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Note: Authority cited: Sections 125070 and 125000(h)(j), Health and Safety Code. Reference: Sections 125000(b), (f), 125005, 125050, 125055, 125060 and 125065, Health and Safety Code.
s 6531. Reporting of Neural Tube Defects.
(a) All cases of neural tube defect in a fetus or an infant under one year of age shall be reported to the Department. Neural tube defects shall mean any malformation of the fetus caused by the failure of the developing spine and skull to properly close.
(b) This report shall be made:
(1) By the health facility in which the case is initially diagnosed;
(2) By the physician making the initial diagnosis if the case is not diagnosed in a health facility;
(3) Within 30 calendar days of the initial diagnosis;
(4) On the form to be provided by the Department for this purpose.
Note: Authority cited: Section 289.7, Health and Safety Code. Reference: Section 289.7, Health and Safety Code.
s 6532. Reporting of Chromosomal Disorders.
(a) All cases of Down's syndrome or other chromosomal defects in a fetus or an infant under one year of age shall be reported to the Department. Chromosomal defects shall mean any abnormality in structure or number of chromosomes.
(b) This report shall be made:
(1) by the cytogenic laboratory performing the chromosomal analysis or by the physician making the diagnosis;
(2) within 30 calendar days of the initial diagnosis;
(3) on a form to be provided by the Department for this purpose.
Note: Authority cited: Section 309, Health and Safety Code. Reference: Section 309, Health and Safety Code.
s 6600. Employee.
An employee of the school is a person on the school's payroll, part time or full time.
Note: Authority cited: Sections 102 and 208, Health and Safety Code. Reference: Sections 3450-3455, Health and Safety Code.
s 6601. Volunteer.
A volunteer is a person not on the school's payroll who meets the following criteria: (a) contributes time and services in support of the school's operation, (b) whose work is regularly scheduled by the school on a continuing basis at least once monthly, and (c) who works on the school premises during school hours.
s 6602. Private and Parochial Schools.
Private and parochial schools are schools offering elementary and secondary daily education in any of the grades, kindergarten through twelfth.
s 6603. Nursery School.
Nursery school is any school receiving and caring for one or more children of preschool age on a partial or full time basis.
s 6604. Elementary School.
Elementary school is any school offering instruction in any of the grades kindergarten through eighth.
s 6605. Secondary School.
Secondary school is any school offering instruction in any of the grades, ninth through twelfth.
s 6606. Minimum Examination.
Minimum examination required is a chest X-ray or the approved skin test. If the tuberculin test is positive (10 mm. or over), it must be followed by a chest X-ray. Private physicians, local health departments or local Tuberculosis and Health Associations may provide these tests and X-rays.
s 6607. Approved Skin Test.
Approved skin test is the intradermal Mantoux 5 TU (.0001 mgm) PPD.
s 6608. Records as Evidence of Compliance.
A school will have satisfactorily complied with the requirements of the law if by two weeks after the opening of the school year the school administrator provides the local health officer with a statement certifying (a) the number of persons employed, (b) the number of volunteers, and (c) that the required certificate for each, signed by a physician licensed to practice medicine in California, or a notice from a public health agency or unit of the Tuberculosis and Health Association indicating freedom from active tuberculosis is on file and available for verification. Thereafter, the legal requirements will be met by obtaining the certificate prior to or within two weeks of date of employment, or acceptance of a volunteer, and repeating every two years.
s 6701. Application and Scope.
Note: Authority cited: Sections 208 and 217, Health and Safety Code. Reference: Section 217, Health and Safety Code.
s 6702. Time Limitation for Training.
Note: Authority cited: Sections 208 and 217, Health and Safety Code. Reference: Section 217, Health and Safety Code.
s 6705. Definitions.
Note: Authority cited: Sections 208 and 217, Health and Safety Code. Reference: Section 217, Health and Safety Code.
s 6710. Scope of Course.
Note: Authority cited: Sections 208 and 217, Health and Safety Code. Reference: Section 217, Health and Safety Code.
s 6711. Required Topics.
Note: Authority cited: Sections 208 and 217, Health and Safety Code. Reference: Section 217, Health and Safety Code.
s 6712. Special Requirements.
Note: Authority cited: Sections 208 and 217, Health and Safety Code. Reference: Section 217, Health and Safety Code.
s 6714. Testing.
Note: Authority cited: Sections 208 and 217, Health and Safety Code. Reference: Section 217, Health and Safety Code.
s 6715. Validation of Course Completion.
Note: Authority cited: Sections 208 and 217, Health and Safety Code. Reference: Section 217, Health and Safety Code.
s 6716. Retraining Requirements.
Note: Authority cited: Sections 208 and 217, Health and Safety Code. Reference: Section 217, Health and Safety Code.
s 6720. Course Approval.
