BILL ANALYSIS Ó
AB 403
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CONCURRENCE IN SENATE AMENDMENTS
AB
403 (Mark Stone)
As Amended September 4, 2015
Majority vote
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|ASSEMBLY: |79-0 |(June 3, 2015) |SENATE: |40-0 |(September 10, |
| | | | | |2015) |
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Original Committee Reference: HUM. S.
SUMMARY: Implements Continuum of Care Reform (CCR)
recommendations to better serve children and youth in
California's child welfare services system. Specifically, this
bill:
1)Declares legislative intent to improve the state's child
welfare system by using comprehensive initial assessments of
children, increasing the use of home-based family care and the
provision of services and supports to families, reducing the
use of congregate care placement settings, and creating faster
paths to permanency to shorten the duration of a child's
involvement in the child welfare and juvenile justice systems.
2)Sunsets, effective January 1, 2017, existing laws pertaining
to group homes, including those permitting a group home to
accept children assessed as being seriously emotionally
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disturbed (SED) and the existing rate classification
structure. Provides for two-year conditional extensions to
individual group homes and an interim rate structure, as
specified.
3)Creates, as of January 1, 2017, a new licensure category of
short-term residential treatment centers (STRTCs) as
residential facilities that provide short-term, specialized
and intensive treatment, and 24-hour care and supervision, to
children in a structured environment, as specified. Requires
STRTCs to have national accreditation from an entity
identified by the Department of Social Services (DSS), as
specified, and authorizes a county to operate an STRTC.
4)Permits STRTCs to have a program that is certified by the
Department of Health Care Services (DHCS) or a county mental
health plan, or a program that is not certified, or both.
Provides that if the program does not have a certification, it
shall solely serve children who are assessed as SED and as
meeting Early and Periodic Screening, Diagnosis, and Treatment
(EPSDT) program medical necessity criteria if it arranges for
a Medi-Cal eligible child to receive EPSDT specialty mental
health services, or other mental health services in all other
cases.
5)Requires STRTCs that have a mental health certification to
solely accept for placement children who do not require
inpatient care in a licensed health facility, have been
assessed as requiring the level of services provided in the
facility to maintain the safety of the child or others, as
specified, and who have been assessed as meeting the medical
necessity criteria for specialty mental health services under
the EPSDT program or have been assessed as being seriously
emotionally disturbed, as defined.
6)Provides that STRTCs that do not have a mental health
certification shall solely accept for placement children who
do not require inpatient care in a licensed health facility,
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have been assessed as requiring the level of services provided
in the facility to maintain the safety of the child or others,
as specified, and who meet at least one of the following
conditions:
a) Have been assessed as meeting the medical necessity
criteria for specialty mental health services under the
EPSDT program;
b) Have been assessed as being seriously emotionally
disturbed, as defined; or
c) Have been assessed as requiring the level of services to
meet his or her specialized behavioral or therapeutic
needs, as described.
1)Authorizes DSS to license a temporary shelter care facility
operated by a county or agency on behalf of a county, and
requires DSS to consult with counties operating shelters to
develop a transition plan for the development of temporary
shelter care facilities to address the unique circumstances
and needs of the populations they serve, as specified.
2)Effective January 1, 2017, sunsets the existing rate-setting
system for Foster Family Agencies (FFAs) and establishes an
interim rate system for FFAs that have been granted an
extension to operate, as specified.
3)Requires DSS to develop a new payment system for FFAs that
provide treatment, intensive treatment and therapeutic foster
care programs that considers federally eligible administrative
activities, social work activities, social work and mental
health services, as well as intensive treatment or therapeutic
services, core services, staff training, licensing
requirements, transition support services, a process for
accreditation, mental health certification and populations
served, as specified.
4)Requires FFAs to have national accreditation from an entity
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identified by DSS, as specified. Provides DSS the authority
to extend provisional licenses for FFAs for up to two years,
if it determines this additional time is required to secure
accreditation.
5)Permits probation agencies to place a probation youth into a
certified family home of an FFA.
6)Requires DSS, commencing January 1, 2018, and in consultation
with the Chief Probation Officers of California, to assess the
capacity and quality of placement options for probation youth
in foster care, as specified. Further, requires DSS to
provide an interim report to the Legislature no later than
January 10, 2019, and a final report no later than January 10,
2021, to include specified data and indicate whether there is
a continued need for probation placement in group homes.
7)Permits FFAs to have a program that is certified by DHCS or a
county mental health plan, or a program that is not certified,
or both, and specifies the children to whom mental health
services can be provided.
