BILL ANALYSIS Ó
SENATE COMMITTEE ON EDUCATION
Senator Carol Liu, Chair
2015 - 2016 Regular
Bill No: AB 580
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|Author: |O'Donnell |
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|Version: |June 24, 2015 Hearing |
| |Date: July 1, 2015 |
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|Urgency: |No | Fiscal: |Yes |
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|Consultant:|Lynn Lorber |
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Subject: Pupil mental health: model referral protocols
SUMMARY
This bill requires the California Department of Education (CDE)
to develop model referral protocols for voluntary use by schools
to address the appropriate and timely referral by school staff
of students with mental health concerns.
BACKGROUND
The federal Individuals with Disabilities Education Act provides
that students with exceptional needs identified as having
"emotional disturbance" may be eligible to receive mental health
services. Mental health services are considered "related
services" and include counseling, psychological services, parent
counseling and training, and residential placement, among
others. (United States Code, Title 20, § 1400 et seq. and Code
of Federation Regulations, Title 34, § 300.34)
AB 114 (Committee on Budget, Chapter 43, Statutes of 2011),
shifted responsibility for mental health services for students
from counties to local educational agencies (LEAs). Any and all
services identified in a student's individualized education
program (IEP) must be provided, whether directly by LEA
employees or through contract with outside providers such as
county mental health agencies. LEAs are required to ensure
services are provided to students regardless of who provides or
pays for those services. (Education Code § 56139)
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ANALYSIS
This bill requires the CDE to develop model referral protocols
for voluntary use by schools to address the appropriate and
timely referral by school staff of students with mental health
concerns.
1)Requires the CDE to consult with the members of the Student
Mental Health Policy Workgroup, LEAs that have served as state
or regional leaders in student mental health initiatives,
county mental health programs, and current classroom teachers
and administrators, classified staff, staff who hold student
personnel services credentials, school nurses, school
counselors and other professionals involved in student mental
health as the CDE deems appropriate.
2)Requires the protocols to be designed for use, on a voluntary
basis, by schoolsites, school districts, county offices of
education, charter schools, and the State Special
Schools, and by preparation programs for teachers,
administrators, school counselors, student personnel services,
and school nurses.
3)Requires the protocols to do all of the following:
a) Address the appropriate and timely referral by school
staff of students with mental health concerns.
b) Reflect a multitiered system of support processes and
positive behavioral interventions and supports.
c) Be adaptable to varied local service arrangements for
mental health services.
d) Reflect evidence-based and culturally appropriate
approaches to student mental health referral.
e) Address the inclusion of parents and guardians in the
referral process.
f) Be written to ensure clarity and ease of use by
certificated and classified school employees.
g) Reflect differentiated referral processes for students
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with disabilities and other populations for whom the
referral process may be distinct.
h) Be written to ensure that school employees act only
within the authorization or scope of their credential or
license.
i) Be consistent with state activities conducted by the
California Department of Education (CDE) in the
administration of federally funded mental health programs.
4)Requires the CDE to post the model referral protocols on its
website.
5)Provides that nothing in this bill is to be construed as
authorizing or encouraging school employees to diagnose or
treat mental illness unless they are specifically licensed and
employed to do so.
6)Provides that the implementation of this bill is contingent upon
funds being appropriated for its purpose, and requires the
model referral protocols to be completed and made available
within two years of the date funds are received or allocated
to implement the provisions of this bill.
STAFF COMMENTS
1)Need for the bill. According to the author, "In surveys,
California educators report their lack of preparedness in
addressing pupil mental health challenges as a major barrier
to instruction. According to the CDE's Student Mental Health
Policy Workgroup, most educators and staff lack training to
identify pupils who may be in need of support, and to make
referrals to help students manage mental health issues and
succeed in school. In particular, the CDE has identified
inadequate
identification and service referral, and inconsistent student
mental health policies, as major factors contributing to
students' lack of access to support for mental health
concerns."
2)What does school staff do now? Statutes are silent with regard
to the process followed by school employees to refer students
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for mental health assessments and services. Teachers are
specifically authorized to make a referral for assessment for
special education and related services, but mental health
needs may not necessitate special education. It is likely
that schools notify the school or school district counselor,
psychologist or nurse of mental health concerns.
3)Existing statewide student mental health initiatives. The state
is currently engaged in a number of initiatives aimed at
improving support for student mental health needs. Among them
are:
Student Mental Health Policy Workgroup. In 2012, the
Superintendent of Public Instruction and the California Mental
Health Services Act (CalMHSA) convened a Student Mental Health
Policy Workgroup (workgroup) to develop policy recommendations
that promote early identification, referral, coordination, and
access to quality mental health services for students. The
workgroup is comprised of teachers, school counselors, school
social workers, school psychologists, school nurses, and
school administrators, as well as state and county mental
health professionals.
The workgroup has noted the connection between mental wellness and
academic achievement, attendance, and behavior. It has also
noted that California's educators acknowledge their lack of
preparedness in addressing pupil mental health challenges as a
major barrier to instruction. The workgroup found that "most
educators and staff lack training to identify pupils who may
be in need of support, make referrals, and, as appropriate, to
help pupils overcome or manage mental health barriers and
succeed in school." They also noted that mental health
challenges disproportionately impact students who face
stressors such as violence, trauma, and poverty.