Note: Authority cited: Sections 208(a) and 217, Health and Safety Code. Reference: Section 217, Health and Safety Code.
s 6721. Additional Requests for Designation.
Note: Authority cited: Sections 208 and 217, Health and Safety Code. Reference: Section 217, Health and Safety Code.
s 6722. Program Review.
[FNa1] Renumbered from Subchapter 11 (Register 74, No. 52).
Note: Authority cited: Sections 208 and 217, Health and Safety Code. Reference: Section 217, Health and Safety Code.
Note: Authority cited: Sections 208 and 1760, Health and Safety Code. Additional authority cited: Section 1760.5, Health and Safety Code. Reference: Sections 1760 and 1760.5, Health and Safety Code.
s 6800. Health Assessment.
(a) "Health assessment" means the following:
(1) A comprehensive health and developmental history, and a physical examination.
(2) Appropriate health screening procedures and immunizations.
(3) Evaluation of results in terms of needed diagnosis and treatment.
(4) Providing the person screened with a copy of the results and an explanation of their meaning.
(5) Health education appropriate to the person's age and health status, including anti-tobacco use education.
Note: Authority cited: Sections 208 and 321, Health and Safety Code; and Section 12, Assembly Bill 75 (Chapter 1331, Statutes of 1989). Reference: Sections 321.2, 324 and 24165.3, Health and Safety Code.
s 6801. Community.
"Community" means an individual county, or a city and county, or counties acting jointly, or a city which operates an independent health agency. In the instance of a city providing the services described in this subchapter, the powers granted a governing body of a county to operate a child health and disability prevention program shall be vested in the governing body of that city.
Note: Authority cited: Sections 208 and 321, Health and Safety Code. Reference: Sections 320, et seq., Health and Safety Code.
s 6802. Community Child Health and Disability Prevention Program.
(a) "Community child health and disability prevention (CHDP) program" means a community based and operated program of activities, approved and funded by the Department, necessary to comply with federal and state legislation and regulations that require:
(1) CHDP services to be made available to Medi-Cal beneficiaries from birth to 21 years of age, and to be reimbursed by the State.
(2) Health assessment and referral to diagnosis and treatment services to be made available to (1) children who are not Medi-Cal beneficiaries from birth until 90 days after entrance into the first grade, and (2) all persons under 19 years of age whose family income is not more than 200% of the federal poverty level. State reimbursement of the costs of health assessment and referral to diagnostic and treatment services for these children is limited by the amount of funds appropriated by the Legislature, and is made available only for those children who meet the age and family income criteria defined by the State Department of Health Services' Child Health and Disability Prevention Program.
(3) Children entering first grade to present a certificate within 90 days after entrance that they have received health assessment within the prior 18 months. A waiver signed by the child's parent or guardian indicating that they do not want or are unable to obtain such health assessment and evaluation services for their children shall be accepted in lieu of the certificate.
Note: Authority cited: Sections 208 and 321, Health and Safety Code; and Section 12, Assembly Bill 75 (Chapter 1331, Statutes of 1989). Reference: Sections 320 and 24165.3, Health and Safety Code.
s 6804. Contract Counties.
"Contract counties" means those counties which contract with the Department for health services and which have not elected to provide the services themselves. The Department is responsible for the child health and disability prevention programs in those counties.
Note: Authority cited: Sections 208 and 321, Health and Safety Code. Reference: Sections 320, et seq., Health and Safety Code.
s 6806. Department.
"Department" means the State Department of Health Services.
Note: Authority cited: Sections 208, 320.2 and 321, Health and Safety Code. Reference: Sections 320, et seq., Health and Safety Code.
s 6808. Diagnosis.
Note: Authority cited: Sections 208 and 321, Health and Safety Code. Reference: Sections 320, et seq., Health and Safety Code.
s 6810. Director.
"Director" means the Director of the State Department of Health Services, unless otherwise specified.
Note: Authority cited: Sections 208 and 321, Health and Safety Code. Reference: Sections 320, et seq., Health and Safety Code.
s 6812. Governing Body.
"Governing Body" means, except where indicated otherwise in this subchapter, the county board of supervisors, or boards of supervisors in the case of counties acting jointly or the city council in the case of a city.
Note: Authority cited: Sections 208 and 321, Health and Safety Code. Reference: Sections 320 et seq., Health and Safety Code.
s 6813. Initiation of Treatment.
"Initiation of treatment" means the first encounter for treatment of the medical and the dental problems disclosed during the health assessment.
Note: Authority cited: Sections 208 and 321, Health and Safety Code. Reference: Section 323.7, Health and Safety Code.
s 6814. Medi-Cal Beneficiary.
