BILL ANALYSIS                                                                                                                                                                                                    



          SENATE COMMITTEE ON HUMAN SERVICES
                               Senator McGuire, Chair
                                2015 - 2016  Regular 

          Bill No:              SB 524
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          |Author:   |Lara                                                  |
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          |----------+-----------------------+-----------+-----------------|
          |Version:  |April 14, 2015         |Hearing    |April 28, 2015   |
          |          |                       |Date:      |                 |
          |----------+-----------------------+-----------+-----------------|
          |Urgency:  |No                     |Fiscal:    |Yes              |
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          |Consultant|Sara Rogers                                           |
          |:         |                                                      |
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          Subject:  Private alternative therapeutic institutions for youth

            SUMMARY
          
          This bill will establish the licensure and regulation category  
          of "private alternative therapeutic institution for youth,"  
          defined to mean any residential facility or program operated by  
          a private entity with a focus on serving persons 18 years of age  
          and younger with emotional, behavioral, or mental health issues  
          or disorders, as specified.

            ABSTRACT
          
          Existing law:


          1)Establishes the Community Care Facilities Act, which provides  
            for the licensure and regulation by the California Department  
            of Social Services (CDSS) of nonmedical residential and  
            non-residential facilities for mentally ill, developmentally  
            and physically disabled individuals, and children and adults  
            who require care or services. (HSC Section 1500 et seq.)


          2)Defines "residential facility" to mean a family home, group  
            care facility, or similar facility providing 24-hour  
            nonmedical care to persons in need of personal services,  
            supervision, or assistance that is essential for sustaining  
            the activities of daily living, or for the protection of the  
            individual. (HSC 1502 (a) (1))








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          3)Prohibits the operation of an unlicensed community care  
            facility, defined as a facility providing, or representing  
            that it provides, care or supervision; or a facility which  
            accepts residents demonstrating the need for care and  
            supervision; or which represents itself as a licensed  
            community care facility, that is not exempted from licensure.  
            (HSC 1503.5)


          4)Exempts specified facilities from the requirements of the  
            Community Care Facilities Act, including a health facility or  
            clinic, as defined, a juvenile placement facility approved by  
            the Department of Corrections and Rehabilitation, Division of  
            Juvenile Justice or any juvenile hall operated by a county,  
            any child day care facility, foster homes, any facility  
            conducted for the adherents of any well-recognized church or  
            religious denomination who depend upon prayer or spiritual  
            means for healing in the practice of the church or  
            denomination, any school dormitory or similar facility  
            determined by the department, any facility that supplies board  
            and room only, or room only, recovery houses providing group  
            living arrangements, and others. (HSC 1505)
          
          This bill:

          1)Makes legislative findings and declarations regarding private  
            nontraditional treatment programs serving youth with  
            behavioral issues, noting thousands of allegations of abuse,  
            including death, and that former students have formed national  
            and local organizations to expose the trauma and abuse they  
            experienced at such facilities.


          2)Defines "private alternative therapeutic institution for  
            youth" to mean any residential facility or program operated by  
            a private entity with a focus on serving persons 18 years of  
            age and younger with emotional, behavioral, or mental health  
            issues or disorders which provides the following:


                 A program with wilderness or outdoor experience,  
               expedition, or intervention.









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                 A boot camp experience or other experience designed to  
               simulate characteristics of basic military training or  
               correctional regimes.


                 A therapeutic boarding school.


                 A behavior modification program.


          1)Prohibits a person or specified entity from operating,  
            establishing, managing, conducting, or maintaining a private  
            alternative therapeutic institution for youth, unless the  
            facility is licensed by the department.


          2)Requires CDSS to adopt regulations no later than June 1, 2016,  
            establishing oversight and monitoring of private alternative  
            therapeutic institutions for youth that, at a minimum, ensure  
            the physical and mental well-being of youth in those  
            institutions, and create mandated personal rights for those  
            youth.


          3)Provides that a school dormitory or similar facility that is a  
            private alternative therapeutic institution for youth, as  
            defined, is not exempt from licensure.



