Senate Budget and Fiscal Review Subcommittee No. 3 on Health and Human Services

On health and human services will now come to order. Good morning, everyone. It's been a different morning today. Happy you can all make it. The senate continues to welcome the public in person and via the teleconference service for public comment. For those who wish to call in and provide a comment, today's number is 1877-226-8163 and the access code is 736-2834 as always, we're holding our subcommitee hearing in room 1200, building 1021.

I ask the rest of the members of the subcommitee to be present here so we can establish our quorum. Today on the agenda, we'll be hearing budget proposals from three departments, Department of Social Services, Department of Child Support Services, and the Department of Community Services and Development. So we'll jump right in. We'll begin to hear presentations from issue number one on childcare rate reform update earlier in the year, the whole Budget Committee as a whole dove right in into childcare rate reform.

This panel is now going to serve as an update as to what we heard earlier this year, not fully diving in since we already did that. So I want to welcome the panelists, director Kim Johnson from Department of Social Services, Kimberly Rosenberger from the Child Care Providers Union, Christina Garcia representing Parent Voices, LaWanda Wesley, the director of government relations from the Child Care Resource Center, and representing LAO Jackie Barocio.

Good morning, Madam Chair. Kim Johnson, California Department of Financial Services, good to see you. I will appreciate the background in the agenda, and so I'll go right to the questions of the committee, and that is to describe the department's approach and progress towards shifting from the current regional market rate methodology to a single rate structure for the field. And so I just want to recognize again the tremendous strides that the administration and legislature have made to expand services and supports for young children and families.

Guided by our master plan for early learning and care, the states made historic multi year and multibillion dollar investments. And of course, within the multi year budget the administration and Legislature committed to rate and quality reform. We are, again, just a quick history, right? We've had two different and unaligned systems for reimbursing early learning and care programs.

The standard reimbursement rate and the regional market rate, and some state subsidy programs reimbursed early learning care and programs using an RMR that varied by county and was determined based on a periodic price survey. Other programs reimbursed early learning and care programs using a flat standard reimbursement rate. So for the past year, the Department of Social Services, in consultation with the Department of Education facilitated rate and Quality stakeholder work groups.

We want to express gratitude for all stakeholders who have participated in those efforts and your agenda outlines on page six the workgroups recommendations, which were published in August of last year. Again building on that work group's report, a joint labor management committee and the Childcare Provider United published and submitted a report on November of last year to the Department of Finance and a governor's office.

That report adopts several components of the workgroup's recommendations and supports a single rate structure that includes an alternative methodology that considers a cost estimation model, base rates, incentives enhancement, rate setting metrics, and the evaluation of the rate structure. The base rate setting metrics includes a cost estimation model that factors the full cost of delivering early learning and care and is representative of the diverse needs of the various childcare and program types in their respective settings.

I also want to just lift up again in both work groups equity and addressing inequities in our system. We're certainly prioritized and lifted up in that we have again opportunities to remedy the long standing issues that have been in place with the existing rate structure.

So the governor's January budget proposes that the state will rely on the approach presented by the Joint Labor Committee and as it continues to develop this single rate structure, our federal rules require the department to obtain pre-approval for an alternative methodology, and that pre-approval requires that we submit a letter to the Federal Government demonstrating that it's met a number of specified steps.

We have done that, and I'm happy to report that that request was submitted to the Administration of Children and Families on March 28th last month. We expect a response from the Administration of Children and Families within 60 days of the confirmed receipt date. ACF confirmed our receipt on March 30, so again, we expect to receive a response within 60 days. Once pre-approved, the department can use the alternative methodology to develop a cost estimation model.

The model will produce information about the cost of care that can be used to set a unified schedule of cost based rates. And again, the final rates must be approved through our overall state plan process that we submit to the Federal Government. We've contracted with prenatal to five fiscal strategies to develop the alternative methodology and cost estimation model. They have been a contractor that there are a few other states who have adopted a similar alternative methodology that have utilized this contractor.

So they have experience in getting approval from the Federal Government, and we're glad to partner with them on that step. So the next steps are the development of the cost estimation model and a unified rate schedule with the base and enhanced rates. And all of our next steps will be taken in collaboration with the legislature, the Department of Education, Child Care Providers United and additional stakeholders.

And then, of course, we'll just also note, as your agenda does, that rates are subject to negotiation between care providers united and the administration, as well as federal requirements. So we'll continue as we are right now in a successor agreement to our current agreement that expires in June of this year as it relates. Again, our state plan submission as I referenced, that's due July of 2024. So we are again taking these pre-approval steps.

The survey processes are changing and we are looking to put that full adoption of this alternative methodology with the submission of the state plan in July of 2024. And then we will work through the implementation steps. There's automation components. Again, we have to analyze the survey results that we have to actually land on what the actual rate ends up being determined. So just note that's our next steps component. You also referenced in the committee agenda some questions related to the increase.

Again, just really grateful for the additional federal support we've received in California. So we are expecting to receive a $170,000,000 increase in the Childcare and Development Block Grant. Federal funds for the childcare and the Childcare and Development Fund, and the proposed plan for expenditure will be captured in our May revision proposal. And then finally, the committee has asked us some questions related to the return of family fees July 1 of 2023 and options available.

Again, we have, through a waiver that we submitted to the Federal Government, have been able to waive family fees through the beginning of the pandemic, through two subsequent fiscal years, through June of this year. In terms of next steps, the requirement is that federal regulations require lead agencies to establish and periodically revise a sliding fee schedule for families that receive federal childcare and development funds.

The fees, in terms of the law requirements, have to enable choice of a range of options for families, be based on income and size of the family, and not be a barrier to accessing care. So states have the discretion to waive family fees for very Low income families or other families receiving or needing protective services or participating in the TANF or our Cal Works program here in California based on criteria that the states establish.

But fees can't universally be waived for all families, which again is why we submitted a waiver to be able to do that in the past few years. So absent statutory change, just as a budgetary implication, we would estimate in budget year to collect between 75 and $80 million in fees in terms of revenue that's then invested back in the program in terms of access to subsidies. So I'll stop there, and I'm glad to answer any questions to the pleasure of the committee.

Thank you so much, Director. We'll hold questions to the end of the panel.

Thank you Madam Chair and members. Kimberly Rosenberger with CCPU childcare Providers United, which is a SEIU and UDW collaborative. When we started our campaign nearly 10 years ago for the right to unionize, there was around 40,000 family childcare providers. And as we entered the final hurdles on our bill, there was about 36,000. The numbers were declining already, and rates are a huge component of that.

And we saw that get worse during COVID So when we say the need for rate reform and why the rates are insufficient, it's because it has created great instability in our family childcare providers. During the pandemic, we lost a significant number of providers, and thanks to the administration and the legislature, there was a significant investment that helped keep them whole and keep providers here. It wasn't just solely rates, and I think that's something we want to highlight.

The rate structure is dependent on these other subsidies, on waiving family fees, on looking at enrollment instead of hold harmless the rates themselves we know aren't sufficient. The P5 study said that only 25% to 30% of the rates covered the actual cost of care. Between the pandemic and the expansion to universal transitional kindergarten, we're seeing a lot of private pay families leave. And as a result, our members aren't able to bridge the gap of the cost of care for these subsidized children.

Without those private pay, families kind of paying that excess that they need to keep operating their businesses. Which is why we came together with the JLMC to address a single rate structure and to approach a different methodology. So we were asked what was agreed upon by the JLMC. I think Director Johnson covered a lot of the high level stuff. So we'll talk more on the equity as a metric, which is an important piece of that JLMC.

We looked at the cost of care model, and we are supporting that proposal because it counts for the real cost for the child. It takes into consideration the ability to scale like a small family. Childcare provider won't be able to spread out the cost of their rent, the diapers staffing that they would if they had a larger business infrastructure where you can scale things up.

So those nuances allow for the state to be flexible and the rates to be flexible to allow for the expansion of family childcare providers and centers, especially the incentives that look at family childcare deserts and can encourage subsidies to reopen where it's most needed. Where critical care is there it has flexibility. And we think that's also really helpful for the legislature bridging the gap where we have CCPU bargaining with administration, but the legislature having the conversation around how they can support childcare.

This methodology allows that conversation to happen. So our recommendation is to move to the alternative methodology known as cost of care as soon as possible. The base rate is the foundational rate. We believe we can start scaling that up and then looking at the flexibility for the other considerations. Ratio and group size, staffing patterns, family engagement, those all contribute to the flexibility and to not just retaining the workforce that we've seen decline, but recruiting and expanding, which we so desperately need.

We have slots that are proposed. We would like to see them continue to be implemented. We know that the January budget proposed delaying it. In large part that was due to delays. We think those delays also add to the instability. We've seen that with the funding that was put in the original contract and through the COVID agreements such as the facility improvement grants, stipends, and most recently dues deductions have all attributed to delays in payments to our family childcare providers.

As such, they are taking on tens of thousands of dollars of debt because they're relying on the state to pay them and they're not seeing those payments in a timely and reasonable manner. We are working with DSS. They know it's an issue, but they also are reliant on contracting, which delays the process further. So, for instance, the stipends that were guaranteed, that was about 1442 per child, up to 15,000, that was agreed upon last year's budget. We were hoping to be released in January.

That's where the conversation was at, and now is being pushed back to the summer. It's not that there's not a recognition of urgency, but ultimately the fees and costs from having the providers pay out of pocket, put it on credit cards, take on debt, won't be reimbursed by the state, so they're just taking on all these additional cost factors. That stability, or lack thereof, makes it really difficult for us to help recruit new workers.

So what we like about the new methodology and why we think there's an urgency is that there is fluidity, there's flexibility. But ultimately, at the end of the day, the base rate takes into consideration actual cost of care and is more substantial. We know that that cost is significant and can't be done overnight. We recognize the budgets in a deficit, but we do think we can start shifting as soon as possible.

As mentioned by the director, we're working with the Federal Government to have that address, but we don't think we need to wait till 2024, when the contract is up with the state. We believe it can be done through an indentum, and we would like and encourage the legislature to be in that conversation as much as possible, recognizing the bargaining. But that is what we at the table are asking for, is an urgency to shift, an urgency to provide a more stable infrastructure.

But again, I want to highlight that what we think is important, in addition to this switch to the alternative methodology, is all those additional factors that help provide stability, which is the family fee waivers, which is going away from attendance, which they don't have control over, and looking at enrollment base because they are still opening their facilities to those children, whether or not they attend every day. And we know little kids get sick. I have, too. They get sick often, no matter the best efforts.

So we don't think they should be penalized. And we support our allies in the ECE world that are asking for those considerations as well. And I'm available for any questions.

Thank you so much. Before we move on, let's establish a quorum.

Senators. [Roll Call] We have a quorum.

Perfect. Thank you so much. Kimberly. Christina.

Good morning. My name is Christina Garcia and I live in Marin County, where I've lived for the past 20 years. I have four kids, a 17 year old, 7 year old twins, and a 2 year old. I'm currently studying psychology with a minor in community action and social change at Dominican University. I'm here to talk about the necessity of continuing to suspend the family fee.

Right now, three of my children are able to receive care thanks to the voucher, which I received last April after being on the waitlist since my twins were little, my 2 year old's in a center based program and has really benefited from being in a high quality childcare program. People mistake her for a 4 year old because of her language, and that's because of that care. Because of the voucher, I was able to enroll my twins in an after school program that also does summer camp.

They get help after school with homework and get to hang out with their friends while I'm running around doing all of my projects. Today I'm representing the 146,000 families who have recently received childcare and the 20,000 families whose access to care rests in your hands. Before I had childcare, things felt impossible. I was able to get my associates last year, but it took several years due to the lack of childcare.

You can't really focus on school when your kids are awake if you want them to be safe. My last semester at College of Marin, I got inspired by a woman of color who got her doctorate. That changed my life, and after her class, I knew I needed to transfer to get my bachelor's in order to access career opportunities. These are essential to be able to live comfortably in my county and do something meaningful with my work. Once again, I can't do that without access to childcare.

I've been able to say yes to opportunities that I never would have been able to. I've been able to go to classes in person, do interviews. I serve on the Marin Indian Alliance Board as a Pomo woman, and we were able to throw our first ever pow wow. I'm able to serve on a scholarship committee at the College of Marin to make scholarship opportunities more accessible to native students like myself. Because I had barriers.

I'm also able to serve on a DEI Committee at my kids'school where I'm the only native parent. The best word to describe what it would mean for my family if these fees come back is soul crushing. It would derail my long term goals for my career that I can't do without my education. Rent in Marin is astronomical at best, the cost of living. There's inflation. Grad school is going to be a lot. I can't afford to pay hundreds of dollars to have care.

The family fee coming back puts me in a difficult situation. I'd be back in a fight or flight mode where I'd be basing my decisions not from a logical perspective, but from a place of fear. I'd be making decisions on what bills to pay to stay housed. Sorry, it's very emotional imagining what this would be like. We'd have to leave the program, which would then mean I would have to step down from spaces where I can't be replaced.

There's not a ton of native people that can go and do this work that I'm doing. Part of getting the bachelor's is only one step to getting my teaching credential, which would help with the teacher shortage, right? Especially considering we don't have indigenous educators and women of color. You're going to have a bigger labor shortage as a state if you make these family fees come back and families can't stay in the program because of it.

You won't see that just in education, but all over the place. It seems criminal to me that the state asks hundreds of dollars per month from the families they know are marginalized and low income who need the childcare the most. It's unjust that the state is asking primarily low income women of color to subsidize the cost of care provided by other low income women of color.

The way that these family fees and rates have been done historically perpetuates systemic racism and a classist system that is built into the very foundation of our country. Colonialism, capitalism, all of those things. These systems are made to keep our most vulnerable and marginalized oppressed people, to keep them in generational poverty. We can do better than that if we have to bring back the fees on a federal level. The current family fee is not sustainable.

That's why I'm here today to ask the committee's support in passing a final budget that continues to suspend family fees as long as possible until we can develop a system that reimbursed the providers based on the true cost of care that they provide and that includes the elimination of unaffordable family fees in the reimbursement model. When you do these things, if you do them in a few years, you're going to see an increase in your labor market.

You're going to see people that have been in generational poverty no longer experiencing that. You're going to see a ripple effect that can only benefit the state. So thank you.

Thank you so much for sharing your story. Moving on to our next panelist.

Greetings, Chairman Menjivar and good morning committee members. I am Dr. LaWanda Wesley, the director of government relations for Childcare Resource Center. Childcare Resource Center serves children and families have been serving children and families since 1976. Currently, we serve about 50,000 children and families in both Los Angeles County and San Bernardino. county.

We're a proud Member of the Early Care and Education Coalition, which is made up of about 34 organizations that advocate for state budget investments and policies that promote quality equity and serving the highest need children. First, we are informed by research and promising practices. Collectively, we are led by the expertise of families and early care and education professionals. And I'll get straight to the ask that we are looking for this coalition.

Our coalition is asking for a 25% increase to the current rates for immediate relief and adopting the cost estimation model that was talked about earlier and including a timeline for implementation for the actual cost of care based on program enrollment without charging families of fees and much to the story that was shared here, by reinstituting family fees, it could cost some families upwards to $595 a month.

And knowing that some families have never known what a family fee has been like, we're also asking for the 20,000 childcare spaces that were to be released for the 2324 budget year, those 20,000 spaces to be released. We know that families can't wait. And as exemplified here, waiting could mean not being able to go to work or pursue your educational career.

I do want to thank you, Senator Menjivar, because you are in our San Fernando area, and to that you came and read to our little ones. And thinking about that time that you spent last month with them, we wanted to let you know who's in your district in particular. There's about 2600 childcare providers in your district. Over 2700 parents, and about 7000 children. A little over 7000 children. And many of you on the committee also have children, families in the ECE workforce in your community.

And so what we're asking for is not to have another decade go by. We've been waiting for about a decade now literally having the same conversation about developing a single rate system. And so what we want to do is take advantage of the work that the rate and quality work group has done to make recommendations about shifting from our current bifurcated and inequitable rate system to a new single rate for all providers based on, again, the cost estimation model.

And what we also know that there's some cost drivers that are happening right now that wasn't there before. And I will say there is a regional market rate that is done every two years, but the last one was done in 2018, but that was sourced from data from 2016. And you think about 2016 to 2018 to 2023, the cost drivers that childcare providers are impacted by is staffing costs being up by 29%.

We have gas that's up by 50%, milk is up by 45%, eggs 70%, and then baby formula 51, and baby wipes, 33. So when you think about all the infrastructure of running a business and a childcare program, family childcare, homer center, the costs are astronomical. And so today we know that there are childcare programs, historic programs, family childcare classrooms that are literally empty. And sometimes we refer to that as classrooms going dark.

And so, meaning that there is room to serve these children, but there isn't staffing capacity to provide the care to the children. And like was said earlier today, we know that children get sick very often, and because of them getting sick very often they're home. And as a result of that, then the childcare provider isn't paid because enrollment, it's based on attendance versus enrollment. So the comment around needing to pay based on enrollment versus attendance is very real.

We also realize many of our childcare workforce is reliant upon other forms of subsidy, which was said earlier, many are relying on Medical, CalFresh, SNAP. And I know that as a preschool teacher myself, I had to rely on those subsidies when I was a preschool teacher in the classroom, who also was a mother of five receiving subsidies. So it is sort of like women of color trying to take care of women of color.

So just to not belabor it too much longer, I just want to let you know that our childcare workforce is leaving our industry to go work for other industries. And all work is dignified work. But when you leave an industry where you're a college educated, skilled, taking professional on and on and on continuously year after year, to go work for In N Out or McDonald's, where they can provide educational assistance, they can provide benefits, and our field still doesn't have that in a comprehensive way.

And so we want parity with other sectors, care, industries and also our K through 12 partners to receive annual COLA raises on a regular basis. And then I'll just end by just saying that the field cannot wait. We are fragile. They are leaving. We're bleeding out. I was going to say a lot, but I don't want to read all of this. I just want to talk to you. The field is bleeding out, it's hemorrhaging.

And literally, I believe there was a report from the Center for the Study Childcare Workforce that said in this the nation, about 2000 ECE folks left our field 2000 just in one month because it's so unattractive. And yet this is a field that most of us came to. If you were a practitioner like myself, in loving and enjoying being with young children, bringing our. I have a doctorate. I went that far because of how much love I had for this field.

But yet you want to pay me, and not that you personally, but we're being paid less than $15 an hour in some cases, and most of the cost of care is usually only paid at a third of what it really cost. So just making that case and blending that with the inflationary climate, we have to do something now. If we don't, we're going to have families not being able to go to work. And I actually benefited from subsidy with my five children as a single mom.

That allowed me to persist. So when you were sharing your story. I got a little emotional because I'm getting older and we need new folks to come in and start doing this work. So I just plead to you today on behalf of the EC coalition, that we put in the 25% increase across the board for all of our EC workforce and I will conclude my testimony.

Thank you, Dr. Wesley. The last panelist we're going to hear from LAO.

Jackie Barocio with the Legislative Analyst Office. I'll start off the comments by just summarizing our comments regarding the family fee waiver expiration and then go into providing an update on a senate budget request that we received in February regarding the potential cost implications of moving to the alternative rate model developed during the work group process. So with regards to family fees, as mentioned in your agenda, the family fee waiver is assumed to expire at the end of June 2023.

In our analysis and through our conversations with stakeholders and the department, the expiration of the waiver may likely create barriers of care for low income families who may not be able to afford these fees.

So with that said, we flag that the legislature may want to ask the administration if they have a sense of just how big of a barrier this will pose to families, but then also ask the administration what changes could be made to the family fee structure in order to mitigate these access barriers, but also while still complying with the federal requirement, and just to provide an update as well.

We're also working with the department to get a better understanding of whether it would be possible to at least potentially extend the waiver to the end of the fiscal year September 2023, just so that the legislature has a bit more time to decide what an alternative family fee schedule could look like. Moving on to our comments regarding the costs associated with the alternative rate model.

So, during the Senate Full Budget hearing in February, we were asked to look into the potential cost impacts of that alternative rate model developed during the work groups referred to in this panel as the cost of care model.