(a) "Medi-Cal beneficiary" means an individual under 21 years of age who is eligible for and certified to receive services under provisions of the California Medical Assistance Program (Chapter 7 of Part 3 of Division 9 of the Welfare and Institutions Code, beginning with Section 14000). Medi-Cal beneficiaries include:
(1) Persons who are certified eligible to receive cash grants under one of the public assistance programs.
(2) Persons who are certified eligible to receive medically needy or medically indigent Medi-Cal benefits.
(3) Other persons who are certified eligible to receive noncash grant Medi-Cal benefits. Other persons include the following:
(A) Children not in school and not in training.
(B) Persons receiving in-home supportive services.
(C) Persons who have lost AFDC eligibility, but are continuing to receive Medi-Cal benefits for four months from the date of lost eligibility.
(D) Persons who were discontinued from cash grants solely due to a 20 percent Social Security increase in 1977.
Note: Authority cited: Sections 208 and 321, Health and Safety Code. Reference: Sections 320, et seq., Health and Safety Code.
s 6816. Person.
"Person" means anyone from birth to 21 years of age eligible to receive services specified in this subchapter. Persons include newborns, infants, children, youth, emancipated minors, young adults and adults. In those instances where the person is not an adult or an emancipated minor, "person" means the person, or his/her parent(s) or guardian(s).
Note: Authority cited: Sections 208 and 321, Health and Safety Code. Reference: Sections 320, et seq., Health and Safety Code.
s 6817. Clinical Laboratory.
"Clinical Laboratory" means a facility for examining and testing specimens for the purpose of obtaining scientific data which may be used to ascertain the presence, progress, and source of disease in human beings.
Note: Authority cited: Sections 208 and 321, Health and Safety Code; Section 14105, Welfare and Institutions Code. Reference: Section 320, Health and Safety Code; Section 14132, Welfare and Institutions Code; and Section 655.6, Business and Professions Code.
s 6818. Screening.
Note: Authority cited: Sections 208 and 321, Health and Safety Code. Reference: Sections 320, et seq., Health and Safety Code.
s 6819. Child Health and Disability Prevention Services in Contract Counties.
The organizational unit within the Department which is responsible for health services in contract counties shall develop annual plans and budgets, and shall conduct a program which is acceptable to the Child Health and Disability Prevention Program, and which is in accordance with the provisions of this subchapter.
Note: Authority cited: Sections 208 and 321, Health and Safety Code. Reference: Section 321.2, Health and Safety Code.
s 6820. Advisory Boards.
(a) Membership. Membership in an advisory board shall be as follows:
(1) Members appointed to the local advisory board by the local governing body shall include, but not be limited to, individuals who, at the time of their appointment, are representatives of health professions concerned with child health, school health personnel and parents of children eligible to receive services under provisions of this subchapter, whether or not the services are eligible for state reimbursement.
(2) The governing body may recognize individuals as alternates who have professional or parent qualifications equivalent to that of the member.
(3) The governing body shall not appoint any employee of the local health department to the advisory board, except that the director and deputy director of the community child health and disability prevention program shall be ex officio, nonvoting members of the board.
(4) Individuals appointed to the advisory board as parents of children eligible to receive services shall neither be employed by an individual or an agency providing health services to the public for fee, nor be a provider of health services to the public for fee.
(b) Responsibilities. The local advisory board shall be responsible for the reviewing, advising and reporting functions related to the community child health and disability prevention program as specified in Section 321.7, Health and Safety Code. The advisory board may also advise the local governing body and appropriate governmental agencies on health matters additional to the community child health and disability prevention program, such as maternal and child health in general.
(c) Tenure. Members of the advisory board shall serve at the pleasure of the appointing authority for a term of three years, except that one-third of the members first appointed in each jurisdiction shall serve for three years, one-third of the members for two years and one-third of the members for one year.
(d) Meetings. The advisory board shall meet at least twice each year, once before March 1, and once after March 1 but before September 1. In addition, the board shall meet on the call of the chairperson of the board or on the call of one-third of its members. Public notice shall be given of the date, time and location of each meeting in advance of the meeting. Meetings shall be open to the public.
(e) Reimbursement. Advisory board members and alternates shall serve without compensation, except that members, and alternates when acting in lieu of members, shall be reimbursed under the approved community plan for actual and necessary expenses incurred in connection with the performance of their duties. Parent members may additionally be reimbursed for their actual and necessary costs of child care and lost wages.
Note: Authority cited: Sections 208 and 321, Health and Safety Code. Reference: Section 321.7, Health and Safety Code.
s 6822. Director and Deputy Director.
