Bill Text: CA AB226 | 2021-2022 | Regular Session | Introduced


Bill Title: Children’s crisis psychiatric residential treatment facilities.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced) 2021-01-12 - From printer. May be heard in committee February 11. [AB226 Detail]

Download: California-2021-AB226-Introduced.html


CALIFORNIA LEGISLATURE— 2021–2022 REGULAR SESSION

Assembly Bill
No. 226


Introduced by Assembly Member Ramos

January 11, 2021


An act to amend Sections 1502, 1562.02, and 1562.03 of the Health and Safety Code, and to amend Sections 11462.01 and 11462.011 of the Welfare and Institutions Code, relating to community care facilities.


LEGISLATIVE COUNSEL'S DIGEST


AB 226, as introduced, Ramos. Children’s crisis psychiatric residential treatment facilities.
The California Community Care Facilities Act (act), among other things, licenses and regulates children’s crisis residential programs and requires a children’s crisis residential program to meet specified requirements that include obtaining and having in good standing a residential mental health program approval that is available to children under the California Work Opportunity and Responsibility to Kids (CalWORKs) program. The CalWORKs program generally provides cash assistance and other benefits to qualified low-income families and individuals and specifically authorizes a children’s crisis residential program to provide a child, under specified conditions, with short-term crisis stabilization, therapeutic intervention, and specialized programming with the goal of supporting the rapid and successful transition of the child back to the community.
This bill would amend the act and related CalWORKs provisions to instead use the term “children’s crisis psychiatric treatment facility.” The bill would delete the requirement for residential mental health program approval and instead require a children’s crisis psychiatric residential treatment facility to obtain and have in good standing a certification that conforms to federal Medicaid psychiatric residential treatment facility requirements and makes the facility eligible for federal reimbursement as a Medicaid psychiatric residential treatment facility, as specified.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: NO  

The people of the State of California do enact as follows:


SECTION 1.

 Section 1502 of the Health and Safety Code is amended to read:

1502.
 As used in this chapter:
(a) “Community care facility” means any facility, place, or building that is maintained and operated to provide nonmedical residential care, day treatment, adult daycare, or foster family agency services for children, adults, or children and adults, including, but not limited to, the physically handicapped, mentally impaired, incompetent persons, and abused or neglected children, and includes the following:
(1) “Residential facility” means any family home, group care facility, or similar facility determined by the department, for 24-hour nonmedical care of persons in need of personal services, supervision, or assistance essential for sustaining the activities of daily living or for the protection of the individual.
(2) “Adult day program” means any community-based facility or program that provides care to persons 18 years of age or older in need of personal services, supervision, or assistance essential for sustaining the activities of daily living or for the protection of these individuals on less than a 24-hour basis.
(3) “Therapeutic day services facility” means any facility that provides nonmedical care, counseling, educational or vocational support, or social rehabilitation services on less than a 24-hour basis to persons under 18 years of age who would otherwise be placed in foster care or who are returning to families from foster care. Program standards for these facilities shall be developed by the department, pursuant to Section 1530, in consultation with therapeutic day services and foster care providers.
(4) “Foster family agency” means any public agency or private organization, organized and operated on a nonprofit basis, engaged in any of the following:
(A) Recruiting, certifying, approving, and training of, and providing professional support to, foster parents and resource families.
(B) Coordinating with county placing agencies to find homes for foster children in need of care.
(C) Providing services and supports to licensed or certified foster parents, county-approved resource families, and children to the extent authorized by state and federal law.
(5) “Foster family home” means 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. The placement may be by a public or private child placement agency or by a court order, or by voluntary placement by a parent, parents, or guardian. It also means a foster family home described in Section 1505.2.
(6) “Small family home” means 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. A small family home may accept children with special health care needs, pursuant to subdivision (a) of Section 17710 of the Welfare and Institutions Code. In addition to placing children with special health care needs, the department may approve placement of children without special health care needs, up to the licensed capacity.
(7) “Social rehabilitation facility” means any residential facility that provides social rehabilitation services for no longer than 18 months in a group setting to adults recovering from mental illness who temporarily need assistance, guidance, or counseling. Program components shall be subject to program standards pursuant to Article 1 (commencing with Section 5670) of Chapter 2.5 of Part 2 of Division 5 of the Welfare and Institutions Code.
(8) “Community treatment facility” means any residential facility that provides mental health treatment services to children in a group setting and that has the capacity to provide secure containment. Program components shall be subject to program standards developed and enforced by the State Department of Health Care Services pursuant to Section 4094 of the Welfare and Institutions Code.

