BILL ANALYSIS Ó SENATE COMMITTEE ON APPROPRIATIONS Senator Ricardo Lara, Chair 2015 - 2016 Regular Session AB 1997 (Mark Stone) - Foster care ----------------------------------------------------------------- | | | | | | ----------------------------------------------------------------- |--------------------------------+--------------------------------| | | | |Version: August 3, 2016 |Policy Vote: HUMAN S. 5 - 0 | | | | |--------------------------------+--------------------------------| | | | |Urgency: No |Mandate: Yes | | | | |--------------------------------+--------------------------------| | | | |Hearing Date: August 8, 2016 |Consultant: Debra Cooper | | | | ----------------------------------------------------------------- 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 AB 1997 (Mark Stone) Page 1 of ? 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 AB 1997 (Mark Stone) Page 2 of ? 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. AB 1997 (Mark Stone) Page 3 of ? 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. AB 1997 (Mark Stone) Page 4 of ? 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 AB 1997 (Mark Stone) Page 5 of ? 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. AB 1997 (Mark Stone) Page 6 of ? 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 AB 1997 (Mark Stone) Page 7 of ? 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. -- END --