Regional K-12 Student Mental Health training. Since 2011, CalMHSA
has funded a Student Mental Health Initiative through the
California County Superintendents Educational Services
Association. This project is designed to build capacity and
cross-system collaboration to develop and sustain school-based
mental health programs addressing prevention and early
identification strategies.
One of the goals of this project is the training of school staff.
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Since 2011 this project has used a train-the-trainer model to
provide educators with tools for the early identification and
prevention of mental health problems. Two thousand trainings
have been conducted, with over 140,000 participants. The
estimated total reach of this project is two million students,
or one third of the state's enrollment.
The major program topics were school climate and culture, bullying
prevention, mental health and wellness, youth development.
Participants included school staff, students, parents, mental
health staff and providers, community organizations, and law
enforcement. According to evaluation responses, these
trainings have significantly increased educators' awareness of
mental health issues and knowledge of referral processes.
California County Superintendents Educational Services
Association (CCSESA) estimates that this program cost an
average of $2.25 per student per year. Since 2014 this
project has declined significantly in size as a result of
decreased funding.
California Department of Education's training project. California
Mental Health Services Act (CalMHSA) has also funded mental
health training through the California Department of Education
(CDE), Training Educators through Recognition and
Identification Strategies (TETRIS), Eliminating Barriers to
Learning (EBL) project. This statewide K-12 Mental Health
Program promotes school and student wellness and academic
achievement by increasing capacity for all school and
administrative staff to identify students who are experiencing
mental health issues early on. To accomplish this goal, the
CDE subcontracted with the Placer County Office of Education
to deliver 11 TETRIS EBL workshops annually through 2019. The
curriculum used for the TETRIS EBL workshops was developed by
the United States Department of Health and Human Services'
Substance Abuse and Mental Health Services Administration
(SAMHSA). Kognito Interactive Online Simulation Program is
also used as an outside source to help support school staff in
initiating conversations with students around the subject of
mental health and suicidal ideation.
SAMHSA "Now is the Time" pilot projects. Following the school
shooting at Sandy Hook Elementary in Connecticut in December
2012, President Obama established a grant program to increase
students' access to mental health services. California
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received $9.7 million from the "Now is the Time Project
Advancing Wellness and Resilience in Education" (NITT AWARE)
grant last fall. According to the CDE, the grant has two
components. Three local educational agencies (LEAs), Garden
Grove Unified School District, Santa Rosa City Schools, and
the San Diego County Office of Education, were selected to
participate in the first component of the grant. The LEAs
will establish a process for referring and connecting children
to mental health services. If successful, the models
developed by these LEAs can be shared statewide. The second
component utilizes a training program called Youth Mental
Health First Aid. The training teaches school staff how to
help youth experiencing mental health or addictions
challenges, or are in crisis.
4)Audit request. Senator Beall requested an audit of mental health
services for students, which was approved by the Joint
Legislative Audit Committee on April 22, 2015. The request
asks for the audit to, among other things:
a) Provide the following information for pre- and post- AB 114
disaggregated by students for whom an individualized
education plan (IEP) identifies them as emotionally
disturbed, for students whose IEP may also call for mental
health services, and for students who qualify or do not
qualify for Med-Cal services:
i) Compare the number of students each special
education local plan area (SELPA) served under AB 3632 to
the number served under AB 114.
ii) Determine whether the type of frequency of service,
and the providers of services, changed under the
transition from AB 3632 to AB 114.
iii) For a selection of students served under AB 3632,
determine whether their individualized education plans
(IEP) were changed during the special education local
plan areas (SELPA) transition to AB 114.
a) Determine whether changes in treatment were made by service
providers as a result of the transition from AB 3632 to AB
114.
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b) Identify the state and federal funding sources for mental
health services for students with disabilities, for the
past five fiscal years.
c) Identify the number of students with mental health issues
in California and compare that to the number of students
actually receiving services.
1)Fiscal impact. According to the Assembly Appropriations
Committee, this bill would result in one-time costs in the
range of $135,000 to $145,000 for the California Department of
Education (CDE) to develop model referral protocols for
addressing student mental health concerns.
2)Related legislation. AB 104 (Committee on Budget, Ch. 13, 2015)
appropriates $10 million to the Superintendent of Public
Instruction to provide technical assistance and develop
statewide resources to assist local educational agencies to
establish and align systems of learning and behavioral
supports.
AB 1133 (Achadjian, 2015 ) establishes a four year pilot program,
the School-Based Early Mental Health Intervention and
Prevention Services Support Program to provide outreach, free
regional training, and technical assistance for local
educational agencies in providing mental health services at
school sites. AB 1133 was held on the Assembly Appropriations
Committee's suspense file.
AB 1018 (Cooper, 2015) requires the CDE and the Department of
Health Care Services (DHCS) to convene a task force to examine
the delivery of mental health services through the Early and
Periodic Screening, Diagnosis, and Treatment services. AB
1018 is pending in the Senate Health Committee.
AB 1299 (Ridley-Thomas, 2015) requires the California Health and
Human Services Agency to coordinate with DHCS and the
Department of Social Services to facilitate the receipt of
medically necessary specialty mental health services by foster
youth. AB 1299 is pending in the Senate Human Services
Committee.
SUPPORT
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California Association of School Counselors
California Medical Association
California School Nurses Organization
Mental Health America of California
Santa Clara County Office of Education
OPPOSITION
None received.
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