Just to provide a bit more context of what that alternative rate model looks like compared to the current rates, which are based off of the market survey that's conducted every two years or currently the 2018 survey, the work group model was designed so that childcare workers generally could receive at least a living wage in addition to benefits such as paid sick leave, but then also that providers could receive funding associated with training and supplies, things like that.

Also, the alternative rates still continued to vary based off of certain factors such as provider setting, age group and region across the board. When we compare the alternative rates to current rates, they are significantly higher. So with that, in terms of what the associated costs would be if we were to move to these rates today, we estimate that that would cost an additional $12.6 billion relative to the Governor's Budget, which also includes $1.2 billion cost in Proposition 98 impact.

And these estimates were based off of the default rate scenarios that were included in the report that came out of one of the work groups. They captured the regional variation in rates, hours of care provided, ages of children serve, and setting of care. And additionally, these estimates are based off of current slot assumptions included in the Governor's Budget, meaning that we're not fully capturing those future slot increases.

If we were to capture those future slot increases, then the additional costs would increase from 12.6 billion to 14.3 billion. And again, these estimates are based off of the default scenarios that were included in the report. Our understanding is that the department has access to this model, and they're able to provide different rate configurations based off of different assumptions about wages or characteristics of the program. And, of course, those would impact the final cost.

But then also, as the department noted, we're very much still in the early phases of even getting federal approval of conducting a survey based off of an alternative rate model. So what ultimately comes out of that survey? They may look different from these cost estimates today, but these cost estimates were just developed based off of the current report that came out of the work group based off of default rates. Thank you.

May I comment on that piece? I know it's a little out of line, but I just wanted to say one thing.

30 seconds.

Okay.

That number is huge, and we know that, but there is no model that's fully implemented at 100%. There's a few states that are at 80%, but that took several rounds of legislation. So I do want to say that's a daunting number, and we acknowledge it, but I don't think that any of us expect to get there tomorrow. That's all.

Great. Thank you so much. I really appreciate. First of all, director, I'm glad to hear that we submitted that waiver, and we have a time frame for that response. The stories that you shared, Ms. Garcia, these are the stories that we constantly hear on a daily basis, and these are the stories we're trying to prevent from getting worse. Right. So our goal up here is to ensure we get to some place where we can provide the assistance of the families that are mostly needed.

So my only question right now is, Kimberly, you mentioned phasing in perhaps doing something now as we continue conversations and Kimberly and director, is there something that you're thinking about how the state can implement a phasing approach? I know we had an idea of perhaps extending the fee waiver until September, giving the administration, the legislature, more time to have conversations. Is there anything else that you can think of how we can implement something right now? Phase in.

Glad to have that continued conversation with the legislature as we move forward in both fronts. Right. I think both in terms of conversations and continuation of what we're hearing on impact of family flee, we recognize and are just appreciative, again, of the partnership, as I've mentioned, of the historic expansion we've had in access to subsidies in the state. So we then also recognize that over the last couple of years, families who have entered the program newly have not had the experience of paying fees. Right.

So we recognize the change and really appreciate the fellow panelists here sharing and lifting up personally what that means to them. So we are glad to continue exploring with the legislature whether it's related to the implementation of the alternative methodology or family fees, additional work we can be doing going forward.

And I think similar to how we look at the regional market rate, and we pay at a percentile. It's just at the end of the day, the number we have to work with we can scale. So if we determine that it's 50,000 per year that a childcare provider needs, we can set the rates at 40,000 or 80% of the cost of care. That's just a number to show. Theoretically, we're not expecting to bridge that full gap.

But if we have a number to work with, we can prioritize what's most important. Like are we going to, the base rate is the crucial piece. But those other elements of the cost of care can be scaled. The amount of investment for professional development, training, the planning and release time, those are all components that have costs, and those are also being discussed at the bargaining table. But I think ultimately we need to know what the costs are and that model being available.

We can play around with the numbers, but we do think that through the partnership of the JLMC, the bargaining table, and the ECE group, we think this methodology could be up and running by the end of this budget year, this fiscal year.

Thank you. Just one quick other question. CCPU doesn't represent all childcare providers. What are we doing to bring in the voices of the other providers in these conversations?

Yeah, glad to. Thank you for that question, Madam Chair. Yes. I mean, part of our next steps in terms of the alternative methodology that I referenced is absolutely working in partnership with CCPU from everything on the survey design of the cost estimation model and forward. But we'll also be working with the field and the rest of the components, the early Childhood Policy Council, which is a much broader group, but with other association groups, etc.

Our intent is absolutely to work with the broader field in terms of looking at the impact and getting their input into the design of our surveys and our process going forward.

Perfect. Thank you. Any other questions?

Just thanks, folks, for coming today and express my continued frustration that we haven't been able to, we've been working on this for quite a while. And so I just want to really encourage everybody to do and to the administration to do everything we can so we can resolve this issue and get some stability in the market.

This is one of the most important things I think that we do is care for our young children, because we just, we've heard examples of the rippling effect it has when we don't do it right. So it's frustrating, and hopefully we're going to get it done before September.

Senator Grove.

Thank you Madam Chair. Thank you for your testimony today. Really do appreciate it. To shed light on this, I know, like I echo my colleagues' comments from Stockton that we've been working on this for a long time, and I just want to applaud the chair for making sure that this issue has continued to be brought to the forefront because we do need to make sure my kids are grown, but I have nine grandkids and 10 on the way, and they all require childcare. So it's a very difficult situation.

And I have young professionals that I've worked with that are friends of my kids that live in the LA area. And actually, just two days ago, she texted me and said her childcare had gone up to almost $1,500 a month. Well, that's like a house payment, but she needs to be able to pay that to be able to go to work. And so it is very costly and it needs to be addressed. So thank you.

I also want to see if a Department of Finance has any additional comments to add to this.

Gabby Santoro, Department of Finance no comments to add, but thank you.

Perfect. Thank you so much. Again I do want to know, Dr. Wesley, her role in this was, we incorporated a stakeholder proposal into this panel. So it was a stakeholder proposal. No further questions. Really, thank you so much for coming in and sharing and providing this update. Dr. Johnson, our director. Johnson, you'll stay here for our next issue. Issue two. Our child healthcare overview.

Thank you, Madam Chair Members. Kim Johnson, California Department of Social Services. I'm going to introduce the Committee again to Dr. Lupe Jaime Milam, who will provide the update on the overview for section two.

Thank you. Good morning Dr. Lupe Jaime Milem and I'm the Deputy Director for the Childcare and Development Division and I will be providing the overview as well as just some highlights based on the questions that were provided ahead of time. So California's Administration and Legislator had made major strides to expand services and supports for young children and their families. Guided by the master plan of Early Learning and Care, the state has made historic multiyear investments totaling 4.1 billion.

As we look through our first question that talks about the highlights of the governor's proposal of Budget 23,24 we know that the agenda has some key highlighted figures. I would just call out a couple bullets in regards to that. The proposed budget includes 6.6 billion for CDSS childcare development programs, including an estimated statutory COLA of 8.13%. The budget also assumes that 20,000 new slots that would have been funded in 2324 will be instead funded in 24, 25.

And under the proposal, it is projected that the 1,600 new cap slots that previously planned for the April 24, 2024 would be pushed back to April 2025 and the 4,000 new CCTR slots, which is General childcare previously planned for October 2023, would be pushed back to October 2024. In terms of there's questions in regards to slots and the allocation of slots, the Budget of 2021 Budget act funded 110,500,000 new slots in 2122 and another 3600 new slots in 22, 23. As of February 2023

Based on the data collected between October 2021 and December 2022, the cap enrollment increased by about 37,238 slots, which is about a 66% increase. So want to take a moment to thank our partners for that because we have been working hard, our contractors have working very hard to continue to increase enrollment. For CCTR, the 2021, 22 award included a 25% of the available funding and contracts for fiscal year 22,23 and to all the 114 applicants with substantial applications.

Submittable applications resulted in about 257 million in newly award funding to serve an estimated about 8,800 children in these slots. While we understand the great need for slots and enrollment, large number of families does take time and during this first year, one of the reasons for the delay was attribute to the issuance of the contract amendment while lifting the new division. We are pleased to share great improvements in our processing of 22, 23 including contract amendments released a month a few months after the budget enactment.

And further, it will take some time for CDSs to process the significant increase in the contract amendments and new contracts to implement slot expansions. Contractors and providers also need time to expand on their staffing to process new enrollments and giving the administrative process enrollment and becoming new contractors. The new contractors were not able to begin enrollment until July 1 of 2022.

So there's also another question in regards to supplemental rates, including stipends in the Budget act, as well as the impact of these supplemental rates payments to providers. So again, the agenda covers some of these highlights. So I'm just going to touch on just a few. So from the very beginning, we have been issuing a series of stipends.

And so some examples of these stipends that have already gone out the door have been a $525 stipend per child for provider or center that has been serving children as it has been serving in 2001. And this particular one went out on June 2021 and was based on November's 2020 enrollment data. There's also a $600 stipend that has a $600 per child stipend that went out in September of 2021 and was based on March 2021 enrollment data.

And the most recent one is the 1442 stipend AB 179 that was eligible for the stipends based on April 22 child enrollment data. That is coming soon, and we're processing as fast as we can to get these out the door in September.

I'm sorry, in the summer of 2023, of those two, there's been other numerous stipends that includes also in partnership and working with our CCPU partners in regards to having stipends go out for the representative Members, and they ranged in different dollar amounts depending on whether they were large license or small, as well as license exempt for those two. And those have been going out in a rolling basis also with that too, in terms of direct service contract providers.

So these are primarily your centers for title five that we reference in consultation with the Legislator, CDE and CDSS determined that the funding appropriated for direct service provider reimbursement rate supplements was sufficient to fund the difference between the reimbursement rate of January 1 of 2022 and the funding equivalent of the 85th percentile of the 2018 Regional Market rate survey.

To this end, one time lump sum payment would distribute to direct service childcare providers contractors in the fall of 2022 based on reimbursement categories under the equivalent of the 85th percentile of the 2018 regional market rate piece there, too.

So I'm going to pause because I know there is quite a few other stipends that I can definitely speak to and realize that we are limited in time, too, but happy to continue that any of those questions in regards to that, in terms of impacts of these stipends, what have they done on the ground? We've heard numerous firsthand accounts in regards to keeping their doors open, making sure that providers are able to continue to, in this case, really navigate the pandemic, as we know exponentially.

There has been a lot of impact in regards to these areas, and so they have definitely come a long way in regards to supporting this too. And then the other piece is in order for providers, for providers, in order to access these stipends, they have to complete what we call an ARPA survey, its requirements from the Federal Government in order to do that.

And so far we've collected about 50,000 or so childcare surveys in regards to that, which are supporting about 3,100 children, just to get an idea of magnitude itself. And then there was also questions in regards to the infrastructure grant. And so let me just do some highlights in regards to that. So there has been awards out for the infrastructure grant in regards to these. We had originally received. We were estimating that the timeline would receive about 2,000 or so RFA applications from the field.

We ended up getting over 5,000. And so that just shows the great need in regards to that. Of that we were able to do awards in regards to those and we are continuing to issue those in a rolling basis. That particular infrastructure grant is for minor renovation and repairs and it's to support any minor renovations in regards to having them continue to care for children in regards to that. And we're continuing to process the batches in budget 22,23 there was an increase to those dollars.

And so therefore we were able to issue what we called conditional letters to potential applicants. But we had to go through the appeal process first in order for us to finalize. And so we're pleased to say that at the end of this week, those conditional letters will now become award letters. And so more individuals will be able to receive now notice in regards to their final award amounts and will be included in the batch information of that too.

As far as major construction and repair, RFA was out, that is for anyone that wants to build a center, for example, or also continue to do some major renovations for a licensed family childcare home. The key thing in regards to statute regarding this is being able to apply in a sense for a license that was increased, right? So making sure that you are adding more slots in a sense, and access in a sense to this work.

And so we are currently reviewing those RFAs and we'll be providing updates then in the near future regarding that. But again, very well received and also received a lot more applications than what the timeline had showed that we were submitting. Let me pause there and see if you would like me to continue through a couple more questions regarding the agenda. This one question number five. On question number five.

Yeah, go ahead.

Perfect. In terms of hold harmless policy, which impacts childcare providers, as of June 30 of 2023, providers will be reimbursed based on contracted hours and attendance. So as you know, we don't have a new proposal in regards to changing this. And we continue to hear a lot of feedback in regards to this particular flexibility that was allowed during the pandemic. In terms of the question number five, regarding the AB 2806 question in regards to this. Let me pause and. Yeah, thank you.

I was like, I don't have the question on here.

I was on a row here.

Before we turn over to Department of Finance, just a couple of questions to you for the development infrastructure grant program. I know it's an ongoing rolling basis. When do you anticipate the last funding to go out?

So the anticipation of the last funding to go out will probably be aligning with, because we just recently went through the appeals and the notifications, and it is taking several months to get the dollars out the door. And although we are pushing the dollars as quickly as we can, it could go through the summer in regards to issuing those.

Perfect. Thank you. Relating to the delays of the slots and the money coming, going out to providers. And you mentioned some of the difficulties were around just opening that new Department and contractor, the contracts also setting that up, moving forward with the additional slots that we will be getting, should they be delayed or not, is the Department prepared now moving forward to release these funds on a more timely manner?

No. I appreciate that question. And again, want to reiterate the urgency. We know that all these funds need to be issued. A couple of things I would just say is that, and you heard Deputy Director Jaime Milan speak to, is that the level of increases weren't in even one funding stream. They were in alternative payment program vouchers. They were in center based care. They were across the board, which is fantastic and phenomenal.

And we want to celebrate and recognize that we've never had this kind of investment in California. That's great and wonderful. We also recognize through this process that those who are actually enrolling families into the program needed more support. Right. And so together, Legislature and Administration put additional dollars in for alternative payment program administrators and resource and referral programs who also do the consumer education piece of where that critical choice that a family makes of where children can be placed.

So they had to staff and ramp up to be able to do the work to do this, as well as the state actually getting contracts in place to get the funds issued, we are both amending existing contracts, frequently bringing in new contractors.

And again, as all of these additional, especially the stipends and relief have been moving forward, we're asking in some cases the same administrators who are enrolling families to also issue these stipends to providers and in some cases also getting additional help to support them in doing that to expedite the process.

Staffing. Contracting, again, not only at the state level, but at the local level to take these components up. So I would say yes. Overall, in terms of the cadence and pace at which we're investing of this expansion, we are kind of recalibrating now from what we had been. It hadn't been this kind of investment. We hadn't been rolling families in this way in prior years. So we are building capacity and infrastructure.

Staffing issue positions within the Department,

And in terms of contracting process, I think we'll continue to have that conversation with the Legislature. We have in various programs across the Department, talked with the Legislature about our authority to, in some cases, have the no competitive bid, these kinds of things that help accelerate, because again, we're talking about six month minimum if we have to put things out to bid for a new contractor to come on board, etcetera. So that's a conversation I think we'll continue.

And we had some of those provisions waived in Covid, in the pandemic. Right.

These are some of the flexibilities we had. So that have gone away. So I think it's going to be a continued conversation for us on contract provisions. But I think in terms of the overall capacity and building of the infrastructure and the additional investments we've made locally as well as within the Department, we're in a different place than we were, let's say23 years ago. Perfect.

Thank you so much. Department of Finance.

Yes. Diana Dominguez, Department of Finance. Are you asking specifically about the slot expansion?

Yes. To go ahead and present on the questions?

Yes, sure.

The Governor's Budget proposes to delay the childcare slot expansion previously slated for the 202324 fiscal year by one year. Under this proposal, the expansion of 206,500 total new childcare slots will be realized in the 2026/27 fiscal year. And this one year delay in continued slot expansion is proposed to allow for more time to implement the 146,500 slots already budgeted through the current fiscal year. So those were in the 2021/22 and 2022/23 fiscal years, as Dr. Jaime Mileham mentioned.

Correct me if I'm wrong. There's a couple more questions on here.

Hi, Tamara Weber, Department of Finance. So we were also asked to provide an update on the expenditure of federal ARPA funds provided for childcare. So we can tell you that the State of California received 3.8 billion total in federal American Rescue Plan Act, known as ARPA funding. And this includes 2.3 billion in ARPA stabilization funds and 1.4 billion in ARPA discretionary funds. Under federal law, ARPA stabilization funds must be obligated by September 30, 2022 and liquidated by September 302023.

ARPA discretionary funds must be obligated by September 30, 2023 and liquidated by September 30, 2024. And to date, the state has spent 2.3 billion in ARPA funding, and that includes 1.8 billion in ARPA funding that's budgeted in the current fiscal year. And the administration is continuously evaluating the expenditure of all our federal funds and will capture any identified balances for proposed allocation in the May revised to the Governor's Budget.

Could you speak a little bit more specific on the childcare allocation?

These numbers were all specifically the childcare. I know there's ARPA in other areas, but this was all ARPA money for childcare.

Okay, so there's still no plan on what to do with the remaining ARPA funds?

There is a plan for. There were funds for this fiscal year, and then the Governor's Budget included the rest of the funding that needs to be obligated. It's there and it's covering rates and slots.

Okay, so there's no funding left that hasn't been allocated to something yet.

There's no funding that hasn't been allocated, but there's still opportunities that the Department is leading on and constantly reevaluating to see where there's money that can be pulled back. If it's from contracts that aren't going to be fully met. We're trying to pull that money out and then redirect it, but there's nothing that is just sitting around and hasn't been allocated.

and we don't know where they could potentially be redirected yet. It could be potentially redirected outside of the childcare sphere.

Well, all of the funds that we're talking about were specifically provided by the Federal Government for childcare.

Okay, perfect.

And I'll move on to the next question. We were asked to explain the administration's methodology for estimating the cost of the 8.13% COLA and is the COLA intended to support all childcare providers regardless of program type, or only General childcare providers receiving the SRR and is the intention to provide the COLA to Alternative Payment Programs as a slot increase. So I'll go through those the methodology that the Administration used to budget for COLA related adjustments ensures that sufficient funding is available to meet statutory requirements.

And as noted in the agenda, the estimated COLA factor at Governor's Budget was 8.13%. The budget amount of COLA funding for childcare programs reflected in the Governor's Budget for fiscal year 23/24 is equal to 8.13% of the current year funding levels for childcare programs. So look at the current funding levels, 8.13% of those. That's what we budget for COLA in the budget year.

Moving on to LAO. Thank you

And as noted in the agenda, the providers are either reimbursed at the standard reimbursement rate known as the SRR, or the regional market rate known as the RMR. Current statute requires that the COLA factor be applied to the SRR, but no such statute exists for the RMR. So for voucher based providers who are reimbursed at the RMR, the statutorily required COLA funding can only be accessed to provide additional services like adding childcare slots rather than as reimbursement increases. So I'll stop there and see if there's any questions.

Jackie Brosa with the Legislative Analyst Office. I'll provide just a general overview of our analysis of the Governor's Budget. Specifically, my comments will touch on one comments associated with the delay in the slots by a year. Also providing an update on federal funds, and then providing comments on the COLA. And then providing comments on the expiration of the federal flexibility or the reimbursement. Flexibility is also referred to as hold timeless.

And then lastly providing an update on Proposition 64 dollarsthat are also used to Fund childcare. So first, related to the slot expansion. As been mentioned, the Governor does propose to delay the future slot expansion by a year. This seems reasonable, just given the magnitude of the recent expansions over the last two years, we're more than doubling the current number of slots, but then also the fact that many of these slots have not been filled yet.

And as the panel noted, a lot of this may have to do with just the fact that there has been a delay in getting the dollars out and executing contracts. Specifically on that point of delay in getting dollars out. We would just flag that in our analysis. Specifically when it comes to the direct contract providers, the way that they get access to these dollars is through an application process.

And as of February 2023, of the total $1.1 billion that we provided over the last two years for new slots for direct contract providers, only 257,000,000 was awarded thus far. We know that the department currently has completed two additional rounds of applications, so that number may go up.

But given that, based off of past application trends, if that continues with these two more recent cycles, our office estimates that at least in the current year, there may be up to at least roughly $800 million in savings that the Legislature could score. How that's split across General Fund Federal Fund that would just require future conversations, but that's the total amount at least.

