AB 1644, as amended, 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 (1991 act), 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 rename the 1991 act
the Healing from Early Adversity to Level the Impact (HEAL) of Trauma in Schools Act or the HEAL Trauma in Schools Act. The bill would expand the definition of an eligible pupil to include a pupil who attends a preschool program at a contracting agency of the California state preschool program or a local educational agency, 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
begin delete State Public
Health Officer,end delete in consultation with the Superintendent of Public begin delete Schools, the Director of Health Care Services,end delete and the Attorney General to establish a 4-year program, the HEAL Trauma in Schools Support Program, to provide outreach, begin delete freeend delete regional training, and technical assistance for local educational agencies in providing mental health services at schoolsites. The bill would require the State Department of begin delete Public Healthend delete to submit specified reports after 2 and 4 years. The bill would make the implementation of the program contingent upon an appropriation in the annual budget act.
The bill would repeal
begin delete these provisionsend delete
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:
The Legislature finds and declares all of the
3(a) California’s communities and systems are currently facing
4challenges to prevent and address the far-reaching impacts of
5childhood adversity, such as Adverse Childhood Experiences
6(ACEs) and childhood trauma, which can result in negative
7educational, health, social, and economic outcomes for children,
8youth, families, and communities across the state.
9(b) In California, 61.7 percent of adults have experienced at
10least one ACE and 16.7 percent have experienced four or more
11ACEs. Compared to an individual who has not experienced an
12ACE, an individual with four or more ACEs is more likely to
13experience chronic disease and engage in negative health behaviors.
14For example, based on results of the California Behavioral Risk
15Factor Surveillance Survey, a person in California with four or
16more ACEs is 1.6 times as likely to have diabetes, 1.9 times as
17likely to have cancer, 2.4 times as likely to suffer from chronic
18obstructive pulmonary disease, 2.9 times as likely to smoke, 4.2
19times as likely to be diagnosed with Alzheimer’s disease or
20dementia, 5.1 times as likely to suffer from depression, 7.4 times
21as likely to be an alcoholic, and 12.2 times as likely to attempt
22suicide. Individuals are similarly impacted by ACEs, regardless
23of race and ethnicity.
24(c) From the 1992-93 fiscal year to the 2011-12 fiscal year,
25inclusive, the State Department of Mental Health awarded funds
26each year in matching grants to local educational agencies to fund
27prevention and early intervention programs, including the Primary
28Intervention Program, for students experiencing mild to moderate
29school adjustment difficulty through the School-based Early Mental
30Health Intervention and Prevention Services for Children Program
31of 1991, known as the Early Mental Health Initiative (EMHI). In
32the 2011-12 fiscal year, the EMHI received $15 million in state
34(d) School adjustment difficulties that can impede learning,
35such as anxiety, withdrawal, and aggressive behaviors, are common
P4 1symptoms of chronic or traumatic stress resulting from exposure
2to ACEs and childhood trauma.
3(e) Authorizing legislation specified that the EMHI would be
4deemed successful if at least 75 percent of the children who
5complete the program show an improvement in at least one of the
6following four areas: learning behaviors, attendance, school
7adjustment, and school-related competencies.
8(f) The EMHI succeeded in meeting these legislative
9requirements. According to the 2010-11 Early Mental Health
10Initiative Statewide Evaluation Report, of the 15,823 students
11located in 424 elementary schools across 66 school districts
12participating in EMHI-funded services during the 2010-11 school
13year, 79 percent exhibited positive social competence and school
14adjustment behaviors more frequently after completing services.
15Furthermore, the magnitude of the improvements was exceptional
16in comparison to evaluations of other programs, especially given
17the short-term and cost-effective nature of the intervention, and
18 improvements were evident across all demographic subgroups.
19(g) The 2010-11 Early Mental Health Initiative Statewide
20Evaluation Report described an unmet demand for EMHI-funded
21services at participating schoolsites, as only 37 percent of the
22students that scored in the appropriate school adjustment difficulty
23range were served with EMHI-funded services due to program
24capacity and funding constraints. Based on demographic
25considerations, similar demand would be expected at schools that
26did not receive EMHI grants.
27(h) The Governor’s realignment for the 2011-12 fiscal year
28renamed the State Department of Mental Health as the State
29Department of State Hospitals and limited that department’s
30mission. The Budget Act of 2012 disbursed Proposition 98 funds,
31which had been used to fund the EMHI, directly to local
32educational agencies in order to provide local schools with
33enhanced flexibility to manage their finances and give greater
34control of local decisions.
