17730. The department shall develop a program to establish
specialized foster care homes for children with special health care
needs with persons specified in subdivision (h) of Section 17710. The
department shall limit the use of group homes for children with
special health care needs pursuant to subdivisions (d) and (e) of
Section 17732. The program shall conform to the requirements set
forth in this chapter, and shall be integrated with the foster care
and child welfare services programs authorized by Article 5
(commencing with Section 11400) of Chapter 2 of Part 3 and Chapter 5
(commencing with Section 16500) of Part 4.
The department, in administering the licensing program, shall not
evaluate or have any responsibility for the evaluation of the in-home
health care provided in specialized foster care homes or group
homes.
This program shall be conducted by county welfare departments in
conformance with procedures established by the department in
accordance with this chapter.
17731. (a) The county shall develop a plan to place children with
special health care needs in foster care. This plan shall be
submitted to the State Department of Social Services and the State
Department of Health Services, not later than April 1, 1990, before
beginning placement of children with special health care needs in
specialized foster care homes. This subdivision shall not invalidate
any placement made before April 1, 1990. A county that has not
submitted a plan by April 1, 1990, shall not continue to make
placements of children with special health care needs until the plan
has been submitted.
(b) Unless a local lead agency has been designated within the
county, as described in Item 4260-113-890 of the Budget Act of 1989,
the county department of social services shall be the lead agency
with the responsibility of developing the plan to be submitted
pursuant to subdivision (a). The county plan shall be formalized in
an interagency agreement between the county department of social
services and the other county and private agencies that are the
involved parties.
(c) The county plan shall meet all the requirements specified in
this subdivision. The regional center shall not be required to submit
a plan. However, all requirements specified in this subdivision
shall be met prior to a regional center placement of a child who is
not a court dependent and who has special health care needs.
(1) Prior to the placement of a child with special health care
needs, an individualized health care plan, which may be the hospital
discharge plan, shall be prepared for the child and, if necessary,
in-home health support services shall be arranged. The individualized
health care plan team shall be convened by the county department of
social services caseworker or the regional center caseworker, to
discuss the specific responsibilities of the person or persons
specified in subdivision (h) of Section 17710 for provision of
in-home health care in accordance with the individualized health care
plan developed by the child's physician or his or her designee. The
plan may also include the identification of any available and funded
medical services that are to be provided to the child in the home,
including, but not limited to, assistance from registered nurses,
licensed vocational nurses, public health nurses, physical
therapists, and respite care workers. The individualized health care
plan team shall delineate in the individualized health care plan the
coordination of health and related services for the child and the
appropriate number of hours needed to be provided by any health care
professional designated to monitor the child's individualized health
care plan pursuant to paragraph (8), including, if the child is in a
certified home, the registered nurse employed by or on contract with
the certifying agency to supervise and monitor the child.
(2) A child welfare services case plan or regional center
individual program plan shall be developed in accordance with
applicable regulations, and arrangements made for nonmedical support
services.
(3) Foster parents shall be trained by health care professionals
pursuant to the discharge plan of the facility releasing the child
being placed in, or currently in, foster care. Additional training
shall be provided as needed during the placement of the child and to
the child's biological parent or parents when the child is being
reunified with his or her family.
(4) Children with special health care needs shall be placed in the
home of the prospective foster parent subsequent to training by a
health care professional pursuant to the discharge plan of the
facility releasing the child being placed in foster care.
(5) Assistant caregivers, on-call assistants, respite care
workers, and other personnel caring for children with special health
care needs shall complete training or additional training by a health
care professional in accordance with paragraph (3).
(6) No foster parent who is a health care professional or staff
member who is a health care professional shall be required to
complete any training or additional training determined by the
responsible individualized health care plan team to be unnecessary on
the basis of his or her professional qualification and expertise.
(7) No health care professional shall provide in-home health care
to any child with special health care needs placed in a group home
after November 1, 1993, unless the individual health care plan team
for the child:
(A) Documents that the health care professional has the necessary
qualifications and expertise to meet the child's in-home health care
needs.
(B) Updates the documentation provided pursuant to subparagraph
(A) each time the child's special health care needs change.
(8) Specialized foster care homes and group homes caring for
children with special health care needs shall be monitored by the
county or regional center according to applicable regulations. The
health care plan for each child with special health care needs shall
designate which health care professional shall monitor the child's
ongoing health care, including in-home health care provided by
persons specified in subdivision (h) of Section 17710. Where the
child is placed in a certified home, the designated health care
professional shall be the registered nurse employed by or on contract
with the foster family agency to supervise and monitor the child.
(9) The workload of the health care professional supervising or
monitoring a child's ongoing health care in a certified home shall be
based on the cumulative total hours specified in the individualized
health care plans for children assigned to the health care
professional. In no case shall the health care professional's regular
workload based on the cumulative total hours specified in the
individualized health care plans for children assigned to the health
care professional be more than 40 hours per week.
(10) The child's individualized health care plan shall be
reassessed at least every six months during the time the child is
placed in the specialized foster care home, to ensure that
specialized care payments are appropriate to meet the child's health
care needs.
