Amended in Senate August 16, 2016

Amended in Senate June 16, 2016

Amended in Senate May 25, 2016

Amended in Assembly May 4, 2015

Amended in Assembly April 15, 2015

California Legislature—2015–16 Regular Session

Assembly BillNo. 741


Introduced by Assembly Member Williams

February 25, 2015


An act to amend Section 1502 of, and to add Sections 1562.02 and 1562.03 to, the Health and Safety Code, and to amendbegin delete Section 11462.01end deletebegin insert Sections 5848.5, 11462.01end insertbegin insert, and 15610.47end insert of the Welfare and Institutions Code, relating to mental health.

LEGISLATIVE COUNSEL’S DIGEST

AB 741, as amended, Williams. Mental health: community care facilities.

begin delete

Existing

end delete

begin insert(1)end insertbegin insertend insertbegin insertExistingend insert 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 short-term residential treatment 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 authorize a short-term residential treatment center to be operated as a children’s crisis residential center, as defined, and would require the department to regulate those programs, as specified. The bill would require the State Department of Health Care Services, in consultation with the County Behavioral Health Directors Association ofbegin delete California,end deletebegin insert California andend insert representatives of provider associations,begin delete children’s advocates, and other stakeholders,end delete to establishbegin insert interimend insert 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.

begin delete

Existing

end delete

begin insert (2)end insertbegin insertend insertbegin insertExistingend insert 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 isbegin delete inend deletebegin insert experiencing aend insert 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.

begin insert

(3) Existing law establishes the Investment in Mental Health Wellness Act of 2013. Existing law provides that funds appropriated by the Legislature to the California Health Facilities Financing Authority for the purposes of the act be made available to selected counties or counties acting jointly, except as otherwise provided, and used to provide, among other things, a complete continuum of crisis services for children and youth 21 years of age and under regardless of where they live in the state. The act requires grant awards made by the authority to be used to expand local resources for the development, capital, equipment acquisition, and applicable program startup or expansion costs to increase capacity for client assistance and crisis services for children and youth 21 years of age and under in specified areas, including crisis residential treatment as authorized by specified provisions.

end insert
begin insert

This bill would include within these specified areas crisis residential treatment provided at a children’s crisis residential center.

end insert
begin insert

(4) This bill would also make nonsubstantive, conforming changes.

end insert
begin delete

The

end delete

begin insert (5)end insertbegin insertend insertbegin insertTheend insert 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:

P3    1

SECTION 1.  

The Legislature finds and declares all of the
2following:

3(a) There is an urgent need to provide more crisis care
4alternatives to hospitals for children and youth experiencing mental
5health crises.

6(b) The problems are especially acute for children and youth
7who may have to wait for days for a hospital bed and who may be
8transported, without a parent, to the nearest facility hundreds of
9miles away.

10(c) In 2012, the California Hospital Association reported that
11two-thirds of the people taken to a hospital for a psychiatric
12 emergency did not meet the criteria for that level of care, but the
13care they needed was not available.

P4    1(d) The type of care that is needed includes crisis residential
2treatment for children.

3(e) This level of care is part of the full continuum of care
4considered medically necessary for many children with serious
5emotional disturbances.

6(f) In 2013, the Legislature enacted the Investment in Mental
7Health Wellness Act (Senate Bill 82, Chapter 34 of the Statutes
8of 2013) to provide one-time funding to counties to expand the
9availability of mental health crisis care services, including
10short-term crisis residential treatment services. However, there is
11currently no state licensing category for short-term crisis residential
12programs for children. As a result, counties wanting to expand
13local capacity to meet the needs of children and youth for crisis
14residential treatment services were ineligible for this competitive
15grant program.

16(g) In most communities, inpatient crisis treatment is completely
17unavailable for children and youth, even though it may be
18medically necessary.

19(h) Crisis residential care is an essential level of care for the
20treatment of children and youth with serious emotional disturbances
21in a mental health crisis, and it often serves as an alternative to
22hospitalization.

23(i) It is imperative that California identify a licensing category
24specifically for mental health crisis residential care that can be
25utilized for children and youth who are beneficiaries of both public
26and private health care plans.

27

SEC. 2.  

Section 1502 of the Health and Safety Code is amended
28to read:

29

1502.  

(a) As used in this chapter:

30(1) “Community care facility” means any facility, place, or
31building that is maintained and operated to provide nonmedical
32residential care, day treatment, adult day care, or foster family
33agency services for children, adults, or children and adults,
34including, but not limited to, the physically handicapped, mentally
35impaired, incompetent persons, and abused or neglected children,
36and includes the following:

37(A) “Residential facility” means any family home, group care
38facility, or similar facility determined by the director, for 24-hour
39nonmedical care of persons in need of personal services,
P5    1supervision, or assistance essential for sustaining the activities of
2daily living or for the protection of the individual.

3(B) “Adult day program” means any community-based facility
4or program that provides care to persons 18 years of age or older
5in need of personal services, supervision, or assistance essential
6for sustaining the activities of daily living or for the protection of
7these individuals on less than a 24-hour basis.

8(C) “Therapeutic day services facility” means any facility that
9provides nonmedical care, counseling, educational or vocational
10support, or social rehabilitation services on less than a 24-hour
11basis to persons under 18 years of age who would otherwise be
12placed in foster care or who are returning to families from foster
13care. Program standards for these facilities shall be developed by
14the department, pursuant to Section 1530, in consultation with
15therapeutic day services and foster care providers.

16(D) “Foster family agency” means any public agency or private
17organization engaged in the recruiting, certifying, and training of,
18and providing professional support to, foster parents, or in finding
19homes or other places for placement of children for temporary or
20permanent care who require that level of care. Private foster family
21agencies shall be organized and operated on a nonprofit basis.

22(E) “Foster family home” means any residential facility
23providing 24-hour care for six or fewer foster children that is
24owned, leased, or rented and is the residence of the foster parent
25or parents, including their family, in whose care the foster children
26have been placed. The placement may be by a public or private
27child placement agency or by a court order, or by voluntary
28placement by a parent, parents, or guardian. It also means a foster
29family home described in Section 1505.2.

30(F) “Small family home” means any residential facility, in the
31licensee’s family residence, that provides 24-hour care for six or
32fewer foster children who have mental disorders or developmental
33or physical disabilities and who require special care and supervision
34as a result of their disabilities. A small family home may accept
35children with special health care needs, pursuant to subdivision
36(a) of Section 17710 of the Welfare and Institutions Code. In
37addition to placing children with special health care needs, the
38department may approve placement of children without special
39health care needs, up to the licensed capacity.

P6    1(G) “Social rehabilitation facility” means any residential facility
2that provides social rehabilitation services for no longer than 18
3months in a group setting to adults recovering from mental illness
4 who temporarily need assistance, guidance, or counseling. Program
5components shall be subject to program standards pursuant to
6Article 1 (commencing with Section 5670) of Chapter 2.5 of Part
72 of Division 5 of the Welfare and Institutions Code.