35(i) Multitiered systems and supports, which integrate mental
36health, special education, and school climate interventions, have
37been developed as a model framework within which to implement
38these services. Pilot programs in the Counties of San Bernardino
39and Alameda are demonstrating that implementing these services
40as part of a multitiered system is cost effective because the cost
P5 1of the services is more than fully offset by the reduction in the
2need for high-cost, nonpublic school placements.
3(j) The evidence-based, cost-effective services provided by the
4EMHI support the “Triple Aim” of better health, better care, and
5lower costs. By helping children early on, evidence-based,
6cost-effective services also support the recommendations of the
7Let’s Get Healthy California Task Force, which used the “Triple
8Aim” as its foundation and articulated Healthy Beginnings: Laying
9the Foundation for a Healthy Life, as a goal that includes reducing
10childhood trauma, improving early learning, and improving mental
11health and well-being as priorities.
12(k) Providing early mental health service for children exposed
13to childhood adversity, such as ACEs and childhood trauma,
14additionally furthers the goal of the California Defending
15Childhood State Policy Initiative, which is to more effectively
16align, integrate, and mobilize multisectoral resources to equitably
17prevent, identify, and heal the impacts of violence and trauma on
18children and youth.
Section 4370 of the Welfare and Institutions Code is
20amended to read:
This part shall be known and may be cited as the Healing
22from Early Adversity to Level the Impact (HEAL) of Trauma in
23Schools Act or the HEAL Trauma in Schools Act.
Section 4371 of the Welfare and Institutions Code is
25amended to read:
The Legislature finds and declares all of the following:
27(a) Each year in California over 65,000 teenagers become
28adolescent mothers and 230 teenagers commit suicide. Each year
29more than 20 percent of California’s teenagers drop out of high
31(b) Thirty percent of California’s elementary school pupils
32experience school adjustment problems, many of which are evident
33the first four years of school, that is, kindergarten and grades 1 to
35(c) Problems that our children experience, whether in school or
36at home, that remain undetected and untreated grow and manifest
37themselves in all areas of their later lives.
38(d) There is a clear relationship between early adjustment
39problems and later adolescent problems, including, but not limited
40to, poor school attendance, low achievement, delinquency, drug
P6 1abuse, and high school dropout rates. In many cases, signs of these
2problems can be detected in the early grades.
3(e) It is in California’s best interest, both in economic and human
4terms, to identify and treat the minor difficulties that our children
5are experiencing before those difficulties become major barriers
6to later success. It is far more humane and cost-effective to make
7a small investment in early mental health intervention and
8prevention services now and avoid larger costs, including, but not
9limited to, foster care, group home placement, intensive special
10education services, mental health treatment, or probation supervised
12(f) Programs like the Primary Intervention Program and the San
13Diego Unified Counseling Program for Children have proven very
14effective in helping children adjust to the school environment and
15learn more effective coping skills that in turn result in better school
16achievement, increased attendance, and increased self-esteem.
17(g) To create the optimum learning environment for our children,
18schools, teachers, parents, public and private service
19providers, and community-based organizations must enter into
20locally appropriate cooperative agreements to ensure that all pupils
21will receive the benefits of school-based early mental health
22intervention and prevention services that are designed to meet their
23personal, social, and educational needs.
24(h) Adverse Childhood Experiences (ACEs) are traumatic
25experiences that can have a profound impact on a child’s
26developing brain and body and lasting impacts on a person’s health
27and livelihood across their lifetime. ACEs include physical,
28emotional, and sexual abuse; physical and emotional neglect; other
29experiences, such as substance abuse by a household member and
30witnessing domestic violence. Other traumatic experiences can
31include placement instability for foster youth, homelessness, and
32witnessing violence against family and community members.
33(i) The State of California has
long recognized the mental health
34needs of California’s children and the value of addressing these
35needs by supporting the provision of evidence-based mental health
36services in publicly funded preschools and elementary schools, as
37evidenced by the creation in 1981 of the Primary Prevention
38Project, now named the Primary Intervention Program, and the
39creation in 1991 of the School-Based Early Mental Health
P7 1Intervention and Prevention Services for Children Program, known
2as the Early Mental Health Initiative (EMHI).
