BILL NUMBER: SB 118 INTRODUCED
BILL TEXT
INTRODUCED BY Senator Liu
JANUARY 14, 2015
An act to amend Sections 124174, 124174.2, and 124174.6 of the
Health and Safety Code, and to amend Section 1 of Chapter 381 of the
Statutes of 2008, relating to public health.
LEGISLATIVE COUNSEL'S DIGEST
SB 118, as introduced, Liu. School-Based Health and Education
Partnership Program.
Existing law requires the State Department of Public Health, in
cooperation with the State Department of Education, to establish a
Public School Health Center Support Program to assist health centers
in schools and school districts. Existing law establishes a grant
program within the Public School Health Center Support Program to
provide technical assistance, and funding for the expansion,
renovation, and retrofitting of existing school health centers and
the development of new school health centers. These provisions also
provide funding for sustainability grants in amounts between $25,000
and $125,000.
This bill would rename the program the School-Based Health and
Education Partnership Program. The bill would instead provide funding
for the expansion and renovation of existing school health centers.
The bill would change the amount of the sustainability grants that
are available pursuant to the program to between $50,000 and
$100,000, but would make those grants available on a one-time basis
and would revise the purposes for which they may be used. The bill
would also authorize population health grants in amounts between
$50,000 and $125,000 for a funding period of up to 3 years, as
specified.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 124174 of the Health and Safety Code is amended
to read:
124174. The following definitions shall govern
the construction of this article, unless the context requires
otherwise:
(a) "Program" means a Public School the
School-Based Health Center Support and
Education Partnership Program.
(b) "School health center" means a center or program, located at
or near a local educational agency, that provides age-appropriate
health care services at the program site or through referrals. A
school health center may conduct routine physical, mental health, and
oral health assessments, and provide referrals for any services not
offered onsite. A school health center may serve two or more
nonadjacent schools or local educational agencies.
(c) For purposes of this section, "local educational agency" means
a school, school district, charter school, or county office of
education if the county office of education serves students in
kindergarten, or any grades from 1 to 12, inclusive.
(d) "Department" means the State Department of Public Health.
SEC. 2. Section 124174.2 of the Health and Safety Code is amended
to read:
124174.2. (a) The department, in cooperation with the State
Department of Education, shall establish a Public School
the School-Based Health Center Support
and Education Partnership Program.
(b) The program, in collaboration with the State Department of
Education, shall perform the following program functions:
(1) Provide technical assistance to school health centers on
effective outreach and enrollment strategies to identify children who
are eligible for, but not enrolled in, the Medi-Cal program,
the Healthy Families Program, Covered
California, or any other applicable program.
health insurance affordability program for children.
(2) Serve as a liaison between organizations within the
department, including, but not limited to, prevention services,
primary care, and family health.
(3) Serve as a liaison between other state entities, as
appropriate, including, but not limited to, the State Department of
Health Care Services, the Department of Managed Health Care, and
the Office of Emergency Services, and the Managed
Risk Medical Insurance Board. Services.
(4) Provide technical assistance to facilitate and encourage the
establishment, retention, or expansion of, school health centers. For
purposes of this paragraph, technical assistance may include, but is
not limited to, identifying available public and private sources of
funding, which may include federal Medicaid funds, funds from
third-party reimbursements, and available federal or foundation grant
moneys.
(c) The department shall consult with interested parties and
appropriate stakeholders, including the California School
School-Based Health Centers Association
Alliance and representatives of youth and
parents, in carrying out its responsibilities under this article.
SEC. 3. Section 124174.6 of the Health and Safety Code is amended
to read:
124174.6. The department shall establish a grant program within
the Public School School-Based Health
Center Support and Education Partnership
Program to provide technical assistance, and
funding for the expansion, renovation,
expansion and retrofitting renovation
of existing school health centers, and the development of new
school health centers, in accordance with the following procedures
and requirements:
(a) A school health center receiving grant funds pursuant to this
section shall meet or have a plan to meet the following requirements:
(1) Strive to provide a comprehensive set of services including
medical, oral health, mental health, alcohol and substance
abuse, health education, and related services in response to
community needs.
(2) Provide primary and other health care services, provided or
supervised by a licensed professional, which may include all of the
following:
(A) Physical examinations, immunizations, and other preventive
medical services.
(B) Diagnosis and treatment of minor injuries and acute medical
conditions.
(C) Management of chronic medical conditions.
(D) Basic laboratory tests.
(E) Referrals to and followup for specialty care.
(F) Reproductive health services.
(G) Nutrition services.
(H) Mental health services provided or supervised by an
appropriately licensed mental health professional may include:
assessments, crisis intervention, counseling, treatment, and referral
to a continuum of services including emergency psychiatric care,
evidence-based mental health treatment services, community
support programs, inpatient care, and outpatient programs. School
health centers providing mental health services as specified in this
section shall consult with the local county mental health department
for collaboration in planning and service delivery.
(I) Oral health services that may include preventive services,
basic restorative services, and referral to specialty services.
