Existing law provides for the licensure and regulation by the State Department of Social Services of crisis nurseries. Crisis nurseries are nonprofit corporations that care for and supervise children under 6 years of age who are voluntarily placed in the crisis nursery by a parent or legal guardian due to a family crisis or stressful situation for no more than 30 days.

This bill, until January 1, 2018, would require the department to implement a 2-year pilot project in the Counties County of Sacramento and the County of Yolo to conduct a study of the relationship between crisis respite care and incidents of reported child abuse in those counties, and report the results of the study to the Legislature. The bill would make the implementation of this pilot project contingent upon all of the crisis nurseries in those counties voluntarily participating in the project and providing funding for ¹/₂ of the cost of the project. This bill would express the intent of the Legislature to provide state funding for crisis nurseries in the Budget Act of 2015 for community services and this pilot project.

Existing law provides for the licensure and regulation by the State Department of Social Services of crisis nurseries. Crisis nurseries are nonprofit corporations that care for and supervise children under 6 years of age who are voluntarily placed in the crisis nursery by a parent or legal guardian due to a family crisis or stressful situation for no more than 30 days.

This bill, until January 1, 2018, would require the department to implement a 2-year pilot project in the Counties of Sacramento and Yolo to conduct a study of the relationship between crisis respite care and incidents of reported child abuse in those counties, and report the results of the study to the Legislature. The bill would make the implementation of this pilot project contingent upon all of the crisis nurseries in those counties voluntarily participating in the project and providing funding for ¹/₂ of the cost of the project. This bill would express the intent of the Legislature to provide state funding for crisis nurseries in the Budget Act of 2015 for community services and this pilot project.

SENATE COMMITTEE ON APPROPRIATIONS

Senator Ricardo Lara, Chair

2015 - 2016 Regular

SB 174 (Wolk) - Crisis nurseries: study

This bill meets the criteria for referral to the Suspense File.

Bill Summary:

SB 174 would require the Department of Social Services (DSS) to implement a two-year pilot project in the counties of Sacramento and Yolo for the purpose of evaluating the effectiveness of crisis nurseries in lowering the incidence of child abuse in those counties. This bill would require the DSS to conduct a study based on the pilot and report the results to the Legislature on or before December 31, 2017.

Fiscal Impact:

• Significant costs of about $2.7 million (General Fund) over two years to implement the pilot project for the three crisis nurseries in the counties of Sacramento and Yolo, which would consist of half of the costs to operate the crisis nurseries in the pilot counties. Matching private funds would be required to cover the remaining 50 percent of costs of the pilot project.

• One-time costs to the DSS potentially in excess of $200,000 (General Fund) to administer the pilot, as well as conduct and submit the results of the mandated study.

Background:

Existing law provides for the licensure and regulation by the DSS of crisis nurseries. Crisis nurseries are private or public nonprofit corporations that provide short-term, 24-hour nonmedical residential care and supervision for children under six years of age who are voluntarily placed for temporary care by a parent or legal guardian due to a family crisis or stressful situation for no more than 30 days. (Health and Safety Code § 1516(a).)

Existing law authorizes crisis nurseries to provide crisis day services for children under the age of six years at the same site as the crisis residential overnight program. A child may not receive crisis day services at a crisis nursery for more than 14 hours in a day and for no more than 30 calendar days in a six-month period unless the DSS issues an exception.

Currently, there are five crisis nurseries licensed in California, one each in Concord, Davis, and Nevada City, and two in Sacramento. Since 2009, more than 9,000 children have been served by these nurseries. Average lengths of stay have ranged from eight hours to just over 24 hours, with 44 children staying for the maximum allowable days. No exemptions have been requested for children to stay beyond the 30-day limit.

Proposed Law:

This bill would require the DSS to implement a two-year pilot project in the counties of Sacramento and Yolo for the purpose of evaluating the effectiveness of crisis nurseries in lowering the incidence of child abuse in those counties. This bill conditions implementation of the pilot on voluntary participation by all crisis nurseries in those counties and private funding for one-half of the cost of the project. The pilot project shall consist of both of the following:

• Requires DSS to conduct a study of the relationship between crisis respite care and incidents of reported child abuse in pilot project counties.

