BILL ANALYSIS
SB 564
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Date of Hearing: June 20, 2007
ASSEMBLY COMMITTEE ON EDUCATION
Gene Mullin, Chair
SB 564 (Ridley-Thomas) - As Amended: June 13, 2007
[Note: This bill has been double referred to the Assembly Health
Committee and will be heard as it relates to issues under its
jurisdiction.]
SENATE VOTE : 24-14
SUBJECT : Public School Health Center Support Program (PSHCSP)
SUMMARY : Expands the definition of "school health centers" and
requires the State
Department of Public Health (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 school
health centers and the development of new school health centers,
as specified. Specifically, this bill :
1)Expands the definition of "school health center" to allow the
center to conduct routine physical health, mental health, and
oral health assessments, and provide for any services not
offered onsite or through a referral process.
2)Requires DPH to establish a grant program within the PSHCSP to
provide technical assistance, and funding for the expansion,
renovation, and retrofitting of existing school health
centers, and the development of new school health centers, as
specified.
3)Requires a school health center receiving grant funds under
the PSHCSP have a plan regarding how the center will: provide
comprehensive services; provide primary and other health
services including mental health and oral health; work in
partnership with the school nurse; coordinate services with
health care providers; serve all students regardless of
ability to pay; operate during school hours and facilitate
transportation.
4) Provides for four types of grants as follows:
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a) Planning grants, as specified, in amounts between
$25,000 and $50,000 for a 6-12 month period.
b) Facilities and startup grants, as specified, in amounts
between $20,000 and $250,000 per year for a 3-year period,
with the potential addition of $100,000 in the first-year.
c) Sustainability grants, as specified, in amounts between
$25,000 and $125,000 per year for a 3-year period.
d) Technical assistance grants, as specified.
5)Requires DPH to develop a request for proposal (RFP) process
and give preference for grant funding to:
a) Schools with medically underserved populations.
b) Schools with a high percentage of low-income and
uninsured children and youth.
c) Schools with large numbers of limited English proficient
(LEP) students.
d) Low-performing schools with Academic Performance Index
(API) rankings in Deciles 1-3.
6)Requires moneys to be allocated to DPH annually for an
evaluation to be conducted by an outside evaluator that is
selected through a competitive bidding process to document the
number of grantees that establish and sustain school health
centers and describe the challenges and lessons learned in
creating successful school health centers; as specified.
7)Makes the bill contingent upon an appropriation to DPH in the
annual Budget Act or other statute.
EXISTING LAW :
1)Requires the DPH, in cooperation with the California
Department of Education (CDE), to establish a Public School
Health Center Support Program (PSHCSP) to perform specified
functions relating to the establishment, retention, or
expansion of school health centers in California.
2)Defines, for purposes of the PSHCSP, a "school health center"
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to mean a center or program that provides age-appropriate
health care services at the program site or through referrals,
and may be located on or at a local educational agency.
FISCAL EFFECT : According to the Senate Appropriations
Committee, $2 million General Fund (GF) for 2007-08 and $4
million for 2008-09 and 2009-10.
COMMENTS : Background . According to the California School
Health Centers Association (CSHCA), the first school health
centers in California opened in 1987 in Los Angeles, San Jose
and San Francisco. There are currently more than 140 school
health centers in California, 116 of which are located directly
on school campuses, 27 are off campus but "linked" to one or
more schools, and six are mobile vans that serve multiple
schools. Of the centers located on school campuses, 51 are in
elementary schools, 15 are in middle schools, 46 are in high
schools, and 7 are on mixed-grade campuses. In school districts
with school health centers, approximately 22% of the students
live in families with income at or below the federal poverty
level.
According to the Senate Health Committee analysis of this bill,
school health centers are administered by a variety of
organizations, including school districts, Federally Qualified
Health Centers, community health centers, hospitals, county
health departments, and private physician groups. A school
health center will typically include nurse practitioners,
nurses, and mental health care providers as well as part-time
physicians and medical students in training. Lab facilities for
routine tests are often located on the site. Some centers also
offer dental care. School health centers are financed through
grants from state, local, and private sources as well as
reimbursements from Child Health and Disability Prevention
(CHDP), Medi-Cal, Family PACT and Healthy Families. According
to CSHCA, more than half of school health centers recover less
than 50% of their operating costs from billing sources.