(11) The placement agencies shall coordinate the sources of
funding and services available to children with special health care
needs in order to maximize the social services provided to these
children and to avoid duplication of programs and funding.
17732. No more than two foster care children shall reside in a
specialized foster care home with the following exceptions:
(a) A specialized foster care home may have a third child with or
without special health care needs placed in that home provided that
the licensed capacity, as determined by the department pursuant to
paragraph (6) of subdivision (a) of Section 1502 of the Health and
Safety Code is not exceeded and provided that all of the following
conditions have been met:
(1) The child's placement worker has determined and documented
that no other placement is available.
(2) For each child in placement and the child to be placed, the
child's placement worker has determined that his or her psychological
and social needs will be met by placement in the home and has
documented that determination. New determinations shall be made and
documented each time there is an increase or turnover in foster care
children and the two-child capacity limit is exceeded.
(3) The individualized health care plan team responsible for the
ongoing care of each child with special health care needs involved
has determined that the two-child limit may be exceeded without
jeopardizing the health and safety of that child, and has documented
that determination. New determinations shall be made and documented
each time there is an increase or turnover in foster care children
and the two-child capacity limit is exceeded.
(b) A licensed small family home, but not a certified home, may
exceed the placement limit specified in subdivision (a) and accept
children with or without special health care needs up to the licensed
capacity as determined by the department pursuant to paragraph (6)
of subdivision (a) of Section 1502 of the Health and Safety Code if
the conditions in subdivision (a) have been met for both the third
child and each child placed thereafter, and the following additional
conditions have been met:
(1) At least one of the children in the facility is a regional
center client monitored in accordance with Section 56001 and
following of Title 17 of the California Code of Regulations.
(2) Whenever four or more foster care children are physically
present in the facility, the licensee of the small family home has
the assistance of a caregiver to provide specialized in-home health
care to the children except that:
(A) Night assistance shall not be required for those hours that
the individualized health care plan team for each child with special
health care needs has documented that the child will not require
specialized medical services during that time.
(B) The department may determine that additional assistance is
required to provide appropriate care and supervision for all children
in placement. The determination shall only be made after
consultation with the appropriate regional center and any appropriate
individual health care teams.
(3) On-call assistance is available at all times to respond in
case of an emergency. The on-call assistant shall meet the
requirements of paragraph (5) of subdivision (c) of Section 17731.
(4) The home is sufficient in size to accommodate the needs of all
children in the home.
(c) Notwithstanding Section 1523 of the Health and Safety Code, a
foster family home which has more than three children with special
health care needs in its care as of January 1, 1992, and which
applies for licensure as a small family home in order to continue to
provide care for those children, shall be exempt from the application
fee.
(d) Except for children with special health care needs placed in
group homes before January 1, 1992, no child with special health care
needs may be placed in any group home or combination of group homes
for longer than a short-term placement of 120 calendar days. The
short-term placement in the group home shall be on an emergency basis
for the purpose of arranging a subsequent placement in a less
restrictive setting, such as with the child's natural parents or
relatives, with a foster parent or foster family agency, or with
another appropriate person or facility. The 120-day limitation shall
not be extended, except by the approval of the director or his or her
designee. For children placed after January 1, 1992, the 120-day
limitation shall begin on the effective date of the amendments to
this section made during the 1993 portion of the 1993-94 Regular
Session.
(e) A child with special health care needs shall not be placed in
a group home unless the child's placement worker has determined and
documented that the group home has a program that meets the specific
needs of the child being placed and there is a commonalty of needs
with the other children in the group home.
17732.1. (a) It is the intent of the Legislature that minor
children who are residing in specialized foster care home placements
on or after January 1, 1997, be allowed to remain in those homes upon
reaching majority, through 22 years of age, in order to ensure
continuity of care during completion of publicly funded education.
(b) A child with special health care needs may remain in a
licensed foster family home or licensed small family home that is
operating as a specialized foster care home pursuant to subdivision
(i) of Section 17710 after the age of 18 years, if all of the
following requirements are met:
(1) The child was a resident in the home prior to the age of 18.
(2) A determination regarding whether the child may remain as a
resident after the age of 18 years is made through the agreement of
all parties involved, including the resident, the foster parent, the
social worker, the resident's regional center case manager, and the
resident's parent, legal guardian, or conservator, as appropriate.
This determination shall include a needs and service plan that
contains an assessment of the child's needs and of continued
compatibility with the other children in placement. The needs and
service plan shall be completed within the six months prior to the
child's 18th birthday and shall be updated with any significant
change and whenever there is a change in household composition. The
assessment shall be documented and maintained in the child's file,
and shall be made available for inspection by the licensing staff.
(3) The regional center monitors and supervises its placements, as
part of its regular and ongoing services to clients, to ensure the
continued health and safety, appropriate placement, and compatibility
of the developmentally disabled adult with special health care
needs.
(4) The department notifies the foster care applicant, as part of
its orientation process, that the state Foster Family Home and Small
Family Home Insurance Fund does not expand existing coverage in
Article 2.5 (commencing with Section 1527) of Chapter 3 of Division 2
of the Health and Safety Code for liability resulting from the
provision of care to individuals over the age of 18 years.
