HomeMy WebLinkAboutMINUTES - 06092015 - C.47RECOMMENDATION(S):
ADOPT a "Support" position on SB 238 (Mitchell), as amended: Foster Care: Psychotropic Medication, a bill that
would enable county social workers and other key parties to provide more comprehensive oversight for children
receiving child welfare services (CWS) who are prescribed psychotropic medications, as recommended by the
Legislation Committee.
FISCAL IMPACT:
Fiscal Impact to State Budget:
Training development: Potentially significant one-time costs (General Fund) to DSS for the development of the
training component for licensed foster parents, group home administrators, relative and nonrelative extended
family members, court-appointed counsel, child protective services staff, and mandated reporters.
Periodic oversight: Annual costs to the courts of $1.6 million (General Fund*) for workload associated with
document management of monthly reports. Associated costs for county workers are noted under ‘Child
Welfare Services’. Staff notes costs would be dependent on the meaning of “periodic,” which is undefined in
the bill but assumed to be specified in the rules of court to be adopted by the Judicial Council.
APPROVE OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
Action of Board On: 06/09/2015 APPROVED AS RECOMMENDED OTHER
Clerks Notes:
VOTE OF SUPERVISORS
AYE:John Gioia, District I
Supervisor
Candace Andersen, District II
Supervisor
Mary N. Piepho, District III
Supervisor
Karen Mitchoff, District IV
Supervisor
ABSENT:Federal D. Glover, District V
Supervisor
Contact: L. DeLaney, 925-335-1097
I hereby certify that this is a true and correct copy of an action taken and entered on the minutes of the
Board of Supervisors on the date shown.
ATTESTED: June 9, 2015
David Twa, County Administrator and Clerk of the Board of Supervisors
By: June McHuen, Deputy
cc:
C. 47
To:Board of Supervisors
From:LEGISLATION COMMITTEE
Date:June 9, 2015
Contra
Costa
County
Subject:SB 238 (Mitchell) Foster Care: Psychotropic Medication
FISCAL IMPACT: (CONT'D)
Judicial Council Forms/Updates: One-time costs of $77,000 (General Fund*).
Individualized monthly report: Potentially moderate one-time costs in the low hundreds of thousands of dollars
(General Fund) for DSS to develop the monthly report and associated form, to the extent DSS and DHCS are
able to utilize preexisting data from their respective databases to develop the report.
Automatic alert system: Unknown, but potentially major one-time costs potentially in the millions of dollars
(General Fund) for DSS to develop or ensure access to a system that automatically alerts social workers when
psychotropic medication has been prescribed to youth, subject to specified conditions.
Child welfare services: Major costs potentially in the tens of millions of dollars (General Fund**) annually for
increased costs incurred by county social workers, public health nurses, and other county staff for time to attend
additional training, complete more comprehensive court forms, facilitate periodic oversight hearings, respond to
automatic alerts, provide notifications, and provide additional follow-up. While the magnitude of workload
required to meet the mandates in this bill are unknown at this time, for context, even two additional hours per
month of social worker time for the 6,100 youth authorized to receive psychotropic medications would result in
costs of over $10.7 million.
Proposition 30**: Exempts the State from mandate reimbursement for realigned programs, however, legislation
that has an overall effect of increasing the costs already borne by a local agency for realigned programs,
including child welfare services, apply to local agencies only to the extent that the State provides annual funding
for the cost increase.
*Trial Court Trust Fund
Source: Senate Appropriations Committee bill analysis
BACKGROUND:
At its May 7, 2015 meeting, the Legislation Committee considered and accepted the recommendation from the
Assistant Director of Policy and Planning for Employment and Human Services Department to recommend a
position of "Support" to the Board of Supervisors on SB 238.
Introduced: 02/17/2015
Last Amend: 04/07/2015
Disposition: Pending
Location: Senate Appropriations Committee
Status: 05/28/2015 Hearing n SENATE Committee on APPROPRIATIONS.
Bill Summary:
SB 238 would require additional training, oversight, and data collection and reporting by specified entities
involved in the process of the administration of psychotropic medication in the foster care system. This bill would
require the Judicial Council, on or before July 1, 2016, in consultation with various stakeholders, to develop
updates to the forms required to implement the bill’s provisions, as specified.
Background:
Existing law provides that only a juvenile court judicial officer shall have authority to make orders regarding the
administration of psychotropic medications for a minor who has been adjudged a dependent of the court and
removed from the physical custody of his or her parent. Existing law also requires the Judicial Council to adopt
rules of court and develop appropriate forms. (Welfare and Institutions Code § 369.5.)
Pursuant to Rule of Court 5.640, the prescribing physician is required to complete and submit an application to the
court, known as the “JV-220” form. The JV-220 requires the inclusion of specific information, including: (1) the
child’s diagnosis; (2) the specific medication with the recommended maximum daily dosage and length of time
this course of treatment will continue; (3) the anticipated benefits to the child from the use of the medication; (4) a
list of any other medications, prescription or otherwise, that the child is currently taking, and a description of any
effect these medications may produce in combination with the psychotropic medication; and (5) a statement that
the child has been informed in an age-appropriate manner of the recommended course of treatment, the basis for
it, and its possible results. The court is required, upon review of the JV- 220, to deny, grant, or modify the
application for authorization of psychotropic medication within seven days, or to set the matter for hearing. The
court may also set a date for review of the child’s progress and condition.
As noted in the recent analysis of this measure by the Senate Committee on Judiciary (April 28, 2015):
Governing magazine recently noted that children in the United States are on drugs for longer and more often than
kids in any other country. (Chris Kardish, Bad Medicine: How states are overmedicating low-income kids,
Governing, March 2015.) Much of the concern stems from the fact that the long-term effects of psychotropic drugs
on children are unknown, and the short term effects, including obesity, diabetes, and tremors, can be debilitating.
Yet, many medical and child welfare professionals agree that some foster youth may benefit from these
medications at some point in their lives. These children, who have suffered abuse and neglect at the hands of
family, often have clinically significant emotional or behavioral problems. However, when psychotropic
medications are prescribed to a foster child whose parent has been found, at least temporarily, unfit to approve
the administration of the drugs, the question arises as to whether the court is capable of making the important
inquiries that a parent should make before administering any medication to his or her child. (p.2)
Proposed Law:
This bill would provide for various reforms to the process of the administration of psychotropic medication in the
foster care system by requiring additional training, oversight, and data collection, as specified. This bill would
require the Judicial Council, in consultation with various stakeholders, to implement the provisions of this bill.
Specifically, this bill:
Requires trainings for the following groups to additionally include the authorization, uses, risks, benefits,
administration, oversight, and monitoring of psychotropic medication, and trauma, behavioral health, and other
available behavioral health treatments, for children receiving child welfare services, including how to access those
treatments:
o Group home administrator certification;
o Initial pre-placement training of licensed foster parents;
o Post-training of licensed foster parents;
o Training required to be made available to relative and nonrelative extended family members through community
college districts;
o Judicial Council-developed training for dependency judges;
o Training of court-appointed counsel of a child or nonminor dependent;
o Training provided to specified county child protective services social workers, agencies under contract with
county welfare departments to provide child welfare services, and persons defined as mandated reporters pursuant
to the Child Abuse and Neglect Reporting Act.
Requires the Judicial Council, on or before July 1, 2016, in consultation with DSS, the Department of Health Care
Services (DHCS), and specified stakeholders to implement and develop updates to the required forms pertaining to
this bill.
Requires a process for periodic oversight by the court, that is to be facilitated by the county social worker, public
health nurse, or other appropriate county staff, of orders regarding the administration of psychotropic medications
that includes the following:
o The child and his or her caregiver and court-appointed special advocate, if any, have a meaningful opportunity
to provide input on the medications being prescribed;
o Information regarding the child’s overall behavioral health assessment and treatment plan is provided to the
court;
o Information regarding the rationale for the proposed medication, including information on other
pharmacological and non-pharmacological treatments that have been utilized and the child’s response, and an
explanation how the psychotropic medication being prescribed is expected to improve the symptoms;
o Guidance is provided to the court on how to evaluate the request for authorization, including how to proceed if
information, otherwise required to be included in a request for authorization, is not included in a request.
Requires DSS, in consultation with DHCS, the County Welfare Directors Association (CWDA) and other
stakeholders to develop and provide an individualized monthly report to each county child welfare services
agency that includes the following for each child receiving child welfare services:
o Psychotropic medications that have been authorized for the child by the court;
o Data for medications that have been dispensed to the child, including both psychotropic and non-psychotropic
medication;
o Durational information relating to the child’s authorized psychotropic medication, including, but not limited to,
the length of time a medication has been authorized and the length of time for which a medication has been
dispensed by a pharmacy;
o Claims paid for behavioral health services provided to the child, other than claims paid for psychotropic
medication; and
o The dosages of psychotropic medications that have been authorized for the child and that have been dispensed.