3(j) It is in the interest of California’s children, families, schools,
4and communities that the State of California support local decisions
5to provide funding for evidence-based services in publicly funded
6preschools and elementary schools to address the mental health
7needs of children who have been exposed to childhood adversity.
8(k) In addressing these needs, priority should be given to
9children, youth, and communities that experience childhood
10adversity more severely and profoundly, including those that
11experience socioeconomic disadvantage and historical and
12contemporary injustices, vulnerable communities, communities
13of color, and culturally, linguistically, and geographically isolated
Section 4372 of the Welfare and Institutions Code is
16amended to read:
For the purposes of this part, the following definitions
19(a) “Cooperating entity” means a federal, state, or local, public
20or private nonprofit agency providing school-based early mental
21health intervention and prevention services that agrees to offer
22services at a schoolsite through a program assisted under this part.
23(b) “Eligible pupil” means a pupil who attends a preschool
24program at a contracting agency of the California state preschool
25program, as established by Article 7 (commencing with Section
268235) of Chapter 2 of Part 6 of Division 1 of Title 1 of the
27Education Code, or a local educational agency, or who attends a
28publicly funded elementary school and who is in kindergarten,
29transitional kindergarten, or grades 1 to 3, inclusive.
30(c) “Local educational agency” means any school district or
31county office of education, state special school, or charter school.
32(d) “Department” means the State Department of
begin delete Public Health.end delete
34(e) “Director” means the
begin delete State Public Health Officer.end delete
36(f) “Supportive service” means a service that will enhance the
37mental health and social-emotional development of children.
Section 4380 of the Welfare and Institutions Code is
39amended to read:
begin deleteSubject end deleteto the availability of funding each year, the
3Legislature authorizes the director, in consultation with the
4Superintendent of Public Instruction, to award matching grants to
5local educational agencies to pay the state share of the costs of
6providing programs that provide school-based early mental health
7intervention and prevention services to eligible pupils at schoolsites
8of eligible pupils, as follows:
9(a) The director shall award matching grants pursuant to this
10chapter to local educational agencies throughout the state.
11(b) Matching grants awarded under this part shall be awarded
12for a period of not more than three years and no single schoolsite
13shall be awarded more than one
begin delete grant, except for a schoolsite that
14received a grant prior to July 1, 1992.end delete
15(c) The director shall pay to each local educational agency
16having an application approved pursuant to requirements in this
17part the state share of the cost of the activities described in the
begin deleteCommencing July 1, 1993, the end deletestate share of matching
20grants shall be a maximum of 50 percent in each of the three years.
begin deleteCommencing July 1, 1993, the end deletelocal share of matching
22grants shall be at least 50 percent, from a combination of school
23district and cooperating entity funds.
24(f) The local share of the matching grant may be in cash
27 Priority shall be given to those applicants that demonstrate
29(1) The local educational agency will serve the greatest number
30of eligible pupils from low-income families.
31(2) The local educational agency will provide a strong
begin delete parental component.
33(3) The local educational agency will provide supportive services
34with one or more cooperating entities.
35(4) The local educational agency will provide services at a low
36cost per child served in the project.
37(5) The local educational agency will provide programs and
38services that are based on adoption or modification, or both, of
39existing programs that have been shown to be effective.
P9 1(6) The local educational agency will provide services to
2children who are in out-of-home placement or who are at risk of
3being in out-of-home placement.
4(7) The local educational agency will prioritize for receipt of
5services children who have been exposed to childhood trauma,
6including, but not limited to, foster youth, as defined in subdivision
7(b) of Section 42238.01 of the Education Code, and homeless
8children and youth, as defined in Section 11434a(2) of the federal
9McKinney-Vento Homeless Assistance Act (42 U.S.C. Sec. 11301
12 Eligible supportive services may include the following:
13(1) Individual and group intervention and
14 prevention services.
begin delete involvementend delete through
16conferences or training, or both.
17(3) Teacher and staff conferences and training related to meeting
19(4) Referral to outside resources when eligible pupils require
21(5) Use of paraprofessional staff, who are trained and supervised
22by credentialed school psychologists, school counselors, or school
23social workers, to meet with pupils on a short-term weekly basis,
24in a one-on-one setting as in the primary intervention program
25established pursuant to Chapter 4 (commencing with Section 4343)
26of Part 3.
