Amended  IN  Assembly  March 16, 2021

CALIFORNIA LEGISLATURE— 2021–2022 REGULAR SESSION

Assembly Bill
No. 1264

Introduced by Assembly Member Aguiar-Curry

February 19, 2021

An act to add and repeal Article 5.3 (commencing with Section 124000) of Chapter 3 of Part 2 of Division 106 of the Health and Safety Code, relating to public health.


LEGISLATIVE COUNSEL'S DIGEST


AB 1264, as amended, Aguiar-Curry. Project ECHO (registered trademark) Grant Program.
Existing law establishes within state government the California Health and Human Services Agency. Office of Statewide Health Planning and Development. Existing law also establishes various public health programs, including grant programs, throughout the state for purposes of promoting maternal, child, and adolescent health.
This bill would require the agency, office, upon appropriation by the Legislature, to establish, develop, implement, and administer the Project ECHO (registered trademark) Grant Program. Under the grant program, the bill would require participating children’s hospitals to establish yearlong pediatric behavioral health teleECHO (trademark) clinics for specified individuals, including primary care clinicians and educators, to help them develop expertise and tools to better serve the youth that they work with by addressing their mental health needs stemming from the coronavirus pandemic. The bill would authorize an eligible children’s hospital to partner with another eligible children’s hospital, or with another general acute care hospital, to implement its project. The bill would require the agency office to ensure that the grant program includes a maximum of 8 grants that support pediatric behavioral health teleECHO (trademark) clinics to be administered and operated by an eligible children’s hospital, and that grant funding be made available, at a minimum, to participants for specified purposes, such as recruiting efforts and funding salaries and fringe benefits for pediatric behavioral health teleECHO (trademark) clinic personnel. The bill would require a pediatric behavioral health teleECHO (trademark) clinic to target specified audiences, including school-based health care professionals who serve kindergarten and grades 1 to 12, inclusive, and would require a participant to perform prescribed duties, such as preparing a report that evaluates the grant program. The bill would repeal these provisions on January 1, 2027.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: NO  

The people of the State of California do enact as follows:


SECTION 1.

 (a) The Legislature finds and declares all of the following:
(1) California is facing an unprecedented public health crisis as a result of the novel coronavirus (COVID-19) pandemic.
(2) Mental health experts agree that the impacts of the pandemic and statewide stay-at-home orders will have long-lasting impacts on the mental health of all Californians.
(3) A 2013 study from the University of Kentucky, College of Medicine, found that almost one-third of children who experienced isolation or quarantine during the 2002–04 severe acute respiratory syndrome pandemic and the 2009 H1N1 flu pandemic demonstrated symptoms that met the overall threshold for post-traumatic stress disorder (PTSD) and showed significantly higher rates of PTSD symptoms of all kinds compared to children who did not experience isolation or quarantine.
(4) The stay-at-home orders that have been issued across California in response to the COVID-19 pandemic are of a much longer duration, and more widespread, than those that were issued during either of these previous pandemics, which suggests that the negative impacts on children’s mental health will also be more severe and widespread.
(5) School-based professionals and primary care clinicians are in the best position to implement widespread interventions and mental health supports for children, but many do not have the training or expertise needed to address the mental health needs that children will experience in the coming months and years.
(6) Project ECHO (Extension for Community Healthcare Outcomes) (registered trademark) is an innovative educational model and knowledge-sharing network that allows specialists to share their expertise with health care providers and educators in rural and underserved communities. Project ECHO (registered trademark) serves as a model to help pediatric and adolescent mental health teams share their expertise with primary care clinicians and school-based professionals who are on the front-line for the purpose of supporting the mental health needs of children and adolescents.
(7) This low-cost and high-impact intervention is accomplished by linking expert interdisciplinary specialist teams with primary care clinicians, other health care professionals, and educators through pediatric behavioral health teleECHO (trademark) clinics. Experts mentor the clinicians and professionals to help them manage their patient cases, clients, and students, as appropriate, and share their expertise through mentoring, guidance, feedback, and didactic education. This enables primary care clinicians and other professionals to develop the skills and knowledge they need to treat their patients, clients, and students, as appropriate, with common and complex conditions in their own communities communities, thereby reducing travel costs, wait times, and avoidable complications.
(8) The ECHO model (trademark) is not a form of telemedicine. The specialist does not assume the care of the patient, client, or student. Rather, the ECHO model (trademark) is a guided practice model under which the primary care physician or school-based professional retains responsibility for managing the patient, client, or student, and the primary care physician or professional operates with increasing independence as their skills and self-efficacy grow.
(b) For purposes of helping primary care clinicians, other health care professionals, including school-based professionals, and educators meet the mental health needs of children and adolescents stemming from the COVID-19 pandemic, it is the intent of the Legislature to require the California Health and Human Services Agency Office of Statewide Health Planning and Development to establish, develop, implement, and administer a grant program to fund a maximum of eight grants that support pediatric behavioral health teleECHO (trademark) clinics to be administered and operated by eligible children’s hospitals.

