multiple programs

Short Term Residential Therapeutic Programs Placement Criteria, Interagency Placement Committees, Second Level Review for Ongoing Placements

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The California Department of Social Services (CDSS) has recently provided guidance and instructions regarding Interagency Placement Committees (IPCs), Short-Term Residential Therapeutic Programs Placement (STRTP) Criteria, Child and Family Teams (CFTs), and Second Level Review requirements for children and nonminor dependents placed in STRTPs and group homes.

Assembly Bill 403 established new licensed children’s residential facilities called STRTPs, which are public agencies or private organizations licensed with CDSS to provide integrated, high-quality, therapeutic programs. The programs are intended for children whose behavioral and therapeutic need are not met by a home-based family setting, even with supportive services. The goal of the program is to provide trauma-informed therapeutic interventions and integrated programming to address barriers to the child’s ability to safely reside and transition into a home-based family setting. The county placing agency, the STRTP, the caregiver, and the child and their support system must work together to identify and coordinate necessary services.

STRTP homes must be cleared by IPCs and a second level of review which takes into account CFT’s opinions.

The IPC is made up of representatives from county placing agencies and the county Mental Health Plan (MHP). The IPC may work together with other jurisdictions to act as a multi-disciplinary committee for child care and treatment. The IPC must also review and approve placements for STRTPs, group homes with a level of care assessed at Rate Classification Level 13/14 and that have been granted extensions (as determined by ACL 16-65), as well as out-of-state residential programs. The IPC decision is to be made by reviewing all available assessments. To support partner agency compliance, county placing agencies must notify and coordinate needed services with the school of origin regarding educational stability and the case plan, the MHP, and the Regional Center currently serving the child immediately upon the child’s placement.

The child may be placed in a STRTP if the child does not require inpatient care in a licensed health facility and the child’s needs have been assessed and can be provided in a STRTP to maintain the health and well-being of the child. One of the following criteria must also be met:

  • the child meets medical necessity criteria as determined by a mental health professional
  • the child is assessed as Seriously Emotionally Disturbed
  • the child is assessed as requiring the level of services provided by the STRTP
  • OR the child meets the criteria for emergency placement into a STRTP.

Emergency placement determinations may be made prior to the IPC determination if:

  • A mental health professional has made a written determination that the child requires the level of care that STRTP services offer
  • The IPC makes a similar determination within thirty days of an emergency placement (or transmits their disapproval to the STRTP)
  • AND the STRTP is not acting as a temporary placement in the event that a home-based family setting cannot be found. The county placing agency must ensure there is commonality of need with the other children in the placement setting.

If counties decide to integrate the CFT and IPC into single meetings, they should do so via an Interagency Memorandum of Understanding.

STRTP providers are not required to accept any specific child for placement, though they are expected to have the capacity to serve individual children with complex needs. The intake process should be coordinated with the IPC to avoid non-admissions and 7-day notices of denial from an STRTP provider, and information should be conveyed to county placing agencies to allow for CFT meetings pending placement. If STRTP providers demonstrate a pattern of not accepting placements, a review may be conducted by CDSS to assess the technical assistance level of the STRTP in order to prevent unnecessary disruption.

Assembly Bill 1997 provided added requirements, and also requires that the Department of Health Care Services and CDSS develop a dispute resolution process in order to track the number of reported and resolved disputes. While this is developed, county placing agencies should inform the CDSS if there is an unresolved IPC dispute by emailing CDSS.

The Continuum of Care Reform (CCR) uses residential care as a short-term, therapeutic intervention until the child is able to transition into a home-based family setting.  The CCR includes additional requirements on case plan documentation and second level review. The former requires that the case plan for a child placed in a STRTP document that the placement is for the purposes of short-term, specialized and intensive treatment, the need for the placement, the plan for transitioning the child, and the projected timeline for future action. If the child is under 12 years of age of younger, prior approval from the director of the child welfare agency is needed.

