Substitute House Bill No. 6006
Substitute House Bill No. 6006
PUBLIC ACT NO. 97-272
AN ACT CONCERNING THE MENTAL HEALTH MANDATE OF THE
DEPARTMENT OF CHILDREN AND FAMILIES AND
ESTABLISHING A PROGRAM OF SUBSIDIZED GUARDIANSHIP.
Be it enacted by the Senate and House of
Representatives in General Assembly convened:
Section 1. Section 17a-1 of the general
statutes is repealed and the following is
substituted in lieu thereof:
As used in sections 17a-1 to 17a-26,
inclusive, [and] AS AMENDED BY THIS ACT, 17a-28 to
17a-49, inclusive, AND SECTION 2 OF THIS ACT:
[(a)] (1) "Commissioner" means the
Commissioner of Children and Families;
[(b)] (2) "Council" means the State Advisory
Council on Children and Families;
[(c)] (3) "Department" means the Department of
Children and Families;
[(d)] (4) "Child" means any person under
sixteen years of age;
[(e)] (5) "Youth" means any person sixteen to
eighteen years of age;
[(f)] (6) "Delinquent child" shall have the
meaning ascribed thereto in section 46b-120;
(7) "CHILD OR YOUTH WITH MENTAL ILLNESS" MEANS
A CHILD OR YOUTH WHO IS SUFFERING FROM ONE OR MORE
MENTAL DISORDERS AS DEFINED IN THE MOST RECENT
EDITION OF THE AMERICAN PSYCHIATRIC ASSOCIATION'S
"DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL
DISORDERS";
(8) "CHILD OR YOUTH WITH EMOTIONAL
DISTURBANCE" MEANS A CHILD OR YOUTH WHO HAS A
CLINICALLY SIGNIFICANT EMOTIONAL OR BEHAVIORAL
DISORDER, AS DETERMINED BY A TRAINED MENTAL HEALTH
PROFESSIONAL, THAT DISRUPTS THE ACADEMIC OR
DEVELOPMENTAL PROGRESS, FAMILY OR INTERPERSONAL
RELATIONSHIPS OF SUCH CHILD OR YOUTH OR IS
ASSOCIATED WITH PRESENT DISTRESS OR DISABILITY OR
A RISK OF SUFFERING DEATH, PAIN OR DISABILITY;
(9) "INDIVIDUAL SYSTEM OF CARE PLAN" MEANS A
WRITTEN PLAN DEVELOPED BY THE COMMISSIONER OF
CHILDREN AND FAMILIES FOR A CHILD OR YOUTH WHO IS
MENTALLY ILL OR EMOTIONALLY DISTURBED OR AT
PLACEMENT RISK WHICH SHALL BE DEVELOPED WHEN SUCH
CHILD OR YOUTH NEEDS SERVICES FROM AT LEAST TWO
PUBLIC AGENCIES AND WHICH SHALL BE DESIGNED TO
MEET THE NEEDS OF THE CHILD OR YOUTH AND HIS
FAMILY;
(10) "FAMILY" MEANS A CHILD OR YOUTH WHO IS
MENTALLY ILL OR EMOTIONALLY DISTURBED OR AT
PLACEMENT RISK TOGETHER WITH (A) ONE OR MORE
BIOLOGICAL OR ADOPTIVE PARENTS, EXCEPT FOR A
BIOLOGICAL PARENT WHOSE PARENTAL RIGHTS HAVE BEEN
TERMINATED, (B) ONE OR MORE PERSONS TO WHOM LEGAL
CUSTODY OR GUARDIANSHIP HAS BEEN GIVEN, OR (C) ONE
OR MORE ADULT FAMILY MEMBERS WHO HAVE A PRIMARY
RESPONSIBILITY FOR PROVIDING CONTINUOUS CARE TO
SUCH CHILD OR YOUTH;
(11) "CHILD OR YOUTH AT PLACEMENT RISK" MEANS
A MENTALLY ILL OR EMOTIONALLY DISTURBED CHILD OR
YOUTH WHO IS AT RISK OF PLACEMENT OUT OF HIS HOME
OR IS IN PLACEMENT OUT OF HIS HOME FOR THE PRIMARY
PURPOSE OF RECEIVING MENTAL HEALTH TREATMENT; AND
(12) "PARENT" MEANS A BIOLOGICAL OR ADOPTIVE
PARENT, EXCEPT A BIOLOGICAL PARENT WHOSE PARENTAL
RIGHTS HAVE BEEN TERMINATED.