(3) Strive to address the population health of the entire school
campus by focusing on prevention services, such as group and
classroom education, schoolwide prevention programs, and community
outreach strategies.
(4) Strive to provide integrated and individualized support for
students and families and to act as a partner with the student or
family to ensure that health, social, or behavioral challenges are
addressed.
(3)
(5) Work in partnership with the school nurse, if one
is employed by the school or school district,
local educational agency, to provide individual and family
health education; school or districtwide health promotion; first aid
and administration of medications; facilitation of student enrollment
in health insurance programs; screening of students to identify the
need for physical, mental health, and oral health services; referral
and linkage to services not offered onsite; public health and disease
surveillance; and emergency response procedures. A school health
center may receive grant funding pursuant to this section if the
school or school district local educational
agency does not employ a school nurse. However, it is not the
intent of the Legislature that a school health center serve as a
substitute for a school nurse employed by a local school or
school district. educational agency.
(4)
(6) Have a written contract or memorandum of
understanding between the school district
local educational agency and the health care provider or any
other community providers that ensures coordination of services,
ensures confidentiality and privacy of health information consistent
with applicable federal and state laws, and integration of services
into the school environment.
(5)
(7) Serve all registered students in the school
regardless of ability to pay.
(6)
(8) Be open during all normal school hours, or on a
more limited basis if resources are not available, or on a more
expansive basis if dictated by community needs and resources are
available.
(7)
(9) Establish protocols for referring students to
outside services when the school health center is closed.
(8)
(10) Facilitate transportation between the school and
the health center if the health center is not located on
school or school district local educational agency
property.
(b) Planning grants shall be available in amounts between
twenty-five thousand dollars ($25,000) and fifty thousand dollars
($50,000) for a 6- to 12-month period to be used for the costs
associated with assessing the need for a school health center in a
particular community or area, and developing the partnerships
necessary for the operation of a school health center in that
community or area. Applicants for planning grants shall be required
to have a letter of interest from a school or district
local educational agency if the applicant is not
a local education educational agency.
Grantees provided funding pursuant to this subdivision shall be
required to do all of the following:
(1) Seek input from students, parents, school nurses, school staff
and administration, local health providers,
and providers and, if applicable,
special population groups, groups on
community health needs, barriers to health care
care, and the need for a school health center.
(2) Collect data on the school and community to estimate the
percentage of students that lack health insurance and the percentage
that are eligible for Medi-Cal benefits, or other public programs
providing free or low-cost health services.
(3) Assess capacity and interest among health care providers in
the community to provide services in a school health center.
(4) Assess the need for specific cultural or linguistic services
or both.
(c) Facilities and startup grants shall be available in amounts
between twenty thousand dollars ($20,000) and two hundred fifty
thousand dollars ($250,000) per year for a three-year period for the
purpose of establishing a school health center, with the potential
addition of one hundred thousand dollars ($100,000) in the first year
for facilities construction, purchase, or renovation. Grant funds
may be used to cover a portion or all of the costs associated with
designing, retrofitting, renovating, constructing, or buying a
facility, for medical equipment and supplies for a school health
center, or for personnel costs at a school health center. Preference
will be given to proposals that include a plan for cost sharing among
schools, health providers, and community organizations for
facilities construction and renovation costs. Applicants for
facilities and startup grants offered pursuant to this subdivision
shall be required to meet the following criteria:
(1) Have completed a community assessment determining the need for
a school health center.
(2) Have a contract or memorandum of understanding between the
school district local educational agency
and the health care provider, if other than the
district, local educational agency, and any
other provider agencies describing the relationship between the
district local educational agency and
the school health center.
(3) Have a mechanism, described in writing, to coordinate services
to individual students among school and school health center staff
while maintaining confidentiality and privacy of health information
consistent with applicable state and federal laws.
(4) Have a written description of how the school health center
will participate in the following:
(A) School and districtwide health promotion, coordinated school
health, health education in the classroom or on campus,
program/activities that address nutrition, fitness, or other
important public health issues, or promotion of policies that create
a healthy school environment.
(B) Outreach and enrollment of students in health insurance
programs.
(C) Public health prevention, surveillance, and emergency response
for the school population.
(5) Have the ability to provide the linguistic or cultural
services needed by the community. If the school health center is not
yet able to provide these services due to resource limitations, the
school health center shall engage in an ongoing assessment of its
capacity to provide these services.
(6) Have a plan for maximizing available third-party reimbursement
revenue streams.
(d) Sustainability grants shall be available on a one-time
basis in amounts between twenty-five
fifty thousand dollars ($25,000)
($50,000) and one hundred twenty-five
thousand dollars ($125,000) per year
($100,000) for a three-year period for the
purpose of operating a
developing new and leveraging existing funding streams to support
a sustainable funding model for school health
center, or enhancing programming at a fully operational
school health center, including oral health or mental health
services. centers. Examples of existing funding
streams include local educational agency funds available under the
local control funding formula, the federal Patient Protection and
Affordable Care Act (Public Law 111-148), or the Mental Health
Services Act. Applicants for sustainability grants offered
pursuant to this subdivision shall be required to meet all of the
criteria described in subdivision (c), in addition to both of the
following criteria:
(1) The applicant shall be eligible to become or already be an
approved Medi-Cal provider.
