SECTIONS 1179-1179.6 - California Statutes

HEALTH AND SAFETY CODE

SECTION 1179-1179.6

1179. The Legislature finds and declares all of the following:
(a) Outside of California's four major metropolitan areas, the
majority of the state is rural. In general, the rural population is
older, sicker, poorer, and more likely to be unemployed, uninsured,
or underinsured. The lack of primary care, specialty providers and
transportation continue to be significant barriers to access to
health services in rural areas.
(b) There is no coordinated or comprehensive plan of action for
rural health care in California to ensure the health of California's
rural residents. Most of the interventions that have taken place on
behalf of rural communities have been limited in scope and purpose
and were not conceived or implemented with any comprehensive or
systematic approach in mind. Because health planning tends to focus
on approaches for population centers, the unique needs of rural
communities may not be addressed. A comprehensive plan and approach
is necessary to obtain federal support and relief, as well as to
realistically institute state and industry interventions.
(c) Rural communities lack the resources to make the transition
from present practices to managed care, and to make other changes
that may be necessary as the result of health care reform efforts.
With numerous health care reform proposals being debated and with the
extensive changes in the current health care delivery system, a
comprehensive and coordinated analysis must take place regarding the
impact of these proposals on rural areas.
(d) Rural areas lack the technical expertise and resources to
improve and coordinate their local data collection activities, which
are necessary for well-targeted health planning, program development,
and resource development. Data must be available to local
communities to enable them to plan effectively.
(e) The Legislature recognizes the need to take a comprehensive
approach to strengthen and coordinate rural health programs and
health care delivery systems in order to:
(1) Facilitate access to high quality health care for California's
rural communities.
(2) Promote coordinated planning and policy development among
state departments and between the State and local public and private
providers.

1179.1. (a) The Secretary of the Health and Welfare Agency shall
establish an Office of Rural Health, or an alternative organizational
structure, in one of the departments of the Health and Welfare
Agency to promote a strong working relationship between state
government and local and federal agencies, universities, private and
public interest groups, rural consumers, health care providers,
foundations, and other offices of rural health, as well as to develop
health initiatives and maximize the use of existing resources
without duplicating existing effort. The office or alternative
organizational structure shall serve as a key information and
referral source to promote coordinated planning for the delivery of
health services in rural California.
(b) To the extent funds are appropriated by the Legislature, these
efforts may include:
(1) Educating the public and recommending appropriate public
policies regarding the viability of rural health care in California.
(2) Monitoring and working with state and federal agencies to
assess the impact of proposed rules and regulations on rural areas.
(3) Promoting community involvement and community support in
maintaining, rebuilding, and diversifying local health services in
rural areas.
(4) Encouraging and evaluating the use of advanced communications
technology to provide access to health promotion and disease
prevention information, specialty expertise, clinical consultation,
and continuing education for health professionals.
(5) Encouraging the development of regional health care and public
health networks and collaborative efforts, including, but not
limited to, emergency transportation networks.
(6) Working with state and local agencies, universities, and
private and public interest groups to promote research on rural
health issues.
(7) Soliciting the assistance of other offices or programs of
rural health in California to carry out the duties of this part.
(8) Disseminating information and providing technical assistance
to communities, health care providers, and consumers of health care
services.
(9) Promoting strategies to improve health care professional
recruitment and retention in rural areas.
(10) Encouraging innovative responses by public and private
entities to address rural health issues.

1179.2. (a) The Health and Welfare Agency shall establish an
interdepartmental Task Force on Rural Health to coordinate rural
health policy development and program operations and to develop a
strategic plan for rural health.
(b) At a minimum, the following state departmental directors, or
their representatives, shall participate on this task force:
(1) The Director of Health Services.
(2) The Director of Statewide Health Planning and Development.
(3) The Director of Alcohol and Drug Programs.
(4) The Director of the Emergency Medical Services Authority.
(5) The Director of Mental Health.
(6) The Executive Director of the Managed Risk Medical Insurance
Board.
(c) The task force shall review and direct the activities of the
Office of Rural Health or the alternative organizational structure,
as determined by the Secretary of the Health and Welfare Agency.
(d) The task force shall establish appropriate mechanisms, such as
ad hoc or standing advisory committees or the holding of public
hearings in rural communities, for the purpose of soliciting and
receiving input from these communities, including input from rural
hospitals, rural clinics, health care service plans, local
governments, academia, and consumers.