            FISCAL IMPACT
          
          This bill has not been analyzed by a fiscal committee.

            BACKGROUND AND DISCUSSION
          
          Purpose of the bill:


          According to the author, in recent decades hundreds of  
          alternative treatment institutions have been established for  









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          youth with emotional or behavioral problems nationwide and  
          abroad. The author states that such institutions exist across  
          the state and provide services in a range of settings, from  
          residential boarding school facilities to military style  
          academies and boot camps, and offer a range of services such as  
          behavioral programs, emotional counseling, or drug and alcohol  
          treatment. 


          The author further states that many young people have  
          experienced abuse, neglect, and even death at these unregulated  
          institutions. According to the author, survivors report being  
          denied medical care, and subjected to corporal punishment,  
          solitary confinement, gender and sexual orientation  
          discrimination, and non-medically sound therapeutic practices.  
          The author notes that children's residential facilities that  
          receive state or federal funding are required to be licensed by  
          the state. However, according to the author, children sent by  
          their parents or guardians to participate in private programs do  
          not experience the same protections. The author further states  
          that, currently in California, residential boarding schools are  
          exempt from state licensing and do not have any oversight beyond  
          filing a one-page affidavit with the California Department of  
          Education. The current lack of oversight and regulations over  
          private institutions has opened up California's vulnerable youth  
          to abuse, according to the author. 

          Private Children's Residential Facilities


          Private, self-described "therapeutic boarding schools,"  
          "wilderness programs," "residential treatment centers," or  
          "reform schools" are 24-hour residential facilities serving  
          children and adolescents who face emotional, mental, academic,  
          physical or social challenges. In some instances, facilities may  
          be licensed as a residential group home or a residential  
          community treatment facility. However, there are facilities and  
          programs in the state that are unlicensed and either relying on  
          the exemption for "school dormitories" provided for in statute  
          (HSC 1505)   or because there is no licensing provision  
          pertaining to wilderness camps or boot camps. Additionally,  
          numerous programs advertise a presence in California,  
          maintaining corporate offices in-state, with the facility itself  
          located another state such as Utah or Texas, which have minimal  









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          regulatory oversight. 



          According to the National Association of Therapeutic Schools and  
          Programs (NATSAP), its members "provide residential, therapeutic  
          and/or education services to children, adolescents and young  
          adults entrusted to them by parents and guardians. The common  
          mission of NATSAP members is to promote the healthy growth,  
          learning, motivation, and personal well-being of program  
          participants. The objective of member therapeutic and  
          educational programs is to provide excellent treatment for  
          program participants; treatment that is rooted in concern for  
          their well-being and growth; respect for them as human beings;  
          and sensitivity to their individual needs and integrity."<1>


          One for-profit corporation operating over two dozen facilities  
          nationwide, for example, recently operated an unlicensed  
          year-round 24-hour residential facility in Reedley, marketed as  
          serving teens struggling with their weight. The Reedley campus  
          was a self-described college preparatory school for grades 8-12,  
          that promised families that children enrolled "achieve immediate  
          and dramatic weight loss from thorough Diet and Activity  
          Management," and that they "undergo behavioral change through  
          intensive cognitive-behavioral therapy, retraining the brain to  
          make better decisions with regard to diet and physical activity  
          as well as addressing other behavioral issues that may be  
          causing (or resulting from) the weight."<2> 

            Safety and Abuse Concerns


          Aspen Education Group, which operates more than two dozen  
          facilities across the nation, including one in California, has  
          been the subject of numerous lawsuits and accusations of abuse  
          and neglect including incidents of "sexualized role play."


          ---------------------------
          <1> http://www.natsap.org/natsap-principles/

          <2> National Assoc of Therapeutic Schools. 2011 Directory. 

          http://n.b5z.net/i/u/10044700/f/NATSAP_2011.pdf








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          In 2004, a 14-year-old boy died in an Aspen wilderness program  
          after hiking several miles in 90-degree weather. Reportedly, "a  
          combination of excessive heat, a constrictive uniform, and  
          Matthew's obesity caused his body to overheat. He suffered  
          severe heatstroke requiring immediate medical attention however  
          program staffers ignored complaints and the youth died an hour  
          later at the hospital. In 2012, a mother sued Aspen alleging  
          that her 15-year-old daughter was subjected to hours of stress  
          positions, threats of suffocation, exposure to animal abuse and  
          regular public humiliation. On December 11, 2013, the case was  
          dismissed under the two-year statute of limitations that applies  
          for claims involving a health care provider.