Requires DSS, in consultation with DHCS, CDWA and other stakeholders, to develop a form, to be used by a
county child welfare services agency on a monthly basis, to share with the juvenile court, the child’s attorney, and
the court-appointed special advocate, if one has been appointed, the above information regarding a child receiving
child welfare services authorized to receive one or more psychotropic medication.
Requires DSS in consultation with DHCS, CWDA, and other stakeholders to develop, or ensure access to, a
system that automatically alerts a social worker of a child receiving child welfare services when psychotropic
medication has been prescribed that fits the following descriptions:
o Is prescribed in combination with another psychotropic medication and the combination is unusual or has the
potential for a dangerous interaction;
o Is prescribed in a dosage that is unusual for a child of that age; and
o Is not typically indicated for a child of that age.
Requires a child’s social worker, upon receipt of an alert, to indicate to the court that the alert has been received
by the child’s attorney, the child’s caregiver, and the child’s court appointed special advocate, if one has been
appointed
Related Legislation:
SB 253 (Monning) 2015 provides that an order of the juvenile court authorizing psychotropic medication shall
require clear and convincing evidence of specified conditions. This bill prohibits the authorization of psychotropic
medications without a second independent medical opinion under specified circumstances. It also prohibits the
authorization of psychotropic medications unless the court is provided documentation that appropriate lab
screenings, measurements, or tests have been completed, as specified. This bill is pending hearing in this
Committee.
SB 484 (Beall) 2015 requires the CDSS to publish and make available to interested persons specified information
regarding the administration of psychotropic medication in residential facilities serving dependent children.
Additionally, it requires DSS to inspect facilities at least once per year, as specified, if the facility is determined to
have a higher than average rate of psychotropic medication authorization for children residing in the facility and
to monitor corrective action plans, as specified. This bill is pending hearing in this Committee.
SB 319 (Beall) 2015 expands the duties of the foster care public health nurse (PHN) to include monitoring and
oversight of the administration of psychotropic medication to foster children, as specified. It also requires counties
to provide child welfare PHN services by contracting with the community child health and disability prevention
program established by the county. This bill is pending hearing in this Committee.
Staff Comments:
The Judicial Council has indicated three major costs points associated with the provisions of this bill upon the trial
courts and the judicial branch: updating and creating rules of court and forms to update provisions related to the
prescription of psychotropic medications ($77,000 one-time); document management associated with the
“sharing” of specified information on a monthly basis regarding an individual child receiving child welfare
services ($1.6 million annually); and training for judicial officers who are authorized to make orders regarding the
administration of psychotropic medications for a dependent child or ward who has been removed from the
physical custody of his or her parent ($6,000 one-time for training development).
Staff notes that the mandated periodic oversight process to be facilitated by social workers, public health nurses,
or other county staff would also increase trial court workload, the magnitude of which would be dependent on the
frequency and duration of the “periodic” oversight prescribed in the adopted rules of court.
This bill imposes new duties on the DSS as detailed above in the “Proposed Law” section of this analysis. The
DSS would incur one-time, potentially significant workload for the development of the training component to be
completed in consultation with various stakeholders. It is estimated that DSS would incur potentially moderate
one-time costs in the low hundreds of thousands of dollars to develop the individualized monthly report and
associated form. This estimated cost assumes DSS and DHCS are able to utilize pre-existing data from their
respective databases to develop the report. It is estimated that the one-time cost to DSS to develop, or ensure
access to, a system that automatically alerts a social worker of a child receiving child welfare services when
psychotropic medication has been prescribed, could be substantial, potentially in excess of several million dollars.
There would likely be additional costs for ongoing maintenance and operation of the system.
This bill imposes activities on social workers, public health nurses, and other county staff that could significantly
increase the time associated with the provision of child welfare services for this population of youth. Potential
workload increases could be incurred by county social workers, public health nurses, and other county staff for
various activities, including time to attend additional training, complete more comprehensive court forms,
facilitate periodic oversight hearings, respond to automatic alerts, provide notifications, and provide additional
follow-up. While the magnitude of workload required to meet the mandates in this bill are unknown at this time,
for context, even two additional hours per month of social worker time for the 6,100 youth authorized to receive
psychotropic medications would result in costs of over $10.7 million.
Proposition 30, passed by the voters in November 2012, among other provisions, eliminated any potential
mandate funding liability for any new program or higher level of service provided by counties related to realigned
programs. Although the provisions of this bill are a mandate on local agencies, any increased costs would not be
subject to reimbursement by the state. Rather, Proposition 30 specifies that for legislation enacted after September
30, 2012, that has an overall effect of increasing the costs already borne by a local agency for realigned programs
such as child welfare services, the provisions shall apply to local agencies only to the extent that the state provides
annual funding for the cost increase.
While the potential costs of this measure are substantial, the provision of increased system-wide training,
monitoring, and oversight over the process of the prescription of psychotropic medications would promote further
protection of the health and well-being of youth in the child welfare system, and ultimately result in more positive
long-term outcomes for these youth.
CONSEQUENCE OF NEGATIVE ACTION:
Contra Costa County would not have a position on the bill.
ATTACHMENTS
Attachment A - Bill Text
Attachment B - Co-Sponsor Letter from CWDA
AMENDED IN SENATE APRIL 7, 2015
AMENDED IN SENATE MARCH 24, 2015
SENATE BILL No. 238
Introduced by Senators Mitchell and Beall
(Coauthor: Assembly Member Chiu)
February 17, 2015
An act to amend Sections 1522.41 and 1529.2 of the Health and
Safety Code, and to amend Sections 304.7, 317, 369.5, 16003, and
16206 of, and to add Section 16501.4 to, the Welfare and Institutions
Code, relating to foster care.
legislative counsel’s digest
SB 238, as amended, Mitchell. Foster care: psychotropic medication.
Existing law authorizes only a juvenile court judicial officer to make
orders regarding the administration of psychotropic medications for a
dependent child or a ward who has been removed from the physical
custody of his or her parent. Existing law requires the court authorization
for the administration of psychotropic medication to be based on a
request from a physician, indicating the reasons for the request, a
description of the child’s or ward’s diagnosis and behavior, the expected
results of the medication, and a description of any side effects of the
medication. Existing law requires the officer to approve or deny the
request for authorization to administer psychotropic medication, or set
the matter for hearing, as specified, within 7 court days. Existing law
requires the Judicial Council to adopt rules of court and develop
appropriate forms for the implementation of these provisions.
This bill would require the Judicial Council, on or before July 1, 2016,
to, in consultation with the State Department of Social Services, the
State Department of Health Care Services, and stakeholders, develop
97
Attachment A
updates to the implementation of these provisions with regard to
dependent children and related forms. The bill would require the updates
to ensure, among other things, that the child and his or her caregiver
and court-appointed special advocate, if any, have an a meaningful
opportunity to provide input on the medications being prescribed, and
would require the updates to include a process for periodic oversight
by the court of orders regarding the administration of psychotropic
medications. The bill would require the Judicial Council, on or before
July 1, 2016, to adopt or amend rules of court and forms to implement
the updates.
This bill would also require the State Department of Social Services,
in consultation with specified parties, to develop and provide a monthly
report to each county child welfare services agency, and would require
this report to include specified information regarding each child
receiving services from the county child welfare services agency and
for whom one or more psychotropic medications have been authorized,
including, among others things, the psychotropic medications that have
been authorized for the child. The bill would also require a county child
welfare agency to provide, share, on a monthly basis, to with the juvenile
court, the child’s attorney, and the child’s court-appointed special
advocate, if one has been appointed, specified information regarding a
an individual child receiving child welfare services, including, among
other things, the psychotropic medications that have been authorized
for the child. The bill would require the State Department of Social
Services, in consultation with specified parties, to develop, or ensure
access to, a system that automatically alerts a child’s social worker
when psychotropic medication has been prescribed that fits certain
descriptions, and would require the social worker to take specified
actions upon receipt of an alert from that system. By imposing additional
duties on social workers and county child welfare agencies, this bill
would impose a state-mandated local program.
Existing law requires certain individuals involved in the care and
oversight of dependent children, including group home administrators,
foster parents, relative caregivers, nonrelative extended family member
caregivers, social workers, judges, and attorneys, to receive training on
various topics.