Moving on to federal funds, similar conversation is that we did have some key outstanding questions with the Administration and getting updates regarding childcare expenditures, especially on federal funds. And through those conversations, one, we were trying to get a better understanding of how all federal relief funds were going to be spent and if they would be spent by the federal deadline.

And through our conversations and in requesting backup, the Department did identify that thus far, 57 million that was initially allocated for rate increases will not be spent by the September 2023 deadline. So as a result, they would revert back to the Federal Government. And similarly, the Department of Education has also identified that 112,000,000 of unspent federal relief funds that were also intended to cover rate increase costs have not been spent thus far.

So they're in a similar position where if those dollars aren't redirected, they would just revert back to the Federal Government. The Legislature may want to ask the Administration specifically on those dollars that have been identified thus far.

Granted, we will get an update in May, but whether or not there are activities that these dollars could be spent on quickly, before we reach that September 2023 deadline, and then also identifying for those dollars that are expiring September 2024, just getting a better sense of the projected possible and expenditure funds for that bucket.

Another question that we asked was just confirming in the May revision if we would see adjustments to funding levels to reflect the slower than expected takeup of slots, but then also to reflect a more accurate depiction of when these new slot dollars are going out the door. And it's our understanding that we should expect to see that in the May revision.

And then lastly, as the Department mentioned as well, there have been recent increases in federal dollars that are not currently captured in the January budget, but should be captured in May, we will in may be looking at a bigger picture, just trying to get a better understanding of how those increases in federal funds if they're enough to offset the expected needed backfill for the expiration of those temporary federal relief dollars, which right now aren't fully captured in the January budget estimates.

So if those additional federal dollars are enough, we won't need to increase General Fund. But if they're not enough, then there may be a need to increase General Fund in the budget year. So just the Legislature may want to ask the Administration the likelihood if there would be enough federal funds that could backfill the loss of those temporary federal relief dollars.

And then if that is not the case, would we increase the amount of General Fund in the budget year to maintain funding levels flat in the program as it relates to the COLA? As was mentioned, the COLA for direct contract providers would only apply to those providers that receive rates based off of the standard reimbursement rate. However, the way that the costs are budgeted by the Department, they assume that the COLA applies to all providers.

So if we were to readjust the calculation just based off of the SRR providers, the Department said that the cost would go down to 20 million. So that would free up another 120,000,000 within the budget. The Legislature there are many ways you could structure a COLA. For example, you could provide an across the board rate increase COLA and utilize that 120. It wouldn't cost an additional dollar. You could use it to reduce the disparity between those providers that receive the SRR and the RMR.

You could also just score the savings in light of if the budget problem does get worse in May. Moving on to our comments regarding the reimbursement flexibility, as was mentioned during COVID the state did allow providers to continue to receive payment for children regardless of, in some cases, if they attended or regardless of how many hours of service were actually provided for the voucher based program. We do see that there may be some merit to maintain some form of a reimbursement flexibility.

We did hear from providers that that provided a stable payment stream for children. That especially were on variable vouchers where it's very difficult to plan on how much money you would receive for that child. So they said that that just made them more likely to take on that family and enroll that family. And the fact that that was still tied to at least a provider enrolling a child, it still attached the broader goal of ensuring that we're maximizing the number of children served in the program.

However, with the direct contract provider, the way that that reimbursement flexibility was structured, it wasn't tied to enrollment perse. So we don't necessarily find that maintaining that form of reimbursement flexibility would continue to support the overall goal of maximizing the number of children serve, but also doesn't get at the root cause of why these providers may be facing just financial instability. And then lastly, for Prop 64, as I mentioned, a portion of Prop 64 cannabis tax revenue does go to child care.

Last year, the Governor's Budget did provide 150,000,000 1 time General Fund to backfill any losses in Prop $64 that could occur over the next two years. Our understanding is that a portion of that backfill money is being used in the Governor's Budget to maintain program funding levels, including for childcare flat. However, our office projects that Proposition 64 revenues will likely come in lower than what is budget in the Governor's Budget. So there's a question of whether that 150,000,000 would be even enough in that case.

So the Legislature may want to ask the Administration if the $150,000,000 is not enough to maintain program funding levels flat for those that do rely on Proposition 64, including childcare, whether additional General Fund would be provided or. There was also our understanding 185,000,000 in carryover Proposition $64 specifically to childcare. So that could be another alternative that could be considered. Thank you.

Really great insight. That was a lot of great information. Any questions you want to bring up?

No, I know it's a lot. It's a lot, right. And so I want to thank everybody, but both the finance side and the LAO always doing a fantastic analysis. And I hope Department of Finance was taking notes about more questions that we're going to have. And just to thank to the Department. I know this has been a hard few years, and it's hard because we had so much money that we're just trying to get it out, and now we're going into a downward cycle.

So I just want to appreciate that you're managing almost two streams at the same time in this incredibly complex system that we have created to care for our kids. So we're all women here.

Let's get. Right. Let's do it.

Yeah.

Just to flag some of the questions that stood out, the most that I'd love to come back to is the $800 million that was mentioned, the 57 million, and ways that any activities we can spend them on before the deadline of September.

Glad to have that conversation in the May revision and just again, the commitment to funding that's been dedicated for children and families staying with them. So I appreciate that we'll be back.

Perfect. Thank you so much for that. We're going to hold that item open and move on to issue number three as it relates to AB 28. Six.

Welcome back.

Thank you. Good morning, Dr. Lupe Jaime-Mileham and I will be addressing this issue. So, just as an overview of the proposal itself, in September of 2022, AB 286 made a statutory change to the requirement for mental health consultation services and added a new statutory requirement which prohibit CCTR, CAHAN, and CMIG, which are title five contractors, direct service contractors from expelling or unenrolling a child because of a child's behavior.

Specifically, this bill made the following changes and so some of the changes that came is that this bill revised the requirement of the Mental Health Consultation Services Reimbursement factor by expanding the definition of an approved mental health professional who can serve and provide these services.

It eliminates CDSS authority to determine other persons who may provide such services and instead included specific requirements under the definition of a licensed mental health professional that may be a credentialed school counselor or school psychologist employee pursuant of existing law, et cetera regards to this and providing also a requirement that the mental health professional have at least three years of experience service providing mental health consultation to children zero to five years of age, inclusive of who must be training infant, family, mental health childhood mental health services. So, it expands the scope beyond children to include supports of parents and legal guardians, and caregivers.

And it adds an additional requirement, contracting with agencies within the 30 days of contracting to ensure that the mental health professional has met the training requirement. It does require CDSS to progrimate new regulations specifically to this requirement. So, the bill has revised requirements for reimbursement of the cost of early mental health and impacts eligibility for subsidized childcare programs in California, whose reimbursement is based on the standard reimbursement rate, regarding this.

So with this new requirement, we have a BCP, a staffing request to implement the requirements, including but not limited to the development of new state policies, monitoring tools, professional development opportunities, technical assistance and guidance to the field, and collaboration with CDE in compliance with the state and federal reporting requirements, and updating program requirements and funding terms and conditions in regards to this specific matter. Now, there is a second component to that bill, which is the suspension and expulsion bill.

This bill codifies the WIC sections 1491 and 1491.1, which prohibits Title Five programs, childcare and development services for children with severe disability programs, and migrant childcare programs from expelling and unenrolling a child because of specific behaviors. So specifically in this section it defines expulsions, program suspensions, and persistent with severe behaviors. It implements policies and procedure requirements for providers specifically to suspension and expulsion.

It requires facility to report the data annually beginning July 1 of 2030 on use of expansion and suspension procedures, and it's subject to appropriation and would require the California Department of Education and CDSS to publish data annually beginning of 2031.

So the permit facilities to appeal any citation of civil penalties related to a child's behavior of a child, including the action of its staff related to child's behavior, if the facility is in process of complying with specific prohibitions and it requires CDSS to pronate new regulations specifically to these requirements, as well as new statewide policies, monitoring tools, professional development opportunities, and technical assistance and guidance to the field.

There is a clause in regards to CCPU implications for suspension and expulsion, and requirements specifically to suspension and expulsion includes licensed family childcare home providers who are represented by California Childcare Provider United Union of California, CCPU, as there will be a joint labor-management Committee comprised of the state and CCPU representatives on this topic, which is required to make recommendations for potential changes related to suspension and explosions impacting the representative providers.

We do have a staffing request to implement the requirements of this, not limited to, so BCP, opportunities of new statewide policies, monitoring tools, professional development opportunities, technical assistance, and guidance to the field collaboration, of course, with RCD partners in regards to the implementation and rollout of compliance within state and federal requirement requirements, and then updating program requirements such as funding terms and conditions, the workload associated with the planning and development of statewide data systems, regarding this too.

Thank you so much. Just quick question for you. You mentioned the technical assistance and the guidance for the field. Is anything going to be involved regarding training of how to screen and refer children who are developmental delays to resources?

So we're building on the infrastructure that we have right now and currently, right now we have one investment within our quality dollars that calls out specifically in regards to working with what we say quality counts California. One of the areas under quality counts California is screening of the ASQ, which looks specifically as probably familiar with the tool.

And so as we're looking at the BCPs in regards to that, is to build upon that and thinking about how to make sure that not just those that opt into California QCC work, but also the field that is now going to be connected with this new requirement will be able to have access to that. And so there's definitely a need to continue to do and build upon that work.

I'm familiar with ASQ because I have a bill related to childhood screening. Thank you so much, Senator. Any question? Great. We're going to hold the item open and we're going to move on to issue number four as relates to AB 2832. Doctor, go ahead.

Thank you. So again, Dr. Lupe Jaime-Mileham and I will be speaking to issue number four in regards to the whole child community equity, and we also have a BCP in regards to that. So in September of 2022, AB 2832, also referred to as the end of racial and economic inequities in the Childcare of California initiative, mandated a whole child equity workgroup to address racial and economic disparities that have hindered the development of severe historically marginalized communities.

By developing a process to strengthen and expand the early childhood system, the workgroup will accomplish the following goal: to help the following pieces. One is to develop a whole-child equity framework, and this framework would outline categories that are essential to support children from zero to 13 years old using a whole-child approach. This is inclusive but not limited to the access of the childcare, physical and mental health services, education and childcare adversity and community safety, economic and well-being, and built on the environment.

The framework will also be used to develop the equity tool, which is another charge in regards to this workgroup, and so the whole child equity screening tool. The tool will be used to identify the highest-need communities across California by examining community-level data for indicators aligned within the framework categories and classifying community-based on higher or lower values for these indicators.

The workgroup will also provide recommendations using the equity tool, early childhood investments, and the whole child resources to address racial and economic inequities, and the framework and screening tools will utilize valuable and community-level data to target efforts toward the community with the highest needs. Additionally, the research and collected data will track and identify, and help strengthen communities that have multiple compound factors impacting children in areas of including, but not limited to, education, health, community safety, economic well-being, and built-on environments.

Staffing is requested in order to convene the workgroup, develop the framework participating in research design, data measure development, data collection and data analytical supports for the tool, as well as development of the required reports.

Thank you, DOF and LAO. Any questions? Comments? See none. We're going to move on. And Doctor, the next two are pretty straightforward. Just a brief recap of those two, please. I'm going to hold the item open also. Sorry, issue number five, go ahead.

So, issue number five is a request to respond to the following question, and this is a cleanup trailer bill that would align California State Preschool Program CSBP requirements into the childcare and development program requirements by amending the WIC code. So Section 135, when we did the lift and shift, this was left out. It was just such a huge package in there.

And it allowed for the interagency agreements adjustments between different contractors with the same contract type to promote utilization of childcare and development funding and allow for matching of available unused funds with the identified need. So if you had one contractor with one specific contract that is underusing and the same, and the nearby contractor that is overusing, they can do that transfer of funds for the one time.

Perfect. LAO, any comment? DOF, any comment? Seeing none, we're going to hold that item open, move on to issue number six.

Okay? Again, Dr. Lupe Jaime-Mileham, Deputy Director for the Childcare and Development Division. This is getting easier. And so I will also speak in regards to issue six, which is Alternative Payment Programs, reimbursement rate categories, and documentation. And this, again is also part of some cleanup language that we'd like to do. This proposal would amend WIC section 102 to eight to provide clarification regarding alternative payment providers rate sheet and reimbursement rate categories.

And so this specific would add language specific to license exempt family, friend and neighbor care providers that will not be required to submit a copy of their rate sheet, along with a statement confirming that the rates charged for a subsidized childcare provider equals two or less than the rates charged for a non childcare. And so it just adds that additional language in regards to the rate.

LAO, any comment? Department of Finance, any comment? Seeing none over here. We're going to hold the item open. Doctor, thank you so much for joining us. We're going to move on to issue number seven, and these are stakeholder proposals for investment. So I'd like to welcome Denyne Micheletti Colburn from the California Alternative Payment Program to present the family and childcare enrollment, community-based alternative program funding.

Well, good morning. First off, I want to thank Senator Ashby for moving forward with this proposal on behalf of the community-based Alternative Payment Programs that have supported working families throughout California for over 45 years. We are requesting an increase in our funding to support enrolling families in connecting these families to childcare. Before going forward, I just want to make note that of all the stipends you've been talking about in supplemental payments to providers, it's been the Alternative Payment Programs that have done all of this work.

Some of the work done was supported, but not all. Prior to the onset of the pandemic, our program supported fewer than 58,000 voucher childcare slots statewide. Today, our agencies now support over 161,000. However, during this time of tremendous growth, agencies have greatly suffered in being able to support the most fragile of families with supports that they most desperately need. While slots have been added and on this point we are very appreciative, slots are always needed.

So have requirements to implement over 80 separate child develop California Department of Education Management bulletins and California Department of Social Services Childcare bulletins requiring changes to data systems, enrollment disenrollment eligibility criteria, fee waivers, hold harmless policies, childcare provider union agreements, and monthly dues collections, most without being funded. During the pandemic and social distancing requirements, agencies too were forced to invest in the technology needed for caseworkers to stay connected with families.

Also, during the times of crisis, our community agencies deemed as essential also took on the task of supporting enrollment of a new workgroup of families, those workers who were deemed as critical and essential. Because of how agencies are funded, whenever one of the above-referenced unfunded mandates were issued, community agencies had to divert monies out of their budgets to directly support and stabilize, and enroll families. In 2022, agencies statewide were supported with a 20 million one-time statewide allocation, of which we were very appreciative.

But by that time, the funding did little to seal the cracks that many of the agencies were feeling. Additionally, due to an antiquated interpretation from CDE on the funding of our programs, and as you just noted, our programs were moved over during the crisis to the Department of Social Services, agencies have never been stabilized and supported for all of the work needed to enroll a single eligible family. On that note, you have a handout that shows all the work done for enrolling a family.

Actual reimbursement for the work done is not done and captured till a payment is actually made, which could be up to 120 days from the start of the process.

Let's see.

Because of the interpretation on the funding of contracts that was transferred over to DSS in 2021, agencies cannot fully use the percentage allocated based on their contract in a fiscal year if some funds are to be ruled over, although there has been a recent management bulletin where that is being revisited and I understand the legislature will be taking that on.

An example of this is in our current 2022-23 fiscal year, wherein an additional 36,000 childcare slots were allocated, but agencies did not actually receive funding to begin enrollment for those new slots until late November-January. I had shared with you that about 60% to 70% of the families that begin the process will not complete the process.

Just ask if you could quickly wrap up. Thank you.

Let's see. So I'm going to also draw the work that the agencies do to the rates. The contract funding for the agencies is also loosely tied to the reimbursement rate structure. So if the reimbursement rate structure is based on 2016 data, when the minimum wage was 11.50, the funding for the agencies is also tied loosely to that rate.

Additionally, because, as it was mentioned earlier, there's been such a loss of childcare capacity, what we're seeing in the field are families are mostly being able to access only license exempt care, which is about $5 per hour. That means that these agencies are having to serve roughly three families for every one licensed slot. So they're doing more work for less care, an area that I really want to bring up.

Final thoughts? Stakeholder proposals get three minutes. Just any final thoughts real quick on.

The NOAA or on the hold harmless and the family fee, we have to issue over 161 notices of actions to families in May. These families are going to be disenrolled from childcare based on these two actions in May before a decision is made. So, we would strongly support aligning with the LAO to push out any actions until September and not throw families into crisis. Thank you.

Thank you so much. LAO, Any additional comment added? Department of Finance.

Diana Dominguez, Department of Finance. We're aware of this proposal, but have no proposals in the Governor's Budget at this time. Thank you.

Thank you so much. Senators, any question? Thank you so much for presenting no questions on my end. We're going to hold that item open and move on to now the Children and Family Services overview under DSS. Department of Social Services issue eight. Like to welcome Angie Schwartz.

Running to get up here. Good morning, Madam Chair and members of the committee, Angie Schwartz, Deputy Director of the Children and Family Services Division for the Department of Social Services and appreciate the very thorough agenda. So I'll just jump right into the questions. The overview of the Governor's proposed 23-24 budget for children and family services. Child welfare in California is overseen by the state, and administered by the counties.

The current year budget for fiscal year 22-23 includes 9.3 billion total funds, 1.2 billion general fund to support a range of services and supports from prevention to the supports for children once they come into our foster care system, if they come into our foster care system, as well as what's needed in order to successfully reunify them with families or support permanency through adoption or guardianship, as well as support for our older youth through the extended foster care program.

The proposed budget for fiscal year 23-24 includes 9.1 billion total funds, 832.9 million general fund. That year-to-year decrease is largely driven by one-time funding displays of items that had multiple years of expenditure authority, including the pilots for the minor victims of commercial sexual exploitation and the excellence in Family Finding Block grant. The Governor's proposed budget preserves the significant investments made over the last two years, totaling nearly 1 billion in support for the development and expansion of prevention programs.

Family finding aimed at making sure children who are removed stay with their own families and extended family members, as well as the pilots for the CSEC youth, supports for our youth with complex care needs, and supports for our tribes so that they can have dependency representation and access to tribally approved home funds, all of which we'll talk about. In terms of the new investments proposed and moving to the second question in the agenda.

There are three child welfare components of the California Behavioral Health Community-Based Continuum, also known as Cal VHCBC, that waiver, although only one is proposed to start receiving funding in budget year. The three elements are the activity stipends, which will support funding for extracurricular activities for youth in care, and the CDSS portion of that funding is for the social worker time to coordinate those services.

The second is the joint home visits for the mental health providers, and the third, which is the one that is proposed to have funding that starts in budget year, is the child and family team meetings for our family maintenance cases. Currently, supports for child and family team activities are only available once a child is removed, so we don't offer the child and family teams. We don't fund those activities in order to prevent the removal or to support the reunification of children and prevent their reentry.

And so that's what that proposal is focused on. In terms of the timing, the January budget proposal for the cfts in the family maintenance cases is proposed to begin January 1, 2024. But those other two elements that I spoke about, the activity stipends and the joint home visits, are sent to begin implementation January 1, 2025.

In terms of the question about how we will engage with stakeholders, because these activities are associated with the Cal BHCBC waiver, engagement with the stakeholders, including the children and families that are involved, will be coordinated in partnership with the Department of Healthcare Services, who's really lead on that waiver. But as always, we will engage in the county letter development process, which includes formal opportunities for stakeholder review, and we'll also be engaging through webinars and work groups. We also have preexisting processes in place.

We have a peer partner backbone committee, we have a parent partner advisory committee, and peer partner hubs, which are ways that we engage youth, parents, and families that have current and prior experience with our child welfare system. So we'll be using all of those different forums. In terms of the goals of the funding, it's what I was just speaking to.

It's to prevent children from actually coming into our system and teaming with that family before the removal has to occur, or upon reunification with a parent to make sure that that reunification is successful and that child does not re-enter our system. In terms of the update on implementation for the Center for Excellence in Family Finding and the Family Finding Block grants, we have partnered.

DSS has partnered with the UC Davis Resource Center for Family Centered Practice to develop the Center for Excellence in Family Finding, Support, and Engagement, which is being developed to support counties in the use of the $150,000,000 block grant that they are receiving in order to expand or enhance their family finding, engagement and support efforts, the Center for Excellence has already launched in terms of doing a lot of engagement with counties, with judicial officers, with probation, with our tribal partners in order to see what can we build into the Center for Excellence that will really support and enhance this work across the state.

