BILL NUMBER: SB 484 CHAPTERED
BILL TEXT
CHAPTER 540
FILED WITH SECRETARY OF STATE OCTOBER 6, 2015
APPROVED BY GOVERNOR OCTOBER 6, 2015
PASSED THE SENATE SEPTEMBER 10, 2015
PASSED THE ASSEMBLY SEPTEMBER 8, 2015
AMENDED IN ASSEMBLY SEPTEMBER 3, 2015
AMENDED IN ASSEMBLY AUGUST 28, 2015
AMENDED IN ASSEMBLY JULY 8, 2015
AMENDED IN SENATE JUNE 2, 2015
AMENDED IN SENATE APRIL 22, 2015
INTRODUCED BY Senator Beall
(Principal coauthor: Assembly Member Chiu)
(Coauthors: Senators Mitchell and Monning)
FEBRUARY 26, 2015
An act to amend Sections 1507.6 and 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, 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.
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.
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.
(2) Existing law requires the Director of Social Services, 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 to compile specified
information regarding the administration of psychotropic medications
to children in group homes and to post that information on the
department's Internet Web site. The bill would require the
department, in consultation with the State Department of Health Care
Services and stakeholders, to establish a methodology to identify
those group homes that have levels of psychotropic drug utilization
warranting additional review, as specified. 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 authorize
the department, following that inspection, to share relevant
information and observations with county placing agencies, social
workers, probation officers, the court, dependency counsel, or the
Medical Board of California, or share relevant information and
observations with the facility and require the facility to submit a
plan to the department, within 30 days of receiving the department's
information and observations, to address any identified risks within
the control of the facility related to psychotropic medication. The
bill would require the department to approve the plan and verify the
plan's implementation to determine whether those identified risks
have been remedied. Because the failure of the facility to comply
with these provisions would be a misdemeanor, the bill would impose a
state-mandated local program.
(3) 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 alternative programs
and services, as specified. The bill would make related changes.
(4) 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.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 1507.6 of the Health and Safety Code is amended
to read:
1507.6. (a) 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.
(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.
(2) The facility shall maintain in a child's records all of the
following information:
(A) A copy of any court order authorizing the psychotropic
medication for the child.
(B) A separate log for each psychotropic medication prescribed for
the child, showing all of the following:
(i) The name of the medication.
(ii) The date of the prescription.
(iii) The quantity of medication and number of refills initially
prescribed.
(iv) When applicable, any additional refills prescribed.
(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.
(vi) The date and time of each dose taken by the child.
(3) This subdivision does not apply to a runaway and homeless
youth shelter, as defined in Section 1502.
SEC. 2. Section 1536 of the Health and Safety Code is amended to
read:
1536. (a) (1) At least annually, the department 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, runaway and homeless youth shelter, or
short-term residential treatment center, 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, upon request, only to bona fide
professional foster parent organizations and to professional
organizations educating foster parents, including the Foster and
Kinship Care Education Program of the California Community Colleges.
(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 on its Internet
Web site a statewide summary of the information gathered pursuant to
Sections 1538.8 and 1538.9. The summary shall include only
de-identified and aggregate information that does not violate the
confidentiality of a child's identity and records.
SEC. 3. Section 1538.8 is added to the Health and Safety Code, to
read:
1538.8. (a) (1) In order to review and evaluate the use of
psychotropic medications in group homes, the department shall
compile, to the extent feasible and not otherwise prohibited by law
and based on information received from the State Department of Health
Care Services, at least annually, information concerning each 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:
(A) Follow-Up Care for Children Prescribed Attention Deficit
Hyperactivity Disorder Medication (HEDIS ADD), which measures the
number of children 6 to 12 years of age, inclusive, who have a visit
with a provider with prescribing authority within 30 days of the new
prescription.
(B) Use of Multiple Concurrent Antipsychotics in Children and
Adolescents (HEDIS APC), which does both of the following:
(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.
(ii) Reports a total rate and age stratifications including 6 to
11 years of age, inclusive, and 12 to 17 years of age, inclusive.
(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.
