BILL NUMBER: AB 741 AMENDED
BILL TEXT
AMENDED IN SENATE JUNE 16, 2016
AMENDED IN SENATE MAY 25, 2016
AMENDED IN ASSEMBLY MAY 4, 2015
AMENDED IN ASSEMBLY APRIL 15, 2015
INTRODUCED BY Assembly Member Williams
FEBRUARY 25, 2015
An act to amend Section 1502 of, and to add Sections
1502.1 and 1502.2 1562.02 and 1562.03 to, the
Health and Safety Code, and to amend Section 11462.01 of the
Welfare and Institutions Code, relating to mental health.
LEGISLATIVE COUNSEL'S DIGEST
AB 741, as amended, Williams. Mental health: community care
facilities.
Existing law, the California Community Care Facilities Act,
provides for the licensing and regulation of community care
facilities, as defined, by the State Department of Social Services.
Existing law includes within the definition of community care
facility a social rehabilitation facility, which is a
residential facility that provides social rehabilitation services in
a group setting to adults recovering from mental illness. Existing
law also defines for this purpose a short-term residential
treatment center. center, which is a
residential facility licensed by the department and operated by any
public agency or private organization that provides
short-term, specialized, and intensive treatment, and 24-hour care
and supervision to children. A violation of the act is a
misdemeanor.
This bill would expand the definition of a social
rehabilitation facility to include a residential facility that
provides social rehabilitation services in a group setting to
children, adolescents, or adults recovering from mental illness or in
a mental health crisis. The bill would also expand the definition of
a authorize a short-term residential treatment
center to include be operated as a
children's crisis residential center, as defined, and would require
the department to regulate those program,
programs, as specified. The bill would require the State
Department of Health Care Services, in consultation with the County
Behavioral Health Directors Association of California,
representatives of provider associations, children's advocates, and
other stakeholders, to establish Medi-Cal rates for children's crisis
residential services, as prescribed. By expanding the types of
facilities that are regulated as a community care facility, this bill
would expand the scope of an existing crime, thus creating a
state-mandated local program.
Existing law establishes the Aid to Families with Dependent
Children-Foster Care (AFDC-FC) program, under which counties provide
payments to foster care providers on behalf of qualified children in
foster care. In order to be eligible for AFDC-FC, existing law
requires a child or nonminor dependent to be placed in a specified
placement, including, commencing January 1, 2017, a short-term
residential treatment center.
Existing law, effective January 1, 2017, authorizes a short-term
residential treatment center to have a program that is certified by
the State Department of Health Care Services or by a county mental
health plan to which the department has delegated certification
authority, or a program that is not certified, or both, and requires
a short-term residential treatment center to accept for placement
children who meet certain criteria, subject to specified
requirements.
This bill would authorize a short-term residential treatment
center that is operating as a children's crisis residential center
to, subject to specified requirements, accept for admission or
placement any child, referred by a parent or guardian, or by the
representative of a public or private entity that has the right to
make these decisions on behalf of a child who is in mental health
crisis and, absent admission to a children's crisis residential
center, would otherwise require acceptance by the emergency
department of a general hospital, or admission into a psychiatric
hospital or the psychiatric inpatient unit of a general hospital.
The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
This bill would provide that no reimbursement is required by this
act for a specified reason.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: yes.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. The Legislature finds and declares all of the
following:
(a) There is an urgent need to provide more crisis care
alternatives to hospitals for children and youth experiencing mental
health crises.
(b) The problems are especially acute for children and youth who
may have to wait for days for a hospital bed and who may be
transported, without a parent, to the nearest facility hundreds of
miles away.
(c) In 2012, the California Hospital Association reported that
two-thirds of the people taken to a hospital for a psychiatric
emergency did not meet the criteria for that level of care, but the
care they needed was not available.
(d) The type of care that is needed includes crisis residential
treatment for children.
(e) This level of care is part of the full continuum of care
considered medically necessary for many children with serious
emotional disturbances.
(f) In 2013, the Legislature enacted the Investment in Mental
Health Wellness Act (Senate Bill 82, Chapter 34 of the Statutes of
2013) to provide one-time funding to counties to expand the
availability of mental health crisis care services, including
short-term crisis residential treatment services. However, there is
currently no state licensing category for short-term crisis
residential programs for children. As a result, counties wanting to
expand local capacity to meet the needs of children and youth for
crisis residential treatment services were ineligible for this
competitive grant program.
