| Old | New | Differences | |
|---|---|---|---|
| 1 | - | Amended IN | |
| 1 | + | Amended IN Senate May 18, 2023 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 16001.1 of, to add Section 11462.010 to, and to add Chapter 4.5 (commencing with Section 5425) to Part 1 of Division 5 of, 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 and short-term residential therapeutic programs. teams.(1)ExistingExisting 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 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 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. state, as specified. 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.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.(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 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.(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: NO 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 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. 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 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 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, culturally competent, and linguistically capable.(d) Regional health teams shall perform the following activities: activities, which may be delivered at a facility or through mobile services in home or other community-based settings where the youth and family are located:(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. Eligible entities shall include county behavioral health plans, community health centers, hospital-based physician groups, or others as determined by the department.(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) 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 | 2 | ||
| 3 | - | Amended IN | |
| 3 | + | Amended IN Senate May 18, 2023 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 16001.1 of, to add Section 11462.010 to, and to add Chapter 4.5 (commencing with Section 5425) to Part 1 of Division 5 of, 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 and short-term residential therapeutic programs. teams.(1)ExistingExisting 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 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 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. state, as specified. 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.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.(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 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.(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: NO | |
| 4 | 4 | ||
| 5 | - | ||
| 5 | + | Amended IN Senate May 18, 2023 Amended IN Senate May 03, 2023 Amended IN Senate March 14, 2023 | |
| 6 | 6 | ||
| 7 | - | Amended IN Assembly July 13, 2023 | |
| 8 | 7 | Amended IN Senate May 18, 2023 | |
| 9 | 8 | Amended IN Senate May 03, 2023 | |
| 10 | 9 | Amended IN Senate March 14, 2023 | |
| 11 | 10 | ||
| 12 | 11 | CALIFORNIA LEGISLATURE 20232024 REGULAR SESSION | |
| 13 | 12 | ||
| 14 | 13 | Senate Bill | |
| 15 | 14 | ||
| 16 | 15 | No. 408 | |
| 17 | 16 | ||
| 18 | - | Introduced by Senator | |
| 17 | + | Introduced by Senator AshbyFebruary 09, 2023 | |
| 19 | 18 | ||
| 20 | - | Introduced by Senator Ashby | |
| 19 | + | Introduced by Senator Ashby | |
| 21 | 20 | February 09, 2023 | |
| 22 | 21 | ||
| 23 | - | An act to add Chapter 4.5 (commencing with Section 5425) to Part 1 of Division 5 of the Welfare and Institutions Code, relating to foster youth. | |
| 22 | + | An act to amend Section 16001.1 of, to add Section 11462.010 to, and to add Chapter 4.5 (commencing with Section 5425) to Part 1 of Division 5 of, of the Welfare and Institutions Code, relating to foster youth. | |
| 24 | 23 | ||
| 25 | 24 | LEGISLATIVE COUNSEL'S DIGEST | |
| 26 | 25 | ||
| 27 | 26 | ## LEGISLATIVE COUNSEL'S DIGEST | |
| 28 | 27 | ||
| 29 | - | SB 408, as amended, Ashby. Foster youth with complex needs: regional health teams. | |
| 28 | + | SB 408, as amended, Ashby. Foster youth with complex needs: regional health teams and short-term residential therapeutic programs. teams. | |
| 30 | 29 | ||
| 31 | - | 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 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 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, developing a person-centered care plan, and coordinating and providing access to delivering various categories of care and services.The bill would require the department to fund up to provide grants, upon appropriation, to create the necessary startup infrastructure for 10 health teams that are geographically situated to support access to services equitably throughout the state, as specified. 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. as specified.The bill would condition implementation of these provisions on the availability of federal financial participation and receipt of any necessary federal approvals. The bill would authorize the department to implement these provisions through all-county letters or similar instructions. | |
| 30 | + | (1)ExistingExisting 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 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 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. state, as specified. 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.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.(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 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.(4)This bill would provide that a continuous appropriation would not be made for purposes of implementing the bill. | |
| 31 | + | ||
| 32 | + | (1)Existing | |
| 33 | + | ||
| 34 | + | ||
| 32 | 35 | ||
| 33 | 36 | 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. | |
| 34 | 37 | ||
| 35 | 38 | 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. | |
| 36 | 39 | ||