The Governor has declared support for school health centers
however no funding has been proposed for this purpose in the
current budget . The Governor announced a goal of expanding
elementary school health centers to 500 schools during the
Governor's Health Care summit in July 2006. According to the
Administration's White Paper on School-Based Health Centers,
"the Administration will work with healthcare and education
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stakeholders and legislative leaders to develop an initiative to
support and expand school-based health centers (SBHCs) to 500
elementary schools - reflecting the importance of focusing on
children in their early years." Despite this support, the
Governor did not provide funding to expand health centers in his
proposed budget.
According to the author's office, while there is not money in
the current budget, this bill was introduced in part as the
vehicle by which the Governor could make good on his pledge from
last year to expand the number of school health centers from 140
to 500. Even if no money is appropriated for the purposes of
this bill this year, establishing the parameters of the grant
program is an important first step that can be built upon in
future years should money become available.
Prior legislation :
AB 2560 (Ridley-Thomas), Chapter 334, Statutes of 2006, required
DHS, in cooperation with the CDE, to establish a Public School
Health Center Support Program located in the School Health
Connections Office. The bill required the PSHCSP, in
collaboration with CDE and UC, to perform the functions of the
program, as specified.
SB 566 (Escutia) of 1999 sought to establish the School Health
Center Grant Program, to be administered by DHS, to provide
grants to qualifying school health centers in order to assist
the centers in providing health services to students, provided
that funds for this purpose are provided in the annual Budget
Act. The bill also sought to require DHS to establish a study
group to explore long-term strategies for the support of school
health centers, and the incorporation of these centers into a
coordinated, comprehensive health care system. This bill was
held on Senate Floor.
Arguments in support . According to the California Primary Care
Association, "This bill recognizes that school health centers
put the community in control and give families options for their
children's health care. School health centers take health
problems out of the classroom and put them where they belong -
in the hands of doctors, nurses, and counselors. When educators
and health care providers work together, children gain the
opportunity to succeed."
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Arguments in opposition . According to the Citizens Commission
on Human Rights, "SB 564 would allow school health centers to
conduct "routine" mental health assessments. There are no
"routine" mental health assessments in the American Academy of
Pediatrics periodic services schema. The psychiatric industry
has profitably turned childhood emotions and behavior into
"mental disorders". What so called "mental health professionals"
dispense is not medical treatment for actual diseases but
expensive chemical behavior and mood control pills that can
cause horrific physical and social consequences. Please
recognize that the psychiatric industry, those "mental health
professionals," are willing and profiting participants in this
whole fraudulent scheme."
REGISTERED SUPPORT / OPPOSITION :
Support
Alameda Health Consortium
American College of Obstetricians and Gynecologists, District
IX/CA
Asian Pacific Health Care Venture, Inc.
Bay Area Partnership for Children & Youth
California Academy of Family Physicians
California Academy of Ophthalmology
California Adolescent Health Collaborative
California Coalition for Youth
California Dental Association
California Family Health Council
California Mental Health Directors Association
California Primary Care Association
California Primary Care Association
California School Boards Association
California School Health Centers Association
California School Nurses Organization
California Teachers Association
Cedars-Sinai Medical Center C.O.A.C.H. for Kids & Their Families
Program
Children Now
Community Clinic Consortium, Serving Contra Costa & Solano
Counties
Compton Unified School District
Daly City Youth Health Center
El Cerrito High School Community Project
Epilepsy California
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Gateway Unified School District
La Cl?nica de La Raza, Inc.
Latino Coalition for a Healthy California
Los Angeles County Office of Education
Mental Health Association in California
National Council of La Raza
Needles Unified School District
North Coast Clinics Network
Northeast Valley Health Corporation
Novato Youth Wellness Collaborative
Open Door Community Health Centers
Permanent Steering Committee of the Oral Health Access Council
Planned Parenthood Affiliates of California
Planned Parenthood Mar Monte
Redwoods Rural Health Center
School Health Clinics of Santa Clara County
Shasta Community Health Center
South Central Family Health Center
Southern Trinity Health Services
Sweetwater Union High School District
Watts Healthcare Corporation
Youth UpRising
Several Individuals
Opposition
Citizens Commission on Human Rights
Analysis Prepared by : Misty Feusahrens / ED. / (916) 319-2087