8(H) “Community treatment facility” means any residential
9facility that provides mental health treatment services to children
10in a group setting and that has the capacity to provide secure
11containment. Program components shall be subject to program
12standards developed and enforced by the State Department of
13Health Care Services pursuant to Section 4094 of the Welfare and
14Institutions Code.

15(I) (i) “Full-service adoption agency” means any licensed entity
16engaged in the business of providing adoption services, that does
17all of the following:

18(I) Assumes care, custody, and control of a child through
19relinquishment of the child to the agency or involuntary termination
20of parental rights to the child.

21(II) Assesses the birth parents, prospective adoptive parents, or
22child.

23(III) Places children for adoption.

24(IV) Supervises adoptive placements.

25(ii) Private full-service adoption agencies shall be organized
26and operated on a nonprofit basis. As a condition of licensure to
27provide intercountry adoption services, a full-service adoption
28agency shall be accredited and in good standing according to Part
2996 of Title 22 of the Code of Federal Regulations, or supervised
30by an accredited primary provider, or acting as an exempted
31provider, in compliance with Subpart F (commencing with Section
3296.29) of Part 96 of Title 22 of the Code of Federal Regulations.

33(J) (i) “Noncustodial adoption agency” means any licensed
34entity engaged in the business of providing adoption services, that
35does all of the following:

36(I) Assesses the prospective adoptive parents.

37(II) Cooperatively matches children freed for adoption, who are
38under the care, custody, and control of a licensed adoption agency,
39for adoption, with assessed and approved adoptive applicants.

P7    1(III) Cooperatively supervises adoptive placements with a
2full-service adoptive agency, but does not disrupt a placement or
3remove a child from a placement.

4(ii) Private noncustodial adoption agencies shall be organized
5and operated on a nonprofit basis. As a condition of licensure to
6provide intercountry adoption services, a noncustodial adoption
7agency shall be accredited and in good standing according to Part
896 of Title 22 of the Code of Federal Regulations, or supervised
9by an accredited primary provider, or acting as an exempted
10provider, in compliance with Subpart F (commencing with Section
1196.29) of Part 96 of Title 22 of the Code of Federal Regulations.

12(K) “Transitional shelter care facility” means any group care
13facility that provides for 24-hour nonmedical care of persons in
14need of personal services, supervision, or assistance essential for
15sustaining the activities of daily living or for the protection of the
16individual. Program components shall be subject to program
17standards developed by the State Department of Social Services
18pursuant to Section 1502.3.

19(L) “Transitional housing placement provider” means an
20organization licensed by the department pursuant to Section
211559.110 and Section 16522.1 of the Welfare and Institutions Code
22to provide transitional housing to foster children at least 16 years
23of age and not more than 18 years of age, and nonminor
24dependents, as defined in subdivision (v) of Section 11400 of the
25Welfare and Institutions Code, to promote their transition to
26adulthood. A transitional housing placement provider shall be
27privately operated and organized on a nonprofit basis.

28(M) “Group home” means a residential facility that provides
2924-hour care and supervision to children, delivered at least in part
30by staff employed by the licensee in a structured environment. The
31care and supervision provided by a group home shall be
32nonmedical, except as otherwise permitted by law.

33(N) “Runaway and homeless youth shelter” means a group home
34licensed by the department to operate a program pursuant to Section
351502.35 to provide voluntary, short-term shelter and personal
36services to runaway youth or homeless youth, as defined in
37paragraph (2) of subdivision (a) of Section 1502.35.

38(O) “Enhanced behavioral supports home” means a facility
39certified by the State Department of Developmental Services
40pursuant to Article 3.6 (commencing with Section 4684.80) of
P8    1Chapter 6 of Division 4.5 of the Welfare and Institutions Code,
2and licensed by the State Department of Social Services as an adult
3residential facility or a group home that provides 24-hour
4nonmedical care to individuals with developmental disabilities
5who require enhanced behavioral supports, staffing, and
6supervision in a homelike setting. An enhanced behavioral supports
7home shall have a maximum capacity of four consumers, shall
8conform to Section 441.530(a)(1) of Title 42 of the Code of Federal
9Regulations, and shall be eligible for federal Medicaid home- and
10community-based services funding.

11(P) “Community crisis home” means a facility certified by the
12State Department of Developmental Services pursuant to Article
138 (commencing with Section 4698) of Chapter 6 of Division 4.5
14of the Welfare and Institutions Code, and licensed by the State
15Department of Social Services pursuant to Article 9.7 (commencing
16with Section 1567.80), as an adult residential facility, providing
1724-hour nonmedical care to individuals with developmental
18disabilities receiving regional center service, in need of crisis
19intervention services, and who would otherwise be at risk of
20admission to the acute crisis center at Fairview Developmental
21Center, Sonoma Developmental Center, an acute general hospital,
22acute psychiatric hospital, an institution for mental disease, as
23described in Part 5 (commencing with Section 5900) of Division
245 of the Welfare and Institutions Code, or an out-of-state
25placement. A community crisis home shall have a maximum
26capacity of eight consumers, as defined in subdivision (a) of
27Section 1567.80, shall conform to Section 441.530(a)(1) of Title
2842 of the Code of Federal Regulations, and shall be eligible for
29federal Medicaid home- and community-based services funding.

30(Q) “Crisis nursery” means a facility licensed by the department
31to operate a program pursuant to Section 1516 to provide short-term
32care and supervision for children under six years of age who are
33voluntarily placed for temporary care by a parent or legal guardian
34due to a family crisis or stressful situation.

35(R) “Short-term residential treatment center” means a residential
36facility licensed by the department pursuant to Section 1562.01
37and operated by any public agency or private organization that
38provides short-term, specialized, and intensive treatment, and
3924-hour care and supervision to children. The care and supervision
40provided by a short-term residential treatment center shall be
P9    1nonmedical, except as otherwise permitted by law. A short-term
2residential treatment center may be operated as a children’s crisis
3residential center.

4(S) “Children’s crisis residential center” means a short-term
5residential treatment center operated specifically to divert children
6experiencing a mental health crisis from psychiatric hospitalization.

7(2) “Department” or “state department” means the State
8Department of Social Services.

9(3) “Director” means the Director of Social Services.

10(b) Nothing in this section shall be construed to prohibit or
11discourage placement of persons who have mental or physical
12disabilities into any category of community care facility that meets
13the needs of the individual placed, if the placement is consistent
14with the licensing regulations of the department.

15

SEC. 3.  

Section 1562.02 is added to the Health and Safety
16Code
, to read:

17

1562.02.  

(a) The department shall establish regulations for
18short-term residential treatment centers that are operated as
19children’s crisis residential centers. At a minimum, the regulations
20shall include all of the following:

21(1) The children’s crisis residential center shall be used only
22for diversion from admittance to a psychiatric hospitalization.