Nothing in this section shall be construed to

This section does not prohibit or discourage placement of persons who have mental or physical disabilities into any category of community care facility that meets the needs of the individual placed, if the placement is consistent with the licensing regulations of the department.
(9) (A) “Full-service adoption agency” means any licensed entity engaged in the business of providing adoption services, that does all of the following:
(i) Assumes care, custody, and control of a child through relinquishment of the child to the agency or involuntary termination of parental rights to the child.
(ii) Assesses the birth parents, prospective adoptive parents, or child.
(iii) Places children for adoption.
(iv) Supervises adoptive placements.
(B) Private full-service adoption agencies shall be organized and operated on a nonprofit basis. As a condition of licensure to provide intercountry adoption services, a full-service adoption agency shall be accredited and in good standing according to Part 96 (commencing with Section 96.1) of Title 22 of the Code of Federal Regulations, or supervised by an accredited primary provider, or acting as an exempted provider, in compliance with Subpart F (commencing with Section 96.29) of Part 96 of Title 22 of the Code of Federal Regulations.
(10) (A) “Noncustodial adoption agency” means any licensed entity engaged in the business of providing adoption services, that does all of the following:
(i) Assesses the prospective adoptive parents.
(ii) Cooperatively matches children freed for adoption, who are under the care, custody, and control of a licensed adoption agency, for adoption, with assessed and approved adoptive applicants.
(iii) Cooperatively supervises adoption placements with a full-service adoptive agency, but does not disrupt a placement or remove a child from a placement.
(B) Private noncustodial adoption agencies shall be organized and operated on a nonprofit basis. As a condition of licensure to provide intercountry adoption services, a noncustodial adoption agency shall be accredited and in good standing according to Part 96 (commencing with Section 96.1) of Title 22 of the Code of Federal Regulations, or supervised by an accredited primary provider, or acting as an exempted provider, in compliance with Subpart F (commencing with Section 96.29) of Part 96 of Title 22 of the Code of Federal Regulations.
(11) “Transitional shelter care facility” means any group care facility that provides for 24-hour nonmedical care of persons in need of personal services, supervision, or assistance essential for sustaining the activities of daily living or for the protection of the individual. Program components shall be subject to program standards developed by the State Department of Social Services pursuant to Section 1502.3.
(12) “Transitional housing placement provider” means an organization licensed by the department pursuant to Section 1559.110 to provide transitional housing to foster children who are at least 16 years of age to promote their transition to adulthood. A transitional housing placement provider shall be privately operated and organized on a nonprofit basis.
(13) “Group home” means a residential facility that provides 24-hour care and supervision to children, delivered at least in part by staff employed by the licensee in a structured environment. The care and supervision provided by a group home shall be nonmedical, except as otherwise permitted by law.
(14) “Youth homelessness prevention center” means a group home licensed by the department to operate a program pursuant to Section 1502.35 to provide voluntary, short-term, shelter and personal services to homeless youth, youth who are at risk of homelessness, youth who are exhibiting status offender behavior, or runaway youth, as defined in paragraph (2) of subdivision (a) of Section 1502.35.
(15) “Enhanced behavioral supports home” means a facility certified by the State Department of Developmental Services pursuant to Article 3.6 (commencing with Section 4684.80) of Chapter 6 of Division 4.5 of the Welfare and Institutions Code, and licensed by the State Department of Social Services as an adult residential facility or a group home that provides 24-hour nonmedical care to individuals with developmental disabilities who require enhanced behavioral supports, staffing, and supervision in a homelike setting. An enhanced behavioral supports home shall have a maximum capacity of four consumers, shall conform to Section 441.530(a)(1) of Title 42 of the Code of Federal Regulations, and shall be eligible for federal Medicaid home- and community-based services funding.