(a) Designation. Each governing body, except those in contract counties whose programs are administered by the Department, shall appoint a physician, licensed to practice medicine in California, as Director, Child Health and Disability Prevention Program. The director shall have administrative responsibility for the organizational unit concerned with child health in the local health department as defined in Section 1102, Health and Safety Code. If the director is an existing health official, the director or local appointing authority shall also appoint a Deputy Director, Child Health and Disability Prevention Program, with experience in the delivery of health services to children and youth who is assigned to the organizational unit for which the Director, Child Health and Disability Prevention Program, has direct administrative responsibility.
(b) Responsibilities. The responsibilities of the director shall include, but not be limited to:
(1) Developing and implementing the community child health and disability prevention program plan and assuring its compliance with federal and state regulations. To the extent possible, this plan should relate to all community health services for children and youth, and to the integration and coordination of these services with the community's child health and disability prevention program.
(2) Managing funds granted under the state-approved community plan.
(3) Completing all reports and maintaining all records required by the Department.
(4) Providing support staff and services to the community child health and disability prevention advisory board.
(5) Preparing an annual report to the governing body.
(c) Reimbursement. The salary and necessary expenses of the community child health and disability prevention program director or deputy director may be reimbursed by the State under the approved community plan to the extent that the services are directly related to the community child health and disability prevention program. However, if the director is a health officer as defined in Sections 451, 502 or 940 of the Health and Safety Code, no funds from this program shall be used directly or indirectly for reimbursement of the health officer's services rendered to the program. If the director is an existing health official other than the health officer, the official's salary may be reimbursed to the extent the official renders services to the program as indicated in the program's approved annual plan and budget.
Note: Authority cited: Sections 208 and 321, Health and Safety Code. Reference: Sections 321(a) and 322, Health and Safety Code.
s 6824. State and Local Responsibilities.
(a) Annual plan and budget. On or before March 15 of each year, each governing body shall submit to the Department's Child Health and Disability Prevention Program the following:
(1) A summary of the previous fiscal year's activity ending the previous June 30.
(2) A summary of the current fiscal year's activity from the previous July 1 to the date of the revised budget submittal. A projection of activities from the date of the revised budget submittal through June 30 of the current fiscal year is desirable, but optional.
(3) A description of the community program to be offered the next fiscal year, including expected program performance goals and activities. Descriptive material submitted as part of a previously state-approved plan need not be repeated. If the community child health and disability prevention program plan is part of the community's more comprehensive child health plan, the more comprehensive plan may be submitted in lieu of a separate community child health and disability prevention program plan.
(4) A budget for the next fiscal year beginning July 1.
(A) The community child health and disability prevention program budget for the budget year shall be limited to those items, including equipment and remodeling, required to implement the plan approved by the Department's Child Health and Disability Prevention Program.
(B) If the amount appropriated in the State Budget Act and enacted into law for the budget year differs from the amount in the budget submitted by the Governor, each local governing body shall submit to the Department's Child Health and Disability Prevention Program an additional revised plan and budget that reflects the share of the reduction determined by the Director to be applicable to that community child health and disability prevention plan.
(5) A preliminary budget estimate for the following fiscal year beginning the following July 1.
(6) A current agreement between the community child health and disability prevention program and the county welfare department relating to the provision and documentation of child health and disability prevention services to Medi-Cal beneficiaries and setting forth the responsibilities of the community program and the county welfare department to assure adequate informing, outreach, referral and follow-up.
(7) Other information which may be required by the Department's Child Health and Disability Prevention Program.
(b) Informing Medi-Cal beneficiaries. Medi-Cal beneficiaries shall be informed as follows:
(1) No later than 60 days following the date of a family's initial Medi-Cal eligibility determination or of determination after a period of ineligibility, the family must be informed of the availability of CHDP services including dental services. This must be done in writing and using face-to-face contact by a person who can explain these services and benefits. A family who loses and regains eligibility more than twice within a twelve-month period need not be informed more than twice in that twelve-month period. Informing includes the offer of services, assistance with scheduling appointments and transportation, and documenting responses.
(2) If no member of an eligible family participates in the program, the family must be informed in writing at least once each year beginning October 1, 1980. Informing includes offering CHDP services, offering assistance with transportation and scheduling appointments, and documenting responses.
(3) Each of the following must be used to inform an eligible family:
(A) Clear, nontechnical materials for those families who are to be informed in writing.
(B) Procedures suitable for informing persons who are illiterate, blind, deaf, or cannot understand the English language.
(4) A family being informed about the program must be given the following information:
(A) The benefits of preventive health and dental services.
(B) How medical and dental services can be obtained.
(C) How specific information can be obtained on the location of the nearest providers participating in the program.
(D) The health assessment and dental services that are offered.
(E) A summary of the State's periodicity schedule.
(F) That recipients can receive both initial and periodic health assessments and dental services according to the State's periodicity schedule.
(G) That treatment services shall be provided for problems disclosed during screening.
(H) That assistance in referral shall be provided.
