BILL ANALYSIS Ó AB 2228 Page 1 CONCURRENCE IN SENATE AMENDMENTS AB 2228 (Cooley) As Amended August 21, 2014 Majority vote ----------------------------------------------------------------- |ASSEMBLY: |77-0 |(May 27, 2014) |SENATE: |34-0 |(August 25, | | | | | | |2014) | ----------------------------------------------------------------- Original Committee Reference: HUM. S. SUMMARY : Makes a number of changes to existing requirements for crisis nurseries. Specifically, this bill : 1) Clarifies the definition of crisis nursery to specify that a nursery provides non-medical care, and may provide both an overnight residential and day services program. 2) Limits the time period a child may receive crisis day services to no more than 30 calendar days, a maximum of 12 hours per day, or a total of 360 hours in a six-month period unless an exception is issued to allow a child to receive additional crisis day services in a six-month period, as specified. 3) Clarifies that no more than two exceptions, in seven-calendar day or 84-hour increments, may be granted per child in a six-month period. 4) Requires at least 75-square feet per child of outdoor activity space based on the total licensed capacity. Specifies that swimming pools, adjacent pool decking, and natural or man-made hazards shall not be included in the calculation of outdoor activity space. 5) Specifies the maximum licensed capacity for a crisis residential overnight program shall be 14 children and that a child who has been voluntarily placed in a crisis residential overnight program shall be included in the licensed capacity for crisis day services. 6)Permits a crisis nursery's licensed capacity to be based upon 35 square feet of indoor activity space per child, as specified. AB 2228 Page 2 7)Requires crisis nursery licensees to develop, maintain and implement a written staff training plan for the orientation, continuing education, on-the-job training and development, supervision, and evaluation of all lead caregivers, caregivers, and volunteers, which shall be included in the facility's plan of operation. 8)Requires crisis nursery licensees to designate at least one lead caregiver to be present at the crisis nursery at all times when children are present. 9)Requires lead caregivers to have one of the following education and experience qualifications: a) Completion of 12 postsecondary units, as specified, in classes with a focus on early childhood education, child development, or child health at an accredited college or university, and six months of work experience in a licensed group home, licensed infant care center, or comparable group child care program or family day care; b) A current and valid Child Development Associate (CDA) credential, with the appropriate age level endorsement issued by the CDA National Credentialing Program, and at least six months of on-the-job training or work experience in a licensed child care center or comparable group child care program; or c) A current and valid CDA Teacher Permit issued by the California Commission on Teacher Credentialing, as specified. 10)Requires lead caregivers to have a minimum of 24 hours of training and orientation before working with children, permits one year experience in a supervisory position in a child care or group care facility to be substituted for 16 hours of training and orientation, and requires lead caregivers to undergo at least 20 hours of ongoing training, as specified. 11)Requires general caregiver staff to complete a minimum of 24 hours of initial training within the first 90 days of employment, which may include first aid and CPR and shall be included in the written staff training plan, and requires that at least eight hours of training be completed before the AB 2228 Page 3 caregiver may be left alone with children or counted in the staff-to-child ratios, as specified. 12)Doubles the number of hours of training a person must undergo in order to volunteer at a crisis nursery 13)Reduces the number of hours of training a volunteer must undergo before being included in staff-to-child ratio requirements from 20 to 16 hours. 14)Increases staff-to-child ratio requirements for children over the age of 18 months from one-to-three to one-to-six. 15)Increases staff-to-child ratio requirements for children under the age of 18 months from one-to-three to one-to-four during the hours of operation between 7 p.m. and 7 a.m. 16)Requires licensees and caregivers who provide medication assistance to children to do all of the following: a) Assist children with the taking of the medication, follow instructions as provided by an appropriate medical professional, store the medication appropriately, as specified, and administer the medication as directed on the label or as advised by a physician in writing; b) Administer nonprescription medication without the consent of the child's physician as long as the medication is administered in accordance with the product label and the child's parent has consented in writing to the use of the medication, as specified; c) Develop and implement a written plan to record the administration of prescription and nonprescription medications and to inform the child's authorized representative daily, for day care, and upon discharge for overnight care, when the medications have been given; and d) Return all medications to the child's authorized representative when the child is withdrawn from the facility, as specified. The Senate amendments : 1) Clarify the definition of crisis nursery to specify that AB 2228 Page 4 a nursery provides non-medical care, and may provide both an overnight residential and day services program. 