BILL NUMBER: SB 524AMENDED BILL TEXT AMENDED IN ASSEMBLY AUGUST 17, 2015 AMENDED IN ASSEMBLY JULY 8, 2015 AMENDED IN SENATE MAY 5, 2015 AMENDED IN SENATE APRIL 14, 2015 INTRODUCED BY Senator Lara (Coauthors: Senators Liu and McGuire) ( Coauthors: Assembly Members Lopez and Low ) FEBRUARY 26, 2015 An act to amend Sections 1502 and 1505 of, and to add Section 1502.2 to, the Health and Safety Code, relating to care facilities. LEGISLATIVE COUNSEL'S DIGEST SB 524, as amended, Lara. Private or public residential care facilities for youth. Existing law, the California Community Care Facilities Act (the act), provides for the licensure and regulation of community care and residential facilities by the State Department of Social Services. Under existing law, the act does not apply to certain facilities, including, among others, any school dormitory or similar facility determined by the department. Existing law makes a violation of any of these provisions punishable as a misdemeanor. This bill would define "private or public residential care facility for youth," for purposes of the act, and would make those facilities subject to regulation under the act. The bill would require the department to license and inspect these facilities as community care facilities. The bill would prohibit the department from licensing a private or public residential care facility for youth unless all therapeutic components of the programs provided at the facility are licensed by the appropriate agency or department. The bill would require these facilities to submit to the department a training plan for facility staff to be approved by the department prior to the facility implementing the training plan. The bill would specify the minimum number of hours of staff training, specify required training content, and require the department to adopt related regulations. The bill would make a staff member of a private or public residential care facility for youth a mandated child abuse reporter. By making private residential care facilities for youth subject to the criminal penalties under the act, this bill would create new crimes, thereby imposing a state-mandated local program. 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. Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: yes. THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS: SECTION 1. The Legislature finds and declares all of the following: (a) For decades, hundreds of nontraditional treatment programs that are intended to be less restrictive treatment options for children with significant behavioral issues have been established nationwide, with thousands of allegations of abuse, including death. (b) There are currently facilities operating within California that are not licensed by the State Department of Social Services. (c) These facilities are often owned and operated by nonprofit organizations described in Section 501(c)(3) of the Internal Revenue Code. (d) These facilities advertise services for youth with behavioral issues to families who may feel they have no other options. (e) Former students have formed national and local organizations to expose the trauma and abuse they experienced at these facilities. (f) Students at these facilities are previous victims of trauma, have experienced parental rejection based on actual or perceived sexual orientation or gender identity, and have mental health and substance use issues. (g) It is the role of the Legislature to ensure proper licensing and regulation of residential facilities for the protection and care of all citizens. (h) It is the intent of the Legislature that the state license private or public residential care for youth as a community care facility to ensure the safety of children residing in those facilities. SEC. 2. Section 1502 of the Health and Safety Code is amended to read: 1502. As used in this chapter: (a) "Community care facility" means any facility, place, or building that is maintained and operated to provide nonmedical residential care, day treatment, adult 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: (1) "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. (2) "Adult day program" means any community-based facility or program that provides care to persons 18 years of age or older in need of personal services, supervision, or assistance essential for sustaining the activities of daily living or for the protection of these individuals on less than a 24-hour basis. (3) "Therapeutic day services facility" means any facility that provides nonmedical care, counseling, educational or vocational support, or social rehabilitation services on less than a 24-hour basis to persons under 18 years of age who would otherwise be placed in foster care or who are returning to families from foster care. Program standards for these facilities shall be developed by the department, pursuant to Section 1530, in consultation with therapeutic day services and foster care providers. (4) "Foster family agency" means any organization engaged in the recruiting, certifying, and training of, and providing professional support to, foster parents, or in finding homes or other places for placement of children for temporary or permanent care who require that level of care as an alternative to a group home. Private foster family agencies shall be organized and operated on