          General Accounting Office report


          A US General Accounting Office report entitled, "Residential  
          Facilities: Improved Data and Enhanced Oversight Would Help  
          Safeguard the Well-Being of Youth with Behavioral and Emotional  
          Challenges" from May, 2008 evaluated regulatory oversight of  
          residential facilities serving children, including private  
          facilities receiving no government funding. The report  
          identified gaps in regulatory oversight and licensure of private  
          residential facilities serving youth and states:


               Licensing all facilities, public or private, can help  
               ensure that residential facilities meet the relevant  
               standards for protecting youth well-being...


               Facility licensing is also important because parents and  
               others considering placing youth in private facilities at  
               their own expense do not always have the information they  
               need to screen facilities and make an informed decision. In  
               our testimony on private facilities last October, we  
               described cases in which program leaders told parents their  
               programs could provide services that they were not  
               qualified to offer, claimed to have credentials in therapy  
               or medicine that they did not have, and led parents to  
               trust them with youth who had serious mental disabilities.  
               One national association for programs serving youth with  
               behavioral and emotional difficulties testified before  









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               Congress that state licensing was important because the  
               field does not currently have the capacity to certify  
               facility integrity.


               Weaknesses in the current federal-state regulatory  
               structure have failed to safeguard the civil rights and  
               well-being of some of the nation's most vulnerable youth.


          Alliance for the Safe, Therapeutic and Appropriate use of  
          Residential Treatment


            The Alliance for the Safe, Therapeutic and Appropriate use of  
          Residential Treatment (ASTART) a self-described "community of  
          professionals, family members and survivors working to protect  
          children from abuse and neglect in residential programs" states  
          that private therapeutic boarding schools and residential  
          programs for youth often isolate children from parents and  
          advocates. The organization states that contact with parents and  
          the outside world is often limited and that "survivors  
          consistently report that scheduled calls with parents are  
          permitted only rarely, if at all, and are strictly monitored and  
          controlled. Calls are never granted at the request of the child  
          who feels they may be in danger. Mail, if allowed, is censored  
          and/or withheld. The teens almost never see their parents-a few  
          days a year at most-and family members are rarely, if ever,  
          allowed to visit. 


          Additionally, ASTART states that "nearly all youth we've talked  
          to who were confined in these facilities tell us they were  
          required to attend harsh, confrontational group "rap" groups two  
          to three times per week for two to four hours. In these sessions  
          they were forced to accuse and yell at each other. One student  
          becomes the focus of debasing verbal attacks by the group. The  
          attacks go on until the teen is humiliated and sobbing.  
          Survivors tell us that when they did not participate in  
          attacking another teen, they risked being attacked themselves.  
          These abusive "group therapy" sessions take the place of up to  
          12 hours of class time each week."











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          Related legislation:

          SB 1089 (Liu, 2010) would have defined "private nontraditional  
          alternative treatment facility for youth," as any residential or  
          nonresidential facility or program operated by an organization  
          that provides aggressive nontraditional punitive, retaliatory,  
          aversive, or military style behavioral treatment or intervention  
          services for youth, and prohibits their use in California  
          without accreditation by specific entities.  Failed passage in  
          the Assembly Appropriations Committee 2012. 
            
          COMMENTS
          
          The author proposes the following amendments to provide  
          additional direction to CDSS in establishing regulatory  
          oversight of these facilities. These amendments provide for a  
          new licensing category "private residential care facilities for  
          youth" as defined, and establishing a series of rights for youth  
          residents, as specified, and clarifying that facilities  
          providing certain mental health and drug dependency services be  
          certified by the California Department of Health Care Services  
          in accordance with requirements applicable to other community  
          care facilities.

