2007 California Health and Safety Code Article 3. Health Services And Development Projects

CA Codes (hsc:124700-124745)

124700.  The department shall plan and put into operation a number
of health services development projects.  The purpose of the projects
shall be to demonstrate effective ways of providing health care
services in underserved rural health areas.  The director shall make
the final decision on approval of a project.



124705.  Applications may be made for funds for health services
development projects and the projects may be initiated and operated
by any agency, including, but not limited to, the following:
   (a) A community agency, including a National Health Services Corps
site.
   (b) An ongoing rural health program, including migrant health or
American Indian health program.
   (c) A family practice education program.
   (d) A county health department.
   (e) The department.
   (f) Any health facility or licensed nonprofit primary care clinic.



124710.  (a) (1) It is the intent of the Legislature that funds
distributed under this section promote stability for participating
clinics, as a part of the state's health care safety net, and at the
same time be distributed in a manner that best promotes access to
health care to geographically isolated populations.
   (2) The department shall grant funds, for a minimum of three years
per grant, retroactive to funds appropriated in the Budget Act of
2002 (Chapter 379 of the Statutes of 2002), to eligible, private,
nonprofit, community-based primary care clinics for the purpose of
establishing and maintaining rural health services and development
projects as specified under this article.  The department may
continue to pay any grantee whose grant expired on June 30, 2003,
until June 30, 2004, as if the grant had been extended, provided that
funds are appropriated for this purpose in the Budget Act of 2003
and the grantee agrees in writing to expend the money as if the grant
had been extended.
   (b) In order to be eligible to receive funds under this program, a
clinic shall, at a minimum, meet all of the following conditions:
   (1) The clinic shall be licensed under paragraph (1) or (2) of
subdivision (a) of Section 1204.
   (2) The clinic shall operate in a "rural" Medical Study Service
Area, as defined by the Health Manpower Commission.
   (3) The clinic shall operate in a medically underserved area,
including a Health Professional Shortage Area, or serve a medically
underserved population, as designated by the United States Department
of Health and Human Services, or shall be able to demonstrate that
at least 50 percent of its patients are persons with incomes at or
below 200 percent of the federal poverty level.
   (c) The department shall seek input from stakeholders in designing
the methodology for distribution of funds under this section.
   (d) If the funds that are available for purposes of this section
for any fiscal year are greater than funds that were available for
the prior fiscal year, the department shall establish a base funding
level that is applicable to all sites funded in the prior fiscal
year.  To the extent that funds are available, the base funding level
shall not be less than seventy-five thousand dollars (,000) for
each site.  To implement this section, the department shall not be
required to reduce funding for clinics that are above the minimum
awards.


124715.  The department may assist community agencies to develop
grant proposals.



124720.  Project proposals shall be considered that address the
health needs of rural populations, including, but not limited to,
migratory and other agricultural workers, American Indians, and
senior citizens, who have insufficient access to adequate levels of
health care services due to geographical isolation or economic
factors.
   Projects that are approved shall accomplish one or more of the
following:
   (a) Provide primary health care, including preventive health
services and diagnostic, treatment, referral, and followup services.

   (b) Provide comprehensive health care, including specialized
physician services, inpatient and outpatient facilities, laboratory
and X-ray services, home health services, and other specialized
services.
   (c) Provide emergency medical services designed to meet the
special problems of rural isolation.
   (d) Provide transportation appropriate to achieving the goal of
making health care services available to residents of rural areas.
   (e) Provide electronic communication technology to improve health
care delivery and emergency health services in the designated rural
areas.
   (f) Establish regional health systems, including linkage with both
rural and urban health programs and facilities.
   (g) Improve the quality of medical care and the administrative
capabilities of agencies and management systems in rural areas.
   (h) Provide health education programs in the designated rural
areas, including health and nutrition education, and continuing
education for health professionals.
   (i) Promote nurse practitioner and physician assistants programs
and other programs for training and placement of health professionals
in the designated areas to respond to rural manpower shortages.