(g) Federal Medicaid provisions allow for federal matching funds
for mental health services delivered to Medi-Cal beneficiaries under
21 years of age in psychiatric residential treatment facilities,
including short-term crisis residential treatment programs. However,
because there is currently no state licensing category for crisis
residential treatment programs for children, California is unable to
benefit from these otherwise available federal financial resources.
(h)
(g) In most communities, inpatient crisis treatment is
completely unavailable for children and youth, even though it may be
medically necessary.
(i)
(h) Crisis residential care is an essential level of
care for the treatment of children and youth with serious emotional
disturbances in a mental health crisis, and it often serves as an
alternative to hospitalization.
(j) It is imperative that public health care coverage include
these services as a covered benefit.
(i) It is imperative that California identify a licensing category
specifically for mental health crisis residential care that can be
utilized for children and youth who are beneficiaries of both public
and private health care plans.
SEC. 2. Section 1502 of the Health and Safety Code is amended to
read:
1502. (a) As used in this chapter:
(a)
(1) "Community care facility" means any facility,
place, or building that is maintained and operated to provide
nonmedical residential care, day treatment, adult day care, or foster
family agency services for children, adults, or children and adults,
including, but not limited to, the physically handicapped, mentally
impaired, incompetent persons, and abused or neglected children, and
includes the following:
(1)
(A) "Residential facility" means any family home, group
care facility, or similar facility determined by the director, for
24-hour nonmedical care of persons in need of personal services,
supervision, or assistance essential for sustaining the activities of
daily living or for the protection of the individual.
(2)
(B) "Adult day program" means any community-based
facility or program that provides care to persons 18 years of age or
older in need of personal services, supervision, or assistance
essential for sustaining the activities of daily living or for the
protection of these individuals on less than a 24-hour basis.
(3)
(C) "Therapeutic day services facility" means any
facility that provides nonmedical care, counseling, educational or
vocational support, or social rehabilitation services on less than a
24-hour basis to persons under 18 years of age who would otherwise be
placed in foster care or who are returning to families from foster
care. Program standards for these facilities shall be developed by
the department, pursuant to Section 1530, in consultation with
therapeutic day services and foster care providers.
(4)
(D) "Foster family agency" means any public agency or
private organization engaged in the recruiting, certifying, and
training of, and providing professional support to, foster parents,
or in finding homes or other places for placement of children for
temporary or permanent care who require that level of care. Private
foster family agencies shall be organized and operated on a nonprofit
basis.
(5)
(E) "Foster family home" means any residential facility
providing 24-hour care for six or fewer foster children that is
owned, leased, or rented and is the residence of the foster parent or
parents, including their family, in whose care the foster children
have been placed. The placement may be by a public or private child
placement agency or by a court order, or by voluntary placement by a
parent, parents, or guardian. It also means a foster family home
described in Section 1505.2.
(6)
(F) "Small family home" means any residential facility,
in the licensee's family residence, that provides 24-hour care for
six or fewer foster children who have mental disorders or
developmental or physical disabilities and who require special care
and supervision as a result of their disabilities. A small family
home may accept children with special health care needs, pursuant to
subdivision (a) of Section 17710 of the Welfare and Institutions
Code. In addition to placing children with special health care needs,
the department may approve placement of children without special
health care needs, up to the licensed capacity.
(7)
(G) "Social rehabilitation facility" means any
residential facility that provides social rehabilitation services for
no longer than 18 months in a group setting to individuals,
including children, adolescents, and adults, adults
recovering from mental illness or in a mental health
crisis who temporarily need assistance, guidance, or
counseling. Program components shall be subject to program standards
pursuant to Article 1 (commencing with Section 5670) of Chapter 2.5
of Part 2 of Division 5 of the Welfare and Institutions Code.
(8)
(H) "Community treatment facility" means any
residential facility that provides mental health treatment services
to children in a group setting and that has the capacity to provide
secure containment. Program components shall be subject to program
standards developed and enforced by the State Department of Health
Care Services pursuant to Section 4094 of the Welfare and
Institutions Code.
