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 enable local communities to provide health care services or referral, or both, to populations of school-aged teenagers in communities where the need is greatest and at locations where services will be used most effectively to provide health education and general health care and to prevent or intervene early to minimize long-term consequences from: (1) Substance abuse, (2) abuse and neglect, (3) mental or emotional difficulties, or both, (4) nutritional and health care deprivation, (5) sexual activity, (6) sexually transmitted diseases, (7) teen pregnancy, (8) low birthweight babies, (9) 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 and recognizes that health problems are a limitation for children's effective use of educational programs and services.

Therefore, school-based health clinics shall be a separate health care support program working cooperatively with the public school system to enhance the effectiveness of the public schools 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 and make more accessible existing health care resources, and to increase use of these resources 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 that 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 no more than twenty-one members representing the health care community, the education community, and the community-at-large. There shall be at least one of each of the following on the committee:

(a) An adolescent medicine specialist;

(b) A mental health specialist;

(d) A child abuse specialist; and

(e) A drug and alcohol specialist.

(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 to ensure that program decisions are made locally.

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

(4) The temporary advisory committee shall establish a policy for third party payments except where services are confidential.

(5) 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) Issue 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, 1988.

(2) Grants may be awarded either to a primary care provider for services or to a public school district.

(3) The grant applicant shall provide a minimum of twenty-five percent matching funds or resources, including contracted and donated services, in-kind match of space, or contributed equipment and supplies. Applicants are encouraged to seek and use private funds for development and operation.

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

(a) Maximum participation of the school district and existing community service agencies by their support and participation in the planning process and their involvement and contribution to providing services in the clinic;

(b) Demonstrated community needs for additional services;

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

(e) Demonstrated effectiveness to serve client populations in a cost-effective manner.

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

NEW SECTION. Sec. 6. (1) After receiving funding approval, the applicant 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 representative of the health care community, the education community, the parent, teacher, and student association, and the community-at-large.

(2) The advisory board shall develop policies for operation of the clinic that are acceptable to the primary care provider and the school district.

NEW SECTION. Sec. 7. (1) School-based health clinics shall provide direct services or referral, or both, for program components identified in section 1 of this act to assure the physical, emotional, and intellectual development of teenagers. (2) School-based clinics shall educate and promote responsible health care consumption and eventual use of existing community services by teenagers.

(3) 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 in accordance with the law.

NEW SECTION. Sec. 8. By December 1, 1993, 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 at the commencement of the 1994 legislative session 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, 1989, 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 by the department.

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