The goal is to make sure that we are doing family engagement activities that keep children connected with their own relatives and extended family members. We know that 72% of children that are removed and have a first removal into a relative's home are still with that same relative if they're still in care at 12 months. And that's the kind of stability we want for all of our young people in foster care. So we've done webinars. We've held seven regional convenings.

We've also formed the Advisory Committee for the Center for Excellence. We had over 100 applicants for that Advisory Committee. We selected 25 individuals which represent our tribes, our parents, our kinship caregivers, our youth that have experienced foster care, as well as counties probation. We've got a couple of judicial officers, providers, advocates, and we've also made sure to make sure the Advisory Committee is representative of all the different geographic regions of our state so that we have representation from both our urban and rural counties.

Those engagement activities are going to continue and the Center for Excellence will start releasing products such as train the trainers and model policies and programs, and as well as engaging with consultants to support our counties in this work. In terms of the update on the pilot projects to support minor victims of commercial sexual exploitation, that initial pilot was funded in June 2019 with 12.7 million of reappropriated dollars that were not used by the statewide CSEC program in the prior years.

So two sites were selected in that initial pilot. The first was the Department on the Status of Women in San Francisco, and the second the Children's Legacy Center in Shasta County. Both of those contracts ended on March 1 of this year and there was an additional investment, as you all know, in the current year of $25 million for the continuation of those pilots, as well as the expansion to a Southern California site.

So we have executed the extension for the Shasta County pilot with the Children's Legacy Center and we're in the process and it will be extended soon with the San Francisco the urban-based pilot. We also have published a request for proposal for the southern-based pilot and that has a due date or an end date of May 11.

So we'll be looking at the applications received after that time and that pilot will be funded for three years at $10 million, which includes more money than the extension because there's going to be those initial startup and implementation costs.

In terms of the question about the emergency childcare bridge program and the data available on the impacts of the expansion, the preliminary data for the current fiscal year indicates that the number of children unable to secure long-term, stable childcare prior to the 12-month expiration is on pace, excuse me, to be less than half of the previous fiscal year. Still, most of that data is coming from Los Angeles.

In San Bernardino counties, the decrease is likely attributable to the historical expansion of subsidies as well as the language last year allowing for the extensions beyond the 12 months, and the counties have received access to the 35 million for the expansion of the navigators, the training, and the additional vouchers. And that happened in September of 2022.

In terms of the update for implementation for legal counsel for tribes in child welfare cases and support for tribes for tribal home approvals, the first tribal dependency representation, the budget act of the current year budget allocated 5.2 million for tribes to fund legal counsel to represent Indian tribes in California Indian child custody proceedings.

This is unique in the country and addresses an inequity for our tribes who, despite being parties to an Indian child custody proceeding, have never had public funding to support their own legal representation in those proceedings, despite the fact that parents, children and the county child welfare agencies, who are also parties, do have access to those public funds. So this appropriation addresses that inequity and the barriers that tribes have experienced when attempting to exercise their right to intervene, which leads to poor outcomes for Indian children.

The department has engaged in consultation with tribes and is on track to fully implement the Tribal Dependency Representation program and award funds by May 1. In terms of tribally approved homes compensation program, the Indian Child Welfare Act of 1978 established placement preferences for Indian children, requiring that Indian children are made according to the prevailing social and cultural standards of the Indian community, and tribes have the right to license and approve their own homes according to their own tribal standards.

But again, there has never been funding to support that work until this appropriation of 5.2 million ongoing funding in order to make sure that tribes have access to funding to do their tribal home approvals. And we're also on track. We're working on releasing that guidance in the coming weeks and all of these programs in terms of how we're administering them in consultation with the tribes. The department created a process aimed at easing the administrative burden on tribes because it was those two programs.

But there were also carve-outs for the Excellence Family Finding program as well as the flexible family supports programs that were allocated specifically for our tribes. So there's actually a lot of different programs that the tribes can opt to enter into and to implement.

We've created a base MOU, one MOU that the tribes can enter into in order to sort of be able to access each of those programs, tribal dependency representation, tribally approved homes, the family finding, and the flexible family supports, and then they would enter into an exhibit for whichever ones of those programs they want to actually take advantage of.

We're excited to report that they began receiving those base MOUs this last week, and close to 60 tribes have expressed interest in the tribal dependency representation and the tribally approved home programs, and we're in the process of executing those base MOUs right now.

The final question has to do with the foster care rate structure we are aware of and working to meet the statutory deadline of January 2025 and anticipate proposing a final structure as part of the budget process for the coming year. Depending on the extent of the challenges, sorry, not challenges, changes. It's an important word difference, that are included in the final proposal. It may actually take additional time to implement due to whatever automation may actually be necessary if there's significant changes to the current rate structure.

I think those were all of the questions in the agenda, but happy to answer any additional questions.

Perfect. Thank you so much. We're going to turn over to LAO and then questions.

Thank you. Good afternoon, Chair and members, Angela Short with the Legislative Analyst Office. For this issue, we have been asked to share our overall comments on the Governor's proposed 23-24 budget for child welfare, as well as the implementation of recently funded programs. So I will start with our broader comments on the overall implementation of recently funded programs. As you heard from Deputy Director Schwartz, there have been many, many recently funded augmentations for child welfare totaling nearly $1 billion in recent years.

So we did just want to start by acknowledging just the volume of work that DSS has undertaken in terms of working toward full implementation of the various new augmentations. At the same time, the department has been managing various programmatic changes that have resulted from the pandemic. So just wanted to start with that acknowledgment. Within this context, certainly we would expect there will be some lead time between the legislature authorizing funding for new programs as part of the budget process and then developing guidance developing allocations implementation.

So, as detailed throughout your agenda, DSS is at various stages of implementation for the different programs. In general, we found it has taken around six to 12 months, depending on the specific augmentation, for the department to develop the initial guidance and allocations and begin implementation. Of course, that varies significantly depending on the complexity of the specific allocation.

However, we would note that with all of these different timelines and just the volume of new augmentations, that has created some challenges in being able to effectively oversee all of these new programs reaching implementation and has affected the legislature's ability to just track everything efficiently.

So with this in mind, we recommend that the legislature could direct the department to report on the specific steps that go into developing guidance to allow the legislature to just have that fuller understanding and be able to set expectations accordingly as to the implementation process.

Also, the legislature could ask the department to report on if there have been any challenges that have arisen or just any unanticipated complexities in terms of translating budget language into actionable guidance for implementation to inform the legislature's ability to provide that clear guidance going forward. Also, for those program components for which we are still working toward full implementation, the legislature could ask the department to provide more regular updates on planning progress, again just to facilitate transparency and the legislature's ability to track everything more efficiently.

These updates also could include specific timelines on when the legislature could expect data and reporting elements to be available, again so that we know when we will be able to begin assessing the specific outcomes of the many new program components.

Moving on, just a few other more specific comments regarding the CCR permanent rate structure that Deputy Director Schwartz was describing, we suggest that the legislature consider requesting that the administration commit to a specific date for sharing the proposal for that final rate structure just for a little bit more context. Since the initial implementation of CCR, we have been using interim foster care rates for resource families, STRTPs, foster family agencies, et cetera.

As per statute, these rates will expire December 31, 2024, and a new rate structure will need to be in place as of January 1, 2025. Given that these will be the permanent ongoing rates for CCR and will really be important ultimately to ensuring the success of CCR's objectives, we think it will be important for the legislature and stakeholders to have sufficient time to work with the administration to review the proposal for the final rate structure.

So we find it would make sense just to be more specific with a deadline and a timeline for getting that proposal across the finish line in time. And then finally, just a brief comment on the one significant new proposal for child welfare that's included in the Governor's budget. This is the California behavioral health community-based continuum waiver demonstration. As noted, the child welfare component is just one small piece. This is a much broader waiver demonstration that is being primarily driven by DHCs.

There are a few specific components included under the DSS budget for child welfare. We find that certainly the stated goal of the waiver demonstration for child welfare, which is to deliver these earlier interventions to reach children and families before they become involved with the child welfare system or before their involvement becomes deeper within the system, this is certainly a compelling goal. However, at this point, the Governor's proposal does not include specific information about the anticipated outcomes, specific data targets, et cetera.

So we suggest the legislature could consider asking the administration to provide more program detail for the waiver demonstration, including, for example, trailer bill language detailing the specific objectives, outcomes, implementation timeline, et cetera, so that the legislature can review those details to better inform the decision around whether to approve, modify or reject this governor's proposal. So thank you. I'll stop there and happy to help answer any questions.

Thank you so much. Actually, the last question you propose is the question I had, and I don't know if you have anything right now. You know, if you could elaborate on the implementation program for Cal BHCBC, if there's anything you're able to provide right now, the goals.

Panani Kazi, Department of Finance I'm sure the department can elaborate more on the overarching goals and the policies, but would just clarify that at this time there isn't trailer bill language delineating the details of this program and there's nothing provided as part of the 23 Governor's budget. Would just note the administration will monitor whether any statutory changes are needed, but most importantly, would just really emphasize that this component is really one component that's embedded in a much larger behavioral health waiver proposal.

And so any specifics or statutory changes would really need to be considered within that context and coordinated along with the Department of Health Care Services.

Perfect. Thank you. And before I go on with any other questions, Department of Finance, any additional comments?

No additional comments at this time. Thank you.

Great. Thank you. Related to this program, Deputy Director, I know you mentioned this is part of a bigger plan and you mentioned DHCS is overseeing the outreach and so forth. Is there anything you can share on when that outreach of stakeholders and collaboration will begin to get ready for the 2025 year?

Sorry. I believe that outreach is ongoing and there's been many conversations that are happening both with the CDSS teams and DHCS teams, and also in coordination. As these ideas are being developed and as what's been proposed through the Governor's budget has been made available, those conversations are continuing.

Thank you. Senator Eggman.

I would just say on all of these new plans we continue to spend millions and billions of dollars. It's really good to be able to get some metrics and some outcomes that we're shooting for to the department, the administration so that we can actually track what's going on.

It's a lot of money coming from a lot of different sources, and I know the department is working to try to implement all these things, but it is complex and complicated and makes oversight even more difficult when we don't have a clear understanding of our targets. So really being able to identify some targets, I think, and some metrics to go along with that is really good.

And I would ask the Deputy Director, and I know a lot of things aren't all the way finished yet, but when we're talking about, I mean, great news on the tribes and being able to keep kids with their families of origin, have we been able to at least finalize that the dollars that per child follows them wherever they are, so they don't have to be in one system and get a different rate of pay and then move back with a family and that family doesn't get the same rate of pay?

Have we been able to accomplish that?

That's some of what we're looking at through the final rate structure that we're moving towards, and that's a lot of the feedback that we've received. So in terms of developing what that final rates proposal would look like, we did actually hold a series of subgroup meetings to really talk about what's working with our interim rates right now as we think about how to move towards a final rate structure.

And so we had, I think, 30 subgroup meetings focused on the resource homes, the STRTPs, the intensive services, foster care, what we pay to the foster family agencies, as well as our supervised independent living placements. So you can tell by the nature of the subgroups that I just said that there still is some aspect of placement-based rates. The STRTP rate is different. We've been able to innovate around that.

So AB 2944 that passed a couple of years ago gives the counties the ability to develop sort of rates outside of the traditional rate structure that are either for a specific child or a specific program that would serve a certain population of kids. And so we've seen innovations around creating, like STRTPs of one or STRTPs of two, which then you have that child supported in what would be the equivalent kind of professional staffing that you would get in a residential facility.

But in a home-based setting where we know kids often do better. So we have been able to do that within the existing interim rate structure because of those flexibilities that were built into the statute. The funding for those STRTPs of one or two are either from local assistance or there's the child-specific dollars that were made available for youth with complex care needs. So counties have access to those dollars, but it's not sort of standardized within our rate system at this point.

And those are some of the discussions that are underway as we move to the final rates structure.

And as we've begun doing more things more effectively to try to keep kids in their homes. How are you doing dealing with workforce issues as we're expanding the work we're doing and the number of families we're doing it with, how are you able to meet the workforce goals?

That's a really good question. I mean, certainly that's a challenge that we keep hearing from the counties in terms of all of these investments, actually, and trying to sort of figure out how to best leverage them and integrate them into their systems is that there are very significant workforce challenges, I think, specific to the family finding and engagement dollars. We're really looking at a culture change and a transformation within the child welfare system.

And I think the workforce challenges, to the extent that we can fully embrace that change and make sure that the first placement a child goes to is with a relative or extended family member, that is a very different workforce experience in terms of if that child then doesn't experience other placement changes and is with their entire sibling group and more likely to reunify and less likely to reenter care. Those are the overarching goals of what we're trying to achieve.

But that also is a different experience for an individual worker, right. Who doesn't have to constantly look for the next placement that that child's going to go because there's so much stability within those family placements.

And so some of what we're talking about as we're implementing the family finding and engagement program is also how that would ease some of the burden on workforce right now and make for a more satisfying experience in doing this work and really getting to dig deep with that child and their own family of origin with the goals of reunification.

Thank you, Senator Eggman, for those questions. That's just one of the challenges I'm interested in hearing. Any more challenges that are coming with this implementation, I'm most interested in. Some of these programs are coming in, in a year, year and a half to two years. So I am keen to get some regular updates, and we'll be coming back to you, Deputy Director, throughout this year to get some of those. So thank you so much for this.

Absolutely happy to come back.

So we're going to hold the item open, and the next item on our agenda is we've requested a panel as it relates to AB 2083 on the children and youth system of care. We will hear from the Department of, welcome back Director, Social Services, on the recently released multi-year plan for increasing capacity for serving children and youth, as well as three representatives from one county, Placer County, who would describe their county system of care work.

Then Susan Abrams with the Children's Law Center of California will give some remarks as well. Welcome, panelists.

Thank you, Madam Chair and committee members. Kim Johnson, California Department of Social Services I just from the previous issue area want to just recognize again the work that we've been doing together on both ends of the continuum of really preventing abuse and neglect and supporting preventing that entry into the system. But also here, as we talk about this, this is really about the youth with the greatest and most complex needs that are unmet and how we're addressing those going forward.

So Assembly Bill 2083, Children and Youth System of Care, established a joint interagency resolution team comprised of the Department of Social Services, Healthcare Services, Developmental Services, and the Department of Education. The law enacted directed the team, in consultation with county agencies, service providers, advocates, resource families, and more to develop and submit recommendations to the legislature addressing any identified gaps in placement, types or availability needed services for children, resource families or other identified issues for children and youth in foster care who have experienced severe trauma.

And so again, as your agenda outlines the report and plan for that, again, one of the major, I would say, accomplishments of this legislation to date is the collaboration amongst the state and local level partners within the system of care. We had conducted a survey as part of this process regarding experiences in supporting children with complex needs to inform our recommendations. The survey was completed by providers, advocates, and local, county, child welfare, educational, and Regional Center professionals.

In addition to the data resulting from outreach, the report's findings are based on evaluation of a variety of quantitative and qualitative data sources, including data from technical assistance provided by the state and multidepartmental match data. The key findings include siloed practices in planning and delivery. Delivering services are a major actionable cause of the gaps and inefficiencies in how systems assess and respond to the needs of children and families holistically.

Implementation of trauma-focused program models within the system of care is incomplete across the state in terms of the availability of trained professionals, evidence-informed assessments, and evidence-informed intervention models. A statewide gap exists in programming with specialized competencies capable of serving the needs of children, youth, and families who have multiple comorbidities or cross-system needs, and children and families need more proactive and holistic services across systems to stabilize children in their own families and communities and to reduce the incidence of foster care.

The committee asked about the key characteristics of youth who are served in the system of care. Over a quarter of all children in California will come to the attention of child welfare at some point in their childhood. Of those children, 10% will experience substantiated abuse or neglect, and 4% will experience the traumatic disruption of being placed in out-of-home care. Of that 4%, just under 40% of children are placed with relative caregivers and approximately 10% are reunified within three months of entry into foster care.

Most youth are also receiving specialty mental health services and in fiscal year 2018, 82,252 youth in foster care eligible for MediCal, and 31,448 youth in foster care receive those specialty mental health services. 71% of our youth receiving special mentally health services, while 19% are receiving both specialty mental health and non specialty mental health behavioral health services and 10% are solely receiving non specialty mental health services.

In terms of intersection between child welfare and the regional centers that serve youth with Developmental Services, in fiscal year 19-20, approximately 10,370 individuals eligible for regional center services had child welfare involvement, which is 5% of all youth served by regional centers in that year, while only 23% of all regional centers youth ages zero to 21 were in early start individuals in early start are 63% of the duly served youth population, those that are both child welfare and regional center consumers.

Students in foster care have been identified to receive special education services over two times the rate of students who are not in foster care, and what we see beyond this data also shows the high prevalence of youth in foster care within our systems of care is that each of these youth are served by these systems of care have experienced some forms of multiple forms of trauma by the nature of substantiated allegations of abuse or neglect, adjudication as a dependent or ward of the court, removal from primary caregiver, and entry into the foster care system.

Many foster youth have co-occurring behavioral health, substance use, developmental, relational, and educational needs, warranting support from multiple system partners. Through the work of the system of care team, we have focused on how this approach can support youth with complex needs. The characteristics of youth with complex needs are that they are revolving through multiple health care, social services, and other systems without immediate or lasting improvement to their health or well-being.

Their combined medical, behavioral health, developmental, educational, and social challenge result in the need for intensive interventions and there are barriers to appropriate and stable living options and significant patterns of utilization from multiple child-serving systems. So again, we address and identify the gaps in the need for this to be a system of care as opposed to those silos. The committee asked, how many children and youth does the California Health and Human Services Agency estimate have complex needs and how do we define that?

We estimate that about 4% of youth in foster care have complex needs associated with the trauma that they've experienced. However, most of these youth are being supported in family homes or therapeutic settings. There is a subset of the population we estimate roughly, approximately in a point in time, 300 youth have unmet complex care needs, meaning that they are not stably supported and are cycling from placement to placement or experiencing long stays in congregate settings.

And again, this is a conversation we've continued to have with our partners about that definition and through our complex care steering committee. The committee asked the key findings regarding the gaps and the joint interagency's team's recommendations. Again, these are outlined well in your agenda.

I'll quickly cover them gap one the unique needs of children and families involved with child welfare and probation gaps in providing children and families a service array that addresses the interrelationship between trauma, caregiver attachment, the child social environment, and the traditional scope of care. Gap two, essential competencies within services and supports, and specialized models of care. Gap three is around care coordination. Gap four, family finding engagement, which you just heard about. Gap five, education and school stability.

Gap six, case worker ratios gap seven, administrative processes and gap eight, data gaps, local and state.

Many of these current year and past year investments that you're hearing about in the prior panel and hearing in the subsequent panels are aimed at addressing these gaps, including funding to continue to support the caregiver approval process and reduce timeliness to approval emergency caregiver supports foster parent recruitment and retention supporting including the flexible family supports in the Center for Excellence and Family Finding and Engagement funding for the social workers to complete the assessments complex care investments that will be discussed again more in your agenda.

We also have other efforts underway to aid in the implementation. The complex steering committee I mentioned is a new intentional table that's been set with a variety of stakeholders to be focused just on this issue. How are the interventions to the committee's questions about outcomes working, and what else can we be doing to lift up best practices and implement those across? We also have continuous coming together of the system of care team. The committee asked about progress made.

Since 2020, the state has invested significant new resources into meeting the needs of children and youth in foster care, with complex needs including ongoing child-specific child welfare funding and one-time resources to flexibly support families, as well as building county capacity. The state's also invested unprecedented levels of resources into supporting behavioral health for youth, including youth in foster care

And with respect to AB 2083 and the system of care, more specifically, culture change is happening as we are seeing Interagency Leadership Teams, also known as ILTs, increasing their collaborative work to better serve children served by multiple systems. With increasing frequency, there are emergency meetings to unstick barriers for youth. Again, that multidisciplinary team is coming together to look at the needs and the case findings of particular youth and are embedding again our prevention work as we go forward to upstream and do more on the local dating sharing components.

For outcomes, all 58 counties have submitted their Memorandums of Understandings that really speak to how the local systems will be working together and partnering, and the topics of those MOUs are child and family teaming, alignment and coordination of services, data sharing, staff recruitment and training and financial resource management and others. Also, in the past two years, the system of care team supported 261 technical assistance calls as I just referenced, including those strike team calls the AB 2083 team.