(9) (A)
(I) (i) "Full-service adoption
agency" means any licensed entity engaged in the business of
providing adoption services, that does all of the following:
(i)
(I) Assumes care, custody, and control of a child
through relinquishment of the child to the agency or involuntary
termination of parental rights to the child.
(ii)
(II) Assesses the birth parents, prospective adoptive
parents, or child.
(iii)
(III) Places children for adoption.
(iv)
(IV) Supervises adoptive placements.
(B)
(ii) Private full-service adoption agencies shall be
organized and operated on a nonprofit basis. As a condition of
licensure to provide intercountry adoption services, a full-service
adoption agency shall be accredited and in good standing according to
Part 96 of Title 22 of the Code of Federal Regulations, or
supervised by an accredited primary provider, or acting as an
exempted provider, in compliance with Subpart F (commencing with
Section 96.29) of Part 96 of Title 22 of the Code of Federal
Regulations.
(10) (A)
(J) (i) "Noncustodial adoption
agency" means any licensed entity engaged in the business of
providing adoption services, that does all of the following:
(i)
(I) Assesses the prospective adoptive parents.
(ii)
(II) Cooperatively matches children freed for adoption,
who are under the care, custody, and control of a licensed adoption
agency, for adoption, with assessed and approved adoptive applicants.
(iii)
(III) Cooperatively supervises adoptive
placements with a full-service adoptive agency, but does not disrupt
a placement or remove a child from a placement.
(B)
(ii) Private noncustodial adoption agencies shall be
organized and operated on a nonprofit basis. As a condition of
licensure to provide intercountry adoption services, a noncustodial
adoption agency shall be accredited and in good standing according to
Part 96 of Title 22 of the Code of Federal Regulations, or
supervised by an accredited primary provider, or acting as an
exempted provider, in compliance with Subpart F (commencing with
Section 96.29) of Part 96 of Title 22 of the Code of Federal
Regulations.
(11)
(K) "Transitional shelter care facility" means any
group care facility that provides for 24-hour nonmedical care of
persons in need of personal services, supervision, or assistance
essential for sustaining the activities of daily living or for the
protection of the individual. Program components shall be subject to
program standards developed by the State Department of Social
Services pursuant to Section 1502.3.
(12)
(L) "Transitional housing placement provider" means an
organization licensed by the department pursuant to Section 1559.110
and Section 16522.1 of the Welfare and Institutions Code to provide
transitional housing to foster children at least 16 years of age and
not more than 18 years of age, and nonminor dependents, as defined in
subdivision (v) of Section 11400 of the Welfare and Institutions
Code, to promote their transition to adulthood. A transitional
housing placement provider shall be privately operated and organized
on a nonprofit basis.
(13)
(M) "Group home" means a residential facility that
provides 24-hour care and supervision to children, delivered at least
in part by staff employed by the licensee in a structured
environment. The care and supervision provided by a group home shall
be nonmedical, except as otherwise permitted by law.
(14)
(N) "Runaway and homeless youth shelter" means a group
home licensed by the department to operate a program pursuant to
Section 1502.35 to provide voluntary, short-term,
short-term shelter and personal services to runaway youth
or homeless youth, as defined in paragraph (2) of subdivision (a) of
Section 1502.35.
(15)
(O) "Enhanced behavioral supports home" means a
facility certified by the State Department of Developmental Services
pursuant to Article 3.6 (commencing with Section 4684.80) of Chapter
6 of Division 4.5 of the Welfare and Institutions Code, and licensed
by the State Department of Social Services as an adult residential
facility or a group home that provides 24-hour nonmedical care to
individuals with developmental disabilities who require enhanced
behavioral supports, staffing, and supervision in a homelike setting.
An enhanced behavioral supports home shall have a maximum capacity
of four consumers, shall conform to Section 441.530(a)(1) of Title 42
of the Code of Federal Regulations, and shall be eligible for
federal Medicaid home- and community-based services funding.