(16) “Community crisis home” means a facility certified by the State Department of Developmental Services pursuant to Article 8 (commencing with Section 4698) of Chapter 6 of Division 4.5 of the Welfare and Institutions Code, and licensed by the State Department of Social Services pursuant to Article 9.7 (commencing with Section 1567.80), as an adult residential facility, providing 24-hour nonmedical care to individuals with developmental disabilities receiving regional center service, in need of crisis intervention services, and who would otherwise be at risk of admission to the acute crisis center at Fairview Developmental Center, Sonoma Developmental Center, an acute general hospital, acute psychiatric hospital, an institution for mental disease, as described in Part 5 (commencing with Section 5900) of Division 5 of the Welfare and Institutions Code, or an out-of-state placement. A community crisis home shall have a maximum capacity of eight consumers, as defined in subdivision (a) of Section 1567.80, shall conform to Section 441.530(a)(1) of Title 42 of the Code of Federal Regulations, and shall be eligible for federal Medicaid home- and community-based services funding.
(17) “Crisis nursery” means a facility licensed by the department to operate a program pursuant to Section 1516 to provide short-term care and supervision for children under six years of age who are voluntarily placed for temporary care by a parent or legal guardian due to a family crisis or stressful situation.
(18) “Short-term residential therapeutic program” means a residential facility operated by a public agency or private organization and licensed by the department pursuant to Section 1562.01 that provides an integrated program of specialized and intensive care and supervision, services and supports, treatment, and short-term, 24-hour care and supervision to children. The care and supervision provided by a short-term residential therapeutic program shall be nonmedical, except as otherwise permitted by law. Private short-term residential therapeutic programs shall be organized and operated on a nonprofit basis. A short-term residential therapeutic program may be operated as a children’s crisis residential program. psychiatric residential treatment facility.
(19) “Private alternative boarding school” means a group home licensed by the department to operate a program pursuant to Section 1502.2 to provide youth with 24-hour residential care and supervision, which, in addition to providing educational services to youth, provides, or holds itself out as providing, behavioral-based services to youth with social, emotional, or behavioral issues. The care and supervision provided by a private alternative boarding school shall be nonmedical, except as otherwise permitted by law.
(20) “Private alternative outdoor program” means a group home licensed by the department to operate a program pursuant to Section 1502.21 to provide youth with 24-hour residential care and supervision, which provides, or holds itself out as providing, behavioral-based services in an outdoor living setting to youth with social, emotional, or behavioral issues. The care and supervision provided by a private alternative outdoor program shall be nonmedical, except as otherwise permitted by law.
(21) “Children’s crisis residential program” psychiatric residential treatment facility means a facility licensed by the department as a short-term residential therapeutic program pursuant to Section 1562.02 and approved by the State Department of Health Care Services, or a county mental health plan to which the State Department of Health Care Services has delegated approval authority, to operate a children’s crisis residential mental health program approval psychiatric residential treatment facility certified pursuant to Section 11462.011 of the Welfare and Institutions Code, to serve children experiencing mental health crises as an alternative to psychiatric hospitalization.
(b) “Department” or “state department” means the State Department of Social Services.
(c) “Director” means the Director of Social Services.