• Requires DSS to report the results of the study to the Legislature on or before December 31, 2017, as specified.

This bill specifies it shall remain in effect only until January 1, 2018, unless a later enacted statute is enacted before that date, deletes or extends that date.

Related Legislation:

AB 578 (Dickinson) 2014 was virtually identical to this measure. This bill was held on the Suspense File of this Committee.

AB 2228 (Cooley) Chapter 735/2014 revises the regulatory licensing requirements for crisis nurseries including the duration of services provided, licensed capacity, education and training requirements, staff-to-child ratios, and other requirements.

Staff Comments:

Based on historical expenditures for crisis nurseries in the counties of Yolo and Sacramento, annual costs to operate the three crisis nurseries is about $2.7 million ($660,000 for Yolo Crisis Nursery and $2 million for Sacramento Crisis Nurseries). A two-year pilot project would cost about $5.4 million, with 50 percent coming from private funds, and the remaining $2.7 million from the state (General Fund). It is estimated that the revised licensing standards recently enacted under AB 2228 would not have a significant impact on operational costs.

The DSS would incur one-time costs potentially in excess of $200,000 (General Fund) to administer the pilot project, as well as conduct, prepare and submit the results of the mandated study.

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SENATE COMMITTEE ON HUMAN SERVICES

Senator McGuire, Chair

2015 - 2016 Regular

Bill No: SB 174

Subject: Crisis nurseries: study

DIGEST

This bill establishes a two-year pilot project in Sacramento and Yolo counties for the purpose of evaluating the effectiveness of crisis nurseries, as specified. This bill also requires the California Department of Social Services (CDSS) to conduct a study of the relationship between crisis respite care and incidents of child abuse. Additionally, this bill states Legislative intent to provide state funding for crisis nurseries.

Existing law:

1. Enacts the Community Care Facilities Act, which provides for the licensure and oversight of out-of-home placements of abused and neglected children by CDSS. The Act defines “crisis nursery” to mean a facility licensed by CDSS to operate a program to provide short-term care and supervision for children under six years of age who are voluntarily placed for temporary care by a parent or legal guardian due to a family crisis or stressful situation. (HSC 1502 (a) (17))

2. Requires a crisis nursery to be licensed by the department to operate a crisis residential overnight program for no more than 30 days. Provides that the maximum licensed capacity for a crisis residential overnight program shall be 14 children. (HSC 1516 (a), (h)(2) and (f)(2))

3. Permits crisis nurseries to offer crisis day services for children under the age of six, as specified, for no more than 14 hours in a day and for no more than 30 days. Exempts crisis nurseries from licensure as a child day care facility under the California Child Care and Development Services Act (HSC 1516 and 1596.792)

This bill:

1. Requires CDSS to implement a two-year pilot project in Sacramento and Yolo counties for the purpose of evaluating the effectiveness of crisis nurseries in lowering the incidence of child abuse in those counties.

2. Conditions implementation of the pilot on the voluntary participation of all of the crisis nurseries in those counties and on those counties providing private funding for one-half of the cost of the project.

3. Requires that the pilot project shall consist of both of the following:

• A CDSS-conducted study of the relationship between crisis respite care and incidents of reported child abuse in pilot project counties,

• A CDSS report of the results of the study to the Legislature on or before December 31, 2016, as specified.

4. States Legislative intent to provide state funding for crisis nurseries in the Budget Act of 2015 in order to enable crisis nurseries to continue to provide services to the community and to participate in the pilot project established by this section.

5. Enacts a sunset on the above provisions on January 1, 2018.

FISCAL IMPACT

Last year, the Senate Appropriations Committee, in its evaluation of AB 578 (Dickenson) which was substantially similar to this bill, estimated significant costs in the range of $2.7 million (General Fund) over two years to implement the pilot project for the three crisis nurseries in the counties of Sacramento and Yolo. Additionally, the analysis estimated one-time costs to CDSS of about $150,000 (General Fund) to prepare and submit the mandated study.

