BILL NUMBER: SB 564 CHAPTERED
BILL TEXT
CHAPTER 381
FILED WITH SECRETARY OF STATE SEPTEMBER 27, 2008
APPROVED BY GOVERNOR SEPTEMBER 27, 2008
PASSED THE SENATE AUGUST 29, 2008
PASSED THE ASSEMBLY AUGUST 22, 2008
AMENDED IN ASSEMBLY JULY 10, 2007
AMENDED IN ASSEMBLY JUNE 13, 2007
AMENDED IN SENATE MAY 2, 2007
AMENDED IN SENATE APRIL 17, 2007
AMENDED IN SENATE MARCH 29, 2007
INTRODUCED BY Senator Ridley-Thomas
(Principal coauthor: Assembly Member Hayashi)
(Coauthors: Senators Padilla and Torlakson)
FEBRUARY 22, 2007
An act to amend Sections 124174 and 124174.2 of, and to add
Section 124174.6 to, the Health and Safety Code, relating to child
health.
LEGISLATIVE COUNSEL'S DIGEST
SB 564, Ridley-Thomas. Public School Health Center Support
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 perform specified
functions relating to the establishment, retention, or expansion of
school health centers in California. Existing law, for purposes of
those provisions, defines a "school health center" to mean a center
or program that provides age-appropriate health care services at the
program site or through referrals, and may be located on or at a
local educational agency.
This bill would also specify that a "school health center" may
conduct routine physical health, mental health, and oral health
assessments, and provide for any services not offered onsite or
through a referral process.
The bill would require the State Department of Public Health, to
the extent funds are appropriated to the department for
implementation of the Public School Health Center Support Program, to
establish a grant 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, in accordance with specified procedures.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
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 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) School health centers support educational achievement, help
increase attendance rates, and allow educational resources to be more
effectively targeted toward learning.
(8) The Governor has determined that there is a need to expand the
number of sites of school health centers as discussed in his White
Paper on School-Based Health Centers released in July 2006.
(b) It is the intent of the Legislature to support existing school
health centers and expand the number of health centers in
California, and that funds should be placed within the Public School
Health Center Support 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.
SEC. 2. 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 Health Center Support 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. 3. 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 Health
Center Support 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, or any other applicable program.
(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 State Department of Mental Health, the
State Department of Alcohol and Drug Programs, the Department of
Managed Health Care, the Office of Emergency Services, and the
Managed Risk Medical Insurance Board.
(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 Health
Centers Association and representatives of youth and parents, in
carrying out its responsibilities under this article.
SEC. 4. Section 124174.6 is added to the Health and Safety Code,
to read:
124174.6. The department shall establish 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, 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, 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,
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) Work in partnership with the school nurse, if one is employed
by the school or school district, 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 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.
(4) Have a written contract or memorandum of understanding between
the school district 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) Serve all registered students in the school regardless of
ability to pay.
(6) 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) Establish protocols for referring students to outside services
when the school health center is closed.
(8) Facilitate transportation between the school and the health
center if the health center is not located on school or school
district 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 if the
applicant is not a local education 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 if applicable,
special population groups, on community health needs, barriers to
health 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 and the health care provider, if other than the
district, and any other provider agencies describing the relationship
between the district 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 in amounts between
twenty-five thousand dollars ($25,000) and one hundred twenty-five
thousand dollars ($125,000) per year for a three-year period for the
purpose of operating a school health center, or enhancing programming
at a fully operational school health center, including oral health
or mental health services. 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 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) The department shall award technical assistance grants through
a competitive bidding process to qualified contractors to support
grantees receiving grants under subdivisions (b), (c), and (d). 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) 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) 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, 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 Health Center Support
Program. The department shall post the evaluation on its Internet Web
site.
(h) 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.