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SB-320 Public university student health centers: medication abortion readiness: abortion by medication techniques: College Student Health Center Sexual and Reproductive Health Preparation Fund.(2017-2018)



Current Version: 09/05/18 - Enrolled         Compare Versions information image


SECTION 1.
 The Legislature finds and declares all of the following:
(a) Abortion care is a constitutional right and an integral part of comprehensive sexual and reproductive health care.
(b) More than 400,000 students classified as female are educated at California’s public university campuses, and it is central to the mission of California’s public university student health centers to minimize the negative impact of health concerns on students’ studies and to facilitate retention and graduation.
(c) The state has an interest in ensuring that every pregnant person in California who wants to have an abortion can obtain access to that care as easily and as early in pregnancy as possible. When pregnant young people decide that abortion is the best option for them, having early, accessible care can help them stay on track to achieve their educational and other aspirational life plans.
(d) All California public university campuses have on-campus student health centers, but none of these health centers currently provide abortion by medication techniques. Abortion by medication techniques is extremely safe, highly effective, and cost effective. Abortion by medication techniques is an essential part of comprehensive women’s  sexual and reproductive  health care, and should be accessible at on-campus student health centers.
(e) Staff at on-campus student health centers include health professionals who are licensed to provide abortion by medication techniques. Under current California law, all residency programs in obstetrics and gynecology include training in abortion. Physicians, nurse practitioners, physician assistants, and certified nurse-midwives are legally authorized to perform abortions by medication techniques. Any clinician legally authorized to provide abortion, but not currently trained to provide abortion by medication techniques, can be trained inexpensively to do so, and such training falls within the requirements of continuing education for medical providers.
(f) The National Academies of Sciences, Engineering, and Medicine have found that prescribing abortion by medication techniques is no different from prescribing other medications, and have also found that the risks of providing abortion by medication techniques, including via telehealth, are low and similar to the risks of serious adverse effects of taking commonly used prescription and over-the-counter medications.
(f) (g)  Students seeking early pregnancy termination, especially those enrolled at institutions outside of major urban centers, face prohibitively expensive travel, often without reliable means of transportation, to a clinic that may require hours of travel from their campus, out of their city, county, or even geographic region. These financial and time burdens negatively impact academic performance and mental health.
(h) California law recognizes abortion as a basic health service that must be covered by Medi-Cal and by private, managed care insurance plans regulated by the state.
(i) It is the intent of the Legislature that public university student health centers make abortion by medication techniques as accessible and cost-effective for students as possible, and thus public university student health centers should treat abortion by medication techniques as a basic health service.

SEC. 2.

 Chapter 5.5 (commencing with Section 99250) is added to Part 65 of Division 14 of Title 3 of the Education Code, to read:

CHAPTER  5.5. Student Health Care Services
99250.
 For the purposes of this chapter, the following definitions apply:
(a) “Council” means the Medication Abortion Implementation Advisory Council. “Commission” means the Commission on the Status of Women and Girls established by Section 8241 of the Government Code. 
(b) “Fund” means the Medication Abortion Implementation  College Student Health Center Sexual and Reproductive Health Preparation  Fund established by Section 99251.
(c) “Grantee” means any qualifying student health center at a public or private  college or university.
(d) “Implementation of abortion by medication techniques”  “Medication abortion readiness”  includes, but is not limited to, assessment of each individual clinic to determine facility and training needs before beginning to provide abortion by  medication abortion, techniques,  purchasing equipment, making facility improvements, establishing clinical protocols, creating patient educational materials, and training staff. “Medication abortion readiness” does not include the provision of abortion by medication techniques. 
(e) “Public university student health center” means a clinic providing primary health care services to students that is located on the campus of a university within the University of California or California State University systems.
99251.
 (a) On and after January 1, 2022, each public university student health center shall offer abortion by medication techniques.
(b) The Treasurer shall establish an implementation schedule over the three-year time period that will take into account student health centers that are prepared to begin providing abortion by medication techniques in the first, second, or third year based on criteria to be established, which may include whether the clinic has already trained providers and ultrasound machines.
(c) (b)  (1) The Treasurer commission  shall administer the Medication Abortion Implementation  College Student Health Center Sexual and Reproductive Health Preparation  Fund, which is established by this chapter for the purposes of providing private moneys in the form of grants to on-campus student health centers at public and private  colleges and universities for the implementation of abortion by medication techniques.  medication abortion readiness.  Notwithstanding any other law, the Treasurer commission  is authorized to receive moneys from nonstate entities, including, but not necessarily limited to, private sector entities and local and federal government agencies, and deposit these moneys in the fund.
(2) Notwithstanding Section 13340 of the Government Code, the moneys in the fund are continuously appropriated to the Treasurer commission  for allocation for purposes of this chapter.
(3) The Treasurer commission  shall utilize fund moneys to do all of the following:
(A) Provide grants to  a grant of two hundred thousand dollars ($200,000) to each  public university student health centers center  to pay for the cost, both direct and indirect, of implementing abortion by medication techniques. medication abortion readiness. Allowable expenses under these grants include, but are not limited to, all of the following: 
(i) The Treasurer may additionally provide grants to student health centers at other public and private postsecondary educational institutions to pay for direct costs associated with implementing  Purchase of equipment used in the provision of  abortion by medication techniques.
(ii) The Treasurer shall prioritize grants to public university student health centers over grants to student health centers at other public and private postsecondary educational institutions. Facility and security upgrades. 
(iii) Costs associated with enabling the campus health center to deliver telehealth services.
(B) (iv)  Hire appropriate individuals or contract with an external organization or organizations to provide consultation to each public university student health center to establish plans and budgets for implementation  Costs associated with training staff in the provision  of abortion by medication techniques.
(v) Staff cost reimbursement and clinical revenue offset while staff are in trainings.
(B) Provide a grant of two hundred thousand dollars ($200,000) to both the University of California and the California State University, to pay for the cost, both direct and indirect, of the following, for each university system:
(C) (i)  Hire appropriate individuals or contract with external organizations to create and provide appropriate trainings for staff of each  Providing 24-hour, backup medical support by telephone to patients who have obtained abortion by medication techniques at a  public university student health center.
(D) (ii)  Hire an evaluator with experience in evaluating abortion services, to determine provider, staff, and patient satisfaction and experience with the implementation of abortion by medication techniques at each grantee, as well as report on usage and outcomes. One-time fees associated with establishing a corporate account to provide telehealth services. 
(iii) Billing specialist consultation.
(E) (C)  Provide overall coordination of the fund. Paying itself for the costs, both direct and indirect, associated with administration of the fund, including the costs of hiring staff, not to exceed two million four hundred thousand dollars ($2,400,000). 
(F) Pay itself direct costs and overhead.
(G) (D)  Maintain Maintaining  a system of financial reporting and accountability. on all aspects of the fund. 
(4) The Treasurer may directly expend fund moneys for certain aspects of implementation, such as equipment purchases for grantees, if the Treasurer determines that such expenditure of funds would be financially prudent and timely.
(5) (4)  Each public university student health center  grantee shall, as a  condition of receiving a grant award from the fund, participate in an evaluation of their implementation  its medication abortion readiness and its provision  of abortion by medication techniques.
(6) (5)  The requirements of this chapter shall be implemented only if, and  to the extent that private moneys are that, a total of at least nine million six hundred thousand dollars ($9,600,000) in private funds is  made available to the fund in an amount sufficient to fund all of the costs for public university student health centers to implement this chapter by January 1, 2022, and thereafter. The Treasurer shall consult with the State Department of Public Health and the governing bodies of the public universities in making the determination whether funds are sufficient. a timely manner on or after January 1, 2019. 
(7) (6)  Nothing in this chapter shall be interpreted as requiring a  public universities to support implementation of abortion by medication techniques with General Fund appropriations or student fees. university to utilize General Fund moneys or student fees for medication abortion readiness before January 1, 2022. 
(d) The Treasurer shall establish the Medication Abortion Implementation Advisory Council, in accordance with all of the following:
(1) The council shall develop the objectives and priorities of the fund, actively participate in the overall management of the fund, and make final recommendations on which student health centers should be funded based on the technical merits of their proposals.
(2) The council shall determine the qualifications and scope of work in a request for proposals to select an organization that will provide one-on-one support to each public university student health center for the purposes of creating individual student health center implementation plans, proposals, and budgets.
(3) The Treasurer shall work in close collaboration with the council and seek the consent of the council before taking an action different from the action recommended by the council.
(4) The council shall consist of at least nine and no more than 11 members representing a range of expertise and experience, appointed by the Treasurer. Individuals and organizations may submit nominations to the Treasurer, and the Treasurer shall solicit nominations from relevant organizations and individuals. The composition of the council shall be as follows:
(A) Two members from California nonprofit organizations providing supportive services to individuals seeking abortions.
(B) Three members who are scientists or clinicians who study or provide abortion by medication techniques.
(C) Two members who are currently students at a public university, who have utilized student health services in the past 12 months, and who seek to expand access to abortion by medication techniques on campus.
(D) Two members drawn from the ranks of staff or providers, or both, at a public university student health center.
(5) If the Treasurer appoints more than nine members, it is the intent of the Legislature that the proportional representation remains substantially the same as set forth in paragraph (4).
(6) Members of the council shall serve without compensation, but may receive reimbursement for travel and other necessary expenses actually incurred in the performance of their official duties.
(7) Members of the council shall serve at the pleasure of the Treasurer, and any vacancies shall be filled by the Treasurer, in consultation with the remaining council members, keeping the proportional representation as set forth in paragraph (4).
(e) (c)  The Treasurer, commission,  working with the public university student health centers, shall assist and advise on potential pathways for their student health centers to access public and private payers to provide funding for ongoing costs of providing abortion by medication techniques.
(f) (d)  (1) The Treasurer shall report to the Legislature, on  On  or before December 31, 2020, and then again  on or before December 31, 2021, the number of public university student health centers that have begun providing abortion by medication techniques. 31 of each year thereafter until December 31, 2025, the commission shall submit a report to the Legislature, including, but not necessarily limited to, all of the following information for each reporting period, separately for the University of California and the California State University: 
(A) The number of student health centers that provide abortion by medication techniques.
(B) The number of abortions by medication techniques performed at student health centers, disaggregated, to the extent possible, by student health center.
(C) The total amount of funds granted by the commission to the university and the university’s student health centers that is expended on medication abortion readiness, and, separately, the total amount of any other funds expended on medication abortion readiness and the source of those funds, disaggregated by function and, to the extent possible, disaggregated by student health center.
(D) The total amount of funds expended on the provision of abortion by medication techniques and the source of those funds, disaggregated by function and, to the extent possible, disaggregated by student health center.
(2) The report required in paragraph (1), and any associated data collection, shall be conducted in accordance with state and federal privacy law, including, but not necessarily limited to, the state Confidentiality of Medical Information Act (Part 2.6 (commencing with Section 56) of Division 1 of the Civil Code), the federal Family Educational Rights and Privacy Act of 1974 (20 U.S.C. Sec. 1232g), and the federal Health Insurance Portability and Accountability Act of 1996 (Public Law 104-191).
(2) (3)  The requirement for submitting reports under paragraph (1) shall become inoperative on January 1, 2026, pursuant to Section 10231.5 of the Government Code.