BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | AB 1997|
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THIRD READING
Bill No: AB 1997
Author: Mark Stone (D)
Amended: 8/15/16 in Senate
Vote: 21
SENATE HUMAN SERVICES COMMITTEE: 5-0, 6/28/16
AYES: McGuire, Berryhill, Hancock, Liu, Nguyen
SENATE APPROPRIATIONS COMMITTEE: 6-0, 8/11/16
AYES: Lara, Bates, Beall, Hill, McGuire, Mendoza
NO VOTE RECORDED: Nielsen
ASSEMBLY FLOOR: 80-0, 6/1/16 - See last page for vote
SUBJECT: Foster care
SOURCE: The California Department of Social Services
DIGEST: This bill cleans up elements of AB 403 (Stone, Chapter
773, Statutes of 2015), which implemented the Continuum of Care
Reform effort. Included in this cleanup are changes to the
requirements for mental health certification of a short term
residential therapeutic program (STRTP) and modifications to
probation placement oversight. It establishes additional
protocols around the Resource Family Approval process, which
moves from a pilot program to a statewide mandate in January
2017. It requires the basic rate paid to all families be the
same regardless of approval process and other changes. This bill
additionally deletes the option to extend the provisional
license of a foster family agency (FFA) or STRTP if it fails to
obtain accreditation within specified time frames. It makes
other conforming and technical changes, including deletion of
statutory language that will become obsolete on January 1, 2017,
AB 1997
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when this bill is enacted, such as licensure categories and
requirements for group homes. It also changes the name of the
existing short term residential treatment center (STRTC)
category, to the STRTP.
ANALYSIS:
Existing law:
1)Establishes a system of juvenile dependency for children who
are or are at risk of being physically, sexually or
emotionally abused, being neglected or being exploited to
ensure their safety, protection and physical and emotional
well-being. (WIC 300, et seq.)
2)Establishes the licensing category of STRTC -- effective
January 1, 2017 -- and defines it as a residential facility
licensed by California Department of Social Services (CDSS)
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. Requires care and
supervision provided by a center be nonmedical, except as
otherwise permitted by law. (HSC 1502 (a)(18))
3)Provides for licensure of a FFA, defined to mean a public or
private agency engaged in the recruiting, certifying, and
training of, and providing professional support to, foster
parents, or in finding homes or other places for placement for
children for temporary or permanent care, as an alternative to
group care. (HSC 1502(a)(4))
4)Establishes California's Medicaid program, Medi-Cal, though
which eligible low-income individuals receive health care and
mental health services, including foster youth. Under
Medi-Cal, establishes the federal Early and Periodic
Screening, Diagnosis and Treatment (EPSDT) program to provide
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comprehensive and preventive health services including
specialty mental health services to Medi-Cal beneficiaries
under the age of 21. (WIC 14000 et seq., 42 USC Section 1396
et seq and 42 CFR 435.145.)
5)Establishes the Resource Family Approval process to replace
the existing multiple processes for licensing foster family
homes, approving relatives and nonrelative extended family
members as foster care providers, and approving adoptive
families. The process includes a home study, psychosocial
assessment, background check, and other elements. (WIC
16519.5)
6)Establishes in statute the basic rate for a foster child and
codifies modifications to that rate. (WIC 11461)
7)Restricts the placement of children younger than 6 into a
group home or STRTP, except in specified circumstances.
Similarly restricts the placement duration of a child aged
6-12 years old to a treatment facility for no longer than six
months with written authorization required to extend the stay.
(WIC 361.2)
This bill:
1)Makes changes to the STRTP and FFA structure, licensure and
certification:
a) Renames the STRTP from the former Short Term Residential
Treatment Center (STRTC).
b) 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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c) Requires FFA social workers to meet core competencies to
participate in the assessment and evaluation of an
applicant, as specified, and clarifies that a social worker
may obtain a degree more advanced than a master's degree.
d) Defines components of an FFA's plan of operation
including a demonstrated ability to support the needs of
differing children and their families, a demonstrated
ability to provide or obtain treatment services, and
others.
e) 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 determines
that the issue has been corrected or no longer exists.
f) 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 the
accreditation and permits CDSS to revoke licensure if
accreditation is not obtained in that time.
2)Clarifies probation department's role in placing youth into an
STRTP:
a) Requires that if a child is placed in an STRTP through
the probation department, and is older than 13 years old,
the chief probation officer must review and approve the
placement if it exceeds 12 months and no less frequently
than every 12 months thereafter.
b) Requires that a court review the placement decision of a
probation department for necessity and appropriateness.
