124025. The Legislature finds and declares that many physical and
mental disabilities can be prevented, or their impact on an
individual lessened, when they are identified and treated before they
become chronic and irreversible damage occurs. The Legislature finds
and declares that a community-based program of early identification
and referral for treatment of potential handicapping conditions will
be effective in reducing the incidence of the conditions and will
benefit the health and welfare of the citizens of this state.
It is the intent of the Legislature in enacting this article and
Section 120475 to establish child health and disability prevention
programs, that shall be financed and have standards established at
the state level and that shall be operated at the local level, for
the purpose of providing early and periodic assessments of the health
status of children. It is further intended that child health and
disability prevention programs shall make maximum use of existing
health care resources and shall utilize, as the first source of
screening, the child's usual source of health care so that health
screening programs are fully integrated with existing health
services, that health care professionals be appropriately represented
and utilized in these programs, that outreach programs be developed
to stimulate the use of preventive health services, and that services
offered pursuant to this article be efficiently provided and be of
the highest quality.
124030. As used in this article and Section 120475:
(a) "State board" means the State Maternal, Child, and Adolescent
Health Board.
(b) "Department" means the department.
(c) "Director" means the director.
(d) "Governing body" means the county board of supervisors or
boards of supervisors in the case of counties acting jointly.
(e) "Local board" means local maternal, child, and adolescent
health board.
(f) "Local health jurisdiction" means county health department or
combined health department in the case of counties acting jointly or
city health department within the meaning of Section 101185.
(g) "Child Health and Disability Prevention provider" or "CHDP
provider" means any of the following, if approved for participation
in the Child Health and Disability Prevention program by the
community Child Health and Disability program director in accordance
with program standards and as certified by the department:
(1) A physician licensed to practice medicine in California.
(2) A family nurse practitioner certified pursuant to Sections
2834 and 2836 of the Business and Professions Code.
(3) A pediatric nurse practitioner certified pursuant to Sections
2834 and 2836 of the Business and Professions Code.
(4) A primary care center, clinic, or other public or private
agency or organization that provides outpatient health care services.
(5) A physicians' group.
(6) A licensed clinical laboratory.
124033. (a) Commencing July 1, 2003, all applications for services
under the Child Health and Disability Prevention program shall be
filed electronically in accordance with subdivision (b) of Section
14011.7 of the Welfare and Institutions Code.
(b) To implement the program described in subdivisions (b) to (e),
inclusive, of Section 14011.7 of the Welfare and Institutions Code
for the use of an electronic application for the Child Health and
Disability Prevention program and for preenrollment into the Medi-Cal
program or the Healthy Families Program, the following shall apply:
(1) The department may contract with public or private entities,
or utilize existing health care service provider enrollment and
payment mechanisms, including the Medi-Cal program's fiscal
intermediary, only if services provided under the program are
specifically identified and reimbursed in a manner that appropriately
claims federal financial reimbursement.
(2) Contracts, including the Medi-Cal program fiscal intermediary
contract for the Child Health and Disability Prevention Program,
including any contract amendment, any system change pursuant to a
change order, and any project or systems development notice shall be
exempt from Part 2 (commencing with Section 10100) of Division 2 of
the Public Contract Code, Chapter 7 (commencing with Section 11700)
of Part 1 of Division 3 of Title 2 of the Government Code, Section
19130 of the Government Code, and any policies, procedures, or
regulations authorized by these laws.
124035. The department shall administer this article and Section
120475 and shall adopt minimum standards for the approval of
community child health and disability prevention programs and
regulations as necessary. The standards shall allow necessary
flexibility in the administration of county programs, taking into
account the variability of county needs and resources. Standards
shall be adopted for:
(a) Education and experience requirements for directors of
community child health and disability prevention programs.
(b) Health screening, evaluation, and diagnostic procedures for
child health and disability prevention programs.
(c) Public and private facilities and providers that may
participate in community child health and disability prevention
programs.
(d) The department shall develop a methodology for allocating
child health and disability prevention funds to counties for the
administration of this program.
124040. (a) The governing body of each county or counties shall
establish a community child health and disability prevention program
for the purpose of providing early and periodic assessments of the
health status of children in the county or counties by July 1, 1974.
However, this shall be the responsibility of the department for all
counties that contract with the state for health services. Contract
counties, at the option of the board of supervisors, may provide
services pursuant to this article in the same manner as other county
programs, provided the option is exercised prior to the beginning of
each fiscal year. Each plan shall include, but is not limited to, the
following requirements:
(1) Outreach and educational services.
(2) Agreements with public and private facilities and
practitioners to carry out the programs.
(3) Health screening and evaluation services for all children
including a physical examination, immunizations appropriate for the
child's age and health history, and laboratory procedures appropriate
for the child's age and population group performed by, or under the
supervision or responsibility of, a physician licensed to practice
medicine in California or by a certified family nurse practitioner or
a certified pediatric nurse practitioner.
(4) Referral for diagnosis or treatment when needed, including,
for all children eligible for Medi-Cal, referral for treatment by a
provider participating in the Medi-Cal program of the conditions
detected, and methods for assuring referral is carried out.
(5) Recordkeeping and program evaluations.
(6) The health screening and evaluation part of each community
child health and disability prevention program plan shall include,
but is not limited to, the following for each child:
(A) A health and development history.
(B) An assessment of physical growth.
(C) An examination for obvious physical defects.
(D) Ear, nose, mouth, and throat inspection, including inspection
of teeth and gums, and for all children three years of age and older
who are eligible for Medi-Cal, referral to a dentist participating in
the Medi-Cal program.
(E) Screening tests for vision, hearing, anemia, tuberculosis,
diabetes, and urinary tract conditions.
(7) An assessment of nutritional status.
(8) An assessment of immunization status.
(9) Where appropriate, testing for sickle-cell trait, lead
poisoning, and other tests that may be necessary to the
identification of children with potential disabilities requiring
diagnosis and possibly treatment.
(10) For all children eligible for Medi-Cal, necessary assistance
with scheduling appointments for services and with transportation.
(b) Dentists receiving referrals of children eligible for Medi-Cal
under this section shall employ procedures to advise the child's
parent or parents of the need for and scheduling of annual
appointments.