BACKGROUND

The author cites a two-year study¹ published in 2006 examining the relationships between crisis respite care and incidents of reported child abuse. According to the author, the study provided evidence that Child Protective Services (CPS) reports on families that accessed crisis respite were significantly less likely to be substantiated than CPS reports on comparison families without crisis respite available. It found that families receiving respite or crisis resolution services were half as likely to have a CPS investigation substantiated than were those who utilized crisis respite with previous CPS involvement. Further, when parents were asked what alternative choices they would have pursued had a crisis nursery not been available, 26 percent said they would have either requested foster care placement or been unable to provide for their children.

Additionally, the author states that adverse childhood experiences such as child abuse and neglect result in lifelong negative impacts. These include lower family income levels, higher rates of physical and mental health needs, and issues with addiction/substance abuse. The estimated national average lifetime cost per victim of nonfatal child maltreatment is $210,012 in 2010 dollars.

Crisis Nursery Model

Crisis nurseries first were developed as a grassroots movement in the 1960's as a temporary or emergency care model for children at risk of abuse or neglect, and were initially funded through private donations.² In 1986, Congress passed the Temporary Child Care for Children with Disabilities and Crisis Nurseries Act, which established federal funding to create temporary child care demonstration projects including crisis nursery services. Beginning in 1988, competitive federal grants were awarded to private and public agencies across the United States to assist them in developing crisis nursery services, funding that has subsequently been eliminated.

Crisis nurseries were created as a separate licensing category under the Community Care Facilities Act under SB 855 (Machado, Chapter 664, Statutes of 2004), to provide a temporary and emergency housing and shelter facility option for parents. The intent of the care model is to provide a voluntary 24-hour placement option for young children when their families are facing difficult or extreme financial, health, or other challenges to prevent the engagement of child welfare services. Under the statute, the crisis nurseries were limited to specified counties and were intended to serve children under the age of six who were voluntarily placed by a parent or guardian or, under limited circumstances, were temporarily placed by a county child welfare service agency.

Prior to the passage of SB 855, crisis nurseries were licensed as group homes under the Community Care Facility Act, although critics argued that those regulations were excessive and inappropriate for crisis nurseries due to differences between the care needs of very young children who were voluntarily placed by a parent and the needs of children that were removed from parental custody by county child protective services workers due to abuse or neglect. The bill at that time included a sunset of January 1, 2008, which was subsequently extended to January 1, 2014. Due to concerns that crisis nurseries were serving as temporary placements for children removed from their homes by county social workers, SB 1214 (Wolk, Chapter 519, Statutes of 2010) eliminated crisis nurseries as an allowable child welfare placement, effective January 1, 2012. Following this agreement, the state eliminated the sunset, allowing crisis nurseries to exist permanently under SB 1319 (Liu, Chapter 663, Statutes of 2012).

Last year, AB 2228 (Cooley, Chapter 735, Statutes of 2014) revised the regulatory structure of crisis nurseries, permitting facilities operating an overnight and day program to be licensed under a single license. Although crisis day services had previously been exempted from licensure as a day care facility, children in day programs counted against the overnight capacity limit of 14 children. As a result, many facilities sought secondary licensure as a child day care program. AB 2228 permits crisis nurseries to operate day programs that meet specified regulatory requirements without affecting the overnight capacity limit.

Currently, there are five crisis nurseries licensed in California, one each in Concord, Davis, Nevada City and two in Sacramento. Since 2009, more than 9,000 children have been served by these nurseries. On average, the lengths of stay have ranged from eight hours to just over 24 hours with 44 children staying for the maximum allowable days. No exemptions have been requested for children to stay beyond the 30-day limit.

