BILL ANALYSIS                                                                                                                                                                                                    



          SENATE COMMITTEE ON APPROPRIATIONS
                             Senator Ricardo Lara, Chair
                            2015 - 2016  Regular  Session

          SB 524 (Lara) - Private residential care facilities for youth
          
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          |Version: May 5, 2015            |Policy Vote: HUMAN S. 4 - 0     |
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          |Urgency: No                     |Mandate: Yes                    |
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          |Hearing Date: May 18, 2015      |Consultant: Jolie Onodera       |
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          This bill meets the criteria for referral to the Suspense File. 

          

          Bill  
          Summary:  SB 524 would establish the new community care  
          licensure category of "private residential care facility for  
          youth," to be licensed and regulated by the Department of Social  
          Services (DSS), to regulate the operation of private residential  
          facilities and programs focused on serving youth with emotional,  
          behavioral, or mental health issues, as specified.


          Fiscal  
          Impact:  
           One-time costs potentially in excess of $250,000 (General  
            Fund) to develop two sets of regulations for the new licensure  
            category, for the establishment of the new regulatory category  
            as well as for the training plan requirements for these  
            programs.
           Potentially significant ongoing costs in excess of $500,000  
            (General Fund) to the DSS Community Care Licensing (CCL)  
            Division to license, monitor, and inspect additional  
            facilities, to be offset by the authority to charge both  







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            application and regulatory fees. Ongoing costs would be  
            dependent on the number of entities impacted statewide, which  
            is unknown. To the extent the number of new licensees is  
            significant would require additional field staff for  
            monitoring and oversight.
           Potential non-reimbursable local enforcement costs, offset to  
            a degree by fine revenue to the extent licensing and  
            regulatory violations are enforced and prosecuted.


          Background:  Current law establishes various licensing and regulation  
          requirements for child day care facilities under the California  
          Child Day Care Facilities Act. Under existing law, numerous  
          programs are exempt from child care licensing statutes,  
          including but not limited to: health facilities, clinics, school  
          dormitory or similar facilities, as specified, public recreation  
          programs, extended day care programs operated by public/private  
          schools, any alcoholism or drug abuse recovery or treatment  
          facility, as defined, facilities 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 on prayer or spiritual  
          means for healing in the practice of the religion of the church  
          or denomination, child care programs operating under specified  
          time restrictions, and juvenile programs administered by the  
          Department of Corrections and Rehabilitation (CDCR), as  
          specified. (Health and Safety Code  1505.) 

          Treatment programs for troubled youth, commonly referred to as  
          youth "boot camps," wilderness therapy programs, therapeutic  
          boarding schools, or behavior modification programs, have been  
          the subject of controversy within California and nationwide for  
          several years. These non-traditional treatment programs are  
          intended to provide less restrictive options for children with  
          significant behavioral issues and provide a range of services,  
          including drug and alcohol treatment, military-style discipline,  
          and psychological counseling. A 2007 Government Accountability  
          Office (GAO) report, "Residential Treatment Programs: Concerns  
          Regarding Abuse and Death in Certain Programs for Troubled  
          Youth," identified thousands of allegations of abuse, some of  
          which involved death, at such programs. The GAO report noted no  
          single federal agency regulating such programs, and a variety of  
          approaches ranging from statutory regulations that require  
          licensing to no oversight at the state level. 








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              "?while states often regulate publicly funded  
              programs, a number of states do not license or  
              otherwise regulate private programs. Because programs  
              determine how to describe themselves, especially in  
              their marketing materials, there is no standard  
              definition for 'wilderness therapy program,' 'boot  
              camp,' or other terms used to describe the types of  
              programs and facilities considered to be part of this  
              industry." (GAO, Residential Treatment Programs,  
              2007, p. 3)

          A subsequent GAO report entitled, "Residential Facilities: State  
          and Federal Oversight Gaps May Increase Risk to Youth Well-Being  
          (April 2008)," noted: 

              All states have processes in place to license and  
              monitor certain residential facilities, but our  
              survey identified several gaps that allow some of the  
              common causes of youth maltreatment and death to go  
              unaddressed. These gaps include the fact that some  
              types of government and private facilities are exempt  
              from licensing requirements, licensing standards do  
              not always address the primary causes of youth  
              maltreatment and death, and state agencies  
              inconsistently monitor and enforce facility  
              compliance and share their monitoring results. (p. 8)
               