(c) Standards for procedures to carry out health screening and
evaluation services and to establish the age at which particular
tests should be carried out shall be established by the director. At
the discretion of the department, these health screening and
evaluation services may be provided at the frequency provided under
the Healthy Families Program and permitted in managed care plans
providing services under the Medi-Cal program, and shall be
contingent upon appropriation in the annual Budget Act. Immunizations
may be provided at the frequency recommended by the Committee on
Infectious Disease of the American Academy of Pediatrics and the
Advisory Committee on Immunization Practices of the Centers for
Disease Control and Prevention.
(d) Each community child health and disability prevention program
shall, pursuant to standards set by the director, establish a record
system that contains a health case history for each child so that
costly and unnecessary repetition of screening, immunization and
referral will not occur and appropriate health treatment will be
facilitated as specified in Section 124085.
124045. A city that operates an independent health agency may elect
to provide the services described in this article with the approval
of the department. In this instance, the powers granted a governing
body of a county shall be vested in the governing body of the city.
124050. Each community child health and disability program shall
have a director meeting qualification standards by the department,
appointed by the governing body, except for counties contracting with
the state for health services.
124055. Any community child health and disability prevention
program may contract to furnish services to any other county if the
contract is approved by the director.
124060. (a) On or before September 15 of each year, each county
program director shall submit a budget update for the subsequent
fiscal year that provides the following information:
(1) A summary of the previous year's activity, including the
number of children screened, the number of children referred for
diagnosis and treatment, by condition, and the cost of screening
services.
(2) A summary description of the results of cases in that a
treatable disability was identified and referral made.
(3) A projection and cost estimates of the number of children to
be screened for the fiscal year for which the budget is being
submitted.
(b) The multiyear base community child health and disability
prevention plan shall include the following:
(1) An assessment of the adequacy and availability of the
facilities and providers to provide health screening diagnostic and
treatment services.
(2) A description of the child health and disability prevention
program to be offered, including expected participating providers and
outreach mechanisms to be utilized.
(3) A summary description of the current year's activity,
including the number of children screened, the number of children
referred for diagnosis and treatment, by condition, and the cost of
screening services.
(4) A description of how existing school health resources,
including school health personnel, are to be utilized for outreach
and other services.
(5) Budget estimates, including all sources of revenue, for the
budget.
(c) On or before September 15 of each year each governing board
shall submit an update to the multiyear base community child health
and disability prevention plan.
The director shall determine the amount of state funds available
for each county for specified services under an approved multiyear
base community child health and disability prevention plan, as
updated, from state funds appropriated for child health and
disability prevention services.
If the amount appropriated in the Budget Act for the fiscal year
as enacted into law differs from the amount in the budget submitted
by the Governor for the fiscal year, each governing board shall
submit an additional revised update in the form and at the time
specified by the department.
Notwithstanding any other provision of this article, no new
community child health and disability prevention plan shall be
submitted by a county until September 15, 1983. Each county plan and
budget approved for the 1981-82 fiscal year shall be updated on or
before September 15 by the governing body of each county for the
1982-83 and 1983-84 fiscal years pursuant to regulations adopted by
the department. On or before September 15, 1983, the governing body
of each county shall prepare and submit to the department a multiyear
base plan and budget for the 1984-85 fiscal year that shall be
annually updated on or before September 15 of each subsequent year
pursuant to regulations adopted by the department.
The department shall develop and implement the format and
procedures for the preparation and submission of a multiyear base
plan update in order for the counties to have sufficient time prior
to September 15, 1983, to prepare and submit their multiyear base
plan by September 15, 1983.
For the purposes of simplifying and reducing plan requirements,
the Legislature intends that the annual update shall not duplicate
any of the material in the multiyear base plan, but serve as a
progress report both evaluating what has been accomplished over the
past year and describing in more detail what will be accomplished in
relation to each of the elements in the base plan during the coming
year.
124065. Counties shall be reimbursed for the amount required by the
county to carry out its community child health and disability
prevention program in accordance with the approved community child
health and disability prevention plan. Claims for state reimbursement
shall be made in the manner as the director shall provide. Each
claim for state reimbursement shall be payable from the appropriation
made for the fiscal year when the expenses upon which the claim is
based are incurred.
There shall be no reimbursement for expenditures for the treatment
of disabilities identified as a result of the program or for capital
improvements or the purchase or construction of buildings, except
for the equipment items and remodeling expenses as may be allowed by
regulations adopted by the director.
124070. Counties shall be reimbursed for the amount required by the
county to carry out its community child health and disability
prevention program in accordance with the approved community child
health and disability prevention plan. Claims for state reimbursement
shall be made in a manner as the director shall provide. Each claim
for state reimbursement shall be payable from the appropriation made
for the fiscal year in which the expenses upon which the claim is
based are incurred.
There shall be no reimbursement for expenditures for the treatment
of disabilities identified as a result of the program, except for
the costs of immunizations necessary to bring the child current in
his or her immunization status as provided for by regulations of the
department, or for capital improvements or the purchase or
construction of buildings, except for the equipment items and
remodeling expenses as may be allowed by regulations adopted by the
director.
124075. (a) In order to ensure the maximum utilization of the
California Medical Assistance Program and other potential
reimbursement sources, the department shall develop a schedule and
method of reimbursement at reasonable rates for services rendered
pursuant to this article. The reimbursement schedule shall include
provision for well child examinations as well as for administrative
expenses incurred by providers pursuant to meeting this article.
Inquiry shall be made of all recipients of services under this
article as to their entitlement for third-party reimbursement for
medical services. Where an entitlement exists it shall be billed.
Notwithstanding subdivision (c) of Section 14000 of the Welfare and
Institutions Code and Section 14005 of that code, the California
Medical Assistance Program shall be billed for services rendered
pursuant to this article for every Medi-Cal eligible beneficiary.
(b) The department and counties shall maximize the use of federal
funds for carrying out this article, including using state or county
funds to match funds claimable under Title 19 of the Social Security
Act. Services and administrative support costs claimable under
federal law shall include, but not be limited to, outreach, health
education, case management, resource development, and training at
state and local levels. Any federal funds received shall augment and
not replace funds appropriated from the General Fund for carrying out
the purposes of this article.
124080. The department may contract with a private entity for the
performance of processing claims for state reimbursement, so long as
the cost of the contract is no more than 85 percent of the cost of
the service if performed in state service and there is compliance
with other applicable provisions of the Government Code including,
but not limited to, Sections 19130 to 19132, inclusive.
