BILL NUMBER: AB 1644 INTRODUCED
BILL TEXT
INTRODUCED BY Assembly Member Bonta
JANUARY 11, 2016
An act to amend Section 4372 of, and to add and repeal Chapter 4
(commencing with Section 4391) of Part 4 of Division 4 of, the
Welfare and Institutions Code, relating to mental health.
LEGISLATIVE COUNSEL'S DIGEST
AB 1644, as introduced, Bonta. School-based early mental health
intervention and prevention services.
Existing law, the School-based Early Mental Health Intervention
and Prevention Services for Children Act of 1991, authorizes the
Director of Health Care Services, in consultation with the
Superintendent of Public Instruction, to provide matching grants to
local educational agencies to pay the state share of the costs of
providing school-based early mental health intervention and
prevention services to eligible pupils at schoolsites of eligible
pupils, subject to the availability of funding each year. Existing
law defines "eligible pupil" for this purpose as a pupil who attends
a publicly funded elementary school and who is in kindergarten or
grades 1 to 3, inclusive. Existing law also defines "local
educational agency" as a school district or county office of
education or a state special school.
This bill would expand the definition of an eligible pupil to
include a pupil who attends a preschool program at a publicly funded
elementary school and a pupil who is in transitional kindergarten,
thereby extending the application of the act to those persons. The
bill would also include charter schools in the definition of local
educational agency, thereby extending the application of the act to
those entities. The bill would require the State Public Health
Officer, in consultation with the Superintendent of Public Schools
and the Director of Health Care Services, to establish a 4-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 schoolsites. The bill
would require the State Department of Public Health to submit
specified reports after 2 and 4 years. The bill would repeal these
provisions as of January 1, 2022.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. The Legislature finds and declares all of the
following:
(a) California's communities and systems are currently facing
challenges to prevent and address the far-reaching impacts of
childhood adversity, such as Adverse Childhood Experiences (ACEs) and
childhood trauma, which can result in negative educational, health,
social, and economic outcomes for children, youth, families, and
communities across the state.
(b) ACEs are traumatic experiences that can have a profound impact
on a child's developing brain and body and lasting impacts on a
person's health and livelihood across their lifetime. ACEs include
physical, emotional, and sexual abuse; physical and emotional
neglect; and household dysfunction, such as substance abuse by a
household member; and witnessing domestic violence. Other traumatic
experiences can include placement instability for foster youth,
homelessness, and witnessing violence against family and community
members.
(c) In California, 61.7 percent of adults have experienced at
least one ACE and 16.7 percent have experienced four or more ACEs.
Compared to an individual who has not experienced an ACE, an
individual with four or more ACEs is more likely to experience
chronic disease and engage in negative health behaviors. For example,
based on results of the California Behavioral Risk Factor
Surveillance Survey, a person in California with four or more ACEs is
1.6 times as likely to have diabetes, 1.9 times as likely to have
cancer, 2.4 times as likely to suffer from chronic obstructive
pulmonary disease, 2.9 times as likely to smoke, 4.2 times as likely
to be diagnosed with Alzheimer's disease or dementia, 5.1 times as
likely to suffer from depression, 7.4 times as likely to be an
alcoholic, and 12.2 times as likely to attempt suicide. Individuals
are similarly impacted by ACEs, regardless of race and ethnicity.
(d) The State of California has long recognized the mental health
needs of California's children and the value of addressing these
needs by supporting the provision of evidence-based mental health
services in publicly funded preschools and elementary schools, as
evidenced by the creation in 1981 of the Primary Prevention Project,
now named the Primary Intervention Program, and the creation in 1991
of the School-based Early Mental Health Intervention and Prevention
Services for Children Program, known as the Early Mental Health
Initiative (EMHI).
(e) From the 1992-93 fiscal year to the 2011-12 fiscal year,
inclusive, the State Department of Mental Health awarded funds each
year in matching grants to local educational agencies to fund
prevention and early intervention programs, including the Primary
Intervention Program, for students experiencing mild to moderate
school adjustment difficulty through the EMHI. In the 2011-12 fiscal
year, the EMHI received $15 million in state funds.
(f) School adjustment difficulties that can impede learning, such
as anxiety, withdrawal, and aggressive behaviors, are common symptoms
of chronic or traumatic stress resulting from exposure to ACEs and
childhood trauma.
(g) Authorizing legislation specified that the EMHI would be
deemed successful if at least 75 percent of the children who complete
the program show an improvement in at least one of the following
four areas: learning behaviors, attendance, school adjustment, and
school-related competencies.
