BILL ANALYSIS                                                                                                                                                                                                    �






                                  SENATE HUMAN
                               SERVICES COMMITTEE
                            Senator Jim Beall, Chair


          BILL NO:       AB 578                                       
          A
          AUTHOR:        Dickinson                                    
          B
          VERSION:       June 11, 2014
          HEARING DATE:  July 24, 2014                                
          5
          FISCAL:        Yes                                          
          7
                                                                      
          8
          CONSULTANT:    Sara Rogers                                 

                                        

                                     SUBJECT
                                         
                            Crisis nurseries: study

                                     SUMMARY  

          This bill establishes a two-year pilot project in  
          Sacramento and Yolo counties for the purpose of evaluating  
          the effectiveness of crisis nurseries, as specified. This  
          bill also requires the California Department of Social  
          Services (CDSS) to conduct a study of the relationship  
          between crisis respite care and incidents of child abuse.  
          Additionally, this bill states Legislative intent to  
          provide state funding for crisis nurseries.

                                     ABSTRACT  

           Existing Law:
           
          1)Enacts the Community Care Facilities Act, which provides  
            for the licensure and oversight of out-of-home placements  
            of abused and neglected children by CDSS. The Act defines  
            a "crisis nursery" as a facility licensed to provide  
            short-term, 24-hour residential care and supervision for  
            children under the age of six who are voluntarily placed  

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            by their parent or guardian due to a family crisis or  
            stressful situation for not more than 30 days. (HSC 1516)


          2)Exempts crisis nurseries from licensure as a child day  
            care facility under the California Child Care and  
            Development Services Act. (HSC 1596.792)


          3)Establishes the maximum licensed capacity for a crisis  
            nursery as 14 children and requires each crisis nursery  
            to collect and maintain information indicating the total  
            number of children placed in the program, the length of  
            stay, the reasons given for the use of the crisis  
            nursery, and the age of each child. (HSC 1516 (d)(1) and  
            (e))


          4)Provides that a crisis nursery may provide child day care  
            services for children under the age of six at the same  
            site as the crisis nursery, that each child may receive  
            services for no more than 30 calendar days in a six month  
            period and that the child receiving such services shall  
            be counted against the licensed capacity of the crisis  
            nursery. (HSC 1516 (f))


           This bill:


           1)Requires CDSS to implement a two-year pilot project in  
            Sacramento and Yolo counties for the purpose of  
            evaluating the effectiveness of crisis nurseries in  
            lowering the incidence of child abuse in those counties. 


          2)Conditions implementation of the pilot on the voluntary  
            participation of all of the crisis nurseries in those  
            counties and on those counties providing private funding  
            for one-half of the cost of the project. 


          3)Requires that the pilot project shall consist of both of  
            the following:






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                 A CDSS conducted study of the relationship between  
               crisis respite care and incidents of reported child  
               abuse in pilot project counties,
                 A CDSS report the results of the study to the  
               Legislature on or before December 31, 2016, as  
               specified.


          1)States Legislative intent to provide state funding for  
            crisis nurseries in the Budget Act of 2014 in order to  
            enable crisis nurseries to continue to provide services  
            to the community and to participate in the pilot project  
            established by this section.


          2)Enacts a sunset on the above provisions on January 1,  
            2017.


                                  FISCAL IMPACT  

          The Senate Budget Committee, in an informational  
          consideration for a similar proposal states that $2.4  
          million GF, over two years, is requested to fund a pilot  
          project to evaluate the durability of the December 2006  
          ARCH National Respite Network and Resource Center (NRNRC)  
          study results by evaluating the Sacramento and Yolo Crisis  
          Nurseries. The study is contingent on matching private and  
          local support.

                            BACKGROUND AND DISCUSSION  

           Purpose of the bill:


           According the author, Yolo and Sacramento Counties each  
          have Crisis Nurseries which have been linked to studies  
          indicating cost savings for the state, and preventing child  
          abuse. However, now funding has ceased which may prevent  
          their existence, and documentation of their success.


          The author cites a two-year study published in 2006  
          examining the relationships between crisis respite care and  
          incidents of reported child abuse. According to the author,  





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          the study provided evidence that Child Protective Services  
          (CPS) reports on families that accessed crisis respite were  
          significantly less likely to be substantiated than CPS  
          reports on comparison families without crisis respite  
          available. It found that families receiving respite or  
          crisis resolution services were half as likely to have a  
          CPS investigation substantiated than were those who  
          utilized crisis respite with previous CPS involvement.  
          Further, when parents were asked what alternative choices  
          they would have pursued had a crisis nursery not been  
          available, 26 percent said would have either requested  
          foster care placement or been unable to provide for their  
          children. 


