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AB-2052 School-Based Health and Education Partnership Program.(2023-2024)



Current Version: 04/08/24 - Amended Assembly

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AB2052:v98#DOCUMENT

Revised  April 25, 2024
Amended  IN  Assembly  April 08, 2024

CALIFORNIA LEGISLATURE— 2023–2024 REGULAR SESSION

Assembly Bill
No. 2052

Introduced by Assembly Member Jones-Sawyer
(Coauthor: Assembly Member Muratsuchi)

February 01, 2024

An act to amend Section Sections 124174.2, 124174.3, 124174.4, and 124174.6 of of, to repeal Section 124174.5 of, and to repeal and add Section 124174 of, the Health and Safety Code, relating to public health.


LEGISLATIVE COUNSEL'S DIGEST


AB 2052, as amended, Jones-Sawyer. School-Based Health and Education Partnership Program.
Existing law requires the State Department of Public Health, in cooperation with the State Department of Education, to establish a Public School Health Center Support Program to assist health centers in schools and school districts. Existing law requires the State Department of Public Health, subject to an appropriation, to establish a grant program to provide funding for, among other things, expansion, renovation, and retrofitting of existing school health centers. Existing law requires the State Department of Public Health to develop a request for proposal process in order to collect information on applicants and determine which proposals shall receive funding. Existing law requires the State Department of Public Health to give preference to, among others, schools with a high percentage of low-income and uninsured children and youth or schools with a shortage of health professionals. Existing law defines, among other things, a “school health center” for those purposes to mean a center or program, located at or near a local educational agency, that provides age-appropriate health care services at the program site or through referrals.
This bill would instead define a “school-based health center” for those purposes to mean a student-focused health center or clinic that, among other things, is located at or near a school and is organized through school, community, and health provider relationships. This The bill would instead require require, on or before January 1, 2026, the State Department of Public Health to collaborate with the Office of School-Based Health Programs within the State Department of Education in order to award grant funding funding, as specified, to applicants. This bill would revise and reorganize the above-described preferred recipients and give preference to school-based health centers centers, as defined, serving, among others, schools in which more than 55 percent 55% of pupils serviced are unduplicated pupils, as defined, or areas experiencing health disparities in child and adolescent access to primary care, behavioral health, preventative preventive health, or oral health services.
Existing law requires the above-described Public School Health Center Support Program to perform various functions, including, serving as a liaison between organizations within the department, as specified.
This bill would instead require the State Department of Public Health, in collaboration with the Office of School-Based Health Programs within the State Department of Education, to provide the above-described assistance to school-based health centers. The bill would also repeal a related provision requiring the Public School Health Center Support Program, in collaboration with the State Department of Education, to act as a liaison for school-based health centers.
Existing law requires the State Department of Public Health, upon appropriation, to establish standardized data collection procedures and collect certain data, relating to services and funding, from school health centers on an ongoing basis.
This bill would require the school-based health centers to report data to the State Department of Public Health if they receive grant funding. The bill would eliminate the requirement on the State Department of Public Health to collect data on health services provided at a local educational agency outside a school health center.
This bill would make other conforming changes.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: NO  

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


SECTION 1.

 Section 124174 of the Health and Safety Code is repealed.
124174.

The following definitions shall govern the construction of this article, unless the context requires otherwise:

(a)“Program” means a Public School Health Center Support Program.

(b)“School health center” means a center or program, located at or near a local educational agency, that provides age-appropriate health care services at the program site or through referrals. A school health center may conduct routine physical, mental health, and oral health assessments, and provide referrals for any services not offered onsite. A school health center may serve two or more nonadjacent schools or local educational agencies.

(c)For purposes of this section, “local educational agency” means a school, school district, charter school, or county office of education if the county office of education serves students in kindergarten, or any grades from 1 to 12, inclusive.

(d)“Department” means the State Department of Public Health.

SEC. 2.

 Section 124174 is added to the Health and Safety Code, to read:

124174.
 (a) The following definitions shall govern the construction of this article, unless the context requires otherwise.
(b) “Program” means a School-Based Health Center Support Program.
(c) (1) “School-based health center” means a student-focused health center or clinic that meets all of the following conditions:
(A) Is located at or near a school or schools.
(B) Is organized through school, community, and health provider relationships.
(C) Provides age-appropriate, clinical health care services onsite by qualified health professionals.
(2) A “school-based health center” may provide primary medical care, behavioral health services, or dental care services onsite or through mobile health or telehealth.
(d) For purposes of this section, “local educational agency” means a school, school district, charter school, or county office of education if the county office of education serves students in kindergarten, or grades from 1 to 12, inclusive.
(e) “Department” means the State Department of Public Health.

SEC. 3.

