Senate Bill No. 319

Introduced by Senator Beall

(Coauthor: Senator Monning)

February 23, 2015

An act to amend Section 16501.3 of the Welfare and Institutions Code, relating to child welfare services.

LEGISLATIVE COUNSEL’S DIGEST

SB 319, as introduced, Beall. Child welfare services: public health nursing.

Existing law requires the State Department of Social Services to establish a program of public health nursing in the child welfare services program, and requires counties to use the services of the foster care public health nurse under this program. Existing law requires the foster care public health nurse to perform specified duties, including participating in medical care planning and coordinating for a child in foster care. Existing law also requires a county to establish a community child health and disability prevention program to provide early and periodic assessments of the health status of children in the county.

This bill would require a county to provide the services of a foster care public health nurse to children in foster care by contracting with the community child health and disability prevention program established in that county. The bill would require a foster care public health nurse to monitor and oversee each child in foster care who is administered one or more psychotropic medications, as specified. The bill would give the foster care public health nurse access to the child’s medical, dental, and mental health care information in order to fulfill these duties. By imposing these additional duties on foster care public health nurses, this bill would impose a state-mandated local program.

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, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to these statutory provisions.

Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: yes.

The people of the State of California do enact as follows:

SECTION 1.  

Section 16501.3 of the Welfare and Institutions
Code is amended to read:

16501.3.  

(a) The State Department of Social Services shall
establish and maintain a program of public health nursing in the
child welfare services program that meets the federal requirements
for the provision of healthcare to minor and nonminor dependents
in foster care consistent with Section 30026.5 of the Government
Code. The purpose of the public health nursing program shall be
to begin delete identify, respond to, and enhance end delete begin insert promote and protect end insert the
physical, mental, dental, and developmental well-being of children
in the child welfare system.

(b) Under this program, counties shall begin delete use end delete begin insert provide end insert the services
of a foster care public health nurse begin insert to children in foster care by
contracting with the community child health and disability
prevention program established in that county pursuant to Section
124040 of the Health and Safety Code end insert . The foster care public health
nurse begin delete shall work with the appropriate child welfare services
workers to coordinate health care services end delete and begin insert the child’s social
worker shall consult and collaborate to ensure that the child’s
physical, mental, dental, and developmental needs are met. The
foster care public health nurse shall end insert serve as a liaison with health
care professionals and other providers of health-related services.
begin delete This shall include coordination with county mental health plans
and local health jurisdictions, as appropriate. end delete begin insert In order to fulfill
these duties, the foster care public health nurse shall have access
to the child’s medical, dental, and mental health care information. end insert

(c) The duties of a foster care public health nurse shall include,
but need not be limited to, the following:

(1) Documenting that each child in foster care receives initial
and followup health screenings that meet reasonable standards of
medical practice.

(2) Collecting health information and other relevant data on
each foster child as available, receiving all collected information
to determine appropriate referral and services, and expediting
referrals to providers in the community for early intervention
services, specialty services, dental care, mental health services,
and other health-related services necessary for the child.

(3) Participating in medical care planning and coordinating for
the child. This may include, but is not limited to, assisting case
workers in arranging for comprehensive health and mental health
assessments, interpreting the results of health assessments or
evaluations for the purpose of case planning and coordination,
facilitating the acquisition of any necessary court authorizations
for procedures or medications, advocating for the health care needs
of the child and ensuring the creation of linkage among various
providers of care.

(4) Providing followup contact to assess the child’s progress in
meeting treatment goals.

(5) At the request of and under the direction of a nonminor
dependent, as described in subdivision (v) of Section 11400, begin delete assist end delete
begin insert assisting end insert the nonminor dependent in accessing physical health and
mental health care, coordinating the delivery of health and mental
health care services, advocating for the health and mental health
care that meets the needs of the nonminor dependent, begin delete and to assist end delete
begin insert assisting the nonminor dependent to make an informed decision
to begin or continue taking psychotropic medications, and assisting end insert
the nonminor dependent to assume responsibility for his or her
ongoing physical and mental health care management.

begin insert

(6) Monitoring and oversight of each child in foster care who
is administered one or more psychotropic medications. This
oversight shall include the review of each request for psychotropic
medication filed pursuant to Section 369.5 to ensure that lab tests,
other screenings and measurements, evaluations, and assessments
required to meet reasonable standards of medical practice have
been completed. The foster care public health nurse shall also
ensure that all of the following occur:

end insert begin insert

(A) The juvenile court has authorized the psychotropic
medication to be administered to the child.

end insert begin insert

(B) Periodic followup visits with the prescribing physician, lab
work, and other measurements are completed.

end insert begin insert

(C) The child’s health and education passport, as described in
Section 16010, includes accurate documentation concerning the
psychotropic medications authorized for and administered to the
child.

end insert begin insert

(D) The medication’s efficacy in addressing the illness or
symptoms for which it was prescribed are documented.

end insert begin insert

(E) Any adverse effects of the medication reported by the child’s
caregiver are promptly addressed, and, if necessary, brought to
the attention of the court.

end insert

(d) The services provided by foster care public health nurses
under this section shall be limited to those for which reimbursement
may be claimed under Title XIX at an enhanced rate for services
delivered by skilled professional medical personnel.
Notwithstanding any other begin delete provision of end delete law, this section shall be
implemented only if, and to the extent that, the department
determines that federal financial participation, as provided under
Title XIX of the federal Social Security Act (42 U.S.C. Sec. 1396
et seq.), is available.

(e) (1) The State Department of Health Care Services shall seek
any necessary federal approvals for child welfare agencies to
appropriately claim enhanced federal Title XIX funds for services
provided pursuant to this section.

(2) Commencing in the fiscal year immediately following the
fiscal year in which the necessary federal approval pursuant to
paragraph (1) is secured, county child welfare agencies shall
provide health care oversight and coordination services pursuant
to this section, and may accomplish this through agreements with
local public health agencies.

(f) (1) Notwithstanding Section 10101, prior to the 2011-12
fiscal year, there shall be no required county match of the
nonfederal cost of this program.

(2) Commencing in the 2011-12 fiscal year, and each fiscal
year thereafter, funding and expenditures for programs and
activities under this section shall be in accordance with the
requirements provided in Sections 30025 and 30026.5 of the
Government Code.

SEC. 2.  

If the Commission on State Mandates determines that
this act contains 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.