BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | SB 118|
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THIRD READING
Bill No: SB 118
Author: Liu (D)
Amended: 4/7/15
Vote: 21
SENATE EDUCATION COMMITTEE: 8-0, 3/11/15
AYES: Liu, Huff, Block, Hancock, Leyva, Mendoza, Pan, Vidak
SENATE HEALTH COMMITTEE: 9-0, 3/25/15
AYES: Hernandez, Nguyen, Hall, Mitchell, Monning, Nielsen,
Pan, Roth, Wolk
SENATE APPROPRIATIONS COMMITTEE: 7-0, 5/28/15
AYES: Lara, Bates, Beall, Hill, Leyva, Mendoza, Nielsen
SUBJECT: School-Based Health and Education Partnership
Program
SOURCE: Author
DIGEST: This bill modifies and renames an existing school
health center grant program to add a population health grant,
alters existing sustainability grant amounts, adds services for
which the grants may be used, and updates terminology.
ANALYSIS:
Existing law:
School health centers
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1)Requires the Department of Public Health (DPH) to establish
the Public School Health Center Support Program, in
cooperation with the California Department of Education, to
perform specified functions relating to the establishment,
retention, or expansion of school health centers in
California. (Health & Safety Code § 124174.2)
2)Defines "school health center" as a center or program, located
at or near a school, that provides age-appropriate health care
services at the program site or through referrals. Current
law authorizes a school health center to conduct routine
physical, mental health, and oral health assessments, and
provide referrals for any services not offered onsite. (HSC §
124174)
3)Establishes a grant program administered by the DPH to provide
technical assistance and funding to school health centers, to
the extent funds are appropriated for this purpose.
a) Planning grants in amounts between $25,000-$50,000.
b) Facilities and startup grants in amounts between
$20,000-$250,000.
c) Sustainability grants in amounts between
$25,000-$125,000. (HSC § 124174.6)
1)Requires school health centers that receive a grant to meet or
have a plan to meet the following requirements:
a) Strive to provide a comprehensive set of services
including medical, oral health, mental health, health
education, and related services in response to community
needs.
b) Provide primary and other health care services, provided
or supervised by a licensed professional, which may include
physical exams, diagnosis and treatment of minor injuries
and medical conditions, management of chronic medical
conditions, referrals and follow-up for specialty care,
reproductive health services, mental health services as
specified, and oral health services.
c) Work in partnership with the school nurse, as specified.
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d) Have a written contract or memorandum of understanding
between the school district and the health care provider or
other community provider.
e) Serve all students regardless of ability to pay.
f) Be open during all normal school hours, as specified.
g) Establish protocols for referring students to outside
services when the school health center is closed.
h) Facilitate transportation, as specified. (HSC §
124174.6)
Authority to assess and provide services
1)Authorizes credentialed school nurses to perform specified
duties, including assess and evaluate health and development,
refer students and parents to appropriate community resources,
and counsel students and parents. (Education Code § 49426)
2)Authorizes school districts to permit specified licensed
health practitioners to administer an immunizing agent to a
student whose parent or guardian has consented in writing to
the administration of the immunizing agent. (EC § 49403)
3)Requires a psychologist employed by a school district to hold
specified credentials, and prohibits an employee of a school
district from administering psychological tests or engage in
psychological activities unless specified criteria is met.
(EC § 49422 and § 49424)
Pupil Personnel Services credentials authorize individuals to
provide school services in preschool through grades 12 as
counselors, school psychologists, school social workers, or
school child welfare and attendance regulators, according to the
specific specialization area and service authorization listed on
the credential.
Seeking medical services
1)Requires school districts to annually notify students in grades
7-12, and parents of all students enrolled in the school
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district, that schools may excuse students for the purpose of
obtaining confidential medical services without the consent of
the student's parent. (Education Code § 46010.1)
2)Authorizes minors to seek confidential medical services, without
the consent of a parent, as follows:
a) A minor who is 12 years of age or older to consent to
mental health treatment or counseling on an outpatient
basis, or to residential shelter services, if certain
conditions are met. Current law requires the mental health
treatment or counseling of a minor to include involvement
of the minor's parent or guardian unless, in the opinion of
the professional person who is treating or counseling the
minor, the involvement would be inappropriate. (Family
Code § 6924)
b) A minor who is 12 years of age or older to consent to
medical care and counseling relating to the diagnosis and
treatment of a drug- or alcohol-related problem. (FC §
6929)
c) A minor to consent to medical care related to the
prevention or treatment of pregnancy, but may not be
sterilized or receive an abortion without the consent of a
parent, other than in a medical emergency or pursuant to
court order. (FC § 6925)
d) A minor who is 12 years of age or older and who may have
come into contact with an infectious, contagious, or
communicable disease, if the disease or condition is one
that is required to be reported to the local health
officer, or is a related sexually transmitted disease. (FC
§ 6926)
e) A minor who is 12 years of age or older and who is
alleged to have been raped to consent to medical care
related to the diagnosis or treatment of the condition and
the collection of medical evidence with regard to the
alleged rape. (FC § 6927)
f) A minor who is alleged to have been sexually assaulted
to consent to medical care related to the diagnosis and
treatment of the condition, and the collection of medical
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evidence with regard to the alleged sexual assault.
