BILL ANALYSIS                                                                                                                                                                                                    �




                                                                  AB 2023
                                                                  Page A
          Date of Hearing:   April 24, 2012

                        ASSEMBLY COMMITTEE ON HUMAN SERVICES
                                Jim Beall Jr., Chair
                    AB 2023 (Jones) - As Amended:  March 29, 2012
           
          SUBJECT  :  Foster care placement:  rights of children

           SUMMARY  :  Provides that the right of children in foster care to 
          not be locked in a room, building, or facility premises, unless 
          placed in a community treatment facility, does not apply to 
          privately funded residential facilities that treat individuals 
          under 18 years of age for substance or alcohol abuse.

           EXISTING LAW  

          1)Through the State Department of Social Services (DSS) and 
            county welfare departments, establishes a system of child 
            welfare services, including foster care, for children who have 
            been or are at risk of being abused or neglected.  

          2)Provides for the licensure and regulation of group homes by 
            the Community Care Licensing Division of DSS under the 
            Community Care Facilities Act.  Health & Safety (H&S) Code � 
            1500 et seq.

          3)Defines "group home," in part, as "a facility which provides 
            24-hour care and supervision to children, provides services 
            specified ? to a specific client group, and maintains a 
            structured environment, with such services provided at least 
            in part by staff employed by the licensee."  Title 22 
            California Code of Regulations (CCR) � 84001(g)(1).

          4)Establishes requirements for the use of protective separation 
            rooms in group homes, including prohibiting the use of locking 
            or jamming devices to prevent exiting from the room.  22 CCR � 
            84322.1(a)(8).

          5)Specifies rights of children in foster care, including the 
            right to not be locked in a room, building, or facility 
            premises, unless placed in a community treatment facility.  
            Welfare & Institutions (W&I) Code � 16001.9.

          6)Specifies, in regulation, 22 CCR � 84072(c), rights of 
            children residing in group homes, including the right to not 








                                                                  AB 2023
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            be locked in any room, building, or facility premises at any 
            time, subject to the following (22 CCR � 84072(c)(24)):

             a)   The licensee shall not be prohibited from locking 
               exterior doors and windows or from establishing house rules 
               for the protection of clients provided the clients are able 
               to exit the facility.

             b)   The licensee shall be permitted to utilize means other 
               than those specified in a) above for securing exterior 
               doors and windows only provided the clients are able to 
               exit the facility and with the prior approval of the 
               licensing agency.

          7)Defines "community treatment facility" to mean a residential 
            facility that provides mental health treatment services to 
            children in a group setting and that has the capacity to 
            provide secure containment.  H&S Code � 1502(a)(8).

          8)Requires the State Department of Mental Health (DMH) to 
            establish, by regulation, specified program standards for any 
            facility licensed as a community treatment facility.  H&S Code 
            � 1502(a)(8); Title 9 California Code of Regulations (CCR) � 
            1900 et. seq.

           FISCAL EFFECT  :  Unknown

           COMMENTS  :   

           Background
           
           Rights of children in group homes  :  The regulatory rights of 
          children in foster care were consolidated and codified by AB 899 
          (Liu), Chapter 683, Statutes of 2001.  W&I Code � 16001.9.  
          Legislative policy committee analyses at the time noted that the 
          supporters of AB 899 pointed out that abuses often perpetrated 
          by foster care providers on children and youth in care 
          exacerbate the many problems the children encountered that 
          resulted in their being in foster care in the first place.  The 
          sponsor of AB 899 further asserted that reporting of these 
          abuses must be encouraged in order for the foster care system to 
          be more responsive to foster children and thus improve the 
          system.  Currently, the statute delineates 24 distinct rights of 
          children in foster care.









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          The rights of foster children and youth who live in group homes 
          extend to all group home residents.  E.g., 22 CCR � 84072(c).  
          As the Youth Law Center (YLC) points out in its opposition, 
          however, while this bill amends the statute delineating the 
          rights of children in foster care it does not change state law 
          with respect to group home licensing standards or placement of 
          foster children, nor does it change comparable protections that 
          exist elsewhere in law.  Changing the rights in this section of 
          the Welfare and Institutions Code, YLC notes, "could cause 
          confusion if �W&I Code � 16001.9] is inconsistent with these 
          other provisions."

