BILL NUMBER: SB 1570 INTRODUCED
BILL TEXT
INTRODUCED BY Senators Alquist and Ashburn
FEBRUARY 23, 2006
An act to add Chapter 12.87 (commencing with Section 18987.7) to
Part 6 of Division 9 of the Welfare and Institutions Code, relating
to foster care, and making an appropriation therefor.
LEGISLATIVE COUNSEL'S DIGEST
SB 1570, as introduced, Alquist Foster care: residentially based
services: group homes.
Existing law provides for child welfare services, which are public
social services directed toward, among other purposes, protecting
and promoting the welfare of all children, including those in foster
care placement. Existing law provides for the placement of children
in foster care in various settings, including group homes, by foster
placement agencies, under the oversight of the State Department of
Social Services.
Existing law provides for the Aid to Families with Dependent
Children-Foster Care (AFDC-FC) program, under which, pursuant to a
combination of federal, state, and county funds, aid on behalf of
eligible children is paid to foster care providers.
Existing law, the California Community Care Facilities Act,
provides for the licensure and regulation of community care
facilities, including group homes, by the State Department of Social
Services.
Existing law requires the State Department of Social Services,
under the direction of the California Health and Human Services
Agency and in collaboration with other appropriate organizations, as
specified, to reexamine the role of out-of-home placements currently
available for children served within the child welfare services
system.
This bill would require the State Interagency Team for Children
and Youth, within the California Health and Human Services Agency, to
develop a plan for transforming the current system of group care for
foster children or youth and for children with serious emotional
disorders into a system of residentially based services. The bill
would require that the plan contain specified elements, including
elements relating to the services required to be offered by
residentially based programs, administrative oversight of programs,
the placement and assessment of children and youth in those programs,
the use of available funding, agreements to test alternative program
design and funding models, and the issuance by the State Department
of Social Services of waivers with respect to statutory or regulatory
provisions to implement those agreements. The bill would require
that the plan be submitted to the Legislature by July 1, 2008.
The bill would provide that the plan may be developed with the
assistance of an outside consultant with demonstrated national
expertise in statewide foster care and residential systems. It would
appropriate $1,000,000 from the General Fund to the California Health
and Human Services Agency for the purpose of employing such a
consultant.
Vote: 2/3. Appropriation: yes. Fiscal committee: yes.
State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Chapter 12.87 (commencing with Section 18987.7) is
added to Part 6 of Division 9 of the Welfare and Institutions Code,
to read:
CHAPTER 12.87. REFORM OF RESIDENTIALLY BASED SERVICES FOR
CHILDREN AND YOUTH
18987.7. (a) The State Interagency Team for Children and Youth,
within the California Health and Human Services Agency, shall develop
a plan for transforming the current system of group care for foster
children or youth and for children with serious emotional disorders
(SED) into a system of residentially based services.
(b) The plan developed pursuant to subdivision (a) shall be
submitted to the Legislature on or before July 1, 2008, and shall
include recommendations for specific statutory changes necessary for
its implementation. It shall also include a fiscal impact statement
and a specific implementation timetable, including any necessary
regulatory changes.
(c) The plan shall reflect input from public and private nonprofit
stakeholders, including, but not be limited to, representatives of
all of the following: the state departments of Social Services,
Mental Health, Education, Alcohol and Drug Programs, and Corrections
and Rehabilitation; county child welfare, probation, mental health,
and alcohol and drug programs; local education authorities; current
and former foster youth; parents of foster children or youth and
children or youth with SED; private nonprofit agencies operating
group homes; children's advocates; and other interested parties.
(d) The plan shall be based on the reports delivered to the
Legislature pursuant to Section 75 of Chapter 311 of the Statutes of
1998 by the Steering Committee for the Reexamination of the Role of
Group Care in a Family-Based System of Care in June 2001 and August
2002, and the "Framework for a New Vision for residentially based
Services in California" published in January, 2006.
(e) The plan may be developed with the assistance of an outside
consultant with demonstrated national expertise in statewide foster
care and residential systems.
(f) Along with redefining and improving the role of group care, it
is also the intent of the Legislature that state agencies, counties,
and private nonprofit agencies continue to work in partnership to
develop additional community-based services that will make it
possible for more children and youth to be safely and effectively
served in their own homes or in another family-living situation with
a relative, guardian, foster family, or adoptive family.
