BILL ANALYSIS                                                                                                                                                                                                    



                                                                     SB 524


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          SENATE THIRD READING


          SB  
          524 (Lara)


          As Amended  August 17, 2015


          Majority vote


          SENATE VOTE:  35-1


           ------------------------------------------------------------------ 
          |Committee       |Votes|Ayes                  |Noes                |
          |                |     |                      |                    |
          |                |     |                      |                    |
          |                |     |                      |                    |
          |----------------+-----+----------------------+--------------------|
          |Human Services  |7-0  |Chu, Mayes, Calderon, |                    |
          |                |     |Lopez, Maienschein,   |                    |
          |                |     |Mark Stone, Thurmond  |                    |
          |                |     |                      |                    |
          |----------------+-----+----------------------+--------------------|
          |Appropriations  |16-0 |Gomez, Bigelow,       |                    |
          |                |     |Bloom, Bonta,         |                    |
          |                |     |Calderon, Chang,      |                    |
          |                |     |Nazarian, Eggman,     |                    |
          |                |     |                      |                    |
          |                |     |                      |                    |
          |                |     |Eduardo Garcia,       |                    |
          |                |     |Holden, Jones, Quirk, |                    |
          |                |     |Rendon, Wagner,       |                    |
          |                |     |Weber, Wood           |                    |
          |                |     |                      |                    |
          |                |     |                      |                    |








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          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  
            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. 








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          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.


          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.









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          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.


          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  








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            provide for the licensure and regulation of community care  
            facilities.  (Health and Safety Code (HSC) Section 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 Section 1502)


          3)Requires community care facilities operating in California, as  
            specified, to have a valid license.  (HSC Section 1503.5)


          FISCAL EFFECT:  According to the Assembly Appropriations  
          Committee, this bill may result in the following costs:


          1)One-time costs to DSS 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 likely 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  
            application and regulatory fees. Ongoing costs would be  
            dependent on the number of entities impacted statewide, which  








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            is unknown and difficult to ascertain, making it difficult to  
            understand the full cost implications of this bill.  To the  
            extent the number of new licensees is significant, CCL would  
            require additional field staff for monitoring and oversight.


          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:  


          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."


          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  








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            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  
          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:  According to the author:


            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  








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            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.




          Analysis Prepared by:                                             
          Daphne Hunt / HUM. S. / (916) 319-2089  FN: 0001606