BILL ANALYSIS Ó
AB 403
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ASSEMBLY THIRD READING
AB
403 (Mark Stone)
As Amended June 1, 2015
Majority vote
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|Committee |Votes |Ayes |Noes |
| | | | |
| | | | |
|----------------+------+--------------------+---------------------|
|Human Services |7-0 |Chu, Mayes, | |
| | |Calderon, Lopez, | |
| | |Maienschein, | |
| | | | |
| | | | |
| | |Mark Stone, | |
| | |Thurmond | |
| | | | |
|----------------+------+--------------------+---------------------|
|Appropriations |17-0 |Gomez, Bigelow, | |
| | |Bonta, Calderon, | |
| | |Chang, Daly, | |
| | |Eggman, Gallagher, | |
| | | | |
| | | | |
| | |Eduardo Garcia, | |
| | |Gordon, Holden, | |
| | |Jones, Quirk, | |
| | |Rendon, Wagner, | |
| | |Weber, Wood | |
| | | | |
AB 403
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| | | | |
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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, which pertain to 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.
2)Revises and expands training for resource families by, among
other things, adding and updating training topics to include:
health issues in foster care and the administration of
psychotropic and other medications; accessing behavioral health
services available to foster children; cultural needs of
children; and permanence and well-being needs of children.
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.
3)Modifies and expands supports by: including among children and
youth eligible for county wraparound services those who would
otherwise, beginning January 1, 2017, be accepted for placement
into a short-term residential treatment center; revising the
current rate methodology for county wraparound services and
codifying the rate ($8,573/month), as well as indicating
conditions under which the rate will be increased; and
supporting children's connections with their families as a
component of supporting foster parents.
4)Establishes core services to be provided to children in the
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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.
5)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.
6)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. Authorizes
a county to operate an STRTC.
7)Revises the programs in which a child or non-minor dependent can
be placed in order to be eligible for Aid to Families with
Dependent Children-Foster Care (AFDC-FC) funds beginning January
1, 2017, except as specified until January 1, 2018, and includes
among the allowed placement types a licensed foster family
agency (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 assessed as
having an emotional disturbance, as specified.
8)Authorizes placement of a child or youth into a group home, as
applicable, 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
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so, and an 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.
9)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 the
Department of Social Services (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 indicated for
out-of-state group homes that are granted an extension.
10)Requires DSS to license STRTCs, beginning, January 1, 2017, and
requires DSS to establish standards for the education,
qualification, and training of facility managers and child care
staff in STRTCs consistent with the intended role of these
facilities to provide short-term, specialized, and intensive
treatment. Authorizes DSS to license a facility meeting all
applicable criteria as an STRTC prior to January 1, 2017.
11)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 the Department of Health Care Services
(DHCS). Authorizes DSS to inspect FFAs and STRTCs according to
the system developed.
12)Requires DSS to establish requirements for licensed group homes
that are transitioning to STRTCs and authorizes DSS to inspect
an STRTC according to the system of governmental monitoring and
oversight developed.
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13)Authorizes STRTCs and FFAs that provide intensive therapeutic
treatment to accept children who are placed privately, provided
the children have been determined to be having an emotional
disturbance by a mental health professional, as specified.
14)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.
15)Revises the priority of placement when out-of-home placement is
used to attain a child's case plan goals. 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
and resource 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.
16)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.
17)Requires a CFT meeting, as specified, to be convened for the
purpose of determining the appropriateness of a placement and
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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.
18)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.
19)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.
20)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.
21)Requires DSS to develop and establish a 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.
22)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 having an emotional
disturbance to include possible placement in STRTCs and FFAs
that provide treatment services, as specified.
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23)Requires the interagency placement committee to determine
whether a child requires out-of-home care provided by an STRTC
or FFA that provides treatment services, within 30 days of
placement, with recommendations from the CFT, and establishes
procedures through which the child can be referred to a more
appropriate placement pursuant to periodic review of level of
need by the CFT, in addition to other statutorily required
periodic placement reviews, as specified.
24)Requires all STRTCs and FFAs that provide intensive treatment
services to, as a condition of licensure and receipt of an
AFDC-FC rate, 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.
25)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 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 extension provided by
DSS to include time to meet either the program accreditation or
mental health certification requirement.
26)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.
27)Terminates the current FFA rate system as of December 1, 2016,
and prohibits a new FFA from being established pursuant to the
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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.
28)Prohibits DSS from establishing a rate for an STRTC or FFA that
provides treatment services without a recommendation from the
host or primary placing county that the program is needed and
that the provider is willing and capable of operating the
program at the level sought.
29)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.
30)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.
31)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.
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32)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.
33)Replaces numerous references to group homes in existing statute
with references to STRTCs, including provisions related to
administrative requirements for licensing, basic health and
safety requirements, age requirements for individuals providing
care and supervision, the placement of infants with their
parents in care, and civil penalties and enforcement actions.
34)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. Specifically permits, as of January 1, 2017, the continued
operation of facilities that were operating prior to January 1,
2015, that have a licensed capacity greater than 184, and that
offer placements for the purpose of attending an onsite high
school, provided these facilities submit a transition plan
detailing how they will comply with the provisions of this bill
within a timeframe approved by DSS, and provided they are
appropriately licensed by DSS.
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. (Welfare and
Institutions Code (WIC) Section 300.2)
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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 Section
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 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 Section 16501.1(c)(1))
4)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 Section 16010.8)
5)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
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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 Section 11461.2)
6)Requires DSS, in consultation 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, 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 Section
16519.5)
7)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 Section
16001.9)
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8)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 children with
unique needs. (Health and Safety Code (HSC) Section 1529.1)
9)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 eight hours of
foster parent training, as specified, annually. (HSC Section
1529.2(b))
10)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 Section 7911.1)
FISCAL EFFECT: According to the Assembly Appropriations
Committee, the Governor's 2015-16 Budget proposal includes $9.6
million ($7 million General Fund) to begin implementation of the
reforms contained in this bill.
COMMENTS: 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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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.
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 the child welfare services (CWS) system
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.
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 Reform (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
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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).
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.
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 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
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necessary and is identified in his or her 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
having an emotional disturbance.)
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
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other things, the specialized services to be provided and
accreditation requirements.
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
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's or youth's experience and provide a continuum of quality
parenting regardless of whether the child or youth will eventually
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be able to reunify with his or her biological parents.
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, including
county-operated shelters, probation agencies, homeless shelter
providers and residential education providers. (One exception is
for facilities operating prior to January 1, 2015, that have a
licensed capacity greater than 184 and that offer placements for
the purpose of attending an onsite high school; these facilities
will be permitted to continue to operate provided they submit a
transition plan detailing how they will comply with the provisions
of this bill, and provided they are appropriately licensed by
DSS.) 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 of this bill.
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This bill seeks to focus necessary services on the needs of the
child or youth while meeting those needs upfront rather than
counting on the placement type to drive the decisions about
services and causing a child or youth to "fail upwards" into
higher levels of care. Overall, this bill promotes the direct
relationship between the building up of a solid resource family
capacity and decreased congregate care usage to establish a more
supportive and cohesive approach to ensuring the state provides
appropriate services to its vulnerable children and youth.
Analysis Prepared by:
Myesha Jackson / HUM. S. / (916) 319-2089 FN:
0000891