be disclosed except for licensing purposes or required by state or federal law. This bill would also prohibit information obtained by applicants to the Mental Health Practitioner Education Fund loan repayment grant from being considered public record per the Public Records Act. The information would be confidential and used for assessing eligibility or as required by state or federal law. The Committee voted to recommend a position of Support. The Board voted to Support. CAMFT is watching this bill. Senate Bill 374 (Newman) Health Insurance: Discriminatory Practices: Mental Health This CAMFT-cosponsored bill grants the Department of Insurance the authority to require that large group health insurance policies and individual or small group health insurance policies must provide all covered mental health and substance use disorder benefits in compliance with federal law. This is parallel to current authority already given to the Department of Managed Health Care for its regulation of large, individual or small group health care service plans. The Committee voted to recommend a position of Support. The Board voted to Support. CAMFT’s position on this bill is Support. Senate Bill 399 (Portantino) Health Care Coverage: PDD or Autism This bill seeks to close some of the loopholes that insurance companies use to deny treatment for behavioral health treatment. It also revises the definitions of a “qualified autism service professional” and a “qualified autism service paraprofessional.” The Committee voted to recommend taking a Neutral position. The Bill is now a two-year bill and will be re-visited in 2018. CAMFT is watching this bill.
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Senate Bill 572 (Stone) Healing Arts Licenses: Violations: Grace Period This bill would require a healing arts board to grant a licensee a 15-day grace period to correct any violations of law that do not cause irreparable harm before imposing discipline. BBS Staff is concerned that the term “irreparable harm” is not defined, which leaves it open for subjective interpretation. The BBS would have to send more cases to subject matter experts in order to determine if irreparable harm occurred. BBS Staff is also concerned the bill would create a disincentive for licensees to complete their required continuing education. If a licensee was provided with a 15-day grace period to come into compliance, some licensees may decide there is no need to complete their education unless audited. BBS Staff also expressed concerns with the vagueness of when the 15-day window to correct the violations commences. In addition, BBS Staff indicated the 15-day grace period will extend the time it takes to complete some investigations. The current performance measure for completing an investigation is 180 days. The Committee discussed and agreed with Staff’s concerns. The Committee voted to recommend a position of Oppose. This bill is now a two-year bill and will be re-visited in 2018. CAMFT is watching this bill. Senate Bill 636 (Bradford) Addiction: Treatment: Advertising: Payment This bill prohibits persons, including BBS-licensees, who provide counseling services in an alcoholism or drug abuse recovery and treatment program licensed by the Department of Health Care Services (DHCS), from giving or receiving any type of remuneration for patient referrals. It permits DHCS to investigate potential violations and recommend disciplinary action to the relevant licensing board. The Committee discussed whether the BBS wants to share enforcement authority/oversight of BBS-licensees with the DHCS. The Committee discussed supporting the concept of DHCS investigating its licensed facilities and the facilities’ employees, including BBS-licensees and registrants. However, the Committee is concerned about DHCS having the authority to enforce and take disciplinary action against BBS-licensees and registrants. The Committee would rather see DHCS providing a referral to the BBS rather than making a recommendation to the BBS or taking disciplinary action through DHCS’s administrative hearings. The Committee voted a position of Oppose Unless Amended to remove DHCS’s authority to take disciplinary action against BBS-licensees and registrants. The Committee directed staff to provide technical assistance to the author of the bill. The bill is now a two-year bill and will be re-visited in 2018. CAMFT is watching this bill.
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Senate Bill 762 (Hernandez) Healing Arts License: License Activation Fee: Waiver This bill would require all healing arts boards under the Department of Consumer Affairs (DCA) to waive the renewal fee for an inactive licensee returning to active status, if the licensee will solely be providing voluntary, unpaid services to indigent patients in medically underserved or critical-need population areas. The Board discussed concerns that there is no definition of “medically underserved or critical need populations” and it is unclear what documentation would be required to prove the licensee is providing voluntary, unpaid services to indigent patients. It was noted that individuals working in certain settings are already exempt from licensure, so those individuals would not need to activate an inactive license. It was difficult to ascertain the fiscal loss based on currently inactive licensees. Concerns about auditing these individuals to ensure they are still working as volunteers in these population areas and how the limitations could be communicated to the public. The Board voted to Oppose Unless Amended to remove BBS licensees. It was noted that BBS already supports exempt settings to accommodate the delivery of services to underserved populations. CAMFT is watching this bill. Senate Bill 700 (Jones-Sawyer) – Public Health: Alcoholism or Drug Abuse Recovery: Substance Use Disorder Counseling This bill would establish a standardized career ladder for substance use disorder counselors, with classifications for substance use disorder counselor certification or registration. Defines a “substance use disorder counselor” or “SUD counselor” as a person who is certified as an alcohol or other drug counselor by an approved certifying organization and who provides services or treatment at an adult alcoholism or drug abuse recovery or treatment facility. BBS staff worked with the sponsor of the bill and suggested an amendment to clarify that Board trainees and registrants do not have to have a substance use disorder certification to engage in this practice. The sponsor has indicated that they are considering an amendment to expand who may supervise a person seeking certification as an SUD counselor, to include Board licensees. A question was raised about whether it would be appropriate to allow the Board’s associates to supervise these individuals as well. The Board voted to approve staff’s recommendation regarding the amendment, above. CAMFT is watching this bill. Senate Bill 715 (Newman) – DCA: Regulatory Boards: Removal of Board Members This bill would allow the Governor to remove a board member appointed by him or her for failure to attend board meetings. Currently law only allows removal for continued neglect of duties, incompetence, or unprofessional or dishonorable conduct. Failure to attend board
Page 350 of 521 BBS – 12A meetings would specifically qualify as continued neglect of duties. The Board voted to watch this bill. CAMFT is watching this bill. 6. Status of Board-Sponsored Legislation Assembly Bill 93 (Medina) Healing Arts: Licensed Marriage and Family Therapists, Licensed Clinical Social Workers, Licensed Professional Clinical Counselors: Required Supervision and Experience
This bill represents the work of the Board’s Supervision Committee. Its amendments focus on strengthening the qualifications of supervisors, supervisor responsibilities, types of supervision that may be provided, and acceptable work settings for supervisees. The bill also strives to make the Board’s supervision requirements more consistent across its licensed professions.
This bill proposal was approved by the Board at its November 4, 2016 meeting. Minor technical amendments to the bill were approved at the Board’s March 3, 2017 meeting.
Status: AB 93 recently passed the Assembly Business and Professions Committee, and is currently in the Assembly Appropriations Committee.
Board Omnibus Bill - Proposed Technical and Non-Substantive Amendments to Business and Professions Code Sections 801, 801.1, 802, 4980.09, 4999.12.5, 4980.44, 4984.7, 4999.32, 4999.42, 4999.53, 4999.62, 4999.63, 4999.120, 4984.4, 4984.7, 4996.3, 4996.6, 4999.32, 4999.33, 4999.60, 4999.61, 4984.9, 4992.8, 4989.46, 4999.18, 4980.72, 4996.17, 4999.53; Evidence Code Section 1010(f)(o); and Penal Code Section 11165.7(a)(25) and (a)(40) This proposal, approved by the Board at its November 4, 2016 meeting, makes minor, technical, and non-substantive amendments to add clarity and consistency to current licensing law.
One proposed amendment item was rejected by the Senate Business, Professions, and Economic Development Committee as being too substantive. The Committee has indicated that all other amendments the Board requested were accepted. The rejected proposal was as follows: Proposal to Amend BPC Sections 801, 801.1, and 802 – Judgment and Settlement Reporting Amounts
Currently, healing arts licensees must report all judgments or settlements for negligence claims in excess of a certain dollar amount to his or her licensing board. For some boards, this amount is $3,000. For the Board’s LMFT, LCSW, and LPCC licensees, this reporting amount is $10,000. However, there is a reference error in law. The law states Board licensees subject to “Chapter 14 (commencing with Section 4990)” are subject to this reporting requirement. While Chapter 14 refers to LCSW statute, section 4990 is a reference to the beginning of the Board’s general provisions. This error needs to be corrected. In addition, LEPs are not included in the list of licensees that are subject to the
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$10,000 reporting requirement. Instead, they are subject to the $3,000 reporting requirement. The Board’s Enforcement Unit notes that there is no known reason why the reporting threshold should be any different for LEPs, and such a difference for only one Board license type is arbitrary and potentially confusing for staff and licensees.
Additionally, BPC Section 801.1(b) refers to the Board as the “Board of Behavioral Science Examiners.” This language was amended to reference the “Board of Behavioral Sciences.”
BBS Staff indicated the Committee may consider making a recommendation next year to propose amendments to BPC 801, 801.1 and 802 to correct the reference error to Chapter 14.
Board voted to accept staff recommendation. Status: This bill is currently in the Senate Business, Professions, and Economic Development Committee.
7. Status of Board Rulemaking Proposals English as a Second Language: Additional Examination Time: Add Title 16. California Code of Regulations Section 1805.2 This proposal would allow the Board to grant time-and-a-half (1.5x) on a Board-administered examination to an English as a second language (ESL) applicant, if the applicant meets specific criteria demonstrating limited English proficiency. The final proposal was approved by the Board at its meeting in November 2015. It was published in the California Regulatory Notice Register on January 1, 2016. The 45-day public comment period has ended, and the public hearing was held on February 15, 2016. Upon review by the Office of Administrative Law (OAL), staff was notified wording changes that would be necessary for approval. The proposed changes were approved by the Board in March 2017, and a 15-day public comment period was held. The revised language and documents are currently being prepared for approval by the Department of Consumer Affairs (DCA) and OAL. Application Processing Times and Registrant Advertising: Amend Title 16. California Code of Regulations, Sections 1805.1 and 1811
(Chapter 489, Statutes of 2016) which changes the term “intern” to “associate” effective January 1, 2018, and makes several technical changes. This proposal would also amend the regulation that sets forth minimum and maximum application processing time frames.
The final proposal was approved by the Board at its meeting in November 2016. The proposal is currently in the new “initial review phase” process required by DCA. The initial review phase is expected to be completed in the next few weeks, at which time the proposal will be submitted to OAL for publishing in the California Regulatory Notice Register to initiate the 45-day public comment period.
