BILL ANALYSIS Ó
SB 524
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Date of Hearing: July 14, 2015
ASSEMBLY COMMITTEE ON HUMAN SERVICES
Kansen Chu, Chair
SB
524 (Lara) - As Amended July 8, 2015
SENATE VOTE: 35-1
SUBJECT: Private residential care facilities for youth.
SUMMARY: Establishes a new type of community care facility - a
private or public residential care facility for youth - and
provides for its licensure and regulation.
Specifically, this bill:
1)Makes Legislative findings and declarations related to
nontraditional treatment programs for children, including that
such facilities: receive numerous allegations of abuse,
including death; currently operate unlicensed in California;
advertise services for youth who may feel they have no other
options; and have students who may have been previous victims
of trauma, experienced parental rejection based on actual or
perceived sexual orientation or gender identity, and have
mental health and substance use issues. Further, states the
intent of the Legislature that the state license private or
public residential care facilities for youth as community care
facilities to ensure the safety of children residing in those
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facilities.
2)Defines "private or public residential care facility for
youth" as a facility or program licensed by the Department of
Social Services (DSS) as a community care facility to provide
nonmedical care, counseling, or education or vocational
support to persons under the age of 18 with social, emotional,
behavioral, or mental health issues or disorders. Further,
specifies that a private or public residential care facility
for youth may provide any of the following: a program with
wilderness or outdoor experience, expedition, or intervention;
a boot camp or related, experience; a therapeutic boarding
school; or a behavior modification program.
3)Requires DSS to license a private or public residential care
facility for youth as a community care facility.
4)Prohibits DSS from licensing a private or public residential
care facility for youth unless all therapeutic components of
the programs provided are appropriately licensed.
5)Requires staff members of private or public residential care
facility for youth who supervise residents to receive
training, as specified. Further, specifies components to be
included in a private or public residential care facility for
youth's training plan, including components that DSS shall
establish by adopting regulations, and requires the facility
to submit its training plan to DSS for approval prior to
implementing it.
6)States that a staff member of a private or public residential
care facility for youth is a mandated child abuse reporter,
pursuant to current law.
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7)Enumerates rights of residents of private or public
residential care facilities for youth, including, but not
limited to, the right to: be free of corporal punishment,
deprivation of basic necessities, including education, as a
punishment, deterrent, or incentive, and physical restraints
of any kind; be free from abusive, humiliating, degrading, or
traumatizing actions; be accorded dignity in his or her
relationships; and have frequent contact with parents or
guardians. Further, requires a list of these rights to be
publically posted and accessible to residents.
8)Prohibits a private or public residential care facility for
youth from accepting for placement or providing services to a
child assessed as seriously emotionally disturbed, with
exceptions as specified.
9)Prohibits a private or public residential care facility for
youth from advertising or otherwise promoting services, as
specified, related to alcohol or drug use treatment unless the
facility has been licensed accordingly.
10)Prohibits a private or public residential care facility for
youth from using secure containment or restraints of any kind,
with specified exceptions.
11)States that a private or public residential care facility for
youth is not an eligible placement option for dependents or
wards of the court, and is not eligible for a foster care
group home rate.
12)Prohibits a private or public residential care facility for
youth from accepting for residential placement any child under
the age of 12.
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13)Requires a licensee of a private or public residential care
facility for youth that advertises or otherwise promotes
special care, programming, or environments for persons with
mental health, emotional, or social challenges to provide
prospective residents and their parents or guardians with a
written description of its programs and services prior to
admission.
14)Makes conforming technical changes.
EXISTING LAW:
1)Establishes the California Community Care Facilities Act to
provide for the licensure and regulation of community care
facilities. (HSC 1500 et seq.)
