Amended in Assembly April 27, 2015

California Legislature—2015–16 Regular Session

Assembly Bill No. 766

Introduced by Assembly Member Ridley-Thomas

February 25, 2015

An act to amend Section 124174.6 of the Health and Safety Code, relating to child health.

LEGISLATIVE COUNSEL’S DIGEST

AB 766, as amended, 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 located at or near a local educational agency that provides age-appropriate health care services at the program site or through referrals, and may conduct routine physical health, mental health, and oral health assessments. Existing law requires the State Department of Public Health, to the extent funds are appropriated to the department, 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. Existing law requires the department to develop a request for proposal (RFP) process for collecting information on applicants, and determining which proposals shall receive grant funding, giving preference for grant funding to schools in areas designated as federally medically underserved areas or in areas with medically underserved populations, or schools with a high percentage of low-income and uninsured children and youth.

This bill would require the department to also give preference to schools with a high percentage of children and youth who receive free or low-cost health coverage through begin delete Medi-Cal or Covered California. end delete begin insert Medi-Cal. end insert

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 124174.6 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 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 or children and youth who receive free or
low-cost insurance through begin delete Medi-Cal or Covered California. end delete
begin insert Medi-Cal. end insert

(3) Schools with large numbers of begin delete limited English proficient end delete
begin insert limited-English-proficient end insert (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.