Amended in Senate August 19, 2016

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 amend Sections 5848.5, 11462.01, and 15610.47 of the Welfare and Institutions Code, relating to mental health.

LEGISLATIVE COUNSEL’S DIGEST

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

(1) 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 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 of California and representatives of provider associations, to establish interim 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.

(2) 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 experiencing a 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.

(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.

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

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

begin insert

(5) This bill would incorporate additional changes made by SB 524 and AB 1997 that would become operative only if this bill is chaptered last.

end insert
begin delete

(5)

end delete

begin insert (6)end insert 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:

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.

15begin insert

begin insertSEC. 2.1.end insert  

end insert

begin insertSection 1502 of the end insertbegin insertHealth and Safety Codeend insertbegin insert is
16amended to read:end insert

17

1502.  

begin insert(a)end insertbegin insertend insertAs used in this chapter:

begin delete

18(a)

end delete

19begin insert(1)end insert “Community care facility” means any facility, place, or
20building that is maintained and operated to provide nonmedical
21residential care, day treatment, adult day care, or foster family
22agency services for children, adults, or children and adults,
23including, but not limited to, the physically handicapped, mentally
24impaired, incompetent persons, and abused or neglected children,
25and includes the following:

begin delete

26(1)

end delete

27begin insert(A)end insert “Residential facility” means any family home, group care
28facility, or similar facility determined by the director, for 24-hour
29nonmedical care of persons in need of personal services,
30supervision, or assistance essential for sustaining the activities of
31daily living or for the protection of the individual.

begin delete

32(2)

end delete

33begin insert(B)end insert “Adult day program” means any community-based facility
34or program that provides care to persons 18 years of age or older
35in need of personal services, supervision, or assistance essential
36for sustaining the activities of daily living or for the protection of
37these individuals on less than a 24-hour basis.

begin delete

38(3)

end delete

39begin insert(C)end insert “Therapeutic day services facility” means any facility that
40provides nonmedical care, counseling, educational or vocational
P10   1support, or social rehabilitation services on less than a 24-hour
2basis to persons under 18 years of age who would otherwise be
3placed in foster care or who are returning to families from foster
4care. Program standards for these facilities shall be developed by
5the department, pursuant to Section 1530, in consultation with
6therapeutic day services and foster care providers.

begin delete

7(4)

end delete

8begin insert(D)end insert “Foster family agency” means any public agency or private
9organization engaged in the recruiting, certifying, and training of,
10and providing professional support to, foster parents, or in finding
11homes or other places for placement of children for temporary or
12permanent care who require that level of care. Private foster family
13agencies shall be organized and operated on a nonprofit basis.

begin delete

14(5)

end delete

15begin insert(E)end insert “Foster family home” means any residential facility
16providing 24-hour care for six or fewer foster children that is
17owned, leased, or rented and is the residence of the foster parent
18or parents, including their family, in whose care the foster children
19have been placed. The placement may be by a public or private
20child placement agency or by a court order, or by voluntary
21placement by a parent, parents, or guardian. It also means a foster
22family home described in Section 1505.2.

begin delete

23(6)

end delete

24begin insert(F)end insert “Small family home” means any residential facility, in the
25licensee’s family residence, that provides 24-hour care for six or
26fewer foster children who have mental disorders or developmental
27or physical disabilities and who require special care and supervision
28as a result of their disabilities. A small family home may accept
29children with special health care needs, pursuant to subdivision
30(a) of Section 17710 of the Welfare and Institutions Code. In
31addition to placing children with special health care needs, the
32department may approve placement of children without special
33health care needs, up to the licensed capacity.

begin delete

34(7)

end delete

35begin insert(G)end insert “Social rehabilitation facility” means any residential facility
36that provides social rehabilitation services for no longer than 18
37months in a group setting to adults recovering from mental illness
38who temporarily need assistance, guidance, or counseling. Program
39components shall be subject to program standards pursuant to
P11   1Article 1 (commencing with Section 5670) of Chapter 2.5 of Part
22 of Division 5 of the Welfare and Institutions Code.

begin delete

3(8)

end delete

4begin insert(H)end insert “Community treatment facility” means any residential
5facility that provides mental health treatment services to children
6in a group setting and that has the capacity to provide secure
7containment. Program components shall be subject to program
8standards developed and enforced by the State Department of
9Health Care Services pursuant to Section 4094 of the Welfare and
10Institutions Code.

begin delete

11Nothing in this section shall be construed to prohibit or
12discourage placement of persons who have mental or physical
13disabilities into any category of community care facility that meets
14the needs of the individual placed, if the placement is consistent
15with the licensing regulations of the department.

end delete
begin delete

16(9)

end delete

17begin insert(I)end insertbegin insert(i)end insertbegin insertend insert“Full-service adoption agency” means any licensed entity
18engaged in the business of providing adoption services, that does
19all of the following:

begin delete

20(A)

end delete

21begin insert(I)end insert Assumes care, custody, and control of a child through
22relinquishment of the child to the agency or involuntary termination
23of parental rights to the child.

begin delete

24(B)

end delete

25begin insert(II)end insert Assesses the birth parents, prospective adoptive parents, or
26child.

begin delete

27(C)

end delete

28begin insert(III)end insert Places children for adoption.

begin delete

29(D)

end delete

30begin insert(IV)end insert Supervises adoptive placements.

begin delete

31Private

end delete

32begin insert(ii)end insertbegin insertend insertbegin insertPrivateend insert full-service adoption agencies shall be organized
33and operated on a nonprofit basis. As a condition of licensure to
34provide intercountry adoption services, a full-service adoption
35agency shall be accredited and in good standing according to Part
3696 of Title 22 of the Code of Federal Regulations, or supervised
37by an accredited primary provider, or acting as an exempted
38provider, in compliance with Subpart F (commencing with Section
3996.29) of Part 96 of Title 22 of the Code of Federal Regulations.

begin delete

40(10)

end delete

P12   1begin insert(J)end insertbegin insert(i)end insertbegin insertend insert“Noncustodial adoption agency” means any licensed
2entity engaged in the business of providing adoption services, that
3does all of the following:

begin delete

4(A)

end delete

5begin insert(I)end insert Assesses the prospective adoptive parents.

begin delete

6(B)

end delete

7begin insert(II)end insert Cooperatively matches children freed for adoption, who are
8under the care, custody, and control of a licensed adoption agency,
9for adoption, with assessed and approved adoptive applicants.

begin delete

10(C)

end delete

11begin insert(III)end insert Cooperatively supervises adoptive placements with a
12full-service adoptive agency, but does not disrupt a placement or
13remove a child from a placement.

begin delete

14Private

end delete

15begin insert(ii)end insertbegin insertend insertbegin insertPrivateend insert noncustodial adoption agencies shall be organized
16and operated on a nonprofit basis. As a condition of licensure to
17provide intercountry adoption services, a noncustodial adoption
18agency shall be accredited and in good standing according to Part
1996 of Title 22 of the Code of Federal Regulations, or supervised
20by an accredited primary provider, or acting as an exempted
21provider, in compliance with Subpart F (commencing with Section
2296.29) of Part 96 of Title 22 of the Code of Federal Regulations.

begin delete

23(11)

end delete

24begin insert(K)end insert “Transitional shelter care facility” means any group care
25facility that provides for 24-hour nonmedical care of persons in
26need of personal services, supervision, or assistance essential for
27sustaining the activities of daily living or for the protection of the
28individual. Program components shall be subject to program
29standards developed by the State Department of Social Services
30pursuant to Section 1502.3.

begin delete

31(12)

end delete

32begin insert(L)end insert “Transitional housing placement provider” means an
33organization licensed by the department pursuant to Section
341559.110 and Section 16522.1 of the Welfare and Institutions Code
35to provide transitional housing to foster children at least 16 years
36of age and not more than 18 years of age, and nonminor
37dependents, as defined in subdivision (v) of Section 11400 of the
38Welfare and Institutions Code, to promote their transition to
39adulthood. A transitional housing placement provider shall be
40privately operated and organized on a nonprofit basis.

begin delete

P13   1(13)

end delete

2begin insert(M)end insert “Group home” means a residential facility that provides
324-hour care and supervision to children, delivered at least in part
4by staff employed by the licensee in a structured environment. The
5care and supervision provided by a group home shall be
6nonmedical, except as otherwise permitted by law.

begin delete

7(14)

end delete

8begin insert(N)end insert “Runaway and homeless youth shelter” means a group home
9licensed by the department to operate a program pursuant to Section
101502.35 to provide voluntary,begin delete short-term,end deletebegin insert short-termend insert shelter and
11personal services to runaway youth or homeless youth, as defined
12in paragraph (2) of subdivision (a) of Section 1502.35.

begin delete

13(15)

end delete

14begin insert(O)end insert “Enhanced behavioral supports home” means a facility
15certified by the State Department of Developmental Services
16pursuant to Article 3.6 (commencing with Section 4684.80) of
17Chapter 6 of Division 4.5 of the Welfare and Institutions Code,
18and licensed by the State Department of Social Services as an adult
19residential facility or a group home that provides 24-hour
20nonmedical care to individuals with developmental disabilities
21who require enhanced behavioral supports, staffing, and
22supervision in a homelike setting. An enhanced behavioral supports
23home shall have a maximum capacity of four consumers, shall
24conform to Section 441.530(a)(1) of Title 42 of the Code of Federal
25Regulations, and shall be eligible for federal Medicaid home- and
26community-based services funding.

begin delete

27(16)

end delete

28begin insert(P)end insert “Community crisis home” means a facility certified by the
29State Department of Developmental Services pursuant to Article
308 (commencing with Section 4698) of Chapter 6 of Division 4.5
31of the Welfare and Institutions Code, and licensed by the State
32Department of Social Services pursuant to Article 9.7 (commencing
33with Section 1567.80), as an adult residential facility, providing
3424-hour nonmedical care to individuals with developmental
35disabilities receiving regional center service, in need of crisis
36intervention services, and who would otherwise be at risk of
37admission to the acute crisis center at Fairview Developmental
38Center, Sonoma Developmental Center, an acute general hospital,
39acute psychiatric hospital, an institution for mental disease, as
40described in Part 5 (commencing with Section 5900) of Division
P14   15 of the Welfare and Institutions Code, or an out-of-state
2placement. A community crisis home shall have a maximum
3capacity of eight consumers, as defined in subdivision (a) of
4Section 1567.80, shall conform to Section 441.530(a)(1) of Title
5 42 of the Code of Federal Regulations, and shall be eligible for
6federal Medicaid home- and community-based services funding.

begin delete

7(17)

end delete

8begin insert(Q)end insert “Crisis nursery” means a facility licensed by the department
9to operate a program pursuant to Section 1516 to provide short-term
10care and supervision for children under six years of age who are
11voluntarily placed for temporary care by a parent or legal guardian
12due to a family crisis or stressful situation.

begin delete

13(18)

end delete

14begin insert(R)end insert “Short-term residential treatment center” means a residential
15facility licensed by the department pursuant to Section 1562.01
16and operated by any public agency or private organization that
17provides short-term, specialized, and intensive treatment, and
1824-hour care and supervision to children. The care and supervision
19provided by a short-term residential treatment center shall be
20nonmedical, except as otherwise permitted by law.begin insert A short-term
21residential treatment center may be operated as a children’s crisis
22residential center.end insert

begin insert

23
(S) “Children’s crisis residential center” means a short-term
24residential treatment center operated specifically to divert children
25experiencing a mental health crisis from psychiatric
26hospitalization.

end insert
begin insert

27
(T) “Private alternative boarding school” means a group home
28licensed by the department to operate a program pursuant to
29Section 1502.2 to provide youth with 24-hour residential care and
30supervision, which, in addition to providing educational services
31to youth, provides, or holds itself out as providing,
32behavioral-based services to youth with social, emotional, or
33behavioral issues. The care and supervision provided by a private
34alternative boarding school shall be nonmedical, except as
35otherwise permitted by law.

end insert
begin insert

36
(U) “Private alternative outdoor program” means a group
37home licensed by the department to operate a program pursuant
38to Section 1502.21 to provide youth with 24-hour residential care
39and supervision, which provides, or holds itself out as providing,
40behavioral-based services in an outdoor living setting to youth
P15   1with social, emotional, or behavioral issues. The care and
2supervision provided by a private alternative outdoor program
3shall be nonmedical, except as otherwise permitted by law.

end insert
begin delete

4(b)

end delete

5begin insert(2)end insert “Department” or “state department” means the State
6Department of Social Services.

begin delete

7(c)

end delete

8begin insert(3)end insert “Director” means the Director of Social Services.

begin insert

9
(b) Nothing in this section shall be construed to prohibit or
10discourage placement of persons who have mental or physical
11disabilities into any category of community care facility that meets
12the needs of the individual placed, if the placement is consistent
13with the licensing regulations of the department.

