BILL ANALYSIS Ó
AB 403
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Date of Hearing: April 28, 2015
ASSEMBLY COMMITTEE ON HUMAN SERVICES
Kansen Chu, Chair
AB 403
(Mark Stone) - As Amended April 21, 2015
SUBJECT: Public social services: foster care placement:
funding
SUMMARY: Implements Continuum of Care Reform recommendations to
better serve children and youth in California's child welfare
services system.
Specifically, this bill:
1)Describes the goals of the child welfare services system and
the underlying principles of this bill:
a) Declares legislative intent pertaining to improving the
state's child welfare system and its outcomes through
providing more appropriate services and supports and
creating faster paths to permanency for children in the
system through reducing the use of congregate care and
other means, as specified. Further establishes that
implementation of this act will result in an overall
reduction of costs to local agencies and allow savings to
be reinvested in child welfare;
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b) Declares the intent of the Legislature that all children
live with a committed, permanent and nurturing family, and
that services and supports should be tailored to meet the
individual needs of the child and family being served, as
specified. States further that short-term residential
treatment centers (STRTCs) are a short-term, specialized,
and intensive intervention that is just one part of a
continuum of care available to children, youth, young
adults, and their families;
c) Provides that "child welfare services" are best provided
in a framework that integrates service planning and
delivery among multiple service systems, including the
mental health system, using a team-based approach, such as
a child and family team (CFT), and stipulates that use of a
team approach increases efficiency, thereby reducing costs
and increasing coordination of formal services and
integrating the natural and informal supports available to
the child and family; and
d) Declares the intent of the Legislature that STRTCs only
be used for short-term, specialized, and intensive
treatment purposes, consistent with needs identified in a
child's case plan, and encourages DSS to adopt policies,
practices and guidance that ensure the education,
qualification, and training requirements for child care
staff in STRTCs are consistent with their intended role, as
specified, with a particular focus on crisis intervention,
behavioral stabilization, other treatment-related goals,
and connections between those efforts and work towards
permanency for children.
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2)Improves and expands home-based family care through additional
training and support:
a) Declares the intent of the Legislature that all foster
parents have the necessary, knowledge, skills, and
abilities to support the safety, permanency, and well-being
or children in foster care;
b) Provides that training for foster parents should be
ongoing in order to provide them with information on new
practices and requirements and other helpful topics within
the child welfare system, and includes supporting
children's connection with their families as a component of
supporting a foster parent's role in parenting vulnerable
children;
c) Establishes new, expanded foster parent training
standards, beginning January 1, 2017. Requires completion
of training, for a minimum number of hours prescribed by
DSS, prior to initial licensing of prospective foster
parents, as well as annual ongoing training;
d) Adds new training topics for foster parents such as:
health issues in foster care that include the
administration of psychotropic and other medications;
accessing behavioral health services available to foster
children; the rights of children in foster care and the
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foster parent's responsibility to safeguard those rights;
the cultural needs of children; the permanence and
well-being needs of children; the role of foster parents,
including working cooperatively with the child welfare
agency, the child's family, and other service providers
implementing the case plan; and a foster parent's
responsibility to act as a reasonable and prudent parent,
and to maintain the least restrictive, most family-like
environment that serves the needs of the child. Replaces
the training pertaining to emancipation and independent
living skills with training on preparation for youth and
young adults for a successful transition to adulthood;
e) Allows foster parent training to be offered in a
classroom setting, online, or individually;
f) Authorizes a foster family agency (FFA) to require
foster parent training in excess of what is required in
statute, in addition to the current authority granted to
counties to do so;
g) Includes among children and youth eligible for county
wraparound services those who would otherwise, beginning
January 1, 2017, be accepted for placement into an STRTC;
h) Repeals the current rate methodology for county
wraparound services, which is based on the Rate
Classification Level (RCL) system, and codifies the rate
methodology and the current rate of $8,573 per month for
wraparound services. Indicates conditions under which the
rate will be increased, as specified;
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i) Requires counties implementing the resource family
approval process to ensure resource family applicants and
existing resource families receive at least a minimal
number of hours of training to ensure they can
appropriately support the youth in their care, as
specified;
j) Maintains the security of confidential information
related to resource families, and specifies limited
circumstances under which resource family information can
be shared between authorized parties, as specified;
aa) Adds resource families and STRTCs to provisions related
to the administration of emergency medical assistance and
injections, and the use of delayed egress devices, for
purposes of consistency with authority granted to
caregivers in current law, as specified; and
bb) Declares legislative intent to ensure quality care for
children and youth who are placed in the continuum of
foster care settings and makes legislative findings
attesting to the need to attract and retain quality
caregivers and to share necessary information with these
caregivers related to a child's specific needs. Further
provides that these findings are declaratory of existing
law and not intended to impose a new program or higher
level of service upon any local agency; rather, they are
intended to engender a renewed sense of commitment to
engaging foster parents in order to provide quality care to
children and youth in foster care.