Sec. 2. (NEW) (a) The following shall be
established for the purposes of developing and
implementing an individual system of care plan:
(1) Within available appropriations, a child
specific team may be developed by the family of a
child or adolescent at placement risk and include,
but not be limited to, family members, the child
or adolescent if appropriate, clergy, school
personnel, representatives of local or regional
agencies providing programs and services for
children and youth, a family advocate, and other
community or family representatives. The team
shall designate one member to be the team
coordinator. The team coordinator shall make
decisions affecting the implementation of an
individual system of care plan with the consent of
the team, except as otherwise provided by law. If
a case manager, other than the case manager from
the Department of Children and Families, has been
assigned to the child and is not designated as the
team coordinator, such case manager shall not make
decisions affecting the implementation of the
individual system of care plan without the consent
of the team, except as otherwise provided by law;
(2) Within available appropriations, case
review committees may be developed by each
regional office of the Department of Children and
Families and shall be comprised of at least three
parents of children or adolescents with serious
emotional disturbance and representatives of local
or regional agencies and service providers
including, but not limited to, the regional
administrator of the office of the Department of
Children and Families or his designee, a
superintendent of schools or his designee, a
director of a local children's mental health
agency or his designee, the district director of
the district office of the Department of Social
Services or his designee, representatives from the
Departments of Mental Retardation and Mental
Health and Addiction Services who are
knowledgeable of the needs of a child or
adolescent at placement risk, a representative
from a local housing authority and a
representative from the court system. The
functions of the case review committees shall
include, but not be limited to: (A) The
determination of whether or not a child or
adolescent meets the definition of a child or
adolescent at placement risk; (B) assisting
children or families without a child specific team
in the formation of such a team; and (C)
resolution of the development or implementation of
an individual system of care plan not developed,
implemented or agreed upon by a child specific
team. Such functions shall be completed in one
hundred twenty days or less from the date of
referral to the case review committee. In the
event of the need for an individual system of care
plan for a child or adolescent with no
identifiable community, a representative of the
child or adolescent shall make a referral to the
state coordinated care committee, established
pursuant to subdivision (3) of this subsection,
which shall designate responsibility for the
development of an individual system of care plan
to a case review committee. The case review
committee shall also monitor the implementation of
an individual system of care plan when
appropriate. The Department of Children and
Families may assign a system coordinator to each
case review committee. The duties of the system
coordinator shall include, but not be limited to,
assistance and consultation to child specific
teams and assistance with the development of case
review committees and child specific teams.
(3) A coordinated care committee shall be
developed by the Commissioner of Children and
Families and shall be comprised of a parent of a
child or adolescent with serious emotional
disturbance who is currently serving or has served
on a case review committee, a person who is now or
has been a recipient of services for a child or
adolescent at placement risk, representatives of
the Departments of Children and Families,
Education, Mental Health and Addiction Services,
Social Services and Mental Retardation who are
knowledgeable of the needs of a child or
adolescent at placement risk, and a representative
of the Office of Protection and Advocacy for
Persons with Disabilities who is knowledgeable of
the needs of a child or adolescent at placement
risk.
(b) The commissioner, in consultation with the
coordinated care committee, shall submit a report
on the findings and recommendations of programs
for children and youth at placement risk,
including recommendations for budget options or
programmatic changes necessary to enhance the
system of care for such child or youth and his
family, to the joint standing committee and the
select committee of the General Assembly having
cognizance of matters relating to children, on or
before January 1, 1998, and annually thereafter.
(c) The provisions of this section shall not
be construed to grant an entitlement to any child
or youth at placement risk to receive particular
services under this section in an individual
system of care plan if such child or youth is not
otherwise eligible to receive such services from
any state agency or to receive such services
pursuant to any other provision of law.
(d) The Commissioner of Children and Families
may adopt regulations in accordance with chapter
54 of the general statutes for the purpose of
implementing the provisions of this section.