SEC. 2.

 Section 1562.02 of the Health and Safety Code is amended to read:

1562.02.
 (a) The department may license a short-term residential therapeutic program operating as a children’s crisis residential program pursuant psychiatric residential treatment facility to this chapter. A children’s crisis residential program psychiatric residential treatment facility shall meet all of the following requirements:
(1) If the program serves both children who are not experiencing mental health crises and children who are experiencing mental health crises, the program shall have an identifiable and physically separate unit for those children who are experiencing mental health crises. The separate unit shall be indicated on the short-term residential therapeutic program’s license.
(2) If the short-term residential therapeutic program operates on a single site both a program that serves children who are not experiencing mental health crises and a separate program that only serves children experiencing mental health crises, the short-term residential therapeutic program shall obtain, and have in good standing, a mental health program approval, as described in Section 11462.01 of the Welfare and Institutions Code, and a children’s crisis residential mental health program approval, psychiatric residential treatment facility certification, as described in Section 11462.011 of the Welfare and Institutions Code, both of which are issued by the State Department of Health Care Services, or by a county mental health plan to which the department has delegated approval authority. The short-term residential therapeutic program shall obtain a mental health program approval before operating as a children’s crisis residential program. authority, that conforms to federal Medicaid psychiatric residential treatment facility (PRTF) requirements and is, therefore, eligible for federal reimbursement as a PRTF. The department may revoke a program’s license pursuant to Section 1550 for a program’s failure to maintain the mental health program approval.
(3) If the short-term residential therapeutic program serves only children experiencing a mental health crisis, the short-term residential therapeutic program shall obtain, and have in good standing, a children’s crisis residential mental health program approval, psychiatric residential treatment facility certification, as described in Section 11462.011 of the Welfare and Institutions Code, which is issued by the State Department of Health Care Services or by a county mental health plan to which the department has delegated approval authority. The short-term residential therapeutic program shall obtain a mental health program approval before operating as a children’s crisis residential program. psychiatric residential treatment facility. The department may revoke a program’s license pursuant to Section 1550 for a program’s failure to maintain the mental health program approval.
(4) Comply with all applicable licensing standards for a short-term residential therapeutic program, unless the department specifies otherwise in regulations that comply with applicable statutory requirements related to licensure.
(b) Contingent upon an appropriation in the annual Budget Act for these purposes, the department shall begin implementation of this section no later than July 1, 2018, and shall commence the licensing process for children’s crisis residential programs no later than January 1, 2019. psychiatric residential treatment facilities no later than January 1, 2022.

SEC. 3.

 Section 1562.03 of the Health and Safety Code is amended to read:

1562.03.
 (a) The department shall establish regulations for short-term residential therapeutic programs that are operated as children’s crisis residential programs. psychiatric residential treatment facilities. At a minimum, the regulations shall include all of the following:
(1) Therapeutic programming shall be provided seven days a week, including weekends and holidays, with sufficient mental health professional and paraprofessional staff, as required by the facility’s children’s crisis residential mental health program approval in accordance with the standards and procedures established pursuant to Section 11462.011 of the Welfare and Institutions Code, to maintain an appropriate treatment setting and services, based on individual children’s needs.
(2) The program shall be staffed with sufficient personnel to accept children 24 hours per day, seven days a week and to admit children, at a minimum, from 7 a.m. to 11 p.m., seven days a week, 365 days per year. The program shall be sufficiently staffed to discharge children, as appropriate, seven days a week, 365 days per year.
(3) Facilities shall be limited to fewer than 16 beds, with at least 50 percent of those beds in single-occupancy rooms.
(4) Facilities shall include ample physical space for accommodating individuals who provide daily emotional and physical supports to each child and for integrating family members into the day-to-day care of the youth.
(5) The program shall collaborate with each child’s existing mental health team, if applicable, child and family team, if applicable, and other formal and natural supports within 24 hours of intake and throughout the course of care and treatment as appropriate.
(6) The program shall create and assist with the implementation of a plan for transitioning each admitted child from the program to his or her their home and community, including the establishment of a mental health or child and family team if there is not one already.
(b) The program shall annually provide the department with all of the following data as it pertains to children in foster care and children not in foster care in conjunction with its application for licensure renewal:
(1) Age and gender of clients served.
(2) Duration of stay.
(3) Professional classification of staff and contracted staff.
(4) Type of placement the client was discharged to.

SEC. 4.