3)Establishes new out-of-home care and supervision options
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available for children and requirements for placement:
a) Sunsets the operation and use of group homes as a
placement option for children as of January 1, 2017, with
the exception of group homes that have been granted an
extension, as specified, for which operation cannot
continue beyond January 1, 2018;
b) Defines a short-term residential treatment center
(STRTC) as a residential facility that provides short-term,
specialized and intensive treatment, and 24-hour care and
supervision, to children in a structured environment, as
specified, when a child's case plan specifies the need for,
nature of, and anticipated duration of this specialized
treatment. Authorizes a county to operate an STRTC;
c) Revises the programs in which a child or non-minor
dependent can be placed in order to be eligible for AFDC-FC
funds beginning January 1, 2017, except as specified until
January 1, 2018, and includes among the allowed placement
types a licensed FFA for placement into an accredited
treatment foster home or nontreatment foster home, as
specified, an STRTC, and a community treatment facility for
children who are seriously emotionally disturbed, as
specified;
d) As of January 1, 2017, authorizes a community care
facility licensed as an STRTC, or an FFA that provides
treatment services for children, to accept for placement,
and provide care and supervision to, a child assessed as
seriously emotionally disturbed, provided the child does
not need inpatient care in a licensed health facility;
e) Requires a licensee of an STRTC or an FFA that provides
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treatment services, and a group home permitted to operate
between January 1, 2017 and January 1, 2018, to only agree
to accept a child for placement that has been assessed as
seriously emotionally disturbed if the following apply:
i. The child has been assessed as seriously
emotionally disturbed by an interagency placement
committee, a CFT, or a licensed mental health
professional, as specified; and
ii. The program is certified by the State Department of
Health Care Services (DHCS), or a county to which DHCS
has delegated certification authority, as specified.
f) Prohibits DSS from evaluating or having any
responsibility or liability with regard to the evaluation
of the mental health treatment services provided by an
STRTC or an FFA that provides treatment services to
children assessed as being seriously emotionally disturbed,
as specified, consistent with current law;
g) Includes STRTCs in current provisions related to the
Interstate Compact on the Placement of Children and
requires that, as of January 1, 2017, all out-of-state
group homes certified by DSS be accredited, as specified,
and have a mental health certification equivalent to that
required of STRTCs and FFAs that provide treatment services
in order to receive an AFDC-FC rate, except as specified
for out-of-state group homes that are granted an extension;
h) Authorizes DSS to adopt regulations for STRTCs that care
for children younger than six years of age, and for STRTCs
providing minor parent programs that care for children
under six years of age, to the extent the department
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determines they are necessary;
i) Prohibits the placement of a child under age 12 in an
STRTC unless it is indicated in a child's case plan, the
case plan includes transitioning the child to a less
restrictive environment and the projected timeline for
doing so, and prior approval is received, as specified;
j) Authorizes placement of a child into a group home, or an
STRTC, only when the case plan indicates that placement is
for purposes of providing short-term, specialized and
intensive treatment for the child, the case plan specifies
the need for, nature of, and anticipated duration of this
treatment, and the case plan includes transitioning the
child to a less restrictive environment, the projected
timeline for doing so, and indication that the county has
taken into consideration the intent of the Legislature that
no child or youth reside in group care for longer than one
year;
aa) Authorizes STRTCs and FFAs that provide intensive
therapeutic treatment to accept children who are placed
privately, provided the children have been determined to be
seriously emotionally disturbed by a mental health
professional, as specified;
bb) Requires an existing county-operated FFA or group home
to, commencing January 1, 2017, be classified as and meet
the AFDC-FC eligibility requirements set forth for FFAs and
STRTCs, respectively, including mental health certification
and accreditation, as specified;
cc) Revises the priority of placement when out-of-home
placement is used to attain a child's case plan goals.
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Provides that the selection of the most appropriate
environment for a child shall consider, in order of
priority: placement with relatives, nonrelated extended
family members, and tribal members; foster family homes and
nontreatment certified homes of FFAs; treatment and
intensive treatment certified homes of FFAs;
multidimensional treatment foster care homes or therapeutic
foster care homes; group care placements in the order of
STRTCs, group homes, community treatment facilities, and
out-of-state residential treatment, as specified;
dd) Requires a CFT meeting, as specified, to be convened for
the purpose of determining the appropriateness of a
placement and whether there are any appropriate, less
restrictive, and more family-like alternatives, when any
treatment foster care placement is being considered for a
child after January 1, 2016;
ee) Prohibits the acceptance of an AFDC-FC funded child into
an STRTC or FFA that provides treatment services, beginning
January 1, 2017, without approval in writing from the CFT
or the interagency placement committee, except in the case
of an emergency in which certain conditions exist, as
specified.
ff) Restricts out-of-home placement of seriously emotionally
disturbed children pursuant to an individualized education
program (IEP) to instances in which the IEP assessment
indicates that the child or youth is seriously emotionally
disturbed and the child or youth has been determined by the
CFT to require the level of care provided in an STRTC or
FFA that provides treatment services beginning January 1,
2017;
gg) Clarifies that a county may function as an FFA and
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specifies that a child's need for care provided by an FFA
shall be determined by a CFT;
hh) Establishes core services to be provided to children in
the child welfare services system as services that
encompass community services and supports,
permanency-related services, medical and mental health
support and access to services, educational support, life
and social support, transitional support services upon
discharge, biological parent and resource family supports,
and services for nonminor dependents;
ii) Requires DSS to develop and establish an administrator
certification training program for STRTC administrators,
and requires that a separate administrator certification
training program be adopted for group home administrators
who desire to become STRTC administrators; and
jj) Revises provisions in current law related to how
interagency collaboration and children's program services
are structured to facilitate implementation of the
Children's Mental Health Services Act, beginning January 1,
2017. Recasts provisions related to an interagency
placement committee's assessment of a dependent child or
ward of the court as seriously emotionally disturbed to
include possible placement in STRTCs and FFAs that provide
treatment services, and to allow a CFT to utilize the
assessment of an interagency placement committee or an
assessment by a licensed mental health professional, as
specified. Allows these provisions to apply between
January 1, 2017 and January 1, 2018 to group homes granted
an extension to operate.
