Amended IN Senate May 03, 2023 Amended IN Senate March 14, 2023 CALIFORNIA LEGISLATURE 20232024 REGULAR SESSION Senate Bill No. 408Introduced by Senator AshbyFebruary 09, 2023An act to amend Section 1502 of, and to add Section 1562.011 to, the Health and Safety Code, and to amend Sections 11400, 11460, 11462.01, and 16001.1 of, to add Section 11462.010 to, and to add Chapter 4.5 (commencing with Section 5425) of to Part 1 of Division 5 of, the Welfare and Institutions Code, relating to foster youth. LEGISLATIVE COUNSEL'S DIGESTSB 408, as amended, Ashby. Foster youth with complex needs: regional health teams: short-term assessment, treatment, and transition programs. teams and short-term residential therapeutic programs.(1) Existing law generally provides for the placement of foster youth in various placement settings, and governs the provision of child welfare services, which is defined to mean public social services that are directed toward the accomplishment of specified purposes, including protecting and promoting the welfare of all children, preventing the unnecessary separation of children from their families, and restoring to their families children who have been removed. Existing federal law, the Family First Prevention Services Act of 2018, among other things, provides states with an option to use federal funds under Title IV of the federal Social Security Act to provide mental health and substance abuse prevention and treatment services and in-home parent skill-based programs to a child who is a candidate for foster care or a child in foster care who is a pregnant or parenting foster youth, as specified.This bill would require the State Department of Health Care Services, in consultation with the State Department of Social Services, to establish up to 10 regional health teams throughout the state, to serve foster youth and youth who may be at risk of entering foster care. The bill would require the department to submit a state plan amendment to the federal Centers for Medicare and Medicaid Services no later than July 1, 2024, to implement the Medicaid Health Home State Plan Option, as specified, in establishing the regional health teams. The bill would require the department to coordinate with the State Department of Social Services and the State Department of Developmental Services, and to convene and engage specified stakeholders, to develop the regional health teams. TheThe bill would make regional health teams available to children and youth and any adult caregiver or other adult connected with the child or youth under 26 years of age, who are experiencing severe mental illness, emotional disturbance, substance use, intellectual or developmental disability, or special health care needs or chronic health issues, or any combination of those conditions. The bill would specify the required membership of the regional health teams, including, but not limited to, a primary care physician, a licensed clinical social worker, and a public health nurse. The duties of the regional health team would include, but not be limited to, receiving and responding to referrals received from staff from county child welfare agencies, county probation departments, regional centers, and others, and coordinating and providing access to various categories of care and services. TheThe bill would require the department to fund up to 10 health teams that are geographically situated to support access to services equitably throughout the state. The bill would require the regional health teams to be funded by the department pursuant to a competitive procurement process. The bill would declare the intent of the Legislature that the health home state plan option begin no later than December 1, 2024, subject to the receipt of any required federal approvals or waivers.(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.Existing law, the California Community Care Facilities Act, provides for the licensure and regulation by the State Department of Social Services of community care and residential facilities, including specified residential facilities that provide care for foster youth, such as short-term residential therapeutic programs. A violation of the act is a misdemeanor.This bill would create, and would require the department to license, the short-term assessment, treatment, and transition program (STATTP) as a new placement category for children and youth described in the bill. The bill would define the STATTP as a residential facility operated independently, or jointly by a public agency, tribal agency, or private organization, 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, and that is trauma-informed, nonmedical, and nonprofit. The bill would require a STATTP to be comply with requirements of the act applicable to short-term residential therapeutic programs, unless otherwise specified. The bill would establish a per-child, per-month compensation rate for STATTP care of $43,000.The bill would require a STATTP to accept all children and youth referred by a child welfare agency, probation agency, or tribal entity, unless a determination is made by the clinical staff, in consultation with other members of the care team, that the child or youth is in need of a more restrictive inpatient setting, as specified. The bill would require the STATTP to provide enhanced care and supervision for children and youth with intensive, complex needs with the support of a care team, which would deliver services to a child or youth placed in the STATTP and for up to 6 months postdischarge, as needed. The bill would specify the composition and duties of the care team, as well as administrative and medical staffing requirements for STATTPs. The bill would require the STATTP to offer respite care to the next caregiver upon the childs or youths discharge, as specified.The bill would authorize a STATTP to be operated under licensure by counties, nonprofit agencies, tribal agencies, or a combination of those entities. The bill would authorize the department to adopt regulations for STATTPs, as specified, to implement the provisions relating to STATTPs by means of interim licensing standards until regulations are adopted, and, by March 1, 2024, to adopt licensing standards. The bill would require final regulations to be adopted by January 1, 2027, as specified.This bill would require the department to develop an enhanced funding model for short-term residential therapeutic programs that serve up to 4 current or former foster children or nonminor dependents in the foster care system who have complex needs across multiple systems. Under the bill, the enhanced funding would be for additional program staffing to be delivered onsite by a care team composed of appropriate professionals trained in trauma-informed care, as specified. The bill would set forth certain criteria for the delivery of services by the care team.As a condition of receiving enhanced funding, and subject to the above-described requirements, the bill would require the program to accept all children and nonminor dependents referred by a child welfare agency, probation agency, or tribal entity, except as specified. The bill would require the program to continue to serve a child or nonminor dependent admitted to the program until they can be appropriately transitioned to the next level of care and to hold beds open due to temporary transfers to a general acute care hospital or a crisis mental health inpatient setting for up to 14 days.The bill would require the department to develop a separate rate for the enhanced funding, to develop staffing requirements, and to adopt regulations as needed, in consultation with certain stakeholders. The bill would authorize the department to implement these provisions through interim guidance until regulations are adopted.Existing(3) Existing law requires the department to allocate specified funds appropriated to the department in the Budget Act of 2021 through contracts with community-based providers or entities or through local assistance allocations to counties or Indian tribes that support new or expanded programs, services, and practices that ensure the provision of a high-quality continuum of care that is designed to support foster children in the least restrictive setting, as specified. Existing law also requires the department to allocate funds in the same manner to provide and implement the recommendations of child-specific assessments, evaluations, enhanced care planning, ongoing technical assistance, and exceptional supports to meet the complex care needs of children in foster care within California within the least restrictive setting.This bill would revise and expand those funding provisions, including adding to the permissible uses of those funds to include, among other things, STATTPs and short-term therapeutic settings that serve as an alternative to hospital-based settings. future funds to include in-home nursing supports for youth with special health care needs and highly specialized short-term residential therapeutic programs designed to serve children with complex trauma. The bill would require the department to annually allocate funds to county placing agencies and tribal agencies to purchase, procure, or directly provide supports or services to meet the exceptional needs of children and nonminor dependents in the least restrictive setting, and would allow a regional health team to make clinical recommendations to counties and tribal entities for expenditures made under these provisions.(3)Because the creation of a new licensure category for foster youth would increase the duties of county placement agencies, and because a violation of the Community Care Facilities Act by a STATTP would be a crime, the bill would impose 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 specified reasons.(4) This bill would provide that a continuous appropriation would not be made for purposes of implementing the bill.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: YESNO Bill TextThe people of the State of California do enact as follows:SECTION 1. The Legislature finds and declares all of the following:(a) California counties are experiencing a crisis of foster youth with severe trauma and complex, unmet needs who are simply overwhelming county child welfare and probation agencies, regional centers, schools, and behavioral health providers.(b) Foster youth with complex needs are often served by multiple other systems who also struggle with providing timely and appropriate services due to lack of funding and antiquated processes that are not conducive to meeting childrens immediate needs, particularly for foster children experiencing a trauma crisis.(c) Services to this population are currently delayed, lacking, and disjointed, resulting in foster youth often experiencing frequent placement changes because no single provider or entity can meet their needs. This results in a cycle of multiple placement moves, frequent changes in service providers and caregivers, and unnecessary stays in hospital settings and unlicensed settings. These experiences lead to poor outcomes for youth and exacerbate their trauma.(d) While some efforts have been made at the state level to provide additional supports and assess the gaps and service needs, immediate action is necessary to provide a trauma-informed, patient- and youth-centered approach to addressing the individualized needs of foster youth with complex needs.(e) Foster children and their families have experienced trauma that requires a coordinated, multisystem approach to achieve positive outcomes and to build on and leverage existing efforts, such as trauma-informed systems of care, pursuant to AB 2083 (Chapter 815 of the Statutes of 2018), and California Advancing Innovations in and Innovating Medi-Cal (CalAIM).(f) Some foster youth who have experienced significant trauma, coupled with other intensive needs that cross multiple systems, and their families require a targeted approach to service provision that involves a coordinated effort across systems to meet their very unique needs.(g) California can take advantage of tools and enhanced funding available through the federal Medicaid program to help better coordinate care and provide targeted services to foster youth with intensive needs. These needs include mental and physical health needs, developmental services, and other services that address their broad needs through care managers to help reduce hospitalizations or placement into restrictive institutional settings.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 daycare, or foster family agency services for children, adults, or children and adults, including, but not limited to, the physically handicapped, mentally impaired, incompetent persons, and abused or neglected children, and includes the following:(1)Residential facility means any family home, group care facility, or similar facility determined by the department, for 24-hour nonmedical care of persons in need of personal services, supervision, or assistance essential for sustaining the activities of daily living or for the protection of the individual.(2)Adult day program means any community-based facility or program that provides care to persons 18 years of age or older in need of personal services, supervision, or assistance essential for sustaining the activities of daily living or for the protection of these individuals on less than a 24-hour basis.(3)Therapeutic day services facility means any facility that provides nonmedical care, counseling, educational or vocational support, or social rehabilitation services on less than a 24-hour basis to persons under 18 years of age who would otherwise be placed in foster care or who are returning to families from foster care. Program standards for these facilities shall be developed by the department, pursuant to Section 1530, in consultation with therapeutic day services and foster care providers.(4)Foster family agency means any public agency or private organization, organized and operated on a nonprofit basis, engaged in any of the following:(A)Recruiting, certifying, approving, and training of, and providing professional support to, foster parents and resource families.(B)Coordinating with county placing agencies to find homes for foster children in need of care.(C)Providing services and supports to licensed or certified foster parents, county-approved resource families, and children to the extent authorized by state and federal law.(5)Foster family home means any residential facility providing 24-hour care for six or fewer foster children that is owned, leased, or rented and is the residence of the foster parent or parents, including their family, in whose care the foster children have been placed. The placement may be by a public or private child placement agency or by a court order, or by voluntary placement by a parent, parents, or guardian. It also means a foster family home described in Section 1505.2.(6)Small family home means any residential facility, in the licensees 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)(A)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.(B)This section does not prohibit or discourage placement of persons who have mental or physical disabilities into any category of community care facility that meets the needs of the individual placed, if the placement is consistent with the licensing regulations of the department.(9)(A)Full-service adoption agency means any licensed entity engaged in the business of providing adoption services, that does all of the following:(i)Assumes care, custody, and control of a child through relinquishment of the child to the agency or involuntary termination of parental rights to the child.(ii)Assesses the birth parents, prospective adoptive parents, or child.(iii)Places children for adoption.(iv)Supervises adoptive placements.(B)Private full-service adoption agencies shall be organized and operated on a nonprofit basis. As a condition of licensure to provide intercountry adoption services, a full-service adoption agency shall be accredited and in good standing according to Part 96 (commencing with Section 96.1) of Title 22 of the Code of Federal Regulations, or supervised by an accredited primary provider, or acting as an exempted provider, in compliance with Subpart F (commencing with Section 96.29) of Part 96 of Title 22 of the Code of Federal Regulations.(10)(A)Noncustodial adoption agency means any licensed entity engaged in the business of providing adoption services, that does all of the following:(i)Assesses the prospective adoptive parents.(ii)Cooperatively matches children freed for adoption, who are under the care, custody, and control of a licensed adoption agency, for adoption, with assessed and approved adoptive applicants.(iii)Cooperatively supervises adoption placements with a full-service adoptive agency, but does not disrupt a placement or remove a child from a placement.(B)Private noncustodial adoption agencies shall be organized and operated on a nonprofit basis. As a condition of licensure to provide intercountry adoption services, a noncustodial adoption agency shall be accredited and in good standing according to Part 96 (commencing with Section 96.1) of Title 22 of the Code of Federal Regulations, or supervised by an accredited primary provider, or acting as an exempted provider, in compliance with Subpart F (commencing with Section 96.29) of Part 96 of Title 22 of the Code of Federal Regulations.(11)Transitional shelter care facility means any group care facility that provides for 24-hour nonmedical care of persons in need of personal services, supervision, or assistance essential for sustaining the activities of daily living or for the protection of the individual. Program components shall be subject to program standards developed by the State Department of Social Services pursuant to Section 1502.3.(12)Transitional housing placement provider means an organization licensed by the department pursuant to Section 1559.110 to provide transitional housing to foster children who are at least 16 years of age to promote their transition to adulthood. A transitional housing placement provider shall be privately operated and organized on a nonprofit basis.(13)Group home means a residential facility that provides 24-hour care and supervision to children, delivered at least in part by staff employed by the licensee in a structured environment. The care and supervision provided by a group home shall be nonmedical, except as otherwise permitted by law.(14)Youth homelessness prevention center means a group home licensed by the department to operate a program pursuant to Section 1502.35 to provide voluntary, short-term, shelter and personal services to homeless youth, youth who are at risk of homelessness, youth who are exhibiting status offender behavior, or runaway youth, as defined in paragraph (2) of subdivision (a) of Section 1502.35.(15)Enhanced behavioral supports home means a facility certified by the State Department of Developmental Services pursuant to Article 3.6 (commencing with Section 4684.80) of Chapter 6 of Division 4.5 of the Welfare and Institutions Code, and licensed by the State Department of Social Services as an adult residential facility or a group home that provides 24-hour nonmedical care to individuals with developmental disabilities who require enhanced behavioral supports, staffing, and supervision in a homelike setting. An enhanced behavioral supports home shall have a maximum capacity of four consumers, shall conform to Section 441.530(a)(1) of Title 42 of the Code of Federal Regulations, and shall be eligible for federal Medicaid home- and community-based services funding.(16)Community crisis home means a facility certified by the State Department of Developmental Services pursuant to Article 8 (commencing with Section 4698) of Chapter 6 of Division 4.5 of the Welfare and Institutions Code, and licensed by the State Department of Social Services pursuant to Article 9.7 (commencing with Section 1567.80), as an adult residential facility, providing 24-hour nonmedical care to individuals with developmental disabilities receiving regional center service, in need of crisis intervention services, and who would otherwise be at risk of admission to the acute crisis center at Fairview Developmental Center, an acute general hospital, acute psychiatric hospital, an institution for mental disease, as described in Part 5 (commencing with Section 5900) of Division 5 of the Welfare and Institutions Code, or an out-of-state placement. A community crisis home shall have a maximum capacity of eight consumers, as defined in subdivision (a) of Section 1567.80, shall conform to Section 441.530(a)(1) of Title 42 of the Code of Federal Regulations, and shall be eligible for federal Medicaid home- and community-based services funding.(17)Crisis nursery means a facility licensed by the department to operate a program pursuant to Section 1516 to provide short-term care and supervision for children under six years of age who are voluntarily placed for temporary care by a parent or legal guardian due to a family crisis or stressful situation.(18)Short-term residential therapeutic program means a residential facility operated by a public agency or private organization and licensed by the department pursuant to Section 1562.01 that provides an integrated program of specialized and intensive care and supervision, services and supports, treatment, and short-term, 24-hour care and supervision to children that is trauma-informed, as defined in standards and regulations adopted by the department. 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 childrens crisis residential program.(19)Private alternative boarding school means a group home licensed by the department to operate a program pursuant to Section 1502.2 to provide youth with 24-hour residential care and supervision, that, in addition to providing educational services to youth, provides, or holds itself out as providing, behavioral-based services to youth with social, emotional, or behavioral issues. The care and supervision provided by a private alternative boarding school shall be nonmedical, except as otherwise permitted by law.(20)Private alternative outdoor program means a group home licensed by the department to operate a program pursuant to Section 1502.21 to provide youth with 24-hour residential care and supervision, that provides, or holds itself out as providing, behavioral-based services in an outdoor living setting to youth with social, emotional, or behavioral issues. The care and supervision provided by a private alternative outdoor program shall be nonmedical, except as otherwise permitted by law.(21)Childrens crisis residential program means a facility licensed by the department as a short-term residential therapeutic program pursuant to Section 1562.02 and approved by the State Department of Health Care Services, or a county mental health plan to which the State Department of Health Care Services has delegated approval authority, to operate a childrens crisis residential mental health program with approval pursuant to Section 11462.011 of the Welfare and Institutions Code, to serve children experiencing mental health crises as an alternative to psychiatric hospitalization.(22)Group home for children with special health care needs means a group home certified by the State Department of Developmental Services pursuant to Article 3.5 (commencing with Section 4684.50) 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 (commencing with Section 1567.50) of this code that provides 24-hour health care and intensive support services in a homelike setting. A group home for children with special health care needs shall have a maximum capacity of five children with developmental disabilities, as defined in subdivision (a) of Section 4512 of the Welfare and Institutions Code.(23)Short-term assessment, treatment, and transition program or STATTP means a residential facility operated independently, or jointly by a public agency, tribal 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, and that is trauma-informed, as defined in standards and regulations adopted by the department. The care and supervision provided by a short-term assessment, treatment, and transition 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.(b)Department or state department means the State Department of Social Services.(c)Director means the Director of Social Services.SEC. 3.Section 1562.011 is added to the Health and Safety Code, to read:1562.011.(a)The department shall license short-term assessment, treatment, and transition programs or STATTPs, as defined in paragraph (23) of subdivision (a) of Section 1502, pursuant to this chapter. A STATTP shall comply with all requirements of this chapter that are applicable to short-term residential treatment programs pursuant to Section 1562.01, unless otherwise specified, and pursuant to the requirements of this section.(b)(1)A STATTP shall provide enhanced care and supervision for youth with intensive, complex needs with the support of a care team as defined by this section.(2)Notwithstanding Section 1562.01, staffing of each STATTP shall include, at minimum, all of the following:(A)A full-time administrator.(B)Two full-time clinical heads of service, which may be filled by one or more psychologists or licensed clinical social workers.(C)A half-time registered nurse, licensed vocational nurse, or public health nurse.(D)A full-time psychiatric social worker or psychiatric technician.(E)A full-time masters or bachelors level social worker.(F)A full-time facility manager.(G)Approximately two full-time equivalent direct care staff for every three children during the day and at night. Direct care staff shall be 24 years of age or older. Direct care staff shall include, at minimum, four mental health rehabilitation specialists.(H)A full-time special education specialist.(I)A half-time board-certified behavioral analyst.(J)A half-time youth peer.(K)A half-time caregiver peer.(L)A full-time activities coordinator.(M)A full-time training specialist(N)Three full-time equivalent food preparation specialists.(3)(A)The STATTP shall provide intensive, trauma-informed services through a care team for each child or youth. The care team shall be trained in trauma-informed care and led by a clinical head of service and shall include, at minimum, the program social worker, special education specialist, board-certified behavioral analyst, youth peer, and caregiver peer.(B)The care team shall deliver services to a child who is placed at a STATTP and for up to six months postdischarge as needed by the youth and their caregiver to support transition to other residential or community-based care, including family-based care. The care team shall assist in identifying, recruiting, and engaging any identified family or family-like connections to the child or youth to support the childs or youths connection to family. The care team may deliver services directly to the child, family, family-like connections, or other caregivers to support step-downs to family-based care, or may provide consultation to the next direct service provider, to include the biological family, legal guardian, or both, as deemed appropriate and pursuant to the childs or youths care plan, in consultation with any child and family team.(c)(1)The STATTP shall accept all children and youth referred by a child welfare agency, probation agency, or tribal entity unless a determination is made by the clinical staff, in consultation with other members of the care team, that the child or youth is in need of a more restrictive inpatient setting due to the immediate and present risk of serious injury to self or others or due to a commonality of need determination pursuant to subdivision (g). Once admitted, the STATTP shall continue to serve the child or youth until they can be appropriately transitioned to the next level of care with support of the care team. Placements shall comply with the requirements of Section 4096 of the Welfare and Institutions Code.(2)If a resident of the STATTP is temporarily transferred to a general acute care hospital, as defined in subdivision (a) of Section 1250 of the Health and Safety Code, or temporarily placed into any other inpatient setting, the STATTP shall afford the resident an automatic bed hold of 48 hours, which may be extended for up to 14 days pursuant to the requirements in this paragraph. The bed hold option may be exercised by a child 12 years of age or older, by the county placing agency or tribal entity, or the childs authorized representative.(A)Within 24 hours of the childs transfer to a general acute care hospital or other inpatient setting, the STATTP shall inform the child, if 12 years of age or older, the county placing agency, and the childs authorized representative of their right to exercise a bed hold, the steps to take to inform the program of their decision of whether or not to request a bed hold, and the length of time the bed hold is requested, up to seven days.(B)If the right to a bed hold is exercised and the child is not discharged within that time, the program shall inform the child, if 12 years of age or older, the county placing agency, and the childs authorized representative of their right to request an additional bed hold time, for up to a total of 14 days from the date the child left the program. The program shall provide this information at least 24 hours before the release of the bed hold.(C)A public agency that has placed the resident into the STATTP shall be liable to pay reasonable charges, not to exceed the daily rate for care in the program, for bed holds. Any other resident or representative who exercises the bed hold option shall be liable to pay reasonable charges, not to exceed the daily rate for care in the facility as established by the program, for bed hold days.(D)If the patient's attending physician notifies the STATTP in writing that the patient's stay in the general acute care hospital or other inpatient facility is expected to exceed seven days, the program shall not be required to maintain the bed hold.(3)The STATTP shall maintain communication with the youth, county placing agency or tribal agency, any caregivers or authorized representatives, and acute care hospital or other inpatient providers during the bed hold period, to support the residents treatment needs, discharge from the hospital or inpatient setting, and return to the program.(d)The STATTP shall additionally offer respite care to the next caregiver upon discharge from the program. Respite care shall be available for up to six months postdischarge for the youth, upon request of the caregiver, placing agency, or tribal entity. Respite care may be provided for up to 14 days for a youth previously served and shall be available for multiple episodes as needed to aid in the transition. The placing agency shall ensure the STATTP is compensated concurrently with any other paid placement under AFDC-FC during this time.(e)The STATTP shall leverage and coordinate with other service providers, including, but not limited to, regional centers, local education agencies, behavior health agencies, wraparound providers, and others, to maximize services and supports to the child, youth, and their caregivers while the child or youth is receiving services from the program.(f)The STATTP may be operated under licensure by counties, nonprofit agencies, tribal agencies, or a combination thereof. The department shall ensure licensing standards allow for cross-agency staffing when jointly operated.(g)STATTPs shall adhere to commonality of need requirements pursuant to subdivision (c) of Section 16514 of the Welfare and Institutions Code, and shall prioritize children and nonminor dependents placed by county child welfare agencies, probation agencies, and tribal entities for entry into care.(h)The STATTP shall be compensated at a per-child per-month rate of forty-three thousand dollars ($43,000), which shall be adjusted annually on July 1 to reflect any increases or decreases in the cost of living.(i)(1)The department shall adopt regulations to implement this section, collaborating with the State Department of Health Care Services, as necessary, to ensure alignment with mental health program approval requirements, as described in Section 4096.5 of the Welfare and Institutions Code.(2)The department shall consult with the County Welfare Directors Association, Chief Probation Officers of California, California Youth Connection, tribal representatives, County Behavioral Health Directors Association, and other stakeholders as deemed appropriate in the development of regulations.(3)(A)Notwithstanding the rulemaking provisions of the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code), the department may implement, interpret, or make specific this section by means of interim licensing standards until regulations are adopted. These interim licensing standards shall have the same force and effect as regulations until the adoption of regulations.(B)Licensing standards shall be adopted no later than March 1, 2024. If the department utilizes interim licensing standards, final regulations shall be adopted no later than January 1, 2027.SEC. 4.SEC. 2. Chapter 4.5 (commencing with Section 5425) is added to Part 1 of Division 5 of the Welfare and Institutions Code, to read: CHAPTER 4.5. Regional Health Teams5425. (a) The department, in consultation with the State Department of Social Services, shall establish up to 10 regional health teams throughout the state to serve foster youth and youth who may be at risk of entering foster care. In establishing the regional health teams, the department shall submit a state plan amendment to the federal Centers for Medicare and Medicaid Services no later than July 1, 2024, to implement the Medicaid Health Home State Plan Option, pursuant to Sections 2703 and 1945 of the Social Security Act. Section 1945 of the federal Social Security Act, as added by Section 2703 of the federal Patient Protection and Affordable Care Act.(b) The department shall coordinate with the State Department of Social Services and the State Department of Developmental Services and shall convene and engage stakeholders, including, but not limited to, the County Welfare Directors Association of California, the Chief Probation Officers of California, the County Behavioral Health Directors Association of California, the Association of Regional Centers Center Agencies, interested counties, and other stakeholders, as deemed appropriate, to develop the regional health teams.5426. (a) Regional health teams shall be available to children and youth and any adult caregivers or other adults connected with the child or youth under 26 years of age, who are experiencing severe mental illness, emotional disturbance, substance use, intellectual or developmental disability, or special health care needs or chronic health issues, or any combination of the listed conditions, and subject to identification and referral as described pursuant to subdivision (d). For purposes of this chapter, severe mental illness and emotional disturbance means an organic disorder of the brain or a clinically significant disorder of thought, mood, perception, orientation, memory, or behavior, that seriously limits a persons capacity to function in primary aspects of daily living, such as personal relations, living arrangements, work, school, and recreation.(b) Regional health teams shall be physician led and shall be composed of, at a minimum, the following members:(1) A primary care physician.(2) A licensed clinical social worker.(3) A public health nurse.(4) A nutritionist or dietitian.(5) An occupational therapist.(6) A community health worker.(7) A peer support specialist.(8) A training coordinator.(9) Additional behavioral health staff as appropriate.(c) All team members shall be responsible for ensuring that care is person-centered, person centered, culturally competent, and linguistically capable.(d) Regional health teams shall perform the following activities:(1) Receive and respond to referrals received from staff from county child welfare, county probation departments, regional centers, and others as deemed appropriate by the local county system of care, as defined pursuant to Section 16521.6.(2) Provide quality-driven, cost-effective, culturally appropriate, and person- and family-centered health home services.(3) Coordinate and provide access to high-quality health care services informed by evidence-based clinical practice guidelines.(4) Coordinate and provide access to preventive and health promotion services, including prevention of mental illness and substance use disorders.(5) Coordinate and provide access to mental health and substance abuse services.(6) Coordinate and provide access to comprehensive care management, care coordination, and transitional care across settings. For purposes of this chapter, transitional care means appropriate followup from inpatient to other settings, such as participation in discharge planning and facilitating transfer from a pediatric to an adult system of health care.(7) Coordinate and provide access to chronic disease management, including self-management support to individuals and their families.(8) Coordinate and provide access to individual and family supports, including linkage to community, social support, and recovery services.(9) Coordinate and provide access to long-term care supports and services.(10) Promote evidence-based medicine and utilize patient engagement strategies in the implementation of client plans.(11) Develop a person-centered care plan for each individual that coordinates and integrates all of their clinical and nonclinical, health care-related needs and services.(12) Demonstrate a capacity to use health information technology to link services, facilitate communication among team members and between the health team and individual and family caregivers, as well as the placing agency, and provide feedback regarding practices, as feasible and appropriate.(13) Establish a continuous quality improvement program, and collect and report on data that permit an evaluation of increased coordination of care and chronic disease management on individual-level clinical outcomes, experience-of-care outcomes, and quality-of-care outcomes at the population level.(14) Conduct staff training within the regional health team and with other service providers to improve direct care and patient outcomes.(e) Screening and referral for regional health team services shall be determined pursuant to guidelines developed by the local system of care team pursuant to Section 16521.6 in the county or counties served by the regional health team, with priority to current foster youth and those at risk of entering foster care.(f) The department shall fund up to 10 health teams that shall be geographically situated to support access to services equitably throughout the state. Regional health teams shall be funded by the department pursuant to a competitive procurement process.(g) The department, in consultation with the stakeholders identified in subdivision (b) of Section 5425, shall establish performance and outcome measures to be tracked by regional health teams and the intervals at which these teams are required to report information related to those measures to the department. The department shall post the results of these performance and outcome measures on its internet website on at least an annual basis.(h) (1)It is the intent of the Legislature that the health home state plan option established pursuant to this section begin no later than December 1, 2024, subject to the receipt of any required federal approvals or waivers.(2)A report to be submitted to the Legislature pursuant to paragraph (1) shall be submitted in compliance with Section 9795 of the Government Code.SEC. 5.Section 11400 of the Welfare and Institutions Code is amended to read:11400.For purposes of this article, and Article 6 (commencing with Section 11450), the following definitions apply:(a)Aid to Families with Dependent Children-Foster Care (AFDC-FC) means the aid provided on behalf of needy children in foster care under the terms of this division.(b)Case plan means a written document that, at a minimum, specifies the type of home in which the child shall be placed, the safety of that home, and the appropriateness of that home to meet the childs needs. It shall also include the agencys plan for ensuring that the child receive proper care and protection in a safe environment, and shall set forth the appropriate services to be provided to the child, the childs family, and the foster parents, in order to meet the childs needs while in foster care, and to reunify the child with the childs family. In addition, the plan shall specify the services that will be provided or steps that will be taken to facilitate an alternate permanent plan if reunification is not possible.(c)Certified family home means an individual or family certified by a licensed foster family agency and issued a certificate of approval by that agency as meeting licensing standards, and used exclusively by that foster family agency for placements.(d)Family home means the family residence of a licensee in which 24-hour care and supervision are provided for children.(e)Small family home means any residential facility, in the licensees family residence, which 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.(f)Foster care means the 24-hour out-of-home care provided to children whose own families are unable or unwilling to care for them, and who are in need of temporary or long-term substitute parenting.(g)Foster family agency means a licensed community care facility, as defined in paragraph (4) of subdivision (a) of Section 1502 of the Health and Safety Code. Private foster family agencies shall be organized and operated on a nonprofit basis.(h)Group home means a nondetention privately operated residential home, organized and operated on a nonprofit basis only, of any capacity, or a nondetention licensed residential care home operated by the County of San Mateo with a capacity of up to 25 beds, that accepts children in need of care and supervision in a group home, as defined by paragraph (13) of subdivision (a) of Section 1502 of the Health and Safety Code.(i)Periodic review means review of a childs status by the juvenile court or by an administrative review panel, that shall include a consideration of the safety of the child, a determination of the continuing need for placement in foster care, evaluation of the goals for the placement and the progress toward meeting these goals, and development of a target date for the childs return home or establishment of alternative permanent placement.(j)Permanency planning hearing means a hearing conducted by the juvenile court in which the childs future status, including whether the child shall be returned home or another permanent plan shall be developed, is determined.(k)Placement and care refers to the responsibility for the welfare of a child vested in an agency or organization by virtue of the agency or organization having (1) been delegated care, custody, and control of a child by the juvenile court, (2) taken responsibility, pursuant to a relinquishment or termination of parental rights on a child, (3) taken the responsibility of supervising a child detained by the juvenile court pursuant to Section 319 or 636, or (4) signed a voluntary placement agreement for the childs placement; or to the responsibility designated to an individual by virtue of the individual being appointed the childs legal guardian.(l)Preplacement preventive services means services that are designed to help children remain with their families by preventing or eliminating the need for removal.(m)Relative means an adult who is related to the child by blood, adoption, or affinity within the fifth degree of kinship, including stepparents, stepsiblings, and all relatives whose status is preceded by the words great, great-great, or grand or the spouse of any of these persons even if the marriage was terminated by death or dissolution.(n)Nonrelative extended family member means an adult caregiver who has an established familial or mentoring relationship with the child, as described in Section 362.7.(o)Voluntary placement means an out-of-home placement of a child by (1) the county welfare department, probation department, or Indian tribe that has entered into an agreement pursuant to Section 10553.1, after the parents or guardians have requested the assistance of the county welfare department and have signed a voluntary placement agreement, or (2) the county welfare department licensed public or private adoption agency, or the department acting as an adoption agency, after the parents have requested the assistance of either the county welfare department, the licensed public or private adoption agency, or the department acting as an adoption agency for the purpose of adoption planning, and have signed a voluntary placement agreement.(p)Voluntary placement agreement means a written agreement between either the county welfare department, probation department, or Indian tribe that has entered into an agreement pursuant to Section 10553.1, licensed public or private adoption agency, or the department acting as an adoption agency, and the parents or guardians of a child that specifies, at a minimum, the following:(1)The legal status of the child.(2)The rights and obligations of the parents or guardians, the child, and the agency in which the child is placed.(q)Original placement date means the most recent date on which the court detained a child and ordered an agency to be responsible for supervising the child or the date on which an agency assumed responsibility for a child due to termination of parental rights, relinquishment, or voluntary placement.