end insert
14begin insert

begin insertSEC. 2.2.end insert  

end insert

begin insertSection 1502 of the end insertbegin insertHealth and Safety Codeend insertbegin insert is
15amended to read:end insert

16

1502.  

begin insert(a)end insertbegin insertend insert As used in this chapter:

begin delete

17(a)

end delete

18begin insert(end insertbegin insert1)end insert “Community care facility” means any facility, place, or
19building that is maintained and operated to provide nonmedical
20residential care, day treatment, adult day care, or foster family
21agency services for children, adults, or children and adults,
22including, but not limited to, the physically handicapped, mentally
23impaired, incompetent persons, and abused or neglected children,
24and includes the following:

begin delete

25(1)

end delete

26begin insert(A)end insert “Residential facility” means any family home, group care
27facility, or similar facility determined by thebegin delete director,end deletebegin insert department,end insert
28 for 24-hour nonmedical care of persons in need of personal
29services, supervision, or assistance essential for sustaining the
30activities of daily living or for the protection of the individual.

begin delete

31(2)

end delete

32begin insert(end insertbegin insertB)end insert “Adult day program” means any community-based facility
33or program that provides care to persons 18 years of age or older
34in need of personal services, supervision, or assistance essential
35for sustaining the activities of daily living or for the protection of
36these individuals on less than a 24-hour basis.

begin delete

37(3)

end delete

38begin insert(end insertbegin insertC)end insert “Therapeutic day services facility” means any facility that
39provides nonmedical care, counseling, educational or vocational
40support, or social rehabilitation services on less than a 24-hour
P16   1basis to persons under 18 years of age who would otherwise be
2placed in foster care or who are returning to families from foster
3care. Program standards for these facilities shall be developed by
4the department, pursuant to Section 1530, in consultation with
5therapeutic day services and foster care providers.

begin delete

6(4)

end delete

7begin insert(end insertbegin insertD)end insert “Foster family agency” means any public agency or private
8
begin delete organization engaged in the recruiting, certifying, and training of,
9and providing professional support to, foster parents, or in finding
10homes or other places for placement of children for temporary or
11permanent care who require that level of care. Private foster family
12agencies shall be organized and operated on a nonprofit basis.end delete

13
begin insert organization, organized and operated on a nonprofitend insertbegin insert basis,
14engaged in any of the following:end insert

begin insert

15
(i) Recruiting, certifying, approving, and training of, and
16providing professional support to, foster parents and resource
17families.

end insert
begin insert

18
(ii) Coordinating with county placing agencies to find homes
19for foster children in need of care.

end insert
begin insert

20
(iii) Providing services and supports to licensed or certified
21foster parents, county-approved resource families, and children
22to the extent authorized by state and federal law.

end insert
begin delete

23(5)

end delete

24begin insert(end insertbegin insertE)end insert “Foster family home” means any residential facility
25providing 24-hour care for six or fewer foster children that is
26owned, leased, or rented and is the residence of the foster parent
27or parents, including their family, in whose care the foster children
28have been placed. The placement may be by a public or private
29child placement agency or by a court order, or by voluntary
30placement by a parent, parents, or guardian. It also means a foster
31family home described in Section 1505.2.

begin delete

32(6)

end delete

33begin insert(end insertbegin insertF)end insert “Small family home” means any residential facility, in the
34licensee’s family residence, that provides 24-hour care for six or
35fewer foster children who have mental disorders or developmental
36or physical disabilities and who require special care and supervision
37as a result of their disabilities. A small family home may accept
38children with special health care needs, pursuant to subdivision
39(a) of Section 17710 of the Welfare and Institutions Code. In
40addition to placing children with special health care needs, the
P17   1department may approve placement of children without special
2health care needs, up to the licensed capacity.

begin delete

3(7)

end delete

4begin insert(end insertbegin insertG)end insert “Social rehabilitation facility” means any residential facility
5that provides social rehabilitation services for no longer than 18
6months in a group setting to adults recovering from mental illness
7who temporarily need assistance, guidance, or counseling. Program
8components shall be subject to program standards pursuant to
9Article 1 (commencing with Section 5670) of Chapter 2.5 of Part
102 of Division 5 of the Welfare and Institutions Code.

begin delete

11(8)

end delete

12begin insert(end insertbegin insertH)end insert “Community treatment facility” means any residential
13facility that provides mental health treatment services to children
14in a group setting and that has the capacity to provide secure
15containment. Program components shall be subject to program
16standards developed and enforced by the State Department of
17Health Care Services pursuant to Section 4094 of the Welfare and
18Institutions Code.

begin delete

19Nothing in this section shall be construed to prohibit or
20discourage placement of persons who have mental or physical
21disabilities into any category of community care facility that meets
22the needs of the individual placed, if the placement is consistent
23with the licensing regulations of the department.

end delete
begin delete

24(9)

end delete

25begin insert(end insertbegin insertI)end insertbegin insert(i)end insertbegin insertend insert “Full-service adoption agency” means any licensed entity
26engaged in the business of providing adoption services, that does
27all of the following:

begin delete

28(A)

end delete

29begin insert(end insertbegin insertI)end insert Assumes care, custody, and control of a child through
30relinquishment of the child to the agency or involuntary termination
31of parental rights to the child.

begin delete

32(B)

end delete

33begin insert(II)end insert Assesses the birth parents, prospective adoptive parents, or
34child.

begin delete

35(C)

end delete

36begin insert(III)end insert Places children for adoption.

begin delete

37(D)

end delete

38begin insert(IV)end insert Supervises adoptive placements.

39begin insert(ii)end insertbegin insertend insert Private full-service adoption agencies shall be organized
40and operated on a nonprofit basis. As a condition of licensure to
P18   1provide intercountry adoption services, a full-service adoption
2agency shall be accredited and in good standing according to Part
396 of Title 22 of the Code of Federal Regulations, or supervised
4by an accredited primary provider, or acting as an exempted
5provider, in compliance with Subpart F (commencing with Section
696.29) of Part 96 of Title 22 of the Code of Federal Regulations.

begin delete

7(10)

end delete

8begin insert(end insertbegin insertJ)end insertbegin insert(i)end insertbegin insertend insert “Noncustodial adoption agency” means any licensed
9entity engaged in the business of providing adoption services, that
10does all of the following:

begin delete

11(A)

end delete

12begin insert(end insertbegin insertI)end insert Assesses the prospective adoptive parents.

begin delete

13(B)

end delete

14begin insert(II)end insert Cooperatively matches children freed for adoption, who are
15under the care, custody, and control of a licensed adoption agency,
16for adoption, with assessed and approved adoptive applicants.

begin delete

17(C)

end delete

18begin insert(III)end insert Cooperatively supervises adoptive placements with a
19full-servicebegin delete adoptiveend deletebegin insert adoptionend insert agency, but does not disrupt a
20 placement or remove a child from a placement.

21begin insert(ii)end insertbegin insertend insert Private noncustodial adoption agencies shall be organized
22and operated on a nonprofit basis. As a condition of licensure to
23provide intercountry adoption services, a noncustodial adoption
24agency shall be accredited and in good standing according to Part
2596 of Title 22 of the Code of Federal Regulations, or supervised
26by an accredited primary provider, or acting as an exempted
27provider, in compliance with Subpart F (commencing with Section
2896.29) of Part 96 of Title 22 of the Code of Federal Regulations.

begin delete

29(11)

end delete

30begin insert(end insertbegin insertK)end insert “Transitional shelter care facility” means any group care
31facility that provides for 24-hour nonmedical care of persons in
32need of personal services, supervision, or assistance essential for
33sustaining the activities of daily living or for the protection of the
34individual. Program components shall be subject to program
35standards developed by the State Department of Social Services
36pursuant to Section 1502.3.

begin delete

37(12)

end delete

38begin insert(L)end insert “Transitional housing placement provider” means an
39organization licensed by the department pursuant to Section
401559.110 and Section 16522.1 of the Welfare and Institutions Code
P19   1to provide transitional housing to foster children at least 16 years
2of age and not more than 18 years of age, and nonminor
3dependents, as defined in subdivision (v) of Section 11400 of the
4Welfare and Institutions Code, to promote their transition to
5adulthood. A transitional housing placement provider shall be
6privately operated and organized on a nonprofit basis.

begin delete

7(13)

end delete

8begin insert(M)end insert “Group home” means a residential facility that provides
924-hour care and supervision to children, delivered at least in part
10by staff employed by the licensee in a structured environment. The
11care and supervision provided by a group home shall be
12nonmedical, except as otherwise permitted by law.

begin delete

13(14)

end delete

14begin insert(N)end insert “Runaway and homeless youth shelter” means a group home
15licensed by the department to operate a program pursuant to Section
161502.35 to provide voluntary,begin delete short-term,end deletebegin insert short-termend insert shelter and
17personal services to runaway youth or homeless youth, as defined
18in paragraph (2) of subdivision (a) of Section 1502.35.

begin delete

19(15)

end delete

20begin insert(O)end insert “Enhanced behavioral supports home” means a facility
21certified by the State Department of Developmental Services
22pursuant to Article 3.6 (commencing with Section 4684.80) of
23Chapter 6 of Division 4.5 of the Welfare and Institutions Code,
24and licensed by the State Department of Social Services as an adult
25residential facility or a group home that provides 24-hour
26nonmedical care to individuals with developmental disabilities
27who require enhanced behavioral supports, staffing, and
28supervision in a homelike setting. An enhanced behavioral supports
29home shall have a maximum capacity of four consumers, shall
30conform to Section 441.530(a)(1) of Title 42 of the Code of Federal
31Regulations, and shall be eligible for federal Medicaid home- and
32community-based services funding.

begin delete

33(16)

end delete

34begin insert(P)end insert “Community crisis home” means a facility certified by the
35State Department of Developmental Services pursuant to Article
368 (commencing with Section 4698) of Chapter 6 of Division 4.5
37of the Welfare and Institutions Code, and licensed by the State
38Department of Social Services pursuant to Article 9.7 (commencing
39with Section 1567.80), as an adult residential facility, providing
4024-hour nonmedical care to individuals with developmental
P20   1disabilities receiving regional center service, in need of crisis
2intervention services, and who would otherwise be at risk of
3admission to the acute crisis center at Fairview Developmental
4Center, Sonoma Developmental Center, an acute general hospital,
5acute psychiatric hospital, an institution for mental disease, as
6described in Part 5 (commencing with Section 5900) of Division
75 of the Welfare and Institutions Code, or an out-of-state
8placement. A community crisis home shall have a maximum
9capacity of eight consumers, as defined in subdivision (a) of
10Section 1567.80, shall conform to Section 441.530(a)(1) of Title
1142 of the Code of Federal Regulations, and shall be eligible for
12federal Medicaid home- and community-based services funding.

begin delete

13(17)

end delete

14begin insert(Q)end insert “Crisis nursery” means a facility licensed by the department
15to operate a program pursuant to Section 1516 to provide short-term
16care and supervision for children under six years of age who are
17voluntarily placed for temporary care by a parent or legal guardian
18due to a family crisis or stressful situation.

begin delete

19(18)

end delete

20begin insert(R)end insert “Short-term residentialbegin delete treatment center”end deletebegin insert therapeutic
21programend insert
begin insertend insert means a residential facilitybegin insert operated by a public agency
22or private organization andend insert
licensed by the department pursuant
23to Section 1562.01begin delete and operated by any public agency or private
24organization that provides short-term, specialized, and intensive
25treatment, andend delete
begin insert that provides an integrated program of specialized
26and intensive care and supervision, services and supports,
27treatment, and short-term,end insert
24-hour care and supervision to children.
28The care and supervision provided by a short-term residential
29begin delete treatment centerend deletebegin insert therapeutic programend insert shall be nonmedical, except
30as otherwise permitted by law.begin insert Private short-term residential
31therapeutic programs shall be organized and operated on a
32nonprofit basis. A short-term residential therapeutic program may
33be operated as a children’s crisis residential center.end insert

begin insert

34
(S) “Children’s crisis residential center” means a short-term
35residential therapeutic program operated specifically to divert
36children experiencing a mental health crisis from psychiatric
37hospitalization.

end insert
begin delete

38(b)

end delete

39begin insert(end insertbegin insert2)end insert “Department” or “state department” means the State
40Department of Social Services.

begin delete

P21   1(c)

end delete

2begin insert(3)end insert “Director” means the Director of Social Services.

begin insert

3
(b) Nothing in this section shall be construed to prohibit or
4discourage placement of persons who have mental or physical
5disabilities into any category of community care facility that meets
6the needs of the individual placed, if the placement is consistent
7with the licensing regulations of the department.

end insert
8begin insert

begin insertSEC. 2.3.end insert  

end insert

begin insertSection 1502 of the end insertbegin insertHealth and Safety Codeend insertbegin insert is
9amended to read:end insert