23(2) begin insert(A)end insertbegin insertend insert Length of stay for a single admission to a children’s
24crisisbegin insert residentialend insert center shall be limited to 10 consecutive days.
25
begin delete An organization providing children’s crisis residential services
26shall not admit a child for more than twoend delete

27begin insert(B)end insertbegin insertend insertbegin insertNotwithstanding subparagraph (A), the length of stay may
28be extended once for no more than twoend insert
consecutive 10-day lengths
29of begin delete stay during any 12-month period.end delete begin insert stay.end insert Before extending the
30length of stay for a Medi-Cal beneficiary beyond 10 consecutive
31days, an organization providing children’s crisis residential services
32shall obtain prior approval from the county mental health plan
33authorizing those services.

begin insert

34
(C) A child shall not be admitted to a children’s crisis residential
35center regulated under this section for more than 20 total days in
36any six-month period.

end insert

37(3) Therapeutic programming shall be provided seven days a
38week, including weekends and holidays, with sufficient
39professional and paraprofessional staff to maintain an appropriate
40 treatment setting and services, based on individual children’s needs.

P10   1(4) The program shall be staffed with sufficient personnel to
2accept children 24 hours per day, seven days a week and to admit
3children, at a minimum, from 7 a.m. to 11 p.m., seven days a week,
4365 days per year. The program shall be sufficiently staffed to
5discharge children, as appropriate, seven days a week, 365 days
6per year.

7(5) Facilities shall be limited to fewer than 16 beds, with at least
850 percent of those beds in single-occupancy rooms.

9(6) Facilities shall include ample physical space for
10accommodating individuals who provide natural supports to each
11child and for integrating family members into the day-to-day care
12of the youth.

13(7) The center shall collaborate with each child’s mental health
14team, child and family team, and other formal and natural supports
15within 24 hours of intake and throughout the course of care and
16treatment as appropriate.

begin delete

17(b) The department may adopt regulations, as needed, to waive
18the requirements in Section 1562.01 that are in conflict with the
19purposes or best practices of operating a children’s crisis residential
20center.

end delete
begin insert

21
(b) The center shall annually provide the department with all
22of the following data as it pertains to children in foster care and
23children not in foster care in conjunction with its application for
24licensure renewal:

end insert
begin insert

25
(1) Age and gender of clients served.

end insert
begin insert

26
(2) Duration of stay.

end insert
begin insert

27
(3) Professional classification of staff and contracted staff.

end insert
begin insert

28
(4) Type of placement the client was discharged to.

end insert
29

SEC. 4.  

Section 1562.03 is added to the Health and Safety
30Code
, to read:

31

1562.03.  

(a) begin insert(1)end insertbegin insertend insertThe State Department of Health Care
32begin delete Services, in consultation with the County Behavioral Health
33Directors Association of California, representatives of provider
34associations, children’s advocates, and other stakeholdersend delete
begin insert Servicesend insert
35 shall establishbegin insert interimend insert Medi-Cal rates as needed that are sufficient
36to reimburse the costs for children’s crisis residential services in
37excess of any specialty mental health services that would have
38been otherwise authorized, provided, and invoiced for each eligible
39Medi-Cal beneficiary receiving children’s crisis residential services.

begin insert

P11   1
(2) The department shall consult with subject matter experts
2from the County Behavioral Health Directors Association of
3California and provider associations to obtain data and
4background information necessary to ensure sufficiency of the
5rate.

end insert

6(b) For foster children admitted for children’s crisis residential
7services, programs shall receive payment for board and care
8equivalent to the rate paid for short-term residential treatment
9 centers.

10(c) Nothing in this chapter shall prevent a county from providing
11payment in excess of the short-term residential treatment center
12rate in order to meet the needs of individual children.

13begin insert

begin insertSEC. 5.end insert  

end insert

begin insertSection 5848.5 of the end insertbegin insertWelfare and Institutions Codeend insert
14
begin insert is amended to read:end insert

15

5848.5.  

(a) The Legislature finds and declares all of the
16following:

17(1) California has realigned public community mental health
18services to counties and it is imperative that sufficient
19community-based resources be available to meet the mental health
20needs of eligible individuals.

21(2) Increasing access to effective outpatient and crisis
22stabilization services provides an opportunity to reduce costs
23associated with expensive inpatient and emergency room care and
24to better meet the needs of individuals with mental health disorders
25in the least restrictive manner possible.

26(3) Almost one-fifth of people with mental health disorders visit
27a hospital emergency room at least once per year. If an adequate
28array of crisis services is not available, it leaves an individual with
29little choice but to access an emergency room for assistance and,
30potentially, an unnecessary inpatient hospitalization.

31(4) Recent reports have called attention to a continuing problem
32of inappropriate and unnecessary utilization of hospital emergency
33rooms in California due to limited community-based services for
34individuals in psychological distress and acute psychiatric crisis.
35Hospitals report that 70 percent of people taken to emergency
36rooms for psychiatric evaluation can be stabilized and transferred
37to a less intensive level of crisis care. Law enforcement personnel
38report that their personnel need to stay with people in the
39emergency room waiting area until a placement is found, and that
40less intensive levels of care tend not to be available.

P12   1(5) Comprehensive public and private partnerships at both local
2and regional levels, including across physical health services,
3mental health, substance use disorder, law enforcement, social
4services, and related supports, are necessary to develop and
5maintain high quality, patient-centered, and cost-effective care for
6individuals with mental health disorders that facilitates their
7recovery and leads towards wellness.

8(6) The recovery of individuals with mental health disorders is
9important for all levels of government, business, and the local
10community.

11(b) This section shall be known, and may be cited, as the
12Investment in Mental Health Wellness Act of 2013. The objectives
13of this section are to do all of the following:

14(1) Expand access to early intervention and treatment services
15to improve the client experience, achieve recovery and wellness,
16and reduce costs.

17(2) Expand the continuum of services to address crisis
18intervention, crisis stabilization, and crisis residential treatment
19needs that are wellness, resiliency, and recovery oriented.

20(3) Add at least 25 mobile crisis support teams and at least 2,000
21crisis stabilization and crisis residential treatment beds to bolster
22capacity at the local level to improve access to mental health crisis
23services and address unmet mental health care needs.

24(4) Add at least 600 triage personnel to provide intensive case
25management and linkage to services for individuals with mental
26health care disorders at various points of access, such as at
27designated community-based service points, homeless shelters,
28and clinics.

29(5) Reduce unnecessary hospitalizations and inpatient days by
30appropriately utilizing community-based services and improving
31access to timely assistance.

32(6) Reduce recidivism and mitigate unnecessary expenditures
33of local law enforcement.

34(7) Provide local communities with increased financial resources
35to leverage additional public and private funding sources to achieve
36improved networks of care for individuals with mental health
37disorders.

