BILL ANALYSIS
SENATE RULES COMMITTEE
Office of Senate Floor Analyses
1020 N Street, Suite 524
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UNFINISHED BUSINESS
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Bill No: SB 969
Author: Watson (D)
Amended: 9/14/95
Vote: 21
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SENATE HEALTH & HUMAN SERV. COMMITTEE: 6-0, 4/19/95
AYES: Watson, Haynes, Hughes, Mello, Polanco, Solis
NOT VOTING: Leslie, Maddy, Thompson
SENATE APPROPRIATIONS COMMITTEE: 8-2, 5/15/95
AYES: Johnston, Alquist, Greene, Killea, Leslie, Mello,
Mountjoy, Polanco
NOES: Kelley, Leonard
NOT VOTING: Calderon, Dills, Lewis
SENATE FLOOR: 35-1, 5/25/95
AYES: Alquist, Beverly, Boatwright, Calderon, Campbell,
Costa, Craven, Dills, Greene, Haynes, Hughes, Hurtt,
Johannessen, Johnston, Kelley, Killea, Kopp, Leslie,
Lewis, Lockyer, Marks, Mello, Monteith, Mountjoy,
O'Connell, Peace, Petris, Polanco, Rogers, Rosenthal,
Russell, Solis, Thompson, Watson, Wright
NOES: Leonard
NOT VOTING: Ayala, Hayden, Johnson, Maddy
ASSEMBLY FLOOR: 77-0, 9/15/95
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SUBJECT: Intensive treatment foster care program
SOURCE: California Association of Childrenos Homes
California Association of Services for Children
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DIGEST: This bill makes intensive treatment foster care
services available statewide to allow emotionally disturbed
foster children to be treated in family-based settings.
Assembly Amendments:
1. Permit the foster family agency to have a contract or
memorandum of understanding with the county.
2. Revise the intensive treatment foster care rates.
3. Specify the activities that an applicant county would
have to undertake as part of the application process.
ANALYSIS: Current law authorizes the California
Department of Social Services (CDSS) to implement an
intensive treatment foster care (ITFC) pilot program for
emotionally disturbed children in Alameda and Yolo
Counties. In-home support counselors provide a specified
number of hours of intensive support services to the
children and their families to enable them to live in
foster homes instead of institutional care. One foster
family agency (FFA) in each county may serve up to 25
children per year, all of whom must be either placed from a
group home with Rate Classification Level 12 through 14
(the three highest levels of care), or at imminent risk of
psychiatric hospitalization or placement in an RCL 12 or
higher group home. Rates are set according to the level of
services provided to each child. An interim evaluation of
the ITFC pilots was due December 31, 1994, with a final
evaluation due a year later. Intake into the pilot program
will cease June 30, 1996, and authorization for the entire
pilot will expire on January 1, 1999.
This bill would:
1. Permit the ITFC program to operate in any county,
subject to department approval. The limit on one FFA per
county would be removed.
2. Expand the pool of children eligible for ITFC services
to include children voluntarily placed in an RCL 12 or
higher group home pursuant to Section 7572.5 of the
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Government Code (so-called AB 3632 severely emotionally
disturbed children).
3. Remove the 25 child limit on the number of children who
may be served annually but retain the 20% cap on the
number of at-risk children who may be served in the
program.
4. Establish new requirements for FFAs that propose to
serve ITFC children from RCL 12-14 programs. The FFA
must have a contract or memorandum of understanding with
the county that addresses such services as social work
emergency response; psychiatric coverage in emergencies;
a treatment plan for each child, with periodic reviews;
documentation of treatment services provided;
recruitment, selection and training of foster parents and
in-home support counselors; respite services; and
evaluation of outcomes and services.
5. Modify and convert to a monthly basis, the required
hours of ITFC service from in-home support counselors.
Therapy, behavior modification services, respite, family
therapy and other alternative services may be offered in
lieu of in-home support services when determined by the
county interagency review team and FFA to be in the best
interests of the child.