(I) That assistance with transportation shall be provided if the person requests it.
(J) That assistance in scheduling appointments shall be provided if the person requests this assistance.
(K) That as long as the person remains eligible for Medi-Cal, he or she may request these services at any time in the future if the decision is postponed at the time of initial informing.
(L) That the person may choose to receive CHDP services from a provider of the person's choice, and that if the provider does not offer the full range of CHDP services specified in this subchapter, the person can receive the services not offered if the person makes a request to the community CHDP program or welfare department. If such request is made, assistance in scheduling appointments and transportation shall be offered, and the responses documented.
(M) That these CHDP services are available from approved providers at no cost to the family.
(c) Information and training for county welfare employees. Information and training for county welfare department personnel shall be as follows:
(1) The State Departments of Health Services and Social Services shall provide information, training and materials necessary to ensure that county social services and welfare eligibility personnel, and other appropriate welfare department employees, are fully informed as to the purpose, nature, scope and benefits of CHDP services.
(2) Such employees shall be trained in methods of information dissemination that will encourage and motivate eligible individuals to make use of such preventive medical programs.
(3) The provision of such training shall be verified in appropriate sections of the annual plans submitted to the Department's Child Health and Disability Prevention Program by community child health and disability prevention programs.
(d) Information and training for local health department personnel. Information and training for local health department personnel shall be as follows:
(1) The Department shall provide such information, training and materials necessary to ensure that appropriate local health department personnel and other appropriate county and municipal employees are informed as to the purpose, nature, scope and benefits of CHDP services.
(2) Such employees shall be trained in methods of information dissemination that will encourage and motivate eligible individuals to make use of such preventive medical programs.
(3) The provision of such training shall be verified in appropriate sections of the annual plans submitted to the Department's Child Health and Disability Prevention Program by community child health and disability prevention programs.
(e) Required services. Each community child health and disability prevention program shall provide, in accordance with this subchapter, at least the following services:
(1) Outreach and health education, including anti-tobacco use education.
(2) Referral to dentist.
(3) Referral to a health assessment.
(4) Health assessment.
(5) Certification for school entry.
(6) Referral to diagnosis and treatment.
(7) Diagnosis and treatment.
(f) Records and information. Each community child health and disability prevention program shall keep records and provide information on the results of health assessments and follow-up to diagnosis and treatment, and other data about the persons served as may be required by the Department's Child Health and Disability Prevention Program.
(g) Other responsibilities. The Department shall provide the following:
(1) Regulations and minimum standards for quality preventive health services for children and youth, including anti-tobacco use education guidelines.
(2) Consultation services on all aspects of community program development.
(3) Appropriate data collection and reporting forms.
(4) Documentation and data, made available at the state or local level, on all aspects of the program including:
(A) The results of informing services.
(B) The results of screening services.
(C) The results of diagnosis and treatment services.
(D) The results of anti-tobacco education services.
(5) Management reports for state and local program use.
(6) Reports required by the federal Early Periodic Screening Diagnosis and Treatment Program.
Note: Authority cited: Sections 208 and 321, Health and Safety Code; and Section 12, Assembly Bill 75 (Chapter 1331, Statutes of 1989). Reference: Sections 320, 321.2, 322.5, 324 and 24165.3, Health and Safety Code.
s 6826. State and Local Information and Training Responsibilities.
Note: Authority cited: Sections 208 and 321, Health and Safety Code. Reference: Sections 320, et seq., Health and Safety Code.
s 6828. Sanctions for Noncompliance.
(a) If the Chief of the State Child Health and Disability Prevention Program determines that a reasonable period of technical consultation and assistance has been provided or arranged for by the State Child Health and Disability Prevention Program, and further determines that a community child health and disability prevention program director fails to comply with any state or federal law or regulation governing child health and disability prevention services, or with the approved community plan, the Chief of the State Child Health and Disability Prevention Program shall notify the local governing body in writing of the specific areas of noncompliance. A copy of the notice shall be sent to the community pro gram director, the county welfare department director, and to the local child health and disability prevention program advisory board.
(b) If the local governing body fails to provide substantial evidence to the Chief of the State Child Health and Disability Prevention Program within 30 days that the community program director is complying and shall continue to comply with the laws, regulations and the approved community plan, the Director shall convene a hearing for the community program to show cause why the Director should not take action to secure compliance. The Director shall invite the community child health and disability prevention program's advisory board and other persons or organizations interested in the community's child health and disability prevention program to present comments at such hearing. The Department shall give the community program, concerned individuals and organizations, and the general public at least 15 days notice of such hearing.
(c) The Director shall consider the case on the record established at the hearing and render findings and decision on the issues within 30 days following the hearing. The findings and decision shall be submitted in writing by the Director to the local governing body. A copy of the notice shall be sent to the community program director, the county welfare department director, and to the local child health and disability prevention program advisory board.