8)Requires county probation departments to work with group home
providers to develop STRTCs that meet the needs of
probation-supervised youth in foster care and to work with
FFAs to develop strategies to recruit, retain, and support
specialized foster homes for probation youth. Additionally
requires county probation departments to work with DSS on
strategies to identify, engage, and support relative
caregivers and to define probation youth outcome measures to
be collected and analyzed to assess implementation of this
act.
9)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
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program at the level sought.
10)Requires DSS to provide available funding to counties for the
purpose of recruiting, retaining, and supporting foster
parents, relative caregivers, and resource families based on
DSS approval of plans submitted by each county. Includes the
following among the purposes for which that funding can be
used: staffing, exceptional child needs, child care for
caregivers, intensive relative finding, and other emerging
outreach approaches to identify potential foster family homes,
resource families, and relatives, as specified.
11)Sunsets existing foster parent training provisions, effective
January 1, 2017, and replaces current statutory requirements
with an annual training requirement of eight hours and other
revised requirements and structure.
12)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 education and
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.
13)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.
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14)Requires DSS to work with stakeholders, including other state
departments, such as the Department of Health Care Services,
legislative staff, counties, and advocates, to address
critical issues in the initial and ongoing implementation of
this act, as specified.
15)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.
16)Defines the child and family team as a group of individuals
who are convened by the placing agency and who are engaged
through a variety of team-based processes to identify the
strengths and needs of the child or youth and his or her
family, and to help achieve positive outcomes for safety,
permanency, and well-being. Requires the activities of the
team to include, but not be limited to, providing input into
the development of a child and family plan that is
strengths-based, needs-driven, and culturally relevant, and
providing input into the placement decisions made by the
placing agency and the services to be provided in order to
support the child or youth.
17)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 DHCS. Authorizes DSS
to inspect FFAs and STRTCs according to the system developed.
18)Sunsets the operation and use of group homes as a placement
option for children as of January 1, 2017, with the exception
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of group homes that have been granted an extension, as
specified, for which operation cannot continue beyond January
1, 2019.
19)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, 2019,
and includes among the allowed placement types a licensed FFA
for placement into a certified or approved home, as specified,
an STRTC licensed as a community care facility, as defined, an
out-of-state group home meeting strict requirements, as
specified, and a community treatment facility for children who
are assessed as having an emotional disturbance, as specified.
20)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 and
the projected timeline for doing so. Requires placements
lasting longer than six-month to be documented, consistent
with child and family team consideration requirements, and to
be approved by the deputy director or director of the county
child welfare department.
21)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.
22)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.
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23)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.
24)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.
The Senate amendments:
1)Add to the plan of operation requirements for STRTCs and FFAs,
as specified.
2)Revise the definitions of STRTCs, FFAs and core services, and
revise the definition and function of the child and family
team. Add to the child and family team definition regional
center representatives when the child is eligible for regional
center services.
3)Exempt temporary shelter care facilities, as defined, from the
current statutory requirement that applications for licensure
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be denied when necessary to avoid overconcentration of
residential facilities within a neighborhood, as specified.
4)Clarify forfeiture of license requirements for group homes
that become temporary shelter care facilities,
county-contracted temporary shelter care facilities upon
termination of a county contract, and foster family homes that
become approved resource families, as specified.
5)Revise training requirements for STRTC administrators and
staff, licensed and certified foster parents, licensing
program staff, caregivers and resource families, including
more in-depth training for foster parents and resource
families in special circumstances, such as caring for
commercially sexually exploited children, probation youth,
Indian children, and Lesbian, Gay, Bisexual, Transgender,
Questioning youth.
6)Include STRTCs among the facilities available for temporary,
emergency placements of children between six and 12 years of
age, as specified.
7)Delete the nontreatment designation for FFAs, thereby only
allowing DSS to establish a payment structure for FFAs that
provide treatment, intensive treatment, and therapeutic foster
care programs.
8)Require DSS, in consultation with the California State Foster
Parent Association and other interested stakeholders, to
provide information to the Legislature by January 1, 2017
regarding the availability of and cost for liability and
property insurance covering acts committed by children in
care.
9)Add requirements for county probation departments related to
ensuring appropriate placement options exist for probation
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youth, including improved efforts to identify, engage, and
support caregivers, as specified.
10)Increase from one year to two the amount of time for which
DSS may authorize an interim rate and authority to operate for
a group home or FFA that is seeking mental health
certification or accreditation in order to be able to continue
to operate, as specified.
11)Extend the sunset date for the residentially-based services
program to January 1, 2017, and allows continued operation,
upon DSS approval on a case-by-case basis, until January 1,
2019, consistent with group homes and FFAs.
12)Require, on and after January 1, 2017, that all licensed FFAs
approve resource families in lieu of certifying foster homes
and set forth new provisions related to the transition of a
foster home to an approved resource family, as specified.
