BILL ANALYSIS                                                                                                                                                                                                    Ó



          SENATE COMMITTEE ON APPROPRIATIONS
                             Senator Ricardo Lara, Chair
                            2015 - 2016  Regular  Session

          AB 1997 (Mark Stone) - Foster care
          
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          |Version: June 30, 2016          |Policy Vote: HUMAN S. 5 - 0     |
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          |Urgency: No                     |Mandate: Yes                    |
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          |Hearing Date: August 8, 2016    |Consultant: Debra Cooper        |
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          This bill meets the criteria for referral to the Suspense File.


          Bill  
          Summary:  AB 1997 makes several changes to the Education,  
          Family, Government, Health and Safety, Penal, Probate, and  
          Welfare and Institutions codes to revise the provisions AB 403  
          (Stone, Chapter 773, Statutes of 2015) which implemented the  
          Continuum of Care Reform (CCR) efforts. 


          Fiscal  
          Impact:  
           The 2016 Budget Act includes a total of $170.6 million ($129.3  
            million GF) in local assistance and state operations for  
            implementation of CCR efforts. This bill makes modifications  
            to AB 403 necessary to facilitate implementation. The various  
            changes made in this bill are addressed in the budget. (See  
            Staff Comments) 

           The numerous changes to CCR implementation made in this bill  
            would result in unquantifiable costs. To the extent that the  
            changes result in costs that are not included in the 2016  







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            Budget Act, this bill would require additional General Fund  
            costs.


          Background:  
           Continuum of Care Reform effort  : In response to the legislative  
          mandate pursuant to SB 1013 (Committee on Budget and Fiscal  
          Review, Chapter 35, Statutes of 2012), which required the  
          Department of Social Services (DSS) to establish a stakeholder  
          workgroup to develop recommended revisions to the current  
          rate-setting system, services, and programs serving children and  
          families in the continuum of eligible foster care placement  
          settings including, at a minimum, all programs provided by  
          foster family agencies and group homes, DSS led a multi-year  
          effort and produced a report. The January 2015 report,  
          "California's Child Welfare Continuum of Care Reform Report,"  
          outlined a collaborative approach to improve the experience and  
          outcomes of children and youth in foster care by improving  
          assessments of children and families, emphasizing home-based  
          family care placements of children, and changing the goals for  
          congregate (group home) care placements. 


          Through this model, children who cannot initially safely be  
          placed in home-based family care may still go into congregate  
          care, but with a care plan that aims to transition these  
          children into home-based family care with their services  
          following them. The report emphasized that reform efforts cannot  
          be accomplished with isolated standalone components, but rather  
          an interconnected system. Several of the recommendations in the  
          report required short-term upfront investments to phase in  
          changes to the placement system.


           AB 403  : AB 403 (Stone, Chapter 773, Statutes of 2015)  
          established the framework for commencing the development of the  
          reforms to the existing foster care placement system and payment  
          structures through codifying a number of recommendations  
          included in DSS's January 2015 CCR report. Specifically, AB 403:  

           Eliminated the group home category of licensure and created a  
            new licensure category of "short-term residential treatment  
            centers" (STRTCs) defined to mean a residential facility  
            licensed by DSS and operated by a public agency or private  








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            organization that provides short-term, specialized, and  
            intensive  treatment, including core services and 24-hour care  
            and supervision to children. While the group home category was  
            eliminated, this bill permitted a two-year conditional  
            extension to individual group homes to the STRTC model and an  
            interim rate structure for group homes that were unable to  
            transition in the given time frame. 
           Established new requirements for foster family agencies  
            (FFAs), including requiring accreditation of all FFAs,  
            mandating new rates to be established, permitting probation  
            departments to place youth into a certified home of an FFA,  
            permitting mental health certification for programs that  
            provide intensive services, and requiring maintenance of a  
            written plan of operation. 
           Required statewide implementation of the resource family  
            approval (RFA) process by January 1, 2017, approving RFA's in  
            lieu of certifying foster homes. 
           Required DSS to create a new payment structure for STRTCs and  
            FFAs effective January 1, 2017. These rates were released with  
            the Governor's 2016-17 Revised Budget.