124085. On and after July 1, 1976, each child eligible for services
under this article shall, within 90 days after entrance into the
first grade, provide a certificate approved by the department to the
school where the child is to enroll documenting that within the prior
18 months the child has received the appropriate health screening
and evaluation services specified in Section 124040. A waiver signed
by the child's parents or guardian indicating that they do not want
or are unable to obtain the health screening and evaluation services
for their children shall be accepted by the school in lieu of the
certificate. If the waiver indicates that the parent or guardian was
unable to obtain the services for the child, then the reasons why
should be included in the waiver.
124090. Any child between birth and 90 days after entrance into the
first grade and all persons under 21 years of age who are eligible
for the California Medical Assistance Program shall be eligible for
services from the child health and disabilities prevention program in
the county where they are a resident. The department, with review
and recommendation by the board, shall adopt regulations specifying
age groups that shall be given certain types of screening tests and
recommendations for referral.
The first source of referral shall be the child's usual source of
health care. If referral is required and no regular source of health
care can be identified, the facility or provider providing health
screening and evaluation services shall provide a list of three
qualified sources of care, without prejudice for or against any
specific source.
124095. Each community child health and disability prevention
program shall provide the child or his or her parent or guardian with
a copy of the results of the health screening and evaluation, as
well as an explanation of the meaning of the results, and shall,
where the need indicates, refer the child for further diagnosis and
treatment.
124100. (a) In cooperation with the county child health and
disability prevention program, the governing body of every school
district or private school that has children enrolled in kindergarten
shall provide information to the parents or guardians of all
children enrolled in kindergarten of this article and Section 120475.
(b) Each county child health and disability prevention program
shall reimburse school districts for information provided pursuant to
this section. The Superintendent of Public Instruction may withhold
state average daily attendance funds to any school district for any
child for whom a certification or parental waiver is not obtained as
required by Section 124085.
124105. (a) This section shall be known and may be cited as the
"Hughes Children's Health Enforcement Act."
(b) The Legislature recognizes the importance of health to
learning and to a successful academic career. The Legislature also
recognizes the important role of schools in ensuring the health of
pupils through health education and the maintenance of minimal health
standards among the pupil population. Therefore, it is the intent of
the Legislature that schools ensure that pupils receive a health
screening before the end of the first grade.
(c) The governing board of each school district shall exclude from
school, for not more than five days, any first grade pupil who has
not provided either a certificate or a waiver, as specified in
Section 124085, on or before the 90th day after the pupil's entrance
into the first grade. The exclusion shall commence with the 91st
calendar day after the pupil's entrance into the first grade, unless
school is not in session that day, then the exclusion shall commence
on the next succeeding schoolday. A child shall not be excluded under
this section if the pupil's parent or guardian provides to the
district either a certificate or a waiver as specified in Section
124085.
(d) The governing board of a school district may exempt any pupil
from the exclusion described in subdivision (c) if, at least twice
between the first day and the 90th day after the pupil's entrance
into the first grade, the district has contacted the pupil's parent
or guardian and the parent or guardian refuses to provide either a
certificate or a waiver as specified in Section 124085. The number of
exemptions from exclusion granted by a school district pursuant to
this subdivision may not exceed 5 percent of a school district's
first grade enrollment. It is the intent of the Legislature that
exemptions from exclusion be used in extraordinary circumstances,
including, but not limited to, family situations of great dysfunction
or disruption, including substance abuse by parents or guardians,
child abuse, or child neglect.
(e) It is the intent of the Legislature that, upon a pupil's
enrollment in kindergarten or first grade, the governing board of the
school district notify the pupil's parent or guardian of the
obligation to comply with Section 124085 and of the availability for
low-income children of free health screening for up to 18 months
prior to entry into first grade through the Child Health Disabilities
Prevention Program.
(f) It is the intent of the Legislature that school districts
provide information to parents regarding the requirements of Section
124085 within the notification of immunization requirements.
Moreover, the Legislature intends that the information sent to
parents encourage parents to obtain health screenings simultaneously
with immunizations.
124110. All information and results of the health screening and
evaluation of each child shall be confidential and shall not be
released without the informed consent of a parent or guardian of the
child.
The results of the health screening and evaluation shall not be
released to any public or private agency, even with the consent of a
parent or guardian, unless accompanied by a professional
interpretation of what the results mean.
124025. The Legislature finds and declares that many physical and
mental disabilities can be prevented, or their impact on an
individual lessened, when they are identified and treated before they
become chronic and irreversible damage occurs. The Legislature finds
and declares that a community-based program of early identification
and referral for treatment of potential handicapping conditions will
be effective in reducing the incidence of the conditions and will
benefit the health and welfare of the citizens of this state.
It is the intent of the Legislature in enacting this article and
Section 120475 to establish child health and disability prevention
programs, that shall be financed and have standards established at
the state level and that shall be operated at the local level, for
the purpose of providing early and periodic assessments of the health
status of children. It is further intended that child health and
disability prevention programs shall make maximum use of existing
health care resources and shall utilize, as the first source of
screening, the child's usual source of health care so that health
screening programs are fully integrated with existing health
services, that health care professionals be appropriately represented
and utilized in these programs, that outreach programs be developed
to stimulate the use of preventive health services, and that services
offered pursuant to this article be efficiently provided and be of
the highest quality.
124030. As used in this article and Section 120475:
(a) "State board" means the State Maternal, Child, and Adolescent
Health Board.
(b) "Department" means the department.
(c) "Director" means the director.
(d) "Governing body" means the county board of supervisors or
boards of supervisors in the case of counties acting jointly.
(e) "Local board" means local maternal, child, and adolescent
health board.
(f) "Local health jurisdiction" means county health department or
combined health department in the case of counties acting jointly or
city health department within the meaning of Section 101185.
(g) "Child Health and Disability Prevention provider" or "CHDP
provider" means any of the following, if approved for participation
in the Child Health and Disability Prevention program by the
community Child Health and Disability program director in accordance
with program standards and as certified by the department:
(1) A physician licensed to practice medicine in California.
(2) A family nurse practitioner certified pursuant to Sections
2834 and 2836 of the Business and Professions Code.
(3) A pediatric nurse practitioner certified pursuant to Sections
2834 and 2836 of the Business and Professions Code.
(4) A primary care center, clinic, or other public or private
agency or organization that provides outpatient health care services.
(5) A physicians' group.
(6) A licensed clinical laboratory.
