BILL ANALYSIS                                                                                                                                                                                                    �






                                  SENATE HUMAN
                               SERVICES COMMITTEE
                          Senator Leland Y. Yee, Chair


          BILL NO:       AB 346                                       
          A
          AUTHOR:        Stone                                        
          B
          VERSION:       April 1, 2013
          HEARING DATE:  June 11, 2013                                
          3
          FISCAL:        Appropriations                               
          4
                                                                      
          6
          CONSULTANT:    Sara Rogers                                 

                                        

                                     SUBJECT
                                         
             Community Care Facilities Act: Emergency Youth Shelter  
                                   Facilities

                                     SUMMARY  

          This bill establishes "emergency youth shelter facility" as  
          a new subcategory of group home licensure under the  
          Community Care Facilities Act. This bill defines "group  
          home" to mean a residential facility providing 24-hour  
          nonmedical care and supervision to children in a structured  
          environment. Additionally, this bill provides that  
          facilities licensed as an emergency youth shelter facility  
          offer short-term, 24-hour nonmedical care and supervision  
          and personal services to no more than 25 homeless youth, as  
          defined, who are voluntarily present. 

                                     ABSTRACT  

           Existing law:


              1.   Establishes the Community Care Facilities Act,  
               which provides for the licensure and regulation by the  

                                                         Continued---




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               Department of Social Services of nonmedical  
               residential and non-residential facilities for  
               mentally ill, developmentally and physically disabled,  
               and children and adults who require care or services.  
               (HSC Section 1500 et seq.)


             2.   Defines "residential facility" to mean a family  
               home, group care facility, or similar facility  
               providing 24-hour nonmedical care to persons in need  
               of personal services, supervision, or assistance that  
               is essential for sustaining the activities of daily  
               living, or for the protection of the individual. (HSC  
               1502 (a) (1))


             3.   Prohibits the operation of an "unlicensed community  
               care facility," defined as a facility providing, or  
               representing that it provides, care or supervision; or  
               which accepts residents demonstrating the need for  
               care and supervision; or which represents itself as a  
               licensed community care facility, that is not exempted  
               from licensure. (HSC 1503.5)
             4.   Defines "group home" to mean a non-detention,  
               privately operated residential home, organized and  
               operated on a nonprofit basis only, of any capacity.  
               (WIC 11400)


             5.   Through regulation, establishes numerous  
               requirements and standards for group homes pertaining  
               to administrator and personnel qualifications, intake  
               procedures, staff ratios, and physical environment  
               requirements, among others. (CCR Section 84000 of  
               Division 6 of Title 22)


             6.   Requires a group home to maintain a ratio of one  
               staff for every 10 children, except at night. (CCR  
               Section 84065.5 of Division 6 of Title 22)


             7.   Requires group homes to establish a Needs and  
               Services Plan, which includes a time-limited,  
               goal-oriented written plan, implemented by the  





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               licensee, to identify the specific needs of an  
               individual child and delineates the services necessary  
               to meet the child's identified needs. (CCR Section  
               84068.3 of Division 6 of Title 22)


             8.   Under federal law, establishes the Runaway and  
               Homeless Youth Act, which provides grant funding for  
               youth homeless shelters, transitional housing  
               programs, street based outreach services, counseling,  
               and other services to runaway and homeless minors, as  
               defined, subject to compliance with certain  
               requirements. (42 U.S.C. 5601)



             9.   Under federal law, establishes the McKinney-Vento  
               Homeless Assistance Act which defines "homeless  
               children and youths" as individuals who lack a fixed,  
               regular, and adequate nighttime residence, as defined.  
               (42 U.S.C. 11434a)


             10.  Under the Runaway and Homeless Youth Act, defines  
               "homeless youth" for purposes of providing homeless  
               youth shelters with grant funding as an individual who  
               is less than 18 years of age for whom it is not  
               possible to live in a safe environment with a relative  
               and who has no other safe alternative living  
               arrangement. (42 U.S.C. 5601)


             11.  Under the Runaway and Homeless Youth Act, defines  
               "runaway" as an individual who is less than 18 years  
               of age and who absents himself or herself from home or  
               a place of legal residence without the permission of a  
               parent of legal guardian. (42 U.S.C. 5601)


           This bill: 


              1.   Defines "emergency youth shelter facility" to mean  
               a group home licensed by the Department of Social  
               Services (DSS) to operate a program providing  





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               voluntary, short-term, emergency shelter and personal  
               services to youth who are homeless or at risk of  
               homelessness, as defined.


             2.   Defines "group home" to mean a residential facility  
               that provides 24-hour nonmedical care and supervision  
               to children delivered at least in part by staff  
               employed by the licensee in a structured environment.