4)Establishes and sets forth responsibilities of Child and
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Family Teams:
a) Defines a child and family team (CFT) as a supportive
team that informs the process of placement and services to
children and youth in foster care or who are at risk of
foster care placement. Requires the CFT to include, at
least, the child or youth, the child's family, the
caregiver, the placing agency caseworker, a county mental
health representative, and a representative of the child's
tribe or Indian custodian, as applicable, and identifies
others that may also be included in the CFT, as specified;
b) Requires the county mental health representative
included in the CFT to be a licensed mental health
professional if placement into an STRTC occurred or is
being considered for the child;
c) Establishes requirements for the selection and inclusion
of additional CFT members and requirements related to
convening, communication, and the sharing of information
among members of the CFT. Establishes strict
confidentiality standards, as specified; and
d) Requires the CFT or the interagency placement committee
to determine whether a child requires out-of-home placement
due to being seriously emotionally disturbed and needs the
level of care provided by an STRTC or FFA that provides
treatment services, within 30 days of placement, and
establishes procedures through which the child can be
referred to a more appropriate placement pursuant to
periodic review of the placement and level of need by the
CFT or the interagency placement committee.
5)Revises rate structures for the care and supervision of
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children in out-of-home care:
a) Adds STRTCs to the community treatment facilities for
which DSS is required to establish a foster care rat;
b) Sunsets provisions related to the potential
reclassification of group homes through a mental health
certification as of January 1, 2017, except as specified;
c) Requires all STRTCs and FFAs that provide intensive
treatment services to obtain and have in good standing a
mental health certification issued by DHCS or a county to
which DHCS has delegated certification authority, beginning
January 1, 2017. Provides that such certification is a
condition for receiving an AFDC-FC rate, as specified;
d) Sets forth requirements for group homes permitted to
operate until January 1, 2018, to obtain mental health
certification from DHCS during the year of extension for
the purpose of providing mental health treatment services
that meet the needs of seriously emotionally disturbed
children;
e) Requires the rate paid to out-of-state STRTCs to not
exceed the rate for care and supervision provided to
in-state STRTCS and to be developed using the same
considerations used for in-state rates and federal
financial participation;
f) Sunsets the use of the Rate Classification Level (RCL)
system for the purpose of setting rates for group homes as
of January 1, 2017, unless the rate is extended pursuant to
an extension granted by DSS, for up to one year, upon
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receiving a written request and supporting documentation
showing that without the exception there is a material risk
to the welfare of children due to an inadequate supply of
appropriate alternative placement options to meet their
needs;
g) Allows the exception provided by DSS to include time to
meet either the program accreditation or mental health
certification requirement;
h) Prohibits an exception to the group home moratorium from
being granted to a group home provider below RCL 10 for a
program change, commencing January 1, 2017;
i) Prohibits any payment to a group home upon the
termination of the existing group home rate under the RCL
system unless an application is approved and a rate is
granted by DSS for the group home to become an STRTC or an
FFA, as specified;
j) Requires DSS to commence development of a new payment
structure for STRTCs claiming Title IV-E funding. Further
requires DSS to develop a rate system for STRTCs that
includes consideration of: the core services provided,
staff training, requirements of the Health and Safety Code,
accreditation of the program, mental health certification,
and maximization of federal financial participation, as
specified;
aa) Requires DSS to develop a system of governmental
monitoring and oversight, including ensuring program
conformity with federal and state laws through program,
fiscal, and health and safety audits and reviews, which
shall be carried out in coordination with DHCS;
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bb) Prohibits DSS from establishing a rate for an STRTC or
FFA that provides treatment services without a
recommendation from the host county or the primary placing
county that the program is needed and that the provider is
willing and capable of operating the program and the level
sought;
cc) Sunsets the current FFA ratesetting methodology, as of
January 1, 2017, and requires DSS to, commence development
of a new payment structure for the Title IV-E funded FFA
placement option that maximizes federal funding;
dd) Requires the new payment system to apply to FFAs that
provide nontreatment, treatment, intensive treatment and
therapeutic foster care programs and outlines certain
considerations for development of the rate, which include:
core services, intensive treatment or therapeutic services
provided, administrative, social work, and mental health
services that are eligible for federal financial
participation, as specified, staff training, accreditation,
and populations served;
ee) Terminates the current FFA rate system as of December 1,
2016 and prohibits a new FFA from being established
pursuant to the current rate, unless the rate is extended
pursuant to an extension granted by DSS, for up to one
year, upon receiving a written request and supporting
documentation showing that without the exception, there is
a material risk to the welfare of children due to an
inadequate supply of appropriate alternative placement
options to meet their needs. Allows the exception provided
by DSS to include time to meet either the program
accreditation or mental health certification requirement;
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ff) Prohibits any payment to an FFA upon the termination of
the existing FFA rate under the current rate system unless
an application is approved and a rate is granted by DSS for
the FFA to become an STRTC or an FFA under the new rate and
requirements, as specified;
gg) Requires DSS, in the development of new rate structures,
to consider and provide for placement of all children who
are displaced as a result of reclassification of treatment
facilities and to consider the impact on youth being
transitioned to alternate programs as a result of the
ratesetting system, as specified;
hh) Requires the amount paid for care and supervision of a
dependent infant living with a dependent teenage parent
receiving AFDC-FC benefits in an STRTC to equal the infant
supplement rate for STRTCs established by DSS, commencing
January 1, 2017; and
ii) Authorizes DSS to establish participation conditions for
FFAs to participate in early implementation of the resource
family approval program, as specified, and authorizes the
department to adjust the newly established FFA rate for
this purpose.