Sec. 3. (NEW) The Department of Children and
Families shall establish a liaison to the
Department of Social Services to ensure that
Medicaid eligible children and youth receive
mental health services in accordance with federal
law.
Sec. 4. (NEW) There shall be no requirement
for the Department of Children and Families to
seek custody of any child or youth with mental
illness, emotional disturbance, a behavioral
disorder or developmental or physical disability
if such child is voluntarily placed with the
department by a parent or guardian of the child
for the purpose of accessing an out-of-home
placement or intensive outpatient service,
including, but not limited to, residential
treatment programs, therapeutic foster care
programs and extended day treatment programs,
except as permitted pursuant to sections 17a-101g
and 46b-129 of the general statutes. Commitment to
or protective supervision or protection by the
department shall not be a condition for receipt of
services or benefits delivered or funded by the
department.
Sec. 5. Section 17a-11 of the general statutes
is repealed and the following is substituted in
lieu thereof:
(a) The commissioner may, in his discretion,
admit to the department on a voluntary basis any
child or youth who, in his opinion, could benefit
from any of the services offered [in residential
facilities] OR administered by, or under contract
with, or otherwise available to, the department.
Application for voluntary admission shall be made
in writing by the parent or guardian of a child
under fourteen years of age or by such person
himself if he is a child fourteen years of age or
older or a youth.
(b) A child or youth voluntarily admitted to
the department shall be deemed to be within the
care of the commissioner until such admission is
terminated. The commissioner shall terminate the
admission of any child or youth voluntarily
admitted to the department within ten days after
receipt of a written request for termination from
a parent or guardian of any child under fourteen
or from a child if fourteen years of age or over,
or youth, unless prior to the expiration of that
time the commissioner has sought and received from
the Superior Court an order of temporary custody
as provided by law. The commissioner may terminate
the admission of any child or youth voluntarily
admitted to the department after giving reasonable
notice in writing to the parent or guardian of any
child under fourteen years of age [or] AND to a
child over fourteen, [or] AND to any youth. Any
child or youth admitted voluntarily to the
department may be placed in, or transferred to,
any resource, facility or institution within the
department or available to the commissioner except
Long Lane School, [and the Connecticut School for
Boys,] provided the commissioner shall give
written notice to such child or youth [who is
voluntarily admitted] AND TO THE PARENT OR
GUARDIAN OF THE CHILD of his intention to make a
transfer at least ten days prior to any actual
transfer, unless written notice is waived by those
entitled to receive it, or unless an emergency
commitment of such child is made pursuant to
section 17a-502.
(c) NOT MORE THAN ONE HUNDRED TWENTY DAYS
AFTER ADMITTING A CHILD OR YOUTH ON A VOLUNTARY
BASIS, THE DEPARTMENT SHALL PETITION THE PROBATE
COURT FOR A DETERMINATION AS TO WHETHER
CONTINUATION IN CARE IS IN THE CHILD'S BEST
INTEREST AND, IF SO, WHETHER THERE IS AN
APPROPRIATE CASE SERVICE PLAN. UPON RECEIPT OF
SUCH APPLICATION, THE COURT SHALL SET A TIME AND
PLACE FOR HEARING TO BE HELD WITHIN THIRTY DAYS OF
RECEIPT OF THE APPLICATION, UNLESS CONTINUED BY
THE COURT FOR CAUSE SHOWN. THE COURT SHALL ORDER
NOTICE OF THE HEARING TO BE GIVEN BY CERTIFIED
MAIL, RETURN RECEIPT REQUESTED, AT LEAST FIVE DAYS
PRIOR TO THE HEARING TO THE COMMISSIONER OF
CHILDREN AND FAMILIES, THE PARENTS OR GUARDIAN OF
THE CHILD AND THE MINOR, IF OVER TWELVE YEARS OF
AGE. IF THE WHEREABOUTS OF THE PARENT OR GUARDIAN
ARE UNKNOWN, OR IF DELIVERY CANNOT REASONABLY BE
EFFECTED, THEN NOTICE SHALL BE ORDERED TO BE GIVEN
BY PUBLICATION. IN MAKING ITS DETERMINATION THE
COURT SHALL CONSIDER THE ITEMS SPECIFIED IN
SUBSECTION (d) OF THIS SECTION.
