BILL ANALYSIS                                                                                                                                                                                                    Ó




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          |SENATE RULES COMMITTEE            |                        SB 524|
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                                UNFINISHED BUSINESS 


          Bill No:  SB 524
          Author:   Lara (D), et al.
          Amended:  8/19/16  
          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

           SENATE HUMAN SERVICES COMMITTEE:  3-2, 8/26/16 (Pursuant to  
            Senate Rule 29.10)
           AYES:  McGuire, Hancock, Liu
           NOES:  Berryhill, Nguyen

           SENATE FLOOR:  35-1, 6/1/15
           AYES:  Allen, Anderson, Bates, Beall, Berryhill, Block,  
            Cannella, De León, Fuller, Galgiani, Glazer, Hall, Hancock,  
            Hernandez, Hertzberg, Hill, Hueso, Huff, Jackson, Lara, Leno,  
            Leyva, Liu, McGuire, Mendoza, Mitchell, Monning, Moorlach,  
            Nguyen, Pan, Pavley, Roth, Vidak, Wieckowski, Wolk
           NOES:  Morrell
           NO VOTE RECORDED:  Gaines, Nielsen, Runner, Stone

           ASSEMBLY FLOOR:  54-23, 8/24/16 - See last page for vote

           SUBJECT:   Private alternative boarding schools and outdoor  
                     programs


          SOURCE:    Los Angeles LGBT Center









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          DIGEST:  This bill establishes the licensure categories of  
          private alternative boarding school" and "private alternative  
          outdoor program" and makes those facilities subject to  
          regulation under the Community Care Licensing Act as specified.  
          This bill establishes rights for youth admitted to a private  
          alternative boarding school or a private alternative outdoor  
          program and requires each prospective youth and his or her  
          parent or guardian be provided with an accurate written  
          description of the programs. This bill requires training in  
          specified subject areas, and makes other regulatory changes.


          Assembly Amendments substantially revise the licensure  
          requirements and create separate licensure categories for these  
          two types of facilities.


          ANALYSIS:


          Existing law:


           1) Establishes the California Community Care Facilities Act to  
             provide for the licensure and regulation of community care  
             facilities by California Department of Social Services  
             (CDSS).  (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, group homes, foster family homes, full-service  
             adoption agencies, noncustodial adoption agencies,  
             transitional shelters, and others. (HSC 1502) 










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           3) 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  
             1502 (a)(1)) 


           4) Prohibits the operation of an unlicensed community care  
             facility which provides or represents that it provides, care  
             or supervision, or which represents itself as a community  
             care facility that is not exempted from licensure. (HSC  
             1503.5) 


           5) Exempts specified facilities from the Act, including a  
             health facility or clinic, a juvenile placement facility  
             approved by the Department of Corrections and Rehabilitation,  
             a county-operated juvenile hall, child day care facilities,  
             foster homes, a 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, a school dormitory, facilities  
             that supply board and room only, recovery houses, and others.  
             (HSC 1505) 


          This bill:


           1) Makes various legislative findings and declarations,  
             including about the risks of unlicensed behavioral treatment  
             facilities.


           2) Adds to statute the licensure category of "private  
             alternative boarding school" and defines it as  a group home  
             licensed by CDSS to provide youth with 24-hour residential  
             care and supervision, which, in addition to providing  
             educational services to youth, provides, or holds itself out  
             as providing, behavioral-based services to youth with social,  
             emotional, or behavioral issues. 








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           3) Adds to statute the licensure category of "private  
             alternative outdoor program" and defines it to mean a group  
             home licensed by CDSS to operate a program to provide youth  
             with 24-hour residential care and supervision, which  
             provides, or holds itself out as providing, behavioral-based  
             services in an outdoor living setting to youth with social,  
             emotional, or behavioral issues, as specified. 


           4) Requires that the care and supervision provided by private  
             alternative boarding schools and private alternative outdoor  
             programs be nonmedical, except as otherwise permitted by law.