17733. All documentation prepared by the county concerning the
identification of a dependent child as a child with special health
care needs, the placement of such a child in a specialized foster
care home, assessments and reassessments of the level of care
designation, the decision to place more than two children with
special health care needs in a home, and contact among the health
care team plan members who are monitoring the individualized health
care plan of the child, shall be made part of the child's case
record. Reports of training provided by the health care professional
pursuant to the discharge plan of the facility releasing the child
being placed in foster care shall also be included in the case
record.
17734. Each county shall report to the department on a regular
basis on the conduct and effectiveness of the program provided for in
this chapter. These reports shall be submitted in conformance with
instructions provided by the department. These reports shall include,
but not be limited to, all of the following data:
(a) An estimate of the number of children adjudicated dependents
of the juvenile court under Section 300 who have special health care
needs during the reporting period.
(b) The number of children with special health care needs in (1)
hospitals or other institutional placements, (2) group homes, and (3)
small family homes at the beginning of the reporting period.
(c) The number of children with special health care needs in
specialized foster care homes.
(d) The number of children with special health care needs placed
in specialized foster care homes during the reporting period.
(e) The cost of providing specialized placements for children with
special health care needs during the reporting period.
17735. Commencing in 1991, a progress report on the program
provided for in this chapter shall be included in the child welfare
services report to the Legislature required by Section 16512.
The department shall not evaluate or have any responsibility for
the evaluation of the in-home health care provided in specialized
foster care homes.
17736. Notwithstanding any other provision of law, including
Sections 1250, 1251, 1254, 1270, 1501, 1502, 1505, 1507, 1521, 1530.6
(as added by Chapter 391 of the Statutes of 1977), 1550, 11002, and
11154 of the Health and Safety Code, and Sections 2052, 2725, 2732,
and 2795 of the Business and Professions Code, all of the following
shall apply:
(a) (1) Counties and regional centers shall be permitted to place
children with special health care needs in foster family homes, small
family homes, and group homes pursuant to Chapter 3 (commencing with
Section 1500) of Division 2 of the Health and Safety Code.
(2) Foster family agencies shall be permitted to place children
with special health care needs in certified homes pursuant to Chapter
3 (commencing with Section 1500) of Division 2 of the Health and
Safety Code.
(b) Counties, regional centers, and foster family agencies shall
permit all of the following:
(1) A foster parent, an assistant caregiver, an on-call assistant,
and a respite caregiver meeting the requirements of paragraphs (3),
(5), and (6) of subdivision (c) of Section 17731 to provide, in a
specialized foster care home, specialized in-home health care to a
foster child, as described in the child's individualized health care
plan.
(2) The licensee and other personnel meeting the requirements of
paragraphs (3), (5), and (6) of subdivision (c) of Section 17731 to
provide, in a group home, specialized in-home health care to a child,
as described in his or her individualized health care plan, provided
that the child was placed as of November 1, 1993.
17737. Nothing in this chapter shall be construed to prevent
children with special health care needs who have adoption as a case
plan goal from receiving services under this program.
17738. Notwithstanding Chapter 3.5 (commencing with Section 11340)
of Part 1 of Division 3 of Title 2 of the Government Code, the
department shall adopt emergency regulations to implement the program
provided for in this chapter. The emergency regulations shall remain
in effect for no more than 120 days, unless the department complies
with all the provisions of Chapter 3.5 (commencing with Section
11340) as required by subdivision (e) of Section 11346.1 of the
Government Code.
17730. The department shall develop a program to establish
specialized foster care homes for children with special health care
needs with persons specified in subdivision (h) of Section 17710. The
department shall limit the use of group homes for children with
special health care needs pursuant to subdivisions (d) and (e) of
Section 17732. The program shall conform to the requirements set
forth in this chapter, and shall be integrated with the foster care
and child welfare services programs authorized by Article 5
(commencing with Section 11400) of Chapter 2 of Part 3 and Chapter 5
(commencing with Section 16500) of Part 4.
The department, in administering the licensing program, shall not
evaluate or have any responsibility for the evaluation of the in-home
health care provided in specialized foster care homes or group
homes.
This program shall be conducted by county welfare departments in
conformance with procedures established by the department in
accordance with this chapter.
17731. (a) The county shall develop a plan to place children with
special health care needs in foster care. This plan shall be
submitted to the State Department of Social Services and the State
Department of Health Services, not later than April 1, 1990, before
beginning placement of children with special health care needs in
specialized foster care homes. This subdivision shall not invalidate
any placement made before April 1, 1990. A county that has not
submitted a plan by April 1, 1990, shall not continue to make
placements of children with special health care needs until the plan
has been submitted.
(b) Unless a local lead agency has been designated within the
county, as described in Item 4260-113-890 of the Budget Act of 1989,
the county department of social services shall be the lead agency
with the responsibility of developing the plan to be submitted
pursuant to subdivision (a). The county plan shall be formalized in
an interagency agreement between the county department of social
services and the other county and private agencies that are the
involved parties.
(c) The county plan shall meet all the requirements specified in
this subdivision. The regional center shall not be required to submit
a plan. However, all requirements specified in this subdivision
shall be met prior to a regional center placement of a child who is
not a court dependent and who has special health care needs.
