BILL ANALYSIS �
AB 1955
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Date of Hearing: April 29, 2014
ASSEMBLY COMMITTEE ON HEALTH
Richard Pan, Chair
AB 1955 (Pan) - As Amended: April 22, 2014
SUBJECT : Pupil health: Healthy Kids, Healthy Minds
Demonstration.
SUMMARY : Establishes the Healthy Kids, Healthy Minds
Demonstration under which participating schoolsites would employ
a school nurse and a mental health professional, and extend
library hours. Specifically, this bill :
1)Requires the State Superintendent of Public Instruction (SPI)
to establish the Healthy 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
schoolsites' libraries are open one hour before and three
hours after the regular school day.
2)Requires the demonstration to run from July 1, 2015 to June
30, 2018.
3)Allows a local educational agency (LEA) to participate if it
has a percentage of pupils who are either classified as an
English learner, eligible for a free or reduced-price meal, or
are a foster youth, in excess of 55% of the LEAs total school
enrollment.
4)Specifies that if an LEA does not meet the requirement in 3)
above but individual schoolsites within the LEA do, those
schoolsites be allowed to apply and participate in the
demonstration.
5)Requires LEAs, at a minimum, to demonstrate all of the
following to participate in the demonstration:
a) The LEA meets the specified pupil requirements and is
able to achieve the goal of the demonstrations with a
combination of current and additional local funds and
funding received from the grant program;
b) The LEA can meet the goal of employing one full-time
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nurse and one full-time mental health professional, and
provide the extended library hours for three fiscal years;
and,
c) The LEA can show that the proposed use of funds provided
under the demonstration is consistent with its local
control and accountability plan.
6)Requires, upon appropriation by the Legislature, the SPI to
reserve funds each year necessary to operate the demonstration
as a grant program.
7)Requires participating LEAs, with assistance from the
California Department of Education (CDE) to collect and
aggregate data from schoolsites under the jurisdiction of the
LEA, including, among other things, measuring changes in pupil
absenteeism, school climate, reductions in the incidence of
violence, changes in health status among high-needs pupils,
and other relevant benchmarks as defined and determined by the
State Board of Education (SBE) and requires a participating
LEA to transmit this data to the CDE annually.
8)Encourages participating LEAs to offer library programs that
may include, but are not limited to, reading circles, tutoring
programs, online research, and parent outreach for homework
assistance, and requires, to the extent feasible, schoolsites
to make efforts to offer library programming with the
participation of certified bilingual staff.
9)Requires participating LEAs or schoolsites to ensure that
programs are adequately staffed by qualified personnel, but
allows them to include adult volunteers approved by the
schoolsite.
10)Specifies that the demonstration not be interpreted to modify
existing law or school policy regarding what staff
classifications are permitted to operate libraries, including
media technicians and library aides.
11)Requires CDE to compile, analyze, and present the data on the
results of the demonstration project to the Legislature and
SBE no later than December 31, 2018.
12)Allows SBE to adopt emergency regulations to implement the
demonstration program.
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13)Defines a "mental health professional," for purposes of these
provisions, as a school psychologist or a social worker.
14)Requires the Department of Health Care Services (DHCS) and
CDE to coordinate efforts in order to maximize receipt of
federal funds under the School Medi-Cal Administrative
Claiming process and specifies that, to the extent permitted
by federal law, funds used by LEAs under the local control
funding formula, including funds used for the demonstration,
may be included in expenditures certified.
15)Requires DHCS, through an interagency agreement with CDE, to
provide technical advice to LEAs participating in the
demonstration to help set up accounting systems, conduct staff
time studies, and any other activities necessary to certify
and bill valid claims for allowable activities under the
Administrative Claiming process.
16)Requires that entities contracted by DHCS, an LEA, or
educational consortium are a public agency or incorporated as
a nonprofit agency or public benefit corporation.
17)Requires DHCS to seek any necessary federal approvals to
implement these provisions.
18)Sunsets the provisions of this bill on January 1, 2019.
19)Makes various findings and declarations regarding the
importance of school-based health services.
EXISTING LAW :
1)Defines a school nurse as a registered nurse (RN) currently
licensed by the state, who has completed the additional
educational requirements for, and possess a current credential
in, school nursing.
2)Requires the Commission on Teacher Credentialing to award
credentials for school services for positions including, but
not limited to, administrators, school counselors,
speech-language therapists, audiologists, school
psychologists, library media teachers, and school nurses.
3)Allows DHCS to contract with LEAs or local governmental
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consortiums to assist with the performance of administrative
activities necessary for the administration of the Medi-Cal
program, including the school-based Medi-Cal administrative
activities (SMAA) program, and allows LEAs and consortiums to
subcontract with private or public entities to assist with the
performance of administrative activities.
4)Defines a local educational consortium as a local agency that
is one of the service regions of the California County
Superintendent Educational Services Association.
FISCAL EFFECT : This bill has not been analyzed by a fiscal
committee.
COMMENTS :
1)PURPOSE OF THIS BILL . According to the author, California
schools are lacking the level of pupil support personnel
needed to adequately support students and teachers and provide
the type of school environment California students need to
thrive. The author states that for 2012 the ratio of student
to pupil support personnel in California was:
a) Nurses - 2815:1;
b) Librarians - 8137:1;
c) Psychologists - 1469:1; and,
d) Social Workers - 14772:1.