(16)
(P) "Community crisis home" means a facility certified
by the State Department of Developmental Services pursuant to Article
8 (commencing with Section 4698) of Chapter 6 of Division 4.5 of the
Welfare and Institutions Code, and licensed by the State Department
of Social Services pursuant to Article 9.7 (commencing with Section
1567.80), as an adult residential facility, providing 24-hour
nonmedical care to individuals with developmental disabilities
receiving regional center service, in need of crisis intervention
services, and who would otherwise be at risk of admission to the
acute crisis center at Fairview Developmental Center, Sonoma
Developmental Center, an acute general hospital, acute psychiatric
hospital, an institution for mental disease, as described in Part 5
(commencing with Section 5900) of Division 5 of the Welfare and
Institutions Code, or an out-of-state placement. A community crisis
home shall have a maximum capacity of eight consumers, as defined in
subdivision (a) of Section 1567.80, shall conform to Section 441.530
(a)(1) of Title 42 of the Code of Federal Regulations, and shall be
eligible for federal Medicaid home- and community-based services
funding.
(17)
(Q) "Crisis nursery" means a facility licensed by the
department to operate a program pursuant to Section 1516 to provide
short-term care and supervision for children under six years of age
who are voluntarily placed for temporary care by a parent or legal
guardian due to a family crisis or stressful situation.
(18)
(R) "Short-term residential treatment center" means a
residential facility licensed by the department pursuant to Section
1562.01 and operated by any public agency or private organization
that provides short-term, specialized, and intensive treatment, and
24-hour care and supervision to children. The care and supervision
provided by a short-term residential treatment center shall be
nonmedical, except as otherwise permitted by law.
"Short-term A short-term residential treatment
center" includes center may be operated as
a children's crisis residential center.
(S) "Children's crisis residential center" means a short-term
residential treatment center operated specifically to divert children
experiencing a mental health crisis from psychiatric
hospitalization.
(b)
(2) "Department" or "state department" means the State
Department of Social Services.
(c)
(3) "Director" means the Director of Social Services.
(d) Organizations providing children's residential
treatmentservices shall be certified to provide specialty mental
health services under Medi-Cal and the Early and Periodic Screening,
Diagnostic, and Treatment (EPSDT) Program.
(e)
(b) Nothing in this section shall be construed to
prohibit or discourage placement of persons who have mental or
physical disabilities into any category of community care facility
that meets the needs of the individual placed, if the placement is
consistent with the licensing regulations of the department.
SEC. 3. Section 1502.1 is added to the Health
and Safety Code, to read:
1502.1. The department shall establish regulations for short-term
residential treatment centers that are designated as children's
crisis residential centers. At a minimum, the regulations shall
include all of the following:
(a) The children's crisis residential center shall be used only
for diversion from admittance to a psychiatric hospitalization.
(b) Length of stay will be limited to 10 consecutive days.
(c) Therapeutic programming shall be provided seven days a week,
including weekends and holidays, with sufficient professional and
paraprofessional staff to maintain an appropriate treatment setting
and services, based on individual children's needs.
(d) The program shall be staffed with sufficient personnel to
accept and admit children, at a minimum, from 7 a.m. to 11 p.m.,
seven days a week, 365 days per year. The program shall be
sufficiently staffed to discharge children, as appropriate, seven
days a week, 365 days per year.
(e) Facilities shall be limited to fewer than 16 beds, with at
least 50 percent of those beds in single-occupancy rooms.
(f) Facilities shall include ample physical space for working with
individuals who provide natural supports to each child and for
integrating family members into the day-to-day care of the youth.
(g) The center shall collaborate with each child's mental health
team, child and family team, and other paid and natural supports
within 24 hours of intake and throughout the course of care and
treatment as appropriate.
SEC. 4. Section 1502.2 is added to the Health
and Safety Code, to read:
1502.2. (a) The State Department of Health Care Services, in
consultation with the County Behavioral Health Directors Association
of California, representatives of provider associations, children's
advocates, and other stakeholders shall establish Medi-Cal rates as
needed that are sufficient to reimburse the costs for children's
crisis residential services in excess of any specialty mental health
services that would have been otherwise authorized, provided, and
invoiced for each eligible Medi-Cal beneficiary receiving children's
crisis residential services.
(b) For foster children admitted for children's crisis residential
services, programs shall receive payment for board and care
equivalent to the rate paid for short-term residential treatment
centers.
(c) Nothing in this chapter shall prevent a county from providing
payment in excess of the short-term residential treatment center rate
in order to meet the needs of individual children.