10

1502.  

begin insert(a)end insertbegin insertend insertAs used in this chapter:

begin delete

11(a)

end delete

12begin insert(1)end insert “Community care facility” means any facility, place, or
13building that is maintained and operated to provide nonmedical
14residential care, day treatment, adult day care, or foster family
15agency services for children, adults, or children and adults,
16including, but not limited to, the physically handicapped, mentally
17impaired, incompetent persons, and abused or neglected children,
18and includes the following:

begin delete

19(1)

end delete

20begin insert(A)end insert “Residential facility” means any family home, group care
21facility, or similar facility determined by thebegin delete director,end deletebegin insert department,end insert
22 for 24-hour nonmedical care of persons in need of personal
23services, supervision, or assistance essential for sustaining the
24activities of daily living or for the protection of the individual.

begin delete

25(2)

end delete

26begin insert(B)end insert “Adult day program” means any community-based facility
27or program that provides care to persons 18 years of age or older
28in need of personal services, supervision, or assistance essential
29for sustaining the activities of daily living or for the protection of
30these individuals on less than a 24-hour basis.

begin delete

31(3)

end delete

32begin insert(C)end insert “Therapeutic day services facility” means any facility that
33provides nonmedical care, counseling, educational or vocational
34support, or social rehabilitation services on less than a 24-hour
35basis to persons under 18 years of age who would otherwise be
36placed in foster care or who are returning to families from foster
37care. Program standards for these facilities shall be developed by
38the department, pursuant to Section 1530, in consultation with
39therapeutic day services and foster care providers.

begin delete

40(4)

end delete

P22   1begin insert(D)end insert “Foster family agency” means any public agency or private
2
begin delete organization engaged in the recruiting, certifying, and training of,
3and providing professional support to, foster parents, or in finding
4homes or other places for placement of children for temporary or
5permanent care who require that level of care. Private foster family
6agencies shall be organized and operated on a nonprofit basis.end delete

7
begin insert organization, organized and operated on a nonprofitend insertbegin insert basis,
8engaged in any of the following:end insert

begin insert

9
(i) Recruiting, certifying, approving, and training of, and
10providing professional support to, foster parents and resource
11families.

end insert
begin insert

12
(ii) Coordinating with county placing agencies to find homes
13for foster children in need of care.

end insert
begin insert

14
(iii) Providing services and supports to licensed or certified
15foster parents, county-approved resource families, and children
16to the extent authorized by state and federal law.

end insert
begin delete

17(5)

end delete

18begin insert(E)end insert “Foster family home” means any residential facility
19providing 24-hour care for six or fewer foster children that is
20owned, leased, or rented and is the residence of the foster parent
21or parents, including their family, in whose care the foster children
22have been placed. The placement may be by a public or private
23child placement agency or by a court order, or by voluntary
24placement by a parent, parents, or guardian. It also means a foster
25family home described in Section 1505.2.

begin delete

26(6)

end delete

27begin insert(F)end insert “Small family home” means any residential facility, in the
28licensee’s family residence, that provides 24-hour care for six or
29fewer foster children who have mental disorders or developmental
30or physical disabilities and who require special care and supervision
31as a result of their disabilities. A small family home may accept
32children with special health care needs, pursuant to subdivision
33(a) of Section 17710 of the Welfare and Institutions Code. In
34addition to placing children with special health care needs, the
35department may approve placement of children without special
36health care needs, up to the licensed capacity.

begin delete

37(7)

end delete

38begin insert(G)end insert “Social rehabilitation facility” means any residential facility
39that provides social rehabilitation services for no longer than 18
40months in a group setting to adults recovering from mental illness
P23   1who temporarily need assistance, guidance, or counseling. Program
2components shall be subject to program standards pursuant to
3Article 1 (commencing with Section 5670) of Chapter 2.5 of Part
42 of Division 5 of the Welfare and Institutions Code.

begin delete

5(8)

end delete

6begin insert(H)end insert “Community treatment facility” means any residential
7facility that provides mental health treatment services to children
8in a group setting and that has the capacity to provide secure
9containment. Program components shall be subject to program
10standards developed and enforced by the State Department of
11Health Care Services pursuant to Section 4094 of the Welfare and
12Institutions Code.

begin delete

13Nothing in this section shall be construed to prohibit or
14discourage placement of persons who have mental or physical
15disabilities into any category of community care facility that meets
16the needs of the individual placed, if the placement is consistent
17with the licensing regulations of the department.

end delete
begin delete

18(9)

end delete

19begin insert(I)end insertbegin insert(i)end insertbegin insertend insert“Full-service adoption agency” means any licensed entity
20engaged in the business of providing adoption services, that does
21all of the following:

begin delete

22(A)

end delete

23begin insert(I)end insert Assumes care, custody, and control of a child through
24relinquishment of the child to the agency or involuntary termination
25of parental rights to the child.

begin delete

26(B)

end delete

27begin insert(II)end insert Assesses the birth parents, prospective adoptive parents, or
28child.

begin delete

29(C)

end delete

30begin insert(III)end insert Places children for adoption.

begin delete

31(D)

end delete

32begin insert(IV)end insert Supervises adoptive placements.

begin delete

33Private

end delete

34begin insert(ii)end insertbegin insertend insertbegin insertPrivateend insert full-service adoption agencies shall be organized
35and operated on a nonprofit basis. As a condition of licensure to
36provide intercountry adoption services, a full-service adoption
37agency shall be accredited and in good standing according to Part
3896 of Title 22 of the Code of Federal Regulations, or supervised
39by an accredited primary provider, or acting as an exempted
P24   1provider, in compliance with Subpart F (commencing with Section
296.29) of Part 96 of Title 22 of the Code of Federal Regulations.

begin delete

3(10)

end delete

4begin insert(J)end insertbegin insert(i)end insertbegin insertend insert“Noncustodial adoption agency” means any licensed
5entity engaged in the business of providing adoption services, that
6does all of the following:

begin delete

7(A)

end delete

8begin insert(I)end insert Assesses the prospective adoptive parents.

begin delete

9(B)

end delete

10begin insert(II)end insert Cooperatively matches children freed for adoption, who are
11under the care, custody, and control of a licensed adoption agency,
12for adoption, with assessed and approved adoptive applicants.

begin delete

13(C)

end delete

14begin insert(III)end insert Cooperatively supervisesbegin delete adoptiveend deletebegin insert adoptionend insert placements
15with a full-service adoptive agency, but does not disrupt a
16placement or remove a child from a placement.

begin delete

17Private

end delete

18begin insert(ii)end insertbegin insertend insertbegin insertPrivateend insert noncustodial adoption agencies shall be organized
19and operated on a nonprofit basis. As a condition of licensure to
20provide intercountry adoption services, a noncustodial adoption
21agency shall be accredited and in good standing according to Part
2296 of Title 22 of the Code of Federal Regulations, or supervised
23by an accredited primary provider, or acting as an exempted
24provider, in compliance with Subpart F (commencing with Section
2596.29) of Part 96 of Title 22 of the Code of Federal Regulations.

begin delete

26(11)

end delete

27begin insert(end insertbegin insertK)end insert “Transitional shelter care facility” means any group care
28facility that provides for 24-hour nonmedical care of persons in
29need of personal services, supervision, or assistance essential for
30sustaining the activities of daily living or for the protection of the
31individual. Program components shall be subject to program
32standards developed by the State Department of Social Services
33pursuant to Section 1502.3.

begin delete

34(12)

end delete

35begin insert(end insertbegin insertL)end insert “Transitional housing placement provider” means an
36organization licensed by the department pursuant to Section
371559.110 and Section 16522.1 of the Welfare and Institutions Code
38to provide transitional housing to foster children at least 16 years
39of age and not more than 18 years of age, and nonminor
40dependents, as defined in subdivision (v) of Section 11400 of the
P25   1Welfare and Institutions Code, to promote their transition to
2adulthood. A transitional housing placement provider shall be
3privately operated and organized on a nonprofit basis.

begin delete

4(13)

end delete

5begin insert(end insertbegin insertM)end insert “Group home” means a residential facility that provides
624-hour care and supervision to children, delivered at least in part
7by staff employed by the licensee in a structured environment. The
8care and supervision provided by a group home shall be
9nonmedical, except as otherwise permitted by law.

begin delete

10(14)

end delete

11begin insert(end insertbegin insertN)end insert “Runaway and homeless youth shelter” means a group home
12licensed by the department to operate a program pursuant to Section
131502.35 to provide voluntary,begin delete short-term,end deletebegin insert short-termend insert shelter and
14personal services to runaway youth or homeless youth, as defined
15in paragraph (2) of subdivision (a) of Section 1502.35.

begin delete

16(15)

end delete

17begin insert(end insertbegin insertO)end insert “Enhanced behavioral supports home” means a facility
18certified by the State Department of Developmental Services
19pursuant to Article 3.6 (commencing with Section 4684.80) of
20Chapter 6 of Division 4.5 of the Welfare and Institutions Code,
21and licensed by the State Department of Social Services as an adult
22residential facility or a group home that provides 24-hour
23nonmedical care to individuals with developmental disabilities
24who require enhanced behavioral supports, staffing, and
25supervision in a homelike setting. An enhanced behavioral supports
26home shall have a maximum capacity of four consumers, shall
27conform to Section 441.530(a)(1) of Title 42 of the Code of Federal
28Regulations, and shall be eligible for federal Medicaid home- and
29community-based services funding.

begin delete

30(16)

end delete

31begin insert(end insertbegin insertP)end insert “Community crisis home” means a facility certified by the
32State Department of Developmental Services pursuant to Article
338 (commencing with Section 4698) of Chapter 6 of Division 4.5
34of the Welfare and Institutions Code, and licensed by the State
35Department of Social Services pursuant to Article 9.7 (commencing
36with Section 1567.80), as an adult residential facility, providing
3724-hour nonmedical care to individuals with developmental
38disabilities receiving regional center service, in need of crisis
39intervention services, and who would otherwise be at risk of
40admission to the acute crisis center at Fairview Developmental
P26   1Center, Sonoma Developmental Center, an acute general hospital,
2acute psychiatric hospital, an institution for mental disease, as
3described in Part 5 (commencing with Section 5900) of Division
45 of the Welfare and Institutions Code, or an out-of-state
5placement. A community crisis home shall have a maximum
6capacity of eight consumers, as defined in subdivision (a) of
7Section 1567.80, shall conform to Section 441.530(a)(1) of Title
842 of the Code of Federal Regulations, and shall be eligible for
9federal Medicaid home- and community-based services funding.

begin delete

10(17)

end delete

11begin insert(end insertbegin insertQ)end insert “Crisis nursery” means a facility licensed by the department
12to operate a program pursuant to Section 1516 to provide short-term
13care and supervision for children under six years of age who are
14voluntarily placed for temporary care by a parent or legal guardian
15due to a family crisis or stressful situation.

begin delete

16(18)

end delete

17begin insert(end insertbegin insertR)end insert “Short-term residentialbegin delete treatment center”end deletebegin insert therapeutic
18programend insert
begin insertend insert means a residential facilitybegin insert operated by a public agency
19or private organization andend insert
licensed by the department pursuant
20to Section 1562.01begin delete and operated by any public agency or private
21organization that provides short-term, specialized, and intensive
22treatment, andend delete
begin insert that provides an integrated program of specialized
23and intensive care and supervision, services and supports,
24treatment, and short-term,end insert
24-hour care and supervision to children.
25The care and supervision provided by a short-term residential
26begin delete treatment centerend deletebegin insert therapeutic programend insert shall be nonmedical, except
27as otherwise permitted by law.begin insert Private short-term residential
28therapeutic programs shall be organized and operated on a
29nonprofit basis. A short-term residential therapeutic program may
30be operated as a children’s crisis residential center.end insert

begin insert

31
(S) “Children’s crisis residential center” means a short-term
32residential therapeutic program operated specifically to divert
33children experiencing a mental health crisis from psychiatric
34hospitalization.

end insert
begin insert

35
(T) “Private alternative boarding school” means a group home
36licensed by the department to operate a program pursuant to
37Section 1502.2 to provide youth with 24-hour residential care and
38supervision, which, in addition to providing educational services
39to youth, provides, or holds itself out as providing,
40behavioral-based services to youth with social, emotional, or
P27   1behavioral issues. The care and supervision provided by a private
2alternative boarding school shall be nonmedical, except as
3otherwise permitted by law.

end insert
begin insert

4
(U) “Private alternative outdoor program” means a group
5home licensed by the department to operate a program pursuant
6to Section 1502.21 to provide youth with 24-hour residential care
7and supervision, which provides, or holds itself out as providing,
8behavioral-based services in an outdoor living setting to youth
9with social, emotional, or behavioral issues. The care and
10supervision provided by a private alternative outdoor program
11shall be nonmedical, except as otherwise permitted by law.

end insert
begin delete

12(b)

end delete

13begin insert(end insertbegin insert2)end insert “Department” or “state department” means the State
14Department of Social Services.

begin delete

15(c)

end delete

16begin insert(end insertbegin insert3)end insert “Director” means the Director of Social Services.

begin insert

17
(b) Nothing in this section shall be construed to prohibit or
18discourage placement of persons who have mental or physical
19disabilities into any category of community care facility that meets
20the needs of the individual placed, if the placement is consistent
21with the licensing regulations of the department.

end insert
22

SEC. 3.  