This bill would require the training to include training on the
authorization for administration, authorization, uses, risks, benefits,
administration, oversight, and monitoring of psychotropic medications,
and trauma, mental behavioral health, and other available mental
97
— 2 —SB 238
Attachment A
behavioral health treatments, for those children. The bill would require
the State Department of Social Services, in consultation with specified
parties, to develop training that may be used for these purposes. By
imposing additional training requirements on social workers, this bill
would impose a state-mandated local program.
The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the state.
Statutory provisions establish procedures for making that reimbursement.
This bill would provide that no reimbursement is required by this act
for a specified reason.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: yes.
The people of the State of California do enact as follows:
line 1 SECTION 1. Section 1522.41 of the Health and Safety Code
line 2 is amended to read:
line 3 1522.41. (a) The director, in consultation and collaboration
line 4 with county placement officials, group home provider
line 5 organizations, the Director of Health Care Services, and the
line 6 Director of Developmental Services, shall develop and establish
line 7 a certification program to ensure that administrators of group home
line 8 facilities have appropriate training to provide the care and services
line 9 for which a license or certificate is issued.
line 10 (b) (1) In addition to any other requirements or qualifications
line 11 required by the department, an administrator of a group home
line 12 facility shall successfully complete a department-approved
line 13 certification program, pursuant to subdivision (c), prior to
line 14 employment. An administrator employed in a group home on the
line 15 effective date of this section shall meet the requirements of
line 16 paragraph (2) of subdivision (c).
line 17 (2) In those cases when the individual is both the licensee and
line 18 the administrator of a facility, the individual shall comply with all
line 19 of the licensee and administrator requirements of this section.
line 20 (3) Failure to comply with this section shall constitute cause for
line 21 revocation of the license of the facility.
line 22 (4) The licensee shall notify the department within 10 days of
line 23 any change in administrators.
line 24 (c) (1) The administrator certification programs shall require
line 25 a minimum of 40 hours of classroom instruction that provides
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SB 238— 3 — Attachment A
line 1 training on a uniform core of knowledge in each of the following
line 2 areas:
line 3 (A) Laws, regulations, and policies and procedural standards
line 4 that impact the operations of the type of facility for which the
line 5 applicant will be an administrator.
line 6 (B) Business operations.
line 7 (C) Management and supervision of staff.
line 8 (D) Psychosocial and educational needs of the facility residents,
line 9 including, but not limited to, the authorization for administration,
line 10 authorization, uses, risks, benefits, administration, oversight, and
line 11 monitoring of psychotropic medications, and trauma, mental
line 12 behavioral health, and other available mental behavioral health
line 13 treatments, for children receiving child welfare services. services,
line 14 including how to access those treatments.
line 15 (E) Community and support services.
line 16 (F) Physical needs for facility residents.
line 17 (G) Administration, storage, misuse, and interaction of
line 18 medication used by facility residents.
line 19 (H) Resident admission, retention, and assessment procedures,
line 20 including the right of a foster child to have fair and equal access
line 21 to all available services, placement, care, treatment, and benefits,
line 22 and to not be subjected to discrimination or harassment on the
line 23 basis of actual or perceived race, ethnic group identification,
line 24 ancestry, national origin, color, religion, sex, sexual orientation,
line 25 gender identity, mental or physical disability, or HIV status.
line 26 (I) Instruction on cultural competency and sensitivity relating
line 27 to, and best practices for, providing adequate care to lesbian, gay,
line 28 bisexual, and transgender youth in out-of-home care.
line 29 (J) Nonviolent emergency intervention and reporting
line 30 requirements.
line 31 (K) Basic instruction on the existing laws and procedures
line 32 regarding the safety of foster youth at school and the ensuring of
line 33 a harassment- and violence-free school environment contained in
line 34 the School Safety and Violence Prevention Act (Article 3.6
line 35 (commencing with Section 32228) of Chapter 2 of Part 19 of
line 36 Division 1 of Title 1 of the Education Code).
line 37 (2) The department shall adopt separate program requirements
line 38 for initial certification for persons who are employed as group
line 39 home administrators on the effective date of this section. A person
line 40 employed as an administrator of a group home facility on the
97
— 4 —SB 238
Attachment A
line 1 effective date of this section shall obtain a certificate by completing
line 2 the training and testing requirements imposed by the department
line 3 within 12 months of the effective date of the regulations
line 4 implementing this section. After the effective date of this section,
line 5 these administrators shall meet the requirements imposed by the
line 6 department on all other group home administrators for certificate
line 7 renewal.
line 8 (3) Individuals applying for certification under this section shall
line 9 successfully complete an approved certification program, pass a
line 10 written test administered by the department within 60 days of
line 11 completing the program, and submit to the department the
line 12 documentation required by subdivision (d) within 30 days after
line 13 being notified of having passed the test. The department may
line 14 extend these time deadlines for good cause. The department shall
line 15 notify the applicant of his or her test results within 30 days of
line 16 administering the test.
line 17 (d) The department shall not begin the process of issuing a
line 18 certificate until receipt of all of the following:
line 19 (1) A certificate of completion of the administrator training
line 20 required pursuant to this chapter.
line 21 (2) The fee required for issuance of the certificate. A fee of one
line 22 hundred dollars ($100) shall be charged by the department to cover
line 23 the costs of processing the application for certification.
line 24 (3) Documentation from the applicant that he or she has passed
line 25 the written test.
line 26 (4) Submission of fingerprints pursuant to Section 1522. The
line 27 department may waive the submission for those persons who have
line 28 a current clearance on file.
line 29 (5) That person is at least 21 years of age.
line 30 (e) It shall be unlawful for any person not certified under this
line 31 section to hold himself or herself out as a certified administrator
line 32 of a group home facility. Any person willfully making any false
line 33 representation as being a certified administrator or facility manager
line 34 is guilty of a misdemeanor.
line 35 (f) (1) Certificates issued under this section shall be renewed
line 36 every two years and renewal shall be conditional upon the
line 37 certificate holder submitting documentation of completion of 40
line 38 hours of continuing education related to the core of knowledge
line 39 specified in subdivision (c). No more than one-half of the required
line 40 40 hours of continuing education necessary to renew the certificate
97
SB 238— 5 — Attachment A
line 1 may be satisfied through online courses. All other continuing
line 2 education hours shall be completed in a classroom setting. For
line 3 purposes of this section, an individual who is a group home facility
line 4 administrator and who is required to complete the continuing
line 5 education hours required by the regulations of the State Department
line 6 of Developmental Services, and approved by the regional center,
line 7 may have up to 24 of the required continuing education course
line 8 hours credited toward the 40-hour continuing education
line 9 requirement of this section. Community college course hours
line 10 approved by the regional centers shall be accepted by the
line 11 department for certification.
line 12 (2) Every administrator of a group home facility shall complete
line 13 the continuing education requirements of this subdivision.
line 14 (3) Certificates issued under this section shall expire every two
line 15 years on the anniversary date of the initial issuance of the
line 16 certificate, except that any administrator receiving his or her initial
line 17 certification on or after July 1, 1999, shall make an irrevocable
line 18 election to have his or her recertification date for any subsequent
line 19 recertification either on the date two years from the date of issuance
line 20 of the certificate or on the individual’s birthday during the second
line 21 calendar year following certification. The department shall send
line 22 a renewal notice to the certificate holder 90 days prior to the
line 23 expiration date of the certificate. If the certificate is not renewed
line 24 prior to its expiration date, reinstatement shall only be permitted
line 25 after the certificate holder has paid a delinquency fee equal to three
line 26 times the renewal fee and has provided evidence of completion of
line 27 the continuing education required.
line 28 (4) To renew a certificate, the certificate holder shall, on or
line 29 before the certificate expiration date, request renewal by submitting
line 30 to the department documentation of completion of the required
line 31 continuing education courses and pay the renewal fee of one
line 32 hundred dollars ($100), irrespective of receipt of the department’s
line 33 notification of the renewal. A renewal request postmarked on or
line 34 before the expiration of the certificate shall be proof of compliance
line 35 with this paragraph.
line 36 (5) A suspended or revoked certificate shall be subject to
line 37 expiration as provided for in this section. If reinstatement of the
line 38 certificate is approved by the department, the certificate holder,
line 39 as a condition precedent to reinstatement, shall submit proof of
line 40 compliance with paragraphs (1) and (2) of subdivision (f), and
97
— 6 —SB 238
Attachment A
line 1 shall pay a fee in an amount equal to the renewal fee, plus the
line 2 delinquency fee, if any, accrued at the time of its revocation or
line 3 suspension. Delinquency fees, if any, accrued subsequent to the
line 4 time of its revocation or suspension and prior to an order for
line 5 reinstatement, shall be waived for a period of 12 months to allow
line 6 the individual sufficient time to complete the required continuing
line 7 education units and to submit the required documentation.