          Staff recommends the author continue discussions with CDSS to  
          clarify regulatory provisions pertaining to the licensing of  
          wilderness camps that do not have a brick-and-mortar facility  
          serving residents.

            POSITIONS
                                          
          Support:
               American Civil Liberties Union of California
               Equality California
               Gender Health Center
               LGBTQ Center of Long Beach
               Transgender Law Center
               WWASP Survivors
          
          Opposition: 
               None.











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                  Amendments Mock-up for 2015-2016 SB-524 (Lara (S))  
                                           
                      *********Amendments are in BOLD*********
                                          
             Mock-up based on Version Number 98 - Amended Senate 4/14/15
           
           
             The people of the State of California do enact as follows:


          SECTION 1. The Legislature finds and declares all of the  
          following:

          (a) Since the 1990s, hundreds of nontraditional treatment  
          programs that are intended to be less restrictive treatment  
          options for children with significant behavioral issues have  
          been established nationwide, with thousands of allegations of  
          abuse, including death.

          (b) There are currently facilities operating within California  
          that are not licensed by the State Department of Social  
          Services.

          (c) These facilities are often owned and operated by nonprofit  
          organizations described in Section 501(c)(3) of the Internal  
          Revenue Code.

          (d) These facilities advertise services for youth with  
          behavioral issues to families who may feel they have no other  
          options.










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          (e) Former students have formed national and local organizations  
          to expose the trauma and abuse they experienced at these  
          facilities.

          (f) Students at these facilities are previous victims of trauma,  
          have experienced parental rejection based on actual or perceived  
          sexual orientation or gender identity, and have mental health  
          and substance use issues.

          (g) It is the role of the Legislature to ensure proper licensing  
          and regulation of residential facilities for the protection and  
          care of all citizens.


           (h) It is the intent of the legislature that the State of  
          California license private residential care for youth as a  
          community care facility to ensure the safety of children  
          residing in such facilities.
           
          SEC. 2. Section 1502.2 is added to the Health and Safety Code,  
          to read:

          1502.2.  
           
           (a) For purposes of this section, the following definitions  
          apply: 
          (1) "Administrator" means the individual designated by the  
          licensee to act on behalf of the licensee in the overall  
          management of the facility. The licensee, if an individual, and  
          the administrator may be one and the same person. 

          (2)  "Department" means the State Department of Social Services.  


          (3)  "Director" means the Director of Social Services. 

          (4)  "License" means a basic permit to operate a private  
          residential care facility for youth. 

          (5) "Private   alternative therapeutic institution  residential  
          care facility  for youth" means any  24-hour  residential facility  
          or program operated by a private entity  providing nonmedical  
          care, counseling, educational or vocational support to    with a  
          focus on serving   persons 18 years of age and younger with  









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           social,  emotional, behavioral, or mental health issues or  
          disorders,   and that    including a program  that provides any of the  
          following:

          (1) A program with wilderness or outdoor experience, expedition,  
          or intervention.

          (2) A boot camp experience or other experience designed to  
          simulate characteristics of basic military training or  
          correctional regimes.

          (3) A therapeutic boarding school.

          (4) A behavior modification program.

          (b)  (1)  A person, firm, partnership, association, organization,  
          or corporation shall not operate, establish, manage, conduct, or  
          maintain a private   alternative therapeutic institution  
           residential care facility  for youth, unless the facility is  
          licensed by the department.

            (c) The department shall adopt regulations no later than June 1,  
          2016, establishing oversight and monitoring of private  
          alternative therapeutic institutions for youth that, at a  
          minimum, ensure the physical and mental well-being of youth in  
          those institutions, and create mandated personal rights for  
          those youth.
            
           (2) The department shall inspect and license private residential  
          care facilities for youth as a community care facility. A  
          license is not transferable.

           (d)  (c) The department shall not license a private   alternative  
          therapeutic institution  residential care facility  for youth  
          unless all therapeutic components of the programs provided at  
          the institution are licensed by the appropriate agency or  
          department.  