| 37 | - | 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 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, | |
| 40 | + | 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. | |
| 38 | 41 | ||
| 39 | - | The bill would require the department to fund up to | |
| 42 | + | 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. state, as specified. 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. | |
| 40 | 43 | ||
| 41 | - | The bill would condition implementation of these provisions on the availability of federal financial participation and receipt of any necessary federal approvals. The bill would authorize the department to implement these provisions through all-county letters or similar instructions. | |
| 44 | + | (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. | |
| 45 | + | ||
| 46 | + | ||
| 47 | + | ||
| 48 | + | 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. | |
| 49 | + | ||
| 50 | + | ||
| 51 | + | ||
| 52 | + | 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. | |
| 53 | + | ||
| 54 | + | ||
| 55 | + | ||
| 56 | + | 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. | |
| 57 | + | ||
| 58 | + | ||
| 59 | + | ||
| 60 | + | 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. | |
| 61 | + | ||
| 62 | + | ||
| 63 | + | ||
| 64 | + | (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. | |
| 65 | + | ||
| 66 | + | ||
| 67 | + | ||
| 68 | + | This bill would revise and expand those funding provisions, including adding to the permissible uses of 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. | |
| 69 | + | ||
| 70 | + | ||
| 71 | + | ||
| 72 | + | (4)This bill would provide that a continuous appropriation would not be made for purposes of implementing the bill. | |
| 73 | + | ||
| 74 | + | ||
| 42 | 75 | ||
| 43 | 76 | ## Digest Key | |
| 44 | 77 | ||
| 45 | 78 | ## Bill Text | |
| 46 | 79 | ||
| 47 | - | 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 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. 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, State Department of | |
| 80 | + | 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 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. 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 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 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, culturally competent, and linguistically capable.(d) Regional health teams shall perform the following activities: activities, which may be delivered at a facility or through mobile services in home or other community-based settings where the youth and family are located:(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. Eligible entities shall include county behavioral health plans, community health centers, hospital-based physician groups, or others as determined by the department.(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) 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. | |
| 48 | 81 | ||
| 49 | 82 | The people of the State of California do enact as follows: | |
| 50 | 83 | ||
| 51 | 84 | ## The people of the State of California do enact as follows: | |
| 52 | 85 | ||
| 53 | 86 | 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 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. | |
| 54 | 87 | ||
| 55 | 88 | 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 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. | |
| 56 | 89 | ||
| 57 | 90 | SECTION 1. The Legislature finds and declares all of the following: | |
| 58 | 91 | ||
| 59 | 92 | ### SECTION 1. | |
| 60 | 93 | ||
| 61 | 94 | (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. | |
| 62 | 95 | ||
| 63 | 96 | (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. | |
| 64 | 97 | ||
| 65 | 98 | (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. | |
| 66 | 99 | ||
| 67 | 100 | (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. | |
| 68 | 101 | ||
| 69 | 102 | (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 and Innovating Medi-Cal (CalAIM). | |
| 70 | 103 | ||
| 71 | 104 | (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. | |
| 72 | 105 | ||
| 73 | 106 | (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. | |
| 74 | 107 | ||
| 75 | - | 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, State Department of | |
| 108 | + | 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 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 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, culturally competent, and linguistically capable.(d) Regional health teams shall perform the following activities: activities, which may be delivered at a facility or through mobile services in home or other community-based settings where the youth and family are located:(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. Eligible entities shall include county behavioral health plans, community health centers, hospital-based physician groups, or others as determined by the department.(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) 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. | |
| 76 | 109 | ||
| 77 | 110 | 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: | |
| 78 | 111 | ||
| 79 | 112 | ### SEC. 2. | |
| 80 | 113 | ||
| 81 | - | CHAPTER 4.5. Regional Health Teams5425. (a) The department, State Department of | |
| 114 | + | 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 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 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, culturally competent, and linguistically capable.(d) Regional health teams shall perform the following activities: activities, which may be delivered at a facility or through mobile services in home or other community-based settings where the youth and family are located:(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. Eligible entities shall include county behavioral health plans, community health centers, hospital-based physician groups, or others as determined by the department.(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) 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. | |