6)Sets forth new requirements for licensure, program integrity
and transparency:
a) Requires DSS to license STRTCs, beginning, January 1,
2017, and establishes requirements for STRTCs, as
specified, and requires DSS to establish requirements for
the education, qualification, and training of facility
managers and child care staff in STRTCs consistent with the
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intended role of these facilities to provide short-term,
specialized, and intensive treatment;
b) Authorizes DSS to license a facility meeting all
applicable criteria as an STRTC prior to January 1, 2017;
c) Requires DSS to establish requirements for licensed
group homes that are transitioning to STRTCs, and
authorizes DSS to inspect a STRTC according to a system of
governmental monitoring and oversight, which shall include
program, fiscal, and health and safety reviews, that is
carried out in coordination with DHCS;
d) Requires an FFA to prepare and maintain a current,
written plan of operation as required by DSS, which, on and
after January 1, 2017, shall, among other things,
demonstrate the FFA's ability to support the differing
needs of children and their families and describe how the
FFA will comply with the resource family approval standards
and requirements;
e) Requires DSS to establish a foster care rate for each
community treatment facility program and requires all
community treatment facility programs to be accredited by a
nationally recognized accrediting entity identified by DSS,
as specified, commencing January 1, 2017;
f) Requires DSS to publish and make available on its
Internet Web site STRTC and FFA provider performance
indicators beginning January 1, 2017 and at least annually
thereafter;
g) Establishes penalties for STRTCs or FFAs that provide
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intensive and therapeutic treatment that fail to maintain
the level of care and services needed to meet the needs of
children in care or fail to maintain a certified mental
health treatment program, as specified;
h) Applies existing audit, overpayment and collections
requirements, as specified, to STRTCs and FFAs that provide
treatment services; and
i) Requires DSS to develop a system of governmental
monitoring and oversight of STRTCs and FFAs, including
ensuring program conformity with federal and state laws
through program, fiscal, and health and safety audits and
reviews, which shall be carried out in coordination with
DHCS. Authorizes DSS to inspect FFAs and STRTCs according
to the system developed.
7)Replaces group home references with STRTCs in existing statute
related to: administrative requirements for licensing;
reports to licensees by law enforcement agencies when staff is
arrested; the prohibition on gifts to DSS; administrator
training and certification; peer review of plans of operation;
incident and complaint responses and investigations; the
prohibition on smoking; the adoption of regulations for STRTCs
to serve young children; the use of delayed egress or secured
perimeters; locations where client interviews by DSS are
permitted; the list of complaints published by DSS; county
access of disclosable public record information and the
provision of incident reports to counties; incident reports to
the Community Care Licensing Division (CCLD) of DSS, civil
penalties and enforcement actions; the requirement that staff
providing direct care and supervision to children are at least
21 years of age; CCLD licensing personnel training; the
placement of infants with their parents, when appropriate and
approved; out-of-county placements, and; the placement of
wards.
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8)Requires DSS to work with counties that operate shelters,
probation agencies, homeless shelter providers, residential
education providers, and others to identify jointly developed
alternative timeframes or criteria to be met in order to
address the unique circumstances and needs of the populations
they serve, while remaining consistent with the principles of
this act.
EXISTING LAW:
1)States that the purpose of foster care law is to provide
maximum safety and protection for children who are being
physically, sexually or emotionally abused, neglected, or
exploited and to ensure the safety, protection, and physical
and emotional well-being of children at risk of such harm.
(WIC 300.2)
2)Declares the intent of the Legislature to, whenever possible:
preserve and strengthen a child's family ties, reunify a
foster child with his or her relatives, or when family
reunification is not possible or likely, to develop a
permanent alternative. Further states the intent of the
Legislature to reaffirm its commitment to children who are in
out-of-home placement to live in the least restrictive, most
family-like setting and as close to the child's family as
possible, as specified. (WIC 16000)
3)Requires out-of-home placement of a child in foster care to be
based upon selection of a safe setting that is the least
restrictive or most family-like and the most appropriate
setting available and in close proximity to the parent's home,
the child's school, and best suited to meet the child's
special needs and best interests. Further requires the
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selection of placement to consider, in order of priority,
placement with relatives, nonrelated extended family members,
tribal members, and foster family homes, certified homes of
foster family agencies, intensive treatment or
multidimensional treatment foster care homes, group care
placements, such as group homes and community treatment
facilities, and residential treatment, as specified. (WIC
16501.1(c)(1))
4)Specifies that, if group care placement is selected for a
child, the case plan must justify this placement based on the
child's needs and must indicate the plan and timeline for
transitioning the child to a less restrictive setting.