SEC. 3. Section 1562.02 is added to the
Health and Safety Code , to read:
1562.02. (a) The department shall establish regulations for
short-term residential treatment centers that are operated as
children's crisis residential centers. At a minimum, the regulations
shall include all of the following:
(1) The children's crisis residential center shall be used only
for diversion from admittance to a psychiatric hospitalization.
(2) Length of stay for a single admission to a children's crisis
center shall be limited to 10 consecutive days. An organization
providing children's crisis residential services shall not admit a
child for more than two consecutive 10-day lengths of stay during any
12-month period. Before extending the length of stay for a Medi-Cal
beneficiary beyond 10 consecutive days, an organization providing
children's crisis residential services shall obtain prior approval
from the county mental health plan authorizing those services.
(3) Therapeutic programming shall be provided seven days a week,
including weekends and holidays, with sufficient professional and
paraprofessional staff to maintain an appropriate treatment setting
and services, based on individual children's needs.
(4) The program shall be staffed with sufficient personnel to
accept children 24 hours per day, seven days a week and to admit
children, at a minimum, from 7 a.m. to 11 p.m., seven days a week,
365 days per year. The program shall be sufficiently staffed to
discharge children, as appropriate, seven days a week, 365 days per
year.
(5) Facilities shall be limited to fewer than 16 beds, with at
least 50 percent of those beds in single-occupancy rooms.
(6) Facilities shall include ample physical space for
accommodating individuals who provide natural supports to each child
and for integrating family members into the day-to-day care of the
youth.
(7) The center shall collaborate with each child's mental health
team, child and family team, and other formal and natural supports
within 24 hours of intake and throughout the course of care and
treatment as appropriate.
(b) The department may adopt regulations, as needed, to waive the
requirements in Section 1562.01 that are in conflict with the
purposes or best practices of operating a children's crisis
residential center.
SEC. 4. Section 1562.03 is added to the
Health and Safety Code , to read:
1562.03. (a) The State Department of Health Care Services, in
consultation with the County Behavioral Health Directors Association
of California, representatives of provider associations, children's
advocates, and other stakeholders shall establish Medi-Cal rates as
needed that are sufficient to reimburse the costs for children's
crisis residential services in excess of any specialty mental health
services that would have been otherwise authorized, provided, and
invoiced for each eligible Medi-Cal beneficiary receiving children's
crisis residential services.
(b) For foster children admitted for children's crisis residential
services, programs shall receive payment for board and care
equivalent to the rate paid for short-term residential treatment
centers.
(c) Nothing in this chapter shall prevent a county from providing
payment in excess of the short-term residential treatment center rate
in order to meet the needs of individual children.
SEC. 5. Section 11462.01 of the Welfare
and Institutions Code , as added by Section 75
of Chapter 773 of the Statutes of 2015, is amended to read:
11462.01. (a) A short-term residential treatment center, as
defined in subdivision (ad) of Section 11400 and subparagraph
(R) of paragraph (18) (1) of
subdivision (a) of Section 1502 of the Health and Safety Code, may
have a program that is certified by the State Department of Health
Care Services or by a county mental health plan to which the
department has delegated certification authority, pursuant to Section
4096.5, or a program that is not certified, or both. A short-term
residential treatment center , except as specified in
subdivision (d), shall accept for placement children who meet
all of the following criteria, subject to the other requirements of
subdivisions (b) and (c):
(1) The child does not require inpatient care in a licensed health
facility.
(2) The child has been assessed as requiring the level of services
provided in a short-term residential treatment center in order to
maintain the safety and well-being of the child or others due to
behaviors, including those resulting from traumas, that render the
child or those around the child unsafe or at risk of harm, or that
prevent the effective delivery of needed services and supports
provided in the child's own home or in other family settings, such as
with a relative, guardian, foster family, resource family, or
adoptive family.
(3) The child meets at least one of the following conditions:
(A) The child has been assessed as meeting the medical necessity
criteria for Medi-Cal specialty mental health Early and Periodic
Screening, Diagnosis, and Treatment Services, as the criteria are
described in Section 1830.210 of Title 9 of the California Code of
Regulations.
(B) The child has been assessed as seriously emotionally
disturbed, as described in subdivision (a) of Section 5600.3.
(C) The child has been assessed as requiring the level of services
provided in order to meet his or her behavioral or therapeutic
needs. In appropriate circumstances, this may include any of the
following:
(i) A commercially sexually exploited child.