2)Defines "community care facility" to mean any facility, place,
or building that is maintained and operated to provide
nonmedical residential care, day treatment, adult day care, or
foster family agency services for children, adults, or
children and adults, including, but not limited to,
individuals with physical disabilities or mental impairments
and abused or neglected children. Includes within this
definition, among a number of other facilities: group homes,
foster family homes, small family homes, full-service adoption
agencies, noncustodial adoption agencies, and transitional
shelters. (HSC 1502)
3)Requires community care facilities operating in California, as
specified, to have a valid license. (HSC 1503.5)
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4)Requires DSS to conduct unannounced visits of each licensed
community care facility, except for foster family homes, and
requires that no facility or center be visited less frequently
than once every five years. Further requires DSS to conduct
annual unannounced visits of licensed facilities under
specified circumstances, such as when a licensee is on
probation. Additionally requires annual visits of a random
sample of at least 20% of facilities and centers not subject
to annual inspections for specified circumstances and states
that, should the total citations for this 20% of facilities
and centers exceed the previous year's by 10%, the random
sample subject to annual inspection shall increase in the next
year by 10%. Because of this trigger, 30% of eligible
facilities and centers are now randomly sampled each year for
inspection. (HSC 1534)
FISCAL EFFECT: According to the May 18, 2015, analysis by the
Senate Appropriations Committee, this bill may result in the
following costs:
1)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.
2)Potentially significant ongoing costs in excess of $500,000
(General Fund) to the DSS Community Care Licensing Division
(CCLD) to license, monitor, and inspect additional facilities,
to be offset by the authority to charge both 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.
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3)Potential non-reimbursable local enforcement costs, offset to
a degree by fine revenue to the extent licensing and
regulatory violations are enforced and prosecuted.
COMMENTS:
Licensing and oversight of community care facilities: CCLD
licenses and regulates a variety of community care facilities,
defined as "any facility, place, or building that is maintained
and operated to provide nonmedical residential care, day
treatment, adult day care, or foster family agency services for
children, adults, or children and adults, including, but not
limited to, the physically handicapped, mentally impaired,
incompetent persons, and abused or neglected children." There
are a number of different types of community care facilities,
including: adult day programs, foster family agencies, foster
family homes, social rehabilitation facilities, transitional
shelters, group homes, runaway and homeless youth shelters, and
others. CCLD also licenses and regulates child care centers,
residential care facilities for the elderly (RCFEs), and other
facilities. Currently, approximately 65,000 care facilities are
licensed in the state, with the capacity to serve 1.3 million
Californians.
CCLD conducts random inspections of 30% of facilities annually,
and each facility must be visited at least once every five
years. Some exceptions triggering more frequent inspections
exist, and federal funding requires approximately10% of
facilities to be inspected annually. Approximately 500
licensing analysts are employed by CCLD to conduct inspections
and complaint investigations.
Prior to 2004, annual inspections were required for most
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facilities; the 2003-04 state budget reduced this to once every
five years. The last two state budgets enhanced supports and
made changes related to inspections. The 2014-15 budget
included a 10% increase in annual licensing and application
fees, and investments in quality enhancement, including
increased staff, training, a quality assurance unit, and
centralization of application and complaint processes. The
2015-16 budget adopted further supports and reforms, including
enacting upcoming changes to the frequency of inspections:
starting in January 2017, DSS will increase inspections to once
every three years for all facilities, then to once every two
years for all facilities except child care by 2018, then to
annually for adult day care facilities and RCFEs by 2019.
Residential facilities for youth with emotional and behavioral
challenges: In 2008, the United States General Accountability
Office (GAO) released a report entitled, "Residential
Facilities: Improved Data and Enhanced Oversight Would Help
Safeguard the Well-Being of Youth with Behavioral and Emotional
Challenges." This reported described the proliferation since
the 1990s of residential facilities serving youth with
behavioral and emotional challenges. These facilities include
boarding schools and academies, boot camps, and wilderness
camps. Some such facilities have spawned reports of health and
safety risks for the youth who attend them. According to the
GAO report, "annual investigations by the Civil Rights Division
within the Department of Justice, have detailed incidents of
abuse and neglect, which in some cases have been severe enough
to result in hospitalization or death."