(1) Prior to the placement of a child with special health care
needs, an individualized health care plan, which may be the hospital
discharge plan, shall be prepared for the child and, if necessary,
in-home health support services shall be arranged. The individualized
health care plan team shall be convened by the county department of
social services caseworker or the regional center caseworker, to
discuss the specific responsibilities of the person or persons
specified in subdivision (h) of Section 17710 for provision of
in-home health care in accordance with the individualized health care
plan developed by the child's physician or his or her designee. The
plan may also include the identification of any available and funded
medical services that are to be provided to the child in the home,
including, but not limited to, assistance from registered nurses,
licensed vocational nurses, public health nurses, physical
therapists, and respite care workers. The individualized health care
plan team shall delineate in the individualized health care plan the
coordination of health and related services for the child and the
appropriate number of hours needed to be provided by any health care
professional designated to monitor the child's individualized health
care plan pursuant to paragraph (8), including, if the child is in a
certified home, the registered nurse employed by or on contract with
the certifying agency to supervise and monitor the child.
(2) A child welfare services case plan or regional center
individual program plan shall be developed in accordance with
applicable regulations, and arrangements made for nonmedical support
services.
(3) Foster parents shall be trained by health care professionals
pursuant to the discharge plan of the facility releasing the child
being placed in, or currently in, foster care. Additional training
shall be provided as needed during the placement of the child and to
the child's biological parent or parents when the child is being
reunified with his or her family.
(4) Children with special health care needs shall be placed in the
home of the prospective foster parent subsequent to training by a
health care professional pursuant to the discharge plan of the
facility releasing the child being placed in foster care.
(5) Assistant caregivers, on-call assistants, respite care
workers, and other personnel caring for children with special health
care needs shall complete training or additional training by a health
care professional in accordance with paragraph (3).
(6) No foster parent who is a health care professional or staff
member who is a health care professional shall be required to
complete any training or additional training determined by the
responsible individualized health care plan team to be unnecessary on
the basis of his or her professional qualification and expertise.
(7) No health care professional shall provide in-home health care
to any child with special health care needs placed in a group home
after November 1, 1993, unless the individual health care plan team
for the child:
(A) Documents that the health care professional has the necessary
qualifications and expertise to meet the child's in-home health care
needs.
(B) Updates the documentation provided pursuant to subparagraph
(A) each time the child's special health care needs change.
(8) Specialized foster care homes and group homes caring for
children with special health care needs shall be monitored by the
county or regional center according to applicable regulations. The
health care plan for each child with special health care needs shall
designate which health care professional shall monitor the child's
ongoing health care, including in-home health care provided by
persons specified in subdivision (h) of Section 17710. Where the
child is placed in a certified home, the designated health care
professional shall be the registered nurse employed by or on contract
with the foster family agency to supervise and monitor the child.
(9) The workload of the health care professional supervising or
monitoring a child's ongoing health care in a certified home shall be
based on the cumulative total hours specified in the individualized
health care plans for children assigned to the health care
professional. In no case shall the health care professional's regular
workload based on the cumulative total hours specified in the
individualized health care plans for children assigned to the health
care professional be more than 40 hours per week.
(10) The child's individualized health care plan shall be
reassessed at least every six months during the time the child is
placed in the specialized foster care home, to ensure that
specialized care payments are appropriate to meet the child's health
care needs.
(11) The placement agencies shall coordinate the sources of
funding and services available to children with special health care
needs in order to maximize the social services provided to these
children and to avoid duplication of programs and funding.
17732. No more than two foster care children shall reside in a
specialized foster care home with the following exceptions:
(a) A specialized foster care home may have a third child with or
without special health care needs placed in that home provided that
the licensed capacity, as determined by the department pursuant to
paragraph (6) of subdivision (a) of Section 1502 of the Health and
Safety Code is not exceeded and provided that all of the following
conditions have been met:
(1) The child's placement worker has determined and documented
that no other placement is available.
(2) For each child in placement and the child to be placed, the
child's placement worker has determined that his or her psychological
and social needs will be met by placement in the home and has
documented that determination. New determinations shall be made and
documented each time there is an increase or turnover in foster care
children and the two-child capacity limit is exceeded.
(3) The individualized health care plan team responsible for the
ongoing care of each child with special health care needs involved
has determined that the two-child limit may be exceeded without
jeopardizing the health and safety of that child, and has documented
that determination. New determinations shall be made and documented
each time there is an increase or turnover in foster care children
and the two-child capacity limit is exceeded.
(b) A licensed small family home, but not a certified home, may
exceed the placement limit specified in subdivision (a) and accept
children with or without special health care needs up to the licensed
capacity as determined by the department pursuant to paragraph (6)
of subdivision (a) of Section 1502 of the Health and Safety Code if
the conditions in subdivision (a) have been met for both the third
child and each child placed thereafter, and the following additional
conditions have been met:
(1) At least one of the children in the facility is a regional
center client monitored in accordance with Section 56001 and
following of Title 17 of the California Code of Regulations.
