BILL ANALYSIS Ó
SENATE COMMITTEE ON HEALTH
Senator Ed Hernandez, O.D., Chair
BILL NO: AB 1025
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|AUTHOR: |Thurmond |
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|VERSION: |June 2, 2015 |
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|HEARING DATE: |July 15, 2015 | | |
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|CONSULTANT: |Tim Valderrama |
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SUBJECT : Pupil health: multitiered and integrated interventions
pilot program.
SUMMARY : Requires the Department of Education to establish a three-year
pilot program in school districts to encourage inclusive
practices that integrate mental health, special education, and
school climate interventions following a multi-tiered framework.
Existing federal law:
1)Requires the provision of a free, appropriate public education
to all disabled students in least restrictive environment,
which:
a) Is provided at public expense, under public
supervision and direction, and without charge;
b) Meets the standards of the state education
agency;
c) Includes an appropriate preschool, elementary
school, or secondary school in the state; and,
d) Is provided in conformity with the Individual
Education Program established for the child.
2)Establishes the Early and Periodic Screening, Diagnosis, and
Treatment (EPSDT) Program to provide physical and mental
health services to Medicaid (Medi-Cal in California)
beneficiaries under the age of 21, including current and
former foster youth.
Existing state law:
1)Establishes Mental Health Services Act (MHSA) which provides
for local mental health services, including prevention and
early intervention, innovative projects, Full Service
Partnerships, peer support services, housing, and other mental
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health treatment services. Establishes the Mental Health
Services Fund in the state Treasury, continuously appropriated
to and administered by the Department of Health Care Services
(DHCS), to fund specified county mental health programs.
2)Encourages schools, as comprehensive school safety plans are
reviewed and updated, to include in school safety plans clear
guidelines for the roles and responsibilities of mental health
professionals, community intervention professionals, school
counselors, school resource officers, and police officers on
school campus, if the school district uses these people. The
guidelines may include primary strategies to create and
maintain a positive school climate, promote school safety, and
increase pupil achievement, and prioritize mental health and
intervention services, restorative and transformative justice
programs, and positive behavior interventions and support.
3)Requires the individualized education team for each student
with exceptional needs consider the use of positive behavioral
interventions and supports for students whose behavior impedes
his or her learning.
This bill:
1)Requires the California Department of Education (CDE) to
establish a three-year pilot program, as part of the plan to
provide technical assistance and disseminate statewide
resources that encourage and assist local educational agencies
establish and align schoolwide, data-driven systems of
learning, to encourage inclusive practices that integrate
mental health, special education, and school climate
interventions following a multitiered framework.
2)Requires the CDE to establish the pilot program in three
schools in each of five school districts that submit
applications that provide funding estimates for startup and
evaluation of the program and specifying their intended
models.
3)Prohibits the selection of participating schools from
including those that received a federal Substance Abuse and
Mental Health Services Administration's "Now is The Time"
grant.
4)Requires the California CDE to select schools that meet both
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of the following criteria:
a) At least 60% of the student body is eligible
for free and reduced-price meals; and,
b) The application details a model approach that
targets the behavioral, emotional, and academic needs
of students with multi-tiered and integrated mental
health, special education, and school climate
interventions.
5)Requires an applicant's model to include all of the following:
a) Formalized collaboration with local mental
health agencies to provide school-based mental health
services that are integrated within a multi-tiered
system of support;
b) Leverage of school and community resources to
offer comprehensive multi-tiered interventions on a
sustainable basis;
c) An initial school climate assessment that
includes information from multiple stakeholders,
including school staff, students, and families, that
is used to inform the selection of strategies and
interventions that reflect the culture and goals of
the school;
d) A coordination of services team that considers
referrals for services, oversees schoolwide efforts,
and uses data-informed processes to identify
struggling students who require early interventions;
e) Whole school strategies that address school
climate and universal student well-being, such as
positive behavioral interventions and supports or the
Olweus Bullying Prevention Program, as well as
comprehensive professional development opportunities,
that build the capacity of the entire school community
to recognize and respond to the unique
social-emotional, behavioral, and academic needs of
students;
f) Targeted interventions for students with
identified social-emotional, behavioral, and academic
needs, such as a therapeutic group interventions,
functional behavioral analysis and plan development,
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and targeted skills groups;
g) Intensive services, such as wraparound,
behavioral intervention, or one-on-one support, that
can reduce the need for a student's referral to
special education or placement in more restrictive,
isolated settings; and,
h) Specific strategies and practices that ensure
parent engagement with the school and provide parents
with access to resources that support their children's
educational success.