Stipulates that this section of the case plan be reviewed and
updated at least semiannually. (WIC 16501.1(c)(2))
5)States the intent of the Legislature that no child or youth in
foster care reside in group care for longer than one year.
Further requires DSS to update the Legislature regarding the
outcomes of assessments of children and youth who have been in
group homes for longer than one year and the corresponding
outcomes of transitions, or plans to transition them, into
family settings. (WIC 16010.8)
6)Requires the juvenile court to make full consideration of the
proximity of a child's natural parents to the potential foster
care placement of that child in order to facilitate visitation
and family reunification, and if possible, for the placement
to be made in the home of a relative, unless as otherwise
specified. (Family Code 7950(a))
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7)Requires county child welfare agencies to make diligent
efforts to locate an appropriate relative, and the juvenile
court to find that these efforts have been made, prior to any
child may be placed in long-term foster care. Further
provides that nothing may preclude a search for an appropriate
relative while the child is in foster care. (Family Code
7950(a(1) and (c))
8)Requires DSS to establish a working group, in consultation
with stakeholders, charged with developing recommended
revisions to the current rate-setting system, services, and
programs provided by foster family agencies and group homes,
as specified. Further requires the working group to consider,
among other things, how to ensure the provision of services in
family-like settings and submit a report on its
recommendations to the Legislature by October 1, 2014. (WIC
11461.2)
9)Establishes the federal Preventing Sex Trafficking and
Strengthening Families Act, which places a number of
requirements on states, including a number of improvements to
the child welfare system aimed at improving outcomes for
children and youth in foster care. Includes elimination of
the Another Planned Permanent Living Arrangement as a
permanency option for youth under the age of 16. (P.L.
113-183)
10)Requires DSS, in consultations with county child welfare
agencies and other identified stakeholders, to implement a
unified, family friendly, and child-centered resource family
approval process to replace the existing multiple processes
for licensing foster family homes, approving relatives and
nonrelative extended family members as foster care providers,
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and approving adoptive families. Defines resource family as
an individual or couple that a participating county determines
to have successfully met both the home approval standards and
permanency assessment criteria, as specified, necessary for
providing care for a related or unrelated child who is under
the jurisdiction of the juvenile court, or otherwise in the
care of a county child welfare agency or probation department.
(WIC 16519.5)
11)Requires DSS to promote the participation of current and
former foster youth in the development of state foster care
and child welfare policy. (WIC 16001.7)
12)Enumerates rights of minors and nonminors in foster care,
including but not limited to the right to: live in a safe,
healthy, and comfortable home where he or she is treated with
respect; be free from physical, sexual, emotional, or other
abuse, or corporal punishment; receive adequate and healthy
food, adequate clothing, and, for youth in group homes, an
allowance; receive medical, dental, vision, and mental health
services; be involved in the development of his or her own
case plan and plan for permanent placement; and review his or
her own case plan and plan for permanent placement, if he or
she is 12 years of age or older and in a permanent placement,
and receive information about his or her out-of-home placement
and case plan, including being told of changes to the plan.
(WIC 16001.9)
13)States the intent of the Legislature that foster parents, and
potential foster parents, receive training in order to assist
them in being effective caregivers and to enhance the safety
and growth of children placed with them. Further states the
need to develop a basic curriculum, a program for continuing
education, and specialized training for parents caring for
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children with unique needs. (HSC 1529.1)
14)Requires every licensed foster parent to complete a minimum
of 12 hours of foster parent training, as specified, prior to
any foster youth being placed with him or her. Further
requires a licensed foster parent to complete at least 8 hours
of foster parent training, as specified, annually. (HSC
1529.2(b))
15)Requires DSS or its designee to perform initial and
continuing inspections of out-of-state group homes in order to
either certify that they meet all licensure standards required
of group homes operated in California or that the department
has granted a waiver to a specific licensing standard upon a
finding that there exists no adverse impact to health and
safety. (Family Code 7911.1)
FISCAL EFFECT: Unknown
COMMENTS: Built on the efforts of child welfare stakeholders
and the Legislature, and the Continuum of Care Reform report
submitted by DSS, this bill establishes the framework for a sea
change in how California provides treatment and services to
children and families involved in the state's child welfare
system.
Child Welfare Services: California's Child Welfare Services
(CWS) system provides a number of services, supports, and
interventions aimed at protecting children and their health and
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safety. Ultimately, the system aims to preserve and strengthen
families by reuniting children with their biological parents
whenever appropriate. Children who are at risk of abuse,
neglect or abandonment, and for whom county juvenile courts hold
legal jurisdiction, are served through the appointment of a
social worker. Through this system, there are multiple stages
where the custody of a child or his or her placement is
evaluated, reviewed and determined by the judicial system, in
consultation with the child's social worker, to help provide the
best possible services to the child.
Under certain circumstances defined in state law, the juvenile
court may deem a child to be a dependent or ward of the court.