(d) If the Director determines that there is a failure on the part of the community child health and disability prevention program to comply with any state or federal law or regulation governing child health and disability prevention services, or the approved community plan, the Department may invoke any of the following sanctions:
(1) Consistent with federal and state law, withhold part or all of state and federal funds from such community until the local governing body provides written documentation of compliance to the Director.
(2) Bring an action in mandamus or such other action in court as may be appropriate to compel compliance.
(e) Nothing in this section shall be construed as relieving the local governing body of the responsibility to provide funds necessary to continue the child health and disability prevention services required by Sections 320, et seq., Health and Safety Code.
Note: Authority cited: Sections 208 and 321, Health and Safety Code. Reference: Sections 320, et seq., Health and Safety Code.
s 6830. Eligibility for Services.
(a) Medi-Cal beneficiaries shall be eligible for periodic health assessments, and for diagnosis and treatment, if necessary, in accordance with the provisions of this subchapter.
(b) Any child
(1) between birth and 90 days after entrance into the first grade who is not a Medi-Cal beneficiary and
(2) all persons under 19 years of age whose family income is not more than 200 percent of the federal poverty level shall be eligible for health assessments in accordance with the provisions of this subchapter. Availability of services and reimbursement for these services shall depend on the amount of funds appropriated by the Legislature for the services as specified in section 6832(b).
Note: Authority cited: Sections 208 and 321, Health and Safety Code; and Section 12, Assembly Bill 75 (Chapter 1331, Statutes of 1989). Reference: Sections 322.5, 323.7 and 24165.3, Health and Safety Code.
s 6832. Eligibility for Reimbursement.
(a) The costs of periodic health assessments provided to Medi-Cal beneficiaries shall be reimbursed by the State in accordance with the schedule of maximum allowances specified in section 6868.
(b) If the amount of funds appropriated in the State Budget Act are sufficient, the costs of health assessments provided to (1) children between birth and 90 days after entrance into the first grade, who are not Medi-Cal beneficiaries, and (2) all persons under 19 years of age whose family income is not more than 200 percent of federal poverty level shall be reimbursed by the State. To the extent that funds are not sufficient, these costs shall be reimbursed only for those children who meet the age and family income criteria defined by the Department's Child Health and Disability Prevention Program.
(c) The costs of diagnosis and treatment services provided to Medi-Cal beneficiaries as a result of health assessments shall be reimbursed by the State in accordance with the Medi-Cal fee schedules, subject to any applicable Medi-Cal program limitations.
Note: Authority cited: Sections 208 and 321, Health and Safety Code; and Section 12, Assembly Bill 75 (Chapter 1331, Statutes of 1989). Reference: Sections 322.5, 323.2 and 24165.3, Health and Safety Code.
s 6840. Required Services.
Note: Authority cited: Sections 208 and 321, Health and Safety Code. Reference: Sections 321.2 (a)-(e), Health and Safety Code.
s 6842. Outreach and Health Education.
(a) Plan. Each community child health and disability prevention program shall develop, plan and implement community outreach and health education activities which are related to the community's needs and resources. Activities may include, but are not limited to, community organization, staff training, consultation with children and families, staff services to community child health and disability prevention program advisory boards, and the development and dissemination of informational and educational material for the public, potential users and providers of the program's services, advisory board members, local agencies and community groups.
(b) Outreach. An outreach program shall be as follows:
(1) Community child health and disability prevention programs shall develop outreach programs to involve persons in the use of preventive health services. Outreach and health education services shall be designed to ensure that the only reason eligible persons do not participate in the health assessment and referral for diagnosis and treatment portions of the program is because they intelligently and knowingly decline such participation for reasons unrelated to availability and accessibility of the health assessment, diagnosis and treatment services.
(2) In cooperation with the community child health and disability prevention program, the governing body of every school district or private school which has children enrolled in kindergarten shall, at the time the parent or guardian registers a child in kindergarten, inform the parents or guardians as follows:
(A) It is statutorily required that children provide, within 90 days after entrance into the first grade, either a certificate to the school documenting that within the prior 18 months the child has received the appropriate health assessment required by law, or a waiver signed by the parent or guardian indicating that they do not want or are unable to obtain such health assessments for their children.
(B) The health assessment that is required is available from the child's usual source of health care, the local health department, some schools and other places in the community.
(C) Rather than wait until the child actually enters first grade, it is advisable to get the health assessment as early as possible, preferably within six months prior to kindergarten entrance, at which time it is also required that the child's immunizations (a part of the total health assessment) be brought up to date.