(d) NOT MORE THAN TWELVE MONTHS AFTER A CHILD
OR YOUTH IS ADMITTED TO THE DEPARTMENT ON A
VOLUNTARY BASIS, THE COMMISSIONER SHALL FILE A
MOTION IN THE PROBATE COURT REQUESTING A
DISPOSITIONAL HEARING ON THE STATUS OF THE CHILD
OR YOUTH. UPON RECEIPT OF SUCH MOTION, THE COURT
SHALL SET A TIME AND PLACE FOR HEARING TO BE HELD
WITHIN THIRTY DAYS OF RECEIPT OF THE MOTION,
UNLESS CONTINUED BY THE COURT FOR CAUSE SHOWN. THE
COURT SHALL ORDER NOTICE OF THE HEARING TO BE
GIVEN IN ACCORDANCE WITH SUBSECTION (c) OF THIS
SECTION. AT THE DISPOSITIONAL HEARING, ALL PARTIES
SHALL BE HEARD AND ORAL OR WRITTEN REPORTS,
CONTAINING RECOMMENDATIONS AS TO THE BEST
INTERESTS OF THE CHILD OR YOUTH MAY BE PRESENTED.
IN DETERMINING ITS ORDER OF DISPOSITION, THE COURT
SHALL CONSIDER AMONG OTHER THINGS: (1) THE
APPROPRIATENESS OF THE DEPARTMENT'S PLAN FOR
SERVICE TO THE CHILD OR YOUTH AND HIS FAMILY; (2)
THE TREATMENT AND SUPPORT SERVICES THAT HAVE BEEN
OFFERED AND PROVIDED TO THE CHILD OR YOUTH TO
STRENGTHEN AND REUNITE THE FAMILY; (3) IF RETURN
HOME IS NOT LIKELY FOR THE CHILD OR YOUTH, THE
EFFORTS THAT HAVE BEEN MADE OR SHOULD BE MADE TO
EVALUATE AND PLAN FOR OTHER MODES OF CARE; AND (4)
ANY FURTHER EFFORTS WHICH HAVE BEEN OR WILL BE
MADE TO PROMOTE THE BEST INTERESTS OF THE CHILD OR
YOUTH. AT THE CONCLUSION OF THE HEARING, THE COURT
SHALL, IN ACCORDANCE WITH THE BEST INTERESTS OF
THE CHILD OR YOUTH, ENTER AN APPROPRIATE ORDER OF
DISPOSITION. THE ORDER MAY: (A) DIRECT THAT THE
SERVICES BEING PROVIDED, OR THE PLACEMENT OF THE
CHILD OR YOUTH AND REUNIFICATION EFFORTS, BE
CONTINUED IF THE COURT, AFTER HEARING, DETERMINES
THAT CONTINUATION OF THE CHILD OR YOUTH IN
SERVICES OR PLACEMENT IS IN THE CHILD OR YOUTH'S
BEST INTERESTS OR (B) DIRECT THAT THE CHILD OR
YOUTH'S SERVICES OR PLACEMENT BE MODIFIED TO
REFLECT THE CHILD OR YOUTH'S BEST INTEREST. THE
COURT SHALL POSSESS CONTINUING JURISDICTION IN
PROCEEDINGS UNDER THIS SECTION AND SHALL CONDUCT A
FURTHER DEPOSITIONAL HEARING WHENEVER IT DEEMS
NECESSARY OR DESIRABLE, BUT AT LEAST EVERY TWELVE
MONTHS.
[(c)] (e) The commissioner shall adopt
regulations IN ACCORDANCE WITH CHAPTER 54
describing the documentation required for
voluntary admission [to facilities under his
jurisdiction,] and for informal administrative
case review, upon request, of any denial of an
application for voluntary admission.
(f) ANY PERSON AGGRIEVED BY A DECISION OF THE
COMMISSIONER DENYING VOLUNTARY SERVICES MAY APPEAL
SUCH DECISION THROUGH AN ADMINISTRATIVE HEARING
HELD PURSUANT TO CHAPTER 54.
