Amended in Assembly August 28, 2015

Amended in Assembly July 8, 2015

Amended in Senate June 2, 2015

Amended in Senate April 22, 2015

Senate Bill No. 484

Introduced by Senator Beall

(Principal coauthor: Assembly Member Chiu)

(Coauthors: Senators Mitchell and Monning)

February 26, 2015

An act to amend begin delete Section end delete begin insert Sections 1507.6 and end insert 1536 of, and to add Sections 1538.8 and 1538.9 to, the Health and Safety Code, and to amend Section 11469 of the Welfare and Institutions Code, relating to juveniles.

LEGISLATIVE COUNSEL’S DIGEST

SB 484, as amended, Beall. Juveniles.

(1) The California Community Care Facilities Act provides for the licensure and regulation of community care facilities, including foster family homes and group homes, by the State Department of Social Services. A violation of this act is a misdemeanor.

begin insert

Under existing law, a child in a group home may receive mental health services, as deemed necessary by the placing agency and under the case management of that agency. Under existing law, only a juvenile court judicial officer may make orders regarding the administration of psychotropic medications to a child adjudged a dependent or ward of the court and removed from the physical custody of the parent. Existing law requires that the order be based on a request from a physician, indicating the reasons for the request and a description of the child’s diagnosis and behavior, among other requirements.

end insert begin insert

This bill would provide that psychotropic medications may be used at a group home, other than at a runaway and homeless youth shelter, only in accordance with the written directions of the physician prescribing the medication and as authorized by the juvenile court. The bill would require the group home to maintain in the child’s records specified information regarding the administration of those medications.

end insert

begin insert (2) end insert begin insert   end insert Existing law requires the begin delete department director, end delete begin insert Director of Social Services, end insert at least annually, to publish and make available to interested persons a list covering all licensed community care facilities, except as specified, and the services for which each facility has been licensed or issued a special permit.

This bill would require the department begin delete director end delete to compile specified information regarding the administration of psychotropic medications to children in begin delete those facilities end delete begin insert group homes end insert and to post that information begin delete to end delete begin insert on end insert the department’s Internet Web site. The bill would require the begin delete department end delete begin insert department, in consultation with the State Department of Health Care Services and stakeholders, end insert to establish a methodology to identify those group homes that have begin delete disproportionately high and inappropriate end delete levels of psychotropic drug begin delete usage, based on specified criteria. end delete begin insert utilization warranting additional review, as specified. end insert The bill would also require the department, for the facilities identified by the methodology that it establishes, to visit those facilities at least once a year to examine specified factors. The bill would require a begin delete facility that is found to have disproportionately high and inappropriate levels of psychotropic drug usage, which may be caused by inadequate alternative and less invasive psychosocial services, crisis management, and other services, end delete begin insert facility, for which the department, based on that inspection, finds a risk to the health, safety, or personal rights of clients in care, end insert to submit a plan begin insert of correction end insert to begin delete address steps the facility shall take to reduce inappropriate prescribing and treatment regimens end delete begin insert the department end insert within 30 days of receiving notice of the department’s begin delete determination. end delete begin insert findings. end insert The bill would require the department to monitor the facility’s implementation of that plan begin insert of correction end insert begin delete and make a report, as provided. end delete begin insert to determine that the concerns identified during the inspection have been addressed. end insert Because begin delete this bill would create a new crime, end delete begin insert the failure of the facility to comply with these provisions would be a misdemeanor, end insert the bill would impose a state-mandated local program.

begin delete

(2)

end delete

begin insert (3) end insert  Existing law requires the department, on or before January 1, 2016, in consultation with specified associations and other stakeholders, to develop additional performance standards and outcome measures that require group homes to implement programs and services to minimize law enforcement contacts with minors in group homes or under supervision of group home staff.

This bill would require the department, on or before January 1, 2017, in consultation with specified associations and other stakeholders, to develop additional performance standards and outcome measures that require group homes to implement begin insert alternative end insert programs and begin delete services to reduce utilization of psychotropic medications for children in group homes. The bill would also delete an obsolete provision. end delete begin insert services, as specified. end insert

begin delete

(3)

end delete

begin insert (4) 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:

begin insert

begin insert SECTION 1. end insert   

end insert

begin insert Section 1507.6 of the end insert begin insert Health and Safety Code end insert begin insert is
amended to read: end insert

1507.6.  