Section 1562.02 is added to the Health and Safety
23Code
, to read:

24

1562.02.  

(a) The department shall establish regulations for
25short-term residential treatment centers that are operated as
26children’s crisis residential centers. At a minimum, the regulations
27shall include all of the following:

28(1) The children’s crisis residential center shall be used only
29for diversion from admittance to a psychiatric hospitalization.

30(2) (A) Length of stay for a single admission to a children’s
31crisis residential center shall be limited to 10 consecutive days.

32(B) Notwithstanding subparagraph (A), the length of stay may
33be extended once for no more than two consecutive 10-day lengths
34of stay. Before extending the length of stay for a Medi-Cal
35beneficiary beyond 10 consecutive days, an organization providing
36children’s crisis residential services shall obtain prior approval
37from the county mental health plan authorizing those services.

38(C) A child shall not be admitted to a children’s crisis residential
39center regulated under this section for more than 20 total days in
40any six-month period.

P28   1(3) Therapeutic programming shall be provided seven days a
2week, including weekends and holidays, with sufficient
3professional and paraprofessional staff to maintain an appropriate
4 treatment setting and services, based on individual children’s needs.

5(4) The program shall be staffed with sufficient personnel to
6accept children 24 hours per day, seven days a week and to admit
7children, at a minimum, from 7 a.m. to 11 p.m., seven days a week,
8365 days per year. The program shall be sufficiently staffed to
9discharge children, as appropriate, seven days a week, 365 days
10per year.

11(5) Facilities shall be limited to fewer than 16 beds, with at least
1250 percent of those beds in single-occupancy rooms.

13(6) Facilities shall include ample physical space for
14accommodating individuals who provide natural supports to each
15child and for integrating family members into the day-to-day care
16of the youth.

17(7) The center shall collaborate with each child’s mental health
18team, child and family team, and other formal and natural supports
19within 24 hours of intake and throughout the course of care and
20treatment as appropriate.

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:

25(1) Age and gender of clients served.

26(2) Duration of stay.

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

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

29

SEC. 4.  

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

31

1562.03.  

(a) (1) The State Department of Health Care Services
32shall establish interim Medi-Cal rates as needed that are sufficient
33to reimburse the costs for children’s crisis residential services in
34excess of any specialty mental health services that would have
35been otherwise authorized, provided, and invoiced for each eligible
36Medi-Cal beneficiary receiving children’s crisis residential services.

37(2) The department shall consult with subject matter experts
38from the County Behavioral Health Directors Association of
39California and provider associations to obtain data and background
40information necessary to ensure sufficiency of the rate.

P29   1(b) For foster children admitted for children’s crisis residential
2services, programs shall receive payment for board and care
3equivalent to the rate paid for short-term residential treatment
4 centers.

5(c) Nothing in this chapter shall prevent a county from providing
6payment in excess of the short-term residential treatment center
7rate in order to meet the needs of individual children.

8

SEC. 5.  

Section 5848.5 of the Welfare and Institutions Code
9 is amended to read:

10

5848.5.  

(a) The Legislature finds and declares all of the
11following:

12(1) California has realigned public community mental health
13services to counties and it is imperative that sufficient
14community-based resources be available to meet the mental health
15needs of eligible individuals.

16(2) Increasing access to effective outpatient and crisis
17stabilization services provides an opportunity to reduce costs
18associated with expensive inpatient and emergency room care and
19to better meet the needs of individuals with mental health disorders
20in the least restrictive manner possible.

21(3) Almost one-fifth of people with mental health disorders visit
22a hospital emergency room at least once per year. If an adequate
23array of crisis services is not available, it leaves an individual with
24little choice but to access an emergency room for assistance and,
25potentially, an unnecessary inpatient hospitalization.

26(4) Recent reports have called attention to a continuing problem
27of inappropriate and unnecessary utilization of hospital emergency
28rooms in California due to limited community-based services for
29individuals in psychological distress and acute psychiatric crisis.
30Hospitals report that 70 percent of people taken to emergency
31rooms for psychiatric evaluation can be stabilized and transferred
32to a less intensive level of crisis care. Law enforcement personnel
33report that their personnel need to stay with people in the
34emergency room waiting area until a placement is found, and that
35less intensive levels of care tend not to be available.

36(5) Comprehensive public and private partnerships at both local
37and regional levels, including across physical health services,
38mental health, substance use disorder, law enforcement, social
39services, and related supports, are necessary to develop and
40maintain high quality, patient-centered, and cost-effective care for
P30   1individuals with mental health disorders that facilitates their
2recovery and leads towards wellness.

3(6) The recovery of individuals with mental health disorders is
4important for all levels of government, business, and the local
5community.

6(b) This section shall be known, and may be cited, as the
7Investment in Mental Health Wellness Act of 2013. The objectives
8of this section are to do all of the following:

9(1) Expand access to early intervention and treatment services
10to improve the client experience, achieve recovery and wellness,
11and reduce costs.

12(2) Expand the continuum of services to address crisis
13intervention, crisis stabilization, and crisis residential treatment
14needs that are wellness, resiliency, and recovery oriented.

15(3) Add at least 25 mobile crisis support teams and at least 2,000
16crisis stabilization and crisis residential treatment beds to bolster
17capacity at the local level to improve access to mental health crisis
18services and address unmet mental health care needs.

19(4) Add at least 600 triage personnel to provide intensive case
20management and linkage to services for individuals with mental
21health care disorders at various points of access, such as at
22designated community-based service points, homeless shelters,
23and clinics.

24(5) Reduce unnecessary hospitalizations and inpatient days by
25appropriately utilizing community-based services and improving
26access to timely assistance.

27(6) Reduce recidivism and mitigate unnecessary expenditures
28of local law enforcement.

29(7) Provide local communities with increased financial resources
30to leverage additional public and private funding sources to achieve
31improved networks of care for individuals with mental health
32disorders.

33(8) Provide a complete continuum of crisis services for children
34and youth 21 years of age and under regardless of where they live
35in the state. The funds included in the 2016 Budget Act for the
36purpose of developing the continuum of mental health crisis
37services for children and youth 21 years of age and under shall be
38for the following objectives:

39(A) Provide a continuum of crisis services for children and youth
4021 years of age and under regardless of where they live in the state.

P31   1(B) Provide for early intervention and treatment services to
2improve the client experience, achieve recovery and wellness, and
3reduce costs.

4(C) Expand the continuum of community-based services to
5address crisis intervention, crisis stabilization, and crisis residential
6treatment needs that are wellness-, resiliency-, and
7recovery-oriented.

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

9(E) Add at least 120 crisis stabilization services and beds and
10crisis residential treatment beds to increase capacity at the local
11level to improve access to mental health crisis services and address
12unmet mental health care needs.

13(F) Add triage personnel to provide intensive case management
14and linkage to services for individuals with mental health care
15disorders at various points of access, such as at designated
16community-based service points, homeless shelters, schools, and
17clinics.

18(G) Expand family respite care to help families and sustain
19caregiver health and well-being.

20(H) Expand family supportive training and related services
21designed to help families participate in the planning process, access
22services, and navigate programs.

23(I) Reduce unnecessary hospitalizations and inpatient days by
24appropriately utilizing community-based services.

25(J) Reduce recidivism and mitigate unnecessary expenditures
26of local law enforcement.

27(K) Provide local communities with increased financial
28resources to leverage additional public and private funding sources
29to achieve improved networks of care for children and youth 21
30years of age and under with mental health disorders.

31(c) Through appropriations provided in the annual Budget Act
32for this purpose, it is the intent of the Legislature to authorize the
33California Health Facilities Financing Authority, hereafter referred
34to as the authority, and the Mental Health Services Oversight and
35Accountability Commission, hereafter referred to as the
36commission, to administer competitive selection processes as
37provided in this section for capital capacity and program expansion
38to increase capacity for mobile crisis support, crisis intervention,
39crisis stabilization services, crisis residential treatment, and
40specified personnel resources.

P32   1(d) Funds appropriated by the Legislature to the authority for
2purposes of this section shall be made available to selected
3counties, or counties acting jointly. The authority may, at its
4discretion, also give consideration to private nonprofit corporations
5and public agencies in an area or region of the state if a county, or
6counties acting jointly, affirmatively supports this designation and
7collaboration in lieu of a county government directly receiving
8grant funds.

9(1) Grant awards made by the authority shall be used to expand
10local resources for the development, capital, equipment acquisition,
11and applicable program startup or expansion costs to increase
12capacity for client assistance and services in the following areas:

13(A) Crisis intervention, as authorized by Sections 14021.4,
1414680, and 14684.

15(B) Crisis stabilization, as authorized by Sections 14021.4,
1614680, and 14684.

17(C) Crisis residential treatment, as authorized by Sections
1814021.4, 14680, and 14684.

19(D) Rehabilitative mental health services, as authorized by
20Sections 14021.4, 14680, and 14684.

21(E) Mobile crisis support teams, including personnel and
22equipment, such as the purchase of vehicles.

23(2) The authority shall develop selection criteria to expand local
24resources, including those described in paragraph (1), and processes
25for awarding grants after consulting with representatives and
26interested stakeholders from the mental health community,
27including, but not limited to, the County Behavioral Health
28Directors Association of California, service providers, consumer
29organizations, and other appropriate interests, such as health care
30providers and law enforcement, as determined by the authority.
31The authority shall ensure that grants result in cost-effective
32expansion of the number of community-based crisis resources in
33regions and communities selected for funding. The authority shall
34also take into account at least the following criteria and factors
35when selecting recipients of grants and determining the amount
36of grant awards:

37(A) Description of need, including, at a minimum, a
38comprehensive description of the project, community need,
39population to be served, linkage with other public systems of health
40and mental health care, linkage with local law enforcement, social
P33   1services, and related assistance, as applicable, and a description
2of the request for funding.

3(B) Ability to serve the target population, which includes
4individuals eligible for Medi-Cal and individuals eligible for county
5health and mental health services.

6(C) Geographic areas or regions of the state to be eligible for
7grant awards, which may include rural, suburban, and urban areas,
8and may include use of the five regional designations utilized by
9the County Behavioral Health Directors Association of California.

10(D) Level of community engagement and commitment to project
11completion.

12(E) Financial support that, in addition to a grant that may be
13awarded by the authority, will be sufficient to complete and operate
14 the project for which the grant from the authority is awarded.

15(F) Ability to provide additional funding support to the project,
16including public or private funding, federal tax credits and grants,
17foundation support, and other collaborative efforts.

18(G) Memorandum of understanding among project partners, if
19applicable.

20(H) Information regarding the legal status of the collaborating
21partners, if applicable.

22(I) Ability to measure key outcomes, including improved access
23to services, health and mental health outcomes, and cost benefit
24of the project.

25(3) The authority shall determine maximum grants awards,
26which shall take into consideration the number of projects awarded
27to the grantee, as described in paragraph (1), and shall reflect
28reasonable costs for the project and geographic region. The
29authority may allocate a grant in increments contingent upon the
30phases of a project.

31(4) Funds awarded by the authority pursuant to this section may
32be used to supplement, but not to supplant, existing financial and
33resource commitments of the grantee or any other member of a
34collaborative effort that has been awarded a grant.

35(5) All projects that are awarded grants by the authority shall
36be completed within a reasonable period of time, to be determined
37by the authority. Funds shall not be released by the authority until
38the applicant demonstrates project readiness to the authority’s
39satisfaction. If the authority determines that a grant recipient has
40failed to complete the project under the terms specified in awarding
P34   1the grant, the authority may require remedies, including the return
2of all or a portion of the grant.

3(6) A grantee that receives a grant from the authority under this
4 section shall commit to using that capital capacity and program
5expansion project, such as the mobile crisis team, crisis
6stabilization unit, or crisis residential treatment program, for the
7duration of the expected life of the project.

8(7) The authority may consult with a technical assistance entity,
9as described in paragraph (5) of subdivision (a) of Section 4061,
10for purposes of implementing this section.

11(8) The authority may adopt emergency regulations relating to
12the grants for the capital capacity and program expansion projects
13described in this section, including emergency regulations that
14define eligible costs and determine minimum and maximum grant
15amounts.