             3.   Requires a licensed Emergency Youth Shelter  
               Facility (EYSF) to meet the following requirements:


                           Offer short-term (a stay of no more than  
                    21 consecutive days) 24-hr, nonmedical care and  
                    supervision and personal services to youth who  
                    voluntarily enter the facility.  
                           Serve youth between the ages of 12-17, or  
                    if attending high school, up to age 18, who are  
                    homeless or at risk of becoming homeless, as  
                    defined.
                           Limit capacity to 25 youth.
                           Maintain a ratio of one staff person to  
                    every eight youth, including trained volunteers,  
                    as specified.
                           Limit bunk beds to no more than two  
                    tiers.
                           Be owned and operated on a nonprofit  
                    basis by a private nonprofit corporation,  
                    organization or a public agency.


             1.   Requires a licensed EYSF to do the following:


                           Determine, prior to admission, whether a  
                    youth poses a threat to self or others in the  
                    facility, and to deny admission to a youth who  
                    poses such a threat.
                           Assess youth served in the facility  
                    within 72 hours of admission.
                           Assist youth served in obtaining  
                    emergency health-related services.





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                           Establish procedures to assist youth in  
                    securing long term stability including  
                    reconnecting youth with a parent or guardian, or  
                    coordinating with appropriate individuals or  
                    organizations to help youth secure a suitable  
                    foster care placement.
                           Conduct criminal record review for all  
                    staff and volunteers, as specified.
                           Collect, maintain and report specified  
                    data to the department monthly, including number  
                    of youth served, name of youth served, length of  
                    stay, and number of times a youth accessed  
                    services.


             1.   Provides that an EYSF shall not be required to  
               maintain a needs and services plan for youth.


             2.   Permits an EYSF to operate in two separate physical  
               locations if only one location provides overnight  
               residential care.


             3.   Provides that an EYSF is not an eligible placement  
               option for dependent youth.


             4.   Provides that an EYSF or program shall not be  
               eligible for a group home rate.


             5.   Requires DSS to adopt regulations in consultation  
               with interested parties, as specified, to be contained  
               in group home regulations.


             6.   Prior to the adoption of regulations, permits DSS  
               to implement these provisions though informational  
               releases or similar instructions from the department.

                                         

                                 FISCAL IMPACT  






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          The Assembly Appropriations Committee states that costs for  
          DSS to create a subcategory for these facilities under the  
          existing group home licensing category would be minor and  
          absorbable within existing resources. 


          Additionally, the Assembly Appropriations Committee states  
          that emergency youth shelters in California receive between  
          $5 million to $7 million per year in funding in federal  
          Runaway and Homeless Youth Act funding. Funding under the  
          Act is conditional on the facilities compliance with state  
          licensing laws such that absent this legislation California  
          shelters risk federal citation and the loss of federal  
          funding. 

                            BACKGROUND AND DISCUSSION  


          According to the author, emergency youth shelter facilities  
          (EYSFs) fall under conflicting regulatory requirements in  
          federal and state law, which has led to confusion regarding  
          whether the facilities are subject to licensure under the  
          Community Care Facilities Act (CCFA).


          The author states that although homeless shelters serving  
          adults are exempted from licensure under the CCFA, shelters  
          serving youth are not. The author reports that the DSS  
          division of Community Care Licensing has inconsistently  
          interpreted and applied these rules, sometimes requiring a  
          facility to be licensed as a group home, while other times  
          instructing the facility that it is exempt from licensure.   
           


          Additionally, the Department of Social Services, a sponsor  
          of the bill, writes that federal funds available to  
          homeless youth shelters under the Runaway and Homeless  
          Youth Act are contingent on a facility complying with state  
          shelter licensing requirements, but that California does  
          not have any requirements in place currently. The  
          California Coalition for Youth, a co-sponsor of the bill  
          states that some facilities that have not sought licensure  
          as a group home have received citations from the federal  
          Administration of Children and Families and risk the loss  





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          of federal funding. 


          The author further states that existing regulations and  
          programmatic requirements governing foster care-eligible  
          group homes are not completely applicable or appropriate  
          for homeless youth shelters that are intended to provide  
          short-term shelter for youth in need and are not eligible  
          as a foster care placement. According to the author and  
          sponsors, this bill creates a new licensure subcategory of  
          group homes that will provide a more appropriate and  
          consistent regulatory structure for all homeless youth  
          shelters.


