AN ACT Relating to school-based health clinics; adding a new chapter to Title 70 RCW; creating a new section; and making an appropriation.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

NEW SECTION. Sec. 1. It is the intent of the legislature to create school-based health clinics to provide health care services or referral, or both, to populations of teenagers in communities where the need is greatest and at locations where services will be used most effectively in order to intervene early to minimize long-term consequences from: (1) The lack of health education and general health care; (2) the social problems of substance abuse, (3) abuse and neglect, (4) mental or emotional difficulties, or both, (5) nutritional and health care deprivation, (6) sexually transmitted diseases, (7) teen pregnancy, (8) the numbers of low birthweight babies, (9) rates of infant mortality, and (10) disruption of the family unit.

The state of Washington reaffirms its commitment to provide for the educational needs of the children residing in the state. The state of Washington recognizes that health problems are a limitation for children's effective use of educational programs and services.

School-based health clinics shall not be a part of the public school system but shall be a separate health care support program to enhance the effectiveness of the public schools and to work cooperatively with them for the benefit of teenagers and their families. School-based health clinics are not meant to replace or duplicate existing school health care education or services but to support, enhance, and extend those existing services and staff to enable schools to educate children more effectively. School-based health clinics are not intended to replace or duplicate existing health care services and resources in the community, but to enhance existing health care resources and to increase their use by the teen population.

NEW SECTION. Sec. 2. Unless the context clearly requires otherwise, the definitions in this section apply throughout this chapter.

(1) "Board" means the local community advisory board.

(2) "Department" means the department of social and health services.

(3) "Primary care provider" means a local health care provider or nonprofit youth services agency serving the target school district who applies for and receives state funding to develop, operate, and coordinate a health care clinic affiliated with a public secondary school.

(4) "Temporary advisory committee" means the committee created by the department specifically to develop and implement the grant guidelines and goals, determine the contract site selection process, develop the funding distribution process, develop data collection requirements, develop the data collection process, design the evaluation requirement, and implement other pertinent management processes and procedures.

NEW SECTION. Sec. 3. (1) The secretary of the department shall appoint the temporary advisory committee. The temporary advisory committee shall be composed of:

(a) An adolescent medicine specialist;

(b) A department health care specialist;

(d) A representative of a children's advocacy agency;

(e) The parent of a child enrolled in a public school;

(f) A community representative;

(g) A representative of a public health or community health agency;

(h) The superintendent of public instruction or the superintendent's designee;

(i) A child abuse specialist;

(j) A drug and alcohol specialist;

(k) A representative from the family planning field;

(l) An obstetrician - gynecologist; and

(m) A school nursing representative.

(2) In developing rules, processes, and procedures, the temporary advisory committee shall assure maximum flexibility in program design and operation within the parameters of the law to encourage tailoring school-based health care programs to meet the unique needs, resources, and characteristics of the community served and that program decisions are locally determined.

(3) The temporary advisory committee shall establish criteria for competition for the grants.

(4) The temporary advisory committee shall help the department establish a program of school-based health care clinics and shall be terminated at the conclusion of program development.

NEW SECTION. Sec. 4. The department shall:

(1) Submit requests for proposals;

(2) Review grant applications based on established criteria;

(3) Select community proposals based on demonstrated need, including but not limited to:

(a) Fiscal or social factors limiting the accessibility and acceptability of health care to teenagers;

(b) Diversity of target population size;

(d) High rates of teen mental or physical health problems including teen pregnancy;

(4) Gather accurate and pertinent data to determine the effectiveness of the programs in providing health care to unserved populations, in reducing health problems within that population, and conduct an evaluation of each clinic after one year of operation.

NEW SECTION. Sec. 5. (1) First year funding shall be available by January 1, 1987.

(2) In order to receive a grant, a primary care provider shall provide a minimum of twenty-five percent matching funds or resources, including contracted and donated services, an in-kind match of space, or contributed equipment and supplies. Providers are encouraged to seek and to use private funds for development and operation.

(3) Funding preference shall be given to applications demonstrating:

(a) Maximum participation of existing community service agencies by their support and participation in the planning process, their involvement and contribution to providing services in the clinic, demonstrated community needs for additional services, and medical backup;

(b) Maximum participation of community members, representative of the community at-large, in the planning process for funding application and in delivering the program; and

(4) No more than one hundred thousand dollars may be awarded per grant.

NEW SECTION. Sec. 6. After receiving funding approval, the primary care provider selected to receive the funds shall set the terms of and convene a permanent local advisory board representative of the community-at-large, and composed of at least seven members, including:

(1) A member of the local medical community appointed by the local medical society;

(2) A representative appointed by the school board;

(3) A parent of a child enrolled in a school served by the health clinic, appointed by the parent teacher association;

(4) A teacher appointed by a local teachers association;

(5) A school nurse or counselor appointed by the superintendent of the district; and

(6) Others necessary to achieve community representation.

NEW SECTION. Sec. 7. (1) School-based health clinics shall provide direct services or referral for program components identified in section 1 of this act, or both, and may include, but not be limited to:

(a) Psychological counseling;

(b) Parent education;

(d) Dental care referral;

(e) Eye care and vision referral;

(f) Support programs for pregnant teenagers;

(g) Nutrition program;

(h) Day care; and

(i) Other health programs necessary to assure the physical, emotional, and intellectual development of children.

(2) All school-based health clinic health records shall be maintained separate from school records. Confidentiality of participants in the health care aspects of the school-based health clinic shall be maintained.

NEW SECTION. Sec. 8. By December 1, 1991, the institute for public policy at The Evergreen State College shall prepare an analysis of the school-based health clinic programs authorized by chapter 70.-- RCW (sections 1 through 7 of this act) and shall prepare and submit such analysis to the house of representatives and senate ways and means committees and health services committees for review to demonstrate need for continued program funding.

NEW SECTION. Sec. 9. The sum of one million dollars, or as much thereof as may be necessary, is appropriated for the biennium ending June 30, 1987, from the general fund to the department of social and health services for the purposes of this act. No more than five percent of the total amount appropriated may be used for administrative costs.

NEW SECTION. Sec. 10. Sections 1 through 7 of this act shall constitute a new chapter in Title 70 RCW.