(2) The applicant shall have the ability and procedures
in place for billing public insurance programs and managed care
providers.
(3) The applicant shall seek reimbursement and have procedures in
place for billing public and private insurance that covers students
at the school health center.
(e) Population health grants shall be available in amounts between
fifty thousand dollars ($50,000) and one hundred twenty-five
thousand dollars ($125,000) for a funding period of up to three years
to fund interventions to implement population health outcomes and
target specific health or education risk factors including, but not
limited to, obesity prevention programs, asthma prevention programs,
early intervention for mental health, and alcohol and substance abuse
prevention. Applicants for population health grants offered pursuant
to this subdivision shall be required to meet all of the criteria
described in subdivision (c).
(e)
(f) The department shall award technical assistance
grants through a competitive bidding process to qualified contractors
to support grantees receiving grants under subdivisions (b), (c),
(d), and (d). (e). A
qualified contractor means a vendor with demonstrated capacity in all
aspects of planning, facilities development, startup, and operation
of a school health center.
(f)
(g) The department shall also develop a request for
proposal (RFP) process for collecting information on applicants, and
determining which proposals shall receive grant funding. The
department shall give preference for grant funding to the following
schools:
(1) Schools in areas designated as federally medically underserved
areas or in areas with medically underserved populations.
(2) Schools with a high percentage of low-income and uninsured
children and youth.
(3) Schools with large numbers of limited English proficient (LEP)
students.
(4) Schools in areas with a shortage of health professionals.
(5) Low-performing schools with Academic Performance Index (API)
rankings in the deciles of three and below of the state.
(g)
(h) Moneys shall be allocated to the department
annually for evaluation to be conducted by an outside evaluator that
is selected through a competitive bidding process. The evaluation
shall document the number of grantees that establish and sustain
school health centers, centers and
describe the challenges and lessons learned in creating successful
school health centers. The evaluator shall use data collected
pursuant to Section 124174.3, if it is available, and work in
collaboration with the Public School
School-Based Health Center Support and
Education Partnership Program. The department shall post the
evaluation on its Internet Web site.
(h)
(i) This section shall be implemented only to the
extent that funds are appropriated to the department in the annual
Budget Act or other statute for implementation of this article.
SEC. 4. Section 1 of Chapter 381 of the Statutes of 2008 is
amended to read:
SECTION Section 1. The Legislature
finds and declares all of the following:
(a) (1) School health centers provide quality, age and
developmentally appropriate primary health care and other support
services on or near a public school campus.
(2) School health centers are primarily located in areas where
children are underserved, lack health insurance, and face significant
barriers to care.
(3) School health centers provide an optimal setting to promote
healthy lifestyles such as good nutrition and fitness and provide
preventive health care services such as obesity prevention to
children and families.
(4) School health centers increase access to care, reduce health
disparities and provide potential savings through better preventive
care and reduced emergency department utilization, drug utilization,
and inpatient treatment services.
(5) Children do better in school if they are healthy and have
received all of their immunizations and preventive annual exams.
(6) School health centers can be integral to providing the entire
school community with prevention and health integration services by
working collaboratively with school staff and administrators to meet
the spectrum of health and prevention needs in a school community.
(6)
( 7) School health centers have proven to be
particularly important to the Latino population, with recent
estimates showing that approximately 49 percent of youth served at
high school health centers and 66 percent of children served at
elementary school health centers, are Latino.
(7)
( 8) School health centers support
educational achievement, help increase attendance rates, and allow
educational resources to be more effectively targeted toward
learning.
(8)
(9) The Governor has determined that there is
a need to expand the number of sites of federal
Patient Protection and Affordable Care Act (Public Law 111-148)
contains provisions that rec ognize the importance of
school health centers as discussed in his White Paper
on School-Based Health Centers released in July 2006.
in the delivery of quality, affordable health care and that would
call for their expansion. Under the health care reform, California is
developing new strategies to increase access to health care and
reduce health care costs through investing in prevention services.
School health centers are important sites through which to increase
child and adolescent access to health care services and
early identification of chronic diseases, such as asthma or obesity,
and high-risk behaviors, such as mental health disorders,
substance abuse, and teen pregnancy, that significantly impact health
care costs later in life.
(10) Additionally, through education
finance reform, California has increased accountability strategies
for local educational agencies that highlight the need for schools to
address important health-related indicators, such as chronic
absenteeism .
(11) School-based health centers serve
as an effective foundation upon which schools and communities can
build and implement a community schools strategy providing a range of
wrap-around services to students and their families
.
(b) It is the intent of the Legislature to support existing school
health centers and expand the number of health centers in
California, California and that funds should be
placed within the Public School Health Center Support
School-Based Health and Education Partnership
Program, as defined under Article 10 (commencing with Section 124174)
of Chapter 3 of Part 2 of Division 106 of the Health and Safety
Code.