(3) The parents or guardians of children entering the first grade who do not have documentation that the appropriate health assessment has been done or waived shall be informed by the school at that time as follows:
(A) It is statutorily required that children provide, within 90 days after entrance into the first grade, either a certificate to the school documenting that within the prior 18 months the child has received the appropriate health assessment required by law, or a waiver signed by the parent or guardian indicating that they do not want or are unable to obtain such health assessments for their children.
(B) The health assessment that is required is available from the child's usual source of health care, the local health department, some schools and other places in the community.
(c) Informing. Persons eligible to receive CHDP services shall be informed, using effective methods to involve them and in a language understandable to them, about the following:
(1) The value of preventive health services.
(2) Health assessments.
(3) The need for prompt diagnosis and appropriate treatment of suspected disabilities.
(4) The nature, scope and benefits of the Child Health and Disability Prevention Program.
(d) Health Education. Health education, including anti-tobacco use education, shall be an integral part of the health assessment.
Note: Authority cited: Sections 208 and 321, Health and Safety Code; and Section 12, Assembly Bill 75 (Chapter 1331, Statutes of 1989). Reference: Sections 321.2, 323.5, 324.2 and 24165.3, Health and Safety Code.
s 6843. Referral to Dentist.
(a) Availability.
(1) A direct referral to a dentist shall be made for eligible Medi-Cal beneficiaries three years of age and older unless dental services have been declined. The dental referral is for the purpose of diagnosis and treatment. Dental treatment consists of dental care needed for relief of pain and infections, restoration of teeth and maintenance of dental health.
(2) An inspection of the teeth, gums and mouth is part of the health assessment, and referral to a dentist shall be made if appropriate.
(b) Informing and training responsibilities. The provisions of Section 6824 also apply to the information and training responsibilities of the state and community child health and disability prevention programs regarding informing Medi-Cal beneficiaries of the availability of dental services, how the services may be obtained, and of the assistance available with transportation and scheduling appointments.
(c) Frequency. An annual referral to a dentist for dental services shall be offered each eligible Medi-Cal recipient three years of age and older. Dental providers, approved for participation in the Medi-Cal program, shall be reimbursed for diagnosis resulting from this annual referral, and for dental care needed for relief of pain and infections, restoration of teeth and maintenance of dental health.
(d) Offer of assistance with transportation and scheduling appointments. Medi-Cal beneficiaries shall be offered assistance with transportation and scheduling appointments for initial and periodic dental examinations. The response to this offer shall be recorded, and this assistance shall be provided if requested by the beneficiary.
(e) Completion of referral. All reasonable steps shall be taken to ensure that Medi-Cal beneficiaries eligible to receive an initial or a periodic dental examination, and who request a referral, complete the referral. An initial dental examination shall normally be completed within 120 days from either the date the beneficiary requests the referral, or the date the beneficiary was certified eligible to receive Medi-Cal benefits, whichever occurs later. A periodic dental examination shall normally be completed within 120 days from either the date the beneficiary requests the referral, or the last day of the month in which the annual dental examination was due, whichever occurs earlier.
(f) Referral sources. The first source of referral for dental services shall be the person's usual source of licensed dental care. If no usual source of licensed dental care can be identified, the person shall be given, without prejudice for or against any one source, the names and locations of at least three sources of dental care, when available, which have been approved as providers of dental services by the California Medical Assistance Program. Although the family or recipient may choose to receive dental diagnostic and treatment services from a provider of its choice, to be eligible for state reimbursement, these services shall be provided by Medi-Cal approved providers and in accordance with the provisions of the California Administrative Code, Title 22, Division 3 and subject to any applicable Medi-Cal program limitations.
(g) Documentation. If initial or periodic dental services were not provided to a Medi-Cal beneficiary who had requested such services and who also had requested assistance with transportation or scheduling appointments for services, documentation must exist showing that the family or person lost eligibility, could not be located despite a good faith effort to do so, or the person's failure to receive the services was due to an action or decision by the family or person, rather than a failure by the community child health and disability prevention program to meet requirements of this subchapter, including the requirement to offer and provide assistance with transportation and scheduling appointments for services.
Note: Authority cited: Sections 208 and 321, Health and Safety Code. Reference: Sections 321.2, 322.7 and 323.7, Health and Safety Code.
s 6844. Referral to Health Assessment.
(a) The following shall apply to all persons eligible to receive health assessments under the provisions of this subchapter:
(1) All reasonable steps, including assistance in scheduling and completing appointments if requested, and in following up initial efforts, shall be taken to ensure that persons eligible to receive health assessments, and who request a health assessment, receive it.
(2) Appointments for requested health assessments shall be completed in a reasonable period of time, normally not to exceed 60 days.