line 8 Individuals whose certificates will expire within 90 days after the
line 9 order for reinstatement may be granted a three-month extension
line 10 to renew their certificates during which time the delinquency fees
line 11 shall not accrue.
line 12 (6) A certificate that is not renewed within four years after its
line 13 expiration shall not be renewed, restored, reissued, or reinstated
line 14 except upon completion of a certification training program, passing
line 15 any test that may be required of an applicant for a new certificate
line 16 at that time, and paying the appropriate fees provided for in this
line 17 section.
line 18 (7) A fee of twenty-five dollars ($25) shall be charged for the
line 19 reissuance of a lost certificate.
line 20 (8) A certificate holder shall inform the department of his or
line 21 her employment status and change of mailing address within 30
line 22 days of any change.
line 23 (g) Unless otherwise ordered by the department, the certificate
line 24 shall be considered forfeited under either of the following
line 25 conditions:
line 26 (1) The department has revoked any license held by the
line 27 administrator after the department issued the certificate.
line 28 (2) The department has issued an exclusion order against the
line 29 administrator pursuant to Section 1558, 1568.092, 1569.58, or
line 30 1596.8897, after the department issued the certificate, and the
line 31 administrator did not appeal the exclusion order or, after the appeal,
line 32 the department issued a decision and order that upheld the
line 33 exclusion order.
line 34 (h) (1) The department, in consultation and collaboration with
line 35 county placement officials, provider organizations, the State
line 36 Department of Health Care Services, and the State Department of
line 37 Developmental Services, shall establish, by regulation, the program
line 38 content, the testing instrument, the process for approving
line 39 certification training programs, and criteria to be used in
line 40 authorizing individuals, organizations, or educational institutions
97
SB 238— 7 — Attachment A
line 1 to conduct certification training programs and continuing education
line 2 courses. The department may also grant continuing education hours
line 3 for continuing courses offered by accredited educational institutions
line 4 that are consistent with the requirements in this section. The
line 5 department may deny vendor approval to any agency or person in
line 6 any of the following circumstances:
line 7 (A) The applicant has not provided the department with evidence
line 8 satisfactory to the department of the ability of the applicant to
line 9 satisfy the requirements of vendorization set out in the regulations
line 10 adopted by the department pursuant to subdivision (j).
line 11 (B) The applicant person or agency has a conflict of interest in
line 12 that the person or agency places its clients in group home facilities.
line 13 (C) The applicant public or private agency has a conflict of
line 14 interest in that the agency is mandated to place clients in group
line 15 homes and to pay directly for the services. The department may
line 16 deny vendorization to this type of agency only as long as there are
line 17 other vendor programs available to conduct the certification
line 18 training programs and conduct education courses.
line 19 (2) The department may authorize vendors to conduct the
line 20 administrator’s certification training program pursuant to this
line 21 section. The department shall conduct the written test pursuant to
line 22 regulations adopted by the department.
line 23 (3) The department shall prepare and maintain an updated list
line 24 of approved training vendors.
line 25 (4) The department may inspect certification training programs
line 26 and continuing education courses, including online courses, at no
line 27 charge to the department, to determine if content and teaching
line 28 methods comply with regulations. If the department determines
line 29 that any vendor is not complying with the requirements of this
line 30 section, the department shall take appropriate action to bring the
line 31 program into compliance, which may include removing the vendor
line 32 from the approved list.
line 33 (5) The department shall establish reasonable procedures and
line 34 timeframes not to exceed 30 days for the approval of vendor
line 35 training programs.
line 36 (6) The department may charge a reasonable fee, not to exceed
line 37 one hundred fifty dollars ($150) every two years, to certification
line 38 program vendors for review and approval of the initial 40-hour
line 39 training program pursuant to subdivision (c). The department may
line 40 also charge the vendor a fee, not to exceed one hundred dollars
97
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Attachment A
line 1 ($100) every two years, for the review and approval of the
line 2 continuing education courses needed for recertification pursuant
line 3 to this subdivision.
line 4 (7) (A) A vendor of online programs for continuing education
line 5 shall ensure that each online course contains all of the following:
line 6 (i) An interactive portion in which the participant receives
line 7 feedback, through online communication, based on input from the
line 8 participant.
line 9 (ii) Required use of a personal identification number or personal
line 10 identification information to confirm the identity of the participant.
line 11 (iii) A final screen displaying a printable statement, to be signed
line 12 by the participant, certifying that the identified participant
line 13 completed the course. The vendor shall obtain a copy of the final
line 14 screen statement with the original signature of the participant prior
line 15 to the issuance of a certificate of completion. The signed statement
line 16 of completion shall be maintained by the vendor for a period of
line 17 three years and be available to the department upon demand. Any
line 18 person who certifies as true any material matter pursuant to this
line 19 clause that he or she knows to be false is guilty of a misdemeanor.
line 20 (B) Nothing in this subdivision shall prohibit the department
line 21 from approving online programs for continuing education that do
line 22 not meet the requirements of subparagraph (A) if the vendor
line 23 demonstrates to the department’s satisfaction that, through
line 24 advanced technology, the course and the course delivery meet the
line 25 requirements of this section.
line 26 (i) The department shall establish a registry for holders of
line 27 certificates that shall include, at a minimum, information on
line 28 employment status and criminal record clearance.
line 29 (j) Subdivisions (b) to (i), inclusive, shall be implemented upon
line 30 regulations being adopted by the department, by January 1, 2000.
line 31 (k) Notwithstanding any law to the contrary, vendors approved
line 32 by the department who exclusively provide either initial or
line 33 continuing education courses for certification of administrators of
line 34 a group home facility as defined by regulations of the department,
line 35 an adult residential facility as defined by regulations of the
line 36 department, or a residential care facility for the elderly as defined
line 37 in subdivision (k) of Section 1569.2, shall be regulated solely by
line 38 the department pursuant to this chapter. No other state or local
line 39 governmental entity shall be responsible for regulating the activity
line 40 of those vendors.
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SB 238— 9 — Attachment A
line 1 SEC. 2. Section 1529.2 of the Health and Safety Code is
line 2 amended to read:
line 3 1529.2. (a) In addition to the foster parent training provided
line 4 by community colleges, foster family agencies shall provide a
line 5 program of training for their certified foster families.
line 6 (b) (1) Every licensed foster parent shall complete a minimum
line 7 of 12 hours of foster parent training, as prescribed in paragraph
line 8 (3), before the placement of any foster children with the foster
line 9 parent. In addition, a foster parent shall complete a minimum of
line 10 eight hours of foster parent training annually, as prescribed in
line 11 paragraph (4). No child shall be placed in a foster family home
line 12 unless these requirements are met by the persons in the home who
line 13 are serving as the foster parents.
line 14 (2) (A) Upon the request of the foster parent for a hardship
line 15 waiver from the postplacement training requirement or a request
line 16 for an extension of the deadline, the county may, at its option, on
line 17 a case-by-case basis, waive the postplacement training requirement
line 18 or extend any established deadline for a period not to exceed one
line 19 year, if the postplacement training requirement presents a severe
line 20 and unavoidable obstacle to continuing as a foster parent. Obstacles
line 21 for which a county may grant a hardship waiver or extension are:
line 22 (i) Lack of access to training due to the cost or travel required.
line 23 (ii) Family emergency.
line 24 (B) Before a waiver or extension may be granted, the foster
line 25 parent should explore the opportunity of receiving training by
line 26 video or written materials.
line 27 (3) The initial preplacement training shall include, but not be
line 28 limited to, training courses that cover all of the following:
line 29 (A) An overview of the child protective system.
line 30 (B) The effects of child abuse and neglect on child development.
line 31 (C) Positive discipline and the importance of self-esteem.
line 32 (D) Health issues in foster care, including, but not limited to,
line 33 the authorization for administration, authorization, uses, risks,
line 34 benefits, administration, oversight, and monitoring of psychotropic
line 35 medications, and trauma, mental behavioral health, and other
line 36 available mental behavioral health treatments, for children
line 37 receiving child welfare services. services, including how to access
line 38 those treatments.
line 39 (E) Accessing education and health services available to foster
line 40 children.