| 82 | 115 | ||
| 83 | - | CHAPTER 4.5. Regional Health Teams5425. (a) The department, State Department of | |
| 116 | + | 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 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 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, culturally competent, and linguistically capable.(d) Regional health teams shall perform the following activities: activities, which may be delivered at a facility or through mobile services in home or other community-based settings where the youth and family are located:(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. Eligible entities shall include county behavioral health plans, community health centers, hospital-based physician groups, or others as determined by the department.(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) 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. | |
| 84 | 117 | ||
| 85 | 118 | CHAPTER 4.5. Regional Health Teams | |
| 86 | 119 | ||
| 87 | 120 | CHAPTER 4.5. Regional Health Teams | |
| 88 | 121 | ||
| 89 | - | 5425. (a) The department | |
| 122 | + | 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 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 Center Agencies, interested counties, and other stakeholders, as deemed appropriate, to develop the regional health teams. | |
| 90 | 123 | ||
| 91 | 124 | ||
| 92 | 125 | ||
| 93 | - | 5425. (a) The department | |
| 126 | + | 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 Section 1945 of the federal Social Security Act, as added by Section 2703 of the federal Patient Protection and Affordable Care Act. | |
| 94 | 127 | ||
| 95 | 128 | (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 Center Agencies, interested counties, and other stakeholders, as deemed appropriate, to develop the regional health teams. | |
| 96 | 129 | ||
| 97 | - | 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 | |
| 130 | + | 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, culturally competent, and linguistically capable.(d) Regional health teams shall perform the following activities: activities, which may be delivered at a facility or through mobile services in home or other community-based settings where the youth and family are located:(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. Eligible entities shall include county behavioral health plans, community health centers, hospital-based physician groups, or others as determined by the department.(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) 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. | |
| 98 | 131 | ||
| 99 | 132 | ||
| 100 | 133 | ||
| 101 | 134 | 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. | |
| 102 | 135 | ||
| 103 | 136 | (b) Regional health teams shall be physician led and shall be composed of, at a minimum, the following members: | |
| 104 | 137 | ||
| 105 | - | (1) A physician. | |
| 138 | + | (1) A primary care physician. | |
| 106 | 139 | ||
| 107 | - | (2) A licensed clinical social worker. | |
| 140 | + | (2) A licensed clinical social worker. | |
| 108 | 141 | ||
| 109 | 142 | (3) A public health nurse. | |
| 110 | 143 | ||
| 111 | 144 | (4) A nutritionist or dietitian. | |
| 112 | 145 | ||
| 113 | 146 | (5) An occupational therapist. | |
| 114 | 147 | ||
| 115 | 148 | (6) A community health worker. | |
| 116 | 149 | ||
| 117 | 150 | (7) A peer support specialist. | |
| 118 | 151 | ||
| 119 | 152 | (8) A training coordinator. | |
| 120 | 153 | ||
| 121 | 154 | (9) Additional behavioral health staff as appropriate. | |
| 122 | 155 | ||
| 123 | 156 | (c) All team members shall be responsible for ensuring that care is person centered, culturally competent, and linguistically capable. | |
| 124 | 157 | ||
| 125 | - | (d) Regional health teams shall perform the following activities, which may be delivered at a facility or through mobile services in home or other community-based settings where the youth and | |
| 158 | + | (d) Regional health teams shall perform the following activities: activities, which may be delivered at a facility or through mobile services in home or other community-based settings where the youth and family are located: | |
| 126 | 159 | ||
| 127 | - | (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 | |
| 160 | + | (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. | |
| 128 | 161 | ||
| 129 | - | (2) | |
| 162 | + | (2) Provide quality-driven, cost-effective, culturally appropriate, and person- and family-centered health home services. | |
| 130 | 163 | ||
| 131 | - | ( | |
| 164 | + | (3) Coordinate and provide access to high-quality health care services informed by evidence-based clinical practice guidelines. | |
| 132 | 165 | ||
| 133 | - | ( | |
| 166 | + | (4) Coordinate and provide access to preventive and health promotion services, including prevention of mental illness and substance use disorders. | |
| 134 | 167 | ||
| 168 | + | (5) Coordinate and provide access to mental health and substance abuse services. | |
| 135 | 169 | ||
| 170 | + | (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. | |
| 136 | 171 | ||
| 137 | - | ( | |
| 172 | + | (7) Coordinate and provide access to chronic disease management, including self-management support to individuals and their families. | |
| 138 | 173 | ||
| 139 | - | (3) | |
| 140 | - | ||
| 141 | - | ||
| 142 | - | ||
| 143 | - | (ii) Coordinate and provide access to deliver high-quality health care services informed by evidence-based clinical practice guidelines. | |
| 144 | - | ||
| 145 | - | (4) | |
| 146 | - | ||
| 147 | - | ||
| 148 | - | ||
| 149 | - | (iii) Coordinate and provide access to deliver preventive and health promotion services, including prevention of mental illness and substance use disorders. | |