 Section 11462.01 of the Welfare and Institutions Code is amended to read:

11462.01.
 (a) (1) If a program will admit Medi-Cal beneficiaries, no later than 12 months following the date of initial licensure, a short-term residential therapeutic program, as defined in subdivision (ad) of Section 11400 of this code and paragraph (18) of subdivision (a) of Section 1502 of the Health and Safety Code, shall obtain a contract, subject to an agreement on rates and terms and conditions, with a county mental health plan to provide specialty mental health services and demonstrate the ability to meet the therapeutic needs of each child, as identified in any of the following:
(A) A mental health assessment.
(B) The child’s case plan.
(C) The child’s needs and services plan.
(D) Other documentation demonstrating the child has a mental health need.
(2) A short-term residential therapeutic program shall comply with any other mental health program approvals required by the State Department of Health Care Services or by a county mental health plan to which mental health program approval authority has been delegated.
(b) A short-term residential therapeutic program, except as specified in subdivision (c), may accept for placement a child who meets both of the criteria in paragraphs (1) and (2) and at least one of the conditions in paragraph (3).
(1) The child does not require inpatient care in a licensed health facility. For purposes of this paragraph, “inpatient care in a licensed health facility” does not include care provided in a children’s crisis psychiatric residential treatment facility.
(2) The child has been assessed as requiring the level of services provided in a short-term residential therapeutic program in order to maintain the safety and well-being of the child or others due to behaviors, including those resulting from traumas, that render the child or those around the child unsafe or at risk of harm, or that prevent the effective delivery of needed services and supports provided in the child’s own home or in other family settings, such as with a relative, guardian, foster family, resource family, or adoptive family. The assessment shall ensure the child has needs in common with other children or youth in the care of the facility, consistent with subdivision (c) of Section 16514.
(3) The child meets at least one of the following conditions:
(A) The child has been assessed, pursuant to Section 4096, as meeting the medical necessity criteria for Medi-Cal specialty mental health services, as provided for in Section 1830.205 or 1830.210 of Title 9 of the California Code of Regulations.
(B) The child has been assessed, pursuant to Section 4096, as seriously emotionally disturbed, as defined in subdivision (a) of Section 5600.3.
(C) The child requires emergency placement pursuant to paragraph (3) of subdivision (h).
(D) The child has been assessed, pursuant to Section 4096, as requiring the level of services provided by the short-term residential therapeutic program in order to meet his or her the child’s behavioral or therapeutic needs.
(4) Subject to the requirements of this subdivision, a short-term residential therapeutic program may have a specialized program to serve a child, including, but not limited to, the following:
(A) A commercially sexually exploited child.
(B) A private voluntary placement, if the youth exhibits status offender behavior, the parents or other relatives feel they cannot control the child’s behavior, and short-term intervention is needed to transition the child back into the home.
(C) A juvenile sex offender.
(D) A child who is affiliated with, or impacted by, a gang.
(c) (1) A short-term residential therapeutic program that is operating as a children’s crisis residential program, psychiatric residential treatment facility, as defined in Section 1502 of the Health and Safety Code, may accept for admission any child who meets all of the requirements set forth in paragraph (3) of subdivision (c) of Section 11462.011.
(2) The primary function of a children’s crisis residential program psychiatric residential treatment facility is to provide short-term crisis stabilization, therapeutic intervention, and specialized programming in an unlocked, staff-secured setting with a high degree of supervision and structure and the goal of supporting the rapid and successful transition of the child back to the community.
(d) A foster family agency that is certified as a Medi-Cal specialty mental health provider pursuant to Section 1810.435 of Title 9 of the California Code of Regulations by the State Department of Health Care Services, or by a county mental health plan to which the department has delegated certification authority, and which has entered into a contract with a county mental health plan pursuant to Section 1810.436 of Title 9 of the California Code of Regulations, shall provide, or provide access to, specialty mental health services to children under its care who do not require inpatient care in a licensed health facility and who meet the medical necessity criteria for Medi-Cal specialty mental health services provided for in Section 1830.205 or 1830.210 of Title 9 of the California Code of Regulations.
(e) A foster family agency that is not certified as a Medi-Cal specialty mental health provider shall provide access to specialty and non-specialty mental health services in that program for children who do not require inpatient care in a licensed health facility and who meet any of the conditions in paragraph (3) of subdivision (b). In this situation the foster family agency shall do the following:
