BILL ANALYSIS Ó SENATE COMMITTEE ON APPROPRIATIONS Senator Ricardo Lara, Chair 2015 - 2016 Regular Session SB 524 (Lara) - Private residential care facilities for youth ----------------------------------------------------------------- | | | | | | ----------------------------------------------------------------- |--------------------------------+--------------------------------| | | | |Version: May 5, 2015 |Policy Vote: HUMAN S. 4 - 0 | | | | |--------------------------------+--------------------------------| | | | |Urgency: No |Mandate: Yes | | | | |--------------------------------+--------------------------------| | | | |Hearing Date: May 18, 2015 |Consultant: Jolie Onodera | | | | ----------------------------------------------------------------- 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 SB 524 (Lara) Page 1 of ? 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. SB 524 (Lara) Page 2 of ? "?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 SB 524 (Lara) Page 3 of ? 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. SB 524 (Lara) Page 4 of ? 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. SB 524 (Lara) Page 5 of ? 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. -- END --