The court may then keep the child in his or her home or remove
the child from the home; removal may either result in eventual
reunification with the family, or the court may determine that
an alternate permanent placement is more fitting. When
reunification is not possible or appropriate, children are
placed in the setting deemed least restrictive and most
suitable; the court must give preference to potential placements
in the following order: relatives, nonrelative extended family
members, or foster family homes. Placement in group homes or
other intensive treatment placement settings are considered only
in more challenging situations where a child may need
stabilization services in order to transition to a less
restrictive placement, such as with a relative or foster
caregiver.
On January 1, 2015, there were 62,898 children in foster care in
California. Approximately 35% of these youth were placed with
relatives, non-relative extended family members, or in a
tribe-specified home. Another 25% were placed with foster
family agencies or foster family agency certified homes, and
almost 9% were placed in foster family homes and small family
homes. There were 3,796 children and youth placed in group
homes.
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Challenges within the current CWS system: There has been
growing consensus in the field of child welfare, at both the
national and state levels, that institutionalized settings for
foster youth should be used sparingly. The placement of
maltreated children in group home settings has been increasingly
viewed as a temporary solution in instances where emergency or
crisis treatment is warranted. Yet, as of January 2015, 48% of
youth placed in group homes in California via CWS had been there
over two years, and 23% had been there over five years,
indicating stays longer than what might have been necessary if
appropriate, intensive treatments had been deployed upon
placement.
While the state's CWS system is charged with maintaining the
health and safety of children and providing services and
supports the lead to permanency, the flow of funding, and
therefore the availability of certain services and treatment,
have historically been associated with a child's or youth's
placement type. This often causes children and youth to have to
rotate from one placement or program to another to receive the
services they need, which can diminish any positive impact of
the services being provided. Even prior to placement in a group
home, it is common for a child to have multiple foster care
placements. This type of history can be interpreted as the
child being difficult-to-place and causes some, due to this
history, to consider the child's or youth's ability to find
permanency with a family to be limited. In actuality, ensuring
that necessary services and support are available to the child
or youth and the caregiver before considering moving the child
or youth could greatly reduce cases in which children move
multiple times. This bill emphasizes focusing necessary
services on the needs of the child or youth and seeks to meet
those needs upfront rather than counting on the placement type
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to drive the decisions about services and causing a child or
youth to "fail upwards" into higher levels of care.
Continuum of Care Reform: The Legislature has worked and
continues to work with various entities in and around the CWS
system to focus on family reunification and permanency by
seeking ways to best address the needs of foster youth through
less restrictive, more supportive placements and services. SB
1013 (Senate Budget and Fiscal Review) Chapter 35, Statutes of
2012, realigned CWS to counties, established a moratorium on the
licensing of new group homes, and required DSS to convene a
stakeholder workgroup. This workgroup was charged with
examining the use of group homes in California and providing
recommendations to the Legislature and the Governor on how to
reform this use. In January 2015, DSS submitted the Continuum
of Care (CCR) workgroup report to the Legislature, which
included general and fiscal recommendations, alongside
recommendations on home-based family care, residential
treatment, and performance measures and outcomes. The report
reinforced the view that group home settings are best used
sparingly and temporarily, stating that:
"The foundation of [these] recommendations is that all
children, including those in out-of-home care, deserve to grow
up in families and develop a sense of community. Their
families, including foster families, also at times need
assistance and support to address stressors to avert crises.
For those children and youth in crisis or whom otherwise
initially cannot safely get the appropriate breadth and/or
intensity of services they require in a family based setting,
they can access high quality, short term, treatment oriented
congregate care (which includes planning for a move to
home-based family care as soon as reasonably possible)."
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Recruiting, training, and retaining foster parents: The
first-priority settings for a child who has been removed from
his or her home are now, and will continue to be under the
provisions of this bill, home-based family settings that involve
someone with whom the child has a biological or otherwise
familial relationship. When this priority cannot be preserved
due to the inability to locate an appropriate family member,
nonrelative extended family member, or tribal member, with whom
placement would be in the best interest of the child or youth,
placement in foster family homes or nontreatment certified homes
of foster family agencies will continue to be pursued, with the
maintenance of a family structure for the child or youth still
in mind. All other placement options continue to be specific to
the level of treatment needed; even the family-based options
prioritized right after the aforementioned options and before
congregate care settings are available to children and youth who
need more intensive, therapeutic services, and are not meant to
be relied upon simply because other nontreatment options aren't
perceived to be available. An essential component for the
success of the CWS reform outlined in this bill will be the
building up and bolstering of the available corps of resource
families: those individuals or families wishing to provide
foster care, adopt, or both.
As with any parent or caregiver, whether biological or not, a
key factor in ensuring a successful relationship, in addition to
the services available to children and youth, is support for
their parent or caregiver. In 2009, DSS, the County Welfare
Directors Association, and the Youth Law Center joined forces to
establish a statewide approach to the recruitment and retention
of high quality caregivers for the child welfare system called
the Quality Parenting Initiative (QPI). With 18 counties
currently participating, the QPI focuses on using a county-based
recruitment, training, and retention model that encourages
individuals and families to become resource families while
ensuring the system supports families whenever and however
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necessary to help them be effective and loving parents. The key
elements of the QPI, as outlined by the Youth Law Center are:
to define the expectations of caregivers, to clearly articulate
these expectations, and to align the system so that those goals
can become a reality.
