BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | AB 174|
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THIRD READING
Bill No: AB 174
Author: Bonta (D)
Amended: 9/3/13 in Senate
Vote: 21
SENATE HEALTH COMMITTEE : 7-2, 7/3/13
AYES: Hernandez, Beall, De León, DeSaulnier, Monning, Pavley,
Wolk
NOES: Anderson, Nielsen
SENATE APPROPRIATIONS COMMITTEE : 6-1, 8/30/13
AYES: De León, Gaines, Hill, Lara, Padilla, Steinberg
NOES: Walters
ASSEMBLY FLOOR : 52-24, 5/29/13 - See last page for vote
SUBJECT : Public school health centers
SOURCE : California Pan-Ethnic Health Network
California School Health Centers Association
DIGEST : This bill requires the Department of Public Health
(DPH) to establish a pilot grant program in Alameda County, to
the extent that funding is made available, to provide resources
to eligible applicants for activities and services that directly
address the mental health and related needs of students impacted
by trauma.
ANALYSIS :
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Existing law:
1.Requires DPH to establish the Public School Health Center
Support Program (PSHCSP), in collaboration with the Department
of Education, to perform specified functions relating to the
establishment, retention, or expansion of school health
centers (SHCs) in California.
2.Establishes a grant program administered by the PSHCSP to
provide technical assistance and funding to SHCs, to the
extent funds are appropriated for implementation of the
PSHCSP. To date, this grant program has not been funded.
3.Defines a SHC, for purposes of the PSHCSP, as 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:
1. Requires DPH to establish a pilot grant program within
PSHCSP to fund activities and services to directly address
the mental health and related needs of students who are
impacted by trauma.
2. Defines "trauma" or "trauma exposure" as experiencing or
being witness to community violence, terrorism, disaster,
sexual abuse, or other violent acts. Specifies that the
effects of trauma or trauma exposure include emotional,
cognitive, physical, or interpersonal reactions as a result
of the event witnessed or experienced.
3. Names the grant program Promoting Resilience: Offering
Mental Health Interventions to Support Education (PROMISE).
4. Requires DPH to establish the pilot grant program in the
County of Alameda in up to 10 facilities that meet specified
requirements.
5. Requires the pilot grant program to operate for the 2015-16
school year.
6. Requires DPH, within 60 days following completion of the
program, to review and compile the results of the summary
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reports prepared by participating facilities and submit that
information to the appropriate policy and fiscal committees
of the Legislature.
7. Requires grant funds to be used by eligible applicants to
directly address the mental health and related needs of
students who are impacted by trauma.
8. Authorizes grant funds to be used for the following
activities and services, including but not limited to:
A. Individual, family, and group counseling;
B. Targeted outreach and education; school-wide violence
prevention and response efforts;
C. Youth development programming related to trauma and
violence; and,
D. Staff training and consultation on supporting students'
trauma-related needs.
1. Authorizes the individual, family, and group counseling in
#8A above to be provided by specified mental health
professionals licensed by: the Board of Behavioral Sciences
(BBS), the Board of Psychology (BOP); the Board of Registered
Nursing; or, the Medical Board of California. Also
authorizes a school social worker credentialed by the State
of California; and, an unlicensed mental health professional
who is registered by either the BBS or BOP, and who is
receiving clinical supervision as prescribed by that entity.
2. Requires that other activities and services, including
school-wide violence prevention efforts, to be provided or
overseen by a mental health professional as described in #9
above.
3. Authorizes grant funds to be used to provide referrals to
evidence-based mental health treatment services in the
community.
4. Requires eligible applicants for grant funds to include
local education agencies, nonprofit organizations, community
health centers, and the county mental health department.
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5. Requires applicants to comply with a number of specified
program requirements in their grant applications to address
the mental health and other related needs of students who are
impacted by trauma, and to foster a positive school climate,
including, but not limited to:
A. Individual, family and group counseling;
B. Youth development programming related to trauma and
violence;
C. School-wide violence prevention and response efforts,
including, at a minimum, training for staff on trauma and
their roles in preventing and responding to it;
D. Coordination between school-based and community trauma;
a discussion of any components of the program for which
funding does not yet exist or is currently insufficient and
for which they are seeking grant funding;
E. Demonstration that applicant's ability to provide a
dedicated space located on the school campus that will
serve as the hub of the program that will be youth
friendly, and, for middle and high schools, that will be
regularly accessible to students on a drop-in basis; and,
F. Provide evidence of a strong partnership and commitment
to collaboration between the school and any agencies or
organizations that will provide mental health, medical, or
other related services on the school campus, whether funded
by this grant or another funding source.