           Homeless Youth in California

           A point-in-time survey conducted in 2011 by the California  
          Research Bureau within the California State Library,  
          reports that:


               Based on national survey estimates and California's  
               youth population, it is likely that 200,000 youth  
               under the age of 18 and thousands of 18 to 24 year  
               olds are homeless for one or more days a year.<1>


          This figure is based on estimates that homeless youth  
          represent approximately 12 percent of the overall youth  
          population. Additionally, the survey reported there are 34  
          temporary and emergency shelters with 555 beds, and that  
          services for homeless youth are available in only 20 out of  
          58 counties. The report notes that most homeless youth are  
          not involved with the child welfare or juvenile justice  
          systems and therefore are not eligible for services under  
          those programs. Additionally, the survey reports that  
          homeless youth do not typically rely on services intended  
          -------------------------


          <1> California Research Bureau, Homeless Youth Project.  
          "Programs Serving California's Homeless Youth: Results of a  
          Point-in-Time Survey."  January 2011.  
          http://cahomelessyouth.library.ca.gov/docs/pdf/SUMMARY-Inven 
          tory.pdf






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          for homeless adults or families in part because adult  
          facilities are frequently unable to accommodate minors.


           Runaway and Homeless Youth Act


           Based on findings that homeless youth are at greater risk  
          of developing serious health, behavioral and emotional  
          problems and are in urgent need of temporary shelter and  
          services, Congress passed the Runaway and Homeless Youth  
          Act in 1974, and last reauthorized it in 2008.


          This legislation establishes a variety of grants at a 90  
          percent match to fund public and nonprofit programs serving  
          homeless youth. Funded services include temporary shelters,  
          counseling, street-based services, home-based services,  
          drug abuse education and prevention services, sexual abuse  
          and sexual exploitation prevention services.


          California receives between $5 million - $7 million a year  
          in grants made directly to providers, each of which  
          receives a maximum of approximately $200,000. Not all  
          homeless youth shelters receive these funds, and all  
          supplement this funding with a mix of county and private  
          dollars. 


           Title 22 Group Home Regulations


           California Code of Regulations, Title 22, Division 6,  
          Chapter 5 establish licensing standards for group homes,  
          most of which are eligible for Title I-V E or state foster  
          care payments, and which accept children for formal  
          placement by child welfare services.  These regulations are  
          developed and enforced by DSS, Division of Community Care  
          Licensing (CCL).


          Specific standards provided under these regulations include  
          administrator qualification and duties, staff-to-child  
          ratios, professional standards for staff, health and safety  





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          requirements, intake procedures, the creation of needs and  
          services plans for youth, discharge procedures, discipline  
          policies and procedures, restraint and seclusion  
          procedures, and others.


          In some cases, homeless youth shelters have sought  
          licensure as group homes, however many of the rules and  
          requirements applicable for group homes accepting children  
          for formal placement are not applicable or consistent with  
          the purpose and scope of a temporary homeless shelter for  
          runaway youth. As a result, some facilities have been  
          successful at arranging for exemptions from some rules as  
          determined by CCL, while other facilities have been  
          instructed by CCL that no provisions for exemptions exist.


          This bill provides DSS with authority to develop rules and  
          procedures to license these shelters as a subcategory  
          within existing group home regulations, and with  
          appropriate modifications to those existing licensing  
          standards where appropriate.


          Specifically, this bill provides for a slightly stricter  
          staff ratio standard of 1:8 instead of 1:10, and provides  
          no provision for a reduction in nighttime staff as is the  
          case for group homes. DSS reports this stricter standard  
          reflects the nature of emergency homeless youth shelters  
          which may accept youth at all hours of the night, and which  
          may not be able to predict the level of need that a  
          particular youth residing in the shelter may have. Shelters  
          have reported they largely comply with this standard  
          currently.


          Additionally, this bill limits capacity of the shelter to  
          25 youth and limits the maximum stay to 21 days, while  
          group homes generally have no such capacity or length of  
          stay limit. This standard reflects the requirement in the  
          federal Runaway and Homeless Youth Act to establish a  
          maximum capacity and length of stay for homeless youth  
          shelters as a condition of funding.







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          This bill also provides that an emergency homeless youth  
          shelter is not required to establish a needs and services  
          plan for youth, which is developed to ensure that the  
          longer term needs of the youth are met, and which, given  
          the short term nature of the stay is not practically  
          feasible for these facilities, nor implementable. EYSFs are  
          still required to perform an intake assessment of the  
          child's needs upon admission into the shelter that includes  
          a mental health and medical assessment.


          Other variations from standard group home licensing  
          requirements include the ability of EYSFs to use volunteers  
          as staff for purposes of the youth to staff ratio, provided  
          those volunteers meet the educational requirements of group  
          home staff.  Additionally, this bill would explicitly  
          prohibit the formal placement of a child into an EYSF, but  
          would permit a foster child who voluntarily presented at  
          the shelter (after running away from placement) to remain  
          there until the county caseworker was able to locate an  
          alternative placement, but no longer than the maximum 21  
          days.


          DSS, a sponsor of the bill, writes that this bill would  
          provide the department with the statutory authority to  
          license homeless youth shelters by creating a subcategory  
          of group homes under the Community Care Facilities Act. In  
          doing so, this measure would ensure that children who are  
          seeking respite from a potentially harmful environment  
          would be able to access safe, temporary shelter while  
          receiving food, clothing, and medical care, as well as  
          other services that the vulnerable youth need.