(2) Whenever four or more foster care children are physically
present in the facility, the licensee of the small family home has
the assistance of a caregiver to provide specialized in-home health
care to the children except that:
(A) Night assistance shall not be required for those hours that
the individualized health care plan team for each child with special
health care needs has documented that the child will not require
specialized medical services during that time.
(B) The department may determine that additional assistance is
required to provide appropriate care and supervision for all children
in placement. The determination shall only be made after
consultation with the appropriate regional center and any appropriate
individual health care teams.
(3) On-call assistance is available at all times to respond in
case of an emergency. The on-call assistant shall meet the
requirements of paragraph (5) of subdivision (c) of Section 17731.
(4) The home is sufficient in size to accommodate the needs of all
children in the home.
(c) Notwithstanding Section 1523 of the Health and Safety Code, a
foster family home which has more than three children with special
health care needs in its care as of January 1, 1992, and which
applies for licensure as a small family home in order to continue to
provide care for those children, shall be exempt from the application
fee.
(d) Except for children with special health care needs placed in
group homes before January 1, 1992, no child with special health care
needs may be placed in any group home or combination of group homes
for longer than a short-term placement of 120 calendar days. The
short-term placement in the group home shall be on an emergency basis
for the purpose of arranging a subsequent placement in a less
restrictive setting, such as with the child's natural parents or
relatives, with a foster parent or foster family agency, or with
another appropriate person or facility. The 120-day limitation shall
not be extended, except by the approval of the director or his or her
designee. For children placed after January 1, 1992, the 120-day
limitation shall begin on the effective date of the amendments to
this section made during the 1993 portion of the 1993-94 Regular
Session.
(e) A child with special health care needs shall not be placed in
a group home unless the child's placement worker has determined and
documented that the group home has a program that meets the specific
needs of the child being placed and there is a commonalty of needs
with the other children in the group home.
17732.1. (a) It is the intent of the Legislature that minor
children who are residing in specialized foster care home placements
on or after January 1, 1997, be allowed to remain in those homes upon
reaching majority, through 22 years of age, in order to ensure
continuity of care during completion of publicly funded education.
(b) A child with special health care needs may remain in a
licensed foster family home or licensed small family home that is
operating as a specialized foster care home pursuant to subdivision
(i) of Section 17710 after the age of 18 years, if all of the
following requirements are met:
(1) The child was a resident in the home prior to the age of 18.
(2) A determination regarding whether the child may remain as a
resident after the age of 18 years is made through the agreement of
all parties involved, including the resident, the foster parent, the
social worker, the resident's regional center case manager, and the
resident's parent, legal guardian, or conservator, as appropriate.
This determination shall include a needs and service plan that
contains an assessment of the child's needs and of continued
compatibility with the other children in placement. The needs and
service plan shall be completed within the six months prior to the
child's 18th birthday and shall be updated with any significant
change and whenever there is a change in household composition. The
assessment shall be documented and maintained in the child's file,
and shall be made available for inspection by the licensing staff.
(3) The regional center monitors and supervises its placements, as
part of its regular and ongoing services to clients, to ensure the
continued health and safety, appropriate placement, and compatibility
of the developmentally disabled adult with special health care
needs.
(4) The department notifies the foster care applicant, as part of
its orientation process, that the state Foster Family Home and Small
Family Home Insurance Fund does not expand existing coverage in
Article 2.5 (commencing with Section 1527) of Chapter 3 of Division 2
of the Health and Safety Code for liability resulting from the
provision of care to individuals over the age of 18 years.
17733. All documentation prepared by the county concerning the
identification of a dependent child as a child with special health
care needs, the placement of such a child in a specialized foster
care home, assessments and reassessments of the level of care
designation, the decision to place more than two children with
special health care needs in a home, and contact among the health
care team plan members who are monitoring the individualized health
care plan of the child, shall be made part of the child's case
record. Reports of training provided by the health care professional
pursuant to the discharge plan of the facility releasing the child
being placed in foster care shall also be included in the case
record.
17734. Each county shall report to the department on a regular
basis on the conduct and effectiveness of the program provided for in
this chapter. These reports shall be submitted in conformance with
instructions provided by the department. These reports shall include,
but not be limited to, all of the following data:
(a) An estimate of the number of children adjudicated dependents
of the juvenile court under Section 300 who have special health care
needs during the reporting period.
(b) The number of children with special health care needs in (1)
hospitals or other institutional placements, (2) group homes, and (3)
small family homes at the beginning of the reporting period.
(c) The number of children with special health care needs in
specialized foster care homes.
(d) The number of children with special health care needs placed
in specialized foster care homes during the reporting period.
(e) The cost of providing specialized placements for children with
special health care needs during the reporting period.
17735. Commencing in 1991, a progress report on the program
provided for in this chapter shall be included in the child welfare
services report to the Legislature required by Section 16512.
The department shall not evaluate or have any responsibility for
the evaluation of the in-home health care provided in specialized
foster care homes.
