Bill Text: CA AB741 | 2015-2016 | Regular Session | Enrolled
Bill Title: Mental health: community care facilities.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Vetoed) 2016-09-30 - Vetoed by Governor. [AB741 Detail]
Download: California-2015-AB741-Enrolled.html
BILL NUMBER: AB 741 ENROLLED
BILL TEXT
PASSED THE SENATE AUGUST 24, 2016
PASSED THE ASSEMBLY AUGUST 30, 2016
AMENDED IN SENATE AUGUST 19, 2016
AMENDED IN SENATE AUGUST 16, 2016
AMENDED IN SENATE JUNE 16, 2016
AMENDED IN SENATE MAY 25, 2016
AMENDED IN ASSEMBLY MAY 4, 2015
AMENDED IN ASSEMBLY APRIL 15, 2015
INTRODUCED BY Assembly Member Williams
FEBRUARY 25, 2015
An act to amend Section 1502 of, and to add Sections 1562.02 and
1562.03 to, the Health and Safety Code, and to amend Sections 5848.5,
11462.01, and 15610.47 of the Welfare and Institutions Code,
relating to mental health.
LEGISLATIVE COUNSEL'S DIGEST
AB 741, Williams. Mental health: community care facilities.
(1) Existing law, the California Community Care Facilities Act,
provides for the licensing and regulation of community care
facilities, as defined, by the State Department of Social Services.
Existing law includes within the definition of community care
facility a short-term residential treatment center, which is a
residential facility licensed by the department and operated by any
public agency or private organization that provides short-term,
specialized, and intensive treatment, and 24-hour care and
supervision to children. A violation of the act is a misdemeanor.
This bill would authorize a short-term residential treatment
center to be operated as a children's crisis residential center, as
defined, and would require the department to regulate those programs,
as specified. The bill would require the State Department of Health
Care Services, in consultation with the County Behavioral Health
Directors Association of California and representatives of provider
associations, to establish interim Medi-Cal rates for children's
crisis residential services, as prescribed. By expanding the types of
facilities that are regulated as a community care facility, this
bill would expand the scope of an existing crime, thus creating a
state-mandated local program.
(2) Existing law establishes the Aid to Families with Dependent
Children-Foster Care (AFDC-FC) program, under which counties provide
payments to foster care providers on behalf of qualified children in
foster care. In order to be eligible for AFDC-FC, existing law
requires a child or nonminor dependent to be placed in a specified
placement, including, commencing January 1, 2017, a short-term
residential treatment center.
Existing law, effective January 1, 2017, authorizes a short-term
residential treatment center to have a program that is certified by
the State Department of Health Care Services or by a county mental
health plan to which the department has delegated certification
authority, or a program that is not certified, or both, and requires
a short-term residential treatment center to accept for placement
children who meet certain criteria, subject to specified
requirements.
This bill would authorize a short-term residential treatment
center that is operating as a children's crisis residential center
to, subject to specified requirements, accept for admission or
placement any child, referred by a parent or guardian, or by the
representative of a public or private entity that has the right to
make these decisions on behalf of a child who is experiencing a
mental health crisis and, absent admission to a children's crisis
residential center, would otherwise require acceptance by the
emergency department of a general hospital, or admission into a
psychiatric hospital or the psychiatric inpatient unit of a general
hospital.
(3) Existing law establishes the Investment in Mental Health
Wellness Act of 2013. Existing law provides that funds appropriated
by the Legislature to the California Health Facilities Financing
Authority for the purposes of the act be made available to selected
counties or counties acting jointly, except as otherwise provided,
and used to provide, among other things, a complete continuum of
crisis services for children and youth 21 years of age and under
regardless of where they live in the state. The act requires grant
awards made by the authority to be used to expand local resources for
the development, capital, equipment acquisition, and applicable
program startup or expansion costs to increase capacity for client
assistance and crisis services for children and youth 21 years of age
and under in specified areas, including crisis residential treatment
as authorized by specified provisions.
This bill would include within these specified areas crisis
residential treatment provided at a children's crisis residential
center.
(4) This bill would also make nonsubstantive, conforming changes.
(5) This bill would incorporate additional changes made by SB 524
and AB 1997 that would become operative only if this bill is
chaptered last.
(6) The California Constitution requires the state to reimburse
local agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
This bill would provide that no reimbursement is required by this
act for a specified reason.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. The Legislature finds and declares all of the
following:
(a) There is an urgent need to provide more crisis care
alternatives to hospitals for children and youth experiencing mental
health crises.
(b) The problems are especially acute for children and youth who
may have to wait for days for a hospital bed and who may be
transported, without a parent, to the nearest facility hundreds of
miles away.
(c) In 2012, the California Hospital Association reported that
two-thirds of the people taken to a hospital for a psychiatric
emergency did not meet the criteria for that level of care, but the
care they needed was not available.
(d) The type of care that is needed includes crisis residential
treatment for children.
(e) This level of care is part of the full continuum of care
considered medically necessary for many children with serious
emotional disturbances.
(f) In 2013, the Legislature enacted the Investment in Mental
Health Wellness Act (Senate Bill 82, Chapter 34 of the Statutes of
2013) to provide one-time funding to counties to expand the
availability of mental health crisis care services, including
short-term crisis residential treatment services. However, there is
currently no state licensing category for short-term crisis
residential programs for children. As a result, counties wanting to
expand local capacity to meet the needs of children and youth for
crisis residential treatment services were ineligible for this
competitive grant program.
(g) In most communities, inpatient crisis treatment is completely
unavailable for children and youth, even though it may be medically
necessary.
(h) Crisis residential care is an essential level of care for the
treatment of children and youth with serious emotional disturbances
in a mental health crisis, and it often serves as an alternative to
hospitalization.
(i) It is imperative that California identify a licensing category
specifically for mental health crisis residential care that can be
utilized for children and youth who are beneficiaries of both public
and private health care plans.
SEC. 2. Section 1502 of the Health and Safety Code is amended to
read:
1502. (a) As used in this chapter:
(1) "Community care facility" means any facility, place, or
building that is maintained and operated to provide nonmedical
residential care, day treatment, adult day care, 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:
(A) "Residential facility" means any family home, group care
facility, or similar facility determined by the director, 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.
(B) "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.
(C) "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.
(D) "Foster family agency" means any public agency or private
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. Private foster family
agencies shall be organized and operated on a nonprofit basis.