(r)(1)Transitional housing placement provider means an organization licensed by the State Department of Social Services pursuant to Section 1559.110 of the Health and Safety Code to provide supervised transitional housing services to foster children who are at least 16 years of age. A transitional housing placement provider shall be privately operated and organized on a nonprofit basis.(2)Before licensure, a provider shall obtain certification from the applicable county, in accordance with Section 16522.1.(s)Transitional Housing Program-Plus means a provider certified by the applicable county, in accordance with subdivision (c) of Section 16522, to provide transitional housing services to former foster youth who have exited the foster care system on or after their 18th birthday.(t)Whole family foster home means a resource family, licensed foster family home, approved relative caregiver or nonrelative extended family members home, the home of a nonrelated legal guardian whose guardianship was established pursuant to Section 360 or 366.26, certified family home, or a host family of a transitional housing placement provider, that provides foster care for a minor or nonminor dependent parent and their child, and is specifically recruited and trained to assist the minor or nonminor dependent parent in developing the skills necessary to provide a safe, stable, and permanent home for the child. The child of the minor or nonminor dependent parent need not be the subject of a petition filed pursuant to Section 300 to qualify for placement in a whole family foster home.(u)Mutual agreement means any of the following:(1)A written voluntary agreement of consent for continued placement and care in a supervised setting between a minor or, on and after January 1, 2012, a nonminor dependent, and the county welfare services or probation department or tribal agency responsible for the foster care placement, that documents the nonminors continued willingness to remain in supervised out-of-home placement under the placement and care of the responsible county, tribe, consortium of tribes, or tribal organization that has entered into an agreement with the state pursuant to Section 10553.1, remain under the jurisdiction of the juvenile court as a nonminor dependent, and report any change of circumstances relevant to continued eligibility for foster care payments, and that documents the nonminors and social workers or probation officers agreement to work together to facilitate implementation of the mutually developed supervised placement agreement and transitional independent living case plan.(2)An agreement, as described in paragraph (1), between a nonminor former dependent or ward in receipt of Kin-GAP payments under Article 4.5 (commencing with Section 11360) or Article 4.7 (commencing with Section 11385), and the agency responsible for the Kin-GAP benefits, provided that the nonminor former dependent or ward satisfies the conditions described in Section 11403.01, or one or more of the conditions described in paragraphs (1) to (5), inclusive, of subdivision (b) of Section 11403. For purposes of this paragraph and paragraph (3), nonminor former dependent or ward has the same meaning as described in subdivision (aa).(3)An agreement, as described in paragraph (1), between a nonminor former dependent or ward in receipt of AFDC-FC payments under subdivision (e) or (f) of Section 11405 and the agency responsible for the AFDC-FC benefits, provided that the nonminor former dependent or ward described in subdivision (e) of Section 11405 satisfies one or more of the conditions described in paragraphs (1) to (5), inclusive, of subdivision (b) of Section 11403, and the nonminor described in subdivision (f) of Section 11405 satisfies the secondary school or equivalent training or certificate program conditions described in that subdivision.(v)Nonminor dependent means, on and after January 1, 2012, a foster child, as described in Section 675(8)(B) of Title 42 of the United States Code under the federal Social Security Act who is a current dependent child or ward of the juvenile court, or who is a nonminor under the transition jurisdiction of the juvenile court, as described in Section 450, and who satisfies all of the following criteria:(1)The nonminor dependent has attained 18 years of age while under an order of foster care placement by the juvenile court, and is not more than 19 years of age on or after January 1, 2012, not more than 20 years of age on or after January 1, 2013, or not more than 21 years of age on or after January 1, 2014, and as described in Section 10103.5.(2)The nonminor dependent is in foster care under the placement and care responsibility of the county welfare department, county probation department, Indian tribe, consortium of tribes, or tribal organization that entered into an agreement pursuant to Section 10553.1.(3)The nonminor dependent has a transitional independent living case plan pursuant to Section 475(8) of the federal Social Security Act (42 U.S.C. Sec. 675(8)), as contained in the federal Fostering Connections to Success and Increasing Adoptions Act of 2008 (Public Law 110-351), as described in Section 11403.(w)Supervised independent living placement means, on and after January 1, 2012, an independent supervised setting in which the nonminor dependent is living independently, pursuant to Section 472(c) of the federal Social Security Act (42 U.S.C. Sec. 672(c)).(x)Supervised independent living setting, pursuant to Section 472(c) of the federal Social Security Act (42 U.S.C. Sec. 672(c)), includes all of the following:(1)A supervised independent living placement, as defined in subdivision (w), and as specified in a nonminor dependents transitional independent living case plan.(2)A transitional housing unit in which a host family lives with a nonminor dependent who is a participant of a Transitional Housing Placement program, as described in subdivision (a) of Section 1559.110 of the Health and Safety Code, including an apartment, single-family dwelling, or condominium owned, rented, or leased by the host family, with supervised transitional housing services provided by the licensed transitional housing placement provider.(3)A residential housing unit certified by the transitional housing placement provider operating a Transitional Housing Placement program for nonminor dependents, as described in paragraph (2) of subdivision (a) of Section 16522.1.(4)A transitional living setting approved by the county to support youth who are entering or reentering foster care or transitioning between placements. The short-term independent living setting shall not include a youth homelessness prevention center or an adult homeless shelter. A transitional living setting approved by the county for purposes of this paragraph is not subject to licensing pursuant to paragraph (4) of subdivision (l) of Section 1505 of the Health and Safety Code.(y)Transitional independent living case plan means, on or after January 1, 2012, a childs case plan submitted for the last review hearing held before the child reaches 18 years of age or the nonminor dependents case plan, updated every six months, that describes the goals and objectives of how the nonminor will make progress in the transition to living independently and assume incremental responsibility for adult decisionmaking, the collaborative efforts between the nonminor and the social worker, probation officer, or Indian tribal placing entity and the supportive services as described in the transitional independent living plan (TILP) to ensure active and meaningful participation in one or more of the eligibility criteria described in paragraphs (1) to (5), inclusive, of subdivision (b) of Section 11403, the nonminors appropriate supervised placement setting, and the nonminors permanent plan for transition to living independently, which includes maintaining or obtaining permanent connections to caring and committed adults, as set forth in paragraph (16) of subdivision (f) of Section 16501.1.(z)Voluntary reentry agreement means a written voluntary agreement between a former dependent child or ward or a former nonminor dependent, who has had juvenile court jurisdiction terminated pursuant to Section 391, 452, or 607.2, or between a nonminor dependent who has not signed a voluntary reentry agreement after attaining 18 years of age and for whom a petition will be filed pursuant to subdivision (f) of Section 388, and the county welfare or probation department or tribal placing entity that documents the nonminors desire and willingness to reenter foster care, to be placed in a supervised setting under the placement and care responsibility of the placing agency, the nonminors desire, willingness, and ability to immediately participate in one or more of the conditions of paragraphs (1) to (5), inclusive, of subdivision (b) of Section 11403, the nonminors agreement to work collaboratively with the placing agency to develop their transitional independent living case plan within 60 days of reentry, if not previously completed, the nonminors agreement to report any changes of circumstances relevant to continued eligibility for foster care payments, and (1) the nonminors agreement to participate in the filing of a petition for juvenile court jurisdiction as a nonminor dependent pursuant to subdivision (e) of Section 388 within 15 judicial days of the signing of the agreement and the placing agencys efforts and supportive services to assist the nonminor in the reentry process, (2) if the nonminor meets the definition of a nonminor former dependent or ward, as described in subdivision (aa), the nonminors agreement to return to the care and support of their former juvenile court-appointed guardian and meet the eligibility criteria for AFDC-FC pursuant to subdivision (e) of Section 11405, or (3) the nonminor dependents agreement to participate in the filing of a petition pursuant to subdivision (f) of Section 388.(aa)Nonminor former dependent or ward means, on and after January 1, 2012, either of the following:(1)A nonminor who reached 18 years of age while subject to an order for foster care placement, and for whom dependency, delinquency, or transition jurisdiction has been terminated, and who is still under the general jurisdiction of the court.(2)A nonminor who is over 18 years of age and, while a minor, was a dependent child or ward of the juvenile court when the guardianship was established pursuant to Section 360 or 366.26, or subdivision (d) of Section 728, and the juvenile court dependency or wardship was dismissed following the establishment of the guardianship.(ab)Youth homelessness prevention center means a type of group home, as defined in paragraph (14) of subdivision (a) of Section 1502 of the Health and Safety Code, that is not an eligible placement option under Sections 319, 361.2, 450, and 727, and that is not eligible for AFDC-FC funding pursuant to subdivision (c) of Section 11402 or Section 11462.(ac)Transition dependent is a minor between 17 years and five months and 18 years of age who is subject to the courts transition jurisdiction under Section 450.(ad)Short-term residential therapeutic program means a nondetention, licensed community care facility, as defined in paragraph (18) of subdivision (a) of Section 1502 of the Health and Safety Code, that provides an integrated program of specialized and intensive care and supervision, services and supports, and treatment for the child or youth, when the childs or youths case plan specifies the need for, nature of, and anticipated duration of this specialized treatment. Short-term residential therapeutic programs shall be organized and operated on a nonprofit basis.(ae)Resource family means an approved caregiver, as defined in subdivision (c) of Section 16519.5.(af)Core services means services, made available to children, youth, and nonminor dependents either directly or secured through agreement with other agencies, that are trauma informed and culturally relevant, as specified in Sections 11462 and 11463.(ag)Short-term assessment, therapy, and transition program means a nondetention, licensed community care facility, as defined in paragraph (23) of subdivision (a) of Section 1502 of the Health and Safety Code, that provides an intensive, trauma-informed, individualized, and integrated program of care and supervision, services and supports, and treatment for the child or youth, when the childs or youths case plan specifies the need for, nature of, and anticipated duration of, this specialized treatment. Short-term assessment, therapy, and transition programs shall be organized and operated on a nonprofit basis.SEC. 6.Section 11460 of the Welfare and Institutions Code is amended to read:11460.(a)(1)Foster care providers shall be paid a per child per month rate in return for the care and supervision of the AFDC-FC child placed with them. The department is designated the single organizational unit whose duty it shall be to administer a state system for establishing rates in the AFDC-FC program. State functions shall be performed by the department or by delegation of the department to county welfare departments or Indian tribes, consortia of tribes, or tribal organizations that have entered into an agreement pursuant to Section 10553.1.(2)(A)Foster care providers that care for a child in a home-based setting described in paragraph (1) of subdivision (g) of Section 11461, or in a certified home or an approved resource family of a foster family agency, shall be paid the per child per month rate as set forth in subdivision (g) of Section 11461.(B)The basic rate paid to either a certified family home or an approved resource family of a foster family agency shall be paid by the agency to the certified family home or approved resource family from the rate that is paid to the agency pursuant to Section 11463.(3)(A)In addition to administering the state system of rates described in paragraph (1) of subdivision (a), at the request of and in consultation with a county,the department shall have the authority to develop, implement, and approve alternative funding models and set individualized rates for innovative AFDC-FC programs or models of care and servicesthat are consistent with statewide licensing and program requirements and that provide children with service alternatives to residential care, enhance the ability of children to remain in the least restrictive, most family-like setting possible, and promote services that address the needs and strengths of individual children and their families.(B)A county that chooses to request an alternative funding model or individualized rate under this paragraph shall pay the entire nonfederal share of any additional cost for providing these innovative programs or models of care and services that exceeds the nonfederal portions of the state system of rates established pursuant to subdivision (a).(C)(i)The provider shall indicate in theprogram statement theinnovative approach or model of care and servicesfor which there is a recognized need that the county seeks to meet.(ii)The requesting county, in consultation with the department, shall monitorthe performance and outcomes of the provider consistent with the program statement to ensure that the purposes of the innovative program or model of care and serviceswill be achieved commensurate with the alternative funding model or individualized rate.(b)Care and supervision includes food, clothing, shelter, daily supervision, school supplies, a childs personal incidentals, liability insurance with respect to a child, reasonable travel to the childs home for visitation, and reasonable travel for the child to remain in the school in which the child is enrolled at the time of placement. Reimbursement for the costs of educational travel, as provided for in this subdivision, shall be made pursuant to procedures determined by the department, in consultation with representatives of county welfare and probation directors, and additional stakeholders, as appropriate.(1)For a child or youth placed in a short-term residential therapeutic program, group home, or short-term assessment, therapy, and transition program, care and supervision shall also include reasonable administration and operational activities necessary to provide the items listed in this subdivision.(2)For a child or youth placed in a short-term residential therapeutic program, group home, or short-term assessment, therapy, and transition program, care and supervision may also include reasonable activities performed by social workers employed by the program provider that are not otherwise considered daily supervision or administration activities.(3)The department, in consultation with the California State Foster Parent Association, and other interested stakeholders, shall provide information to the Legislature, no later than January 1, 2017, regarding the availability and cost for liability and property insurance covering acts committed by children in care, and shall make recommendations for any needed program development in this area.(c)It is the intent of the Legislature to establish the maximum level of financial participation in out-of-state foster care group home program rates for placements in facilities described in subdivision (h) of Section 11402.(1)The department shall develop regulations that establish the method for determining the level of financial participation in the rate paid for out-of-state placements in facilities described in subdivision (h) of Section 11402. The department shall consider all of the following methods:(A)Until December 31, 2016, a standardized system based on the rate classification level of care and services per child per month.(B)The rate developed for a short-term residential therapeutic program and short-term assessment, therapy, and transition program pursuant to Section 11462.(C)A system that considers the actual allowable and reasonable costs of care and supervision incurred by the out-of-state program.(D)A system that considers the rate established by the host state.(E)Any other appropriate methods as determined by the department.(2)Reimbursement for the Aid to Families with Dependent Children-Foster Care rate to be paid to an out-of-state program described in subdivision (h) of Section 11402 shall only be paid to programs that have done all of the following:(A)Submitted a rate application to the department, which shall include, but not be limited to, both of the following:(i)Commencing January 1, 2017, unless granted an extension from the department pursuant to subdivision (d) or (e) of Section 11462.04, the equivalent of the mental health program approval required in Section 4096.5.(ii)Commencing January 1, 2017, unless granted an extension from the department pursuant to subdivision (d) or (e) of Section 11462.04, the national accreditation required in paragraph (6) of subdivision (b) of Section 11462.(B)Maintained a level of financial participation that shall not exceed any of the following:(i)The current fiscal years standard rate for rate classification level 14 for a group home.(ii)Commencing January 1, 2017, the current fiscal years rate for a short-term residential therapeutic program.(iii)The rate determined by the ratesetting authority of the state in which the facility is located.(C)Agreed to comply with information requests, and program and fiscal audits as determined necessary by the department.(3)Except as specifically provided for in statute, reimbursement for an AFDC-FC rate shall only be paid to a group home, short-term residential therapeutic program, or short-term assessment, therapy, and transition program organized and operated on a nonprofit basis.(d)A foster care provider that accepts payments, following the effective date of this section, based on a rate established under this section, shall not receive rate increases or retroactive payments as the result of litigation challenging rates established prior to the effective date of this section. This shall apply regardless of whether a provider is a party to the litigation or a member of a class covered by the litigation.(e)The county is not precluded from using a portion of its county funds to increase rates paid to family homes, foster family agencies, group homes, short-term residential therapeutic programs, or short-term assessment, therapy, and transition programs within that county, and to make payments for specialized care increments, clothing allowances, or infant supplements to homes within that county, solely at that countys expense.(f)A county is not precluded from providing a supplemental rate to serve commercially sexually exploited foster children to provide for the additional care and supervision needs of these children. To the extent that federal financial participation is available, it is the intent of the Legislature that the federal funding shall be utilized.SEC. 7.Section 11462.01 of the Welfare and Institutions Code is amended to read:11462.01.(a)(1)If a program will admit Medi-Cal beneficiaries, no later than 12 months following the date of initial licensure, a short-term residential therapeutic program, as defined in subdivision (ad) of Section 11400 of this code and paragraph (18) of subdivision (a) of Section 1502 of the Health and Safety Code, and a short-term assessment, therapy, and transition program, as defined in subdivision (ag) of Section 11400 of this code and paragraph (23) 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 childs case plan.(C)The childs needs and services plan.(D)The assessment of a qualified individual, as defined in subdivision (l) of Section 16501.(E)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 specified in subdivision (c), a short-term residential therapeutic program or a short-term assessment, therapy, and transition 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 or a short-term assessment, therapy, and transition 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 childs own home or in other family settings, such as with a relative, guardian, foster family, resource family, or adoptive family. The assessment shall ensure the child has needs in common with other children or youth in the care of the facility, consistent with subdivision (c) of Section 16514.(3)The child meets at least one of the following conditions:(A)The child has been assessed, pursuant to Section 4096, as meeting the medical necessity criteria for Medi-Cal specialty mental health services, as provided for in Section 1830.205 or 1830.210 of Title 9 of the California Code of Regulations.(B)The child has been assessed, pursuant to Section 4096, as seriously emotionally disturbed, as defined in subdivision (a) of Section 5600.3.(C)The child requires emergency placement pursuant to paragraph (3) of subdivision (h).(D)The child has been assessed, pursuant to Section 4096, as requiring the level of services provided by the short-term residential therapeutic program in order to meet the childs behavioral or therapeutic needs.(4)Subject to the requirements of this subdivision, a short-term residential therapeutic program or a short-term assessment, therapy, and transition 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 childs behavior, and short-term intervention is needed to transition the child back into the home.(C)A juvenile sex offender.(D)A child who is affiliated with, or impacted by, a gang.(c)(1)A short-term residential therapeutic program that is operating as a childrens crisis residential program, as defined in Section 1502 of the Health and Safety Code, may accept for admission any child who meets all of the requirements set forth in paragraph (3) of subdivision (c) of Section 11462.011 and subdivisions (a) to (e), inclusive, of Section 4096.(2)The primary function of a childrens crisis residential program is to provide short-term crisis stabilization, therapeutic intervention, and specialized programming in an unlocked, staff-secured setting with a high degree of supervision and structure and the goal of supporting the rapid and successful transition of the child back to the community.(d)A foster family agency that is certified as a Medi-Cal specialty mental health provider pursuant to Section 1810.435 of Title 9 of the California Code of Regulations by the State Department of Health Care Services, or by a county mental health plan to which the department has delegated certification authority, and which has entered into a contract with a county mental health plan pursuant to Section 1810.436 of Title 9 of the California Code of Regulations, shall provide, or provide access to, specialty mental health services to children under its care who do not require inpatient care in a licensed health facility and who meet the medical necessity criteria for Medi-Cal specialty mental health services provided for in Section 1830.205 or 1830.210 of Title 9 of the California Code of Regulations.(e)A foster family agency that is not certified as a Medi-Cal specialty mental health provider shall provide access to specialty and mental health services and other 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 and short-term assessment, therapy, and transition programs shall maintain the level of care and services necessary to meet the needs, including the assessed needs and child-specific goals identified by a qualified individual pursuant to subdivision (g) of Section 4096, as applicable, of the children and youth in their care and shall maintain and have in good standing the appropriate mental health program approval. If a program will admit Medi-Cal beneficiaries, the short-term residential therapeutic program shall obtain 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 childs 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 the short-term residential therapeutic program or short-term assessment, therapy, and transition 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 (j) of Section 4096.(3)An individualized education program team. For the purposes of this section, an AFDC-FC funded child with an individualized education program developed pursuant to Article 2 (commencing with Section 56320) of Chapter 4 of Part 30 of Division 4 of Title 2 of the Education Code that assesses the child as seriously emotionally disturbed, as defined in, and subject to, this section and recommends out-of-home placement at the level of care provided by the provider, shall be deemed to have met the assessment requirement.(4)A qualified individual, as defined in subdivision (l) of Section 16501.(h)(1)The short-term residential therapeutic program or short-term assessment, therapy, and transition program shall maintain documentation of the assessments required pursuant to Section 4096 for AFDC-FC funded children, except as provided for in paragraph (3) of subdivision (g). The short-term residential therapeutic program shall inform the department if the county placing agency does not provide the documentation.(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)Subdivisions (a) to (g), inclusive, and this subdivision do not prevent an emergency placement of a child or youth into a certified short-term residential therapeutic program prior to the determination by the interagency placement committee, but only if a licensed mental health professional, as defined in subdivision (j) of Section 4096, has made a written determination within 72 hours of the childs or youths 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 their behavioral or therapeutic needs. If the short-term residential therapeutic program serves children placed by county child welfare agencies and children placed by probation departments, the interagency placement committee shall also ensure the requirements of subdivision (c) of Section 16514 have been met with respect to commonality of need.(i)The interagency placement committee, as appropriate, shall, within 30 days of placement, make the determinations, with recommendations from the child and family team, required by this subdivision.(ii)If it determines the placement is appropriate, the interagency placement committee, with recommendations from the child and family team, shall transmit the approval, in writing, to the county placing agency and the short-term residential therapeutic program or short-term assessment, therapy, and transition 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 or short-term assessment, therapy, and transition program and shall include a recommendation as to the childs appropriate level of care and placement to meet the childs 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. On and after October 1, 2021, federal AFDC-FC shall not be used to fund the placement for more than 30 days from the date that the qualified individual or interagency placement committee determined that the placement is no longer recommended or the court disapproved the placement.(iii)Notwithstanding clause (ii), if the interagency placement committee determined the placement was not appropriate due to a health and safety concern, immediate arrangements for the child to transition to an appropriate placement shall occur.(i)Commencing January 1, 2017, for AFDC-FC funded children or youth, only those children or youth who are approved for placement, as set forth in this section, may be accepted by a short-term residential therapeutic program or short-term assessment, therapy, and transition program.(j)The department shall, through regulation, establish consequences for the failure of a short-term residential therapeutic program or short-term assessment, therapy, and transition program to obtain written approval for placement of an AFDC-FC funded child or youth pursuant to this section.(k)The department shall not establish a rate for a short-term residential therapeutic program or short-term assessment, therapy, and transition 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 departments AFDC-FC ratesetting regulations.(l) Any short-term residential therapeutic program or short-term assessment, therapy, and transition program shall be reclassified and paid at the appropriate program rate for which it is qualified if any of the following occur:(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 departments 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 or short-term assessment, therapy, and transition 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. During any appeal, the short-term residential therapeutic program or short-term assessment, therapy, and transition program shall maintain the appropriate level of care.(2)It fails to maintain a mental health treatment program as required by subdivision (f).(3)It fails to timely obtain or maintain accreditation as required by state law or fails to provide proof of that accreditation to the department upon request.(m)In addition to any other review required by law, the child and family team as defined in paragraph (4) of subdivision (a) of Section 16501 may periodically review the placement of the child or youth. If the child and family team make a recommendation that the child or youth no longer needs, or is not benefiting from, placement in a short-term residential therapeutic program, the team shall transmit the disapproval, in writing, to the county placing agency to consider a more appropriate placement.(n)The department shall develop a process to address placements when, subsequent to the childs or youths 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 countys plan, and a timeframe, for removal of the child or youth in writing to the short-term residential therapeutic program that provides intensive and therapeutic treatment.(3)Referral to an appropriate placement.(4)Actions to be taken if a child or youth is not timely removed from the short-term residential therapeutic program that provides intensive and therapeutic treatment or placed in an appropriate placement.(o)(1)This section does not prohibit a short-term residential therapeutic program or a short-term assessment, therapy, and transition program from accepting private admissions of children or youth.(2)When a referral is not from a public agency and public funding is not involved, there is no requirement for public agency review or determination of need.(3)Children and youth subject to paragraphs (1) and (2) shall have been determined to be seriously emotionally disturbed, as described in subdivision (a) of Section 5600.3, and subject to Section 1502.4 of the Health and Safety Code, by a licensed mental health professional, as defined in subdivision (j) of Section 4096.SEC. 3. Section 11462.010 is added to the Welfare and Institutions Code, immediately following Section 11462.01, to read:11462.010. (a) (1) The department shall develop an enhanced funding model for short-term residential therapeutic programs that serve up to four current or former foster children or nonminor dependents in the foster care system who have complex needs across multiple systems.(2) The enhanced funding shall be for additional program staffing to be delivered onsite by a care team composed of appropriate professionals trained in trauma-informed care across physical health, developmental disabilities, educational, and behavioral health care inclusive of substance abuse, in order to provide the services to a child or nonminor dependent, and overseen by appropriate administrative staff as required by the department.(3) The program shall leverage and coordinate with other service providers, including regional centers, local educational agencies, behavioral health agencies, wraparound providers, and others, to maximize services and supports to the child, nonminor dependent, and their caregivers while the child or nonminor dependent is receiving services from the program.(b) The enhanced program shall provide intensive, trauma-informed services through a care team for each child or nonminor dependent. The care team shall be led by a clinical head of service and shall include, at a minimum, the program social worker, special education specialist, board-certified behavioral analyst, youth peer, and caregiver peer.(c) The care team shall deliver services to a child or nonminor dependent who is placed at an enhanced short-term residential therapeutic program and for up to six months postdischarge, as needed by the child or nonminor dependent and their caregiver to support transition to other residential or community-based care, including family-based care. The care team may also deliver services to the family, family-like connections, or other caregivers to support stepdowns to family-based care, or may provide consultation to the next direct service provider, to include the biological family, legal guardian, or both, as deemed appropriate and pursuant to the childs or nonminor dependents care plan, in consultation with any child and family team.(d) The department shall develop staffing requirements in consultation with stakeholders, including, but not limited to, the County Welfare Directors Association of California, the Chief Probation Officers of California, the County Behavioral Health Directors Association of California, the California Youth Connection, and tribal and provider representatives.(e) (1) As a condition of receiving enhanced funding, and subject to the other requirements described in this section, the program shall accept all children and nonminor dependents referred by a child welfare agency, probation agency, or tribal entity, unless a determination is made by the clinical staff, in consultation with other members of the care team, that the child or nonminor dependent is in need of a more restrictive inpatient setting due to the immediate and present risk of serious injury to self or others or due to a commonality of need.(2) The program shall continue to serve a child or nonminor dependent admitted to the program until they can be appropriately transitioned to the next level of care with support of the care team and shall hold beds open due to temporary transfers to a general acute care hospital or a crisis mental health inpatient setting for up to 14 days.(f) (1) The department shall develop a separate rate for the enhanced funding pursuant to Section 11462 and shall adopt regulations as needed to implement this section.(2) The department shall consult with the State Department of Health Care Services, the County Welfare Directors Association of California, the Chief Probation Officers of California, the California Youth Connection, tribal representatives, the County Behavioral Health Directors Association of California, provider representatives, and other stakeholders as deemed appropriate in the development of regulations.(g) Notwithstanding the rulemaking provisions of the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code), the department may implement, interpret, or make specific this section by means of interim guidance until regulations are adopted.SEC. 8.SEC. 4. Section 16001.1 of the Welfare and Institutions Code is amended to read:16001.1. (a) It is the intent of the Legislature to support the urgent and exceptional needs of children and nonminor dependents in foster care under the supervision of a county child welfare agency or probation department, including those who otherwise may be placed in an out-of-state residential facility.(b) (1) The department shall allocate funds appropriated to the department for this purpose in the Budget Act of 2021, and in any future fiscal year, through local assistance allocations to counties or Indian tribes that have entered into an agreement pursuant to Section 10553.1 that support new or expanded programs, services, practices, and training that builds system capacity and ensures the provision of a high-quality continuum of care that is designed to support foster children in the least restrictive setting, consistent with a childs permanency plan.(2) Pursuant to guidance and a process established by the department and the State Department of Health Care Services, in consultation with the County Welfare Directors Association of California, Chief Probation Officers of California, and County Behavioral Health Directors Association of California, fund recipients shall use the allocated funds to supplement county efforts to build system capacity for any of the following activities:(A) Specialized models of professional foster care, including therapeutic foster care, intensive services foster care, or other models as may be developed in collaboration with counties, including the County Behavioral Health Directors Association of California, and providers.(B) Intensive child-specific recruitment, family finding and engagement, and support programs for children with complex needs, including specialized permanency support services as described in Section 16501 and activities associated with the Active Supportive Intervention Services for Transition program.(C) Specialized models of integrated care and support for family-based settings, including high-fidelity wraparound, in-home nursing supports for youth with special health care needs, and community-based treatment models that create alternatives to out-of-home or residential placement.(D) Highly individualized short-term residential therapeutic programs designed to serve children with complex needs who otherwise may have been placed in an out-of-state residential facility.(E) A Childrens Crisis Continuum Pilot Program established pursuant to Chapter 6 (commencing with Section 16550).(F)Highly specialized short-term residential therapeutic programs and short-term assessment, treatment, and transition programs designed to serve children with complex trauma or cooccurring intellectual or developmental disabilities and behavioral health needs.(G)Short-term therapeutic settings that serve as an alternative to hospital-based settings and temporary placement settings.(F) Highly specialized short-term residential therapeutic programs designed to serve children with complex trauma or cooccurring intellectual or developmental disabilities and behavioral health needs.(3) Allocations made pursuant to this subdivision shall be conditioned on qualitative and outcomes standards that are established by the department, in consultation with the State Department of Health Care Services, counties, tribes, and other entities that may receive funding.(c) (1) The department shall allocate or expend, through contracts with community-based providers or entities or through local assistance allocations to counties or Indian tribes that have entered into an agreement pursuant to Section 10553.1, funds appropriated to the department for this purpose in the Budget Act of 2021, and in any future fiscal year, to provide and implement the recommendations of child-specific assessments, evaluations, enhanced care planning, ongoing technical assistance, and exceptional supports to meet the complex care needs of children in foster care within California within the least restrictive setting.(2) The department shall annually allocate funds to county placing agencies and tribal entities to purchase, procure, or directly provide supports or services that are needed to support the exceptional needs of a child or nonminor dependent in the least restrictive setting. Counties and tribal entities shall ensure expenditures are based upon the recommendation of a qualified individual, technical assistance provided by the department, or a clinical determination of an interagency placement committee or regional health team that considers the recommendations of a child and family team. Counties shall document these recommendations in the case plan of the child or nonminor dependent. Funds allocated pursuant to this paragraph may be expended for the following services and supports:(A) Direct services for the youth or family to help stabilize an existing placement, facilitate a new placement, or prevent a placement into foster care. Services may include, but are not limited to, accessing diagnostic testing and enhanced clinical assessments, therapies and treatments, developmental service supports, and medical and health-related services.(B) Enhanced family finding, engagement, and supports to enable placement with relatives or other family-like connections through intensive searches, or to support continued connection, engagement engagement, and support from relatives or other family-like connections. Access to funding for this purpose is permitted if the county or tribal entity has not opted into the Excellence in Family Finding, Engagement, and Support Program pursuant to Section 16546.5, or if the county or tribal entity has opted into the program and the youth has additional needs that cannot be fully met by the program.(C) Payments to providers to support respite care for caregivers.(D) Therapeutic or wraparound services.(E) Consultation or assessment with service providers or those with specialized expertise in care and treatment of youth with complex needs.(F) Durable medical equipment and supplies or other tangible items.(G) Enhanced care and supervision delivered by county staff, foster care providers, or other personnel subject to the requirements of Section 1522 of the Health and Safety Code.(H) Preplacement engagement and support and transitional support activities designed to facilitate access to therapies and treatment settings for youth.(I) Translation services in different languages, including American Sign Language.(J) Access to alternative therapies or extracurricular activities.(K) Other services or supports pursuant to guidance issued by the department, in consultation with counties.(3) Funds made available pursuant to this subdivision shall be conditioned on qualitative and outcomes standards that are established by the department. Outcomes standards shall include a continuous quality improvement process designed to address systematic gaps or barriers to meeting the needs of children and nonminor dependents in the least restrictive setting. Those outcomes standards shall be developed by the department and the State Department of Health Care Services, in consultation with counties, tribes, and other entities that may receive funding.(d) The department shall consult with the joint interagency resolution team, the County Welfare Directors Association of California, the Chief Probation Officers of California, the California Behavioral Health Directors Association of California, legislative staff, and other stakeholders with respect to the implementation of this section.(e) Funding made available to counties pursuant to this section shall only be used to supplement, and not supplant, existing funding, unless the receipt of funding or services from other sources are not readily available to meet the immediate needs of a youth, in which case the county may utilize funds appropriated pursuant to this section.(f) It is the intent of the Legislature that funding pursuant to this section that is not expended during a given fiscal year shall be made available for expenditure in the following fiscal year.SEC. 9.(a)To the extent that this act has an overall effect of increasing the costs already borne by a local agency for programs or levels of service mandated by the 2011 Realignment Legislation within the meaning of Section 36 of Article XIII of the California Constitution, it shall apply to local agencies only to the extent that the state provides annual funding for the cost increase. Any new program or higher level of service provided by a local agency pursuant to this act above the level for which funding has been provided shall not require a subvention of funds by the state or otherwise be subject to Section 6 of Article XIII B of the California Constitution.(b)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.SEC. 5. No appropriation pursuant to Section 15200 of the Welfare and Institutions Code shall be made for purposes of this act.
