Bill Text: CA AB1955 | 2013-2014 | Regular Session | Amended

NOTE: There are more recent revisions of this legislation. Read Latest Draft

---

Bill Title: Pupil health: Healthy Kids, Healthy Minds Demonstration.

Spectrum: Partisan Bill (Democrat 3-0)

Status: (Introduced - Dead) 2014-05-23 - In committee: Set, second hearing. Held under submission. [AB1955 Detail]

Download: California-2013-AB1955-Amended.html

---

BILL NUMBER: AB 1955	AMENDED
	BILL TEXT

	AMENDED IN ASSEMBLY  APRIL 22, 2014
	AMENDED IN ASSEMBLY  MARCH 28, 2014

INTRODUCED BY   Assembly Member Pan
    (   Coauthors:   Assembly Members 
 Gonzalez   and Nazarian   ) 

                        FEBRUARY 19, 2014

   An act to add and repeal Section 42238.054 of the Education Code,
and to amend Section 14132.47 of the Welfare and Institutions Code,
relating to pupil health.


	LEGISLATIVE COUNSEL'S DIGEST


   AB 1955, as amended, Pan.  Healthy   Pupil
health: Healthy  Kids, Healthy Minds Demonstration.
   Existing law establishes a public school financing system that
requires state funding for county superintendents of schools, school
districts, and charter schools to be calculated pursuant to a local
control funding formula, as specified. Existing law requires the
Superintendent of Public Instruction to annually calculate a local
control funding formula grant for each school district and charter
school based on data submitted by local educational agencies, as
specified, in accordance with instructions specified by the
Controller.
   This bill would require the Superintendent to establish and
implement the Healthy Kids, Healthy Minds Demonstration for the
period of  September   July  1, 2015, until
 December 31   June 30  , 2018, under
which participating schoolsites would employ a school nurse and a
mental health professional,  as defined,  and extend library
hours. The bill would authorize local educational agencies that have
a percentage of unduplicated pupils, as defined, in excess of 55
percent of the local educational agency's total school enrollment to
apply  to the Superintendent  for funding for these
purposes, as specified and upon appropriation. The bill would
authorize individual schoolsites to apply for this funding if the
local educational agency does not have the required percentage of
unduplicated pupils. The bill would require participating local
educational agencies to collect and aggregate certain pupil data 
,  and  transmit this data annually to the State Department
of Education. The bill  would encourage participating local
educational agencies to offer specified library programs. The bill
would require the State Department of Education to compile, analyze,
and present the results of the demonstration to the State Board of
Education and the Legislature no later than  August 
 December  31, 2018.
   Existing law provides for the Medi-Cal program, which is
administered by the State Department of Health Care Services, under
which qualified low-income individuals receive health care services.
The Medi-Cal program is, in part, governed and funded by federal
Medicaid Program provisions. Existing law establishes an
Administrative Claiming process under which local governmental
agencies and local educational consortia contract with the State
Department of Health Care Services for the purpose of obtaining
federal matching funds to assist with the performance of
administrative activities relating to the Medi-Cal program.
   This bill would require the State Department of Health Care
Services and the State Department of Education to cooperate and
coordinate efforts in order to maximize receipt of federal matching
funds under these provisions, and would require the State Department
of Health Care Services to, through an interagency agreement with the
State Department of Education, provide technical advice and
consultation services to local educational agencies, as specified.
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  The Legislature finds and declares all of the
following:
   (a) School-based health services lead to academic improvements,
better attendance, reduced suspension and expulsion rates, and lower
dropout rates.
   (b) Adverse childhood experiences, such as abuse or neglect,
violence, and physical health conditions, such as asthma and dental
caries, impact school readiness, classroom behavior, and absentee
rates.
   (c) Only 2 percent of California's schools have a school-based
health center and 57 percent of California school districts report
not having any full-time school nurse.
   (d) The ratio of pupils to school nurses in California is 2,815 to
1, and the National Association of School Nurses recommends that
school districts provide one nurse for every 750 well pupils.
   (e) The ratio of pupils to school psychologists in California is
1,469 to 1, and the National Association of School Psychologists'
Practice Model recommends a ratio of one psychologist for every
 500-700   500 to 700  pupils.
   (f) School library programs and the presence of school librarians
can make significant differences in pupil success, literacy,
information technology skills, and overall academic achievement.
   (g) Research shows that  ,  when children have access to
libraries with plenty of books and adequate staffing, they read more
and do better on reading tests.
   (h) California ranks 51st nationally, including the District of
Columbia, in the number of pupils per librarian.
   (i) Given the promise of education reform, the scarcity of health
professionals in the schools, and the steady decline in numbers of
library staff, the state must find innovative ways to spend its
limited fiscal resources and leverage federal funding, in order to
facilitate for local educational agencies the task of connecting
health services to schools, and assist in returning schools and
school libraries to their traditional missions as centers of learning
and community life.
  SEC. 2.  Section 42238.054 is added to the Education Code, to read:

   42238.054.  (a) The demonstration project established pursuant to
this section shall be known, and may be cited, as the Healthy Kids,
Healthy Minds Demonstration.
   (b) The Superintendent shall establish the Healthy Kids, Healthy
Minds Demonstration in accordance with this section to increase the
base grant amounts received by local educational agencies pursuant to
Sections 2574 and 42238.02. The purpose of the demonstration is for
participating schoolsites to employ one full-time school nurse and
one full-time mental health professional, and to ensure that the
schoolsites' libraries are open one hour before, and three hours
after, the regular schoolday.
   (c) The Superintendent shall implement the demonstration for the
period of  September   July  1, 2015, to
 December 31   June 30  , 2018, inclusive.
   (d) (1) Except as provided in paragraph (2), a local educational
agency is eligible to participate in the demonstration if it has a
percentage of unduplicated pupils, as determined pursuant to Section
42238.02, in excess of 55 percent of the local educational agency's
total school enrollment.
   (2) Notwithstanding paragraph (1), local educational agencies that
do not meet the requirements of paragraph (1) shall allow individual
schoolsites that meet the requirements of paragraph (1) and are
interested in participating to apply and participate in the
demonstration.
   (e) To participate in the demonstration, a local educational
agency's application shall, at a minimum, demonstrate all of the
following:
   (1) The local educational agency meets the requirements of
subdivision (d) and is able to achieve the goal of the demonstration
with  a combination of  current and additional local funds
 and funding received from the grant program  .
   (2) The local educational agency can meet the goal of employing
one-full time nurse and one full-time mental health professional, and
providing the extended library hours described in subdivision (b),
for three fiscal years.
   (3) The local educational agency can show that the proposed use of
the funds provided under the demonstration is consistent with its
local control and accountability plan. 
   (f) (1) Applicants selected to participate in the demonstration
shall receive a 5 percent increase in their base grant per unit of
average daily attendance for kindergarten and grades 1 to 8,
inclusive, as certified on July 20 for each budget year and
calculated for purposes of the advance principal apportionment.
 