(E) "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.
(F) "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.
(G) "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.
(H) "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.
(I) (i) "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.
(ii) 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
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.
(J) (i) "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 adoptive placements with a
full-service adoptive agency, but does not disrupt a placement or
remove a child from a placement.
(ii) 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
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.
(K) "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.
(L) "Transitional housing placement provider" means an
organization licensed by the department pursuant to Section 1559.110
and Section 16522.1 of the Welfare and Institutions Code to provide
transitional housing to foster children at least 16 years of age and
not more than 18 years of age, and nonminor dependents, as defined in
subdivision (v) of Section 11400 of the Welfare and Institutions
Code, to promote their transition to adulthood. A transitional
housing placement provider shall be privately operated and organized
on a nonprofit basis.
(M) "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.
(N) "Runaway and homeless youth shelter" 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 runaway youth or homeless youth, as defined in paragraph
(2) of subdivision (a) of Section 1502.35.
(O) "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.
(P) "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.
(Q) "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.
(R) "Short-term residential treatment center" means a residential
facility licensed by the department pursuant to Section 1562.01 and
operated by any public agency or private organization that provides
short-term, specialized, and intensive treatment, and 24-hour care
and supervision to children. The care and supervision provided by a
short-term residential treatment center shall be nonmedical, except
as otherwise permitted by law. A short-term residential treatment
center may be operated as a children's crisis residential center.
(S) "Children's crisis residential center" means a short-term
residential treatment center operated specifically to divert children
experiencing a mental health crisis from psychiatric
hospitalization.
(2) "Department" or "state department" means the State Department
of Social Services.
(3) "Director" means the Director of Social Services.
(b) Nothing in this section shall be construed to 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.
SEC. 2.1. Section 1502 of the Health and Safety Code is amended to
read:
1502. (a) As used in this chapter:
(1) "Community care facility" means any facility, place, or
building that is maintained and operated to provide nonmedical
residential care, day treatment, adult day care, 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:
(A) "Residential facility" means any family home, group care
facility, or similar facility determined by the director, 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.
(B) "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.
(C) "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.
(D) "Foster family agency" means any public agency or private
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. Private foster family
agencies shall be organized and operated on a nonprofit basis.
(E) "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.
(F) "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.
(G) "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.
(H) "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.
(I) (i) "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.
(ii) 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
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.
(J) (i) "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 adoptive placements with a
full-service adoptive agency, but does not disrupt a placement or
remove a child from a placement.
(ii) 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
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.
(K) "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.
(L) "Transitional housing placement provider" means an
organization licensed by the department pursuant to Section 1559.110
and Section 16522.1 of the Welfare and Institutions Code to provide
transitional housing to foster children at least 16 years of age and
not more than 18 years of age, and nonminor dependents, as defined in
subdivision (v) of Section 11400 of the Welfare and Institutions
Code, to promote their transition to adulthood. A transitional
housing placement provider shall be privately operated and organized
on a nonprofit basis.
(M) "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.
(N) "Runaway and homeless youth shelter" 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 runaway youth or homeless youth, as defined in paragraph
(2) of subdivision (a) of Section 1502.35.
(O) "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.
(P) "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.
(Q) "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.
(R) "Short-term residential treatment center" means a residential
facility licensed by the department pursuant to Section 1562.01 and
operated by any public agency or private organization that provides
short-term, specialized, and intensive treatment, and 24-hour care
and supervision to children. The care and supervision provided by a
short-term residential treatment center shall be nonmedical, except
as otherwise permitted by law. A short-term residential treatment
center may be operated as a children's crisis residential center.
(S) "Children's crisis residential center" means a short-term
residential treatment center operated specifically to divert children
experiencing a mental health crisis from psychiatric
hospitalization.
(T) "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.
(U) "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.
(2) "Department" or "state department" means the State Department
of Social Services.
(3) "Director" means the Director of Social Services.
(b) Nothing in this section shall be construed to 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.
SEC. 2.2. Section 1502 of the Health and Safety Code is amended to
read:
1502. (a) As used in this chapter:
(1) "Community care facility" means any facility, place, or
building that is maintained and operated to provide nonmedical
residential care, day treatment, adult day care, 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:
(A) "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.
(B) "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.
(C) "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.
(D) "Foster family agency" means any public agency or private
organization, organized and operated on a nonprofit basis, engaged in
any of the following:
(i) Recruiting, certifying, approving, and training of, and
providing professional support to, foster parents and resource
families.
(ii) Coordinating with county placing agencies to find homes for
foster children in need of care.
(iii) 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.
(E) "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.
(F) "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.
(G) "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.
(H) "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.
(I) (i) "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.
(ii) 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
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.
(J) (i) "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 adoptive placements with a
full-service adoption agency, but does not disrupt a placement or
remove a child from a placement.
(ii) 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
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.
(K) "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.
(L) "Transitional housing placement provider" means an
organization licensed by the department pursuant to Section 1559.110
and Section 16522.1 of the Welfare and Institutions Code to provide
transitional housing to foster children at least 16 years of age and
not more than 18 years of age, and nonminor dependents, as defined in
subdivision (v) of Section 11400 of the Welfare and Institutions
Code, to promote their transition to adulthood. A transitional
housing placement provider shall be privately operated and organized
on a nonprofit basis.
(M) "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.
(N) "Runaway and homeless youth shelter" 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 runaway youth or homeless youth, as defined in paragraph
(2) of subdivision (a) of Section 1502.35.
(O) "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.
(P) "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.
(Q) "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.
(R) "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 center.
(S) "Children's crisis residential center" means a short-term
residential therapeutic program operated specifically to divert
children experiencing a mental health crisis from psychiatric
hospitalization.
(2) "Department" or "state department" means the State Department
of Social Services.
(3) "Director" means the Director of Social Services.
(b) Nothing in this section shall be construed to 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.
SEC. 2.3. Section 1502 of the Health and Safety Code is amended to
read:
1502. (a) As used in this chapter:
(1) "Community care facility" means any facility, place, or
building that is maintained and operated to provide nonmedical
residential care, day treatment, adult day care, 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:
(A) "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.
(B) "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.
(C) "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.
(D) "Foster family agency" means any public agency or private
organization, organized and operated on a nonprofit basis, engaged in
any of the following:
(i) Recruiting, certifying, approving, and training of, and
providing professional support to, foster parents and resource
families.