(ii) A private voluntary placement, if the youth exhibits status
offender behavior, the parents or other relatives feel they cannot
control the child's behavior, and short-term intervention is needed
to transition the child back into the home.
(iii) A juvenile sex offender.
(iv) A child who is affiliated with, or impacted by, a gang.
(b) A short-term residential treatment center program that is
certified by the State Department of Health Care Services, or by a
county mental health plan to which the department has delegated
certification authority, pursuant to Section 4096.5, shall solely
accept for placement, and provide access to mental health services
to, children who meet the criteria in paragraphs (1) and (2) of
subdivision (a), and meet the conditions of subparagraph (A) or (B)
of paragraph (3) of subdivision (a), or both of those subparagraphs.
Mental health services are provided directly by the certified
program.
(c) A short-term residential treatment center program that is not
certified pursuant to Section 4096.5 shall solely accept for
placement in that program a child who meets the criteria in
paragraphs (1) and (2) of subdivision (a), and meets the conditions
of subparagraph (A), (B), or (C) of paragraph (3) of subdivision (a),
or any combination of those subparagraphs. A child who meets the
conditions of subparagraphs (A) and (B) of paragraph (3) of
subdivision (a) may be accepted for placement, if the interagency
placement committee determines that a short-term residential
treatment facility that is not certified has a program that meets the
specific needs of the child and there is a commonality of needs with
the other children in the short-term residential treatment center.
In this situation, the short-term residential treatment center shall
do either of the following:
(1) In the case of a child who is a Medi-Cal beneficiary, arrange
for the child to receive specialty mental health services from the
county mental health plan.
(2) In all other cases, arrange for the child to receive mental
health services.
(d) A short-term residential treatment center that is operating as
a children's crisis residential center, as defined in Section 1502
of the Health and Safety Code, and subject to the other requirements
of subdivisions (b) and (c), may accept for admission or placement
any child, referred by a parent or guardian, or by the representative
of a public or private entity, including, but not limited to, the
county probation agency or child welfare services agency with
responsibility for the placement of a child in foster care, that has
the right to make these decisions on behalf of a child who is in
mental health crisis and, absent admission to a
children's crisis residential center, would
otherwise require acceptance by the emergency department of a general
hospital, or admission into a psychiatric hospital or the
psychiatric inpatient unit of a general hospital.
(d)
(e) A foster family agency, as defined in subdivision
(g) of Section 11400 and subparagraph (D) of paragraph
(4) (1) of subdivision (a) of Section
1502 of the Health and Safety Code, may have a program that is
certified by the State Department of Health Care Services, or by a
county mental health plan to which the department has delegated
certification authority, pursuant to Section 1810.435 or 1810.436 of
Title 9 of the California Code of Regulations, or a program that is
not certified, or both. A program, subject to subdivisions
(e) and (f), (f) and (g), shall provide access
to mental health services to the children. A foster family agency,
depending on whether or not it has a certified program, shall provide
access to mental health services to children who do not require
inpatient care in a licensed health facility and who meet any one or
more of the following conditions:
(1) A child who has been assessed as meeting the medical necessity
criteria for specialty mental health services under the Medi-Cal
Early and Periodic Screening, Diagnosis, and Treatment benefit, as
the criteria are described in Section 1830.210 of Title 9 of the
California Code of Regulations.
(2) A child who has been assessed as seriously emotionally
disturbed, as described in subdivision (a) of Section 5600.3.
(3) A child who has been assessed as requiring the level of
services to meet his or her behavioral or therapeutic needs.
(e)
(f) A foster family agency that is certified as a
provider pursuant to Section 1810.435 or 1810.436 of Title 9 of the
California Code of Regulations by the State Department of Health Care
Services, or by a county mental health plan to which the department
has delegated certification authority, shall provide access to mental
health services directly to children in its program who do not
require inpatient care in a licensed health facility and who meet the
conditions of paragraph (1) or (2) of subdivision (d).
(e).
(f)
(g) A foster family agency that is not certified as
described in subdivision (e) (f) may
provide access to mental health services in that program for children
who do not require inpatient care in a licensed health facility and
who meet the conditions of paragraphs (1) and (2) of subdivision
(d). (e). In this situation the foster
family agency shall do the following:
(1) In the case of a child who is a Medi-Cal beneficiary, have
written interagency protocols in place to arrange for specialty
mental health services from the county mental health plan or an
organizational provider, as defined in Section 1810.231 of Title 9 of
California Code of Regulations.