Built on the same assumption that training on, and preparation
for, caring for a child or youth is an essential resource that
facilitates successful outcomes, this bill recasts training
requirements for all resource families and includes new training
topics (e.g., the rights of children in foster care and the
foster parent's responsibility to safeguard those rights, the
permanence and well-being needs of children, a foster parent's
responsibility to act as a reasonable and prudent parent and to
maintain the least restricive, most family-like environment that
serves the needs of the child), which are intented to help
normalize a child or youth's experience and provide a continuum
of quality parenting regardless of whether the child or youth
will eventually be able to reunify with his or her biological
parents.
New service models and requirements: For some children and
youth, the abuse, neglect and other factors that led to their
removal from their home necessitate intensive, therapeutic
treatment that is beyond the scope of what a nontreatment family
setting can provide for them. Within the current child welfare
system, foster family agencies (FFAs) that provide treatment are
used by counties to provide children and youth more intensive
treatment services than what can be provided to them in an
available family home and without which, group home placement
would be necessary. With the same focus on ensuring a child or
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youth's treatment needs can be met, this bill creates and
authorizes licensure of new, short-term congregate care settings
and phases out group homes as they are known and used today.
Short-term residential treatment centers (STRTCs) are created
under this bill to provide short-term, intensive and specialized
24-hour care and supervision to a child or youth who cannot be
safely served at home and for whom such care has been determined
necessary by a child and family team or interagency placement
committee and is identified in a child's case plan. The care
provided in an STRTC is intended to help a child or youth
stabilize quickly for reunification or a move to a resource
family.
In order to ensure children and youth receive the services
necessary to meet their mental health needs, FFAs that provide
treatment and STRTCs will be required, under this bill, to be
certified by the Department of Health Care Services or a county
mental health plan to provide medically necessary mental health
services. (This certification requirement exists in current law
for high level group homes that accept children identified as
seriously emotionally disturbed.) Although this bill renews the
emphasis on congregate care as settings that provide intensive
treatment services, the assessments conducted by child and
family teams are not meant to immediately trigger a child or
youth's placement in an intensive treatment facility. Rather,
they are meant to first consider and, whenever possible, lead to
home-based treatment and supports that are already available and
fit the needs of the child or youth. According to the author,
this will help to reduce the rate of removal from the home and
reduce overall placements in congregate care settings.
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Additionally, to further the goals of reunifying children with
their families when possible or moving them to less restrictive
settings, this bill requires both FFAs and STRTCs to provide
"core services" that "encompass community service and supports,
permanency-related services, medical and mental health support
and access to services, educational support, life and social
support, transitional support services upon discharge,
biological parent and resource family supports, and services for
nonminor dependents." DSS is explicitly encouraged to adopt
policies, practices and guidance to ensure that the education
and training for care staff in STRTCs is particularly focused on
"crisis intervention, behavioral stabilization, other
treatment-related goals, and connections between those efforts
and work towards permanency for children."
Finally, as a means of ensuring FFAs and STRTCS are providing
high quality services, this bill requires FFAs and STRTCS to be
accredited by, and remain in good standing with, a national
accrediting body identified by DSS in order to receive a foster
care rate. This bill phases-out the rate setting methodologies
in current law for existing CWS services and placement types,
and requires DSS to establish new rates that will consider,
among other things, the specialized services to be provided and
accreditation requirements.
Retooling the decision-making process: Under current law,
initial placement decisions are based on an assessment made by a
child's caseworker. While team decision making can be utilized
for making critical decisions about a child or youth's
placement, the model is not relied upon as the source of initial
assessment of a child's or youth's needs, nor is the team always
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convened to reevaluate and make subsequent decisions about a
child or youth's placement based on his or her changing service
needs.
The Katie A. et al. v. Bonta Settlement Agreement of 2011 (Katie
A.) addresses the medically necessary mental health services
that children who are in foster care or are at risk of being in
foster care are entitled to receive under federal Medicaid law.
Pursuant to Katie A., these services, which are intended to
facilitate reunification, and to meet their needs for safety,
permanence and well-being, are to be provided in the most
home-like family-based setting appropriate. Among the many
useful tools resulting from Katie A. is the refined child and
family team, which is to be used to identify a child's and
family's strengths and needs during their initial interactions
with a child welfare worker. Similarly, this bill establishes
requirements for child and family teams, which will be
responsible for assessing the placement needs of a child or
youth and determining whether there are appropriate, less
restrictive, and more family-like alternatives to placement in
an STRTC or another treatment-based placement option. This
shift in practice will ensure decisions are not made by
caseworkers in isolation without the input of other
professionals and people who love and care for the child or
youth in question.
Performance review and transparency: Under current law and
regulations, DSS audits group home providers based on their Rate
Classification Level (RCL) to determine their compliance in
providing the level of service required within a particular
level and whether proper documentation was maintained to justify
the rate they received based on the RCL system. While these
audits also evaluate whether a group home is meeting staffing,
education and training, mental health treatment services and
other licensing requirements, they do not include a full program
review to evaluate the group home's overall effectiveness in
improving outcomes for the children and youth they serve. This
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bill requires the development and execution of an oversight
system that involves the Department of Health Care Services and
will add to the current administrative review process a review
of the services a program provides and outcomes to ensure
providers are adequately addressing and meeting local needs.
Additionally, this bill builds on DSS' existing Internet Web
site on which licensed community care facility information is
available by requiring DSS to, at least annually, post
information pertaining to FFA and STRTC performance indicators.