a nonprofit basis. (5) "Foster family home" means any residential facility providing 24-hour care for six or fewer foster children that is owned, leased, or rented and is the residence of the foster parent or parents, including their family, in whose care the foster children have been placed. The placement may be by a public or private child placement agency or by a court order, or by voluntary placement by a parent, parents, or guardian. It also means a foster family home described in Section 1505.2. (6) "Small family home" means any residential facility, in the licensee's family residence, that provides 24-hour care for six or fewer foster children who have mental disorders or developmental or physical disabilities and who require special care and supervision as a result of their disabilities. A small family home may accept children with special health care needs, pursuant to subdivision (a) of Section 17710 of the Welfare and Institutions Code. In addition to placing children with special health care needs, the department may approve placement of children without special health care needs, up to the licensed capacity. (7) "Social rehabilitation facility" means any residential facility that provides social rehabilitation services for no longer than 18 months in a group setting to adults recovering from mental illness who temporarily need assistance, guidance, or counseling. Program components shall be subject to program standards pursuant to Article 1 (commencing with Section 5670) of Chapter 2.5 of Part 2 of Division 5 of the Welfare and Institutions Code. (8) "Community treatment facility" means any residential facility that provides mental health treatment services to children in a group setting and that has the capacity to provide secure containment. Program components shall be subject to program standards developed and enforced by the State Department of Health Care Services pursuant to Section 4094 of the Welfare and Institutions Code. Nothing in this section shall be construed to prohibit or discourage placement of persons who have mental or physical disabilities into any category of community care facility that meets the needs of the individual placed, if the placement is consistent with the licensing regulations of the department. (9) "Full-service adoption agency" means any licensed entity engaged in the business of providing adoption services, that does all of the following: (A) 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. (B) Assesses the birth parents, prospective adoptive parents, or child. (C) Places children for adoption. (D) Supervises adoptive placements. 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. (10) "Noncustodial adoption agency" means any licensed entity engaged in the business of providing adoption services, that does all of the following: (A) Assesses the prospective adoptive parents. (B) 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. (C) Cooperatively supervises adoptive placements with a full-service adoptive agency, but does not disrupt a placement or remove a child from a placement. 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. (11) "Transitional shelter care facility" means any group care facility that provides for 24-hour nonmedical care of persons in need of personal services, supervision, or assistance essential for sustaining the activities of daily living or for the protection of the individual. Program components shall be subject to program standards developed by the State Department of Social Services pursuant to Section 1502.3. (12) "Transitional housing placement provider" means an organization licensed by the department pursuant to Section 1559.110 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. (13) "Group home" means a residential facility that provides 24-hour care and supervision to children, delivered at least in part by staff employed by the licensee in a structured environment. The care and supervision provided by a group home shall be nonmedical, except as otherwise permitted by law. (14) "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. (15) "Enhanced behavioral supports home" means a facility certified by the State Department of Developmental Services pursuant to Article 3.6 (commencing with Section 4684.80) of Chapter 6 of Division 4.5 of the Welfare and Institutions Code, and licensed by the State Department of Social Services as an adult residential facility or a group home that provides 24-hour nonmedical care to individuals with developmental disabilities who require enhanced behavioral supports, staffing, and supervision in a homelike setting. An enhanced behavioral supports home shall have a maximum capacity of four consumers, shall conform to Section 441.530(a)(1) of Title 42 of the Code of Federal Regulations, and shall be eligible for federal Medicaid home- and community-based services funding. (16) "Community crisis home" means a facility certified by the State Department of Developmental Services pursuant to Article 8 (commencing with Section 4698) of Chapter 6 of Division 4.5 of the Welfare and Institutions Code, and licensed by the State Department of Social Services pursuant to Article 9.7 (commencing with Section 1567.80), as an adult residential facility, providing 24-hour nonmedical care to individuals with developmental disabilities receiving