(2) In all other cases, arrange for the child to receive mental
health services.
(g)
(h) All short-term residential treatment centers and
foster family agencies that operate a certified program shall
maintain the level of care and services necessary to meet the needs
of the children and youth in their care and shall maintain and have
in good standing the appropriate mental health certification issued
by the State Department of Health Care Services or a county mental
health plan to which the department has delegated certification
authority, pursuant to Section 4096.5 of this code or Section
1810.435 or 1810.436 of Title 9 of the California Code of
Regulations.
(h)
(i) The assessments described in subparagraphs (A) and
(B) of paragraph (3) of subdivision (a) and paragraphs (1) and (2) of
subdivision (d), (e), shall be made by
all of the following, as applicable:
(1) An interagency placement committee, as described in Section
4096, considering the recommendations from the child and family team,
if any are available.
(2) A licensed mental health professional as defined in
subdivision (g) of Section 4096.
(3) For the purposes of this section, an AFDC-FC funded child with
an individualized education program developed pursuant to Article 2
(commencing with Section 56320) of Chapter 4 of Part 30 of Division 4
of Title 2 of the Education Code that assesses the child as
seriously emotionally disturbed, as defined in, and subject to, this
section and recommends out-of-home placement at the level of care
provided by the provider, shall be deemed to have met the assessment
requirement.
(4) For the purposes of this section, and only for placement into
a foster family agency, an AFDC-FC funded child assessed pursuant to
subdivision (b) of Section 706.6 or paragraph (2) of subdivision (c)
of Section 16501.1, in consultation with a mental health
professional, as defined in subdivision (g) of Section 4096.5, shall
be deemed to have met the assessment requirement.
(i)
(j) The assessments described in subparagraph (C) of
paragraph (3) of subdivision (a) and paragraph (3) of subdivision
(d) (e) shall be made pursuant to
subdivision (b) of Section 706.6 or paragraph (2) of subdivision (c)
of Section 16501.1.
(j)
(k) (1) The provider shall ensure that AFDC-FC funded
children, assessed pursuant to subparagraphs (A) and (B) of paragraph
(3) of subdivision (a) or paragraphs (1) and (2) of subdivision
(d), (e), who are accepted for
placement have been approved for placement by an interagency
placement committee, as described in Section 4096, except as provided
for in paragraphs (3) and (4) of subdivision (h).
(i).
(2) The approval shall be in writing and shall indicate that the
interagency placement committee has determined all of the following:
(A) The child meets the medical necessity criteria for Medi-Cal
specialty mental health Early and Periodic Screening, Diagnosis, and
Treatment services, as the criteria are described in Section 1830.210
of Title 9 of the California Code of Regulations.
(B) The child is seriously emotionally disturbed, as described in
subdivision (a) of Section 5600.3.
(C) Subject to Section 1502.4 of the Health and Safety Code, the
child needs the level of care provided by the program.
(3) (A) Nothing in subdivisions (a) to (i),
(j), inclusive, or this subdivision shall prevent an
emergency placement of a child or youth into a certified short-term
residential treatment center , children's crisis residential
center, or foster family agency program prior to the
determination by the interagency placement committee, but only if a
licensed mental health professional, as defined in subdivision (g) of
Section 4096, has made a written determination within 72 hours of
the child's or youth's placement, that the child or youth is
seriously emotionally disturbed or has made a written
determination within 24 hours of the child's or youth's placement in
a children's crisis residential center that the child or youth is
experiencing a mental health crisis as defined in subdivision (d),
and is in need of the care and services provided by the
certified short-term residential treatment center , children's
crisis residential center, or foster family agency.
(i) The interagency placement committee, as appropriate, shall,
within 30 days of placement, make the determinations, with
recommendations from the child and family team, required by this
subdivision.
(ii) If it determines the placement is appropriate, the
interagency placement committee, with recommendations from the child
and family team, shall transmit the approval, in writing, to the
county placing agency and the short-term residential treatment center
or foster family agency.
(iii) If it determines the placement is not appropriate, the
interagency placement committee shall respond pursuant to
subparagraph (B).