The state team is partnering with the local teams and local associations to hold regional convenings focused on operationalizing the Memorandums of Understandings to better support the needs of children and families. And the AB 2083 work informs the complex care capacity-building efforts that we funded together with the legislature. And so this funding requires the local interagency leadership team to engage regarding the gaps in those local capacity of services and placement settings.

In many jurisdictions, the local interagency teams are supporting decision-making regarding other initiatives such as our BCHIP through healthcare services community placement plan. So again, we're leveraging the totality of investments in support of how we go forward. The committee asks what the key barriers that remain in meeting the needs of these children and youth. And again, while there are areas of great success, we do have more work to do together.

There still are some variances in implementation and engagement across counties with respect to the system of care framework, as we've evidenced by the technical assistance data in reports of infrequent care meetings and utilization of the MOU actually operationalizing what was outlined in those documents. Also, system change and integration takes time and commitment and is still a work in progress. We need to continue as a state to look at how the system of care as a framework becomes the foundation for other initiatives happening across the system.

The framework is the only formally mandated space that includes critical youth serving partners, and the governance structure should be maximized to allow for additional components around data and information sharing mapping to inform capacity needs locally, development of shared state system of care metrics, such system change improvements and continued analysis of data across systems to improve understanding of the intersectionality of youth strengths and needs.

Also, ongoing policy review to address any of the statutory barriers that might be at present, as well as moving the systems from just being trauma-informed to trauma models and robust services to respond to the needs and being a healing, informed culture. And then finally the committee asked the administration to describe how we're going to implement the recommendations over time.

I've mentioned kind of what we've been doing to date, but I will say that for the Department of Social Services, you're going to hear again on the subsequent panels, on some of the other work, the rates work you just heard a bit about, our children's crisis continuum pilot. We have eight grants that have been awarded in that space, the complex care funding that I've referenced. We also have the family first part four high fidelity wraparound aftercare component, as well as the prevention component and more.

The Department of Healthcare Services has the MediCal strategy to support health and opportunity for children and families, consisting of a number of key initiatives. Of course, we have the behavioral health community-based continuum at healthcare services, CalAIM the Children and Youth Behavioral Initiative and more. Also, the Department of Developmental Services has two community crisis homes and two enhanced behavioral health support homes for children in foster care that have launched.

Again, they have additional staffing to have system of care coordination amongst the Regional Centers, braided funding for Regional Center vendorized residential services, early start tribal outreach, and again, more. So again, we are continuing to look across these systems and the progress that we have to do. But as I said, we've had success and we are learning from those. And I'm sure you'll hear more from the panel on both what's working and what more we have to do together. Thank you.

Thank you so much.

Thank you. So good morning. My name is Twyla Abrahamson and thank you for allowing us to present to you today about our Placer County Interagency Leadership team, which we call Smart. However, with AB 2083, it has catalyzed statewide thinking and conversation around integrated care delivery for children, youth and families. For many counties, this is still very difficult to implement fully.

Some counties have progressed very little beyond completing their MOU because it's very challenging to bring interagency teams together to actually craft new policy and revision of practice in the key areas indicated. It's important to understand that the essential nature of integrated care models will only be present if the system is able to jointly create and agree upon a shared mission and values.

Making structural changes such as colocation of partners and community agencies and the ability to debraid and share funding streams create and thirdly, create functional change at the direct staff level. So we're here to tell you a little bit of a story. So before AB 2083, we had Placer County. Since 1988, we have worked in this manner. And again, I mentioned our ILT is called Smart.

We've worked through its systems management, advocacy and resource team to promote system change and expand coordinated services for children and their families. The organizational structure of smart consists of a policy board and a policy Executive Advisory Committee, a juvenile court judge, which is fairly unique to Placer county services, the chair for our smart policy board, so that's the chair of our ILT.

Members are also from Health and Human Services, Probation, County Office of Education, Public Health, the children's system of care, parent and youth advocacy, and most recently, our Regional Center. One reason for Placer's success is the presiding bench officer leads the ILT meetings, and they set expectations about collaboration. The mission of Smart has been always to ensure that all public programs for children and families will provide services in a culturally responsive, comprehensive, and integrated manner, regardless of which agency door by which families enter.

So, for our children's system of care, the strength of CSOC lies in its trauma informed, multidisciplinary approach to case management and service delivery. As a team, smart Members and CSOC develop and Demonstrate Cross Functional proficiency in a variety of areas, including family preservation, mental health, probation, child protective services, sexual abuse treatment, special and alternative education, public health, substance abuse, foster placement, diversion, and program evaluation. And comprehensive service delivery is not managed by a single worker. It's by rather cross functional, trained, interdisciplinary teams.

So CSOC, we integrate child welfare, children's mental health, probation, public health, nursing, substance use services, and education with this no wrong door policy. CSOC also locates individuals from each of these disciplines, as well as family advocates, peer partners in promotoris so that we can work as seamless teams. And our community based service providers such as family resource centers, child advocates, cultural brokers, behavioral health service providers and others round out the team.

In fact, if you come to our offices, you may not know actually who you're running into. It may be a probation officer, it might be somebody from the community. We co locate as many people as we can as possible to make this easier for seamless teams. So one important way that CSOC is able to serve complex care high needs youth and their families is what we call our family resource community collaborative.

The FRCC convening occurs with the youth and family present, and all service sector decision makers are present to make a joint service and resources support plan. And this is sometimes in a child and family team, but it's also sometimes in again, our family led family resources community collaborative. It is facilitated by one of our family partners, so sustainability the plaster system of care takes time and attention.

Smart policy team meets every other week at 07:30 a.m. This close collaboration is critical to ensure relationships are nurtured and any issues are recognized and addressed before fracturing the system. Trust is an essential element. Each of the system partners must rely on each other to be available to help find resources, support tenuous placements, and create stability. Shared responsibility is a must, and even with this deep partnership and extensive collaboration, Placer county still struggles at time to serve all youth.

If one sector of the community does not feel a sense of urgency, the system will become lopsided and responsibility falls to one partner. Complex care youth are being discussed through another item on your agenda, but suffice it to say that when these youth present with multiple developmental and neurological difficulties, ongoing and severe traumas, inadequate or maladaptive coping skills leading to behavioral and sexually acting out, then equally complex living situations are also necessary and are also very limited.

Our collaboration, creativity and determination are proving to be inadequate at times to create enough community based placement for kids. But we are not able to stop trying because we need to find enough of these homes quickly enough for the youth that need them, because they need them now.

So there are many barriers for counties to operate in an integrated manner as we've talked about, but there are a few that you should know about, including siloed and one time funding streams, overwhelming new initiatives and mandates, and turnover in the workforce.

As you mentioned earlier, however, I think California is faring better than some other states due to the good work that CDSs, DHCs, counties, and your Legislature has accomplished in the past few years, although there are still unintended challenges from past legislative actions that hinder our ability to ensure children grow up in families and not in congregate care. But we're all trying.

So the 2083 report reflects that we have collectively made a good start on this communitywide issue, and it also shows that we need to evolve it further. We should ask what is the plan to implement all the ideas and recommendations in this report to make actual changes? And what we know is that counties cannot do it alone. We need and rely on our state partners to evolve and shift in the same ways as counties have been asked to do.

We need a shared mission, shared structure, and a shared functions to be integrated and aligned to make real and lasting change. And we also need shared urgency and shared responsibility to better care for our shared children and youth. Thank you.

Thank you so much.

Thank you. Mike Lombardo I'm with Placer County Office of Education, a collaborative partner in our system of care. As you've heard, system of care is more efficient, more effective at serving children and youth with complex needs. The County Office of Education collaborates and has collaborated since 1988. In our system of care, we support integrated teams for foster students, homeless students, transition age wraparound teams, prevention of CSEC, and a multitude number of other responses to community needs.

One example is the COVID pandemic, as we're all aware, was excessively hard on schools and districts. So the county collaborated to create a team, a countywide intervention team, kind of satin, as an intermediary before the family resource community collaborative. This is an integrated team with community based partners, our systems partners probation, child welfare, mental health and more to meet the needs of students. An example is a school district may be struggling with a student may not be able to meet their needs at their local level.

They can do an electronic referral to the county office of ED. We evaluate whether we can easily access a community based support, connect the school district and family to that support. Or should we use an integrated team process with the community partners that I previously mentioned? If that intermediary team is unable to be successful, then we refer it to our Executive level team, the Family Resource Community Collaborative.

One example of outcomes from this process and our integration is Placer county suspension rate for foster students is 6.9% and the state average is 20%. Another example is our foster use stability rate in schools is about 80% 79% and the state average is about 65%. So systems of care work taking 2083 a little bit further.

We've looked at Placer County and we've met the needs of very complex youth at the tier three or most interventive level and have decided to deepen our system of care into schools. At Placer County, we braid and blend funding to do that. We were fortunate enough to receive several different funding sources through the Mental Health Student Services Act, SB 82 local dollars and philanthropy dollars to create a total of 18 wellness centers in Placer County schools. I wish every school had a wellness center.

Right now we're at 18, and these centers are places where the integrated team that Twyla described happens at the school site level. So bringing together that school ecology of counselors, social workers, mental health providers, administrators and academic staff to look at a continuum of support, what do we do for all students and staff to create a wellness campus?

How do we help support staff and students identify needs, identify symptoms of distress, and address those needs on a universal level for students need a little bit more, we'll do group interventions, and then for students who need more intensive, more critical services, we do individual and case referral services and case management for them, building skills for the whole campus to create a space for students where there's support as well as staff. Part of the problem is that, as you've heard, funding is always an issue.

The funding sources that I've mentioned are wholly one time funding. While the state has made a significant investment into schools through community schools and through the Child Youth Behavioral Health Incentive program, as these come online, the other funding sources are ended and there's a bit of a gap or a bridge needed. It'll take a while for Cybhi to be fully effective or community schools to get fully funded as Covid resources are ended.

I'm getting a lot of calls from school districts saying we're going to have to lay off staff in the intermediary time before we can do a fee for service schedule or Bill manage medical. So to fully realize the system of. Care.

There's funding to do the services, but there's not funding for 2083 or for developing a system of care and technical assistance necessary. Thank you.

Good afternoon. My name is Jennifer Bloom, and I am the Director of client services at Alta California Regional Center. We serve 10 counties in our catchment area and are proud partners with Placer county. As one of those partners, Alta California Regional Center and all system of care partners meet regularly. As you've heard and through these meetings, we've developed rapport and relationships with one another, and through these relationships we're able to create open dialogue and are able to locate resources for our duly served youth.

Our connections and collaborative approach have led to successful outcomes where we have secured loving and stable care for the youth we serve, the no wrong door approach that Twyla mentioned several times, and that mentality really serves our youth and families well. All partners take responsibility for our youth. It's not us. Mentality is gone. We're making great progress. We continue to learn and to streamline our procedures.

One thing we know is that youth do not often stay in one particular Regional Center catchment area in order to finish the eligibility determination process. So we're working on a procedure and a process whereby the Regional Center who starts that eligibility determination process will finish it. This will aid in streamlining and getting services in place quickly for our duly served youth.

Our work extends beyond 2083 also, where these relationships that we meet, that we've developed are really allowing us to just pick up the phone and know who to call. If we have a question about behavioral health or mental health or we think, oh my gosh, I know that person from probation. Because of our meetings, I want to share a little case example of a six year old child. Regional Center and Placer county served. Born at 26 weeks and who spent 79 nights in the NICU.

He was placed in foster care through Placer county at age three, and since then he's learned to walk, to eat solid foods. He's starting to communicate with vocal approximations and gestures. He's gaining tolerance and assistance with his self care tasks. He loves playing hot wheels and runs those cars on tracks all day long. He's easing going, has a beautiful smile. He receives respite and a specialized bed. Through the Regional Center he receives incontinence supplies

through Medi Cal he receives support, counseling support through Placer County and Placer County Office of Education provides him a special placement in a kindergarten classroom where he receives occupational therapy, physical therapy and speech therapy and transportation. His aggressive behaviors have decreased significantly. When I think about that case example, we think about, that's not just a case example. That's a child, that's a life and a family, and we're proud to be a part of this partnership.

Within the system of care. There are things that our partners have mentioned that would streamline processes, things that we do have some work to continue doing. We would love to see uniformity in terms of a funding structure that would really be helpful in our system of care if we had a consistent way of funding. Sometimes debates, and I don't mean debates in an angry way, but just like, okay, who does, what kind of a way those debates arise?

And a consistent funding formula would help alleviate those concerns. And then I also want to recommend that the courts consider the question of determining and providing readily the educational rights holder information for the children and families of early start. We must have that determination in order to pursue eligibility determination and services for the children and families of early start. And sometimes that information is hard to get right away.

We know that that would really help mitigate delays in children and families of early start, birth to age three, in accessing services. Thank you.

Thank you so much, Ms. Abrams.

Good morning. Good afternoon, actually. Madam Chair and honorable Members of the Committee, my name is Susan Abrams and I'm the Deputy Director with Children's Law center of California. And we are the court appointed attorneys. So we provide legal representation for over 25,000 children and youth under the jurisdiction of the dependency court in three counties, Placer, and then also Los Angeles and Sacramento. And I've been asked to discuss what services, supports and structures we see as being integral to supporting our clients with complex needs.

And I think it's critical. I want to start by talking about relationships. So we often hear our in house psychologists say a relationship is the basis of healing trauma. Yes, we need formal services, but they can't provide the long lasting and nurturing that are needed for our children to thrive. So we see a priority as making sure that our clients have relationships that are consistent and ongoing. And what could those investments look like? First, extracurricular and enrichment activities, the pro social activities that help build community.

Also, robust investment into family reunification services. The 2083 report did talk about prevention services to keep families from being separated. But we also need to invest in reuniting families who have been separating by the system. And we see a lot of geographical disparities, like in Placer County, they pay for reunification services for families, but not in Los Angeles, and also ensuring that separated families can spend a lot of time together, including siblings who are separated. With respect to system of care.

Some of the systemic improvements that we've seen in our practice include better communication between agencies, absolutely, especially mental health and child welfare, intensive services, foster care. Those homes are incredibly effective. There's not many of them, and they're meant to be short term, which sometimes can be problematic. But we're definitely seeing those homes as being effective to serve our clients with complex needs. And then also family finding. We're really encouraged by the state's emphasis on family finding.

We're in strong support of the ongoing, robust investment in family finding, both at the front end when a child's first removed, which is mostly the focus in the report, but also continuously throughout the case. I just learned this week about a case where a client was in an STRTP and adult siblings and a grandmother was identified three years into the case. And so we really need to make sure we're doing that ongoing family finding, but we're still seeing some gaps in implementation.

I think the gaps identified in the 2083 report are very much in line with what we're seeing in our practice and we appreciate the comprehensive approach laid out in the report. To address the gaps, I'll highlight a few areas that we view as priorities. First in home support services to stabilize placements. So placement stability is key, key for reducing trauma, promoting caregiver attachment, and also it's the only way to get formal services in place.

We heard about the challenges with Regional Center when our clients are moved, the assessment process starts all over and it's very difficult to get those services in place. Yet we're still seeing lots of gaps and inconsistencies when it comes to providing in home support services for caregivers. Wraparound is a good example. Sometimes it's very effective and there's fidelity to the model and then other situations.

It's really just a weekly meeting and I know there are efforts to switch to high fidelity wraparound and that needs to happen sooner rather than later. We've also seen inconsistent implementation of complex care funding. From our experience, it's not easy to put into place and sometimes it feels like our clients have to fail up to get that funding. And we suggest that there are local processes in place where advocates and attorneys can raise up the needs of these kids.

And there's still some communication gaps between agencies, especially in the larger counties. The term complex care is very common now in the policy world, but if you say to an individual social worker, can you access complex care funding? They most of the time won't know what you're talking about. And so trying to get everyone at the table, especially for our clients who have dual diagnosis or co occurring issues and need support from multiple systems like Regional Center or substance abuse intervention, is critical.

Some other investments to consider to better support placement stability is a better continuum of funding for caregivers that Senator Eggman raised earlier. Quick anecdote one of my first cases, my client, and I'll never forget his name and I'll never forget this number. He had 64 placements and his cycle was very similar.

So he would start in a foster home and do very well, but had significant issues in school, and eventually the caregiver would have to get called to the school over and over again, and the caregiver would be afraid of losing their job and would ask for him to be removed from the home.

And I always thought, why aren't we giving the caregiver enough funding so the caregiver can go to school, so we can get the school services in place and keep the placement stable? And I think that was one of the promises of CCR, was that we would have this very wide continuum of funding available for caregivers. But I don't know that that's been actualized. And the last thing is better transition planning.

So oftentimes we see our clients moving from higher levels of care, but not all the programs and services are in place in the lower levels of care, and so those placements quickly fail. And then lastly, want to talk about some issues with STRTPs, which are the congregate care settings available for our clients now in California. I think with CCR there's certainly been huge positives, which is a major reduction in the population of youth who are in strtps.

However, we're still seeing some big, major issues with congregate care in the transition with CCR, most of the small family like group homes had to close, and so now we're left with what are really, for the most part, they feel like institutions. One criticism of the 2086 report is there really is a lack of direct feedback from the youth and the families who are served by the child welfare system.

However, page 30 of the report does cite youth feedback from a national study, and this feedback is very much in line with the experiences that many of our clients describe. Living in an STRTP, feeling shame, unworthy, isolated, undeserving of a family, staff lack training, not culturally sensitive. The trauma is not tended to in a humane way.

We need to ensure that youth in foster care are truly only being placed in congregate care when it is absolutely necessary and for the shortest time possible to stabilize and invest in improvements that include staff who are paid more and trained, better incentives to keep the facilities small, or the placement small, where children can live in homes instead of facilities and have their own room if needed.

The report mentioned small capacity STRTPs several times, and that's a term we're not familiar with and not sure how that's being incentivized. And lastly, a wider continuum of treatment providers that are available to youth and strtps. Oftentimes they're only allowed to see the one therapist who's on staff and to make sure there's alternative forms of therapy available. So I want to close by thanking the Committee for allowing me to speak today and also for focusing on these critical issues.

Thank you so much. We're going to turn over to LAO for any comment.

Thank you. Angela Short, again with the LAO. Just a brief comment to really highlight what Director Johnson and other speakers have touched on in that many of the recent budget augmentations for child welfare, which we're talking about today, we really do see those as in alignment with many of the gaps identified through the AB 2083 report. That's not to say we expect the funding to be able to fully address the gaps. And for all of the recently funded programs, we're still in the early phases of implementation.

So it's too soon to say for certain what those impacts will be in relation to helping to close the AB 2083 gaps. But that is something that we'll be continuing to assess moving forward as implementation progresses for these programs. Thank you.

Thank you.

Department of Finance, any comments?

No comments at this time. Thank you.

Struggle, though. Great first question. I mean, we've heard this utopian, ideal way of approaching it from Placer County. I represent LA County. It's way bigger than that. I always think because of the size of the county I represent, it's so difficult to get to that. Deputy Director Abrams, you briefly spoke about that, and I don't know if this is under your jurisdiction, if you're able to speak about the attempts of collaboration on this level of LA County and if we could ever get to that point.

I hope so. As the attorneys, we're not privy to be part of the collaborative. We've asked several times to be invited to the meetings, but I think they're happening at the higher level. But what's trickling down to the actual social workers on the ground and the Regional Center workers, it's not necessarily that same collaboration.

And so I think that's part of the problem is really training the workers on the ground to engage in this kind of collaboration, making sure that everyone's at the CFT and there's really no oversight. The court's not involved and there's no oversight to make sure all of these agencies are there together. So we're still seeing, especially in larger counties like LA, big gaps in the collaboration and everybody being there.

And in Placer County, I think the challenge that was raised is there's not as much of a continuum of placement options or services available in LA County. There actually is. There's a lot, but it's really hard to know what exists. So it's really hard for child welfare to know what's available necessarily for a youth with dual diagnosis who might be able to access a Regional Center placement.

And so I think we're still continuing to see those challenges from an advocacy perspective, trying to, we can join agencies into court and we do that when we can and when we're really seeing a lack of collaboration, but it's definitely something we need to continue working towards.