13)Set forth a criminal records clearance process for public and
private FFAs approving resource families. Revise tribal
authority to approve tribal homes and clarify provisions
pertaining to criminal history checks for the approval of
tribal homes.
14)Require DSS to provide periodic progress updates to the
Legislature on the implementation of this bill.
15)Make other technical, clarifying changes consistent with the
intent of this bill and non-substantive changes to avoid
chaptering conflicts.
EXISTING LAW:
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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)
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)
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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 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 environment assessment
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.
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(WIC Section 16001.9)
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
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 Senate Appropriations
Committee, this bill may have the following fiscal impact:
1)Local child welfare and probation agencies: Major initial
investments in the tens of millions of dollars (General Fund*)
annually over a number of years to local agencies for
increased costs for activities including but not limited to
comprehensive initial child assessments, recruitment,
retention, and support services (including staffing, training,
specialized care, and child care) for home-based family care
providers, increased services costs for higher rates for
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wraparound services, foster family agencies (FFAs), and
short-term residential treatment centers (STRTCs), performance
and outcome measurement and data collection, and accelerated
statewide implementation of the Resource Family Approval (RFA)
process.
2)2015 Budget Act: Includes initial funding to support
recommendations in the CCR report consisting of $20.3 million
($17.2 million General Fund) to increase foster parent and
relative caregiver recruitment, retention, and training
efforts, and $7.3 million ($4.3 million General Fund) to fund
a 15% increase in FFA social worker rates.
3)DSS licensing, oversight, and administration: Significant
one-time and ongoing costs (General Fund) for the development
of revised rate structures, multiple sets of regulations for
new and revised licensing categories and RFA due process
procedures, stakeholder workgroup activities, development and
implementation of a system of governmental monitoring and
oversight, the development of revised training curricula, and
automation system changes. The magnitude and duration of
these costs will be dependent on the complexity and structure
of the processes developed, which are undetermined at this
time.
4)DHCS administration: Significant one-time costs (General
Fund) to promulgate regulations regarding program standards,
oversight, enforcement, and due process for the mental health
certification of STRTCs and FFAs that provide intensive or
therapeutic treatment services, and to collaborate with DSS on
a monitoring and oversight program.
5)EPSDT/specialty mental health services: Major costs
potentially in the millions to tens of millions of dollars
(Federal Funds/Local Revenue Fund 2011(Behavioral Health
Subaccount)) annually for increased services and
administration for both new and existing cases to the extent
the bill's reforms result in more appropriate placements and
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assessments of need for children entitled to these services.
Pursuant to 2011 Realignment, responsibility for specialty
mental health and EPSDT services rests with the counties.
6)Long-term impact: Unknown, potentially significant future
cost savings to the child welfare and juvenile justice systems
to the extent the reforms result in better-informed and
appropriate initial placements provided with targeted
services, coupled with greater use of family-based care and
declining use and duration of congregate care placements and
costs, resulting in shorter and/or fewer stays in the child
welfare and juvenile justice systems. This overall savings is
predicated on numerous interdependent factors including but
not limited to the availability of adequate capacity and
quality of placement options for youth, the successful
provision of services to meet the individual needs of each
child, an effective system of monitoring and local interagency
coordination to ensure identified services are being provided
and transitions to home-based family care are made timely, the
rates developed for STRTCs/FFAs and the number of group home
placements from each rate classification level transitioned to
the restructured rates, successful efforts to maximize federal
financial participation, the ability of families to meet the
specialized needs of this population, and performance measures
and standards developed including data collection to enable
analysis and accountability.
7)Proposition 30*: Provides that to the extent this legislation
has an overall effect of increasing the costs already borne by
a local agency for programs or levels of service mandated by
2011 Realignment, it shall apply to local agencies only to the
extent that the state provides annual funding for the cost
increase. Recognizing the wide variation between counties in
geographic size, population of impacted children, and the
level and costs of services and supports currently being
provided, as well as the varying impacts and timing of this
measure on local agencies within each county (including child
welfare, county probation, county mental health), the point at
which each local agency's overall costs may decrease will
likewise vary. At this time, the methodology including
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baseline assumptions for calculating this "overall effect"
pursuant to Proposition 30 is unclear.
8)Annual Transitional Housing Program-Plus Foster Care COLA: To
the extent the specified provision in this bill is determined
to codify existing law with regard to the rate structure
established by the workgroup pursuant to WIC Sections 11402(b)
and 11403.3(a)(1)(B), no new state costs.
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. 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
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less restrictive, more supportive placements and services. SB
1013 (Budget and Fiscal Review Committee), 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 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).
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.
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
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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: 0002284