City and County of San Francisco year Budget Task...County Health Mandates - Updated Nov 2011 Community Behavioral Health Services Program Area Mandate Citation. ... Counties accepting

County Health Mandates - Updated Nov 2011

Community Behavioral Health Services

Program Area Mandate Citation Mandate DescriptionIs a level of

service mandated?

Adult and Children's Mental Health Services

1) CCR, Title 9, Div. 1, Chapter 11; 2) W&I Code, Div. 5, §§5000 et seq.; 3) Government Code, Title 1, Div. 7, Chap. 26.5, §§7570-7587 (impact of Realignment 2011?)

1) Specialty mental health services shall be provided to Medi-Cal beneficiaries of each county through a mental health plan which contracts with the CA Department of Mental Health to provide services to Medi-Cal beneficiaries and to share in the financial risk of providing those services; 2) The California Mental Health Act, including the Lanterman Petris-Short Act and Bronzan-McCorquodale Act; 3) Services necessary to provide a child with a disability (including mental health) with a free public education.

1) & 2) Medi-Cal

Entitlement 3) Sep

Entitlement Yes

Alcohol and Drug Abuse Services 1) Penal Code §§1210-1210.1; Health and Safety Code §§ 11999.4 - 11999.13, 11999.20 - 11999.25; 2) CCR, Title 9, Div. 4, Chap. 3; 3) Penal Code §§ 1000 - 1000.6, 1000.8 - 1000.10

1) Certain non violent adult drug offenders are placed on formal probation and are required to participate in drug treatment, in lieu of incarceration; 2) Regulates Programs for Alcohol and Drug Impaired Drivers; 3) Regulates Deferred Entry of Judgement (PC 1000) Programs.

Somewhat

Alcohol, tobacco, and drug abuse prevention services throughout the County.

1) PL 102-321; 2) CCR Title 22, Div. 5; 3) H&S Code, Div. 10.5, §§11750 et seq. and Div. 10.7, §11999 et seq.; 4) 45 CFR 96.124&96.125; 5) SB 627, Statutes of 1992; 6) H&S Code, §11802

1) Counties accepting mental health and substance abuse block grants agree to provide services in accordance with federal and State statute; 2) Regulates substance abuse prevention and treatment services; 3) Regulates substance abuse prevention and treatment services; 4) Federal regulations governing Substance Abuse Prevention and Treatment Block Grants; 5) Authorizes Negotiated Net Amount Contract between State and County to administer substance abuse funding; 6) Regulates primary prevention activities between County and schools.

Through Negotiated Net Amount Contract with

State.

Behavioral Health Services Admin. 1) CCR, Title 9, Div. 1 and Div. 4; 2) W&I Code §§ 5751 - 5751.2; 3) W&I Code, §§ 5520 - 5523

1) Includes administrative requirements for community mental health and county alcohol & drug programs; 2) Regulates qualifications of local mental health directors, staff, and contractors ; 3) State requirements for patients' rights avocates.

Yes

City and County of San FranciscoSummary of Service Mandates Related to Health

1



service mandated?

Children and Youth Services 1) Government Code, Title 1, Div. 7, Chap. 26.5, §§7570 - 7587 (impact of Realignment 2011?) ; 2) W&I Code §§5600 et seq.; 3) CCR, Title 15, Div. 4; 4) CCR Title 9, Div. 1, Chap. 11, and Title 22, Divs. 5 - 6

1) Services necessary to provide a child with a disability (including mental health) with a free public education 2) Mental health (Bronzan-McCorquodale Act) services provided to seriously emotionally disturbed children and adolescents; 3) Juvenile health services, (includies mental health services) provided to youthful offenders detained at juvenile halls, juvenile homes, campus, or forestry camps; 4) Medi-Cal Specialty Mental Health Services provided to children under age 21 to correct or ameliorate a mental illness.