Thank you so much. It just seems like finding a way to get to the social workers themselves and the mental health therapists who have these cases and ensure they have every single tool in their toolbox to provide to their clients.

Absolutely right. Because there is such a continuum of options now, especially with complex care funding, but making sure they understand it and know about it and can access it has been, I think, the challenge really in implementation.

Thank you.

Director, if I might, too. I just want to say I had the great privilege of meeting with the leaders of Placer County and seeing that model. This is part of our work at the state, is going out into communities and understanding what it is that's taking when this is really successful and working into the outcomes and metrics that were presented.

One thing I just have to say that I think no matter what the size of the county, the culture shift and idea that everyone's coming to the table with how they can contribute as a system of care with their resources is just a critical kind of pivot and change. It's not the finger pointing of who's youth. Right. It is.

We are here to see what we can bring from our perspective into the solutioning of supports for a youth and their family. And so I think that's just a critical change. No matter, again, what size of the county, that if that is the way in which you're approaching the relationship and the goal is just key to success.

Thank you.

And then one other question. I think I can't remember who mentioned this, and correct me if I'm wrong here, the Placer County pays reunification fees.

We pay for services for reunification fees.

For the family to go through the process.

Correct. And some other counties do not do that. That is correct. I don't know if that's been their decision making, but we do pay for services. So we try to utilize their insurance, of course, if it's for certain types of behavioral health services or whatnot. But when it comes down to it, if they don't have the resources or they haven't followed through with it or whatever we do pay for them.

And is that a barrier? You shared a story, but it took three years for a family to be reunified with a grandma. Is paying of these fees a barrier, and why it's prolonging this?

Yeah, I think you'll hear parents, attorneys in Los Angeles County bring this up often, that both waitlists and then access to programs and payment for programs is a huge barrier to be able to reunify children and their parents.

If I can also just add one other thing with that, too, is that we work with our partners here. We're obviously talking about CDCS, but we work with our partners in DHCS, of course, too, on the behavioral health side. And we do really need to ensure that our managed care plans and our private insurance carriers also have the same sense of urgency and the same sense of responsibility that we're talking about. We really need to broaden the field here.

We need to broaden the partnerships so that when they do have insurance, that they're able to access it, access the services, and that they have the same array of services as well. That it's not just they can have counseling once a month, but if they really need counseling two or three times a week, that's what they should get. And that's what our commercial insurance plans and our managed care partners should also provide.

Thank you. One last question, Mr. Lombardo. You mentioned the process of when an LEA perhaps has a child with complex needs, behavioral issues, that then your County of Education steps in. Can you just dive a little bit more on that process?

Sure. So we put a lot of effort into teaching LEAs what the local resources are. There's groups of students who are just beyond what the education district can do or the school site can do. It's too complex. And we help the district get across that sidewalk, connect the district or the school site to resources in the community. The process generally came out of the COVID pandemic because schools were still the place of support. Whether they were in session or not, they had multiple needs.

So we responded and created this collaborative team where schools could send an electronic referral to my staff. I redeployed my entire staff in pattern to help support schools access resources, whether that was food resources, housing, child care, etcetera. We were able to mobilize that way. As the pandemic ended, we realized that was a really critical opportunity that we had not had in place. The gap remained between school sites and the family resource community collaborative that Twyla talked about.

It was too far of a distance to get from here to here, you needed to be in a system, you needed to be on probation, or you needed to have a child welfare case. So we kept the team going. That was developed during COVID to be an intermediary way to address those needs for students.

And in that process, did the Regional Center at any point get included in those conversations?

The Regional Center partners, we have a core team of partners, but if we have a Regional Center client, we invite them to that meeting. And so we have the ability to identify the student ahead of time and invite them to the meeting. So there's a core group that meets, and then we make a determination on an ad hoc basis, if you will, to bring them in.

Perfect. Thank you so much, Senator Egwen.

Can somebody talk about. So I was here when we passed CCR, CCC and had some concerns about getting rid of the larger group homes and where those kids are going to go. I mean, I believe in the utopia that every child should be in a good and loving home and also understand the complexities of trying to find those good and loving homes that are willing to accept really complicated kids.

So how have we done in realizing that dream of being able to have the recruitment of more foster homes and the smaller strps to be able to provide that bridge? So we don't read reports like we keep reading about kids being housed in old juvenile halls in different places because there's no place for them.

I don't have it at my fingertips, but I will ask Deputy Director Schwartz when she comes back up to share the specific percentages. But we have increased the placements into both relative caregivers, as she referenced on the earlier panel, especially that placement being continued.

I think we have, and it's been part of our conversations, whether it's in complex care steering Committee or otherwise, been really looking at the short term therapeutic residential model in terms of what we've learned to date, and I think to the point of other panelists here, what does it mean to have a larger number of youth that have greater needs in the same space? What does it mean in terms of the competency of the workforce and the supports and trauma, those kinds of things?

We certainly have shifted in the right direction in terms of where we know youth have the greatest outcomes. That is the goal and direction that we continue to work for and achieve. But to the points that Deputy Director Schwartz mentioned earlier, we also are looking at kind of the overall structure of those particular settings. In terms of are they actually short term? Are they actually leading to then a step down lower level of care needed post placement, those kinds of components.

And again, what else is needed to shore up the model overall? So we do have more capacity than we have youth in them. But again, in terms of the model itself, I think it's something that we'll continue to look at in terms of changes to come.

Okay.

Did you want to say something? I see your, if I might see your face.

Thank you. I spent half my career actually working in what we would call STRTPs now, which was at that time we had the level system of care, and I worked in the level 14. And I just want to say just to, one of the things that you're bringing up is the larger institutionalizing. And of course, we heard that as well earlier, as opposed to the smaller group homes as well.

It is clear clinically as well, just when we come down to the individual child that if you have more of these children together, obviously you're going to have more difficulties because of course they all start to egg each other on and different things happen, and then you have runaways and everything else. But we also need to realize that some STRPS are probably necessary, and they're necessary for short periods of time when we have really, really high clinical acuity.

That's just short of being in, obviously, a psychiatric hospital. And we do appreciate that DHCs and CDSs together have partnered to also provide some funding, and it'll take a while to build out through the behavioral health infrastructure continuum programs. But I do want to just realize that there are some of those group homes that we know, maybe even the lower level, more mom and pop type group homes.

If they could somehow fit into the model that we still need, there is still a place for them as well for some of our kids and families. We just need to do them well and find out where they fit into that continuum.

Yeah. Amen. I agree. Can you talk about the difference in caseloads between Placer county and LA County?

Yeah, I'll hand that over to placer because I'm not sure you're talking about social workers.

I'm talking about social workers. I'm just talking about the differences in the system. I mean, it's one thing if you have a caseload you can manage. It's another thing if you have a caseload that's so big you can't manage it. It's harder to come to the table in open hearted collaboration.

Absolutely. And I would think that many of our social workers would in Placer County would tell you that they are terribly overworked and they have way too many kids on their caseloads and families. And ideally, we would like to have everybody to have six or seven kids and families on their caseloads, wouldn't we? It would be lovely, but that doesn't always necessarily be the case. So an answer to your question is a little more complicated.

When we have 11 or 12 or whatnot, that seems to be a doable kind of number. When folks start to get up into the 18s and 20s. We've had histories. When we've had turnover and different times in Placer County, where it succeeded into the mid 20s, it has been really horrible. And that also depends on your workforce. So while we deliberately try to keep our caseloads as low as possible, the workforce does make a difference.

So it's difficult to also compare LA because they have so many social workers and so many families and children. I imagine their ebbs and flows are a little bit differently in placer. If we lose two or three social workers, then those caseloads can go up pretty dramatically, pretty quickly. So, yes, I agree. It's a piece of the puzzle. It definitely is one that we would want another caseload study for social workers, and we would like to see that come to a place.

It's so much more complicated now. Families are so much more complicated. Children's issues are so much more complicated. Social media is so much more complicated. I think that if we were to do a caseload study today, rather than the last one, which I believe was upwards of 20 or 30 years ago, we would find that we should probably have even dramatically lower caseloads. But it is a factor. It certainly is a factor.

And I would imagine that's also a factor then, in being able to recruit and maintain foster home placements. Because if a family feels like they're out there on their own, they're not going to be as likely to take kids.

Clearly, and having those community supports and our provider agencies, it is truly, as we've said over and over here, again, it is about those relationships. So people know that there's somebody that they can reach out and call on a moment's notice and that they'll at least get a call back or somebody on the phone or somebody out at their house to support them.

And just to say, I'm doing some work with Dr. Galley on the behavioral health side. But really bringing the plans to the table is part of that conversation that it can't just be all using MHSA or using Medi Cal for everything. The plans that people have, private insurance, they must be at the table and pay their fair share thank you for.

Your diligence and your advocacy on that that is extremely important and very appreciated.

Related to that question just thought of something LA County Department of Mental Health is dealing with about approximately a 30% vacancy rate when it's social workers Placer County are you facing that kind of.

Vacancy not today I can tell you in 2010 we were at about a 36% vacancy at that particular time I do know some of our sister counties to right around here have been upwards during COVID they were upward to 60% we are not there we are not but again we're considering a small medium county so if we lose a few then we definitely have some vacancy rates but we're not there at right at the moment I would say it's more around 12%, 12 to 15.

Thank you so much any other additional really appreciate the time thank you.

We're going to move on to issue number 10 welcome back Deputy Director.

Good afternoon. I think it was morning last time I was here, Madam Chair. Let's hope. Members of the Committee, Angie Schwartz, Deputy Director of the Children and Family Services Division. And we were asked to provide an overview of the complex care funding that you were just talking about in the prior panel. There were actually three different parts of that investment, 18.1 million in ongoing funding. We've been talking about that both in the first two panels. That's to support individual children with extraordinary needs.

And so some of the members of your last panel spoke to how those dollars are being utilized. There's also 43.3 million. Those are one-time funds that have five years of expenditure authority to support capacity building. Those funds are available to counties to establish that high-quality continuum Senator Eggman, that you were just talking about to address those specific gaps that exist within local jurisdictions.

And there's also 61.3 million also one-time funds to establish a crisis continuum pilot or several crisis continuum pilots across the state. Those funds allow those selected counties that will be participating in the pilot to test the theory that if all those aspects of the continuum are managed within a single entity, are we more effectively able to support children within that full continuum and move them through the range of settings that they need to be in in order to continue to heal and thrive.

In terms of the implementation updates specific to the child-specific dollars and the capacity building dollars, for the first fiscal year that those funds were available2122. For the child-specific dollars, we received 246 requests that were approved that totaled 7.7 million. That was across 30 different child welfare departments and four of our probation departments. For current year, there have been 119 requests so far. Obviously, the year is not over, totaling 7.4 million. That's across 28 child welfare departments and two of our probation departments.

Counties are generally requesting those child-specific dollars for things that we've already talked about, sort of that one-on-one staffing, developing those STRTPs of one, some of the assessments that are needed that are often not covered by Medi-Cal, extraordinary travel costs. In terms of the capacity building, the counties have to do gaps assessment and really kind of understand and work with the interagency leadership team. You're just talking about that.

So they have to work with that team in sort of assessing their gaps and putting together their plans. So counties are in that process. To date, we've received five plans, and four of them have been approved. That's Riverside, San Bernardino, Stanislaus, and Los Angeles. And we're working with Orange County to approve the plan that they've submitted. We're also providing technical assistance and support to the counties that have not yet submitted their proposals to us.

The ones that have been approved so far would total 12.6 million out of the 43.5 million available of those one-time funds. And the kinds of things that are being proposed in the plans and approved to be built are those intensive stabilization services, an increase of the transitional foster homes, enhanced intensive services foster care. So we're talking in the last panel about ISFC, but really making sure that you have all of the more intensive services and wraparound, high Fidelity Wrap really embedded into those programs.

Crisis stabilization units, crisis residential programs. Again, startup costs associated with making sure that there are sufficient STRTPs of one within the county, some of the specialized training that's necessary for staffing.

In terms of the insights that we're gaining on implementation of those programs, I think we've been talking about those themes for the last couple of issue areas, but we are continuing to see the themes around those needs for highly specialized, more individualized types of settings that have that kind of professional support, but in those more individualized family-based models, and those are also themes Director Johnson talked about the complex care Steering Committee, and we're seeing those same themes emerge from that Committee.

That Committee has actually developed a problem statement that we've all agreed to that sort of is like, what is the problem that we're trying to tackle when it comes to really supporting our youth with the most complex needs and have found that it's really centered around our ability to appropriately assess and treat and support youth within family settings. And our current inability to do that in some of these cases is about implementing the most appropriate treatment plan in the least restrictive setting.

And based on that assessment, making sure that we understand what's going on with the trauma that that particular young person has experienced and being able to address that trauma. We're working with some real trauma experts, Dr. Bruce Perry, Dr. Kate Messina, in sort of really understanding how can we systematize practices that allow us to really do better upfront work and understanding that assessment or that trauma that the young person has experienced so that they really can be stabilized within a family where we know children heal.

We've identified some of the contributing factors. We've spoken about those already today as well. Some of it has to do with workforce issues and continuous staff turnover, as well as just lacking the necessary understanding of what those assessments are, how to access the assessments, and then what are their appropriate interventions, and how do you access those interventions as a result of what you learn through those assessments.

So that's a lot of the sort of system work that we're trying to build through the Complex Care Steering Committee and that we're also seeing counties doing that work through their capacity-building dollars and also their child-specific dollars. In terms of the barriers that exist, I think there's always sort of a natural ramp-up anytime you've got new dollars that were in the second year for the child-specific dollars.

We know that the funds have not been fully expended, but we don't think that that's because there's a lack of need. We think there's sort of a natural ramp up as counties are becoming more familiar.

Ms. Abrams spoke on the last panel about just the need to really make sure that folks really at the practice level know about the funds and how to access funds, that there are local practices in place that allow those requests to get approved up through the chains, that they have to be approved through the local process. Initially, when we implemented the dollars, counties and probation agencies reported that the form that was created to request funding was too burdensome.

So we put a work group together, streamlined that form that has been posted since February of this year, and we have started to see an uptick with a more streamlined form. We've worked to make sure that the requests that come in through the county are approved within 24-48 hours. We are quick at turning around the approvals for those requests, but we expect to see the use of those dollars continue to increase.

In terms of the capacity-building dollars, stakeholders have shared with us that one of the challenges is that it's one-time dollars. So we're trying to build capacity with one-time dollars that once that capacity is built, it has to be sustained and those dollars will no longer be available. So counties are working to identify the best way to leverage those dollars and make sure that the capacity they build will be able to be sustained over time.

And that's one of the challenges as they're developing these plans, which may be why we haven't seen all of the counties submit their plans at this point. In terms of the feedback that we've received, some of it is what I just shared with you. We also got feedback that it would be helpful to have a list of sort of the kinds of services and supports that you could use the one-time funds for.

And so we worked with CWDA in order to publish kind of both a complex care resource guide that sort of lists the different resources around the state that can help support youth with complex care needs, but then also an example of the kinds of things you can do with these child-specific dollars and the kinds of things that would be allowable uses of those dollars to sort of, again, try to streamline the process and make it easier for counties to identify how can these dollars be utilized?

And those are both published on our website. The next question, recognizing the programs are at early stages, what are the promising practices? I think we've heard some specific examples. We have our own examples of the child-specific dollars that we've seen real success through some of our TA work with the counties.

We had a sister that was able to take in her sibling that had very intensive needs because the child specific dollars allowed the county to bring in the professional kinds of supports that sibling would need in order to be able to successfully live with and support that sibling.

We also had a county have a young person who was about to be released from a psychiatric hospital who was diagnosed with PTSD, a mood disorder, depression, anxiety, and again, through a TA call, got involved with the local Behavioral Health Department and made sure services would be immediately in place to support the youth and identified an STRTP of one which was able to be funded with the use of those child-specific dollars.

So we're seeing those kinds of examples coming out and sort of hearing those success stories, which I think is really promising in terms of the timeline to fully implement these dollars. The expenditure authority for the capacity building dollars is through June 30 of 2026.

And we really do expect that it will take that time to really fully develop that capacity and be working with those systems of care approaches in order to make sure that they get integrated not just within child welfare, but within all the other systems of care as well. We do anticipate that the child-specific dollars will continue to see that uptake. We're already seeing it. So we expect that over the coming years, those dollars will start to be fully utilized.

In terms of how many individuals we expect to have increased capacity to serve, we're estimating that there's about 300 young people in any given year that have unmet complex care needs that can really benefit from the use of these child-specific dollars and sort of the specific kinds of innovating that counties are doing around serving youth with unmet needs.

And when we say unmet needs, we're really talking about the youth that are cycling in and out of offices or spending time in other kinds of unlicensed settings, or having experience of being sort of cycled from one STRTP to another and not really finding that stability. For the capacity building so far, River San Bernardino is anticipating that they'll have 21 new slots available to support youth in sort of some of these more specific settings.

LA, 150 children, more children with 18 new specialty type programs and beds available. So we have some sense at this point of the additional capacity, but happy to come back and continue to report as we get additional plans and we sort of see more in terms of what those plans are showing us about the additional capacity that we're able to create. I think that's the end of the questions that were asked, but happy to answer additional questions.

Thank you so much. LAO, any comment?

No comments to add thank you.

Department of Finance?

No comments. Happy to answer any questions.

Just one question for me. We heard from the other panelists regarding the need for the social workers to know of the resources, and you mentioned partnering with CWDA on publishing those resources on the website. Is that a direct, is it related to the resources that we were talking about?

So those guides that we published on our website, we also sent out through all county information notices. We also put e-blasts out to make those available. So it's our intention that we disseminate those broadly so that folks have access to that information so it exists.

It's just a matter of guiding people to this website to see the resources.

Exactly. We created a complex care landing page on the department's website that includes not just those two resources, but webinars and trainings, all the ACLs, all the fiscal letters, so that it's all in one place and you don't have to go looking for it.

Thank you so much, Senator Eggman.

Just, do you know, are county employers using that in various counties?

I mean, I don't know the answer to that. Okay. I hope so.

But that'd be interesting, right? If people are just bearing, just trying to dig their way out of a hole, if they're actually using the resources that you've created.

Right.

Perfect. No further questions. Thank you so much. You're on here for issue 11.

Yes, I think we're all stay.

Welcome back. Please present.

Well, the next issue is really talking more about those dollars. So the crisis continuum pilot, and the first was just asking for an overview of the pilot, I'm sorry, of the trailer bill that we've proposed for continuing the pilot for a couple of more years. And the intent of that trailer bill is to allow the crisis continuum pilot to actually operate for the full five years as intended by the authorizing statute. It effectively extends the pilot from June 30, 2026 until June 30, 2028.

We've selected the eight pilot sites. But the request for applications was really complex in nature and in order to sort of do the kinds of engagement that we needed to do with the counties and with the stakeholders, and that was a jointly developed request for applications with the Department of Healthcare Services, we had to dedicate more time to putting that together than we had originally anticipated and that the statute contemplated.

In addition, once it went out, the applicants actually wanted and requested additional time in order to develop the kind of robust proposals that the application required. And so the deadline for submitting applicant's applications was also extended. And as a result of that, the pilot sites were just selected in the first quarter of this year and we have the eight pilot sites selected, but they're just going to start implementing in quarter two of 23-24.

So we do want the full five years of being able to test that pilot and to be able to effectively evaluate it. And so that's what the proposed trailer bill would enable us to do. In terms of how the model addresses the gaps identified in 2083, we really find it consistent. I mean, this is about developing a trauma-informed system of care with the intensive care, the qualified supervision, all managed within sort of one continuum, so within one entity.

So we're just talking about sort of the need to be able to know, how can you make sure that you've got that level of coordination, everything from the crisis residential program into the intensive services that the child's provided in a family setting, and be able to de-escalate the sort of circumstances in which individuals are experiencing those mental health crises in order to prevent those hospitalizations and any other unnecessary interactions with law enforcement.

So this is all about piloting a different way of doing that and creating a network of services for our young people that require the highest level ssof intervention and the ability to move more efficiently between the levels of services that they need in terms of the implementation, like I said, we've selected eight counties.