(ii) Coordinating with county placing agencies to find homes for
foster children in need of care.
(iii) 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.
(E) "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.
(F) "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.
(G) "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.
(H) "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.
(I) (i) "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.
(ii) 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
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.
(J) (i) "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.
(ii) 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
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.
(K) "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.
(L) "Transitional housing placement provider" means an
organization licensed by the department pursuant to Section 1559.110
and Section 16522.1 of the Welfare and Institutions Code to provide
transitional housing to foster children at least 16 years of age and
not more than 18 years of age, and nonminor dependents, as defined in
subdivision (v) of Section 11400 of the Welfare and Institutions
Code, to promote their transition to adulthood. A transitional
housing placement provider shall be privately operated and organized
on a nonprofit basis.
(M) "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.
(N) "Runaway and homeless youth shelter" 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 runaway youth or homeless youth, as defined in paragraph
(2) of subdivision (a) of Section 1502.35.
(O) "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.
(P) "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.
(Q) "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.
(R) "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 center.
(S) "Children's crisis residential center" means a short-term
residential therapeutic program operated specifically to divert
children experiencing a mental health crisis from psychiatric
hospitalization.
(T) "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.
(U) "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.
(2) "Department" or "state department" means the State Department
of Social Services.
(3) "Director" means the Director of Social Services.
(b) Nothing in this section shall be construed to 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.
SEC. 3. Section 1562.02 is added to the Health and Safety Code, to
read:
1562.02. (a) The department shall establish regulations for
short-term residential treatment centers that are operated as
children's crisis residential centers. At a minimum, the regulations
shall include all of the following:
(1) The children's crisis residential center shall be used only
for diversion from admittance to a psychiatric hospitalization.
(2) (A) Length of stay for a single admission to a children's
crisis residential center shall be limited to 10 consecutive days.
(B) Notwithstanding subparagraph (A), the length of stay may be
extended once for no more than two consecutive 10-day lengths of
stay. Before extending the length of stay for a Medi-Cal beneficiary
beyond 10 consecutive days, an organization providing children's
crisis residential services shall obtain prior approval from the
county mental health plan authorizing those services.
(C) A child shall not be admitted to a children's crisis
residential center regulated under this section for more than 20
total days in any six-month period.
(3) Therapeutic programming shall be provided seven days a week,
including weekends and holidays, with sufficient professional and
paraprofessional staff to maintain an appropriate treatment setting
and services, based on individual children's needs.
(4) 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.
(5) Facilities shall be limited to fewer than 16 beds, with at
least 50 percent of those beds in single-occupancy rooms.
(6) Facilities shall include ample physical space for
accommodating individuals who provide natural supports to each child
and for integrating family members into the day-to-day care of the
youth.
(7) The center shall collaborate with each child's mental health
team, child and family team, and other formal and natural supports
within 24 hours of intake and throughout the course of care and
treatment as appropriate.
(b) The center 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 1562.03 is added to the Health and Safety Code, to
read:
1562.03. (a) (1) The State Department of Health Care Services
shall establish interim Medi-Cal rates as needed that are sufficient
to reimburse the costs for children's crisis residential services in
excess of any specialty mental health services that would have been
otherwise authorized, provided, and invoiced for each eligible
Medi-Cal beneficiary receiving children's crisis residential
services.
(2) The department shall consult with subject matter experts from
the County Behavioral Health Directors Association of California and
provider associations to obtain data and background information
necessary to ensure sufficiency of the rate.
(b) For foster children admitted for children's crisis residential
services, programs shall receive payment for board and care
equivalent to the rate paid for short-term residential treatment
centers.
(c) Nothing in this chapter shall prevent a county from providing
payment in excess of the short-term residential treatment center rate
in order to meet the needs of individual children.
SEC. 5. Section 5848.5 of the Welfare and Institutions Code is
amended to read:
5848.5. (a) The Legislature finds and declares all of the
following:
(1) California has realigned public community mental health
services to counties and it is imperative that sufficient
community-based resources be available to meet the mental health
needs of eligible individuals.
(2)
Increasing access to effective outpatient and crisis stabilization
services provides an opportunity to reduce costs associated with
expensive inpatient and emergency room care and to better meet the
needs of individuals with mental health disorders in the least
restrictive manner possible.
(3) Almost one-fifth of people with mental health disorders visit
a hospital emergency room at least once per year. If an adequate
array of crisis services is not available, it leaves an individual
with little choice but to access an emergency room for assistance
and, potentially, an unnecessary inpatient hospitalization.
(4) Recent reports have called attention to a continuing problem
of inappropriate and unnecessary utilization of hospital emergency
rooms in California due to limited community-based services for
individuals in psychological distress and acute psychiatric crisis.
Hospitals report that 70 percent of people taken to emergency rooms
for psychiatric evaluation can be stabilized and transferred to a
less intensive level of crisis care. Law enforcement personnel report
that their personnel need to stay with people in the emergency room
waiting area until a placement is found, and that less intensive
levels of care tend not to be available.
(5) Comprehensive public and private partnerships at both local
and regional levels, including across physical health services,
mental health, substance use disorder, law enforcement, social
services, and related supports, are necessary to develop and maintain
high quality, patient-centered, and cost-effective care for
individuals with mental health disorders that facilitates their
recovery and leads towards wellness.
(6) The recovery of individuals with mental health disorders is
important for all levels of government, business, and the local
community.
(b) This section shall be known, and may be cited, as the
Investment in Mental Health Wellness Act of 2013. The objectives of
this section are to do all of the following:
(1) Expand access to early intervention and treatment services to
improve the client experience, achieve recovery and wellness, and
reduce costs.
(2) Expand the continuum of services to address crisis
intervention, crisis stabilization, and crisis residential treatment
needs that are wellness, resiliency, and recovery oriented.
(3) Add at least 25 mobile crisis support teams and at least 2,000
crisis stabilization and crisis residential treatment beds to
bolster capacity at the local level to improve access to mental
health crisis services and address unmet mental health care needs.
(4) Add at least 600 triage personnel to provide intensive case
management and linkage to services for individuals with mental health
care disorders at various points of access, such as at designated
community-based service points, homeless shelters, and clinics.
(5) Reduce unnecessary hospitalizations and inpatient days by
appropriately utilizing community-based services and improving access
to timely assistance.