Amended IN Senate May 03, 2023 Amended IN Senate March 14, 2023 CALIFORNIA LEGISLATURE 20232024 REGULAR SESSION Senate Bill No. 408Introduced by Senator AshbyFebruary 09, 2023An act to amend Section 1502 of, and to add Section 1562.011 to, the Health and Safety Code, and to amend Sections 11400, 11460, 11462.01, and 16001.1 of, to add Section 11462.010 to, and to add Chapter 4.5 (commencing with Section 5425) of to Part 1 of Division 5 of, the Welfare and Institutions Code, relating to foster youth. LEGISLATIVE COUNSEL'S DIGESTSB 408, as amended, Ashby. Foster youth with complex needs: regional health teams: short-term assessment, treatment, and transition programs. teams and short-term residential therapeutic programs.(1) Existing law generally provides for the placement of foster youth in various placement settings, and governs the provision of child welfare services, which is defined to mean public social services that are directed toward the accomplishment of specified purposes, including protecting and promoting the welfare of all children, preventing the unnecessary separation of children from their families, and restoring to their families children who have been removed. Existing federal law, the Family First Prevention Services Act of 2018, among other things, provides states with an option to use federal funds under Title IV of the federal Social Security Act to provide mental health and substance abuse prevention and treatment services and in-home parent skill-based programs to a child who is a candidate for foster care or a child in foster care who is a pregnant or parenting foster youth, as specified.This bill would require the State Department of Health Care Services, in consultation with the State Department of Social Services, to establish up to 10 regional health teams throughout the state, to serve foster youth and youth who may be at risk of entering foster care. The bill would require the department to submit a state plan amendment to the federal Centers for Medicare and Medicaid Services no later than July 1, 2024, to implement the Medicaid Health Home State Plan Option, as specified, in establishing the regional health teams. The bill would require the department to coordinate with the State Department of Social Services and the State Department of Developmental Services, and to convene and engage specified stakeholders, to develop the regional health teams. TheThe bill would make regional health teams available to children and youth and any adult caregiver or other adult connected with the child or youth under 26 years of age, who are experiencing severe mental illness, emotional disturbance, substance use, intellectual or developmental disability, or special health care needs or chronic health issues, or any combination of those conditions. The bill would specify the required membership of the regional health teams, including, but not limited to, a primary care physician, a licensed clinical social worker, and a public health nurse. The duties of the regional health team would include, but not be limited to, receiving and responding to referrals received from staff from county child welfare agencies, county probation departments, regional centers, and others, and coordinating and providing access to various categories of care and services. TheThe bill would require the department to fund up to 10 health teams that are geographically situated to support access to services equitably throughout the state. The bill would require the regional health teams to be funded by the department pursuant to a competitive procurement process. The bill would declare the intent of the Legislature that the health home state plan option begin no later than December 1, 2024, subject to the receipt of any required federal approvals or waivers.(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.Existing law, the California Community Care Facilities Act, provides for the licensure and regulation by the State Department of Social Services of community care and residential facilities, including specified residential facilities that provide care for foster youth, such as short-term residential therapeutic programs. A violation of the act is a misdemeanor.This bill would create, and would require the department to license, the short-term assessment, treatment, and transition program (STATTP) as a new placement category for children and youth described in the bill. The bill would define the STATTP as a residential facility operated independently, or jointly by a public agency, tribal agency, or private organization, 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, and that is trauma-informed, nonmedical, and nonprofit. The bill would require a STATTP to be comply with requirements of the act applicable to short-term residential therapeutic programs, unless otherwise specified. The bill would establish a per-child, per-month compensation rate for STATTP care of $43,000.The bill would require a STATTP to accept all children and youth referred by a child welfare agency, probation agency, or tribal entity, unless a determination is made by the clinical staff, in consultation with other members of the care team, that the child or youth is in need of a more restrictive inpatient setting, as specified. The bill would require the STATTP to provide enhanced care and supervision for children and youth with intensive, complex needs with the support of a care team, which would deliver services to a child or youth placed in the STATTP and for up to 6 months postdischarge, as needed. The bill would specify the composition and duties of the care team, as well as administrative and medical staffing requirements for STATTPs. The bill would require the STATTP to offer respite care to the next caregiver upon the childs or youths discharge, as specified.The bill would authorize a STATTP to be operated under licensure by counties, nonprofit agencies, tribal agencies, or a combination of those entities. The bill would authorize the department to adopt regulations for STATTPs, as specified, to implement the provisions relating to STATTPs by means of interim licensing standards until regulations are adopted, and, by March 1, 2024, to adopt licensing standards. The bill would require final regulations to be adopted by January 1, 2027, as specified.This bill would require the department to develop an enhanced funding model for short-term residential therapeutic programs that serve up to 4 current or former foster children or nonminor dependents in the foster care system who have complex needs across multiple systems. Under the bill, the enhanced funding would be for additional program staffing to be delivered onsite by a care team composed of appropriate professionals trained in trauma-informed care, as specified. The bill would set forth certain criteria for the delivery of services by the care team.As a condition of receiving enhanced funding, and subject to the above-described requirements, the bill would require the program to accept all children and nonminor dependents referred by a child welfare agency, probation agency, or tribal entity, except as specified. The bill would require the program to continue to serve a child or nonminor dependent admitted to the program until they can be appropriately transitioned to the next level of care and to hold beds open due to temporary transfers to a general acute care hospital or a crisis mental health inpatient setting for up to 14 days.The bill would require the department to develop a separate rate for the enhanced funding, to develop staffing requirements, and to adopt regulations as needed, in consultation with certain stakeholders. The bill would authorize the department to implement these provisions through interim guidance until regulations are adopted.Existing(3) Existing law requires the department to allocate specified funds appropriated to the department in the Budget Act of 2021 through contracts with community-based providers or entities or through local assistance allocations to counties or Indian tribes that support new or expanded programs, services, and practices that ensure the provision of a high-quality continuum of care that is designed to support foster children in the least restrictive setting, as specified. Existing law also requires the department to allocate funds in the same manner to provide and implement the recommendations of child-specific assessments, evaluations, enhanced care planning, ongoing technical assistance, and exceptional supports to meet the complex care needs of children in foster care within California within the least restrictive setting.This bill would revise and expand those funding provisions, including adding to the permissible uses of those funds to include, among other things, STATTPs and short-term therapeutic settings that serve as an alternative to hospital-based settings. future funds to include in-home nursing supports for youth with special health care needs and highly specialized short-term residential therapeutic programs designed to serve children with complex trauma. The bill would require the department to annually allocate funds to county placing agencies and tribal agencies to purchase, procure, or directly provide supports or services to meet the exceptional needs of children and nonminor dependents in the least restrictive setting, and would allow a regional health team to make clinical recommendations to counties and tribal entities for expenditures made under these provisions.(3)Because the creation of a new licensure category for foster youth would increase the duties of county placement agencies, and because a violation of the Community Care Facilities Act by a STATTP would be a crime, the bill would impose 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 specified reasons.(4) This bill would provide that a continuous appropriation would not be made for purposes of implementing the bill.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: YESNO
Amended IN Senate May 03, 2023 Amended IN Senate March 14, 2023
Amended IN Senate May 03, 2023
Amended IN Senate March 14, 2023
CALIFORNIA LEGISLATURE 20232024 REGULAR SESSION
Senate Bill
No. 408
Introduced by Senator AshbyFebruary 09, 2023
Introduced by Senator Ashby
February 09, 2023
An act to amend Section 1502 of, and to add Section 1562.011 to, the Health and Safety Code, and to amend Sections 11400, 11460, 11462.01, and 16001.1 of, to add Section 11462.010 to, and to add Chapter 4.5 (commencing with Section 5425) of to Part 1 of Division 5 of, the Welfare and Institutions Code, relating to foster youth.
LEGISLATIVE COUNSEL'S DIGEST
## LEGISLATIVE COUNSEL'S DIGEST
SB 408, as amended, Ashby. Foster youth with complex needs: regional health teams: short-term assessment, treatment, and transition programs. teams and short-term residential therapeutic programs.
(1) Existing law generally provides for the placement of foster youth in various placement settings, and governs the provision of child welfare services, which is defined to mean public social services that are directed toward the accomplishment of specified purposes, including protecting and promoting the welfare of all children, preventing the unnecessary separation of children from their families, and restoring to their families children who have been removed. Existing federal law, the Family First Prevention Services Act of 2018, among other things, provides states with an option to use federal funds under Title IV of the federal Social Security Act to provide mental health and substance abuse prevention and treatment services and in-home parent skill-based programs to a child who is a candidate for foster care or a child in foster care who is a pregnant or parenting foster youth, as specified.This bill would require the State Department of Health Care Services, in consultation with the State Department of Social Services, to establish up to 10 regional health teams throughout the state, to serve foster youth and youth who may be at risk of entering foster care. The bill would require the department to submit a state plan amendment to the federal Centers for Medicare and Medicaid Services no later than July 1, 2024, to implement the Medicaid Health Home State Plan Option, as specified, in establishing the regional health teams. The bill would require the department to coordinate with the State Department of Social Services and the State Department of Developmental Services, and to convene and engage specified stakeholders, to develop the regional health teams. TheThe bill would make regional health teams available to children and youth and any adult caregiver or other adult connected with the child or youth under 26 years of age, who are experiencing severe mental illness, emotional disturbance, substance use, intellectual or developmental disability, or special health care needs or chronic health issues, or any combination of those conditions. The bill would specify the required membership of the regional health teams, including, but not limited to, a primary care physician, a licensed clinical social worker, and a public health nurse. The duties of the regional health team would include, but not be limited to, receiving and responding to referrals received from staff from county child welfare agencies, county probation departments, regional centers, and others, and coordinating and providing access to various categories of care and services. TheThe bill would require the department to fund up to 10 health teams that are geographically situated to support access to services equitably throughout the state. The bill would require the regional health teams to be funded by the department pursuant to a competitive procurement process. The bill would declare the intent of the Legislature that the health home state plan option begin no later than December 1, 2024, subject to the receipt of any required federal approvals or waivers.(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.Existing law, the California Community Care Facilities Act, provides for the licensure and regulation by the State Department of Social Services of community care and residential facilities, including specified residential facilities that provide care for foster youth, such as short-term residential therapeutic programs. A violation of the act is a misdemeanor.This bill would create, and would require the department to license, the short-term assessment, treatment, and transition program (STATTP) as a new placement category for children and youth described in the bill. The bill would define the STATTP as a residential facility operated independently, or jointly by a public agency, tribal agency, or private organization, 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, and that is trauma-informed, nonmedical, and nonprofit. The bill would require a STATTP to be comply with requirements of the act applicable to short-term residential therapeutic programs, unless otherwise specified. The bill would establish a per-child, per-month compensation rate for STATTP care of $43,000.The bill would require a STATTP to accept all children and youth referred by a child welfare agency, probation agency, or tribal entity, unless a determination is made by the clinical staff, in consultation with other members of the care team, that the child or youth is in need of a more restrictive inpatient setting, as specified. The bill would require the STATTP to provide enhanced care and supervision for children and youth with intensive, complex needs with the support of a care team, which would deliver services to a child or youth placed in the STATTP and for up to 6 months postdischarge, as needed. The bill would specify the composition and duties of the care team, as well as administrative and medical staffing requirements for STATTPs. The bill would require the STATTP to offer respite care to the next caregiver upon the childs or youths discharge, as specified.The bill would authorize a STATTP to be operated under licensure by counties, nonprofit agencies, tribal agencies, or a combination of those entities. The bill would authorize the department to adopt regulations for STATTPs, as specified, to implement the provisions relating to STATTPs by means of interim licensing standards until regulations are adopted, and, by March 1, 2024, to adopt licensing standards. The bill would require final regulations to be adopted by January 1, 2027, as specified.This bill would require the department to develop an enhanced funding model for short-term residential therapeutic programs that serve up to 4 current or former foster children or nonminor dependents in the foster care system who have complex needs across multiple systems. Under the bill, the enhanced funding would be for additional program staffing to be delivered onsite by a care team composed of appropriate professionals trained in trauma-informed care, as specified. The bill would set forth certain criteria for the delivery of services by the care team.As a condition of receiving enhanced funding, and subject to the above-described requirements, the bill would require the program to accept all children and nonminor dependents referred by a child welfare agency, probation agency, or tribal entity, except as specified. The bill would require the program to continue to serve a child or nonminor dependent admitted to the program until they can be appropriately transitioned to the next level of care and to hold beds open due to temporary transfers to a general acute care hospital or a crisis mental health inpatient setting for up to 14 days.The bill would require the department to develop a separate rate for the enhanced funding, to develop staffing requirements, and to adopt regulations as needed, in consultation with certain stakeholders. The bill would authorize the department to implement these provisions through interim guidance until regulations are adopted.Existing(3) Existing law requires the department to allocate specified funds appropriated to the department in the Budget Act of 2021 through contracts with community-based providers or entities or through local assistance allocations to counties or Indian tribes that support new or expanded programs, services, and practices that ensure the provision of a high-quality continuum of care that is designed to support foster children in the least restrictive setting, as specified. Existing law also requires the department to allocate funds in the same manner to provide and implement the recommendations of child-specific assessments, evaluations, enhanced care planning, ongoing technical assistance, and exceptional supports to meet the complex care needs of children in foster care within California within the least restrictive setting.This bill would revise and expand those funding provisions, including adding to the permissible uses of those funds to include, among other things, STATTPs and short-term therapeutic settings that serve as an alternative to hospital-based settings. future funds to include in-home nursing supports for youth with special health care needs and highly specialized short-term residential therapeutic programs designed to serve children with complex trauma. The bill would require the department to annually allocate funds to county placing agencies and tribal agencies to purchase, procure, or directly provide supports or services to meet the exceptional needs of children and nonminor dependents in the least restrictive setting, and would allow a regional health team to make clinical recommendations to counties and tribal entities for expenditures made under these provisions.(3)Because the creation of a new licensure category for foster youth would increase the duties of county placement agencies, and because a violation of the Community Care Facilities Act by a STATTP would be a crime, the bill would impose 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 specified reasons.(4) This bill would provide that a continuous appropriation would not be made for purposes of implementing the bill.
(1) Existing law generally provides for the placement of foster youth in various placement settings, and governs the provision of child welfare services, which is defined to mean public social services that are directed toward the accomplishment of specified purposes, including protecting and promoting the welfare of all children, preventing the unnecessary separation of children from their families, and restoring to their families children who have been removed. Existing federal law, the Family First Prevention Services Act of 2018, among other things, provides states with an option to use federal funds under Title IV of the federal Social Security Act to provide mental health and substance abuse prevention and treatment services and in-home parent skill-based programs to a child who is a candidate for foster care or a child in foster care who is a pregnant or parenting foster youth, as specified.
This bill would require the State Department of Health Care Services, in consultation with the State Department of Social Services, to establish up to 10 regional health teams throughout the state, to serve foster youth and youth who may be at risk of entering foster care. The bill would require the department to submit a state plan amendment to the federal Centers for Medicare and Medicaid Services no later than July 1, 2024, to implement the Medicaid Health Home State Plan Option, as specified, in establishing the regional health teams. The bill would require the department to coordinate with the State Department of Social Services and the State Department of Developmental Services, and to convene and engage specified stakeholders, to develop the regional health teams. The
The bill would make regional health teams available to children and youth and any adult caregiver or other adult connected with the child or youth under 26 years of age, who are experiencing severe mental illness, emotional disturbance, substance use, intellectual or developmental disability, or special health care needs or chronic health issues, or any combination of those conditions. The bill would specify the required membership of the regional health teams, including, but not limited to, a primary care physician, a licensed clinical social worker, and a public health nurse. The duties of the regional health team would include, but not be limited to, receiving and responding to referrals received from staff from county child welfare agencies, county probation departments, regional centers, and others, and coordinating and providing access to various categories of care and services. The
The bill would require the department to fund up to 10 health teams that are geographically situated to support access to services equitably throughout the state. The bill would require the regional health teams to be funded by the department pursuant to a competitive procurement process. The bill would declare the intent of the Legislature that the health home state plan option begin no later than December 1, 2024, subject to the receipt of any required federal approvals or waivers.
(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.
Existing law, the California Community Care Facilities Act, provides for the licensure and regulation by the State Department of Social Services of community care and residential facilities, including specified residential facilities that provide care for foster youth, such as short-term residential therapeutic programs. A violation of the act is a misdemeanor.
This bill would create, and would require the department to license, the short-term assessment, treatment, and transition program (STATTP) as a new placement category for children and youth described in the bill. The bill would define the STATTP as a residential facility operated independently, or jointly by a public agency, tribal agency, or private organization, 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, and that is trauma-informed, nonmedical, and nonprofit. The bill would require a STATTP to be comply with requirements of the act applicable to short-term residential therapeutic programs, unless otherwise specified. The bill would establish a per-child, per-month compensation rate for STATTP care of $43,000.
The bill would require a STATTP to accept all children and youth referred by a child welfare agency, probation agency, or tribal entity, unless a determination is made by the clinical staff, in consultation with other members of the care team, that the child or youth is in need of a more restrictive inpatient setting, as specified. The bill would require the STATTP to provide enhanced care and supervision for children and youth with intensive, complex needs with the support of a care team, which would deliver services to a child or youth placed in the STATTP and for up to 6 months postdischarge, as needed. The bill would specify the composition and duties of the care team, as well as administrative and medical staffing requirements for STATTPs. The bill would require the STATTP to offer respite care to the next caregiver upon the childs or youths discharge, as specified.
The bill would authorize a STATTP to be operated under licensure by counties, nonprofit agencies, tribal agencies, or a combination of those entities. The bill would authorize the department to adopt regulations for STATTPs, as specified, to implement the provisions relating to STATTPs by means of interim licensing standards until regulations are adopted, and, by March 1, 2024, to adopt licensing standards. The bill would require final regulations to be adopted by January 1, 2027, as specified.
This bill would require the department to develop an enhanced funding model for short-term residential therapeutic programs that serve up to 4 current or former foster children or nonminor dependents in the foster care system who have complex needs across multiple systems. Under the bill, the enhanced funding would be for additional program staffing to be delivered onsite by a care team composed of appropriate professionals trained in trauma-informed care, as specified. The bill would set forth certain criteria for the delivery of services by the care team.
As a condition of receiving enhanced funding, and subject to the above-described requirements, the bill would require the program to accept all children and nonminor dependents referred by a child welfare agency, probation agency, or tribal entity, except as specified. The bill would require the program to continue to serve a child or nonminor dependent admitted to the program until they can be appropriately transitioned to the next level of care and to hold beds open due to temporary transfers to a general acute care hospital or a crisis mental health inpatient setting for up to 14 days.
The bill would require the department to develop a separate rate for the enhanced funding, to develop staffing requirements, and to adopt regulations as needed, in consultation with certain stakeholders. The bill would authorize the department to implement these provisions through interim guidance until regulations are adopted.
Existing
(3) Existing law requires the department to allocate specified funds appropriated to the department in the Budget Act of 2021 through contracts with community-based providers or entities or through local assistance allocations to counties or Indian tribes that support new or expanded programs, services, and practices that ensure the provision of a high-quality continuum of care that is designed to support foster children in the least restrictive setting, as specified. Existing law also requires the department to allocate funds in the same manner to provide and implement the recommendations of child-specific assessments, evaluations, enhanced care planning, ongoing technical assistance, and exceptional supports to meet the complex care needs of children in foster care within California within the least restrictive setting.
This bill would revise and expand those funding provisions, including adding to the permissible uses of those funds to include, among other things, STATTPs and short-term therapeutic settings that serve as an alternative to hospital-based settings. future funds to include in-home nursing supports for youth with special health care needs and highly specialized short-term residential therapeutic programs designed to serve children with complex trauma. The bill would require the department to annually allocate funds to county placing agencies and tribal agencies to purchase, procure, or directly provide supports or services to meet the exceptional needs of children and nonminor dependents in the least restrictive setting, and would allow a regional health team to make clinical recommendations to counties and tribal entities for expenditures made under these provisions.
(3)Because the creation of a new licensure category for foster youth would increase the duties of county placement agencies, and because a violation of the Community Care Facilities Act by a STATTP would be a crime, the bill would impose 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 specified reasons.
(4) This bill would provide that a continuous appropriation would not be made for purposes of implementing the bill.
## Digest Key
## Bill Text
The people of the State of California do enact as follows:SECTION 1. The Legislature finds and declares all of the following:(a) California counties are experiencing a crisis of foster youth with severe trauma and complex, unmet needs who are simply overwhelming county child welfare and probation agencies, regional centers, schools, and behavioral health providers.(b) Foster youth with complex needs are often served by multiple other systems who also struggle with providing timely and appropriate services due to lack of funding and antiquated processes that are not conducive to meeting childrens immediate needs, particularly for foster children experiencing a trauma crisis.(c) Services to this population are currently delayed, lacking, and disjointed, resulting in foster youth often experiencing frequent placement changes because no single provider or entity can meet their needs. This results in a cycle of multiple placement moves, frequent changes in service providers and caregivers, and unnecessary stays in hospital settings and unlicensed settings. These experiences lead to poor outcomes for youth and exacerbate their trauma.(d) While some efforts have been made at the state level to provide additional supports and assess the gaps and service needs, immediate action is necessary to provide a trauma-informed, patient- and youth-centered approach to addressing the individualized needs of foster youth with complex needs.(e) Foster children and their families have experienced trauma that requires a coordinated, multisystem approach to achieve positive outcomes and to build on and leverage existing efforts, such as trauma-informed systems of care, pursuant to AB 2083 (Chapter 815 of the Statutes of 2018), and California Advancing Innovations in and Innovating Medi-Cal (CalAIM).(f) Some foster youth who have experienced significant trauma, coupled with other intensive needs that cross multiple systems, and their families require a targeted approach to service provision that involves a coordinated effort across systems to meet their very unique needs.(g) California can take advantage of tools and enhanced funding available through the federal Medicaid program to help better coordinate care and provide targeted services to foster youth with intensive needs. These needs include mental and physical health needs, developmental services, and other services that address their broad needs through care managers to help reduce hospitalizations or placement into restrictive institutional settings.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 daycare, or foster family agency services for children, adults, or children and adults, including, but not limited to, the physically handicapped, mentally impaired, incompetent persons, and abused or neglected children, and includes the following:(1)Residential facility means any family home, group care facility, or similar facility determined by the department, for 24-hour nonmedical care of persons in need of personal services, supervision, or assistance essential for sustaining the activities of daily living or for the protection of the individual.(2)Adult day program means any community-based facility or program that provides care to persons 18 years of age or older in need of personal services, supervision, or assistance essential for sustaining the activities of daily living or for the protection of these individuals on less than a 24-hour basis.(3)Therapeutic day services facility means any facility that provides nonmedical care, counseling, educational or vocational support, or social rehabilitation services on less than a 24-hour basis to persons under 18 years of age who would otherwise be placed in foster care or who are returning to families from foster care. Program standards for these facilities shall be developed by the department, pursuant to Section 1530, in consultation with therapeutic day services and foster care providers.(4)Foster family agency means any public agency or private organization, organized and operated on a nonprofit basis, engaged in any of the following:(A)Recruiting, certifying, approving, and training of, and providing professional support to, foster parents and resource families.(B)Coordinating with county placing agencies to find homes for foster children in need of care.(C)Providing services and supports to licensed or certified foster parents, county-approved resource families, and children to the extent authorized by state and federal law.(5)Foster family home means any residential facility providing 24-hour care for six or fewer foster children that is owned, leased, or rented and is the residence of the foster parent or parents, including their family, in whose care the foster children have been placed. The placement may be by a public or private child placement agency or by a court order, or by voluntary placement by a parent, parents, or guardian. It also means a foster family home described in Section 1505.2.(6)Small family home means any residential facility, in the licensees 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)(A)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.(B)This section does not prohibit or discourage placement of persons who have mental or physical disabilities into any category of community care facility that meets the needs of the individual placed, if the placement is consistent with the licensing regulations of the department.(9)(A)Full-service adoption agency means any licensed entity engaged in the business of providing adoption services, that does all of the following:(i)Assumes care, custody, and control of a child through relinquishment of the child to the agency or involuntary termination of parental rights to the child.(ii)Assesses the birth parents, prospective adoptive parents, or child.(iii)Places children for adoption.(iv)Supervises adoptive placements.(B)Private full-service adoption agencies shall be organized and operated on a nonprofit basis. As a condition of licensure to provide intercountry adoption services, a full-service adoption agency shall be accredited and in good standing according to Part 96 (commencing with Section 96.1) of Title 22 of the Code of Federal Regulations, or supervised by an accredited primary provider, or acting as an exempted provider, in compliance with Subpart F (commencing with Section 96.29) of Part 96 of Title 22 of the Code of Federal Regulations.(10)(A)Noncustodial adoption agency means any licensed entity engaged in the business of providing adoption services, that does all of the following:(i)Assesses the prospective adoptive parents.(ii)Cooperatively matches children freed for adoption, who are under the care, custody, and control of a licensed adoption agency, for adoption, with assessed and approved adoptive applicants.(iii)Cooperatively supervises adoption placements with a full-service adoptive agency, but does not disrupt a placement or remove a child from a placement.(B)Private noncustodial adoption agencies shall be organized and operated on a nonprofit basis. As a condition of licensure to provide intercountry adoption services, a noncustodial adoption agency shall be accredited and in good standing according to Part 96 (commencing with Section 96.1) of Title 22 of the Code of Federal Regulations, or supervised by an accredited primary provider, or acting as an exempted provider, in compliance with Subpart F (commencing with Section 96.29) of Part 96 of Title 22 of the Code of Federal Regulations.(11)Transitional shelter care facility means any group care facility that provides for 24-hour nonmedical care of persons in need of personal services, supervision, or assistance essential for sustaining the activities of daily living or for the protection of the individual. Program components shall be subject to program standards developed by the State Department of Social Services pursuant to Section 1502.3.(12)Transitional housing placement provider means an organization licensed by the department pursuant to Section 1559.110 to provide transitional housing to foster children who are at least 16 years of age to promote their transition to adulthood. A transitional housing placement provider shall be privately operated and organized on a nonprofit basis.(13)Group home means a residential facility that provides 24-hour care and supervision to children, delivered at least in part by staff employed by the licensee in a structured environment. The care and supervision provided by a group home shall be nonmedical, except as otherwise permitted by law.(14)Youth homelessness prevention center means a group home licensed by the department to operate a program pursuant to Section 1502.35 to provide voluntary, short-term, shelter and personal services to homeless youth, youth who are at risk of homelessness, youth who are exhibiting status offender behavior, or runaway youth, as defined in paragraph (2) of subdivision (a) of Section 1502.35.(15)Enhanced behavioral supports home means a facility certified by the State Department of Developmental Services pursuant to Article 3.6 (commencing with Section 4684.80) of Chapter 6 of Division 4.5 of the Welfare and Institutions Code, and licensed by the State Department of Social Services as an adult residential facility or a group home that provides 24-hour nonmedical care to individuals with developmental disabilities who require enhanced behavioral supports, staffing, and supervision in a homelike setting. An enhanced behavioral supports home shall have a maximum capacity of four consumers, shall conform to Section 441.530(a)(1) of Title 42 of the Code of Federal Regulations, and shall be eligible for federal Medicaid home- and community-based services funding.(16)Community crisis home means a facility certified by the State Department of Developmental Services pursuant to Article 8 (commencing with Section 4698) of Chapter 6 of Division 4.5 of the Welfare and Institutions Code, and licensed by the State Department of Social Services pursuant to Article 9.7 (commencing with Section 1567.80), as an adult residential facility, providing 24-hour nonmedical care to individuals with developmental disabilities receiving regional center service, in need of crisis intervention services, and who would otherwise be at risk of admission to the acute crisis center at Fairview Developmental Center, an acute general hospital, acute psychiatric hospital, an institution for mental disease, as described in Part 5 (commencing with Section 5900) of Division 5 of the Welfare and Institutions Code, or an out-of-state placement. A community crisis home shall have a maximum capacity of eight consumers, as defined in subdivision (a) of Section 1567.80, shall conform to Section 441.530(a)(1) of Title 42 of the Code of Federal Regulations, and shall be eligible for federal Medicaid home- and community-based services funding.(17)Crisis nursery means a facility licensed by the department to operate a program pursuant to Section 1516 to provide short-term care and supervision for children under six years of age who are voluntarily placed for temporary care by a parent or legal guardian due to a family crisis or stressful situation.(18)Short-term residential therapeutic program means a residential facility operated by a public agency or private organization and licensed by the department pursuant to Section 1562.01 that provides an integrated program of specialized and intensive care and supervision, services and supports, treatment, and short-term, 24-hour care and supervision to children that is trauma-informed, as defined in standards and regulations adopted by the department. 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 childrens crisis residential program.(19)Private alternative boarding school means a group home licensed by the department to operate a program pursuant to Section 1502.2 to provide youth with 24-hour residential care and supervision, that, in addition to providing educational services to youth, provides, or holds itself out as providing, behavioral-based services to youth with social, emotional, or behavioral issues. The care and supervision provided by a private alternative boarding school shall be nonmedical, except as otherwise permitted by law.(20)Private alternative outdoor program means a group home licensed by the department to operate a program pursuant to Section 1502.21 to provide youth with 24-hour residential care and supervision, that provides, or holds itself out as providing, behavioral-based services in an outdoor living setting to youth with social, emotional, or behavioral issues. The care and supervision provided by a private alternative outdoor program shall be nonmedical, except as otherwise permitted by law.(21)Childrens crisis residential program means a facility licensed by the department as a short-term residential therapeutic program pursuant to Section 1562.02 and approved by the State Department of Health Care Services, or a county mental health plan to which the State Department of Health Care Services has delegated approval authority, to operate a childrens crisis residential mental health program with approval pursuant to Section 11462.011 of the Welfare and Institutions Code, to serve children experiencing mental health crises as an alternative to psychiatric hospitalization.(22)Group home for children with special health care needs means a group home certified by the State Department of Developmental Services pursuant to Article 3.5 (commencing with Section 4684.50) 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 (commencing with Section 1567.50) of this code that provides 24-hour health care and intensive support services in a homelike setting. A group home for children with special health care needs shall have a maximum capacity of five children with developmental disabilities, as defined in subdivision (a) of Section 4512 of the Welfare and Institutions Code.(23)Short-term assessment, treatment, and transition program or STATTP means a residential facility operated independently, or jointly by a public agency, tribal 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, and that is trauma-informed, as defined in standards and regulations adopted by the department. The care and supervision provided by a short-term assessment, treatment, and transition 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.(b)Department or state department means the State Department of Social Services.(c)Director means the Director of Social Services.SEC. 3.Section 1562.011 is added to the Health and Safety Code, to read:1562.011.(a)The department shall license short-term assessment, treatment, and transition programs or STATTPs, as defined in paragraph (23) of subdivision (a) of Section 1502, pursuant to this chapter. A STATTP shall comply with all requirements of this chapter that are applicable to short-term residential treatment programs pursuant to Section 1562.01, unless otherwise specified, and pursuant to the requirements of this section.(b)(1)A STATTP shall provide enhanced care and supervision for youth with intensive, complex needs with the support of a care team as defined by this section.(2)Notwithstanding Section 1562.01, staffing of each STATTP shall include, at minimum, all of the following:(A)A full-time administrator.(B)Two full-time clinical heads of service, which may be filled by one or more psychologists or licensed clinical social workers.(C)A half-time registered nurse, licensed vocational nurse, or public health nurse.(D)A full-time psychiatric social worker or psychiatric technician.(E)A full-time masters or bachelors level social worker.(F)A full-time facility manager.(G)Approximately two full-time equivalent direct care staff for every three children during the day and at night. Direct care staff shall be 24 years of age or older. Direct care staff shall include, at minimum, four mental health rehabilitation specialists.(H)A full-time special education specialist.