[(d)] (g) Notwithstanding any provision of
sections 17a-1 to 17a-26, inclusive, and 17a-28 to
17a-49, inclusive, to the contrary, any person
already under the care and supervision of the
Commissioner of Children and Families who has
passed his eighteenth birthday but has not yet
reached his twenty-first birthday, may be
permitted to remain voluntarily under the
supervision of the commissioner, provided said
commissioner, in his discretion determines that
such person would benefit from further care and
support from the Department of Children and
Families.
Sec. 6. Section 17a-3 of the general statutes
is repealed and the following is substituted in
lieu thereof:
The department shall plan, create, develop,
operate or arrange for, administer and evaluate a
comprehensive and integrated state-wide program of
services, including preventive services, for
children and youth whose behavior does not conform
to the law or to acceptable community standards,
or who are mentally ill, including deaf and
hearing impaired children and youth who are
mentally ill, emotionally disturbed, substance
abusers, delinquent, abused, neglected or uncared
for, including all children and youth who are or
may be committed to it by any court, and all
children and youth voluntarily admitted to the
department for services of any kind. Services
shall not be denied to any such child or youth
solely because of other complicating or multiple
disabilities. The department shall work in
cooperation with other child-serving agencies and
organizations to provide or arrange for preventive
programs, including but not limited to teenage
pregnancy and youth suicide prevention, for
children and youth and their families. THE PROGRAM
SHALL PROVIDE SERVICES AND PLACEMENTS THAT ARE
CLINICALLY INDICATED AND APPROPRIATE TO THE NEEDS
OF THE CHILD OR YOUTH. In furtherance of this
purpose, the department shall: (a) Maintain Long
Lane School and other appropriate facilities
exclusively for delinquents; (b) develop a
comprehensive program for prevention of problems
of children and youth and provide a flexible,
innovative and effective program for the
placement, care and treatment of children and
youth committed by any court to the department,
transferred to the department by other
departments, or voluntarily admitted to the
department; (c) provide appropriate services to
families of children and youth as needed to
achieve the purposes of sections 17a-1 to 17a-26,
inclusive, 17a-28 to 17a-49, inclusive, and
17a-51; (d) establish incentive paid work programs
for children and youth under the care of the
department and the rates to be paid such children
and youth for work done in such programs and may
provide allowances to children and youth in his
custody; (e) be responsible to collect, interpret
and publish statistics relating to children and
youth within the department; (f) conduct studies
of any program, service or facility developed,
operated, contracted for or supported by the
department in order to evaluate its effectiveness;
(g) establish staff development and other training
and educational programs designed to improve the
quality of departmental services and programs,
provided no social worker trainee shall be
assigned a case load prior to completing training,
and may establish educational or training programs
for children, youth, parents or other interested
persons on any matter related to the promotion of
the well-being of children, or the prevention of
mental illness, emotional disturbance, delinquency
and other disabilities in children and youth; (h)
develop and implement aftercare and follow-up
services appropriate to the needs of any child or
youth under his care; (i) establish a case audit
unit to monitor each region's compliance with
regulations and procedures; (j) develop and
maintain a database listing available community
service programs funded by the department; (k)
provide outreach and assistance to persons caring
for children whose parents are unable to do so by
informing such persons of programs and benefits
for which they may be eligible; (l) collect data
sufficient to identify the housing needs of
children served by the department and share such
data with the Department of Economic and Community
Development; (m) prepare and submit biennially to
the General Assembly a five-year master plan. The
master plan shall include, but not be limited to:
(1) The long-range goals and the current level of
attainment of such goals of the department; (2) a
detailed description of the types and amounts of
services presently provided to the department's
clients; (3) a detailed forecast of the service
needs of current and projected target populations;
(4) detailed cost projections for alternate means
of meeting projected needs; (5) funding priorities
for each of the five years included in the plan
and specific plans indicating how the funds are to
be used; (6) a written plan for the prevention of
child abuse and neglect; (7) a comprehensive
mental health plan for children and adolescents,
including children with complicating or multiple
disabilities; (8) a comprehensive plan for
children and youth who are substance abusers,
developed in conjunction with the Department of
Mental Health and Addiction Services pursuant to
the provisions of sections 19a-2a and 19a-7; and
(9) an overall assessment of the adequacy of
children's services in Connecticut. The plan shall
be prepared within existing funds appropriated to
the department.