Yes

Crisis Counseling 1) Robert T. Stafford Disaster Relief and Emergency Assistance Act (as amended by Public Law 100-707), §416 (42 U.S.C. §5183; 2) Government Code §3100 et.seq.; 3) Government Code §8607; 4) W&I Code §5600.3

1) Federal law regarding crisis counseling services following presidential declaration of disaster; 2) California regulations declare all public employees to function as disaster services workers; 3) California regulations establish standardized emergency management system; 4) California regulations specify mental health programs' target population to include persons who need brief treatment as a result of natural disaster or severe local emergency.

No

2



service mandated?

Communicable disease and epidemic investigation and control

H&S Code §§120130, 120175-120250, 120275-120300; CCR Title 17, Div. 1, Chap. 3, §1276(c), Chap. 4, §§2501(a), 2514-2524, 2530-2592, 2594-2606.2, 2608-2640

Health Officer responsibilities and powers to control the communicable diseases, including the use of quarantine and isolation

Yes

Reportable diseases and conditions

CCR, Title 17, Div. 1, Chap. 4, §§2500-2643.20

Duties of Health Officer related to reporting of reportable diseases to the State Department of Public Health

Yes

Tuberculosis control H&S Code §§121360-121460; CCR, Title 17, Div. 1, Chap. 3, §1276(c)

Local health department and Health Officer requirements related to tuberculosis identification and control

Yes

STD control H&S Code §§120500-120715; CCR, Title 17, Div. 1, Chap. 3, §1276(c)

Local health department and Health Officer requirements related to sexually transmitted disease control

Yes

Refugee health 8 USC §1521 (Immigration & Naturalization Act §411)

Federal requirements to notify and pay local health authorities for refugees determined to have medical conditions affecting the public health and requiring treatment

No

Immunization H&S Code §§120400 et seq. Health Officer may establish immunization programs, including for childhood immunization, rubella, measles, and anti-rabic treatment

No

Travel immunization None N/A No

Adult influenza immunization None N/A No


Communicable Disease Control & Prevention

3



service mandated?

Refugee health 8 USC §1521 (Immigration & Naturalization Act §411)

Federal requirements to notify and pay local health authorities for refugees determined to have medical conditions affecting the public health and requiring treatment

No

Juvenile hall health and mental health services

CCR, Title 15, Div. 1, Chap. 1, §§1400, et seq.; W&I Code §§209, 14029.5; specific juvenile court orders

Determines level of medical and mental health services to be provided to minors in detention

Yes


Community Programs

4


Emergency Medical Services


service mandated?

Advanced life support (paramedic) program

H&S Code §§1797, et seq. Counties with an EMS system must designate a local EMS agency to plan, implement and evaluate an EMS system, have a medical director to provide medical control and to assure medical accountability, and be responsible for implementation of advanced life support systems and for monitoring of training programs.

Yes

Paramedic base hospitals; trauma centers

H&S Code §§1798, et seq. Mandates the local EMS agency to designate and contract with base hospitals to provide medical direction of prehospital emergency medical care personnel; requires the local EMS agency implementing a trauma care system to establish policies and procedures and to designate and regulate the trauma centers.

Yes

Disaster management H&S Code §§1797.150-1797.153 Requires the State EMS Authority to coordinate through local EMS agencies, medical and hospital disaster preparedness with other local, state and federal agencies and departments having a responsibility relating to disaster response, including authority to mobilize and coordinate emergency medical mutual aid resources

No

Bioterrorism Preparedness and Response

CDC Local Public Health Preparedness and Response to Bioterrorism Program Agreement

Establishes key focus areas for strengthening the public health response to bioterrorism. By accepting the agreement with CDPH, the Department agrees to plan and implement preparedness and response activities consistent with the agreement

Yes, per agreement with CDPH

Natural or intentional biological, chemical, or other health threats

H&S Code §101230 Use of public health funds allowed to increase capacity to respond to natural or intentional biological, chemical, or other health threats

No


5


Environmental and Occupational Health Services


service mandated?

Beach monitoring program H&S Code §§115875-115915 Local requirements for beach testing, sanitation, closure, and posting Yes

Well monitoring program H&S Code §§116325-116345 Local requirements for inspection, monitoring, and surveillance of water supply systems.

