BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | SB 524|
|Office of Senate Floor Analyses | |
|(916) 651-1520 Fax: (916) | |
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THIRD READING
Bill No: SB 524
Author: Lara (D), et al.
Amended: 5/5/15
Vote: 21
SENATE HUMAN SERVICES COMMITTEE: 4-0, 4/28/15
AYES: McGuire, Berryhill, Hancock, Liu
NO VOTE RECORDED: Nguyen
SENATE APPROPRIATIONS COMMITTEE: 5-0, 5/28/15
AYES: Lara, Beall, Hill, Leyva, Mendoza
NO VOTE RECORDED: Bates, Nielsen
SUBJECT: Private residential care facilities for youth
SOURCE: Los Angeles LGBT Center
DIGEST: This bill establishes a new community care licensure
category of "private residential care facility for youth," to
regulate a 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.
ANALYSIS:
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
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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" as 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
Section 1502 (a) (1))
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 Section 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 CDSS, any facility that supplies board and room
only, or room only, recovery houses providing group living
arrangements, and others. (HSC Section 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 residential care facility for youth"
(PRCFY) to mean any 24-hour residential facility or program
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operated by a private entity providing nonmedical care,
counseling, educational or vocational support to persons age
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:
a) A program with wilderness or outdoor experience,
expedition, or intervention.
b) A boot camp experience or other experience designed to
simulate characteristics of basic military training or
correctional regimes.
c) A therapeutic boarding school.
d) A behavior modification program.
3) Prohibits a person or specified entity from operating,
establishing, managing, conducting, or maintaining a PRCFY,
unless the facility is licensed by CDSS.
4) Requires the CDSS to license and inspect a PRCFY as a
community care facility.
5) Prohibits CDSS from licensing a PRCFY unless all therapeutic
components of the programs provided at the facility are
licensed by the appropriate agency or department.
6) Requires a person desiring issuance of a license for PRCFY
to file an application that includes specified information
and evidence.
7) Requires the above evidence to include a criminal record
clearance, as specified, employment history, and character
references, among others.
8) Authorizes CDSS to charge an application fee, adjusted by
capacity, for the issuance of a license to operate a PRCFY,
in an amount not to exceed the costs reasonably borne by CDSS
in licensing these facilities.
9) Requires a staff member of a PRCFY who supervises residents
to receive appropriate training including 10 hours within the
first four weeks of employment and eight hours annually
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thereafter.
10)Requires a PRCFY to submit its training plan to CDSS, and
require the training include the following subject areas:
a) Resident's rights, as specified.
b) Psychosocial needs of youth.
c) Appropriate response to emergencies.
d) Physical needs for youth residents.
e) Cultural competency and sensitivity in issues relating
to underserved, lesbian, gay, bisexual and transgender
communities.
f) Laws and regulations pertaining to community care
facilities and programs of PRCFY.
11)Enumerates 14 rights of a resident of a PRCFY including:
a) To be accorded dignity in his or her personal
relationships with staff, residents, and other persons;
b) To have frequent contact with parents or guardians,
including scheduled and unscheduled telephone
conversations, unrestricted written correspondence, and
electronic communications;
c) To be free of corporal punishment, deprivation of
basic necessities, including education, as a punishment,
deterrent, or incentive, and physical restraints of any
kind; and
d) To receive supportive mental and emotional
health-related services from trained staff who are
licensed or are overseen by licensed mental health
professionals.
12) Provides that a PRCFY shall not accept for
residential placement a child younger than 12 years of age.
13) Prohibits a PRCFY from accepting for placement, or
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provide care or supervision to, a child assessed as seriously
emotionally disturbed, unless the Department of Health Care
Services (DHCS) has certified the facility as a program meets
the standards to provide mental health treatment services for
a seriously emotionally disturbed child, as specified.
14) Prohibits a PRCFY from advertising or promoting
services designed to promote the treatment of, or maintain
recovery from, alcohol or drug use, unless the facility has
been licensed as an alcoholism or drug abuse recovery or
treatment facility, as specified.
15) Prohibits a PRCFY from providing secure containment
or from using restraints of any kind unless the program
components are subject to program standards developed and
enforced by DHCS, as specified.
16) Provides that PRCFY for youth is not an eligible
placement option for dependent children and youth, or wards
and is not eligible for a rate pursuant to Section 11462 of
the Welfare and Institutions Code.
Background
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. Such facilities are intended to provide a
less-restrictive alternative to incarceration or
hospitalization, or an intervention for troubled youth. In some
instances, facilities may be licensed as a residential group
home or a residential community treatment facility. However, an
unknown number of unlicensed facilities and programs operate in
the state, relying on the licensure exemption for "school
dormitories" or because there is no licensing provision for to
wilderness camps or boot camps.
General Accounting Office report. A 2008 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" evaluated
regulatory oversight of residential facilities serving children,
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including private facilities receiving no government funding.
The report identified gaps in regulatory oversight and licensure
of private residential facilities serving youth and states:
"?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."
"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 Congress that state
licensing was important because the field does not
currently have the capacity to certify facility
integrity."
Safety and abuse concerns. Private residential facilities for
youth have been the subject of numerous lawsuits and accusations
of abuse and neglect including incidents of "sexualized role
play." In 2004, a 14-year-old boy died in wilderness program
after hiking several miles in 90-degree weather. The child had
suffered severe heatstroke requiring immediate medical attention
however program staffers reportedly ignored complaints and the
youth died an hour later at the hospital. In 2012, a mother sued
a facility alleging that her 15-year-old daughter was subjected
to hours of stress positions, threats of suffocation, exposure
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to animal abuse and regular public humiliation.
The Alliance for the Safe, Therapeutic and Appropriate use of
Residential Treatment states it has received hundreds of
personal accounts of abuse in residential programs for teens
including "traumatic transportation to the program, harsh and
cruel punishment, inadequate education, unqualified staff, short
stays that grow into multi-year confinements, and lack of access
to parents and advocates to whom they might report abuse."
Additionally the organization states that facilities rely on
deceptive marketing practices to enroll children.
FISCAL EFFECT: Appropriation: No Fiscal
Com.:YesLocal: Yes
According to the Senate Appropriations Committee, this bill will
result in expected 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. Additionally, there are
potentially significant ongoing costs in excess of $500,000
(General Fund) to the CDSS Community Care Licensing Division to
license, monitor, and inspect additional facilities, to be
offset by the authority to charge both application and
regulatory fees. Ongoing costs will be dependent on the number
of entities impacted statewide, which is unknown. To the extent
the number of new licensees is significant, it will require
additional field staff for monitoring and oversight.
The Senate Appropriations Committee additionally estimates
potential non-reimbursable local enforcement costs, offset to a
degree by fine revenue to the extent licensing and regulatory
violations are enforced and prosecuted.
SUPPORT: (Verified 5/28/15)
Los Angeles LGBT Center (source)
American Civil Liberties Union of California
Equality California
Gender Health Center
LGBTQ Center of Long Beach
Transgender Law Center
WWASP Survivors
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OPPOSITION: (Verified5/28/15)
None received
ARGUMENTS IN SUPPORT: According to the author, in recent
decades hundreds of alternative treatment institutions have been
established for youth with emotional or behavioral problems
nationwide and abroad. The author 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 and that the current lack of oversight of private
residential institutions has left California's youth vulnerable
to abuse.
Prepared by:Sara Rogers / HUMAN S. / (916) 651-1524
5/30/15 16:57:51
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