SCHOOL-BASED CLINICS: Davis Vetoes Measure

      Gov. Gray Davis yesterday vetoed AB 1363, which would have allowed school-based health clinics to bill the Healthy Families program for services provided to uninsured children. It also would have "established a list of suggested guidelines for local school boards to consider voluntarily if they wanted to bill the private health plans of students with insurance" (Rojas, Sacramento Bee, 10/7). The bill had become a lightning rod for controversy of late, with conservative advocacy groups arguing that it "would expand the number of school medical clinics and result in the delivery of controversial medical services, such as contraceptives." Opponents also worry that the measure would have rationalized inadequate literacy rates as products of mental illness or genetic problems. Overall, opponents argued, "medical services should be delivered by professionals outside the school system." But supporters, including bill sponsor Susan Davis (D-San Diego) said schools are an effective way to reach the uninsured, and services are only provided where communities request them, and where parents have given consent (Mendel, San Diego Union-Tribune, 10/7).

From Davis' Desk
      In his veto message, Davis wrote: "While I believe that school- based clinics have a legitimate role in providing health care to children, it is unclear how the placement of voluntary guidelines into statute will assist the formation or continuation of such programs or the integration into managed care networks." He noted, however, that he has directed the Managed Risk Medical Insurance Board to report by Dec. 31 on any barriers to including school clinics in the Healthy Families program (release, 10/6).

Back Door Enactment?
      Davis' veto did not end the controversy, however, as opponents are concerned the bill will be implemented by other means. Michael Abbott, a consultant to Assemblywoman Davis, said, "The governor basically said he likes school-based clinics and he wants the (state board) to remove contracting barriers, but he doesn't like turning voluntary guidelines into state law" (Bee, 10/7). One of her aides said, "Even though he vetoed the bill, much of what was intended ... will go forward." But Mark Washington, president of the Capital Resource Institute, said, "The governor is going to try to sneak this in the back door. But we do have a victory because now the uphill fight is his instead of ours." A statement by the group vowed to "fight 'district by district and class by class' against any attempt to implement the provisions of the bill without legislation" (Union-Tribune, 10/7).