The Placement Timeframes for Second Level Reviews are age-specific. For children ages 0-6, STRTP placements are extremely rare and not to exceed 120 days. For children ages 6-12, STRTP placements shall not exceed 6 months unless the county made progress toward implementation of the case plan (including the child’s future transition), circumstances beyond the county’s control have impeded the county from obtaining those services, and the need for additional time is documented by a caseworker and approved by the Child Welfare Deputy Director.  For children older than age 13 under the supervision of the dependency court, the placement shall not exceed 6 months unless the Child Welfare Deputy Director or Director has approved the case plan. For children older than age 13 under the supervision of the delinquency court, the placement shall not exceed 12 months unless the Chief Probation Officer of the county has approved the continued placement no less frequently than every 12 months thereafter.

County placing agencies should have established processed to ensure that these processes are followed immediately for children placed in STRTPs or group homes.  (ACL 17-122, January 9, 2018.)

 

Hearing representative responsibilities and privileges process

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The California Department of Social Services (CDSS) has issued clarification about county hearing representative responsibilities before a hearing.  The county hearing representative initially impartially reviews the hearing request.  After the review, the hearings representative either orders the county to take corrective action or defends the action at hearing.  The county hearings representative also provides claimants with information about the hearing process, including preparing a position statement.

The county hearings representative ensues that aid paid pending is paid when appropriate, identifies the issues raised in the hearing request, reviewed the disputed action(s) based on available evidence and regulations, and determines whether the case can be resolved or should proceed to hearing.

The county hearings representative also must provide reasonable accommodations for claimant’s disabilities, and services for limited English proficient claimants, including using forms that have been translated and using an interpreter for communication with the claimant at no cost to the claimant.

If the hearings representative cannot identify the issues from the hearing request, the hearings representative should attempt to contact the claimant to discuss the case.  If the hearings representative cannot reach the claimant, the hearings representative should review the case file for 90 days prior to the hearing request to determine issues.  If the hearings representative still cannot determine the issues, the hearings representative should write a limited position statement for the hearing. If the issues are identified on the day of the hearing and the hearings representative and claimant cannot reach a resolution, the hearings representative can request postponement of the hearing.

If the hearings representative determines the county action is correct, the county hearings representative should contact the claimant to explain the basis for the county action.  The hearings representative cannot imply that the claimant cannot or should not proceed with the hearing.  The hearings representative can explain the claimant’s right to withdraw if the claimant states they do not want to proceed with the hearing, but the county hearings representative cannot request a withdrawal.

If the hearings representative determines the county action is incorrect, the county representative must contact the case worker to take corrective action.  The county hearings representative must also contact the claimant to resolve the case without a hearing.  If that resolution is a conditional withdrawal, the language of the conditional withdrawal must be specific regarding the duties of the county and claimant for the action to be corrected.  A conditional withdrawal that states the county will re-review its action is insufficient. Conditional withdrawals should be in writing.  The county must ensure that corrective action is completed within 30 days.  If the claimant still chooses to attend the hearing, the hearings representative must be prepared for the hearing.

The hearings representative should inform the claimant of their right to review the case file and provide that access in two business days.  If the hearings representative withholds documents from the claimant pursuant to a claim of privilege, the hearings representative must prepare and give to the claimant a form identifying the withheld documents and the basis of the claim of privilege or confidentiality.  Welfare fraud investigation information from an active investigation is confidential unless that information has been used or relied on by the county in making its decision to take administrative action.  When the claimant challenges a county claim of privilege or confidentiality, the administrative law judge will convene an in camera proceeding to adjudicate that claim.

Finally, CDSS has issued guidelines for the content and format of county position statements for hearings.  (ACL 17-102, September 29, 2017.)

Position Statements in CDSS hearings

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CDSS has issued instructions implementing AB 2346 about position statements.  Previously, public and private agencies other than the Department of Health Care Services were required to make paper copies of their position statements available to claimants at least two business days prior to the hearing.  AB 2346 extends this requirement to the Department of Health Care Services.  This means that position statements in Medi-Cal cases must now be made available two business days before the hearing.

In addition, position statements can now be provided to the claimant in one of three ways: 1) secure electronic transmission at least two business days before the hearing, with the claimant’s permission, and if the agency can comply with state and federal electronic privacy laws, 2) first class mail with mailing early enough for the claimant to receive the position statement two business days before the hearing, or 3) paper copy available at the appropriate office of the county welfare department two business days before the hearing, with public or private agencies that are not part of the county welfare department mailing a paper copy of the position statement to the county early enough for the county welfare department to make it available at least two business days before the hearing.