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3)Revises the Resource Family Approval (RFA) Process in the
following ways:
a) 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.
b) Requires an FFA to make an announced annual inspection
visit, and authorizes inspection of resource family homes
as often as necessary to ensure the quality of care.
c) Requires CDSS to develop a basic rate that ensures that
a child placed in a licensed foster family home, a
certified family home, or with a resource family approved
by a county or foster family agency is eligible for the
same basic rate.
4)Makes the following changes to Mental Health components:
a) 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), and requires
that a licensed STRTP that has not obtained a program
approval to provide children in its care access to
appropriate mental health services.
b) 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.
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c) Authorizes DHCS and county mental health plans to issue
a provisional mental health approval for up to one year and
requires DHCS and CDSS to issue regulations defining due
process for centers that are seeking to appeal any part of
the licensure and program approval process.
d) Requires out-of-state group homes to have a mental
health program approval equivalent to California's to
accept placement of California youth.
e) Removes the requirement for FFAs to obtain a mental
health certification or program approval and deletes
references to treatment in FFAs throughout the bill.
f) Replaces the requirement that an FFA document how it
will provide treatment services, with the requirement that
an FFA submit a copy of its program statement to all
placing agencies.
g) Requires DHCS and CDSS to identify a dispute resolution
process to address disputed interagency placement committee
assessments or determinations of a child's service need.
Background
Approximately 62,000 children and youth in California are in
foster care or roughly 1 in 7 foster children nationwide. For
more than a decade California has implemented prevention and
early intervention efforts to strengthen families and reduce the
number of children in out-of-home foster care placements,
resulting in a decline from more than 100,000 youths in foster
care in 1999 to the current 62,000. About 85 percent were
removed from their families due to neglect, 8 percent due to
physical abuse, and 2 percent due to sexual abuse. The median
length of time California children spent in foster care was
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about 15 months, as of 2012.
At the same time the population was declining, there was a
growing national consensus in the field of child welfare that
institutionalized settings should be used sparingly. The
placement of maltreated children in group care settings has been
increasingly viewed as a temporary solution in instances where
emergency or crisis treatment is warranted. Yet, as of January
2015, 48 percent of youth placed in group homes in California
through the child welfare services system had been there more
than two years, and 23 percent had been there more than five
years
Continuum of Care Reform effort. In 2012, CDSS convened a
working group to recommend changes to the current rate-setting
system, services, and programs serving children and families in
the continuum of foster care settings. The three-year effort
came in response to statutory requirements in budget trailer
bill (SB 1013, Senate Budget Committee, Chapter 25, Statutes of
2012), which mandated the workgroup consider, at a minimum,
reforms to programs provided by FFAand group homes, and how to
ensure the provision of services in family-like settings,
including after care services, when appropriate.
In January 2015, the CDSS published the "California's Child
Welfare Continuum of Care Reform" report. It outlined an
interdependent approach to improving California's child welfare
system by improving assessments of children and families, and
centering support services for children in home-based family
care settings rather than in group care.
AB 403 (Stone). AB 403 enacted major components of the CCR
effort. The bill eliminated the licensure category of children's
group homes and declared Legislative intent to improve
California's child welfare system by using comprehensive initial
child assessments, increasing the use of and the supports to
home-based family care and relying less on congregate care. The
bill targeted the delivery of appropriate treatment and services
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to the child regardless of living arrangement, rather than using
the placement setting to drive decisions about services which
historically has caused a child to "fail upwards" into higher
levels of care. Overall, it emphasized the creation of supports
for resource families to decrease group care.
Short Term Residential Treatment Centers (STRTCs). AB 403 bill
created a new licensure category to replace the eliminated group
home category, effective January 1, 2017. All STRTCs are
required to have national accreditation from an entity
identified by CDSS as well as a mental health approval.
Placement of a child into a STRTC is authorized only when the
case plan specifies the need for, nature of, and anticipated
duration of the identified treatment and includes a plan for
transitioning the child to a less restrictive environment and
the projected timeline.
This bill clarifies the process for an STRTC to obtain mental
health approval and makes continued licensure by CDSS contingent
upon obtaining the mental health approval. It permits emergency
placements of youth and children into STRTCs pending further
evaluation. For children with behavioral challenges that are not
diagnosed as needing specialty mental health services by a
county mental health plan, this bill permits an STRTC to remain
licensed and to provide children in its care access to
appropriate mental health services.
Foster Family Agencies (FFAs). Private FFAs are used by county
placing departments for children who require more intensive care
than a typical foster family home, but do not need the intensive
services of a group home, or an STRTP. FFAs recruit, certify and
train foster parents and provide social workers and other
supports to the foster families. AB 403 maintained the licensure
category of FFAs, but required all FFAs to become accredited,
mandated new rates be established, permitted probation
departments to place youth into a certified home of an FFA and
permitted mental health certification for programs that provide
intensive services, according to law.
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This bill removes the requirement that an FFA seek and obtain
mental health program approval, however an FFA may still secure
mental health treatment for children living within the FFA's
foster homes.