           5) Requires a private alternative boarding school or private  
             alternative outdoor program to comply with all statutory   
             provisions applicable to group homes, unless otherwise  
             indicated, and requires the facility to do all of the  
             following:


              a)    Be owned and operated on a nonprofit basis and prepare  
                and maintain a current, written plan of operation, as  
                defined by CDSS.


              b)    Offer 24-hour, nonmedical care and supervision to  
                youth who voluntarily consent to being admitted to the  
                program and who are voluntarily admitted by a parent or  
                legal guardian.


              c)    Not admit a child younger than 12 years of age or  
                employ secure containment or manual or mechanical  
                restraints. 


              d)    Not admit a youth who has been assessed by a licensed  
                mental health professional as seriously emotionally  
                disturbed, unless the youth does not require care in a  








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                licensed health facility and the facility is certified to  
                provide appropriate mental health treatment, as specified.


              e)    Provide each prospective youth and his or her parent  
                or legal guardian with an accurate written description of  
                the programs and services to be provided, including a  
                written description of how advertised special programming  
                or services are intended to achieve the promoted claims,  
                as specified.


              f)    Ensure that all individuals providing behavioral-based  
                services to youth at the facility are licensed or  
                certified by the appropriate agency, department, or  
                accrediting body, as specified by the department in  
                regulation, and that 


              g)    If it offers access to, or holds itself out as  
                offering access to, mental health service or alcohol or  
                substance abuse treatments, it shall ensure that those  
                services are provided by a licensed or certified provider  
                of those services.


           6) Requires a staffing ratio in private alternative outdoor  
             programs be one staff person to every four youths, and  
             requires that staff who supervise youth receive an additional  
             number of hours of initial and annual training, to be  
             determined by CDSS in regulations developed in consultation  
             with stakeholders in addition to the training required of  
             group home staff by CDSS regulations.


           7) Requires a private alternative boarding school or private  
             alternative outdoor program to submit a staff training plan  
             to CDSS as part of its plan of operation. In addition to  
             other required training, as specified, requires training in  
             youth rights, the physical and psychosocial needs of youth,  
             appropriate responses to emergencies, as specified, cultural  
             competency and sensitivity in issues relating to the lesbian,  








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             gay, bisexual, and transgender communities, and laws  
             pertaining to residential care facilities for youth.


           8) Requires, additionally, training in the following areas for  
             staff of private alternative outdoor programs:


              a)    Low-impact camping.
              b)    Navigation skills.
              c)    Water, food, and shelter procurement.
              d)    Recognition of poisonous plants.
              e)    Wilderness first aid.
              f)    Health issues related to acclimation and exposure.
              g)    Report writing and log maintenance.

           9) Exempts providers from adhering to the existing bill of  
             rights for foster children in group homes, as specified in  
             regulation. Instead, requires youths admitted to a licensed  
             private alternative boarding school or private alternative  
             outdoor program to be accorded specified rights, and requires  
             the list of rights to be publicly posted and accessible to  
             youth. Specifies that the youth's rights shall not require a  
             licensee to take any action that would impair the health or  
             safety of youth in the facility. Included in these rights  
             are:


                 To be accorded dignity in his or her personal  
               relationships with staff, youth, and other persons, and to  
               be free from physical, sexual, emotional, or other abuse,  
               or corporal punishment, physical restraints of any kind,  
               and deprivation of basic necessities, as a punishment,  
               deterrent, or incentive.

                 To live in a safe, healthy, and comfortable environment  
               where he or she is treated with respect, and to be granted  
               a reasonable level of personal privacy, as specified.

                 To be served food and beverages of the quality and in  
               the quantity necessary to meet his or her nutritional and  
               physical needs.








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                 To be able to contact parents or legal guardians,  
               including visits and scheduled and unscheduled private  
               telephone conversations, written correspondence, and  
               electronic communications, as specified.

                 To have his or her parents or legal guardians remove him  
               or her from the program.

                 To consent to have visitors or telephone calls during  
               reasonable hours, privately and without prior notice,  
               provided the visitors or telephone calls do not disrupt  
               planned activities and are not prohibited by court order or  
               by the youth's parent or legal guardian.