(6) Reduce recidivism and mitigate unnecessary expenditures of
local law enforcement.
(7) Provide local communities with increased financial resources
to leverage additional public and private funding sources to achieve
improved networks of care for individuals with mental health
disorders.
(8) Provide a complete continuum of crisis services for children
and youth 21 years of age and under regardless of where they live in
the state. The funds included in the 2016 Budget Act for the purpose
of developing the continuum of mental health crisis services for
children and youth 21 years of age and under shall be for the
following objectives:
(A) Provide a continuum of crisis services for children and youth
21 years of age and under regardless of where they live in the state.
(B) Provide for early intervention and treatment services to
improve the client experience, achieve recovery and wellness, and
reduce costs.
(C) Expand the continuum of community-based services to address
crisis intervention, crisis stabilization, and crisis residential
treatment needs that are wellness-, resiliency-, and
recovery-oriented.
(D) Add at least 200 mobile crisis support teams.
(E) Add at least 120 crisis stabilization services and beds and
crisis residential treatment beds to increase capacity at the local
level to improve access to mental health crisis services and address
unmet mental health care needs.
(F) Add triage personnel to provide intensive case management and
linkage to services for individuals with mental health care disorders
at various points of access, such as at designated community-based
service points, homeless shelters, schools, and clinics.
(G) Expand family respite care to help families and sustain
caregiver health and well-being.
(H) Expand family supportive training and related services
designed to help families participate in the planning process, access
services, and navigate programs.
(I) Reduce unnecessary hospitalizations and inpatient days by
appropriately utilizing community-based services.
(J) Reduce recidivism and mitigate unnecessary expenditures of
local law enforcement.
(K) Provide local communities with increased financial resources
to leverage additional public and private funding sources to achieve
improved networks of care for children and youth 21 years of age and
under with mental health disorders.
(c) Through appropriations provided in the annual Budget Act for
this purpose, it is the intent of the Legislature to authorize the
California Health Facilities Financing Authority, hereafter referred
to as the authority, and the Mental Health Services Oversight and
Accountability Commission, hereafter referred to as the commission,
to administer competitive selection processes as provided in this
section for capital capacity and program expansion to increase
capacity for mobile crisis support, crisis intervention, crisis
stabilization services, crisis residential treatment, and specified
personnel resources.
(d) Funds appropriated by the Legislature to the authority for
purposes of this section shall be made available to selected
counties, or counties acting jointly. The authority may, at its
discretion, also give consideration to private nonprofit corporations
and public agencies in an area or region of the state if a county,
or counties acting jointly, affirmatively supports this designation
and collaboration in lieu of a county government directly receiving
grant funds.
(1) Grant awards made by the authority shall be used to expand
local resources for the development, capital, equipment acquisition,
and applicable program startup or expansion costs to increase
capacity for client assistance and services in the following areas:
(A) Crisis intervention, as authorized by Sections 14021.4, 14680,
and 14684.
(B) Crisis stabilization, as authorized by Sections 14021.4,
14680, and 14684.
(C) Crisis residential treatment, as authorized by Sections
14021.4, 14680, and 14684.
(D) Rehabilitative mental health services, as authorized by
Sections 14021.4, 14680, and 14684.
(E) Mobile crisis support teams, including personnel and
equipment, such as the purchase of vehicles.
(2) The authority shall develop selection criteria to expand local
resources, including those described in paragraph (1), and processes
for awarding grants after consulting with representatives and
interested stakeholders from the mental health community, including,
but not limited to, the County Behavioral Health Directors
Association of California, service providers, consumer organizations,
and other appropriate interests, such as health care providers and
law enforcement, as determined by the authority. The authority shall
ensure that grants result in cost-effective expansion of the number
of community-based crisis resources in regions and communities
selected for funding. The authority shall also take into account at
least the following criteria and factors when selecting recipients of
grants and determining the amount of grant awards:
(A) Description of need, including, at a minimum, a comprehensive
description of the project, community need, population to be served,
linkage with other public systems of health and mental health care,
linkage with local law enforcement, social services, and related
assistance, as applicable, and a description of the request for
funding.
(B) Ability to serve the target population, which includes
individuals eligible for Medi-Cal and individuals eligible for county
health and mental health services.
(C) Geographic areas or regions of the state to be eligible for
grant awards, which may include rural, suburban, and urban areas, and
may include use of the five regional designations utilized by the
County Behavioral Health Directors Association of California.
(D) Level of community engagement and commitment to project
completion.
(E) Financial support that, in addition to a grant that may be
awarded by the authority, will be sufficient to complete and operate
the project for which the grant from the authority is awarded.
(F) Ability to provide additional funding support to the project,
including public or private funding, federal tax credits and grants,
foundation support, and other collaborative efforts.
(G) Memorandum of understanding among project partners, if
applicable.
(H) Information regarding the legal status of the collaborating
partners, if applicable.
(I) Ability to measure key outcomes, including improved access to
services, health and mental health outcomes, and cost benefit of the
project.
(3) The authority shall determine maximum grants awards, which
shall take into consideration the number of projects awarded to the
grantee, as described in paragraph (1), and shall reflect reasonable
costs for the project and geographic region. The authority may
allocate a grant in increments contingent upon the phases of a
project.
(4) Funds awarded by the authority pursuant to this section may be
used to supplement, but not to supplant, existing financial and
resource commitments of the grantee or any other member of a
collaborative effort that has been awarded a grant.
(5) All projects that are awarded grants by the authority shall be
completed within a reasonable period of time, to be determined by
the authority. Funds shall not be released by the authority until the
applicant demonstrates project readiness to the authority's
satisfaction. If the authority determines that a grant recipient has
failed to complete the project under the terms specified in awarding
the grant, the authority may require remedies, including the return
of all or a portion of the grant.
(6) A grantee that receives a grant from the authority under this
section shall commit to using that capital capacity and program
expansion project, such as the mobile crisis team, crisis
stabilization unit, or crisis residential treatment program, for the
duration of the expected life of the project.
(7) The authority may consult with a technical assistance entity,
as described in paragraph (5) of subdivision (a) of Section 4061, for
purposes of implementing this section.
(8) The authority may adopt emergency regulations relating to the
grants for the capital capacity and program expansion projects
described in this section, including emergency regulations that
define eligible costs and determine minimum and maximum grant
amounts.
