BILL NUMBER: SB 1239 AMENDED
BILL TEXT
AMENDED IN SENATE APRIL 1, 2014
INTRODUCED BY Senator Wolk
FEBRUARY 20, 2014
An act to amend Section 49427 of the Education Code,
relating to pupil health. An act to add Section 49428
to the Education Code, to add Section 1371.34 to the Health and
Safety Code, and to add Section 10133.68 to the Insurance Code,
relating to pupil health care services.
LEGISLATIVE COUNSEL'S DIGEST
SB 1239, as amended, Wolk. Pupil health: school health
services. Pupil health care services: school nurses.
(1) Existing law requires the governing board of a school district
to give diligent care to the health and physical development of
pupils, and authorizes the governing board of a school district to
employ properly certified persons for the work. Existing law
authorizes a school nurse, subject to approval by the governing board
of the school district, to perform various pupil health services,
including, among others, evaluating the health and developmental
status of pupils, and designing and implementing health maintenance
plans to meet the individual health needs of pupils.
This bill, on and after July 1, 2016, would require the governing
board of a school district that is eligible for concentration funding
pursuant to the provisions of the local control funding formula to
employ at least one school nurse as a supervisor of health, and would
require a supervisor of health to supervise other school nurses,
registered nurses, or other licensed vocational nurses employed by a
school district and, if applicable, a nurse of a county office of
education under contract, as provided. The bill would require the
governing board of a school district to consider specified factors in
determining the number of nurses to be supervised by the supervisor
of health, including, among others, the acuity of pupil health care
needs. Because the bill would require school districts to perform new
duties, the bill would impose a state-mandated local program.
(2) Existing law, the Knox-Keene Health Care Service Plan Act of
1975, provides for the licensure and regulation of health care
service plans by the Department of Managed Health Care and makes a
willful violation of the act a crime. Existing law also provides for
the regulation of health insurers by the Department of Insurance.
Existing law provides for the reimbursement of claims and the
resolution of claim and coverage disputes, as specified. Existing law
requires a health care service plan to reimburse providers for
emergency services and care provided to its enrollees until the care
results in stabilization of the enrollee and also requires group
plans to authorize and permit assignment of the enrollee's right to
reimbursement for covered health care services to the State
Department of Health Care Services when services are provided to a
Medi-Cal beneficiary. Existing law provides for the direct payment of
group insurance medical benefits by a health insurer to the person
or persons furnishing or paying for hospitalization or medical or
surgical aid or, in the case of a Medi-Cal beneficiary, to the State
Department of Health Care Services, as specified. Existing law
provides that specified services provided by a local educational
agency are covered Medi-Cal benefits and authorizes providers to bill
for those services.
This bill would require a health care service plan or health
insurer to reimburse a school district for the health care services
provided by a school nurse, registered nurse, or licensed vocational
nurse employed by, or under contract with, a school district to an
enrollee or insured that would otherwise be covered by the enrollee's
plan contract or the insured's health insurance policy and would
authorize the school district to submit a claim to a health care
service plan or health insurer for reimbursement of the cost of those
services. Because a willful violation of the bill's requirements
with respect to health care service plans would be a crime, the bill
would impose a state-mandated local program.
(3) The California Constitution requires the state to reimburse
local agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
This bill would provide that with regard to certain mandates no
reimbursement is required by this act for a specified reason.
With regard to any other mandates, this bill would provide that,
if the Commission on State Mandates determines that the bill contains
costs so mandated by the state, reimbursement for those costs shall
be made pursuant to the statutory provisions noted above.
Existing law establishes criteria for employment of school medical
personnel, and declares the intent of the Legislature that
fundamental school health services be maintained, by the governing
board of each school district and each county superintendent of
schools, at a level that is adequate to accomplish specified goals,
including, among others, fulfilling existing state requirements and
policies regarding pupil health.
This bill would make a nonsubstantive change to these provisions.
Vote: majority. Appropriation: no. Fiscal committee: no
yes . State-mandated local program: no
yes .
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. (a) The
Legislature finds and declares both of the following:
(1) The health needs of pupils are not being adequately met in
California's schools due to a lack of qualified health professionals
employed by school districts who have access to local school
campuses.