          (d) Any person or entity desiring issuance of a license for a  
          private residential care facility for youth under this chapter  
          shall file an application on forms furnished by the department.  
          The application shall include, but not be limited to, all of the  
          following:









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          (1)  Evidence satisfactory to the department of the ability of  
          the applicant to comply with this section and any rules and  
          regulations adopted by the department under this section. 

          (2) (A) Evidence satisfactory to the department that the  
          applicant is of reputable and responsible character. 

          (B) The evidence shall include, but not be limited to, all of  
          the following:
          (i)(I) A criminal record clearance pursuant to Section 1522. The  
          law enforcement agency from which a criminal record is requested  
          may charge a reasonable fee sufficient to cover its cost in  
          providing the criminal record in accordance with this paragraph.
          (II) The department shall review the criminal record to  
          determine whether the applicant has ever been convicted of a  
          crime other than a minor traffic violation or arrested for any  
          crime specified in subdivision (c) of Section 290 of the Penal  
          Code, or for violating Section 245, 273ab, or 273.5, subdivision  
          (b) of Section 273a, or, prior to January 1, 1994, paragraph (2)  
          of Section 273a, of the Penal Code, or for any crime for which  
          the department is prohibited from granting a criminal record  
          exemption. If the applicant has been convicted of one of these  
          crimes, the department shall not license the applicant.
          (ii) Employment history.
          (iii) Character references. 
          (C) If the applicant is a firm, association, organization,  
          partnership, business trust, corporation, or company, the  
                                       evidence required by this paragraph shall be submitted for  
          members or shareholders of the entity and the person who will  
          act as administrator. 

          (3)  Evidence satisfactory to the department that the applicant  
          has sufficient financial resources to maintain the standards of  
          service required by this section and regulations adopted  
          pursuant to this section. 

          (4) Disclosure of any revocation or other disciplinary action  
          taken, or in the process of being taken, against a license held  
          or previously held by applicant.
           
          (5) Evidence satisfactory to the department of the applicant's  
          ability to meet regulatory requirements for the level of care  
          the applicant intends to provide.









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          (6)  Evidence satisfactory to the department of adequate  
          knowledge of supportive services and other community supports  
          which may be necessary to meet the needs of youth residents.

          (7)  Designation by the applicant of the individual who will be  
          the administrator of the facility, including, if the applicant  
          is an individual, whether or not the licensee will also be the  
          administrator. 

            (8)  A signed statement that the person desiring issuance of a  
          license has read and understood the private residential care  
          facility for youth statutes and regulations. 

            (9)   Any other information as may be required by the department  
          for the proper administration and enforcement of this chapter. 

          (10) The facilities plan of operation in accordance with Section  
          80022 of Title 22 of the California Code of Regulations.

          (e) A prospective applicant for licensure shall be notified at  
          the time of the initial request for information regarding  
          application for licensure that, prior to obtaining licensure,  
          the facility shall secure and maintain a fire clearance approval  
          from the local fire enforcing agency, as defined in Section  
          13244, or the State Fire Marshal, whichever has primary fire  
          protection jurisdiction. The prospective applicant shall be  
          notified of the provisions of Section 13235, relating to the  
          fire safety clearance application. The prospective applicant for  
          licensure shall be notified that the fire clearance shall be in  
          accordance with state and local fire safety regulations.

          (f)  Failure of the applicant to cooperate with the department  
          in the completion of the application shall result in the denial  
          of the application. Failure to cooperate means that the  
          information described in this section and in regulations of the  
          department has not been provided, or not provided in the form  
          requested by the department, or both. 

          (g) Any duly authorized officer, employee, or agent of the  
          department may, upon presentation of proper identification,  
          enter and inspect any place providing personal care,  
          supervision, and services at any time, with or without advance  
          notice, to secure compliance with, or to prevent a violation of,  









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          this chapter.
           
           (h) (1) The department may charge a reasonable application fee  
          adjusted by facility and capacity for the issuance of a license  
          to operate private residential care facilities for youth. 

          (2) The department may also charge an annual regulatory fee on  
          each anniversary of the effective date of the license.