(I)A half-time board-certified behavioral analyst.(J)A half-time youth peer.(K)A half-time caregiver peer.(L)A full-time activities coordinator.(M)A full-time training specialist(N)Three full-time equivalent food preparation specialists.(3)(A)The STATTP shall provide intensive, trauma-informed services through a care team for each child or youth. The care team shall be trained in trauma-informed care and led by a clinical head of service and shall include, at minimum, the program social worker, special education specialist, board-certified behavioral analyst, youth peer, and caregiver peer.(B)The care team shall deliver services to a child who is placed at a STATTP and for up to six months postdischarge as needed by the youth and their caregiver to support transition to other residential or community-based care, including family-based care. The care team shall assist in identifying, recruiting, and engaging any identified family or family-like connections to the child or youth to support the childs or youths connection to family. The care team may deliver services directly to the child, family, family-like connections, or other caregivers to support step-downs to family-based care, or may provide consultation to the next direct service provider, to include the biological family, legal guardian, or both, as deemed appropriate and pursuant to the childs or youths care plan, in consultation with any child and family team.(c)(1)The STATTP shall accept all children and youth referred by a child welfare agency, probation agency, or tribal entity unless a determination is made by the clinical staff, in consultation with other members of the care team, that the child or youth is in need of a more restrictive inpatient setting due to the immediate and present risk of serious injury to self or others or due to a commonality of need determination pursuant to subdivision (g). Once admitted, the STATTP shall continue to serve the child or youth until they can be appropriately transitioned to the next level of care with support of the care team. Placements shall comply with the requirements of Section 4096 of the Welfare and Institutions Code.(2)If a resident of the STATTP is temporarily transferred to a general acute care hospital, as defined in subdivision (a) of Section 1250 of the Health and Safety Code, or temporarily placed into any other inpatient setting, the STATTP shall afford the resident an automatic bed hold of 48 hours, which may be extended for up to 14 days pursuant to the requirements in this paragraph. The bed hold option may be exercised by a child 12 years of age or older, by the county placing agency or tribal entity, or the childs authorized representative.(A)Within 24 hours of the childs transfer to a general acute care hospital or other inpatient setting, the STATTP shall inform the child, if 12 years of age or older, the county placing agency, and the childs authorized representative of their right to exercise a bed hold, the steps to take to inform the program of their decision of whether or not to request a bed hold, and the length of time the bed hold is requested, up to seven days.(B)If the right to a bed hold is exercised and the child is not discharged within that time, the program shall inform the child, if 12 years of age or older, the county placing agency, and the childs authorized representative of their right to request an additional bed hold time, for up to a total of 14 days from the date the child left the program. The program shall provide this information at least 24 hours before the release of the bed hold.(C)A public agency that has placed the resident into the STATTP shall be liable to pay reasonable charges, not to exceed the daily rate for care in the program, for bed holds. Any other resident or representative who exercises the bed hold option shall be liable to pay reasonable charges, not to exceed the daily rate for care in the facility as established by the program, for bed hold days.(D)If the patient's attending physician notifies the STATTP in writing that the patient's stay in the general acute care hospital or other inpatient facility is expected to exceed seven days, the program shall not be required to maintain the bed hold.(3)The STATTP shall maintain communication with the youth, county placing agency or tribal agency, any caregivers or authorized representatives, and acute care hospital or other inpatient providers during the bed hold period, to support the residents treatment needs, discharge from the hospital or inpatient setting, and return to the program.(d)The STATTP shall additionally offer respite care to the next caregiver upon discharge from the program. Respite care shall be available for up to six months postdischarge for the youth, upon request of the caregiver, placing agency, or tribal entity. Respite care may be provided for up to 14 days for a youth previously served and shall be available for multiple episodes as needed to aid in the transition. The placing agency shall ensure the STATTP is compensated concurrently with any other paid placement under AFDC-FC during this time.(e)The STATTP shall leverage and coordinate with other service providers, including, but not limited to, regional centers, local education agencies, behavior health agencies, wraparound providers, and others, to maximize services and supports to the child, youth, and their caregivers while the child or youth is receiving services from the program.(f)The STATTP may be operated under licensure by counties, nonprofit agencies, tribal agencies, or a combination thereof. The department shall ensure licensing standards allow for cross-agency staffing when jointly operated.(g)STATTPs shall adhere to commonality of need requirements pursuant to subdivision (c) of Section 16514 of the Welfare and Institutions Code, and shall prioritize children and nonminor dependents placed by county child welfare agencies, probation agencies, and tribal entities for entry into care.(h)The STATTP shall be compensated at a per-child per-month rate of forty-three thousand dollars ($43,000), which shall be adjusted annually on July 1 to reflect any increases or decreases in the cost of living.(i)(1)The department shall adopt regulations to implement this section, collaborating with the State Department of Health Care Services, as necessary, to ensure alignment with mental health program approval requirements, as described in Section 4096.5 of the Welfare and Institutions Code.(2)The department shall consult with the County Welfare Directors Association, Chief Probation Officers of California, California Youth Connection, tribal representatives, County Behavioral Health Directors Association, and other stakeholders as deemed appropriate in the development of regulations.(3)(A)Notwithstanding the rulemaking provisions of the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code), the department may implement, interpret, or make specific this section by means of interim licensing standards until regulations are adopted. These interim licensing standards shall have the same force and effect as regulations until the adoption of regulations.(B)Licensing standards shall be adopted no later than March 1, 2024. If the department utilizes interim licensing standards, final regulations shall be adopted no later than January 1, 2027.SEC. 4.SEC. 2. Chapter 4.5 (commencing with Section 5425) is added to Part 1 of Division 5 of the Welfare and Institutions Code, to read: CHAPTER 4.5. Regional Health Teams5425. (a) The department, in consultation with the State Department of Social Services, shall establish up to 10 regional health teams throughout the state to serve foster youth and youth who may be at risk of entering foster care. In establishing the regional health teams, the department shall submit a state plan amendment to the federal Centers for Medicare and Medicaid Services no later than July 1, 2024, to implement the Medicaid Health Home State Plan Option, pursuant to Sections 2703 and 1945 of the Social Security Act. Section 1945 of the federal Social Security Act, as added by Section 2703 of the federal Patient Protection and Affordable Care Act.(b) The department shall coordinate with the State Department of Social Services and the State Department of Developmental Services and shall convene and engage stakeholders, including, but not limited to, the County Welfare Directors Association of California, the Chief Probation Officers of California, the County Behavioral Health Directors Association of California, the Association of Regional Centers Center Agencies, interested counties, and other stakeholders, as deemed appropriate, to develop the regional health teams.5426. (a) Regional health teams shall be available to children and youth and any adult caregivers or other adults connected with the child or youth under 26 years of age, who are experiencing severe mental illness, emotional disturbance, substance use, intellectual or developmental disability, or special health care needs or chronic health issues, or any combination of the listed conditions, and subject to identification and referral as described pursuant to subdivision (d). For purposes of this chapter, severe mental illness and emotional disturbance means an organic disorder of the brain or a clinically significant disorder of thought, mood, perception, orientation, memory, or behavior, that seriously limits a persons capacity to function in primary aspects of daily living, such as personal relations, living arrangements, work, school, and recreation.(b) Regional health teams shall be physician led and shall be composed of, at a minimum, the following members:(1) A primary care physician.(2) A licensed clinical social worker.(3) A public health nurse.(4) A nutritionist or dietitian.(5) An occupational therapist.(6) A community health worker.(7) A peer support specialist.(8) A training coordinator.(9) Additional behavioral health staff as appropriate.(c) All team members shall be responsible for ensuring that care is person-centered, person centered, culturally competent, and linguistically capable.(d) Regional health teams shall perform the following activities:(1) Receive and respond to referrals received from staff from county child welfare, county probation departments, regional centers, and others as deemed appropriate by the local county system of care, as defined pursuant to Section 16521.6.(2) Provide quality-driven, cost-effective, culturally appropriate, and person- and family-centered health home services.(3) Coordinate and provide access to high-quality health care services informed by evidence-based clinical practice guidelines.(4) Coordinate and provide access to preventive and health promotion services, including prevention of mental illness and substance use disorders.(5) Coordinate and provide access to mental health and substance abuse services.(6) Coordinate and provide access to comprehensive care management, care coordination, and transitional care across settings. For purposes of this chapter, transitional care means appropriate followup from inpatient to other settings, such as participation in discharge planning and facilitating transfer from a pediatric to an adult system of health care.(7) Coordinate and provide access to chronic disease management, including self-management support to individuals and their families.(8) Coordinate and provide access to individual and family supports, including linkage to community, social support, and recovery services.(9) Coordinate and provide access to long-term care supports and services.(10) Promote evidence-based medicine and utilize patient engagement strategies in the implementation of client plans.(11) Develop a person-centered care plan for each individual that coordinates and integrates all of their clinical and nonclinical, health care-related needs and services.(12) Demonstrate a capacity to use health information technology to link services, facilitate communication among team members and between the health team and individual and family caregivers, as well as the placing agency, and provide feedback regarding practices, as feasible and appropriate.(13) Establish a continuous quality improvement program, and collect and report on data that permit an evaluation of increased coordination of care and chronic disease management on individual-level clinical outcomes, experience-of-care outcomes, and quality-of-care outcomes at the population level.(14) Conduct staff training within the regional health team and with other service providers to improve direct care and patient outcomes.(e) Screening and referral for regional health team services shall be determined pursuant to guidelines developed by the local system of care team pursuant to Section 16521.6 in the county or counties served by the regional health team, with priority to current foster youth and those at risk of entering foster care.(f) The department shall fund up to 10 health teams that shall be geographically situated to support access to services equitably throughout the state. Regional health teams shall be funded by the department pursuant to a competitive procurement process.(g) The department, in consultation with the stakeholders identified in subdivision (b) of Section 5425, shall establish performance and outcome measures to be tracked by regional health teams and the intervals at which these teams are required to report information related to those measures to the department. The department shall post the results of these performance and outcome measures on its internet website on at least an annual basis.(h) (1)It is the intent of the Legislature that the health home state plan option established pursuant to this section begin no later than December 1, 2024, subject to the receipt of any required federal approvals or waivers.(2)A report to be submitted to the Legislature pursuant to paragraph (1) shall be submitted in compliance with Section 9795 of the Government Code.SEC. 5.Section 11400 of the Welfare and Institutions Code is amended to read:11400.For purposes of this article, and Article 6 (commencing with Section 11450), the following definitions apply:(a)Aid to Families with Dependent Children-Foster Care (AFDC-FC) means the aid provided on behalf of needy children in foster care under the terms of this division.(b)Case plan means a written document that, at a minimum, specifies the type of home in which the child shall be placed, the safety of that home, and the appropriateness of that home to meet the childs needs. It shall also include the agencys plan for ensuring that the child receive proper care and protection in a safe environment, and shall set forth the appropriate services to be provided to the child, the childs family, and the foster parents, in order to meet the childs needs while in foster care, and to reunify the child with the childs family. In addition, the plan shall specify the services that will be provided or steps that will be taken to facilitate an alternate permanent plan if reunification is not possible.(c)Certified family home means an individual or family certified by a licensed foster family agency and issued a certificate of approval by that agency as meeting licensing standards, and used exclusively by that foster family agency for placements.(d)Family home means the family residence of a licensee in which 24-hour care and supervision are provided for children.(e)Small family home means any residential facility, in the licensees family residence, which 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.(f)Foster care means the 24-hour out-of-home care provided to children whose own families are unable or unwilling to care for them, and who are in need of temporary or long-term substitute parenting.(g)Foster family agency means a licensed community care facility, as defined in paragraph (4) of subdivision (a) of Section 1502 of the Health and Safety Code. Private foster family agencies shall be organized and operated on a nonprofit basis.(h)Group home means a nondetention privately operated residential home, organized and operated on a nonprofit basis only, of any capacity, or a nondetention licensed residential care home operated by the County of San Mateo with a capacity of up to 25 beds, that accepts children in need of care and supervision in a group home, as defined by paragraph (13) of subdivision (a) of Section 1502 of the Health and Safety Code.(i)Periodic review means review of a childs status by the juvenile court or by an administrative review panel, that shall include a consideration of the safety of the child, a determination of the continuing need for placement in foster care, evaluation of the goals for the placement and the progress toward meeting these goals, and development of a target date for the childs return home or establishment of alternative permanent placement.(j)Permanency planning hearing means a hearing conducted by the juvenile court in which the childs future status, including whether the child shall be returned home or another permanent plan shall be developed, is determined.(k)Placement and care refers to the responsibility for the welfare of a child vested in an agency or organization by virtue of the agency or organization having (1) been delegated care, custody, and control of a child by the juvenile court, (2) taken responsibility, pursuant to a relinquishment or termination of parental rights on a child, (3) taken the responsibility of supervising a child detained by the juvenile court pursuant to Section 319 or 636, or (4) signed a voluntary placement agreement for the childs placement; or to the responsibility designated to an individual by virtue of the individual being appointed the childs legal guardian.(l)Preplacement preventive services means services that are designed to help children remain with their families by preventing or eliminating the need for removal.(m)Relative means an adult who is related to the child by blood, adoption, or affinity within the fifth degree of kinship, including stepparents, stepsiblings, and all relatives whose status is preceded by the words great, great-great, or grand or the spouse of any of these persons even if the marriage was terminated by death or dissolution.(n)Nonrelative extended family member means an adult caregiver who has an established familial or mentoring relationship with the child, as described in Section 362.7.(o)Voluntary placement means an out-of-home placement of a child by (1) the county welfare department, probation department, or Indian tribe that has entered into an agreement pursuant to Section 10553.1, after the parents or guardians have requested the assistance of the county welfare department and have signed a voluntary placement agreement, or (2) the county welfare department licensed public or private adoption agency, or the department acting as an adoption agency, after the parents have requested the assistance of either the county welfare department, the licensed public or private adoption agency, or the department acting as an adoption agency for the purpose of adoption planning, and have signed a voluntary placement agreement.(p)Voluntary placement agreement means a written agreement between either the county welfare department, probation department, or Indian tribe that has entered into an agreement pursuant to Section 10553.1, licensed public or private adoption agency, or the department acting as an adoption agency, and the parents or guardians of a child that specifies, at a minimum, the following:(1)The legal status of the child.(2)The rights and obligations of the parents or guardians, the child, and the agency in which the child is placed.(q)Original placement date means the most recent date on which the court detained a child and ordered an agency to be responsible for supervising the child or the date on which an agency assumed responsibility for a child due to termination of parental rights, relinquishment, or voluntary placement.(r)(1)Transitional housing placement provider means an organization licensed by the State Department of Social Services pursuant to Section 1559.110 of the Health and Safety Code to provide supervised transitional housing services to foster children who are at least 16 years of age. A transitional housing placement provider shall be privately operated and organized on a nonprofit basis.(2)Before licensure, a provider shall obtain certification from the applicable county, in accordance with Section 16522.1.(s)Transitional Housing Program-Plus means a provider certified by the applicable county, in accordance with subdivision (c) of Section 16522, to provide transitional housing services to former foster youth who have exited the foster care system on or after their 18th birthday.(t)Whole family foster home means a resource family, licensed foster family home, approved relative caregiver or nonrelative extended family members home, the home of a nonrelated legal guardian whose guardianship was established pursuant to Section 360 or 366.26, certified family home, or a host family of a transitional housing placement provider, that provides foster care for a minor or nonminor dependent parent and their child, and is specifically recruited and trained to assist the minor or nonminor dependent parent in developing the skills necessary to provide a safe, stable, and permanent home for the child. The child of the minor or nonminor dependent parent need not be the subject of a petition filed pursuant to Section 300 to qualify for placement in a whole family foster home.(u)Mutual agreement means any of the following:(1)A written voluntary agreement of consent for continued placement and care in a supervised setting between a minor or, on and after January 1, 2012, a nonminor dependent, and the county welfare services or probation department or tribal agency responsible for the foster care placement, that documents the nonminors continued willingness to remain in supervised out-of-home placement under the placement and care of the responsible county, tribe, consortium of tribes, or tribal organization that has entered into an agreement with the state pursuant to Section 10553.1, remain under the jurisdiction of the juvenile court as a nonminor dependent, and report any change of circumstances relevant to continued eligibility for foster care payments, and that documents the nonminors and social workers or probation officers agreement to work together to facilitate implementation of the mutually developed supervised placement agreement and transitional independent living case plan.(2)An agreement, as described in paragraph (1), between a nonminor former dependent or ward in receipt of Kin-GAP payments under Article 4.5 (commencing with Section 11360) or Article 4.7 (commencing with Section 11385), and the agency responsible for the Kin-GAP benefits, provided that the nonminor former dependent or ward satisfies the conditions described in Section 11403.01, or one or more of the conditions described in paragraphs (1) to (5), inclusive, of subdivision (b) of Section 11403. For purposes of this paragraph and paragraph (3), nonminor former dependent or ward has the same meaning as described in subdivision (aa).(3)An agreement, as described in paragraph (1), between a nonminor former dependent or ward in receipt of AFDC-FC payments under subdivision (e) or (f) of Section 11405 and the agency responsible for the AFDC-FC benefits, provided that the nonminor former dependent or ward described in subdivision (e) of Section 11405 satisfies one or more of the conditions described in paragraphs (1) to (5), inclusive, of subdivision (b) of Section 11403, and the nonminor described in subdivision (f) of Section 11405 satisfies the secondary school or equivalent training or certificate program conditions described in that subdivision.(v)Nonminor dependent means, on and after January 1, 2012, a foster child, as described in Section 675(8)(B) of Title 42 of the United States Code under the federal Social Security Act who is a current dependent child or ward of the juvenile court, or who is a nonminor under the transition jurisdiction of the juvenile court, as described in Section 450, and who satisfies all of the following criteria:(1)The nonminor dependent has attained 18 years of age while under an order of foster care placement by the juvenile court, and is not more than 19 years of age on or after January 1, 2012, not more than 20 years of age on or after January 1, 2013, or not more than 21 years of age on or after January 1, 2014, and as described in Section 10103.5.(2)The nonminor dependent is in foster care under the placement and care responsibility of the county welfare department, county probation department, Indian tribe, consortium of tribes, or tribal organization that entered into an agreement pursuant to Section 10553.1.(3)The nonminor dependent has a transitional independent living case plan pursuant to Section 475(8) of the federal Social Security Act (42 U.S.C. Sec. 675(8)), as contained in the federal Fostering Connections to Success and Increasing Adoptions Act of 2008 (Public Law 110-351), as described in Section 11403.(w)Supervised independent living placement means, on and after January 1, 2012, an independent supervised setting in which the nonminor dependent is living independently, pursuant to Section 472(c) of the federal Social Security Act (42 U.S.C. Sec. 672(c)).(x)Supervised independent living setting, pursuant to Section 472(c) of the federal Social Security Act (42 U.S.C. Sec. 672(c)), includes all of the following:(1)A supervised independent living placement, as defined in subdivision (w), and as specified in a nonminor dependents transitional independent living case plan.(2)A transitional housing unit in which a host family lives with a nonminor dependent who is a participant of a Transitional Housing Placement program, as described in subdivision (a) of Section 1559.110 of the Health and Safety Code, including an apartment, single-family dwelling, or condominium owned, rented, or leased by the host family, with supervised transitional housing services provided by the licensed transitional housing placement provider.(3)A residential housing unit certified by the transitional housing placement provider operating a Transitional Housing Placement program for nonminor dependents, as described in paragraph (2) of subdivision (a) of Section 16522.1.(4)A transitional living setting approved by the county to support youth who are entering or reentering foster care or transitioning between placements. The short-term independent living setting shall not include a youth homelessness prevention center or an adult homeless shelter. A transitional living setting approved by the county for purposes of this paragraph is not subject to licensing pursuant to paragraph (4) of subdivision (l) of Section 1505 of the Health and Safety Code.(y)Transitional independent living case plan means, on or after January 1, 2012, a childs case plan submitted for the last review hearing held before the child reaches 18 years of age or the nonminor dependents case plan, updated every six months, that describes the goals and objectives of how the nonminor will make progress in the transition to living independently and assume incremental responsibility for adult decisionmaking, the collaborative efforts between the nonminor and the social worker, probation officer, or Indian tribal placing entity and the supportive services as described in the transitional independent living plan (TILP) to ensure active and meaningful participation in one or more of the eligibility criteria described in paragraphs (1) to (5), inclusive, of subdivision (b) of Section 11403, the nonminors appropriate supervised placement setting, and the nonminors permanent plan for transition to living independently, which includes maintaining or obtaining permanent connections to caring and committed adults, as set forth in paragraph (16) of subdivision (f) of Section 16501.1.(z)Voluntary reentry agreement means a written voluntary agreement between a former dependent child or ward or a former nonminor dependent, who has had juvenile court jurisdiction terminated pursuant to Section 391, 452, or 607.2, or between a nonminor dependent who has not signed a voluntary reentry agreement after attaining 18 years of age and for whom a petition will be filed pursuant to subdivision (f) of Section 388, and the county welfare or probation department or tribal placing entity that documents the nonminors desire and willingness to reenter foster care, to be placed in a supervised setting under the placement and care responsibility of the placing agency, the nonminors desire, willingness, and ability to immediately participate in one or more of the conditions of paragraphs (1) to (5), inclusive, of subdivision (b) of Section 11403, the nonminors agreement to work collaboratively with the placing agency to develop their transitional independent living case plan within 60 days of reentry, if not previously completed, the nonminors agreement to report any changes of circumstances relevant to continued eligibility for foster care payments, and (1) the nonminors agreement to participate in the filing of a petition for juvenile court jurisdiction as a nonminor dependent pursuant to subdivision (e) of Section 388 within 15 judicial days of the signing of the agreement and the placing agencys efforts and supportive services to assist the nonminor in the reentry process, (2) if the nonminor meets the definition of a nonminor former dependent or ward, as described in subdivision (aa), the nonminors agreement to return to the care and support of their former juvenile court-appointed guardian and meet the eligibility criteria for AFDC-FC pursuant to subdivision (e) of Section 11405, or (3) the nonminor dependents agreement to participate in the filing of a petition pursuant to subdivision (f) of Section 388.(aa)Nonminor former dependent or ward means, on and after January 1, 2012, either of the following:(1)A nonminor who reached 18 years of age while subject to an order for foster care placement, and for whom dependency, delinquency, or transition jurisdiction has been terminated, and who is still under the general jurisdiction of the court.(2)A nonminor who is over 18 years of age and, while a minor, was a dependent child or ward of the juvenile court when the guardianship was established pursuant to Section 360 or 366.26, or subdivision (d) of Section 728, and the juvenile court dependency or wardship was dismissed following the establishment of the guardianship.(ab)Youth homelessness prevention center means a type of group home, as defined in paragraph (14) of subdivision (a) of Section 1502 of the Health and Safety Code, that is not an eligible placement option under Sections 319, 361.2, 450, and 727, and that is not eligible for AFDC-FC funding pursuant to subdivision (c) of Section 11402 or Section 11462.(ac)Transition dependent is a minor between 17 years and five months and 18 years of age who is subject to the courts transition jurisdiction under Section 450.(ad)Short-term residential therapeutic program means a nondetention, licensed community care facility, as defined in paragraph (18) of subdivision (a) of Section 1502 of the Health and Safety Code, that provides an integrated program of specialized and intensive care and supervision, services and supports, and treatment for the child or youth, when the childs or youths case plan specifies the need for, nature of, and anticipated duration of this specialized treatment. Short-term residential therapeutic programs shall be organized and operated on a nonprofit basis.(ae)Resource family means an approved caregiver, as defined in subdivision (c) of Section 16519.5.(af)Core services means services, made available to children, youth, and nonminor dependents either directly or secured through agreement with other agencies, that are trauma informed and culturally relevant, as specified in Sections 11462 and 11463.(ag)Short-term assessment, therapy, and transition program means a nondetention, licensed community care facility, as defined in paragraph (23) of subdivision (a) of Section 1502 of the Health and Safety Code, that provides an intensive, trauma-informed, individualized, and integrated program of care and supervision, services and supports, and treatment for the child or youth, when the childs or youths case plan specifies the need for, nature of, and anticipated duration of, this specialized treatment. Short-term assessment, therapy, and transition programs shall be organized and operated on a nonprofit basis.SEC. 6.Section 11460 of the Welfare and Institutions Code is amended to read:11460.(a)(1)Foster care providers shall be paid a per child per month rate in return for the care and supervision of the AFDC-FC child placed with them. The department is designated the single organizational unit whose duty it shall be to administer a state system for establishing rates in the AFDC-FC program. State functions shall be performed by the department or by delegation of the department to county welfare departments or Indian tribes, consortia of tribes, or tribal organizations that have entered into an agreement pursuant to Section 10553.1.(2)(A)Foster care providers that care for a child in a home-based setting described in paragraph (1) of subdivision (g) of Section 11461, or in a certified home or an approved resource family of a foster family agency, shall be paid the per child per month rate as set forth in subdivision (g) of Section 11461.(B)The basic rate paid to either a certified family home or an approved resource family of a foster family agency shall be paid by the agency to the certified family home or approved resource family from the rate that is paid to the agency pursuant to Section 11463.(3)(A)In addition to administering the state system of rates described in paragraph (1) of subdivision (a), at the request of and in consultation with a county,the department shall have the authority to develop, implement, and approve alternative funding models and set individualized rates for innovative AFDC-FC programs or models of care and servicesthat are consistent with statewide licensing and program requirements and that provide children with service alternatives to residential care, enhance the ability of children to remain in the least restrictive, most family-like setting possible, and promote services that address the needs and strengths of individual children and their families.(B)A county that chooses to request an alternative funding model or individualized rate under this paragraph shall pay the entire nonfederal share of any additional cost for providing these innovative programs or models of care and services that exceeds the nonfederal portions of the state system of rates established pursuant to subdivision (a).(C)(i)The provider shall indicate in theprogram statement theinnovative approach or model of care and servicesfor which there is a recognized need that the county seeks to meet.(ii)The requesting county, in consultation with the department, shall monitorthe performance and outcomes of the provider consistent with the program statement to ensure that the purposes of the innovative program or model of care and serviceswill be achieved commensurate with the alternative funding model or individualized rate.(b)Care and supervision includes food, clothing, shelter, daily supervision, school supplies, a childs personal incidentals, liability insurance with respect to a child, reasonable travel to the childs home for visitation, and reasonable travel for the child to remain in the school in which the child is enrolled at the time of placement. Reimbursement for the costs of educational travel, as provided for in this subdivision, shall be made pursuant to procedures determined by the department, in consultation with representatives of county welfare and probation directors, and additional stakeholders, as appropriate.(1)For a child or youth placed in a short-term residential therapeutic program, group home, or short-term assessment, therapy, and transition program, care and supervision shall also include reasonable administration and operational activities necessary to provide the items listed in this subdivision.(2)For a child or youth placed in a short-term residential therapeutic program, group home, or short-term assessment, therapy, and transition program, care and supervision may also include reasonable activities performed by social workers employed by the program provider that are not otherwise considered daily supervision or administration activities.(3)The department, in consultation with the California State Foster Parent Association, and other interested stakeholders, shall provide information to the Legislature, no later than January 1, 2017, regarding the availability and cost for liability and property insurance covering acts committed by children in care, and shall make recommendations for any needed program development in this area.(c)It is the intent of the Legislature to establish the maximum level of financial participation in out-of-state foster care group home program rates for placements in facilities described in subdivision (h) of Section 11402.(1)The department shall develop regulations that establish the method for determining the level of financial participation in the rate paid for out-of-state placements in facilities described in subdivision (h) of Section 11402. The department shall consider all of the following methods:(A)Until December 31, 2016, a standardized system based on the rate classification level of care and services per child per month.(B)The rate developed for a short-term residential therapeutic program and short-term assessment, therapy, and transition program pursuant to Section 11462.(C)A system that considers the actual allowable and reasonable costs of care and supervision incurred by the out-of-state program.(D)A system that considers the rate established by the host state.(E)Any other appropriate methods as determined by the department.(2)Reimbursement for the Aid to Families with Dependent Children-Foster Care rate to be paid to an out-of-state program described in subdivision (h) of Section 11402 shall only be paid to programs that have done all of the following:(A)Submitted a rate application to the department, which shall include, but not be limited to, both of the following:(i)Commencing January 1, 2017, unless granted an extension from the department pursuant to subdivision (d) or (e) of Section 11462.04, the equivalent of the mental health program approval required in Section 4096.5.(ii)Commencing January 1, 2017, unless granted an extension from the department pursuant to subdivision (d) or (e) of Section 11462.04, the national accreditation required in paragraph (6) of subdivision (b) of Section 11462.(B)Maintained a level of financial participation that shall not exceed any of the following:(i)The current fiscal years standard rate for rate classification level 14 for a group home.(ii)Commencing January 1, 2017, the current fiscal years rate for a short-term residential therapeutic program.(iii)The rate determined by the ratesetting authority of the state in which the facility is located.(C)Agreed to comply with information requests, and program and fiscal audits as determined necessary by the department.(3)Except as specifically provided for in statute, reimbursement for an AFDC-FC rate shall only be paid to a group home, short-term residential therapeutic program, or short-term assessment, therapy, and transition program organized and operated on a nonprofit basis.(d)A foster care provider that accepts payments, following the effective date of this section, based on a rate established under this section, shall not receive rate increases or retroactive payments as the result of litigation challenging rates established prior to the effective date of this section. This shall apply regardless of whether a provider is a party to the litigation or a member of a class covered by the litigation.(e)The county is not precluded from using a portion of its county funds to increase rates paid to family homes, foster family agencies, group homes, short-term residential therapeutic programs, or short-term assessment, therapy, and transition programs within that county, and to make payments for specialized care increments, clothing allowances, or infant supplements to homes within that county, solely at that countys expense.(f)A county is not precluded from providing a supplemental rate to serve commercially sexually exploited foster children to provide for the additional care and supervision needs of these children. To the extent that federal financial participation is available, it is the intent of the Legislature that the federal funding shall be utilized.SEC. 7.Section 11462.01 of the Welfare and Institutions Code is amended to read:11462.01.(a)(1)If a program will admit Medi-Cal beneficiaries, no later than 12 months following the date of initial licensure, a short-term residential therapeutic program, as defined in subdivision (ad) of Section 11400 of this code and paragraph (18) of subdivision (a) of Section 1502 of the Health and Safety Code, and a short-term assessment, therapy, and transition program, as defined in subdivision (ag) of Section 11400 of this code and paragraph (23) 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 childs case plan.(C)The childs needs and services plan.(D)The assessment of a qualified individual, as defined in subdivision (l) of Section 16501.(E)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 specified in subdivision (c), a short-term residential therapeutic program or a short-term assessment, therapy, and transition 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 or a short-term assessment, therapy, and transition 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 childs own home or in other family settings, such as with a relative, guardian, foster family, resource family, or adoptive family. The assessment shall ensure the child has needs in common with other children or youth in the care of the facility, consistent with subdivision (c) of Section 16514.(3)The child meets at least one of the following conditions:(A)The child has been assessed, pursuant to Section 4096, as meeting the medical necessity criteria for Medi-Cal specialty mental health services, as provided for in Section 1830.205 or 1830.210 of Title 9 of the California Code of Regulations.(B)The child has been assessed, pursuant to Section 4096, as seriously emotionally disturbed, as defined in subdivision (a) of Section 5600.3.(C)The child requires emergency placement pursuant to paragraph (3) of subdivision (h).(D)The child has been assessed, pursuant to Section 4096, as requiring the level of services provided by the short-term residential therapeutic program in order to meet the childs behavioral or therapeutic needs.(4)Subject to the requirements of this subdivision, a short-term residential therapeutic program or a short-term assessment, therapy, and transition 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 childs behavior, and short-term intervention is needed to transition the child back into the home.(C)A juvenile sex offender.(D)A child who is affiliated with, or impacted by, a gang.(c)(1)A short-term residential therapeutic program that is operating as a childrens crisis residential program, as defined in Section 1502 of the Health and Safety Code, may accept for admission any child who meets all of the requirements set forth in paragraph (3) of subdivision (c) of Section 11462.011 and subdivisions (a) to (e), inclusive, of Section 4096.(2)The primary function of a childrens crisis residential program is to provide short-term crisis stabilization, therapeutic intervention, and specialized programming in an unlocked, staff-secured setting with a high degree of supervision and structure and the goal of supporting the rapid and successful transition of the child back to the community.(d)A foster family agency that is certified as a Medi-Cal specialty mental health provider pursuant to Section 1810.435 of Title 9 of the California Code of Regulations by the State Department of Health Care Services, or by a county mental health plan to which the department has delegated certification authority, and which has entered into a contract with a county mental health plan pursuant to Section 1810.436 of Title 9 of the California Code of Regulations, shall provide, or provide access to, specialty mental health services to children under its care who do not require inpatient care in a licensed health facility and who meet the medical necessity criteria for Medi-Cal specialty mental health services provided for in Section 1830.205 or 1830.210 of Title 9 of the California Code of Regulations.