Part 5. Office Of Rural Health of California Health And Safety Code >> Division 1. >> Part 5.
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
(2) Promote coordinated planning and policy development among
state departments and between the State and local public and private
(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
(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
(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
(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.
(a) (1) The Office of Statewide Health Planning and
Development shall develop and administer a competitive grants program
for projects located in rural areas of California.
(2) The office 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
(4) The office 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 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 office, the Emergency Medical Services Authority, the
State Department of Health Care Services, the State Department of
Public Health, 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
(b) The Office of Statewide Health Planning and Development 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
(c) The Office of Statewide Health Planning and Development shall
make information regarding the status of the funded projects
available at the public meetings described in subdivision (b).
(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
(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
(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
(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.