124033. (a) Commencing July 1, 2003, all applications for services
under the Child Health and Disability Prevention program shall be
filed electronically in accordance with subdivision (b) of Section
14011.7 of the Welfare and Institutions Code.
(b) To implement the program described in subdivisions (b) to (e),
inclusive, of Section 14011.7 of the Welfare and Institutions Code
for the use of an electronic application for the Child Health and
Disability Prevention program and for preenrollment into the Medi-Cal
program or the Healthy Families Program, the following shall apply:
(1) The department may contract with public or private entities,
or utilize existing health care service provider enrollment and
payment mechanisms, including the Medi-Cal program's fiscal
intermediary, only if services provided under the program are
specifically identified and reimbursed in a manner that appropriately
claims federal financial reimbursement.
(2) Contracts, including the Medi-Cal program fiscal intermediary
contract for the Child Health and Disability Prevention Program,
including any contract amendment, any system change pursuant to a
change order, and any project or systems development notice shall be
exempt from Part 2 (commencing with Section 10100) of Division 2 of
the Public Contract Code, Chapter 7 (commencing with Section 11700)
of Part 1 of Division 3 of Title 2 of the Government Code, Section
19130 of the Government Code, and any policies, procedures, or
regulations authorized by these laws.
124035. The department shall administer this article and Section
120475 and shall adopt minimum standards for the approval of
community child health and disability prevention programs and
regulations as necessary. The standards shall allow necessary
flexibility in the administration of county programs, taking into
account the variability of county needs and resources. Standards
shall be adopted for:
(a) Education and experience requirements for directors of
community child health and disability prevention programs.
(b) Health screening, evaluation, and diagnostic procedures for
child health and disability prevention programs.
(c) Public and private facilities and providers that may
participate in community child health and disability prevention
programs.
(d) The department shall develop a methodology for allocating
child health and disability prevention funds to counties for the
administration of this program.
124040. (a) The governing body of each county or counties shall
establish a community child health and disability prevention program
for the purpose of providing early and periodic assessments of the
health status of children in the county or counties by July 1, 1974.
However, this shall be the responsibility of the department for all
counties that contract with the state for health services. Contract
counties, at the option of the board of supervisors, may provide
services pursuant to this article in the same manner as other county
programs, provided the option is exercised prior to the beginning of
each fiscal year. Each plan shall include, but is not limited to, the
following requirements:
(1) Outreach and educational services.
(2) Agreements with public and private facilities and
practitioners to carry out the programs.
(3) Health screening and evaluation services for all children
including a physical examination, immunizations appropriate for the
child's age and health history, and laboratory procedures appropriate
for the child's age and population group performed by, or under the
supervision or responsibility of, a physician licensed to practice
medicine in California or by a certified family nurse practitioner or
a certified pediatric nurse practitioner.
(4) Referral for diagnosis or treatment when needed, including,
for all children eligible for Medi-Cal, referral for treatment by a
provider participating in the Medi-Cal program of the conditions
detected, and methods for assuring referral is carried out.
(5) Recordkeeping and program evaluations.
(6) The health screening and evaluation part of each community
child health and disability prevention program plan shall include,
but is not limited to, the following for each child:
(A) A health and development history.
(B) An assessment of physical growth.
(C) An examination for obvious physical defects.
(D) Ear, nose, mouth, and throat inspection, including inspection
of teeth and gums, and for all children three years of age and older
who are eligible for Medi-Cal, referral to a dentist participating in
the Medi-Cal program.
(E) Screening tests for vision, hearing, anemia, tuberculosis,
diabetes, and urinary tract conditions.
(7) An assessment of nutritional status.
(8) An assessment of immunization status.
(9) Where appropriate, testing for sickle-cell trait, lead
poisoning, and other tests that may be necessary to the
identification of children with potential disabilities requiring
diagnosis and possibly treatment.
(10) For all children eligible for Medi-Cal, necessary assistance
with scheduling appointments for services and with transportation.
(b) Dentists receiving referrals of children eligible for Medi-Cal
under this section shall employ procedures to advise the child's
parent or parents of the need for and scheduling of annual
appointments.
(c) Standards for procedures to carry out health screening and
evaluation services and to establish the age at which particular
tests should be carried out shall be established by the director. At
the discretion of the department, these health screening and
evaluation services may be provided at the frequency provided under
the Healthy Families Program and permitted in managed care plans
providing services under the Medi-Cal program, and shall be
contingent upon appropriation in the annual Budget Act. Immunizations
may be provided at the frequency recommended by the Committee on
Infectious Disease of the American Academy of Pediatrics and the
Advisory Committee on Immunization Practices of the Centers for
Disease Control and Prevention.
(d) Each community child health and disability prevention program
shall, pursuant to standards set by the director, establish a record
system that contains a health case history for each child so that
costly and unnecessary repetition of screening, immunization and
referral will not occur and appropriate health treatment will be
facilitated as specified in Section 124085.
124045. A city that operates an independent health agency may elect
to provide the services described in this article with the approval
of the department. In this instance, the powers granted a governing
body of a county shall be vested in the governing body of the city.
124050. Each community child health and disability program shall
have a director meeting qualification standards by the department,
appointed by the governing body, except for counties contracting with
the state for health services.
124055. Any community child health and disability prevention
program may contract to furnish services to any other county if the
contract is approved by the director.
124060. (a) On or before September 15 of each year, each county
program director shall submit a budget update for the subsequent
fiscal year that provides the following information:
(1) A summary of the previous year's activity, including the
number of children screened, the number of children referred for
diagnosis and treatment, by condition, and the cost of screening
services.
(2) A summary description of the results of cases in that a
treatable disability was identified and referral made.
(3) A projection and cost estimates of the number of children to
be screened for the fiscal year for which the budget is being
submitted.
(b) The multiyear base community child health and disability
prevention plan shall include the following:
(1) An assessment of the adequacy and availability of the
facilities and providers to provide health screening diagnostic and
treatment services.
(2) A description of the child health and disability prevention
program to be offered, including expected participating providers and
outreach mechanisms to be utilized.
(3) A summary description of the current year's activity,
including the number of children screened, the number of children
referred for diagnosis and treatment, by condition, and the cost of
screening services.
(4) A description of how existing school health resources,
including school health personnel, are to be utilized for outreach
and other services.
(5) Budget estimates, including all sources of revenue, for the
budget.