6)Requires CDE, in accordance with an appropriation in the
Budget Act or another statute, to provide startup and
evaluation funds to each participating school in the following
amounts:
a) $250,000 in year one;
b) $200,000 in year two; and,
c) $150,000 in year three.
7)Requires DHCS, the Mental Health Services Oversight and
Accountability Commission, and the CDE to develop a
comprehensive evaluation plan to assess the impact of the
pilot program and disseminate best practices.
8)Requires outcomes and indicators to be reported by
participating schools to include those already being collected
by schools, as well as designated measures of student
well-being, academic achievement, and school engagement and
attendance.
9)Requires CDE to submit a report to the Legislature at the end
of the three-year period evaluating the success of the program
and making further recommendations
10)Requires the CDE to make the report to the Legislature
available to the public and to post it on CDE's website.
11)Requires the Mental Health Services Oversight and
Accountability Commission to revise its guidelines and
regulations for Prevention and Early Intervention Programs of
the Mental Health Services Act to require the prevention and
early intervention programs in K-12 schools to be designed to
support the implementation or expansion of model programs in
accordance with the criteria set forth in this bill.
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12)Sunsets the provisions of this bill on January 1, 2020.
13)Makes various legislative findings and declarations stating
that all California's pupils deserve adequate behavioral and
academic support to achieve their full potential and declares
legislative intent, upon demonstrated success of the pilot
program, that evaluated models be adopted by a large number of
schools.
FISCAL
EFFECT : According to the Assembly Appropriations Committee, in
excess of $400,000 in administrative General Fund costs to CDE
and $600,000, over three years, for startup and evaluation
funding to each school participating in the program. As proposed
to be amended, this bill establishes pilot programs in a total
of 10 schools.
PRIOR
VOTES :
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|Assembly Floor: |69 - 9 |
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|Assembly Appropriations Committee: |11 - 4 |
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|Assembly Education Committee: |6 - 0 |
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COMMENTS :
1)Author's statement. According to the author, students in
disadvantaged communities face relational and environmental
stressors that, when left unaddressed, hinder their ability to
achieve their full potential. Compounded traumatic stressors
including poverty and exposure to violence have been found to
negatively affect student academic achievement, learning and
emotional development, and result in disproportionately high
referral rates to special education services. Risk factors
that are known to negatively impact the social-emotional
well-being and academic achievement of students are
widespread. Nearly one in four youth are living in poverty,
almost 60,000 youth are currently placed in foster care and it
is estimated that 20% of youth are in need of mental health
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intervention.
Unfortunately, the needs of students facing such challenges
often go unrecognized or are misunderstood. Unaddressed
student needs frequently result in more profound behavioral
and academic challenges that can necessitate costly,
restrictive interventions including entering into the juvenile
justice system. The fragmentation of our education and mental
health systems only makes the situation worse. The school
setting presents an important opportunity to identify and
respond to the comprehensive needs of youth, reducing barriers
to access as well as the stigma that is often associated with
seeking help. Working in partnership with mental health
providers, the school community can be empowered with the
skills and resources to promote the wellbeing and achievement
of all students.
2)Mental health services in schools. According to the CDE,
mental health services in schools include a broad range of
services, settings, and strategies. Psychological and mental
health services in schools apply learning theory for
individuals and groups to improve instruction and coordinate
and evaluate plans to meet unique individual needs for
learning or behavior problems. School psychologists also use
research to design prevention and intervention programs, and
provide crisis intervention, suicide prevention, and other
mental health strategies as part of a student support services
team. Mental health services that are provided in schools may
include academic counseling, brief interventions to address
behavior problems, and assessments or referrals to other
systems. However, most of the mental health services provided
by schools are within the context of special education and
meeting the requirements specified in a student's
individualized education program.