(9) The authority shall provide reports to the fiscal and policy
committees of the Legislature on or before May 1, 2014, and on or
before May 1, 2015, on the progress of implementation, that include,
but are not limited to, the following:
(A) A description of each project awarded funding.
(B) The amount of each grant issued.
(C) A description of other sources of funding for each project.
(D) The total amount of grants issued.
(E) A description of project operation and implementation,
including who is being served.
(10) A recipient of a grant provided pursuant to paragraph (1)
shall adhere to all applicable laws relating to scope of practice,
licensure, certification, staffing, and building codes.
(e) Of the funds specified in paragraph (8) of subdivision (b), it
is the intent of the Legislature to authorize the authority and the
commission to administer competitive selection processes as provided
in this section for capital capacity and program expansion to
increase capacity for mobile crisis support, crisis intervention,
crisis stabilization services, crisis residential treatment, family
respite care, family supportive training and related services, and
triage personnel resources for children and youth 21 years of age and
under.
(f) Funds appropriated by the Legislature to the authority to
address crisis services for children and youth 21 years of age and
under for the purposes of this section shall be made available to
selected counties or counties acting jointly. The authority may, at
its discretion, also give consideration to private nonprofit
corporations and public agencies in an area or region of the state if
a county, or counties acting jointly, affirmatively support this
designation and collaboration in lieu of a county government directly
receiving grant funds.
(1) Grant awards made by the authority shall be used to expand
local resources for the development, capital, equipment acquisition,
and applicable program startup or expansion costs to increase
capacity for client assistance and crisis services for children and
youth 21 years of age and under in the following areas:
(A) Crisis intervention, as authorized by Sections 14021.4, 14680,
and 14684.
(B) Crisis stabilization, as authorized by Sections 14021.4,
14680, and 14684.
(C) Crisis residential treatment, as authorized by Sections
14021.4, 14680, and 14684 and as provided at a children's crisis
residential center, as defined in Section 1502 of the Health and
Safety Code.
(D) Mobile crisis support teams, including the purchase of
equipment and vehicles.
(E) Family respite care.
(2) The authority shall develop selection criteria to expand local
resources, including those described in paragraph (1), and processes
for awarding grants after consulting with representatives and
interested stakeholders from the mental health community, including,
but not limited to, county mental health directors, service
providers, consumer organizations, and other appropriate interests,
such as health care providers and law enforcement, as determined by
the authority. The authority shall ensure that grants result in
cost-effective expansion of the number of community-based crisis
resources in regions and communities selected for funding. The
authority shall also take into account at least the following
criteria and factors when selecting recipients of grants and
determining the amount of grant awards:
(A) Description of need, including, at a minimum, a comprehensive
description of the project, community need, population to be served,
linkage with other public systems of health and mental health care,
linkage with local law enforcement, social services, and related
assistance, as applicable, and a description of the request for
funding.
(B) Ability to serve the target population, which includes
individuals eligible for Medi-Cal and individuals eligible for county
health and mental health services.
(C) Geographic areas or regions of the state to be eligible for
grant awards, which may include rural, suburban, and urban areas, and
may include use of the five regional designations utilized by the
California Behavioral Health Directors Association.
(D) Level of community engagement and commitment to project
completion.
(E) Financial support that, in addition to a grant that may be
awarded by the authority, will be sufficient to complete and operate
the project for which the grant from the authority is awarded.
(F) Ability to provide additional funding support to the project,
including public or private funding, federal tax credits and grants,
foundation support, and other collaborative efforts.
(G) Memorandum of understanding among project partners, if
applicable.
(H) Information regarding the legal status of the collaborating
partners, if applicable.
(I) Ability to measure key outcomes, including utilization of
services, health and mental health outcomes, and cost benefit of the
project.
(3) The authority shall determine maximum grant awards, which
shall take into consideration the number of projects awarded to the
grantee, as described in paragraph (1), and shall reflect reasonable
costs for the project, geographic region, and target ages. The
authority may allocate a grant in increments contingent upon the
phases of a project.
(4) Funds awarded by the authority pursuant to this section may be
used to supplement, but not to supplant, existing financial and
resource commitments of the grantee or any other member of a
collaborative effort that has been awarded a grant.
(5) All projects that are awarded grants by the authority shall be
completed within a reasonable period of time, to be determined by
the authority. Funds shall not be released by the authority until the
applicant demonstrates project readiness to the authority's
satisfaction. If the authority determines that a grant recipient has
failed to complete the project under the terms specified in awarding
the grant, the authority may require remedies, including the return
of all, or a portion, of the grant.
(6) A grantee that receives a grant from the authority under this
section shall commit to using that capital capacity and program
expansion project, such as the mobile crisis team, crisis
stabilization unit, family respite care, or crisis residential
treatment program, for the duration of the expected life of the
project.
(7) The authority may consult with a technical assistance entity,
as described in paragraph (5) of subdivision (a) of Section 4061, for
the purposes of implementing this section.
(8) The authority may adopt emergency regulations relating to the
grants for the capital capacity and program expansion projects
described in this section, including emergency regulations that
define eligible costs and determine minimum and maximum grant
amounts.
(9) The authority shall provide reports to the fiscal and policy
committees of the Legislature on or before January 10, 2018, and
annually thereafter, on the progress of implementation, that include,
but are not limited to, the following:
(A) A description of each project awarded funding.
(B) The amount of each grant issued.
(C) A description of other sources of funding for each project.
(D) The total amount of grants issued.
(E) A description of project operation and implementation,
including who is being served.
(10) A recipient of a grant provided pursuant to paragraph (1)
shall adhere to all applicable laws relating to scope of practice,
licensure, certification, staffing, and building codes.
(g) Funds appropriated by the Legislature to the commission for
purposes of this section shall be allocated for triage personnel to
provide intensive case management and linkage to services for
individuals with mental health disorders at various points of access.
These funds shall be made available to selected counties, counties
acting jointly, or city mental health departments, as determined by
the commission through a selection process. It is the intent of the
Legislature for these funds to be allocated in an efficient manner to
encourage early intervention and receipt of needed services for
individuals with mental health disorders, and to assist in navigating
the local service sector to improve efficiencies and the delivery of
services.