(c) On or before September 15 of each year each governing board
shall submit an update to the multiyear base community child health
and disability prevention plan.
The director shall determine the amount of state funds available
for each county for specified services under an approved multiyear
base community child health and disability prevention plan, as
updated, from state funds appropriated for child health and
disability prevention services.
If the amount appropriated in the Budget Act for the fiscal year
as enacted into law differs from the amount in the budget submitted
by the Governor for the fiscal year, each governing board shall
submit an additional revised update in the form and at the time
specified by the department.
Notwithstanding any other provision of this article, no new
community child health and disability prevention plan shall be
submitted by a county until September 15, 1983. Each county plan and
budget approved for the 1981-82 fiscal year shall be updated on or
before September 15 by the governing body of each county for the
1982-83 and 1983-84 fiscal years pursuant to regulations adopted by
the department. On or before September 15, 1983, the governing body
of each county shall prepare and submit to the department a multiyear
base plan and budget for the 1984-85 fiscal year that shall be
annually updated on or before September 15 of each subsequent year
pursuant to regulations adopted by the department.
The department shall develop and implement the format and
procedures for the preparation and submission of a multiyear base
plan update in order for the counties to have sufficient time prior
to September 15, 1983, to prepare and submit their multiyear base
plan by September 15, 1983.
For the purposes of simplifying and reducing plan requirements,
the Legislature intends that the annual update shall not duplicate
any of the material in the multiyear base plan, but serve as a
progress report both evaluating what has been accomplished over the
past year and describing in more detail what will be accomplished in
relation to each of the elements in the base plan during the coming
year.
124065. Counties shall be reimbursed for the amount required by the
county to carry out its community child health and disability
prevention program in accordance with the approved community child
health and disability prevention plan. Claims for state reimbursement
shall be made in the manner as the director shall provide. Each
claim for state reimbursement shall be payable from the appropriation
made for the fiscal year when the expenses upon which the claim is
based are incurred.
There shall be no reimbursement for expenditures for the treatment
of disabilities identified as a result of the program or for capital
improvements or the purchase or construction of buildings, except
for the equipment items and remodeling expenses as may be allowed by
regulations adopted by the director.
124070. Counties shall be reimbursed for the amount required by the
county to carry out its community child health and disability
prevention program in accordance with the approved community child
health and disability prevention plan. Claims for state reimbursement
shall be made in a manner as the director shall provide. Each claim
for state reimbursement shall be payable from the appropriation made
for the fiscal year in which the expenses upon which the claim is
based are incurred.
There shall be no reimbursement for expenditures for the treatment
of disabilities identified as a result of the program, except for
the costs of immunizations necessary to bring the child current in
his or her immunization status as provided for by regulations of the
department, or for capital improvements or the purchase or
construction of buildings, except for the equipment items and
remodeling expenses as may be allowed by regulations adopted by the
director.
124075. (a) In order to ensure the maximum utilization of the
California Medical Assistance Program and other potential
reimbursement sources, the department shall develop a schedule and
method of reimbursement at reasonable rates for services rendered
pursuant to this article. The reimbursement schedule shall include
provision for well child examinations as well as for administrative
expenses incurred by providers pursuant to meeting this article.
Inquiry shall be made of all recipients of services under this
article as to their entitlement for third-party reimbursement for
medical services. Where an entitlement exists it shall be billed.
Notwithstanding subdivision (c) of Section 14000 of the Welfare and
Institutions Code and Section 14005 of that code, the California
Medical Assistance Program shall be billed for services rendered
pursuant to this article for every Medi-Cal eligible beneficiary.
(b) The department and counties shall maximize the use of federal
funds for carrying out this article, including using state or county
funds to match funds claimable under Title 19 of the Social Security
Act. Services and administrative support costs claimable under
federal law shall include, but not be limited to, outreach, health
education, case management, resource development, and training at
state and local levels. Any federal funds received shall augment and
not replace funds appropriated from the General Fund for carrying out
the purposes of this article.
124080. The department may contract with a private entity for the
performance of processing claims for state reimbursement, so long as
the cost of the contract is no more than 85 percent of the cost of
the service if performed in state service and there is compliance
with other applicable provisions of the Government Code including,
but not limited to, Sections 19130 to 19132, inclusive.
124085. On and after July 1, 1976, each child eligible for services
under this article shall, within 90 days after entrance into the
first grade, provide a certificate approved by the department to the
school where the child is to enroll documenting that within the prior
18 months the child has received the appropriate health screening
and evaluation services specified in Section 124040. A waiver signed
by the child's parents or guardian indicating that they do not want
or are unable to obtain the health screening and evaluation services
for their children shall be accepted by the school in lieu of the
certificate. If the waiver indicates that the parent or guardian was
unable to obtain the services for the child, then the reasons why
should be included in the waiver.
124090. Any child between birth and 90 days after entrance into the
first grade and all persons under 21 years of age who are eligible
for the California Medical Assistance Program shall be eligible for
services from the child health and disabilities prevention program in
the county where they are a resident. The department, with review
and recommendation by the board, shall adopt regulations specifying
age groups that shall be given certain types of screening tests and
recommendations for referral.
The first source of referral shall be the child's usual source of
health care. If referral is required and no regular source of health
care can be identified, the facility or provider providing health
screening and evaluation services shall provide a list of three
qualified sources of care, without prejudice for or against any
specific source.
124095. Each community child health and disability prevention
program shall provide the child or his or her parent or guardian with
a copy of the results of the health screening and evaluation, as
well as an explanation of the meaning of the results, and shall,
where the need indicates, refer the child for further diagnosis and
treatment.
124100. (a) In cooperation with the county child health and
disability prevention program, the governing body of every school
district or private school that has children enrolled in kindergarten
shall provide information to the parents or guardians of all
children enrolled in kindergarten of this article and Section 120475.
(b) Each county child health and disability prevention program
shall reimburse school districts for information provided pursuant to
this section. The Superintendent of Public Instruction may withhold
state average daily attendance funds to any school district for any
child for whom a certification or parental waiver is not obtained as
required by Section 124085.
124105. (a) This section shall be known and may be cited as the
"Hughes Children's Health Enforcement Act."
(b) The Legislature recognizes the importance of health to
learning and to a successful academic career. The Legislature also
recognizes the important role of schools in ensuring the health of
pupils through health education and the maintenance of minimal health
standards among the pupil population. Therefore, it is the intent of
the Legislature that schools ensure that pupils receive a health
screening before the end of the first grade.