Yes

Food safety program H&S Code §§113700-113725.3 Requirements and local enforcement of California Retail Food Code NoHazardous waste management program

H&S Code §§25100-25250.30 Requirements regarding the proper disposal and handling of hazardous waste

Yes

Underground storage tanks H&S Code §§25280-25299.8 Inspection and permitting of underground storage tanks YesSolid waste management Penal Code §§374.3-374.5 Local authority regarding proper disposal of solid waste NoSwimming pool & spa program Yes, CHSC Local inspection of public pools and spas YesChildhood Lead Poisoning Prevention

H&S Code §§105275-105310, 124125-124165; CCR, Title 17, Div. 1, Chap. 6, §33008

Local requirements related to the Childhood Lead Poisoning Prevention Program

Yes

California Smoke-free Workplace Law.

Labor Code §6404.5 Local enforcement of California's Smoke-free Workplace law Yes

Vector control H&S Code §§101275-101285, 116110-116112, 116175-116183

Local authority and requirements on prevention of and response to vector borne diseases

No

Body art H&S Code §§119300-119309 Register practicioners and inspect local body arts establishments NoMedical waste regulation H&S Code §§117600-118360 Disposal requirements of medical waste including local authority and

requirementsYes

Housing and institutions H&S Code §§17000-17910, 17920-17928, 18897, 101045

Inspection authority for hotels, motels, detention facilities, employee housing, labor camps, and organized camps

No

Rodent extermination H&S Code §§116125-116170 Local authority regarding extermination of rodent infestations YesEnvironmental health specialists H&S Code §§10600-106735 Requirements related to registered enviornmental health specialists NoEmployee health 1) CCR, Title 17, Div. 1, Chap. 3,

§1276(j); 2) CCR, Title 17, Div. 1, Chap. 3, §1306; 3) CCR, Title 8, Div. 1, Chap. 4, §5193; 4) CCR, Title 8, Div. 1, Chap. 4, §5197

1) Occupational health as a basic health service of a local health department; 2) Qualifications for occupational health trained staff; 3) Bloodborne pathology control plan, post-exposure evaluation and treatment; 4) Aerosol transmissible diseases

Yes, but level flexible


6


Health Promotion & Prevention


service mandated?

Health Education CCR, Title 17, Div. 1, Chap. 3, §1276(b)

Minimum standards for health education programs. No

Bicycle, Scooter, Skateboard, Skate Helmet Requirement

VC §21212 Establishes requirements for helmet use by individuals under age 18, distribution of fines for non-use, including to local health departments, and appropriate expenditures of trust fund

No

Child Passenger Restraint Requirements

VC §§27360, et seq. Establishes requirements for child passenger restraint, distribution of fines for non-use, including to local health departments, and appropriate expenditures of trust fund

No

Tobacco Control CCR, Title 17, Div. 1, Chap. 4, §§6901-6905; H&S Code §104350-104495

Requirements for local tobacco control activities Yes

California Smoke-free Workplace Law.

Labor Code §6404.5 Local enforcement of California's Smoke-free Workplace law Yes


7



service mandated?

Ryan White-funded services Title XXVI of the Public Health Services Act (PL 111-87)

Provisions of funding under the Ryan White HIV/AIDS Treatment Extension Act of 2009

Yes


HIV Health Services

8



service mandated?

HIV testing, reporting, and intervention

H&S Code §§120900-121140, 121025-121035; CCR, Title 17, Div. 1, Chap. 4, §§2641.5-2643.20

Responsibilities and requirements related to HIV testing, reporting, and intervention, including partner notification

Yes

Reportable diseases and conditions

CCR, Title 17, Div. 1, Chap. 4, §§2500-2643.20

Duties of Health Officer related to reporting of reportable diseases to the State Department of Public Health

Yes


HIV Prevention Services

9


Jail Health Services


service mandated?