begin insert (a) end insert begin insert   end insert Mental health services, as deemed necessary by
the placing agency, may be provided to children in a group home.
Except for the physical safety and direct care and supervision of
children so placed, the State Department of Social Services and
its agents shall not evaluate or have responsibility or liability for
the evaluation of mental health services provided in those homes.
Supervision of mental health treatment services provided to a child
in a group home shall be a case management responsibility of the
placing agency.

begin insert

(b) (1) Psychotropic medications shall be used only in
accordance with the written directions of the physician prescribing
the medication and as authorized by the juvenile court pursuant
to Section 369.5 or 739.5 of the Welfare and Institutions Code.

end insert begin insert

(2) The facility shall maintain in a child’s records all of the
following information:

end insert begin insert

(A) A copy of any court order authorizing the psychotropic
medication for the child.

end insert begin insert

(B) A separate log for each psychotropic medication prescribed
for the child, showing all of the following:

end insert begin insert

(i) The name of the medication.

end insert begin insert

(ii) The date of the prescription.

end insert begin insert

(iii) The quantity of medication and number of refills initially
prescribed.

end insert begin insert

(iv) When applicable, any additional refills prescribed.

end insert begin insert

(v) The required dosage and directions for use as specified in
writing by the physician prescribing the medication, including any
changes directed by the physician.

end insert begin insert

(vi) The date and time of each dose taken by the child.

end insert begin insert

(3) This subdivision does not apply to a runaway and homeless
youth shelter, as defined in Section 1502.

end insert

begin delete SECTION 1. end delete
begin insert SEC. 2. end insert   

Section 1536 of the Health and Safety Code is amended
to read:

1536.  

(a) (1) At least annually, the begin delete director end delete begin insert department end insert shall
publish and make available to interested persons a list or lists
covering all licensed community care facilities, other than foster
family homes and certified family homes of foster family agencies
providing 24-hour care for six or fewer foster children, and the
services for which each facility has been licensed or issued a special
permit.

(2) For a group home, transitional housing placement provider,
community treatment facility, or runaway and homeless youth
shelter, the list shall include both of the following:

(A) The number of licensing complaints, types of complaint,
and outcomes of complaints, including citations, fines, exclusion
orders, license suspensions, revocations, and surrenders.

(B) The number, types, and outcomes of law enforcement
contacts made by the facility staff or children, as reported pursuant
to subdivision (a) of Section 1538.7.

(b) Subject to subdivision (c), to encourage the recruitment of
foster family homes and certified family homes of foster family
agencies, protect their personal privacy, and to preserve the security
and confidentiality of the placements in the homes, the names,
addresses, and other identifying information of facilities licensed
as foster family homes and certified family homes of foster family
agencies providing 24-hour care for six or fewer children shall be
considered personal information for purposes of the Information
Practices Act of 1977 (Chapter 1 (commencing with Section 1798)
of Title 1.8 of Part 4 of Division 3 of the Civil Code). This
information shall not be disclosed by any state or local agency
pursuant to the California Public Records Act (Chapter 3.5
(commencing with Section 6250) of Division 7 of Title 1 of the
Government Code), except as necessary for administering the
licensing program, facilitating the placement of children in these
facilities, and providing names and addresses only to bona fide
professional foster parent organizations upon request.

(c) Notwithstanding subdivision (b), the department, a county,
or a foster family agency may request information from, or divulge
information to, the department, a county, or a foster family agency,
regarding a prospective certified parent, foster parent, or relative
caregiver for the purpose of, and as necessary to, conduct a
reference check to determine whether it is safe and appropriate to
license, certify, or approve an applicant to be a certified parent,
foster parent, or relative caregiver.

(d) The department may issue a citation and, after the issuance
of that citation, may assess a civil penalty of fifty dollars ($50) per
day for each instance of a foster family agency’s failure to provide
the department with the information required by subdivision (h)
of Section 88061 of Title 22 of the California Code of Regulations.

(e) The Legislature encourages the department, when funds are
available for this purpose, to develop a database that would include
all of the following information:

(1) Monthly reports by a foster family agency regarding family
homes.

(2) A log of family homes certified and decertified, provided
by a foster family agency to the department.

(3) Notification by a foster family agency to the department
informing the department of a foster family agency’s determination
to decertify a certified family home due to any of the following
actions by the certified family parent:

(A) Violating licensing rules and regulations.

(B) Aiding, abetting, or permitting the violation of licensing
rules and regulations.

(C) Conducting oneself in a way that is inimical to the health,
morals, welfare, or safety of a child placed in that certified family
home.

(D) Being convicted of a crime while a certified family parent.