124725.  Project funding shall be for up to three years.
Continuation of funding for a project shall depend on progress toward
achieving the goals of the project.  The director shall make the
final decision to continue or discontinue a project.  In evaluating
the success of a project, the director shall take into account the
number of additional persons who are receiving quality health care as
a result of the operation of the project and the improvement in
health status of the population served by the project.



124730.  Each applicant shall form an advisory committee for the
project.  The advisory committee shall participate in all of the
following:
   (a) Planning the project.
   (b) Reviewing the progress of the project.
   (c) Proposing changes in the project.
   (d) Planning for the continuation of the project after the grant
period through self-sufficiency.
   At least one-half of the members of the advisory committee shall
be consumers, as defined by Public Law 93-641.  The advisory
committee shall include, where feasible, representatives of the
health service agencies, the Seasonal Agricultural and Migratory
Workers Advisory Committee, the American Indian Health Policy Panel,
consumers selected from rural target populations, such as American
Indians, senior citizens, Medi-Cal recipients, isolated rural
residents, and agricultural and forestry workers, providers from
rural areas, and persons with knowledge of rural areas from
educational institutions, and state, county, and federal agencies.



124735.  Each grant for a project shall require the grantee agency
to seek third-party reimbursements, including Medi-Cal and private
insurance, for any person served under the grant.  Each grant shall
require the grantee agency to provide reports to the department on
reimbursements and may require the grantee agencies to contribute all
or part of the proceeds of reimbursements to the department for
deposit in the State Treasury in accordance with regulations to be
adopted by the department after the regulations are approved by the
Director of Finance.


124740.  State-operated projects shall be established only in
accordance with all of the following:
   (a) The health of the population in a rural area would be
substantially improved by the establishment of a project.
   (b) There exists no local public or nonprofit agency willing and
able to undertake the project.
   (c) The project contains two or more of the elements specified in
Section 124720.
   A project may employ staff, and may purchase, rent, or lease
supplies and equipment where required.  A project may also rent or
lease land and buildings where required.



124745.  (a) Notwithstanding any other provision of law, the
department shall, to the extent that funds are available, provide to
a grantee semiannual prospective payments during a 12-month fiscal
year.
   (b) An amount equal to not more than 50 percent of the total grant
shall be processed for payment to the grantee following the
enactment of the annual Budget Act, and upon formal execution of the
grant by the state.  The processing by the department of the grantee'
s first semiannual prospective payment shall also be contingent upon
both of the following:
   (1) A written request for payment from the grantee.
   (2) Except as provided in this paragraph, the third quarter
progress budget and expenditure report.  If the grantee is currently
under the first fiscal year of a three-year multiple grant, this
requirement shall not apply as a condition for the grantee's first
semiannual prospective payment.  If the grantee is currently under
the second or third fiscal year of a three-year, multiple-year grant,
the department's processing of the first semiannual prospective
payment for the current grant year shall be contingent upon the
grantee's timely and accurate submission, and the department's
approval of, the third quarter progress and budget expenditure report
from the previous grant year.
   (c) Based upon the grantee's timely and accurate submission of the
first quarterly progress and budget expenditure report from the
grant year, and satisfactory performance under the grant, the
processing of a second semiannual prospective payment of not more
than 40 percent of the total grant shall be processed by the
department for payment to a grantee no earlier than January 1 during
the term of the grant year.  The processing of the grantee's second
semiannual prospective payment by the department shall be contingent
upon all of the following:
   (1) A written request for payment from the grantee.
   (2) The grantee's timely and accurate submission, and the
department's approval, of the first quarterly progress and budget
expenditure report.
   (3) If the grantee is currently under the second or third fiscal
year of a three-year, multiple-year grant, the grantee's timely and
accurate submission, and the department's approval, of the fourth
quarterly progress and budget expenditure report, and the annual
reconciliation report, from the prior year.
   (d) An amount equal to 10 percent of the total grant award shall
be retained by the department, pending satisfactory submission by the
grantee of all quarterly progress and budget expenditure reports and
an annual reconciliation report for the grant year.  Payment of the
withheld 10 percent shall be processed by the department for payment
to the grantee upon the grantee's satisfactory completion and
submission, and the department's approval, of these reports.