 Section 124174.2 of the Health and Safety Code is amended to read:

124174.2.
 (a) The department, in cooperation with the Office of School-Based Health Programs in the State Department of Education, shall establish a Public School School-Based Health Center Support Program.
(b) The program, in collaboration with the State Department of Education, shall perform the following program functions:
(1) Provide technical assistance to school school-based health centers on effective outreach and enrollment strategies to identify children who are eligible for, but not enrolled in, the Medi-Cal program, the Healthy Families Program, Covered California, or any other applicable program. health insurance affordability program for children.
(2) Serve as a liaison between organizations within the department, including, but not limited to, prevention services, primary care, health equity, oral health, behavioral health, and family health.
(3) Serve as a liaison between other state entities, as appropriate, including, but not limited to, the State Department of Health Care Services, the Department of Managed Health Care, and the Office of Emergency Services, and the Managed Risk Medical Insurance Board. Services.
(4) Provide technical assistance to facilitate and encourage the establishment, retention, or expansion of, school school-based health centers. For purposes of this paragraph, technical assistance may include, but is not limited to, identifying available public and private sources of funding, which may include federal Medicaid funds, funds from third-party reimbursements, state demonstration projects or incentive programs, and available federal or foundation grant moneys.
(c) In addition to the duties described in subdivision (b), the department may enter into a contract with an entity that coordinates the efforts of school-based health centers for the purpose of providing assistance to school-based health centers that receive grant moneys. A contract entered into under this subdivision shall require the entity to perform the following:
(1) Provide technical assistance and community-specific ongoing training to school-based health centers, school districts, and local education agencies.
(2) Assist school-based health centers in improving business practices, including, but not limited to, practices related to billing and efficiencies.
(3) Assist school-based health centers in expanding their relationships with coordinated care organizations, sponsors of medical care for schoolage children, and other community-based providers of school-based health and mental health services.
(4) Facilitate the integration of health and education policies and programs at the local level so that school-based health centers operate in an optimal environment.

(c)

(d) The department shall consult with interested parties and appropriate health and education stakeholders, including the California School School-Based Health Centers Association Alliance and representatives of youth and parents, in carrying out its responsibilities under this article.

SEC. 4.

 Section 124174.3 of the Health and Safety Code is amended to read:

124174.3.
 (a) The department shall establish standardized data collection procedures and collect data specified in subdivisions (c) and (d) from school subdivision (c) from school-based health centers on an ongoing basis. School-based health centers shall report data to the department only to the extent that state funding is provided to school-based health centers under the program.
(b) The data collected pursuant to this section shall be submitted in a format determined by the department in accordance with applicable state and federal requirements for confidentiality and protected health information.
(c) Data collected pursuant to this section shall include the following:
(1) The name of the primary contact person, telephone numbers, including facsimile facsimile, physical address, and the e-mail email address, if applicable, for each school school-based health center.
(2) The annual number of schoolage children receiving health services or mental health services from the school school-based health center.
(3) The type and volume of services provided by the school school-based health centers.
(4) The funding mechanisms used by the school school-based health centers.
(5) Information on other programs offered by school school-based health centers with an emphasis on preventative health services that address health issues unique to schoolage children, including, but not limited to, childhood obesity, asthma, immunizations against communicable diseases, and child and adolescent mental health disorders.

(d)To the extent feasible, the department shall collect data on health services provided at a local educational agency outside a school health center.

(e)

(d) This section shall be implemented only to the extent funds are appropriated for this purpose in the Budget Act or pursuant to the enactment of legislation subsequent to the addition of this section.

SEC. 5.

 Section 124174.4 of the Health and Safety Code is amended to read:

124174.4.
 The Office of School-Based Health Programs in the State Department of Education, in collaboration with the department, shall perform the following functions:
(a) Coordination of programs within the State Department of Education that support school health centers and programs within the State Department of Health Care Services, where appropriate. school-based health centers.
(b) The provision of technical assistance to facilitate and encourage the establishment, retention, and expansion of school school-based health centers in public schools. local educational agencies. For purposes of this subdivision, “technical assistance” may include the provision of information to local educational agencies and other entities regarding the utilization of facilities, liability insurance, cooperative agreements with community-based providers, and other issues pertinent to school school-based health centers.

SEC. 6.

 Section 124174.5 of the Health and Safety Code is repealed.
124174.5.

The program, in collaboration with the State Department of Education, shall act as a liaison for school-based health centers.

SECTION 1.SEC. 7.

