BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 421
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          Date of Hearing:   April 22, 2009

                           ASSEMBLY COMMITTEE ON EDUCATION
                                Julia Brownley, Chair
                     AB 421 (Beall) - As Amended:  April 13, 2009
           
           [This bill was double referred to and heard by the Assembly  
          Human Services Committee as it relates to the issues under its  
          jurisdiction]
           
          SUBJECT  :  Seriously emotionally disturbed children:  out-of-home  
          placement  

           SUMMARY  :  Authorizes payments for 24-hour care of a child  
          classified as seriously emotionally disturbed (SED) and placed  
          out-of-home in an out-of-state, for-profit residential facility  
          pursuant to special education provisions.  Specifically,  this  
          bill, an urgency measure  :   

          1)Authorizes, until January 1, 2011, payments on behalf of  
            children placed in out-of-state privately operated residential  
            facilities that meet applicable licensing requirements of that  
            state, as required under the Interstate Compact on the  
            Placement of Children, as specified in the California Family  
            Code.

          2)Authorizes, from January 1, 2010 until January 1, 2013,  
            payments to out-of-state, for-profit residential facilities  
            that meet applicable licensing requirements in the state in  
            which they are located for 24-hour, out-of-home care of a SED  
            child placed there pursuant to an Individualized Education  
            Program (IEP) if either:

             a)   The county or the local educational agency (LEA) placed  
               the child in the facility after due process proceedings  
               were initiated under state special education provisions and  
               either of the following occurred:

               i)     Following a due process hearing, the hearing officer  
                 finds that, after a thorough search, no other comparable  
                 private nonprofit or publicly licensed residential  
                 facility was identified that is both willing to accept  
                 placement and capable of providing an appropriate  
                 education in compliance with law; or,









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               ii)    A written mediation or settlement agreement was  
                 reached, which includes documentation that a thorough  
                 search was conducted and no other comparable private  
                 nonprofit or publicly licensed residential facility was  
                 identified that is both willing to accept placement and  
                 capable of providing an appropriate education in  
                 compliance with law; or,

             b)   The IEP team agreed, and the placement was made, after a  
               thorough search in which no other comparable private  
               nonprofit or publicly licensed residential facility was  
               identified that is both willing to accept placement and  
               capable of providing an appropriate education in compliance  
               with law.  The placing agency shall document its efforts  
               and the reasons no other placement option can be  
               identified.

          3)Specifies that the provisions described above are not intended  
            to change existing procedures, protections or requirements  
            regarding the placement of children in out-of-state  
            facilities, including out-of-state community care licensing  
            requirements.

          4)Requires the Department of Mental Health (DMH), in  
            collaboration wit the California Mental Health Directors  
            Association, to annually provide information to Senate and  
            Assembly budget committees on:

             a)   The number of in-state and out-of-state placements of  
               children with serious emotional disturbances in nonprofit  
               and for-profit residential facilities; 

             b)   The average length of stay of those children in each  
               type of facility; and 

             c)   The number of those children who were dependents, wards  
               or voluntarily placed in foster care at the time of their  
               placement pursuant to an IEP.

          5)Provides that to the extent that any county fails to  
            voluntarily provide the required information to DMH, the DMH  
            shall note that as the reason for the omission of information  
            relevant to that county.

          6)Deems to be reimbursable, county claims submitted to the  








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            Controller for mental health services required by, and 24-hour  
            care provided to an SED child placed in an out-of-state  
            for-profit residential facility pursuant to an IEP on or  
            before the date this bill is enacted, and specifies that the  
            state Controller may still dispute whether claims for costs  
            exceed what is allowable.

          7)Prohibits reimbursement for new past claims based on the  
            provisions of this bill.

          8)Makes findings and declarations relative to requirements under  
            federal law for the provision of a free and appropriate public  
            education to individuals with disabilities. 

           EXISTING LAW :

          1)Establishes the right of individuals with exceptional needs to  
            receive a free appropriate public education and ensures the  
            right to special instruction and related services needed to  
            meet their individual and unique needs, in conformity with  
            federal law and regulations.

          1)Authorizes out-of-home residential placements, pursuant to an  
            IEP, when necessary for a child classified as SED to benefit  
            from educational services.  Requires designation of the county  
            mental health department as the lead case manager and requires  
            regular review of such placements.  