16(9) The authority shall provide reports to the fiscal and policy
17committees of the Legislature on or before May 1, 2014, and on
18or before May 1, 2015, on the progress of implementation, that
19include, but are not limited to, the following:

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

21(B) The amount of each grant issued.

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

23(D) The total amount of grants issued.

24(E) A description of project operation and implementation,
25including who is being served.

26(10) A recipient of a grant provided pursuant to paragraph (1)
27shall adhere to all applicable laws relating to scope of practice,
28licensure, certification, staffing, and building codes.

29(e) Of the funds specified in paragraph (8) of subdivision (b),
30it is the intent of the Legislature to authorize the authority and the
31commission to administer competitive selection processes as
32provided in this section for capital capacity and program expansion
33to increase capacity for mobile crisis support, crisis intervention,
34crisis stabilization services, crisis residential treatment, family
35respite care, family supportive training and related services, and
36triage personnel resources for children and youth 21 years of age
37and under.

38(f) Funds appropriated by the Legislature to the authority to
39address crisis services for children and youth 21 years of age and
40under for the purposes of this section shall be made available to
P35   1selected counties or counties acting jointly. The authority may, at
2its discretion, also give consideration to private nonprofit
3corporations and public agencies in an area or region of the state
4if a county, or counties acting jointly, affirmatively support this
5designation and collaboration in lieu of a county government
6directly receiving grant funds.

7(1) Grant awards made by the authority shall be used to expand
8local resources for the development, capital, equipment acquisition,
9and applicable program startup or expansion costs to increase
10capacity for client assistance and crisis services for children and
11youth 21 years of age and under in the following areas:

12(A) Crisis intervention, as authorized by Sections 14021.4,
1314680, and 14684.

14(B) Crisis stabilization, as authorized by Sections 14021.4,
1514680, and 14684.

16(C) Crisis residential treatment, as authorized by Sections
1714021.4, 14680, and 14684 and as provided at a children’s crisis
18residential center, as defined in Section 1502 of the Health and
19Safety Code.

20(D) Mobile crisis support teams, including the purchase of
21equipment and vehicles.

22(E) Family respite care.

23(2) The authority shall develop selection criteria to expand local
24resources, including those described in paragraph (1), and processes
25for awarding grants after consulting with representatives and
26interested stakeholders from the mental health community,
27including, but not limited to, county mental health directors, service
28providers, consumer organizations, and other appropriate interests,
29such as health care providers and law enforcement, as determined
30by the authority. The authority shall ensure that grants result in
31cost-effective expansion of the number of community-based crisis
32resources in regions and communities selected for funding. The
33authority shall also take into account at least the following criteria
34and factors when selecting recipients of grants and determining
35the amount of grant awards:

36(A) Description of need, including, at a minimum, a
37comprehensive description of the project, community need,
38population to be served, linkage with other public systems of health
39and mental health care, linkage with local law enforcement, social
P36   1services, and related assistance, as applicable, and a description
2of the request for funding.

3(B) Ability to serve the target population, which includes
4individuals eligible for Medi-Cal and individuals eligible for county
5health and mental health services.

6(C) Geographic areas or regions of the state to be eligible for
7grant awards, which may include rural, suburban, and urban areas,
8and may include use of the five regional designations utilized by
9the California Behavioral Health Directors Association.

10(D) Level of community engagement and commitment to project
11completion.

12(E) Financial support that, in addition to a grant that may be
13awarded by the authority, will be sufficient to complete and operate
14the project for which the grant from the authority is awarded.

15(F) Ability to provide additional funding support to the project,
16including public or private funding, federal tax credits and grants,
17foundation support, and other collaborative efforts.

18(G) Memorandum of understanding among project partners, if
19applicable.

20(H) Information regarding the legal status of the collaborating
21partners, if applicable.

22(I) Ability to measure key outcomes, including utilization of
23services, health and mental health outcomes, and cost benefit of
24the project.

25(3) The authority shall determine maximum grant awards, which
26shall take into consideration the number of projects awarded to
27the grantee, as described in paragraph (1), and shall reflect
28reasonable costs for the project, geographic region, and target ages.
29The authority may allocate a grant in increments contingent upon
30the phases of a project.

31(4) Funds awarded by the authority pursuant to this section may
32be used to supplement, but not to supplant, existing financial and
33resource commitments of the grantee or any other member of a
34 collaborative effort that has been awarded a grant.

35(5) All projects that are awarded grants by the authority shall
36be completed within a reasonable period of time, to be determined
37by the authority. Funds shall not be released by the authority until
38the applicant demonstrates project readiness to the authority’s
39satisfaction. If the authority determines that a grant recipient has
40failed to complete the project under the terms specified in awarding
P37   1the grant, the authority may require remedies, including the return
2of all, or a portion, of the grant.

3(6) A grantee that receives a grant from the authority under this
4section shall commit to using that capital capacity and program
5expansion project, such as the mobile crisis team, crisis
6stabilization unit, family respite care, or crisis residential treatment
7program, for the duration of the expected life of the project.

8(7) The authority may consult with a technical assistance entity,
9as described in paragraph (5) of subdivision (a) of Section 4061,
10for the purposes of implementing this section.

11(8) The authority may adopt emergency regulations relating to
12the grants for the capital capacity and program expansion projects
13described in this section, including emergency regulations that
14define eligible costs and determine minimum and maximum grant
15amounts.

16(9) The authority shall provide reports to the fiscal and policy
17committees of the Legislature on or before January 10, 2018, and
18annually thereafter, on the progress of implementation, that include,
19but are not limited to, the following:

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

21(B) The amount of each grant issued.

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

23(D) The total amount of grants issued.

24(E) A description of project operation and implementation,
25including who is being served.

26(10) A recipient of a grant provided pursuant to paragraph (1)
27shall adhere to all applicable laws relating to scope of practice,
28licensure, certification, staffing, and building codes.

29(g) Funds appropriated by the Legislature to the commission
30for purposes of this section shall be allocated for triage personnel
31to provide intensive case management and linkage to services for
32individuals with mental health disorders at various points of access.
33These funds shall be made available to selected counties, counties
34acting jointly, or city mental health departments, as determined
35by the commission through a selection process. It is the intent of
36the Legislature for these funds to be allocated in an efficient manner
37to encourage early intervention and receipt of needed services for
38individuals with mental health disorders, and to assist in navigating
39the local service sector to improve efficiencies and the delivery of
40services.

P38   1(1) Triage personnel may provide targeted case management
2services face to face, by telephone, or by telehealth with the
3individual in need of assistance or his or her significant support
4person, and may be provided anywhere in the community. These
5service activities may include, but are not limited to, the following:

6(A) Communication, coordination, and referral.

7(B) Monitoring service delivery to ensure the individual accesses
8and receives services.

9(C) Monitoring the individual’s progress.

10(D) Providing placement service assistance and service plan
11development.

12(2) The commission shall take into account at least the following
13criteria and factors when selecting recipients and determining the
14amount of grant awards for triage personnel as follows:

15(A) Description of need, including potential gaps in local service
16connections.

17(B) Description of funding request, including personnel and use
18of peer support.

19(C) Description of how triage personnel will be used to facilitate
20linkage and access to services, including objectives and anticipated
21outcomes.

22(D) Ability to obtain federal Medicaid reimbursement, when
23applicable.

24(E) Ability to administer an effective service program and the
25degree to which local agencies and service providers will support
26and collaborate with the triage personnel effort.

27(F) Geographic areas or regions of the state to be eligible for
28grant awards, which shall include rural, suburban, and urban areas,
29and may include use of the five regional designations utilized by
30the County Behavioral Health Directors Association of California.

31(3) The commission shall determine maximum grant awards,
32and shall take into consideration the level of need, population to
33be served, and related criteria, as described in paragraph (2), and
34shall reflect reasonable costs.

35(4) Funds awarded by the commission for purposes of this
36section may be used to supplement, but not supplant, existing
37financial and resource commitments of the county, counties acting
38jointly, or city mental health department that received the grant.

39(5) Notwithstanding any other law, a county, counties acting
40jointly, or city mental health department that receives an award of
P39   1funds for the purpose of supporting triage personnel pursuant to
2this subdivision is not required to provide a matching contribution
3of local funds.

4(6) Notwithstanding any other law, the commission, without
5taking any further regulatory action, may implement, interpret, or
6make specific this section by means of informational letters,
7bulletins, or similar instructions.

8(7) The commission shall provide a status report to the fiscal
9and policy committees of the Legislature on the progress of
10implementation no later than March 1, 2014.

11(h) Funds appropriated by the Legislature to the commission
12pursuant to paragraph (8) of subdivision (b) for the purposes of
13addressing children’s crisis services shall be allocated to support
14triage personnel and family supportive training and related services.
15These funds shall be made available to selected counties, counties
16acting jointly, or city mental health departments, as determined
17by the commission through a selection process. The commission
18may, at its discretion, also give consideration to private nonprofit
19corporations and public agencies in an area or region of the state
20if a county, or counties acting jointly, affirmatively supports this
21 designation and collaboration in lieu of a county government
22directly receiving grant funds.

23(1) These funds may provide for a range of crisis-related services
24for a child in need of assistance, or his or her parent, guardian, or
25caregiver. These service activities may include, but are not limited
26to, the following:

27(A) Intensive coordination of care and services.

28(B) Communication, coordination, and referral.

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

30(D) Monitoring the child’s progress.

31(E) Providing placement service assistance and service plan
32development.

33(F) Crisis or safety planning.

34(2) The commission shall take into account at least the following
35criteria and factors when selecting recipients and determining the
36amount of grant awards for these funds, as follows:

37(A) Description of need, including potential gaps in local service
38connections.

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

P40   1(C) Description of how personnel and other services will be
2used to facilitate linkage and access to services, including
3objectives and anticipated outcomes.

4(D) Ability to obtain federal Medicaid reimbursement, when
5applicable.

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

7(F) Ability to administer an effective service program and the
8degree to which local agencies and service providers will support
9and collaborate with the triage personnel effort.

10(G) Geographic areas or regions of the state to be eligible for
11grant awards, which shall include rural, suburban, and urban areas,
12and may include use of the five regional designations utilized by
13the County Behavioral Health Directors Association of California.

14(3) The commission shall determine maximum grant awards,
15and shall take into consideration the level of need, population to
16be served, and related criteria, as described in paragraph (2), and
17shall reflect reasonable costs.

18(4) Funds awarded by the commission for purposes of this
19section may be used to supplement, but not supplant, existing
20financial and resource commitments of the county, counties acting
21jointly, or a city mental health department that received the grant.

22(5) Notwithstanding any other law, a county, counties acting
23jointly, or a city mental health department that receives an award
24of funds for the purpose of this section is not required to provide
25a matching contribution of local funds.

26(6) Notwithstanding any other law, the commission, without
27taking any further regulatory action, may implement, interpret, or
28make specific this section by means of informational letters,
29bulletins, or similar instructions.

30(7) The commission may waive requirements in this section for
31counties with a population of 100,000 or less, if the commission
32determines it is in the best interest of the state and meets the intent
33of the law.

34(8) The commission shall provide a status report to the fiscal
35and policy committees of the Legislature on the progress of
36implementation no later than January 10, 2018, and annually
37thereafter.

38

SEC. 6.  

Section 11462.01 of the Welfare and Institutions Code,
39as added by Section 75 of Chapter 773 of the Statutes of 2015, is
40amended to read:

P41   1

11462.01.  

(a) A short-term residential treatment center, as
2defined in subdivision (ad) of Section 11400 and subparagraph
3(R) of paragraph (1) of subdivision (a) of Section 1502 of the
4Health and Safety Code, may have a program that is certified by
5the State Department of Health Care Services or by a county mental
6health plan to which the department has delegated certification
7authority, pursuant to Section 4096.5, or a program that is not
8certified, or both. A short-term residential treatment center, except
9as specified in subdivision (d), shall accept for placement children
10who meet all of the following criteria, subject to the other
11requirements of subdivisions (b) and (c):

12(1) The child does not require inpatient care in a licensed health
13facility.

14(2) The child has been assessed as requiring the level of services
15provided in a short-term residential treatment center in order to
16maintain the safety and well-being of the child or others due to
17behaviors, including those resulting from traumas, that render the
18child or those around the child unsafe or at risk of harm, or that
19prevent the effective delivery of needed services and supports
20provided in the child’s own home or in other family settings, such
21as with a relative, guardian, foster family, resource family, or
22adoptive family.

23(3) The child meets at least one of the following conditions:

24(A) The child has been assessed as meeting the medical necessity
25criteria for Medi-Cal specialty mental health Early and Periodic
26Screening, Diagnosis, and Treatment Services, as the criteria are
27described in Section 1830.210 of Title 9 of the California Code of
28Regulations.

29(B) The child has been assessed as seriously emotionally
30disturbed, as described in subdivision (a) of Section 5600.3.

