Amended in Assembly March 19, 2013

California Legislature—2013–14 Regular Session

Assembly BillNo. 174

Introduced by Assembly Member Bonta

January 24, 2013

An actbegin insert to add Section 124174.7 to the Health and Safety Code,end insert relating tobegin delete weaponsend deletebegin insert public healthend insert.


AB 174, as amended, Bonta. begin deleteWeapons: grandfather clauses. end deletebegin insertPublic school health centers.end insert

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Existing law establishes the Public School Health Center Support Program, pursuant to which the State Department of Public Health, in collaboration with the State Department of Education, provides, among other duties, 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 and provides technical assistance to facilitate and encourage the establishment, retention, or expansion of school health centers, among other duties.

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This bill would require the State Department of Public Health to establish a grant program within the Public School Health Center Support Program that would be known as Promoting Resilience: Offering Mental Health Interventions to Support Education (PROMISE). The program would provide resources to eligible applicants, including local education agencies, nonprofit organizations, and community health centers, to fund activities and services to directly address the mental health and related needs of students who are impacted by trauma, as specified. The bill would require the department to implement these provisions only to the extent that funding is made available, upon appropriation by the Legislature, for these purposes from public and private sources, as specified. The bill would also include legislative findings and declarations.

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Existing law prohibits the possession of various weapons. Under existing law, certain of these bans exempted from their scope weapons that were possessed prior to the ban, if prescribed conditions met, are authorized.

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This bill would declare the intent of the Legislature to subsequently amend this bill to include provisions that would end all of those exemptions.

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Vote: majority. Appropriation: no. Fiscal committee: begin deleteno end deletebegin insertyesend insert. State-mandated local program: no.

The people of the State of California do enact as follows:

P2    1begin insert

begin insertSECTION 1.end insert  

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(a) Trauma has serious short- and long-term
2consequences for health, educational achievement, and well-being.
3Trauma has been defined as experiences or situations that are
4emotionally painful and distressing, and that overwhelm an
5individual’s ability to cope, and as chronic adversity, including,
6but not limited to, discrimination, racism, oppression, and poverty.

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7(b) Children and youth who are neglected or abused, or who
8feel unsafe in their homes, schools, or communities, experience
9trauma that can have lasting negative impacts.

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10(c) Children and youth in low-income neighborhoods are
11disproportionately impacted by trauma, including, but not limited
12to, violence. For example, 20 percent of California children with
13family incomes below $25,000 feel somewhat unsafe or very unsafe
14in their neighborhoods, versus just 2 percent of California children
15with family incomes above $125,000.

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16(d) Children and youth of color are disproportionately impacted
17by violence. Compared to Caucasians, African American children
18and youth are three times more likely, and Latino children and
19youth are two times more likely, to be exposed to shootings, bombs,
20and riots.

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21(e) Boys and young men of color are particularly likely to be
22impacted by trauma. For example, compared to rates among
23Caucasians, boys and young men of color have more than twice
24the risk of witnessing domestic violence, being abused and
P3    1neglected, or having an incarcerated parent. Homicide is the
2leading cause of death among male African American adolescents,
3occurring at a rate 15 times greater than among Caucasians.

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4(f) The likelihood of boys and young men suffering from
5post-traumatic stress disorder is two and one-half times greater
6among African American boys and young men and four and
7one-tenth times greater among Latino boys and young men, as
8compared to among Caucasians.

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9(g) Mental health services can have a positive and significant
10impact on life outcomes for children and adolescents impacted by

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12(h) However, of the almost 13 percent of adolescents who report
13needing help for emotional or mental health problems, over 60
14percent do not receive counseling. Among adolescents living below
15 the poverty line, 92 percent of those who report needing help for
16emotional or mental health problems did not receive counseling
17in the past year. The percentage of adolescents who report needing
18help for emotional or mental health problems is widely assumed
19to be less than the percentage who would benefit from these

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21(i) Adolescents are less likely than almost all other age groups
22to have a usual source of health care. Male adolescents, and
23particularly male adolescents of color, are even less likely to have
24a usual place to go when they are sick or need health advice.