38(8) Provide a complete continuum of crisis services for children
39and youth 21 years of age and under regardless of where they live
40in the state. The funds included in the 2016 Budget Act for the
P13   1purpose of developing the continuum of mental health crisis
2services for children and youth 21 years of age and under shall be
3for the following objectives:

4(A) Provide a continuum of crisis services for children and youth
521 years of age and under regardless of where they live in the state.

6(B) Provide for early intervention and treatment services to
7improve the client experience, achieve recovery and wellness, and
8reduce costs.

9(C) Expand the continuum of community-based services to
10address crisis intervention, crisis stabilization, and crisis residential
11treatment needs that are wellness-, resiliency-, and
12recovery-oriented.

13(D) Add at least 200 mobile crisis support teams.

14(E) Add at least 120 crisis stabilization services and beds and
15crisis residential treatment beds to increase capacity at the local
16level to improve access to mental health crisis services and address
17unmet mental health care needs.

18(F) Add triage personnel to provide intensive case management
19and linkage to services for individuals with mental health care
20disorders at various points of access, such as at designated
21community-based service points, homeless shelters, schools, and
22clinics.

23(G) Expand family respite care to help families and sustain
24caregiver health and well-being.

25(H) Expand family supportive training and related services
26designed to help families participate in the planning process, access
27services, and navigate programs.

28(I) Reduce unnecessary hospitalizations and inpatient days by
29appropriately utilizing community-based services.

30(J) Reduce recidivism and mitigate unnecessary expenditures
31of local law enforcement.

32(K) Provide local communities with increased financial
33resources to leverage additional public and private funding sources
34to achieve improved networks of care for children and youth 21
35years of age and under with mental health disorders.

36(c) Through appropriations provided in the annual Budget Act
37for this purpose, it is the intent of the Legislature to authorize the
38California Health Facilities Financing Authority, hereafter referred
39to as the authority, and the Mental Health Services Oversight and
40Accountability Commission, hereafter referred to as the
P14   1commission, to administer competitive selection processes as
2provided in this section for capital capacity and program expansion
3to increase capacity for mobile crisis support, crisis intervention,
4crisis stabilization services, crisis residential treatment, and
5specified personnel resources.

6(d) Funds appropriated by the Legislature to the authority for
7purposes of this section shall be made available to selected
8counties, or counties acting jointly. The authority may, at its
9discretion, also give consideration to private nonprofit corporations
10and public agencies in an area or region of the state if a county, or
11counties acting jointly, affirmatively supports this designation and
12collaboration in lieu of a county government directly receiving
13grant funds.

14(1) Grant awards made by the authority shall be used to expand
15local resources for the development, capital, equipment acquisition,
16and applicable program startup or expansion costs to increase
17capacity for client assistance and services in the following areas:

18(A) Crisis intervention, as authorized by Sections 14021.4,
1914680, and 14684.

20(B) Crisis stabilization, as authorized by Sections 14021.4,
2114680, and 14684.

22(C) Crisis residential treatment, as authorized by Sections
2314021.4, 14680, and 14684.

24(D) Rehabilitative mental health services, as authorized by
25Sections 14021.4, 14680, and 14684.

26(E) Mobile crisis support teams, including personnel and
27equipment, such as the purchase of vehicles.

28(2) The authority shall develop selection criteria to expand local
29resources, including those described in paragraph (1), and processes
30for awarding grants after consulting with representatives and
31interested stakeholders from the mental health community,
32including, but not limited to, the County Behavioral Health
33Directors Association of California, service providers, consumer
34organizations, and other appropriate interests, such as health care
35providers and law enforcement, as determined by the authority.
36The authority shall ensure that grants result in cost-effective
37expansion of the number of community-based crisis resources in
38regions and communities selected for funding. The authority shall
39also take into account at least the following criteria and factors
P15   1when selecting recipients of grants and determining the amount
2of grant awards:

3(A) Description of need, including, at a minimum, a
4comprehensive description of the project, community need,
5population to be served, linkage with other public systems of health
6and mental health care, linkage with local law enforcement, social
7services, and related assistance, as applicable, and a description
8of the request for funding.

9(B) Ability to serve the target population, which includes
10individuals eligible for Medi-Cal and individuals eligible for county
11health and mental health services.

12(C) Geographic areas or regions of the state to be eligible for
13grant awards, which may include rural, suburban, and urban areas,
14and may include use of the five regional designations utilized by
15the County Behavioral Health Directors Association of California.

16(D) Level of community engagement and commitment to project
17completion.

18(E) Financial support that, in addition to a grant that may be
19awarded by the authority, will be sufficient to complete and operate
20the project for which the grant from the authority is awarded.

21(F) Ability to provide additional funding support to the project,
22including public or private funding, federal tax credits and grants,
23foundation support, and other collaborative efforts.

24(G) Memorandum of understanding among project partners, if
25applicable.

26(H) Information regarding the legal status of the collaborating
27partners, if applicable.

28(I) Ability to measure key outcomes, including improved access
29to services, health and mental health outcomes, and cost benefit
30of the project.

31(3) The authority shall determine maximum grants awards,
32which shall take into consideration the number of projects awarded
33to the grantee, as described in paragraph (1), and shall reflect
34reasonable costs for the project and geographic region. The
35authority may allocate a grant in increments contingent upon the
36phases of a project.

37(4) Funds awarded by the authority pursuant to this section may
38be used to supplement, but not to supplant, existing financial and
39resource commitments of the grantee or any other member of a
40collaborative effort that has been awarded a grant.

P16   1(5) All projects that are awarded grants by the authority shall
2be completed within a reasonable period of time, to be determined
3by the authority. Funds shall not be released by the authority until
4the applicant demonstrates project readiness to the authority’s
5satisfaction. If the authority determines that a grant recipient has
6failed to complete the project under the terms specified in awarding
7the grant, the authority may require remedies, including the return
8of all or a portion of the grant.

9(6) A grantee that receives a grant from the authority under this
10 section shall commit to using that capital capacity and program
11expansion project, such as the mobile crisis team, crisis
12stabilization unit, or crisis residential treatment program, for the
13duration of the expected life of the project.

14(7) The authority may consult with a technical assistance entity,
15as described in paragraph (5) of subdivision (a) of Section 4061,
16for purposes of implementing this section.

17(8) The authority may adopt emergency regulations relating to
18the grants for the capital capacity and program expansion projects
19described in this section, including emergency regulations that
20define eligible costs and determine minimum and maximum grant
21amounts.

22(9) The authority shall provide reports to the fiscal and policy
23committees of the Legislature on or before May 1, 2014, and on
24or before May 1, 2015, on the progress of implementation, that
25include, but are not limited to, the following:

26(A) A description of each project awarded funding.

27(B) The amount of each grant issued.

28(C) A description of other sources of funding for each project.

29(D) The total amount of grants issued.

30(E) A description of project operation and implementation,
31including who is being served.