          Proposed Law:  
            This bill makes a number of changes to CCR implementation in  
          the following ways: 
           Changes to STRTC and FFA structures, licensure, and  
          certification  : 
           Changes the licensure category from "short-term residential  
            treatment centers" to "short-term residential therapeutic  
            programs" (STRTP) and clarifies that it is a residential  
            facility operated by a public agency or private organization  
            that provides an integrated program of specialized and  
            intensive care and supervision, services and supports,  
            treatment, and short-term, 24-hour care and supervision to  
            children. 

           Requires that private STRTPs be organized and operated on a  
            nonprofit basis.

           Requires an FFA or STRTP to include with an application, a  
            letter of recommendation from county placing agencies to  
            identify a need for the program prior to licensure.








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           Requires FFA social workers to meet core competencies to  
            participate in the assessment and evaluation of an applicant.

           Deletes the ability of an FFA or STRTP to receive a  
            provisional license in order to obtain accreditation, provides  
            each FFA with a 24-month window to receive accreditation, and  
            permits DSS to revoke licensure if accreditation is not  
            obtained in that time. 

           Prohibits an FFA from considering an applicant who has had a  
            denial within the preceding year or a previous rescission,  
            revocation, or exemption denial, but permits an FFA to  
            continue to review an application if it has determined that  
            the reasons for the previous denial, rescission, or revocation  
            were due to circumstances that either have been corrected or  
            are no longer in existence. 


           Role of the probation department in regards to STRTP  :
           Requires the chief probation officer to review and approve  
            placement of a child in an STRTP through the probation  
            department if the youth is older than 13 years old and the  
            placement exceeds 12 months, and requires the chief probation  
            officer to review no less frequently than every 12 months  
            thereafter.

           Authorizes a court to affirm or reject the placement  
            determination of a probation department and specifies the  
            courts actions if the court rejects the placement  
            determination. 


           Changes to the RFA Process  :
           Establishes the RFA as the only method to approving homes  
            within a foster family agency, sunsets provisions that allow  
            for certification of homes under the prior statute, and  
            requires an FFA to document various aspects of the RFA  
            process. 

           Requires an FFA to make an annual announced inspection visit  
            and authorizes inspection of resource family homes as often as  
            necessary to ensure the resource family is conforming to all  
            applicable laws and the written directives or regulations.








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           Requires a licensed or certified foster home or existing  
            approved resource family home to forfeit its current  
            licensure, certification, or approval concurrent with its  
            approval as a resource family by an FFA or county.

           Requires DSS to develop a basic rate that ensures that a child  
            placed in a licensed foster family home and a child placed in  
            a certified family home or with a resource family approved by  
            a county or foster family agency is eligible for the same  
            basic rate and specifies that the rates shall not be lower  
            than the rates proposed as part of the Governor's 2016 May  
            Revision.

           Clarifies that there is no fundamental right to approval as a  
            resource family.


           Changes to mental health components of CCR  :
           Prohibits an STRTP from providing specialty mental health  
            services without a current mental health program approval from  
            the county mental health plan or state Department of Health  
            Care Services (DHCS).

           Requires that county mental health plans ensure that Medi-Cal  
            specialty mental health services, including, but not limited  
            to, services under the Early and Periodic Screening, Diagnosis  
            and Treatment benefit, are provided to all Medi-Cal  
            beneficiaries served by short-term residential therapeutic  
            programs who meet medical necessity criteria. 

           Authorizes DHCS and county mental health plans to suspend or  
            revoke a mental health program approval, impose monetary  
            penalties, place a mental health program on probation or  
            require a program to prepare and comply with a corrective  
            action plan.