(c) The governing board of each school district shall exclude from
school, for not more than five days, any first grade pupil who has
not provided either a certificate or a waiver, as specified in
Section 124085, on or before the 90th day after the pupil's entrance
into the first grade. The exclusion shall commence with the 91st
calendar day after the pupil's entrance into the first grade, unless
school is not in session that day, then the exclusion shall commence
on the next succeeding schoolday. A child shall not be excluded under
this section if the pupil's parent or guardian provides to the
district either a certificate or a waiver as specified in Section
124085.
(d) The governing board of a school district may exempt any pupil
from the exclusion described in subdivision (c) if, at least twice
between the first day and the 90th day after the pupil's entrance
into the first grade, the district has contacted the pupil's parent
or guardian and the parent or guardian refuses to provide either a
certificate or a waiver as specified in Section 124085. The number of
exemptions from exclusion granted by a school district pursuant to
this subdivision may not exceed 5 percent of a school district's
first grade enrollment. It is the intent of the Legislature that
exemptions from exclusion be used in extraordinary circumstances,
including, but not limited to, family situations of great dysfunction
or disruption, including substance abuse by parents or guardians,
child abuse, or child neglect.
(e) It is the intent of the Legislature that, upon a pupil's
enrollment in kindergarten or first grade, the governing board of the
school district notify the pupil's parent or guardian of the
obligation to comply with Section 124085 and of the availability for
low-income children of free health screening for up to 18 months
prior to entry into first grade through the Child Health Disabilities
Prevention Program.
(f) It is the intent of the Legislature that school districts
provide information to parents regarding the requirements of Section
124085 within the notification of immunization requirements.
Moreover, the Legislature intends that the information sent to
parents encourage parents to obtain health screenings simultaneously
with immunizations.
124110. All information and results of the health screening and
evaluation of each child shall be confidential and shall not be
released without the informed consent of a parent or guardian of the
child.
The results of the health screening and evaluation shall not be
released to any public or private agency, even with the consent of a
parent or guardian, unless accompanied by a professional
interpretation of what the results mean.
124025. The Legislature finds and declares that many physical and
mental disabilities can be prevented, or their impact on an
individual lessened, when they are identified and treated before they
become chronic and irreversible damage occurs. The Legislature finds
and declares that a community-based program of early identification
and referral for treatment of potential handicapping conditions will
be effective in reducing the incidence of the conditions and will
benefit the health and welfare of the citizens of this state.
It is the intent of the Legislature in enacting this article and
Section 120475 to establish child health and disability prevention
programs, that shall be financed and have standards established at
the state level and that shall be operated at the local level, for
the purpose of providing early and periodic assessments of the health
status of children. It is further intended that child health and
disability prevention programs shall make maximum use of existing
health care resources and shall utilize, as the first source of
screening, the child's usual source of health care so that health
screening programs are fully integrated with existing health
services, that health care professionals be appropriately represented
and utilized in these programs, that outreach programs be developed
to stimulate the use of preventive health services, and that services
offered pursuant to this article be efficiently provided and be of
the highest quality.
124030. As used in this article and Section 120475:
(a) "State board" means the State Maternal, Child, and Adolescent
Health Board.
(b) "Department" means the department.
(c) "Director" means the director.
(d) "Governing body" means the county board of supervisors or
boards of supervisors in the case of counties acting jointly.
(e) "Local board" means local maternal, child, and adolescent
health board.
(f) "Local health jurisdiction" means county health department or
combined health department in the case of counties acting jointly or
city health department within the meaning of Section 101185.
(g) "Child Health and Disability Prevention provider" or "CHDP
provider" means any of the following, if approved for participation
in the Child Health and Disability Prevention program by the
community Child Health and Disability program director in accordance
with program standards and as certified by the department:
(1) A physician licensed to practice medicine in California.
(2) A family nurse practitioner certified pursuant to Sections
2834 and 2836 of the Business and Professions Code.
(3) A pediatric nurse practitioner certified pursuant to Sections
2834 and 2836 of the Business and Professions Code.
(4) A primary care center, clinic, or other public or private
agency or organization that provides outpatient health care services.
(5) A physicians' group.
(6) A licensed clinical laboratory.
124033. (a) Commencing July 1, 2003, all applications for services
under the Child Health and Disability Prevention program shall be
filed electronically in accordance with subdivision (b) of Section
14011.7 of the Welfare and Institutions Code.
(b) To implement the program described in subdivisions (b) to (e),
inclusive, of Section 14011.7 of the Welfare and Institutions Code
for the use of an electronic application for the Child Health and
Disability Prevention program and for preenrollment into the Medi-Cal
program or the Healthy Families Program, the following shall apply:
(1) The department may contract with public or private entities,
or utilize existing health care service provider enrollment and
payment mechanisms, including the Medi-Cal program's fiscal
intermediary, only if services provided under the program are
specifically identified and reimbursed in a manner that appropriately
claims federal financial reimbursement.
(2) Contracts, including the Medi-Cal program fiscal intermediary
contract for the Child Health and Disability Prevention Program,
including any contract amendment, any system change pursuant to a
change order, and any project or systems development notice shall be
exempt from Part 2 (commencing with Section 10100) of Division 2 of
the Public Contract Code, Chapter 7 (commencing with Section 11700)
of Part 1 of Division 3 of Title 2 of the Government Code, Section
19130 of the Government Code, and any policies, procedures, or
regulations authorized by these laws.
124035. The department shall administer this article and Section
120475 and shall adopt minimum standards for the approval of
community child health and disability prevention programs and
regulations as necessary. The standards shall allow necessary
flexibility in the administration of county programs, taking into
account the variability of county needs and resources. Standards
shall be adopted for:
(a) Education and experience requirements for directors of
community child health and disability prevention programs.
(b) Health screening, evaluation, and diagnostic procedures for
child health and disability prevention programs.
(c) Public and private facilities and providers that may
participate in community child health and disability prevention
programs.
(d) The department shall develop a methodology for allocating
child health and disability prevention funds to counties for the
administration of this program.
124040. (a) The governing body of each county or counties shall
establish a community child health and disability prevention program
for the purpose of providing early and periodic assessments of the
health status of children in the county or counties by July 1, 1974.
