SB 1109 California Senate · 2025-2026 Regular Session

Short-term residential therapeutic programs.

Summary

Existing law, the California Community Care Facilities Act, provides for the licensing and regulation of community care facilities, including short-term residential therapeutic programs, by the State Department of Social Services, and defines a short-term residential therapeutic program as a residential facility licensed by the department and operated by any public agency or private organization that provides an integrated program of specialized and intensive care and supervision, services and supports, treatment, and short-term, 24-hour care and supervision to children that is trauma-informed. Under the act, the department is authorized to issue citations for violations of these provisions. This bill would, notwithstanding any law and commencing January 1, 2027, require licenses for short-term residential therapeutic programs to be renewed annually if the licensee has a total of 5 or more specified citations in the past 12 months. The bill would require that the licensee not be subject to ongoing annual review if it receives less than 5 violations in the 12 months following an annual license review.

Issues: ✓ Healthcare

Bill status passed 3 of 5 stages cleared

Introduction

Feb 2026

Committee Review

Jul 2026

Senate Passage

May 2026

Assembly Passage

Governor

Introduced Feb 17, 2026 Last action Jul 1, 2026

Maddy AI version diff · 4 comparisons

What changed between versions

04/13/26 - Amended Senate → 04/28/26 - Amended Senate · 5 edits · Apr 28, 2026

MODERATE

SB 1109 was significantly narrowed in this amendment. The bill previously added two new sections (1520.15 and 1520.16) and amended an existing section, imposing board of supervisors approval requirements, a licensing prohibition for small counties, and annual renewal triggers. The amended version removes all board of supervisors involvement, eliminates the outright ban on licensing in small counties, and retains only the annual renewal requirement triggered by citations or operation in a small county without a high school or hospital.

Scope change

The bill's scope was substantially reduced. It no longer gives county boards of supervisors a role in approving or opposing short-term residential therapeutic programs, and it no longer bans such programs in small counties. The remaining provision is narrower: it only requires annual license renewal for programs that have accumulated citations or operate in small counties without certain infrastructure.

SCOPE

Section 1520.16 was removed entirely from the bill. The bill now only adds Section 1520.15 to the Health and Safety Code, rather than adding two sections and amending an existing one.

The prohibition on issuing or renewing licenses for short-term residential therapeutic programs in counties with fewer than 75,000 residents that lack a high school or general acute care hospital was removed. Small counties can still license these programs; they just trigger annual renewal review.

REQUIREMENT

All requirements involving county boards of supervisors were eliminated: no longer requires applicants to submit program statements to the board for review, no longer requires a letter of recommendation from the board in licensing applications, and no longer requires the department to cease processing if the board opposes the program.

The citation threshold for triggering annual license renewal appears narrowed in the introductory text from 'type A or type B citations' to 'type A citations only,' though the numbered paragraph (1) still references both types, creating apparent internal inconsistency in the bill text.

FISCAL

The bill's designation as a state-mandated local program changed from 'yes' to 'no,' meaning it no longer imposes reimbursable costs on local agencies under the California Constitution.

03/25/26 - Amended Senate → 04/13/26 - Amended Senate · 6 edits · Apr 13, 2026

MODERATE

SB 1109 was dramatically narrowed from a comprehensive regulatory package for short-term residential therapeutic programs to a single conditional license renewal provision. The April 13 amendment removed all detailed program requirements (accreditation, staff training, plan of operation standards), eliminated the blanket ban on new facilities in small counties, and replaced universal annual renewal with a targeted approach that only triggers annual review for programs with 5 or more citations in 12 months or those operating in counties under 75,000 residents without a high school or hospital.

SCOPE

Annual license renewal (Section 1520.15) changed from applying to ALL short-term residential therapeutic programs starting January 1, 2027, to only applying when either the licensee has 5 or more type A or type B citations in the past 12 months, or the program operates in a county with fewer than 75,000 residents and no high school or general acute care hospital.

Section 1520.16 was entirely removed. This section had prohibited the department from issuing new licenses or renewing existing licenses for short-term residential therapeutic programs in any county with fewer than 75,000 residents that lacks a high school or general acute care hospital.

The amendment to Section 16001.7 of the Welfare and Institutions Code (regarding California Youth Connection contract and foster youth participation in policy development) was removed from the bill entirely.

REQUIREMENT

New provision allowing a licensee subject to annual review due to citations to exit ongoing annual renewal if they have fewer than 5 violations in the 12 months following an annual license review.

The entire amendment to Section 1562.01 was removed, which had contained detailed requirements including national accreditation within 24 months, mental health program approval and Medi-Cal certification within 12 months, extensive plan of operation content (trauma-informed treatment model, family engagement, aftercare planning), staff training topics, minimum age requirements for staff, nursing staff availability, and conflict of interest mitigation plans.