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Contact Information; Application Requirements; Incapacitated Supervisors: Amend Title 16. California Code of Regulations, Sections 1804, 1805 and 1820.7; Add Section 1815.8 This proposal would: Require all registrants and licensees to provide and maintain a current, confidential telephone number and email address with the Board. Codify the Board’s current practice of requiring applicants for registration or licensure to provide the Board with a public mailing address, and ask applicants for a confidential telephone number and email address. Codify the Board’s current practice of requiring applicants to provide documentation that demonstrates compliance with legal mandates, such as official transcripts; to submit a current photograph; and for examination candidates to sign a security agreement. Require certain applications and forms to be signed under penalty of perjury. Provide standard procedures for cases where a registrant’s supervisor dies or is incapacitated before the completed hours of experience have been signed off.
The final proposal was approved by the Board at its meeting in March 2017, and is being prepared for in the new “initial review phase” process required by DCA, which can take up to four months. Upon completion of the DCA review, the proposal will be submitted to OAL for publishing to initiate the 45-day public comment period. Supervision
This proposal would:
• Revise the qualifications to become supervisor;
• Require supervisors to perform a self-assessment of qualifications and submit the self- assessment to the Board;
• Set forth requirements for substitute supervisors;
• Update and strengthen supervisor training requirements;
• Strengthen supervisor responsibilities, including provisions pertaining to monitoring and evaluating supervisees;
• Strengthen requirements pertaining to documentation of supervision;
• Make supervision requirements consistent across the three licensed professions; and
• Address supervision gained outside of California.
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The proposal was approved by the Board at its meeting in November 2016, and is being prepared for in the new “initial review phase” process required by DCA. Upon completion of the DCA review, as well as the passage of the Board’s supervision legislation (AB 93), the proposal will be submitted to OAL for publishing to initiate the 45-day public comment period.
Enforcement
This proposal would result in updates to the Board’s disciplinary process. It would also make updates to the Board’s “Uniform Standards Related to Substance Abuse and Disciplinary Guidelines (Revised October 2015),” which are incorporated by reference into the Board’s regulations. The proposed changes fall into three general categories:
1. Amendments seeking to strengthen certain penalties that are available to the Board;
2. Amendments seeking to update regulations or the Uniform Standards/Guidelines in response to statutory changes to the Business and Professions Code; and
3. Amendments to clarify language that has been identified as unclear or needing further detail.
The proposal was approved by the Board at its meeting in February 2017, and is being prepared for in the new “initial review phase” process required by DCA. Upon completion of the DCA review, the proposal will be submitted to OAL for publishing to initiate the 45-day public comment period.
8. Future Agenda
CALPCC suggested allowing LMFTs apply for the LPCC and accept their supervised experience as the BBS is doing for out-of-state applicants.
AAMFT-CA suggested an item addressing issues with the MFT exams regarding pass rates and exam development.
Rene Loner suggested an item regarding the time for licensees on probation to petition for changes.
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LEGISLATIVE AND REGULATORY UPDATE
STATE ADVOCACY
CAMFT Legislation for 2017
AB 191 (Wood)—Psychiatric Holds: This bill would add LMFTs and LPCCs to the list of eligible providers who can act as a second signatory to extend involuntary commitments. Currently, extensions on involuntary mental health holds need to be signed first by a psychiatrist or psychologist and then either a second psychiatrist/psychologist or social worker or registered nurse (RN). Although LMFTs and LPCCs routinely work as part of the treatment team within treatment centers where assessments are made, they are unable to act as secondary signers. When treatment teams need to find a secondary signer, there are often delays because the pool of signers is limited and, thus the patient could end up being held longer than the 72 hours, breaching the patient’s rights. The addition of LMFTs and LPCCs allows facilities the flexibility to efficiently utilize their provider care teams while maintaining patient safety and patient’s rights. This bill passed out of the Assembly with a 75-0 vote, and has now been referred to the Senate Health Committee.
SB 374 (Newman)--Mental Health Parity: CAMFT is a co-sponsor of this legislation, that would mandate health care plans regulated by the Department of Insurance (DOI) to cover mental health and substance use disorder benefits in compliance with the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). This would be a follow-up bill to SB 857 (2014--Committee on Budget and Fiscal Review) that mandated the same for plans covered by the Department of Managed Health Care. The purpose of the bill is to reinforce and clarify that the DOI has the authority to enforce the MHPAEA. The California Psychiatric Association is a co-sponsor, and it is likely that other co-sponsors will join as the legislative season moves forward. This bill is now in the Assembly.
Other 2017 State Legislation
AB 93 (Medina)—Supervision Requirements: This bill, sponsored by the Board of Behavioral Sciences (BBS), would revise and recast 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), the proposed legislation discussed below, as well as regulations that will be introduced in the next year or two. Some of the more notable changes in AB 93 include:
Supervisors to monitor for and address clinical dynamics, including countertransference, intrapsychic-, interpersonal-, or trauma-related issues that may affect the supervisory or the practitioner-patient relationship; Supervisors to directly observe or review recordings of supervisee’s counseling, as deemed appropriate;
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Supervisors to review supervisee’s progress notes, process notes and other patient treatment records, as deemed appropriate; The BBS will obtain the right to audit the records of supervisors to verify completion of supervisor qualifications; and, One hour of face to face supervision will now include “triadic supervision” which means one hour of face-to-face between one supervisor and two supervisees.
CAMFT participated in all stakeholder meetings and has taken a position of support on this legislation.
AB 154 (Levine)—Prisoners and Mental Health: This bill allows the court to order a defendant to serve all, or part, of their state prison or county jail sentence in a residential mental health facility, when a defendant establishes that they meet specified criteria regarding mental illness. Defendants with a current conviction for a violent felony would not qualify. This bill also mandates that the California Department of Corrections and Rehabilitation (CDCR) or the county jail prepare a post-release mental health treatment plan six months prior to the defendant's release. CAMFT currently has a watch position on this bill, but will move to support if it makes it off the suspense file.
AB 254 (Thurmond)—LEA and Mental Health Services: This bill requires the Department of Health Care Services, if funded, to establish the Local Educational Agency Pilot for Overall Needs program for the purpose of improving the mental health outcomes of K-12 students through a “whole person care approach” including mental health. Given CAMFT’s priority of increasing mental health within the K-12 public school system, CAMFT took a support position on this bill.
AB 387 (Thurmond)—Minimum Wage and Allied Health Professionals: This bill expands the definition of employer under provisions related to minimum wage, to include any person who persons engaged in a period of supervised work experience to satisfy requirements for licensure, registration, or certification as an allied health professional (as defined under federal law). This bill has met with fierce opposition from numerous health care provider and hospital advocacy groups with concerns about fiscal implications. This bill has not yet been given a price tag, but it most certainly will be quite high given the impact on counties and state agencies. This bill remains unclear as to its definition of what professions actually fall under “allied health professional.” Although this bill is being heavily lobbied by labor advocacy groups, it is not likely to move forward, as currently written given the opposition by state, county, private employers and provider groups.
CAMFT is aware of the controversial nature of this issue, not only within the California work arena, but within the CAMFT membership. The CAMFT Board of Directors has long prioritized ensuring that pre- licensees are not exploited, and that the therapy field is open to a financially diverse population. CAMFT is also aware of the financial struggles of low or no-pay client service agencies. Until further fiscal analysis is put forward, CAMFT has taken a neutral position on this bill. The CAMFT Board of Directors will be asked to weigh in on this legislation.
AB 595 (Wood): This bill would require plans regulated under the Department of Managed Health Care that intend to merge with, consolidate, acquire, purchase, or control a health care service plan doing business in California to give notice to, and secure the prior approval from, the Department. Consolidation of the health industry can often mean fewer choices and competition, with little to no benefit to the consumer or the provider. The state must be able to scrutinize these deals and ensure that the mergers are good for California consumers. CAMFT has taken a position of support on this legislation.
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AB 834 (O’Donnell)—School Based Health Programs: This bill would establish an Office of School-Based Health Programs (OSBH) that would support and advise school districts on issues related to the delivery of school-based health services. Due to a recent federal change, schools will soon have access to far greater resources to pay for these services. This change means that many more students will be eligible to receive health services at school, including school nurse services for chronic conditions, mental health and counseling services, occupational therapy, speech pathology, audiology, and targeted case management. The OSBH program would develop infrastructure within the various state departments to increase access to services and remove barriers to reimbursement. CAMFT has selected increasing mental health services within the K-12 system as a priority and has taken a position of support on this legislation.
AB 1074 (Maienschein)—Coverage of ABA Services: Current law requires managed care plans to cover behavioral health treatment for pervasive developmental disorder (PDD) or autism by qualified autism service providers and qualified autism service professionals working under supervision. This bill would amend the supervision requirements for qualified autism service professionals and qualified autism service paraprofessionals. This bill would also expand the scope of qualified autism service professionals to include clinical case management and case supervision. Although CAMFT is supportive of the use and coverage of behavioral health treatment for PDD and autism, it is essential to protect this vulnerable patient population by ensuring that the providers of this care are properly educated and experienced, as well as supervised. CAMFT has concerns that this bill could lower the supervision requirements for non- licensed providers creating a potential for patient harm. CAMFT is putting forward a letter of concern to the Legislature to help ensure that requirements do not continue to weaken.
AB 1116 (Grayson)—Peer Support and Crisis Referral: This bill would provide that a communication made by emergency service personnel to a crisis hotline or crisis referral service is confidential and shall not be disclosed in a civil or administrative proceeding. This bill originally added this communication under the psychotherapist-patient privilege; concerned about unintended consequences of the odd placement within the Evidence Code, CAMFT originally opposed this bill. After negotiations, the author amended the language to include this confidential communication in a more appropriate location, and given the merits of the bill in itself, CAMFT has taken a position of support.
AB 1188 (Nazarian)—Loan Repayment: Current law allows MFTs, and other BBS and Board of Psychology licensees, who work at publicly funded mental health facilities or nonprofit mental health facilities, and provide direct patient care, to apply for grants under the Licensed Mental Health Service Provider Education Program to reimburse for educational loans. This bill would increase each licensee’s annual renewal fee by $10 to be applied towards the existing Education fund for his/her license. The CAMFT Board of Directors has made it a priority to advocate that pre-licensees and newly licensed MFTs have increased opportunities for paid employment—CAMFT believes this bill will assist in that goal. This bill is co-sponsored by NASW and CALPCC, and supported by the California Psychological Association. CAMFT is in support of this legislation.