| 150 | - | ||
| 151 | - | (5) | |
| 152 | - | ||
| 153 | - | ||
| 154 | - | ||
| 155 | - | (iv) Coordinate and provide access to deliver mental health and substance abuse services. If the child or youth already has a mental health provider, the regional health team shall attempt to engage with that provider in order to exchange relevant information and provide guidance to the treating mental health provider, upon the agreement of the individual served or their medical rights holder. | |
| 156 | - | ||
| 157 | - | (6) | |
| 158 | - | ||
| 159 | - | ||
| 160 | - | ||
| 161 | - | (v) Coordinate and provide access to deliver 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. | |
| 162 | - | ||
| 163 | - | (7) | |
| 164 | - | ||
| 165 | - | ||
| 166 | - | ||
| 167 | - | (vi) Coordinate and provide access to deliver chronic disease management, including self-management support to individuals and their families. | |
| 168 | - | ||
| 169 | - | (8) | |
| 170 | - | ||
| 171 | - | ||
| 172 | - | ||
| 173 | - | (vii) Coordinate and provide access to deliver individual and family supports, including linkage to community, social support, and recovery services. | |
| 174 | + | (8) Coordinate and provide access to individual and family supports, including linkage to community, social support, and recovery services. | |
| 174 | 175 | ||
| 175 | 176 | (9) Coordinate and provide access to long-term care supports and services. | |
| 176 | 177 | ||
| 177 | - | ||
| 178 | - | ||
| 179 | - | (viii) Develop transition plans with individuals and their families. | |
| 180 | - | ||
| 181 | - | (e) Regional health teams shall implement each of the following strategies to support their delivery of services: | |
| 182 | - | ||
| 183 | - | (10) | |
| 184 | - | ||
| 185 | - | ||
| 186 | - | ||
| 187 | - | (1) Promote evidence-based medicine and utilize patient engagement strategies in the implementation of client plans. | |
| 178 | + | (10) Promote evidence-based medicine and utilize patient engagement strategies in the implementation of client plans. | |
| 188 | 179 | ||
| 189 | 180 | (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. | |
| 190 | 181 | ||
| 182 | + | (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. | |
| 191 | 183 | ||
| 184 | + | (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. | |
| 192 | 185 | ||
| 193 | - | ( | |
| 186 | + | (14) Conduct staff training within the regional health team and with other service providers to improve direct care and patient outcomes. | |
| 194 | 187 | ||
| 188 | + | (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. | |
| 195 | 189 | ||
| 190 | + | (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. Eligible entities shall include county behavioral health plans, community health centers, hospital-based physician groups, or others as determined by the department. | |
| 196 | 191 | ||
| 197 | - | ( | |
| 192 | + | (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. | |
| 198 | 193 | ||
| 199 | - | (13) | |
| 200 | - | ||
| 201 | - | ||
| 202 | - | ||
| 203 | - | (3) 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. | |
| 204 | - | ||
| 205 | - | (14) | |
| 206 | - | ||
| 207 | - | ||
| 208 | - | ||
| 209 | - | (4) Conduct staff training within the regional health team and with other service providers to improve direct care and patient outcomes. | |
| 210 | - | ||
| 211 | - | (e) | |
| 212 | - | ||
| 213 | - | ||
| 214 | - | ||
| 215 | - | (f) 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. | |
| 216 | - | ||
| 217 | - | (f)The department shall fund up to | |
| 218 | - | ||
| 219 | - | ||
| 220 | - | ||
| 221 | - | (g) Subject to an appropriation made by the Legislature for this purpose, the department shall provide grants to create the necessary startup infrastructure for 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. Eligible entities shall include county behavioral health plans, community health centers, hospital-based physician groups, or others as determined by the department. | |
| 222 | - | ||
| 223 | - | (g) | |
| 224 | - | ||
| 225 | - | ||
| 226 | - | ||
| 227 | - | (h) The department, in consultation with the stakeholders identified in subdivision (b) of Section 5425, shall establish do both of the following: | |
| 228 | - | ||
| 229 | - | (1) 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. | |
| 230 | - | ||
| 231 | - | (2) Develop a payment methodology, including, but not limited to, fee-for-service or per-member per-month (PMPM) payment structures that may include tiered payment rates that take into account the intensity of services provided by regional health teams pursuant to this chapter. | |
| 232 | - | ||
| 233 | - | (h) | |
| 234 | - | ||
| 235 | - | ||
| 236 | - | ||
| 237 | - | (i) 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. waivers, in accordance with Section 5427. | |
| 238 | - | ||
| 239 | - | 5427. (a) This chapter shall be implemented only to the extent that federal financial participation is available and any necessary federal approvals have been obtained.(b) Notwithstanding 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 chapter by means of all-county letters, plan letters, plan or provider bulletins, or similar instructions, without taking any further regulatory action. | |
| 240 | - | ||
| 241 | - | ||
| 242 | - | ||
| 243 | - | 5427. (a) This chapter shall be implemented only to the extent that federal financial participation is available and any necessary federal approvals have been obtained. | |
| 244 | - | ||
| 245 | - | (b) Notwithstanding 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 chapter by means of all-county letters, plan letters, plan or provider bulletins, or similar instructions, without taking any further regulatory action. | |
| 194 | + | (h) 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. |