          (3) The Legislature finds that all revenues generated by fees  
          for licenses computed under this section and used for the  
          purposes for which they were imposed are not subject to Article  
          XIII B of the California Constitution.

          (i) (1) The Legislature finds that the quality of services  
          provided to residents of a private residential care facility for  
          youth is dependent upon the training and skills of staff. It is  
          the intent of the Legislature in enacting this section to ensure  
          that a direct-care staff member has the knowledge and  
          proficiency to carry out the tasks of his or her job.

          (2) A staff members of a private residential care facility for  
          youth who supervises residents shall receive appropriate  
          training. This training shall consist of 10 hours of training  
          within the first four weeks of employment and eight hours  
          annually thereafter. This training shall be administered on the  
          job, or in a classroom setting, or any combination of the two.  
          The department shall establish the subject matter required for  
          this training.

          (3) The training shall be approved by the department and shall  
          include, but not be limited to, all of the following:

          (A) Residents' rights as described in subdivision (j).

          (B) Psychosocial needs of youth.

          (C) Appropriate response to emergencies.

          (4) Physical needs for youth residents.

          (5) Cultural competency and sensitivity in issues relating to  
          the underserved, lesbian, gay, bisexual, and transgender  
          community.









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          (6) Laws and regulations pertaining to community care facilities  
          and private residential care programs for youth.

          (j) Residents of a private residential care facility for youth  
          shall have all of the following rights:

           (1) To be accorded dignity in their personal relationships with  
          staff, residents, and other persons.

          (2) To be granted a reasonable level of personal privacy in  
          accommodations, medical care, personal care and assistance,  
          visits, written and electronic communications, and telephone  
          conversations.

          (3) To confidential care of their records and personal  
          information and to approve their release, except as authorized  
          by law.

           (4) To care, supervision, and services that meet their  
          individual needs and are delivered by staff that are sufficient  
          in numbers, qualifications, and competency to meet their needs  
          and ensure their safety.

          (5) To be served food of the quality and in the quantity  
          necessary to meet their nutritional needs.

          (6) To present grievances and recommend changes in policies,  
          procedures, and services to the staff of the facility, the  
          facility's management and governing authority, and to any other  
          person without restraint, coercion, discrimination, reprisal, or  
          other retaliatory actions. The licensee shall take prompt  
          actions to respond to residents' grievances.

          (7) To have frequent contact with parents or guardians including  
          scheduled and unscheduled phone calls, unrestricted  
          correspondence, and electronic communications. 

          (8) To be fully informed, as evidenced by the resident's written  
          acknowledgement, prior to or at the time of admission, of all  
          rules governing residents' conduct and responsibilities. 

          (9) To receive in the admission agreement information that  
          details the planned treatments and care for the resident. 









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          (10) For parents or guardians to remove youth from a facility.

          (11) To consent to have relatives and other individuals of the  
          resident's choosing visit or call during reasonable hours,  
          privately and without prior notice.

          (12) To be free of corporal punishment, depravation of basic  
          necessities, including education, as a punishment or incentive,  
          and physical restraints of any kind.

          (13) To receive supportive mental and emotional health-related  
          services from trained staff who are licensed or are overseen by  
          licensed mental health professionals.

          (14) To be free from abusive, humiliating, degrading and  
          traumatizing activities.


           (k) A community care facility licensed as a private residential  
          care facility for youth pursuant to this chapter shall not  
          accept for placement, and provide care and supervision to, a  
          child assessed as seriously emotionally disturbed unless the  
          facility has been certified by the State Department of Social  
          Services pursuant to Section 4096.5 of the Welfare and  
          Institutions Code as a program that provides mental health  
          treatment services for seriously emotionally disturbed children.

          (1) "Seriously emotionally disturbed" means the same as  
          paragraph (2) of subdivision (a) of Section 5600.3 of the  
          Welfare and Institutions Code.

          (l) A community care facility licensed as a private residential  
          care facility for youth shall not advertise or promote services  
          designed to promote treatment and maintain recovery from alcohol  
          or drug problems which includes one or more of the following:  
          detoxification, group sessions, individual sessions, educational  
          sessions, and/or alcoholism or drug abuse recovery or treatment  
          planning unless the facility has been licensed as an alcoholism  
          or drug abuse recovery or treatment facility pursuant to Section  
          11834.01.