(3) The first source of referral for a health assessment shall be the person's usual source of health care. Preference should be given to the comprehensive care provider. If no usual source of health care can be identified, the person shall be given, without prejudice for or against any one provider, the names and locations of at least three providers, when available, who have been approved as providers of health assessments by the community child health and disability prevention program director. The availability of health assessments directly from the clinic operated by the community program may also be made known to the person.
(4) Although a person may choose to receive a health assessment from a provider of the person's choice, to be eligible for state reimbursement, the health assessment shall be provided by providers who have been approved to bill the Department for these services.
(b) Additional to (a), above, the following shall apply to Medi-Cal beneficiaries who request health assessments:
(1) Medi-Cal beneficiaries shall be offered assistance with transportation and scheduling health assessment appointments. The response to this offer shall be recorded, and this assistance shall be provided if requested by the beneficiary.
(2) If a person chooses to receive a health assessment from a provider that does not furnish the full range of services as specified in this subchapter, the community child health and disability prevention program shall, if requested, provide or arrange for provision of all such services that are not offered by that provider. At the time of the request, the person must be offered assistance with transportation and scheduling appointments. The response to this offer shall be recorded, and this assistance shall be provided if requested.
(3) If an initial or a periodic health assessment is not provided to a Medi-Cal beneficiary who requests such services and who also requests assistance with transportation or scheduling appointments for services, documentation must exist showing that the family or person lost eligibility, could not be located despite a good faith effort to do so, or the person's failure to receive the services was due to an action or decision by the family or person, rather than a failure by the community child health and disability prevention program to meet requirements of this subchapter, including the requirement to offer and provide assistance with transportation and scheduling appointments for services.
Note: Authority cited: Sections 208 and 321, Health and Safety Code. Reference: Sections 321.2 (d) and 323.7, Health and Safety Code.
s 6846. Health Assessment.
(a) Conditions. The following conditions apply to health assessments provided to eligible persons:
(1) A health assessment shall not be provided without the voluntary consent of the patient.
(2) A health assessment shall not be provided to minors without the prior and written consent of the minor's parent or guardian unless one or more of the following circumstances exist:
(A) The minor is emancipated.
(B) The minor is married.
(C) The minor is a member of the military forces.
(D) Provision of the service is exempted from parental consent by federal or state statute or regulation.
(b) Required screening procedures. Unless medically contraindicated or deemed inappropriate by the health assessment provider, or refused by the person, health assessments shall include the following procedures:
(1) Health and developmental history.
(2) Unclothed physical examination including assessment of physical growth.
(3) Assessment of nutritional status.
(4) Inspection of ears, nose, mouth, throat, teeth and gums.
(5) Vision screening.
(6) Hearing screening.
(7) Tuberculin testing and laboratory tests appropriate to age and sex, including tests for anemia, diabetes and urinary tract infections.
(8) Testing for sickle cell trait and lead poisoning where appropriate.
(9) Immunizations appropriate to age and health history necessary to make status current. (Patient shall also receive, subsequent to the health assessment, any immunizations which could not be given during the assessment, and any immunizations necessary to complete a series which could not be completed during the assessment.)
(10) Health education and anticipatory guidance appropriate to age and health status.
(c) Additional screening procedures. A community child health and disability prevention program may include screening procedures in its program, additional to the ones included in this section, if these procedures are approved by the Department and the State Child Health Board.
(d) Rechecks. In those instances where a person is eligible for state reimbursement of health assessment costs, reimbursement may be made for one recheck of those screening procedures (excluding the Health History and Physical Examination) and laboratory tests where such a recheck is medically indicated because questionable or marginal results were obtained during the prior screening.
(e) Results of health assessment. The results of the health assessment shall be handled as follows:
(1) Health assessment providers shall provide the person with a copy of the results of the screening tests, with an appropriate explanation of the results. Such notification and discussion of screening test results, unless provided by a licensed or certified practitioner of the healing arts, shall be free of diagnostic statements or suggestions that the person needs any particular treatment. Specifically, no medical care or special education plan shall be instituted solely on the basis of the health screening results.
(2) The results of the health assessment shall be recorded on forms provided by the Department.
(f) Concurrent diagnosis and treatment. Nothing in these regulations shall be interpreted to mean that a licensed or certified practitioner of the healing arts may not provide diagnosis and treatment, in conjunction with the health assessment, if medically indicated.
(g) Nonspecified procedures. Health screening procedures that are approved for reimbursement by the Department are specified, together with their maximum allowable reimbursements, in Section 6868. Reimbursement for procedures not specified in Section 6868 shall not be made without written approval of the Department.
Note: Authority cited: Sections 208, 321 and 323.7, Health and Safety Code. Reference: Sections 321.2 and 324, Health and Safety Code.
s 6847. Periodicity of Health Assessments.
(a) Eligibility. Medi-Cal beneficiaries who have received an initial health assessment are also eligible for subsequent, periodic health assessments. (continued)