(1) In the case of a child who is a Medi-Cal beneficiary, arrange for specialty mental health services from the county mental health plan.
(2) In all other cases, arrange for the child to receive mental health services.
(f) All short-term residential therapeutic programs shall maintain the level of care and services necessary to meet the needs of the children and youth in their care and shall maintain and have in good standing the appropriate mental health program approval. If a program will admit Medi-Cal beneficiaries, the mental health program approval shall include a certification to provide Medi-Cal specialty mental health services issued by the State Department of Health Care Services or a county mental health plan to which the department has delegated mental health program approval authority, pursuant to Section 4096.5 of this code or Section 1810.435 or 1810.436 of Title 9 of the California Code of Regulations. All foster family agencies that are certified as a Medi-Cal specialty mental health provider pursuant to Section 1810.435 of Title 9 of the California Code of Regulations shall maintain the level of care and services necessary to meet the needs of children and youth in their care and shall maintain and have in good standing the Medi-Cal specialty mental health provider certification issued by the State Department of Health Care Services or a county mental health plan to which the department has delegated certification authority.
(g) The assessments described in subparagraphs (A), (B), (C), and (D) of paragraph (3) of subdivision (b) shall ensure the child’s individual behavioral or treatment needs are consistent with, and can be met by, the facility and shall be made by one of the following, as applicable:
(1) An interagency placement committee, as described in Section 4096, considering the recommendations from the child and family team, if any are available. If the short-term residential therapeutic program serves children who are placed by county child welfare agencies and children who are placed by probation departments, the interagency placement committee shall also ensure the requirements of subdivision (c) of Section 16514 have been met with respect to commonality of need.
(2) A licensed mental health professional as defined in subdivision (g) of Section 4096.
(3) An individualized education program team. For the purposes of this section, an AFDC-FC funded child with an individualized education program developed pursuant to Article 2 (commencing with Section 56320) of Chapter 4 of Part 30 of Division 4 of Title 2 of the Education Code that assesses the child as seriously emotionally disturbed, as defined in, and subject to, this section and recommends out-of-home placement at the level of care provided by the provider, shall be deemed to have met the assessment requirement.
(4) The placing agency, with input from the child and family team. The assessment described in subparagraph (D) of paragraph (3) of subdivision (b) shall be made pursuant to subdivision (b) of Section 706.6 or paragraph (2) of subdivision (d) of Section 16501.1.
(h) (1) The provider shall ensure that AFDC-FC funded children, assessed pursuant to subparagraphs (A) and (B) of paragraph (3) of subdivision (b), who are accepted for placement have been approved for placement by an interagency placement committee, as described in Section 4096, except as provided for in paragraphs (3) and (4) of subdivision (g).
(2) The approval shall be in writing and shall indicate that the interagency placement committee has determined one of the following:
(A) The child meets the medical necessity criteria for Medi-Cal specialty mental health services, as provided for in Section 1830.205 or 1830.210 of Title 9 of the California Code of Regulations.
(B) The child is seriously emotionally disturbed, as described in subdivision (a) of Section 5600.3.
(3) (A) Nothing in subdivisions (a) to (g), inclusive, or this subdivision shall This subdivision and subdivisions (a) to (g), inclusive, do not prevent an emergency placement of a child or youth into a certified short-term residential therapeutic program prior to the determination by the interagency placement committee, but only if a licensed mental health professional, as defined in subdivision (g) of Section 4096, has made a written determination within 72 hours of the child’s or youth’s placement, that the child or youth requires the level of services and supervision provided by the short-term residential therapeutic program in order to meet his or her their behavioral or therapeutic needs. If the short-term residential therapeutic program serves children placed by county child welfare agencies and children placed by probation departments, the interagency placement committee shall also ensure the requirements of subdivision (c) of Section 16514 have been met with respect to commonality of need.
(i) The interagency placement committee, as appropriate, shall, within 30 days of placement, make the determinations, with recommendations from the child and family team, required by this subdivision.
(ii) If it determines the placement is appropriate, the interagency placement committee, with recommendations from the child and family team, shall transmit the approval, in writing, to the county placing agency and the short-term residential therapeutic program.
(iii) If it determines the placement is not appropriate, the interagency placement committee shall respond pursuant to subparagraph (B).