Current law requires the professional person providing
medical treatment to attempt to contact the minor's parent
or guardian. (FC § 6928)
g) A minor to consent to the minor's medical care or dental
care if the minor is 15 years of age or older, is living
separate and apart from the minor's parents with or without
the consent of the parent, and is managing the minor's own
financial affairs, regardless of the source of income. (FC
§ 6922)
This bill:
1)Renames the Public School Health Center Support Program to the
School-Based Health and Education Partnership Program.
2)Adds the following to the elements that school health center
grantees must include or provide:
a) 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.
b) 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.
c) Alcohol and substance abuse services.
3)Adds the referral to evidence-based mental health or alcohol
and substance abuse treatment services to the list of mental
health services that may be provided or supervised by an
appropriately licensed mental health professional.
4)Establishes population health grants in amounts $50,000 to
$125,000 for a funding period of up to three years to fund
interventions to target specific health or education risk
factors that affect a larger segment of the population
including, but not limited to:
a) Obesity prevention programs.
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b) Asthma prevention programs.
c) Early intervention for mental health.
d) Alcohol and substance abuse prevention.
5)Limits sustainability grants from a three-year period to a
one-time basis, and modifies the grant amounts as follows:
a) Increases the minimum grant amount from $25,000 to
$50,000.
b) Decreases the maximum grant amount from $125,000 to
$100,000.
6)Modifies the purpose of sustainability grants from operating a
school health center, or enhancing programming at a fully
operational school health center, including oral health or
mental health services, to:
a) Developing new and leveraging existing funding streams
to support a sustainable funding model for school health
centers.
b) Examples of existing funding streams include school
district funds available under the Local Control Funding
Formula, federal Affordable Care Act, or Mental Health
Services Act.
7)Strikes reference to the obsolete Healthy Families Program and
Managed Risk Medical Insurance Board, adds references to
Covered California, and modifies the name of the grant
program.
8)Adds the following to uncodified legislative findings and
declarations:
a) 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.
b) School-based health centers serve as an effective
foundation upon which schools and communities can build and
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implement a community schools strategy providing a range of
wrap-around services to students and their families.
Background
Schools currently have the discretion to provide health services
to students, or refer students to county and community
organizations. There are currently 231 school-based health
centers (40% are in high schools, 25% are in elementary schools,
10% are in middle schools, and 25% are "school-linked" or mobile
medical vans) in the State serving over 242,000 students and
providing a range of services including comprehensive health
assessments, treatment for acute illness, asthma treatment, oral
health education, dental screenings, mental health assessments,
crisis intervention, brief and long-term therapy, and other
services. Services are provided on-site by qualified
professionals and those that require expertise or specialization
beyond the school health center's capacity may be referred to
county agencies and community organizations.
School health centers are administered by a variety of
organizations, including school districts, Federally Qualified
Health Centers, county health departments, hospitals,
community-based agencies, and private physician groups. School
health centers are financed through various sources, including
grants, reimbursements from public programs such as the Child
Health and Disability Prevention Program and Medi-Cal,
partnerships with local community clinics and nonprofit, and
fundraising efforts by school districts.
Comments
Will kids be provided services without parental consent?
Current law authorizes school districts to permit specified
licensed health practitioners to administer an immunizing agent
to a student whose parent or guardian has consented in writing
to the administration of the immunizing agent.
Current law prohibits a student from being tested by a school
for a behavioral, mental, or emotional evaluation without the
informed written consent of the parent, prohibits a minor from
being sterilized or receiving an abortion without parental
consent (other than in a medical emergency or pursuant to court
order), and places other restrictions on minors receiving
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medical care without parental consent (see Background).
Generally speaking, parental consent is required for a minor's
medical treatment. (American Academy of Pediatrics v. Lungren
(1997)) There are, however, exceptions such as when the public
interest in preserving the health of a minor takes precedence
over the parent's interest in custody and control of the minor.
(Wisconsin v. Yoder (1972)) In addition, a number of "medical
emancipation" statutes allow minors to consent to medical
treatment without parental knowledge, approval or consent (see
existing law).
FISCAL EFFECT: Appropriation: No Fiscal
Com.:YesLocal: No
According to the Senate Appropriations Committee, this bill
imposes unknown costs to provide additional grants (General Fund
or other, unknown fund source). The bill does not identify a
source of funds for these new grants. The current program has
been authorized in statute for eight years, but has never been
funded.
SUPPORT: (Verified5/29/15)
Alliance for Boys and Men of Color
Auburndale Intermediate School
California Black Health Network
California Pan-Ethnic Health Network
California Primary Care Association
Children Now
Common Sense Kids Action
Community Clinic Association of Los Angeles County
James Morehouse Project
Mental Health America of California
Partnership for Children & Youth
Planned Parenthood Affiliates of California
PolicyLink
The Greenlining Institute
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OPPOSITION: (Verified5/29/15)
None received
ARGUMENTS IN SUPPORT: According to the California Pan-Ethnic
Health Network, research shows that users of school-based health
centers are more likely to have yearly dental and medical
check-ups and are less likely to go to the Emergency Room or be
hospitalized. Students enrolled in a school with a school-based
health center are absent three times less often than students
not utilizing a school-based health center.
Prepared by:Lynn Lorber / ED. / (916) 651-4105
5/30/15 18:34:05
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