          Among the listed rights of children in foster care is the right: 
           "To not be locked in a room, building, or facility premises, 
          unless placed in a community treatment facility �CTF]."  W&I 
          Code � 16001.9(a)(12).  The same right extends to all children 
          in group homes.  22 CCR � 84072(c)(24).  This bill provides 
          that, in addition to the CTF exception, at least for children in 
          foster care, this right also would not apply to children who are 
          placed in privately funded residential facilities that treat 
          individuals under 18 years of age for substance or alcohol 
          abuse.  

           Community treatment facilities (CTFs)  :  CTFs were first 
          authorized in 1985 by SB 874, Chapter 1473, Statutes of 1985.  
          CTFs are DSS-licensed, DMH-regulated, residential facilities 
          that provides mental health treatment services to seriously 
          emotionally disturbed children in a group setting for whom other 
          less restrictive mental health interventions are not 
          appropriate, and who may require periods of  secure containment. 
           W&I Code � 4094.5(a).  CTFs serving children in foster care 
          must be incorporated as a nonprofit organization.  Secure 
          containment means that all or part of a facility may be locked 
          or secure.  W&I Code � 4094.5(b).  The CTF statutes and 
          regulations contemplate that they would include both secure and 
          non-secure portions.  E.g., 9 CCR �� 1901(u) and (ee).  Clearly 
          in recognition of the highly restrictive nature of CTFs, they 
          are limited to 400 beds statewide.  W&I Code � 4094.7.  
          According to March 2012 DSS statistics, only three CTFs 
          currently exist statewide, with a capacity for 86 children.

           Need for this bill
           
          The author points out that privately funded residential alcohol 
          and substance abuse facilities for individuals under the age of 








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          18 are licensed by DSS as group homes.  As such, the residents 
          are entitled to the same rights as other children and youth in 
          group homes, including individuals placed through the foster 
          care system.  These rights include the right to not be locked in 
          a room, building or facility premises unless placement is in a 
          CTF.

          The author cites to research indicating that substance abuse is 
          a leading cause of youth suicide and asserts that "permitting a 
          minor to check themselves out of a treatment facility is a 
          reckless policy that could ultimately be perilous to their 
          health and safety."  According to the author,

               It is a sad reality that families are literally forced 
               to go out of state in order to place their alcohol or 
               drug addicted child in a secured treatment facility.  
               As such, this is an issue that is in desperate need of 
               further dialogue.  Determining what laws govern the 
               treatment/placement of such minors in a safe and 
               secure environment was challenging to nail down, as it 
               appears that regulating agencies were also unclear as 
               to why a child could leave a facility within minutes 
               of being admitted for drug/alcohol treatment by a 
               parent or guardian.  

          It is unclear on what basis the author claims that a minor can 
          simply leave or check out of a group home.  To the contrary, 
          children are placed in group homes on the authority of a parent, 
          guardian, or other individual or entity with legal authority.  
          The group home has responsibility under statute and regulation, 
          as well as the admissions agreement, to provide the child with 
          "24-hour care and supervision."  

          Group home licensees are to use a "reasonable and prudent parent 
          standard" when determining whether to allow a child in care to 
          participate in extracurricular, enrichment and social 
          activities.  22 CCR � 84001(r)(1).  Licensees must develop and 
          maintain a written "runaway plan" that describes how the 
          facility will respond to runaway<1> children and children 
          outside of the facility property without permission, but within 
          view of the facility personnel.  22 CCR � 84322.2.  For children 
          with a history of running away from placement, the facility 
          ---------------------------
          <1> "Runaway" means a child who absents himself or herself from 
          the facility without permission from facility personnel.  22 CCR 
          � 84001(r)(2).








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          social work personnel and the child's authorized representative 
          must develop an individualized plan for that particular child.  
          22 CCR � 84322.2(e).  Thus, if a child runs away from a group 
          home, the group home staff would be remiss if they failed to 
          take appropriate steps to seek the child's safe return, 
          including calling the police.  While children in group homes 
          have to be able to exit the facility, that does not mean they 
          can do so without permission, or in a manner that is contrary to 
          reasonable house rules or that would place them in danger.