(B) (i) If the interagency placement committee determines at any time that the placement is not appropriate, it shall, with recommendations from the child and family team, transmit the disapproval, in writing, to the county placing agency and the short-term residential therapeutic program and shall include a recommendation as to the child’s appropriate level of care and placement to meet his or her their service needs. The necessary interagency placement committee representative or representatives shall participate in any child and family team meetings to refer the child or youth to an appropriate placement, as specified in this section.
(ii) The child may remain in the placement for the amount of time necessary to identify and transition the child to an alternative, suitable placement.
(iii) Notwithstanding clause (ii), if the interagency placement committee determined the placement was not appropriate due to a health and safety concern, immediate arrangements for the child to transition to an appropriate placement shall occur.
(i) Commencing January 1, 2017, for AFDC-FC funded children or youth, only those children or youth who are approved for placement, as set forth in this section, may be accepted by a short-term residential therapeutic program.
(j) The department shall, through regulation, establish consequences for the failure of a short-term residential therapeutic program to obtain written approval for placement of an AFDC-FC funded child or youth pursuant to this section.
(k) The department shall not establish a rate for a short-term residential therapeutic program unless the provider submits a recommendation from the host county or the primary placing county that the program is needed and that the provider is willing and capable of operating the program at the level sought. For purposes of this subdivision, “host county,” and “primary placing county,” mean the same as defined in the department’s AFDC-FC ratesetting regulations.
(l)  Any certified short-term residential therapeutic program shall be reclassified and paid at the appropriate program rate for which it is qualified if either of the following occurs:
(1) (A) It fails to maintain the level of care and services necessary to meet the needs of the children and youth in care, as required by subdivision (a). The determination shall be made consistent with the department’s AFDC-FC ratesetting regulations developed pursuant to Section 11462 and shall take into consideration the highest level of care and associated rates for which the program may be eligible if granted an extension pursuant to Section 11462.04 or any reduction in rate associated with a provisional or probationary rate granted or imposed under Section 11466.01.
(B) In the event of a determination under this paragraph, the short-term residential therapeutic program may appeal the finding or submit a corrective action plan. The appeal process specified in Section 11466.6 shall be available to a short-term residential therapeutic program that provides intensive and therapeutic treatment. During any appeal, the short-term residential therapeutic program that provides intensive and therapeutic treatment shall maintain the appropriate level of care.
(2) It fails to maintain a certified mental health treatment program as required by subdivision (f).
(m) In addition to any other review required by law, the child and family team as defined in paragraph (4) of subdivision (a) of Section 16501 may periodically review the placement of the child or youth. If the child and family team make a recommendation that the child or youth no longer needs, or is not benefiting from, placement in a short-term residential therapeutic program, the team shall transmit the disapproval, in writing, to the county placing agency to consider a more appropriate placement.
(n) The department shall develop a process to address placements when, subsequent to the child’s or youth’s placement, a determination is made by the interagency placement team and shall consider the recommendations of the child and family team, either that the child or youth is not in need of the care and services provided by the certified program. The process shall include, but not be limited to:
(1) Notice of the determination in writing to both the county placing agency and the short-term residential therapeutic program or foster family agency that provides intensive and therapeutic treatment.
(2) Notice of the county’s plan, and a timeframe, for removal of the child or youth in writing to the short-term residential therapeutic program that provides intensive and therapeutic treatment.
(3) Referral to an appropriate placement.
(4) Actions to be taken if a child or youth is not timely removed from the short-term residential therapeutic program that provides intensive and therapeutic treatment or placed in an appropriate placement.
(o) (1) Nothing in this section shall This section does not prohibit a short-term residential therapeutic program from accepting private admissions of children or youth.
(2) When a referral is not from a public agency and public funding is not involved, there is no requirement for public agency review or determination of need.
(3) Children and youth subject to paragraphs (1) and (2) shall have been determined to be seriously emotionally disturbed, as described in subdivision (a) of Section 5600.3, and subject to Section 1502.4 of the Health and Safety Code, by a licensed mental health professional, as defined in subdivision (g) of Section 4096.