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Attachment A
line 1 (F) The right of a foster child to have fair and equal access to
line 2 all available services, placement, care, treatment, and benefits, and
line 3 to not be subjected to discrimination or harassment on the basis
line 4 of actual or perceived race, ethnic group identification, ancestry,
line 5 national origin, color, religion, sex, sexual orientation, gender
line 6 identity, mental or physical disability, or HIV status.
line 7 (G) Instruction on cultural competency and sensitivity relating
line 8 to, and best practices for, providing adequate care to lesbian, gay,
line 9 bisexual, and transgender youth in out-of-home care.
line 10 (H) Basic instruction on the existing laws and procedures
line 11 regarding the safety of foster youth at school and the ensuring of
line 12 a harassment and violence free school environment contained in
line 13 the California Student Safety and Violence Prevention Act of 2000
line 14 (Article 3.6 (commencing with Section 32228) of Chapter 2 of
line 15 Part 19 of Division 1 of Title 1 of the Education Code).
line 16 (4) The postplacement annual training shall include, but not be
line 17 limited to, training courses that cover all of the following:
line 18 (A) Age-appropriate child development.
line 19 (B) Health issues in foster care, including, but not limited to,
line 20 the authorization for administration, authorization, uses, risks,
line 21 benefits, administration, oversight, and monitoring of psychotropic
line 22 medications, and trauma, mental behavioral health, and other
line 23 available mental behavioral health treatments, for children
line 24 receiving child welfare services. services, including how to access
line 25 those treatments.
line 26 (C) Positive discipline and the importance of self-esteem.
line 27 (D) Emancipation and independent living skills if a foster parent
line 28 is caring for youth.
line 29 (E) The right of a foster child to have fair and equal access to
line 30 all available services, placement, care, treatment, and benefits, and
line 31 to not be subjected to discrimination or harassment on the basis
line 32 of actual or perceived race, ethnic group identification, ancestry,
line 33 national origin, color, religion, sex, sexual orientation, gender
line 34 identity, mental or physical disability, or HIV status.
line 35 (F) Instruction on cultural competency and sensitivity relating
line 36 to, and best practices for, providing adequate care to lesbian, gay,
line 37 bisexual, and transgender youth in out-of-home care.
line 38 (5) Foster parent training may be attained through a variety of
line 39 sources, including community colleges, counties, hospitals, foster
97
SB 238— 11 — Attachment A
line 1 parent associations, the California State Foster Parent Association’s
line 2 Conference, adult schools, and certified foster parent instructors.
line 3 (6) A candidate for placement of foster children shall submit a
line 4 certificate of training to document completion of the training
line 5 requirements. The certificate shall be submitted with the initial
line 6 consideration for placements and provided at the time of the annual
line 7 visit by the licensing agency thereafter.
line 8 (c) Nothing in this section shall preclude a county from requiring
line 9 county-provided preplacement or postplacement foster parent
line 10 training in excess of the requirements in this section.
line 11 SEC. 3. Section 304.7 of the Welfare and Institutions Code is
line 12 amended to read:
line 13 304.7. (a) The Judicial Council shall develop and implement
line 14 standards for the education and training of all judges who conduct
line 15 hearings pursuant to Section 300. The training shall include, but
line 16 not be limited to, all of the following:
line 17 (1) A component relating to Section 300 proceedings for newly
line 18 appointed or elected judges and an annual training session in
line 19 Section 300 proceedings.
line 20 (2) Cultural competency and sensitivity relating to, and best
line 21 practices for, providing adequate care to lesbian, gay, bisexual,
line 22 and transgender youth.
line 23 (3) The authorization for administration, authorization, uses,
line 24 risks, benefits, administration, oversight, and monitoring of
line 25 psychotropic medications, and trauma, mental behavioral health,
line 26 and other available mental behavioral health treatments, for
line 27 children receiving child welfare services. services, including how
line 28 to access those treatments.
line 29 (b) A commissioner or referee who is assigned to conduct
line 30 hearings held pursuant to Section 300 shall meet the minimum
line 31 standards for education and training established pursuant to
line 32 subdivision (a), by July 31, 1998.
line 33 (c) The Judicial Council shall submit an annual report to the
line 34 Legislature on compliance by judges, commissioners, and referees
line 35 with the education and training standards described in subdivisions
line 36 (a) and (b).
line 37 SEC. 4. Section 317 of the Welfare and Institutions Code is
line 38 amended to read:
line 39 317. (a) (1) When it appears to the court that a parent or
line 40 guardian of the child desires counsel but is presently financially
97
— 12 —SB 238
Attachment A
line 1 unable to afford and cannot for that reason employ counsel, the
line 2 court may appoint counsel as provided in this section.
line 3 (2) When it appears to the court that a parent or Indian custodian
line 4 in an Indian child custody proceeding desires counsel but is
line 5 presently unable to afford and cannot for that reason employ
line 6 counsel, the provisions of Section 1912(b) of Title 25 of the United
line 7 States Code and Section 23.13 of Title 25 of the Code of Federal
line 8 Regulations shall apply.
line 9 (b) When it appears to the court that a parent or guardian of the
line 10 child is presently financially unable to afford and cannot for that
line 11 reason employ counsel, and the child has been placed in
line 12 out-of-home care, or the petitioning agency is recommending that
line 13 the child be placed in out-of-home care, the court shall appoint
line 14 counsel for the parent or guardian, unless the court finds that the
line 15 parent or guardian has made a knowing and intelligent waiver of
line 16 counsel as provided in this section.
line 17 (c) (1) If a child or nonminor dependent is not represented by
line 18 counsel, the court shall appoint counsel for the child or nonminor
line 19 dependent, unless the court finds that the child or nonminor
line 20 dependent would not benefit from the appointment of counsel. The
line 21 court shall state on the record its reasons for that finding.
line 22 (2) A primary responsibility of counsel appointed to represent
line 23 a child or nonminor dependent pursuant to this section shall be to
line 24 advocate for the protection, safety, and physical and emotional
line 25 well-being of the child or nonminor dependent.
line 26 (3) Counsel may be a district attorney, public defender, or other
line 27 member of the bar, provided that he or she does not represent
line 28 another party or county agency whose interests conflict with the
line 29 child’s or nonminor dependent’s interests. The fact that the district
line 30 attorney represents the child or nonminor dependent in a
line 31 proceeding pursuant to Section 300 as well as conducts a criminal
line 32 investigation or files a criminal complaint or information arising
line 33 from the same or reasonably related set of facts as the proceeding
line 34 pursuant to Section 300 is not in and of itself a conflict of interest.
line 35 (4) The court may fix the compensation for the services of
line 36 appointed counsel.
line 37 (5) (A) The appointed counsel shall have a caseload and training
line 38 that ensures adequate representation of the child or nonminor
line 39 dependent. The Judicial Council shall promulgate rules of court
line 40 that establish caseload standards, training requirements, and
97
SB 238— 13 — Attachment A
line 1 guidelines for appointed counsel for children and shall adopt rules
line 2 as required by Section 326.5 no later than July 1, 2001.
line 3 (B) The training requirements imposed pursuant to subparagraph
line 4 (A) shall include instruction on both of the following:
line 5 (i) Cultural competency and sensitivity relating to, and best
line 6 practices for, providing adequate care to lesbian, gay, bisexual,
line 7 and transgender youth in out-of-home care.
line 8 (ii) The authorization for administration, authorization, uses,
line 9 risks, benefits, administration, oversight, and monitoring of
line 10 psychotropic medications, and trauma, mental behavioral health,
line 11 and other available mental behavioral health treatments, for
line 12 children receiving child welfare services. services, including how
line 13 to access those treatments.
line 14 (d) Counsel shall represent the parent, guardian, child, or
line 15 nonminor dependent at the detention hearing and at all subsequent
line 16 proceedings before the juvenile court. Counsel shall continue to
line 17 represent the parent, guardian, child, or nonminor dependent unless
line 18 relieved by the court upon the substitution of other counsel or for
line 19 cause. The representation shall include representing the parent,
line 20 guardian, or the child in termination proceedings and in those
line 21 proceedings relating to the institution or setting aside of a legal
line 22 guardianship. On and after January 1, 2012, in the case of a
line 23 nonminor dependent, as described in subdivision (v) of Section
line 24 11400, no representation by counsel shall be provided for a parent,
line 25 unless the parent is receiving court-ordered family reunification
line 26 services.
line 27 (e) (1) Counsel shall be charged in general with the
line 28 representation of the child’s interests. To that end, counsel shall
line 29 make or cause to have made any further investigations that he or
line 30 she deems in good faith to be reasonably necessary to ascertain
line 31 the facts, including the interviewing of witnesses, and shall
line 32 examine and cross-examine witnesses in both the adjudicatory and
line 33 dispositional hearings. Counsel may also introduce and examine
line 34 his or her own witnesses, make recommendations to the court
line 35 concerning the child’s welfare, and participate further in the
line 36 proceedings to the degree necessary to adequately represent the
line 37 child. When counsel is appointed to represent a nonminor
line 38 dependent, counsel is charged with representing the wishes of the
line 39 nonminor dependent except when advocating for those wishes
line 40 conflicts with the protection or safety of the nonminor dependent.