Out of state placements. California statute requires that any
out-of-state group home meet at least the same rigorous
standards it would have to meet in California. It requires CDSS
or its designee - typically a county child welfare agency - to
perform initial and continuing inspections of out-of-state group
homes in order to either certify that the out-of-state group
home meets all licensure standards required of group homes
operated in California or that the CDSS has granted a waiver to
a specific licensing standard upon a finding that there exists
no adverse impact to health and safety. AB 403 mandated that
after January 1, 2017, the licensing standards applicable to
out-of-state group homes be the same as those required of
STRTCs, unless the out-of-state group home is granted an
extension or waiver, as specified. In January 2016, there were
62 youths placed in out-of-state placements from the child
welfare system, and 252 from the probation, or delinquency,
system, as reflected in the chart on the next page. This bill
extends the requirement for mental health certification to
out-of-state placements.
Rates. With the establishment of new types of treatment and the
new STRTC category, AB 403 required CDSS to create a new payment
structure for STRTCs and for FFAs, effective January 1, 2017.
These rates were expected to be released in March 2016, however
CDSS was delayed in releasing them and they were unveiled with
the May Revise. In response to stakeholder concerns about the
methodology for creating the rates, the Senate and Assembly
budget committees adopted special reporting language requiring
CDSS to work with stakeholders through the summer of 2016, and
to report back on Aug. 10th the results of those conversations
in order to determine if rate adjustments are necessary.
Resource Family Approval. Prior to AB 403, the Legislature
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approved and CDSS enacted a pilot project to combine the review
and approval processes of California's various foster care and
adoption programs into a single approval process, the Resource
Family Approval (RFA) Process. AB 403 made the pilot statewide,
effective January 1, 2017.
This bill clarifies the process for conducting an RFA for a
family member who is sheltering a foster child. The typical RFA
process requires a background check, psychosocial assessment and
home study prior to the placement of a child in a foster home.
However many family placements are done on an emergency basis,
without the ability to establish approval prior to placement.
This bill establishes a process for emergency placement of a
child with a relative, pending final approval through the RFA
process.
FISCAL EFFECT: Appropriation: No Fiscal
Com.:YesLocal: Yes
According to an analysis by the Senate Appropriations Committee,
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. The various changes made in this
bill are addressed in the budget. The analysis also notes that
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 Budget
Act, this bill would require additional General Fund costs.
SUPPORT: (Verified8/12/16)
California Department of Social Services (Source)
California Council of Community Behavioral Health Agencies
California Department of Finance
California State Association of Counties
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County Welfare Directors Association of California
Los Angeles Unified School District
National Association of Social Workers, California Chapter
OPPOSITION: (Verified8/12/16)
None received
ARGUMENTS IN SUPPORT: The California Department of Social
Services, the bill's sponsor, writes that the department
continues to work in close collaboration with county partners,
stakeholders and advocate groups to further the CCR reform
effort. "This initiative will enhance the lives of children and
youth in foster care, increasing their chances to grow into
self-sufficient, successful adults," writes the department's
legislative director, Robert Smith.
The author states that while most youth in foster care are
placed with resource families about 3,000 youth live in group
placements, where they often stay for years. These long stays
are problematic because foster youth who live in congregate care
settings are more likely to suffer a variety of negative short-
and long-term outcomes, the author states. These can include
lifelong institutionalized behaviors, and increased likelihood
of involvement with the criminal justice system as well as low
educational attainment.
ASSEMBLY FLOOR: 80-0, 6/1/16
AYES: Achadjian, Alejo, Travis Allen, Arambula, Atkins, Baker,
Bigelow, Bloom, Bonilla, Bonta, Brough, Brown, Burke,
Calderon, Campos, Chang, Chau, Chávez, Chiu, Chu, Cooley,
Cooper, Dababneh, Dahle, Daly, Dodd, Eggman, Frazier, Beth
Gaines, Gallagher, Cristina Garcia, Eduardo Garcia, Gatto,
Gipson, Gomez, Gonzalez, Gordon, Gray, Grove, Hadley, Harper,
Roger Hernández, Holden, Irwin, Jones, Jones-Sawyer, Kim,
AB 1997
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Lackey, Levine, Linder, Lopez, Low, Maienschein, Mathis,
Mayes, McCarty, Medina, Melendez, Mullin, Nazarian, Obernolte,
O'Donnell, Olsen, Patterson, Quirk, Ridley-Thomas, Rodriguez,
Salas, Santiago, Steinorth, Mark Stone, Thurmond, Ting,
Wagner, Waldron, Weber, Wilk, Williams, Wood, Rendon
Prepared by:Mareva Brown / HUMAN S. / (916) 651-1524
8/15/16 19:36:14
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