SEC. 5.

 Section 11462.011 of the Welfare and Institutions Code is amended to read:

11462.011.
 (a) The State Department of Health Care Services shall, in consultation with the Department of Managed Health Care, the State Department of Social Services, the County Behavioral Health Directors Association of California, the County Welfare Directors Association of California, the Chief Probation Officers of California, provider representatives, and other relevant stakeholders, establish program standards and procedures for oversight, enforcement, and issuance of children’s crisis residential mental health program approvals, psychiatric residential treatment facility certifications, including provisional approvals certifications that are effective for a period of less than one year. The State Department of Health Care Services shall also establish due process protections related to the children’s crisis residential mental health program approval process.
(b) The State Department of Health Care Services shall, in collaboration with the department, the County Behavioral Health Directors Association of California, provider representatives, and other relevant stakeholders, provide guidance to counties for the provision of children’s crisis residential services, including funding for children who are Medi-Cal beneficiaries and who are admitted to a children’s crisis residential program. psychiatric residential treatment facility. This subdivision shall only be implemented to the extent that any necessary federal approvals are obtained and federal financial participation is available and is not otherwise jeopardized.
(c) (1) The children’s crisis residential program psychiatric residential treatment facility shall be used only as a diversion to admittance to a psychiatric hospital.
(2) (A) The length of the initial authorization for admission to a children’s crisis residential program psychiatric residential treatment facility shall be limited to 10 consecutive days.
(B) If a determination is made by a health care professional that a children’s crisis residential program psychiatric residential treatment facility is medically necessary and is the appropriate continued level of care, either of the following shall occur:
(i) In the case of a Medi-Cal beneficiary, the children’s crisis residential program psychiatric residential treatment facility shall notify the county mental health plan authorizing those services before extending the length of stay beyond 10 consecutive days.
(ii) In the case of non-Medi-Cal beneficiaries, reauthorizations for admission shall be obtained using the process established by the entity providing coverage.
(C) With the exception of clause (ii) of subparagraph (B), this paragraph shall be implemented only to the extent that any necessary federal approvals are obtained and the State Department of Health Care Services determines, in its sole discretion, that federal financial participation is not jeopardized.
(3) A children’s crisis residential program psychiatric residential treatment facility may accept for admission any child who meets all of the following requirements:
(A) The child is referred by a parent or guardian, physician, or licensed mental health professional, or by the representative of a public or private entity, including, but not limited to, the county probation agency or child welfare services agency with responsibility for the placement of a child in foster care, that has the right to make these decisions on behalf of a child who is in mental health crisis.
(B) The child is under 19, 20, or 21 years of age, depending on a program’s licensing requirements.
(C) The child has a serious behavioral health disorder.
(D) The child requires a 24-hours-a-day, seven-days-a-week, staff-secured, unlocked treatment setting.
(d) A children’s crisis residential mental health program approval psychiatric residential treatment facility certification issued by the State Department of Health Care Services, or a county mental health plan to which the department has delegated approval authority, shall be a condition of continued licensure for a short-term residential therapeutic program operating as a children’s crisis residential program. psychiatric residential treatment facility.
(e) The State Department of Health Care Services, or a county mental health plan to which the department has delegated approval authority, may enforce the children’s crisis residential mental health program approval psychiatric residential treatment facility certification standards by taking any of the following actions against a noncompliant children’s crisis residential program: psychiatric residential treatment facility:
(1) Suspend or revoke a children’s crisis residential mental health program approval.psychiatric residential treatment facility certification.
(2) Impose monetary penalties.
(3) Place a children’s crisis residential mental health program psychiatric residential treatment facility on probation.
(4) Require a children’s crisis residential mental health program psychiatric residential treatment facility to prepare and comply with a corrective action plan.
(f) The State Department of Health Care Services, or a county mental health plan to which the department has delegated approval authority, shall provide a children’s crisis residential mental health program psychiatric residential treatment facility with due process protections when taking any of the actions described in subdivision (e).
(g) Contingent upon an appropriation in the annual Budget Act for these purposes, the department shall begin implementation of this section no later than July 1, 2018, and shall commence the operation of the approval process for children’s crisis residential mental health program approvalspsychiatric residential treatment facility no later than January 1, 2019.- 2022.

feedback