                 To have caregivers who have received instruction on  
               cultural competency and sensitivity relating to, and best  
               practices for, providing adequate care to lesbian, gay,  
               bisexual, and transgender youth in out-of-home care.

                 To be free from acts that seek to change his or her  
               sexual orientation, including efforts to change gender  
               expressions, or to eliminate or reduce sexual or romantic  
               attractions or feelings toward individuals of the same sex.

                 To be free from abusive, humiliating, degrading, or  
               traumatizing actions.


           1) Prohibits placement of youth in either of these new  
             licensing categories from the child welfare or probation  
             systems and prohibits the payment of a rate for a Short Term  
             Residential Therapeutic Program.


           2) Exempts the licensure requirements of a private alternative  
             boarding school from applying to any facility operated,  
             licensed, or certified by the Department of Corrections and  
             Rehabilitation and its Division of Juvenile Justice, the  
             California Conservation Corps, the Military Department, or  
             any other governmental entity or to a boarding school that  
             solely focuses on academics.








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           3) Exempts the licensure requirements of a private alternative  
             outdoor program from applying to those same programs, as well  
             as to any organized camp, as defined, outdoor activities for  
             youth designed to be primarily recreational, including, but  
             not limited to, activities organized by Outward Bound, Boy  
             Scouts, Girl Scouts, Camp Fire, and others, as specified.


           4) Permits CDSS to adopt emergency regulations and requires  
             adoption of regulations by January 1, 2018, for private  
             alternative boarding schools, and by January 1, 2019, for  
             private alternative outdoor programs in consultation with  
             stakeholders, as specified, and requires that existing  
             programs in each of these categories be compliant with new  
             regulations no later than six months after those dates. In  
             the meantime, requires that these programs be governed by  
             specified existing group home regulations.


           5) Requires individuals who are volunteer candidates for  
             mentoring children in these facilities to be subject to a  
             criminal background investigation, prior to having  
             unsupervised contact with the children.


           6) Restricts the existing licensure exemption for spiritual  
             programs by removing the exemption for a private alternative  
             boarding school or private alternative outdoor program that  
             uses prayer or spiritual means as a component of its  
             programming or services in addition to behavioral based  
             services, thus making those facilities subject to licensure.  
             Similarly, specifies that the existing licensure exemption  
             for a school dormitory or similar facility does not include a  
             private alternative boarding school or private alternative  
             outdoor program.


           7) Permits CDSS to set licensure fees via regulation for both  
             types of new programs. 









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           8) Exempts private alternative boarding schools and private  
             alternative outdoor programs from participating in  
             psychotropic medication monitoring and oversight measures  
             currently required for child welfare placements, as  
             specified, and exempts such facilities from requirements of  
             the "reasonable and prudent parent standard," required for  
             foster homes and group homes.


          Background 


          The Community Care Licensing Division (CCL) of CDSS licenses and  
          regulates a variety of facilities which provide nonmedical  
          residential care, day treatment, adult day care, or foster  
          family agency services for children, adults, or children and  
          adults. CCL also licenses and regulates child care centers,  
          residential care facilities for the elderly, and other  
          facilities. Approximately 65,000 care facilities are licensed in  
          the state, with the capacity to serve 1.3 million Californians.


          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. In some instances, facilities may be licensed  
          as a residential group home or a residential community treatment  
          facility. However, CDSS reports there are facilities and  
          programs in the state that are unlicensed and either relying on  
          the exemption for "school dormitories" provided for in statute  
          (HSC 1505)  or because there is no licensing provision for  
          wilderness camps or boot camps. 


