BILL ANALYSIS Ó
SB 118
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Date of Hearing: June 23, 2015
ASSEMBLY COMMITTEE ON HEALTH
Rob Bonta, Chair
SB
118 (Liu) - As Amended April 7, 2015
SENATE VOTE: 38-1
SUBJECT: School-Based Health and Education Partnership Program
SUMMARY: Renames the Public School Health Center Support
Program (PSHCSP) the School-Based Health and Education
Partnership Program (SBHEPP) and changes funding criteria and
amounts for the grants and specifies that school health centers
can provide alcohol and substance abuse assessments, screening,
and services. Specifically this bill:
1)Provides that sustainability grants be made available on a
one-time basis in amounts between $50,000 and $100,000 for the
purpose of developing new, and leveraging existing, funding
streams to support a sustainable funding model for
school-based health centers (SBHCs).
2)Establishes population health grants in amounts between
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$50,000 and $125,000 for up to three years to fund
interventions to implement population health outcomes and
target specific health or education risk factors such as
obesity prevention programs, asthma prevention programs, early
intervention for mental health, and alcohol and substance
abuse prevention.
EXISTING LAW:
1)Defines a SBHC as 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 that
may conduct routine physical health, mental health, and oral
health assessments, and provide referrals for any services not
offered onsite.
2)Establishes the PSHCSP for the purpose of providing technical
assistance and grant funding to SHCs in amounts of $20,000 to
$250,000 for the purposes of identifying children who are
eligible for the Medi-Cal program and similar low or no cost
health insurance programs and enrolling them into appropriate
programs.
3)Requires any grants to SBHCs to have a plan to provide a
comprehensive set of primary and other health care services
including medical, oral health, mental health, health
education, and related services in response to community
needs, as specified.
4)Does not provide funding for the PSHCSP.
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FISCAL EFFECT: According to the Senate Appropriations
Committee, unknown costs to provide additional grants (General
Fund or other, unknown fund source).
COMMENTS:
1)PURPOSE OF THIS BILL. According to the author, SBHCs are
locally designed to meet the specific needs of the student
population, and are an effective anchor for a broader
community school strategy. The community school strategy is a
nationally recognized approach for organizing the resources of
the community around student success. It is both a place and
a set of partnerships among the school and other community
resources. Its integrated focus on academics, health, and
social services, youth, and community engagement leads to
improved student learning, stronger families, and healthier
communities. For years, the existing program has not only
remained unfunded, but is also outdated. The author states
that this bill creates a stronger framework upon which schools
may expand and seek additional resources to fund their
school-based health centers. The author concludes that with
reductions in funding for other critical safety net programs
in recent years, school-based health centers are more
important than ever.
2)BACKGROUND. SBHCs 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. SBHCs have mental health providers on
staff to offer mental health assessments, crisis intervention,
brief and long-term therapy, and other services. SBHCs are
the primary, and occasionally only, available health care for
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many children and adolescents. The National School-Based
Health Alliance states that Congress recognized the importance
of SBHCs as a key link in the nation's health care safety net
by providing $50 million a year for four years in one-time
funding for construction, renovation, and equipment for SBHCs
in the ACA and more than 350 applicants from around the nation
are seeking funding through the first round of competitive
grants created under the law.
There are approximately 200 SBHCs in California. Half of SBHC's
are in high schools, a third are in elementary schools and the
remainder are in middle schools or in mobile medical vans.
Many SBHCs are located in schools serving some of the state's
most vulnerable children and on campuses with SBHCs, about 70%
of students receive free or reduced price meals. According to
the California School-Based Health Alliance (CSBHA), 13,500
children have gained access to health care in their school
since 2012, through the expansion of SBHCs. SBHCs 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. They are financed through grants from
state, local, and private sources as well as reimbursements
from public programs, such as the Child Health and Disability
Prevention Program and Medi-Cal. According to CSBHA, more
than half of SHCs recover less than 50% of their operating
costs from billing sources.
3)SUPPORT. CSBHA, the California Primary Care Association,
Children Now, Children's Defense Fund-California, the Los
Angeles Trust for Children's Health, and the Partnership for
Children & Youth state that children attend school daily
suffering from mental health issues, poor nutrition, asthma,
diabetes, and other conditions that seriously impact their
ability to learn and succeed. Even though 93 percent of
children have health insurance, almost 20 percent of them did
not have a recommended annual preventive medical visit in
2011. The California Black Health Network states that SBHCs
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can specifically help boys and young men of color, who are
more likely than whites to characterize their health as "poor"
or "fair," through a range of services designed to meet their
needs. Students who use SBHCs are more likely to use primary
care more consistently and are less likely to visit the
emergency room or be hospitalized.
4)RELATED LEGISLATION.
a) AB 1025 (Thurmond) requires CDE to establish a
three-year pilot program to encourage inclusive practices
that integrate mental health, special education, and school
climate interventions following a multitiered framework.
AB 1025 is pending in the Assembly Education Committee.
b) AB 1133 (Achadjian) makes technical changes to existing
law regarding grants to LEAs to pay the state share of
costs of providing school-based early mental health
intervention and prevention services to eligible students.
AB 1133 is pending in the Assembly Health Committee.
c) AB 766 (Ridley-Thomas, 2015) expands the characteristics
of schools that are to receive preference in the awarding
of PSHCSP grants to include schools with a high percentage
of youth who receive free- or low-cost insurance through
Medi-Cal. AB 766 is pending referral in the Senate.
5)PREVIOUS LEGISLATION.
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a) SB 1055 (Liu, 2014) was identical to this bill. SB 1055
passed the Sen. Education, Health, and Appropriations
committees but was re-referred to and held in the Sen.
Rules committee.
b) AB 2555 (Bocanegra, 2014) required the Superintendent of
Public Instruction (SPI), in collaboration with the
Department of Social Services and a number of entities, to
develop a five-year plan for expanding cradle-to-career
initiatives, as specified, throughout the State. AB 2555
was held on the Assembly Appropriations committee's
suspense file.
c) AB 1955 (Pan, 2014) required the SPI to establish the
Health Kids, Healthy Minds Demonstration which will provide
grants to local educational agencies for the purpose of
employing one full-time school nurse and one full-time
mental health professional, and ensuring that the schools'
libraries are open one hour before and three hours after
the regular school day. AB 1955 was held on the Assembly
Appropriations committee's suspense file.
d) SB 596 (Yee, 2014) required CDE to establish a
three-year pilot program to encourage inclusive practices
that integrate mental health, special education, and school
climate interventions following a multi-tiered framework.
SB 596 was held at the Assembly Desk.
6)POLICY COMMENT. Existing law does not provide funding for the
currently existing PSHCSP. This bill does not include
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provisions to provide for future funding, so it is unclear
what the impact of the SBEHPP will be.
7)DOUBLE REFERRAL. This bill is double referred; upon passage
in this Committee, this bill will be referred to the Assembly
Education Committee.
REGISTERED SUPPORT / OPPOSITION:
Support
Alliance for Boys and Men of Color
Auburndale Intermediate School
California Association of School Business Officials
California Black Health Network
California Council of Community Mental Health Agencies
California Pan-Ethnic Health Network
California Primary Care Association
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California State Parent Teachers Association
Children's Defense Fund - California
Children Now
Common Sense Kids Action
Community Clinic Association of Los Angeles County
Fight Crime: Invest in Kids California
James Morehouse Project
Mental Health America of California
Planned Parenthood Affiliates of California
PolicyLink
The Greenlining Institute
Opposition
None on file.
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Analysis Prepared by:Paula Villescaz / HEALTH / (916)
319-2097