(E) Knowingly allowing any child to have illegal drugs or
alcohol.

(F) Committing an act of child abuse or neglect or an act of
violence against another person.

(f) At least annually, the department shall post begin delete to end delete begin insert on end insert its Internet
Web site a statewide summary begin delete report end delete of the begin delete data end delete begin insert information end insert
gathered pursuant to Sections 1538.8 and 1538.9. The summary
begin delete report end delete shall begin delete exclude all personally identifiable information and
shall not identify individual group homes. end delete begin insert include only de-identified
and aggregate information that does not violate the confidentiality
of a child’s identity and records. end insert

begin delete SEC. 2. end delete
begin insert SEC. 3. end insert   

Section 1538.8 is added to the Health and Safety Code,
to read:

1538.8.  

(a)  begin insert (1) end insert begin insert   end insert In order to begin delete identify group homes in which end delete
begin insert review and evaluate the use of end insert psychotropic medications begin delete may be
inappropriately administered to children the director end delete begin insert in group
homes, the department end insert shall compile, begin insert to the extent feasible and
not otherwise prohibited by law and based on information received
from the State Department of Health Care Services, end insert at least
annually, begin delete the following end delete information concerning each begin delete home: end delete begin insert group
home, including, but not limited to, the child welfare psychotropic
medication measures developed by the department and the
following Healthcare Effectiveness Data and Information Set
(HEDIS) measures related to psychotropic medications: end insert

begin delete

(1) The number of children in the facility to whom psychotropic
medications were administered.

(2) The number of children in the facility who are 6 to 11 years
of age, inclusive, to whom psychotropic medications were
administered.

(3) The number of children in the facility who are 12 to 17 years
of age, inclusive, to whom psychotropic medications were
administered.

(4) The number of children for whom the juvenile court
preauthorized the administration of psychotropic medication.

(5) The number of children to whom psychotropic medications
were administered on an emergency basis.

(6) The number of children to whom antipsychotic, mood
stabilizing, or antidepressant medications were administered.

(7) The number of children who received two or more drugs
from the same class, including, but not limited to, antidepressants,
antipsychotics, and antianxiety medications.

(8) The number of children who received two or more
psychotropic medications concurrently, and whether those children
received two, three, four, or more than four psychotropic
medications concurrently.

(9) The number of children who received one or more
medications for more than 90 days.

(10) The number of children who received psychosocial services
while in a group home placement while they received a
psychotropic medication.

(11) The number of children who received a dosage of a
psychotropic medication at a dosage above the maximum dosage
approved by the federal Food and Drug Administration.

(12) The number of children who received metabolic monitoring
in accordance with professional standards of care while they
received psychotropic medication.

(13) The number of children who were prescribed antipsychotic
medications for a use not approved by the federal Food and Drug
Administration.

end delete begin insert

(A) Follow-Up Care for Children Prescribed Attention Deficit
Hyperactivity Disorder Medication (HEDIS ADD), which measures
the number of children six to 12 years of age, inclusive, who have
a visit with a provider with prescribing authority within 30 days
of the new prescription.

end insert begin insert

(B) Use of Multiple Concurrent Antipsychotics in Children and
Adolescents (HEDIS APC), which does both of the following:

end insert begin insert

(i) Measures the number of children receiving an antipsychotic
medication for at least 60 out of 90 days and the number of
children who additionally receive a second antipsychotic
medication that overlaps with the first.

end insert begin insert

(ii) Reports a total rate and age stratifications including 6 to
11 years of age, inclusive, and 12 to 17 years of age, inclusive.

end insert begin insert

(C) Use of First-Line Psychosocial Care for Children and
Adolescents on Antipsychotics (HEDIS APP), which measures
whether a child has received psychosocial services 90 days before
through 30 days after receiving a new prescription for an
antipsychotic medication.

end insert begin insert

(D) Metabolic Monitoring for Children and Adolescents on
Antipsychotics (HEDIS APM), which does both of the following:

end insert begin insert

(i) Measures testing for glucose or HbA1c and lipid or
cholesterol of a child who has received at least two different
antipsychotic prescriptions on different days.

end insert begin insert

(ii) Reports a total rate and age stratifications including 6 to
11 years of age, inclusive, and 12 to 17 years of age, inclusive.

end insert begin insert

(2) The department shall post the list of data to be collected
pursuant to this subdivision on the department’s Internet Web site.