17736. Notwithstanding any other provision of law, including
Sections 1250, 1251, 1254, 1270, 1501, 1502, 1505, 1507, 1521, 1530.6
(as added by Chapter 391 of the Statutes of 1977), 1550, 11002, and
11154 of the Health and Safety Code, and Sections 2052, 2725, 2732,
and 2795 of the Business and Professions Code, all of the following
shall apply:
(a) (1) Counties and regional centers shall be permitted to place
children with special health care needs in foster family homes, small
family homes, and group homes pursuant to Chapter 3 (commencing with
Section 1500) of Division 2 of the Health and Safety Code.
(2) Foster family agencies shall be permitted to place children
with special health care needs in certified homes pursuant to Chapter
3 (commencing with Section 1500) of Division 2 of the Health and
Safety Code.
(b) Counties, regional centers, and foster family agencies shall
permit all of the following:
(1) A foster parent, an assistant caregiver, an on-call assistant,
and a respite caregiver meeting the requirements of paragraphs (3),
(5), and (6) of subdivision (c) of Section 17731 to provide, in a
specialized foster care home, specialized in-home health care to a
foster child, as described in the child's individualized health care
plan.
(2) The licensee and other personnel meeting the requirements of
paragraphs (3), (5), and (6) of subdivision (c) of Section 17731 to
provide, in a group home, specialized in-home health care to a child,
as described in his or her individualized health care plan, provided
that the child was placed as of November 1, 1993.
17737. Nothing in this chapter shall be construed to prevent
children with special health care needs who have adoption as a case
plan goal from receiving services under this program.
17738. Notwithstanding Chapter 3.5 (commencing with Section 11340)
of Part 1 of Division 3 of Title 2 of the Government Code, the
department shall adopt emergency regulations to implement the program
provided for in this chapter. The emergency regulations shall remain
in effect for no more than 120 days, unless the department complies
with all the provisions of Chapter 3.5 (commencing with Section
11340) as required by subdivision (e) of Section 11346.1 of the
Government Code.
17730. The department shall develop a program to establish
specialized foster care homes for children with special health care
needs with persons specified in subdivision (h) of Section 17710. The
department shall limit the use of group homes for children with
special health care needs pursuant to subdivisions (d) and (e) of
Section 17732. The program shall conform to the requirements set
forth in this chapter, and shall be integrated with the foster care
and child welfare services programs authorized by Article 5
(commencing with Section 11400) of Chapter 2 of Part 3 and Chapter 5
(commencing with Section 16500) of Part 4.
The department, in administering the licensing program, shall not
evaluate or have any responsibility for the evaluation of the in-home
health care provided in specialized foster care homes or group
homes.
This program shall be conducted by county welfare departments in
conformance with procedures established by the department in
accordance with this chapter.
17731. (a) The county shall develop a plan to place children with
special health care needs in foster care. This plan shall be
submitted to the State Department of Social Services and the State
Department of Health Services, not later than April 1, 1990, before
beginning placement of children with special health care needs in
specialized foster care homes. This subdivision shall not invalidate
any placement made before April 1, 1990. A county that has not
submitted a plan by April 1, 1990, shall not continue to make
placements of children with special health care needs until the plan
has been submitted.
(b) Unless a local lead agency has been designated within the
county, as described in Item 4260-113-890 of the Budget Act of 1989,
the county department of social services shall be the lead agency
with the responsibility of developing the plan to be submitted
pursuant to subdivision (a). The county plan shall be formalized in
an interagency agreement between the county department of social
services and the other county and private agencies that are the
involved parties.
(c) The county plan shall meet all the requirements specified in
this subdivision. The regional center shall not be required to submit
a plan. However, all requirements specified in this subdivision
shall be met prior to a regional center placement of a child who is
not a court dependent and who has special health care needs.
(1) Prior to the placement of a child with special health care
needs, an individualized health care plan, which may be the hospital
discharge plan, shall be prepared for the child and, if necessary,
in-home health support services shall be arranged. The individualized
health care plan team shall be convened by the county department of
social services caseworker or the regional center caseworker, to
discuss the specific responsibilities of the person or persons
specified in subdivision (h) of Section 17710 for provision of
in-home health care in accordance with the individualized health care
plan developed by the child's physician or his or her designee. The
plan may also include the identification of any available and funded
medical services that are to be provided to the child in the home,
including, but not limited to, assistance from registered nurses,
licensed vocational nurses, public health nurses, physical
therapists, and respite care workers. The individualized health care
plan team shall delineate in the individualized health care plan the
coordination of health and related services for the child and the
appropriate number of hours needed to be provided by any health care
professional designated to monitor the child's individualized health
care plan pursuant to paragraph (8), including, if the child is in a
certified home, the registered nurse employed by or on contract with
the certifying agency to supervise and monitor the child.
(2) A child welfare services case plan or regional center
individual program plan shall be developed in accordance with
applicable regulations, and arrangements made for nonmedical support
services.
(3) Foster parents shall be trained by health care professionals
pursuant to the discharge plan of the facility releasing the child
being placed in, or currently in, foster care. Additional training
shall be provided as needed during the placement of the child and to
the child's biological parent or parents when the child is being
reunified with his or her family.
(4) Children with special health care needs shall be placed in the
home of the prospective foster parent subsequent to training by a
health care professional pursuant to the discharge plan of the
facility releasing the child being placed in foster care.
