BILL NUMBER: SB 1055 INTRODUCED
BILL TEXT
INTRODUCED BY Senator Liu
FEBRUARY 18, 2014
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 1055, as introduced, Liu. 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 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 Health Center Support
Program. the School-Based Health 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
Health Center Support Program. the School-Based Health
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 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
Health Centers Association School-Based Health
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 Health Center Support Program
School-Based Health and Education Partnership Program to
provide technical assistance, and funding for the expansion
, and 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) 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, 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)
(6) 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)
(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 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 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 for a three-year period
($100,000) 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. developing new and
leveraging existing funding streams to support a sustainable funding
model for school health centers. Examples of existing funding streams
include school district funds available under the Local Control
Funding Formula, federal Patient Protection and Affordable Care Act,
or 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 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), 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)
(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, 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 School-Based Health 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 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) 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.
(9) The federal Patient Protection and Affordable Care Act
contains provisions that recognize the importance of school health
centers 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 and obesity,
and high-risk health 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 school districts 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, and that funds should be placed within the
Public School Health Center Support Program
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.