end insert

(b) The data in subdivision (a) concerning psychotropic
medication, mental health services, and placement shall be drawn
from existing data begin delete systems, including, but not limited to, the
Medicaid Management Information System’s medical and
pharmacy claims data, and the Child Welfare Services/Case
Management System, through the data sharing agreement between end delete
begin insert maintained by end insert the State Department of Health Care Services and
the State Department of Social begin delete Services. end delete begin insert Services and shared
pursuant to a data sharing agreement meeting the requirements
of all applicable state and federal laws and regulations. end insert

begin insert

(c) This section does not apply to a runaway and homeless youth
shelter, as defined in Section 1502.

end insert

begin delete SEC. 3. end delete
begin insert SEC. 4. end insert   

Section 1538.9 is added to the Health and Safety Code,
to read:

1538.9.  

(a) (1) (A) The department shall consult with the
begin delete foster care ombudsman end delete begin insert State Department of Health Care Services end insert
and begin delete the Quality Improvement Project Clinical Workgroup end delete
begin insert stakeholders end insert to establish a methodology for identifying those group
homes begin insert providing services under the AFDC-FC program pursuant
to Sections 11460 and 11462 of the Welfare and Institutions Code end insert
that have begin delete disproportionately high and inappropriate end delete levels of
psychotropic drug begin delete usage end delete begin insert utilization end insert warranting additional begin delete review
of the facility. The criteria for determining if a group home has
disproportionately high and inappropriate levels of psychotropic
drug usage shall be based upon the end delete begin delete California Guidelines for the
Use of Psychotropic Medication with Children and Youth in Foster
Care end delete begin delete and shall take into consideration, among other things, the
factors listed in paragraphs (1) to (13), inclusive, of subdivision
(a) of Section 1538.8. end delete begin insert review. end insert The methodology shall be adopted
on or before July 1, 2016.

(B) Every three years after adopting the methodology developed
under subparagraph (A), or earlier if needed, the department shall
consult with the begin delete foster care ombudsman and the Quality
Improvement Project Clinical Workgroup end delete begin insert State Department of
Health Care Services and stakeholders end insert and revise the begin delete methodology. end delete
begin insert methodology, if necessary. end insert

(2) If the department, applying the methodology described in
paragraph (1), determines that a facility appears to have
begin delete disproportionately high and inappropriate end delete levels of psychotropic
drug begin delete usage, which may be caused by, among other things,
inadequate alternative and less invasive psychosocial services,
crisis management, and other services, end delete begin insert utilization warranting
additional review, end insert it shall inspect the facility at least once a year.

(3) The inspection of the facility shall include, but not be limited
to, begin insert a review of end insert the following:

begin delete

(A) A review of the facility’s:

end delete begin delete

(i)

end delete

begin insert (A) end insert  Plan of operation, policies, procedures, and practices.

begin delete

(ii)

end delete

begin insert (B) end insert  Child-to-staff ratios.

begin delete

(iii)

end delete

begin insert (C) end insert  Staff qualifications and training.

begin delete

(iv)

end delete

begin insert (D) end insert  Implementation of children’s needs and services plan.

begin delete

(v)

end delete

begin insert (E) end insert  Availability of psychosocial and other alternative treatments
to the use of psychotropic medications.

begin delete

(vi)

end delete

begin insert (F) end insert  Other factors that the department determines contribute to
begin delete disproportionately high and inappropriate end delete levels of psychotropic
drug begin delete usage. end delete begin insert utilization that warrant additional review. end insert

begin delete

(B)

end delete

begin insert (G) end insert  Confidential interviews begin delete with youth end delete begin insert of children end insert residing in
the facility at the time of the begin delete inspection, with youth who resided
in the facility within the last six months, and confidential
discussions with physicians identified as prescribing the
medications. The State Department of Health Care Services and
the State Department of Social Services shall, using existing data
systems, identify prescribers’ names, addresses, and contact
information in order to facilitate interviews with prescribers. end delete
begin insert inspection. end insert

begin delete

(b) If, as a result of an inspection pursuant to subdivision (a),
the department finds, based on measures established pursuant to
this section, that the facility has disproportionately high and
inappropriate levels of psychotropic drug usage, which may be
caused by, among other things, inadequate alternative and less
invasive psychosocial services, crisis management, and other
services, the facility shall submit to the department a plan of
correction describing the steps it shall take to reduce or eliminate
inappropriate psychotropic drug usage. The plan of correction shall
be submitted to the department within 30 days after the facility
has received the department’s notice of a determination of
disproportionately high and inappropriate levels of psychotropic
drug usage at the facility. The plan of correction may include, but
not be limited to, the following:

(1) An improved crisis management plan, including deescalation
techniques and procedures in which their staff will be trained.