 Section 124174.6 of the Health and Safety Code is amended to read:

124174.6.
 The department shall establish a grant program within the Public School School-Based Health Center Support Program to provide technical assistance, and funding for the expansion, renovation, and retrofitting of existing school school-based health centers, and the development of new school school-based health centers, in accordance with the following procedures and requirements:
(a) A school health center receiving grant funds pursuant to this section shall meet or have a plan to meet the following requirements:
(1) Strive to provide a comprehensive set of services including medical, oral health, mental health, Provide primary medical care. The health center may also provide other health care services, including behavioral health, dental care, health education, and related services in response to community needs.
(2) Provide primary and Strive to provide a comprehensive and integrated set of other health care services, provided or supervised by a licensed professional, which licensed or credentialed professional that may include all of the following:
(A) Physical examinations, immunizations, and other preventive medical services.
(B)  Diagnosis and treatment of minor injuries and acute medical conditions.
(C) Management of chronic medical conditions.
(D) Basic laboratory tests.
(E) Referrals to and followup for specialty care.
(F) Reproductive health services.
(G) Nutrition services.
(H) Mental health services provided or supervised by an appropriately licensed or credentialed mental health professional may include: assessments, crisis intervention, counseling, treatment, and referral to a continuum of services including emergency psychiatric care, community support programs, inpatient care, and outpatient programs. School health centers providing mental health services as specified in this section shall consult with the local county mental health department for collaboration in planning and service delivery.
(I) Substance use disorder services, including education, prevention, screening, early interventions, counseling, and referral to treatment services.

(I)

(J) Oral health services that may include preventive services, basic restorative services, and referral to specialty services.
(3) Strive to address the population health of the entire school campus by focusing on prevention services, including, but not limited to, group and classroom education, schoolwide prevention programs, and community outreach strategies within the school’s multitiered system of support or other similar framework employed by the local educational agency.
(4) 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.
(5) Strive to integrate the school-based health center in the school or local educational agency’s community school model, if applicable.

(3)

(6) Work in partnership with the school nurse, if one is employed by the school or school district, local educational agency, to provide individual and family health education; school or districtwide health promotion; first aid and administration of medications; facilitation of student enrollment in health insurance programs; screening of students to identify the need for physical, mental health, and oral health services; referral and linkage to services not offered onsite; public health and disease surveillance; and emergency response procedures. A school school-based health center may receive grant funding pursuant to this section if the school or school district does not employ a school nurse. However, it is not the intent of the Legislature that a school health center serve as a substitute for a school nurse employed by a local school or school district. educational agency.

(4)

(7) Have a written contract or memorandum of understanding between the school district local educational agency and the health care provider or any other community providers that ensures coordination of services, ensures confidentiality and privacy of health information consistent with applicable federal and state laws, and integration of services into the school environment.

(5)

(8) Serve all registered students in the school regardless of ability to pay.

(6)

(9) Be open during all normal school hours, or on a more limited basis if resources are not available, or on a more expansive basis if dictated by community needs and resources are available.

(7)

(10) Establish protocols for referring students to outside services when the school health center is closed.

(8)

