(a) No more than two children with or without special health care needs shall reside in a specialized foster care home with the following exceptions:

(1) A specialized foster care home may have a third child with or without special health care needs placed in that home provided that the capacity, as determined by the department or county pursuant to Chapter 3 (commencing with Section 1500) of Division 2 of the Health and Safety Code or Article 2 (commencing with Section 16519.5) of Chapter 5 of Part 4 is not exceeded and provided that all of the following conditions have been met:

(A) The child’s placement worker has determined and documented that no other placement is available.

(B) For each child in placement and the child to be placed, the child’s placement worker has determined that the child’s psychological and social needs will be met by placement in the home and has documented that determination. New determinations shall be made and documented each time there is an increase or turnover in children placed in the specialized foster care home and the two-child capacity limit is exceeded.

(C) The individualized health care plan team responsible for the ongoing care of each child with special health care needs involved has considered the number of adoptive, biological, and foster children, and children in guardianship living in the home and determined that the two-child limit may be exceeded without jeopardizing the health and safety of that child, and has documented that determination. New determinations shall be made and documented each time there is an increase or turnover in children placed in the specialized foster care home and the two-child capacity limit is exceeded.

(2) A licensed small family home may exceed the two-child placement limit and accept children with or without special health care needs up to capacity, as determined by the department pursuant to Chapter 3 (commencing with Section 1500) of Division 2 of the Health and Safety Code, if the conditions in paragraph (1) have been met for both the third foster child and each foster child placed thereafter, and the following additional conditions have been met:

(A) At least one of the children in the facility is a regional center client monitored in accordance with Section 56001 and following of Title 17 of the California Code of Regulations.

(B) Whenever four or more children are physically present in the facility, the licensee of the small family home has the assistance of a caregiver to provide specialized in-home health care to the children except that:

(i) Night assistance shall not be required for those hours that the individualized health care plan team for each child with special health care needs has documented that the child will not require specialized medical services during that time.

(ii) The department may determine that additional assistance is required to provide appropriate care and supervision for all children in placement. The determination shall only be made after consultation with the appropriate regional center and any appropriate individual health care teams.

(C) On-call assistance is available at all times to respond in case of an emergency. The on-call assistant shall meet the requirements of paragraph (5) of subdivision (c) of Section 17731.

(D) The home is sufficient in size to accommodate the needs of all children in the home.

(b) Notwithstanding § 1523.1 of the Health and Safety Code, a foster family home that has more than three children with special health care needs in its care as of January 1, 1992, and that applies for licensure as a small family home in order to continue to provide care for those children, shall be exempt from the application fee.

(c) Except for children with special health care needs placed in group homes before January 1, 1992, or placed in a group home for children with special health care needs, as defined in paragraph (22) of subdivision (a) of § 1502 of the Health and Safety Code, a child with special health care needs shall not be placed in any group home, short-term residential therapeutic programs, or combination of group homes, or combination of short-term residential therapeutic programs, for longer than a short-term placement of 120 calendar days. The short-term placement in the group home or short-term residential therapeutic program shall be on an emergency basis for the purpose of arranging a subsequent placement in a less restrictive setting, such as with the child’s natural parents or relatives, with a foster parent or foster family agency, or with another appropriate person or facility. The 120-day limitation shall not be extended, except by the approval of the director or their designee. For children placed after January 1, 1992, the 120-day limitation shall begin on the effective date of the amendments to this section made during the 1993 portion of the 1993-94 Regular Session.

(d) A child with special health care needs shall not be placed in a group home or short-term residential therapeutic program unless the child’s placement worker has determined and documented that the group home or short-term residential therapeutic program has a program that meets the specific needs of the child being placed and there is a commonalty of needs with the other children in the group home or short-term residential therapeutic program.

(e) The Legislature finds and declares that the amendments to this section made by the act that added this subdivision are declaratory of existing law.

(Amended by Stats. 2021, Ch. 76, Sec. 62. (AB 136) Effective July 16, 2021.)