          (m) A community care facility licensed as a private residential  
          care facility for youth shall not  provide secure containment or  









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          use restraints of any kind unless the program components are  
          subject to program standards developed and enforced by the State  
          Department of Mental Health pursuant to Section 4094 of the  
          Welfare and Institutions Code.

          (n) A community care facility licensed as a private residential  
          care facility for youth is not an eligible placement option  
          pursuant to Sections 319, 361.2, 450, and 727 of the Welfare and  
          Institutions Code.

          (o) A community care facility licensed as a private residential  
          care facility for youth shall not be eligible for a rate  
          pursuant to Section 11462 of the Welfare and Institutions Code.

          (p) A community care facility licensed as a private residential  
          care facility for youth shall not accept children under the age  
          of 12 for residential placement. 
           

           (q) A licensee of a private residential care facility for youth  
          that advertises or promotes special care, programming, or  
          environments for persons with a mental health, emotional, or  
          social related challenge, shall provide to each prospective  
          resident and their parent or guardian an accurate narrative  
          description of these programs and services. The description  
          shall be provided in writing prior to admission. 

           
          SEC. 3. Section 1505 of the Health and Safety Code is amended to  
          read:
            
          1505. This chapter does not apply to any of the following:

          (a) Any health facility, as defined by Section 1250.

          (b) Any clinic, as defined by Section 1202.

          (c) Any juvenile placement facility approved by the Department  
          of Corrections and Rehabilitation, Division of Juvenile Justice,  
          or any juvenile hall operated by a county.

          (d) Any place in which a juvenile is judicially placed pursuant  
          to subdivision (a) of Section 727 of the Welfare and  
          Institutions Code.









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          (e) Any child day care facility, as defined in Section 1596.750.

          (f) Any facility conducted by and for the adherents of any  
          well-recognized church or religious denomination for the purpose  
          of providing facilities for the care or treatment of the sick  
          who depend  solely  upon prayer or spiritual means for healing in  
          the practice of the religion of the church or denomination.

          (g) Any school dormitory or similar facility determined by the  
          department, except a private   alternative therapeutic institution    
           residential care facility  for youth as defined in Section  
          1502.2.

          (h) Any house, institution, hotel, homeless shelter, or other  
          similar place that supplies board and room only, or room only,  
          or board only, provided that no resident thereof requires any  
          element of care as determined by the director.

          (i) Recovery houses or other similar facilities providing group  
          living arrangements for   persons    adults  recovering from  
          alcoholism or drug addiction where the facility provides no care  
          or supervision.

          (j) Any alcoholism or drug abuse recovery or treatment facility  
           serving adults,  as defined by Section 11834.11.

          (k) Any arrangement for the receiving and care of persons by a  
          relative or any arrangement for the receiving and care of  
          persons from only one family by a close friend of the parent,  
          guardian, or conservator, if the arrangement is not for  
          financial profit and occurs only occasionally and irregularly,  
          as defined by regulations of the department. For purposes of  
          this chapter, arrangements for the receiving and care of persons  
          by a relative shall include relatives of the child for the  
          purpose of keeping sibling groups together.

          (l) (1) Any home of a relative caregiver of children who are  
          placed by a juvenile court, supervised by the county welfare or  
          probation department, and the placement of whom is approved  
          according to subdivision (d) of Section 309 of the Welfare and  
          Institutions Code.

          (2) Any home of a nonrelative extended family member, as  









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          described in Section 362.7 of the Welfare and Institutions Code,  
          providing care to children who are placed by a juvenile court,  
          supervised by the county welfare or probation department, and  
          the placement of whom is approved according to subdivision (d)  
          of Section 309 of the Welfare and Institutions Code.