3)Individualized education programs (IEP). Pursuant to the
Individuals with Disabilities Education Act (IDEA), each
public school student who receives special education and
related services must have an IEP. An IEP is a written
document developed by a multi-disciplinary team that is
designed for one student and must be truly individualized.
Federal and state law require the instruction and related
services detailed in an IEP to be provided to the student
irrespective of the internal capacity of the school to provide
the instruction and services. In order to meet the
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requirements set forth in an IEP, schools may employ qualified
staff directly, partner with county mental health agencies or
contract with private providers.
Prior to 2011, state law required a partnership between school
districts and county mental health agencies to deliver mental
health services to students with IEPs. AB 114 (Committee on
Budget, Chapter 43, Statutes of 2011), repealed the state
mandate on special education and county mental health agencies
and eliminated related references to mental health services in
California statute. As a result of this legislation, school
districts are now solely responsible for ensuring that
students with disabilities receive special education and
related services to meet their needs pursuant to IDEA. Special
education funding can only be used for instruction and related
services specifically identified in IEPs and cannot be used
for any other purpose, such as school-wide interventions.
4)Medi-Cal services. EPSDT is a Medi-Cal benefit for
individuals under the age of 21 who have full-scope Medi-Cal.
This benefit allows for periodic screenings to determine
health care needs and includes all services covered by
Medi-Cal, as well as other services that are determined to be
medically necessary.
According to the DHCS, EPSDT mental health services are Medi-Cal
services that correct or improve mental health problems that a
doctor or other health care provider identifies, even if the
health problem will not go away entirely. EPSDT mental health
services must be approved and provided by county mental health
departments. Some of the EPSDT mental health benefits
available are individual or group therapy, family therapy,
crisis counseling, case management, special day programs
medication and Therapeutic Behavioral Services (TBS). TBS are
an EPSDT specialty mental health service that are designed to
help children and young adults who have severe emotional
problems, live in or are at risk of a mental health placement,
or have been or are at risk of being hospitalized for mental
health problems. Schools are not authorized to directly seek
reimbursement for EPSDT benefits but may be reimbursed with
EPSDT funds if agreed to by the county mental health agency.
5)Student Mental Health Initiative (SMHI). The SMHI is a
California Mental Health Services Authority prevention and
early intervention program that identifies strategies to
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address student mental health needs across the K-12 and higher
education systems. The program offers four year grants, funded
by the MHSA, to institutions to develop a comprehensive system
of campus-based mental health services and supports for
students. The author indicates this bill has objectives
similar to the SMHI but would be administered through CDE
directly to schools rather than through the county mental
health agency and would focus more on early intervention.
6)Recent budget action. AB 104 (Committee on Budget, Chapter
13, Statutes of 2015), among other things, appropriates $10
million in one-time funds to a county office of education (or
two applying jointly) to provide technical assistance and to
develop and disseminate statewide resources that encourage and
assist local educational agencies and charter schools in
establishing and aligning school-wide, data-driven systems of
learning and behavioral supports for the purpose of meeting
the needs of the state's diverse learners in the most
inclusive environments possible.
7)Double referral. This bill was heard in the Senate Education
Committee on July 8, 2015 and passed with an 8-1 vote.
8)Related legislation. SB 463 (Hancock), would require the CDE,
to the extent that funding is available in the Budget Act of
2015, to designate a county office of education to be the
fiduciary agent for the Safe and Supportive Schools Train the
Trainer Program. SB 463 is pending in the Assembly Education
Committee.
AB 1133 (Achadjian), would have required the State Public
Health Officer to establish a four-year pilot program to,
among other things, provide free regional training and
technical assistance in support services that include
intervention and prevention services, use of trained staff to
meet with students on a short-term weekly basis in a
one-on-one setting, the potential for support services to help
fulfill state priorities described by the local control
funding formula and local goals described by local control and
accountability plans, and state resources available to support
student mental health and positive learning environments. AB
1133 was held in the Assembly Appropriations Committee.
AB 580 (O'Donnell), would require the CDE to develop model
referral protocols for voluntary use by schools to address the
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appropriate and timely referral by school staff of students
with mental health concerns. AB 580 is pending in the Senate
Appropriations Committee.
AB 1018 (Cooper),would require the CDE and the 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 Senate
Appropriations Committee.