32(10) A recipient of a grant provided pursuant to paragraph (1)
33shall adhere to all applicable laws relating to scope of practice,
34licensure, certification, staffing, and building codes.

35(e) Of the funds specified in paragraph (8) of subdivision (b),
36it is the intent of the Legislature to authorize the authority and the
37commission to administer competitive selection processes as
38provided in this section for capital capacity and program expansion
39to increase capacity for mobile crisis support, crisis intervention,
40crisis stabilization services, crisis residential treatment, family
P17   1respite care, family supportive training and related services, and
2triage personnel resources for children and youth 21 years of age
3and under.

4(f) Funds appropriated by the Legislature to the authority to
5address crisis services for children and youth 21 years of age and
6under for the purposes of this section shall be made available to
7selected counties or counties acting jointly. The authority may, at
8its discretion, also give consideration to private nonprofit
9corporations and public agencies in an area or region of the state
10if a county, or counties acting jointly, affirmatively support this
11designation and collaboration in lieu of a county government
12directly receiving grant funds.

13(1) Grant awards made by the authority shall be used to expand
14local resources for the development, capital, equipment acquisition,
15and applicable program startup or expansion costs to increase
16capacity for client assistance and crisis services for children and
17youth 21 years of age and under in the following areas:

18(A) Crisis intervention, as authorized by Sections 14021.4,
1914680, and 14684.

20(B) Crisis stabilization, as authorized by Sections 14021.4,
2114680, and 14684.

22(C) Crisis residential treatment, as authorized by Sections
2314021.4, 14680, and begin delete14684.end deletebegin insert 14684 and as provided at a children’s
24crisis residential center, as defined in Section 1502 of the Health
25and Safety Code.end insert

26(D) Mobile crisis support teams, including the purchase of
27equipment and vehicles.

28(E) Family respite care.

29(2) The authority shall develop selection criteria to expand local
30resources, including those described in paragraph (1), and processes
31for awarding grants after consulting with representatives and
32interested stakeholders from the mental health community,
33including, but not limited to, county mental health directors, service
34providers, consumer organizations, and other appropriate interests,
35such as health care providers and law enforcement, as determined
36by the authority. The authority shall ensure that grants result in
37cost-effective expansion of the number of community-based crisis
38resources in regions and communities selected for funding. The
39authority shall also take into account at least the following criteria
P18   1and factors when selecting recipients of grants and determining
2the amount of grant awards:

3(A) Description of need, including, at a minimum, a
4comprehensive description of the project, community need,
5population to be served, linkage with other public systems of health
6and mental health care, linkage with local law enforcement, social
7services, and related assistance, as applicable, and a description
8of the request for funding.

9(B) Ability to serve the target population, which includes
10individuals eligible for Medi-Cal and individuals eligible for county
11health and mental health services.

12(C) Geographic areas or regions of the state to be eligible for
13grant awards, which may include rural, suburban, and urban areas,
14and may include use of the five regional designations utilized by
15the California Behavioral Health Directors Association.

16(D) Level of community engagement and commitment to project
17completion.

18(E) Financial support that, in addition to a grant that may be
19awarded by the authority, will be sufficient to complete and operate
20the project for which the grant from the authority is awarded.

21(F) Ability to provide additional funding support to the project,
22including public or private funding, federal tax credits and grants,
23foundation support, and other collaborative efforts.

24(G) Memorandum of understanding among project partners, if
25applicable.

26(H) Information regarding the legal status of the collaborating
27partners, if applicable.

28(I) Ability to measure key outcomes, including utilization of
29services, health and mental health outcomes, and cost benefit of
30the project.

31(3) The authority shall determine maximum grant awards, which
32shall take into consideration the number of projects awarded to
33the grantee, as described in paragraph (1), and shall reflect
34reasonable costs for the project, geographic region, and target ages.
35The authority may allocate a grant in increments contingent upon
36the phases of a project.

37(4) Funds awarded by the authority pursuant to this section may
38be used to supplement, but not to supplant, existing financial and
39resource commitments of the grantee or any other member of a
40 collaborative effort that has been awarded a grant.

P19   1(5) All projects that are awarded grants by the authority shall
2be completed within a reasonable period of time, to be determined
3by the authority. Funds shall not be released by the authority until
4the applicant demonstrates project readiness to the authority’s
5satisfaction. If the authority determines that a grant recipient has
6failed to complete the project under the terms specified in awarding
7the grant, the authority may require remedies, including the return
8of all, or a portion, of the grant.

9(6) A grantee that receives a grant from the authority under this
10section shall commit to using that capital capacity and program
11expansion project, such as the mobile crisis team, crisis
12stabilization unit, family respite care, or crisis residential treatment
13program, for the duration of the expected life of the project.

14(7) The authority may consult with a technical assistance entity,
15as described in paragraph (5) of subdivision (a) of Section 4061,
16for the purposes of implementing this section.

17(8) The authority may adopt emergency regulations relating to
18the grants for the capital capacity and program expansion projects
19described in this section, including emergency regulations that
20define eligible costs and determine minimum and maximum grant
21amounts.

22(9) The authority shall provide reports to the fiscal and policy
23committees of the Legislature on or before January 10, 2018, and
24annually thereafter, on the progress of implementation, that include,
25but are not limited to, the following:

26(A) A description of each project awarded funding.

27(B) The amount of each grant issued.

28(C) A description of other sources of funding for each project.

29(D) The total amount of grants issued.

30(E) A description of project operation and implementation,
31including who is being served.

32(10) A recipient of a grant provided pursuant to paragraph (1)
33shall adhere to all applicable laws relating to scope of practice,
34licensure, certification, staffing, and building codes.

35(g) Funds appropriated by the Legislature to the commission
36for purposes of this section shall be allocated for triage personnel
37to provide intensive case management and linkage to services for
38individuals with mental health disorders at various points of access.
39These funds shall be made available to selected counties, counties
40acting jointly, or city mental health departments, as determined
P20   1by the commission through a selection process. It is the intent of
2the Legislature for these funds to be allocated in an efficient manner
3to encourage early intervention and receipt of needed services for
4individuals with mental health disorders, and to assist in navigating
5the local service sector to improve efficiencies and the delivery of
6services.

7(1) Triage personnel may provide targeted case management
8services face to face, by telephone, or by telehealth with the
9individual in need of assistance or his or her significant support
10person, and may be provided anywhere in the community. These
11service activities may include, but are not limited to, the following:

12(A) Communication, coordination, and referral.

13(B) Monitoring service delivery to ensure the individual accesses
14and receives services.

15(C) Monitoring the individual’s progress.

16(D) Providing placement service assistance and service plan
17development.

18(2) The commission shall take into account at least the following
19criteria and factors when selecting recipients and determining the
20amount of grant awards for triage personnel as follows:

21(A) Description of need, including potential gaps in local service
22connections.

23(B) Description of funding request, including personnel and use
24of peer support.

