BILL ANALYSIS Ó
SB 118
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Date of Hearing: July 15, 2015
ASSEMBLY COMMITTEE ON EDUCATION
Patrick O'Donnell, Chair
SB
118 (Liu) - As Amended April 7, 2015
[This bill was double referred to the Assembly Health Committee
and was heard as it relates to that committee's jurisdiction.]
SENATE VOTE: 38-1
SUBJECT: School-Based Health and Education Partnership Program.
SUMMARY: Renames the "Public School Health Center Support
Program" as the "School-Based Health and Education Partnership
Program;" changes funding amounts for the grants; and, specifies
that school health centers can provide alcohol and substance
abuse prevention information and services. Specifically, this
bill:
1)Specifies that sustainability grants shall be available on a
one-time basis in amounts between fifty thousand dollars and
one hundred thousand dollars for the purpose of developing new
and leveraging existing funding streams to support a
sustainable funding model for school health centers.
2)Specifies population health grants shall be available in
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amounts between fifty thousand dollars and one hundred
twenty-five thousand dollars 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.
3)Makes the following Legislative findings and declarations:
a) 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.
b) 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 or obesity, and high-risk
behaviors, such as mental health disorders, substance
abuse, and teen pregnancy, that significantly impact health
care costs later in life.
c) Through education finance reform, California has
increased accountability strategies for local educational
agencies that highlight the need for schools to address
important health-related indicators, such as chronic
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absenteeism.
d) 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.
EXISTING LAW:
1)Requires the Department of Public Health 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 (HSC) 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. 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 Department of
Public Health 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)
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4)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.
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)
FISCAL EFFECT: According to the Senate Appropriations
Committee, unknown costs to provide additional grants (General
Fund or other, unknown fund source). The bill authorizes a new
category of grants that may be issued to schools with school
health centers for interventions such as obesity prevention or
mental health prevention. 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
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funded.
COMMENTS: This bill changes the name of the "Public School
Health Center Support Program" to the "School-Based Health and
Education Partnership Program;" changes funding amounts for the
grants; and, specifies that school health centers can provide
alcohol and substance abuse prevention information and services.
According to the author, school based-health centers (SBHCs)
provide a range of services that are designed to meet the
specific needs of the local student population. The Public
School Health Center Support Program has existed in statute for
nine years but has yet has to be funded. Further, this program
is outdated. Without intervention, California lacks a coherent
and comprehensive system of support for schools to build and
sustain the partnerships, resources, and programs necessary to
address issues that affect students and the school environment.
This bill updates and enhances the framework of how SBHCs may be
funded and provides schools with guidance on developing optimal
and sustainable SBHC funding strategies.
Existing school health centers. Schools currently have the
discretion to provide health services to students, or refer
students to county and community organizations. Of the existing
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. They serve 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.
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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.
This bill modifies the existing grant program to assist school
districts to establish and maintain school health centers. This
bill does not provide funding for the school health center grant
program.
Changes to School Health Center Grants. The Public School
Health Center Support Program has existed in statute for eight
years but has never been funded, and therefore never
implemented. This bill makes the following substantive changes
to this grant program:
1)Establishes population health grants, in amounts between
$50,000-$125,000 for up to a three-year period, to fund
interventions to target specific health or education risk
factors that affect a larger segment of the population
including, but not limited to obesity prevention programs,
asthma prevention programs, early intervention for mental
health, alcohol and substance abuse prevention.
2)Limits sustainability grants from a three-year period to a
one-time basis, increases the minimum grant amount from
$25,000 to $50,000, and decreases the maximum grant amount
from $125,000 to $100,000.
3)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
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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.
4)Adds the referral to evidence-based mental health treatment
services 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.
This bill does not modify the existing condition that the grant
program be implemented only to the extent that funds are
appropriated to the Department of Public Health for that
purpose. It is unclear if the program is intended to be funded
in the near future.
Related and Previous Legislation. AB 766 (Ridley-Thomas) from
2015, is pending hearing in the Senate, expands the
characteristics of schools that are to receive preference in the
awarding of Public School Health Center Support grants to
include schools with a high percentage of youth who receive
free- or low-cost insurance through Medi-Cal or Covered
California.
SB 1055 (Liu) from 2014 was identical to this bill. SB 1055
passed the Senate Education, Health and Appropriations
committees but was re-referred to and held in the Senate Rules
Committee prior to a vote on the Senate Floor.
AB 174 (Bonta) from 2013 would have required the Department of
Public Health to establish a pilot program in Alameda County, to
the extent that funding is made available, to provide grants to
eligible applicants for activities and services that directly
address the mental health and related needs of students impacted
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by trauma. AB 174 was vetoed by the Governor, with the
following veto message:
"I support the efforts of the bill but am returning it
without my signature, as Alameda County can establish such
a program without state intervention and may even be able
to use Mental Health Services Act funding to do so.
Waiting for the state to act may cause unnecessary delays
in delivering valuable mental health services to students.
All counties - not just Alameda- should explore all
potential funding options, including Mental Health Services
Act funds, to tailor programs that best meet local needs."
REGISTERED SUPPORT / OPPOSITION:
Support
Advancement Project
Alliance for Boys and Men of Color
Auburndale Intermediate School
California Association of School Business Officials
California Association of School Business Officials
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California Black Health Network
California Council of Community Mental Health Agencies
California Pan Ethnic Health Network
California Primary Care Association
California State PTA
Children Now
Children's Defense Fund-California
Common Sense Kids Action
Community Clinic Association of Los Angeles County
James Morehouse Project
Mental Health America of California
National Association of Social Workers, California Chapter
Planned Parenthood
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PolicyLink
Steinberg Institute
The Greenlining Institute
An Individual
Opposition
None on file.
Analysis Prepared by:Chelsea Kelley / ED. / (916)
319-2087