regional center service, in need of crisis intervention services, and who would otherwise be at risk of admission to the acute crisis center at Fairview Developmental Center, Sonoma Developmental Center, an acute general hospital, acute psychiatric hospital, an institution for mental disease, as described in Part 5 (commencing with Section 5900) of Division 5 of the Welfare and Institutions Code, or an out-of-state placement. A community crisis home shall have a maximum capacity of eight consumers, as defined in subdivision (a) of Section 1567.80, shall conform to Section 441.530 (a)(1) of Title 42 of the Code of Federal Regulations, and shall be eligible for federal Medicaid home- and community-based services funding. (17) "Crisis nursery" means a facility licensed by the department to operate a program pursuant to Section 1516 to provide short-term care and supervision for children under six years of age who are voluntarily placed for temporary care by a parent or legal guardian due to a family crisis or stressful situation. (18) "Private or public residential care facility for youth" means a facility or program licensed by the department to operate pursuant to Section 1502.2 to provide nonmedical care, counseling, or educational or vocational support to persons under 18 years of age with social, emotional, behavioral, or mental health issues or disorders. (b) "Department" or "state department" means the State Department of Social Services. (c) "Director" means the Director of Social Services. SEC. 3. Section 1502.2 is added to the Health and Safety Code, to read: 1502.2. (a) The department shall license a private or public residential care facility for youth as a community care facility pursuant to this chapter. A private or public residential care facility for youth may provide any of the following: (1) A program with wilderness or outdoor experience, expedition, or intervention. (2) A boot camp experience or other experience designed to simulate characteristics of basic military training or correctional regimes. (3) A therapeutic boarding school. (4) A behavior modification program. (b) The department shall not license a private or public residential care facility for youth unless all therapeutic components of the programs provided at the facility are licensed by the appropriate agency or department. (c) (1) A staff member of a private or public residential care facility for youth who supervises residents shall receive appropriate training consisting of 10 hours within the first four weeks of employment and 8 hours annually thereafter. This training shall be administered while the staff is working at the facility, or in a classroom setting, or a combination of those settings. (2) A staff member of a private or public residential care facility for youth is a mandated child abuse reporter, as described in subdivision (a) of Section 11165.7 of the Penal Code. (3) A private or public residential care facility for youth shall submit its training plan to the department and shall implement the training plan only after the department has approved the plan. The training plan shall include, but not be limited to, all of the following subject areas: (A) Residents' rights as described in subdivision (d). (B) Psychosocial needs of youth. (C) Appropriate response to emergencies. (D) Physical needs for youth residents. (E) Cultural competency and sensitivity in issues relating to the underserved, lesbian, gay, bisexual, and transgender communities. (F) Laws and regulations pertaining to community care facilities and programs of private or public residential care facilities for youth. (G) The department shall adopt regulations that establish additional subject matter required to be included in this training. (d) A resident of a private or public residential care facility for youth has all of the following rights, a list of which shall be publically posted and accessible to residents: (1) To be accorded dignity in his or her personal relationships with staff, residents, and other persons. (2) To be granted a reasonable level of personal privacy in accommodations, medical care, personal care and assistance, visits, written and electronic communications, and telephone conversations. (3) To confidential care of his or her records and personal information, and to approve release of those records prior to their release, except as otherwise authorized or required by law. (4) To care, supervision, and services that meet his or her individual needs and are delivered by staff that are sufficient in numbers, qualifications, and competency to meet his or her needs and ensure his or her safety. (5) To be served food of the quality and in the quantity necessary to meet his or her nutritional needs. (6) (A) To present grievances and recommend changes in policies, procedures, and services to the facility's staff, management, and governing authority, and any other person without restraint, coercion, discrimination, reprisal, or other retaliatory actions. (B) To have the licensee take prompt actions to respond to those grievances. (7) To have frequent contact with parents or guardians, including scheduled and unscheduled telephone conversations, unrestricted written correspondence, and electronic communications. (8) To be fully informed, as evidenced by the resident's written