Legislature sends to governor bill to close gap in children’s crisis residential services

For immediate release:

SACRAMENTO—State lawmakers approved on their last night of session a measure to help close an urgent need for children’s residential psychiatric beds. The measure, AB 226, was introduced by Assemblymember James C. Ramos (D-Highland) and received bipartisan and unanimous support from the CA State Legislature.

“Since 2008, mental health needs have accounted for the largest share of hospital admissions of children ages 0 to 17 in California. California is not prepared to care for the increasing number of pediatric mental health crises,” Ramos said. “This gap forces families to scramble in a crisis to seek life-saving care, and they often wait days or weeks in a hospital without mental health services for their children. That’s unacceptable and creates untold hardship, difficulty, and trauma, and we must do better to ensure the well-being of the children.”

Ramos added, “AB 226 would create a new licensing category in state statute to establish children’s residential treatment facilities and help ensure in-state access to care for families and their children.”

“The pandemic has further fueled the surge of children in crisis. Children are often waiting days or even weeks in emergency room hallways and exam rooms, and they wait without mental health treatment,” said Christine Stoner-Mertz, CEO of the California Alliance of Child and Family Services. “AB 226 would create opportunities for counties and their community non-profit partners to establish short term treatment options for youth in crisis. Rather than ending up in emergency rooms that are ill-equipped to help them, children can work through their crises in residential settings surrounded by support and then transition back to families and communities. It has never been more important to expand the mental health crisis options for children and adolescents.  We urge Governor Gavin Newsom to sign AB 226.”


Ramos criticized California for lacking “a complete and adequate mental health service system, especially for children, and the result is shameful and preventable tragedy.” He noted little, if anything, has changed since 2013, when a public radio story reported that, “In the entire state there are now fewer than 100 beds reserved for children 12 and under…and the overwhelming majority of California's 58 counties have no beds at all for children experiencing psychiatric emergencies.”

Eight years since that story aired, only 11 of California’s 58 counties have child psychiatric hospital inpatient beds for children under 12 years and fewer than 70 such beds exist statewide. According to the National Alliance on Mental Illness, approximately 20 percent of youth between ages 13 and 18 live with a mental health condition. Ramos said an estimated three out of four children in the United States do not receive the mental health services they need, and suicide is the second leading cause of death among adolescents. Also underscoring the need is a January 2015 report from California’s leading mental health organizations, “Kids in Crisis: California’s Failure to Provide Appropriate Services for Youth Experiencing a Mental Health Crisis.”

Ramos’s measure would require that regulations and certification align with federal Medicaid provisions to maximize federal financing and aid in ensuring affordable access. AB 226 would help counties and their community-based providers develop crisis residential programs with an appropriate licensing category. Ramos’s measure would also require that regulations and certification align with federal Medicaid provisions to maximize federal financing. If enacted, the new licensing process would begin no later than January 1, 2022.


AB 226 is sponsored by the California Alliance of Child and Family Services. Supporters include the California Children's Hospital Association, the County Behavioral Health Directors Association of California, the California State Association of Counties, the County Welfare Directors Association, the California Children’s Trust, the California Council of Community Behavioral Health Agencies, SEIU California, the County Probation Officers of California, California Access Coalition, Five Acres – The Boys’ and Girls’ Aid Society of Los Angeles County, Greater Hope Foundation for Children INC, National Association of Social Workers (California Chapter), Casa Pacifica Centers for Children and Families, Sycamores, Seneca Family of Agencies, Uplift Family Services, Side by Side, Vista Del Mar Child and Family Services and Didi Hirsch Mental Health Services.


Assemblymember James Ramos proudly represents the 40th Assembly district which includes Highland, Loma Linda, Mentone, Rancho Cucamonga, Redlands, and San Bernardino. He is the first and only California Native American serving in the state’s legislature.