SB 527 (Liu), would establish the Safe Neighborhoods and
Schools Fund Grant Program, using Proposition 47 funds to
reward school districts that have demonstrated a commitment
to, and developed a comprehensive plan for, utilizing
research-based strategies to increase attendance rates, to
reduce school removals of all types and referrals to police,
to address trauma, mental health needs and other social and
emotional factors that impact pupil outcomes, to address and
to remedy school push-out and dropout rates, coordinate pupil
support programs with community and other public agencies at
school sites and across the school district, and create a
strong and supportive school culture that identifies and
addresses the needs of pupils, including victims of crime,
abuse, and neglect. SB 527 is scheduled to be heard by Senate
Education Committee on July 15.
9)Prior legislation. SB 1396 (Hancock, 2014), would have
required CDE, to the extent one-time funding is available in
the 2014-15 Budget Act, to designate funds to a county office
of education to establish professional development activities
to support the development and expansion of multi-tiered
intervention and support programs, including but not limited
to, schoolwide positive behavior intervention and support. SB
1396 was held on the Assembly Appropriations Committee's
suspense file.
SB 596 (Yee, 2014) would have required the CDE to establish a
three-year pilot program to encourage inclusive practices that
integrate mental health, special education, and school climate
interventions following a multi-tiered framework. SB 596 was
held at the Assembly Desk.
10)Support. The Steinberg Institute argues that for many years,
educators have recognized that signs of mental health issues
emerge at an early age and that early intervention is key in
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preventing children afflicted with a mental illness from
worsening symptoms, falling behind and dropping out of school,
juvenile delinquency, and a future marked by a lower standard
of living than their peers. They express hope that this bill
will be a step in the right direction towards making early
intervention programs more readily available in our public
schools. The Association of California School Administrators
state that youth with mental health challenges often fail to
receive the services they need and our youngest learners,
especially those from low income backgrounds, often will
perform substantially below their higher income peers in areas
of social and emotional skill, social and emotional
development, engagement in school, and physical well-being.
They believe this gap in performance is noticeable if mental
health challenges are not identified by the third grade and
that current funding practices do not invest in preventative
measures that would reduce overall cost of special education.
The California State PTA maintain that youth in economically
depressed circumstances are particularly vulnerable to social,
emotional and academic pressures and may not have access to
services that can ease these pressures. Placing the pilot
program in multiple schools and school districts that have at
least 60% of the student body eligible for free and reduced
price meal programs supports the needs of these children.
11)Opposition. The Special Education Local Plan Area
Administrators of California opposes this bill and argues it
would draw funding from a recent budget allocation intended
for broader purposes as recommended by the Statewide Task
Force on Special Education. They state that this bill would
specifically link pilot programs that are narrowly targeted
for mental health and only available in a small number of
schools to a one-time $10 million dollar budget augmentation
that was intended to assist students with learning
disabilities, cognitive disabilities or behavioral needs
statewide.
12)Author's amendments. The author wishes to amend this bill as
follows:
a) Require the designated county office of education to
establish the pilot program, rather than requiring the
California Department of Education (CDE) to establish the
pilot program.
b) Reduce the number of pilot programs, from three to two,
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schools in each of the five school districts that apply to
participate.
c) Require applications to provide evidence of a plan to
serve students using a combination of school funds and
mental health funds.
d) Modify the required components of an applicant school's
model approach to:
i. Delete reference to formalized collaboration
with local mental health agencies.
ii. Add reference to partnerships with the county
and demonstrations of access to adequate funding to
serve Medi-Cal eligible students who are not receiving
special education or related services.
e) Delete the requirement that the State Department of
Health Care Services, the Mental Health Services Oversight
and Accountability Commission, and the CDE to develop a
comprehensive evaluation plan to assess the impact of the
pilot program and disseminate best practices.
SUPPORT AND OPPOSITION :
Support: Association of California School Administrators
Association of Regional Center Agencies
California Alliance of Child and Family Services
California Chapter of the National Association of
Social Workers
California Council of Community Mental Health Agencies
California Pan-Ethnic Health Network
California Psychological Association
California State PTA
Children Now
Mental Health America of California
Pacific Clinics
Steinberg Institute
Oppose: Special Education Local Plan Area Administrators of
California
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