There were eight counties that applied and we decided that we would award all eight of those sites the ability to participate in the pilot, and many of those sites are doing it in collaboration with other counties. So we've got San Francisco collaborating with Solano, Marin, Contra Costa, and Sonoma in order to develop a crisis continuum pilot. Fresno, in collaboration with Madeira, Stan's laws, in collaboration with San Joaquin and Merced. Three counties are doing their pilots alone. So that's San Diego, Los Angeles, and Monterey.

And then we also have San Luis Obispo in collaboration with Santa Barbara and Riverside in collaboration with San Bernardino. So we're excited that we've got sort of that breadth of counties that are participating in the pilot. They're working on their final work plans right now.

And as I said, we expect that those dollars will start flowing and the pilots will start to be developed. In terms of the interaction between the crisis continuum pilot and AB 20317 which created the children's psychiatric residential treatment programs, the PRTFs are really a new medical facility type intended to provide the least restrictive alternatives to hospital settings for youth that need inpatient psychiatric care.

So a more specialized population than who served in the crisis continuum pilot, which could be youth that are not just in need of sort of those psychiatric inpatient type settings. It's also a completely different licensing category, which hasn't been developed yet. So DHCS is in the process of developing the standards for that licensing category. So likely the PRTFs and the crisis continuum pilots will be being stood up at the same time.

The crisis continuum pilots are using existing licensing authority to sort of stand up the kinds of things that we already have as part of our licensing structure. So that's the crisis stabilization units, the crisis residential programs, the psychiatric health facilities, the intensive services foster home, and other community-based resources. And I think that might be the end of the questions on this one, but happy to answer any additional questions.

LAO, any comments?

Just regarding the proposed trailer BIll, we have reviewed the language and have no concerns to raise at this time.

Thank you. Department of Finance.

No comments. Thank you.

Great. Thank you so much. Seeing none, we're going to move on to issue number 11 and hold that item open. 12.

Just kidding. We're going to move on to issue number 12 and hold that item open. Go ahead, Deputy Director.

Great. This issue is on our proposal around the adoption facilitator unit. And the first question was asking us to describe how the adoption facilitators and the adoption facilitator registry are distinct from the licensed adoption agencies and to sort of describe the existing law. So in terms of the existing law, the adoption facilitator program was first established in 1996. It was sponsored by the Academy of California Adoption Lawyers, and the goal was to assist connecting children with families that were interested in adoption.

Leading up to 2006, there were reports of fraud and abuse and sort of exploitation of families, both the birth parents and the prospective adoptive parents. And so there were further legislation that was passed to provide better protections for families against misleading advertising and to ensure consistency among the educational and background requirements for facilitators.

Our proposed trailer bill language seeks to further expand those protections by establishing true oversight and accountability of the adoption facilitators by making facilitation or registry through the, I'm sorry, making the registry of adoption facilitators a requirement, and then also establishing the complaint process in tandem with an investigation and review mechanism. Regarding the distinction between facilitators and private adoption agencies and adoption attorneys, the difference is primarily around the role that they play.

So the adoption facilitators are not finalizing adoptions, they are just doing the matching component between the birth parent and the prospective adoptive parent or family. Whereas the independent and private adoption agencies, as well as the private adoption attorneys can do all of those things, they can do the matching, but they also are primarily focused on the work to finalize those adoptions themselves.

In terms of the changes that we're seeking through the proposed trailer bill, we believe we need additional oversight of the facilitators in terms of their interactions and agreements that are being made with the prospective adoptive parents.

We also need to be able to have increased accountability, so making sure that the facilitators are registered and that we can do annual re-registration so that we can have some sense of who these facilitators, how many of those matches that are being made, and the kind of work that they're doing, as well as be able to have that formal complaint process in place. We've never had the staffing within the Department to really be able to.

We can take complaints right now, but to do those formal investigations and assess the civil penalties that the statute would contemplate, those are some of the additional authorities that we would have through the proposed trailer bill. In terms of the fact that some states actually just banned adoption facilitators. And our approach is to strengthen the oversight of our adoption facilitators. The Legislature implemented the statutory scheme around adoption facilitators.

As I mentioned in answer to the first question, we are really seeing that we need to have heightened, if that's how we're proceeding, you need to have the heightened oversight and really the things that we've proposed in the trailer bill in order to really do the effective oversight of those individuals and make sure that they are not defrauding families, the birth parents, or the prospective adoptive parents.

If we were to go the route of banding it all together, that would have required an entirely different statutory scheme. You would still need to figure out what's the oversight entity that would then make sure that individuals aren't acting outside the scope of the law and have sort of the oversight and ability for some entity to regulate that as well.

I guess I would just say like, no matter what, in order to have oversight of the practice, there needs to be extensive statutory scheme developed. In terms of the plan of operation and what that would entail. It would provide us a more clear understanding of what the adoption facilitators are proposing their services would be and how they would have relationships with their clients, both the prospective adoptive parents and the birth parents.

It would provide crucial information about how payment and services are exchanged and ensure more transparency in the operation and compliance with the legal requirements. And it would also enable us to have an annual review of those plans of operations. We do have a plan implemented to start gathering data about the adoption facilitators through those annual reviews.

And so that would be the way in which we would be able to learn more about the number of adoptions that are finalized and sort of the relationships and how the dollars are being exchanged. I think that that's all of the questions that were asked.

Yes. Thank you so much. Stakeholders have expressed concerns with this proposal. So at this time, I want to welcome Jill Jacobs with family builders to present these concerns.

Good afternoon, Madam Chair and senators and members of the committee. I am Jill Jacobs. I'm the CEO of Family Builders and I am chair of the Adoption Committee of the California Alliance of Child and Family Services. Family Builders provides foster care, permanency and adoption services for children and youth in foster care.

The California alliance represents over 160 nonprofit, community based organizations that provide services to children, youth and families across the state, including licensed adoption agencies that support children and youth in foster care, as well as services to birth parents. Adoption agencies are licensed by the Department of Social Services and are bound by an extensive regulatory structure.

The current interim licensing standards to approve and monitor and support prospective families caring for children in foster care is 337 pages of regulations, educational experience requirements, regular monitoring by the state, national accreditation, and strong ethical standards. This is a sharp contrast from the practice of adoption facilitators, who are the only entities who can provide Child Welfare Services that are unregulated, unlicensed, not accredited, have no oversight or accountability, and therefore can prey upon vulnerable prospective adoptive families and birth parents.

Independent adoptions were originally structured for situations where the birth mother could choose someone she knew to adopt her child. However, over time this has been exploited as a profitable business. Baby brokers, both birth parents and prospective adoptive parents are extremely vulnerable in this process. Both are often in very desperate situations, which increases their risk of exploitation. Adoption facilitators, of which there are currently 14 in California, must be registered with the state, which on CDS's website clearly states.

Listing on the website is not intended to be an endorsement by any means of the Department of Social Services, and it also states that CDSS does not provide oversight over adoption facilitators. Adoption facilitators are less regulated than nail salons, although they have the lives of children and vulnerable families in their hands, which should require strong regulation, accountability and ethical standards. An example is a child's dreams, the name of adoption facilitator. It states on their website that they're a licensed adoption facilitator.

That's a status that does not exist. It's misleading. The California alliance respectfully requests the legislature reject the budget change proposal and trailer bill language, which would marginally increase oversight of adoption facilitators, and instead take a stronger stance to prohibit the practice of adoption facilitators.

At the bare minimum, if the legislature decides to continue the practice of adoption facilitators, we recommend that all be fingerprinted and criminal record cleared through the CDSS background check process, have home study or family evaluation that fees the facilitators require be approved and regulated by CDSS, just as they are for adoption agencies, and that facilitators should be required to inform both birth parents and prospective adoptive parents of their rights, obligations, complaint process fees, and other aspects of the process through a signed statement of understanding.

Thank you for the opportunity to testify before you, and I'm happy to answer any questions.

Thank you. LAO, any comment?

Yes, thank you. Given the current structure of the adoption facilitator program, we find that the administration's BCP and trailer bill language request seem reasonable to again implement the statute as it is written and would improve oversight, as Deputy Director Schwartz described, including by requiring registration and other actions.

However, as we just heard and as is detailed in your agenda, we also recognize there are much broader concerns about the adoption facilitator program overall, including whether this is an effective program or one that the state should continue to allow. We are still in the process of working to make sure we fully understand all of these concerns, as well as the role that the adoption facilitators play in the overall adoption process.

So at this point in time, we would concur with the staff recommendation to keep this open to allow the legislature to continue considering a range of options, whether in addition to the administration's current proposal or other potential other statutory changes. Thank you.

Thank you. Department of Finance.

Department of Finance. We are aware of the advocate proposals in this area. At this point, can't comment on anything outside of the Governor's Budget, but happy to continue engaging on these issues.

Perfect. Thank you so much. This item and I appreciate we will be holding this item open for further discussion and significant gets a more restrictive manner of oversight. I'd like to hear what the oversight looks like, because from my understanding, it's a reactive enforcement and we're operating within the parameters of this perhaps illegal parameter. Right. The registration still happens. This isn't going to add registration. They're already registered. They're unlicensed.

And I find it difficult to continue allowing an entity that if it no longer existed, families would still be able to adopt in a more safe and regulated manner. So if you could just talk a little bit more about the actual enforcement.

Here in terms of the current way.

That it's enforced, the proposed enforcement.

Okay. In terms of the proposed enforcement right now, there is the ability to register as an adoption facilitator. They're not all even registered at the moment. It's not a requirement. So one of the things that the proposed trailer bill would do is require that registration and we would be able to assess fees against those individuals that failed to register but were engaging in the practice.

So that's our foothold into being able to know who exactly is engaged in this work in the first instance, and then be able to sort of have, what's it called? The plan of operation would also enable us to get more information about the work that those individuals are intending to do, how they're collecting fees. I think similar to what Ms. Jacobs was just talking about would allow us to see what's your plan of operation? What are you planning on doing?

How much are you planning on charging those kinds of things, and be able to at least engage in that work of understanding what the facilitators are doing, and then also be able to receive complaints, be able to do full investigations of those complaints, offer the requisite due process, but also be able to assess the civil fines and penalties against individuals that are engaging outside of what the law would allow. So those are the additional ways that we see working.

Again, I think, as Ms. Short pointed out, working within sort of the statutory structure that's been created within California and having increased oversight and the ability to actually manage that way of how adoption facilitators have been created within California.

Just quick clarification. You'd be able to see the fees, but as it proposed, wouldn't need to approve them.

We would have to approve the program, the plan of operation, and it would be embedded within that. So we would be approving that plan of operation.

Given the recent article on the SAC B, you can see where my concern is. Approximately $250,000 out of 12 families, and not a single adoption came out of that. So there's a lot of concern within this BCP, and I'll leave it at that. Senator Eggman, if you have anything to add.

Yeah, just to say that, embarrassingly, I wasn't even really aware that we had this going on in the state. And I wonder how many other, are there other states that use this kind of facilitator?

Many have prohibited them and outlawed them. I don't know how many currently allow it or if it happens without regulation or without permission, but a number of other states have discontinued the practice.

Yeah. So I would just say that I would agree with Ms. Jacobs that if we are going to fund this, that we really need to get some teeth into it and bring it up in line with other things that we oversee and regulate. And I won't be here for the years to come, but this is an area that I think really should be taken on, and we should not have these kinds of folks out potentially selling babies.

No, absolutely. I do want to see more teeth. I'll take your words there. I do want to see more know I am receptive to some of the suggestions that Ms. Jacobs proposed in terms of the fingerprints and so forth. I want to see you did mention approving the overall plan, but I really want to make sure that the fees are being specifically approved and moving forward with them and the families know their rights.

If I was a mean, I do have a family, but if I was looking to adopt someone, if I went on an official state website and I see this list there, I would assume they have the complete green light by the State of California. So you can see it could be misleading when know I'm really trying to create a family with children and so forth. So I just want to make it clear for our families.

I think the other thing, if I could add would be the credentials of the people making these decisions. In licensed adoption agencies, we have to have master's level social workers. That's required, and there's no requirement around educational requirement at all for adoption facilitators.

Thank you so much. See no additional comments. We're going to hold this item open and move on to issue number 13 as it relates to AB 1735, and I'll welcome Mr. Fluharty. Welcome, sir.

Thank you. Ah, Madam Chair and Members of the Committee, good afternoon. Larry Fluharty, California State Foster Care Ombudsperson and I'm here to talk about the BCP regarding AB 1735, regarding language access for foster youth Bill of Rights. And so most of the background of the Office of the Foster Care Ombudsperson is described in the agenda.

But I will state that the Office of the Foster Care Ombudsperson and I will start saying OFCO, because it's much Shorter, is an autonomous entity within the Department of Social Services, which is housed in the Office of Equity. And our role in part is to receive and investigate complaints regarding care placement and services for foster youth who are in care, and to resolve those complaints either informally or formally.

So one of the mandates of the OFCO is to create and distribute materials describing the foster youth Bill of Rights in age appropriate language. And the Bill of Rights was created more than 20 years ago. It had 21 rights, and it was updated in 2019 with AB 175 and increased it to 41 rights.

And at that point, all of the materials which had been developed in 2002 were updated to include the new rights and were released to include a poster, a coloring book, a handbook, and a trifold pamphlet of the rights. So at that time, in 2021, when they began distribution of those rights, we had translated it into Spanish, so we had English and Spanish versions.

And the social workers are required, or the probation officer, whoever is responsible for the use, is required to provide a copy of the rights in our material produced by the OFCO every six months, every time the child enters care, or every time they have a change in placement. And what has changed is that AB 1735 added the requirement that the rights be provided in the youth's primary language, as well as that they be provided and discussed with the youth.

And in addition, it also added the requirement to the Bill of Rights, that it became a right to have those rights. So it modified the Bill of Rights. And as a result of that, the Bill of Rights will need to be updated, and we'll need to update our material.

So the overall purpose of the BCP is for the Office of the Foster Care and Budsperson to be able to implement the legislation, which was a language access bill, which was created to offer greater access to those who speak languages other than English, to know what their rights are, and also to receive certain other documents, case plan and court reports in their primary language.

So the OFCO is required by statute to consult with a fairly diverse group and broadly defined group of community members of youth and organizations who work with foster youth to develop the materials. And the materials need to be created in a way that is age appropriate for the youth. And the purpose of the BCP is for us to do that work and to create those, and also because now we have the requirement to translate them, to translate them into the primary languages.

And so the plan is for us to translate initially, in addition to Spanish, into 16 other languages that are identified through different data sources as being largely used within the fosters community. And then whenever another language is requested, that we would then translate into whatever language is requested, and we would make those available as downloads on the Foster Care Ombudsperson's website, and print copies would be available upon request. The point is to really identify the language spoken at home by the youth.

And this is consistent with the mission of the Administration, the mission of DSS and the agency to provide greater access to all Californians and to bring about knowledge to foster youth of what their rights are in writing on a regular basis. And that is my overview of the proposal. If you have questions, please let me know.

Thank you so much. LAO, any comment?

We have no concerns with this BCP.

Thank you.

DOF.

Perfect. No comments or questions on my end. Thank you so much. We're going to hold the item open. We're going to move on to issue number 14.

Thank you.

I Welcome back, Deputy Director.

I keep walking over there. There's a door right here's. Good afternoon again, this issue is around the Family First Prevention Services Act. And to put it in some context, Family First Prevention Services Act, which passed by the Federal Government in 2018, is about what California has been working to do since initiation of the continuum of care reform.

So it's all about how can we make sure children are residing in family settings, reduce our reliance on congregate care, and actually make sure that we're doing much more effective prevention work in keeping children from ever being separated from a parenting, coming into the child welfare system at all. So there were two different kinds of funding so similar to that.

And before I sort of dive into that, I think there was a question in the system of care panel about sort of how we have been doing on those efforts. And I would just say we have seen an increase in first placements with relatives and extended family members. And when we've really honed into this work in California, we've really said that it needs to not just be a family placement, but a placement within the child's own family.

And so we've gone from 27% of children with first placements with relatives in 2017% to 34% in 2021. Predominant placements with relatives, which is mean, that's where they spent most of their time while they were in care, was with a relative, went from 39% in 2017% to 49% in 2021. And for those kids that have that initial connection to relatives, the vast majority, three quarters of them, don't experience placement changes. They're still with that same relative. And we looked at the data for what that happens.

When the child's have a first placement with a non relative, those kids are four times more likely to not just experience placement changes, but four or more placement changes within that same 12 month period of time. So we really see the impact of doing this work and making sure that we're connecting kids to their own family Members. We also know that 70% of children with relatives are with their entire sibling group. So not some of their siblings, all of their siblings.

And that's compared to just 52%, I think, of kids with non relatives. So those kinship placements are really impactful. Family first, in particular, is focused on two different interventions. We often talk about part one and part four. Part one is the prevention side of the Family First Prevention Services Act.

That's the part of the law that's optional to states and gives us the ability, if we so choose, to start drawing down federal funds, title four e funds, to support prevention services so that children never are removed, don't have to come into the system at all. We've obviously opted to take advantage of that. It required the development of a five year prevention plan that had to be approved by the administration for children and families.

I'm really pleased to announce that it just was approved on April 7, last week or two weeks ago, very recently, after three different rounds of submissions to ACF, as they sort of continued to have questions and comments about our proposed plan. So we submitted our first plan to them back in, I think, August of 2021, and then the second proposal was submitted in November, and then we just got our plan approved on April 7. So we're really excited to be able to start that implementation.

California didn't wait for those federal funds to become available. As you know, in the 2021-22 fiscal year, there was the 222,000,000 of funding appropriated for prevention work within California with a block grant that has been provided to our counties. So counties are already taking advantage of those dollars. 50 of our counties have opted to receive that block grant funding and start to provide those services.

That's one time funds that are available for five years of expenditure authority, and it's really to help them prepare to be able to transition to receiving some of these prevention dollars through the four e source of funds that will become available once we fully implemented all of the different elements that are required to be implemented in order to start drawing down those federal dollars. In terms of the other part of family first that we frequently talk about, that's part four.

That was a required component of the law. So we were required to implement the provisions that were in part four that were really focused on restricting the use of congregate care settings for young people, which, of course, we had already started that work through CCR, the federal family first law imposed essentially five new requirements on our continued use of strtps. And so if we hadn't come into compliance with those five requirements by October of 2021, we would have lost federal funding for those placements.

Those five requirements were making sure there's a qualified individual to assess the appropriateness of the placement, and then there also has to be court approval of those placements, additional court reporting, hearing, and review requirements, the ability to have 24/7 nursing services available to children in those settings, the offering of aftercare services to children that are stepping down from those settings for a period of six months, as well as new case plan requirements.

All of those elements were implemented by October of 2021 so that the federal funds could continue to flow for those placements. Happy to answer any additional questions about the implementation of those elements, if there are any. In terms of the 222,000,000, I think I already jumped ahead and answered that question in terms of the kinds of prevention services that counties are proposing as part of those comprehensive prevention plans. We've seen that the counties are in various stages, and I guess I should jump back.

So we've had 50 counties indicate that they are intending to participate and take advantage of the startup dollars that have been available for the Prem prevention planning. Counties have until the end of July to submit their comprehensive prevention plans, which is a requirement within the statute to continue to participate in that state funded block grant program.

So counties are in various stages of actually preparing those comprehensive prevention plans and sort of looking at how are they going to utilize not just those block grant funds, but also their other title four b funds, their Medicaid dollars, their TANF dollars, the new 4E dollars that will be available.

There's lots of different funding streams that can support prevention work, and we're really asking counties to engage in looking comprehensively and working with their system of care partners and working with their tribes in order to really look at where are there gaps within their local continuum and how can these dollars help to fill those gaps, and what is prevention going to look like in that county? So we've had five counties that have completed a community needs assessment and asset mapping.

We've had 14 counties who are in the progress of developing their goals and strategies and work plans. We have 24 counties that are really working on addressing that disproportionality within their systems and developing those aspects of their plans. So counties are in sort of various stages. We expect to start receiving those comprehensive prevention plans coming in, obviously in the coming months, and they're due to us by the end of July.

In terms of the data system that will be able to track the prevention spending on a per child basis. That's one of the requirements, to be able to start drawing down the federal dollars on a per child basis. So we have to be able to track exactly how much was spent in terms of those prevention services for that particular child, and that is scoped to be part of our functionality within CWS cares version one.