6. Update ITFC rates to the 1995-96 fiscal year, with the
maximum rate set at $3,733. The rate paid cannot exceed
what would have been paid if the child had remained in
group home placement (for children placed from group
homes), or the rate determined by the interagency review
team at time of placement (for at-risk children).
7. Repeal the two sunset dates for the current ITFC pilot
programs.
According to Senate Health and Human Services Committee:
The intensive treatment foster care program was established
by SB 2234 (Presley; Chapter 1250, Statutes of 1990) to
show that severely emotionally disturbed foster children
could thrive in a foster home with family-based therapeutic
foster services. Utilizing extensively trained foster
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parents as the primary caregivers, this program blends the
"normalizing" features of foster home placement with
intensive counseling, case management, and support services
provided by in-home support counselors. Absent the pilot,
the placement choice for these children is high level
institutional group care or psychiatric hospitalization.
Two FFAs--Seneca Center for Children in San Leandro and
FamiliesFirst in Davis--are participating in the pilot.
Children in the Seneca program are typically 10 years old,
male and members of an ethnic minority. They have suffered
abuse and neglect from an early age; have been in multiple
foster placements, often from a very young age; and have
emotional, behavioral and learning problems that make
treating them in a family-based environment a formidable
challenge. The FamiliesFirst program serves children who
tend to be male and slightly older, 12 to 13 years old.
Like the Seneca children, they have experienced multiple
placements; have been subjected to serious neglect and
abuse; have developed what is referred to as
ooinstitutionalized behavior patternsoo such as lying,
acting aggressively, and lack of trust of adults and peers;
have a poor self-image; and have difficulty developing life
skills and solving problems on their own.
Recently completed independent evaluations of both pilot
programs have shown very positive outcomes for the
children, exceeding even the expectations of the
participating FFAs. Children receiving ITFC services have
shown significant improvements in such areas as
psychosocial functioning and development of life skills,
some showing improvement as early as six months. They
experienced longer periods of placement stability than
similar children in standard foster care and cost savings
have accrued from use of lower levels of residential
treatment. Over 90% of children and youth previously
served in high level institutional care have been
successfully served in the ITFC pilots. Their placement in
lower levels of residential treatment have also generated
savings in foster care costs. Annual projected savings per
child range from $2,500 to $7,000 and higher.
Additionally, foster parents, county social workers, and
program staff have expressed support for the program.
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This bill would make the ITFC program available to more
emotionally disturbed foster children than currently are
served. Access to ITFC services would be expanded
geographically (available statewide at county option).
Participating FAAs would have to meet additional
requirements in recognition of the increased difficulty of
serving these children. The program design would be
modified based on operational experience over the last four
years, and current sunset dates would be repealed in the
conversion to non-pilot status for the ITFC program.
This bill implements a recommendation from the Legislative
Analyst to expand the ITFC pilot program statewide, with
county participation voluntary (Analysis of the 1995-96
Budget Bill, page C-123).
FISCAL EFFECT: Appropriation: No Fiscal Com.: Yes
Local: No
According to Assembly Appropriations Committee:
Unknown, but potentially major savings to the General Fund,
federal funds and county funds for reduced foster care
placement costs for seriously emotionally disturbed
children. Counties, however, would accept the full risk of
increased costs. The extent of this risk cannot be
quantified.
Based on preliminary pilot project results, statewide
expansion of ITFC has the potential to result in major
savings to the foster care system. These savings would
result because the ITFC pilot approach has been able to
reduce the cost of treatment for some of the most expensive
children in the foster care system. The limited scope of
the pilot program, however, makes it difficult to predict
the actual savings that would result from potential
statewide expansion. Moreover, because the bill requires
that expansion result in no new General Fund costs,
counties would, presumably undertake the full risk of
increased costs. As a result, it is not clear how many
counties would decide to pursue an ITFC application with
the CDSS.
SUPPORT: (Verified 9/11/95)
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California Association of Childrenos Homes (co-source)
California Association of Services for Children (co-source)
Seneca Center for Children, San Leandro
FamiliesFirst, Davis
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CP:sl 9/14/95 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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