(e)A foster family agency that is not certified as a Medi-Cal specialty mental health provider shall provide access to specialty and mental health services and other 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 and short-term assessment, therapy, and transition programs shall maintain the level of care and services necessary to meet the needs, including the assessed needs and child-specific goals identified by a qualified individual pursuant to subdivision (g) of Section 4096, as applicable, of the children and youth in their care and shall maintain and have in good standing the appropriate mental health program approval. If a program will admit Medi-Cal beneficiaries, the short-term residential therapeutic program shall obtain 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 childs 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 the short-term residential therapeutic program or short-term assessment, therapy, and transition 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 (j) of Section 4096.(3)An individualized education program team. For the purposes of this section, an AFDC-FC funded child with an individualized education program developed pursuant to Article 2 (commencing with Section 56320) of Chapter 4 of Part 30 of Division 4 of Title 2 of the Education Code that assesses the child as seriously emotionally disturbed, as defined in, and subject to, this section and recommends out-of-home placement at the level of care provided by the provider, shall be deemed to have met the assessment requirement.(4)A qualified individual, as defined in subdivision (l) of Section 16501.(h)(1)The short-term residential therapeutic program or short-term assessment, therapy, and transition program shall maintain documentation of the assessments required pursuant to Section 4096 for AFDC-FC funded children, except as provided for in paragraph (3) of subdivision (g). The short-term residential therapeutic program shall inform the department if the county placing agency does not provide the documentation.(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)Subdivisions (a) to (g), inclusive, and this subdivision do not prevent an emergency placement of a child or youth into a certified short-term residential therapeutic program prior to the determination by the interagency placement committee, but only if a licensed mental health professional, as defined in subdivision (j) of Section 4096, has made a written determination within 72 hours of the childs or youths 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 their behavioral or therapeutic needs. If the short-term residential therapeutic program serves children placed by county child welfare agencies and children placed by probation departments, the interagency placement committee shall also ensure the requirements of subdivision (c) of Section 16514 have been met with respect to commonality of need.(i)The interagency placement committee, as appropriate, shall, within 30 days of placement, make the determinations, with recommendations from the child and family team, required by this subdivision.(ii)If it determines the placement is appropriate, the interagency placement committee, with recommendations from the child and family team, shall transmit the approval, in writing, to the county placing agency and the short-term residential therapeutic program or short-term assessment, therapy, and transition 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 or short-term assessment, therapy, and transition program and shall include a recommendation as to the childs appropriate level of care and placement to meet the childs 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. On and after October 1, 2021, federal AFDC-FC shall not be used to fund the placement for more than 30 days from the date that the qualified individual or interagency placement committee determined that the placement is no longer recommended or the court disapproved the placement.(iii)Notwithstanding clause (ii), if the interagency placement committee determined the placement was not appropriate due to a health and safety concern, immediate arrangements for the child to transition to an appropriate placement shall occur.(i)Commencing January 1, 2017, for AFDC-FC funded children or youth, only those children or youth who are approved for placement, as set forth in this section, may be accepted by a short-term residential therapeutic program or short-term assessment, therapy, and transition program.(j)The department shall, through regulation, establish consequences for the failure of a short-term residential therapeutic program or short-term assessment, therapy, and transition program to obtain written approval for placement of an AFDC-FC funded child or youth pursuant to this section.(k)The department shall not establish a rate for a short-term residential therapeutic program or short-term assessment, therapy, and transition 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 departments AFDC-FC ratesetting regulations.(l) Any short-term residential therapeutic program or short-term assessment, therapy, and transition program shall be reclassified and paid at the appropriate program rate for which it is qualified if any of the following occur:(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 departments 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 or short-term assessment, therapy, and transition 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. During any appeal, the short-term residential therapeutic program or short-term assessment, therapy, and transition program shall maintain the appropriate level of care.(2)It fails to maintain a mental health treatment program as required by subdivision (f).(3)It fails to timely obtain or maintain accreditation as required by state law or fails to provide proof of that accreditation to the department upon request.(m)In addition to any other review required by law, the child and family team as defined in paragraph (4) of subdivision (a) of Section 16501 may periodically review the placement of the child or youth. If the child and family team make a recommendation that the child or youth no longer needs, or is not benefiting from, placement in a short-term residential therapeutic program, the team shall transmit the disapproval, in writing, to the county placing agency to consider a more appropriate placement.(n)The department shall develop a process to address placements when, subsequent to the childs or youths 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 countys plan, and a timeframe, for removal of the child or youth in writing to the short-term residential therapeutic program that provides intensive and therapeutic treatment.(3)Referral to an appropriate placement.(4)Actions to be taken if a child or youth is not timely removed from the short-term residential therapeutic program that provides intensive and therapeutic treatment or placed in an appropriate placement.(o)(1)This section does not prohibit a short-term residential therapeutic program or a short-term assessment, therapy, and transition program from accepting private admissions of children or youth.(2)When a referral is not from a public agency and public funding is not involved, there is no requirement for public agency review or determination of need.(3)Children and youth subject to paragraphs (1) and (2) shall have been determined to be seriously emotionally disturbed, as described in subdivision (a) of Section 5600.3, and subject to Section 1502.4 of the Health and Safety Code, by a licensed mental health professional, as defined in subdivision (j) of Section 4096.SEC. 3. Section 11462.010 is added to the Welfare and Institutions Code, immediately following Section 11462.01, to read:11462.010. (a) (1) The department shall develop an enhanced funding model for short-term residential therapeutic programs that serve up to four current or former foster children or nonminor dependents in the foster care system who have complex needs across multiple systems.(2) The enhanced funding shall be for additional program staffing to be delivered onsite by a care team composed of appropriate professionals trained in trauma-informed care across physical health, developmental disabilities, educational, and behavioral health care inclusive of substance abuse, in order to provide the services to a child or nonminor dependent, and overseen by appropriate administrative staff as required by the department.(3) The program shall leverage and coordinate with other service providers, including regional centers, local educational agencies, behavioral health agencies, wraparound providers, and others, to maximize services and supports to the child, nonminor dependent, and their caregivers while the child or nonminor dependent is receiving services from the program.(b) The enhanced program shall provide intensive, trauma-informed services through a care team for each child or nonminor dependent. The care team shall be led by a clinical head of service and shall include, at a minimum, the program social worker, special education specialist, board-certified behavioral analyst, youth peer, and caregiver peer.(c) The care team shall deliver services to a child or nonminor dependent who is placed at an enhanced short-term residential therapeutic program and for up to six months postdischarge, as needed by the child or nonminor dependent and their caregiver to support transition to other residential or community-based care, including family-based care. The care team may also deliver services to the family, family-like connections, or other caregivers to support stepdowns to family-based care, or may provide consultation to the next direct service provider, to include the biological family, legal guardian, or both, as deemed appropriate and pursuant to the childs or nonminor dependents care plan, in consultation with any child and family team.(d) The department shall develop staffing requirements in consultation with stakeholders, including, but not limited to, the County Welfare Directors Association of California, the Chief Probation Officers of California, the County Behavioral Health Directors Association of California, the California Youth Connection, and tribal and provider representatives.(e) (1) As a condition of receiving enhanced funding, and subject to the other requirements described in this section, the program shall accept all children and nonminor dependents referred by a child welfare agency, probation agency, or tribal entity, unless a determination is made by the clinical staff, in consultation with other members of the care team, that the child or nonminor dependent is in need of a more restrictive inpatient setting due to the immediate and present risk of serious injury to self or others or due to a commonality of need.(2) The program shall continue to serve a child or nonminor dependent admitted to the program until they can be appropriately transitioned to the next level of care with support of the care team and shall hold beds open due to temporary transfers to a general acute care hospital or a crisis mental health inpatient setting for up to 14 days.(f) (1) The department shall develop a separate rate for the enhanced funding pursuant to Section 11462 and shall adopt regulations as needed to implement this section.(2) The department shall consult with the State Department of Health Care Services, the County Welfare Directors Association of California, the Chief Probation Officers of California, the California Youth Connection, tribal representatives, the County Behavioral Health Directors Association of California, provider representatives, and other stakeholders as deemed appropriate in the development of regulations.(g) Notwithstanding the rulemaking provisions of the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code), the department may implement, interpret, or make specific this section by means of interim guidance until regulations are adopted.SEC. 8.SEC. 4. Section 16001.1 of the Welfare and Institutions Code is amended to read:16001.1. (a) It is the intent of the Legislature to support the urgent and exceptional needs of children and nonminor dependents in foster care under the supervision of a county child welfare agency or probation department, including those who otherwise may be placed in an out-of-state residential facility.(b) (1) The department shall allocate funds appropriated to the department for this purpose in the Budget Act of 2021, and in any future fiscal year, through local assistance allocations to counties or Indian tribes that have entered into an agreement pursuant to Section 10553.1 that support new or expanded programs, services, practices, and training that builds system capacity and ensures the provision of a high-quality continuum of care that is designed to support foster children in the least restrictive setting, consistent with a childs permanency plan.(2) Pursuant to guidance and a process established by the department and the State Department of Health Care Services, in consultation with the County Welfare Directors Association of California, Chief Probation Officers of California, and County Behavioral Health Directors Association of California, fund recipients shall use the allocated funds to supplement county efforts to build system capacity for any of the following activities:(A) Specialized models of professional foster care, including therapeutic foster care, intensive services foster care, or other models as may be developed in collaboration with counties, including the County Behavioral Health Directors Association of California, and providers.(B) Intensive child-specific recruitment, family finding and engagement, and support programs for children with complex needs, including specialized permanency support services as described in Section 16501 and activities associated with the Active Supportive Intervention Services for Transition program.(C) Specialized models of integrated care and support for family-based settings, including high-fidelity wraparound, in-home nursing supports for youth with special health care needs, and community-based treatment models that create alternatives to out-of-home or residential placement.(D) Highly individualized short-term residential therapeutic programs designed to serve children with complex needs who otherwise may have been placed in an out-of-state residential facility.(E) A Childrens Crisis Continuum Pilot Program established pursuant to Chapter 6 (commencing with Section 16550).(F)Highly specialized short-term residential therapeutic programs and short-term assessment, treatment, and transition programs designed to serve children with complex trauma or cooccurring intellectual or developmental disabilities and behavioral health needs.(G)Short-term therapeutic settings that serve as an alternative to hospital-based settings and temporary placement settings.(F) Highly specialized short-term residential therapeutic programs designed to serve children with complex trauma or cooccurring intellectual or developmental disabilities and behavioral health needs.(3) Allocations made pursuant to this subdivision shall be conditioned on qualitative and outcomes standards that are established by the department, in consultation with the State Department of Health Care Services, counties, tribes, and other entities that may receive funding.(c) (1) The department shall allocate or expend, through contracts with community-based providers or entities or through local assistance allocations to counties or Indian tribes that have entered into an agreement pursuant to Section 10553.1, funds appropriated to the department for this purpose in the Budget Act of 2021, and in any future fiscal year, to provide and implement the recommendations of child-specific assessments, evaluations, enhanced care planning, ongoing technical assistance, and exceptional supports to meet the complex care needs of children in foster care within California within the least restrictive setting.(2) The department shall annually allocate funds to county placing agencies and tribal entities to purchase, procure, or directly provide supports or services that are needed to support the exceptional needs of a child or nonminor dependent in the least restrictive setting. Counties and tribal entities shall ensure expenditures are based upon the recommendation of a qualified individual, technical assistance provided by the department, or a clinical determination of an interagency placement committee or regional health team that considers the recommendations of a child and family team. Counties shall document these recommendations in the case plan of the child or nonminor dependent. Funds allocated pursuant to this paragraph may be expended for the following services and supports:(A) Direct services for the youth or family to help stabilize an existing placement, facilitate a new placement, or prevent a placement into foster care. Services may include, but are not limited to, accessing diagnostic testing and enhanced clinical assessments, therapies and treatments, developmental service supports, and medical and health-related services.(B) Enhanced family finding, engagement, and supports to enable placement with relatives or other family-like connections through intensive searches, or to support continued connection, engagement engagement, and support from relatives or other family-like connections. Access to funding for this purpose is permitted if the county or tribal entity has not opted into the Excellence in Family Finding, Engagement, and Support Program pursuant to Section 16546.5, or if the county or tribal entity has opted into the program and the youth has additional needs that cannot be fully met by the program.(C) Payments to providers to support respite care for caregivers.(D) Therapeutic or wraparound services.(E) Consultation or assessment with service providers or those with specialized expertise in care and treatment of youth with complex needs.(F) Durable medical equipment and supplies or other tangible items.(G) Enhanced care and supervision delivered by county staff, foster care providers, or other personnel subject to the requirements of Section 1522 of the Health and Safety Code.(H) Preplacement engagement and support and transitional support activities designed to facilitate access to therapies and treatment settings for youth.(I) Translation services in different languages, including American Sign Language.(J) Access to alternative therapies or extracurricular activities.(K) Other services or supports pursuant to guidance issued by the department, in consultation with counties.(3) Funds made available pursuant to this subdivision shall be conditioned on qualitative and outcomes standards that are established by the department. Outcomes standards shall include a continuous quality improvement process designed to address systematic gaps or barriers to meeting the needs of children and nonminor dependents in the least restrictive setting. Those outcomes standards shall be developed by the department and the State Department of Health Care Services, in consultation with counties, tribes, and other entities that may receive funding.(d) The department shall consult with the joint interagency resolution team, the County Welfare Directors Association of California, the Chief Probation Officers of California, the California Behavioral Health Directors Association of California, legislative staff, and other stakeholders with respect to the implementation of this section.(e) Funding made available to counties pursuant to this section shall only be used to supplement, and not supplant, existing funding, unless the receipt of funding or services from other sources are not readily available to meet the immediate needs of a youth, in which case the county may utilize funds appropriated pursuant to this section.(f) It is the intent of the Legislature that funding pursuant to this section that is not expended during a given fiscal year shall be made available for expenditure in the following fiscal year.SEC. 9.(a)To the extent that this act has an overall effect of increasing the costs already borne by a local agency for programs or levels of service mandated by the 2011 Realignment Legislation within the meaning of Section 36 of Article XIII of the California Constitution, it shall apply to local agencies only to the extent that the state provides annual funding for the cost increase. Any new program or higher level of service provided by a local agency pursuant to this act above the level for which funding has been provided shall not require a subvention of funds by the state or otherwise be subject to Section 6 of Article XIII B of the California Constitution.(b)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.SEC. 5. No appropriation pursuant to Section 15200 of the Welfare and Institutions Code shall be made for purposes of this act.
The people of the State of California do enact as follows:
## The people of the State of California do enact as follows:
SECTION 1. The Legislature finds and declares all of the following:(a) California counties are experiencing a crisis of foster youth with severe trauma and complex, unmet needs who are simply overwhelming county child welfare and probation agencies, regional centers, schools, and behavioral health providers.(b) Foster youth with complex needs are often served by multiple other systems who also struggle with providing timely and appropriate services due to lack of funding and antiquated processes that are not conducive to meeting childrens immediate needs, particularly for foster children experiencing a trauma crisis.(c) Services to this population are currently delayed, lacking, and disjointed, resulting in foster youth often experiencing frequent placement changes because no single provider or entity can meet their needs. This results in a cycle of multiple placement moves, frequent changes in service providers and caregivers, and unnecessary stays in hospital settings and unlicensed settings. These experiences lead to poor outcomes for youth and exacerbate their trauma.(d) While some efforts have been made at the state level to provide additional supports and assess the gaps and service needs, immediate action is necessary to provide a trauma-informed, patient- and youth-centered approach to addressing the individualized needs of foster youth with complex needs.(e) Foster children and their families have experienced trauma that requires a coordinated, multisystem approach to achieve positive outcomes and to build on and leverage existing efforts, such as trauma-informed systems of care, pursuant to AB 2083 (Chapter 815 of the Statutes of 2018), and California Advancing Innovations in and Innovating Medi-Cal (CalAIM).(f) Some foster youth who have experienced significant trauma, coupled with other intensive needs that cross multiple systems, and their families require a targeted approach to service provision that involves a coordinated effort across systems to meet their very unique needs.(g) California can take advantage of tools and enhanced funding available through the federal Medicaid program to help better coordinate care and provide targeted services to foster youth with intensive needs. These needs include mental and physical health needs, developmental services, and other services that address their broad needs through care managers to help reduce hospitalizations or placement into restrictive institutional settings.
SECTION 1. The Legislature finds and declares all of the following:(a) California counties are experiencing a crisis of foster youth with severe trauma and complex, unmet needs who are simply overwhelming county child welfare and probation agencies, regional centers, schools, and behavioral health providers.(b) Foster youth with complex needs are often served by multiple other systems who also struggle with providing timely and appropriate services due to lack of funding and antiquated processes that are not conducive to meeting childrens immediate needs, particularly for foster children experiencing a trauma crisis.(c) Services to this population are currently delayed, lacking, and disjointed, resulting in foster youth often experiencing frequent placement changes because no single provider or entity can meet their needs. This results in a cycle of multiple placement moves, frequent changes in service providers and caregivers, and unnecessary stays in hospital settings and unlicensed settings. These experiences lead to poor outcomes for youth and exacerbate their trauma.(d) While some efforts have been made at the state level to provide additional supports and assess the gaps and service needs, immediate action is necessary to provide a trauma-informed, patient- and youth-centered approach to addressing the individualized needs of foster youth with complex needs.(e) Foster children and their families have experienced trauma that requires a coordinated, multisystem approach to achieve positive outcomes and to build on and leverage existing efforts, such as trauma-informed systems of care, pursuant to AB 2083 (Chapter 815 of the Statutes of 2018), and California Advancing Innovations in and Innovating Medi-Cal (CalAIM).(f) Some foster youth who have experienced significant trauma, coupled with other intensive needs that cross multiple systems, and their families require a targeted approach to service provision that involves a coordinated effort across systems to meet their very unique needs.(g) California can take advantage of tools and enhanced funding available through the federal Medicaid program to help better coordinate care and provide targeted services to foster youth with intensive needs. These needs include mental and physical health needs, developmental services, and other services that address their broad needs through care managers to help reduce hospitalizations or placement into restrictive institutional settings.
SECTION 1. The Legislature finds and declares all of the following:
### SECTION 1.
(a) California counties are experiencing a crisis of foster youth with severe trauma and complex, unmet needs who are simply overwhelming county child welfare and probation agencies, regional centers, schools, and behavioral health providers.
(b) Foster youth with complex needs are often served by multiple other systems who also struggle with providing timely and appropriate services due to lack of funding and antiquated processes that are not conducive to meeting childrens immediate needs, particularly for foster children experiencing a trauma crisis.
(c) Services to this population are currently delayed, lacking, and disjointed, resulting in foster youth often experiencing frequent placement changes because no single provider or entity can meet their needs. This results in a cycle of multiple placement moves, frequent changes in service providers and caregivers, and unnecessary stays in hospital settings and unlicensed settings. These experiences lead to poor outcomes for youth and exacerbate their trauma.
(d) While some efforts have been made at the state level to provide additional supports and assess the gaps and service needs, immediate action is necessary to provide a trauma-informed, patient- and youth-centered approach to addressing the individualized needs of foster youth with complex needs.
(e) Foster children and their families have experienced trauma that requires a coordinated, multisystem approach to achieve positive outcomes and to build on and leverage existing efforts, such as trauma-informed systems of care, pursuant to AB 2083 (Chapter 815 of the Statutes of 2018), and California Advancing Innovations in and Innovating Medi-Cal (CalAIM).
(f) Some foster youth who have experienced significant trauma, coupled with other intensive needs that cross multiple systems, and their families require a targeted approach to service provision that involves a coordinated effort across systems to meet their very unique needs.
(g) California can take advantage of tools and enhanced funding available through the federal Medicaid program to help better coordinate care and provide targeted services to foster youth with intensive needs. These needs include mental and physical health needs, developmental services, and other services that address their broad needs through care managers to help reduce hospitalizations or placement into restrictive institutional settings.
As used in this chapter:
(a)Community care facility means any facility, place, or building that is maintained and operated to provide nonmedical residential care, day treatment, adult daycare, or foster family agency services for children, adults, or children and adults, including, but not limited to, the physically handicapped, mentally impaired, incompetent persons, and abused or neglected children, and includes the following:
(1)Residential facility means any family home, group care facility, or similar facility determined by the department, for 24-hour nonmedical care of persons in need of personal services, supervision, or assistance essential for sustaining the activities of daily living or for the protection of the individual.
(2)Adult day program means any community-based facility or program that provides care to persons 18 years of age or older in need of personal services, supervision, or assistance essential for sustaining the activities of daily living or for the protection of these individuals on less than a 24-hour basis.
(3)Therapeutic day services facility means any facility that provides nonmedical care, counseling, educational or vocational support, or social rehabilitation services on less than a 24-hour basis to persons under 18 years of age who would otherwise be placed in foster care or who are returning to families from foster care. Program standards for these facilities shall be developed by the department, pursuant to Section 1530, in consultation with therapeutic day services and foster care providers.
(4)Foster family agency means any public agency or private organization, organized and operated on a nonprofit basis, engaged in any of the following:
(A)Recruiting, certifying, approving, and training of, and providing professional support to, foster parents and resource families.
(B)Coordinating with county placing agencies to find homes for foster children in need of care.
(C)Providing services and supports to licensed or certified foster parents, county-approved resource families, and children to the extent authorized by state and federal law.
(5)Foster family home means any residential facility providing 24-hour care for six or fewer foster children that is owned, leased, or rented and is the residence of the foster parent or parents, including their family, in whose care the foster children have been placed. The placement may be by a public or private child placement agency or by a court order, or by voluntary placement by a parent, parents, or guardian. It also means a foster family home described in Section 1505.2.
(6)Small family home means any residential facility, in the licensees 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)(A)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.
(B)This section does not prohibit or discourage placement of persons who have mental or physical disabilities into any category of community care facility that meets the needs of the individual placed, if the placement is consistent with the licensing regulations of the department.
(9)(A)Full-service adoption agency means any licensed entity engaged in the business of providing adoption services, that does all of the following:
(i)Assumes care, custody, and control of a child through relinquishment of the child to the agency or involuntary termination of parental rights to the child.
(ii)Assesses the birth parents, prospective adoptive parents, or child.
(iii)Places children for adoption.
(iv)Supervises adoptive placements.
(B)Private full-service adoption agencies shall be organized and operated on a nonprofit basis. As a condition of licensure to provide intercountry adoption services, a full-service adoption agency shall be accredited and in good standing according to Part 96 (commencing with Section 96.1) of Title 22 of the Code of Federal Regulations, or supervised by an accredited primary provider, or acting as an exempted provider, in compliance with Subpart F (commencing with Section 96.29) of Part 96 of Title 22 of the Code of Federal Regulations.
(10)(A)Noncustodial adoption agency means any licensed entity engaged in the business of providing adoption services, that does all of the following:
(i)Assesses the prospective adoptive parents.
(ii)Cooperatively matches children freed for adoption, who are under the care, custody, and control of a licensed adoption agency, for adoption, with assessed and approved adoptive applicants.
(iii)Cooperatively supervises adoption placements with a full-service adoptive agency, but does not disrupt a placement or remove a child from a placement.
(B)Private noncustodial adoption agencies shall be organized and operated on a nonprofit basis. As a condition of licensure to provide intercountry adoption services, a noncustodial adoption agency shall be accredited and in good standing according to Part 96 (commencing with Section 96.1) of Title 22 of the Code of Federal Regulations, or supervised by an accredited primary provider, or acting as an exempted provider, in compliance with Subpart F (commencing with Section 96.29) of Part 96 of Title 22 of the Code of Federal Regulations.
(11)Transitional shelter care facility means any group care facility that provides for 24-hour nonmedical care of persons in need of personal services, supervision, or assistance essential for sustaining the activities of daily living or for the protection of the individual. Program components shall be subject to program standards developed by the State Department of Social Services pursuant to Section 1502.3.
(12)Transitional housing placement provider means an organization licensed by the department pursuant to Section 1559.110 to provide transitional housing to foster children who are at least 16 years of age to promote their transition to adulthood. A transitional housing placement provider shall be privately operated and organized on a nonprofit basis.
(13)Group home means a residential facility that provides 24-hour care and supervision to children, delivered at least in part by staff employed by the licensee in a structured environment. The care and supervision provided by a group home shall be nonmedical, except as otherwise permitted by law.
(14)Youth homelessness prevention center means a group home licensed by the department to operate a program pursuant to Section 1502.35 to provide voluntary, short-term, shelter and personal services to homeless youth, youth who are at risk of homelessness, youth who are exhibiting status offender behavior, or runaway youth, as defined in paragraph (2) of subdivision (a) of Section 1502.35.
(15)Enhanced behavioral supports home means a facility certified by the State Department of Developmental Services pursuant to Article 3.6 (commencing with Section 4684.80) of Chapter 6 of Division 4.5 of the Welfare and Institutions Code, and licensed by the State Department of Social Services as an adult residential facility or a group home that provides 24-hour nonmedical care to individuals with developmental disabilities who require enhanced behavioral supports, staffing, and supervision in a homelike setting. An enhanced behavioral supports home shall have a maximum capacity of four consumers, shall conform to Section 441.530(a)(1) of Title 42 of the Code of Federal Regulations, and shall be eligible for federal Medicaid home- and community-based services funding.
(16)Community crisis home means a facility certified by the State Department of Developmental Services pursuant to Article 8 (commencing with Section 4698) of Chapter 6 of Division 4.5 of the Welfare and Institutions Code, and licensed by the State Department of Social Services pursuant to Article 9.7 (commencing with Section 1567.80), as an adult residential facility, providing 24-hour nonmedical care to individuals with developmental disabilities receiving regional center service, in need of crisis intervention services, and who would otherwise be at risk of admission to the acute crisis center at Fairview Developmental Center, an acute general hospital, acute psychiatric hospital, an institution for mental disease, as described in Part 5 (commencing with Section 5900) of Division 5 of the Welfare and Institutions Code, or an out-of-state placement. A community crisis home shall have a maximum capacity of eight consumers, as defined in subdivision (a) of Section 1567.80, shall conform to Section 441.530(a)(1) of Title 42 of the Code of Federal Regulations, and shall be eligible for federal Medicaid home- and community-based services funding.
(17)Crisis nursery means a facility licensed by the department to operate a program pursuant to Section 1516 to provide short-term care and supervision for children under six years of age who are voluntarily placed for temporary care by a parent or legal guardian due to a family crisis or stressful situation.
(18)Short-term residential therapeutic program means a residential facility operated by a public agency or private organization and licensed by the department pursuant to Section 1562.01 that provides an integrated program of specialized and intensive care and supervision, services and supports, treatment, and short-term, 24-hour care and supervision to children that is trauma-informed, as defined in standards and regulations adopted by the department. 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 childrens crisis residential program.
(19)Private alternative boarding school means a group home licensed by the department to operate a program pursuant to Section 1502.2 to provide youth with 24-hour residential care and supervision, that, in addition to providing educational services to youth, provides, or holds itself out as providing, behavioral-based services to youth with social, emotional, or behavioral issues. The care and supervision provided by a private alternative boarding school shall be nonmedical, except as otherwise permitted by law.
(20)Private alternative outdoor program means a group home licensed by the department to operate a program pursuant to Section 1502.21 to provide youth with 24-hour residential care and supervision, that provides, or holds itself out as providing, behavioral-based services in an outdoor living setting to youth with social, emotional, or behavioral issues. The care and supervision provided by a private alternative outdoor program shall be nonmedical, except as otherwise permitted by law.
(21)Childrens crisis residential program means a facility licensed by the department as a short-term residential therapeutic program pursuant to Section 1562.02 and approved by the State Department of Health Care Services, or a county mental health plan to which the State Department of Health Care Services has delegated approval authority, to operate a childrens crisis residential mental health program with approval pursuant to Section 11462.011 of the Welfare and Institutions Code, to serve children experiencing mental health crises as an alternative to psychiatric hospitalization.
(22)Group home for children with special health care needs means a group home certified by the State Department of Developmental Services pursuant to Article 3.5 (commencing with Section 4684.50) 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 (commencing with Section 1567.50) of this code that provides 24-hour health care and intensive support services in a homelike setting. A group home for children with special health care needs shall have a maximum capacity of five children with developmental disabilities, as defined in subdivision (a) of Section 4512 of the Welfare and Institutions Code.
(23)Short-term assessment, treatment, and transition program or STATTP means a residential facility operated independently, or jointly by a public agency, tribal 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, and that is trauma-informed, as defined in standards and regulations adopted by the department. The care and supervision provided by a short-term assessment, treatment, and transition 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.
(b)Department or state department means the State Department of Social Services.
(c)Director means the Director of Social Services.
(a)The department shall license short-term assessment, treatment, and transition programs or STATTPs, as defined in paragraph (23) of subdivision (a) of Section 1502, pursuant to this chapter. A STATTP shall comply with all requirements of this chapter that are applicable to short-term residential treatment programs pursuant to Section 1562.01, unless otherwise specified, and pursuant to the requirements of this section.
(b)(1)A STATTP shall provide enhanced care and supervision for youth with intensive, complex needs with the support of a care team as defined by this section.
(2)Notwithstanding Section 1562.01, staffing of each STATTP shall include, at minimum, all of the following:
(A)A full-time administrator.
(B)Two full-time clinical heads of service, which may be filled by one or more psychologists or licensed clinical social workers.
(C)A half-time registered nurse, licensed vocational nurse, or public health nurse.
(D)A full-time psychiatric social worker or psychiatric technician.
(E)A full-time masters or bachelors level social worker.
(F)A full-time facility manager.
(G)Approximately two full-time equivalent direct care staff for every three children during the day and at night. Direct care staff shall be 24 years of age or older. Direct care staff shall include, at minimum, four mental health rehabilitation specialists.
(H)A full-time special education specialist.
(I)A half-time board-certified behavioral analyst.
(J)A half-time youth peer.
(K)A half-time caregiver peer.
(L)A full-time activities coordinator.
(M)A full-time training specialist
(N)Three full-time equivalent food preparation specialists.
(3)(A)The STATTP shall provide intensive, trauma-informed services through a care team for each child or youth. The care team shall be trained in trauma-informed care and led by a clinical head of service and shall include, at minimum, the program social worker, special education specialist, board-certified behavioral analyst, youth peer, and caregiver peer.
(B)The care team shall deliver services to a child who is placed at a STATTP and for up to six months postdischarge as needed by the youth and their caregiver to support transition to other residential or community-based care, including family-based care. The care team shall assist in identifying, recruiting, and engaging any identified family or family-like connections to the child or youth to support the childs or youths connection to family. The care team may deliver services directly to the child, family, family-like connections, or other caregivers to support step-downs to family-based care, or may provide consultation to the next direct service provider, to include the biological family, legal guardian, or both, as deemed appropriate and pursuant to the childs or youths care plan, in consultation with any child and family team.
(c)(1)The STATTP shall accept all children and youth referred by a child welfare agency, probation agency, or tribal entity unless a determination is made by the clinical staff, in consultation with other members of the care team, that the child or youth is in need of a more restrictive inpatient setting due to the immediate and present risk of serious injury to self or others or due to a commonality of need determination pursuant to subdivision (g). Once admitted, the STATTP shall continue to serve the child or youth until they can be appropriately transitioned to the next level of care with support of the care team. Placements shall comply with the requirements of Section 4096 of the Welfare and Institutions Code.
(2)If a resident of the STATTP is temporarily transferred to a general acute care hospital, as defined in subdivision (a) of Section 1250 of the Health and Safety Code, or temporarily placed into any other inpatient setting, the STATTP shall afford the resident an automatic bed hold of 48 hours, which may be extended for up to 14 days pursuant to the requirements in this paragraph. The bed hold option may be exercised by a child 12 years of age or older, by the county placing agency or tribal entity, or the childs authorized representative.
(A)Within 24 hours of the childs transfer to a general acute care hospital or other inpatient setting, the STATTP shall inform the child, if 12 years of age or older, the county placing agency, and the childs authorized representative of their right to exercise a bed hold, the steps to take to inform the program of their decision of whether or not to request a bed hold, and the length of time the bed hold is requested, up to seven days.
(B)If the right to a bed hold is exercised and the child is not discharged within that time, the program shall inform the child, if 12 years of age or older, the county placing agency, and the childs authorized representative of their right to request an additional bed hold time, for up to a total of 14 days from the date the child left the program. The program shall provide this information at least 24 hours before the release of the bed hold.