   (2) Applicants selected to participate in the demonstration shall
receive a 2 percent increase in their base grant per unit of average
daily attendance for grades 9 to 12, inclusive, as certified on July
20 for each budget year and calculated for purposes of the advance
principal apportionment.  
   (g) 
    (   f)  Upon appropriation by the Legislature,
the Superintendent shall reserve funds each year necessary to operate
the demonstration  , and establish a separate account from
which to apportion the additional base grant amounts to local
educational agencies pursuant to subdivision (f)   as a
grant program  . 
   (h) 
    (  g)  A participating local educational
agency, with assistance from the department, shall collect and
aggregate data from schoolsites under the jurisdiction of the local
educational agency that measures changes in pupil absenteeism, school
climate, reductions in  the  incidence of violence,
successful intervention against suicide attempts and pupil bullying,
changes in health status among high-needs pupils, such as low income,
English learners, and foster youth, general pupil outcomes and
achievement, and other relevant benchmarks as defined and determined
by the state board.  A participating local educational agency
shall transmit this data to the department annually.  
   (i) 
    (   h)  Participating local educational
agencies are encouraged to offer library programs that may include,
but are not limited to, reading circles, tutoring programs, online
research, parent engagement or classes, and parent outreach for
homework assistance. To the extent feasible, schoolsites shall make
every effort to offer library programming with the participation of
certified bilingual staff that aims to serve the language needs of
its local community. Participating local educational agencies or
individual schoolsites shall ensure that programs are adequately
staffed by qualified personnel, as described in subdivision 
(j)   (i)  , but may also include adult volunteers
who are approved by the schoolsite. 
   (j) 
    (   i)  This section shall not be interpreted
to modify existing law or school policy regarding what staff
classification is permitted to operate libraries, which includes
levels of certificated and classified staff, to include media
technicians and library aides. 
   (k) 
    (   j)  The department shall compile, analyze,
and present the results of the demonstration to the Legislature and
the state board no later than  August   December
 31, 2018. 
   (l) 
    (  k)  The  department  
state board  may adopt emergency regulations for purposes of
this section, including, but not limited to, the process for
selecting applicants to participate in the demonstration, and the
adoption of the emergency regulations shall be deemed to be an
emergency and necessary for the immediate preservation of the public
peace, health and safety, or general welfare for purposes of Sections
11346.1 and 11349.6 of the Government Code. 
   (l) For purposes of this section, "mental health professional"
means a school psychologist or social worker. 
   (m) This section shall remain in effect only until January 1,
2019, and as of that date is repealed, unless a later enacted
statute, that is enacted before January 1, 2019, deletes or extends
that date.
  SEC. 3.  Section 14132.47 of the Welfare and Institutions Code is
amended to read:
   14132.47.  (a) It is the intent of the Legislature to provide
local governmental agencies the choice of participating in either or
both of the Targeted Case Management (TCM) and Administrative
Claiming process programs at their option, subject to the
requirements of this section and Section 14132.44.
   (b) The department may contract with each participating local
governmental agency or each local educational consortium to assist
with the performance of administrative activities necessary for the
proper and efficient administration of the Medi-Cal program, pursuant
to Section 1903a of the federal Social Security Act (42 U.S.C. Sec.
1396b(a)), and this activity shall be known as the Administrative
Claiming process.
   (c) (1) Subject to the requirements of paragraph (2) of
subdivision (f), as a condition for participation in the
Administrative Claiming process, each participating local
governmental agency or each local educational consortium shall, for
the purpose of claiming federal Medicaid reimbursement, enter into a
contract with the department and shall certify to the department the
total amount the local governmental agency or each local educational
consortium expended on the allowable administrative activities.
   (2) The department shall deny the claim if it determines that the
certification is not adequately supported, or does not otherwise
comply with federal requirements, for purposes of claiming federal
financial participation.
   (d) Each participating local governmental agency or local
educational consortium may subcontract with private or public
entities to assist with the performance of administrative activities
necessary for the proper and efficient administration of the Medi-Cal
program under the conditions specified by the department in
regulations.
   (e) Each Administrative Claiming process contract shall include a
requirement that each participating local governmental agency or each
local educational consortium submit a claiming plan in a manner that
shall be prescribed by the department in regulations, developed in
consultation with local governmental agencies.
   (f) (1) The department shall require that each participating local
governmental agency or each local educational consortium certify to
the department both of the following:
   (A)  The expenditure of 100 percent of the cost of performing
Administrative Claiming process activities. The funds expended for
this purpose shall be from the local governmental agency's general
fund or the general funds of local educational agencies or from any
other funds allowed under federal law and regulation.
   (B) In each fiscal year that its expenditures represent costs that
are eligible for federal financial participation for that fiscal
year. The department shall deny the claim if it determines that the
certification is not adequately supported for purposes of federal
financial participation.
   (2) (A) (i) A city that is not a participating local governmental