And so that's when we expect that that per child claiming and tracking can happen. We can start claiming the 4E admin dollars for prevention services now, and we can claim those back to October of 2021. But the per child spending and being able to claim $40 on that per child basis requires us to have to be able to do that individual data tracking, and that functionality is being built into CWS cares.

That is not the only thing that has to be implemented in order to be able to do the per child claiming with these new federal dollars. So like I said, we're really excited that the prevention plan has been approved. But now we have to work to make sure that we get the appropriate guidance to the counties on the payer of last resort rules.

One of the limitations in the federal dollars is that the title IV funds are the payer of last resort, meaning if you can claim Medicaid for the service, you have to use Medicaid first. The kinds of services that are available with the New Federal Dollars are limited to substance use programs, mental health treatment programs, and in home supportive services programs. So you can see from the nature of those three categories, many of them are programs that do qualify for Medicaid spending.

So we are working with DHCs through a work group process to sort of develop those pair of last resort rules and make sure that we know which of the four e services that we're able to offer, which parts of that can be claimed with four e, and which parts of that can be claimed with the Medicaid Dollars. So that's another thing that we have to work through in order to start claiming these new federal dollars.

You also have to offer one of the services that's available in the Flora prevention clearing house, and you have to spend a certain portion of your allocation on well supported practices. So there's a lot of different guidance that still needs to be developed and released to make sure that we're doing the appropriate claiming and tracking that we're offering the services and that we're using the right funding source in terms of what actually pays for that service.

So we're in process of developing all of those things right now, which is a long way of answering the last question about how long it's going to take or how much federal $40. Are we foregoing not having that capacity right now? And I would say I don't know that there's a clear answer to that. But we know all states are struggling with this.

So the recent federal HHS budget and brief states that in 2022 fiscal year 2022, 6400 children across the entire country received bore prevention services. And that is because there are so many requirements that have to be implemented in order to start claiming those. So I know, like us in California. Other states are also in the process of developing all of those different mechanisms.

But I don't know that we know how many actual federal dollars, all of the federal dollars that we would want to claim require us to have that capacity. We did estimate that about 60 million in federal reimbursements would be available for prevention services based on the block grant funding that was authorized in the 21-22 budget.

Thank you so much, Deputy Director. LAO, any comment?

Yes, just one point to add for FFPSA. We did just want to note that as part of the 2022-23 budget package, the Legislature included supplemental report language for FFPSA. According to that language, the Department will be sharing a report with the Legislature providing more specific data outputs and other updates related both to the newly implementing prevention services as well as the newly required elements that Deputy Director Schwartz described, such as the new court reporting requirements, nursing services, et cetera.

Based on that language, the report was requested as of February. The department has needed some additional time, but we expect the report will be available soon, very soon, and the department has also very kindly agreed to provide a briefing for legislative staff when the report is available. So just a note that we'll be looking forward to receiving that report when it's available.

Thank you so much. Department of Finance?

Nothing further. Thank you.

Nothing further on us. Thank you so much for that update. We're going to move on to issue number 15.

You're done with me.

Like to welcome Rachel Trusti, and Cynthia Tocher, Talker.

Good afternoon. Thank you very much for having us. My name is Cynthia Tucker. I'm a Deputy Director with the Office of Systems Integration, overseeing the Child Welfare Digital Services, which includes the CWS Cares project.

Good afternoon. Rachel Trustee from the Child Welfare System branch, part of the California Department of Social Services.

So we were asked to come and kind of provide an overview and answer a couple of questions with regards to this project. So the goal for the CWS care system is to replace the existing Child Welfare Services case management system, which is used by our 58 counties for child welfare. The goal is to meet both the programmatic or reporting needs that the legacy system can't keep up with.

And it's also to ensure that we can continue and more broadly support as child welfare, as legislation and things change, that we're able to actually support the program and the work that's on the ground. The system, it's not a singular replacement, because with the CWS CMS and there's a gap between what it can accomplish or what can it do and really what the workers need.

Our goal with this new system is to not just provide the functionality, but it's also to minimize and close that gap, which has required a lot of external systems and a lot of workarounds for the counties. There was a question about providing an update on the project, what's been accomplished over the lifetime?

So in 2019, the project completed a statewide rollout of a small system that had three product feature sets and it's called the Cares live application and it consists of a tool for the child and adolescent needs and strengths assessment facility search, which allows a user to search for both licensed placement facilities as well as county approved homes. And then the child welfare History Snapshot, which provides ability to search for clients, view relationships, demographics, gives a little bit more information.

In February 2022, the project completed a proof of concept, or what we call the Greenfield module, and that was for the resource family approval, application submission, review and approval process, rather long. We call it the RFA application just to shorten it a bit. So we implemented that to five pilot counties and we are currently supporting that implementation. Just like the cares live implementation, we do provide feature set updates, things like that, fixes when there's an issue, et cetera, et cetera.

With regards to the delivery of cares, RFA was that first piece, and cares will fall into as two major releases. There is a version one which is to cover the functionality and support the new programs and policies in order to move the social workers of the 58 counties, as well as CDSS program staff that use it off a legacy system and give them a newer system that can really help them with their work.

It also will lay the foundation for the comprehensive child welfare information system compliance. And that's a compliance from our federal partners, the Administration for children, youth and families. And then the second piece would be to continue. Version two would be to continue to get to that compliance. So in June 2022, the project began version one.

Development activities, design, development, testing, interactions with our core constituents, which are counties, tribes, cdss program to get feedback on what the true business requirements are, develop and then get feedback from them as well. And so, so far, pardon me, we have completed the capabilities for core functionality for screening, which is the work for a hotline worker to take client information, person information, let's say, as well as allegations.

When someone calls in with a concern of potential abuse, or for someone to call in and say, I need assistance, can you help me with services? Right. We want to make sure that there is no wrong door for someone to contact and get assistance as well. The core functionality we've completed also for what they call service provider profile and for services. And really it was talked about in the previous issue, but we're talking about tracking dollars.

So we're implementing where the service provider, that profile, that contract information, et cetera, can be maintained, and then the services can be attached and connected to that. So that base construct has been built out. And of course, because of the interdependency in child welfare, one functional area or one business function does not stand completely separately and alone. They all intertwine.

So while I say core functionality, as we add more things will get updated to be able to account for the interdependency across the continuum of service that child welfare provides. We are actively now, since we've completed those three which were identified in your agenda, we are actively working on the functionality to support the business functions for investigations, allegation abuse comes in, someone needs to go out, investigate, as well as the beginnings of case management.

Case management is a key component for child welfare, and a lot of subsequent processes really tie into that. And then the initial placement as well as the initial request to determine eligibility. Those are all active pieces of functionality that we're working on now. What remains is the rest of the continuum. We have to do adoptions, we have to do redeterminations for eligibility. You have to get the initial functionality in and then kind of build off on that.

So I'm just going to keep moving through unless you have a question. Okay, so for question two, what is the current time frame for this project to be completed in the agenda. It did focus on SPR five. Our SPR that we have submitted to California Department of Technology does include our new timeframe, and once we have received approval on that special project report, we'd be able to discuss those specifics. The next question, please describe why am I saying the question? Have it right.

Okay, so with regards to the third question, the project has been working hand in hand with the California Department of Technology to address the risks and issues that have been identified already. We are constantly working with them to identify. They identify. We identify areas of opportunities for improvement or areas of concern that we may need to be watching for. So that partnership has been very helpful in this project.

And then with regards to some specifics, when you would talk about the red in the agenda, the project has updated the roadmap and the schedule. We have completed the updated strategy for our implementation and rollout to the 58 counties and tribes, and we've also completed the updated county engagement model.

All of those items that were discussed in here, as far as when they noted it went to red, have been completed and they are part of this SPR, the special project report submission which CDT is actively reviewing.

I just want to address the final question which was related to when cares will have the functionality to support the county's drawing down on specific child specific prevention services. That functionality is embedded within the version one of curves, the first release of cares. The timing of that is within the SPR six and as soon as we have approval of that, we can discuss the timeline further.

Thank you. LAO any comment?

We would just note we will look forward to reviewing SPR six once it becomes available later this spring. And as was noted, that will include a more precise cost as well as schedule for CWS care. So we'll look forward to that. Thank you to no additional comments. Happy to answer any questions. Thank you.

Quick question. I know you know CDT flagged red last year. You've responded by checking off some of those items. Are we still in red?

We are. The process, as I understand and I can, we'll defer to CDT if they have anything further, is that we're waiting for that SPR approval to kind of reset.

Okay.

Would you like to add anything?

Great.

Anything else? That's it on my end. Thank you so much.

Thank you.

We have now come up to issue 16 and this is our proposals for investment. The Subcommitee received stakeholder proposals for investment related to CDSS, children and family services. The first one will be hearing and just a quick reminder, each stakeholder, you have three minutes to present on your proposal. We'd like to welcome first Anna Johnson from the John Burden Advocates for youth. They'll be presenting housing affordability for foster youth and supervised independent living placement.

Good afternoon, chair and Senator. My name is Anna Johnson. I'm the associate Director of housing and health at John Burton Advocates for Youth. And I'm here to talk about the budget request for 16.5 million to support housing stability and safety for children in extended foster care. This proposal would draw down approximately 10.8 million in an additional federal funding match of foster care funds.

Right now, California's housing crisis has put safe and stable housing out of reach for our 18, 19 and 20 year olds in extended foster care. This proposal would augment the statewide monthly foster care rate paid to them so that they can actually afford housing in the local rental market, specifically in the supervised independent living placement called a SILP. The SILP is the single most utilized placement with 41% of youth and extended foster care in that setting. That's about 3300 youth in a silp.

Youth are responsible for identifying and finding their housing on the market in real time and paying their own rent. To do this, they're provided their foster care payment directly, which is currently $1,129, no matter which county you live in. So you can imagine how far that goes with current costs. Housing affordability is a significant issue for youth in silps. The average annual income of these youth is $10,000, well below the federal poverty level for youth this age.

Housing is a barrier to pursuing higher education and of course, puts them at risk for experiencing homelessness, where one in five youth does experience homelessness by the time they exit care. This proposal would augment the monthly payment by providing supplemental funding to adequately cover local costs in real time. It's modeled after a policy enacted in 2020, the THPNMD housing supplement, which is another placement for youth this age where transitional housing providers help them find housing on the rental market as well.

So we've been issuing those payments, and it's been successful. Since the extended foster care was implemented, the cost of housing in our counties has outpaced the rate of growth of the payment. So the silk payment has grown 41% over time according to the California Necessities Index. But the 15 highest cost counties where most of our foster youth live, it's grown by 80% and in some 113%. So we're just not able to keep pace with this housing crisis.

So, like the THPNMD housing supplement, this supplement would augment the silp rate based on fair market rent annually, which is a system developed by the US Housing Department, HUD, to determine the allowable rent for section eight housing vouchers. So that's at 40% of the median area rent. So the goal is to equip youth with enough purchasing power to secure safe and stable housing where they work, go to school, or where they have connections.

The common measure used by HUD for affordable housing is to ensure that no more than 30% of your income goes towards the cost of rent or housing. And so we're looking at 30% of this use. Monthly income is spent on rent according to fair market rent in their county annually each year. And so that's how it will be an evergreen policy. It'll always address this issue. So youth can always afford housing on the market.

So thank you for your time and to the opportunity to give youth their first apartment, their first dorm, a chance to finish school, a chance to be by their friends and family, and to really transition to adulthood with the support of our communities. Thank you.

Thank you so much. Next up, Cliff Costa, California Judges Association, presenting on raising the age of extended foster care.

Madam Chair and Senator, thank you so much for letting us present today. Cliff Costa. As you just mentioned, on behalf of California Judges Association, our budget request is for 25 million and is associated with Senate Bill Nine by Senator Cortese. SB Nine is attempting to expand the extended foster care program by one year to age 22. And the intent behind that is to help those youth who are being aged out of the system.

And we believe there's about 4500 of them who are aging out of the system every year to be given the opportunity to stay in the system one more year if they are at risk of homelessness or could potentially be reasonably at risk of immediate homelessness.

Our juvenile court judges of California, which is a section of the California Judges Association, has been seeing the success of the extended foster care program this past decade and truly believes that an expansion of the program would be consistent with the brain science that shows that adolescent development really continues out till age 25. However, that is extremely expensive, as we all know. And unfortunately, anything beyond age 21 up would result in no federal matching dollars or no federal funds.

And so from our perspective, we are trying to figure out a way to help these youth who could end up homeless once they are aged out of the system. And so that's what SB Nine is attempting to do now. The $25 million, we are modeling it after efforts that this Legislature and the Governor took during the pandemic back in the 2021 fiscal budget, you actually extended the age of extended foster care by one additional year to help those youth who were in the system.

During the 2020/2021 pandemic, we believe that budget allocation was about 32 million. We also know from the children's bureau that about 20% of the youth who are aging out could be at risk of homelessness. So taking that 20% of the 4,500 youth who are aged out and taking the $32 million that was the budget allocation back in 2021, we are thinking a $25 million request should be sufficient to cover at least this youth.

We imagine it would likely be higher than the 20% who could be eligible, but at the same time, any additional funds that would be allocated under our request, we would want to go to help our social workers and others who would be impacted by the extension of this program. And so at this moment, we would appreciate your consideration and available to ask any or answer any questions.

Thank you so much.

Thank you.

Last time I didn't ask you for any. If you had any questions. Do you have any questions on this one? Okay, good. No comments on my end. Thank you so much. We're going to hold the item open, and now I'll move on to the third proposal and welcome. Cathy Senderling Mcdonald, county welfare Director, Association presenting on serving youth with complex needs.

Thank you, Madam Chair, Senator Eggman, Cathy Senderling CWDA there are three parts to this proposal, which is co sponsored by CWDA and the chief probation officers of California, and it's also contained an SB 408 by Senator Ashby along with a concomitant budget request. As noted in the agenda, the Bill and budget ask contain needed next steps to address an urgent placement capacity crisis that counties are continuing to face, especially for children with the most complex needs, who often have faced needs crossing multiple systems.

We've lost significant numbers of placement and treatment options for our youth in the past several years. I'm happy to detail those if you wish, but the issues in General stem from the implementation of several state and federal law and policy changes, as well as a growing demand for congregate based care from other systems, such as education, health and even private pay, which have taken up an estimated 30% of available placement space statewide.

The first part of the proposal is to create a new type of temporary placement for youth who we otherwise would be unable to locate a placement for initially with either a relative, foster family or strtp. Currently, we're experiencing a shortage of appropriate licensed placements, and so you are likely well aware that counties have been using offices, hotels, Airbnbs and other facilities that are unlicensed and typically offer fewer, if any services while they look for a placement for the youth.

This proposal would create a new, richly staffed and service rich temporary license placement called a stat short term assessment, treatment and transition. This builds on the current STRTP model. We're not starting from scratch. Think of it as a highly enhanced STRTP, and a key difference is that the stats would be required to accept placement of these youth on a short term basis. While we look for that placement, they could not refuse placement as Strtps currently may do.

It is also not the same as the discussion from the previous panel regarding PRTFs as well as the continuum of crisis care reform. Those are both very behaviorally health focused. This would cross over other areas as well. Youth may have education needs, developmental disabilities, or delays that the Regional Center gets involved with and other physical health, not just behavioral health needs.

And so the idea would be, as we look for that placement, which could be a supported family based caregiver or a congregate caregiver, those services and supports would be provided to them. They would not need to wait for those to start. There would also be six months of intensive aftercare once they're placed to ensure the services follow the child, something that was a hallmark of CCR, but we don't always see happening.

To ensure that the placements are working out and hopefully avoid additional disruptions for these youth. The second area is creating regional health teams in up to 10 areas to provide coordinated and collaborative services to children and youth with higher needs. Again, that often cross over.

Systems quickly wrap up.

I have this much, I can do it. The idea is to ensure that all the systems are talking and collaborating so that services are provided timely. There's lots of similar sounding efforts in Medi Cal right now, but I want to be clear. Most of the children in foster care today are in fee for service. They're not in managed care. Even as proposed in the budget, we still would have around half of our youth and children remain in fee for service.

So this would assist those children in getting the services that they need in a coordinated way. Finally, the last portion is funding. We have 43 million, as you've heard, in existing capacity building funding that was provided two budget cycles ago. We're working to spend that, but it's really hard to build capacity with one time funding. So the proposal is to allow it to be ongoing funding and continuing from year to year.

And we also propose some changes to the way in which counties draw down and spend the $18 million in individual children.

Thank you.

Thank you so much. I have a quick question on this one. The last two parts of your proposal, you talked to me more. We just heard from Panos talking about the need short term moving away from congregate homes. Can you explain why there's a need to move back to that kind of model?

Thank you.

Well, we don't really see it as moving back to the model. What is happening right now is because we have lost placement capacity. And in particular, we had around 250 youth across probation and child welfare be brought back from out of state placements, some of which were not good, but some of which were working for the children and youth. And all of a sudden, in the end of 2020, we had to find new placements for them. We've overtaxed our system.

And what is happening is that counties, both child welfare and probation, along with the other systems that I mentioned, education, private pay, health care, we are all competing for a shrinking number of placements. At the same time, we're doing our best to try to get relatives, as you're hearing from the family, finding efforts.

But sometimes with the youth with these complex needs, a relative has had a poor experience with that youth and wants to know that services are going to be in place before they're willing to take them back and try again. We may be able to get there with them, but in the meantime, that youth has to go somewhere.

And right now, where that somewhere is, is too often the office, the hotel, with a couple of social workers who didn't sign up to be sitting in a hotel staring at a kid. They run away. A lot of them, frankly, end up in juvenile hall. That is not a good alternative. We've tried to be super transparent about this.

And starting from 2020, when those out of state youth were brought back, we said we don't think there's enough capacity in the system, at least for a temporary bit of time. You're going to see kids in places you do not want them. And guess what? That is what we are seeing. So what we're trying to do is get something together that counties can have more control over, that can't say no. That must take that child. While we ensure that we're looking for that right placement.

Ideally it's a family, ideally it's a relative. We would want that. But we need to make sure services are in place. And as you heard from the other panels, they're not always in place right away. So what we want is something where the services are there for them. They're getting something and it's licensed while we get, as quickly as possible them into that family home. That's the idea.

Thank you so much. Any additional comment? Question? Great. Perfect. We'll make room for the next stakeholder proposals. I would like to welcome Michael Williams from the Child Abuse prevention center. He's going to present on stabilizing and straightening family resource centers.

Yeah, I didn't know how we're going.

To work out the seating, and now I figured it out.

Okay.

Thank you, Chair Menjivar and Committee, thank you for this opportunity to speak on behalf of the California Family Resource Association. Excuse me. And 500 family resource centers around the state. I know, Senator Menjivar, you're very supportive of El Nido Family resource center in your district. And Senator Eggman, we met at the community partnerships for families in San Joaquin, and we have a proposal of $75 million over three years for family resource centers. The National Family Support Network calls Family Resource Centers America's best kept secret.

That's because they play an often invisible or quiet role for connecting families to much needed services, many of which are supported by this Committee, including Cal Works, calfresh, Regional Centers, Medi Cal, and child abuse prevention, as well as support in the pandemic, natural disasters and economic downturns. So family resource centers are the unseen key ingredient to the success for these programs. Quite often, national and state research has shown family resource centers to be effective in supporting family well being and reducing child abuse and neglect.

A recent study of the Westminster Family Resource center in Orange County showed a 365% return on investment for child welfare and prevented placements. And recently, the Child Welfare Council and Department of Social Services have noted family resource centers as a key ingredient in building out the Community pathway for the Family First Prevention Services act and other supports. What makes family resource centers so effective?

Their cultural responsiveness, their embeddedness in their communities, the human scale, and most of all, the trust that they enjoy with parents are exactly those things that don't have stable funding. Family resource centers patch together time limited and program specific grants and contracts to survive, and not all do survive. The California Family Resource Association appreciates Senator Marie Alvarado-Gil's sponsorship of this budget ask.

We thank this Subcommitee for your consideration, and we look forward to California joining 20 states and the District of Columbia in supporting family resource centers. And I'm glad to be here for any questions.

I don't have any questions or comments. None.

Thank you.

Great.