(1) Triage personnel may provide targeted case management services
face to face, by telephone, or by telehealth with the individual in
need of assistance or his or her significant support person, and may
be provided anywhere in the community. These service activities may
include, but are not limited to, the following:
(A) Communication, coordination, and referral.
(B) Monitoring service delivery to ensure the individual accesses
and receives services.
(C) Monitoring the individual's progress.
(D) Providing placement service assistance and service plan
development.
(2) The commission shall take into account at least the following
criteria and factors when selecting recipients and determining the
amount of grant awards for triage personnel as follows:
(A) Description of need, including potential gaps in local service
connections.
(B) Description of funding request, including personnel and use of
peer support.
(C) Description of how triage personnel will be used to facilitate
linkage and access to services, including objectives and anticipated
outcomes.
(D) Ability to obtain federal Medicaid reimbursement, when
applicable.
(E) Ability to administer an effective service program and the
degree to which local agencies and service providers will support and
collaborate with the triage personnel effort.
(F) Geographic areas or regions of the state to be eligible for
grant awards, which shall include rural, suburban, and urban areas,
and may include use of the five regional designations utilized by the
County Behavioral Health Directors Association of California.
(3) The commission shall determine maximum grant awards, and shall
take into consideration the level of need, population to be served,
and related criteria, as described in paragraph (2), and shall
reflect reasonable costs.
(4) Funds awarded by the commission for purposes of this section
may be used to supplement, but not supplant, existing financial and
resource commitments of the county, counties acting jointly, or city
mental health department that received the grant.
(5) Notwithstanding any other law, a county, counties acting
jointly, or city mental health department that receives an award of
funds for the purpose of supporting triage personnel pursuant to this
subdivision is not required to provide a matching contribution of
local funds.
(6) Notwithstanding any other law, the commission, without taking
any further regulatory action, may implement, interpret, or make
specific this section by means of informational letters, bulletins,
or similar instructions.
(7) The commission shall provide a status report to the fiscal and
policy committees of the Legislature on the progress of
implementation no later than March 1, 2014.
(h) Funds appropriated by the Legislature to the commission
pursuant to paragraph (8) of subdivision (b) for the purposes of
addressing children's crisis services shall be allocated to support
triage personnel and family supportive training and related services.
These funds shall be made available to selected counties, counties
acting jointly, or city mental health departments, as determined by
the commission through a selection process. The commission may, at
its discretion, also give consideration to private nonprofit
corporations and public agencies in an area or region of the state if
a county, or counties acting jointly, affirmatively supports this
designation and collaboration in lieu of a county government directly
receiving grant funds.
(1) These funds may provide for a range of crisis-related services
for a child in need of assistance, or his or her parent, guardian,
or caregiver. These service activities may include, but are not
limited to, the following:
(A) Intensive coordination of care and services.
(B) Communication, coordination, and referral.
(C) Monitoring service delivery to the child or youth.
(D) Monitoring the child's progress.
(E) Providing placement service assistance and service plan
development.
(F) Crisis or safety planning.
(2) The commission shall take into account at least the following
criteria and factors when selecting recipients and determining the
amount of grant awards for these funds, as follows:
(A) Description of need, including potential gaps in local service
connections.
(B) Description of funding request, including personnel.
(C) Description of how personnel and other services will be used
to facilitate linkage and access to services, including objectives
and anticipated outcomes.
(D) Ability to obtain federal Medicaid reimbursement, when
applicable.
(E) Ability to provide a matching contribution of local funds.
(F) Ability to administer an effective service program and the
degree to which local agencies and service providers will support and
collaborate with the triage personnel effort.
(G) Geographic areas or regions of the state to be eligible for
grant awards, which shall include rural, suburban, and urban areas,
and may include use of the five regional designations utilized by the
County Behavioral Health Directors Association of California.
(3) The commission shall determine maximum grant awards, and shall
take into consideration the level of need, population to be served,
and related criteria, as described in paragraph (2), and shall
reflect reasonable costs.
(4) Funds awarded by the commission for purposes of this section
may be used to supplement, but not supplant, existing financial and
resource commitments of the county, counties acting jointly, or a
city mental health department that received the grant.
(5) Notwithstanding any other law, a county, counties acting
jointly, or a city mental health department that receives an award of
funds for the purpose of this section is not required to provide a
matching contribution of local funds.
(6) Notwithstanding any other law, the commission, without taking
any further regulatory action, may implement, interpret, or make
specific this section by means of informational letters, bulletins,
or similar instructions.
(7) The commission may waive requirements in this section for
counties with a population of 100,000 or less, if the commission
determines it is in the best interest of the state and meets the
intent of the law.
(8) The commission shall provide a status report to the fiscal and
policy committees of the Legislature on the progress of
implementation no later than January 10, 2018, and annually
thereafter.
SEC. 6. Section 11462.01 of the Welfare and Institutions Code, as
added by Section 75 of Chapter 773 of the Statutes of 2015, is
amended to read:
11462.01. (a) A short-term residential treatment center, as
defined in subdivision (ad) of Section 11400 and subparagraph (R) of
paragraph (1) of subdivision (a) of Section 1502 of the Health and
Safety Code, may have a program that is certified by the State
Department of Health Care Services or by a county mental health plan
to which the
department has delegated certification authority, pursuant to Section
4096.5, or a program that is not certified, or both. A short-term
residential treatment center, except as specified in subdivision (d),
shall accept for placement children who meet all of the following
criteria, subject to the other requirements of subdivisions (b) and
(c):
(1) The child does not require inpatient care in a licensed health
facility.
(2) The child has been assessed as requiring the level of services
provided in a short-term residential treatment center 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.
(3) The child meets at least one of the following conditions:
(A) The child has been assessed as meeting the medical necessity
criteria for Medi-Cal specialty mental health Early and Periodic
Screening, Diagnosis, and Treatment Services, as the criteria are
described in Section 1830.210 of Title 9 of the California Code of
Regulations.
(B) The child has been assessed as seriously emotionally
disturbed, as described in subdivision (a) of Section 5600.3.
(C) The child has been assessed as requiring the level of services
provided in order to meet his or her behavioral or therapeutic
needs. In appropriate circumstances, this may include any of the
following:
(i) A commercially sexually exploited child.
(ii) 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.
(iii) A juvenile sex offender.
(iv) A child who is affiliated with, or impacted by, a gang.