Sec. 7. (NEW) (a) As used in this section,
"relative caregiver" means a person who is caring
for a child because the parent of the child has
died or become otherwise unable to care for the
child for reasons that make reunification with the
parent not a viable option within the foreseeable
future and "commissioner" means the Commissioner
of Children and Families.
(b) The Commissioner of Children and Families
shall establish a program of subsidized
guardianship for the benefit of children in the
care or custody of the commissioner who are living
with relative caregivers and who have been in
foster care or certified relative care for not
less than eighteen months. A relative caregiver
may request a guardianship subsidy from the
commissioner. If adoption of the child by the
relative caregiver is an option, the commissioner
shall counsel the caregiver about the advantages
and disadvantages of adoption and subsidized
guardianship so that the decision by the relative
caregiver to request a subsidized guardianship may
be a fully informed one.
(c) The subsidized guardianship program shall
provide the following subsidies for the benefit of
any child in the care of a relative caregiver who
has been appointed the guardian or coguardian of
the child by any court of competent jurisdiction:
(1) A special-need subsidy, which shall be a lump
sum payment for one-time expenses resulting from
the assumption of care of the child when no other
resource is available to pay for such expense; and
(2) a medical subsidy comparable to the medical
subsidy to children in the subsidized adoption
program if the child lacks private health
insurance. The subsidized guardianship program
shall also provide a monthly subsidy on behalf of
the child payable to the relative caregiver that
shall be equal to the prevailing foster care rate.
The commissioner may establish an asset test for
eligibility under the program.
(d) On or before January 1, 1998, the
commissioner shall adopt regulations in accordance
with chapter 54 of the general statutes
implementing the subsidized guardianship program
established under this section. Such regulations
shall require, as a prerequisite to payment of a
guardianship subsidy for the benefit of a minor
child, that a home study report be filed with the
court having jurisdiction of the case of the minor
within fifteen days of the request for a subsidy,
provided that no such report shall be required to
be filed if a report has previously been provided
to the court or if the caregiver has been
determined to be a certified relative caregiver by
the commissioner. The regulations shall also
establish a procedure comparable to that for the
subsidized adoption program to determine the types
and amounts of subsidy to be granted by the
commissioner as provided in subsection (c) of this
section, for annual review of the subsidy as
provided in subsection (e) of this section and for
appeal from decisions by the commissioner denying,
modifying or terminating such subsidies.
(e) The guardianship subsidy provided under
this section shall continue until the child
reaches the age of eighteen or the age of twenty
one if such child is in full time attendence at a
secondary school, technical school or college or
is in a state accredited job training program.
Annually, the subsidized guardian shall submit to
the commissioner a sworn statement that the child
is still living with and receiving support from
the guardian. The parent of any child receiving
assistance through the subsidized guardianship
program shall remain liable for the support of the
chid as required by the general statutes.
(f) A guardianship subsidy shall not be
included in the calculation of household income in
determining eligibility for benefits of the
relative caregiver of the subsidized child or
other persons living within the household of the
relative caregiver.
(g) Payments for guardianship subsidies shall
be made from moneys available from any source to
the commissioner for child welfare purposes. The
commissioner shall develop and implement a plan
that: (1) Maximizes use of the subsidized
guardianship program to decrease the number of
children in the legal custody of the Commissioner
of Children and Families and to reduce the number
of children who would otherwise be placed into
foster care when there is a family member willing
to provide care; (2) maximizes federal
reimbursement for the costs of the subsidized
guardianship program, provided whatever federal
maximization method is employed shall not result
in the relative caregiver of a child being subject
to work requirements as a condition of receipt of
benefits for the child or the benefits restricted
in time or scope other than as specified in
subsection (c) of this section; and (3) ensures
necessary transfers of funds between agencies and
interagency coordination in program
implementation. The Commissioner of Children and
Families shall seek all federal waivers as are
necessary and appropriate to implement this plan.
Sec. 8. (NEW) The provisions of this act shall
not be construed to apply to any nongovernmental
insurance policy or health care center contract or
alter any contractual or statutory obligation of
the insurer or health care center.
Sec. 9. This act shall take effect July 1,
1997, except that sections 1 to 6, inclusive,
shall take effect October 1, 1997.
Approved June 27, 1997