FISCAL

Fiscal committee review changed from 'no' to 'yes,' and state-mandated local program designation changed from 'yes' to 'no,' reflecting the reduced scope of the bill.

02/17/26 - Introduced → 03/25/26 - Amended Senate · 11 edits · Mar 25, 2026

MAJOR

SB 1109 was dramatically expanded from a minor technical amendment to the California Youth Connection contract into a comprehensive regulatory overhaul of short-term residential therapeutic programs for foster youth. The amended bill adds annual license renewal requirements with county board of supervisor approval, prohibits new licenses in small counties lacking basic infrastructure, and imposes extensive new operational standards including national accreditation, 24/7 nursing staff, detailed family engagement plans, and mandatory staff training. This matters because it gives local governments significant power to block or shut down therapeutic facilities serving foster youth.

SCOPE

The bill now amends the Health and Safety Code (Sections 1520.15, 1520.16, and 1562.01) in addition to the original Welfare and Institutions Code amendment, expanding scope from a single technical fix to a full regulatory framework for short-term residential therapeutic programs.

Starting January 1, 2027, the department is prohibited from issuing or renewing licenses for short-term residential therapeutic programs in counties with fewer than 75,000 residents that also lack a high school or general acute care hospital operating in the county.

REQUIREMENT

Starting January 1, 2027, all short-term residential therapeutic program licenses must be renewed annually. The renewal application must include a form completed by the county board of supervisors indicating whether they support the program's operation in the county. If the board does not support it, the department must cease further action on the renewal.

New applicants must include a letter of recommendation from the board of supervisors of the county where the program will operate. If the board does not support the program or no letter is included, the department must cease review of the application. Exception: programs owned and operated by the county itself or by a private nonprofit under county contract.

Programs must obtain national accreditation within 24 months of licensure and mental health program approval plus Medi-Cal certification within 12 months. The department may revoke licenses for failure to meet these deadlines.

Extensive plan of operation requirements including: a comprehensive trauma-informed treatment model, individualized family-based aftercare support plans for at least six months post-discharge, family engagement and sibling connection documentation, and transition planning to less restrictive settings.

Mandatory staff training covering child development, trauma effects, anti-discrimination, cultural competency, commercial sexual exploitation awareness, the Indian Child Welfare Act, positive discipline, de-escalation techniques, and other topics. Training must be completed before unsupervised care, within 180 days of employment, and annually.

All direct care staff and facility managers must be at least 21 years old (with an exception for staff employed before October 1, 2014 at facilities previously licensed as group homes).

Programs must ensure licensed nursing staff are available 24 hours a day, 7 days a week, providing care within the scope of their practice. If a child requires regular onsite nursing care, the program must provide it or partner with the county to arrange it.

FISCAL

Fiscal committee review changed from 'no' to 'yes' and state-mandated local program changed from 'no' to 'yes', indicating the bill now imposes costs on local agencies that require fiscal analysis and reimbursement consideration.

TECHNICAL

The original technical amendment to Section 16001.7 (California Youth Connection contract language) is retained but renumbered as Section 5, with minor wording changes such as removing 'the' before 'California Youth Connection' and changing 'between the ages of 14 and 21 years' to 'between 14 and 21 years of age.'

Floor votes · Senate May 22, 2026

How they voted

33–0

Passed · 7 other

Total votes 40

May 22, 2026

D Democratic30

25 Yea 5

83% Yea

R Republican10

8 Yea 2

80% Yea

Vote distribution

All Yea All Nay Mixed No data

Full legislative history

Actions timeline

Total actions

Key actions

Committee

Amendments

Jul 1, 2026

Lower · Passed

June 30 set for first hearing. Held in committee without recommendation.

lower

Jun 1, 2026

Committee

Referred to Com. on HUM. S.

lower

May 22, 2026

Upper · Passed

Read third time. Passed. (Ayes 33. Noes 0. Page 4419.) Ordered to the Assembly.

upper

May 14, 2026

Upper · Passed

From committee: Do pass. (Ayes 7. Noes 0. Page 4265.) (May 14).

upper

Apr 28, 2026

Upper · Passed

Read second time and amended. Re-referred to Com. on APPR.

upper

Apr 27, 2026

Upper · Passed

From committee: Do pass as amended and re-refer to Com. on APPR. (Ayes 4. Noes 0. Page 3955.) (April 20).

upper

Apr 13, 2026

Upper · Passed

From committee with author's amendments. Read second time and amended. Re-referred to Com. on HUMAN S.

upper

Apr 8, 2026

Committee

Re-referred to Com. on HUMAN S.

upper

Mar 25, 2026

Upper · Passed

From committee with author's amendments. Read second time and amended. Re-referred to Com. on RLS.

upper

Feb 26, 2026

Committee

Referred to Com. on RLS.

upper

Feb 17, 2026

Introduced

Introduced. Read first time. To Com. on RLS. for assignment. To print.

upper

1 primary · 1 co-sponsor