           Lack of statutory and regulatory safeguards and requirements 
          under this bill

           The foster care rights statute, and other provisions concerning 
          the rights of children in group homes, prohibit placing children 
          in a locked room, building, or facility premises, except in the 
          case of a CTF.  Because they are locked or secure facilities, 
          CTFs are highly regulated and are subject to explicit admission 
          and retention criteria, due process procedures and safeguards, 
          and program standards.  Determinations of the need for secure 
          placement must be based on a child's case plan and safety, not 
          simply the fact that they are seriously emotionally disturbed 
          and receiving mental health treatment.  Following are some of 
          the requirements that apply to CTFs:

                 Any minor admitted to a CTF shall have the same due 
               process rights afforded to a minor who may be admitted to a 
               state hospital, including, for children age 14 through 17, 
               the notice and preadmission hearing rights recognized by 
               the California Supreme Court in In re Roger S. (1977) 19 
               Cal.3d 921.  W&I Code � 4094(h); 9 CCR � 1923.
                 A locked or secure program in a facility shall not be 
               used for disciplinary purposes.  W&I Code � 4094.5(b).
                 The use of the secure facility program shall be for as 
               short a period as possible, consistent with the child's 
               case plan and safety.  Id.
                 Authorizes CTFs to secure or lock all or part of a 
               facility, including its perimeter, but not a room alone.  
               Id. 
                 Children admitted or eligible for admission to a CTF 
               have the rights provided under the Lanterman-Petris-Short 
               Act (W&I Code �� 5325.1, 5325.2, 5326), which include the 
               right to treatment provided in ways that are least 
               restrictive of the personal liberty of the individual (W&I 
               Code � 4094.6), and a right to a hearing by writ of habeas 








                                                                  AB 2023
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               corpus.  Id.
                 Admission requires a written statement signed by an 
               appropriate licensed mental health professional certifying 
               that the child requires periods of containment to 
               participate in and benefit from treatment.
                 Physical restraint and seclusion shall be used only when 
               alternative methods are not sufficient to protect the child 
               or others from immediate injury; shall not be used as a 
               substitute for more effective programming, or for the 
               convenience of staff; and shall be used with a written 
               order designed to lead to a less restrictive way of 
               managing, and ultimately eliminating, the behavior for 
               which the restraint or seclusion is applied.  9 CCR � 1929.

          This bill, on the other hand, would give blanket authority to 
          residential facilities to lock residents in a room, building, or 
          the facility, without any of the statutory or regulatory 
          safeguards, standards, or individualized determinations required 
          in CTFs, on the sole basis that the placement is privately 
          funded and the facility provides substance or alcohol abuse 
          treatment for individuals in foster care under the age of 18.

           Slippery slope

           Children with alcohol or substance abuse problems are, of 
          course, not the only vulnerable groups who live in group homes.  
          Group homes also provide care and supervision for abused and 
          neglected children, juvenile offenders, and children who are 
          seriously emotionally disturbed or have significant cognitive 
          and intellectual disabilities.  Many if not most of these 
          children would also be endangered if they ran away from or left 
          a group home unsupervised.  Whatever justification there is for 
          authorizing locked facilities for group homes providing alcohol 
          and substance abuse treatment to minors would also reasonably 
          apply to group homes serving these other populations.

           Arguments in opposition  

          In opposing this bill, YLC says that the prohibition on locking 
          up children and other vulnerable individuals is a longstanding 
          health and safety standard.  "It helps to prevent death or 
          serious injury in the event of fire, earthquake, or other 
          hazards; avert suicide and self-injuring behavior; ensure that 
          residents are not isolated from the community; and promote 
          accountability for the conditions in which these individuals 








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          live and the services they receive."  Exceptions are rare, YLC 
          notes.  "They exist only when no less restrictive alternative is 
          available to protect the safety of residents or other 
          individuals and when accompanied by protections to afford proper 
          oversight and ensure that residents are safe."  (See discussion 
          of CTFs, above.)

          YLC asserts that the definition of facilities "that treat 
          individual under 18 years of age for substance or alcohol abuse" 
          is unclear.  For example, YLC asks, does it mean only 
          single-purpose facilities, or does it refer to any group home 
          that accepts individuals with substance or alcohol abuse 
          problems that may require treatment?

          YLC also points out that the term "privately funded" is not 
          defined.  It could be read to exclude facilities that receive 
          any public funds, such as Medicaid; foster care funding; or 
          local, state or federal substance abuse treatment funds.  YLC 
          says that reference to "privately funded" facilities in the 
          statutory provision delineating the rights of children in foster 
          care is inapt, moreover, because placements for most children in 
          foster care are paid for with public funds AFDC-FC (foster care 
          benefits) and Medicaid.  In any event, YLC, argues, 
          "�p]rotections afforded to children in community care facilities 
          should not be dependent on the source of payment for their 
          care."

           REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           
          None on file

           Opposition 
           
          Youth Law Center (YLC)
           
          Analysis Prepared by  :    Eric Gelber / HUM. S. / (916) 319-2089