These facilities may also carry out concerning (and in some
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cases, illegal) practices such as "conversion therapy." For
example, a sponsor of this bill, the Los Angeles LGBT Center,
reports that, "Many LGBT young people have been sent to these
institutions to change their sexual orientation or gender
identity. These 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."
Regarding the licensure and regulation of these types of
facilities, the 2008 GAO report observed that:
"States are primarily responsible for ensuring the well-being
of youth in facilities and other settings, and states vary in
how they license and monitor facilities in accordance with
individual state standards of care. In addition, in return
for receiving funds under various federal grant programs,
state agencies agree to comply with federal program
requirements, including those related to youth well-being.
These programs generally fall under the purview of three
federal agencies: The Department of Health and Human Services
(HHS) provides funds to states for child welfare, mental
health, and substance abuse; the Department of Justice (DOJ),
for serving delinquent youth; and the Department of Education
(Education), for educating youth. These agencies have
authority to hold states accountable for state-operated or
private facilities that serve youth under federally funded
state programs. However, the federal government does not have
oversight authority for other private facilities that serve
only youth placed and funded by parents or other private
entities."
Nonetheless, the federal government has taken note of these
types of facilities and the potentially associated problems.
The existence of a GAO report on the issue is a testament to
this, as were bills introduced in Congress. While it ultimately
didn't pass, the "Stop Child Abuse in Residential Programs for
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Teens Act" was introduced in 2013 (H.R. 1981) and 2014 (S.
2054). This Act would have required certain standards and
enforcement provisions for the prevention of child abuse and
neglect in residential programs.
Need for this bill: Reports of abuse and neglect taking place
in certain residential facilities for youth - including accounts
of highly troubling practices of discrimination and so-called
"conversion" related to sexual orientation and gender identity -
raise the question of how such programs are able to continue
unlicensed and unregulated. The current lack of licensure
requirements also makes it difficult to even get a sense of how
many and what types of these facilities exist across the state,
and the impacts (positive or negative) on the youth who attend
them.
The 2008 GAO report found that, "States could take action to
improve the well-being of youth in residential facilities
through their licensing processes, contract provisions, or
accreditation requirements. Expanding licensing coverage would
allow states to establish minimum standards for youth in all
facilities, but may require state legislation to provide
necessary authority, as well as increased funding for oversight
and enforcement."
According to the author:
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"Tragically, many young people have experienced horrendous
abuse, neglect, and even death at unregulated boot camps,
wilderness camps, and residential institutions. Survivors
report being denied medical care, corporal punishment,
solitary confinement, discrimination due to sexual
orientation. Often parents and guardians have no idea that
the facility they are sending their child to is not held to
any standards and does not have any oversight.
The current lack of oversight and regulations over these
private institutions has opened up California's most
vulnerable youth to abuse. While private institutions should
retain the right to offer the unique programs they specialize
in, all children regardless of where they are should have
their essential health and safety needs met."
PRIOR LEGISLATION
SB 1089 (Liu), 2012, sought to license and regulate "private
nontraditional alternative treatment facilities for youth." It
died in the Assembly Appropriations Committee.
REGISTERED SUPPORT / OPPOSITION:
Support
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AIDS Project Los Angeles (APLA)
American Civil Liberties Union of California
BIENESTAR Human Services Inc.
California Alliance of Child and Family Services
California LGBT Health & Human Services Network
City Council of the City of West Hollywood
City of Los Angeles
Equality California (EQCA)
Gender Health Center
Los Angeles LGBT Center, co-sponsor
Sacramento LGBT Community Center
SIA Organization
Stonewall Democratic Club
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Transgender Law Center
WWASP Survivors
Opposition
None on file.
Analysis Prepared by:Daphne Hunt / HUM. S. / (916)
319-2089