BILL ANALYSIS                                                                                                                                                                                                    �






                                  SENATE HUMAN
                               SERVICES COMMITTEE
                            Senator Carol Liu, Chair


          BILL NO:       SB 1319                                     
          S
          AUTHOR:        Liu                                         
          B
          VERSION:       February 23, 2012
          HEARING DATE:  April 10, 2012                              
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          FISCAL:        Yes                                         
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          CONSULTANT:    Sara Rogers                                 
          9

                                        

                                     SUBJECT
                                         
                                 Child Welfare
                                         
                                    SUMMARY
                                         
          Provides that licensed foster family homes are not subject 
          to civil penalties under the California Community Care 
          Facilities Act.  Allows the California Department of Social 
          Services (CDSS) to renew or extend current performance 
          agreement waivers with private non-profit agencies serving 
          children.  Removes the sunset date for existing law which 
          exempts certain community treatment facilities from 24-hour 
          on site nursing staff requirements.

                                     ABSTRACT
                                         
           Existing law

           1.Enacts the California Community Care Facilities Act which 
            provides for the licensure and regulation by the State 
            Department of Social Services (DSS) of community care 
            facilities, as defined, including foster family agencies 
            that certify foster family homes and licensed foster 
            family homes. 
                                                         Continued---



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          2.Defines "foster family agency" to mean any organization 
            engaged in the recruiting, certifying, and training of, 
            and providing professional support to, foster parents, or 
            in finding homes or other places for placement of 
            children for temporary or permanent care who require that 
            level of care as an alternative to a group home. 

          3.Defines "foster family home" to mean any residential 
            facility providing 24-hour care for six or fewer foster 
            children that is owned, leased, or rented and is the 
            residence of the foster parent or parents, including 
            their family, in whose care the foster children have been 
            placed. 

          4.Defines "small family home" to mean any residential 
            facility, in the licensee's family residence, that 
            provides 24-hour care for six or fewer foster children 
            who have mental disorders or developmental or physical 
            disabilities and who require special care and supervision 
            as a result of their disabilities. 

          5.Requires the department, in establishing regulations for 
            foster family homes and certified family homes of foster 
            family agencies, to consider these homes as private 
            residences, and to establish regulations for them as a 
            separate regulation package from regulations for all 
            other community care facilities. 

          6.Requires the State Department of Mental Health (DMH) to 
            establish, by regulation, specified program standards for 
            any facility licensed as a community treatment facility. 

          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.  

          8.Provides that, until January 1, 2013, community treatment 
            facilities shall not be required by DMH to have 24-hour 
            onsite licensed nursing staff, but shall retain at least 
            one full-time registered nurse onsite under certain 
            conditions. 

          9.Provides that a county may enter into performance 




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            agreements with nonprofit agencies to encourage 
            innovation in the delivery of children's services, to 
            develop services not available in the community, and to 
            promote change in the child welfare services system. 

          10.Authorizes DSS to waive regulations relating to foster 
            care payments and the operation of group homes for a 
            period of up to 3 years, in order to facilitate these 
            performance agreements. Existing law authorizes the 
            department to extend the regulation waivers for up to 3 
            additional years.

           This bill
           
          1.Adds licensed foster family homes to the list of foster 
            care license categories which are not subject to civil 
            penalties under the California Community Care Facilities 
            Act. 

          2.Deletes the January 1, 2013, expiration date applicable 
            to the nursing staff requirements for community treatment 
            facilities, thus making those staffing requirements 
            permanent.

          3.Authorizes DSS to extend a waiver of regulations relating 
            to foster care payments and the operation of group homes 
            beyond the current period of up to 3 years, in order to 
            sustain positive outcomes demonstrated as a result of the 
            waiver.  Provides that the extension shall continue until 
            rate setting reforms have been adopted.




                                  FISCAL IMPACT  

          This bill has not been analyzed by a fiscal committee

                            BACKGROUND AND DISCUSSION  

           Purpose of the bill
           
          According to the author, this bill enacts three minor 
          statutory changes related to the foster care program which 
          improve the efficiency of program administration and ensure 




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          the continuation of valuable services and supports provided 
          to vulnerable children and families. 

          Civil penalties for county licensed foster homes
          The author states that AB 978 (Benoit, Chapter 291, 
          Statutes of 2008) broadly amended statutes governing the 
          administration of civil penalties for community care 
          facilities (CCFs) in response to a California State Auditor 
          report investigating DSS oversight of licensed child care 
          facilities.  According to the author, small family homes 
          and foster homes certified by foster family agencies were 
          exempted from the civil penalties enacted in the bill; 
          however, licensed foster homes were left out, unbeknownst 
          to the counties who license these foster homes.  The author 
          states that this bill cleans up the inadvertent exclusion 
          of county licensed foster homes.