97
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Attachment A
line 1 If the court finds that a nonminor dependent is not competent to
line 2 direct counsel, the court shall appoint a guardian ad litem for the
line 3 nonminor dependent.
line 4 (2) If the child is four years of age or older, counsel shall
line 5 interview the child to determine the child’s wishes and assess the
line 6 child’s well-being, and shall advise the court of the child’s wishes.
line 7 Counsel shall not advocate for the return of the child if, to the best
line 8 of his or her knowledge, return of the child conflicts with the
line 9 protection and safety of the child.
line 10 (3) Counsel shall investigate the interests of the child beyond
line 11 the scope of the juvenile proceeding, and report to the court other
line 12 interests of the child that may need to be protected by the institution
line 13 of other administrative or judicial proceedings. Counsel
line 14 representing a child in a dependency proceeding is not required to
line 15 assume the responsibilities of a social worker, and is not expected
line 16 to provide nonlegal services to the child.
line 17 (4) (A) At least once every year, if the list of educational
line 18 liaisons is available on the Internet Web site for the State
line 19 Department of Education, both of the following shall apply:
line 20 (i) Counsel shall provide his or her contact information to the
line 21 educational liaison, as described in subdivision (b) of Section
line 22 48853.5 of the Education Code, of each local educational agency
line 23 serving counsel’s foster child clients in the county of jurisdiction.
line 24 (ii) If counsel is part of a firm or organization representing foster
line 25 children, the firm or organization may provide its contact
line 26 information in lieu of contact information for the individual
line 27 counsel. The firm or organization may designate a person or
line 28 persons within the firm or organization to receive communications
line 29 from educational liaisons.
line 30 (B) The child’s caregiver or other person holding the right to
line 31 make educational decisions for the child may provide the contact
line 32 information of the child’s attorney to the child’s local educational
line 33 agency.
line 34 (C) Counsel for the child and counsel’s agent may, but are not
line 35 required to, disclose to an individual who is being assessed for the
line 36 possibility of placement pursuant to Section 361.3 the fact that the
line 37 child is in custody, the alleged reasons that the child is in custody,
line 38 and the projected likely date for the child’s return home, placement
line 39 for adoption, or legal guardianship. Nothing in this paragraph shall
97
SB 238— 15 — Attachment A
line 1 be construed to prohibit counsel from making other disclosures
line 2 pursuant to this subdivision, as appropriate.
line 3 (5) Nothing in this subdivision shall be construed to permit
line 4 counsel to violate a child’s attorney-client privilege.
line 5 (6) The changes made to this subdivision during the 2011–12
line 6 Regular Session of the Legislature by the act adding subparagraph
line 7 (C) of paragraph (4) and paragraph (5) are declaratory of existing
line 8 law.
line 9 (7) The court shall take whatever appropriate action is necessary
line 10 to fully protect the interests of the child.
line 11 (f) Either the child or counsel for the child, with the informed
line 12 consent of the child if the child is found by the court to be of
line 13 sufficient age and maturity to consent, which shall be presumed,
line 14 subject to rebuttal by clear and convincing evidence, if the child
line 15 is over 12 years of age, may invoke the psychotherapist-client
line 16 privilege, physician-patient privilege, and clergyman-penitent
line 17 privilege. If the child invokes the privilege, counsel may not waive
line 18 it, but if counsel invokes the privilege, the child may waive it.
line 19 Counsel shall be the holder of these privileges if the child is found
line 20 by the court not to be of sufficient age and maturity to consent.
line 21 For the sole purpose of fulfilling his or her obligation to provide
line 22 legal representation of the child, counsel shall have access to all
line 23 records with regard to the child maintained by a health care facility,
line 24 as defined in Section 1545 of the Penal Code, health care providers,
line 25 as defined in Section 6146 of the Business and Professions Code,
line 26 a physician and surgeon or other health practitioner, as defined in
line 27 former Section 11165.8 of the Penal Code, as that section read on
line 28 January 1, 2000, or a child care custodian, as defined in former
line 29 Section 11165.7 of the Penal Code, as that section read on January
line 30 1, 2000. Notwithstanding any other law, counsel shall be given
line 31 access to all records relevant to the case that are maintained by
line 32 state or local public agencies. All information requested from a
line 33 child protective agency regarding a child who is in protective
line 34 custody, or from a child’s guardian ad litem, shall be provided to
line 35 the child’s counsel within 30 days of the request.
line 36 (g) In a county of the third class, if counsel is to be provided to
line 37 a child at the county’s expense other than by counsel for the
line 38 agency, the court shall first use the services of the public defender
line 39 before appointing private counsel. Nothing in this subdivision shall
line 40 be construed to require the appointment of the public defender in
97
— 16 —SB 238
Attachment A
line 1 any case in which the public defender has a conflict of interest. In
line 2 the interest of justice, a court may depart from that portion of the
line 3 procedure requiring appointment of the public defender after
line 4 making a finding of good cause and stating the reasons therefor
line 5 on the record.
line 6 (h) In a county of the third class, if counsel is to be appointed
line 7 to provide legal counsel for a parent or guardian at the county’s
line 8 expense, the court shall first use the services of the alternate public
line 9 defender before appointing private counsel. Nothing in this
line 10 subdivision shall be construed to require the appointment of the
line 11 alternate public defender in any case in which the public defender
line 12 has a conflict of interest. In the interest of justice, a court may
line 13 depart from that portion of the procedure requiring appointment
line 14 of the alternate public defender after making a finding of good
line 15 cause and stating the reasons therefor on the record.
line 16 SEC. 5. Section 369.5 of the Welfare and Institutions Code is
line 17 amended to read:
line 18 369.5. (a) (1) If a child is adjudged a dependent child of the
line 19 court under Section 300 and the child has been removed from the
line 20 physical custody of the parent under Section 361, only a juvenile
line 21 court judicial officer shall have authority to make orders regarding
line 22 the administration of psychotropic medications for that child. The
line 23 juvenile court may issue a specific order delegating this authority
line 24 to a parent upon making findings on the record that the parent
line 25 poses no danger to the child and has the capacity to authorize
line 26 psychotropic medications. Court authorization for the
line 27 administration of psychotropic medication shall be based on a
line 28 request from a physician, indicating the reasons for the request, a
line 29 description of the child’s diagnosis and behavior, the expected
line 30 results of the medication, and a description of any side effects of
line 31 the medication.
line 32 (2) (A) On or before July 1, 2016, the Judicial Council shall,
line 33 in consultation with the State Department of Social Services, the
line 34 State Department of Health Care Services, and stakeholders,
line 35 including, but not limited to, the County Welfare Directors
line 36 Association, associations representing current and former foster
line 37 children, county behavioral health departments, caregivers, and
line 38 children’s attorneys, develop updates to the implementation of this
line 39 section and related forms.
97
SB 238— 17 — Attachment A
line 1 (B) The implementation updates developed pursuant to
line 2 subparagraph (A) shall ensure all of the following:
line 3 (i) The child and his or her caregiver and court-appointed special
line 4 advocate, if any, have an a meaningful opportunity to provide input
line 5 on the medications being prescribed.
line 6 (ii) Information regarding the child’s overall mental behavioral
line 7 health assessment and treatment plan is provided to the court.
line 8 (iii) Information regarding the rationale for the proposed
line 9 medication, provided in the context of past and current treatment
line 10 efforts, is provided to the court. This information shall include,
line 11 but not be limited to, information on other pharmacological and
line 12 non-pharmacological treatments that have been utilized and the
line 13 child’s response to those treatments, a discussion of symptoms not
line 14 alleviated or ameliorated by other current or past treatment efforts,
line 15 and an explanation of how the psychotropic medication being
line 16 prescribed is expected to improve the child’s symptoms.
line 17 (iv) Guidance is provided to the court on how to evaluate the
line 18 request for authorization, including how to proceed if information,
line 19 otherwise required to be included in a request for authorization
line 20 under this section, is not included in a request for authorization
line 21 submitted to the court.
line 22 (C) The implementation updates developed pursuant to
line 23 subparagraph (A) shall include a process for periodic oversight by
line 24 the court of orders regarding the administration of psychotropic
line 25 medications that includes the caregiver’s and child’s observations
line 26 relating to the effectiveness of the medication and side effects,
line 27 information on medication management appointments and other
line 28 follow-up appointments with medical practitioners, and information
line 29 on the delivery of other mental behavioral health treatments that
line 30 are a part of the child’s overall treatment plan. The periodic
line 31 oversight shall be facilitated by the county social worker, public
line 32 health nurse, or other appropriate county staff. This oversight
line 33 process may be conducted in conjunction with other court hearings
line 34 and reports provided to the court by the county child welfare
line 35 agency.