Currently there are no state or federal monies made available to crisis nurseries, with all five nurseries relying upon philanthropic support and local funds to operate (some facilities may receive funding through their Local First Five Commission). In many instances a related group home provider will support and manage a local crisis nursery, usually at a substantial financial loss. As a result, crisis nurseries rely substantially on trained volunteers to meet the staffing requirements. Crisis nursery staff and volunteers are subject to the same criminal record clearance requirements as child care providers and the education and experience requirements are similar to those of teachers in child care regulations.³

Budget Committee 2014 hearing

In 2014, the Senate Budget Committee heard, as an informational item, a similar proposal to that proposed under this bill. The committee declined to take action on the proposal. As background, the committee provided the following information:

Usage data for the Yolo Crisis Nursery

EMQ Families First Yolo Crisis

Nursery

CY 2009 CY 2010 CY 2011 CY 2012 CY 2013 Total

Respite Day Services

# of 30 day stays per facility 0 0 0 0 0 0

# of children the facility has served 381 339 368 329 372 1789

Average length of stay per child, per

facility (days) 1.25 1.28 1.19 1.32 1.43 1.29

Overnight Services

# of 30 day stays per facility 0 1 0 0 0 1

# of children the facility has served 73 88 101 38 6 306

Average length of stay per facility

(nights) 5.45 4.74 3 3.71 3.67 2.93

Budget history of both Sacramento Crisis Nursery and Yolo Crisis Nursery

Sacramento Crisis Nurseries

o FY 2012- 13, total expense of $2,136,724, with a deficit of $566,724.

o FY 2013-14 (projected), total expense will be $2,015,452, with deficit of $500,697.

Yolo Crisis Nursery

o FY 2012-13, total expense was $603,000, with a loss of $438,000.

o FY 2013-2014 (projected), total expense will be $659,000, with loss of $480,000.

Crisis Nursery Outcomes

A 2004 report⁴ studying crisis nursery outcomes cites a literature review from 1980 that identified crisis nurseries “along with access to counseling for parents as extremely inexpensive forms of prevention when compared to the cost of foster care placements.”

The report also cites a study that found that “thirty-six parents reported a decrease in parenting stress for problems related to their children as well as financial and housing problems when they accessed crisis nursery services and that “parents using crisis nursery services also reported significant improvements in parenting stress based on pre- and post-test scores on the Parenting Stress Index/Short Form.”

Additionally, the report cites a user survey in which caregivers reported that “if crisis nursery services were not available they might choose to leave their children alone, in the care of an inappropriate caregiver, or have the child accompany them to a place the parent perceived as dangerous for the child.” However, the report states there is “limited research addresses the role crisis nurseries play in strengthening families and developing independence beyond time-limited crisis intervention.”

Prior legislation:

SB 2228 (Cooley, Chapter 735, Statutes of 2014) revises the licensing requirements for crisis nurseries and onsite day care centers.

AB 578 (Dickinson, 2014) sought to establish a two-year pilot project in Sacramento and Yolo counties for the purpose of evaluating the effectiveness of crisis nurseries. This bill was held in the Senate Appropriations Committee.

SB 1319 (Liu, Chapter 663, Statutes of 2012) eliminated the sunset date for the establishment of crisis nurseries.

SB 1214 (Wolk, Chapter 519, Statutes of 2010) extended the sunset date to January 1, 2014, but eliminated provisions of the original legislation which permitted crisis nurseries to provide emergency respite care for a limited number of foster children. Effective July 1, 2012, crisis nurseries were only permitted to serve children placed voluntarily by their parents or legal guardians.

SB 104 (Machado, Chapter 288, Statutes of 2007) extended the sunset date to January 1, 2011.

SB 855 (Machado, Chapter 664, Statutes of 2004) established crisis nurseries as a separate licensing category, with a sunset date of January 1, 2009.

COMMENTS

This bill states it is the intent of the Legislature to provide state funding in the 2015 Budget Act for the purposes specified in this bill. Last year, a similar item was heard in budget committee, though no appropriation was included. Should the Legislature intend to include this item in the Budget Act this year, it would be necessary for it to be considered and appropriated through the budget process.

Staff recommends amending the bill to strike Lines 17-20 on Page 2 inclusive, referencing intent language referring to the budget appropriation.

POSITIONS

Support: None.

Oppose: None.

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