1. Provides that priority for awarding a grant must be given to
eligible applicants that demonstrate one or more specified
factors as detailed in the request for applications.
2. Requires eligible applicants that receive grant funds to
commit to all of the following:
A. Establish a written memorandum of understanding, as
specified, between the school, the school district, and
other agencies or organizations providing grant-funded
mental health, medical, or other related services, in an
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effort to develop a strong collaborative partnership, as
specified, between involved entities;
B. Make services available to all students in the school,
regardless of ability to pay; and
C. Submit an annual report to DPH, within 30 days following
the completion of the program that contains specified
information.
1. Directs DPH to implement this bill only to the extent that
funding is made available from nonstate resources, including
federal funding, in-kind assistance, private funding,
foundation support for the operation and distribution of
grants for this program, and for administrative costs
incurred by DPH in implementing these provisions.
2. Establishes a sunset date of January 1, 2019.
Comments
Trauma . According to a 2009 study by United States Department of
Justice (DOJ), children's exposure to violence, whether as
victims or witnesses, is often associated with long-term
physical, psychological, and emotional harm and that children
exposed to violence are also at a higher risk of engaging in
criminal behavior later in life and becoming part of a cycle of
violence. According to the National Child Traumatic Stress
Network (Network), child trauma is a common problem both
domestically and internationally. Although some children are at
greater risk of being exposed to trauma than others, traumatic
events happen to children of all ages, from all socioeconomic
strata, racial and ethnic groups, and geographic regions in the
US. However, according to the Network, children and youth
living in low-income neighborhoods, as well as children and
youth of color, are disproportionately impacted by trauma.
SHCs . According to the National Assembly on School-Based Care,
SHCs provide a broad array of primary care and preventive
services, including comprehensive health assessments;
prescriptions for medications; treatment for acute illness;
asthma treatment; oral health education; and dental screenings.
Approximately 75% of SHCs also have mental health providers on
staff to offer mental health assessments, crisis intervention,
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brief and long term therapy, and, other services. SHCs are the
primary, and occasionally only, available health care for many
children and adolescents who otherwise would have no access.
According to background information provided by a cosponsor of
this bill, the California School Health Centers Association
(CSHCA), there are currently 200 SHCs in California. Forty-four
percent of SHCs are in high schools, 31% are in elementary
schools, 13% are in middle schools, and 12% are "school-linked"
or mobile medical vans. CSHCA points out that many SHCs are
located in schools serving some of the state's most vulnerable
children and on campuses with SHCs, about 70% of students
receive free or reduced price meals. Since 2012, CSHCA
estimates that 13,500 children have gained access to health care
in their school through the expansion of SHCs.
Alameda County . Alameda County is located in northern
California occupying the East Bay region of the San Francisco
Bay Area and its major cities include Oakland, Freemont,
Berkeley and Hayward. According to the California DOJ, Alameda
County has the second highest rate of violence per 100,000
people in the state next to San Joaquin County. According to a
recent CBS news report, Oakland has one of the top five highest
violent crime rates in the country. In 2011, Oakland averaged
three street shootings per day, some of which caused injury or
death to innocent bystanders. In addition to these conditions,
the author maintains that Alameda County was chosen because it
has the largest number of SHCs within a single county.
Twenty-two of the 200 SHCs located in California are located in
Alameda County.
Prior Legislation
AJR 10 (Brownley, Resolution Chapter 68, Statutes of 2011) urges
Congress to include an appropriation to fund SHCs in the
reauthorization of the federal Elementary and Secondary
Education Act.
SB 564 (Ridley-Thomas, Chapter 381, Statutes of 2008) provides a
definition of SHCs and requires DPH, to the extent funds are
appropriated for implementation of the PSHCSP, to establish a
grant program to provide technical assistance and funding for
the expansion, renovation, and retrofitting of existing SHCs and
the development of new SHCs, as specified.
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AB 2560 (Ridley-Thomas, Chapter 334, Statutes of 2006) requires
the Department of Health Services (DHS), now DPH, to establish
the PSHCSP.
SB 566 (Escutia, 1999) would have established the SHC Grant
Program, to be administered by DHS, to provide grants to
qualifying SHCs in order to assist the centers in providing
health services to students, provided that funds were
appropriated in the annual Budget Act. This bill also would
have required DHS to convene a study group to explore long-term
strategies to support SHCs and incorporate these centers into a
comprehensive and coordinated health care system. This bill was
moved to the inactive file on the Senate Floor.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: Yes
According to the Senate Appropriations Committee:
Unknown costs to provide grants (federal funds or private
funds). The bill specifies that the program would be
limited to a one-year pilot project in Alameda County at up
to ten facilities. However, the bill does not specify the
total amount of funding or the potential fund source.