25(C) Description of how triage personnel will be used to facilitate
26linkage and access to services, including objectives and anticipated
27outcomes.

28(D) Ability to obtain federal Medicaid reimbursement, when
29applicable.

30(E) Ability to administer an effective service program and the
31degree to which local agencies and service providers will support
32and collaborate with the triage personnel effort.

33(F) Geographic areas or regions of the state to be eligible for
34grant awards, which shall include rural, suburban, and urban areas,
35and may include use of the five regional designations utilized by
36the County Behavioral Health Directors Association of California.

37(3) The commission shall determine maximum grant awards,
38and shall take into consideration the level of need, population to
39be served, and related criteria, as described in paragraph (2), and
40shall reflect reasonable costs.

P21   1(4) Funds awarded by the commission for purposes of this
2section may be used to supplement, but not supplant, existing
3financial and resource commitments of the county, counties acting
4jointly, or city mental health department that received the grant.

5(5) Notwithstanding any other law, a county, counties acting
6jointly, or city mental health department that receives an award of
7funds for the purpose of supporting triage personnel pursuant to
8this subdivision is not required to provide a matching contribution
9of local funds.

10(6) Notwithstanding any other law, the commission, without
11taking any further regulatory action, may implement, interpret, or
12make specific this section by means of informational letters,
13bulletins, or similar instructions.

14(7) The commission shall provide a status report to the fiscal
15and policy committees of the Legislature on the progress of
16implementation no later than March 1, 2014.

17(h) Funds appropriated by the Legislature to the commission
18pursuant to paragraph (8) of subdivision (b) for the purposes of
19addressing children’s crisis services shall be allocated to support
20triage personnel and family supportive training and related services.
21These funds shall be made available to selected counties, counties
22acting jointly, or city mental health departments, as determined
23by the commission through a selection process. The commission
24may, at its discretion, also give consideration to private nonprofit
25corporations and public agencies in an area or region of the state
26if a county, or counties acting jointly, affirmatively supports this
27 designation and collaboration in lieu of a county government
28directly receiving grant funds.

29(1) These funds may provide for a range of crisis-related services
30for a child in need of assistance, or his or her parent, guardian, or
31caregiver. These service activities may include, but are not limited
32to, the following:

33(A) Intensive coordination of care and services.

34(B) Communication, coordination, and referral.

35(C) Monitoring service delivery to the child or youth.

36(D) Monitoring the child’s progress.

37(E) Providing placement service assistance and service plan
38development.

39(F) Crisis or safety planning.

P22   1(2) The commission shall take into account at least the following
2criteria and factors when selecting recipients and determining the
3amount of grant awards for these funds, as follows:

4(A) Description of need, including potential gaps in local service
5connections.

6(B) Description of funding request, including personnel.

7(C) Description of how personnel and other services will be
8used to facilitate linkage and access to services, including
9objectives and anticipated outcomes.

10(D) Ability to obtain federal Medicaid reimbursement, when
11applicable.

12(E) Ability to provide a matching contribution of local funds.

13(F) Ability to administer an effective service program and the
14degree to which local agencies and service providers will support
15and collaborate with the triage personnel effort.

16(G) Geographic areas or regions of the state to be eligible for
17grant awards, which shall include rural, suburban, and urban areas,
18and may include use of the five regional designations utilized by
19the County Behavioral Health Directors Association of California.

20(3) The commission shall determine maximum grant awards,
21and shall take into consideration the level of need, population to
22be served, and related criteria, as described in paragraph (2), and
23shall reflect reasonable costs.

24(4) Funds awarded by the commission for purposes of this
25section may be used to supplement, but not supplant, existing
26financial and resource commitments of the county, counties acting
27jointly, or a city mental health department that received the grant.

28(5) Notwithstanding any other law, a county, counties acting
29jointly, or a city mental health department that receives an award
30of funds for the purpose of this section is not required to provide
31a matching contribution of local funds.

32(6) Notwithstanding any other law, the commission, without
33taking any further regulatory action, may implement, interpret, or
34make specific this section by means of informational letters,
35bulletins, or similar instructions.

36(7) The commission may waive requirements in this section for
37counties with a population of 100,000 or less, if the commission
38determines it is in the best interest of the state and meets the intent
39of the law.

P23   1(8) The commission shall provide a status report to the fiscal
2and policy committees of the Legislature on the progress of
3implementation no later than January 10, 2018, and annually
4thereafter.

5

begin deleteSEC. 5.end delete
6
begin insertSEC. 6.end insert  

Section 11462.01 of the Welfare and Institutions Code,
7as added by Section 75 of Chapter 773 of the Statutes of 2015, is
8amended to read:

9

11462.01.  

(a) A short-term residential treatment center, as
10defined in subdivision (ad) of Section 11400 and subparagraph
11(R) of paragraph (1) of subdivision (a) of Section 1502 of the
12Health and Safety Code, may have a program that is certified by
13the State Department of Health Care Services or by a county mental
14health plan to which the department has delegated certification
15authority, pursuant to Section 4096.5, or a program that is not
16certified, or both. A short-term residential treatment center, except
17as specified in subdivision (d), shall accept for placement children
18who meet all of the following criteria, subject to the other
19requirements of subdivisions (b) and (c):

20(1) The child does not require inpatient care in a licensed health
21facility.

22(2) The child has been assessed as requiring the level of services
23provided in a short-term residential treatment center in order to
24maintain the safety and well-being of the child or others due to
25behaviors, including those resulting from traumas, that render the
26child or those around the child unsafe or at risk of harm, or that
27prevent the effective delivery of needed services and supports
28provided in the child’s own home or in other family settings, such
29as with a relative, guardian, foster family, resource family, or
30adoptive family.

31(3) The child meets at least one of the following conditions:

32(A) The child has been assessed as meeting the medical necessity
33criteria for Medi-Cal specialty mental health Early and Periodic
34Screening, Diagnosis, and Treatment Services, as the criteria are
35described in Section 1830.210 of Title 9 of the California Code of
36Regulations.

37(B) The child has been assessed as seriously emotionally
38disturbed, as described in subdivision (a) of Section 5600.3.

39(C) The child has been assessed as requiring the level of services
40provided in order to meet his or her behavioral or therapeutic needs.
P24   1In appropriate circumstances, this may include any of the
2following:

3(i) A commercially sexually exploited child.

4(ii) A private voluntary placement, if the youth exhibits status
5offender behavior, the parents or other relatives feel they cannot
6control the child’s behavior, and short-term intervention is needed
7to transition the child back into the home.

8(iii) A juvenile sex offender.

9(iv) A child who is affiliated with, or impacted by, a gang.