18987.71. (a) (1) For purposes of this chapter, "residentially
based services" means behavioral or therapeutic interventions
delivered in nondetention group care settings in which multiple
children or youth live in the same housing unit and receive care and
supervision from paid staff.
(2) The plan developed pursuant to Section 18987.7 shall be based
upon an understanding that residentially based services are most
effectively used as intensive, short-term interventions when children
have unmet needs of such severity and complexity that their behavior
renders them or those around them unsafe, or prevents them from
benefiting from services and supports provided in the children's own
homes or in other family settings, such as with a relative, guardian,
foster family, or adoptive family.
(b) The plan developed pursuant to Section 18987.7 shall do all of
the following:
(1) Require that a program offering residentially based services
establish a safe, stable, and structured living environment in which
behavioral or therapeutic interventions can be provided in order to
mitigate the barrier behaviors to a level sufficient to allow
children or youth to transition to their own homes or another
permanent or stable family setting. A program shall also offer any
assistance to families or other primary care givers that is necessary
to help them successfully prepare for and retain the children or
youth in their setting.
(2) Require that a program offering residentially based services
include interventions that include all of the following:
(A) Environmental interventions that establish a safe, stable, and
structured living situation in which children or youth can receive
the comfort, attention, structure, and guidance needed to help them
reduce the intensity of barrier behaviors so that their caregivers
can identify and address the factors driving those behaviors.
(B) Intensive treatment interventions that facilitate the rapid
movement of children or youth toward connection or reconnection with
appropriate and natural home, school, and community ecologies by
helping them and their families find ways to understand, reduce, and
replace the persistent and difficult barrier behaviors that have been
associated with those needs with positive and productive
alternatives.
(C) Parallel, predischarge community-based interventions that help
family members, and other people in the social ecologies that
children and youth will be joining or rejoining, to prepare for
connection or reconnection. These preparations should be initiated
upon placement and proceed apace with the environmental interventions
being provided within the residential setting.
(D) Followup, postdischarge support and services provided as
needed after children or youth have exited the residential component
and returned to their own family or to another family living
situation in order to ensure the stability and success of the
connection or reconnection with home, school, and community.
(3) Include all of the following elements:
(A) Clear and objective placement criteria to be applied when
determining whether a child's and family's circumstances are such
that placement of the child in a program offering residentially based
services is necessary in order to address the unmet needs of the
child that prevent the child and family from receiving and benefiting
from assistance provided in the child's own home or in a family
setting with a relative, guardian, foster family, or adoptive family.
(B) The identification of the comprehensive assessment process to
be used by county placement agencies when deciding whether placement
in a program providing residentially based services is the option
most likely to effectively meet the needs of a child or youth, and
his or her family, and help him or her achieve the outcomes that are
the goals of the intervention.
(C) The identification of the process to be used by county
placement agencies and private, nonprofit agencies operating programs
that provide residentially based services to insure that the
specific program chosen for a child or youth is able to provide the
types and level of care and services needed to meet the needs of that
child or youth. This may involve the development of categories for
residentially based services programs based on the target population
of children or youth they are designed to serve and the types and
levels of care and services they provide.
(D) The identification of processes and procedures that will
ensure the active involvement of children or youth and their families
in the initial development and ongoing management of plans of care
and the delivery of services and treatment.
(E) The identification of a functional system for collaborative
decisionmaking regarding the use of residentially based services in
each county that ensures full participation by the county placement
agency, other public agencies involved with providing or funding
services needed by the children and their families, the residentially
based services programs, and other involved parties, including
children or youth and their families.
(F) The development of administrative mechanisms, such as
community care licensing, to ensure that the residentially based
services programs and the facilities they use meet appropriate health
and safety standards. These standards should not create
inappropriate barriers that inhibit the children or youth in
placement from engaging in activities that are necessary for their
development.
(G) The development of administrative mechanisms to ensure that
each agency offering residentially based services programs
demonstrates its programmatic and organizational competencies with
respect to its mission, values, administration, management, staffing,
and quality assurance.
(H) The development of administrative mechanisms to ensure that
each agency offering residentially based services programs
demonstrates its competency in all of the following phases of its
service planning and delivery system: engagement, planning,
implementation, coordination, and evaluation and quality improvement.