              One reason that private residential facilities may be  
              exempt from licensing requirements is that state  
              agencies do not have the necessary statutory or  
              regulatory authority. Regarding residential schools  
              and academies, for example, all agencies in 15 of the  
              33 states that responded to all three agency surveys  
              reported that they did not have either the authority  
              or the regulatory responsibility to license these  
              facilities. The lack of licensing for all facilities  
              serving youth has several consequences, in that there  
              are no commonly accepted definitions of facility  
              types. Within individual states, facility operators  
              may bypass state licensing requirements by  
              self-identifying their business as a type that is  
              exempt from state licensing. In Texas, for example, a  
              residential program self-identified as a private  








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              boarding school is not regulated by the state  
              licensing agency, but the same facility would require  
              a license if it self-identified as a residential  
              treatment center or therapeutic camp. Inconsistent  
              licensing practices across states can have  
              implications as well. For example, a 2007 directory  
              showed that Utah, which only recently implemented  
              licensing requirements covering wilderness camps, was  
              home to over 25 percent of registered wilderness  
              programs in the United States. 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.  
              (p. 9)


          Proposed Law:  
            This bill would create the new licensure category of "private  
          residential care facility for youth," as follows:


                 Defines "private residential care facility for youth,"  
               as any 24-hour residential facility or program operated by  
               a private entity providing nonmedical care, counseling,  
               educational or vocational support to persons from 12 to 18  
               years of age with social, emotional, behavioral, or mental  
               health issues or disorders, including a program that  
               provides any of the following:
                  o         A program with wilderness or outdoor  
                    experience, expedition, or intervention.
                  o         A boot camp experience or other experience  
                    designed to simulate characteristics of basic military  
                    training or correctional regimes.
                  o         A therapeutic boarding school.
                  o         A behavior modification program.
                 Prohibits a person, firm, partnership, association,  
               organization, corporation, or other entity from operating,  
               establishing, managing, conducting, or maintaining a  
               private residential care facility for youth, unless the  
               facility is licensed by DSS.
                 Requires DSS to license and inspect a private  
               residential care facility for youth as a community care  
               facility. Specifies that a license is not transferable.








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                 Prohibits DSS from licensing a private residential care  
               facility for youth unless all therapeutic components of the  
               programs provided at the facility are licensed by the  
               appropriate agency or department.
                 Requires any person desiring issuance of a license for a  
               private residential care facility for youth under this  
               chapter to file an application on forms furnished by the  
               DSS to include specified information. 
                 Authorizes DSS to charge an application fee, adjusted by  
               capacity, for the issuance of a license to operate a  
               private residential care facility for youth, in an amount  
               not to exceed the costs reasonably borne by the DSS in  
               licensing these facilities.
                 Authorizes DSS to charge a regulatory fee on each annual  
               anniversary of the effective date of the license, in an  
               amount not to exceed the costs reasonably borne by the DSS  
               in regulating these facilities.
                 Provides that fee moneys collected shall be available to  
               the DSS, upon appropriation of the Legislature, solely for  
               the purposes of this bill's provisions.
                 Requires staff members of a private residential care  
               facility for youth who supervise residents to receive  
               appropriate training consisting of 10 hours within the  
               first four weeks of employment and eight hours annually  
               thereafter.
                 Requires a facility to submit its training plan to DSS  
               and to implement the training plan only after DSS has  
               approved the plan. Requires the DSS to adopt regulations  
               that establish additional subject matter required to be  
               included in this training.
                 Provides that a private residential care facility for  
               youth shall not accept for residential placement a child  
               younger than 12 years of age.
                 Requires 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 challenge, to provide  
               each prospective resident and his or her parent or guardian  
               an accurate narrative description of these programs and  
               services. Requires the facility to provide the description  
               in writing prior to admitting the prospective resident.
                 Makes conforming changes in existing law to specify  
               these facilities are no longer exempt from licensure.









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          Related  
          Legislation:  SB 1089 (Liu) 2012 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. This bill  
          was held on the Suspense File of the Assembly Committee on  
          Appropriations.


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