BILL ANALYSIS                                                                                                                                                                                                    �



                                                                            



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                                    THIRD READING


          Bill No:  SB 1055
          Author:   Liu (D)
          Amended:  5/7/14
          Vote:     21

           
           SENATE HEALTH COMMITTEE  :  7-1, 3/26/14
          AYES:  Hernandez, Beall, De Le�n, DeSaulnier, Evans, Monning,  
            Wolk
          NOES:  Anderson
          NO VOTE RECORDED:  Nielsen

           SENATE EDUCATION COMMITTEE  :  8-1, 4/30/14
          AYES:  Liu, Wyland, Block, Correa, Galgiani, Hancock, Hueso,  
            Monning
          NOES:  Huff

           SENATE APPROPRIATIONS COMMITTEE  :  7-0, 5/23/14
          AYES:  De Le�n, Walters, Gaines, Hill, Lara, Padilla, Steinberg


           SUBJECT  :    Public School Health Center Support Program

           SOURCE  :     California School-Based Health Alliance


           DIGEST  :    This bill renames the Public School Health Center  
          Support Program (PSHCSP) the School-Based Health and Education  
          Partnership Program (SBHEPP) and makes changes to the  
          requirements and funding levels.  This bill creates a new type  
          of grant to fund interventions related to obesity, asthma,  
          alcohol and substance abuse, and mental health.

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           ANALYSIS  :    Existing law:

          1.Requires the Department of Public Health (DPH) to establish  
            the PSHCSP, in collaboration with the California Department of  
            Education (CDE), to perform specified functions relating to  
            the establishment, retention, or expansion of school health  
            centers (SHCs) in California.  

          2.Establishes a grant program administered by DPH to provide  
            technical assistance and funding to SHCs, to the extent funds  
            are appropriated for implementation of the PSHCSP.  Provides  
            for planning, facilities and startup, and sustainability  
            grants, as specified.  

          3.Defines an SHC, for purposes of the PSHCSP, as a center or  
            program located on a school campus or at a local educational  
            agency that provides age-appropriate health care services at  
            the program site or through referrals.

          This bill:

           1. Renames the PSHCSP the SBHEPP.  Changes sustainability grant  
             amount from between $25,000 and $125,000 per year for a  
             three-year period to between $50,000 and $100,000 on a  
             one-time basis.  Deletes the requirement that the grant be  
             used for operating SHCs or enhancing programming at SHCs to  
             include oral health or mental health services and instead  
             requires the grant funds be used to develop new and  
             leveraging existing funding streams to support a sustainable  
             funding model for SHCs.  Provides examples of existing  
             funding streams, such as local educational agency funds  
             available under the local control funding formula, the  
             federal Affordable Care Act (ACA), or the Mental Health  
             Services Act.

           2. Creates a new population health grant in amounts between  
             $50,000 and $125,000 for a 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.   
             Requires applicants for this grant to meet the same criteria  
             as those for the facilities and startup grant in existing  

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             law.

           3. Adds to requirements for SBHEPP grantees to strive to  
             address the population health of an entire school by focusing  
             on prevention services, such as group and classroom  
             education, school wide prevention programs, community  
             outreach strategies; also strives to provide integrated and  
             individualized support for students and families, and to act  
             as a partner with students or families to ensure that health,  
             social, or behavioral challenges are addressed. 

           4. Clarifies that SBHEPP is required, in collaboration with  
             CDE, to also provide technical assistance to SHCs on  
             effective outreach and enrollment strategies to identify  
             children who are eligible for, but not enrolled in Covered  
             California, or any other applicable health insurance  
             affordability program for children.

           5. Adds alcohol and substance abuse to the comprehensive set of  
             services SHCs are required to provide. 

           6. Adds evidence-based mental health treatment services to the  
             services an appropriately licensed mental health professional  
             is authorized to provide. 

           7. Makes several legislative findings related to SHCs including  
             the following:  

              A.    SHCs 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 ACA contains provisions that recognize the  
                importance of SHCs in the delivery of quality, affordable  
                health care and that would call for their expansion.   
                Under the ACA, California is developing new strategies to  
                increase access to health care and reduce health care  
                costs through investing in prevention services. 