The author states that these ratios put California far behind
other states and below recommended ratios for these critical
support services in schools. The author notes that California
ranks 51st nationally, behind all other states and the
District of Columbia, in both the number of students per
guidance counselors and librarians. The author also notes
that research shows a direct link between having school-based
health and other support services and student success. For
example, studies have shown that having school-based health
services can lead to academic improvements, improved
attendance, reduced suspension and expulsion rates, and lower
dropout rates.
2)BACKGROUND . According to CDE, a counseling program is an
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integral component of the educational system and is vital in
preparing and assisting students to be successful, lifelong
learners. School counselors and other members of the student
support team (school psychologists, school social workers,
child welfare and attendance supervisors, and school nurses)
assist students in making decisions, managing emotions, coping
with crises, overcoming barriers to learning, and seeking
access to the core curriculum. School counselors and members
of the support team help students set short- and long-term
goals, improve attendance, reduce and resolve conflicts, and
prevent youth suicide. This support team works to create a
positive learning environment; teaches self-management skills;
acts as advocates for students; and, provides relevant
academic, career, and personal/social counseling to enable
students to make informed decisions toward achieving their
future goals.
3)SCHOOL-BASED MEDI-CAL ADMINISTRATIVE ACTIVITIES . A federal
reimbursement of approximately 50% is available for the
administrative costs incurred by government agencies,
including schools, that support efforts to identify and enroll
children into the Medicaid program. In California the program
is referred to as the SMAA program. This program supports
linking children to Medi-Cal and to Medi-Cal covered services.
Administrative activities include conducting Medicaid
outreach; facilitating Medicaid eligibility determinations;
and, providing medical/Medicaid-related training, translation,
and general administration.
4)SUPPORT . The California Federation of Teachers is the sponsor
of this bill and states that school library programs and the
presence of school librarians can make a significant
difference in student success. They further argue that,
similarly, school-based health services lead to better
attendance, reduced suspension and expulsions, and lower
dropout rates.
The American Nurses Association/California writes in support
that only 43% of California schools report having a full-time
school nurse and this bill will improve the welfare and
wellbeing of California pupils. The California Labor
Federation support this bill because it takes full advantage
of Medi-Cal funds to help pay for activities carried out by
school nurses and school psychologists.
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The California Professional Firefighters supports this bill
because having nurses and mental health professionals on
school sites can ultimately help mitigate the need to call 911
for related services, thereby reducing the demand on already
scarce local emergency medical resources.
5)PREVIOUS LEGISLATION .
a) AJR 24 (Bonilla), Chapter 55, Statutes of 2012, calls
upon the members of California's congressional delegation
to sign on as cosponsors of, and requests the Congress and
the President of the United States enact, the proposed
federal Student-to-School Nurse Ratio Improvement Acts of
2011 and 2012.
b) AB 722 (Corbett) Chapter 250, Statutes of 2001, requires
the CDE to conduct a study of pupil support services,
including the ratio of students to counselors, social
workers, and nurses.
6)DOUBLE REFERRAL . This bill is double referred and passed the
Assembly Committee on Education with a vote of 6-1 on April 9,
2014.
7)POLICY COMMENT . The author has stated that one of the goals
of this legislation is to help maximize LEA billing and draw
down additional federal funds to provide health services in
California's schools. Having additional school nurses and
mental health professionals would certainly help achieve that
goal. However, it should be noted that after an audit in 2012
found some irregularities in three school districts billing
claims, the Centers for Medicare and Medicaid (CMS) have
deferred all LEAs claims in California for reimbursements in
the SMAA program until a new claiming methodology is put in
place. DHCS is currently in negotiations with CMS to resolve
this issue, however until that is accomplished, no additional
SMAA funds will flow to California.
8)TECHNICAL AMENDMENTS .
a) As currently drafted this bill requires an interagency
agreement between CDE and DHCS to provide technical advice
to LEAs participating in the demonstration project in order
to help them meet the requirements of the SMAA claiming
process. DHCS already provides training to LEAs on the
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SMAA claiming process, therefore an interagency agreement
with CDE is not necessary and that provision should be
deleted from this bill.
b) This bill contains a drafting error that references
local control funding formula provisions that were intended
to be deleted in the last set of amendments, which should
be corrected.
c) As currently drafted this bill requires any entity
contracted by DHCS, LEAs, or local educational consortium
to be a public agency or incorporated as a nonprofit or
public benefit corporation. However, current law and
regulations governing the SMAA program allow LEAs and
others to contract with private entities; therefore this
bill could place the state in conflict with federal
requirements. That provision should be deleted from this
bill.
REGISTERED SUPPORT / OPPOSITION :
Support
California Federation of Teachers (sponsor)
Alliance of Californians for Community Empowerment
American Nurses Association/California
California Calls
California Labor Federation
California Partnership
California Professional Firefighters
Courage Campaign
Human Impact Partners
Maternal and Child Health Access
Mobilize the Immigrant Vote
National Association of Social Workers - California Chapter
PICO California
Public Advocates
Opposition
None on file.
Analysis Prepared by : Lara Flynn / HEALTH / (916) 319-2097
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