           Crisis Nursery Model


           Crisis nurseries first were developed as a grassroots  
          movement in the 1960's as a temporary or emergency care  
          model for children at risk of abuse or neglect, and were  
          initially funded through private donations.<1> In 1986,  
          Congress passed the Temporary Child Care for Children with  
          Disabilities and Crisis Nurseries Act, which established  
          federal funding to create temporary child care  
          demonstration projects including crisis nursery services.  
          Beginning in 1988, competitive federal grants were awarded  
          to private and public agencies across the United States to  
          assist them in developing crisis nursery services, funding  
          that has subsequently been eliminated. 


          Crisis nurseries were created as a separate licensing  
          category under the Community Care Facilities Act under SB  
          855 (Machado), Chapter 664, Statutes of 2004, to provide a  
          temporary and emergency housing and shelter facility option  
          for parents.  The intent of the care model is to provide a  
          voluntary 24-hour placement option for young children when  
          their families are facing difficult or extreme financial,  
          health, or other challenges to prevent the engagement of  
          -------------------------


          <1> Cole, Susan.  Crisis nurseries: Important services in a  
          system of care for families and children.  University of  
          Illinois School of Social Work. September 2004.






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          child welfare services. Under the statute, the crisis  
          nurseries were limited to specified counties and were  
          intended to serve children under the age of six who were  
          voluntarily placed by a parent or guardian or, under  
          limited circumstances, were temporarily placed by a county  
          child welfare service agency.


          Prior to the passage of SB 855, crisis nurseries were  
          licensed as group homes under the Community Care Facility  
          Act, although critics argued that those regulations were  
          excessive and inappropriate for crisis nurseries due to  
          differences between the care needs of very young children  
          who were voluntarily placed by a parent and the needs of  
          children that were removed from parental custody by county  
          child protective services workers due to abuse or neglect.  
          The bill at that time included a sunset of January 1, 2008,  
          which was subsequently extended to January 1, 2014. Due to  
          concerns that crisis nurseries were serving as temporary  
          placements for children removed from their homes by county  
          social workers, SB 1214 (Wolk) Chapter 519, Statutes of  
          2010 eliminated crisis nurseries as an allowable child  
          welfare placement, effective January 1, 2012. Following  
          this agreement, the state eliminated the sunset, allowing  
          crisis nurseries to exist permanently under SB 1319 (Liu)  
          Chapter 663, Statutes of 2012.  


          Currently, there are five crisis nurseries licensed in  
          California, one each in Concord, Davis, Nevada City and two  
          in Sacramento.  Since 2009, more than 9,000 children have  
          been served by these nurseries. On average, the lengths of  
          stay have ranged from eight hours to just over 24 hours  
          with 44 children staying for the maximum allowable days.   
          No exemptions have been requested for children to stay  
          beyond the 30-day limit. 


          Currently there are no state or federal monies made  
          available to crisis nurseries, with all five nurseries  
          relying upon philanthropic support and local funds to  
          operate (some facilities may receive funding through their  
          Local First Five Commission). In many instances a related  
          group home provider will support and manage a local crisis  
          nursery, usually at a substantial financial loss. As a  





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          result, crisis nurseries rely substantially on trained  
          volunteers to meet the staffing requirements. 


          Crisis Nursery Day Care Services


          Currently, in addition to the provision of 24-hour care  
          provided to children, many crisis nurseries provide respite  
          day care service to families. In such instances, the crisis  
          nursery must either count a child receiving day care  
          services against their maximum licensed capacity of 14  
          children, or they must be separately licensed as a day  
          care. However, unlike traditional child care providers,  
          crisis nurseries are permitted to use volunteers to count  
          toward the caregiver-child ratios. Crisis nursery staff and  
          volunteers are subject to the same criminal record  
          clearance requirements as child care providers and the  
          education and experience requirements are similar to those  
          of teachers in child care regulations.<2> 


          Budget Committee hearing on similar proposal


          The Senate Budget Committee heard, as an informational  
          item, a similar proposal to that proposed under this bill.  
          The committee declined to take action on the proposal,  
          deferring to the policy committee process. As background,  
          the committee provided the following information:


                      Usage data for the Yolo Crisis Nursery


           EMQ Families First Yolo Crisis
          Nursery
                                  CY 2009    CY 2010    CY 2011    CY  
                         2012    CY 2013   Total
          Respite Day Services
          # of 30 day stays per facility          0             0     
          0                          0           0              0
          -------------------------
          <2> CCR Title 22 101216.1






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          # of kids the facility has served       381          339   
          368            329             372         1789
          Average length of stay per child, per
          facility (days)          1.25           1.28             
          1.19             1.32           1.43          1.29


          Overnight Services
          # of 30 day stays per facility         0                1    
                        0                  0                0          
                1
          # of kids the facility has served              73            
              88              101              38                6     
                   306
          Average length of stay per facility
          (nights)                                               5.45  
                                             4.74   3      3.71        
             3.67          2.93


            Budget history of both Sacramento Crisis Nursery and Yolo  
                                 Crisis Nursery
           
          Sacramento Crisis Nurseries
          o FY 2012- 13, total expense of $2,136,724, with a deficit  
          of $566,724.
          o FY 2013-14 (projected), total expense will be $2,015,452,  
          with deficit of $500,697.