(C)A public agency that has placed the resident into the STATTP shall be liable to pay reasonable charges, not to exceed the daily rate for care in the program, for bed holds. Any other resident or representative who exercises the bed hold option shall be liable to pay reasonable charges, not to exceed the daily rate for care in the facility as established by the program, for bed hold days.
(D)If the patient's attending physician notifies the STATTP in writing that the patient's stay in the general acute care hospital or other inpatient facility is expected to exceed seven days, the program shall not be required to maintain the bed hold.
(3)The STATTP shall maintain communication with the youth, county placing agency or tribal agency, any caregivers or authorized representatives, and acute care hospital or other inpatient providers during the bed hold period, to support the residents treatment needs, discharge from the hospital or inpatient setting, and return to the program.
(d)The STATTP shall additionally offer respite care to the next caregiver upon discharge from the program. Respite care shall be available for up to six months postdischarge for the youth, upon request of the caregiver, placing agency, or tribal entity. Respite care may be provided for up to 14 days for a youth previously served and shall be available for multiple episodes as needed to aid in the transition. The placing agency shall ensure the STATTP is compensated concurrently with any other paid placement under AFDC-FC during this time.
(e)The STATTP shall leverage and coordinate with other service providers, including, but not limited to, regional centers, local education agencies, behavior health agencies, wraparound providers, and others, to maximize services and supports to the child, youth, and their caregivers while the child or youth is receiving services from the program.
(f)The STATTP may be operated under licensure by counties, nonprofit agencies, tribal agencies, or a combination thereof. The department shall ensure licensing standards allow for cross-agency staffing when jointly operated.
(g)STATTPs shall adhere to commonality of need requirements pursuant to subdivision (c) of Section 16514 of the Welfare and Institutions Code, and shall prioritize children and nonminor dependents placed by county child welfare agencies, probation agencies, and tribal entities for entry into care.
(h)The STATTP shall be compensated at a per-child per-month rate of forty-three thousand dollars ($43,000), which shall be adjusted annually on July 1 to reflect any increases or decreases in the cost of living.
(i)(1)The department shall adopt regulations to implement this section, collaborating with the State Department of Health Care Services, as necessary, to ensure alignment with mental health program approval requirements, as described in Section 4096.5 of the Welfare and Institutions Code.
(2)The department shall consult with the County Welfare Directors Association, Chief Probation Officers of California, California Youth Connection, tribal representatives, County Behavioral Health Directors Association, and other stakeholders as deemed appropriate in the development of regulations.
(3)(A)Notwithstanding the rulemaking provisions of the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code), the department may implement, interpret, or make specific this section by means of interim licensing standards until regulations are adopted. These interim licensing standards shall have the same force and effect as regulations until the adoption of regulations.
(B)Licensing standards shall be adopted no later than March 1, 2024. If the department utilizes interim licensing standards, final regulations shall be adopted no later than January 1, 2027.
SEC. 4.SEC. 2. Chapter 4.5 (commencing with Section 5425) is added to Part 1 of Division 5 of the Welfare and Institutions Code, to read: CHAPTER 4.5. Regional Health Teams5425. (a) The department, in consultation with the State Department of Social Services, shall establish up to 10 regional health teams throughout the state to serve foster youth and youth who may be at risk of entering foster care. In establishing the regional health teams, the department shall submit a state plan amendment to the federal Centers for Medicare and Medicaid Services no later than July 1, 2024, to implement the Medicaid Health Home State Plan Option, pursuant to Sections 2703 and 1945 of the Social Security Act. Section 1945 of the federal Social Security Act, as added by Section 2703 of the federal Patient Protection and Affordable Care Act.(b) The department shall coordinate with the State Department of Social Services and the State Department of Developmental Services and shall convene and engage stakeholders, including, but not limited to, the County Welfare Directors Association of California, the Chief Probation Officers of California, the County Behavioral Health Directors Association of California, the Association of Regional Centers Center Agencies, interested counties, and other stakeholders, as deemed appropriate, to develop the regional health teams.5426. (a) Regional health teams shall be available to children and youth and any adult caregivers or other adults connected with the child or youth under 26 years of age, who are experiencing severe mental illness, emotional disturbance, substance use, intellectual or developmental disability, or special health care needs or chronic health issues, or any combination of the listed conditions, and subject to identification and referral as described pursuant to subdivision (d). For purposes of this chapter, severe mental illness and emotional disturbance means an organic disorder of the brain or a clinically significant disorder of thought, mood, perception, orientation, memory, or behavior, that seriously limits a persons capacity to function in primary aspects of daily living, such as personal relations, living arrangements, work, school, and recreation.(b) Regional health teams shall be physician led and shall be composed of, at a minimum, the following members:(1) A primary care physician.(2) A licensed clinical social worker.(3) A public health nurse.(4) A nutritionist or dietitian.(5) An occupational therapist.(6) A community health worker.(7) A peer support specialist.(8) A training coordinator.(9) Additional behavioral health staff as appropriate.(c) All team members shall be responsible for ensuring that care is person-centered, person centered, culturally competent, and linguistically capable.(d) Regional health teams shall perform the following activities:(1) Receive and respond to referrals received from staff from county child welfare, county probation departments, regional centers, and others as deemed appropriate by the local county system of care, as defined pursuant to Section 16521.6.(2) Provide quality-driven, cost-effective, culturally appropriate, and person- and family-centered health home services.(3) Coordinate and provide access to high-quality health care services informed by evidence-based clinical practice guidelines.(4) Coordinate and provide access to preventive and health promotion services, including prevention of mental illness and substance use disorders.(5) Coordinate and provide access to mental health and substance abuse services.(6) Coordinate and provide access to comprehensive care management, care coordination, and transitional care across settings. For purposes of this chapter, transitional care means appropriate followup from inpatient to other settings, such as participation in discharge planning and facilitating transfer from a pediatric to an adult system of health care.(7) Coordinate and provide access to chronic disease management, including self-management support to individuals and their families.(8) Coordinate and provide access to individual and family supports, including linkage to community, social support, and recovery services.(9) Coordinate and provide access to long-term care supports and services.(10) Promote evidence-based medicine and utilize patient engagement strategies in the implementation of client plans.(11) Develop a person-centered care plan for each individual that coordinates and integrates all of their clinical and nonclinical, health care-related needs and services.(12) Demonstrate a capacity to use health information technology to link services, facilitate communication among team members and between the health team and individual and family caregivers, as well as the placing agency, and provide feedback regarding practices, as feasible and appropriate.(13) Establish a continuous quality improvement program, and collect and report on data that permit an evaluation of increased coordination of care and chronic disease management on individual-level clinical outcomes, experience-of-care outcomes, and quality-of-care outcomes at the population level.(14) Conduct staff training within the regional health team and with other service providers to improve direct care and patient outcomes.(e) Screening and referral for regional health team services shall be determined pursuant to guidelines developed by the local system of care team pursuant to Section 16521.6 in the county or counties served by the regional health team, with priority to current foster youth and those at risk of entering foster care.(f) The department shall fund up to 10 health teams that shall be geographically situated to support access to services equitably throughout the state. Regional health teams shall be funded by the department pursuant to a competitive procurement process.(g) The department, in consultation with the stakeholders identified in subdivision (b) of Section 5425, shall establish performance and outcome measures to be tracked by regional health teams and the intervals at which these teams are required to report information related to those measures to the department. The department shall post the results of these performance and outcome measures on its internet website on at least an annual basis.(h) (1)It is the intent of the Legislature that the health home state plan option established pursuant to this section begin no later than December 1, 2024, subject to the receipt of any required federal approvals or waivers.(2)A report to be submitted to the Legislature pursuant to paragraph (1) shall be submitted in compliance with Section 9795 of the Government Code.
SEC. 4.SEC. 2. Chapter 4.5 (commencing with Section 5425) is added to Part 1 of Division 5 of the Welfare and Institutions Code, to read:
### SEC. 4.SEC. 2.
CHAPTER 4.5. Regional Health Teams5425. (a) The department, in consultation with the State Department of Social Services, shall establish up to 10 regional health teams throughout the state to serve foster youth and youth who may be at risk of entering foster care. In establishing the regional health teams, the department shall submit a state plan amendment to the federal Centers for Medicare and Medicaid Services no later than July 1, 2024, to implement the Medicaid Health Home State Plan Option, pursuant to Sections 2703 and 1945 of the Social Security Act. Section 1945 of the federal Social Security Act, as added by Section 2703 of the federal Patient Protection and Affordable Care Act.(b) The department shall coordinate with the State Department of Social Services and the State Department of Developmental Services and shall convene and engage stakeholders, including, but not limited to, the County Welfare Directors Association of California, the Chief Probation Officers of California, the County Behavioral Health Directors Association of California, the Association of Regional Centers Center Agencies, interested counties, and other stakeholders, as deemed appropriate, to develop the regional health teams.5426. (a) Regional health teams shall be available to children and youth and any adult caregivers or other adults connected with the child or youth under 26 years of age, who are experiencing severe mental illness, emotional disturbance, substance use, intellectual or developmental disability, or special health care needs or chronic health issues, or any combination of the listed conditions, and subject to identification and referral as described pursuant to subdivision (d). For purposes of this chapter, severe mental illness and emotional disturbance means an organic disorder of the brain or a clinically significant disorder of thought, mood, perception, orientation, memory, or behavior, that seriously limits a persons capacity to function in primary aspects of daily living, such as personal relations, living arrangements, work, school, and recreation.(b) Regional health teams shall be physician led and shall be composed of, at a minimum, the following members:(1) A primary care physician.(2) A licensed clinical social worker.(3) A public health nurse.(4) A nutritionist or dietitian.(5) An occupational therapist.(6) A community health worker.(7) A peer support specialist.(8) A training coordinator.(9) Additional behavioral health staff as appropriate.(c) All team members shall be responsible for ensuring that care is person-centered, person centered, culturally competent, and linguistically capable.(d) Regional health teams shall perform the following activities:(1) Receive and respond to referrals received from staff from county child welfare, county probation departments, regional centers, and others as deemed appropriate by the local county system of care, as defined pursuant to Section 16521.6.(2) Provide quality-driven, cost-effective, culturally appropriate, and person- and family-centered health home services.(3) Coordinate and provide access to high-quality health care services informed by evidence-based clinical practice guidelines.(4) Coordinate and provide access to preventive and health promotion services, including prevention of mental illness and substance use disorders.(5) Coordinate and provide access to mental health and substance abuse services.(6) Coordinate and provide access to comprehensive care management, care coordination, and transitional care across settings. For purposes of this chapter, transitional care means appropriate followup from inpatient to other settings, such as participation in discharge planning and facilitating transfer from a pediatric to an adult system of health care.(7) Coordinate and provide access to chronic disease management, including self-management support to individuals and their families.(8) Coordinate and provide access to individual and family supports, including linkage to community, social support, and recovery services.(9) Coordinate and provide access to long-term care supports and services.(10) Promote evidence-based medicine and utilize patient engagement strategies in the implementation of client plans.(11) Develop a person-centered care plan for each individual that coordinates and integrates all of their clinical and nonclinical, health care-related needs and services.(12) Demonstrate a capacity to use health information technology to link services, facilitate communication among team members and between the health team and individual and family caregivers, as well as the placing agency, and provide feedback regarding practices, as feasible and appropriate.(13) Establish a continuous quality improvement program, and collect and report on data that permit an evaluation of increased coordination of care and chronic disease management on individual-level clinical outcomes, experience-of-care outcomes, and quality-of-care outcomes at the population level.(14) Conduct staff training within the regional health team and with other service providers to improve direct care and patient outcomes.(e) Screening and referral for regional health team services shall be determined pursuant to guidelines developed by the local system of care team pursuant to Section 16521.6 in the county or counties served by the regional health team, with priority to current foster youth and those at risk of entering foster care.(f) The department shall fund up to 10 health teams that shall be geographically situated to support access to services equitably throughout the state. Regional health teams shall be funded by the department pursuant to a competitive procurement process.(g) The department, in consultation with the stakeholders identified in subdivision (b) of Section 5425, shall establish performance and outcome measures to be tracked by regional health teams and the intervals at which these teams are required to report information related to those measures to the department. The department shall post the results of these performance and outcome measures on its internet website on at least an annual basis.(h) (1)It is the intent of the Legislature that the health home state plan option established pursuant to this section begin no later than December 1, 2024, subject to the receipt of any required federal approvals or waivers.(2)A report to be submitted to the Legislature pursuant to paragraph (1) shall be submitted in compliance with Section 9795 of the Government Code.
CHAPTER 4.5. Regional Health Teams5425. (a) The department, in consultation with the State Department of Social Services, shall establish up to 10 regional health teams throughout the state to serve foster youth and youth who may be at risk of entering foster care. In establishing the regional health teams, the department shall submit a state plan amendment to the federal Centers for Medicare and Medicaid Services no later than July 1, 2024, to implement the Medicaid Health Home State Plan Option, pursuant to Sections 2703 and 1945 of the Social Security Act. Section 1945 of the federal Social Security Act, as added by Section 2703 of the federal Patient Protection and Affordable Care Act.(b) The department shall coordinate with the State Department of Social Services and the State Department of Developmental Services and shall convene and engage stakeholders, including, but not limited to, the County Welfare Directors Association of California, the Chief Probation Officers of California, the County Behavioral Health Directors Association of California, the Association of Regional Centers Center Agencies, interested counties, and other stakeholders, as deemed appropriate, to develop the regional health teams.5426. (a) Regional health teams shall be available to children and youth and any adult caregivers or other adults connected with the child or youth under 26 years of age, who are experiencing severe mental illness, emotional disturbance, substance use, intellectual or developmental disability, or special health care needs or chronic health issues, or any combination of the listed conditions, and subject to identification and referral as described pursuant to subdivision (d). For purposes of this chapter, severe mental illness and emotional disturbance means an organic disorder of the brain or a clinically significant disorder of thought, mood, perception, orientation, memory, or behavior, that seriously limits a persons capacity to function in primary aspects of daily living, such as personal relations, living arrangements, work, school, and recreation.(b) Regional health teams shall be physician led and shall be composed of, at a minimum, the following members:(1) A primary care physician.(2) A licensed clinical social worker.(3) A public health nurse.(4) A nutritionist or dietitian.(5) An occupational therapist.(6) A community health worker.(7) A peer support specialist.(8) A training coordinator.(9) Additional behavioral health staff as appropriate.(c) All team members shall be responsible for ensuring that care is person-centered, person centered, culturally competent, and linguistically capable.(d) Regional health teams shall perform the following activities:(1) Receive and respond to referrals received from staff from county child welfare, county probation departments, regional centers, and others as deemed appropriate by the local county system of care, as defined pursuant to Section 16521.6.(2) Provide quality-driven, cost-effective, culturally appropriate, and person- and family-centered health home services.(3) Coordinate and provide access to high-quality health care services informed by evidence-based clinical practice guidelines.(4) Coordinate and provide access to preventive and health promotion services, including prevention of mental illness and substance use disorders.(5) Coordinate and provide access to mental health and substance abuse services.(6) Coordinate and provide access to comprehensive care management, care coordination, and transitional care across settings. For purposes of this chapter, transitional care means appropriate followup from inpatient to other settings, such as participation in discharge planning and facilitating transfer from a pediatric to an adult system of health care.(7) Coordinate and provide access to chronic disease management, including self-management support to individuals and their families.(8) Coordinate and provide access to individual and family supports, including linkage to community, social support, and recovery services.(9) Coordinate and provide access to long-term care supports and services.(10) Promote evidence-based medicine and utilize patient engagement strategies in the implementation of client plans.(11) Develop a person-centered care plan for each individual that coordinates and integrates all of their clinical and nonclinical, health care-related needs and services.(12) Demonstrate a capacity to use health information technology to link services, facilitate communication among team members and between the health team and individual and family caregivers, as well as the placing agency, and provide feedback regarding practices, as feasible and appropriate.(13) Establish a continuous quality improvement program, and collect and report on data that permit an evaluation of increased coordination of care and chronic disease management on individual-level clinical outcomes, experience-of-care outcomes, and quality-of-care outcomes at the population level.(14) Conduct staff training within the regional health team and with other service providers to improve direct care and patient outcomes.(e) Screening and referral for regional health team services shall be determined pursuant to guidelines developed by the local system of care team pursuant to Section 16521.6 in the county or counties served by the regional health team, with priority to current foster youth and those at risk of entering foster care.(f) The department shall fund up to 10 health teams that shall be geographically situated to support access to services equitably throughout the state. Regional health teams shall be funded by the department pursuant to a competitive procurement process.(g) The department, in consultation with the stakeholders identified in subdivision (b) of Section 5425, shall establish performance and outcome measures to be tracked by regional health teams and the intervals at which these teams are required to report information related to those measures to the department. The department shall post the results of these performance and outcome measures on its internet website on at least an annual basis.(h) (1)It is the intent of the Legislature that the health home state plan option established pursuant to this section begin no later than December 1, 2024, subject to the receipt of any required federal approvals or waivers.(2)A report to be submitted to the Legislature pursuant to paragraph (1) shall be submitted in compliance with Section 9795 of the Government Code.
CHAPTER 4.5. Regional Health Teams
CHAPTER 4.5. Regional Health Teams
5425. (a) The department, in consultation with the State Department of Social Services, shall establish up to 10 regional health teams throughout the state to serve foster youth and youth who may be at risk of entering foster care. In establishing the regional health teams, the department shall submit a state plan amendment to the federal Centers for Medicare and Medicaid Services no later than July 1, 2024, to implement the Medicaid Health Home State Plan Option, pursuant to Sections 2703 and 1945 of the Social Security Act. Section 1945 of the federal Social Security Act, as added by Section 2703 of the federal Patient Protection and Affordable Care Act.(b) The department shall coordinate with the State Department of Social Services and the State Department of Developmental Services and shall convene and engage stakeholders, including, but not limited to, the County Welfare Directors Association of California, the Chief Probation Officers of California, the County Behavioral Health Directors Association of California, the Association of Regional Centers Center Agencies, interested counties, and other stakeholders, as deemed appropriate, to develop the regional health teams.
5425. (a) The department, in consultation with the State Department of Social Services, shall establish up to 10 regional health teams throughout the state to serve foster youth and youth who may be at risk of entering foster care. In establishing the regional health teams, the department shall submit a state plan amendment to the federal Centers for Medicare and Medicaid Services no later than July 1, 2024, to implement the Medicaid Health Home State Plan Option, pursuant to Sections 2703 and 1945 of the Social Security Act. Section 1945 of the federal Social Security Act, as added by Section 2703 of the federal Patient Protection and Affordable Care Act.
(b) The department shall coordinate with the State Department of Social Services and the State Department of Developmental Services and shall convene and engage stakeholders, including, but not limited to, the County Welfare Directors Association of California, the Chief Probation Officers of California, the County Behavioral Health Directors Association of California, the Association of Regional Centers Center Agencies, interested counties, and other stakeholders, as deemed appropriate, to develop the regional health teams.
5426. (a) Regional health teams shall be available to children and youth and any adult caregivers or other adults connected with the child or youth under 26 years of age, who are experiencing severe mental illness, emotional disturbance, substance use, intellectual or developmental disability, or special health care needs or chronic health issues, or any combination of the listed conditions, and subject to identification and referral as described pursuant to subdivision (d). For purposes of this chapter, severe mental illness and emotional disturbance means an organic disorder of the brain or a clinically significant disorder of thought, mood, perception, orientation, memory, or behavior, that seriously limits a persons capacity to function in primary aspects of daily living, such as personal relations, living arrangements, work, school, and recreation.(b) Regional health teams shall be physician led and shall be composed of, at a minimum, the following members:(1) A primary care physician.(2) A licensed clinical social worker.(3) A public health nurse.(4) A nutritionist or dietitian.(5) An occupational therapist.(6) A community health worker.(7) A peer support specialist.(8) A training coordinator.(9) Additional behavioral health staff as appropriate.(c) All team members shall be responsible for ensuring that care is person-centered, person centered, culturally competent, and linguistically capable.(d) Regional health teams shall perform the following activities:(1) Receive and respond to referrals received from staff from county child welfare, county probation departments, regional centers, and others as deemed appropriate by the local county system of care, as defined pursuant to Section 16521.6.(2) Provide quality-driven, cost-effective, culturally appropriate, and person- and family-centered health home services.(3) Coordinate and provide access to high-quality health care services informed by evidence-based clinical practice guidelines.(4) Coordinate and provide access to preventive and health promotion services, including prevention of mental illness and substance use disorders.(5) Coordinate and provide access to mental health and substance abuse services.(6) Coordinate and provide access to comprehensive care management, care coordination, and transitional care across settings. For purposes of this chapter, transitional care means appropriate followup from inpatient to other settings, such as participation in discharge planning and facilitating transfer from a pediatric to an adult system of health care.(7) Coordinate and provide access to chronic disease management, including self-management support to individuals and their families.(8) Coordinate and provide access to individual and family supports, including linkage to community, social support, and recovery services.(9) Coordinate and provide access to long-term care supports and services.(10) Promote evidence-based medicine and utilize patient engagement strategies in the implementation of client plans.(11) Develop a person-centered care plan for each individual that coordinates and integrates all of their clinical and nonclinical, health care-related needs and services.(12) Demonstrate a capacity to use health information technology to link services, facilitate communication among team members and between the health team and individual and family caregivers, as well as the placing agency, and provide feedback regarding practices, as feasible and appropriate.(13) Establish a continuous quality improvement program, and collect and report on data that permit an evaluation of increased coordination of care and chronic disease management on individual-level clinical outcomes, experience-of-care outcomes, and quality-of-care outcomes at the population level.(14) Conduct staff training within the regional health team and with other service providers to improve direct care and patient outcomes.(e) Screening and referral for regional health team services shall be determined pursuant to guidelines developed by the local system of care team pursuant to Section 16521.6 in the county or counties served by the regional health team, with priority to current foster youth and those at risk of entering foster care.(f) The department shall fund up to 10 health teams that shall be geographically situated to support access to services equitably throughout the state. Regional health teams shall be funded by the department pursuant to a competitive procurement process.(g) The department, in consultation with the stakeholders identified in subdivision (b) of Section 5425, shall establish performance and outcome measures to be tracked by regional health teams and the intervals at which these teams are required to report information related to those measures to the department. The department shall post the results of these performance and outcome measures on its internet website on at least an annual basis.(h) (1)It is the intent of the Legislature that the health home state plan option established pursuant to this section begin no later than December 1, 2024, subject to the receipt of any required federal approvals or waivers.(2)A report to be submitted to the Legislature pursuant to paragraph (1) shall be submitted in compliance with Section 9795 of the Government Code.
5426. (a) Regional health teams shall be available to children and youth and any adult caregivers or other adults connected with the child or youth under 26 years of age, who are experiencing severe mental illness, emotional disturbance, substance use, intellectual or developmental disability, or special health care needs or chronic health issues, or any combination of the listed conditions, and subject to identification and referral as described pursuant to subdivision (d). For purposes of this chapter, severe mental illness and emotional disturbance means an organic disorder of the brain or a clinically significant disorder of thought, mood, perception, orientation, memory, or behavior, that seriously limits a persons capacity to function in primary aspects of daily living, such as personal relations, living arrangements, work, school, and recreation.
(b) Regional health teams shall be physician led and shall be composed of, at a minimum, the following members:
(1) A primary care physician.
(2) A licensed clinical social worker.
(3) A public health nurse.
(4) A nutritionist or dietitian.
(5) An occupational therapist.
(6) A community health worker.
(7) A peer support specialist.
(8) A training coordinator.
(9) Additional behavioral health staff as appropriate.
(c) All team members shall be responsible for ensuring that care is person-centered, person centered, culturally competent, and linguistically capable.
(d) Regional health teams shall perform the following activities:
(1) Receive and respond to referrals received from staff from county child welfare, county probation departments, regional centers, and others as deemed appropriate by the local county system of care, as defined pursuant to Section 16521.6.
(2) Provide quality-driven, cost-effective, culturally appropriate, and person- and family-centered health home services.
(3) Coordinate and provide access to high-quality health care services informed by evidence-based clinical practice guidelines.
(4) Coordinate and provide access to preventive and health promotion services, including prevention of mental illness and substance use disorders.
(5) Coordinate and provide access to mental health and substance abuse services.
(6) Coordinate and provide access to comprehensive care management, care coordination, and transitional care across settings. For purposes of this chapter, transitional care means appropriate followup from inpatient to other settings, such as participation in discharge planning and facilitating transfer from a pediatric to an adult system of health care.
(7) Coordinate and provide access to chronic disease management, including self-management support to individuals and their families.
(8) Coordinate and provide access to individual and family supports, including linkage to community, social support, and recovery services.
(9) Coordinate and provide access to long-term care supports and services.
(10) Promote evidence-based medicine and utilize patient engagement strategies in the implementation of client plans.
(11) Develop a person-centered care plan for each individual that coordinates and integrates all of their clinical and nonclinical, health care-related needs and services.
(12) Demonstrate a capacity to use health information technology to link services, facilitate communication among team members and between the health team and individual and family caregivers, as well as the placing agency, and provide feedback regarding practices, as feasible and appropriate.
(13) Establish a continuous quality improvement program, and collect and report on data that permit an evaluation of increased coordination of care and chronic disease management on individual-level clinical outcomes, experience-of-care outcomes, and quality-of-care outcomes at the population level.
(14) Conduct staff training within the regional health team and with other service providers to improve direct care and patient outcomes.
(e) Screening and referral for regional health team services shall be determined pursuant to guidelines developed by the local system of care team pursuant to Section 16521.6 in the county or counties served by the regional health team, with priority to current foster youth and those at risk of entering foster care.
(f) The department shall fund up to 10 health teams that shall be geographically situated to support access to services equitably throughout the state. Regional health teams shall be funded by the department pursuant to a competitive procurement process.
(g) The department, in consultation with the stakeholders identified in subdivision (b) of Section 5425, shall establish performance and outcome measures to be tracked by regional health teams and the intervals at which these teams are required to report information related to those measures to the department. The department shall post the results of these performance and outcome measures on its internet website on at least an annual basis.
(h) (1)It is the intent of the Legislature that the health home state plan option established pursuant to this section begin no later than December 1, 2024, subject to the receipt of any required federal approvals or waivers.
(2)A report to be submitted to the Legislature pursuant to paragraph (1) shall be submitted in compliance with Section 9795 of the Government Code.
For purposes of this article, and Article 6 (commencing with Section 11450), the following definitions apply:
(a)Aid to Families with Dependent Children-Foster Care (AFDC-FC) means the aid provided on behalf of needy children in foster care under the terms of this division.
(b)Case plan means a written document that, at a minimum, specifies the type of home in which the child shall be placed, the safety of that home, and the appropriateness of that home to meet the childs needs. It shall also include the agencys plan for ensuring that the child receive proper care and protection in a safe environment, and shall set forth the appropriate services to be provided to the child, the childs family, and the foster parents, in order to meet the childs needs while in foster care, and to reunify the child with the childs family. In addition, the plan shall specify the services that will be provided or steps that will be taken to facilitate an alternate permanent plan if reunification is not possible.
(c)Certified family home means an individual or family certified by a licensed foster family agency and issued a certificate of approval by that agency as meeting licensing standards, and used exclusively by that foster family agency for placements.
(d)Family home means the family residence of a licensee in which 24-hour care and supervision are provided for children.
(e)Small family home means any residential facility, in the licensees family residence, which 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.
(f)Foster care means the 24-hour out-of-home care provided to children whose own families are unable or unwilling to care for them, and who are in need of temporary or long-term substitute parenting.
(g)Foster family agency means a licensed community care facility, as defined in paragraph (4) of subdivision (a) of Section 1502 of the Health and Safety Code. Private foster family agencies shall be organized and operated on a nonprofit basis.
(h)Group home means a nondetention privately operated residential home, organized and operated on a nonprofit basis only, of any capacity, or a nondetention licensed residential care home operated by the County of San Mateo with a capacity of up to 25 beds, that accepts children in need of care and supervision in a group home, as defined by paragraph (13) of subdivision (a) of Section 1502 of the Health and Safety Code.
(i)Periodic review means review of a childs status by the juvenile court or by an administrative review panel, that shall include a consideration of the safety of the child, a determination of the continuing need for placement in foster care, evaluation of the goals for the placement and the progress toward meeting these goals, and development of a target date for the childs return home or establishment of alternative permanent placement.
(j)Permanency planning hearing means a hearing conducted by the juvenile court in which the childs future status, including whether the child shall be returned home or another permanent plan shall be developed, is determined.
(k)Placement and care refers to the responsibility for the welfare of a child vested in an agency or organization by virtue of the agency or organization having (1) been delegated care, custody, and control of a child by the juvenile court, (2) taken responsibility, pursuant to a relinquishment or termination of parental rights on a child, (3) taken the responsibility of supervising a child detained by the juvenile court pursuant to Section 319 or 636, or (4) signed a voluntary placement agreement for the childs placement; or to the responsibility designated to an individual by virtue of the individual being appointed the childs legal guardian.
(l)Preplacement preventive services means services that are designed to help children remain with their families by preventing or eliminating the need for removal.
(m)Relative means an adult who is related to the child by blood, adoption, or affinity within the fifth degree of kinship, including stepparents, stepsiblings, and all relatives whose status is preceded by the words great, great-great, or grand or the spouse of any of these persons even if the marriage was terminated by death or dissolution.
(n)Nonrelative extended family member means an adult caregiver who has an established familial or mentoring relationship with the child, as described in Section 362.7.
(o)Voluntary placement means an out-of-home placement of a child by (1) the county welfare department, probation department, or Indian tribe that has entered into an agreement pursuant to Section 10553.1, after the parents or guardians have requested the assistance of the county welfare department and have signed a voluntary placement agreement, or (2) the county welfare department licensed public or private adoption agency, or the department acting as an adoption agency, after the parents have requested the assistance of either the county welfare department, the licensed public or private adoption agency, or the department acting as an adoption agency for the purpose of adoption planning, and have signed a voluntary placement agreement.
(p)Voluntary placement agreement means a written agreement between either the county welfare department, probation department, or Indian tribe that has entered into an agreement pursuant to Section 10553.1, licensed public or private adoption agency, or the department acting as an adoption agency, and the parents or guardians of a child that specifies, at a minimum, the following:
(1)The legal status of the child.
(2)The rights and obligations of the parents or guardians, the child, and the agency in which the child is placed.
(q)Original placement date means the most recent date on which the court detained a child and ordered an agency to be responsible for supervising the child or the date on which an agency assumed responsibility for a child due to termination of parental rights, relinquishment, or voluntary placement.
(r)(1)Transitional housing placement provider means an organization licensed by the State Department of Social Services pursuant to Section 1559.110 of the Health and Safety Code to provide supervised transitional housing services to foster children who are at least 16 years of age. A transitional housing placement provider shall be privately operated and organized on a nonprofit basis.
(2)Before licensure, a provider shall obtain certification from the applicable county, in accordance with Section 16522.1.
(s)Transitional Housing Program-Plus means a provider certified by the applicable county, in accordance with subdivision (c) of Section 16522, to provide transitional housing services to former foster youth who have exited the foster care system on or after their 18th birthday.
(t)Whole family foster home means a resource family, licensed foster family home, approved relative caregiver or nonrelative extended family members home, the home of a nonrelated legal guardian whose guardianship was established pursuant to Section 360 or 366.26, certified family home, or a host family of a transitional housing placement provider, that provides foster care for a minor or nonminor dependent parent and their child, and is specifically recruited and trained to assist the minor or nonminor dependent parent in developing the skills necessary to provide a safe, stable, and permanent home for the child. The child of the minor or nonminor dependent parent need not be the subject of a petition filed pursuant to Section 300 to qualify for placement in a whole family foster home.
(u)Mutual agreement means any of the following:
(1)A written voluntary agreement of consent for continued placement and care in a supervised setting between a minor or, on and after January 1, 2012, a nonminor dependent, and the county welfare services or probation department or tribal agency responsible for the foster care placement, that documents the nonminors continued willingness to remain in supervised out-of-home placement under the placement and care of the responsible county, tribe, consortium of tribes, or tribal organization that has entered into an agreement with the state pursuant to Section 10553.1, remain under the jurisdiction of the juvenile court as a nonminor dependent, and report any change of circumstances relevant to continued eligibility for foster care payments, and that documents the nonminors and social workers or probation officers agreement to work together to facilitate implementation of the mutually developed supervised placement agreement and transitional independent living case plan.
(2)An agreement, as described in paragraph (1), between a nonminor former dependent or ward in receipt of Kin-GAP payments under Article 4.5 (commencing with Section 11360) or Article 4.7 (commencing with Section 11385), and the agency responsible for the Kin-GAP benefits, provided that the nonminor former dependent or ward satisfies the conditions described in Section 11403.01, or one or more of the conditions described in paragraphs (1) to (5), inclusive, of subdivision (b) of Section 11403. For purposes of this paragraph and paragraph (3), nonminor former dependent or ward has the same meaning as described in subdivision (aa).