AB 1134 (Gloria)-- MHSOAC Fellowship Program: This bill authorizes the Mental Health Services Oversight and Accountability Commission to establish a fellowship program for the purpose of providing an experiential learning opportunity for a mental health consumer and a mental health professional. The fellowships provided for in this bill would complement the make-up of the Commission, which includes two mental health consumers, as well as two mental health professionals appointed by the Governor. Bringing fellows with professional and life experience into the Commission's offices would
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fortify its ability to ensure that it has access to subject matter experts who can inform and guide the Commission's operations. CAMFT is in support of this legislation.
AB 1591 (Berman): -- LPCCs within the FQHC/RHCs: law provides that federally qualified health center services and rural health clinic services, as defined, are covered benefits under the Medi-Cal program to be reimbursed, to the extent that federal financial participation is obtained, to providers on a per-visit basis. "Visit" is defined as a face-to-face encounter between a patient of a federally qualified health center or a rural health clinic and specified health care professionals. Similar to CAMFT’s AB 1863 (2016), this bill would include a marriage and family therapist within those health care professionals covered under that definition. CAMFT is in support of this legislation.
SB 191 (Beall)—Pupil Health: This bill will create the County and Local Educational Agency Partnership Fund to promote partnerships between counties and school districts in an effort to better address student mental health and substance use disorders. This bill will reduce barriers to access for children and families, such as stigma, affordability, and problems recognizing symptoms, and provide maximal coverage for universal prevention and early intervention programs. As noted above, CAMFT has prioritized increasing mental health services in the K-12 system, and believe this legislation will assist in that effort. CAMFT is in support of this legislation.
SB 562 (Lara)--The Health California Act: The primary intent of this bill is to replace private medical insurance with a government health care system providing comprehensive universal single-payer health care coverage and a health care cost control system for the benefit of all 38 million residents of the state. Proponents of a single-payer system have gained a lot of traction over the last few years, especially with the recent threat of an ACA repeal. With that said, historically single-payer bills have been given a hefty price-tag – often an amount that exceeds the entire California state budget.. This legislation will be heavily opposed by health care plans, and likely see varying responses from provider groups across the state. The bill, as currently written, does not address the specifics of financing and no financial assessment has been released by the state or legislature to date. Until further analysis is put forward, including financial assessment, CAMFT has taken a neutral position on this bill. The Board will be asked to weigh in on this bill given its controversial nature within the membership.
SB 798 (Hill)—Healing Arts Board: This bill, among other things, removes confidentiality protections of the psychotherapist-patient privilege by making private patient information protected by the privilege subject to investigations or proceedings conducted by the Medical Board without patient consent. There is concern within the psychotherapy community, that this bill allows the Medical Board to overstep their authority and access client files regardless of patient consent—files that contain patient’s most embarrassing and private information. Although this bill does not directly affect MFTs, it is not unlikely that the intent and language will move from the Medical Board to the BBS. In addition, there is concurrent case law (Cross v. Superior Court (Kidane)) being reviewed that would likely impact the policy of this legislation. For the above reasons, CAMFT has joined the California Psychiatric Association in opposing this legislation unless this particular section is removed.
Non-Legislative Advocacy
LMFTs within FQHCs/RHCs: CAMFT-sponsored Assembly Bill 1863 (2016-Wood) added LMFTs as providers within Federally Qualified Health Centers (“FQHCs”) and Rural Health Clinics (“RHCs”). The bill was intended to increase the pool of licensed professionals who could be hired in these entities so that
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adequate mental health services could be provided to the patients. The bill was signed by Governor Brown in 2016 and was set to go into effect on January 1, 2017. Unfortunately, in response to concerns about a possible ACA repeal, Governor Brown (through his draft state budget) delayed implementation of AB 1863 until at least July 2018. CAMFT has been lobbying the California Legislature, through the budget process, to remove the delaying language or at least change the language to “implement by July 2018”. We are hopeful that the Legislature will back CAMFT’s efforts to challenge the Governor’s existing draft budget on this budget item.
Insurance Reimbursement Rates: Although CAMFT is limited in the kind of activism it can participate in when advocating for increased rates for providers, CAMFT has begun contacting plans directly to educate and suggesting an in-person meeting. CAMFT is illustrating the negative ramifications of maintaining low reimbursement rates (for example, fewer providers willing to serve on panels) as provider costs are increasing. To date, CAMFT has contacted large plans (i.e., Anthem, Kaiser, Aetna, Magellan, Optum/UBH, and Value Options) and will reach out to mid-sized plans moving forward.
Volk v. De Meerleer : This Washington state case caused angst amongst some in the psychotherapy world, fearing it expanded the duty of a psychotherapist when confronted with a dangerous patient. Although we do believe it expanded the duty in Washington to include foreseeable (versus named) victims, we do not believe it has much impact here in California; California psychotherapists already practice under the rule of Tarasoff and have a duty to foreseeable victims (as expanded by Jablonski). As such, CAMFT need not take any action on this matter.
DMV Gender Identity: In March 2013, CAMFT submitted a proposal requesting an amendment to Section 20.05 of Adm. Code, Title 13, adding licensed Marriage and Family Therapists (LMFTs) to the list of those who can certify that gender identification is transitional and will require a change. This certification appears on DMV Form DL 329: Medical Certification and Authorization. CAMFT continues to put pressure on the Department of Motor Vehicles (“DMV”) to put this proposal out for public comment.
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April 17, 2017
Richard Rodriguez Director, Behavioral Health Network Services OptumHealth Behavioral Solutions of California 425 Market Street San Francisco, CA 94105
RE: CAMFT Membership Surveys on Managed Care
Dear Mr. Rodriguez:
The California Association of Marriage and Family Therapists ("CAMFT") is comprised of over 32,000 members, including approximately 18,500 clinical members who are Licensed Marriage and Family Therapists ("LMFTs") throughout the State, many of whom are contracted with Optum. CAMFT has collected feedback from recent surveys related to managed care issues to help better understand the challenges faced by providers. This information may prove helpful to Optum and its relationships with network providers.
The California legislature recognizes “Healthy individuals and healthy families and healthy relationships are inherently beneficial and crucial to a healthy society, and are our most precious and valuable natural resource. Licensed marriage and family therapists provide a crucial support for the well-being of the people and the State of California.”1 Given the increasing number of individuals covered by health insurance in California, it is vital that individuals who are desperate need of behavioral health services in California have access to qualified behavioral health network providers. CAMFT is concerned that consumers who are enrolled in managed care plans may have and continue to experience difficulty in accessing treatment and care from quality behavioral health providers.
According to membership surveys we have distributed recently, CAMFT has noticed a decrease in members who participate in managed care panels. Respondents indicated they have discontinued working with a managed care plan due to low provider reimbursement rates. Other common reasons for terminating relationship with managed care plans include burdensome paperwork and delays in reimbursement.
1 Cal. Bus. & Prof. Code §4980(a)(2)
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In another survey, a vast majority of members noted an increase in practice costs of ten percent (10%) to fifty percent (50%) in the last ten years. However, the average managed care provider reimbursement rates have remained unchanged over the last ten years (reported as an average of $61-$75 per psychotherapy session from our 2015 Demographic Survey).
The top billing and payment related challenges noted by the survey were 1) poor phone/technical support; 2) too much administrative work; 3) denial of payments; and 4) denial of services.
We are grateful for the long-standing relationship Optum has maintained with our LMFT community. Optum has been very responsive to CAMFT on our members’ concerns pertaining to various issues and we hope to continue the collaboration between our two organizations to improve consumers’ access to quality behavioral healthcare in California.
I would love the opportunity to meet with you to discuss the challenges reported by our members. I can be reached at 858-292-2638.
Thank you for your time and for your shared interest in providing excellent health care to Californians.
Sincerely,
Jill Epstein, J.D. Executive Director
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To: Board of Directors; Jill Epstein, Executive Director
From: Cathy Atkins, Deputy Executive Director
RE: Amicus Brief in Bianka M v. Superior Court
Date: May 13, 2017
In May 2016, CAMFT acted as amici curiae (an interested party and signatory) in support of a petition for review to the California Supreme Court in Bianka M v. Superior Court of California. This case deals with Special Immigrant Juvenile Status (SIJS), which is a federal statutory scheme that allows for children who have been abused, abandoned, or neglected by one or both parents in their home country to stay in the United States lawfully. The federal scheme requires that a state court make a finding that the child has in fact been abused, abandoned, or neglected. For children with both parents in their home country, the avenue into court is clearer for purposes of dependency and guardianship. However, when a child has one parent in the United States, the avenue to obtain a state court finding is less clear.
In this case, the child sought a sole custody order for her mother who is in the United States and also requested that the court make the SIJS finding. The state court refused to grant the sole custody order, saying that a parentage determination must be made first and because the father is in Honduras, the court is unable to make the determination. Thus, the court denied the sole custody order and refused to make the SIJS finding.
On appeal, the court upheld the family court decision and went on to hold that the child who sought a sole custody order for her mother did not have a bona fide need for the sole custody order. The court of appeal also published the decision, which means it has binding effect on lower family courts and courts across California will close their doors to any children who seek SIJS orders in this way. We are responding to the court’s holding to say that a child’s immediate mental health needs as well as future mental health is benefited by the sole custody order and the SIJS finding that the child requested the court make. A child who has suffered trauma benefits from having a stable parent and the guarantee that she will not be forced to return to the abusive parent in her home country. Additionally, a sole custody order provides the legal groundwork for a child who needs mental health treatment to receive that treatment and medication. That is, in instances where both parents’ consent would ordinarily be sought, a sole custody order allows the child to obtain treatment with only the consent of the loving parent in the United States.
Subsequent to the petition for review, the California Supreme Court granted the petition and agreed to hear the case on appeal. Accordingly, CAMFT signed onto an Amicus Brief (a much larger and more in depth version of what was submitted in 2016) that will be introduced before the Court. The brief is attached. Page 362 of 521 BIANKA M. V SUPERIOR COURT - 12B.i
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S233757 IN THE SUPREME COURT OF CALIFORNIA
BIANKA M., Petitioner, v. THE SUPERIOR COURT OF CALIFORNIA FOR THE COUNTY OF LOS ANGELES, Respondent; GLADYS M., Real Party in Interest.
AFTER A PUBLISHED DECISION BY THE COURT OF APPEAL, SECOND APPELLATE DISTRICT, DIVISION THREE · CASE NO. B267454
BRIEF OF MENTAL HEALTH ORGANIZATIONS AS AMICI CURIAE IN SUPPORT OF PETITIONER BIANKA M.