(2) An overall behavioral management plan which shall be a
trauma-informed plan.

(3) A quantifiable goal to decrease the use of antipsychotic
medications for behavioral control, to decrease polypharmacy, and
to decrease the use of pro re nata medications.

(4) A quantifiable goal for improving appropriate metabolic
monitoring as set forth in the California Guidelines for the Use of
Psychotropic Medication with Children and Youth in Foster Care,
and increasing psychosocial, physical, mental, behavioral, and
nutritional services for children prescribed psychotropic
medications while placed in that facility.

(c) The department shall monitor a facility’s implementation of
the plan submitted pursuant to subdivision (b) to determine all of
the following:

(1) Whether the facility has reduced the rate at which residents
are administered pro re nata, multiple, and off-label psychotropic
medications, and, if so, the percentage decrease in the
administration of those medications.

(2) Whether and to what extent alternative, less invasive
treatments are being provided to residents, and, if so, the percentage
increase in the provision of those services.

(3) Whether and to what extent appropriate metabolic monitoring
is being conducted and, if so, the percentage increase in the
provision of appropriate monitoring.

(d) (1) Following an inspection pursuant to subdivision (a), the
Community Care Licensing Division shall provide a report to the
department’s Children and Family Services Division and to any
other public agency that has certified the facility’s program or any
component of the facility’s program, including, but not limited to,
the State Department of Health Care Services, which certifies
group homes pursuant to Section 4096.5 of the Welfare and
Institutions Code.

(2) If, as a result of the inspection, the Community Care
Licensing Division suspects that a prescriber has failed to comply
with Section 2242 of the Business and Professions Code, or with
the California Guidelines for the Use of Psychotropic Medication
with Children and Youth in Foster Care, it shall report its concerns
to the Medical Board of California.

(3) If, as a result of the inspection, the Community Care
Licensing Division suspects there has been a violation of applicable
requirements prescribed by statutes or regulations of this state, it
shall conduct the appropriate investigation pursuant to Section
1538 of the Health and Safety Code.

end delete begin insert

(4) The inspection of the facility may include, but is not limited
to, the following:

end insert begin insert

(A) Confidential interviews of children who resided in the facility
within the last six months.

end insert begin insert

(B) Confidential discussions with physicians identified as
prescribing the medications.

end insert begin insert

(b) Based upon an inspection conducted pursuant to subdivision
(a), the department shall share relevant information or
observations with county placing agencies, social workers,
probation officers, the court, dependency counsel, or the Medical
Board of California. If, as a result of the inspection conducted
pursuant to subdivision (a), the department finds a risk to the
health, safety, or personal rights of clients in care, the facility shall
submit a plan of correction to the department. The plan of
correction shall be submitted to the department within 30 days
after the facility has received the department’s notice of findings.
The department shall monitor the implementation of the plan of
correction to determine that the concerns identified during the
inspection have been addressed. This subdivision does not prevent
the department from taking any other corrective action as permitted
under any other law or any regulation adopted pursuant to this
chapter.

end insert begin delete

(e)

end delete

begin insert (c) end insert  (1) Notwithstanding the rulemaking provisions of the
Administrative Procedure Act (Chapter 3.5 (commencing with
Section 11340) of Part 1 of Division 3 of Title 2 of the Government
Code), until emergency regulations are filed with the Secretary of
State, the department may implement this section through
all-county letters or similar begin delete instructions from the director. end delete
begin insert instructions. end insert

(2) On or before January 1, 2017, the department shall adopt
regulations to implement this section. The initial adoption,
amendment, or repeal of a regulation authorized by this subdivision
is deemed to address an emergency, for purposes of Sections
11346.1 and 11349.6 of the Government Code, and the department
is hereby exempted for that purpose from the requirements of
subdivision (b) of Section 11346.1 of the Government Code. After
the initial adoption, amendment, or repeal of an emergency
regulation pursuant to this section, the department may twice
request approval from the Office of Administrative Law to readopt
the regulation as an emergency regulation pursuant to Section
11346.1 of the Government Code. The department shall adopt final
regulations on or before January 1, 2018.

begin delete

(f)

end delete

begin insert (d) end insert  Nothing in this section is intended to replace or alter other
requirements for responding to complaints and making inspections
or visits to group homes, including, but not limited to, those set
forth in Sections 1534 and 1538.

begin insert

(e) This section does not apply to a runaway and homeless youth
shelter, as defined in Section 1502.

end insert

begin delete SEC. 4. end delete
begin insert SEC. 5. end insert   

Section 11469 of the Welfare and Institutions Code is
amended to read:

11469.  