27(6) Any other service or activity that will improve the mental
28health of eligible pupils, particularly evidence-based interventions
29and promising practices intended to mitigate the consequences of
30childhood adversity and cultivate resilience and protective factors.
31Prior to participation by an eligible pupil in either individual or
32group services, consent of a parent or guardian shall be obtained.
34 Each local educational agency seeking a grant under this
35chapter shall submit an application to the director at the time, in
36a manner, and accompanied by any information the director may
39 Each matching grant application submitted shall include all
40of the following:
P10 1(1) Documentation of need for the school-based early mental
2health intervention and prevention services.
3(2) A description of the school-based early mental health
4intervention and prevention services expected to be provided at
6(3) A statement of program goals.
7(4) A list of cooperating entities that will participate in the
8provision of services. A letter from each cooperating entity
9confirming its participation in the provision of services shall be
10included with the list. At least one letter shall be from a cooperating
11entity confirming that it will agree to screen referrals of low-income
12children the program has determined may be in need of mental
13health treatment services and that, if the cooperating entity
14determines that the child is in need of those services and if the
15cooperating entity determines that according to its priority process
16the child is eligible to be served by it, the cooperating entity will
17agree to provide those mental health treatment services.
18(5) A detailed budget and budget narrative.
19(6) A description of the proposed plan for parent
begin delete involvementend delete
20 in the program.
21(7) A description of the population anticipated to be served,
22including number of pupils to be served and socioeconomic
23indicators of sites to receive funds.
24(8) A description of the matching funds from a combination of
25local education agencies and cooperating entities.
26(9) A plan describing how the proposed school-based early
27mental health intervention and prevention services program will
28be continued after the matching grant has expired.
29(10) Assurance that grants would supplement and not supplant
30existing local resources provided for early mental health
31intervention and prevention services.
32(11) A description of an evaluation plan that includes
33quantitative and qualitative measures of school and pupil
34characteristics, and a comparison of children’s adjustment to
37 Matching grants awarded pursuant to this article may be used
38for salaries of staff responsible for implementing the school-based
39early mental health intervention and prevention services program,
40equipment and supplies, training, and insurance.
P11 1(l )end delete
2 Salaries of administrative staff and other administrative costs
3associated with providing services shall be limited to 5 percent of
4the state share of assistance provided under this section.
6 No more than
begin delete 10end delete percent of each matching grant awarded
7pursuant to this article may be used for matching grant evaluation.
9 No more than 10 percent of the moneys allocated to the
10director pursuant to this chapter may be utilized for program
11administration and evaluation.
12Program administration shall include both state staff and field
13staff who are familiar with and have successfully implemented
14school-based early mental health intervention and prevention
15services. Field staff may be contracted with by local school districts
16or community mental health programs. Field staff shall provide
17support in the timely and effective implementation of school-based
18early mental health intervention and prevention services. Reviews
19of each project shall be conducted at least once during the first
20 year of funding.
22 Subject to the approval of the director, at the end of the fiscal
23year, a school district may apply unexpended funds to the budget for the subsequent funding
27 Contracts for the program
and administration, or ancillary
28services in support of the program, shall be exempt from the
29requirements of the Public Contract Code and the State
30Administrative Manual, and from approval by the Department of
Chapter 4 (commencing with Section 4391) is added
20to Part 4 of Division 4 of the Welfare and Institutions Code, to
(a) The director shall establish a four-year program, in
26consultation with the Superintendent of Public
begin delete Instruction, the and the Attorney
27Director of Health Care Services,end delete
begin delete Generalend delete to encourage
29and support local decisions to provide funding for the eligible
30support services as provided in this section.
31(b) The department shall provide outreach to local educational
begin delete and county mental health agenciesend delete to inform individuals
33responsible for local funding decisions of the program established
34pursuant to this section.
35(c) The department shall provide
begin delete free regional trainingend delete on all of the
begin delete following:end delete
38(1) Eligible support services, which may include any or all of
P13 1(A) Individual and group intervention and
3(B) Parent engagement through conference or
4training, or both.
5(C) Teacher and staff conferences and training related to meeting
7(D) Referral to outside resources when eligible pupils require
9(E) Use of paraprofessional staff, who are trained and supervised
10by credentialed school psychologists, school counselors, or school
11social workers, to meet with pupils on a short-term weekly basis,
12in a one-on-one setting as in the primary intervention program
13established pursuant to Chapter 4 (commencing with Section 4343)
14of Part 3.