          The other sponsor, the California Coalition for Youth,  
          representing the shelters that would be licensed pursuant  
          to this bill, writes that although some existing emergency  
          shelters are licensed under the existing group home  
          category, with exemptions or major programmatic  
          modifications that are challenging to implement, other  
          shelters have been told they do not need a license to  
          operate. The California Coalition for Youth states that  
          this bill attempts to find a balance and create consistency  
          across the state to license these shelters and ensure that  





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          federal funds are not jeopardized.


          Comments:


          1.Housing youth as young as 12 with older youth, up to age  
            18, may be detrimental to the safety of the younger  
            youth. Staff recommends the author consider amending the  
            bill to instruct the department to establish appropriate  
            standards and safeguards for facilities that accept  
            younger youth to appropriately separate those youth from  
            older youth.


          2.DSS, the California Coalition for Youth and the author  
            have recently negotiated a series of amendments, which  
            staff recommends are accepted as committee amendments.  
            These include (see attached mock-up):


                 A minor technical change to the definition of  
               "group home."


                 Replaces the name "Emergency Youth Shelter  
               Facility" with the term "Runaway and Homeless Youth  
               Shelter" to avoid confusion with the existing facility  
               type "Emergency Shelter Facility" which may accept  
               formal foster care placements on an emergency basis.  
               The Department states that this term is also more  
               consistent with the federal Runaway and Homeless Youth  
               Act.


                 When referencing Runaway and Homeless Youth  
               Shelters (RHYSs), generally replaces references to  
               "facility" with "shelter."


                 In defining the term "homeless youth" removes the  
               reference to the McKinney Vento Homeless Assistance  
               Act and replaces with a new definition that is  
               intended to be consistent with the Runaway and  
               Homeless Youth Act. The new definition for "runaway  





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               youth" is as follows:


                   o         "Homeless youth" means a youth 12 to 17,  
                    inclusive, or 18 years of age if the youth is  
                    completing high school or its equivalent, who is  
                    in need of services and without a place of  
                    shelter.  


                   o         "Runaway youth" means a youth 12 to 17,  
                    inclusive, or 18 years of age if the youth is  
                    completing high school or its equivalent, who  
                    absents himself or herself from home or place of  
                    legal residence without the permission of his or  
                    her family, legal guardian, or foster caregiver.


                 Clarifies that, although a shelter shall be  
               required to assess a youth within 72 hours, it shall  
               not be required to perform an assessment prior to  
               admission of the youth into the facility. (The shelter  
               is still required to determine whether a youth poses a  
               threat to self or others, to deny admission if so, and  
               to assist youth in obtaining emergency health-related  
               services).


                 Pursuant to the federal grant program, adds a  
               requirement that RHYSs develop adequate procedures to  
               assist youth in securing long term stability that  
               include reconnecting the youth with family, legal  
               guardian, or nonrelative extended family members, when  
               possible, and coordinating with appropriate  
               individuals, local governmental agencies or  
               organizations to help foster youth secure a suitable  
               foster care placement.


                 Clarifies that an RHYS is not a placement option  
               for foster youth, and is not eligible for a foster  
               care rate.


                 Clarifies that, although an RHYS is not a placement  





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               option for foster youth, this does not preclude a  
               runaway and homeless youth shelter from receiving  
                                                        reimbursement for providing services to a foster youth  
               as may be provided at the discretion of a County. 


               This amendment addresses the reality that foster youth  
               who run away from foster care placements often present  
               themselves voluntarily at an RHYS. Some counties have  
               established contracts to reimburse shelters for the  
               care provided to a foster youth, however no county is  
               required to do so. This amendment is intended to  
               clarify that the bill does not prohibit such  
               contracts.


          Related Legislation:


          SB 119 (Lowenthal, 2012) would have created a licensing  
          category for emergency youth shelter facilities and would  
          have directed CDSS to adopt regulations for them by January  
          1, 2013. It was held in Senate Appropriations Committee. At  
          the time, it was not clear whether DSS could implement  
          these provisions through regulation or whether statute was  
          needed. 


                                   PRIOR VOTES


           Assembly Floor:               76-0
          Assembly Appropriations Committee:17-0
          Assembly Human Services Committee:  7-0

                                    POSITIONS  

          Support:  California Department of Social Services  
          (Sponsor)
                    California Coalition for Youth (Sponsor)
                    California State PTA
                    California Communities United Institute
                    California Welfare Directors Association
                    Home Start, Inc.
                    Housing California





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                    Mendocino County Youth Project and Mendocino  
               Family and Youth Services
                    National Association for the Education of  
               Homeless Children and Youth
                    San Diego Youth Services
                    The Arc and United Cerebral Palsy in California  
               (if amended)

          Oppose:None received



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