line 36 (D) On or before July 1, 2016, the Judicial Council shall adopt
line 37 or amend rules of court and forms to implement the updates
line 38 developed pursuant to this paragraph.
line 39 (b) (1) In counties in which the county child welfare agency
line 40 completes the request for authorization for the administration of
97
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Attachment A
line 1 psychotropic medication, the agency is encouraged to complete
line 2 the request within three business days of receipt from the physician
line 3 of the information necessary to fully complete the request.
line 4 (2) Nothing in this subdivision is intended to change current
line 5 local practice or local court rules with respect to the preparation
line 6 and submission of requests for authorization for the administration
line 7 of psychotropic medication.
line 8 (c) Within seven court days from receipt by the court of a
line 9 completed request, the juvenile court judicial officer shall either
line 10 approve or deny in writing a request for authorization for the
line 11 administration of psychotropic medication to the child, or shall,
line 12 upon a request by the parent, the legal guardian, or the child’s
line 13 attorney, or upon its own motion, set the matter for hearing.
line 14 (d) Psychotropic medication or psychotropic drugs are those
line 15 medications administered for the purpose of affecting the central
line 16 nervous system to treat psychiatric disorders or illnesses. These
line 17 medications include, but are not limited to, anxiolytic agents,
line 18 antidepressants, mood stabilizers, antipsychotic medications,
line 19 anti-Parkinson agents, hypnotics, medications for dementia, and
line 20 psychostimulants.
line 21 (e) Nothing in this section is intended to supersede local court
line 22 rules regarding a minor’s right to participate in mental health
line 23 decisions.
line 24 (f) This section does not apply to nonminor dependents, as
line 25 defined in subdivision (v) of Section 11400.
line 26 SEC. 6. Section 16003 of the Welfare and Institutions Code is
line 27 amended to read:
line 28 16003. (a) In order to promote the successful implementation
line 29 of the statutory preference for foster care placement with a relative
line 30 caretaker as set forth in Section 7950 of the Family Code, each
line 31 community college district with a foster care education program
line 32 shall make available orientation and training to the relative or
line 33 nonrelative extended family member caregiver into whose care
line 34 the county has placed a foster child pursuant to Section 1529.2 of
line 35 the Health and Safety Code, including, but not limited to, courses
line 36 that cover the following:
line 37 (1) The role, rights, and responsibilities of a relative or
line 38 nonrelative extended family member caregiver caring for a child
line 39 in foster care, including the right of a foster child to have fair and
line 40 equal access to all available services, placement, care, treatment,
97
SB 238— 19 — Attachment A
line 1 and benefits, and to not be subjected to discrimination or
line 2 harassment on the basis of actual or perceived race, ethnic group
line 3 identification, ancestry, national origin, color, religion, sex, sexual
line 4 orientation, gender identity, mental or physical disability, or HIV
line 5 status.
line 6 (2) An overview of the child protective system.
line 7 (3) The effects of child abuse and neglect on child development.
line 8 (4) Positive discipline and the importance of self-esteem.
line 9 (5) Health issues in foster care, including, but not limited to,
line 10 the authorization for administration, authorization, uses, risks,
line 11 benefits, administration, oversight, and monitoring of psychotropic
line 12 medications, and trauma, mental behavioral health, and other
line 13 available mental behavioral health treatments, for children
line 14 receiving child welfare services. services, including how to access
line 15 those treatments.
line 16 (6) Accessing education and health services that are available
line 17 to foster children.
line 18 (7) Relationship and safety issues regarding contact with one
line 19 or both of the birth parents.
line 20 (8) Permanency options for relative or nonrelative extended
line 21 family member caregivers, including legal guardianship, the
line 22 Kinship Guardianship Assistance Payment Program, and kin
line 23 adoption.
line 24 (9) Information on resources available for those who meet
line 25 eligibility criteria, including out-of-home care payments, the
line 26 Medi-Cal program, in-home supportive services, and other similar
line 27 resources.
line 28 (10) Instruction on cultural competency and sensitivity relating
line 29 to, and best practices for, providing adequate care to lesbian, gay,
line 30 bisexual, and transgender youth in out-of-home care.
line 31 (11) Basic instruction on the existing laws and procedures
line 32 regarding the safety of foster youth at school and the ensuring of
line 33 a harassment and violence free school environment contained in
line 34 the California Student Safety and Violence Prevention Act of 2000
line 35 (Article 3.6 (commencing with Section 32228) of Chapter 2 of
line 36 Part 19 of Division 1 of Title 1 of the Education Code).
line 37 (b) In addition to training made available pursuant to subdivision
line 38 (a), each community college district with a foster care education
line 39 program shall make training available to a relative or nonrelative
97
— 20 —SB 238
Attachment A
line 1 extended family member caregiver that includes, but need not be
line 2 limited to, courses that cover all of the following:
line 3 (1) Age-appropriate child development.
line 4 (2) Health issues in foster care, including, but not limited to,
line 5 the authorization for administration, authorization, uses, risks,
line 6 benefits, administration, oversight, and monitoring of psychotropic
line 7 medications, and trauma, mental behavioral health, and other
line 8 available mental behavioral health treatments, for children
line 9 receiving child welfare services. services, including how to access
line 10 to those treatments.
line 11 (3) Positive discipline and the importance of self-esteem.
line 12 (4) Emancipation and independent living.
line 13 (5) Accessing education and health services available to foster
line 14 children.
line 15 (6) Relationship and safety issues regarding contact with one
line 16 or both of the birth parents.
line 17 (7) Permanency options for relative or nonrelative extended
line 18 family member caregivers, including legal guardianship, the
line 19 Kinship Guardianship Assistance Payment Program, and kin
line 20 adoption.
line 21 (8) Basic instruction on the existing laws and procedures
line 22 regarding the safety of foster youth at school and the ensuring of
line 23 a harassment and violence free school environment contained in
line 24 the California Student Safety and Violence Prevention Act of 2000
line 25 (Article 3.6 (commencing with Section 32228) of Chapter 2 of
line 26 Part 19 of Division 1 of Title 1 of the Education Code).
line 27 (c) In addition to the requirements of subdivisions (a) and (b),
line 28 each community college district with a foster care education
line 29 program, in providing the orientation program, shall develop
line 30 appropriate program parameters in collaboration with the counties.
line 31 (d) Each community college district with a foster care education
line 32 program shall make every attempt to make the training and
line 33 orientation programs for relative or nonrelative extended family
line 34 member caregivers highly accessible in the communities in which
line 35 they reside.
line 36 (e) When a child is placed with a relative or nonrelative extended
line 37 family member caregiver, the county shall inform the caregiver
line 38 of the availability of training and orientation programs and it is
line 39 the intent of the Legislature that the county shall forward the names
line 40 and addresses of relative or nonrelative extended family member
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SB 238— 21 — Attachment A
line 1 caregivers to the appropriate community colleges providing the
line 2 training and orientation programs.
line 3 (f) This section shall not be construed to preclude counties from
line 4 developing or expanding existing training and orientation programs
line 5 for foster care providers to include relative or nonrelative extended
line 6 family member caregivers.
line 7 SEC. 7. Section 16206 of the Welfare and Institutions Code is
line 8 amended to read:
line 9 16206. (a) The purpose of the program is to develop and
line 10 implement statewide coordinated training programs designed
line 11 specifically to meet the needs of county child protective services
line 12 social workers assigned emergency response, family maintenance,
line 13 family reunification, permanent placement, and adoption
line 14 responsibilities. It is the intent of the Legislature that the program
line 15 include training for other agencies under contract with county
line 16 welfare departments to provide child welfare services. In addition,
line 17 the program shall provide training programs for persons defined
line 18 as a mandated reporter pursuant to the Child Abuse and Neglect
line 19 Reporting Act, Article 2.5 (commencing with Section 11164) of
line 20 Chapter 2 of Title 1 of Part 4 of the Penal Code. The program shall
line 21 provide the services required in this section to the extent possible
line 22 within the total allocation. If allocations are insufficient, the
line 23 department, in consultation with the grantee or grantees and the
line 24 Child Welfare Training Advisory Board, shall prioritize the efforts
line 25 of the program, giving primary attention to the most urgently
line 26 needed services. County child protective services social workers
line 27 assigned emergency response responsibilities shall receive first
line 28 priority for training pursuant to this section.
line 29 (b) The training program shall provide practice-relevant training
line 30 for mandated child abuse reporters and all members of the child
line 31 welfare delivery system that will address critical issues affecting
line 32 the well-being of children, and shall develop curriculum materials
line 33 and training resources for use in meeting staff development needs
line 34 of mandated child abuse reporters and child welfare personnel in
line 35 public and private agency settings.
line 36 (c) The training provided pursuant to this section shall include
line 37 all of the following:
line 38 (1) Crisis intervention.
line 39 (2) Investigative techniques.
line 40 (3) Rules of evidence.