(B) If the interagency placement committee determines at any time
that the placement is not appropriate, it shall, with recommendations
from the child and family team, transmit the disapproval, in
writing, to the county placing agency and the short-term residential
treatment center or foster family agency, and the child or youth
shall be referred to an appropriate placement, as specified in this
section.
(k)
(l) Commencing January 1, 2017, for AFDC-FC funded
children or youth, only those children or youth who are approved for
placement, as set forth in this section, may be accepted by a
short-term residential treatment center or foster family agency.
(l)
(m) The department shall, through regulation, establish
consequences for the failure of a short-term residential treatment
center, or a foster family agency, to obtain written approval for
placement of an AFDC-FC funded child or youth pursuant to this
section.
(m)
(n) The department shall not establish a rate for a
short-term residential treatment center or foster family agency
unless the provider submits 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 at the level
sought. For purposes of this subdivision, "host county," and
"primary placing county," mean the same as defined in the department'
s AFDC-FC ratesetting regulations.
(n)
(o) Any certified short-term residential treatment
center or foster family agency shall be reclassified and paid at the
appropriate program rate for which it is qualified if either of the
following occurs:
(1) (A) It fails to maintain the level of care and services
necessary to meet the needs of the children and youth in care, as
required by subdivision (a). The determination shall be made
consistent with the department's AFDC-FC ratesetting regulations
developed pursuant to Sections 11462 and 11463 and shall take into
consideration the highest level of care and associated rates for
which the program is eligible.
(B) In the event of a determination under this paragraph, the
short-term residential treatment center or foster family agency may
appeal the finding or submit a corrective action plan. The appeal
process specified in Section 11466.6 shall be available to a
short-term residential treatment center or foster family agency that
provides intensive and therapeutic treatment. During any appeal, the
short-term residential treatment center or foster family agency that
provides intensive and therapeutic treatment shall maintain the
appropriate level of care.
(2) It fails to maintain a certified mental health treatment
program as required by subdivision (g). (h).
(o)
(p) In addition to any other review required by law,
the child and family team as defined in paragraph (4) of subdivision
(a) of Section 16501 may periodically review the placement of the
child or youth. If the child and family team make a recommendation
that the child or youth no longer needs, or is not benefiting from,
placement in a short-term residential treatment center or foster
family agency, or one of its programs, the team shall transmit the
disapproval, in writing, to the county placing agency to consider a
more appropriate placement.
(p)
(q) The department shall develop a process to address
placements when, subsequent to the child's or youth's placement, a
determination is made by the interagency placement team and shall
consider the recommendations of the child and family team, either
that the child or youth is not in need of the care and services
provided by the certified program. The process shall include, but not
be limited to:
(1) Notice of the determination in writing to both the county
placing agency and the short-term residential treatment center or
foster family agency that provides intensive and therapeutic
treatment.
(2) Notice of the county's plan, and a time frame, for removal of
the child or youth in writing to the short-term residential treatment
center or foster family agency that provides intensive and
therapeutic treatment.
(3) Referral to an appropriate placement.
(4) Actions to be taken if a child or youth is not timely removed
from the short-term residential treatment center or foster family
agency that provides intensive and therapeutic treatment or placed in
an appropriate placement.
(q)
(r) (1) Nothing in this section shall prohibit a
short-term residential treatment center or foster family agency from
accepting private placements of children or youth.
(2) When a referral is not from a public agency and no public
funding is involved, there is no requirement for public agency review
nor determination of need.
(3) Children and youth subject to paragraphs (1) and (2) shall
have been determined to be seriously emotionally disturbed, as
described in subdivision (a) of Section 5600.3, and subject to
Section 1502.4 of the Health and Safety Code, by a licensed mental
health professional, as defined in subdivision (g) of Section 4096.
(r)
(s) This section shall become operative on January 1,
2017.
SEC. 5. SEC. 6. No reimbursement is
required by this act pursuant to Section 6 of Article XIII B of the
California Constitution because the only costs that may be incurred
by a local agency or school district will be incurred because this
act creates a new crime or infraction, eliminates a crime or
infraction, or changes the penalty for a crime or infraction, within
the meaning of Section 17556 of the Government Code, or changes the
definition of a crime within the meaning of Section 6 of Article XIII
B of the California Constitution.