(h) The EMHI succeeded in meeting these legislative requirements.
According to the 2010-2011 Early Mental Health Initiative Statewide
Evaluation Report, of the 15,823 students located in 424 elementary
schools across 66 school districts participating in EMHI-funded
services during the 2010-11 school year, 79 percent exhibited
positive social competence and school adjustment behaviors more
frequently after completing services. Furthermore, the magnitude of
the improvements was exceptional in comparison to evaluations of
other programs, especially given the short-term and cost-effective
nature of the intervention, and improvements were evident across all
demographic subgroups.
(i) The 2010-2011 Early Mental Health Initiative Statewide
Evaluation Report described an unmet demand for EMHI-funded services
at participating schoolsites, as only 37 percent of the students that
scored in the appropriate school adjustment difficulty range were
served with EMHI-funded services due to program capacity and funding
constraints. Based on demographic considerations, similar demand
would be expected at schools that did not receive EMHI grants.
(j) The Governor's realignment for the 2011-12 fiscal year renamed
the State Department of Mental Health as the State Department of
State Hospitals and limited that department's mission. The Budget Act
of 2012 disbursed Proposition 98 funds, which had been used to fund
the EMHI, directly to local educational agencies in order to provide
local schools with enhanced flexibility to manage their finances and
give greater control of local decisions.
(k) It is in the interest of California's children, families,
schools, and communities that the State of California support local
decisions to provide funding for evidence-based services to address
the mental health needs of children who have been exposed to
childhood adversity in publicly funded preschools and elementary
schools.
(l) In addressing these needs, priority should be given to
children, youth, and communities that experience childhood adversity,
more severely and profoundly, including those that experience
socioeconomic disadvantage and historical and contemporary
injustices, vulnerable communities, communities of color, and
culturally, linguistically, and geographically isolated communities.
(m) Multitiered systems and supports, which integrate mental
health, special education, and school climate interventions, have
been developed as a model framework within which to implement these
services. Pilot programs in the Counties of San Bernardino and
Alameda are demonstrating that implementing these services as part of
a multitiered system is cost effective because the cost of the
services is more than fully offset by the reduction in the need for
high-cost, nonpublic school placements.
(n) The evidence-based, cost-effective services provided by the
EMHI support the "Triple Aim" of better health, better care, and
lower costs. By helping children early on, evidence-based,
cost-effective services also support the recommendations of the Let's
Get Healthy California Task Force, which used the "Triple Aim" as
its foundation and articulated Healthy Beginnings: Laying the
Foundation for a Healthy Life, as a goal that includes reducing
childhood trauma, improving early learning, and improving mental
health and well-being as priorities.
(o) Providing early mental health service for children exposed to
childhood adversity, such as ACEs and childhood trauma, additionally
furthers the goal of the California Defending Childhood State Policy
Initiative, which is to more effectively align, integrate, and
mobilize multisectoral resources to equitably prevent, identify, and
heal the impacts of violence and trauma on children and youth.
SEC. 2. Section 4372 of the Welfare and Institutions Code is
amended to read:
4372. For the purposes of this part, the following definitions
shall apply:
(a) "Cooperating entity" means any a
federal, state, or local, public or private nonprofit agency
providing school-based early mental health intervention and
prevention services that agrees to offer services at a schoolsite
through a program assisted under this part.
(b) "Eligible pupil" means a pupil who attends a preschool
program at a publicly funded elementary school, or who
attends a publicly funded elementary school and who is in
kindergarten kindergarten, transitional
kindergarten, or grades 1 to 3, inclusive.
(c) "Local educational agency" means any school district or county
office of education, or state special
school, or charter school.
(d) "Department" means the State Department of Public Health.
(d)
(e) "Director" means the State Director of
Mental Health. Public Health Officer.
(e)
(f) "Supportive service" means a service that will
enhance the mental health and social
social-emotional development of children.
SEC. 3. Chapter 4 (commencing with Section 4391) is added to Part
4 of Division 4 of the Welfare and Institutions Code, to read:
CHAPTER 4. SCHOOL-BASED EARLY MENTAL HEALTH INTERVENTION AND
PREVENTION SERVICES SUPPORT PROGRAM
4391. (a) The State Public Health Officer shall establish a
four-year pilot program, in consultation with the Superintendent of
Public Instruction and the Director of Health Care Services, to
encourage and support local decisions to provide funding for the
eligible support services as provided in this section.
(b) The department shall provide outreach to local educational
agencies and county mental health agencies to inform individuals
responsible for local funding decisions of the program established
pursuant to this section.