15(F) Any other service or activity that will improve the mental
16health of eligible pupils, particularly evidence-based interventions
17and promising practices intended to mitigate the consequences of
18childhood adversity and cultivate resilience and protective factors.
19(2) The potential for the eligible support services defined in this
20section to help fulfill state priorities described by the local control
21funding formula and local goals described by local control and
23(3) How educational, mental health, and other funds subject to
24local control can be used to finance the eligible support services
25defined in this section.
26(4) External resources available to support the eligible support
27services defined in this section, which may include workshops,
28training, conferences, and peer learning networks.
29(5) State resources available to support student mental health
30and resilience, and positive, trauma-informed learning
31environments, which may include any of the following:
32(A) Foundational aspects of learning, childhood social-emotional
33development, mental health and resilience, toxic stress, childhood
34trauma, and Adverse Childhood Experiences.
35(B) Inclusive multitiered systems of behavioral and academic
36supports, Schoolwide Positive Behavior Interventions and Supports,
37restorative justice or restorative practices, trauma-informed
38practices, social and emotional learning, bullying prevention,
39mental health consultation, and parent-child group supports.
P14 1(d) The department shall provide technical assistance to local
2educational agencies that provide or seek to provide eligible
3services defined in this section. Technical assistance shall include
4assistance in any of the following:
5(1) Designing programs.
6(2) Training program staff in intervention skills.
7(3) Conducting local evaluations.
8(4) Coordinating with county mental health agencies and
10(5) Leveraging educational, mental health, and other funds that
11are subject to local control and assisting in budget development.
12(e) In providing outreach pursuant to subdivision (b), training
13pursuant to subdivision (c), and technical assistance pursuant to
14subdivision (d), the department shall select and support schoolsites
16(1) (A) During the first 12 months of the program, the
begin deletedepartmentend delete shall support, strengthen, and expand the
19provision of eligible services at schoolsites that previously received
20funding pursuant to the former School-Based Early Mental Health
21Intervention and Prevention Services Matching Grant Program
22and have continued to provide eligible support services.
begin delete In working
23with these selected schoolsites, the department shall develop
24methods and standards for providing services and practices to new
26(B) The department shall develop a process to identify
27schoolsites that demonstrate the willingness and capacity to
28participate in the program.
29(2) During the subsequent 36 months of the program, the
30department shall select new schoolsites that are not providing
31eligible support services but that demonstrate the willingness and
32capacity to participate in the program.
begin delete The department shall work
33with these schoolsites to deliver eligible support services.end delete
34(3) In selecting schoolsites and providing support, the
35department shall prioritize the following:
36(A) Schoolsites in communities
begin delete that have experiencedend delete high levels of
begin delete such as Adverse Childhood Experiences
39childhood trauma.end delete
6(B) Schoolsites that prioritize for receipt of services children
7who have been exposed to childhood trauma, including, but not
8limited to, foster youth, as defined in subdivision (b) of Section
942238.01 of the Education Code, and homeless children and youth,
10as defined in Section 11434a(2) of the federal McKinney-Vento
11Homeless Assistance Act (42 U.S.C. Sec. 11301 et seq.)
12(C) Geographic diversity, program effectiveness, program
13efficiency, and long-term program sustainability.
14(f) The department shall submit, in compliance with Section
159795 of the Government Code, an interim report to the Legislature
16at the end of the second year of the program that details the
17department’s work to support the schoolsites selected pursuant to
18paragraph (1) of subdivision (e) and includes an assessment of the
19demand and impact of funding for the HEAL Trauma in Schools
20Act established pursuant to this part. The department shall make
21the report available to the public and shall post the report on its
22Internet Web site.
23(g) The department shall develop an evaluation plan to assess
24the impact of the program. The department, in compliance with
25Section 9795 of the Government Code, shall submit a report to the
26Legislature at the end of the four-year period evaluating the impact
27of the program and providing recommendations for further
28implementation. The department shall make the report available
29to the public and shall post the report on its Internet Web site.
Implementation of this chapter is contingent upon an
2appropriation in the annual budget act.
This chapter shall remain in effect only until January 1,
42022, and as of that date is repealed, unless a later enacted statute,
5that is enacted before January 1, 2022, deletes or extends that date.