31(C) The child has been assessed as requiring the level of services
32provided in order to meet his or her behavioral or therapeutic needs.
33In appropriate circumstances, this may include any of the
34following:

35(i) A commercially sexually exploited child.

36(ii) A private voluntary placement, if the youth exhibits status
37offender behavior, the parents or other relatives feel they cannot
38control the child’s behavior, and short-term intervention is needed
39to transition the child back into the home.

40(iii) A juvenile sex offender.

P42   1(iv) A child who is affiliated with, or impacted by, a gang.

2(b) A short-term residential treatment center program that is
3certified by the State Department of Health Care Services, or by
4a county mental health plan to which the department has delegated
5certification authority, pursuant to Section 4096.5, shall solely
6accept for placement, and provide access to mental health services
7to, children who meet the criteria in paragraphs (1) and (2) of
8subdivision (a), and meet the conditions of subparagraph (A) or
9(B) of paragraph (3) of subdivision (a), or both of those
10subparagraphs. Mental health services are provided directly by the
11certified program.

12(c) A short-term residential treatment center program that is not
13certified pursuant to Section 4096.5 shall solely accept for
14placement in that program a child who meets the criteria in
15paragraphs (1) and (2) of subdivision (a), and meets the conditions
16of subparagraph (A), (B), or (C) of paragraph (3) of subdivision
17(a), or any combination of those subparagraphs. A child who meets
18the conditions of subparagraphs (A) and (B) of paragraph (3) of
19subdivision (a) may be accepted for placement, if the interagency
20placement committee determines that a short-term residential
21treatment facility that is not certified has a program that meets the
22specific needs of the child and there is a commonality of needs
23with the other children in the short-term residential treatment
24center. In this situation, the short-term residential treatment center
25shall do either of the following:

26(1) In the case of a child who is a Medi-Cal beneficiary, arrange
27for the child to receive specialty mental health services from the
28county mental health plan.

29(2) In all other cases, arrange for the child to receive mental
30health services.

31(d) A short-term residential treatment center that is operating
32as a children’s crisis residential center, as defined in Section 1502
33of the Health and Safety Code, and subject to the other
34requirements of subdivisions (b) and (c), may accept for admission
35or placement any child, referred by a parent or guardian, or by the
36 representative of a public or private entity, including, but not
37limited to, the county probation agency or child welfare services
38agency with responsibility for the placement of a child in foster
39care, that has the right to make these decisions on behalf of a child
40who is in mental health crisis and, absent admission to a children’s
P43   1crisis residential center, would otherwise require acceptance by
2the emergency department of a general hospital, or admission into
3a psychiatric hospital or the psychiatric inpatient unit of a general
4hospital.

5(e) A foster family agency, as defined in subdivision (g) of
6Section 11400 and subparagraph (D) of paragraph (1) of
7subdivision (a) of Section 1502 of the Health and Safety Code,
8may have a program that is certified by the State Department of
9Health Care Services, or by a county mental health plan to which
10the department has delegated certification authority, pursuant to
11Section 1810.435 or 1810.436 of Title 9 of the California Code of
12Regulations, or a program that is not certified, or both. A program,
13subject to subdivisions (f) and (g), shall provide access to mental
14health services to the children. A foster family agency, depending
15on whether or not it has a certified program, shall provide access
16to mental health services to children who do not require inpatient
17care in a licensed health facility and who meet any one or more of
18the following conditions:

19(1) A child who has been assessed as meeting the medical
20necessity criteria for specialty mental health services under the
21Medi-Cal Early and Periodic Screening, Diagnosis, and Treatment
22benefit, as the criteria are described in Section 1830.210 of Title
239 of the California Code of Regulations.

24(2) A child who has been assessed as seriously emotionally
25disturbed, as described in subdivision (a) of Section 5600.3.

26(3) A child who has been assessed as requiring the level of
27services to meet his or her behavioral or therapeutic needs.

28(f) A foster family agency that is certified as a provider pursuant
29to Section 1810.435 or 1810.436 of Title 9 of the California Code
30of Regulations by the State Department of Health Care Services,
31or by a county mental health plan to which the department has
32delegated certification authority, shall provide access to mental
33health services directly to children in its program who do not
34require inpatient care in a licensed health facility and who meet
35the conditions of paragraph (1) or (2) of subdivision (e).

36(g) A foster family agency that is not certified as described in
37subdivision (f) may provide access to mental health services in
38that program for children who do not require inpatient care in a
39licensed health facility and who meet the conditions of paragraphs
P44   1(1) and (2) of subdivision (e). In this situation the foster family
2agency shall do the following:

3(1) In the case of a child who is a Medi-Cal beneficiary, have
4written interagency protocols in place to arrange for specialty
5mental health services from the county mental health plan or an
6organizational provider, as defined in Section 1810.231 of Title 9
7of California Code of Regulations.

8(2) In all other cases, arrange for the child to receive mental
9health services.

10(h) All short-term residential treatment centers and foster family
11agencies that operate a certified program shall maintain the level
12of care and services necessary to meet the needs of the children
13and youth in their care and shall maintain and have in good
14standing the appropriate mental health certification issued by the
15State Department of Health Care Services or a county mental health
16plan to which the department has delegated certification authority,
17pursuant to Section 4096.5 of this code or Section 1810.435 or
181810.436 of Title 9 of the California Code of Regulations.

19(i) The assessments described in subparagraphs (A) and (B) of
20paragraph (3) of subdivision (a) and paragraphs (1) and (2) of
21subdivision (e), shall be made by all of the following, as applicable:

22(1) An interagency placement committee, as described in Section
234096, considering the recommendations from the child and family
24team, if any are available.

25(2) A licensed mental health professional as defined in
26subdivision (g) of Section 4096.

27(3) For the purposes of this section, an AFDC-FC funded child
28with an individualized education program developed pursuant to
29Article 2 (commencing with Section 56320) of Chapter 4 of Part
3030 of Division 4 of Title 2 of the Education Code that assesses the
31child as seriously emotionally disturbed, as defined in, and subject
32to, this section and recommends out-of-home placement at the
33level of care provided by the provider, shall be deemed to have
34met the assessment requirement.

35(4) For the purposes of this section, and only for placement into
36a foster family agency, an AFDC-FC funded child assessed
37pursuant to subdivision (b) of Section 706.6 or paragraph (2) of
38subdivision (c) of Section 16501.1, in consultation with a mental
39health professional, as defined in subdivision (g) of Section 4096.5,
40shall be deemed to have met the assessment requirement.

P45   1(j) The assessments described in subparagraph (C) of paragraph
2(3) of subdivision (a) and paragraph (3) of subdivision (e) shall be
3made pursuant to subdivision (b) of Section 706.6 or paragraph
4(2) of subdivision (c) of Section 16501.1.

5(k) (1) The provider shall ensure that AFDC-FC funded
6children, assessed pursuant to subparagraphs (A) and (B) of
7paragraph (3) of subdivision (a) or paragraphs (1) and (2) of
8subdivision (e), who are accepted for placement have been
9approved for placement by an interagency placement committee,
10as described in Section 4096, except as provided for in paragraphs
11(3) and (4) of subdivision (i).

12(2) The approval shall be in writing and shall indicate that the
13interagency placement committee has determined all of the
14following:

15(A) The child meets the medical necessity criteria for Medi-Cal
16specialty mental health Early and Periodic Screening, Diagnosis,
17and Treatment services, as the criteria are described in Section
181830.210 of Title 9 of the California Code of Regulations.

19(B) The child is seriously emotionally disturbed, as described
20in subdivision (a) of Section 5600.3.

21(C) Subject to Section 1502.4 of the Health and Safety Code,
22the child needs the level of care provided by the program.

23(3) (A) Nothing in subdivisions (a) to (j), inclusive, or this
24subdivision shall prevent an emergency placement of a child or
25youth into a certified short-term residential treatment center,
26children’s crisis residential center, or foster family agency program
27prior to the determination by the interagency placement committee,
28but only if a licensed mental health professional, as defined in
29subdivision (g) of Section 4096, has made a written determination
30within 72 hours of the child’s or youth’s placement, that the child
31or youth is seriously emotionally disturbed or has made a written
32determination within 24 hours of the child’s or youth’s placement
33in a children’s crisis residential center that the child or youth is
34experiencing a mental health crisis as defined in subdivision (d),
35and is in need of the care and services provided by the certified
36short-term residential treatment center, children’s crisis residential
37center, or foster family agency.

38(i) The interagency placement committee, as appropriate, shall,
39within 30 days of placement, make the determinations, with
P46   1recommendations from the child and family team, required by this
2subdivision.

3(ii) If it determines the placement is appropriate, the interagency
4placement committee, with recommendations from the child and
5family team, shall transmit the approval, in writing, to the county
6placing agency and the short-term residential treatment center or
7foster family agency.

8(iii) If it determines the placement is not appropriate, the
9interagency placement committee shall respond pursuant to
10subparagraph (B).

11(B) If the interagency placement committee determines at any
12time that the placement is not appropriate, it shall, with
13recommendations from the child and family team, transmit the
14disapproval, in writing, to the county placing agency and the
15short-term residential treatment center or foster family agency,
16and the child or youth shall be referred to an appropriate placement,
17as specified in this section.

18(l) Commencing January 1, 2017, for AFDC-FC funded children
19or youth, only those children or youth who are approved for
20placement, as set forth in this section, may be accepted by a
21short-term residential treatment center or foster family agency.

22(m) The department shall, through regulation, establish
23consequences for the failure of a short-term residential treatment
24center, or a foster family agency, to obtain written approval for
25placement of an AFDC-FC funded child or youth pursuant to this
26section.

27(n) The department shall not establish a rate for a short-term
28residential treatment center or foster family agency unless the
29provider submits a recommendation from the host county or the
30primary placing county that the program is needed and that the
31provider is willing and capable of operating the program at the
32level sought. For purposes of this subdivision, “host county,” and
33“primary placing county,” mean the same as defined in the
34department’s AFDC-FC ratesetting regulations.

35(o) Any certified short-term residential treatment center or foster
36family agency shall be reclassified and paid at the appropriate
37program rate for which it is qualified if either of the following
38occurs:

39(1) (A) It fails to maintain the level of care and services
40necessary to meet the needs of the children and youth in care, as
P47   1required by subdivision (a). The determination shall be made
2consistent with the department’s AFDC-FC ratesetting regulations
3developed pursuant to Sections 11462 and 11463 and shall take
4into consideration the highest level of care and associated rates
5for which the program is eligible.

6(B) In the event of a determination under this paragraph, the
7short-term residential treatment center or foster family agency may
8appeal the finding or submit a corrective action plan. The appeal
9process specified in Section 11466.6 shall be available to a
10short-term residential treatment center or foster family agency that
11provides intensive and therapeutic treatment. During any appeal,
12the short-term residential treatment center or foster family agency
13that provides intensive and therapeutic treatment shall maintain
14the appropriate level of care.

15(2) It fails to maintain a certified mental health treatment
16program as required by subdivision (h).

17(p) In addition to any other review required by law, the child
18and family team as defined in paragraph (4) of subdivision (a) of
19Section 16501 may periodically review the placement of the child
20or youth. If the child and family team make a recommendation
21that the child or youth no longer needs, or is not benefiting from,
22placement in a short-term residential treatment center or foster
23family agency, or one of its programs, the team shall transmit the
24disapproval, in writing, to the county placing agency to consider
25a more appropriate placement.

26(q) The department shall develop a process to address
27placements when, subsequent to the child’s or youth’s placement,
28a determination is made by the interagency placement team and
29shall consider the recommendations of the child and family team,
30either that the child or youth is not in need of the care and services
31provided by the certified program. The process shall include, but
32not be limited to:

33(1) Notice of the determination in writing to both the county
34placing agency and the short-term residential treatment center or
35foster family agency that provides intensive and therapeutic
36treatment.

37(2) Notice of the county’s plan, and a time frame, for removal
38of the child or youth in writing to the short-term residential
39treatment center or foster family agency that provides intensive
40and therapeutic treatment.

P48   1(3) Referral to an appropriate placement.

2(4) Actions to be taken if a child or youth is not timely removed
3from the short-term residential treatment center or foster family
4agency that provides intensive and therapeutic treatment or placed
5in an appropriate placement.

6(r) (1) Nothing in this section shall prohibit a short-term
7residential treatment center or foster family agency from accepting
8private placements of children or youth.

9(2) When a referral is not from a public agency and no public
10funding is involved, there is no requirement for public agency
11review nor determination of need.

12(3) Children and youth subject to paragraphs (1) and (2) shall
13have been determined to be seriously emotionally disturbed, as
14described in subdivision (a) of Section 5600.3, and subject to
15Section 1502.4 of the Health and Safety Code, by a licensed mental
16health professional, as defined in subdivision (g) of Section 4096.