O’MELVENY & MYERS LLP *MATTHEW W. CLOSE (S.B. 188570) [email protected] DAVID A. LASH (S.B. 94081) [email protected] MARION M. READ (S.B. 287172) [email protected] KELLY VOLKAR (S.B. 301377) [email protected] KATIE GOSEWEHR (S.B. 313458) [email protected] 400 SOUTH HOPE STREET LOS ANGELES, CALIFORNIA 90071-2899 TELEPHONE: (213) 430-6000 ATTORNEYS FOR AMICI CURIAE MENTAL HEALTH ORGANIZATIONS
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TABLE OF CONTENTS
Page INTRODUCTION ...... 10 ARGUMENT ...... 13 I. CHILDREN WHO EXPERIENCE ABUSE, ABANDONMENT, AND NEGLECT OFTEN SUFFER FROM SEVERE MENTAL HEALTH CONSEQUENCES ...... 13 A. Abuse, Abandonment, and Neglect Inflict Immediate, Concrete Harms on a Child ...... 14 B. The Negative Impact of Abuse, Abandonment, and Neglect Is Lasting: It Affects Future Relationships, Well-Being, and Opportunity ...... 17 II. IMMIGRANT CHILDREN FACE UNIQUE MENTAL HEALTH TRAUMAS ...... 21 A. The Conditions in Immigrant Children’s Countries of Origin Frequently Add to Their Mental Trauma ...... 22 B. Immigrant Children Often Endure Additional Layers of Trauma During Their Journeys to and Adjustment Within the United States ...... 24 C. Fear of Deportation May Also Weigh Heavily on the Child ...... 27 III. REQUIRING THE ABUSIVE, ABANDONING, OR NEGLECTFUL PARENT TO APPEAR IN THE CASE IMPOSES AN ADDITIONAL OBSTACLE THAT CAN EXACERBATE THE DAMAGE TO THE MENTAL HEALTH OF THE CHILD ...... 28 A. Forcing the Child to Contact the Abusive or Absent Parent May Damage the Child by Re- Triggering Past Trauma...... 29 B. Requiring the Abusive, Neglectful, or Abandoning Parent’s Appearance Grants That Parent the Power to Control the Child’s Fate, Inviting Manipulation and Further Abuse of the Child ...... 30
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TABLE OF CONTENTS (continued)
Page C. An Abandoning or Neglectful Parent Is Unlikely to Cooperate with Court Procedures Designed to Help the Child ...... 31 D. The United States Supreme Court Has Acknowledged the Vital Importance of Protecting Children from Retraumatization Even Where a Countervailing Constitutional Right Was at Issue ...... 32 IV. A SOLE CUSTODY ORDER AND SIJS FINDINGS PROVIDE STABILITY WHICH BENEFIT THE MENTAL HEALTH OF THE CHILD ...... 34 A. A Stable Family Environment Is Necessary for the Mental Well-Being of Abused, Abandoned, or Neglected Children, and a Sole Custody Order Cements That Stability ...... 34 B. A Sole Custody Order Would Also Facilitate Access to the Relief SIJS Intended ...... 37 CONCLUSION ...... 39 APPENDIX...... 40
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TABLE OF AUTHORITIES
Page CASES Bianka M. v. Superior Court (2016) 245 Cal.App.4th 406 ...... 11, 28 Maryland v. Craig (1990) 497 U.S. 836 ...... 32, 33
STATUTES Code Civ. Proc., § 155...... 10, 11, 13, 38 Fam. Code, § 3011...... 11 Fam. Code, § 3020, subd. (a) ...... 11 Fam. Code, § 3021, subd. (f) ...... 11 Fam. Code, § 3022...... 11 Fam. Code, § 3421, subd. (b) ...... 11 Fam. Code, § 6924, subd. (f) ...... 37
OTHER AUTHORITIES Alvarez & Alegría, Understanding and Addressing the Needs of Unaccompanied Immigrant Minors: Depression, Conduct Problems and PTSD Among Unaccompanied Immigrant Minors (June 2016) Am. Psychol. Ass’n, available at
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TABLE OF AUTHORITIES (continued)
Page American Psychological Association Presidential Task Force on Immigration, Crossroads: The Psychology Of Immigration In The New Century (2012) ...... 25 American Psychological Association Presidential Task Force on Immigration, Working With Immigrant-Origin Clients: An Update for Mental Health Professionals (2013) ...... 26 Aranda, Living in the Shadows: Plight of the Undocumented (2016) 72 J. of Clinical Psychol. 795, available at
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TABLE OF AUTHORITIES (continued)
Page California Health & Human Services, California Minor Consent Laws — Mental Health Services,
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TABLE OF AUTHORITIES (continued)
Page Hovey, Acculturative Stress, Depression, and Suicidal Ideation Among Central American Immigrants (2000) 30 Suicide & Life-Threatening Behavior 125 ...... 25 James, Freud Was Right: Mean Mothers Scar for Life (May 7, 2010), ABC News, available at
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TABLE OF AUTHORITIES (continued)
Page Lawson & Quinn, Complex Trauma in Children and Adolescents: Evidence-Based Practice in Clinical Settings (2013) 69 J. of Clinical Psychol. 497 ...... 26, 35 Lawson, Understanding and Treating Children Who Experience Interpersonal Maltreatment: Empirical Findings (2009) 87 J. of Counseling & Development 204 ...... passim Moroz, The Effects of Psychological Trauma on Children and Adolescents (June 30, 2005), Report Prepared for the Vermont Agency of Human Services ...... 17, 35 National Center on Domestic Violence, Trauma & Mental Health, Preparing for Court Proceedings with Survivors of Domestic Violence (March 2013) ...... 29, 30, 31 Orlans & Levy, Attachment, Trauma, and Healing: Understanding and Treating Attachment Disorder in Children, Families, and Adults (2d ed. 2014) ...... 15, 16, 19, 20 Pearlman & Courtois, Clinical Applications of the Attachment Framework: Relational Treatment of Complex Trauma (2005) 18 J. of Traumatic Stress 449 ...... 16, 18, 19 Perry, Bonding and Attachment in Maltreated Children (2013),
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TABLE OF AUTHORITIES (continued)
Page Substance Abuse & Mental Health Services Administration, Treatment Improvement Protocol (TIP) Series 57: Trauma Informed Care in Behavioral Health Services (2014) ...... 36 Summers, Children’s Exposure to Domestic Violence (2006) ...... 35 UNHCR, Children on the Run (Mar. 2014) ...... 22, 23 UNHCR, Sexual Violence against Refugees: Guidelines on Prevention and Response (Extracts) (1995) 7 Int’l J. Refugee L. 720 ...... 29 UNICEF, Worrying Trend of Violence Against Children Emerging in Honduras, Warns UNICEF (May 2014),
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INTRODUCTION This case arises from an immigrant child’s search for relief under federal law establishing Special Immigrant Juvenile Status (“SIJS”). Amici Curiae1 write to emphasize the significant, non-immigration consequences the Court of Appeal’s decision will have if not reversed. A sole custody order, like the one sought by Petitioner Bianka M. (“Bianka”), clears the way for immigrant children to receive critical mental health treatment in furtherance of Amici’s goals. The federal government provides an avenue to humanitarian relief for immigrant children who qualify for SIJS because of abuse, abandonment, or neglect by one or both parents. (See Opening Brief on the Merits (“Op. Br.”) at 6–7.) The process of seeking SIJS has both federal and state law components. While discretion to grant or deny SIJS to a child “is reserved exclusively to the federal government through USCIS” (Op. Br. at 7), state courts play a pivotal role in the application process by making the underlying requisite SIJS findings.2 California Code of Civil Procedure section 155 effectuates this policy by giving California courts both jurisdiction and the obligation to make SIJS findings when supported by the evidence. (See Op. Br. at 2, 8–9.) California family courts logically
1 A full list of Amici is attached to this brief as Appendix A. Pursuant to California Rule of Court 8.200(c), no party or counsel for a party authored this brief, either in whole or in part. No person or entity made a monetary contribution to the preparation and submission of this brief. 2 As discussed at length in the Opening Brief on the Merits, state courts must make the following SIJS findings before a child may petition the federal government for SIJS: “(1) the child is ‘dependent’ upon a juvenile court or ‘committed to, or placed under the custody of’ the State or other court-appointed individual or entity; (2) the child cannot be reunified with one or both parents ‘due to abuse, neglect, abandonment, or a similar basis found under State law,’ and (3) it is not in the child’s ‘best interest’ to be ‘returned’ to her country of origin.” (Op. Br. at 7–8 (citations omitted).)
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would be imbued with the jurisdiction granted under section 155 because California family courts have “the exclusive jurisdictional basis for making a child custody determination[.]” (Fam. Code, § 3421, subd. (b); see also Op. Br. at 11–15 (providing a more detailed discussion of the necessity of involving family courts in the SIJS process).) Family courts may make an initial child custody determination if California is the child’s home state and the order is in the child’s best interest. (See Fam. Code, §§ 3011, 3021, subd. (f), 3022.) The family court’s primary concern in making a custody determination is the child’s health, safety, and welfare—including the child’s mental health. (Id., § 3020, subd. (a).) Amici write to emphasize the unnecessary barriers the Court of Appeal’s decision threatens to impose on immigrant children in need of, or receiving, mental health treatment.3 By setting up hurdles to a single parent’s ability to obtain a sole custody order, the court’s decision calls into question the authority of a single parent or guardian to authorize and decide treatment questions for the minor in consultation with mental health providers. Immigrant children who have been abused, abandoned, or neglected by a parent usually experience extreme trauma, which is complicated and exacerbated by the often arduous and dangerous journey to the United States and the perilous circumstances that forced them to flee
3 The Court of Appeal held that the lack of a controversy over custody demonstrated that Bianka’s “primary goal . . . was to obtain an order containing SIJ[S] findings,” and thus “not a bona fide custody proceeding[.]” (Bianka M. v. Superior Court (2016) 245 Cal.App.4th 406, 427–28, 433.) The appellate court further held that the family court had discretion to compel Bianka to join her father to the proceeding, despite the personal jurisdiction issues such a joinder would entail. (Id. at pp. 430–31.) The Court of Appeal acknowledged obtaining personal jurisdiction over Bianka’s alleged father would be difficult, but suggested entering into a stipulated judgment of paternity with him to address this difficulty. (Id. at p. 416.)