SEC. 2.

 Article 5.3 (commencing with Section 124000) is added to Chapter 3 of Part 2 of Division 106 of the Health and Safety Code, to read:
Article  5.3. Project ECHO (registered trademark) Grant Program
Article  5.3. 

124000.
 For purposes of this article, the following definitions apply:
(a) “Eligible children’s hospital” means any hospital that is identified in Section 10727 of the Welfare and Institutions Code.
(b) “Grant program” means the grant program established under this article.
(c) “Participant” means an applicant that has been approved to implement the grant program.

124001.
 (a) (1) Upon appropriation by the Legislature for this purpose, the California Health and Human Services Agency Office of Statewide Health Planning and Development shall establish, develop, implement, and administer the Project ECHO (registered trademark) Grant Program. Under the grant program, participating children’s hospitals shall establish yearlong pediatric behavioral health teleECHO (trademark) clinics for primary care clinicians, other health care professionals, including school-based health professionals, and educators to help them develop expertise and tools to better serve the children and adolescents that they work with by addressing their mental health needs stemming from the coronavirus (COVID-19) pandemic.
(2) The agency office shall ensure that the grant program includes a maximum of eight grants that support pediatric behavioral health teleECHO (trademark) clinics to be administered and operated by an eligible children’s hospital. clinics. Each one-time grant shall not exceed two hundred twenty-five thousand dollars ($225,000), and one grant shall be available to each eligible children’s hospital to fund a one yearlong project. An eligible children’s hospital may partner with another eligible children’s hospital, or another general acute care hospital, to implement its project. If two or more eligible hospitals apply jointly, the maximum allowable grant award shall be multiplied to reflect the number of joint applicants. If any funding is available following an initial application period, the agency office shall offer a secondary application period to exhaust available funding, subject to the funding limitations described in this paragraph.
(3) A participating children’s hospital shall consult with the county behavioral health agencies in each county where its project will be implemented to obtain information on appropriate referrals to local public children’s behavioral health programs for the purposes of providing this information to its project participants.
(b) The agency office shall ensure that grant funding be made available, at a minimum, to participants for all of the following purposes:
(1) Planning and developing curriculum.
(2) Printing and duplication costs.
(3) Recruiting.
(4) Funding all of the following:
(A) Salaries and fringe benefits for pediatric behavioral health teleECHO (trademark) clinic personnel.
(B) Supplies and equipment, including capital and noncapital.
(C) Travel costs associated with Replication Training at the ECHO (registered trademark) Institute and recruitment of pediatric behavioral health teleECHO (trademark) clinic participants.
(D) Facilities and administrative fees.
(E) Consultant fees.
(c) A pediatric behavioral health teleECHO (trademark) clinic shall target one or more of the following audiences or a subset of that audience:
(1) Primary care providers.
(2) School-based health care professionals who serve kindergarten and grades 1 to 12, inclusive.
(3) School-based mental health professionals who serve kindergarten and grades 1 to 12, inclusive.
(4) School administrators who serve kindergarten and grades 1 to 12, inclusive.
(5) Educators who serve kindergarten and grades 1 to 12, inclusive.
(d) Under the grant program, a participant shall perform specified duties in furtherance of the legislative objectives of this program, as directed by the agency. office. At a minimum, a participant shall do all of the following:
(1) Prioritize working with community providers and school-based professionals who predominantly serve low-income populations or those serving in rural or underserved areas of the state.
(2) Adhere to the four principles of the ECHO (registered trademark) model in the pediatric behavioral health teleECHO (trademark) clinics, which includes all of the following:
(A) Use technology to leverage scarce resources.
(B) Share best practices to reduce disparity.
(C) Employ case-based learning to master complexity.
(D) Use an internet web-based database to monitor outcomes.
(3) Prepare a report evaluating the grant program upon the conclusion of the one-year program, and submit that report to the agency office for review.

124002.
 This article shall remain in effect only until January 1, 2027, and as of that date is repealed.