(a) The begin delete department, in end delete begin insert department shall develop,
following end insert consultation with group home providers, the County
Welfare Directors Association of California, the Chief Probation
Officers of California, the begin delete California Mental Health Directors
Association, and end delete begin insert County Behavioral Health Directors Association
of California, end insert the State Department of Health Care Services, begin delete shall
develop end delete begin insert and stakeholders, end insert performance standards and outcome
measures for determining the effectiveness of the care and
supervision, as defined in subdivision (b) of Section 11460,
provided by group homes under the AFDC-FC program pursuant
to Sections 11460 and 11462. These standards shall be designed
to measure group home program performance for the client group
that the group home program is designed to serve.

(1) The performance standards and outcome measures shall be
designed to measure the performance of group home programs in
areas over which the programs have some degree of influence, and
in other areas of measurable program performance that the
department can demonstrate are areas over which group home
programs have meaningful managerial or administrative influence.

(2) These standards and outcome measures shall include, but
are not limited to, the effectiveness of services provided by each
group home program, and the extent to which the services provided
by the group home assist in obtaining the child welfare case plan
objectives for the child.

(3) In addition, when the group home provider has identified
as part of its program for licensing, ratesetting, or county placement
purposes, or has included as a part of a child’s case plan by mutual
agreement between the group home and the placing agency,
specific mental health, education, medical, and other child-related
services, the performance standards and outcome measures may
also measure the effectiveness of those services.

(b) Regulations regarding the implementation of the group home
performance standards system required by this section shall be
adopted no later than one year prior to implementation. The
regulations shall specify both the performance standards system
and the manner by which the AFDC-FC rate of a group home
program shall be adjusted if performance standards are not met.

(c) Except as provided in subdivision (d), effective July 1, 1995,
group home performance standards shall be implemented. Any
group home program not meeting the performance standards shall
have its AFDC-FC rate, set pursuant to Section 11462, adjusted
according to the regulations required by this section.

(d) A group home program shall be classified at rate
classification level 13 or 14 only if all of the following are met:

(1) The program generates the requisite number of points for
rate classification level 13 or 14.

(2) The program only accepts children with special treatment
needs as determined through the assessment process pursuant to
paragraph (2) of subdivision (a) of Section 11462.01.

(3) The program meets the performance standards designed
pursuant to this section.

(e) Notwithstanding subdivision (c), the group home program
performance standards system shall not be implemented prior to
the implementation of the AFDC-FC performance standards
system.

(f) On or before January 1, 2016, the begin delete department, in end delete begin insert department
shall develop, following end insert consultation with the County Welfare
Directors Association of California, the Chief Probation Officers
of California, the begin delete California Mental Health Directors Association, end delete
begin insert County Behavioral Health Directors Association of California, end insert
research entities, foster begin delete youth, end delete begin insert children, end insert advocates for foster begin delete youth, end delete
begin insert children, end insert foster care provider business entities organized and
operated on a nonprofit basis, Indian tribes, and other stakeholders,
begin delete shall develop end delete additional performance standards and outcome
measures that require group homes to implement programs and
services to minimize law enforcement contacts and delinquency
petition filings arising from incidents of allegedly unlawful
behavior by minors occurring in group homes or under the
supervision of group home staff, including individualized behavior
management programs, emergency intervention plans, and conflict
resolution processes.

(g) On or before January 1, 2017, the begin delete department, in end delete begin insert department
shall develop, following end insert consultation with the County Welfare
Directors Association of California, the Chief Probation Officers
of California, the begin delete California Mental Health Directors Association, end delete
begin insert County Behavioral Health Directors Association of California,
the Medical Board of California, end insert research entities, foster begin delete youth, end delete
begin insert children end insert advocates for foster begin delete youth, end delete begin insert children, end insert foster care provider
business entities organized and operated on a nonprofit basis,
Indian tribes, and other stakeholders, begin delete shall develop end delete additional
performance standards and outcome measures that require group
homes to implement begin insert alternative end insert programs and begin delete services to reduce
the utilization of psychotropic medications for children in group
homes, end delete begin insert services, end insert including individualized behavior management
programs, emergency intervention plans, and conflict resolution
processes.

begin delete SEC. 5. end delete
begin insert SEC. 6. end insert   

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