          2)Requires that payments for 24-hour out-of-home care pursuant  
            to an IEP for a child classified as SED be made to privately  
            operated residential facilities licensed in accordance with  
            the Community Care Facilities Act and based on rates  
            established by Aid to Families with Dependent Children-Foster  
            Care (AFDC-FC) provisions.  

          3)Requires that out-of-state placements pursuant to an IEP be  
            made only in a privately operated school certified by the  
            Department of Education (CDE), and that a plan be developed  
            for using a less restrictive, in-state alternative (unless in  
            child's best interest to stay out-of-state).   

          4)Requires LEAs to document efforts to locate a nonpublic school  
            (NPS) in California before contracting with an out-of-state  
            NPS.  Requires out-of-state NPSs to be certified or licensed  
            to provide special education in their own state and that IEP  








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            teams report to the Superintendent of Public Instruction  
            within 15 days of placement in any out-of-state NPS and LEAs  
            indicate the anticipated date for the child to return to the  
            state.

          5)Requires local mental health departments to report information  
            to the Department of Mental Health (DMH) regarding each  
            out-of-state residential placement of an SED child pursuant to  
            an IEP, including provisions for case management, supervision  
            and family visitation.  

          6)For a dependent child, requires the court to state on the  
            record that in-state placements could not meet the child's  
            needs before approving an out-of-state placement pursuant to  
            an IEP.  

           FISCAL EFFECT  :   Unknown 

           COMMENTS  :  Pursuant to the Individuals with Disabilities  
          Education Act (IDEA), every pupil with disabilities is entitled  
          to a free and appropriate public education (FAPE) in the least  
          restrictive environment (LRE).  Special education and related  
          services are provided as specified in a pupil's IEP.  The IEP is  
          reviewed periodically between school officials and the pupil's  
          parents. 

           AB 3632 services :  In providing mental health treatment and  
          assessment to pupils with disabilities, AB 3632 (Brown) Chapter  
          1747, Statutes of 1984, transferred the mental health  
          responsibility from local education agencies (LEAs) to county  
          mental health agencies.  AB 3632 services are mental health  
          services provided as part of a child's IEP to ensure that he or  
          she benefits from his or her education.  AB 3632 services may  
          include: individual, group or family psychotherapy; day  
          treatment services; or residential placement.  Mental health  
          services are provided through the County Department of Mental  
          Health (CDMH). 

          There are two eligibility requirements that must be met for a  
          child to receive AB 3632 mental health services:  The child must  
          be eligible for special education services but not necessarily  
          have been identified as "emotionally disturbed," and the child  
          must need mental health services in order to benefit from his or  
          her special education program.  The AB 3632 regulations outline  
          a process for identifying and placing children who have a  








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          serious emotional disturbance and need a residential placement  
          to benefit from FAPE.  Additionally, to receive a residential  
          placement, the child must require a 24-hour therapeutic program  
          in order to benefit from his or her educational program.  

           What is the need for this bill  :  According to information  
          provided by the author, "In 1992, the federal government enacted  
          legislation prohibiting placement of SED children in residential  
          facilities operated on a 'for-profit' basis.  The 1992 statutory  
          change prohibited any use of public funds for residential  
          placement into 'for-profit' facilities, both in California and  
          throughout the country. As a result, in California virtually all  
          placement agencies converted to 'not-for-profit' status or  
          ceased working with publicly funded children. California law was  
          subsequently changed to conform to federal law."

          In 1996, the federal government reversed itself and authorized  
          out of state placements in for-profit residential facilities,  
          which also applies to students placed pursuant to the IDEA.   
          However, California did not change its own laws to conform to  
          allow placements - either in state or out of state - in  
          for-profit facilities.

          Furthermore, the author suggests that "some out-of-state  
          residential providers are owned by 'for-profit' entities,  
          usually hospital/behavioral health corporations.  Some  
          'not-for-profit' residential providers are operated by the  
          parent company thru a subsidiary contract.  In a good faith  
          effort to comply with the state law, counties contract for  
          services for some SED students, with the "not-for-profit"  
          entities.   Counties placed students in these facilities  
          believing that, so long as the contracted company was  
          'not-for-profit' this was in compliance with the letter and the  
          intent of federal and state law.  Counties have historically  
          (past 13 years, until 2005) been reimbursed by the state for the  
          costs of these placements, and therefore had no reason to  
          believe they did not comply with state law." 

