Assembly Bill 210 Information Sharing for Homeless Adult and Family Multidisciplinary Teams Elizabeth Ben-Ishai, LA County CEO Homeless Initiative June 21, 2018 CES Leadership Team Meeting

Overview What is AB 210? Who can participate? How are MDTs formed? What information is shared? Confidentiality Next steps

What is AB 210? Assembly Bill 210 was signed by the Governor on October 7, 2017 and became effective January 1, 2018.The bill was sponsored by Los Angeles County. AB 210 authorizes counties to establish homeless adult and family multidisciplinary teams (MDTs) in order to expedite identification, assessment, and linkage of homeless individuals and families to housing and supportive services. Note: AB 210 MDT≠ E6 MDT

What is AB 210? State laws generally prohibit the sharing of an individual’s confidential health, mental health, criminal history, and public social services information. AB 210 authorizes MDT members to share such information to improve coordination of housing and supportive services, increase continuity of care, and decrease duplication of services. Expected outcomes: Better quality service delivery Increased ability to match clients to appropriate services and housing Reduced costs to County systems

What is AB 210? Examples of AB 210 Information Sharing Usage Outreach teams Currently, outreach workers have limited access to information about clients; for example, they may not know whether an individual is on probation or receiving benefits such as CalFresh or CalWORKs. Under AB 210, they will likely be able to access this information, enabling teams to connect clients to appropriate resources. High-Cost Service User List The County produces a list of homeless clients who are heavy users of costly County services. Currently, the list only includes names and identifying information. Under AB 210, client service history and other relevant info can be shared so that these vulnerable clients can be more effectively targeted for housing and other services.

Who can participate? AB 210 MDTs may include staff from: County Departments Agencies affiliated with the County (i.e. Los Angeles Homeless Services Authority) Contracted agencies of the County or of County-affiliated agencies Governmental agencies (i.e. city, state, or federal agencies) Non-governmental agencies (i.e. private hospitals) All participating agencies must sign the Participating Agency Agreement, and all staff must be trained and sign the confidentiality agreement.  

Who can participate? The following non-exclusive list provides examples of the types of staff who may participate in AB 210 MDTs: Mental health and substance abuse services personnel and practitioners or other trained counseling personnel. Legal counsel for the adult or family representing them in a criminal matter. Medical personnel with sufficient training to provide health services. Social services workers with experience or training in the provision of services to homeless adults or families or funding and eligibility for services. Veterans services providers and counselors. Domestic violence victim service organizations, as defined in subdivision (b) of Section 1037.1 of the Evidence Code. Any public or private school teacher, administrative officer, or certified pupil personnel employee. Housing or homeless services provider agencies and designated personnel. Police officers, probation officers, or other law enforcement agents.

How are MDTs formed? AB 210 MDTs are made up of two or more members. Two types of teams Ongoing AB 210 MDTs: Eligible personnel who work together on an ongoing basis and regularly share information to effectively serve clients, i.e. outreach teams. Ongoing teams may also be established to share data to prioritize services for high utilizers of County services. Client-specific AB 210 MDTs: Team forms around a specific client after members verify eligibility to share information. Verification may take place through an automated system or through Agency point people.

How are MDTs formed? During the initial implementation of AB 210 (Phase 1), when the automated system is not yet available, only the following Departments/Agencies and their contractors will be eligible to share information under AB 210: Department of Public Social Services Department of Mental Health Department of Health Services Los Angeles Sheriff’s Department Probation Department Department of Public Health Los Angeles Homeless Services Authority

What information is shared? AB 210 MDT members can share information that is otherwise confidential under state law if it is “generally relevant to the identification, assessment, and linkage of homeless adults and families to housing and supportive services” and the agency that owns the data has authorized it to be shared. Under AB 210, an adult or family is “homeless” if they have self-identified as homeless within the last 12 months or if any element in their service records indicates that they have experienced homelessness in the last 12 months. AB 210 authority does not supersede any federal laws or regulations. “Homeless” means any recorded instance of an adult or family self-identifying as homeless within the most recent 12 months, or any element contained in service utilization records indicating that an adult or family experienced homelessness within the most recent 12 months.

What information is shared? The following non-exclusive list includes relevant categories of information that may be shared under AB 210: Demographic Information Criminal History and Status Contact Information Probation Status Service and Program History Domestic Violence Status Veteran Status Medical History Employment/Educational History and Status Mental Health History Disability Status High Risk Behavior, Violence, or Aggression History Housing and Homeless History and Status Benefit History and Status Each agency participating in AB 210 MDTs will determine which information it will share, with whom, and through which mechanisms.

What Information is Shared? Restrictions on Information Sharing Testimony concerning information shared under AB 210 can’t be used in any court proceeding. Information shared is protected from discovery and disclosure. Law enforcement cannot use any information shared under AB 210 for purposes other than identifying, assessing, and linking homeless individuals and families to housing and supportive services. Representatives of domestic violence (DV) service organizations must obtain clients’ consent to share information about a DV survivor or the survivor’s family. The only information the Department of Public Health and its contractors can share concerning substance abuse treatment is to verify that there is no record of the individual in the Substance Abuse Prevention and Control (SAPC) records.

Confidentiality While AB 210 enables members of AB 210 MDTs to share otherwise confidential information, maintaining the confidentiality of information shared under AB 210 is still of critical importance. AB 210 MDT members must sign the Employee Participation and Confidentiality Agreement. MDT members at agencies that are covered by HIPAA must be familiar with and abide by all HIPAA rules. MDT members should be familiar with and abide by their agencies’ applicable, existing policies regarding confidentiality of client information.

Next steps Key documents: Protocol: Delineates which types of agencies can participate, what documents must be signed to participate, methods of info sharing, oversight responsibilities, etc. Countywide Policies and Procedures: A set of policies and procedures that all participating agencies must agree to abide by. Department/Agency Policies and Procedures: Participating agencies may establish their own agency- specific policies and procedures. Training: Available via LA County Learning Management System to all participating agencies.

Next Steps Phase 2 participation: Broader group of agencies: Phase 2 of implementation will extend the opportunity to participate to a broader group of agencies. Estimated launch date is January 2019. Automated System: The launch of Phase 2 will coincide with the completion of the AB 210 automated system, which will enable some AB 210 MDT members to share information electronically through an automated data system that is currently under development. Additional training will be required for use. Information shared electronically by County Departments under AB 210 is subject to the Los Angeles County Board of Supervisors Policy 6.100, Information Technology and Security Policy.

Next Steps To sign up: Complete Participating Agency Agreement (signed by individual with signing authority for org) Complete Training Sign Up Spreadsheet, listing all employees who will take the training and providing requested info Submit signed Acceptable Use Agreements for all employees listed on Training Sign Up. All three documents must be submitted to move forward! Information shared electronically by County Departments under AB 210 is subject to the Los Angeles County Board of Supervisors Policy 6.100, Information Technology and Security Policy.

Next Steps Please consult with agency’s counsel for legal advice on participation in AB 210 information sharing. Information shared electronically by County Departments under AB 210 is subject to the Los Angeles County Board of Supervisors Policy 6.100, Information Technology and Security Policy.

Elizabeth Ben-Ishai, Ph.D. Principal Analyst Homeless Initiative Kenneth Hahn Hall of Administration 500 West Temple Street, Room 493 Los Angeles, CA 90012 (213) 974-2566 eben-ishai@ceo.lacounty.gov FOR UP TO DATE INFORMATION VISIT US AT: Homeless.lacounty.gov