If electronic transmission does not apply, the county can choose whether to mail the position statement or make it available at the county welfare department office, but the county should discuss with the claimant how the claimant would prefer to receive the position statement.

If the position statement is not made available to the claimant two business days before the hearing or the agency modifies the position statement after providing it to the claimant, the claimant will have good cause to postpone the hearing.  The claimant must waive the 90 day deadline for a decision to get this postponement.  Because the postponement was caused by the county’s failure to provide the position statement as required, this postponement will be considered the claimant first postponement for purposes of evaluating subsequent postponement requests.

(ACL 17-21, February 16, 2017.)

County Welfare Department Use of Consumer Credit Reports

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NOTE — The section of this ACL regarding the Work Number being used in conjunction with, but not in lieu of, existing income and eligibility sources, is superseded by ACL 21-23.

CDSS has issued instructions to counties about SB 1232 regarding county welfare department use of consumer credit reports.  An example of a consumer credit report is a report from “The Work Number.”  These requirements are mandatory effective January 1, 2017.

Counties cannot obtain consumer credit reports without written authorization of the applicant or recipient.  Consumer credit reports can be used in conjunction with existing fraud detection resources.  Consumer credit reports cannot be used as the only means of verification.  The SAWS 2 Plus, CF 285 and CF 37 have been modified to include authorization for counties to obtain consumer credit reports.

If a county takes adverse action based on information in a consumer credit report, the county must provide an informing notice in addition to the notice of action.  The informing notice must include the name, address and telephone number of the consumer credit reporting agency, a statement that the consumer credit reporting agency did not make the decision, a statement of the right to free disclosure from the consumer credit reporting agency within 60 days and a statement of the right to dispute the accuracy of the information with the consumer credit reporting agency.

Information from a consumer credit report must be made available to an applicant or recipient who requests it from the county welfare department or if an applicant requests a fair hearing to regarding the information in the consumer credit report.  Note that information received from “The Work Number” is not considered verified upon receipt for CalFresh.  Counties cannot require applicants or recipients to submit hard-copy documentation that is duplicative of the information obtained from a consumer credit report.  ACL 16-118 (December 30, 2016).

 

Benefits and same-sex marriages and domestic partnerships

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The California Department of Social Services has issued policies about how same-sex marriages and domestic partnerships are treated for purposes of various programs.  For CalWORKs, same-sex spouses and registered domestic partners who have adopted the children are treated as members of the assistance unit who are subject to welfare-to-work requirements.  These households are considered two parent households for purposes of welfare-to-work requirements.  Same-sex spouses and registered domestic partners who have not adopted the children are considered step-parents, meaning they can be considered part of the assistance unit and participate in welfare-to-work but are not required to do so.

For purposes of eligibility for child care, same-sex spouses and registered domestic partners who have adopted the children are treated as members of the assistance unit, meaning the same-sex spouse or registered domestic partner can be considered an able and available parents who can provide child care.  Same-sex spouses and registered domestic partners who have not adopted the children are considered optional step-parents and are not considered for purposes of eligibility for child care.

For purposes of CalFresh, any group of persons who customarily purchase and prepare meals together are considered a household.   Same-sex spouses are considered spouses and must be included in the CalFresh household.  However, registered domestic partners are not considered spouses and are not automatically included in the household.  Registered domestic partners who are part of the CalWORKs assistance unit or customarily purchase and prepare meals with the family must be included in the CalFresh household.

Refugee Cash Assistance has the same requirements as CalWORKs.  Registered domestic partners have the same status as married couples for purposes of eligibility for Refugee Cash Assistance.  ACL 16-13 (March 28, 2016).

Free copies of birth certificates for homeless persons

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AB 1733, which became effective on July 1, 2015, requires the registrar or county recorder to provide free certified copies of birth certificates to homeless persons. County Welfare Departments (CWDs) are considered homeless services providers under the statute. This means that CWDs are required to assist homeless clients who need to get a birth certificate by completing an affidavit that the client is homeless. The form for the affidavit is part of California Department of Public Health ACL 15-05, which is attached to CDSS’ instructions. This duty is in addition to the CWDs duty to cover fees if necessary to obtain information or verification to receive benefits. ACIN I-90-15 (11/25/15).