acknowledgment, prior to, or at the time of, admission to the facility, of all the rules governing the resident's conduct and responsibilities. (9) To receive in the admission agreement, information that details the planned treatments and care for the resident. (10) For custodial parents or guardians to remove the resident from the facility. (11) To consent to have a relative or other person of the resident' s choosing visit or telephone during reasonable hours, privately and without prior notice. (12) To be free of corporal punishment, deprivation of basic necessities, including education, as a punishment, deterrent, or incentive, and physical restraints of any kind. (13) To receive supportive mental and emotional health-related services from trained staff who are licensed or are overseen by licensed mental health professionals. (14) To be free from abusive, humiliating, degrading, or traumatizing actions. (e) (1) A private or public residential care facility for youth shall not accept for placement, or provide care or supervision to, a child assessed as seriously emotionally disturbed, unless the State Department of Health Care Services has certified the facility as a program that meets the standards to provide mental health treatment services for a seriously emotionally disturbed child set forth in Section 4096.5 of the Welfare and Institutions Code. (2) "Seriously emotionally disturbed" has the meaning defined in paragraph (2) of subdivision (a) of Section 5600.3 of the Welfare and Institutions Code. (f) Unless a private or public residential care facility for youth has been licensed as an alcoholism or drug abuse recovery or treatment facility pursuant to Section 11834.01, the facility shall not advertise or promote services designed to promote the treatment of, or maintain recovery from, alcohol or drug use, which services include one or more of the following types of treatment: (1) Detoxification. (2) Group sessions. (3) Individual sessions. (4) Educational sessions. (5) Alcoholism or drug abuse recovery or treatment planning. (g) A private or public residential care facility for youth shall not provide secure containment or use restraints of any kind unless the program components are 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. (h) A private or public residential care facility for youth is not an eligible placement option pursuant to Section 319, 361.2, 450, or 727 of the Welfare and Institutions Code. (i) A private or public residential care facility for youth is not eligible for a rate pursuant to Section 11462 of the Welfare and Institutions Code. (j) A private or public residential care facility for youth shall not accept for residential placement a child younger than 12 years of age. (k) A licensee of a private or public residential care facility for youth that advertises or promotes special care, programming, or environments for persons with a mental health, emotional, or social challenge, shall provide each prospective resident and his or her parent or guardian an accurate narrative description of these programs and services. The facility shall provide the description in writing prior to admitting the prospective resident. SEC. 4. Section 1505 of the Health and Safety Code is amended to read: 1505. This chapter does not apply to any of the following: (a) Any health facility, as defined by Section 1250. (b) Any clinic, as defined by Section 1202. (c) Any juvenile placement facility approved by the Department of Corrections and Rehabilitation, Division of Juvenile Justice, or any juvenile hall operated by a county. (d) Any place in which a juvenile is judicially placed pursuant to subdivision (a) of Section 727 of the Welfare and Institutions Code. (e) Any child day care facility, as defined in Section 1596.750. (f) Any facility conducted by and for the adherents of any well-recognized church or religious denomination for the purpose of providing facilities for the care or treatment of the sick who depend solely upon prayer or spiritual means for healing in the practice of the religion of the church ordenomination.denomination, except a private or public residential care facility for youth as defined in subdivision (a) of Section 1502. (g) Any school dormitory or similar facility determined by the department, except a private or public residential care facility for youth as defined in subdivision (a) of Section1502.21502 . (h) Any house, institution, hotel, homeless shelter, or other similar place that supplies board and room only, or room only, or board only, provided that no resident thereof requires any element of care as determined by the director. (i) Recovery houses or other similar facilities providing group living arrangements for adults recovering from alcoholism or drug addiction where the facility provides no care or supervision. (j) Any alcoholism or drug abuse recovery or treatment facility serving adults as defined by Section 11834.11. (k) Any arrangement for the receiving and care of persons by a relative or any arrangement for the receiving and care of persons from only one family by a close friend of the parent, guardian, or conservator, if the arrangement is not for financial profit and occurs only occasionally and irregularly, as defined by regulations of the department. For purposes of this chapter, arrangements for the