Jail medical services Penal Code §§4000 et seq., 6030 et seq.; CCR, Title 15, Div. 1, Chap. 1, §§1200, et seq.; Federal Case Law (Estelle v. Gamble, Stewart v. Gates)

Minimum required level of health services, or need to identify alternative services (e.g., contract hospital), availble to adults in correctional facilities. Case Law establishes standard of access to health care. Can be done through Sheriff via contract.

Yes

Jail mental health services Penal Code §§4000 et seq., 6030 et seq.; Title 15, Div. 1, Chap. 1, §§1200, et seq.; Federal Case Law (Estelle v. Gamble, Stewart v. Gates, Coleman v. Schwarzenegger)

Minimum required level of mental health services, or need to identify alternative services, availble to adults in correctional facilities. Case Law establishes standard of access to mental health care. Can be done by Sheriff via contract.

Yes


10


Maternal, Child, and Adolescent Health (MCAH)


service mandated?

MCAH Services Generally CCR, Title 17, Div. 1, Chap. 3, §1276

Requirement that local health provide medical, nursing, educational, and other services to promote maternal and child health

No

Comprehensive Perinatal Services H&S Code §§123225-123255, W&I Code §14134.5

Establishes local requirements for local Comprehensive Perintal Services programs

Yes

Childhood Health, Disability & Prevention Services (CHDP)

H&S Code §§ 124025-124110; CCR, Title 17, Div. 1, Chap. 4, §§6800 et seq.; CCR, Title 22, Div. 3, Chap. 3, §§51340, 51532

Requirements for the CHDP program, including EPSDT services provided through CHDP

Yes

Pediatric Immunization H&S Code §§120325-120380, 120400-120435

Requirements related to pediatric immunization Yes

Perinatal Hepatitis B Program Not mandated but a State contract requirement; H&S Code §§125080-125105

Designate a Perinatal Hep B coordinator & case manage low income women (& their babies) testing Hep B positive at time of birth

Yes

Adolescent Family Life & Sibling Pregnancy Prevention Programs (AFLP)

Not mandated but State contract requirement; H&S Code §§124175-124200

Designate an AFLP coordinator & coordinate an AFLP incl providing medical/social/nutritional/education case management to parenting/pregnant teens

Yes

Family Planning CCR, Title 17, Div. 1, Chap. 3, §1276(k), H&S Code §§101050, 101055, 124300; W&I Code §14132; Title X of the Public Health Service Act (PL 91-572)

Requirements related to family planning, birth control, and pregnancy services.

Yes, but can be available

via community clinics

Family Planning Education H&S Code, §§101050, 101055, 124300; CCR, Title 17, Div. 1, Chap. 3, §1276(k); Title X of the Public Health Service Act (PL 91-572)

Designates Title X Family Planning Coordinator and coordinates Title X activities, including clinical and educational interventions, at local level

Yes

Well Child / Sick Child clinics 1) CCR, Title 17, Div. 1, Chap. 4, §§6800, et seq., W&I Code §§16934 et seq. ; 2) CCR, Title 22, Div. 3, Chap. 3, §§51340, 51532, et seq.

1) Requirements under CHDP; 2) Service mandates for EPSDT Yes


11



service mandated?

Pediatric Immunization H&S Code §§120325-120380, 120400-120435

Requirements related to pediatric immunization Yes

Child Health and Disability Prevention Education

H&S Code §§124025-124110, 104395

Designates CHDP Medical Director and delineates CHDP activities at local level

Yes

Sudden Infant Death Syndrome H&S Code, §123740 Establishes qualifications and duties of SIDS follow up by local health departments

Yes

12


Maternal, Child, and Adolescent Health (MCAH)


service mandated?