2) Limit the time period a child may receive crisis day services to no more than 30 calendar days, a maximum of 12 hours per day, or a total of 360 hours in a six-month period unless an exception is issued to allow a child to receive additional crisis day services in a six-month period, as specified. 3) Clarify that no more than two exceptions, in seven-calendar day or 84-hour increments, may be granted per child in a six-month period. 4) Require the maximum licensed capacity for crisis day services to be based on 35 square feet of indoor activity space per child. Specify that bedrooms, bathrooms, halls, offices, isolation areas, food-preparation areas, and storage places shall not be included in the calculation of indoor activity space. Include floor area under tables, desks, chairs, and other equipment intended for use as part of children's activities in the calculation of indoor space. 5) Require at least 75-square feet per child of outdoor activity space based on the total licensed capacity. Specify that swimming pools, adjacent pool decking, and natural or man-made hazards shall not be included in the calculation of outdoor activity space. 6) Specify the maximum licensed capacity for a crisis residential overnight program shall be 14 children and that a child who has been voluntarily placed in a crisis residential overnight program shall be included in the licensed capacity for crisis day services. 7) Requires a nursery's plan of operation to address how it will deal with unexpected circumstances related to staffing and ensure that additional caregivers are available when needed. 8) Modifies the staff-to-child ratio for children under the age of 18 months. AS PASSED BY THE ASSEMBLY , this bill: AB 2228 Page 5 1)Deleted the authority of a crisis nursery to provide child day care services for children under six years of age and instead permits a crisis nursery to provide "crisis day respite services." 2)Deleted the prohibition on a crisis nursery providing child day care services to eligible children for more than 30 calendar days within a six-month period, unless otherwise permitted by the Department of Social Services (DSS). 3)Deleted the requirement that a child receiving child day care services from a crisis nursery are counted towards its licensed capacity. 4)Permitted a crisis nursery's licensed capacity to be based upon 35 square feet of indoor activity space per child, as specified. 5)Required at least one crisis nursery caregiver to have certification in cardiopulmonary resuscitation (CPR) and pediatric first aid, as specified. 6)Required crisis nursery licensees to develop, maintain and implement a written staff training plan for the orientation, continuing education, on-the-job training and development, supervision, and evaluation of all lead caregivers, caregivers, and volunteers, which shall be included in the facility's plan of operation. 7)Required crisis nursery licensees to designate at least one lead caregiver to be present at the crisis nursery at all times when children are present. 8)Required lead caregivers to have one of the following education and experience qualifications, as specified. 9)Required lead caregivers to have a minimum of 24 hours of training and orientation before working with children, permits one year experience in a supervisory position in a child care or group care facility to be substituted for 16 hours of training and orientation, and requires lead caregivers to undergo at least 20 hours of ongoing training, as specified. 10)Required general caregiver staff to complete a minimum of 24 AB 2228 Page 6 hours of initial training within the first 90 days of employment, which may include first aid and CPR and shall be included in the written staff training plan, and requires that at least eight hours of training be completed before the caregiver may be left alone with children or counted in the staff-to-child ratios, as specified. 11)Reduced the number of hours of training a person must undergo in order to volunteer at a crisis nursery from eight to five hours, as specified. 12)Added "child guidance techniques" to existing training requirements for volunteers. 