           Provides DHCS and county mental health plans with authority to  
            issue a provisional approval for up to one year and requires  
            DHCS and DSS to issue regulations defining due process for  
            centers that are seeking to appeal any part of the licensure  
            and program approval process. 

           Clarifies the role of the interagency placement committee in  








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            assessing children for placement in to STRTPs.

           Establishes that out-of-state group homes must have a mental  
            health program approval equivalent to California's to accept  
            placement of California youth.

           Requires DSS to track the number of licensed STRTPs that were  
            unable to obtain a mental health program approval and provide  
            that information to the Legislature annually as part of the  
            State Budget process.


           Technical and clarifying changes  : 
           Specifies that DSS, the county adoption agency, or licensed  
            adoption agency may obtain arrest or conviction records or  
            reports from any law enforcement agency as necessary to  
            perform its duties, as appropriate.

           Requires DSS and DHCS to develop a dispute resolution process  
            or utilize an existing process to jointly review a disputed  
            interagency placement committee assessment or determination  
            and to report the number of disputes reported and resolved to  
            the Legislature annually as part of the State Budget process.




          Related  
          Legislation:  
          AB 403 (Stone, Chapter 773, Statutes of 2015) implemented CCR to  
          better serve children and youth in California's child welfare  
          services system and also required statewide implementation of  
          the Resource Family Approval Process.


          SB 1013 (Senate Budget and Fiscal Review, Chapter 35, Statutes  
          of 2012) realigned CWS to counties and established a moratorium  
          on the licensing of new group homes. This bill also required DSS  
          to convene a stakeholder workgroup to examine the use of group  
          homes and discuss and recommend changes to the continuum of care  
          within CWS and how to reform the use of congregate care.











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          Staff  
          Comments:  
          The Governor's 2016-17 May Revised Budget included $165.5  
          million ($127.3 million GF) for CCR implementation. The revised  
          budget makes allocations for the changes to CCR implementation  
          that are in this bill including, among other things:
                 $35.7 million ($33 million GF) for Home-Based Family  
               Care Rates
                 $3.8 million (GF) for Foster Family Agency Social Worker  
               rate increase
                 $2.8 million ($1.4 million GF) for accreditation
                 $12 million ($8 million GF) for Resource Family Approval
                 $0.4 million ($0.2 million GF) for STRTC certification
                 $0.3 million ($0.1 million GF) for mental health  
               assessments


          The 2016 Budget Act includes $170.6 million ($129.3 million in  
          General Fund) for CCR implementation efforts contained in AB  
          403, including $164.8 million ($126.2 million General Fund) for  
          local assistance costs. The Department of Finance (DOF) states  
          that this bill "is not anticipated to result in additional  
          General Fund costs beyond the amount already included in the  
          2016 Budget Act." Additionally, DOF estimates that local  
          assistance for CCR will decrease to $83.9 million in fiscal year  
          2017-18, and will decrease to less than $300,000 annually  
          beginning in fiscal year 2018-19.


          Proposition 30 (November 2012) eliminated any potential mandate  
          funding liability for any new program or higher level of service  
          mandated on local agencies related to realigned programs,  
          including child welfare services and foster care. Legislation  
          enacted after September 30, 2012, that has an overall effect of  
          increasing the costs already borne by a local agency for  
          programs or levels of service mandated by realignment only apply  
          to local agencies to the extent that the state provides annual  
          funding for the cost increase. Local agencies are not obligated  
          to provide programs or levels of service required by legislation  
          above the level for which funding has been provided.


          The potential local and state fiscal impacts of this bill will  








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          be dependent on numerous factors including but not limited to  
          the outcomes of processes and structures required pursuant to  
          the bill's provisions. While the 2016 Budget Act includes $129.3  
          million General Fund in one-time funding to continue CCR  
          implementation in 2016-17, significant additional investments  
          will likely be required in order to continue to build on these  
          efforts.




          Proposed Author  
          Amendments:  The author has indicated numerous technical  
          amendments are forthcoming.


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