(5) Assistant caregivers, on-call assistants, respite care
workers, and other personnel caring for children with special health
care needs shall complete training or additional training by a health
care professional in accordance with paragraph (3).
(6) No foster parent who is a health care professional or staff
member who is a health care professional shall be required to
complete any training or additional training determined by the
responsible individualized health care plan team to be unnecessary on
the basis of his or her professional qualification and expertise.
(7) No health care professional shall provide in-home health care
to any child with special health care needs placed in a group home
after November 1, 1993, unless the individual health care plan team
for the child:
(A) Documents that the health care professional has the necessary
qualifications and expertise to meet the child's in-home health care
needs.
(B) Updates the documentation provided pursuant to subparagraph
(A) each time the child's special health care needs change.
(8) Specialized foster care homes and group homes caring for
children with special health care needs shall be monitored by the
county or regional center according to applicable regulations. The
health care plan for each child with special health care needs shall
designate which health care professional shall monitor the child's
ongoing health care, including in-home health care provided by
persons specified in subdivision (h) of Section 17710. Where the
child is placed in a certified home, the designated health care
professional shall be the registered nurse employed by or on contract
with the foster family agency to supervise and monitor the child.
(9) The workload of the health care professional supervising or
monitoring a child's ongoing health care in a certified home shall be
based on the cumulative total hours specified in the individualized
health care plans for children assigned to the health care
professional. In no case shall the health care professional's regular
workload based on the cumulative total hours specified in the
individualized health care plans for children assigned to the health
care professional be more than 40 hours per week.
(10) The child's individualized health care plan shall be
reassessed at least every six months during the time the child is
placed in the specialized foster care home, to ensure that
specialized care payments are appropriate to meet the child's health
care needs.
(11) The placement agencies shall coordinate the sources of
funding and services available to children with special health care
needs in order to maximize the social services provided to these
children and to avoid duplication of programs and funding.
17732. No more than two foster care children shall reside in a
specialized foster care home with the following exceptions:
(a) A specialized foster care home may have a third child with or
without special health care needs placed in that home provided that
the licensed capacity, as determined by the department pursuant to
paragraph (6) of subdivision (a) of Section 1502 of the Health and
Safety Code is not exceeded and provided that all of the following
conditions have been met:
(1) The child's placement worker has determined and documented
that no other placement is available.
(2) For each child in placement and the child to be placed, the
child's placement worker has determined that his or her psychological
and social needs will be met by placement in the home and has
documented that determination. New determinations shall be made and
documented each time there is an increase or turnover in foster care
children and the two-child capacity limit is exceeded.
(3) The individualized health care plan team responsible for the
ongoing care of each child with special health care needs involved
has determined that the two-child limit may be exceeded without
jeopardizing the health and safety of that child, and has documented
that determination. New determinations shall be made and documented
each time there is an increase or turnover in foster care children
and the two-child capacity limit is exceeded.
(b) A licensed small family home, but not a certified home, may
exceed the placement limit specified in subdivision (a) and accept
children with or without special health care needs up to the licensed
capacity as determined by the department pursuant to paragraph (6)
of subdivision (a) of Section 1502 of the Health and Safety Code if
the conditions in subdivision (a) have been met for both the third
child and each child placed thereafter, and the following additional
conditions have been met:
(1) At least one of the children in the facility is a regional
center client monitored in accordance with Section 56001 and
following of Title 17 of the California Code of Regulations.
(2) Whenever four or more foster care children are physically
present in the facility, the licensee of the small family home has
the assistance of a caregiver to provide specialized in-home health
care to the children except that:
(A) Night assistance shall not be required for those hours that
the individualized health care plan team for each child with special
health care needs has documented that the child will not require
specialized medical services during that time.
(B) The department may determine that additional assistance is
required to provide appropriate care and supervision for all children
in placement. The determination shall only be made after
consultation with the appropriate regional center and any appropriate
individual health care teams.
(3) On-call assistance is available at all times to respond in
case of an emergency. The on-call assistant shall meet the
requirements of paragraph (5) of subdivision (c) of Section 17731.
(4) The home is sufficient in size to accommodate the needs of all
children in the home.
(c) Notwithstanding Section 1523 of the Health and Safety Code, a
foster family home which has more than three children with special
health care needs in its care as of January 1, 1992, and which
applies for licensure as a small family home in order to continue to
provide care for those children, shall be exempt from the application
fee.
(d) Except for children with special health care needs placed in
group homes before January 1, 1992, no child with special health care
needs may be placed in any group home or combination of group homes
for longer than a short-term placement of 120 calendar days. The
short-term placement in the group home shall be on an emergency basis
for the purpose of arranging a subsequent placement in a less
restrictive setting, such as with the child's natural parents or
relatives, with a foster parent or foster family agency, or with
another appropriate person or facility. The 120-day limitation shall
not be extended, except by the approval of the director or his or her
designee. For children placed after January 1, 1992, the 120-day
limitation shall begin on the effective date of the amendments to
this section made during the 1993 portion of the 1993-94 Regular
Session.
(e) A child with special health care needs shall not be placed in
a group home unless the child's placement worker has determined and
documented that the group home has a program that meets the specific
needs of the child being placed and there is a commonalty of needs
with the other children in the group home.