13)Reduced the number of hours of training a volunteer must undergo before being included in staff-to-child ratio requirements from 20 to eight hours. 14)Deleted existing training requirements that volunteers must undergo 12 hours of CPR training and eight hours of child health and safety training and instead requires eight hours of training that covers child care health and safety issues, trauma informed care, the importance of family and sibling relationships, temperaments of children, self-regulation skills and techniques, and program child guidance techniques. 15)Permitted volunteers who have not met specified training requirements necessary to be included in staff-to-child ratio requirements to supervise napping children without being under the direct supervision of staff. 16)Increased staff-to-child ratio requirements for preschool age children from one-to-three to one-to-six. 17)Increased staff-to-child ratio requirements for infants from one-to-three to one-to-four during the hours of operation between 7 a.m. and 7 p.m. 18)Increased staff-to-child ratio requirements for all children from one-to-four to one-to-six during the hours of operation between 7 p.m. and 7 a.m. 19)Required licensees and caregivers who provide medication assistance to children to follow specified instructions as provided for by a licensed medical professional, as specified. AB 2228 Page 7 FISCAL EFFECT : According to the Senate Appropriations Committee, pursuant to Senate Rule 28.8, negligible state costs. COMMENTS : Background on crisis nurseries: Established in 2004 by SB 855 (Machado), Chapter 664, Statutes of 2004, crisis nurseries were created as a separate licensing category to provide a temporary housing and shelter facility placement option for parents. The goal of crisis nurseries is to provide an alternative voluntary placement option for families with young children who are facing difficult or extreme financial, health, or other challenges and to prevent the need for or the engagement of child welfare services. This limits the role of crisis nurseries to only serve children under the age of six who are voluntarily placed by their parent or guardian under their temporary care. Prior to SB 855's adoption, crisis nurseries were subject to licensure as a group home under the Community Care Facilities Act (CCFA). According to the Assembly Human Services August 26, 2004, analysis of SB 855, the author argued that group home licensing requirements were "inappropriate for crisis nurseries, since the demands of very young children who are voluntarily placed by a parent are less serious than those of older children who have been removed from parental custody by county child protective services workers due to abuse or neglect." Further, operators of crisis nurseries argued "that the costs of complying with group home regulations are excessive and threaten their viability." To allow for the monitoring and evaluation of this licensing category, SB 855 was approved with a sunset of January 1, 2008. That sunset was extended by two subsequent measures to establish the current sunset of January 1, 2014, to provide additional time for DSS to establish licensing regulations. Crisis nurseries were originally allowed to serve a limited number of foster youth, however, that authority was eliminated effective January 1, 2012, pursuant to SB 1214 (Wolk), Chapter 519, Statutes of 2010. Finally, in 2012, the state adopted SB 1319 (Liu), Chapter 663, Statutes of 2012, which eliminated the sunset and allowed crisis nurseries to exist in perpetuity. Had the sunset been allowed to take effect, crisis nurseries would have, again, had to comply with group home licensing requirements under the CCFA. AB 2228 Page 8 According to DSS, there are currently five licensed crisis nurseries in California. All five are located in northern California; Concord, Davis, Nevada City, and two in Sacramento. Since 2009, approximately 9,155 children have been served by these nurseries, except for the Concord facility. On average, the lengths of stay have ranged from eight hours to just over 24 hours with 44 children staying for the maximum allowable days. No exemptions have been requested or granted for children to stay beyond the 30-day limit. Need for the bill: Stating the need for the bill, the author writes: The current law and regulations governing Crisis Nurseries has not been updated to reflect changes made by SB 1214 (Wolk) Chapter 93, Statutes of 2010, prohibiting the use of Crisis Nurseries for foster children, effective July 1, 2012. This has resulted in laws and regulations that are unnecessary for Crisis Nurseries. The increased cost of providing services is preventing Crisis Nurseries from making the most effective use of qualified volunteers, in support of paid employees, to care for children voluntarily placed by their own parents or legal guardians. Analysis Prepared by : Chris Reefe / HUM. S. / (916) 319-2089 FN: 0005470