(D) Metabolic Monitoring for Children and Adolescents on
Antipsychotics (HEDIS APM), which does both of the following:
(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.
(ii) Reports a total rate and age stratifications including 6 to
11 years of age, inclusive, and 12 to 17 years of age, inclusive.
(2) The department shall post the list of data to be collected
pursuant to this subdivision on the department's Internet Web site.
(b) The data in subdivision (a) concerning psychotropic
medication, mental health services, and placement shall be drawn from
existing data maintained by the State Department of Health Care
Services and the State Department of Social Services and shared
pursuant to a data sharing agreement meeting the requirements of all
applicable state and federal laws and regulations.
(c) This section does not apply to a runaway and homeless youth
shelter, as defined in Section 1502.
SEC. 4. Section 1538.9 is added to the Health and Safety Code, to
read:
1538.9. (a) (1) (A) The department shall consult with the State
Department of Health Care Services and stakeholders to establish a
methodology for identifying those group homes providing care under
the AFDC-FC program pursuant to Sections 11460 and 11462 of the
Welfare and Institutions Code that have levels of psychotropic drug
utilization warranting additional review. 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 State Department of Health Care Services and
stakeholders and revise the methodology, if necessary.
(2) If the department, applying the methodology described in
paragraph (1), determines that a facility appears to have levels of
psychotropic drug utilization warranting additional review, it shall
inspect the facility at least once a year.
(3) The inspection of the facility shall include, but not be
limited to, a review of the following:
(A) Plan of operation, policies, procedures, and practices.
(B) Child-to-staff ratios.
(C) Staff qualifications and training.
(D) Implementation of children's needs and services plan.
(E) Availability of psychosocial and other alternative treatments
to the use of psychotropic medications.
(F) Other factors that the department determines contribute to
levels of psychotropic drug utilization that warrant additional
review.
(G) Confidential interviews of children residing in the facility
at the time of the inspection.
(4) The inspection of the facility may include, but is not limited
to, the following:
(A) Confidential interviews of children who resided in the
facility within the last six months.
(B) Confidential discussions with physicians identified as
prescribing the medications.
(b) Following an inspection conducted pursuant to this section,
the department, as it deems appropriate, may do either or both of the
following:
(1) Share relevant information and observations with county
placing agencies, social workers, probation officers, the court,
dependency counsel, or the Medical Board of California, as
applicable.
(2) Share relevant information and observations with the facility
and require the facility to submit a plan, within 30 days of
receiving the information and observations from the department, to
address any identified risks within the control of the facility
related to psychotropic medication. The department shall approve the
plan and verify implementation of the plan to determine whether those
risks have been remedied.
(c) (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 instructions.
(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.
(d) Nothing in this section does any of the following:
(1) Replaces or alters 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.
(2) Prevents or precludes the department from taking any other
action permitted under any other law, including any regulation
adopted pursuant to this chapter.
(e) This section does not apply to a runaway and homeless youth
shelter, as defined in Section 1502.
SEC. 5. Section 11469 of the Welfare and Institutions Code is
amended to read:
11469. (a) The department shall develop, following consultation
with group home providers, the County Welfare Directors Association
of California, the Chief Probation Officers of California, the County
Behavioral Health Directors Association of California, the State
Department of Health Care Services, and stakeholders, 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 department shall develop,
following consultation with the County Welfare Directors Association
of California, the Chief Probation Officers of California, the County
Behavioral Health Directors Association of California, research
entities, foster children, advocates for foster children, foster care
provider business entities organized and operated on a nonprofit
basis, Indian tribes, and other stakeholders, 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 department shall develop,
following consultation with the County Welfare Directors Association
of California, the Chief Probation Officers of California, the County
Behavioral Health Directors Association of California, the Medical
Board of California, research entities, foster children advocates for
foster children, foster care provider business entities organized
and operated on a nonprofit basis, Indian tribes, and other
stakeholders, additional performance standards and outcome measures
that require group homes to implement alternative programs and
services, including individualized behavior management programs,
emergency intervention plans, and conflict resolution processes.
SEC. 6. 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.