              C.    Additionally, through education finance reform,  
                California has increased accountability strategies for  
                local educational agencies that highlight the need for  

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                schools to address important health-related indicators,  
                such as chronic absenteeism.

           1. Makes technical, clarifying changes.

          Prior Legislation
           
          AB 174 (Bonta, 2013) would have required DPH to establish a  
          pilot grant program in Alameda County, to the extent that  
          funding is made available, to provide resources to eligible  
          applicants for activities and services that directly address the  
          mental health and related needs of students impacted by trauma.   
          The bill was vetoed by Governor Brown.

          SB 564 (Ridley-Thomas, Chapter 381, Statutes of 2008) specified  
          that an SHC may conduct routine physical health, mental health,  
          and oral health assessments, and provide for any services not  
          offered onsite or through a referral process.  The bill also  
          required DPH, to the extent funds are appropriated for  
          implementation of the PSHCSP, to establish a grant program to  
          provide technical assistance, and funding for the expansion,  
          renovation, and retrofitting of existing SHCs, and the  
          development of new SHCs, in accordance with specified  
          procedures.

          AB 2560 (Ridley-Thomas, Chapter 334, Statutes of 2006) required  
          the Department of Health Services (DHS), in cooperation with  
          CDE, to establish the PSHCSP to perform specified functions  
          relating to the establishment, retention, or expansion of SHCs.

          AB 2105 (Scott, 2000) would have required the Director of Mental  
          Health, in consultation with the Secretary of Child Development  
          and Education and the Superintendent of Public Instruction, to  
          establish a program to award planning grants to counties for the  
          provision of school-based mental health services to children, as  
          specified.  The bill failed in the Assembly Appropriations  
          Committee.

          SB 566 (Escutia, 1999) would have established the SHC Grant  
          Program, to be administered by DHS, to provide grants to  
          qualifying SHCs in order to assist the centers in providing  
          health services to students, provided that funds were  
          appropriated in the annual Budget Act.  The bill was moved to  
          the Inactive File on the Senate Floor.

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           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes    
          Local:  No

          According to the Senate Appropriations Committee, unknown costs  
          to provide additional grants (General Fund or other, unknown  
          fund source).  This bill authorizes a new category of grants  
          that may be issued to schools with SHCs for interventions such  
          as obesity prevention or mental health prevention.  This 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  :   (Verified  5/23/14)

          California School-Based Health Alliance (source)
          California Alliance of Child and Family Services 
          California Association of School Business Officials
          California Charter Schools Association Advocates
          California Primary Care Association
          California School-Based Health Alliance
          California State PTA
          Children Now
          Health Access California
          Hispanas Organized for Political Equality
          Partnership for Children and Youth
          San Diego Unified School District

           OPPOSITION  :    (Verified  5/23/14)

          California Right to Life Committee

           ARGUMENTS IN SUPPORT  :    The California School-Based Health  
          Alliance (CSBHA), the sponsor of this bill, states that children  
          attend school every day while suffering from mental health  
          issues, poor nutrition, asthma, diabetes, and other conditions  
          that seriously impact their ability to succeed.  CSBHA states  
          that in 2011 even though about nine out of 10 California  
          children had health insurance, almost 20% of them did not have a  
          recommended annual preventive medical visit.

          The California Primary Care Association, which represents nearly  
          1,000 not-for-profit community clinics and health centers,  
          writes in support of this bill and SHCs, which provide  

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          approximately 228,000 students with a range of services,  
          including primary medical care, mental health, and  
          nutrition/fitness.

          The Partnership for Children and Youth states that in their  
          direct work with community-based organizations and school  
          districts they have seen first-hand the vital role that access  
          to SHCs has on students and their families and the communities  
          at large.

           ARGUMENTS IN OPPOSITION  :    The California Right to Life  
          Committee (CRLC) states that this bill represents advocacy for  
          minors' treatment in many health areas, including reproductive  
          health services, as well as advances the governance format of  
          public-private partnerships, which CRLC argues erode  
          representative government.  
           

          JL:k  5/25/14   Senate Floor Analyses 

                           SUPPORT/OPPOSITION:  SEE ABOVE

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