(I) The establishment of criteria to ensure that discharge plans
and timelines are developed concurrently with treatment and service
plans at the time of placement, and are subsequently monitored and
updated based on the progress of the children or youth and their
families' circumstances, with the goal of reconnecting the children
or youth with their families, schools, and communities.
(J) The establishment of criteria to ensure that service and
discharge planning include the identification and preparation of
relatives, guardians, adoptive families, or foster families with whom
the children or youth can live either on a permanent basis, or until
they can be reunified with their parents, in those cases when it is
not possible to reunify children or youth with their own parents or
other appropriate family.
(K) The creation and definition of specific and objective outcome
indicators, and the development of tools and systems for measuring
them, to reflect progress made by children or youth placed in
programs offering residentially based services toward the goals of
safety, permanence, and well-being within the context of the
California Child Welfare Outcomes and Accountability System.
(L) The development of administrative mechanisms to ensure that
private nonprofit agencies operating residentially based services
programs use the funding they receive through the Aid to Families
with Dependent Children-Foster Care (AFDC-FC) program (Art. 5
(commencing with Sec. 11400), Ch. 2, P. 3) and other public programs
to provide quality care and services to the children or youth and
their families, consistent with federal and state requirements and
county placement agreements.
(M) The development of a new methodology for providing funding
through the AFDC-FC program for care, supervision, and social work
activities, and the development of an additional funding mechanism to
pay for the costs of parallel, predischarge community-based
interventions and followup and postdischarge support, either as new
components of the AFDC-FC program or as new separate funding streams.
The new funding methodology for residentially based services
programs shall do all of the following:
(i) Support the values and goals for residentially based services
described above, including active child and family involvement,
permanence, team decisionmaking, and outcome measurement.
(ii) Ensure that quality care and effective services are delivered
to appropriate children or youth at a reasonable cost to the public.
(iii) Ensure that payment levels are adequate to cover the cost of
the private nonprofit agencies operating residentially based
services programs, including the cost of hiring and retaining
qualified staff to provide care and services to the children or youth
and their families.
(iv) Facilitate compliance with state requirements and the
attainment of federal performance objectives.
(v) Control overall program costs by providing incentives for the
private nonprofit agencies to use the most cost-effective approaches
for achieving positive outcomes for the children or youth and their
families.
(vi) Encourage the private nonprofit agencies to access other
available public sources of funding and services to meet the needs of
the children or youth placed in their residentially based services
programs.
(vii) Enable the braiding of various funding streams necessary to
meet the full range of services needed by foster children or youth in
residentially based services programs, with particular reference to
funding for mental health treatment services through the Medi-Cal
Early and Periodic Screening, Diagnosis, and Treatment program.
(viii) Maximize federal financial participation to the extent that
it does not inordinately impede the effective delivery of services
to children or youth and families, and the achievement of positive
outcomes.
(ix) Include provisions for effective administrative oversight and
enforcement mechanisms in order to ensure programmatic and fiscal
accountability.
(4) Identify and define the modifications necessary to address the
particular and diverse requirements associated with children or
youth placed for residentially based services by each major component
of the system, including child welfare, probation, mental health,
and education.
(5) Identify and define in each of the elements adaptations
necessary to support the effective and efficient operation of
residentially based services programs designed to provide care,
supervision, services, and treatment for children or youth with
barrier behaviors or similar challenges or conditions, including, but
not limited to, programs designed primarily to serve any of the
following:
(A) Children and youth in need of emergency shelter and
assessment.
(B) Pregnant or parenting youth.
(C) Older youth preparing to emancipate from the foster care
system.
(D) Youth in the juvenile justice system.
(E) Youth with substance abuse problems.
(F) Juvenile sex offenders.
(G) Children and youth with emotional disturbance or mental
illness.
(H) Lesbian, gay, bisexual, transgender, or questioning youth.
(6) Use the existing level of federal, state, and county funding
in a more cost-effective manner than under current law by improving
the upfront assessment and placement processes, and permitting
private nonprofit agencies to provide services and support to
families while their children or youth are in placement and after
they are discharged, with the goals of reducing the average length of
stay and achieving better long-term outcomes.