(11) Facilitate transportation between the school and the health center if the health center is not located on school or school district property.
(b) Planning Commencing on or before January 1, 2026, planning grants shall be available in amounts between twenty-five thousand dollars ($25,000) and fifty thousand dollars ($50,000) for a 6- to 12-month and one hundred thousand dollars ($100,000), inclusive, for up to a 24-month period to be used for the costs associated with assessing the need for a school school-based health center in a particular community or area, and developing the partnerships necessary for the operation of a school school-based health center in that community or area. Applicants for planning grants shall be required to have a letter of interest from a school or district local educational agency if the applicant is not a local education educational agency. Grantees provided funding pursuant to this subdivision shall be required to do all of the following:
(1) Seek input from students, parents, school nurses, school staff and administration, local health providers, and if applicable, special population groups, on community health needs, barriers to health care and the need for a school school-based health center.
(2) Collect data on the school and community to estimate the percentage of students that lack health insurance and the percentage that are eligible for Medi-Cal or private health care coverage benefits, or other public programs providing free or low-cost health services.
(3) Assess capacity and interest among health care providers in the community to provide services in a school school-based health center. 
(4) Assess the need for specific cultural or linguistic services or both.
(c) Facilities Commencing on or before January 1, 2026, facilities and startup grants shall be available in amounts between twenty thousand dollars ($20,000) and two hundred fifty thousand dollars ($250,000) three hundred thousand dollars ($300,000) and eight hundred fifty thousand dollars ($850,000), inclusive, per year for a three-year period for the purpose of establishing a school health center, with the potential addition of one hundred thousand dollars ($100,000) in the first year for facilities construction, purchase, or renovation. school-based health center. Grant funds may be used to cover a portion or all of the costs associated with designing, retrofitting, renovating, constructing, or buying a facility, facility or mobile health unit, for medical equipment and supplies for a school school-based health center, or for personnel costs at a school health center. Preference will be given to proposals that include a plan for cost sharing among schools, local educational agencies health providers, and community organizations or that identify match funding for facilities construction and renovation costs. Preference will be given to proposals that include plans to provide integrated primary medical care and behavioral health services. Applicants for facilities and startup grants offered pursuant to this subdivision shall be required to meet the following criteria:
(1) Have completed a community assessment determining the need for a school school-based health center.
(2) Have a contract or memorandum of understanding between the school district local educational agency and the health care provider, if other than the district, local educational agency, and any other provider agencies describing the relationship between the district local educational agency and the school school-based health center.
(3) Have a mechanism, described in writing, to coordinate services to individual students among school school-based and school health center staff while maintaining confidentiality and privacy of health information consistent with applicable state and federal laws.
(4) Have a written description of how the school school-based health center will participate in the following:
(A) School and districtwide health promotion, coordinated school school-based health, health education in the classroom or on campus, program/activities that address nutrition, fitness, or other important public health issues, or promotion of policies that create a healthy school environment.
(B) Outreach and enrollment of students in health insurance programs.
(C) Public health prevention, surveillance, and emergency response for the school population.
(5) Have the ability to provide the linguistic or cultural services needed by the community. If the school health center is not yet able to provide these services due to resource limitations, the school health center shall engage in an ongoing assessment of its capacity to provide these services.
(6) Have a plan for maximizing available third-party reimbursement revenue streams.
(d) Sustainability Commencing on or before January 1, 2026, expansion grants shall be available in amounts between twenty-five thousand dollars ($25,000) and one hundred twenty-five thousand dollars ($125,000) per year one hundred fifty thousand dollars ($150,000) and three hundred thousand dollars ($300,000), inclusive, for up to a three-year period for the purpose of operating a school renovating and improving an existing school-based health center, or enhancing programming at a fully operational school health center, including oral health or mental health services. adding physical health, oral health, or behavioral health services, or supporting operations at a fully operational school-based health center. Preference will be given to proposals that increase access to comprehensive health care services at the school-based health center by adding staff or service or expanding the facility. Applicants for sustainability expansion grants offered pursuant to this subdivision shall be required to meet all of the criteria described in subdivision (c), in addition to both all of the following criteria:
(1) The applicant shall be eligible to become or already be an approved Medi-Cal provider.
(2) The applicant shall have ability and procedures in place for billing public insurance programs and managed care providers. programs, managed care health plans, or county mental health plans.
(3) The applicant shall seek reimbursement and have procedures in place for billing public and private insurance that covers students at the school health center. develop a plan to sustain expanded services at the school-based health center after the grant period.
(e) Commencing on or before January 1, 2026, sustainability grants shall be available in amounts between one hundred fifty thousand dollars ($150,000) and three hundred thousand dollars ($300,000), inclusive, per year ongoing for the purpose of operating a school health center. Applicants for sustainability grants offered pursuant to this subdivision shall be required to meet all of the following criteria described in subdivision (c), in addition to all of the following criteria:

(e)The department shall award technical assistance grants through a competitive bidding process to qualified contractors to support grantees receiving grants under subdivisions (b), (c), and (d). A qualified contractor means a vendor with demonstrated capacity in all aspects of planning, facilities development, startup, and operation of a school health center.

(1) The applicant shall be eligible to become or already be an approved Medi-Cal provider.
(2) The applicant shall have ability and procedures in place for billing public insurance programs, managed care health plans, or county mental health plans.
(3) The applicant shall seek reimbursement and have procedures in place for billing public and private insurance that covers students at the school health center.
(f) The department shall award technical assistance grants through a competitive bidding process to qualified contractors to support grantees receiving grants under subdivisions (b), (c), (d), and (e). A “qualified contractor” means a vendor with demonstrated capacity in all aspects of planning, facilities, development, startup, and operation of a school-based health center.

(f)

(g) The department, in collaboration with the Office of School-Based Health Programs in the State Department of Education, shall also develop a request for proposal (RFP) process for collecting information on applicants, and determining which proposals shall receive grant funding. The department shall give preference for grant funding to school-based health centers serving any of the following:
(1) Areas designated as federally medically underserved areas or with medically underserved populations or areas with a shortage of health professionals.
(2) Areas experiencing health disparities in child and adolescent access to primary care, behavioral health, preventative preventive health, or oral health services.
(3) Schools in which more than 55 percent of pupils serviced are unduplicated pupils, as defined in Section 42238.02 of the Education Code.

(g)

(h) Moneys shall be allocated to the department annually for evaluation to be conducted by an outside evaluator that is selected through a competitive bidding process. The evaluation shall document the number of grantees that establish and sustain school school-based health centers, and describe the challenges and lessons learned in creating successful school school-based health centers. The evaluator shall use data collected pursuant to Section 124174.3, if it is available, and work in collaboration with the Public School School-Based Health Center Support Program. The department shall post the evaluation on its internet website.

(h)

(i) This section shall be implemented only to the extent that funds are appropriated to the department in the annual Budget Act or other statute for implementation of this article.

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REVISIONS:
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