agency, or any other local public entity, that contracts with a local
governmental agency pursuant to subdivision (d) and that is located
within a county that is a participating local governmental agency
pursuant to this section, may submit certification to the local
governmental agency of amounts expended for Administrative Claiming
services in accordance with Section 433.51 of Title 42 of the Code of
Federal Regulations.
   (ii) A city or other local public entity that submits
certification pursuant to this paragraph shall comply with the
requirements of paragraph (1), with other requirements applicable to
local governmental agencies that the department determines, in
regulations, to be applicable, and with all applicable federal
requirements.
   (iii) The local governmental agency shall forward the city's or
local public entity's certification to the department for the
purposes of claiming federal financial participation.
   (iv) As applicable, the local governmental agency shall obtain and
retain appropriate certifications from the expending city or local
public entity, together with documentation of the underlying
expenditures, as required by the department.
   (B) A tribe or tribal organization, as defined in subdivision (n),
that is not participating in Administrative Claiming process
activities as a local governmental agency, may contract with, and
submit to a tribe or tribal organization that is contracting with,
the department pursuant to subdivision (b) amounts expended for
Administrative Claiming process activities that it is certifying in
accordance with Section 433.51 of Title 42 of the Code of Federal
Regulations and other applicable federal law and regulations. The
tribe or tribal organization receiving the certification shall
forward it to the department for purposes of claiming federal
financial participation. The certification shall comply with all of
the requirements for certification set forth in subparagraph (A).
   (g) (1) Notwithstanding any other provision of this section, the
state shall be held harmless, in accordance with paragraphs (2) and
(3), from any federal audit disallowance and interest resulting from
payments made to a participating local governmental agency or local
educational consortium pursuant to this section, for the disallowed
claim.
   (2) To the extent that a federal audit disallowance and interest
results from a claim or claims for which any participating local
governmental agency or local educational consortium has received
reimbursement for Administrative Claiming process activities, the
department shall recoup from the local governmental agency or local
educational consortium that submitted the disallowed claim, through
offsets or by a direct billing, amounts equal to the amount of the
disallowance and interest, in that fiscal year, for the disallowed
claim. All subsequent claims submitted to the department applicable
to any previously disallowed administrative activity or claim, may be
held in abeyance, with no payment made, until the federal
disallowance issue is resolved.
   (3) Notwithstanding paragraph (2), to the extent that a federal
audit disallowance and interest results from a claim or claims for
which the participating local governmental agency or local
educational consortium has received reimbursement for Administrative
Claiming process activities performed by an entity under contract
with, and on behalf of, the participating local governmental agency
or local educational consortium, the department shall be held
harmless by that particular participating local governmental agency
or local educational consortium for 100 percent of the amount of the
federal audit disallowance and interest, for the disallowed claim.
   (h) The use of local funds required by this section shall not
create, lead to, or expand the health care funding obligations or
service obligations for current or future years for any participating
local governmental agency or local educational consortium, except as
required by this section or as may be required by federal law.
   (i) The department shall deny any claim from a participating local
governmental agency or local educational consortium if the
department determines that the claim is not adequately supported in
accordance with criteria established pursuant to this subdivision and
implementing regulations before it forwards the claim for
reimbursement to the federal Medicaid Program. In consultation with
local governmental agencies and local educational consortia, the
department shall adopt regulations that prescribe the requirements
for the submission and payment of claims for administrative
activities performed by each participating local governmental agency
and local educational consortium.
   (j) Administrative activities shall be those determined by the
department to be necessary for the proper and efficient
administration of the state's Medicaid plan and shall be defined in
regulation.
   (k) If the department denies any claim submitted under this
section, the affected participating local governmental agency or
local educational consortium may, within 30 days after receipt of
written notice of the denial, request that the department reconsider
its action. The participating local governmental agency or local
educational consortium may request a meeting with the director or his
or her designee within 30 days to present its concerns to the
department after the request is filed. If the director or his or her
designee cannot meet, the department shall respond in writing
indicating the specific reasons for which the claim is out of
compliance to the participating local governmental agency or local
educational consortium in response to its appeal. Thereafter, the
decision of the director shall be final.
   (l) To the extent consistent with federal law and regulations,
participating local governmental agencies or local educational
consortium may claim the actual costs of nonemergency, nonmedical
transportation of Medi-Cal eligibles to Medi-Cal covered services,
under guidelines established by the department, to the extent that
these costs are actually borne by the participating local
governmental agency or local educational consortium. A local
educational consortium may only claim for nonemergency, nonmedical
transportation of Medi-Cal eligibles for Medi-Cal covered services,