California Children's Services H&S Code §§123800-123995; CCR Title 17, Div. 1, Chap. 3, §1253, Div. 1, Chap. 4, §§2890-2932; CCR Title 22, Div. 2, Chaps. 1-13, §§41510-42720

Regulation for administration of California Children Services program, county match, determination of eligiblity, and administrative staffing standards

Yes

California Children's Services CCR, Title 22, Div. 3, Chap. 3, §51013

Case Management of Medi-Cal beneficiaries Yes

California Children's Services CCR, Title 2, Div. 9, Chap. 1, §§60300-60330; Government Code §§7570-7587

Medical Therapy Program relationship with Education Agencies Yes

California Children's Services Insurance Code §§12693.62-12693.69

California Children Services program carve-out from Healthy Families Yes

California Children's Services W&I Code §§14093-14094.3 California Children Services program carve-out from Medi-Cal managed careYes


13


Maternal, Adolescent and Child Health (MCAH) - Pubic Health Nursing


service mandated?

Public Health Nursing H&S Code §§101100-1011115; CCR, Title 17, Div. 1, Chap. 3, §§1253, 1276(d)

Requirements for local Public Health Nursing, including basic services (communicable and infectious disease control; maternal, child & adolescent health; abuse prevention & detection in the home; case management of handicapped children; assessment/prevention of accidents in the home; & provision of services for populations at risk)

No

Registered Nurses CCR Title 16, Div. 14, Art. 9, §§1409-1459, 1470-1474

Nursing regulations for Registered Nurses Yes

Public Health Nurses CCR Title 16, Div. 14, Art. 9 §§1490- 1494

Certification requirements for Public Health Nurses Yes

Pre- and Perinatal Substance Abuse

H&S Code, Sec.123600, 123605 Pre- and perinatal substance abuse protocols Yes

Foster Care Public Health Nursing W&I Code §§160101-16010.6, 16501.3

Health Care Program for Children in Foster Care Yes

Services for Children with Special Health Care Needs

W&I Code §17710 Requirements for children with special health care needs, including individualized health care plan and individualized health care team

Yes

Mandated Reporters W&I Code §§15610-15610.65, 15630-15632, 15659

Mandated reporting of abuse of the elderly and dependent adults No

Mandated Reporters PC §§11164-11174.3 Mandated reporting of child abuse or neglect NoPublic health nurses H&S Code §§101100-101115 Cities or counties may employ public health nurse(s), who are registered

nurses, and who shall attend to the health and sanitary conditions of the city or county

Yes


14


Medically Indigent Programs


service mandated?

Medical services for indigents W&I Code §§17000, et seq. Requires County to relieve and support all incompetent, poor, indigent persons, and those incapacitated by age, disease, or accident, when such persons are not supported and relieved by their relatives or friends, their own means, by state hospitals or other state or private institutions

No

Emergency Medical Services (Maddy) Fund (EMSF)

H&S §§1797.98(a), et seq. Authorizes establishment of the Emergency Medical Services Fund and provides specifications on the distribution of penalty assessments

No

Emergency Medical Services Appropriation (EMSA)

AB 430, Chapter 171, Statutes of 2001

Reimbursement of uncompensated emergency services provided by physicians to the indigent population

No

Trauma Care Funds (TCF) H&S Code §1797.199 Reimbursement for hospitals that provide trauma care services Yes


15


Population Health & Prevention (PHP) - General Public Health Mandates


service mandated?

Appointment of a Health Officer H&S Code §§101000-101010 Mandate and qualifications for a Health Officer Yes

Enforcement of Health Officer orders by Sheriff and peace officers

H&S Code §101029 Sheriff and peace officers may enforce orders of Health Officer to prevent the spread of any contagious, infectious, or communicable disease

No

Control of communicable disease H&S Code §101030 The Health Officer shall enforce orders and ordinances of the board of supervisors, pertaining to the public health and sanitary matters; orders, including quarantine and other regulations, prescribed by CDPH; and statutes relating to public health

No

Medical advisement H&S Code §101035 The Health Officer shall advise on medical matters any board or body vested with the management of any county pension or retirement system

No

Emergency measures H&S Code §101040 The Health Officer may take necessary preventive measures during "state of war emergency," "state of emergency," or "local emergency" as defined in Government Code, and may certify any public health disaster condition if required for federal or state disaster relief

No

Sanitary conditions of jails and detention facilities

H&S Code §101045 The Health Officer shall investigate health and sanitary conditions in every county jail, every other publicly operated detention facility in the county and all private work furlough facilities and programs

No

County family planning and birth control clinics

H&S Code §101050 The Health Officer shall prepare a list of family planning and birth control clinics located in the county

No

Control of prescription drugs and controlled substances

H&S Code §101070 The Health Officer may take action against a person who, without a license, is distributing a prescription drug, controlled substance, or dangerous drug or device

No

Local public health funding H&S Code §101230 Formula for and uses of public health funding including communicable disease control and public health surveillance activities

No


16



service mandated?

