11462.04. (Amended by Stats. 2020, Ch. 370, Sec. 276.)

(b) Notwithstanding subdivision (a), the department may grant an exception as appropriate, on a case-by-case basis, when a written request and supporting documentation are provided by a county placing agency, including a county welfare or probation director, that absent the granting of that exception, there is a material risk to the welfare of children due to an inadequate supply of appropriate alternative placement options to meet the needs of children.

(c) For group homes being paid under the RCL system, and those granted an exception pursuant to paragraph (b), group home rates shall terminate on December 31, 2016, unless granted an extension under the exception process in subdivision (d) or (e).

(d) A group home may request an exception to extend its rate as follows:

(1) The department may grant an extension for up to two years, through December 31, 2018, except as provided in paragraph (2), on a case-by-case basis, when a written request and supporting documentation are provided by a county placing agency, including a county welfare or probation director, that absent the granting of that exception, there is a material risk to the welfare of children due to an inadequate supply of appropriate alternative placement options to meet the needs of children. The exception may include time to meet the program accreditation requirement or the mental health certification requirement.

(A) The department may grant an additional extension to a group home beyond December 31, 2018, upon a county child welfare agency submitting a written request on behalf of a provider and providing documentation in a format to be determined by the department pursuant to subparagraph (B). If granted, the extension requests shall be provided in increments up to six months and may be renewed by the department if the documentation is provided. Extensions granted pursuant to this subparagraph shall not exceed a total of 12 months.

(B) In order to be eligible to maintain placement of placed foster youth in a group home receiving an extension pursuant to subparagraph (A), the county child welfare agency, in partnership with the county mental health plan, shall submit a plan to the department by August 15, 2018. This plan shall do all of the following:

(i) Describe the agency’s plan to transition all foster youth under the jurisdiction of the county residing in group homes into a home-based placement, or, if determined by the interagency placement committee, to a licensed short-term residential therapeutic program (STRTP) within the extension period.

(ii) Address the need, availability, and capacity of STRTPs and other therapeutic placement options for the youth under the jurisdiction of the county and document prior and ongoing efforts taken to solicit or develop needed STRTP capacity.

(iii) Develop and document child specific transition plans that include a description of all of the following:

(I) Intensive family finding and engagement for every child lacking an identified home-based caregiver, including those youth identified for STRTP transition.

(II) Child and family team-driven case plans that identify and respond to barriers to home-based placement.

(III) Documentation of the trauma-informed and permanency-competent specialty mental health services to be provided, including wraparound, collateral, intensive care coordination and intensive home-based services, and therapeutic behavioral services.

(iv) Document efforts to expand or establish intensive services foster care, therapeutic foster care programs, and other home-based services that provide timely access to trauma-informed care, in conjunction with the county behavioral health department.

(v) Detail any barriers to achieving the goals in clauses (i) to (iv), inclusive, that have led the county to support the extension.

(vi) Identify any additional solutions to the barriers that are not addressed in the efforts identified in clauses (i) to (iv), inclusive, which may include needed action from partner agencies such as county boards of supervisors, county behavioral health directors, the department, the State Department of Health Care Services, STRTPs, foster family agencies, or other local agencies, including, but not limited to, regional centers and special education agencies, that would aid the county child welfare agency in delivering appropriate services to foster youth.

(C) The department shall require a provider on whose behalf an extension is being sought pursuant to subparagraph (A) to document the provider’s efforts to convert to an STRTP, foster family agency, or other service provider.

(2) Pursuant to Section 11462.041, after the expiration of the extension afforded in paragraph (1), the department may grant an additional extension to a group home beyond December 31, 2018, upon a provider submitting a written request and the county probation department providing documentation stating that absent the granting of that extension, there is a significant risk to the safety of the youth or the public, due to an inadequate supply of short-term residential therapeutic programs or resource families necessary to meet the needs of probation youth. The extension granted to any provider through this section may be reviewed annually by the department if concerns arise regarding that provider’s facility. Pursuant to subdivision (e) of Section 11462.041, the final report submitted to the Legislature shall address whether or not the extensions are still necessary.

(3) The exception shall allow the provider to continue to receive the rate under the prior ratesetting system.

(4) A provider granted an extension pursuant to this section shall continue to operate and be governed by the applicable laws and regulations that were operative on December 31, 2016.

(5) If the exception request granted pursuant to this subdivision is not made by the host county, the placing county shall notify and provide a copy to the host county.

(e) (1) It is the intent of the Legislature to ensure that foster youth with more intensive needs receive timely access to services and supports that will reduce the use of, and the length of stay in, congregate care settings, while acknowledging that the ultimate goal for these youth is placement in a home-based setting that will lead to permanency. It is also the intent of the Legislature to acknowledge that continued development of home-based intensive services capacity is necessary to reduce the use of congregate care, and that state and county agencies and foster care providers must work together during the extension period described in this section to address the barriers to building the needed capacity to serve foster youth in a variety of high-quality settings.