          In 2005, an unpublished administrative law judge decision in a  
          special education due process hearing found that these  
          facilities did not meet the definition of "not-for-profit," and  
          therefore California children are prohibited by state law from  
          being placed in them.  This decision prompted the State  
          Controller's Office to dispute counties' eligibility for mandate  
          reimbursement for these out-of-state placements.  








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           Out-of-state placements  :  A 2003 report prepared by the American  
          Institutes for Research (AIR) studied the education of children  
          residing in out-of-home placements.  According to this report,  
          currently, most of the youth placed in out-of-state facilities  
          are mental health/AB 3632 placements.  As a result of the  
          passage of foster care reform legislation, SB 933 Chapter 311,  
          Statutes of 1998, some counties now prohibit the Department of  
          Social Services (DSS) and the Department of Probation from  
          placing youth outside the state.  SB 933, which applies to  
          dependents and wards, but not to those governed by AB 3632,  
          requires that all in-state options must be pursued before  
          out-of-state placement is considered and all out-of-state  
          placements must meet California's licensing requirements.  The  
          AIR report contends that because SB 933 has resulted in fewer  
          dependents and wards placed outside of California, fewer  
          in-state beds remain for AB 3632 youth.

           For-profit placements  : Some historical news articles state that  
          the federal government's original exclusion of for-profit  
          companies from receiving foster care funds was in part because  
          Congress feared repetition of nursing home scandals in the  
          1970s, when public funding triggered growth of a badly monitored  
          institutional care industry.  California's current policy of  
          limiting payments to nonprofit group homes continues to ensure  
          that the goal of serving children's interests is not mixed with  
          the goal of private profit.  Nonprofits are also generally  
          subject to more oversight, including that of a financially  
          disinterested board.  

          CDE monitors some education-related services in out-of-state  
          nonpublic schools that serve California students.  Existing  
          regulations implementing case management-related statutes  
          require quarterly onsite contacts between local mental health  
          case managers and students residentially placed as a result of  
          an IEP.  However, neither CDE nor the Department of Social  
          Services (DSS) conducts certification, monitoring or complaint  
          investigation of the residential component of placements at  
          issue.  Some county mental health agencies report taking on  
          additional oversight responsibility not required by statute.  

           Estimates of placements  :  December, 2007 data from the CDE  
          reflects 45 California-certified non-public schools outside of  
          California that served 862 students.  Of these 45 schools, 13  
          were affiliated with a licensed children's residential  








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          institution and classified by CDE as for-profit.  A total of 243  
          California children were attending out-of-state non-public  
          schools with affiliated licensed children's residential  
          institutions that CDE classified as for-profit.  
          It is not clear how many children classified as SED are  
          residentially placed pursuant to IEPs.  

          Although this bill seeks to resolve an issue relative to the  
          reimbursement to counties for services that have been provided  
          to children classified as SED, this bill also raises questions  
          relative to the placement of these children in such restrictive  
          residential facilities that are far from their homes and  
          families and in facilities that are operated in a for-profit  
          basis.  The primary objective of for-profit facilities is to  
          maximize profit.  This bill demonstrates the need for non profit  
          facilities in the state that can meet the needs of SED children.  
           This measure sunsets in 2013, and the author has expressed  
          interest in holding hearings and studying this issue in the  
          years during which this measure would be in effect to explore  
          potential solutions to expand the availability of services that  
          meet the needs of SED children in the state. 

           Arguments in support  :  The County of San Bernardino writes,  
          "Absent a change in state law to conform to federal law,  
          counties have been forced to find alternative arrangements for  
          hundreds of special education students with mental health needs.  
           Also counties that have placed and paid for such placements in  
          the past- believing them to be compliant with both state and  
          federal law- are at risk of losing a significant amount of  
          reimbursement for these state and federally mandated services  
          unless California law is changed retroactively.  In San  
          Bernardino County alone, the Behavioral Health Department has  
          spent $280,000 over the last 5 years for unreimbursed placement  
          costs for seriously emotionally disturbed children placed in  
          these facilities, money that could be used for other needed  
          services."