          (3) On and after January 1, 2012, any supervised independent  
          living placement for nonminor dependents, as defined in  
          subdivision (w) of Section 11400 of the Welfare and Institutions  
          Code, who are placed by the juvenile court, supervised by the  
          county welfare department, probation department, Indian tribe,  
          consortium of tribes, or tribal organization that entered into  
          an agreement pursuant to Section 10553.1 of the Welfare and  
          Institutions Code, and whose placement is approved pursuant to  
          subdivision (k) of Section 11400 of the Welfare and Institutions  
          Code.

          (4) A Transitional Housing Program-Plus, as defined in  
          subdivision (s) of Section 11400 of the Welfare and Institutions  
          Code, that serves only eligible former foster youth over 18  
          years of age who have exited from the foster care system on or  
          after their 18th birthday, and that has obtained certification  
          from the applicable county in accordance with subdivision (c) of  
          Section 16522 of the Welfare and Institutions Code.

          (m) Any supported living arrangement for individuals with  
          developmental disabilities, as defined in Section 4689 of the  
          Welfare and Institutions Code.

          (n) (1) Any family home agency, family home, or family teaching  
          home as defined in Section 4689.1 of the Welfare and  
          Institutions Code, that is vendored by the State Department of  
          Developmental Services and that does any of the following:

          (A) As a family home approved by a family home agency, provides  
          24-hour care for one or two adults with developmental  
          disabilities in the residence of the family home provider or  
          providers and the family home provider or providers' family, and  
          the provider is not licensed by the State Department of Social  
          Services or the State Department of Public Health or certified  
          by a licensee of the State Department of Social Services or the  
          State Department of Public Health.

          (B) As a family teaching home approved by a family home agency,  









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          provides 24-hour care for a maximum of three adults with  
          developmental disabilities in independent residences, whether  
          contiguous or attached, and the provider is not licensed by the  
          State Department of Social Services or the State Department of  
          Public Health or certified by a licensee of the State Department  
          of Social Services or the State Department of Public Health.

          (C) As a family home agency, engages in recruiting, approving,  
          and providing support to family homes.

          (2) No part of this subdivision shall be construed as  
          establishing by implication either a family home agency or  
          family home licensing category.

          (o) Any facility in which only Indian children who are eligible  
          under the federal Indian Child Welfare Act (Chapter 21  
          (commencing with Section 1901) of Title 25 of the United States  
          Code) are placed and that is one of the following:

          (1) An extended family member of the Indian child, as defined in  
          Section 1903 of Title 25 of the United States Code.

          (2) A foster home that is licensed, approved, or specified by  
          the Indian child's tribe pursuant to Section 1915 of Title 25 of  
          the United States Code.

          (p) (1) (A) Any housing occupied by elderly or disabled persons,  
          or both, that is initially approved and operated under a  
          regulatory agreement pursuant to Section 202 of Public Law  
          86-372 (12 U.S.C. Sec. 1701q), or Section 811 of Public Law  
          101-625 (42 U.S.C. Sec. 8013), or whose mortgage is insured  
          pursuant to Section 236 of Public Law 90-448 (12 U.S.C. Sec.  
          1715z), or that receives mortgage assistance pursuant to Section  
          221d (3) of Public Law 87-70 (12 U.S.C. Sec. 1715l), where  
          supportive services are made available to residents at their  
          option, as long as the project owner or operator does not  
          contract for or provide the supportive services.

          (B) Any housing that qualifies for a low-income housing credit  
          pursuant to Section 252 of Public Law 99-514 (26 U.S.C. Sec. 42)  
          or that is subject to the requirements for rental dwellings for  
          low-income families pursuant to Section 8 of Public Law 93-383  
          (42 U.S.C. Sec. 1437f), and that is occupied by elderly or  
          disabled persons, or both, where supportive services are made  









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          available to residents at their option, as long as the project  
          owner or operator does not contract for or provide the  
          supportive services.

          (2) The project owner or operator to which paragraph (1) applies  
          may coordinate, or help residents gain access to, the supportive  
          services, either directly, or through a service coordinator.

          (q) A resource family, as defined in Section 16519.5 of the  
          Welfare and Institutions Code

          (r) Any similar facility determined by the director.

          SEC. 4.  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.