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

18begin insert

begin insertSEC. 6.1.end insert  

end insert

begin insertSection 11462.01 of the end insertbegin insertWelfare and Institutions
19Code
end insert
begin insert, as added by Section 75 of Chapter 773 of the Statutes of
202015, is amended to read:end insert

21

11462.01.  

(a)  begin deleteA short-term residential treatment center, end delete begin insert(1)end insertbegin insertend insertbegin insertNo
22later than 12 months following the date of initial licensure, a
23short-term residential therapeutic program, end insert
as defined in
24subdivision (ad) of Section 11400begin delete and paragraph (18)end deletebegin insert of this code
25and subparagraph (R) of paragraph (1)end insert
of subdivision (a) of
26Section 1502 of the Health and Safety Code,begin delete may have a program
27that is certified by the State Department of Health Care Services
28or by a county mental health plan to which the department has
29delegated certification authority, pursuant to Section 4096.5, or a
30program that is not certified, or both. A short-term residential
31treatment center shall accept for placement children who meet all
32of the following criteria, subject to the other requirements of
33subdivisions (b) and (c):end delete
begin insert shall obtain a contract, subject to an
34agreement on rates and terms and conditions, with a county mental
35health plan to end insert
begin insertprovide specialty mental health services and
36demonstrate the ability to meet the therapeutic needs of each child,
37as identified in any of the following:end insert

begin insert

38
(A) A mental health assessment.

end insert
begin insert

39
(B) The child’s case plan.

end insert
begin insert

40
(C) The child’s needs and services plan.

end insert
begin insert

P49   1
(D) Other documentation demonstrating the child has a mental
2health need.

end insert
begin insert

3
(2) A short-term residential therapeutic program shall comply
4with any other mental health program approvals required by the
5State Department of Health Care Services or by a county mental
6health plan to which mental health program approval authority
7has been delegated.

end insert
begin insert

8
(b) Except as otherwise specified in subdivision (c), a short-term
9residential therapeutic program may accept for placement a child
10who meets both of the criteria in paragraphs (1) and (2) and at
11least one of the conditions in paragraph (3).

end insert

12(1) The child does not require inpatient care in a licensed health
13facility.

14(2) The child has been assessed as requiring the level of services
15provided in a short-term residentialbegin delete treatment centerend deletebegin insert therapeutic
16programend insert
in order to maintain the safety and well-being of the child
17or others due to behaviors, including those resulting from traumas,
18that render the child or those around the child unsafe or at risk of
19harm, or that prevent the effective delivery of needed services and
20supports provided in the child’s own home or in other family
21settings, such as with a relative, guardian, foster family, resource
22family, or adoptive family.begin insert The assessment shall ensure the child
23has needs in common with other children or youth in the care of
24the facility, consistent with subdivision (c) of Section 16514.end insert

25(3) The child meets at least one of the following conditions:

26(A) The child has beenbegin delete assessedend deletebegin insert assessed, pursuant to Section
274096,end insert
as meeting the medical necessity criteria for Medi-Cal
28specialty mental healthbegin delete Early and Periodic Screening, Diagnosis,
29and Treatment Services, as the criteria are described in Sectionend delete

30begin insert services, as provided for in Section 1830.205 orend insert 1830.210 of Title
319 of the California Code of Regulations.

32(B) The child has beenbegin delete assessedend deletebegin insert assessed, pursuant to Section
334096,end insert
as seriously emotionally disturbed, as described in
34subdivision (a) of Section 5600.3.

begin insert

35
(C) The child requires emergency placement pursuant to
36paragraph (3) of subdivision (i).

end insert
begin delete

37(C)

end delete

38begin insert(end insertbegin insertD)end insert The child has beenbegin delete assessedend deletebegin insert end insertbegin insertassessed, pursuant to Section
394096,end insert
as requiring the level of services providedbegin insert by the short-term
40residential therapeutic programend insert
in order to meet his or her
P50   1behavioral or therapeutic needs.begin delete In appropriate circumstances, this
2may include any of the following:end delete

begin insert

3
(4) Subject to the requirements of this subdivision, a short-term
4residential therapeutic program may have a specialized program
5to serve a child, including, but not limited to, the following:

end insert
begin delete

6(i)

end delete

7begin insert(A)end insert A commercially sexually exploited child.

begin delete

8(ii)

end delete

9begin insert(B)end insert A private voluntary placement, if the youth exhibits status
10offender behavior, the parents or other relatives feel they cannot
11control the child’s behavior, and short-term intervention is needed
12to transition the child back into the home.

begin delete

13(iii)

end delete

14begin insert(C)end insert A juvenile sex offender.

begin delete

15(iv)

end delete

16begin insert(D)end insert A child who is affiliated with, or impacted by, a gang.

begin delete

17(b) A short-term residential treatment center program that is
18certified by the State Department of Health Care Services, or by
19a county mental health plan to which the department has delegated
20certification authority, pursuant to Section 4096.5, shall solely
21accept for placement, and provide access to mental health services
22to, children who meet the criteria in paragraphs (1) and (2) of
23subdivision (a), and meet the conditions of subparagraph (A) or
24(B) of paragraph (3) of subdivision (a), or both of those
25subparagraphs. Mental health services are provided directly by the
26certified program.

27(c) A short-term residential treatment center program that is not
28certified pursuant to Section 4096.5 shall solely accept for
29placement in that program a child who meets the criteria in
30paragraphs (1) and (2) of subdivision (a), and meets the conditions
31of subparagraph (A), (B), or (C) of paragraph (3) of subdivision
32(a), or any combination of those subparagraphs. A child who meets
33the conditions of subparagraphs (A) and (B) of paragraph (3) of
34subdivision (a) may be accepted for placement, if the interagency
35placement committee determines that a short-term residential
36treatment facility that is not certified has a program that meets the
37specific needs of the child and there is a commonality of needs
38with the other children in the short-term residential treatment
39center. In this situation, the short-term residential treatment center
40shall do either of the following:

P51   1(1) In the case of a child who is a Medi-Cal beneficiary, arrange
2for the child to receive specialty mental health services from the
3county mental health plan.

4(2) In all other cases, arrange for the child to receive mental
5health services.

6(d)  A foster family agency, as defined in subdivision (g) of
7Section 11400 and paragraph (4) of subdivision (a) of Section 1502
8of the Health and Safety Code, may have a program that is certified
9by the State Department of Health Care Services, or by a county
10mental health plan to which the department has delegated
11certification authority, pursuant to Section 1810.435 or 1810.436
12of Title 9 of the California Code of Regulations, or a program that
13is not certified, or both. A program, subject to subdivisions (e) and
14(f), shall provide access to mental health services to the children.
15A foster family agency, depending on whether or not it has a
16certified program, shall provide access to mental health services
17to children who do not require inpatient care in a licensed health
18facility and who meet any one or more of the following conditions:

19(1) A child who has been assessed as meeting the medical
20necessity criteria for specialty mental health services under the
21Medi-Cal Early and Periodic Screening, Diagnosis, and Treatment
22benefit, as the criteria are described in Section 1830.210 of Title
239 of the California Code of Regulations.

24(2) A child who has been assessed as seriously emotionally
25disturbed, as described in subdivision (a) of Section 5600.3.

26(3) A child who has been assessed as requiring the level of
27services to meet his or her behavioral or therapeutic needs.

end delete
begin insert

28
(c) A short-term residential therapeutic program that is
29operating as a children’s crisis residential center, as defined in
30Section 1502 of the Health and Safety Code, may accept for
31admission or placement any child, referred by a parent or
32guardian, or by the representative of a public or private entity,
33including, but not limited to, the county probation agency or child
34welfare services agency with responsibility for the placement of a
35child in foster care, that has the right to make these decisions on
36behalf of a child who is in mental health crisis and, absent
37admission to a children’s crisis residential center, would otherwise
38require acceptance by the emergency department of a general
39hospital, or admission into a psychiatric hospital or the psychiatric
40inpatient unit of a general hospital.

end insert
begin delete

P52   1(e)

end delete

2begin insert(d)end insert A foster family agency that is certified as abegin insert Medi-Cal
3specialty mental healthend insert
provider pursuant to Section 1810.435begin delete or
41810.436end delete
of Title 9 of the California Code of Regulations by the
5State Department of Health Care Services, or by a county mental
6health plan to which the department has delegated certification
7authority,begin delete shall provide access toend deletebegin insert and which has entered into a
8contract with a county mental health plan pursuant to Section
91810.436 of Title 9 of the California Code of Regulations, shall
10provide, or provide access to, specialtyend insert
mental health services
11begin delete directlyend delete to childrenbegin delete in its programend deletebegin insert under its careend insert who do not require
12inpatient care in a licensed health facility and who meet the
13
begin delete conditions of paragraph (1) or (2) of subdivision (d).end deletebegin insert medical
14necessity criteria for Medi-Cal specialty mental health services
15provided for in Section 1830.205 or 1830.210 of Title 9 of the
16California Code of Regulations.end insert

begin delete

17(f)

end delete

18begin insert(e)end insert A foster family agency that is not certified asbegin delete described in
19subdivision (e) may provide access toend delete
begin insert a Medi-Cal specialty mental
20health provider shall provide access to specialty and nonspecialtyend insert

21 mental health services in that program for children who do not
22require inpatient care in a licensed health facility and who meet
23begin delete the conditions of paragraphs (1) and (2) of subdivision (d).end deletebegin insert any of
24the conditions in paragraph (3) of subdivision (b).end insert
In this situation
25the foster family agency shall do the following:

26(1) In the case of a child who is a Medi-Cal beneficiary,begin delete have
27written interagency protocols in place toend delete
arrange for specialty
28mental health services from the county mental healthbegin delete plan or an
29organizational provider, as defined in Section 1810.231 of Title 9
30of California Code of Regulations.end delete
begin insert plan.end insert

31(2) In all other cases, arrange for the child to receive mental
32health services.

begin delete

33(g)

end delete

34begin insert(f)end insert All short-term residentialbegin delete treatment centers and foster family
35agencies that operate a certified programend delete
begin insert therapeutic programsend insert
36 shall maintain the level of care and services necessary to meet the
37needs of the children and youth in their care and shall maintain
38and have in good standing the appropriate mental health
39begin delete certificationend deletebegin insert program approval that includes a certification to
40provide Medi-Cal specialty mental health servicesend insert
issued by the
P53   1State Department of Health Care Services or a county mental health
2plan to which the department has delegatedbegin delete certificationend deletebegin insert mental
3health program approvalend insert
authority, pursuant to Section 4096.5 of
4this code or Section 1810.435 or 1810.436 of Title 9 of the
5California Code of Regulations.begin insert All foster family agencies that are
6certified as a Medi-Cal specialty mental health provider pursuant
7to Section 1810.435 of Title 9 of the California Code of Regulations
8shall maintain the level of care and services necessary to meet the
9needs of children and youth in their care and shall maintain and
10have in good standing the Medi-Cal specialty mental health
11provider certification issued by the State Department of Health
12Care Services or a county mental health plan to which the
13department has delegated certification authority.end insert

begin delete

14(h)

end delete

15begin insert(g)end insert The assessments described in subparagraphsbegin delete (A) and (B)end delete
16begin insert (A), (B), (C), and (D)end insert of paragraph (3) of subdivision begin delete (a) and
17paragraphs (1) and (2) of subdivision (d),end delete
begin insert (b) shall ensure the
18child’s individual behavioral or treatment needs are consistent
19with, and can be met by, the facility andend insert
shall be made bybegin delete allend deletebegin insert oneend insert
20 of the following, as applicable:

21(1) An interagency placement committee, as described in Section
224096, considering the recommendations from the child and family
23team, if any are available.begin insert If the short-term residential therapeutic
24program serves children who are placed by county child welfare
25agencies and children who are placed by probation departments,
26the interagency placement committee shall also ensure the
27requirements of subdivision (c) of Section 16514 have been met
28with respect to commonality of need.end insert

29(2) A licensed mental health professional as defined in
30subdivision (g) of Section 4096.