10(b) A short-term residential treatment center program that is
11certified by the State Department of Health Care Services, or by
12a county mental health plan to which the department has delegated
13certification authority, pursuant to Section 4096.5, shall solely
14accept for placement, and provide access to mental health services
15to, children who meet the criteria in paragraphs (1) and (2) of
16subdivision (a), and meet the conditions of subparagraph (A) or
17(B) of paragraph (3) of subdivision (a), or both of those
18subparagraphs. Mental health services are provided directly by the
19certified program.

20(c) A short-term residential treatment center program that is not
21certified pursuant to Section 4096.5 shall solely accept for
22placement in that program a child who meets the criteria in
23paragraphs (1) and (2) of subdivision (a), and meets the conditions
24of subparagraph (A), (B), or (C) of paragraph (3) of subdivision
25(a), or any combination of those subparagraphs. A child who meets
26the conditions of subparagraphs (A) and (B) of paragraph (3) of
27subdivision (a) may be accepted for placement, if the interagency
28placement committee determines that a short-term residential
29treatment facility that is not certified has a program that meets the
30specific needs of the child and there is a commonality of needs
31with the other children in the short-term residential treatment
32center. In this situation, the short-term residential treatment center
33shall do either of the following:

34(1) In the case of a child who is a Medi-Cal beneficiary, arrange
35for the child to receive specialty mental health services from the
36county mental health plan.

37(2) In all other cases, arrange for the child to receive mental
38health services.

39(d) A short-term residential treatment center that is operating
40as a children’s crisis residential center, as defined in Section 1502
P25   1of the Health and Safety Code, and subject to the other
2requirements of subdivisions (b) and (c), may accept for admission
3or placement any child, referred by a parent or guardian, or by the
4 representative of a public or private entity, including, but not
5limited to, the county probation agency or child welfare services
6agency with responsibility for the placement of a child in foster
7care, that has the right to make these decisions on behalf of a child
8who is in mental health crisis and, absent admission to a children’s
9crisis residential center, would otherwise require acceptance by
10the emergency department of a general hospital, or admission into
11a psychiatric hospital or the psychiatric inpatient unit of a general
12hospital.

13(e) A foster family agency, as defined in subdivision (g) of
14Section 11400 and subparagraph (D) of paragraph (1) of
15subdivision (a) of Section 1502 of the Health and Safety Code,
16may have a program that is certified by the State Department of
17Health Care Services, or by a county mental health plan to which
18the department has delegated certification authority, pursuant to
19Section 1810.435 or 1810.436 of Title 9 of the California Code of
20Regulations, or a program that is not certified, or both. A program,
21subject to subdivisions (f) and (g), shall provide access to mental
22health services to the children. A foster family agency, depending
23on whether or not it has a certified program, shall provide access
24to mental health services to children who do not require inpatient
25care in a licensed health facility and who meet any one or more of
26the following conditions:

27(1) A child who has been assessed as meeting the medical
28necessity criteria for specialty mental health services under the
29Medi-Cal Early and Periodic Screening, Diagnosis, and Treatment
30benefit, as the criteria are described in Section 1830.210 of Title
319 of the California Code of Regulations.

32(2) A child who has been assessed as seriously emotionally
33disturbed, as described in subdivision (a) of Section 5600.3.

34(3) A child who has been assessed as requiring the level of
35services to meet his or her behavioral or therapeutic needs.

36(f) A foster family agency that is certified as a provider pursuant
37to Section 1810.435 or 1810.436 of Title 9 of the California Code
38of Regulations by the State Department of Health Care Services,
39or by a county mental health plan to which the department has
40delegated certification authority, shall provide access to mental
P26   1health services directly to children in its program who do not
2require inpatient care in a licensed health facility and who meet
3the conditions of paragraph (1) or (2) of subdivision (e).

4(g) A foster family agency that is not certified as described in
5subdivision (f) may provide access to mental health services in
6that program for children who do not require inpatient care in a
7licensed health facility and who meet the conditions of paragraphs
8(1) and (2) of subdivision (e). In this situation the foster family
9agency shall do the following:

10(1) In the case of a child who is a Medi-Cal beneficiary, have
11written interagency protocols in place to arrange for specialty
12mental health services from the county mental health plan or an
13organizational provider, as defined in Section 1810.231 of Title 9
14of California Code of Regulations.

15(2) In all other cases, arrange for the child to receive mental
16health services.

17(h) All short-term residential treatment centers and foster family
18agencies that operate a certified program shall maintain the level
19of care and services necessary to meet the needs of the children
20and youth in their care and shall maintain and have in good
21standing the appropriate mental health certification issued by the
22State Department of Health Care Services or a county mental health
23plan to which the department has delegated certification authority,
24pursuant to Section 4096.5 of this code or Section 1810.435 or
251810.436 of Title 9 of the California Code of Regulations.

26(i) The assessments described in subparagraphs (A) and (B) of
27paragraph (3) of subdivision (a) and paragraphs (1) and (2) of
28subdivision (e), shall be made by all of the following, as applicable:

29(1) An interagency placement committee, as described in Section
304096, considering the recommendations from the child and family
31team, if any are available.

32(2) A licensed mental health professional as defined in
33subdivision (g) of Section 4096.

34(3) For the purposes of this section, an AFDC-FC funded child
35with an individualized education program developed pursuant to
36Article 2 (commencing with Section 56320) of Chapter 4 of Part
3730 of Division 4 of Title 2 of the Education Code that assesses the
38child as seriously emotionally disturbed, as defined in, and subject
39to, this section and recommends out-of-home placement at the
P27   1level of care provided by the provider, shall be deemed to have
2met the assessment requirement.

3(4) For the purposes of this section, and only for placement into
4a foster family agency, an AFDC-FC funded child assessed
5pursuant to subdivision (b) of Section 706.6 or paragraph (2) of
6subdivision (c) of Section 16501.1, in consultation with a mental
7health professional, as defined in subdivision (g) of Section 4096.5,
8shall be deemed to have met the assessment requirement.

9(j) The assessments described in subparagraph (C) of paragraph
10(3) of subdivision (a) and paragraph (3) of subdivision (e) shall be
11made pursuant to subdivision (b) of Section 706.6 or paragraph
12(2) of subdivision (c) of Section 16501.1.

13(k) (1) The provider shall ensure that AFDC-FC funded
14children, assessed pursuant to subparagraphs (A) and (B) of
15paragraph (3) of subdivision (a) or paragraphs (1) and (2) of
16subdivision (e), who are accepted for placement have been
17approved for placement by an interagency placement committee,
18as described in Section 4096, except as provided for in paragraphs
19(3) and (4) of subdivision (i).

20(2) The approval shall be in writing and shall indicate that the
21interagency placement committee has determined all of the
22following:

23(A) The child meets the medical necessity criteria for Medi-Cal
24specialty mental health Early and Periodic Screening, Diagnosis,
25and Treatment services, as the criteria are described in Section
261830.210 of Title 9 of the California Code of Regulations.

27(B) The child is seriously emotionally disturbed, as described
28in subdivision (a) of Section 5600.3.