(7) Use the savings created by reducing the average length of stay
to pay adequate rates under the AFDC-FC program to the private
nonprofit agencies for the time that the children or youth are
participating in their residential programs. These savings may also
be used to pay the private nonprofit agencies for costs associated
with new predischarge family support and postdischarge services, to
fund county implementation of more effective upfront assessment and
placement procedures, and to fund other related community-based
services and support.
(8) Propose any appropriate pilot projects to test the use of
residentially based services to meet the diverse needs of children or
youth and families in the child welfare, juvenile justice, and
mental health systems.
(9) Allow the State Department of Social Services to enter into
voluntary agreements with individual counties and private nonprofit
agencies to test alternative program design and funding models for
residentially based services prior to statewide implementation of the
plan, including agreements to transform all or part of existing
group home programs in accordance with the requirements of the plan,
if the agreements satisfy all of the following requirements.
(A) Incorporate and address all of the elements for residentially
based services included in the plan.
(B) Reflect active collaboration among the private nonprofit
agency that will operate the residentially based services program and
county departments of social services, mental health, or juvenile
justice, alcohol and drug programs, county offices of education, or
other public entities, as appropriate, to ensure that children,
youth, and families receive the services and support necessary to
meet their needs.
(C) Include provisions for the preparation of an annual evaluation
report, to be prepared jointly by the county and the private
nonprofit agency. The plan shall require that these provisions
include analyses of the outcomes for children and youth, including
achievement of permanency, involvement of children or youth and their
families, client satisfaction, the use of the program by the county,
the operation of the program by the private nonprofit agency,
payments made to the private nonprofit agency by the county, and
actual costs incurred by the nonprofit agency for the operation of
the program. The plan shall also require that the county send a copy
of each annual evaluation report to the director, and that the
director make these reports available to the Legislature upon
request.
(D) Include provisions that permit amendments and modifications of
the agreement to be made, with the mutual consent of both parties,
based on the evaluations described in subparagraph (C) and on
experience and information acquired from the implementation and the
ongoing operation of the program.
(10) Provide that, upon request from a county, the director may
waive statutory or regulatory provisions governing child welfare
services, AFDC-FC payments, or the operation of programs licensed as
group homes in order to enable a county and a private nonprofit
agency to implement an agreement described in paragraph (9). The plan
shall also provide that a waiver granted by the director shall be
applicable only to the development, implementation, and ongoing
operation of a residentially based services program and related
county activities provided under the terms of the agreement and for
the duration of the agreement, and shall be granted only when all of
the following apply:
(A) The agreement promises to offer a worthwhile test related to
the development, implementation, and ongoing operation of a
residentially based services program as described in the plan.
(B) Existing statutory or regulatory provisions impose barriers
for the effective, efficient, and timely implementation of the
agreement.
(C) The requesting county proposes to monitor the agreement for
compliance with the terms of the waiver.
(D) The waiver will not result in a substantial loss of federal
funds or an increase in the costs to the General Fund for rate
payments under the AFDC-FC program, measured over a period not to
exceed three years. This would permit higher AFDC-FC rate payments to
be made when children or youth are initially placed in a
residentially based services program, with savings to offset these
higher costs being achieved through shorter lengths of stay in the
program as the result of the provision of predischarge support and
postdischarge services to the children or youth and their families.
(11) Provide that, to the extent that some of the care, services,
and other activities associated with a residentially based services
program operated under an agreement described in paragraph (9) are
not eligible for federal financial participation as foster care
maintenance payments under Part E of Title IV of the federal Social
Security Act (42 U.S.C. Sec. 670 et seq.), but may be eligible for
federal financial participation as administration or training, or may
be eligible for federal financial participation under other
programs, including, but not limited to, Title XIX of the federal
Social Security Act (42 U.S.C. Sec. 1396 et seq.), the appropriate
state departments shall take measures to obtain that federal funding.
(12) Provide that, prior to approving any waiver pursuant to
paragraph (10), the director shall make a determination that the
design of the residentially based services program to be operated
under the agreement described in paragraph (9) would ensure the
health and safety of children or youth to be served.
SEC. 2. There is hereby appropriated the sum of one million
dollars ($1,000,000) from the General Fund to the California Health
and Human Services Agency for the purpose of employing an outside
consultant pursuant to subdivision (e) of Section 18987.7 of the
Welfare and Institutions Code, as added by Section 1 of this act.