16553. (Added by Stats. 2021, Ch. 86, Sec. 53.)

(b) (1) A participating entity shall develop, in collaboration with a workgroup, a highly integrated continuum of care for the foster youth served in the pilot program. Except where otherwise indicated in this chapter, the continuum of care shall be designed within current statutes and regulations for crisis stabilization units, children’s crisis residential programs, psychiatric health facilities, intensive services foster care and other resource families, and short-term residential therapeutic programs to permit the seamless transition for the appropriate treatment of the foster youth, between treatment settings and programs. The continuum shall include, at a minimum, all of the following:

(A) A crisis stabilization unit.

(i) The crisis stabilization unit shall have the capacity to provide assessment and stabilization for up to 23 hours and 59 minutes for up to eight foster youth, be licensed as a 24-hour health care facility or hospital-based outpatient program or provider site, and comply with all regulations contained in Chapter 11 (commencing with Section 1810.100) of Division 1 of Title 9 of the California Code of Regulations that are applicable to the provision of crisis stabilization, and specifically including Section 1810.210.

(ii) The crisis stabilization unit shall be colocated with, or within 30 miles of, a psychiatric health facility or other secure hospital alternative setting capable of meeting the needs of youth experiencing a mental health crisis in order to reduce delays in care when the host county mental health plan has found inpatient treatment to be medically necessary.

(B) A crisis residential program.

(i) The crisis residential program shall provide highly individualized stabilization services for foster youth who do not require inpatient treatment. The crisis residential program shall be operated in accordance with all statutes and regulations governing the placements of foster youth, including the California Community Care Facilities Act (Article 1 (commencing with Section 1500) of Chapter 3 of Division 2 of the Health and Safety Code). The crisis residential program shall be operated in accordance with all statutes and regulations governing its licensure category, including, for short-term residential therapeutic programs, the interagency placement committee process established pursuant to Section 4096.

(ii) The crisis residential program may be a program that receives funding pursuant to paragraph (3) of subdivision (a) of Section 11460 to the extent federal Medicaid funding is not available and is not otherwise jeopardized.

(iii) The crisis residential program shall not serve more than four foster youth at a time.

(C) A psychiatric health facility, as defined in Section 1250.2 of the Health and Safety Code.

(i) The psychiatric health facility shall be licensed by the State Department of Health Care Services and shall provide a secure, highly individualized, therapeutic, hospital-like setting for foster youth who require inpatient treatment and shall be operated in accordance with Chapter 9 (commencing with Section 77001) of Division 5 of Title 22 of the California Code of Regulations.

(ii) The psychiatric health facility shall not have more than four beds.

(iii) Before placement into a psychiatric health facility, the participating entity shall submit a report to the director or the director’s designee using a template established by the department, in collaboration with the State Department of Health Care Services and county entities. The report shall include a statement describing the circumstances that necessitate a psychiatric health facility placement, the results of assessments, prior services provided to the foster youth, the anticipated duration of the treatment in the setting, and identification of any barriers to serving the foster youth in a less restrictive setting.

(iv) These intensive crisis programs shall be integrated with community-based supports and tiered placement settings, including Intensive Services Foster Care (ISFC) and Enhanced ISFC homes.

(D) Intensive services foster care homes participating in this pilot that have integrated specialty mental health services.

(i) To support foster youth in stepping down to less restrictive placements and maintain available capacity in more acute treatment settings, a participating entity shall maintain at least two times the number of intensive services foster care homes participating in this pilot as the number of beds available in the treatment settings described in subparagraphs (A) to (C), inclusive.

(ii) Intensive services foster care homes participating in this pilot shall be enhanced to include in-home staff who are available to provide care, additional behavioral support, permanency services, specialty mental health services, and educational services 24 hours a day, 7 days a week, as needed.

(iii) The residence of an intensive services foster care home participating in this pilot may be owned or operated by the foster parent or parents, a county, or by a private nonprofit organization. For purposes of this chapter, the limitations of Section 18360.35 do not apply.

(E) Community-based supportive services.

(i) Community-based supportive services shall be available 24 hours a day, 7 days a week.

(ii) A participating entity shall utilize a community-based model that provides intensive transition planning and aftercare services using a team approach. Each county child welfare agency, probation department, and mental health plan, in consultation with the local interagency leadership team established pursuant to Section 16521.6, shall jointly provide, arrange for, or ensure the provision of, at least six months of aftercare services for foster youth in the placement and care responsibility of the county child welfare agency or county probation department who are discharged from a short-term residential therapeutic program to a family-based setting. The model shall include the development of an individualized family-based aftercare support plan that identifies necessary supports, services, and treatment.

(iii) Community-based supportive services shall be available to provide front-end and back-end integrated transition services and supports to continue treatment gains made in more restrictive placements and minimize reliance on interventions that may be traumatic for foster youth, including ambulance transport, emergency department visits, and law enforcement involvement.

(iv) Community-based supportive services shall include an intensive transition planning team consisting of, at a minimum, a mental health professional with a master’s degree who is either licensed or license-eligible, a support counselor with a bachelor’s degree, and a peer partner. An expedited transition planning services team may serve up to four foster youth at a time and shall have the ability to support foster youth in any out-of-home treatment setting in the continuum of care. The department may approve an alternate proposal for these transition planning services, including modified standards.

(2) Notwithstanding paragraph (1), the department may consider a proposal that does not include a psychiatric health facility, or a psychiatric health facility and a crisis stabilization unit.

(c) A participating entity shall provide a foster youth participating in the continuum of care, or ensure foster youth participating in the continuum of care are provided, with all of the following:

(1) One-on-one services, when clinically indicated.

(2) Single occupancy rooms, unless a double occupancy room is clinically indicated by the individual plan of care developed by a multidisciplinary treatment team.

(3) A deinstitutionalized environment with warm and comforting decor, food, and clothing that maintains safety at all times.

(d) The continuum of care created by a participating entity shall, across all service settings, reflect all of the following core program features and service approaches:

(1) Highly individualized and trauma-informed services.

(2) Culturally and linguistically responsive and competent treatment.

(3) Alignment with the integrated core practice model and a commitment to encouraging the voices of foster youth and their families and a team approach to all decisionmaking. The child and family team shall be involved in all treatment planning and decisions and family engagement and involvement in treatment shall be central to all programs within the continuum of care.

(4) Coordinated and streamlined assessment practices to ensure that level-of-care determinations are appropriate and that foster youth are able transition between more restrictive and less restrictive placements across the continuum of care, as needed.

(e) A participating entity shall establish policies and procedures that demonstrate compliance at all times with the notification and due process requirements of the Lanterman-Petris-Short Act (Chapter 1 (commencing with Section 5000) of Part 1 of Division 5) and any other applicable laws pertaining to involuntary treatment. This subdivision does not limit the protections to foster youth related to voluntary or involuntary treatment settings.

(f) The department, jointly with the State Department of Health Care Services, may establish operational procedures, performance and evaluation standards, and utilization criteria for participating entities pursuant to this section. These standards and criteria shall be developed in consultation with the State Department of Developmental Services, the State Department of Education, the Judicial Council of California, county placing agencies, behavioral health plans, and other interested stakeholders.