BILL ANALYSIS Ó
SENATE COMMITTEE ON HEALTH
Senator Ed Hernandez, O.D., Chair
BILL NO: AB 580
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|AUTHOR: |O'Donnell |
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|VERSION: |June 24, 2015 |
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|HEARING DATE: |July 8, 2015 | | |
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|CONSULTANT: |Reyes Diaz |
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SUBJECT : Pupil mental health: model referral protocols.
SUMMARY : Requires the Department of Education (CDE), upon receiving
funding, to develop model referral protocols, as specified, for
addressing pupil mental health concerns. Specifies that the
protocols are to be used on a voluntary basis by specified
educational institutions. Requires CDE to post the protocols on
its Internet Web site.
Existing federal law:
1)Establishes the Individuals with Disabilities Education Act,
which provides that students with exceptional needs, who are
identified as having emotional disturbance, may be eligible to
receive mental health (MH) services, including counseling,
psychological services, parent counseling and training, and
residential placement.
2)Specifies that schools have the responsibility for
educationally related MH services.
3)Requires local educational agencies (LEAs) to update the
Individualized Education Plan (IEP) of each child that will
experience a change in services.
4)Requires the provision of a free, appropriate public education
to all disabled students in the least restrictive environment.
Existing state law:
1)Establishes school districts as the responsible agency for MH
services for students with IEPs.
2)Requires all services identified in a student's IEP to be
provided, whether directly by LEA employees or through
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contract with outside providers, such as county MH agencies.
Requires LEAs to ensure services are provided to students
regardless of who provides or pays for those services.
This bill:
1)Requires CDE to develop model referral protocols for
addressing pupil MH concerns, and to consult with the
following:
a) The Student MH Policy Workgroup;
b) LEAs that have served as state or regional
leaders in state or federal pupil MH initiatives;
c) County MH programs;
d) Current classroom teachers and administrators;
e) Current schoolsite classified staff;
f) Current schoolsite staff who hold pupil
personnel services credentials;
g) Current school nurses; and,
h) Current school counselors.
i) Other professionals involved in pupil MH as
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, state special schools for the
blind and deaf; teacher, administrator, school counselor,
pupil personnel services; and, school nurse preparation
programs operated by institutions of higher learning.
3)Requires the protocols to do all of the following:
a) Address the appropriate and timely referral by
school staff of pupils with MH concerns;
b) Reflect a multitiered system of support
processes and positive behavioral interventions and
supports;
c) Be adaptable to varied local service
arrangements for MH services;
d) Reflect evidence-based and culturally
appropriate approaches to pupil MH 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
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pupils 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. Specifies the provisions in
this bill do not authorize or encourage school
employees to diagnose or treat MH illness unless they
are specifically licensed and employed to do so; and,
i) Be consistent with state activities conducted
by CDE in the administration of federally funded MH
programs.
4)Requires CDE to post the protocols on its Internet Web site
for access by schools and institutions of higher learning.
5)Specifies that the provisions in this bill are contingent upon
funds being appropriated to CDE in the annual Budget Act or
other legislation, or state, federal, or private funds being
allocated for this purpose.
6)Requires the protocols to be completed and made available
within two years of the date funds are received or allocated
to implement the provisions in this bill.
FISCAL
EFFECT : According to the Assembly Appropriations Committee,
this bill has one-time costs in the range of $135,000 to
$145,000 for CDE and a designated county office of education to
jointly develop a model referral protocol for addressing pupil
MH concerns.
PRIOR
VOTES :
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|Assembly Floor: |77 - 0 |
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|Assembly Appropriations Committee: |15 - 0 |
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|Assembly Education Committee: |6 - 0 |
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COMMENTS :
1)Author's statement. According to the author, numerous studies
point to a strong connection between mental wellness and
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academic achievement, behavior in school, and attendance.
Research indicates that while 20% of children have MH issues,
80% of those issues are undiagnosed and untreated, and that MH
challenges disproportionately impact students who face
stressors, such as violence, trauma, and poverty. In spite of
the significant impact of MH on academic and life outcomes,
many schools lack the information they need to make
appropriate and timely referrals for MH concerns. CDE has
identified inadequate identification and service referral, as
well as inconsistent student MH policies, as major factors
contributing to this problem. Currently, there is no state
guidance on best practices for student MH referral. This bill
provides schools a vital tool for addressing the needs of
their students by requiring CDE to develop evidence-based
model referral protocols for student MH concerns, for
voluntary use by schools. These protocols would be adaptable
to varied service arrangements and culturally appropriate, and
would in no way authorize school staff to diagnose or treat MH
conditions.
2)Background. Current law is silent on how school employees
should refer students for MH assessments and services.