through the Medi-Cal administrative activities program. Medi-Cal
medical transportation services shall be claimed under the local
educational agency Medi-Cal billing option, pursuant to Section
14132.06.
   (m) As a condition of participation in the Administrative Claiming
process and in recognition of revenue generated to each
participating local governmental agency and each local educational
consortium in the Administrative Claiming process, each participating
local governmental agency and each local educational consortium
shall pay an annual participation fee through a mechanism agreed to
by the state and local governmental agencies and local educational
consortia, or, if no agreement is reached by August 1 of each year,
directly to the state. The participation fee shall be used to cover
the cost of administering the Administrative Claiming process,
including, but not limited to, claims processing, technical
assistance, and monitoring. The department shall determine and report
staffing requirements upon which projected costs will be based. The
amount of the participation fee shall be based upon the anticipated
salaries, benefits, and operating expenses, to administer the
Administrative Claiming process and other costs related to that
process.
   (n) (1) For purposes of this section, "participating local
governmental agency" means a county, chartered city, Native American
Indian tribe, tribal organization, or subgroup of a Native American
Indian tribe or tribal organization, under contract with the
department pursuant to subdivision (b).
   (2) Each participating Native American Indian tribe, tribal
organization, or subgroup of a Native American Indian tribe or tribal
organization may claim, as a Medi-Cal Administrative Activity,
facilitating Medi-Cal applications, which includes, but is not
limited to, using the California Healthcare Eligibility, Enrollment,
and Retention System.
   (o) For purposes of this section, "local educational agency" means
a local educational agency, as defined in subdivision (h) of Section
14132.06, that participates under the Administrative Claiming
process as a subcontractor to the local educational consortium in its
service region.
   (p) (1) For purposes of this section, "local educational
consortium" means a local agency that is one of the service regions
of the California County Superintendent Educational Services
Association.
   (2) Each local educational consortium shall contract with the
department pursuant to paragraph (1) of subdivision (c).
   (q) (1) Each participating local educational consortium shall be
responsible for the local educational agencies in its service region
that participate in the Administrative Claiming process. This
responsibility includes, but is not limited to, the preparation and
submission of all administrative claiming plans, training of local
educational agency staff, overseeing the local educational agency
time survey process, and the submission of detailed quarterly
invoices on behalf of the participating local educational agency.
   (2) Each participating local educational consortium shall ensure
local educational agency compliance with all requirements of the
Administrative Claiming process established for local governmental
agencies.
   (3) Ninety days prior to the initial participation in the
Administrative Claiming process, each local educational consortium
shall notify the department of its intent to participate in the
process, and shall identify each local educational agency that will
be participating as its subcontractor.
   (r) (1) Each local educational agency that elects to participate
in the Administrative Claiming process shall submit claims through
its local educational consortium or through the local governmental
agency, but not both.
   (2) Each local educational agency participating as a subcontractor
to a local educational consortium shall comply with all requirements
of the Administrative Claiming process established for local
governmental agencies.
   (s) A participating local governmental agency or a local
educational consortium may charge an administrative fee to any entity
claiming Administrative Claiming through that agency.
   (t) The department shall continue to administer the Administrative
Claiming process in conformity with federal requirements.
   (u) The department shall provide technical assistance to all
participating local governmental agencies and local educational
consortia in order to maximize federal financial participation in the
Administrative Claiming process.
   (v) This section shall be applicable to Administrative Claiming
process activities performed, and to moneys paid to participating
local governmental agencies for those activities in the 1994-95
fiscal year and thereafter, and to local educational consortia in the
1998-99 fiscal year and thereafter.
   (w) Nothing in this section or Section 14132.44 shall be construed
to prevent any state agency from participating in the Administrative
Claiming process or from contracting with others to engage in these
activities.
   (x) (1) The department and the State Department of Education shall
cooperate and coordinate efforts in order to maximize receipt of
federal financial participation under the Administrative Claiming
process pursuant to this section. To the extent permitted by federal
law, funds used by local educational agencies under the local control
funding formula, including funds used under Section 42238.054 of the
Education Code, may be included in expenditures certified under
subdivision (f).
   (2) The department, through an interagency agreement with the
State Department of Education, shall provide technical advice and
consultation to local educational agencies participating in the
demonstration project established pursuant to Section 42238.054 of
the Education Code, in order to help set up accounting systems,
conduct initial staff time studies, and any other necessary
requirements to certify and bill valid claims for allowable
activities under the Administrative Claiming process. Any entity
contracted by the department, a local educational agency, or
educational consortium for purposes of this subdivision shall be a
public agency or incorporated as a nonprofit agency or public benefit
corporation under state law.
   (3) The department shall seek any necessary federal approvals to
implement this subdivision.