(b) A short-term residential treatment center program that is
certified by the State Department of Health Care Services, or by a
county mental health plan to which the department has delegated
certification authority, pursuant to Section 4096.5, shall solely
accept for placement, and provide access to mental health services
to, children who meet the criteria in paragraphs (1) and (2) of
subdivision (a), and meet the conditions of subparagraph (A) or (B)
of paragraph (3) of subdivision (a), or both of those subparagraphs.
Mental health services are provided directly by the certified
program.
(c) A short-term residential treatment center program that is not
certified pursuant to Section 4096.5 shall solely accept for
placement in that program a child who meets the criteria in
paragraphs (1) and (2) of subdivision (a), and meets the conditions
of subparagraph (A), (B), or (C) of paragraph (3) of subdivision (a),
or any combination of those subparagraphs. A child who meets the
conditions of subparagraphs (A) and (B) of paragraph (3) of
subdivision (a) may be accepted for placement, if the interagency
placement committee determines that a short-term residential
treatment facility that is not certified has a program that meets the
specific needs of the child and there is a commonality of needs with
the other children in the short-term residential treatment center.
In this situation, the short-term residential treatment center shall
do either of the following:
(1) In the case of a child who is a Medi-Cal beneficiary, arrange
for the child to receive specialty mental health services from the
county mental health plan.
(2) In all other cases, arrange for the child to receive mental
health services.
(d) A short-term residential treatment center that is operating as
a children's crisis residential center, as defined in Section 1502
of the Health and Safety Code, and subject to the other requirements
of subdivisions (b) and (c), may accept for admission or placement
any child, referred by a parent or guardian, 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 and, absent admission to a children's crisis
residential center, would otherwise require acceptance by the
emergency department of a general hospital, or admission into a
psychiatric hospital or the psychiatric inpatient unit of a general
hospital.
(e) A foster family agency, as defined in subdivision (g) of
Section 11400 and subparagraph (D) of paragraph (1) of subdivision
(a) of Section 1502 of the Health and Safety Code, may have a program
that is certified by the State Department of Health Care Services,
or by a county mental health plan to which the department has
delegated certification authority, pursuant to Section 1810.435 or
1810.436 of Title 9 of the California Code of Regulations, or a
program that is not certified, or both. A program, subject to
subdivisions (f) and (g), shall provide access to mental health
services to the children. A foster family agency, depending on
whether or not it has a certified program, shall provide access to
mental health services to children who do not require inpatient care
in a licensed health facility and who meet any one or more of the
following conditions:
(1) A child who has been assessed as meeting the medical necessity
criteria for specialty mental health services under the Medi-Cal
Early and Periodic Screening, Diagnosis, and Treatment benefit, as
the criteria are described in Section 1830.210 of Title 9 of the
California Code of Regulations.
(2) A child who has been assessed as seriously emotionally
disturbed, as described in subdivision (a) of Section 5600.3.
(3) A child who has been assessed as requiring the level of
services to meet his or her behavioral or therapeutic needs.
(f) A foster family agency that is certified as a provider
pursuant to Section 1810.435 or 1810.436 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, shall provide access to mental
health services directly to children in its program who do not
require inpatient care in a licensed health facility and who meet the
conditions of paragraph (1) or (2) of subdivision (e).
(g) A foster family agency that is not certified as described in
subdivision (f) may provide access to mental health services in that
program for children who do not require inpatient care in a licensed
health facility and who meet the conditions of paragraphs (1) and (2)
of subdivision (e). In this situation the foster family agency shall
do the following:
(1) In the case of a child who is a Medi-Cal beneficiary, have
written interagency protocols in place to arrange for specialty
mental health services from the county mental health plan or an
organizational provider, as defined in Section 1810.231 of Title 9 of
California Code of Regulations.
(2) In all other cases, arrange for the child to receive mental
health services.
(h) All short-term residential treatment centers and foster family
agencies that operate a certified program 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 certification issued by the State
Department of Health Care Services or a county mental health plan to
which the department has delegated certification 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.
(i) The assessments described in subparagraphs (A) and (B) of
paragraph (3) of subdivision (a) and paragraphs (1) and (2) of
subdivision (e), shall be made by all 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.
(2) A licensed mental health professional as defined in
subdivision (g) of Section 4096.
(3) 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) For the purposes of this section, and only for placement into
a foster family agency, an AFDC-FC funded child assessed pursuant to
subdivision (b) of Section 706.6 or paragraph (2) of subdivision (c)
of Section 16501.1, in consultation with a mental health
professional, as defined in subdivision (g) of Section 4096.5, shall
be deemed to have met the assessment requirement.
(j) The assessments described in subparagraph (C) of paragraph (3)
of subdivision (a) and paragraph (3) of subdivision (e) shall be
made pursuant to subdivision (b) of Section 706.6 or paragraph (2) of
subdivision (c) of Section 16501.1.
(k) (1) The provider shall ensure that AFDC-FC funded children,
assessed pursuant to subparagraphs (A) and (B) of paragraph (3) of
subdivision (a) or paragraphs (1) and (2) of subdivision (e), 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 (i).
(2) The approval shall be in writing and shall indicate that the
interagency placement committee has determined all of the following:
(A) The child meets the medical necessity criteria for Medi-Cal
specialty mental health Early and Periodic Screening, Diagnosis, and
Treatment services, as the criteria are described in Section 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.
(C) Subject to Section 1502.4 of the Health and Safety Code, the
child needs the level of care provided by the program.
(3) (A) Nothing in subdivisions (a) to (j), inclusive, or this
subdivision shall prevent an emergency placement of a child or youth
into a certified short-term residential treatment center, children's
crisis residential center, or foster family agency 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 is
seriously emotionally disturbed or has made a written determination
within 24 hours of the child's or youth's placement in a children's
crisis residential center that the child or youth is experiencing a
mental health crisis as defined in subdivision (d), and is in need of
the care and services provided by the certified short-term
residential treatment center, children's crisis residential center,
or foster family agency.
(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 treatment center
or foster family agency.
(iii) If it determines the placement is not appropriate, the
interagency placement committee shall respond pursuant to
subparagraph (B).
(B) 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
treatment center or foster family agency, and the child or youth
shall be referred to an appropriate placement, as specified in this
section.
(l) 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 treatment center or foster family agency.
(m) The department shall, through regulation, establish
consequences for the failure of a short-term residential treatment
center, or a foster family agency, to obtain written approval for
placement of an AFDC-FC funded child or youth pursuant to this
section.