          According to the California Welfare Directors Association, 
          the sponsor for this provision of the bill, foster homes 
          are generally exempted from community care facility civil 
          penalties because significant violations of health and 
          safety standards would lead to the removal of the child 
          from the foster home rather than civil penalties.  The 
          sponsor points out that there is no policy justification 
          for exempting small family homes and foster homes certified 
          by foster agencies from civil penalties, but to exclude 
          county licensed foster homes from such an exemption.  The 
          California State Association of Counties writes that county 
          licensed foster homes are a key component of California's 
          child welfare system and that this bill will make it easier 
          to recruit and retain foster parents.

          Performance Agreement Waiver extension
          SB 933 (Thompson, Chapter 311, Statutes of 1998) provided 
          the initial authorization for counties to enter into 
          performance agreements with private nonprofit entities to 
          encourage innovation, develop services for children that 
          are not available in the community and promote change in 
          the child welfare system, and provided authority for DSS to 
          grant waivers upon the request of a county to enact those 
          performance agreements.  The initial legislation provided 
          that those agreements would remain in effect for three 
          years.  AB 488 (Torres and Hagman, Chapter 445, Statutes of 
          2009) authorized DSS to renew or extend those waivers for 
          an additional three years.  This bill would permit DSS to 




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          extend the waivers in order to sustain the positive 
          outcomes demonstrated as a result of the waiver until rate 
          setting reforms have been adopted.  

          Boys Republic represents five campuses located in San 
          Bernadino County and Los Angeles County, and is the only 
          nonprofit agency operating under this waiver at this time.  
          However, there is no statutory limitation on the number of 
          providers.  A contract compliance monitoring review of Boys 
          Republic completed by the Los Angeles County Probation 
          Department dated August 19, 2011 found minor deficiencies 
          requiring corrective action but that, "Generally, the 
          Agency is providing the services as outlined in their 
          program statement?Overall, the child interviews indicated 
          that the children are happy at the various Group Home 
          sites, and the Group Home staff treats them with respect.  
          They are satisfied with the personal living space as well 
          as their common living areas.  The children report that the 
          food is good, and they are given sufficient daily snacks."
                    
          According to the California Alliance of Child and Family 
          Services, the Boys Republic facility has been in operation 
          for more than 100 years and is widely recognized as a model 
          of rehabilitation for young men and women with significant 
          behavior issues and with moderate to serious offence 
          histories.  According to the Alliance, this model of care 
          serves as a placement alternative to locked juvenile 
          detention facilities and to the State-run Division of 
          Juvenile Justice.  The Alliance further states that this 
          bill would give the California Department of Social 
          Services the flexibility to extend waivers it has already 
          granted to counties, and is essential for Boys Republic to 
          continue to operate its highly successful program for 
          delinquent youth.

          Nurse staffing requirements for community treatment 
          facilities
          AB 1370 (Yee, Chapter 575, Statutes of 2003) provided that 
          community treatment facilities are not required by the 
          Department of Mental Health to have 24-hour onsite licensed 
          nursing staff, and instead must retain at least one 
          full-time, or full-time equivalent, registered nurse onsite 
          if the facility does not use mechanical restraint and only 
          admits children who have been assessed by a licensed 
          primary care provider and a licensed psychiatrist, who have 




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          concluded that the child does not require medical services 
          requiring 24-hour nursing coverage. This bill included a 
          sunset date of January 1, 2007.  AB 2776 (Yee, Chapter 796, 
          Statutes of 2006) extended the sunset to January 1, 2010.   
           SB 597 (Liu, Chapter 339, Statutes of 2009) extended the 
          sunset to January 1, 2013.

          According to the California Alliance of Child and Family 
          Services, the sponsor for this provision of the bill, 
          Community Treatment Facilities (CTFs) are residential 
          community care facilities which operate much like high 
          level RCL 14 residential group homes, but offer more 
          intensive staffing and provide for a locked perimeter to 
          assure the safety of emotionally disturbed children.  The 
          sponsor states that this provision has been used 
          successfully for eight years, and that this issue will have 
          been considered by the legislature four times should this 
          measure pass.

           Comments
           
          The following technical amendments are suggested to improve 
          clarity in the statute regarding nurse staffing 
          requirements for community treatment facilities. 

          Amendment 1: On page 4, line 18, delete "both" and insert 
          "all"

          Amendment 2: On page 4, line 33, delete "(2)" and insert 
          "(C)"

          Amendment 3: On page 4, line 36, delete "(3)" and insert 
          "(D)"

          Amendment 4: On page 5, line 1, delete "(4)" and insert 
          "(2)"
                                    POSITIONS


           Support:
                                                                      

          California Alliance for Child and Family Services - sponsor
          California Welfare Directors Association - sponsor
          Boys Republic - sponsor




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          California State Association of Counties
          City of Chino

          Oppose:   none received





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