          Yolo Crisis Nursery
          o FY 2012-13, total expense was $603,000, with a loss of  
          $438,000.
          o FY 2013-2014 (projected), total expense will be $659,000,  
          with loss of $480,000.


          Crisis Nursery Outcomes 












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          A 2004 report<3> studying crisis nursery outcomes cites a  
          literature review from 1980 that identified crisis  
          nurseries "along with access to counseling for parents as  
          extremely inexpensive forms of prevention when compared to  
          the cost of foster care placements."


          The report also cites a study that found that "thirty-six  
          parents reported a decrease in parenting stress for  
          problems related to their children as well as financial and  
          housing problems when they accessed crisis nursery services  
          and that "parents using crisis nursery services also  
          reported significant improvements in parenting stress based  
          on pre- and post-test scores on the Parenting Stress  
          Index/Short Form." 


          Additionally, the report cites a user survey in which  
          caregivers reported that "if crisis nursery services were  
          not available they might choose to leave their children  
          alone, in the care of an inappropriate caregiver, or have  
          the child accompany them to a place the parent perceived as  
          dangerous for the child." However, the report states there  
          is "limited research addresses the role crisis nurseries  
          play in strengthening families and developing independence  
          beyond time-limited crisis intervention." 


           Related Legislation:


           SB 2228 (Cooley) 2014 revises the licensing requirements  
          for crisis nurseries and onsite day care centers. This bill  
          is being heard in this committee today.


          SB 855 (Machado) Chapter 664, Statutes of 2004 established  
          Crisis Nurseries as a separate licensing category, with a  
          sunset date of January 1, 2009.

          -------------------------
          <3> Cole, Susan.  Crisis nurseries: Important services in a  
          system of care for families and children.  University of  
          Illinois School of Social Work. September 2004.






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          SB 104 (Machado) Chapter 288, Statutes of 2007 extended the  
          sunset date to January 1, 2011.


          SB 1214 (Wolk) Chapter 519, Statutes of 2010 extended the  
          sunset date to January 1, 2014, but eliminated provisions  
          permitting Crisis Nurseries to provide emergency respite  
          care for a limited number of foster children.  Effective  
          July 1, 2012, Crisis Nurseries were only permitted to serve  
          children placed voluntarily by their parents or legal  
          guardians.


           SB 1319 (Liu) Chapter 663, Statutes of 2012 eliminated the  
          sunset date.


                                     COMMENTS

           This bill states it is the intent of the legislature to  
          provide state funding in the 2014 Budget Act for the  
          purposes specified in this bill. This year, though this  
          item was heard in budget committee, no appropriation was  
          included. 


          Staff recommends amending the bill to strike Lines 15-17 on  
          Page 3 inclusive, referencing intent language referring to  
          the budget appropriation, as follows:


          1517. (a) The department shall implement a two-year pilot  
          project in the County of Sacramento and the County of Yolo  
          for the purpose of evaluating the effectiveness of crisis  
          nurseries in lowering the incidence of child abuse in those  
          counties. This pilot project shall be implemented only if  
          all of the crisis nurseries in those counties voluntarily  
          participate in the project and provide private funding for  
          one-half of the cost of the project. The pilot project  
          shall consist of both of the following:


          (1) The department shall conduct a study of the  
          relationship between crisis respite care and incidents of  





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          reported child abuse in pilot project counties.


          (2) The department shall report the results of the study to  
          the Legislature on or before December 31, 2016, pursuant to  
          Section 9795 of the Government Code.


            (b) It is the intent of the Legislature to provide state  
          funding for crisis nurseries in the Budget Act of 2014 in  
          order to enable crisis nurseries to continue to provide  
          services to the community and to participate in the pilot  
          project established by this section.


           (c)  (b) This section shall remain in effect only until  
          January 1, 2017, and as of that date is repealed, unless a  
          later enacted statute, that is enacted before January 1,  
          2017, deletes or extends that date.

          Additionally, the author has requested to add Senator Wolk  
          as a principal co-author. 
          
                                   PRIOR VOTES 

          This version of the bill has not been voted upon. Prior  
          votes related to language that was stricken and in the  
          jurisdiction of another committee. 

                                    POSITIONS  

          Support:       California Professional Fire Fighters 
                         EMQ Families First
                         Friends of the Yolo Crisis Nursery

          Oppose:   None received.



                                   -- END --
          









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