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their home countries. Consequently, it is essential that mental health treatment be accessible and readily authorized. The Court of Appeal’s decision sets up a catch-22 for children like Bianka: she must show that she cannot reunify with one parent due to abuse, abandonment, or neglect to qualify for SIJS, but she must also join that demonstrably derelict parent to the proceedings in order to obtain the custody order. This requirement will frequently put the onus on the abused, neglected, or abandoned child to contact the parent from whom she is seeking to dissociate herself. The Court of Appeal’s joinder requirement is unrealistic,4 probably futile, and will in some cases perpetuate the trauma the minor is trying to put behind her. The very purpose of SIJS—to protect abused, abandoned, and neglected children—is frustrated by requiring a child to contact and rely upon a parent who has harmed her. Impeding access to a sole custody order in this manner also means that the caring parent will have an obviously more difficult road to demonstrating the authority necessary to procure mental health services for the child without risk of disturbance or interruption by custody questions. The result will be to aggravate the impact that source of trauma has on the arc of these children’s lives. A sole custody order effectively paves the way to ready access to critical mental health treatment for such children without forcing the child and her caring parent to locate and reengage with the abusive, abandoning, or neglectful parent. A sole custody order also benefits abused, neglected, and abandoned children by increasing their security and stability and reducing their anxiety—thereby improving their overall health and welfare.
4 The Amicus Curiae Respondent’s Brief requested by the Court agrees that joinder of the absent parent is unnecessary. (See Respondent’s Brief at 35– 36.)
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Amici have an interest in ensuring that all children, and especially immigrant children, can access vital mental health resources. If the Court of Appeal’s holding stands, the trauma inflicted on these children will be exacerbated, and single, caring, and present parents will often be stripped of the ability to adequately address their children’s mental health needs. The decision below not only denies vulnerable immigrant children an avenue to remain in the United States but also creates roadblocks for much-needed mental health services, with potentially lifelong consequences. A reversal of the Court of Appeal’s decision best effectuates the policy behind the SIJS statute and California Code of Civil Procedure section 155 by safeguarding the mental health of abused, abandoned, and neglected children.
ARGUMENT
I. CHILDREN WHO EXPERIENCE ABUSE, ABANDONMENT, AND NEGLECT OFTEN SUFFER FROM SEVERE MENTAL HEALTH CONSEQUENCES Social science literature demonstrates that mistreatment in the form of abuse, abandonment, or neglect often has devastating consequences for a child. In the short term, a child may experience trauma, behavioral and psychological problems, and even harmful changes in brain chemistry. But the adverse impact of abuse does not stop there. The effects of post- traumatic stress disorder (“PTSD”) can haunt a mistreated child well into adulthood. And her mistreatment can set in motion a cycle of abuse impacting future relationships, mental health, and even the abused child’s eventual children. A parent’s legal authority to make treatment decisions, reinforced by a sole custody order, would help facilitate prompt treatment in order to avoid this cycle of abuse.
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A. Abuse, Abandonment, and Neglect Inflict Immediate, Concrete Harms on a Child Research shows that disrupted bonding and attachment with a primary caregiver may cause biochemical changes in a child’s brain, impeding cognitive development. Children exposed to repeated, stressful events are highly likely to develop PTSD, which can result in a range of harmful symptoms. (Lawson, Understanding and Treating Children Who Experience Interpersonal Maltreatment: Empirical Findings (2009) 87 J. of Counseling & Development 204, 204.) PTSD develops following an extreme stressor threatening one’s physical integrity; “maltreatment is a particularly salient trauma for PTSD in youth.” (Kearney et al., Posttraumatic Stress Disorder in Maltreated Youth: A Review of Contemporary Research and Thought (2010) 13 Clin. Child Fam. Psychol. Rev. 46, 50.) PTSD manifests through persistent and intrusive recollections of the stressful event such as through dreams or flashbacks, and intense distress when exposed to cues that remind the child of the event. (Ibid.) It can also cause the child to have trouble falling asleep or concentrating, as well as increased irritability, and feelings of hopelessness, defeat, and detachment from others. (American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders (5th ed. 2013) pp. 271–72; see also Schore, The Effects of Early Relational Trauma on Right Brain Development, Affect Regulation, and Infant Mental Health (2001) 22 Infant Mental Health J. 201, 214.) PTSD often appears concurrently with other problems such as anxiety, depression, social withdrawal, and delinquent and aggressive behavior. (Kearney, supra, 13 Clin. Child Fam. Psychol. Rev. at p. 50.) Moreover, the timing of maltreatment in the earliest years of a child’s life can profoundly magnify the harm.
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Along with symptoms of PTSD, children who suffer from abuse, abandonment, and neglect frequently undergo behavioral changes—with slightly differing, but all harmful, consequences. Some researchers have observed that abused children tend toward aggression and anger under stress, while neglected children demonstrated significant developmental delays and helplessness when stressed. (Orlans & Levy, Attachment, Trauma, and Healing: Understanding and Treating Attachment Disorder in Children, Families, and Adults (2d ed. 2014) p. 109.) Severe childhood abuse is also strongly correlated with borderline personality disorder. (Lawson, supra, 87 J. of Counseling & Development at p. 205.) This disorder manifests in a pattern of unstable relationships, impulsivity, recurrent suicidal behavior, and displays of inappropriate anger or emotion. (American Psychiatric Association, What Are Personality Disorders? (Feb. 2016),
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Survivors’ Experiences in Healthcare (2010), Dissertation Presented to the Nursing and the Graduate Faculty of the Univ. of Kansas, p. 9.) When these security bonds are disrupted through loss, separation, threat of separation, violence, abuse, or neglect—termed “insecure attachment”— the disruption often leads to psychological problems, including depression, anger, and emotional detachment. (Pearlman & Courtois, Clinical Applications of the Attachment Framework: Relational Treatment of Complex Trauma (2005) 18 J. of Traumatic Stress 449, 451.) Children who experience a type of insecure attachment—such as neglected or abandoned children seeking SIJS relief—often fail to develop “self-regulation” abilities. (Orlans & Levy, supra, at p. 92.) In other words, they have an impaired ability to monitor and control their behaviors and emotions because their caregivers failed to provide the support and security they needed. (Ibid.) In parallel with these sobering effects on a child’s behavior and psychology, abuse, abandonment, and neglect are linked to adverse physical changes in the child’s brain. Researchers opine that parenting “chisels” the brain—its physical structure and its function. (Belsky & de Haan, Annual Research Review: Parenting and Children’s Brain Development: The End of the Beginning (2011) 52 J. of Child Psychol. & Psych. 409, 418–19, 423–25). The vast majority of brain organization occurs in childhood, so early life experiences have a disproportionate impact on the developing brain. (Orlans & Levy, supra, at p. 120.) Sustained, elevated levels of stress, which can be caused by continuous abuse, may alter brain function by accelerating the loss of neurons or delaying the development of certain brain regions. (De Bellis et al., Developmental Traumatology Part II: Brain Development in Biological Psychiatry (May 1999) p. 1272.) These adverse effects on the brain may result in increased susceptibility to schizophrenia, language and intellectual
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deficiencies, and poor school performance. (Id. at p. 1280.) Simply put, the damage may occur in early childhood but its effects are lasting. The timing of maltreatment in the earliest years of a child’s life can magnify the harm experienced. Only a few months of neglect in infancy can require years of mental health treatment to repair. (Perry, supra, at p. 4.) Children’s particular vulnerability stems from their unavoidable reliance on adults—the same adults who may be inflicting the abuse—and because they lack coping skills developed later in life. Because trauma in early childhood sets exposed children on a negative trajectory and places them at high risk of debilitating developmental effects, unobstructed access to mental health care is particularly crucial for these children. (See Moroz, The Effects of Psychological Trauma on Children and Adolescents (June 30, 2005), Report Prepared for the Vermont Agency of Human Services, pp. 7, 19.) Fortunately, early assessment and intervention during the initial post- trauma period can significantly reduce PTSD symptoms in youth. (See Wamser-Nanney et al., Early Treatment Response in Children and Adolescents Receiving CBT for Trauma (2016) 41 J. of Pediatric Psychol. 128, 128.) Providing effective, unhindered access to mental health treatment is a mission and goal of Amici. In accordance with this goal, permitting Bianka and other SIJS-eligible children to obtain a sole custody order and the requisite SIJS findings paves the way to obtain critical mental health services without risk of disruption.
B. The Negative Impact of Abuse, Abandonment, and Neglect Is Lasting: It Affects Future Relationships, Well- Being, and Opportunity Childhood maltreatment often plagues the child into adolescence and even throughout life. (Larkin et al., The Health and Social Consequences of Adverse Childhood Experiences (ACE) Across the Lifespan in The
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Adverse Childhood Experiences (ACE) Study (2012) p. 4.) Stress from abuse, abandonment, or neglect in infancy sets the stage for later childhood, adolescent, and adult stress disorders or PTSD. (See Schore, supra, 22 Infant Mental Health J. at p. 214.) Ready access to mental health services is critical to treatment and long-term quality of life for these children. (See Lawson, supra, 87 J. of Counseling & Development at p. 206.) Take the example of Dianna who immigrated from the Middle East with her mother to escape her abusive father. Dianna fled to the United States hoping to foster a bright future by attending college. She was forced to drop out, however, because of the debilitating symptoms of PTSD that she suffered, including flashbacks, nightmares, and a reduced ability to function. (Babbel, Escape from an Emotionally and Verbally Abusive Father, Psychology Today (2012),
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attachment figures from the past leading to additional harm and abandonment. (Id. at p. 450.) Moreover, prolonged separate and insecure attachment predisposes children to permanent changes in neurochemistry that result in high sensitivity to loss. (See ibid.) Childhood abuse, abandonment, and neglect put an individual’s long-term health at risk, impacting even the physical well-being of the child. Adults who experienced abuse and neglect as children “report considerably higher rates of virtually every type of psychopathology including depression, anxiety, drug and alcohol disorders, personality disorders, and generalized distress” across their lifetimes. (Armstrong & Kelley, Early Trauma and Subsequent Antisocial Behavior in Adults (2008), 8 Brief Treatment & Crisis Intervention 294, 295.) In fact, physically abused adolescents were seven times more likely to develop a major depressive disorder than children who were not abused. (Id. at pp. 295–96.) Women abused as children are even more likely to exhibit later physical symptoms such as cardiovascular and respiratory disease, gastrointestinal illnesses, cancer, and chronic fatigue syndrome. (Orlans & Levy, supra, at p. 114.) Abused or neglected individuals also report higher levels of stress across a lifetime and higher rates of relationship disruption—namely, divorce and separation—than those who did not experience childhood mistreatment. (Armstrong & Kelley, supra, 8 Brief Treatment & Crisis Intervention at p. 295.)5 Finding a strong correlation between childhood abuse or neglect and a lifetime of impaired health, another study posited that stressful childhood events, such as abuse, cause children to turn to unhealthy (and addictive) coping behaviors like risky sexual activity,
5 Notably, the study also posits that psychological treatment interventions focusing on the underlying psychopathology, rather than its symptoms, could reduce the burdens of child trauma on society. (Id. at p. 294).