1179.3. (a) (1) The Rural Health Policy Council shall develop and
administer a competitive grants program for projects located in rural
areas of California.
(2) The Rural Health Policy Council shall define "rural area" for
the purposes of this section after receiving public input and upon
recommendation of the Interdepartmental Rural Health Coordinating
Committee and the Rural Health Programs Liaison.
(3) The purpose of the grants program shall be to fund innovative,
collaborative, cost-effective, and efficient projects that pertain
to the delivery of health and medical services in rural areas of the
state.
(4) The Rural Health Policy Council shall develop and establish
uses for the funds to fund special projects that alleviate problems
of access to quality health care in rural areas and to compensate
public and private health care providers associated with direct
delivery of patient care. The funds shall be used for medical and
hospital care and treatment of patients who cannot afford to pay for
services and for whom payment will not be made through private or
public programs.
(5) The Office of Statewide Health Planning and Development shall
administer the funds appropriated by the Legislature for purposes of
this section. Entities eligible for these funds shall include rural
health providers served by the programs operated by the departments
represented on the Rural Health Policy Council, which include the
State Department of Alcohol and Drug Programs, the Emergency Medical
Services Authority, the State Department of Health Services, the
State Department of Mental Health, the Office of Statewide Health
Planning and Development, and the Managed Risk Medical Insurance
Board. The grant funds shall be used to expand existing services or
establish new services and shall not be used to supplant existing
levels of service. Funds appropriated by the Legislature for this
purpose may be expended in the fiscal year of the appropriation or
the subsequent fiscal year.
(b) The Rural Health Policy Council shall establish the criteria
and standards for eligibility to be used in requests for proposals or
requests for application, the application review process,
determining the maximum amount and number of grants to be awarded,
preference and priority of projects, compliance monitoring, and the
measurement of outcomes achieved after receiving comment from the
public at a meeting held pursuant to the Bagley-Keene Open Meeting
Act (Article 9 (commencing with Section 11120) of Chapter 1 of Part 1
of Division 3 of Title 2 of the Government Code).
(c) The Office of Statewide Health Planning and Development shall
periodically report to the Rural Health Policy Council on the status
of the funded projects. This information shall also be available at
the public meetings.

1179.5. (a) The Rural Health Policy Office within the Office of
Statewide Health Planning and Development serving as staff to the
Rural Health Policy Council shall develop an annual workplan which is
adopted by the council. The workplan shall describe how the council
shall meet specific, measurable performance objectives. The workplan
shall be designed to further the goals of the Rural Health Policy
Council to improve access to, and the quality of, health care in
rural areas.
(b) The workplan required under subdivision (a) shall include
information on how the council intends to address, at a minimum, all
of the following topics:
(1) Increased standardization and consolidation of financial and
statistical reporting, billing, audits, contracts, and budgets.
(2) Network delivery and integrated delivery systems.
(3) Streamlining the regulatory process.
(4) Assessing the impact of managed care in rural communities.
(5) Reviewing and proposing changes necessary to improve current
funding issues.
(6) Increasing the use of technology.
(7) Supporting innovative efforts to improve patient
transportation.
(8) Providing strategic planning for local communities.
(9) Improving communication between the state and rural providers.
(10) Increasing workforce availability in rural areas.
(c) The Rural Health Policy Council shall provide an annual report
to the chairs of the fiscal and policy committees of the Legislature
on the outcomes achieved by the office during the preceding 12
months and what changes it will incorporate into the workplan for the
following year. The first report pursuant to this section shall be
provided to the Legislature by February 1, 1999.

1179.6. (a) (1) In order to provide improved delivery of services
to the families of agricultural workers, the State Department of
Health Services shall review and survey the extent to which
agricultural workers and their families utilize those public health
programs for which they are eligible. In conducting the survey, the
department shall ensure the full participation of entities that
provide services to agricultural workers, including clinics,
community-based agencies, public health departments, and
organizations and associations involved with agricultural worker
health and well-being. Programs considered in the survey shall
include, but shall not be limited to, all of the following:
(A) The Medi-Cal program.
(B) The Healthy Families program.
(C) The Early and Periodic Screening, Diagnostic, and Treatment
Program (EPSDT).
(D) The Child Health and Disability Prevention Program (CHDP).
(E) Health clinics.
(F) Public health prevention programs.
(G) Immunization programs.
(H) Community mental health programs.
(I) Programs funded under the California Children and Families
Program.
(J) Parenting programs.
(K) Teen pregnancy prevention and case management programs.
(L) Domestic violence and child abuse prevention programs.
(M) Any other relevant programs available in communities of
agricultural workers.
(2) The department shall use the results of the survey to prepare
an implementation plan that maximizes access and streamlines service
delivery, in order to make comprehensive family wellness programs
readily available to agricultural workers and their families. In
developing the implementation plan, the department shall ensure the
full participation of entities contributing to the survey of
available services. The implementation plan shall be based on the
principles set forth in subdivision (g) of Section 50517.5, including
all of the following:
(A) Involvement of agricultural workers and their families in
program design and delivery.
(B) Community collaboration on the local level among available
public and private agencies.
(C) Coordination with the provision of adequate housing.
(b) (1) The survey shall address the extent to which outreach
programs are directed to, and succeed in, reaching agricultural
workers and their families, and shall identify any geographical,
cultural, linguistic, or other barriers that may prevent full
utilization of available services.
(2) The survey shall place significant emphasis on actual
experiences of agricultural workers and their families.
(c) The department shall report the results of the survey required
by this section to the Legislature on or before March 1, 2001, and
shall present the Legislature with the implementation plan required
by paragraph (2) of subdivision (a) on or before December 31, 2001.