(2) Nurses are uniquely qualified to attend to the primary care of
pupils suffering from chronic and acute health conditions.
(b) It is therefore the intent of the Legislature in enacting this
act to ensure that a school district that is eligible for
concentration funding under the local control funding formula employ
at least one school nurse, in accordance with standards accepted by
national professional nursing organizations.
SEC. 2. Section 49428 is added to the
Education Code , to read:
49428. (a) The governing board of a school district that is
eligible to receive concentration funding under the local control
funding formula pursuant to subdivision (f) of Section 42238.02 shall
employ at least one school nurse as a supervisor of health. The
supervisor of health shall supervise other school nurses, registered
nurses, or licensed vocational nurses employed by the school district
and, if applicable, a school nurse of a county office of education
under contract pursuant to subdivision (d).
(b) The governing board of a school district shall consider the
following factors in determining the number of nurses to be
supervised by the supervisor of health:
(1) The acuity of pupil health care needs.
(2) The distance and travel time between schools under the
supervision of the school nurse.
(3) The total healthy pupil population at each schoolsite.
(c) A registered nurse or licensed vocational nurse shall provide
health care services to pupils under the supervision of a school
nurse.
(d) A school district may contract with a county office of
education for the services of a school nurse employed by the county
office of education.
(e) This section shall not apply to schools served by a school
health center, as defined in Section 124174 of the Health and Safety
Code. However, the Legislature encourages schools with a school
health center to also employ a school nurse.
(f) For purposes of this section, the following definitions apply:
(1) "Licensed vocational nurse" means a licensed vocational nurse
licensed under Chapter 6.5 (commencing with Section 2840) of Division
2 of the Business and Professions Code.
(2) "Registered nurse" means a registered nurse licensed under
Chapter 6 (commencing with Section 2700) of Division 2 of the
Business and Professions Code.
(3) "School nurse" has the same meaning as set forth in Section
49426.
(g) This section shall be operative on July 1, 2016.
SEC. 3. Section 1371.34 is added to the
Health and Safety Code , to read:
1371.34. A health care service plan shall reimburse a school
district for the health care services provided by a school nurse,
registered nurse, or licensed vocational nurse employed by, or under
contract with, a school district, pursuant to Section 49428 of the
Education Code, to an enrollee of the plan that would otherwise be
covered by the enrollee's plan contract. The school district may
submit a claim to a health care service plan for reimbursement of the
services described in this section. The enrollee shall not be
responsible for any share of the cost of providing the services
described in this section.
SEC. 4. Section 10133.68 is added to the
Insurance Code , to read:
10133.68. A health insurer shall reimburse a school district for
the health care services provided by a school nurse, registered
nurse, or licensed vocational nurse employed by, or under contract
with, a school district, pursuant to Section 49428 of the Education
Code, to an insured of the insurer that would otherwise be covered by
the insured's policy of health insurance. The school district may
submit a claim to a health insurer for reimbursement of the services
described in this section. The insured shall not be responsible for
any share of the cost of providing the services described in this
section.
SEC. 5. No reimbursement is required by this act
pursuant to Section 6 of Article XIII B of the California
Constitution for certain costs that may be incurred by a local agency
or school district because, in that regard, this act creates a new
crime or infraction, eliminates a crime or infraction, or changes the
penalty for a crime or infraction, within the meaning of Section
17556 of the Government Code, or changes the definition of a crime
within the meaning of Section 6 of Article XIII B of the California
Constitution.
However, if the Commission on State Mandates determines that this
act contains other costs mandated by the state, reimbursement to
local agencies and school districts for those costs shall be made
pursuant to Part 7 (commencing with Section 17500) of Division 4 of
Title 2 of the Government Code.
SECTION 1. Section 49427 of the Education Code
is amended to read:
49427. (a) It is the intent of the Legislature that the governing
board of each school district and each county superintendent of
schools maintain fundamental school health services at a level that
is adequate to accomplish all of the following:
(1) Preserve pupils' ability to learn.
(2) Fulfill existing state requirements and policies regarding
pupil health.
(3) Contain health care costs through preventive programs and
education.
(b) The Legislature finds and declares that the provision of these
services may be in jeopardy due to the current caseloads in the
public schools, and that failure to maintain adequate health services
and standards will result in pupils' poorer health and ability to
learn.