17732.1. (a) It is the intent of the Legislature that minor
children who are residing in specialized foster care home placements
on or after January 1, 1997, be allowed to remain in those homes upon
reaching majority, through 22 years of age, in order to ensure
continuity of care during completion of publicly funded education.
(b) A child with special health care needs may remain in a
licensed foster family home or licensed small family home that is
operating as a specialized foster care home pursuant to subdivision
(i) of Section 17710 after the age of 18 years, if all of the
following requirements are met:
(1) The child was a resident in the home prior to the age of 18.
(2) A determination regarding whether the child may remain as a
resident after the age of 18 years is made through the agreement of
all parties involved, including the resident, the foster parent, the
social worker, the resident's regional center case manager, and the
resident's parent, legal guardian, or conservator, as appropriate.
This determination shall include a needs and service plan that
contains an assessment of the child's needs and of continued
compatibility with the other children in placement. The needs and
service plan shall be completed within the six months prior to the
child's 18th birthday and shall be updated with any significant
change and whenever there is a change in household composition. The
assessment shall be documented and maintained in the child's file,
and shall be made available for inspection by the licensing staff.
(3) The regional center monitors and supervises its placements, as
part of its regular and ongoing services to clients, to ensure the
continued health and safety, appropriate placement, and compatibility
of the developmentally disabled adult with special health care
needs.
(4) The department notifies the foster care applicant, as part of
its orientation process, that the state Foster Family Home and Small
Family Home Insurance Fund does not expand existing coverage in
Article 2.5 (commencing with Section 1527) of Chapter 3 of Division 2
of the Health and Safety Code for liability resulting from the
provision of care to individuals over the age of 18 years.
17733. All documentation prepared by the county concerning the
identification of a dependent child as a child with special health
care needs, the placement of such a child in a specialized foster
care home, assessments and reassessments of the level of care
designation, the decision to place more than two children with
special health care needs in a home, and contact among the health
care team plan members who are monitoring the individualized health
care plan of the child, shall be made part of the child's case
record. Reports of training provided by the health care professional
pursuant to the discharge plan of the facility releasing the child
being placed in foster care shall also be included in the case
record.
17734. Each county shall report to the department on a regular
basis on the conduct and effectiveness of the program provided for in
this chapter. These reports shall be submitted in conformance with
instructions provided by the department. These reports shall include,
but not be limited to, all of the following data:
(a) An estimate of the number of children adjudicated dependents
of the juvenile court under Section 300 who have special health care
needs during the reporting period.
(b) The number of children with special health care needs in (1)
hospitals or other institutional placements, (2) group homes, and (3)
small family homes at the beginning of the reporting period.
(c) The number of children with special health care needs in
specialized foster care homes.
(d) The number of children with special health care needs placed
in specialized foster care homes during the reporting period.
(e) The cost of providing specialized placements for children with
special health care needs during the reporting period.
17735. Commencing in 1991, a progress report on the program
provided for in this chapter shall be included in the child welfare
services report to the Legislature required by Section 16512.
The department shall not evaluate or have any responsibility for
the evaluation of the in-home health care provided in specialized
foster care homes.
17736. Notwithstanding any other provision of law, including
Sections 1250, 1251, 1254, 1270, 1501, 1502, 1505, 1507, 1521, 1530.6
(as added by Chapter 391 of the Statutes of 1977), 1550, 11002, and
11154 of the Health and Safety Code, and Sections 2052, 2725, 2732,
and 2795 of the Business and Professions Code, all of the following
shall apply:
(a) (1) Counties and regional centers shall be permitted to place
children with special health care needs in foster family homes, small
family homes, and group homes pursuant to Chapter 3 (commencing with
Section 1500) of Division 2 of the Health and Safety Code.
(2) Foster family agencies shall be permitted to place children
with special health care needs in certified homes pursuant to Chapter
3 (commencing with Section 1500) of Division 2 of the Health and
Safety Code.
(b) Counties, regional centers, and foster family agencies shall
permit all of the following:
(1) A foster parent, an assistant caregiver, an on-call assistant,
and a respite caregiver meeting the requirements of paragraphs (3),
(5), and (6) of subdivision (c) of Section 17731 to provide, in a
specialized foster care home, specialized in-home health care to a
foster child, as described in the child's individualized health care
plan.
(2) The licensee and other personnel meeting the requirements of
paragraphs (3), (5), and (6) of subdivision (c) of Section 17731 to
provide, in a group home, specialized in-home health care to a child,
as described in his or her individualized health care plan, provided
that the child was placed as of November 1, 1993.
17737. Nothing in this chapter shall be construed to prevent
children with special health care needs who have adoption as a case
plan goal from receiving services under this program.
17738. Notwithstanding Chapter 3.5 (commencing with Section 11340)
of Part 1 of Division 3 of Title 2 of the Government Code, the
department shall adopt emergency regulations to implement the program
provided for in this chapter. The emergency regulations shall remain
in effect for no more than 120 days, unless the department complies
with all the provisions of Chapter 3.5 (commencing with Section
11340) as required by subdivision (e) of Section 11346.1 of the
Government Code.