29(C) Subject to Section 1502.4 of the Health and Safety Code,
30the child needs the level of care provided by the program.

31(3) (A) Nothing in subdivisions (a) to (j), inclusive, or this
32subdivision shall prevent an emergency placement of a child or
33youth into a certified short-term residential treatment center,
34children’s crisis residential center, or foster family agency program
35prior to the determination by the interagency placement committee,
36but only if a licensed mental health professional, as defined in
37subdivision (g) of Section 4096, has made a written determination
38within 72 hours of the child’s or youth’s placement, that the child
39or youth is seriously emotionally disturbed or has made a written
40determination within 24 hours of the child’s or youth’s placement
P28   1in a children’s crisis residential center that the child or youth is
2experiencing a mental health crisis as defined in subdivision (d),
3and is in need of the care and services provided by the certified
4short-term residential treatment center, children’s crisis residential
5center, or foster family agency.

6(i) The interagency placement committee, as appropriate, shall,
7within 30 days of placement, make the determinations, with
8recommendations from the child and family team, required by this
9subdivision.

10(ii) If it determines the placement is appropriate, the interagency
11placement committee, with recommendations from the child and
12family team, shall transmit the approval, in writing, to the county
13placing agency and the short-term residential treatment center or
14foster family agency.

15(iii) If it determines the placement is not appropriate, the
16interagency placement committee shall respond pursuant to
17subparagraph (B).

18(B) If the interagency placement committee determines at any
19time that the placement is not appropriate, it shall, with
20recommendations from the child and family team, transmit the
21disapproval, in writing, to the county placing agency and the
22short-term residential treatment center or foster family agency,
23and the child or youth shall be referred to an appropriate placement,
24as specified in this section.

25(l) Commencing January 1, 2017, for AFDC-FC funded children
26or youth, only those children or youth who are approved for
27placement, as set forth in this section, may be accepted by a
28short-term residential treatment center or foster family agency.

29(m) The department shall, through regulation, establish
30consequences for the failure of a short-term residential treatment
31center, or a foster family agency, to obtain written approval for
32placement of an AFDC-FC funded child or youth pursuant to this
33section.

34(n) The department shall not establish a rate for a short-term
35residential treatment center or foster family agency unless the
36provider submits a recommendation from the host county or the
37primary placing county that the program is needed and that the
38provider is willing and capable of operating the program at the
39level sought. For purposes of this subdivision, “host county,” and
P29   1“primary placing county,” mean the same as defined in the
2department’s AFDC-FC ratesetting regulations.

3(o) Any certified short-term residential treatment center or foster
4family agency shall be reclassified and paid at the appropriate
5program rate for which it is qualified if either of the following
6occurs:

7(1) (A) It fails to maintain the level of care and services
8necessary to meet the needs of the children and youth in care, as
9required by subdivision (a). The determination shall be made
10consistent with the department’s AFDC-FC ratesetting regulations
11developed pursuant to Sections 11462 and 11463 and shall take
12into consideration the highest level of care and associated rates
13for which the program is eligible.

14(B) In the event of a determination under this paragraph, the
15short-term residential treatment center or foster family agency may
16appeal the finding or submit a corrective action plan. The appeal
17process specified in Section 11466.6 shall be available to a
18short-term residential treatment center or foster family agency that
19provides intensive and therapeutic treatment. During any appeal,
20the short-term residential treatment center or foster family agency
21that provides intensive and therapeutic treatment shall maintain
22the appropriate level of care.

23(2) It fails to maintain a certified mental health treatment
24program as required by subdivision (h).

25(p) In addition to any other review required by law, the child
26and family team as defined in paragraph (4) of subdivision (a) of
27Section 16501 may periodically review the placement of the child
28or youth. If the child and family team make a recommendation
29that the child or youth no longer needs, or is not benefiting from,
30placement in a short-term residential treatment center or foster
31family agency, or one of its programs, the team shall transmit the
32disapproval, in writing, to the county placing agency to consider
33a more appropriate placement.

34(q) The department shall develop a process to address
35placements when, subsequent to the child’s or youth’s placement,
36a determination is made by the interagency placement team and
37shall consider the recommendations of the child and family team,
38either that the child or youth is not in need of the care and services
39provided by the certified program. The process shall include, but
40not be limited to:

P30   1(1) Notice of the determination in writing to both the county
2placing agency and the short-term residential treatment center or
3foster family agency that provides intensive and therapeutic
4treatment.

5(2) Notice of the county’s plan, and a time frame, for removal
6of the child or youth in writing to the short-term residential
7treatment center or foster family agency that provides intensive
8and therapeutic treatment.

9(3) Referral to an appropriate placement.

10(4) Actions to be taken if a child or youth is not timely removed
11from the short-term residential treatment center or foster family
12agency that provides intensive and therapeutic treatment or placed
13in an appropriate placement.

14(r) (1) Nothing in this section shall prohibit a short-term
15residential treatment center or foster family agency from accepting
16private placements of children or youth.

17(2) When a referral is not from a public agency and no public
18funding is involved, there is no requirement for public agency
19review nor determination of need.

20(3) Children and youth subject to paragraphs (1) and (2) shall
21have been determined to be seriously emotionally disturbed, as
22described in subdivision (a) of Section 5600.3, and subject to
23Section 1502.4 of the Health and Safety Code, by a licensed mental
24health professional, as defined in subdivision (g) of Section 4096.

25(s) This section shall become operative on January 1, 2017.

26begin insert

begin insertSEC. 7.end insert  

end insert

begin insertSection 15610.47 of the end insertbegin insertWelfare and Institutions Codeend insert
27
begin insert is amended to read:end insert

28

15610.47.  

“Long-term care facility” means any of the
29following:

30(a) Any long-term health care facility, as defined in subdivision
31(a) of Section 1418 of the Health and Safety Code.

32(b) Any community care facility, as defined inbegin delete paragraphs (1)
33and (2)end delete
begin insert subparagraphs (A) and (B) of paragraph (1)end insert of subdivision
34(a) of Section 1502 of the Health and Safety Code, whether licensed
35or unlicensed.

36(c) Any swing bed in an acute care facility, or any extended
37care facility.

38(d) Any adult day health care facility as defined in subdivision
39(b) of Section 1570.7 of the Health and Safety Code.

P31   1(e) Any residential care facility for the elderly as defined in
2Section 1569.2 of the Health and Safety Code.

3

begin deleteSEC. 6.end delete
4
begin insertSEC. 8.end insert  

No reimbursement is required by this act pursuant to
5Section 6 of Article XIII B of the California Constitution because
6the only costs that may be incurred by a local agency or school
7district will be incurred because this act creates a new crime or
8infraction, eliminates a crime or infraction, or changes the penalty
9for a crime or infraction, within the meaning of Section 17556 of
10the Government Code, or changes the definition of a crime within
11the meaning of Section 6 of Article XIII B of the California
12Constitution.



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