Teachers are specifically authorized to make a referral for
assessment for special education and related services, but MH
needs may not necessitate special education. It is likely that
employees notify the school or school district counselor,
psychologist, or nurse of students' MH concerns. The state is
currently engaged in a number of initiatives aimed at
improving support for student MH needs, such as:
a) Student Mental Health Policy Workgroup. In 2012,
the Superintendent of Public Instruction and the
California Mental Health Services Authority (CalMHSA)
convened a Student Mental Health Policy Workgroup to
develop policy recommendations that promote early
identification, referral, coordination, and access to
quality MH 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 MH
professionals.
b) Regional K-12 Student Mental Health training. Since
2011, CalMHSA has funded a Student Mental Health
Initiative through the California County Superintendents
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Educational Services Association. This project is
designed to build capacity and cross-system collaboration
to develop and sustain school-based MH programs
addressing prevention and early identification
strategies. One of the goals of this project is the
training of school staff. Since 2011, this project has
used a train-the-trainer model to provide educators with
tools for the early identification and prevention of MH
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. According to evaluation
responses, these trainings have significantly increased
educators' awareness of MH issues and knowledge of
referral processes. The California County Superintendents
Educational Services Association estimates that this
program costs an average of $2.25 per student per year.
Since 2014, this project has declined significantly in
size as a result of decreased funding.
c) CDE training project. CalMHSA has also funded MH
training through the 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 MH issues early
on.
d) Federal "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 MH
services. California received $9.7 million from the "Now
is the Time Project Advancing Wellness and Resilience in
Education" grant last fall. Three 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 MH services. If successful, the models
developed by these LEAs can be shared statewide. Another
component of the grant utilizes a training program called
Youth Mental Health First Aid. The training teaches
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school staff how to help youth experiencing MH or
substance abuse challenges, or who are in crisis.
3)Audit request. Senator Beall requested an audit of MH services
for students, which was approved by the Joint Legislative
Audit Committee on April 22, 2015. The audit request covers MH
services more broadly than EPSDT services. Specifically, the
request asks for the audit to, among other things:
a) Provide the following information for pre- and
post-AB 114 (Committee on Budget, Chapter 43, Statutes of
2011) disaggregated by students for whom an IEP
identifies them as emotionally disturbed, for students
whose IEP may also call for MH services, and for students
who qualify or do not quality 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; and,
iii. For a selection of students served under
AB 3632, determine whether their IEPs were changed
during the SELPA's transition to AB 114.
b) Determine whether changes in treatment were made by
service providers as a result of the transition from AB
3632 to AB 114.
c) Identify the state and federal funding sources for
MH services for students with disabilities for the past
five fiscal years.
d) Identify the number of students with MH issues in
California and compare that to the number of students
actually receiving services.
4)Double referral. This bill was heard in the Senate Education
Committee and passed out on a 7-0 vote.
5)Related legislation. AB 104 (Committee on Budget, Chapter 13,
Statutes of 2015) appropriates $10 million to the
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Superintendent of Public Instruction to provide technical
assistance and develop statewide resources to assist LEAs to
establish and align systems of learning and behavioral
supports.
AB 1018 (Cooper), requires the CDE and the Department of
Health Care Services (DHCS) to convene a task force to examine
the delivery of MH services through the Early and Periodic
Screening, Diagnosis, and Treatment (EPSDT) services. AB 1018
was heard in the Senate Health Committee on July 1, 2015, and
passed out on a 7-0 vote.
AB 1025 (Thurmond), requires the CDE to establish additional
pilot programs to encourage inclusive practices that integrate
MH, special education, and school climate interventions
following a multi-tiered framework. AB 1025 is set for hearing
in the Senate Education Committee on July 8, 2015.
AB 1133 (Achadjian), 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 MH services at school sites.
AB 1133 was held on the Assembly Appropriations Committee's
suspense file.
AB 1299 (Ridley-Thomas), 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 MH services by foster youth. AB
1299 is set for hearing in the Senate Human Services Committee
on July 14, 2015.
6)Prior legislation. AB 2212 (Gray, 2014), required DHCS to
allow county MH plans to contract with LEAs to provide EPSDT
services. AB 2212 was held on the Assembly Appropriations
Committee's suspense file.
AB 114 shifted responsibility for MH services for students
from counties to LEAs.
7)Support. Supporters argue that the protocols required in this
bill will greatly assist in addressing the MH and academic
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needs of students, as educators and school counselors
sometimes express feeling unprepared to address pupil MH
challenges.
SUPPORT AND OPPOSITION :
Support: California Association of School Counselors
California Medical Association
California School Employees Association
California School Nurses Organization
Mental Health America of California
Santa Clara County Office of Education
Oppose: None received.
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