Unknown costs to administer the program (federal funds or
private funds). Typically, the cost to administer a grant
program is about 5% of total grant spending.
SUPPORT : (Verified 8/30/13)
California Pan-Ethnic Health Network (co-sponsor)
California School Health Centers Association (co-sponsor)
AFSCME
Alameda County Board of Supervisors
Asian Health Services
Bienvenidos
California Academy of Family Physicians
California Alliance of Child and Family Services
California Black Health Network
California Immigrant Policy Center
California Latino School Boards Association
California Medical Association
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California Partnership to End Domestic Violence
California Primary Care Association
California School Board Association
California School Employees Association
California School Nurses Organization
California Parent Teachers Association
Catholic Charities of the East Bay
Children Now
Children's Defense Fund - California
Children's Hospital & Research Center Oakland
City of Oakland
Compton Unified School District
East Bay Agency for Children
Fight Crime: Invest in Kids California
Hundreds of Individuals
James Morehouse Project
Kaiser Permanente
Latino Coalition for a Healthy California
Lifelong Medical Care
Lincoln Child Center
Los Angeles Trust for Children's Health
Native American Health Center
Oakland Unified School District
Partnership for Children and Youth
PICO California
Policy Link
Street Level Health Project
The Children's Partnership
The Greenlining Institute
The Los Angeles County Education Foundation
United Way of the Bay Area
Urban Strategies Council
Youth ALIVE!
OPPOSITION : (Verified 8/30/13)
California Right to Life Committee, Inc.
ARGUMENTS IN SUPPORT : According to the author's office, all
forms of violence, including gun violence, have become a tragic
fact of life for children in districts throughout the state. In
particular, communities of color are disproportionately affected
by violence and exposure to trauma. The author argues there is
currently a lack of services to help students who have been
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exposed to trauma.
According to the author's office, this bill seeks to rectify
this problem through the creation of a pilot grant program to
support services to students suffering from trauma exposure,
including individual, group and family counseling; youth
development programming focused on preventing and addressing
violence; school-wide violence prevention programs; and support
for teachers and other staff in identifying and responding to
students' trauma-related needs. .
The California Pan-Ethnic Health Network, a co-sponsor of this
bill, writes in support that trauma has serious short and
long-term consequences for health, educational achievement, and
well-being. The California School Health Centers Association,
also a co-sponsor, writes that the PROMISE program has potential
to create a model that could be expanded in the future to the
rest of the state and result in significant costs savings for
California. Children Now, Latino Coalition for a Healthy
California, Los Angeles Trust for Children's Health, and a
number of other supporting organizations write that research
shows school-based mental health services are effective and can
reduce depression and post-traumatic stress syndrome.
ARGUMENTS IN OPPOSITION : The California Right to Life
Committee, Inc. opposes this bill because it expands school
health centers and the services they provide, which include
contraceptive services, abortion referrals or actual abortions
to minors without parental notifications or consent.
ASSEMBLY FLOOR : 52-24, 05/29/13
AYES: Alejo, Ammiano, Atkins, Bloom, Blumenfield, Bocanegra,
Bonilla, Bonta, Bradford, Brown, Buchanan, Ian Calderon,
Campos, Chau, Chesbro, Cooley, Daly, Dickinson, Fong, Fox,
Frazier, Garcia, Gatto, Gomez, Gonzalez, Gordon, Gray, Hall,
Roger Hernández, Jones-Sawyer, Levine, Lowenthal, Medina,
Mitchell, Mullin, Muratsuchi, Nazarian, Pan, Perea, V. Manuel
Pérez, Quirk, Quirk-Silva, Rendon, Salas, Skinner, Stone,
Ting, Weber, Wieckowski, Williams, Yamada, John A. Pérez
NOES: Achadjian, Allen, Bigelow, Chávez, Conway, Dahle,
Donnelly, Beth Gaines, Gorell, Grove, Hagman, Harkey, Jones,
Logue, Maienschein, Mansoor, Melendez, Morrell, Nestande,
Olsen, Patterson, Wagner, Waldron, Wilk
NO VOTE RECORDED: Eggman, Holden, Linder, Vacancy
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JL:nl 9/3/13 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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