(c) The department shall provide free regional training on all of
the following:
(1) Eligible support services, which may include any or all of the
following:
(A) Individual and group intervention and prevention services.
(B) Parent engagement through conference or training, or both.
(C) Teacher and staff conferences and training related to meeting
project goals.
(D) Referral to outside resources when eligible pupils require
additional services.
(E) Use of paraprofessional staff, who are trained and supervised
by credentialed school psychologists, school counselors, or school
social workers, to meet with pupils on a short-term weekly basis, in
a one-on-one setting as in the primary intervention program
established pursuant to Chapter 4 (commencing with Section 4343) of
Part 3.
(F) Any other service or activity that will improve the mental
health of eligible pupils, particularly evidence-based interventions
and promising practices intended to mitigate the consequences of
childhood adversity and cultivate resilience and protective factors.
(2) The potential for the eligible support services defined in
this section to help fulfill state priorities described by the local
control funding formula and local goals described by local control
and accountability plans.
(3) How educational, mental health, and other funds subject to
local control can be used to finance the eligible support services
defined in this section.
(4) External resources available to support the eligible support
services defined in this section, which may include workshops,
training, conferences, and peer learning networks.
(5) State resources available to support student mental health and
resilience, and positive, trauma-informed learning environments,
which may include any of the following:
(A) Foundational aspects of learning, childhood social-emotional
development, mental health and resilience, toxic stress, childhood
trauma, and Adverse Childhood Experiences.
(B) Inclusive multitiered systems of behavioral and academic
supports, Schoolwide Positive Behavior Interventions and Supports,
restorative justice or restorative practices, trauma-informed
practices, social and emotional learning, and bullying prevention.
(d) The department shall provide technical assistance to local
educational agencies that provide or seek to provide eligible
services defined in this section. Technical assistance shall include
assistance in any of the following:
(1) Designing programs.
(2) Training program staff in intervention skills.
(3) Conducting local evaluations.
(4) Leveraging educational, mental health, and other funds that
are subject to local control and assisting in budget development.
(e) In providing outreach pursuant to subdivision (b), training
pursuant to subdivision (c), and technical assistance pursuant to
subdivision (d), the department shall select and support schoolsites
as follows:
(1) During the first 18 months of the program, the department
shall support, strengthen, and expand the provision of eligible
services at schoolsites that previously received funding pursuant to
the School-Based Early Mental Health Intervention and Prevention
Services Matching Grant Program (Chapter 2 (commencing with Section
4380)) and have continued to provide eligible support services. In
working with these selected schoolsites, the department shall develop
methods and standards for providing services and practices to new
schoolsites.
(2) During the subsequent 18 months of the program, the department
shall select new schoolsites that are not providing eligible support
services but that demonstrate the willingness and capacity to
participate in the program. The department shall work with these
schoolsites to deliver eligible support services.
(3) In selecting schoolsites and providing support, the department
shall prioritize the following:
(A) Schoolsites in communities that have experienced high levels
of childhood adversity, such as Adverse Childhood Experiences and
childhood trauma.
(B) Schoolsites that prioritize for receipt of services children
who have been exposed to childhood trauma, including, but not limited
to, foster youth, as defined in subdivision (b) of Section 42238.01
of the Education Code, and homeless children and youth, as defined in
Section 11434a(2) of the federal McKinney-Vento Homeless Assistance
Act (42 U.S.C. Sec. 11301 et seq.)
(C) Geographic diversity, program effectiveness, program
efficiency, and long-term program sustainability.
(f) The department shall submit, in compliance with Section 9795
of the Government Code, an interim report to the Legislature at the
end of the second year of the pilot program that details the
department's work to support the schoolsites selected pursuant to
paragraph (1) of subdivision (e) and includes an assessment of the
demand and impact of funding for the School-Based Early Mental Health
Intervention and Prevention Services Matching Grant Program
established pursuant to Chapter 3 (commencing with Section 4390). The
department shall make the report available to the public and shall
post the report on the its Internet Web site.
(g) The department shall develop an evaluation plan to assess the
impact of the pilot program. The department, in compliance with
Section 9795 of the Government Code, shall submit a report to the
Legislature at the end of the four-year period evaluating the impact
of the pilot program and providing recommendations for further
implementation. The department shall make the report available to the
public and shall post the report on its Internet Web site.
4392. This chapter shall remain in effect only until January 1,
2022, and as of that date is repealed, unless a later enacted
statute, that is enacted before January 1, 2022, deletes or extends
that date.