However, this shall be the responsibility of the department for all
counties that contract with the state for health services. Contract
counties, at the option of the board of supervisors, may provide
services pursuant to this article in the same manner as other county
programs, provided the option is exercised prior to the beginning of
each fiscal year. Each plan shall include, but is not limited to, the
following requirements:
(1) Outreach and educational services.
(2) Agreements with public and private facilities and
practitioners to carry out the programs.
(3) Health screening and evaluation services for all children
including a physical examination, immunizations appropriate for the
child's age and health history, and laboratory procedures appropriate
for the child's age and population group performed by, or under the
supervision or responsibility of, a physician licensed to practice
medicine in California or by a certified family nurse practitioner or
a certified pediatric nurse practitioner.
(4) Referral for diagnosis or treatment when needed, including,
for all children eligible for Medi-Cal, referral for treatment by a
provider participating in the Medi-Cal program of the conditions
detected, and methods for assuring referral is carried out.
(5) Recordkeeping and program evaluations.
(6) The health screening and evaluation part of each community
child health and disability prevention program plan shall include,
but is not limited to, the following for each child:
(A) A health and development history.
(B) An assessment of physical growth.
(C) An examination for obvious physical defects.
(D) Ear, nose, mouth, and throat inspection, including inspection
of teeth and gums, and for all children three years of age and older
who are eligible for Medi-Cal, referral to a dentist participating in
the Medi-Cal program.
(E) Screening tests for vision, hearing, anemia, tuberculosis,
diabetes, and urinary tract conditions.
(7) An assessment of nutritional status.
(8) An assessment of immunization status.
(9) Where appropriate, testing for sickle-cell trait, lead
poisoning, and other tests that may be necessary to the
identification of children with potential disabilities requiring
diagnosis and possibly treatment.
(10) For all children eligible for Medi-Cal, necessary assistance
with scheduling appointments for services and with transportation.
(b) Dentists receiving referrals of children eligible for Medi-Cal
under this section shall employ procedures to advise the child's
parent or parents of the need for and scheduling of annual
appointments.
(c) Standards for procedures to carry out health screening and
evaluation services and to establish the age at which particular
tests should be carried out shall be established by the director. At
the discretion of the department, these health screening and
evaluation services may be provided at the frequency provided under
the Healthy Families Program and permitted in managed care plans
providing services under the Medi-Cal program, and shall be
contingent upon appropriation in the annual Budget Act. Immunizations
may be provided at the frequency recommended by the Committee on
Infectious Disease of the American Academy of Pediatrics and the
Advisory Committee on Immunization Practices of the Centers for
Disease Control and Prevention.
(d) Each community child health and disability prevention program
shall, pursuant to standards set by the director, establish a record
system that contains a health case history for each child so that
costly and unnecessary repetition of screening, immunization and
referral will not occur and appropriate health treatment will be
facilitated as specified in Section 124085.
124045. A city that operates an independent health agency may elect
to provide the services described in this article with the approval
of the department. In this instance, the powers granted a governing
body of a county shall be vested in the governing body of the city.
124050. Each community child health and disability program shall
have a director meeting qualification standards by the department,
appointed by the governing body, except for counties contracting with
the state for health services.
124055. Any community child health and disability prevention
program may contract to furnish services to any other county if the
contract is approved by the director.
124060. (a) On or before September 15 of each year, each county
program director shall submit a budget update for the subsequent
fiscal year that provides the following information:
(1) A summary of the previous year's activity, including the
number of children screened, the number of children referred for
diagnosis and treatment, by condition, and the cost of screening
services.
(2) A summary description of the results of cases in that a
treatable disability was identified and referral made.
(3) A projection and cost estimates of the number of children to
be screened for the fiscal year for which the budget is being
submitted.
(b) The multiyear base community child health and disability
prevention plan shall include the following:
(1) An assessment of the adequacy and availability of the
facilities and providers to provide health screening diagnostic and
treatment services.
(2) A description of the child health and disability prevention
program to be offered, including expected participating providers and
outreach mechanisms to be utilized.
(3) A summary description of the current year's activity,
including the number of children screened, the number of children
referred for diagnosis and treatment, by condition, and the cost of
screening services.
(4) A description of how existing school health resources,
including school health personnel, are to be utilized for outreach
and other services.
(5) Budget estimates, including all sources of revenue, for the
budget.
(c) On or before September 15 of each year each governing board
shall submit an update to the multiyear base community child health
and disability prevention plan.
The director shall determine the amount of state funds available
for each county for specified services under an approved multiyear
base community child health and disability prevention plan, as
updated, from state funds appropriated for child health and
disability prevention services.
If the amount appropriated in the Budget Act for the fiscal year
as enacted into law differs from the amount in the budget submitted
by the Governor for the fiscal year, each governing board shall
submit an additional revised update in the form and at the time
specified by the department.
Notwithstanding any other provision of this article, no new
community child health and disability prevention plan shall be
submitted by a county until September 15, 1983. Each county plan and
budget approved for the 1981-82 fiscal year shall be updated on or
before September 15 by the governing body of each county for the
1982-83 and 1983-84 fiscal years pursuant to regulations adopted by
the department. On or before September 15, 1983, the governing body
of each county shall prepare and submit to the department a multiyear
base plan and budget for the 1984-85 fiscal year that shall be
annually updated on or before September 15 of each subsequent year
pursuant to regulations adopted by the department.
The department shall develop and implement the format and
procedures for the preparation and submission of a multiyear base
plan update in order for the counties to have sufficient time prior
to September 15, 1983, to prepare and submit their multiyear base
plan by September 15, 1983.
For the purposes of simplifying and reducing plan requirements,
the Legislature intends that the annual update shall not duplicate
any of the material in the multiyear base plan, but serve as a
progress report both evaluating what has been accomplished over the
past year and describing in more detail what will be accomplished in
relation to each of the elements in the base plan during the coming
year.
124065. Counties shall be reimbursed for the amount required by the
county to carry out its community child health and disability
prevention program in accordance with the approved community child
health and disability prevention plan. Claims for state reimbursement
shall be made in the manner as the director shall provide. Each
claim for state reimbursement shall be payable from the appropriation
made for the fiscal year when the expenses upon which the claim is
based are incurred.
There shall be no reimbursement for expenditures for the treatment
of disabilities identified as a result of the program or for capital
improvements or the purchase or construction of buildings, except
for the equipment items and remodeling expenses as may be allowed by
regulations adopted by the director.
