BILL REQ. #:  H-4757.1 

READ FIRST TIME 02/02/06.   

     AN ACT Relating to creating a foster care health unit in the department of social and health services; amending RCW 74.13.031; adding a new section to chapter 13.34 RCW; adding a new section to chapter 74.13 RCW; and creating a new section.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

NEW SECTION.  Sec. 1   The legislature recognizes that foster children have enhanced health care needs and that it is necessary to improve the system of providing health care for foster children. The legislature further recognizes the importance of meeting the mental health needs of children in foster care, as well as their medical and dental health care needs. The legislature finds that there must be greater coordination and integration of systems, in particular coordination between children's administration and the health and recovery services administration as well as other agencies that provide or pay for health services for foster youth, to ensure that the health care needs of children in foster care are met in a timely manner.

NEW SECTION.  Sec. 2   A new section is added to chapter 13.34 RCW to read as follows:
     Whenever a child is ordered removed from his or her home pursuant to this chapter, the agency charged with his or her care may authorize an evaluation and treatment for the child's routine and necessary medical, dental, or mental health care, and all necessary emergency care.

Sec. 3   RCW 74.13.031 and 2004 c 183 s 3 are each amended to read as follows:
     The department shall have the duty to provide child welfare services and shall:
     (1) Develop, administer, supervise, and monitor a coordinated and comprehensive plan that establishes, aids, and strengthens services for the protection and care of runaway, dependent, or neglected children.
     (2) Within available resources, recruit an adequate number of prospective adoptive and foster homes, both regular and specialized, i.e. homes for children of ethnic minority, including Indian homes for Indian children, sibling groups, handicapped and emotionally disturbed, teens, pregnant and parenting teens, and annually report to the governor and the legislature concerning the department's success in: (a) Meeting the need for adoptive and foster home placements; (b) reducing the foster parent turnover rate; (c) completing home studies for legally free children; and (d) implementing and operating the passport program required by RCW 74.13.285. The report shall include a section entitled "Foster Home Turn-Over, Causes and Recommendations."
     (3) Investigate complaints of any recent act or failure to act on the part of a parent or caretaker that results in death, serious physical or emotional harm, or sexual abuse or exploitation, or that presents an imminent risk of serious harm, and on the basis of the findings of such investigation, offer child welfare services in relation to the problem to such parents, legal custodians, or persons serving in loco parentis, and/or bring the situation to the attention of an appropriate court, or another community agency: PROVIDED, That an investigation is not required of nonaccidental injuries which are clearly not the result of a lack of care or supervision by the child's parents, legal custodians, or persons serving in loco parentis. If the investigation reveals that a crime against a child may have been committed, the department shall notify the appropriate law enforcement agency.
     (4) Offer, on a voluntary basis, family reconciliation services to families who are in conflict.
     (5) Monitor out-of-home placements, on a timely and routine basis, to assure the safety, well-being, and quality of care being provided is within the scope of the intent of the legislature as defined in RCW 74.13.010 and 74.15.010, and annually submit a report measuring the extent to which the department achieved the specified goals to the governor and the legislature.
     (6) Have authority to accept custody of children from parents and to accept custody of children from juvenile courts, where authorized to do so under law, to provide child welfare services including placement for adoption, to provide for the routine and necessary medical, dental, and mental health care, or necessary emergency care of the children, and to provide for the physical care of such children and make payment of maintenance costs if needed. Except where required by Public Law 95-608 (25 U.S.C. Sec. 1915), no private adoption agency which receives children for adoption from the department shall discriminate on the basis of race, creed, or color when considering applications in their placement for adoption.
     (7) Have authority to provide temporary shelter to children who have run away from home and who are admitted to crisis residential centers.
     (8) Have authority to purchase care for children; and shall follow in general the policy of using properly approved private agency services for the actual care and supervision of such children insofar as they are available, paying for care of such children as are accepted by the department as eligible for support at reasonable rates established by the department.
     (9) Establish a children's services advisory committee which shall assist the secretary in the development of a partnership plan for utilizing resources of the public and private sectors, and advise on all matters pertaining to child welfare, licensing of child care agencies, adoption, and services related thereto. At least one member shall represent the adoption community.
     (10) Have authority to provide continued foster care or group care for individuals from eighteen through twenty years of age to enable them to complete their high school or vocational school program.
     (11) Refer cases to the division of child support whenever state or federal funds are expended for the care and maintenance of a child, including a child with a developmental disability who is placed as a result of an action under chapter 13.34 RCW, unless the department finds that there is good cause not to pursue collection of child support against the parent or parents of the child.
     (12) Have authority within funds appropriated for foster care services to purchase care for Indian children who are in the custody of a federally recognized Indian tribe or tribally licensed child-placing agency pursuant to parental consent, tribal court order, or state juvenile court order; and the purchase of such care shall be subject to the same eligibility standards and rates of support applicable to other children for whom the department purchases care.
     Notwithstanding any other provision of RCW 13.32A.170 through 13.32A.200 and 74.13.032 through 74.13.036, or of this section all services to be provided by the department of social and health services under subsections (4), (6), and (7) of this section, subject to the limitations of these subsections, may be provided by any program offering such services funded pursuant to Titles II and III of the federal juvenile justice and delinquency prevention act of 1974.
     (13) Within amounts appropriated for this specific purpose, provide preventive services to families with children that prevent or shorten the duration of an out-of-home placement.
     (14) Have authority to provide independent living services to youths, including individuals eighteen through twenty years of age, who are or have been in foster care.

NEW SECTION.  Sec. 4   A new section is added to chapter 74.13 RCW to read as follows:
     Within existing resources, the department shall establish a foster care health unit within the children's administration.
     (1) The health unit shall review and provide recommendations to the legislature by September 1, 2006, regarding issues including, but not limited to, the following:
     (a) Creation of an office within the department to consolidate and coordinate physical, dental, and mental health services provided to children who are in the custody of the department;
     (b) Alternative payment structures for health care organization. The department may consider managed care as an alternative structure for health care; however, the department may not implement managed care for health care services for children without authorization from the legislature;
     (c) Improving coordination of health care for children in foster care, including medical, dental, and mental health care;
     (d) Improving access to health information available to the children's administration for providers of health services for children in foster care, including the use of the child profile as a means to facilitate access to such information;
     (e) Establishing a medical home for each child placed in foster care to ensure that appropriate, timely, and necessary quality care is available through a coordinated system of care and analyzing how a medical home might be utilized to meet the unique needs of children in foster care. In establishing a medical home, the department shall consider primary care that is accessible, continuous, comprehensive, family centered, coordinated, compassionate, and culturally effective;
     (f) Examining how existing resources are being utilized to provide health care for foster children and options for improving how the resources are utilized. Particular emphasis shall be placed on the following:
     (i) Whether the health care services provided to foster children are evidence-based;
     (ii) Whether resources are duplicative or redundant between agencies or departments in the provision of medical, dental, or mental health services for children; and
     (iii) Identification of where resources are inadequate to meet the routine and necessary medical, dental, and mental health needs of children in foster care; and
     (g) Any other issues related to medical, dental, or mental health care for children in foster care.
     (2)(a) The foster care health unit, in collaboration with regional medical consultants, shall develop a statewide, uniform role for the regional medical consultants with emphasis placed on the mental health needs of the children in foster care.
     (b) By September 1, 2006, the department shall implement the utilization of the statewide, uniform role for the regional medical consultants developed in (a) of this subsection.