receiving and care of persons by a relative shall include relatives of the child for the purpose of keeping sibling groups together. (l) (1) Any home of a relative caregiver of children who are placed by a juvenile court, supervised by the county welfare or probation department, and the placement of whom is approved according to subdivision (d) of Section 309 of the Welfare and Institutions Code. (2) Any home of a nonrelative extended family member, as described in Section 362.7 of the Welfare and Institutions Code, providing care to children who are placed by a juvenile court, supervised by the county welfare or probation department, and the placement of whom is approved according to subdivision (d) of Section 309 of the Welfare and Institutions Code. (3) On and after January 1, 2012, any supervised independent living placement for nonminor dependents, as defined in subdivision (w) of Section 11400 of the Welfare and Institutions Code, who are placed by the juvenile court, supervised by the county welfare department, probation department, Indian tribe, consortium of tribes, or tribal organization that entered into an agreement pursuant to Section 10553.1 of the Welfare and Institutions Code, and whose placement is approved pursuant to subdivision (k) of Section 11400 of the Welfare and Institutions Code. (4) A Transitional Housing Program-Plus, as defined in subdivision (s) of Section 11400 of the Welfare and Institutions Code, that serves only eligible former foster youth over 18 years of age who have exited from the foster care system on or after their 18th birthday, and that has obtained certification from the applicable county in accordance with subdivision (c) of Section 16522 of the Welfare and Institutions Code. (m) Any supported living arrangement for individuals with developmental disabilities, as defined in Section 4689 of the Welfare and Institutions Code. (n) (1) Any family home agency, family home, or family teaching home as defined in Section 4689.1 of the Welfare and Institutions Code, that is vendored by the State Department of Developmental Services and that does any of the following: (A) As a family home approved by a family home agency, provides 24-hour care for one or two adults with developmental disabilities in the residence of the family home provider or providers and the family home provider or providers' family, and the provider is not licensed by the State Department of Social Services or the State Department of Public Health or certified by a licensee of the State Department of Social Services or the State Department of Public Health. (B) As a family teaching home approved by a family home agency, provides 24-hour care for a maximum of three adults with developmental disabilities in independent residences, whether contiguous or attached, and the provider is not licensed by the State Department of Social Services or the State Department of Public Health or certified by a licensee of the State Department of Social Services or the State Department of Public Health. (C) As a family home agency, engages in recruiting, approving, and providing support to family homes. (2) No part of this subdivision shall be construed as establishing by implication either a family home agency or family home licensing category. (o) Any facility in which only Indian children who are eligible under the federal Indian Child Welfare Act (Chapter 21 (commencing with Section 1901) of Title 25 of the United States Code) are placed and that is one of the following: (1) An extended family member of the Indian child, as defined in Section 1903 of Title 25 of the United States Code. (2) A foster home that is licensed, approved, or specified by the Indian child's tribe pursuant to Section 1915 of Title 25 of the United States Code. (p) (1) (A) Any housing occupied by elderly or disabled persons, or both, that is initially approved and operated under a regulatory agreement pursuant to Section 202 of Public Law 86-372 (12 U.S.C. Sec. 1701q), or Section 811 of Public Law 101-625 (42 U.S.C. Sec. 8013), or whose mortgage is insured pursuant to Section 236 of Public Law 90-448 (12 U.S.C. Sec. 1715z), or that receives mortgage assistance pursuant to Section 221d (3) of Public Law 87-70 (12 U.S.C. Sec. 1715 l ), where supportive services are made available to residents at their option, as long as the project owner or operator does not contract for or provide the supportive services. (B) Any housing that qualifies for a low-income housing credit pursuant to Section 252 of Public Law 99-514 (26 U.S.C. Sec. 42) or that is subject to the requirements for rental dwellings for low-income families pursuant to Section 8 of Public Law 93-383 (42 U.S.C. Sec. 1437f), and that is occupied by elderly or disabled persons, or both, where supportive services are made available to residents at their option, as long as the project owner or operator does not contract for or provide the supportive services. (2) The project owner or operator to which paragraph (1) applies may coordinate, or help residents gain access to, the supportive services, either directly, or through a service coordinator. (q) A resource family, as defined in Section 16519.5 of the Welfare and Institutions Code. (r) Any similar facility determined by the director. SEC. 5. 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.