124070. Counties shall be reimbursed for the amount required by the
county to carry out its community child health and disability
prevention program in accordance with the approved community child
health and disability prevention plan. Claims for state reimbursement
shall be made in a manner as the director shall provide. Each claim
for state reimbursement shall be payable from the appropriation made
for the fiscal year in which the expenses upon which the claim is
based are incurred.
There shall be no reimbursement for expenditures for the treatment
of disabilities identified as a result of the program, except for
the costs of immunizations necessary to bring the child current in
his or her immunization status as provided for by regulations of the
department, or for capital improvements or the purchase or
construction of buildings, except for the equipment items and
remodeling expenses as may be allowed by regulations adopted by the
director.
124075. (a) In order to ensure the maximum utilization of the
California Medical Assistance Program and other potential
reimbursement sources, the department shall develop a schedule and
method of reimbursement at reasonable rates for services rendered
pursuant to this article. The reimbursement schedule shall include
provision for well child examinations as well as for administrative
expenses incurred by providers pursuant to meeting this article.
Inquiry shall be made of all recipients of services under this
article as to their entitlement for third-party reimbursement for
medical services. Where an entitlement exists it shall be billed.
Notwithstanding subdivision (c) of Section 14000 of the Welfare and
Institutions Code and Section 14005 of that code, the California
Medical Assistance Program shall be billed for services rendered
pursuant to this article for every Medi-Cal eligible beneficiary.
(b) The department and counties shall maximize the use of federal
funds for carrying out this article, including using state or county
funds to match funds claimable under Title 19 of the Social Security
Act. Services and administrative support costs claimable under
federal law shall include, but not be limited to, outreach, health
education, case management, resource development, and training at
state and local levels. Any federal funds received shall augment and
not replace funds appropriated from the General Fund for carrying out
the purposes of this article.
124080. The department may contract with a private entity for the
performance of processing claims for state reimbursement, so long as
the cost of the contract is no more than 85 percent of the cost of
the service if performed in state service and there is compliance
with other applicable provisions of the Government Code including,
but not limited to, Sections 19130 to 19132, inclusive.
124085. On and after July 1, 1976, each child eligible for services
under this article shall, within 90 days after entrance into the
first grade, provide a certificate approved by the department to the
school where the child is to enroll documenting that within the prior
18 months the child has received the appropriate health screening
and evaluation services specified in Section 124040. A waiver signed
by the child's parents or guardian indicating that they do not want
or are unable to obtain the health screening and evaluation services
for their children shall be accepted by the school in lieu of the
certificate. If the waiver indicates that the parent or guardian was
unable to obtain the services for the child, then the reasons why
should be included in the waiver.
124090. Any child between birth and 90 days after entrance into the
first grade and all persons under 21 years of age who are eligible
for the California Medical Assistance Program shall be eligible for
services from the child health and disabilities prevention program in
the county where they are a resident. The department, with review
and recommendation by the board, shall adopt regulations specifying
age groups that shall be given certain types of screening tests and
recommendations for referral.
The first source of referral shall be the child's usual source of
health care. If referral is required and no regular source of health
care can be identified, the facility or provider providing health
screening and evaluation services shall provide a list of three
qualified sources of care, without prejudice for or against any
specific source.
124095. Each community child health and disability prevention
program shall provide the child or his or her parent or guardian with
a copy of the results of the health screening and evaluation, as
well as an explanation of the meaning of the results, and shall,
where the need indicates, refer the child for further diagnosis and
treatment.
124100. (a) In cooperation with the county child health and
disability prevention program, the governing body of every school
district or private school that has children enrolled in kindergarten
shall provide information to the parents or guardians of all
children enrolled in kindergarten of this article and Section 120475.
(b) Each county child health and disability prevention program
shall reimburse school districts for information provided pursuant to
this section. The Superintendent of Public Instruction may withhold
state average daily attendance funds to any school district for any
child for whom a certification or parental waiver is not obtained as
required by Section 124085.
124105. (a) This section shall be known and may be cited as the
"Hughes Children's Health Enforcement Act."
(b) The Legislature recognizes the importance of health to
learning and to a successful academic career. The Legislature also
recognizes the important role of schools in ensuring the health of
pupils through health education and the maintenance of minimal health
standards among the pupil population. Therefore, it is the intent of
the Legislature that schools ensure that pupils receive a health
screening before the end of the first grade.
(c) The governing board of each school district shall exclude from
school, for not more than five days, any first grade pupil who has
not provided either a certificate or a waiver, as specified in
Section 124085, on or before the 90th day after the pupil's entrance
into the first grade. The exclusion shall commence with the 91st
calendar day after the pupil's entrance into the first grade, unless
school is not in session that day, then the exclusion shall commence
on the next succeeding schoolday. A child shall not be excluded under
this section if the pupil's parent or guardian provides to the
district either a certificate or a waiver as specified in Section
124085.
(d) The governing board of a school district may exempt any pupil
from the exclusion described in subdivision (c) if, at least twice
between the first day and the 90th day after the pupil's entrance
into the first grade, the district has contacted the pupil's parent
or guardian and the parent or guardian refuses to provide either a
certificate or a waiver as specified in Section 124085. The number of
exemptions from exclusion granted by a school district pursuant to
this subdivision may not exceed 5 percent of a school district's
first grade enrollment. It is the intent of the Legislature that
exemptions from exclusion be used in extraordinary circumstances,
including, but not limited to, family situations of great dysfunction
or disruption, including substance abuse by parents or guardians,
child abuse, or child neglect.
(e) It is the intent of the Legislature that, upon a pupil's
enrollment in kindergarten or first grade, the governing board of the
school district notify the pupil's parent or guardian of the
obligation to comply with Section 124085 and of the availability for
low-income children of free health screening for up to 18 months
prior to entry into first grade through the Child Health Disabilities
Prevention Program.
(f) It is the intent of the Legislature that school districts
provide information to parents regarding the requirements of Section
124085 within the notification of immunization requirements.
Moreover, the Legislature intends that the information sent to
parents encourage parents to obtain health screenings simultaneously
with immunizations.
124110. All information and results of the health screening and
evaluation of each child shall be confidential and shall not be
released without the informed consent of a parent or guardian of the
child.
The results of the health screening and evaluation shall not be
released to any public or private agency, even with the consent of a
parent or guardian, unless accompanied by a professional
interpretation of what the results mean.