Collection, tabulation, and analysis of public health statistics

CCR Title 17, Div. 1, Chap. 3, §1276(a).

Collection, tabulation and analysis of public health statistics, including mortality, natality, and morbidity, are required

Type of product is at discretion of the Health

Officer

17


Population Health & Prevention (PHP) - Public Health Laboratory


service mandated?

Availability of public health laboratory services

H&S Code §§101150 et seq. The local health department shall have the services of a public health laboratory for the examination of specimens from suspected cases of infectious and environmental diseases.

No

Public Health Laboratory H&S Code §101150-101160; CCR, Title 17, Div. 1, Chap. 2, §§1029 et seq., 1705-1084

Requirement that the public health, the local health department of a city or county have available the services of a public health laboratory for the examination of specimens from suspected cases of infectious and environmental disease. Requires the laboratory and its personnel be approved by the State Department of Public Health and comply with the requirements of the federal Clinical Laboratory Improvement Amendments (CLIA).

Yes, but can be done

regionally

Public Health Laboratory CCR, Title 17, Div. 1, Chap. 2, §§1255 and 1302

Standards and requirements of the Public Health Laboratory Director Yes

Public Health Laboratory Yes, CCR, Title 17, Div. 1, Chap. 2, §1276

Basic public health laboratories required for counties of 50,000 or more Yes

Public Health Laboratory CCR, Title 17, Div. 1, Chap. 4, §2505

Reporting requirements for laboratories confirming specific diseases or agents

Yes


Public health laboratory test requirements for release of a case or carrier of specified communicable diseases

Yes


Clearance of food handlers for amebiasis must be performed by a public health laboratory

Yes

Public Health Laboratory CCR, Title 17, Div. 1., Chap. 4, §2606

Requirements for testing of rabies samples by a public health laboratory Yes


Requirements for testing of salmonella infection samples by a public health laboratory

Yes

Public Health Laboratory CCR, Title 17, Div. 1., Chap. 4, §2613

Requirements for testing of shigella infection samples by a public health laboratory

Yes


Requirements for testing of typhoid fever samples by a public health laboratory

Yes


18


Central Administration - Vital Records


service mandated?

Registration of all births and deaths, including fetal deaths, and issuance of burial permits

H&S Code §§ 102275 et seq.; CCR Title 17, Div. 1., Chapter 1, §§901 - 916 and Chapter 3, §1276(a); Elections Code §2205

Local administration of birth and death registration and role of local health departments; sets fee amounts; regulations for records and statistics and public health services; requires notification of deaths to County election officials; can be done in conjunction with County Recorder's office.

Yes

Sale of certified copies of the record of births, fetal deaths, and deaths

H&S Code §103525 et seq. The local registrar shall, upon request and payment of the required fee, supply a certified copy of the record of any birth, fetal death, or death registered with the official.

Yes

Data entry of birth, fetal death, and death information into the Automated Vital Statistics System (AVSS)

CCR Title 17, Sec 1276(a). Requirement to collect, tabulate and analyze all public health statistics, including population data, natality, mortality and morbidity records

The method is at the

discretion of the Health

Officer


19

CBHSCDCPCommunity ProgEMSEHSHealth EdHIV Health SvcsHIV Prevention SvcsJail HealthMCAHMCAH-CCSMCAH-PH NursingMedically IndigentPHP-GeneralPHP-PH LabVital Recs.

Documents

City and County of San Francisco year Budget Task...County Health Mandates - Updated Nov 2011 Community Behavioral Health Services Program Area Mandate Citation. ... Counties accepting