Markers set for future steps to be taken: Although this bill
establishes an overall framework for reforming how the state
uses and pays for congregate care and other CWS services, some
details are not spelled out and are left to be developed by DSS,
often in concert with child welfare stakeholders. One such
detail pertains to the rates set for STRTCs and FFAs. This bill
makes the requirement for DSS to develop those rates operative
on January 1, 2017, which coincides with the date any existing
group homes or FFAs are required to meet new requirements
unless, due to the needs of the children and youth they serve,
they have an extension to operate in their current form.
However, because current law already designates DSS as the
single organizational unit whose duty it is to establish foster
care rates, the rate development process can begin now to ensure
an appropriate rate structure is in place when DSS begins to
license the new program models.
This bill also mentions, but does not yet establish new
requirements for, the existing residentially-based services that
are not classified as traditional group homes (i.e.:
county-operated shelters, probation agencies, homeless shelter
providers, residential education providers). Acknowledging the
need to ensure the safety and wellbeing of children served in
these unique settings, this bill requires DSS to work with
counties and the other providers of these programs to jointly
develop alternative timeframes or criteria for these programs to
meet while maintaining consistency with the underlying efforts
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of this bill.
Need for this bill: In addition to establishing logistical
considerations for this restructuring of the CWS system (e.g.,
timeline for the implementation of new, short-term treatment
oriented care models, phasing out of group home settings and
their associated rate methodologies) this bill goes beyond what
is written in current CWS law and how it is implemented across
the state to uphold the notion that every child has the right to
be raised in a family instead of an institutional setting.
Promoting the direct relationship between the building up of a
solid resource family capacity and decreased congregate care
usage, this bill establishes a more cohesive approach to
ensuring the state provides appropriate services to its
vulnerable children and youth.
In expressing the need for this bill, the author states:
"[This bill] is a comprehensive reform effort to make sure
that youth in foster care have their day-to-day physical,
mental, and emotional needs met; that they have the greatest
chance to grow up in permanent and supportive homes; and that
they have the opportunity to grow into self-sufficient,
successful adults.
To the extent that the children are provided needed services
and support, this bill transitions children away from
congregate care into home-based family care with resource
families. In addition to new services and supports for
resource families, the measure establishes targeted training
and support that can better prepare families to help care for
foster youth.
For children who are not yet ready to enter a family setting,
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the bill makes changes to the existing model for group homes.
This is important because foster youth who are placed for long
stays in group homes are more likely than those in family
settings to suffer a variety of negative short- and long-term
outcomes. Such placements are associated with an increased
likelihood of being involved with the juvenile justice system
and the adult correctional system, as well as low educational
attainment levels. Further, children who leave group home
care to return to live with their families are more likely
than those who were in placed in family-based care to return
to the foster system. This bill is necessary to advance
California's long-standing goal to move away from the use of
long-term group home care by increasing youth placement in
family settings and by transforming existing group home care
into places where youth who are not ready to be placed with
families can receive short term, intensive treatment. The
measure creates a timeline to implement this shift in
placement options, and it calls for the adoption of new
standards and performance measures.
Ultimately, when children enter foster care, they need a safe,
comfortable, and supportive place to stay, whether that is
with a relative, a foster family, or a in treatment center.
Current options along the continuum of care spectrum do not
always meet these requirements. The reforms in this bill will
provide youth with the support they need in foster care to
return to their families or to find a permanent home if
returning to their families is not an option."
Technical amendment: While the requirements in this bill
pertaining to accreditation for STRTCs and FFAs are consistent,
Section 11462(b)(4)(A) inadvertently includes "foster family
agencies" instead of "short-term residential treatment centers,"
which would be more consistent with this Section. Committee
staff recommends the bill be amended to do the following:
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1) On page 120, line 32, strike out "foster family
agencies" and insert:
short-term residential treatment centers
Staff comments: While the author plans to continue to work with
DSS and other stakeholders to further refine the provisions of
this bill as needed to address stakeholder concerns and meet the
needs of children and youth, committee staff recommends the
author continue to work on two details in particular, should
this bill move forward:
1) Due to the emphasis on STRTCs being available for
short-term intensive treatment, and the mental health
services components that are required of them to that end,
some of the provisions of this bill are unclear as to
whether a child or youth who has not been assessed as
seriously emotionally disturbed can still receive services
in an STRTC if he or she is assessed as needing them. The
author may wish to further clarify the criteria for
placement in an STRTC.
2) While the Child and Family Team structure generated by
the Katie A. Settlement Agreement provides details
regarding who facilitates the CFT, this bill lacks any
detail to that effect. The author may wish to further
clarify how the CFT is convened and by whom.
PRIOR LEGISLATION:
SB 1013 (Senate Budget and Fiscal Review) Chapter 35, Statutes
of 2012, realigned the child welfare services system to
counties, established a moratorium on the licensing of new group
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homes, and required the Department of Social Services to convene
a workgroup to discuss and recommend changes to the continuum of
care within child welfare services and how to reform the use of
congregate care.
REGISTERED SUPPORT / OPPOSITION:
Support
California Department of Social Services (CDSS) sponsor
California Alliance of Child and Family Services
Opposition
None on file.
Analysis Prepared by:Myesha Jackson / HUM. S. / (916) 319-2089
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