(n) The department shall not establish a rate for a short-term
residential treatment center or foster family agency 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.
(o) Any certified short-term residential treatment center or
foster family agency 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 Sections 11462 and 11463 and shall take into
consideration the highest level of care and associated rates for
which the program is eligible.
(B) In the event of a determination under this paragraph, the
short-term residential treatment center or foster family agency 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 treatment center or foster family agency that
provides intensive and therapeutic treatment. During any appeal, the
short-term residential treatment center or foster family agency 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 (h).
(p) 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 treatment center or foster family agency,
or one of its programs, the team shall transmit the disapproval, in
writing, to the county placing agency to consider a more appropriate
placement.
(q) 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 treatment center or
foster family agency that provides intensive and therapeutic
treatment.
(2) Notice of the county's plan, and a time frame, for removal of
the child or youth in writing to the short-term residential treatment
center or foster family agency 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 treatment center or foster family
agency that provides intensive and therapeutic treatment or placed in
an appropriate placement.
(r) (1) Nothing in this section shall prohibit a short-term
residential treatment center or foster family agency from accepting
private placements of children or youth.
(2) When a referral is not from a public agency and no public
funding is involved, there is no requirement for public agency review
nor 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.
(s) This section shall become operative on January 1, 2017.
SEC. 6.1. Section 11462.01 of the Welfare and Institutions Code,
as added by Section 75 of Chapter 773 of the Statutes of 2015, is
amended to read:
11462.01. (a) (1) 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
subparagraph (R) of paragraph (1) 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) Except as otherwise specified in subdivision (c), a short-term
residential therapeutic program 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.
(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 described in subdivision (a) of
Section 5600.3.
(C) The child requires emergency placement pursuant to paragraph
(3) of subdivision (i).
(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
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) A short-term residential therapeutic program that is operating
as a children's crisis residential center, as defined in Section
1502 of the Health and Safety Code, may accept for admission or
placement any child, referred by a parent or guardian, 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 and, absent admission to a children's
crisis residential center, would otherwise require acceptance by the
emergency department of a general hospital, or admission into a
psychiatric hospital or the psychiatric inpatient unit of a general
hospital.
(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 nonspecialty 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 that includes
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) 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.
(h) The evaluation described in subparagraph (A) of paragraph (3)
of subdivision (i) shall be made pursuant to subdivision (b) of
Section 706.6 or paragraph (2) of subdivision (c) of Section 16501.1.
(i) (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 (h), inclusive, or this
subdivision shall prevent an emergency placement of a child or youth
into a certified short-term residential therapeutic program or
children's crisis residential center 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 behavioral or therapeutic needs,
or has made a written determination within 24 hours of the child's or
youth's placement in a children's crisis residential center that the
child or youth is experiencing a mental health crisis as defined in
subdivision (c) and is in need of the care and services provided by
the children's crisis residential center. 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 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.
(j) 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.
(k) 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.
(l) 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.
(m) 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).
(n) 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.
(o) 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 time frame, 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.
(p) (1) Nothing in this section shall prohibit a short-term
residential therapeutic program from accepting private placements of
children or youth.
(2) When a referral is not from a public agency and no public
funding is 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. 7. Section 15610.47 of the Welfare and Institutions Code is
amended to read:
15610.47. "Long-term care facility" means any of the following:
(a) Any long-term health care facility, as defined in subdivision
(a) of Section 1418 of the Health and Safety Code.
(b) Any community care facility, as defined in subparagraphs (A)
and (B) of paragraph (1) of subdivision (a) of Section 1502 of the
Health and Safety Code, whether licensed or unlicensed.
(c) Any swing bed in an acute care facility, or any extended care
facility.
(d) Any adult day health care facility as defined in subdivision
(b) of Section 1570.7 of the Health and Safety Code.
(e) Any residential care facility for the elderly as defined in
Section 1569.2 of the Health and Safety Code.
SEC. 8. (a) (1) Section 2.1 of this bill incorporates amendments
to Section 1502 of the Health and Safety Code proposed by both this
bill and Senate Bill 524. It shall only become operative if (A) both
bills are enacted and become effective on or before January 1, 2017,
(B) each bill amends Section 1502 of the Health and Safety Code, (C)
Assembly Bill 1997 is not enacted or as enacted does not amend that
section, and (D) this bill is enacted after Senate Bill 524, in which
case Sections 2, 2.2, and 2.3 of this bill shall not become
operative
(2) Section 2.2 of this bill incorporates amendments to Section
1502 of the Health and Safety Code proposed by both this bill and
Assembly Bill 1997. It shall only become operative if (A) both bills
are enacted and become effective on or before January 1, 2017, (B)
each bill amends Section 1502 of the Health and Safety Code, and (C)
Senate Bill 524 is not enacted or as enacted does not amend that
section, and (D) this bill is enacted after Assembly Bill 1997, in
which case Sections 2, 2.1, and 2.3 of this bill shall not become
operative.
(3) Section 2.3 of this bill incorporates amendments to Section
1502 of the Health and Safety Code proposed by this bill, Senate Bill
524, and Assembly Bill 1997. It shall only become operative if (A)
all three bills are enacted and become effective on or before January
1, 2017, (B) all three bills amend Section 1502 of the Health and
Safety Code, and (C) this bill is enacted after Senate Bill 524 and
Assembly Bill 1997, in which case Sections 2, 2.1, and 2.2 of this
bill shall not become operative.
(b) Section 6.1 of this bill incorporates amendments to Section
11462.01 of the Welfare and Institutions Code proposed by both this
bill and Assembly Bill 1997. It shall only become operative if (1)
both bills are enacted and become effective on or before January 1,
2017, (2) each bill amends Section 11462.01 of the Welfare and
Institutions Code, and (3) this bill is enacted after Assembly Bill
1997, in which case Section 6 of this bill shall not become
operative.
SEC. 9. No reimbursement is required by this act pursuant to
Section 6 of Article XIII B of the California Constitution because
the only costs that may be incurred by a local agency or school
district will be incurred because this act creates a new crime or
infraction, eliminates a crime or infraction, or changes the penalty
for a crime or infraction, within the meaning of Section 17556 of the
Government Code, or changes the definition of a crime within the
meaning of Section 6 of Article XIII B of the California
Constitution.