(2) The department may grant an extension to a group home beyond December 31, 2019, and until December 31, 2020, upon a county child welfare agency submitting a written request on behalf of a provider that includes an update to any previously submitted documentation described in subdivision (d). In order to be eligible to maintain placement of placed foster youth in a group home receiving an extension pursuant to this subdivision, the county child welfare agency and the county mental health plan shall submit a collaborative plan to the department and the State Department of Health Care Services by December 15, 2019. The plan shall do all of the following:

(A) Update the child-specific transition plans previously submitted pursuant to clause (iii) of subparagraph (B) of paragraph (1) of subdivision (d), or provide new child-specific transition plans, if not previously submitted, for any foster youth who remains in a group home that is currently transitioning to STRTP licensure and for any foster child who remains in a group home that is not transitioning to STRTP licensure, as evidenced by the department not having received an STRTP program statement or having been denied licensure as an STRTP. The updated or new child-specific transition plans shall include the following:

(i) Verification that family finding activities were previously attempted on behalf of the child and a description of family finding activities currently underway, or other activities to connect the child to caring adults outside of the congregate care setting who can provide emotional support to the child.

(ii) A summary of child and family team meetings and case plan efforts to address the child’s strengths and needs, as informed by the Child and Adolescent Needs and Strengths (CANS) assessment, and any planned activities to support the child’s transition to another appropriate placement.

(iii) A summary of the specialty mental health services planned or provided to the child to support the case plan goals, as informed by the CANS assessment and the child and family team.

(B) Based on an analysis by the department, in consultation with the county child welfare agencies and behavioral health agencies, update and validate the needed congregate care capacity and capacity of intensive, home-based services as an alternative to congregate care and existing or planned contracts with congregate care or family-based providers.

(C) Identify any existing or planned contracts or efforts to directly provide or contract for intensive family finding and child-specific recruitment for children in congregate care or other family-based settings.

(D) Identify any existing or planned specialty mental health services targeted to address the mental health service needs of a foster child transitioning from congregate care to permanency or other family-based care setting and any gaps that remain. For children residing in group homes who require the level of care provided by an STRTP, as determined by an interagency placement committee, or who are placed into an STRTP without a mental health contract, provide a description of the specialty mental health services arranged for by the county mental health plan to address the mental health service needs of children placed into the facilities.

(3) A county that did not submit a request and plan for extension pursuant to subparagraph (B) of paragraph (1) of subdivision (d), may submit a request for an extension pursuant to this subdivision, but the county shall also submit the information required pursuant to paragraph (2) of subdivision (d).

(4) The department, the State Department of Health Care Services, the County Welfare Directors Association of California, the County Behavioral Health Directors Association of California, the Chief Probation Officers of California, the California Alliance of Child and Family Services, and other stakeholders, shall meet to develop a collaborative plan to address barriers to building high-quality services in residential treatment programs and in family-based settings, including, but not limited to, all of the following:

(A) Developing technical assistance to support youth who have more intensive service needs to prevent placement disruptions and out-of-state placements and support transitions to relative-based care or other family-based care.

(B) Identifying ways to increase intensive family-based home capacity to support foster youth transitioning from congregate care and to prevent congregate care placement.

(C) Identifying systemic improvements and technical assistance options to assist providers in navigating processes, such as STRTP licensure, mental health plan approval, Medi-Cal billing, Medi-Cal certification, implementing trauma-informed programming and services, and transitioning to other facility types and services.

(D) Evaluating the timing of STRTP licensure, accreditation, mental health plan approval, and Medi-Cal certification processes to facilitate the conversion of quality group homes into licensed STRTPs and make recommendations regarding adjustments to those timelines.

(f) (1) The extended rate granted pursuant to either paragraph (1) or (2) of subdivision (d) or subdivision (e) shall be provisional and subject to terms and conditions set by the department during the provisional period.

(2) Consistent with Section 11466.01, for provisional rates, the following shall be established:

(A) Terms and conditions, including the duration of the provisional rate.

(B) An administrative review process for provisional rate determinations, including denials, reductions, and terminations.

(C) An administrative review process that includes a departmental review, corrective action, and a protest with the department. Notwithstanding the rulemaking provisions of the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code), this process shall be disseminated by written directive pending the promulgation of regulations.

(g) Upon termination of an existing group home rate under the RCL system, a new rate shall not be paid until an application is approved and a rate is granted by the department pursuant to Section 11462 as a short-term residential therapeutic program or, effective January 1, 2017, the rate set pursuant to Section 11463 as a foster family agency.

(h) The department shall, in the development of the new rate structures, consider and provide for placement of all children who are displaced as a result of reclassification of treatment facilities.

(i) Notwithstanding the provisions of the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code), the department may implement this section through all-county letters.