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Attachment A
line 1 (4) Indicators of abuse and neglect.
line 2 (5) Assessment criteria, including the application of guidelines
line 3 for assessment of relatives for placement according to the criteria
line 4 described in Section 361.3.
line 5 (6) Intervention strategies.
line 6 (7) Legal requirements of child protection, including
line 7 requirements of child abuse reporting laws.
line 8 (8) Case management.
line 9 (9) Use of community resources.
line 10 (10) Information regarding the dynamics and effects of domestic
line 11 violence upon families and children, including indicators and
line 12 dynamics of teen dating violence.
line 13 (11) Posttraumatic stress disorder and the causes, symptoms,
line 14 and treatment of posttraumatic stress disorder in children.
line 15 (12) The importance of maintaining relationships with
line 16 individuals who are important to a child in out-of-home placement,
line 17 including methods to identify those individuals, consistent with
line 18 the child’s best interests, including, but not limited to, asking the
line 19 child about individuals who are important, and ways to maintain
line 20 and support those relationships.
line 21 (13) The legal duties of a child protective services social worker,
line 22 in order to protect the legal rights and safety of children and
line 23 families from the initial time of contact during investigation
line 24 through treatment.
line 25 (14) The authorization for administration, authorization, uses,
line 26 risks, benefits, administration, oversight, and monitoring of
line 27 psychotropic medications, and trauma, mental behavioral health,
line 28 and other available mental behavioral health treatments, for
line 29 children receiving child welfare services. services, including how
line 30 to access those treatments.
line 31 (d) The training provided pursuant to this section may also
line 32 include any or all of the following:
line 33 (1) Child development and parenting.
line 34 (2) Intake, interviewing, and initial assessment.
line 35 (3) Casework and treatment.
line 36 (4) Medical aspects of child abuse and neglect.
line 37 (e) The training program in each county shall assess the
line 38 program’s performance at least annually and forward it to the State
line 39 Department of Social Services for an evaluation. The assessment
line 40 shall include, at a minimum, all of the following:
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SB 238— 23 — Attachment A
line 1 (1) Workforce data, including education, qualifications, and
line 2 demographics.
line 3 (2) The number of persons trained.
line 4 (3) The type of training provided.
line 5 (4) The degree to which the training is perceived by participants
line 6 as useful in practice.
line 7 (5) Any additional information or data deemed necessary by
line 8 the department for reporting, oversight, and monitoring purposes.
line 9 (f) The training program shall provide practice-relevant training
line 10 to county child protective services social workers who screen
line 11 referrals for child abuse or neglect and for all workers assigned to
line 12 provide emergency response, family maintenance, family
line 13 reunification, and permanent placement services. The training shall
line 14 be developed in consultation with the Child Welfare Training
line 15 Advisory Board and domestic violence victims’ advocates and
line 16 other public and private agencies that provide programs for victims
line 17 of domestic violence or programs of intervention for perpetrators.
line 18 SEC. 8. Section 16501.4 is added to the Welfare and
line 19 Institutions Code, to read:
line 20 16501.4. In order to ensure the oversight of psychotropic
line 21 medications that are prescribed for children receiving child welfare
line 22 services, all of the following shall occur:
line 23 (a) (1) A county child welfare agency shall use the form
line 24 developed pursuant to paragraph (2) to provide a monthly report
line 25 to the juvenile court, the child’s attorney, and the child’s
line 26 court-appointed special advocate, if one has been appointed. In
line 27 consultation with the State Department of Health Care Services,
line 28 the County Welfare Directors Association, and other stakeholders,
line 29 the State Department of Social Services shall develop and provide
line 30 an individualized monthly report to each county child welfare
line 31 services agency. At a minimum, that report shall include all of the
line 32 following information regarding a each child receiving child
line 33 welfare services: services from the county child welfare services
line 34 agency and for whom one or more psychotropic medications have
line 35 been authorized:
line 36 (A)
line 37 (1) Psychotropic medications that have been authorized for the
line 38 child. child pursuant to Section 369.5.
line 39 (B)
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Attachment A
line 1 (2) Paid claims data Data for medications that have been
line 2 prescribed dispensed to the child, including both psychotropic and
line 3 non-psychotropic medication.
line 4 (C)
line 5 (3) Durational information relating to the child’s prescribed
line 6 authorized psychotropicmedication, including, but not limited to,
line 7 the length of time a medication has been authorized and the length
line 8 of time for which claims have been paid for a filled prescription.
line 9 a medication has been dispensed by a pharmacy.
line 10 (D)
line 11 (4) Claims paid for mental behavioral health services provided
line 12 to the child, other than claims paid for psychotropic medication.
line 13 (E)
line 14 (5) The dosage of psychotropic medications that have been
line 15 authorized for the child and for which a claim has been paid. that
line 16 have been dispensed.
line 17 (b) (1) On a monthly basis, a county child welfare services
line 18 agency shall use the form developed pursuant to paragraph (2) to
line 19 share with the juvenile court, the child’s attorney, and the
line 20 court-appointed special advocate, if one has been appointed, the
line 21 information described in subdivision (a) regarding an individual
line 22 child receiving child welfare services and for whom one or more
line 23 psychotropic medications have been authorized.
line 24 (2) In consultation with the State Department of Health Care
line 25 Services, the County Welfare Directors Association, and other
line 26 stakeholders, the State Department of Social Services shall develop
line 27 a form to be utilized in making the reports sharing the information
line 28 required by paragraph (1).
line 29 (b)
line 30 (c) (1) In consultation with the State Department of Health Care
line 31 Services, the County Welfare Directors Association, and other
line 32 stakeholders, the State Department of Social Services shall either
line 33 develop, or ensure access to, a system that automatically alerts the
line 34 social worker of a child receiving child welfare services when
line 35 psychotropic medication has been prescribed that fits any of the
line 36 following descriptions:
line 37 (A) The psychotropic medication has been prescribed in
line 38 combination with another psychotropic medication and the
line 39 combination is unusual or has the potential for a dangerous
line 40 interaction.
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SB 238— 25 — Attachment A
line 1 (B) The psychotropic medication is prescribed in a dosage that
line 2 is unusual for a child of that age.
line 3 (C) The psychotropic medication has the potential for a
line 4 dangerous interaction with other prescribed psychotropic or
line 5 non-psychotropic medications.
line 6 (D) The psychotropic medication is not typically indicated for
line 7 a child of that age.
line 8 (2) If a child’s social worker receives an alert from the system
line 9 described in paragraph (1), upon receipt of the alert, the social
line 10 worker shall indicate to the court, the child’s attorney, the child’s
line 11 caregiver, and the child’s court-appointed special advocate, if one
line 12 has been appointed, that the alert has been received. The social
line 13 worker shall also include a discussion of the alert and the
line 14 resolution, if any, of the issue raised by the alert in the next court
line 15 report filed in the child’s case.
line 16 (c)
line 17 (d) In consultation with the State Department of Health Care
line 18 Services, the Judicial Council, the County Welfare Directors
line 19 Association, and other stakeholders, the State Department of Social
line 20 Services shall develop training that may be provided to county
line 21 child welfare social workers, courts, children’s attorneys, children’s
line 22 caregivers, court-appointed special advocates, and other relevant
line 23 staff who work with children receiving child welfare services that
line 24 addresses the authorization for administration, authorization, uses,
line 25 risks, benefits, administration, oversight, and monitoring of
line 26 psychotropic medications, and trauma, mental behavioral health,
line 27 and other available mental behavioral health treatments, for
line 28 children receiving child welfare services. services, including how
line 29 to access those treatments.
line 30 SEC. 9. To the extent that this act has an overall effect of
line 31 increasing the costs already borne by a local agency for programs
line 32 or levels of service mandated by the 2011 Realignment Legislation
line 33 within the meaning of Section 36 of Article XIII of the California
line 34 Constitution, it shall apply to local agencies only to the extent that
line 35 the state provides annual funding for the cost increase. Any new
line 36 program or higher level of service provided by a local agency
line 37 pursuant to this act above the level for which funding has been
line 38 provided shall not require a subvention of funds by the state nor
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Attachment A
line 1 otherwise be subject to Section 6 of Article XIII B of the California
line 2 Constitution.
O
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SB 238— 27 — Attachment A
Attachment B
Attachment B