(3)An agreement, as described in paragraph (1), between a nonminor former dependent or ward in receipt of AFDC-FC payments under subdivision (e) or (f) of Section 11405 and the agency responsible for the AFDC-FC benefits, provided that the nonminor former dependent or ward described in subdivision (e) of Section 11405 satisfies one or more of the conditions described in paragraphs (1) to (5), inclusive, of subdivision (b) of Section 11403, and the nonminor described in subdivision (f) of Section 11405 satisfies the secondary school or equivalent training or certificate program conditions described in that subdivision.
(v)Nonminor dependent means, on and after January 1, 2012, a foster child, as described in Section 675(8)(B) of Title 42 of the United States Code under the federal Social Security Act who is a current dependent child or ward of the juvenile court, or who is a nonminor under the transition jurisdiction of the juvenile court, as described in Section 450, and who satisfies all of the following criteria:
(1)The nonminor dependent has attained 18 years of age while under an order of foster care placement by the juvenile court, and is not more than 19 years of age on or after January 1, 2012, not more than 20 years of age on or after January 1, 2013, or not more than 21 years of age on or after January 1, 2014, and as described in Section 10103.5.
(2)The nonminor dependent is in foster care under the placement and care responsibility of the county welfare department, county probation department, Indian tribe, consortium of tribes, or tribal organization that entered into an agreement pursuant to Section 10553.1.
(3)The nonminor dependent has a transitional independent living case plan pursuant to Section 475(8) of the federal Social Security Act (42 U.S.C. Sec. 675(8)), as contained in the federal Fostering Connections to Success and Increasing Adoptions Act of 2008 (Public Law 110-351), as described in Section 11403.
(w)Supervised independent living placement means, on and after January 1, 2012, an independent supervised setting in which the nonminor dependent is living independently, pursuant to Section 472(c) of the federal Social Security Act (42 U.S.C. Sec. 672(c)).
(x)Supervised independent living setting, pursuant to Section 472(c) of the federal Social Security Act (42 U.S.C. Sec. 672(c)), includes all of the following:
(1)A supervised independent living placement, as defined in subdivision (w), and as specified in a nonminor dependents transitional independent living case plan.
(2)A transitional housing unit in which a host family lives with a nonminor dependent who is a participant of a Transitional Housing Placement program, as described in subdivision (a) of Section 1559.110 of the Health and Safety Code, including an apartment, single-family dwelling, or condominium owned, rented, or leased by the host family, with supervised transitional housing services provided by the licensed transitional housing placement provider.
(3)A residential housing unit certified by the transitional housing placement provider operating a Transitional Housing Placement program for nonminor dependents, as described in paragraph (2) of subdivision (a) of Section 16522.1.
(4)A transitional living setting approved by the county to support youth who are entering or reentering foster care or transitioning between placements. The short-term independent living setting shall not include a youth homelessness prevention center or an adult homeless shelter. A transitional living setting approved by the county for purposes of this paragraph is not subject to licensing pursuant to paragraph (4) of subdivision (l) of Section 1505 of the Health and Safety Code.
(y)Transitional independent living case plan means, on or after January 1, 2012, a childs case plan submitted for the last review hearing held before the child reaches 18 years of age or the nonminor dependents case plan, updated every six months, that describes the goals and objectives of how the nonminor will make progress in the transition to living independently and assume incremental responsibility for adult decisionmaking, the collaborative efforts between the nonminor and the social worker, probation officer, or Indian tribal placing entity and the supportive services as described in the transitional independent living plan (TILP) to ensure active and meaningful participation in one or more of the eligibility criteria described in paragraphs (1) to (5), inclusive, of subdivision (b) of Section 11403, the nonminors appropriate supervised placement setting, and the nonminors permanent plan for transition to living independently, which includes maintaining or obtaining permanent connections to caring and committed adults, as set forth in paragraph (16) of subdivision (f) of Section 16501.1.
(z)Voluntary reentry agreement means a written voluntary agreement between a former dependent child or ward or a former nonminor dependent, who has had juvenile court jurisdiction terminated pursuant to Section 391, 452, or 607.2, or between a nonminor dependent who has not signed a voluntary reentry agreement after attaining 18 years of age and for whom a petition will be filed pursuant to subdivision (f) of Section 388, and the county welfare or probation department or tribal placing entity that documents the nonminors desire and willingness to reenter foster care, to be placed in a supervised setting under the placement and care responsibility of the placing agency, the nonminors desire, willingness, and ability to immediately participate in one or more of the conditions of paragraphs (1) to (5), inclusive, of subdivision (b) of Section 11403, the nonminors agreement to work collaboratively with the placing agency to develop their transitional independent living case plan within 60 days of reentry, if not previously completed, the nonminors agreement to report any changes of circumstances relevant to continued eligibility for foster care payments, and (1) the nonminors agreement to participate in the filing of a petition for juvenile court jurisdiction as a nonminor dependent pursuant to subdivision (e) of Section 388 within 15 judicial days of the signing of the agreement and the placing agencys efforts and supportive services to assist the nonminor in the reentry process, (2) if the nonminor meets the definition of a nonminor former dependent or ward, as described in subdivision (aa), the nonminors agreement to return to the care and support of their former juvenile court-appointed guardian and meet the eligibility criteria for AFDC-FC pursuant to subdivision (e) of Section 11405, or (3) the nonminor dependents agreement to participate in the filing of a petition pursuant to subdivision (f) of Section 388.
(aa)Nonminor former dependent or ward means, on and after January 1, 2012, either of the following:
(1)A nonminor who reached 18 years of age while subject to an order for foster care placement, and for whom dependency, delinquency, or transition jurisdiction has been terminated, and who is still under the general jurisdiction of the court.
(2)A nonminor who is over 18 years of age and, while a minor, was a dependent child or ward of the juvenile court when the guardianship was established pursuant to Section 360 or 366.26, or subdivision (d) of Section 728, and the juvenile court dependency or wardship was dismissed following the establishment of the guardianship.
(ab)Youth homelessness prevention center means a type of group home, as defined in paragraph (14) of subdivision (a) of Section 1502 of the Health and Safety Code, that is not an eligible placement option under Sections 319, 361.2, 450, and 727, and that is not eligible for AFDC-FC funding pursuant to subdivision (c) of Section 11402 or Section 11462.
(ac)Transition dependent is a minor between 17 years and five months and 18 years of age who is subject to the courts transition jurisdiction under Section 450.
(ad)Short-term residential therapeutic program means a nondetention, licensed community care facility, as defined in paragraph (18) of subdivision (a) of Section 1502 of the Health and Safety Code, that provides an integrated program of specialized and intensive care and supervision, services and supports, and treatment for the child or youth, when the childs or youths case plan specifies the need for, nature of, and anticipated duration of this specialized treatment. Short-term residential therapeutic programs shall be organized and operated on a nonprofit basis.
(ae)Resource family means an approved caregiver, as defined in subdivision (c) of Section 16519.5.
(af)Core services means services, made available to children, youth, and nonminor dependents either directly or secured through agreement with other agencies, that are trauma informed and culturally relevant, as specified in Sections 11462 and 11463.
(ag)Short-term assessment, therapy, and transition program means a nondetention, licensed community care facility, as defined in paragraph (23) of subdivision (a) of Section 1502 of the Health and Safety Code, that provides an intensive, trauma-informed, individualized, and integrated program of care and supervision, services and supports, and treatment for the child or youth, when the childs or youths case plan specifies the need for, nature of, and anticipated duration of, this specialized treatment. Short-term assessment, therapy, and transition programs shall be organized and operated on a nonprofit basis.
(a)(1)Foster care providers shall be paid a per child per month rate in return for the care and supervision of the AFDC-FC child placed with them. The department is designated the single organizational unit whose duty it shall be to administer a state system for establishing rates in the AFDC-FC program. State functions shall be performed by the department or by delegation of the department to county welfare departments or Indian tribes, consortia of tribes, or tribal organizations that have entered into an agreement pursuant to Section 10553.1.
(2)(A)Foster care providers that care for a child in a home-based setting described in paragraph (1) of subdivision (g) of Section 11461, or in a certified home or an approved resource family of a foster family agency, shall be paid the per child per month rate as set forth in subdivision (g) of Section 11461.
(B)The basic rate paid to either a certified family home or an approved resource family of a foster family agency shall be paid by the agency to the certified family home or approved resource family from the rate that is paid to the agency pursuant to Section 11463.
(3)(A)In addition to administering the state system of rates described in paragraph (1) of subdivision (a), at the request of and in consultation with a county,the department shall have the authority to develop, implement, and approve alternative funding models and set individualized rates for innovative AFDC-FC programs or models of care and servicesthat are consistent with statewide licensing and program requirements and that provide children with service alternatives to residential care, enhance the ability of children to remain in the least restrictive, most family-like setting possible, and promote services that address the needs and strengths of individual children and their families.
(B)A county that chooses to request an alternative funding model or individualized rate under this paragraph shall pay the entire nonfederal share of any additional cost for providing these innovative programs or models of care and services that exceeds the nonfederal portions of the state system of rates established pursuant to subdivision (a).
(C)(i)The provider shall indicate in theprogram statement theinnovative approach or model of care and servicesfor which there is a recognized need that the county seeks to meet.
(ii)The requesting county, in consultation with the department, shall monitorthe performance and outcomes of the provider consistent with the program statement to ensure that the purposes of the innovative program or model of care and serviceswill be achieved commensurate with the alternative funding model or individualized rate.
(b)Care and supervision includes food, clothing, shelter, daily supervision, school supplies, a childs personal incidentals, liability insurance with respect to a child, reasonable travel to the childs home for visitation, and reasonable travel for the child to remain in the school in which the child is enrolled at the time of placement. Reimbursement for the costs of educational travel, as provided for in this subdivision, shall be made pursuant to procedures determined by the department, in consultation with representatives of county welfare and probation directors, and additional stakeholders, as appropriate.
(1)For a child or youth placed in a short-term residential therapeutic program, group home, or short-term assessment, therapy, and transition program, care and supervision shall also include reasonable administration and operational activities necessary to provide the items listed in this subdivision.
(2)For a child or youth placed in a short-term residential therapeutic program, group home, or short-term assessment, therapy, and transition program, care and supervision may also include reasonable activities performed by social workers employed by the program provider that are not otherwise considered daily supervision or administration activities.
(3)The department, in consultation with the California State Foster Parent Association, and other interested stakeholders, shall provide information to the Legislature, no later than January 1, 2017, regarding the availability and cost for liability and property insurance covering acts committed by children in care, and shall make recommendations for any needed program development in this area.
(c)It is the intent of the Legislature to establish the maximum level of financial participation in out-of-state foster care group home program rates for placements in facilities described in subdivision (h) of Section 11402.
(1)The department shall develop regulations that establish the method for determining the level of financial participation in the rate paid for out-of-state placements in facilities described in subdivision (h) of Section 11402. The department shall consider all of the following methods:
(A)Until December 31, 2016, a standardized system based on the rate classification level of care and services per child per month.
(B)The rate developed for a short-term residential therapeutic program and short-term assessment, therapy, and transition program pursuant to Section 11462.
(C)A system that considers the actual allowable and reasonable costs of care and supervision incurred by the out-of-state program.
(D)A system that considers the rate established by the host state.
(E)Any other appropriate methods as determined by the department.
(2)Reimbursement for the Aid to Families with Dependent Children-Foster Care rate to be paid to an out-of-state program described in subdivision (h) of Section 11402 shall only be paid to programs that have done all of the following:
(A)Submitted a rate application to the department, which shall include, but not be limited to, both of the following:
(i)Commencing January 1, 2017, unless granted an extension from the department pursuant to subdivision (d) or (e) of Section 11462.04, the equivalent of the mental health program approval required in Section 4096.5.
(ii)Commencing January 1, 2017, unless granted an extension from the department pursuant to subdivision (d) or (e) of Section 11462.04, the national accreditation required in paragraph (6) of subdivision (b) of Section 11462.
(B)Maintained a level of financial participation that shall not exceed any of the following:
(i)The current fiscal years standard rate for rate classification level 14 for a group home.
(ii)Commencing January 1, 2017, the current fiscal years rate for a short-term residential therapeutic program.
(iii)The rate determined by the ratesetting authority of the state in which the facility is located.
(C)Agreed to comply with information requests, and program and fiscal audits as determined necessary by the department.
(3)Except as specifically provided for in statute, reimbursement for an AFDC-FC rate shall only be paid to a group home, short-term residential therapeutic program, or short-term assessment, therapy, and transition program organized and operated on a nonprofit basis.
(d)A foster care provider that accepts payments, following the effective date of this section, based on a rate established under this section, shall not receive rate increases or retroactive payments as the result of litigation challenging rates established prior to the effective date of this section. This shall apply regardless of whether a provider is a party to the litigation or a member of a class covered by the litigation.
(e)The county is not precluded from using a portion of its county funds to increase rates paid to family homes, foster family agencies, group homes, short-term residential therapeutic programs, or short-term assessment, therapy, and transition programs within that county, and to make payments for specialized care increments, clothing allowances, or infant supplements to homes within that county, solely at that countys expense.
(f)A county is not precluded from providing a supplemental rate to serve commercially sexually exploited foster children to provide for the additional care and supervision needs of these children. To the extent that federal financial participation is available, it is the intent of the Legislature that the federal funding shall be utilized.
(a)(1)If a program will admit Medi-Cal beneficiaries, no later than 12 months following the date of initial licensure, a short-term residential therapeutic program, as defined in subdivision (ad) of Section 11400 of this code and paragraph (18) of subdivision (a) of Section 1502 of the Health and Safety Code, and a short-term assessment, therapy, and transition program, as defined in subdivision (ag) of Section 11400 of this code and paragraph (23) 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 childs case plan.
(C)The childs needs and services plan.
(D)The assessment of a qualified individual, as defined in subdivision (l) of Section 16501.
(E)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 specified in subdivision (c), a short-term residential therapeutic program or a short-term assessment, therapy, and transition 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 or a short-term assessment, therapy, and transition 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 childs own home or in other family settings, such as with a relative, guardian, foster family, resource family, or adoptive family. The assessment shall ensure the child has needs in common with other children or youth in the care of the facility, consistent with subdivision (c) of Section 16514.
(3)The child meets at least one of the following conditions:
(A)The child has been assessed, pursuant to Section 4096, as meeting the medical necessity criteria for Medi-Cal specialty mental health services, as provided for in Section 1830.205 or 1830.210 of Title 9 of the California Code of Regulations.
(B)The child has been assessed, pursuant to Section 4096, as seriously emotionally disturbed, as defined in subdivision (a) of Section 5600.3.
(C)The child requires emergency placement pursuant to paragraph (3) of subdivision (h).
(D)The child has been assessed, pursuant to Section 4096, as requiring the level of services provided by the short-term residential therapeutic program in order to meet the childs behavioral or therapeutic needs.
(4)Subject to the requirements of this subdivision, a short-term residential therapeutic program or a short-term assessment, therapy, and transition 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 childs behavior, and short-term intervention is needed to transition the child back into the home.
(C)A juvenile sex offender.
(D)A child who is affiliated with, or impacted by, a gang.
(c)(1)A short-term residential therapeutic program that is operating as a childrens crisis residential program, as defined in Section 1502 of the Health and Safety Code, may accept for admission any child who meets all of the requirements set forth in paragraph (3) of subdivision (c) of Section 11462.011 and subdivisions (a) to (e), inclusive, of Section 4096.
(2)The primary function of a childrens crisis residential program is to provide short-term crisis stabilization, therapeutic intervention, and specialized programming in an unlocked, staff-secured setting with a high degree of supervision and structure and the goal of supporting the rapid and successful transition of the child back to the community.
(d)A foster family agency that is certified as a Medi-Cal specialty mental health provider pursuant to Section 1810.435 of Title 9 of the California Code of Regulations by the State Department of Health Care Services, or by a county mental health plan to which the department has delegated certification authority, and which has entered into a contract with a county mental health plan pursuant to Section 1810.436 of Title 9 of the California Code of Regulations, shall provide, or provide access to, specialty mental health services to children under its care who do not require inpatient care in a licensed health facility and who meet the medical necessity criteria for Medi-Cal specialty mental health services provided for in Section 1830.205 or 1830.210 of Title 9 of the California Code of Regulations.
(e)A foster family agency that is not certified as a Medi-Cal specialty mental health provider shall provide access to specialty and mental health services and other 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 and short-term assessment, therapy, and transition programs shall maintain the level of care and services necessary to meet the needs, including the assessed needs and child-specific goals identified by a qualified individual pursuant to subdivision (g) of Section 4096, as applicable, of the children and youth in their care and shall maintain and have in good standing the appropriate mental health program approval. If a program will admit Medi-Cal beneficiaries, the short-term residential therapeutic program shall obtain 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 childs 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 the short-term residential therapeutic program or short-term assessment, therapy, and transition 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 (j) of Section 4096.
(3)An individualized education program team. For the purposes of this section, an AFDC-FC funded child with an individualized education program developed pursuant to Article 2 (commencing with Section 56320) of Chapter 4 of Part 30 of Division 4 of Title 2 of the Education Code that assesses the child as seriously emotionally disturbed, as defined in, and subject to, this section and recommends out-of-home placement at the level of care provided by the provider, shall be deemed to have met the assessment requirement.
(4)A qualified individual, as defined in subdivision (l) of Section 16501.
(h)(1)The short-term residential therapeutic program or short-term assessment, therapy, and transition program shall maintain documentation of the assessments required pursuant to Section 4096 for AFDC-FC funded children, except as provided for in paragraph (3) of subdivision (g). The short-term residential therapeutic program shall inform the department if the county placing agency does not provide the documentation.
(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)Subdivisions (a) to (g), inclusive, and this subdivision do not prevent an emergency placement of a child or youth into a certified short-term residential therapeutic program prior to the determination by the interagency placement committee, but only if a licensed mental health professional, as defined in subdivision (j) of Section 4096, has made a written determination within 72 hours of the childs or youths 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 their behavioral or therapeutic needs. If the short-term residential therapeutic program serves children placed by county child welfare agencies and children placed by probation departments, the interagency placement committee shall also ensure the requirements of subdivision (c) of Section 16514 have been met with respect to commonality of need.
(i)The interagency placement committee, as appropriate, shall, within 30 days of placement, make the determinations, with recommendations from the child and family team, required by this subdivision.
(ii)If it determines the placement is appropriate, the interagency placement committee, with recommendations from the child and family team, shall transmit the approval, in writing, to the county placing agency and the short-term residential therapeutic program or short-term assessment, therapy, and transition 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 or short-term assessment, therapy, and transition program and shall include a recommendation as to the childs appropriate level of care and placement to meet the childs 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. On and after October 1, 2021, federal AFDC-FC shall not be used to fund the placement for more than 30 days from the date that the qualified individual or interagency placement committee determined that the placement is no longer recommended or the court disapproved the placement.
(iii)Notwithstanding clause (ii), if the interagency placement committee determined the placement was not appropriate due to a health and safety concern, immediate arrangements for the child to transition to an appropriate placement shall occur.
(i)Commencing January 1, 2017, for AFDC-FC funded children or youth, only those children or youth who are approved for placement, as set forth in this section, may be accepted by a short-term residential therapeutic program or short-term assessment, therapy, and transition program.
(j)The department shall, through regulation, establish consequences for the failure of a short-term residential therapeutic program or short-term assessment, therapy, and transition program to obtain written approval for placement of an AFDC-FC funded child or youth pursuant to this section.
(k)The department shall not establish a rate for a short-term residential therapeutic program or short-term assessment, therapy, and transition 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 departments AFDC-FC ratesetting regulations.
(l) Any short-term residential therapeutic program or short-term assessment, therapy, and transition program shall be reclassified and paid at the appropriate program rate for which it is qualified if any of the following occur:
(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 departments 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 or short-term assessment, therapy, and transition 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. During any appeal, the short-term residential therapeutic program or short-term assessment, therapy, and transition program shall maintain the appropriate level of care.
(2)It fails to maintain a mental health treatment program as required by subdivision (f).
(3)It fails to timely obtain or maintain accreditation as required by state law or fails to provide proof of that accreditation to the department upon request.
(m)In addition to any other review required by law, the child and family team as defined in paragraph (4) of subdivision (a) of Section 16501 may periodically review the placement of the child or youth. If the child and family team make a recommendation that the child or youth no longer needs, or is not benefiting from, placement in a short-term residential therapeutic program, the team shall transmit the disapproval, in writing, to the county placing agency to consider a more appropriate placement.
(n)The department shall develop a process to address placements when, subsequent to the childs or youths 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 countys plan, and a timeframe, for removal of the child or youth in writing to the short-term residential therapeutic program that provides intensive and therapeutic treatment.
(3)Referral to an appropriate placement.
(4)Actions to be taken if a child or youth is not timely removed from the short-term residential therapeutic program that provides intensive and therapeutic treatment or placed in an appropriate placement.
(o)(1)This section does not prohibit a short-term residential therapeutic program or a short-term assessment, therapy, and transition program from accepting private admissions of children or youth.
(2)When a referral is not from a public agency and public funding is not involved, there is no requirement for public agency review or determination of need.
(3)Children and youth subject to paragraphs (1) and (2) shall have been determined to be seriously emotionally disturbed, as described in subdivision (a) of Section 5600.3, and subject to Section 1502.4 of the Health and Safety Code, by a licensed mental health professional, as defined in subdivision (j) of Section 4096.
SEC. 3. Section 11462.010 is added to the Welfare and Institutions Code, immediately following Section 11462.01, to read:11462.010. (a) (1) The department shall develop an enhanced funding model for short-term residential therapeutic programs that serve up to four current or former foster children or nonminor dependents in the foster care system who have complex needs across multiple systems.(2) The enhanced funding shall be for additional program staffing to be delivered onsite by a care team composed of appropriate professionals trained in trauma-informed care across physical health, developmental disabilities, educational, and behavioral health care inclusive of substance abuse, in order to provide the services to a child or nonminor dependent, and overseen by appropriate administrative staff as required by the department.(3) The program shall leverage and coordinate with other service providers, including regional centers, local educational agencies, behavioral health agencies, wraparound providers, and others, to maximize services and supports to the child, nonminor dependent, and their caregivers while the child or nonminor dependent is receiving services from the program.(b) The enhanced program shall provide intensive, trauma-informed services through a care team for each child or nonminor dependent. The care team shall be led by a clinical head of service and shall include, at a minimum, the program social worker, special education specialist, board-certified behavioral analyst, youth peer, and caregiver peer.(c) The care team shall deliver services to a child or nonminor dependent who is placed at an enhanced short-term residential therapeutic program and for up to six months postdischarge, as needed by the child or nonminor dependent and their caregiver to support transition to other residential or community-based care, including family-based care. The care team may also deliver services to the family, family-like connections, or other caregivers to support stepdowns to family-based care, or may provide consultation to the next direct service provider, to include the biological family, legal guardian, or both, as deemed appropriate and pursuant to the childs or nonminor dependents care plan, in consultation with any child and family team.(d) The department shall develop staffing requirements in consultation with stakeholders, including, but not limited to, the County Welfare Directors Association of California, the Chief Probation Officers of California, the County Behavioral Health Directors Association of California, the California Youth Connection, and tribal and provider representatives.(e) (1) As a condition of receiving enhanced funding, and subject to the other requirements described in this section, the program shall accept all children and nonminor dependents referred by a child welfare agency, probation agency, or tribal entity, unless a determination is made by the clinical staff, in consultation with other members of the care team, that the child or nonminor dependent is in need of a more restrictive inpatient setting due to the immediate and present risk of serious injury to self or others or due to a commonality of need.(2) The program shall continue to serve a child or nonminor dependent admitted to the program until they can be appropriately transitioned to the next level of care with support of the care team and shall hold beds open due to temporary transfers to a general acute care hospital or a crisis mental health inpatient setting for up to 14 days.(f) (1) The department shall develop a separate rate for the enhanced funding pursuant to Section 11462 and shall adopt regulations as needed to implement this section.(2) The department shall consult with the State Department of Health Care Services, the County Welfare Directors Association of California, the Chief Probation Officers of California, the California Youth Connection, tribal representatives, the County Behavioral Health Directors Association of California, provider representatives, and other stakeholders as deemed appropriate in the development of regulations.(g) Notwithstanding the rulemaking provisions of the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code), the department may implement, interpret, or make specific this section by means of interim guidance until regulations are adopted.
SEC. 3. Section 11462.010 is added to the Welfare and Institutions Code, immediately following Section 11462.01, to read:
### SEC. 3.
11462.010. (a) (1) The department shall develop an enhanced funding model for short-term residential therapeutic programs that serve up to four current or former foster children or nonminor dependents in the foster care system who have complex needs across multiple systems.(2) The enhanced funding shall be for additional program staffing to be delivered onsite by a care team composed of appropriate professionals trained in trauma-informed care across physical health, developmental disabilities, educational, and behavioral health care inclusive of substance abuse, in order to provide the services to a child or nonminor dependent, and overseen by appropriate administrative staff as required by the department.(3) The program shall leverage and coordinate with other service providers, including regional centers, local educational agencies, behavioral health agencies, wraparound providers, and others, to maximize services and supports to the child, nonminor dependent, and their caregivers while the child or nonminor dependent is receiving services from the program.(b) The enhanced program shall provide intensive, trauma-informed services through a care team for each child or nonminor dependent. The care team shall be led by a clinical head of service and shall include, at a minimum, the program social worker, special education specialist, board-certified behavioral analyst, youth peer, and caregiver peer.(c) The care team shall deliver services to a child or nonminor dependent who is placed at an enhanced short-term residential therapeutic program and for up to six months postdischarge, as needed by the child or nonminor dependent and their caregiver to support transition to other residential or community-based care, including family-based care. The care team may also deliver services to the family, family-like connections, or other caregivers to support stepdowns to family-based care, or may provide consultation to the next direct service provider, to include the biological family, legal guardian, or both, as deemed appropriate and pursuant to the childs or nonminor dependents care plan, in consultation with any child and family team.(d) The department shall develop staffing requirements in consultation with stakeholders, including, but not limited to, the County Welfare Directors Association of California, the Chief Probation Officers of California, the County Behavioral Health Directors Association of California, the California Youth Connection, and tribal and provider representatives.(e) (1) As a condition of receiving enhanced funding, and subject to the other requirements described in this section, the program shall accept all children and nonminor dependents referred by a child welfare agency, probation agency, or tribal entity, unless a determination is made by the clinical staff, in consultation with other members of the care team, that the child or nonminor dependent is in need of a more restrictive inpatient setting due to the immediate and present risk of serious injury to self or others or due to a commonality of need.(2) The program shall continue to serve a child or nonminor dependent admitted to the program until they can be appropriately transitioned to the next level of care with support of the care team and shall hold beds open due to temporary transfers to a general acute care hospital or a crisis mental health inpatient setting for up to 14 days.(f) (1) The department shall develop a separate rate for the enhanced funding pursuant to Section 11462 and shall adopt regulations as needed to implement this section.(2) The department shall consult with the State Department of Health Care Services, the County Welfare Directors Association of California, the Chief Probation Officers of California, the California Youth Connection, tribal representatives, the County Behavioral Health Directors Association of California, provider representatives, and other stakeholders as deemed appropriate in the development of regulations.(g) Notwithstanding the rulemaking provisions of the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code), the department may implement, interpret, or make specific this section by means of interim guidance until regulations are adopted.
11462.010. (a) (1) The department shall develop an enhanced funding model for short-term residential therapeutic programs that serve up to four current or former foster children or nonminor dependents in the foster care system who have complex needs across multiple systems.(2) The enhanced funding shall be for additional program staffing to be delivered onsite by a care team composed of appropriate professionals trained in trauma-informed care across physical health, developmental disabilities, educational, and behavioral health care inclusive of substance abuse, in order to provide the services to a child or nonminor dependent, and overseen by appropriate administrative staff as required by the department.(3) The program shall leverage and coordinate with other service providers, including regional centers, local educational agencies, behavioral health agencies, wraparound providers, and others, to maximize services and supports to the child, nonminor dependent, and their caregivers while the child or nonminor dependent is receiving services from the program.(b) The enhanced program shall provide intensive, trauma-informed services through a care team for each child or nonminor dependent. The care team shall be led by a clinical head of service and shall include, at a minimum, the program social worker, special education specialist, board-certified behavioral analyst, youth peer, and caregiver peer.(c) The care team shall deliver services to a child or nonminor dependent who is placed at an enhanced short-term residential therapeutic program and for up to six months postdischarge, as needed by the child or nonminor dependent and their caregiver to support transition to other residential or community-based care, including family-based care. The care team may also deliver services to the family, family-like connections, or other caregivers to support stepdowns to family-based care, or may provide consultation to the next direct service provider, to include the biological family, legal guardian, or both, as deemed appropriate and pursuant to the childs or nonminor dependents care plan, in consultation with any child and family team.(d) The department shall develop staffing requirements in consultation with stakeholders, including, but not limited to, the County Welfare Directors Association of California, the Chief Probation Officers of California, the County Behavioral Health Directors Association of California, the California Youth Connection, and tribal and provider representatives.(e) (1) As a condition of receiving enhanced funding, and subject to the other requirements described in this section, the program shall accept all children and nonminor dependents referred by a child welfare agency, probation agency, or tribal entity, unless a determination is made by the clinical staff, in consultation with other members of the care team, that the child or nonminor dependent is in need of a more restrictive inpatient setting due to the immediate and present risk of serious injury to self or others or due to a commonality of need.(2) The program shall continue to serve a child or nonminor dependent admitted to the program until they can be appropriately transitioned to the next level of care with support of the care team and shall hold beds open due to temporary transfers to a general acute care hospital or a crisis mental health inpatient setting for up to 14 days.(f) (1) The department shall develop a separate rate for the enhanced funding pursuant to Section 11462 and shall adopt regulations as needed to implement this section.(2) The department shall consult with the State Department of Health Care Services, the County Welfare Directors Association of California, the Chief Probation Officers of California, the California Youth Connection, tribal representatives, the County Behavioral Health Directors Association of California, provider representatives, and other stakeholders as deemed appropriate in the development of regulations.(g) Notwithstanding the rulemaking provisions of the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code), the department may implement, interpret, or make specific this section by means of interim guidance until regulations are adopted.
11462.010. (a) (1) The department shall develop an enhanced funding model for short-term residential therapeutic programs that serve up to four current or former foster children or nonminor dependents in the foster care system who have complex needs across multiple systems.(2) The enhanced funding shall be for additional program staffing to be delivered onsite by a care team composed of appropriate professionals trained in trauma-informed care across physical health, developmental disabilities, educational, and behavioral health care inclusive of substance abuse, in order to provide the services to a child or nonminor dependent, and overseen by appropriate administrative staff as required by the department.(3) The program shall leverage and coordinate with other service providers, including regional centers, local educational agencies, behavioral health agencies, wraparound providers, and others, to maximize services and supports to the child, nonminor dependent, and their caregivers while the child or nonminor dependent is receiving services from the program.(b) The enhanced program shall provide intensive, trauma-informed services through a care team for each child or nonminor dependent. The care team shall be led by a clinical head of service and shall include, at a minimum, the program social worker, special education specialist, board-certified behavioral analyst, youth peer, and caregiver peer.(c) The care team shall deliver services to a child or nonminor dependent who is placed at an enhanced short-term residential therapeutic program and for up to six months postdischarge, as needed by the child or nonminor dependent and their caregiver to support transition to other residential or community-based care, including family-based care. The care team may also deliver services to the family, family-like connections, or other caregivers to support stepdowns to family-based care, or may provide consultation to the next direct service provider, to include the biological family, legal guardian, or both, as deemed appropriate and pursuant to the childs or nonminor dependents care plan, in consultation with any child and family team.(d) The department shall develop staffing requirements in consultation with stakeholders, including, but not limited to, the County Welfare Directors Association of California, the Chief Probation Officers of California, the County Behavioral Health Directors Association of California, the California Youth Connection, and tribal and provider representatives.(e) (1) As a condition of receiving enhanced funding, and subject to the other requirements described in this section, the program shall accept all children and nonminor dependents referred by a child welfare agency, probation agency, or tribal entity, unless a determination is made by the clinical staff, in consultation with other members of the care team, that the child or nonminor dependent is in need of a more restrictive inpatient setting due to the immediate and present risk of serious injury to self or others or due to a commonality of need.(2) The program shall continue to serve a child or nonminor dependent admitted to the program until they can be appropriately transitioned to the next level of care with support of the care team and shall hold beds open due to temporary transfers to a general acute care hospital or a crisis mental health inpatient setting for up to 14 days.(f) (1) The department shall develop a separate rate for the enhanced funding pursuant to Section 11462 and shall adopt regulations as needed to implement this section.(2) The department shall consult with the State Department of Health Care Services, the County Welfare Directors Association of California, the Chief Probation Officers of California, the California Youth Connection, tribal representatives, the County Behavioral Health Directors Association of California, provider representatives, and other stakeholders as deemed appropriate in the development of regulations.(g) Notwithstanding the rulemaking provisions of the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code), the department may implement, interpret, or make specific this section by means of interim guidance until regulations are adopted.
