Revision: May 9, 2024, 1:09 p.m.
Senate Judiciary
May 9, 2024
2024-1877s
05/06
Amendment to HB 1573-FN
Amend the title of the bill by replacing it with the following:
AN ACT relative to state oversight of residential treatment programs for children and making an appropriation therefor.
Amend the bill by replacing all after the enacting clause with the following:
1 Statement of Purpose and Findings. The general court makes the following findings regarding children in state care:
I. Children in the care of the state have fundamental rights, as recognized by RSA 170-G:21.
II. When a child is placed under the care and custody of the state pursuant to RSA 169-B, RSA 169-C, or RSA 169-D, it is the responsibility of the state to ensure that a child receives appropriate housing, nutrition, medical and mental health care, education, and basic standards of care.
III. Children who are removed from their homes must be placed in the least restrictive alternate setting. When removal and placement cannot be avoided, the disruption that the child may experience is minimized, and emotional trauma may be reduced, by placing the child in the most familiar, least restrictive setting. The first alternative considered is placement with a relative or a close friend, “kin” or “fictive kin”, to offer the child some degree of familiarity and continuity. When placement with kin or fictive kin is not possible, the least restrictive placement of choice is placement in a licensed foster home.
IV. Residential facilities are appropriate only for children who cannot be safely maintained in their own home or a community-based alternative; a shortage or lack of foster family homes or community-based resources shall not be an acceptable reason for placement in a residential facility. Residential facilities are congregate care placements, are considered the most restrictive settings for receiving treatment, and are generally not appropriate for children under 12 years of age. Therefore, placement in a residential setting is used only as a last alternative for children age 12 and older. Special consideration will be given to children under age 12, if deemed clinically appropriate due to a therapeutic or medical necessity.
V. Placing children in facilities must be viewed as a time-limited and only for the purpose of treatment and services. The purpose is to stabilize the child, provide treatment, and to prepare him or her for a less restrictive setting. The goal is to facilitate family/caregiver integration or another plan consistent with the agency's policy of permanency planning.
VI. To best meet the needs of the children placed in a residential setting, the department of health and human services (DHHS), in coordination with the office of child advocate (OCA), will expand and enhance certification requirements, visits and enforcement. DHHS and OCA will continue this coordination through regular meetings and coordinated visits.
2 Residential Care and Child-Placing Agency Licensing; Deemed Licensed. Amend RSA 170-E:31-a to read as follows:
170-E:31-a Deemed Licensed. Any [qualified] residential treatment program accredited by organizations as specified in Title 42 of the Social Security Act, 42 U.S.C. section 672(k)(4)(G), as amended, shall submit a completed license application or renewal application. Such child care institutions and child care agencies defined as group homes, specialized care, or homeless youth programs, shall be deemed licensed under this subdivision and shall be exempt from inspections carried out under RSA 170-E:31, IV. This section shall only apply to the activities or portions of the facility or agency accredited under Title 42 of the Social Security Act, 42 U.S.C. section 672(k)(4)(G), as amended. Any childcare institution or childcare agency deemed licensed under this section shall be subject to the requirements of this chapter, RSA 169-F, and RSA 170-G:4, XVIII.
3 New Section; Court Ordered Placements; Residential Treatment Programs; Certification Required. Amend RSA 169-F by inserting after section 4 the following new section:
169-F:5 Residential Treatment Programs; Certification Required.
I. No child shall be placed by the department in a residential treatment program, including a psychiatric residential treatment program, unless the program has been licensed in accordance with RSA 170-E or the laws of the state in which they operate, and certified by the department under this chapter. Any program not certified by the department shall not be eligible to receive state funds or federal funds disbursed by the state of New Hampshire.
II. On or before January 2, 2025, the department shall establish a certification team, responsible for the certification, recertification, and oversight of all residential treatment programs utilized by the department, and certified for placements and payment by the department. Such assessments shall include an in-person visit of the facility and review of all appropriate records and certification criteria. The team shall give priority to all residential treatment programs where children are currently placed on the effective date of this section.
III. The team shall develop a standard operating procedure and form for assessment of the programs to be completed during each in-person visit, in consultation with the office of the child advocate.
IV. The department shall assess and certify every in-state and out-of-state program including residential treatment programs and psychiatric residential treatment programs prior to entering into an agreement for payment, and prior to the placement of any child in that facility. To be certified by the department, the program shall demonstrate compliance with staff training and program requirements and offer an appropriate therapeutic milieu and culture centered in trauma-informed care, in accordance with standards adopted by the department, in consultation of the office of the child advocate.
V. The department shall make monitoring visits at least twice per year, including at least one unannounced visit, to all facilities where New Hampshire children are currently placed by the state in residential treatment. The department shall continue to make annual certification or technical assistance visits to all certified residential placement facilities; if a child is being placed at a residential facility that did not currently have a New Hampshire child placed, the department shall make a visit prior to the placement of that child unless a department visit has occurred within the past 120 days. Clear and comprehensive records shall be maintained by the department on each facility showing the dates and findings of each such visit. Such records shall be available to the facility and provided to the office of the child advocate, as well as included in the paperwork for the certification and/or re-certification process. If the facility is found not to be in compliance with the statute, the rules adopted by the commissioner, or the contract, if applicable, a corrective action plan shall be submitted to the department, and the department shall notify the licensing agency of that facility and the office of the child advocate. Failure to submit an acceptable plan or a failure to take the necessary corrective actions shall result in the immediate removal of all New Hampshire children from that facility, and/or revocation of the certification.
VI. Any placement of a child outside of New England shall require the approval of the division for children youth and families’ director prior to placement, with specific findings regarding the need for such placement.
4 Reallocation of Monies Saved. Any monies saved by the department of health and human services, including the division for children, youth and families and the bureau of children’s behavioral health, in preventing the out-of-home placement of children pursuant to this act shall be used by the department to provide services pursuant to RSA 135-F, the system of care for children’s mental health, and any other community-based intervention services.
5 Appropriation; Department of Health and Human Services; Staffing and Travel Costs Associated with Certification Team. The department of health and human services is authorized to establish and fill the positions necessary to implement the provisions of this act. The sum of $1,000,000 for the biennium ending June 30, 2025, is hereby appropriated to the department of health and human services for the purpose of implementing the provisions of this act, including staffing and travel expenses. The governor is authorized to draw a warrant for said sum from any money in the treasury not otherwise appropriated.
6 Report. The department of health and human services shall provide an interim report on or before November 1, 2024, with an annual report thereafter, on the implementation of this act including, but not limited to, progress on the implementation of this act, reports from certified out-of-state residential facilities, and the progress on the reduction of placement of New Hampshire youth in out-of-state residential facilities, to the chairs of the house children and family law committee and the senate judiciary committee, the oversight commission on children’s services, established by RSA 21-V:10, the health and human services oversight committee established by RSA 126-A:13, and the office of the child advocate.
7 Effective Date. This act shall take effect July 1, 2024.
2024-1877s
AMENDED ANALYSIS
This bill requires court-ordered residential treatment programs for children to be licensed and certified by the department of health and human services. The bill directs the department to establish certification teams to make monitoring visits and ensure compliance with certification criteria. The bill makes an appropriation to the department of health and human services for this purpose and requires the department to submit a report regarding implementation.