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smoking, alcohol, or drug abuse. (Felitti et al., Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults (1998) 14 Am. J. Prev. Med. 245, 252–54.) One study of criminal offenders indicated that childhood trauma and maltreatment are significant precursors to the participants’ adult antisocial behavioral patterns—typically characterized by a lack of empathy for others, egocentrism, and exploitation of others—and psychopathology. (Armstrong & Kelley, supra, 8 Brief Treatment & Crisis Intervention at pp. 301–02; American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders (5th ed. 2013) p. 476.) PTSD—which maltreated children develop at rates ranging from 20 to 63%—is associated with lower income, absenteeism from work, and lower educational and occupational success. (Lawson, supra, 87 J. of Counseling & Development at p. 204; see also American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders (5th ed. 2013) p. 279). It is clear that—if left untreated—abuse, abandonment, or neglect of a child sets her up for failure, or at least immense challenges, in the family, work, and emotional facets of her adulthood. But perhaps the most poignant impact on abused, abandoned, and neglected children is that their trauma propels a cycle of abuse that affects future generations. Children who are neglected, abandoned, or abused by caregivers—and thereby lack secure attachments with those caregivers— frequently grow up to be parents who are incapable of establishing healthy attachments with their own children. (Orlans & Levy, supra, at p. 18.) And so the cycle continues: “Instead of following the instinct to protect, nurture, and love their children, they abuse, neglect, and abandon[,]” in turn. (Ibid.) With appropriate consent from an authorized parent or custodian, Amici can help reverse some of these devastating effects of abuse,
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abandonment, and mistreatment, as they have for countless children. For example, St. John’s treated a young girl from Central America whose mother abandoned her and left her to be abused physically and sexually by gang members. Since arriving in the United States, she has reunited with her father and received therapy; she is now demonstrating healing and resiliency. Because of the potential for abused, abandoned, and neglected children to suffer ongoing and long-lasting harm, early and decisive intervention is crucial. In many cases, this intervention could be effectuated by a single parent with a sole custody order. The more time that passes between the incidence of maltreatment and treatment, the more time and effort will be required to alter the negative effects of the maltreatment. (See Lawson, supra, 87 J. of Counseling & Development at pp. 204–06.) Impeding access to a sole custody order means that the caring parent will have an obviously more difficult road to demonstrating the authority necessary to procure mental health services for the child without risk of disturbance or interruption by custody questions. For many children like Bianka, a sole custody order would pave the way for quick and effective treatment by making the parent’s authority to initiate treatment clear and legally enforceable. A sole custody order is thus a powerful tool to further the well-being of abused, abandoned, and neglected children.
II. IMMIGRANT CHILDREN FACE UNIQUE MENTAL HEALTH TRAUMAS Immigrant children, in particular, come to the United States with unique mental health struggles stemming from the often dangerous—and always uncertain—journey to this country. Immigrant children who qualify for SIJS have likely suffered a trifecta of traumatic events: (1) they often immigrate from countries where violence and instability are the norm; (2) they undergo a haunting journey to arrive in the United States;
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(3) and—in order to qualify for SIJS—they have been abused, abandoned, or neglected by at least one parent. These layers of traumatic stress increase the mental health needs of the child going forward. Unimpeded access to authorized mental health treatment is crucial for these children to avoid the negative long-term effects associated with these traumas.
A. The Conditions in Immigrant Children’s Countries of Origin Frequently Add to Their Mental Trauma Immigrants coming into California, particularly from Central America, often leave behind fear and uncertainty only to face it again in their new home. Extreme and sustained violence inside and outside of the home, in the absence of state protection, has driven Mexican and Central American women and children in particular to the United States. In 2014, UNICEF reported increasing, generalized violence against children, including murder and torture, in Bianka’s native country of Honduras. (UNICEF, Worrying Trend of Violence Against Children Emerging in Honduras, Warns UNICEF (May 2014),
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Reports indicate that children quit school in their country of origin because of gang threats. (See Collier, Helping Immigrant Children Heal (2015) 46 Monitor on Psychol. 58, 60, available at
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B. Immigrant Children Often Endure Additional Layers of Trauma During Their Journeys to and Adjustment Within the United States The demands of immigration and adjustment to a new country make the stability provided by a legally empowered parent or guardian that much more essential. For example, a 2008 review of 22 studies of unaccompanied refugee minors’ arrivals to the United States from 1998 to 2008 found higher levels of PTSD symptoms for unaccompanied minors than either normal populations or accompanied refugee minors. (Collier, supra, 46 Monitor on Psychol. at p. 60 (citation omitted).) “[Unaccompanied refugee minors] frequently arrive in the United States having suffered trauma from a myriad of causes including abandonment, displacement, violence, extreme poverty, and the horrors of war.” (Kindel, Psychosocial Accompaniment of Unaccompanied Central American Youth: A Collaborative Inquiry (2016), Dissertation Presented to the Pacifica Graduate Institute for a Doctor of Philosophy in Depth Psychology, p.8, available at
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I could be disappeared, I could be beaten,’ but the reality is those risks are lesser, they feel, than the ones they run if they stay.” (Collier, supra, 46 Monitor on Psychol. at p. 60; see also Aranda, Living in the Shadows: Plight of the Undocumented (2016) 72 J. of Clinical Psychol. 795, available at
6 “Acculturation” refers to the psychological process that immigrants experience as they adapt to the culture of their new home country. (APA, Crossroads, supra, at p. 6.)
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treatment and follow-up care. A study of immigrant youth during the five years after migration found that having been separated from parents resulted in higher symptoms of anxiety and depression during the initial years after migration.” (Alvarez & Alegría, Understanding Needs, supra (citations omitted).) Conversely, reunifying with a loving parent can bring stability to a child’s life that would reduce anxiety and increase the child’s ability to manage stress, including acculturative stress. (See Lawson & Quinn, Complex Trauma in Children and Adolescents: Evidence-Based Practice in Clinical Settings (2013) 69 J. of Clinical Psychol. 497, 499 (observing that attachment with committed caregiver is a crucial component of treating complex trauma in children).) And a sole custody order would give a legal imprimatur to this relationship, providing further assurances and stability to the child in her new home. Reunification with family members in the United States is important for exactly this reason. While reunification does not itself erase the psychological impact of immigration, it is an important first step on a child’s road to recovery. “The longer the separation, the more complicated the family reunification and the greater the likelihood that children will report psychological symptoms.” (American Psychological Association Presidential Task Force on Immigration, Working With Immigrant-Origin Clients: An Update for Mental Health Professionals (2013) p. 1.) The psychological impacts of the journey to and adjustment within the United States must be addressed as part of comprehensive mental health care, and is significantly aided by the presence of a caring, stabilizing parent or guardian. Amici understand the long-lasting effects of this trauma and the necessity of access to quality mental health care to enable impacted children to grow and thrive. Therefore, Amici urge the removal of any
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extraneous hurdles placed between these children in need and access to available services.
C. Fear of Deportation May Also Weigh Heavily on the Child In addition to adversity in their native countries, the long, challenging journey to the United States, and abuse, abandonment, or neglect, SIJS-seeking children may face further instability after their arrival in the United States. Even if they have recently reunited with a loving and caring parent, the continued risk of deportation contributes to immigrant children’s ongoing fear and stress. A sole custody order not only cements the stabilizing relationship with a caring parent or guardian, but also opens a path for these children to seek humanitarian relief under SIJS, which may ameliorate the fear of being deported. Children who fear negative immigration consequences if they seek social and health services provided by governmental agencies or associated agencies are less likely to receive the healing benefits they need to overcome the traumas they have faced. “[I]mmigrant stress is compounded for those persons who are undocumented because of the constant fear of exposure and deportation.” (Cavazos-Rehg et al., Legal Status, Emotional Well-Being and Subjective Health Status of Latino Immigrants (2007) 99 J. Nat’l Med. Ass’n 1126, 1130.) These children are faced with the possibility of being sent back to the conditions from which they barely escaped. They may be subjected yet again to an abuser, or further left to fend for themselves due to abandonment or neglect. In one study, more than a third of a sample population of undocumented immigrants “indicated that they did not visit social or government agencies for fear of deportation[.]” (Ibid.) As a result, “[e]ven when undocumented immigrants need psychological, social and medical services, they may not come forward, wary that they will also come to the attention of immigration authorities and face deportation.” (Ibid.)
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Access to SIJS findings and an accompanying sole custody order, by contrast, provide legitimate avenues to interact with these governmental agencies without fear of reprisal. Thus, a court order can provide the force of law behind a caregiver’s right to make mental health treatment determinations on behalf of his or her child. An immigrant child’s need for mental health services is inherently entwined with the legal security and stability provided by a loving caregiver and someone with decision-making power over her mental health treatment. The child receives further security in knowing she will not be subjected to deportation while the SIJS application is being processed. Such reassurance fosters resilience and creates a path to healing and eventual mental well-being. The Court of Appeal’s ruling imposes unnecessary hurdles to these immigrant children’s access to mental health care, thereby jeopardizing their ability to heal over time.