11462.010. (a) (1) The department shall develop an enhanced funding model for short-term residential therapeutic programs that serve up to four current or former foster children or nonminor dependents in the foster care system who have complex needs across multiple systems.
(2) The enhanced funding shall be for additional program staffing to be delivered onsite by a care team composed of appropriate professionals trained in trauma-informed care across physical health, developmental disabilities, educational, and behavioral health care inclusive of substance abuse, in order to provide the services to a child or nonminor dependent, and overseen by appropriate administrative staff as required by the department.
(3) The program shall leverage and coordinate with other service providers, including regional centers, local educational agencies, behavioral health agencies, wraparound providers, and others, to maximize services and supports to the child, nonminor dependent, and their caregivers while the child or nonminor dependent is receiving services from the program.
(b) The enhanced program shall provide intensive, trauma-informed services through a care team for each child or nonminor dependent. The care team shall be led by a clinical head of service and shall include, at a minimum, the program social worker, special education specialist, board-certified behavioral analyst, youth peer, and caregiver peer.
(c) The care team shall deliver services to a child or nonminor dependent who is placed at an enhanced short-term residential therapeutic program and for up to six months postdischarge, as needed by the child or nonminor dependent and their caregiver to support transition to other residential or community-based care, including family-based care. The care team may also deliver services to the family, family-like connections, or other caregivers to support stepdowns to family-based care, or may provide consultation to the next direct service provider, to include the biological family, legal guardian, or both, as deemed appropriate and pursuant to the childs or nonminor dependents care plan, in consultation with any child and family team.
(d) The department shall develop staffing requirements in consultation with stakeholders, including, but not limited to, the County Welfare Directors Association of California, the Chief Probation Officers of California, the County Behavioral Health Directors Association of California, the California Youth Connection, and tribal and provider representatives.
(e) (1) As a condition of receiving enhanced funding, and subject to the other requirements described in this section, the program shall accept all children and nonminor dependents referred by a child welfare agency, probation agency, or tribal entity, unless a determination is made by the clinical staff, in consultation with other members of the care team, that the child or nonminor dependent is in need of a more restrictive inpatient setting due to the immediate and present risk of serious injury to self or others or due to a commonality of need.
(2) The program shall continue to serve a child or nonminor dependent admitted to the program until they can be appropriately transitioned to the next level of care with support of the care team and shall hold beds open due to temporary transfers to a general acute care hospital or a crisis mental health inpatient setting for up to 14 days.
(f) (1) The department shall develop a separate rate for the enhanced funding pursuant to Section 11462 and shall adopt regulations as needed to implement this section.
(2) The department shall consult with the State Department of Health Care Services, the County Welfare Directors Association of California, the Chief Probation Officers of California, the California Youth Connection, tribal representatives, the County Behavioral Health Directors Association of California, provider representatives, and other stakeholders as deemed appropriate in the development of regulations.
(g) Notwithstanding the rulemaking provisions of the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code), the department may implement, interpret, or make specific this section by means of interim guidance until regulations are adopted.
SEC. 8.SEC. 4. Section 16001.1 of the Welfare and Institutions Code is amended to read:16001.1. (a) It is the intent of the Legislature to support the urgent and exceptional needs of children and nonminor dependents in foster care under the supervision of a county child welfare agency or probation department, including those who otherwise may be placed in an out-of-state residential facility.(b) (1) The department shall allocate funds appropriated to the department for this purpose in the Budget Act of 2021, and in any future fiscal year, through local assistance allocations to counties or Indian tribes that have entered into an agreement pursuant to Section 10553.1 that support new or expanded programs, services, practices, and training that builds system capacity and ensures the provision of a high-quality continuum of care that is designed to support foster children in the least restrictive setting, consistent with a childs permanency plan.(2) Pursuant to guidance and a process established by the department and the State Department of Health Care Services, in consultation with the County Welfare Directors Association of California, Chief Probation Officers of California, and County Behavioral Health Directors Association of California, fund recipients shall use the allocated funds to supplement county efforts to build system capacity for any of the following activities:(A) Specialized models of professional foster care, including therapeutic foster care, intensive services foster care, or other models as may be developed in collaboration with counties, including the County Behavioral Health Directors Association of California, and providers.(B) Intensive child-specific recruitment, family finding and engagement, and support programs for children with complex needs, including specialized permanency support services as described in Section 16501 and activities associated with the Active Supportive Intervention Services for Transition program.(C) Specialized models of integrated care and support for family-based settings, including high-fidelity wraparound, in-home nursing supports for youth with special health care needs, and community-based treatment models that create alternatives to out-of-home or residential placement.(D) Highly individualized short-term residential therapeutic programs designed to serve children with complex needs who otherwise may have been placed in an out-of-state residential facility.(E) A Childrens Crisis Continuum Pilot Program established pursuant to Chapter 6 (commencing with Section 16550).(F)Highly specialized short-term residential therapeutic programs and short-term assessment, treatment, and transition programs designed to serve children with complex trauma or cooccurring intellectual or developmental disabilities and behavioral health needs.(G)Short-term therapeutic settings that serve as an alternative to hospital-based settings and temporary placement settings.(F) Highly specialized short-term residential therapeutic programs designed to serve children with complex trauma or cooccurring intellectual or developmental disabilities and behavioral health needs.(3) Allocations made pursuant to this subdivision shall be conditioned on qualitative and outcomes standards that are established by the department, in consultation with the State Department of Health Care Services, counties, tribes, and other entities that may receive funding.(c) (1) The department shall allocate or expend, through contracts with community-based providers or entities or through local assistance allocations to counties or Indian tribes that have entered into an agreement pursuant to Section 10553.1, funds appropriated to the department for this purpose in the Budget Act of 2021, and in any future fiscal year, to provide and implement the recommendations of child-specific assessments, evaluations, enhanced care planning, ongoing technical assistance, and exceptional supports to meet the complex care needs of children in foster care within California within the least restrictive setting.(2) The department shall annually allocate funds to county placing agencies and tribal entities to purchase, procure, or directly provide supports or services that are needed to support the exceptional needs of a child or nonminor dependent in the least restrictive setting. Counties and tribal entities shall ensure expenditures are based upon the recommendation of a qualified individual, technical assistance provided by the department, or a clinical determination of an interagency placement committee or regional health team that considers the recommendations of a child and family team. Counties shall document these recommendations in the case plan of the child or nonminor dependent. Funds allocated pursuant to this paragraph may be expended for the following services and supports:(A) Direct services for the youth or family to help stabilize an existing placement, facilitate a new placement, or prevent a placement into foster care. Services may include, but are not limited to, accessing diagnostic testing and enhanced clinical assessments, therapies and treatments, developmental service supports, and medical and health-related services.(B) Enhanced family finding, engagement, and supports to enable placement with relatives or other family-like connections through intensive searches, or to support continued connection, engagement engagement, and support from relatives or other family-like connections. Access to funding for this purpose is permitted if the county or tribal entity has not opted into the Excellence in Family Finding, Engagement, and Support Program pursuant to Section 16546.5, or if the county or tribal entity has opted into the program and the youth has additional needs that cannot be fully met by the program.(C) Payments to providers to support respite care for caregivers.(D) Therapeutic or wraparound services.(E) Consultation or assessment with service providers or those with specialized expertise in care and treatment of youth with complex needs.(F) Durable medical equipment and supplies or other tangible items.(G) Enhanced care and supervision delivered by county staff, foster care providers, or other personnel subject to the requirements of Section 1522 of the Health and Safety Code.(H) Preplacement engagement and support and transitional support activities designed to facilitate access to therapies and treatment settings for youth.(I) Translation services in different languages, including American Sign Language.(J) Access to alternative therapies or extracurricular activities.(K) Other services or supports pursuant to guidance issued by the department, in consultation with counties.(3) Funds made available pursuant to this subdivision shall be conditioned on qualitative and outcomes standards that are established by the department. Outcomes standards shall include a continuous quality improvement process designed to address systematic gaps or barriers to meeting the needs of children and nonminor dependents in the least restrictive setting. Those outcomes standards shall be developed by the department and the State Department of Health Care Services, in consultation with counties, tribes, and other entities that may receive funding.(d) The department shall consult with the joint interagency resolution team, the County Welfare Directors Association of California, the Chief Probation Officers of California, the California Behavioral Health Directors Association of California, legislative staff, and other stakeholders with respect to the implementation of this section.(e) Funding made available to counties pursuant to this section shall only be used to supplement, and not supplant, existing funding, unless the receipt of funding or services from other sources are not readily available to meet the immediate needs of a youth, in which case the county may utilize funds appropriated pursuant to this section.(f) It is the intent of the Legislature that funding pursuant to this section that is not expended during a given fiscal year shall be made available for expenditure in the following fiscal year.
SEC. 8.SEC. 4. Section 16001.1 of the Welfare and Institutions Code is amended to read:
### SEC. 8.SEC. 4.
16001.1. (a) It is the intent of the Legislature to support the urgent and exceptional needs of children and nonminor dependents in foster care under the supervision of a county child welfare agency or probation department, including those who otherwise may be placed in an out-of-state residential facility.(b) (1) The department shall allocate funds appropriated to the department for this purpose in the Budget Act of 2021, and in any future fiscal year, through local assistance allocations to counties or Indian tribes that have entered into an agreement pursuant to Section 10553.1 that support new or expanded programs, services, practices, and training that builds system capacity and ensures the provision of a high-quality continuum of care that is designed to support foster children in the least restrictive setting, consistent with a childs permanency plan.(2) Pursuant to guidance and a process established by the department and the State Department of Health Care Services, in consultation with the County Welfare Directors Association of California, Chief Probation Officers of California, and County Behavioral Health Directors Association of California, fund recipients shall use the allocated funds to supplement county efforts to build system capacity for any of the following activities:(A) Specialized models of professional foster care, including therapeutic foster care, intensive services foster care, or other models as may be developed in collaboration with counties, including the County Behavioral Health Directors Association of California, and providers.(B) Intensive child-specific recruitment, family finding and engagement, and support programs for children with complex needs, including specialized permanency support services as described in Section 16501 and activities associated with the Active Supportive Intervention Services for Transition program.(C) Specialized models of integrated care and support for family-based settings, including high-fidelity wraparound, in-home nursing supports for youth with special health care needs, and community-based treatment models that create alternatives to out-of-home or residential placement.(D) Highly individualized short-term residential therapeutic programs designed to serve children with complex needs who otherwise may have been placed in an out-of-state residential facility.(E) A Childrens Crisis Continuum Pilot Program established pursuant to Chapter 6 (commencing with Section 16550).(F)Highly specialized short-term residential therapeutic programs and short-term assessment, treatment, and transition programs designed to serve children with complex trauma or cooccurring intellectual or developmental disabilities and behavioral health needs.(G)Short-term therapeutic settings that serve as an alternative to hospital-based settings and temporary placement settings.(F) Highly specialized short-term residential therapeutic programs designed to serve children with complex trauma or cooccurring intellectual or developmental disabilities and behavioral health needs.(3) Allocations made pursuant to this subdivision shall be conditioned on qualitative and outcomes standards that are established by the department, in consultation with the State Department of Health Care Services, counties, tribes, and other entities that may receive funding.(c) (1) The department shall allocate or expend, through contracts with community-based providers or entities or through local assistance allocations to counties or Indian tribes that have entered into an agreement pursuant to Section 10553.1, funds appropriated to the department for this purpose in the Budget Act of 2021, and in any future fiscal year, to provide and implement the recommendations of child-specific assessments, evaluations, enhanced care planning, ongoing technical assistance, and exceptional supports to meet the complex care needs of children in foster care within California within the least restrictive setting.(2) The department shall annually allocate funds to county placing agencies and tribal entities to purchase, procure, or directly provide supports or services that are needed to support the exceptional needs of a child or nonminor dependent in the least restrictive setting. Counties and tribal entities shall ensure expenditures are based upon the recommendation of a qualified individual, technical assistance provided by the department, or a clinical determination of an interagency placement committee or regional health team that considers the recommendations of a child and family team. Counties shall document these recommendations in the case plan of the child or nonminor dependent. Funds allocated pursuant to this paragraph may be expended for the following services and supports:(A) Direct services for the youth or family to help stabilize an existing placement, facilitate a new placement, or prevent a placement into foster care. Services may include, but are not limited to, accessing diagnostic testing and enhanced clinical assessments, therapies and treatments, developmental service supports, and medical and health-related services.(B) Enhanced family finding, engagement, and supports to enable placement with relatives or other family-like connections through intensive searches, or to support continued connection, engagement engagement, and support from relatives or other family-like connections. Access to funding for this purpose is permitted if the county or tribal entity has not opted into the Excellence in Family Finding, Engagement, and Support Program pursuant to Section 16546.5, or if the county or tribal entity has opted into the program and the youth has additional needs that cannot be fully met by the program.(C) Payments to providers to support respite care for caregivers.(D) Therapeutic or wraparound services.(E) Consultation or assessment with service providers or those with specialized expertise in care and treatment of youth with complex needs.(F) Durable medical equipment and supplies or other tangible items.(G) Enhanced care and supervision delivered by county staff, foster care providers, or other personnel subject to the requirements of Section 1522 of the Health and Safety Code.(H) Preplacement engagement and support and transitional support activities designed to facilitate access to therapies and treatment settings for youth.(I) Translation services in different languages, including American Sign Language.(J) Access to alternative therapies or extracurricular activities.(K) Other services or supports pursuant to guidance issued by the department, in consultation with counties.(3) Funds made available pursuant to this subdivision shall be conditioned on qualitative and outcomes standards that are established by the department. Outcomes standards shall include a continuous quality improvement process designed to address systematic gaps or barriers to meeting the needs of children and nonminor dependents in the least restrictive setting. Those outcomes standards shall be developed by the department and the State Department of Health Care Services, in consultation with counties, tribes, and other entities that may receive funding.(d) The department shall consult with the joint interagency resolution team, the County Welfare Directors Association of California, the Chief Probation Officers of California, the California Behavioral Health Directors Association of California, legislative staff, and other stakeholders with respect to the implementation of this section.(e) Funding made available to counties pursuant to this section shall only be used to supplement, and not supplant, existing funding, unless the receipt of funding or services from other sources are not readily available to meet the immediate needs of a youth, in which case the county may utilize funds appropriated pursuant to this section.(f) It is the intent of the Legislature that funding pursuant to this section that is not expended during a given fiscal year shall be made available for expenditure in the following fiscal year.
16001.1. (a) It is the intent of the Legislature to support the urgent and exceptional needs of children and nonminor dependents in foster care under the supervision of a county child welfare agency or probation department, including those who otherwise may be placed in an out-of-state residential facility.(b) (1) The department shall allocate funds appropriated to the department for this purpose in the Budget Act of 2021, and in any future fiscal year, through local assistance allocations to counties or Indian tribes that have entered into an agreement pursuant to Section 10553.1 that support new or expanded programs, services, practices, and training that builds system capacity and ensures the provision of a high-quality continuum of care that is designed to support foster children in the least restrictive setting, consistent with a childs permanency plan.(2) Pursuant to guidance and a process established by the department and the State Department of Health Care Services, in consultation with the County Welfare Directors Association of California, Chief Probation Officers of California, and County Behavioral Health Directors Association of California, fund recipients shall use the allocated funds to supplement county efforts to build system capacity for any of the following activities:(A) Specialized models of professional foster care, including therapeutic foster care, intensive services foster care, or other models as may be developed in collaboration with counties, including the County Behavioral Health Directors Association of California, and providers.(B) Intensive child-specific recruitment, family finding and engagement, and support programs for children with complex needs, including specialized permanency support services as described in Section 16501 and activities associated with the Active Supportive Intervention Services for Transition program.(C) Specialized models of integrated care and support for family-based settings, including high-fidelity wraparound, in-home nursing supports for youth with special health care needs, and community-based treatment models that create alternatives to out-of-home or residential placement.(D) Highly individualized short-term residential therapeutic programs designed to serve children with complex needs who otherwise may have been placed in an out-of-state residential facility.(E) A Childrens Crisis Continuum Pilot Program established pursuant to Chapter 6 (commencing with Section 16550).(F)Highly specialized short-term residential therapeutic programs and short-term assessment, treatment, and transition programs designed to serve children with complex trauma or cooccurring intellectual or developmental disabilities and behavioral health needs.(G)Short-term therapeutic settings that serve as an alternative to hospital-based settings and temporary placement settings.(F) Highly specialized short-term residential therapeutic programs designed to serve children with complex trauma or cooccurring intellectual or developmental disabilities and behavioral health needs.(3) Allocations made pursuant to this subdivision shall be conditioned on qualitative and outcomes standards that are established by the department, in consultation with the State Department of Health Care Services, counties, tribes, and other entities that may receive funding.(c) (1) The department shall allocate or expend, through contracts with community-based providers or entities or through local assistance allocations to counties or Indian tribes that have entered into an agreement pursuant to Section 10553.1, funds appropriated to the department for this purpose in the Budget Act of 2021, and in any future fiscal year, to provide and implement the recommendations of child-specific assessments, evaluations, enhanced care planning, ongoing technical assistance, and exceptional supports to meet the complex care needs of children in foster care within California within the least restrictive setting.(2) The department shall annually allocate funds to county placing agencies and tribal entities to purchase, procure, or directly provide supports or services that are needed to support the exceptional needs of a child or nonminor dependent in the least restrictive setting. Counties and tribal entities shall ensure expenditures are based upon the recommendation of a qualified individual, technical assistance provided by the department, or a clinical determination of an interagency placement committee or regional health team that considers the recommendations of a child and family team. Counties shall document these recommendations in the case plan of the child or nonminor dependent. Funds allocated pursuant to this paragraph may be expended for the following services and supports:(A) Direct services for the youth or family to help stabilize an existing placement, facilitate a new placement, or prevent a placement into foster care. Services may include, but are not limited to, accessing diagnostic testing and enhanced clinical assessments, therapies and treatments, developmental service supports, and medical and health-related services.(B) Enhanced family finding, engagement, and supports to enable placement with relatives or other family-like connections through intensive searches, or to support continued connection, engagement engagement, and support from relatives or other family-like connections. Access to funding for this purpose is permitted if the county or tribal entity has not opted into the Excellence in Family Finding, Engagement, and Support Program pursuant to Section 16546.5, or if the county or tribal entity has opted into the program and the youth has additional needs that cannot be fully met by the program.(C) Payments to providers to support respite care for caregivers.(D) Therapeutic or wraparound services.(E) Consultation or assessment with service providers or those with specialized expertise in care and treatment of youth with complex needs.(F) Durable medical equipment and supplies or other tangible items.(G) Enhanced care and supervision delivered by county staff, foster care providers, or other personnel subject to the requirements of Section 1522 of the Health and Safety Code.(H) Preplacement engagement and support and transitional support activities designed to facilitate access to therapies and treatment settings for youth.(I) Translation services in different languages, including American Sign Language.(J) Access to alternative therapies or extracurricular activities.(K) Other services or supports pursuant to guidance issued by the department, in consultation with counties.(3) Funds made available pursuant to this subdivision shall be conditioned on qualitative and outcomes standards that are established by the department. Outcomes standards shall include a continuous quality improvement process designed to address systematic gaps or barriers to meeting the needs of children and nonminor dependents in the least restrictive setting. Those outcomes standards shall be developed by the department and the State Department of Health Care Services, in consultation with counties, tribes, and other entities that may receive funding.(d) The department shall consult with the joint interagency resolution team, the County Welfare Directors Association of California, the Chief Probation Officers of California, the California Behavioral Health Directors Association of California, legislative staff, and other stakeholders with respect to the implementation of this section.(e) Funding made available to counties pursuant to this section shall only be used to supplement, and not supplant, existing funding, unless the receipt of funding or services from other sources are not readily available to meet the immediate needs of a youth, in which case the county may utilize funds appropriated pursuant to this section.(f) It is the intent of the Legislature that funding pursuant to this section that is not expended during a given fiscal year shall be made available for expenditure in the following fiscal year.
16001.1. (a) It is the intent of the Legislature to support the urgent and exceptional needs of children and nonminor dependents in foster care under the supervision of a county child welfare agency or probation department, including those who otherwise may be placed in an out-of-state residential facility.(b) (1) The department shall allocate funds appropriated to the department for this purpose in the Budget Act of 2021, and in any future fiscal year, through local assistance allocations to counties or Indian tribes that have entered into an agreement pursuant to Section 10553.1 that support new or expanded programs, services, practices, and training that builds system capacity and ensures the provision of a high-quality continuum of care that is designed to support foster children in the least restrictive setting, consistent with a childs permanency plan.(2) Pursuant to guidance and a process established by the department and the State Department of Health Care Services, in consultation with the County Welfare Directors Association of California, Chief Probation Officers of California, and County Behavioral Health Directors Association of California, fund recipients shall use the allocated funds to supplement county efforts to build system capacity for any of the following activities:(A) Specialized models of professional foster care, including therapeutic foster care, intensive services foster care, or other models as may be developed in collaboration with counties, including the County Behavioral Health Directors Association of California, and providers.(B) Intensive child-specific recruitment, family finding and engagement, and support programs for children with complex needs, including specialized permanency support services as described in Section 16501 and activities associated with the Active Supportive Intervention Services for Transition program.(C) Specialized models of integrated care and support for family-based settings, including high-fidelity wraparound, in-home nursing supports for youth with special health care needs, and community-based treatment models that create alternatives to out-of-home or residential placement.(D) Highly individualized short-term residential therapeutic programs designed to serve children with complex needs who otherwise may have been placed in an out-of-state residential facility.(E) A Childrens Crisis Continuum Pilot Program established pursuant to Chapter 6 (commencing with Section 16550).(F)Highly specialized short-term residential therapeutic programs and short-term assessment, treatment, and transition programs designed to serve children with complex trauma or cooccurring intellectual or developmental disabilities and behavioral health needs.(G)Short-term therapeutic settings that serve as an alternative to hospital-based settings and temporary placement settings.(F) Highly specialized short-term residential therapeutic programs designed to serve children with complex trauma or cooccurring intellectual or developmental disabilities and behavioral health needs.(3) Allocations made pursuant to this subdivision shall be conditioned on qualitative and outcomes standards that are established by the department, in consultation with the State Department of Health Care Services, counties, tribes, and other entities that may receive funding.(c) (1) The department shall allocate or expend, through contracts with community-based providers or entities or through local assistance allocations to counties or Indian tribes that have entered into an agreement pursuant to Section 10553.1, funds appropriated to the department for this purpose in the Budget Act of 2021, and in any future fiscal year, to provide and implement the recommendations of child-specific assessments, evaluations, enhanced care planning, ongoing technical assistance, and exceptional supports to meet the complex care needs of children in foster care within California within the least restrictive setting.(2) The department shall annually allocate funds to county placing agencies and tribal entities to purchase, procure, or directly provide supports or services that are needed to support the exceptional needs of a child or nonminor dependent in the least restrictive setting. Counties and tribal entities shall ensure expenditures are based upon the recommendation of a qualified individual, technical assistance provided by the department, or a clinical determination of an interagency placement committee or regional health team that considers the recommendations of a child and family team. Counties shall document these recommendations in the case plan of the child or nonminor dependent. Funds allocated pursuant to this paragraph may be expended for the following services and supports:(A) Direct services for the youth or family to help stabilize an existing placement, facilitate a new placement, or prevent a placement into foster care. Services may include, but are not limited to, accessing diagnostic testing and enhanced clinical assessments, therapies and treatments, developmental service supports, and medical and health-related services.(B) Enhanced family finding, engagement, and supports to enable placement with relatives or other family-like connections through intensive searches, or to support continued connection, engagement engagement, and support from relatives or other family-like connections. Access to funding for this purpose is permitted if the county or tribal entity has not opted into the Excellence in Family Finding, Engagement, and Support Program pursuant to Section 16546.5, or if the county or tribal entity has opted into the program and the youth has additional needs that cannot be fully met by the program.(C) Payments to providers to support respite care for caregivers.(D) Therapeutic or wraparound services.(E) Consultation or assessment with service providers or those with specialized expertise in care and treatment of youth with complex needs.(F) Durable medical equipment and supplies or other tangible items.(G) Enhanced care and supervision delivered by county staff, foster care providers, or other personnel subject to the requirements of Section 1522 of the Health and Safety Code.(H) Preplacement engagement and support and transitional support activities designed to facilitate access to therapies and treatment settings for youth.(I) Translation services in different languages, including American Sign Language.(J) Access to alternative therapies or extracurricular activities.(K) Other services or supports pursuant to guidance issued by the department, in consultation with counties.(3) Funds made available pursuant to this subdivision shall be conditioned on qualitative and outcomes standards that are established by the department. Outcomes standards shall include a continuous quality improvement process designed to address systematic gaps or barriers to meeting the needs of children and nonminor dependents in the least restrictive setting. Those outcomes standards shall be developed by the department and the State Department of Health Care Services, in consultation with counties, tribes, and other entities that may receive funding.(d) The department shall consult with the joint interagency resolution team, the County Welfare Directors Association of California, the Chief Probation Officers of California, the California Behavioral Health Directors Association of California, legislative staff, and other stakeholders with respect to the implementation of this section.(e) Funding made available to counties pursuant to this section shall only be used to supplement, and not supplant, existing funding, unless the receipt of funding or services from other sources are not readily available to meet the immediate needs of a youth, in which case the county may utilize funds appropriated pursuant to this section.(f) It is the intent of the Legislature that funding pursuant to this section that is not expended during a given fiscal year shall be made available for expenditure in the following fiscal year.
16001.1. (a) It is the intent of the Legislature to support the urgent and exceptional needs of children and nonminor dependents in foster care under the supervision of a county child welfare agency or probation department, including those who otherwise may be placed in an out-of-state residential facility.
(b) (1) The department shall allocate funds appropriated to the department for this purpose in the Budget Act of 2021, and in any future fiscal year, through local assistance allocations to counties or Indian tribes that have entered into an agreement pursuant to Section 10553.1 that support new or expanded programs, services, practices, and training that builds system capacity and ensures the provision of a high-quality continuum of care that is designed to support foster children in the least restrictive setting, consistent with a childs permanency plan.
(2) Pursuant to guidance and a process established by the department and the State Department of Health Care Services, in consultation with the County Welfare Directors Association of California, Chief Probation Officers of California, and County Behavioral Health Directors Association of California, fund recipients shall use the allocated funds to supplement county efforts to build system capacity for any of the following activities:
(A) Specialized models of professional foster care, including therapeutic foster care, intensive services foster care, or other models as may be developed in collaboration with counties, including the County Behavioral Health Directors Association of California, and providers.
(B) Intensive child-specific recruitment, family finding and engagement, and support programs for children with complex needs, including specialized permanency support services as described in Section 16501 and activities associated with the Active Supportive Intervention Services for Transition program.
(C) Specialized models of integrated care and support for family-based settings, including high-fidelity wraparound, in-home nursing supports for youth with special health care needs, and community-based treatment models that create alternatives to out-of-home or residential placement.
(D) Highly individualized short-term residential therapeutic programs designed to serve children with complex needs who otherwise may have been placed in an out-of-state residential facility.
(E) A Childrens Crisis Continuum Pilot Program established pursuant to Chapter 6 (commencing with Section 16550).
(F)Highly specialized short-term residential therapeutic programs and short-term assessment, treatment, and transition programs designed to serve children with complex trauma or cooccurring intellectual or developmental disabilities and behavioral health needs.
(G)Short-term therapeutic settings that serve as an alternative to hospital-based settings and temporary placement settings.
(F) Highly specialized short-term residential therapeutic programs designed to serve children with complex trauma or cooccurring intellectual or developmental disabilities and behavioral health needs.
(3) Allocations made pursuant to this subdivision shall be conditioned on qualitative and outcomes standards that are established by the department, in consultation with the State Department of Health Care Services, counties, tribes, and other entities that may receive funding.
(c) (1) The department shall allocate or expend, through contracts with community-based providers or entities or through local assistance allocations to counties or Indian tribes that have entered into an agreement pursuant to Section 10553.1, funds appropriated to the department for this purpose in the Budget Act of 2021, and in any future fiscal year, to provide and implement the recommendations of child-specific assessments, evaluations, enhanced care planning, ongoing technical assistance, and exceptional supports to meet the complex care needs of children in foster care within California within the least restrictive setting.
(2) The department shall annually allocate funds to county placing agencies and tribal entities to purchase, procure, or directly provide supports or services that are needed to support the exceptional needs of a child or nonminor dependent in the least restrictive setting. Counties and tribal entities shall ensure expenditures are based upon the recommendation of a qualified individual, technical assistance provided by the department, or a clinical determination of an interagency placement committee or regional health team that considers the recommendations of a child and family team. Counties shall document these recommendations in the case plan of the child or nonminor dependent. Funds allocated pursuant to this paragraph may be expended for the following services and supports:
(A) Direct services for the youth or family to help stabilize an existing placement, facilitate a new placement, or prevent a placement into foster care. Services may include, but are not limited to, accessing diagnostic testing and enhanced clinical assessments, therapies and treatments, developmental service supports, and medical and health-related services.
(B) Enhanced family finding, engagement, and supports to enable placement with relatives or other family-like connections through intensive searches, or to support continued connection, engagement engagement, and support from relatives or other family-like connections. Access to funding for this purpose is permitted if the county or tribal entity has not opted into the Excellence in Family Finding, Engagement, and Support Program pursuant to Section 16546.5, or if the county or tribal entity has opted into the program and the youth has additional needs that cannot be fully met by the program.
(C) Payments to providers to support respite care for caregivers.
(D) Therapeutic or wraparound services.
(E) Consultation or assessment with service providers or those with specialized expertise in care and treatment of youth with complex needs.
(F) Durable medical equipment and supplies or other tangible items.
(G) Enhanced care and supervision delivered by county staff, foster care providers, or other personnel subject to the requirements of Section 1522 of the Health and Safety Code.
(H) Preplacement engagement and support and transitional support activities designed to facilitate access to therapies and treatment settings for youth.
(I) Translation services in different languages, including American Sign Language.
(J) Access to alternative therapies or extracurricular activities.
(K) Other services or supports pursuant to guidance issued by the department, in consultation with counties.
(3) Funds made available pursuant to this subdivision shall be conditioned on qualitative and outcomes standards that are established by the department. Outcomes standards shall include a continuous quality improvement process designed to address systematic gaps or barriers to meeting the needs of children and nonminor dependents in the least restrictive setting. Those outcomes standards shall be developed by the department and the State Department of Health Care Services, in consultation with counties, tribes, and other entities that may receive funding.
(d) The department shall consult with the joint interagency resolution team, the County Welfare Directors Association of California, the Chief Probation Officers of California, the California Behavioral Health Directors Association of California, legislative staff, and other stakeholders with respect to the implementation of this section.
(e) Funding made available to counties pursuant to this section shall only be used to supplement, and not supplant, existing funding, unless the receipt of funding or services from other sources are not readily available to meet the immediate needs of a youth, in which case the county may utilize funds appropriated pursuant to this section.
(f) It is the intent of the Legislature that funding pursuant to this section that is not expended during a given fiscal year shall be made available for expenditure in the following fiscal year.
(a)To the extent that this act has an overall effect of increasing the costs already borne by a local agency for programs or levels of service mandated by the 2011 Realignment Legislation within the meaning of Section 36 of Article XIII of the California Constitution, it shall apply to local agencies only to the extent that the state provides annual funding for the cost increase. Any new program or higher level of service provided by a local agency pursuant to this act above the level for which funding has been provided shall not require a subvention of funds by the state or otherwise be subject to Section 6 of Article XIII B of the California Constitution.
(b)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.
SEC. 5. No appropriation pursuant to Section 15200 of the Welfare and Institutions Code shall be made for purposes of this act.
SEC. 5. No appropriation pursuant to Section 15200 of the Welfare and Institutions Code shall be made for purposes of this act.
SEC. 5. No appropriation pursuant to Section 15200 of the Welfare and Institutions Code shall be made for purposes of this act.
### SEC. 5.