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25(j) California’s 200 school health centers are predominantly
26located in low-income communities, where students are
27disproportionately impacted by trauma. For example, 80 percent
28of school health center clients seen in the County of Alameda in
29the 2010-11 school year had witnessed violence or been a victim
30 of violence during their lifetime.

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31(k) Among adolescents in managed care plans, those with access
32to a school health center are 10 times more likely to access mental
33health or substance abuse services than those without access to a
34school health center.

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35(l) School health centers see higher proportions of adolescent
36males than other care settings, including community clinics or
37private practices.

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38(m) Research shows that students receiving mental health
39services at school health centers have significant improvements
40in their presenting problems and that school-based mental health
P4    1services can be more efficacious than those provided in community

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3(n) School-based mental health programs focused specifically
4on trauma have been shown to reduce post-traumatic stress
5disorder, depression, and psychosocial dysfunction.

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6(o) Schools and school health centers do not currently have
7access to sufficient funding to reach more than a fraction of the
8students impacted by trauma and who would benefit from mental
9health services. The many barriers to securing sufficient funding
10include, but are not limited to, high proportions of uninsured
11students and restrictions on the services that are reimbursable
12through programs such as the California Victim Compensation
13Program (CalVCP) and Medi-Cal.

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14(p) The Early and Periodic Screening, Diagnosis and Treatment
15(EPSDT) Program, a Medi-Cal program that is a major source
16of funding for school-based mental health services, excludes many
17of the young people who need its services. Barriers include, but
18are not limited to, Medi-Cal eligibility, low provider participation,
19restrictive diagnostic and medical necessity criteria, and the
20requirement that a parent or guardian consent for services.

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begin insertSEC. 2.end insert  

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begin insertSection 124174.7 is added to the end insertbegin insertHealth and Safety
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begin insert124174.7.end insert  

(a) The State Department of Public Health shall
24establish a grant program within the Public School Health Center
25Support Program to fund activities and services to directly address
26the mental health and related needs of students who are impacted
27by trauma. This grant program shall be named Promoting
28Resilience: Offering Mental Health Interventions to Support
29Education (PROMISE).

30(b) Grant funds shall be used according to the following

32(1) Grant funds shall be used by eligible applicants to directly
33address the mental health and related needs of students who are
34impacted by trauma.

35(2) Grant funds may be used for the following activities and

37(A) Individual, family, and group counseling.

38(B) Targeted outreach and education.

39(C) Risk screening, triage, and referral to campus-based

P5    1(D) Schoolwide violence prevention and response efforts.

2(E) Youth development programming related to trauma and

4(F) Crisis response coordination and services.

5(G) Case management services.

6(H) Coordination with off-campus mental health and support

8(I) Staff training and consultation on supporting students’
9trauma-related needs.

10(J) Oversight, coordination, and evaluation of the above
11activities and services.

12(3) Individual, family, and group counseling funded by a grant
13awarded pursuant to this section may be provided by any of the

15(A) A mental health clinician licensed by the Board of
16Behavioral Sciences, including a licensed marriage and family
17therapist, a licensed clinical social worker, or a licensed
18educational psychologist.

19(B) A clinical psychologist licensed by the Board of Psychology.

20(C) A psychiatric nurse practitioner licensed by the Board of
21 Registered Nursing.

22(D) A psychiatrist licensed by the Medical Board of California.

23(E) A school social worker credentialed by the State of

25(F) An unlicensed mental health professional who is registered
26by either the Board of Behavioral Sciences or the Board of
27Psychology, and who is receiving clinical supervision as prescribed
28by that entity.

29(4) Other activities and services, including schoolwide violence
30prevention efforts, shall be provided or overseen by a mental health
31professional as described in subparagraphs (A) through (F),
32inclusive, of paragraph (3).

33(c) Grant funds shall be awarded according to the following

35(1) Eligible applicants shall include:

36(A) Local education agencies.

37(B) Nonprofit organizations.

38(C) Community health centers.

39(D) County mental health departments.