          Safety and Abuse Concern. Various wilderness programs have been  
          the subject of lawsuits and accusations of abuse and neglect  
          including incidents of "sexualized role play." In 2004, a  
          14-year-old boy died in a wilderness program after hiking  
          several miles in 90-degree weather. Reportedly, a combination of  








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          excessive heat, a constrictive uniform, and the boy's obesity  
          caused his body to overheat. He suffered severe heatstroke  
          requiring immediate medical attention but program staffers  
          ignored complaints and the youth died an hour later at the  
          hospital. In 2012, a mother filed a lawsuit alleging that her  
          15-year-old daughter was subjected to hours of stress positions,  
          threats of suffocation, exposure to animal abuse and regular  
          public humiliation. 


          General Accounting Office report. A U.S. 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" from May, 2008,  
          evaluated regulatory oversight of residential facilities serving  
          children, including private facilities receiving no government  
          funding. The report identified significant gaps in regulatory  
          oversight and licensure of private residential facilities  
          serving youth.


          Related/Prior Legislation


          SB 1089 (Liu, 2012) sought to license and regulate "private  
          nontraditional alternative treatment facilities for youth" and  
          was similar to this bill. It was held in the Assembly  
          Appropriations Committee


          FISCAL EFFECT:   Appropriation:    No          Fiscal  
          Com.:YesLocal:   Yes


          Unknown.


          SUPPORT:   (Verified8/26/16)












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          Los Angeles LGBT Center (source) 
          AIDS Project LA
          Buenstar Human Services Inc. 
          California Alliance of Child and Family Services
          California LGBT Health and Human Services Network
          City of Los Angeles
          City of West Hollywood
          Equality California
          Gender Health Center
          LGBTQ Center of Long Beach 
          Sacramento LGBT Center
          SIA Organization
          Stonewall Democratic Club
          Transgender Law Center
          WWASP Survivors


          OPPOSITION:   (Verified8/26/16)


          Freeing American Children from Exploitation and Sexual Slavery
          Riverview Christian Academy


          ARGUMENTS IN SUPPORT:     According to the author, residential  
          boarding schools currently are exempt from state licensing and  
          do not have oversight "beyond filing a one-page affidavit with  
          the Department of Education." The author states that the lack of  
          oversight and regulation has opened the door to abuse and  
          parents and guardians often have no idea that a facility is not  
          subject to rigorous licensure standards. "Tragically, many young  
          people have experienced horrendous abuse, neglect, and even  
          death at unregulated boot camps, wilderness camps, and  
          residential institutions," the author states.


          ARGUMENTS IN OPPOSITION:     The organization Freeing American  
          Children from Exploitation and Sexual Slavery writes that the  
          bill will imperil sex trafficked minors by eliminating  
          alternatives to group homes, where "a majority of recruitment of  
          minors into sex trafficking" takes place. It further states that  
          CCL's oversight of group homes has been poor and that CCL will  








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          not have the ability to successfully manage all the private  
          residential schools in California. 

          ASSEMBLY FLOOR:  54-23, 8/24/16
          AYES:  Alejo, Arambula, Atkins, Baker, Bloom, Bonilla, Bonta,  
            Brown, Burke, Calderon, Campos, Chau, Chiu, Chu, Cooley,  
            Cooper, Dababneh, Daly, Dodd, Eggman, Frazier, Cristina  
            Garcia, Eduardo Garcia, Gatto, Gipson, Gomez, Gonzalez,  
            Gordon, Roger Hernández, Holden, Irwin, Jones-Sawyer, Levine,  
            Lopez, Low, Maienschein, Mayes, McCarty, Medina, Mullin,  
            Nazarian, O'Donnell, Quirk, Ridley-Thomas, Rodriguez, Salas,  
            Santiago, Mark Stone, Thurmond, Ting, Weber, Williams, Wood,  
            Rendon
          NOES:  Achadjian, Travis Allen, Bigelow, Brough, Chang, Chávez,  
            Dahle, Beth Gaines, Gallagher, Gray, Grove, Harper, Jones,  
            Lackey, Mathis, Melendez, Obernolte, Olsen, Patterson,  
            Steinorth, Wagner, Waldron, Wilk
          NO VOTE RECORDED:  Hadley, Kim, Linder


          Prepared by:Mareva Brown / HUMAN S. / (916) 651-1524
          8/26/16 14:26:50


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