31(3) For the purposes of this section, an AFDC-FC funded child
32with an individualized education program developed pursuant to
33Article 2 (commencing with Section 56320) of Chapter 4 of Part
3430 of Division 4 of Title 2 of the Education Code that assesses the
35child as seriously emotionally disturbed, as defined in, and subject
36to, this section and recommends out-of-home placement at the
37level of care provided by the provider, shall be deemed to have
38met the assessment requirement.

begin delete

39(4) For the purposes of this section, and only for placement into
40a foster family agency, an AFDC-FC funded child assessed
P54   1pursuant to subdivision (b) of Section 706.6 or paragraph (2) of
2subdivision (c) of Section 16501.1, in consultation with a mental
3health professional, as defined in subdivision (g) of Section 4096.5,
4shall be deemed to have met the assessment requirement.

end delete
begin delete

5(i)

end delete

6begin insert(h)end insert Thebegin delete assessmentsend deletebegin insert evaluationend insert described in subparagraphbegin delete (C)end delete
7begin insert (A)end insert of paragraph (3) of subdivisionbegin delete (a) and paragraph (3) of
8subdivision (d)end delete
begin insert (i)end insert shall be made pursuant to subdivision (b) of
9Section 706.6 or paragraph (2) of subdivision (c) of Section
1016501.1.

begin delete

11(j)

end delete

12begin insert(i)end insert (1) The provider shall ensure that AFDC-FC funded children,
13assessed pursuant to subparagraphs (A) and (B) of paragraph (3)
14of subdivisionbegin delete (a) or paragraphs (1) and (2) of subdivision (d),end deletebegin insert (b),end insert
15 who are accepted for placement have been approved for placement
16by an interagency placement committee, as described in Section
174096, except as provided for in paragraphs (3) and (4) of
18subdivisionbegin delete (h).end deletebegin insert (g).end insert

19(2) The approval shall be in writing and shall indicate that the
20interagency placement committee has determinedbegin delete allend deletebegin insert oneend insert of the
21following:

22(A) The child meets the medical necessity criteria for Medi-Cal
23specialty mental healthbegin delete Early and Periodic Screening, Diagnosis,
24and Treatment services, as the criteria are described in Sectionend delete
begin insert end insert
25begin insertservices, as provided for in Section 1830.205 orend insert 1830.210 of Title
269 of the California Code of Regulations.

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

begin delete

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

end delete

31(3) (A) Nothing in subdivisions (a) tobegin delete (i),end deletebegin insert (h),end insert inclusive, or this
32subdivision shall prevent an emergency placement of a child or
33youth into a certified short-term residentialbegin delete treatment center or
34foster family agencyend delete
begin insert therapeutic program or children’s crisis
35residential centerend insert
program prior to the determination by the
36interagency placement committee, but only if a licensed mental
37health professional, as defined in subdivision (g) of Section 4096,
38has made a written determination within 72 hours of the child’s
39or youth’s placement, that the child or youthbegin delete is seriously
40emotionally disturbedend delete
begin insert requires the level of services and supervision
P55   1provided by the short-term residential therapeutic program in
2order to meet his or her behavioral or therapeutic needs, or has
3made a written determination within 24 hours of the child’s or
4youth’s placement in a children’s crisis residential center that the
5child or youth is experiencing a mental health crisis as defined in
6subdivision (c)end insert
and is in need of the care and services provided by
7thebegin delete certified short-term residential treatment center or foster family
8agency.end delete
begin insert children’s crisis residential center. If the short-term
9residential therapeutic program serves children placed by county
10child welfare agencies and children placed by probation
11departments, the interagency placement committee shall also
12ensure the requirements of subdivision (c) of Section 16514 have
13been met with respect to commonality of need.end insert

14(i) The interagency placement committee, as appropriate, shall,
15within 30 days of placement, make the determinations, with
16recommendations from the child and family team, required by this
17subdivision.

18(ii) If it determines the placement is appropriate, the interagency
19placement committee, with recommendations from the child and
20family team, shall transmit the approval, in writing, to the county
21placing agency and the short-term residentialbegin delete treatment center or
22foster family agency.end delete
begin insert therapeutic program.end insert

23(iii) If it determines the placement is not appropriate, the
24interagency placement committee shall respond pursuant to
25subparagraph (B).

26(B) begin insert(i)end insertbegin insertend insertIf the interagency placement committee determines at
27any time that the placement is not appropriate, it shall, with
28recommendations from the child and family team, transmit the
29disapproval, in writing, to the county placing agency and the
30short-term residentialbegin delete treatment center or foster family agency,
31andend delete
begin insert therapeutic program and shall include a recommendation as
32to the child’s appropriate level of care and placement to meet his
33or her service needs. The necessary interagency placement
34committee representative or representatives shall participate in
35any child and family team meetings to referend insert
the child or youthbegin delete shall
36be referredend delete
to an appropriate placement, as specified in this section.

begin insert

37
(ii) The child may remain in the placement for the amount of
38time necessary to identify and transition the child to an alternative,
39suitable placement.

end insert
begin insert

P56   1
(iii) Notwithstanding clause (ii), if the interagency placement
2committee determined the placement was not appropriate due to
3a health and safety concern, immediate arrangements for the child
4to transition to an appropriate placement shall occur.

end insert
begin delete

5(k)

end delete

6begin insert(j)end insert Commencing January 1, 2017, for AFDC-FC funded children
7or youth, only those children or youth who are approved for
8placement, as set forth in this section, may be accepted by a
9short-term residentialbegin delete treatment center or foster family agency.end delete
10
begin insert therapeutic program.end insert

begin delete

11(l)

end delete

12begin insert(k)end insert The department shall, through regulation, establish
13consequences for the failure of a short-term residentialbegin delete treatment
14center, or a foster family agency,end delete
begin insert therapeutic programend insert to obtain
15written approval for placement of an AFDC-FC funded child or
16youth pursuant to this section.

begin delete

17(m)

end delete

18begin insert(l)end insert The department shall not establish a rate for a short-term
19residentialbegin delete treatment center or foster family agencyend deletebegin insert therapeutic
20programend insert
unless the provider submits a recommendation from the
21host county or the primary placing county that the program is
22needed and that the provider is willing and capable of operating
23the program at the level sought. For purposes of this subdivision,
24“host county,” and “primary placing county,” mean the same as
25defined in the department’s AFDC-FC ratesetting regulations.

begin delete

26(n)

end delete

27begin insert(m)end insert Any certified short-term residentialbegin delete treatment center or
28foster family agencyend delete
begin insert therapeutic programend insert shall be reclassified and
29paid at the appropriate program rate for which it is qualified if
30either of the following occurs:

31(1) (A) It fails to maintain the level of care and services
32necessary to meet the needs of the children and youth in care, as
33required by subdivision (a). The determination shall be made
34consistent with the department’s AFDC-FC ratesetting regulations
35developed pursuant tobegin delete Sections 11462 and 11463end deletebegin insert Section 11462end insert
36 and shall take into consideration the highest level of care and
37associated rates for which the programbegin delete is eligible.end deletebegin insert may be eligible
38if granted an extension pursuant to Section 11462.04 or any
39reduction in rate associated with a provisional or probationary
40rate granted or imposed under Section 11466.01.end insert
begin insert end insert

P57   1(B) In the event of a determination under this paragraph, the
2short-term residentialbegin delete treatment center or foster family agencyend delete
3begin insert therapeutic programend insert may appeal the finding or submit a corrective
4action plan. The appeal process specified in Section 11466.6 shall
5be available to a short-term residentialbegin delete treatment center or foster
6family agencyend delete
begin insert therapeutic programend insert that provides intensive and
7therapeutic treatment. During any appeal, the short-term residential
8begin delete treatment center or foster family agencyend deletebegin insert therapeutic programend insert that
9provides intensive and therapeutic treatment shall maintain the
10appropriate level of care.

11(2) It fails to maintain a certified mental health treatment
12program as required by subdivisionbegin delete (g).end deletebegin insert (f).end insert

begin delete

13(o)

end delete

14begin insert(n)end insert In addition to any other review required by law, the child
15and family team as defined in paragraph (4) of subdivision (a) of
16Section 16501 may periodically review the placement of the child
17or youth. If the child and family team make a recommendation
18that the child or youth no longer needs, or is not benefiting from,
19placement in a short-term residentialbegin delete treatment center or foster
20family agency, or one of its programs,end delete
begin insert therapeutic programend insert the
21team shall transmit the disapproval, in writing, to the county
22placing agency to consider a more appropriate placement.

begin delete

23(p)

end delete

24begin insert(o)end insert The department shall develop a process to address
25placements when, subsequent to the child’s or youth’s placement,
26a determination is made by the interagency placement team and
27shall consider the recommendations of the child and family team,
28either that the child or youth is not in need of the care and services
29provided by the certified program. The process shall include, but
30not be limited to:

31(1) Notice of the determination in writing to both the county
32placing agency and the short-term residentialbegin delete treatment centerend delete
33begin insert therapeutic programend insert or foster family agency that provides intensive
34and therapeutic treatment.

35(2) Notice of the county’s plan, and a time frame, for removal
36of the child or youth in writing to the short-term residential
37begin delete treatment center or foster family agencyend deletebegin insert therapeutic programend insert that
38provides intensive and therapeutic treatment.

39(3) Referral to an appropriate placement.

P58   1(4) Actions to be taken if a child or youth is not timely removed
2from the short-term residentialbegin delete treatment center or foster family
3agencyend delete
begin insert therapeutic programend insert that provides intensive and therapeutic
4treatment or placed in an appropriate placement.

begin delete

5(q)

end delete

6begin insert(p)end insert (1) Nothing in this section shall prohibit a short-term
7residentialbegin delete treatment center or foster family agencyend deletebegin insert therapeutic
8programend insert
from accepting private placements of children or youth.

9(2) When a referral is not from a public agency and no public
10funding is involved, there is no requirement for public agency
11reviewbegin delete norend deletebegin insert orend insert determination of need.

12(3) Children and youth subject to paragraphs (1) and (2) shall
13have been determined to be seriously emotionally disturbed, as
14described in subdivision (a) of Section 5600.3, and subject to
15Section 1502.4 of the Health and Safety Code, by a licensed mental
16health professional, as defined in subdivision (g) of Section 4096.

begin delete

17(r)  This section shall become operative on January 1, 2017.

end delete
18

SEC. 7.  

Section 15610.47 of the Welfare and Institutions Code
19 is amended to read:

20

15610.47.  

“Long-term care facility” means any of the
21following:

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

24(b) Any community care facility, as defined in subparagraphs
25(A) and (B) of paragraph (1) of subdivision (a) of Section 1502 of
26the Health and Safety Code, whether licensed or unlicensed.

27(c) Any swing bed in an acute care facility, or any extended
28care facility.

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

31(e) Any residential care facility for the elderly as defined in
32Section 1569.2 of the Health and Safety Code.

33begin insert

begin insertSEC. 8.end insert  

end insert

begin insert(a)end insertbegin insertend insertbegin insert(1)end insertbegin insertend insertbegin insertSection 2.1 of this bill incorporates
34amendments to Section 1502 of the Health and Safety Code
35proposed by both this bill and Senate Bill 524. It shall only become
36operative if (A) both bills are enacted and become effective on or
37before January 1, 2017, (B) each bill amends Section 1502 of the
38Health and Safety Code, (C) Assembly Bill 1997 is not enacted or
39as enacted does not amend that section, and (D) this bill is enacted
P59   1after Senate Bill 524end insert
begin insert, in which case Sections 2, 2.2, and 2.3 of this
2bill shall not become operativeend insert

begin insert

3
(2) Section 2.2 of this bill incorporates amendments to Section
41502 of the Health and Safety Code proposed by both this bill and
5Assembly Bill 1997. It shall only become operative if (A) both bills
6are enacted and become effective on or before January 1, 2017,
7(B) each bill amends Section 1502 of the Health and Safety Code,
8and (C) Senate Bill 524 is not enacted or as enacted does not
9amend that section, and (D) this bill is enacted after Assembly Bill
101997, in which case Sections 2, 2.1, and 2.3 of this bill shall not
11become operative.

end insert
begin insert

12
(3) Section 2.3 of this bill incorporates amendments to Section
131502 of the Health and Safety Code proposed by this bill, Senate
14Bill 524, and Assembly Bill 1997. It shall only become operative
15if (A) all three bills are enacted and become effective on or before
16January 1, 2017, (B) all three bills amend Section 1502 of the
17Health and Safety Code, and (C) this bill is enacted after Senate
18Bill 524 and Assembly Bill 1997, in which case Sections 2, 2.1,
19and 2.2 of this bill shall not become operative.

end insert
begin insert

20
(b) Section 6.1 of this bill incorporates amendments to Section
2111462.01 of the Welfare and Institutions Code proposed by both
22this bill and Assembly Bill 1997. It shall only become operative if
23(1) both bills are enacted and become effective on or before
24January 1, 2017, (2) each bill amends Section 11462.01 of the
25Welfare and Institutions Code, and (3) this bill is enacted after
26Assembly Bill 1997, in which case Section 6 of this bill shall not
27become operative.

end insert
28

begin deleteSEC. 8.end delete
29
begin insertSEC. 9.end insert  

No reimbursement is required by this act pursuant to
30Section 6 of Article XIII B of the California Constitution because
31the only costs that may be incurred by a local agency or school
32district will be incurred because this act creates a new crime or
33infraction, eliminates a crime or infraction, or changes the penalty
34for a crime or infraction, within the meaning of Section 17556 of
35the Government Code, or changes the definition of a crime within
36the meaning of Section 6 of Article XIII B of the California
37Constitution.



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