III. REQUIRING THE ABUSIVE, ABANDONING, OR NEGLECTFUL PARENT TO APPEAR IN THE CASE IMPOSES AN ADDITIONAL OBSTACLE THAT CAN EXACERBATE THE DAMAGE TO THE MENTAL HEALTH OF THE CHILD At the same time its decision impedes SIJS-seeking children’s access to mental health services, the Court of Appeal’s decision also lays the foundation for further mental health harm. In upholding the family court’s decision requiring Bianka’s father to be joined to the action, the appellate court would impose a contradictory and self-defeating set of conditions on a child seeking SIJS. It would demand that a child demonstrate that one parent had abused, abandoned, or neglected her, while requiring the child to obtain that very same parent’s presence at the proceedings. Most abusive and neglectful parents like Bianka’s father have already demonstrated their absolute indifference—at best—toward the child and her well-being. (See Bianka M. v. Superior Court (2016) 245 Cal.App.4th 406, 429–30.) Yet this decision effectively obligates Bianka to contact her father and plead for
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his cooperation in the proceedings, inviting further abuse, manipulation, and control by the parent from whom the child is seeking to dissociate herself. The court’s recommendation that Bianka obtain personal jurisdiction by entering a stipulated judgment of paternity with her father is equally unrealistic. (See id. at p. 416.) The Court of Appeal’s holding thus places the child in a catch-22 by imposing the impracticable requirement that the uncaring parent be called upon to help the child while the child must simultaneously demonstrate that same parent was derelict in his or her parental duties; in so doing, the court’s opinion frustrates the purpose of promoting the child’s health.
A. Forcing the Child to Contact the Abusive or Absent Parent May Damage the Child by Re-Triggering Past Trauma A child who has experienced trauma is likely to experience renewed trauma by encountering people or places that invoke memories of the initial trauma, such as by facing her childhood abuser. The term “retraumatization” refers to a triggering event that causes the victim to be overwhelmed by memories and feelings from previous trauma, and may cause further suffering. (See UNHCR, Sexual Violence against Refugees: Guidelines on Prevention and Response (Extracts) (1995) 7 Int’l J. Refugee L. 720, 733, 739.) Retraumatization has been described as “the psychological equivalent of having a scab torn off. It is painful, and can deplete what little emotional resources the victim has built up.” (Dallam, supra, at p. 29.) This process of opening up old wounds would be triggered every time a child is required to reengage with an abusive, neglectful, or abandoning parent, even many years after the initial harm. Reminders of prior trauma can be invoked by seeing people, places, or activities associated with past traumatic events. (National Center on Domestic
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Violence, Trauma & Mental Health, Preparing for Court Proceedings with Survivors of Domestic Violence (Mar. 2013) p. 1.) It can trigger fear, distress, or “restart” post-traumatic stress reactions even years after the trauma occurred. (Ibid.) Requiring a child to join or negotiate a stipulation with the absent parent asks the child to subject herself to renewed fear, PTSD, and emotional depletion, which unfairly punishes the child for seeking protections from the very harm she has already endured.
B. Requiring the Abusive, Neglectful, or Abandoning Parent’s Appearance Grants That Parent the Power to Control the Child’s Fate, Inviting Manipulation and Further Abuse of the Child Abusive relationships are often characterized by the abuser’s exertion of dominance and control over the victim. (Dore, Downward Adjustment and the Slippery Slope: The Use of Duress in Defense of Battered Offenders (1995) 56 Ohio State L.J. 665, 695 & n.119.) In a parent-child abusive relationship, as is the case for abused children seeking SIJS findings, the parent’s ability to exert and abuse his or her control over the child may be magnified by the intrinsically dominant position of a parent. Psychological abuse—potentially just as damaging as physical or sexual abuse—may include acts designed to make the victim feel powerless, such as name-calling or shaming. This abuse could include coercing the victim to perform degrading tasks, isolating the victim from family and friends, or other behaviors designed to manipulate the victim’s emotions. (See James, Freud Was Right: Mean Mothers Scar for Life (May 7, 2010), ABC News, available at
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implicitly allows the continued victimization of the child by giving that parent another source of power. An abusive parent may intentionally use the court process itself to make the survivor feel uneasy or afraid, such as by taking advantage of court procedures to create opportunities for contact. (National Center on Domestic Violence, Trauma & Mental Health, supra, at p. 2.) The parent sought to be joined in a SIJS case could perpetuate psychological abuse by prolonging the decision whether to appear in the case; threatening to interfere with or object to the custody determination; or otherwise manipulating the child’s emotions during an important, stressful process that will determine the child’s future.
C. An Abandoning or Neglectful Parent Is Unlikely to Cooperate with Court Procedures Designed to Help the Child By definition, a child’s attempts to gain the assistance of a parent who has abandoned or neglected her will most likely prove futile. The very acts of abandonment and neglect have demonstrated the parent’s absolute disregard for the child’s well-being; seeking to engage that parent’s aid is highly unlikely to be successful, if the child even knows how to contact the parent. For example, consider seventeen-year-old Adrian who grew up on the streets of Guatemala City with a crack addict for a father and an absent mother. (Gordon, 70,000 Kids Will Show Up Alone at Our Border This Year: What Happens to Them? (July/August 2014) Mother Jones, available at
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Court of Appeal’s opinion would make his immigration status dependent on successfully making such contact. Adrian’s story is not unique. (See Krogstad, U.S. Border Apprehensions of Families and Unaccompanied Children Jump Dramatically (May 4, 2016) Pew Research Center,
D. The United States Supreme Court Has Acknowledged the Vital Importance of Protecting Children from Retraumatization Even Where a Countervailing Constitutional Right Was at Issue The United States Supreme Court has recognized the importance of protecting children from facing their past abusers in other trial court contexts. When faced with the prospect of imposing additional trauma on a child, constitutional protections have been adjusted to accommodate the fundamental goal of protecting child welfare. Indeed, the U.S. Supreme Court has held that the Confrontation Clause right of criminal defendants to confront witnesses called against them could be abridged where necessary to protect a child from the trauma that would be caused by testifying in the presence of her abuser. (Maryland v. Craig (1990) 497 U.S. 836, 857.) The Court carved out an exception to a criminal defendant’s Confrontation Clause right where a child witness was abused
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by the defendant. The Court recognized the State’s “transcendent interest” in protecting children’s welfare and the “growing body of academic literature documenting the psychological trauma suffered by child abuse victims who must testify in court,” finding this to be a sufficiently important interest to accommodate the child witness by having her testify by a one-way closed circuit television. (Id. at 855.) Likewise, even if it is generally the case that both parents should be provided notice of and joined to a custody determination proceeding, the paramount policy of preventing retraumatization should take precedence where a child has been abused, abandoned, or neglected by one of the parents. In these cases, a parent’s due process rights are still fairly respected—as in the Confrontation Clause context—by preserving its essential elements: here, notice and an opportunity to be heard. The case for deferring to the overarching importance of protecting a child from retraumatization may be even stronger where instead of being called to testify, the child is compelled to cajole her abusive, neglectful, or abandoning parent into court. Where a child is seeking to join a parent in order to qualify for SIJS relief, she will not benefit from the countervailing sense of justice and public accountability that derives from testifying in court. (See Awan, Balancing a Child’s Right to Be Heard with Protective Measures Undertaken in “the Best Interests of the Child”: Does the International Criminal Court Get it Right? (2015) 35 Child. Legal Rts. J. 98, 101–03.) Rather, she is being asked to contact the harmful parent privately, without the protections of a courtroom and the supervision of a judge. Thus, in this context, instead of instilling feelings of empowerment and participation by enabling a child’s right to be heard in court, forcing a child to confront her abuser will exacerbate her sense of powerlessness and may further harm her mental health. (Cf. ibid.)
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By requiring the child to join her abusive, neglectful, or abandoning parent to the proceeding, the Court of Appeal’s decision is not just unreasonable, but it may also damage the child’s mental health by forcing her to rely upon her abuser or abandoner. Renewed contact with, or reliance upon, the ill-treating parent may retrigger the child’s trauma and gives that parent an opportunity to perpetuate abuse—and all this risk is incurred with a very low chance of success, given that it is dependent on the parent’s willingness to affirmatively help the child he or she has already harmed. To protect the child from additional harm, she should not be required to join or enter a stipulation of paternity with the abandoning, neglectful, or abusive parent.
IV. A SOLE CUSTODY ORDER AND SIJS FINDINGS PROVIDE STABILITY WHICH BENEFIT THE MENTAL HEALTH OF THE CHILD A sole custody order and access to SIJS findings help ameliorate the traumas immigrant children have faced by providing stability for children suffering from the lasting mental health effects of childhood abuse, abandonment, or neglect. “A custody order has intrinsic value to Bianka in ensuring a stable home situation that protects her health, safety and welfare.” (Op. Br. at 11.) Research has consistently demonstrated that the presence of a stable and nurturing caregiver is a critical factor in improving a traumatized child’s long-term outcome, and a sole custody order is a method of legally proving a caregiver is responsible for the child. A sole custody order also provides the legal groundwork for these children who desperately need mental health treatment.
A. A Stable Family Environment Is Necessary for the Mental Well-Being of Abused, Abandoned, or Neglected Children, and a Sole Custody Order Cements That Stability Research consistently shows that the presence of a stable and nurturing caregiver greatly improves a traumatized child’s long-term
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outcome because safety and stability in the home are among the protective factors that best foster resilience. (Centers for Disease Control, Strategic Direction for Child Maltreatment Prevention,
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children and thus have a large impact on a child’s well-being).) Therefore, whether the family court is ruling on SIJS findings or making a sole custody determination, these decisions “concern[ ] the care and custody of the child” as SIJS envisions. Moreover, a sole custody order also provides the legal groundwork for a child who needs mental health treatment. Standard protocol for mental health providers is to consider the legal implications of treatment, including child custody issues. (See, e.g., Substance Abuse & Mental Health Services Administration, Treatment Improvement Protocol (TIP) Series 57: Trauma Informed Care in Behavioral Health Services (2014) p. 99.) Most organizations consider obtaining the consent of both parents to be the best practice before administering treatment. (See Benitez, Consent for the Treatment of Minors with Divorced Parents (Nov./Dec. 2001) The Therapist, at p. 2.) Before one parent alone can obtain necessary mental health services for the child, that parent may be asked to provide a court order, such as a sole custody order, particularly where court involvement is likely. (See Shumaker & Medoff, Ethical and Legal Considerations When Obtaining Informed Consent for Treating Minors of High-Conflict Divorced or Separated Parents (2013) 21 The Family J. Counseling & Therapy for Couples & Families 318, 321.) Thus, a sole custody order can be a critical tool to ensure that a child receives the treatment she needs. It is naive to believe the alternative to producing a sole custody order is a viable option: that a parent, already struggling with the implications of his or her child’s mental health, will reengage with the parent whose behavior led to pain and suffering in the first place to obtain that parent’s consent to treatment. Yet another example of when a child may need a sole custody order to obtain necessary mental health treatment involves the administering of psychotropic medication. These children have often faced severe trauma
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for which psychotherapy alone may not be sufficient and for which medication may be proscribed. A provider must obtain parental consent before prescribing psychotropic medications, which include antidepressants, mood stabilizers, and antipsychotic medications. (See Fam. Code § 6924, subd. (f) (stating that a minor may not receive psychotropic drugs without the consent of the minor’s parent or guardian); California Health & Human Services, California Minor Consent Laws — Mental Health Services,
B. A Sole Custody Order Would Also Facilitate Access to the Relief SIJS Intended Being granted a sole custody order in family court without requiring the presence of the abusive, neglectful, or abandoning parent is one method of ensuring the ready availability of essential mental health benefits. The
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SIJS program was enacted to protect immigrating children in the United States who have been abused, abandoned, or neglected. (See U.S. Citizenship and Immigration Services (“USCIS”), Special Immigrant Juvenile (SIJ) Status (June 15, 2015),
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APPENDIX A
AMICI MENTAL HEALTH ORGANIZATIONS
IN SUPPORT OF PETITIONER BIANKA M.