           Arguments in opposition  :  Disability Rights California (DRC)  
          states an "opposed unless amended" position and writes,  
          "Disability Rights California still has significant concerns  
          with this legislation because it makes it much easier for  
          counties and districts to place special education students in  
          out-of-state residential facilities. While all residential  
          educational placements are highly restrictive, out-of-state  
          placements are the most restrictive because children in  








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          facilities far from home are isolated from regular interactions  
          with family, friends, and other children without disabilities."

          DRC further states, "we believe that additional data should be  
          provided to Disability Rights California, California's  
          protection and advocacy agency, regarding injuries and deaths of  
          California children placed in out-of- state residential  
          facilities. The collection of this data can be achieved at no  
          cost to the counties or the state because it can be done via a  
          contractual agreement by the county and the provider.  
          Contractual language would require the out of state provider to  
          send the incidents of injury or death of California residents  
          directly to Disability Rights California for our review. Such a  
          provision allows for additional, necessary monitoring of these  
          facilities."

           Staff suggests  the author consider amending the bill to add a  
          provision to the reporting requirements in the bill to include  
          reporting the number of serious injury incidents that were  
          reported to counties. 

          This bill was heard by the Assembly Human Services Committee on  
          April 14, 2009 and passed with a vote of 6-0.
           Amendments from the Human Services Committee  :  The following  
          amendments were agreed to in the Human Services Committee and  
          will be processed by this Committee:

            The Legislature finds and declares as follows:
                 (a) As required by federal law, all  schoolaged   
             school-aged  children are legally required to receive a Free  
            and Appropriate Public Education (FAPE) for kindergarten and  
            grades 1 to 12, inclusive (20 U.S.C. Sec. 1412(a)(1)).
                 (b)  In accordance with federal law, California has  
            delegated the FAPE requirements to the  local education  
            agencies and  counties (Chapter 2.5 (commencing with Section  
            56195 of Part 30 of Division 4 of Title 2 of the Education  
            Code.
                  (c)  Counties are sometimes required to place specified  
            severely emotionally disturbed children in the most  
            appropriate placement to accomplish the goal of FAPE.
                  (d)   (c)    Counties   Local education agencies and counties   
            recognize, in rare instances, that the  most   only available   
            appropriate placement may not be a nonprofit facility, but  
            meets the needs of the child, as required by federal law.
                 (e)  It is the intent of the Legislature in enacting this  








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            act to ensure that counties receive reimbursement for  
            adherence to state and federal law  as they act in the best  
            interest of the child   in ensuring that every child receives a  
            FAPE  .

           Previous legislation  :  SB 292 (Wiggins) of 2008 authorizes  
          payments for 24-hour care of a child classified as seriously  
          emotionally disturbed (SED) and placed out-of-home in an  
          out-of-state, for-profit residential facility pursuant to  
          special education provisions.  SB 292 was held on the Assembly  
          Floor. 

          AB 1805 (Committee on Budget) of 2008 authorizes payments for  
          24-hour care of a child classified as SED and placed out-of-home  
          in an out-of-state, for-profit residential facility pursuant to  
          special education provisions. contained substantially similar  
          provisions and was vetoed by the Governor.  In his veto message,  
          the Governor states:  

          "I strongly support providing care to children with serious  
          emotional disturbances, including the provision of care in  
          whichever facility can best address their needs.  While I  
          support the intent and policy behind this bill, I cannot sign it  
          in its current form because it will allow the open-ended  
          reimbursement of claims, including claims submitted and denied  
          prior to 2006-07.  Given our state's ongoing fiscal challenges,  
          I cannot support any bill that exposes the state General Fund to  
          such a liability.  I would support legislation that clarifies  
          and narrows state reimbursement for these important services to  
          a specified time period and would ask the Legislature to work  
          with my Administration in January to address this important  
          issue."

           REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           
          Board of Supervisors County of Santa Clara
          California Alliance of Child and Family Services 
          California Council of Community Mental Health Agencies
          California Psychological Association 
          California Society for Clinical Social Work
          California State Association of Counties 
          County Welfare Directors Association of California 
          Los Angeles County Board of Supervisors








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          Mental Health Association in California 
          San Bernardino County Board of Supervisors 
          Special Education Local Plan Area Administrators 
          Urban Counties Caucus 
          Individuals 

           Opposition 
           
          Disability Rights California (unless amended)
           
          Analysis Prepared by  :    Marisol Avi?a / ED. / (916) 319-2087