40(2) Grant applications shall comply with all of the following:

P6    1(A) Applicants shall describe their program to address the
2mental health and other related needs of students who are impacted
3by trauma, and to foster a positive school climate. At a minimum,
4the program described in the application shall include:

5(i) Individual, family, and group counseling.

6(ii) Youth development programming related to trauma and

8(iii) Schoolwide violence prevention and response efforts,
9including, at a minimum, training for staff on trauma and their
10roles in preventing and responding to it.

11(iv) Coordination between school-based and community

13(v) A discussion of any components of the program for which
14funding does not yet exist or is currently insufficient and for which
15they are seeking grant funding.

16(B) Demonstrate the applicant’s ability to provide a dedicated
17space located on the school campus that will serve as the hub of
18the program, that will be youth friendly, and, for middle and high
19schools, that will be regularly accessible to students on a drop-in

21(C) Provide evidence of a strong partnership and commitment
22to collaboration between the school and any agencies or
23organizations that will provide mental health, medical, or other
24related services on the school campus, whether funded by this
25grant or another funding source. Specific mechanisms by which
26applicants shall provide this evidence shall be detailed in the
27request for applications, but may include letters of agreement or
28support, memoranda of understanding, or draft, signed

30(3) Priority for awarding a grant shall be given to eligible
31applicants that demonstrate all of the following:

32(A) High levels of exposure to trauma and violence among the
33target population.

34(B) Limited access to mental health services among the target

36(C) An ability to meet the cultural and linguistic needs of the
37target population.

38(D) An ability to engage and serve subgroups of students within
39the target population who are disproportionately impacted by
40trauma and violence.

P7    1(E) A plan to hire staff with similar backgrounds and
2experiences to the target population and who can therefore
3enhance program impact.

4(F) A plan to obtain additional sources of funding or third-party
5reimbursement to create a robust and sustainable school-based
6mental health program.

7(G) A plan to integrate mental health and related services with
8primary medical care.

9(d) An eligible applicant that receives grant funds shall commit
10to all of the following:

11(1) Establish a written memorandum of understanding (MOU)
12between the school, the school district, and other agencies or
13organizations providing grant-funded mental health, medical, or
14other related services, in an effort to develop a strong collaborative
15partnership between involved entities.

16(A) The collaborative partnership shall do all of the following:

17(i) Include local education agency-employed personnel,
18including school administrators, teachers, and staff, and any school
19health personnel, including school nurses or social workers.

20(ii) Include personnel employed by other agencies or
21 organizations, including community health centers, who provide
22relevant services on campus.

23(iii) Establish and implement regular communication protocols
24between the school and agencies or organizations.

25(iv) Engage all relevant personnel in identifying students who
26would benefit from mental health or other related services and
27linking them to those services.

28(v) Promote the integration of funded services into the overall
29school environment.

30(B) The MOU shall do both of the following:

31(i) Describe how services are coordinated on the campus and
32how services will be integrated into the overall school environment.

33(ii) Ensure the confidentiality and privacy of both education
34and health information, consistent with applicable federal and
35state laws.

36(2) Make services available to all students in the school,
37regardless of ability to pay.

38(3) Submit an annual report, including a discussion of all of the

40(A) The activities and services funded through the grant award.

P8    1(B) The number of students served through specific activities
2and services.

3(C) The roles and credentials of personnel funded through the
4grant award.

5(D) Any additional funding sources that are available to enhance
6or sustain activities and services. To the extent possible, grant
7reporting requirements shall be consistent with those required by
8other funding mechanisms that support the program.

9(e) The department shall implement this section only to the
10extent that funding is made available, upon appropriation by the
11Legislature, from the following sources:

12(1) From funding made available through public sources, to
13the extent permitted by law, including, but not limited to, the Early
14and Periodic Screening, Diagnosis, and Treatment Program and
15local education agency Medi-Cal billing.

16(2) From private resources, including in-kind assistance, federal
17funding, and foundation support for the operation and distribution
18of grants for this program.

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Under current law, certain banned weapons are
20permitted under various “grandfathering in” clauses. It is the intent
21of the Legislature to subsequently amend this measure to include
22provisions that would end all of those exemptions.

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