The Children’s Institute Shields for Families 2121 West Temple Street 11601 S. Western Avenue Los Angeles, CA 90026 Los Angeles, CA 90047
St. John’s Well Child & Family Center California Association of Marriage 808 W. 58th Street & Family Therapists Los Angeles, CA 90037 7901 Raytheon Road San Diego, CA 92111
Family Violence & Sexual Assault California Association for Licensed Institute Professional Clinical Counselors 10065 Old Grove Road, Suite 101 1240 India Street, Unit 1302 San Diego, CA 92131 San Diego, CA 92101-8552
American Association for Marriage and Amanecer Community Counseling Family Therapy – California Division Services P.O. Box 6907 1200 Wilshire Blvd., Suite 200 Santa Barbara, CA 93160 Los Angeles, CA 90017
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PROOF OF SERVICE BY MAIL
I am over the age of eighteen years and not a party to the within action. I am a resident of or employed in the county where the service described below occurred. My business address is 2 Embarcadero Center, 28th Floor, San Francisco, CA 94111.
On April 6, 2017, I served the following:
BRIEF OF MENTAL HEALTH ORGANIZATIONS AS AMICI CURIAE IN SUPPORT OF PETITIONER BIANKA M.
by putting a true and correct copy thereof together with an unsigned copy of this declaration, in a sealed envelope, with delivery fees paid or provided for, for delivery the next business day to:
Attorneys for Petitioner, Bianka M. Attorneys for Petitioner, Bianka M. MILLER BARONDESS LLP PUBLIC COUNSEL Joshua C. Lee Judith London [email protected] [email protected] 1999 Avenue of the Stars, Suite 1000 610 South Ardmore Avenue Los Angeles, CA 90067 Los Angeles, CA 90005 Telephone: (310) 552-4400 Telephone: (213) 385-2977 Facsimile: (310) 552-8400 Facsimile: (213) 385-9089 Attorneys for Petitioner, Bianka M. Amicus Curiae for Respondent L. IMMIGRANT DEFENDERS LAW Rachel Lerman CENTER BARNES & THORNBURG LLP Nickole G. Miller L. Rachel Lerman [email protected] Joseph Wahl 634 South Spring Street, Third Floor 2029 Century Park East, Suite 300 Los Angeles, CA 90014 Los Angeles, CA 90067 Telephone: (213) 438-9021 Telephone: (310) 284-3880 Facsimile: (213) 282-3133 Facsimile: (310) 284-3894 Real Party in Interest Legal Aid Society of San Mateo Gladys M. County Allison W. Meredith Vedder Price 1925 Century Park East, Suite 1900 Los Angeles, CA 90067 Telephone: (424) 204 7700 Facsimile: (424) 204 7702
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Page 412 of 521 FEDERAL LEGISLATION REPORT – 12C
LEGISLATIVE AND REGULATORY UPDATE
FEDERAL ADVOCACY
Affordable Care Act: In early 2017, the American Health Care Act (AHCA) was introduced to repeal and replace the Affordable Care Act (ACA). During this time, CAMFT utilized internal lobbying methods, and grassroots efforts, to advocate that if the ACA was indeed replaced, mental and behavioral health essential benefits needed to be protected for all Californian consumers. Due to opposition from various advocacy groups, as well as non-consensus within the majority party, the AHCA was pulled from the House floor in late March.
However, on May 3rd it was announced that the House majority was able to garner additional support from the House Freedom Caucus by providing additional concessions- enough to allow a vote to move forward the following day. CAMFT utilized its grassroots reach in a last ditch effort to hold off a House vote, with 658 members contacting their House Representatives within a 24-hour turnaround (this included 10% of Congressman David Valadao’s district—a vulnerable California legislator who was being publically courted and pressured by GOP leadership). Unfortunately on May 4th, the House was able to pass the AHCA.
The AHCA now moves to the Senate. The CBO score is not expected to be released until late May, likely moving a Senate vote until early June, at the earliest. The Senate has already articulated numerous concerns about the Act (as currently written), from both sides of the aisle.
CAMFT will continue to advocate that all Californians must have access to and coverage of life-saving mental and behavioral health benefits.
Medicare: CAMFT’s priority on the federal landscape is to pass legislation that will allow LMFTs to reimburse as Medicare providers. Because we have a new Congress in 2017, CAMFT will need to reintroduce legislation similar to bi-partisan HR 2759/ S 1830 (2015). CAMFT is working with Rep. Thompson to identify a new Republican sponsor in the House of Representatives as Rep. Gibson, the sponsor for the last two Congresses has retired. It is expected that Senator Barrasso (R-WY) and Senator Stabenow (D-MI) will re-introduce our bill in the Senate by summer.
Veterans Affairs: CAMFT continues to monitor Department of Veteran Affairs (VA) as they discuss implementation of the Military Construction, Veterans Affairs, and Related Agencies Appropriation Bill. This bill, signed into law in 2016 removed 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, have begun drafting the new employment standards for LMFT hiring with a target date of completion of early Fall. It then goes through a multi-tiered internal department review CAMFT will continue to lobby a swift review and implementation.
Oregon to Recognize CA LMFTs: The Oregon Board of Licensed Professional Counselors and Therapists is proposing a rule amendment that would make it easier for California licensed MFTs to obtain licensure in Oregon. The rule amendment would add California’s BBS MFT Written Clinical Exam as an approved competency exam for licensure as a Licensed Marriage and Family Therapist in Oregon. Note: The Oregon Board previously adopted a temporary administrative rule amendment to accept the California
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exam, effective December 12, 2016 through June 9, 2017. This current permanent rulemaking proposal will allow for continued acceptance of the exam. CAMFT has provided written comment in support of this proposed rule amendment.
Nuclear Regulatory Commission (NRC): In 2010, CAMFT petitioned the NRC to include LMFTs as “Substance Abuse Experts.” Over the last six years, numerous delays at the NRC have impeded CAMFT’s petition to be put out to public comment. Although CAMFT was assured that this process would begin by late 2016, the NRC expects additional delays given President Trump’s recent cautions about new regulatory packages. This is disappointing news, given our work to date, but we remain vigilant to push this package forward. In coming months, CAMFT will be asking members to write the NRC directly, advocating to advance this package.
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MEMORANDUM
To: Jill Epstein, Executive Director; Board of Directors
From: Cathy Atkins, Deputy Executive Director
Date: May 13, 2017
RE: Grassroots Advocacy Teams: Federal and State
Federal Lobbying Trip:
CAMFT’s federal grassroots advocacy team (GAT) descended on Washington DC on April 16, 2017, to lobby targeted members of Congress for the purpose of obtaining co-sponsors for upcoming federal legislation that would add LMFTs as Medicare reimbursed providers. Meetings were held on April 17th and 18th with members of Congress, as well as both Senators. Most the meetings went very well and we are hopeful will turn into co-sponsorships when the House and Senate bills drop in the coming months.
The following is a list of districts/delegates:
Targeted District Member Attending Speier Chris Trailer Matsui Sara Coffill McNerney Nancy Brison-Moll Eshoo Lisa Hills Nunes Heather Janz McCarthy No member applied Cardenas Holly Daniels Ruiz No member applied Sanchez Juan Gavidia Royce Huda Bayaa Calvert Cathryn Leff Walters Tammy Shelton Lieu Katie Vernoy
In addition, Board members Patty Ravitz, Curt Widhalm, and Danah Williams attended. The GAT members all reported a positive experience and continued excitement to assist CAMFT in its grassroots efforts moving forward.
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Next steps include scheduling in-person meetings by the GAT members when the bills drop, to both the targeted House members, as well as both Senators. GAT members have also been asked to facilitate meetings between Chapters and elected officials, as well as attend town-hall meetings if appropriate. In addition, CAMFT will ask all 32,000 members of CAMFT to reach out to their elected officials to ask for co-sponsorship of both bills.
A survey was sent to all attendees to get feedback and suggestions for future GAT trips.
State Lobbying Day:
CAMFT hosted its first California Lobbying Day on March 27, 2017 in Sacramento- attended by both state GAT members, and some board members. The focus of the meetings were to thank targeted Assemblymembers for their “yes” vote on AB 191 (Wood), as well as to ask that the delaying language of AB 1863 (Wood-2016) be removed from the California budget.
The following is a list of districts/delegates:
Targeted District Member Attending Wood Member Unavailable McCarty No member applied Thurmond No member applied Stone Member Unavailable Arambuia No member applied Salas No member applied Rodriquez Ava Phillips Santiago No member applied Burke No member applied Q-Silva No member applied Brough No member applied Waldron Cathyrn Leff Maienschein Alan Bisarya
In addition, Board members Patty Ravitz, Jonathon Flier, Curt Widhalm, Danah Williams and Katie Vernoy attended. Although only two GAT members attended the trip, they both seemed very thankful for the opportunity and excited about the experience.
Next steps include GAT members continuing their relationships with their elected officials for the purpose of educating both the legislator and their staff about the MFT profession, and their expertise. GAT members will also be asked to facilitate a relationship between Chapters and the elected officials in the area.
A survey was sent to all attendees to get feedback and suggestions for future GAT trips. CAMFT will also be moving onto a new phase of adding additional members to the state GAT team to make local visits, targeting committees of jurisdiction in both the state Senate and Assembly.
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