BILL ANALYSIS Ó
AB 1644
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Date of Hearing: April 6, 2016
ASSEMBLY COMMITTEE ON EDUCATION
Patrick O'Donnell, Chair
AB 1644
(Bonta) - As Amended March 8, 2016
[Note: This bill is doubled referred to the Assembly Health
Committee and will be heard by that Committee as it relates to
issues under its jurisdiction.]
SUBJECT: School-based early mental health intervention and
prevention services
SUMMARY: Recasts and renames the Early Mental Health Initiative
(EMHI) as the HEAL Trauma in Schools Act, expands the program to
serve preschool and transitional Kindergarten students, and
establishes an initiative to encourage and support local
decisions to provide funding for services offered in that
program.
Specifically, this bill:
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1)Makes findings and declarations regarding the importance
preventing and addressing Adverse Childhood Experiences (ACEs)
and childhood trauma.
2)Renames the EMHI as the Healing from Early Adversity to Level
the impact of Trauma in Schools Act or the HEAL Trauma in
Schools Act.
3)Expands the definition of eligible pupils to include preschool
and transitional Kindergarten students, and extends the
program to charter schools.
4)Names the Department of Public Health (DPH), and the Director
of the DPH as the administrators of the program.
5)Requires that, in determining which students receive services
under the program, local educational agencies prioritize
children who have been exposed to childhood trauma, including
students in foster care and students who are homeless.
6)Includes, as services which may be funded under the program,
evidence-based interventions and promising practices intended
to mitigate the consequences of childhood adversity and
cultivate resilience and protective factors.
7)Establishes the School-Based Early Mental Health Intervention
and Prevention Services Support Program, administered by the
DPH, in consultation with the Superintendent of Public
Instruction (SPI), the Director of Health Care Services, and
the Attorney General to encourage and support local decisions
to provide funding for the eligible support services.
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8)Requires the DPH to provide outreach to local education
agencies (LEAs) and county mental health agencies to inform
them of the program.
9)Requires the DPH to provide free regional training on eligible
support services, including individual and group intervention
and prevention services, parent engagement, teacher and staff
conferences and training, referral to outside resources, use
of trained and supervised paraprofessional staff, and other
services to improve student mental health, particularly
evidence-based interventions and promising practices intended
to mitigate the consequences of childhood adversity and
cultivate resilience and protective factors.
10) Requires the DPH to also provide free regional training on:
a) the potential for the support services to help fulfill
state priorities described by the local control funding
formula (LCFF) and local control and accountability plans
(LCAPs)
b) how educational, mental health, and other funds subject
to local control can be used to finance the eligible
support services
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c) external resources available to support the eligible
support services, including workshops, training,
conferences, and peer learning networks
d) state resources available to support student mental
health and positive, trauma-informed learning environments
11) Requires DPH to provide technical assistance to LEAs,
including assistance in designing programs, training staff;
and conducting evaluations; coordination with county mental
health agencies and professionals; and leveraging local funds.
12) Requires the DPH to select and support schoolsites as
follows:
a) requires, during the first 12 months of the program, the
DPH to support, strengthen, and expand the provision of
eligible services at schoolsites that previously received
funding for EMHI and have continued to provide eligible
support services
b) requires the DPH to develop a process to identify
schoolsites that demonstrate the willingness and capacity
to participate in the program
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c) requires the DPH, during the subsequent 36 months of the
program, to select new schoolsites that are not providing
eligible support services but that demonstrate the
willingness and capacity to participate in the program.
Requires the DPH to work with these schoolsites to deliver
eligible support services
13) Requires the DPH to prioritize school sites in communities
that have experienced high levels of childhood adversity, such
as adverse childhood experiences and childhood trauma, and
schoolsites that prioritize children who have been exposed to
childhood trauma, such as students in foster care and those
who are homeless. Also requires that DPH prioritize
geographic diversity, program effectiveness, program
efficiency, and long-term program sustainability.
14) Requires the DPH to submit an interim report to the
Legislature at the end of the second year of the program, and
to submit an evaluation at the end of the four year pilot and
submit it to the Legislature.
15) States that implementation of the support program is
contingent upon an appropriation in the annual budget act.
16) Sunsets the support program on January 1, 2022.
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EXISTING LAW:
1)Establishes the School-based Early Mental Health Intervention
and Prevention Services for Children Act of 1991, and
authorizes the Director of the Department of Health Care
Services, in consultation with the SPI, to provide matching
grants to LEAs to pay the state share of the costs of
providing school-based early mental health intervention and
prevention services to eligible students, subject to the
availability of funding each year.
2)Defines "eligible pupil" for this purpose as a student 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,
county office of education, or a state special school.
3)Establishes the Primary Intervention Program (PIP) a
school-based program designed for the early detection and
prevention of emotional, behavioral, and learning problems in
primary grade children with services provided by child aides
or unpaid volunteers under the supervision of mental health
professionals.
FISCAL EFFECT: Unknown
COMMENTS:
Need for the bill. The author states: "For 20 years, the EMHI
Matching Grant Program was a highly successful state program
that provided matching grants to local education agencies to
provide school-based mental health supports to young pupils
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experiencing mild to moderate school adjustment difficulties.
EMHI supported Primary Intervention Programs consisting of
one-on-one services or services delivered in small groups to
address social skills, anger management, friendship groups, or
topic-specific issues such as bullying or divorce; and indirect
services such as parent and teacher services and classroom
curricula.
The EMHI Matching Grant Program served over 15,000 children per
year and its services were in great demand. Despite its success
and the demand for services, the program was defunded in 2012.
Additionally, with the dissolution of the Department of Mental
Health, its oversight and agency was eliminated, effectively
ending the program.
Studies such as the Centers for Disease Control's Adverse
Childhood Experiences (ACE) study indicate that childhood
exposure to abuse, neglect, and other traumatic experiences has
lifelong health impacts. Left unaddressed, ACEs expose children
to toxic stress, keeping them in a constant state of
fight-or-flight and taking years off their lives and damaging
their health. I believe that restoring and expanding the EMHI
Program is a significant step towards addressing the harmful and
long-lasting effects of ACEs, and will give our children a
better shot at success."
EMHI program history and outcomes. In 1981 the Legislature
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created the Primary Prevention Project, now named the Primary
Intervention Program, and in 1991 created the School-based Early
Mental Health Intervention and Prevention Services for Children
Program, known as EMHI.
From 1992 to 2012, the Department of Mental Health awarded
matching grants to LEAs to fund prevention and early
intervention programs, including EMHI. In the 2011-12 fiscal
year, the EMHI received $15 million in state funds, and there
was significant unmet demand for services. At its peak, there
were 15,823 students receiving EMHI-funded services. Funding
for the program was eliminated in 2012. It is now a local
decision whether to continue this program without state matching
grant support.
According to the author, the legislation authorizing this
program set a target of at least 75 percent of the participating
children showing an improvement in at least one of the following
four areas: learning behaviors, attendance, school adjustment,
and school-related competencies. A 2010-11 evaluation showed
that 79 percent had met that target.
When state funding for this program was eliminated, LEAs could
continue the program using local resources, and limited evidence
suggests that some have continued to operate programs using a
range of funding, from federal Title I funds to county mental
health funding, to local general purpose funds.
The Adverse Childhood Experiences study and trauma-informed
practices. The Adverse Childhood Experiences (ACE) study is a
landmark investigation into associations between childhood
maltreatment and later-life health and well-being. The ACE study
is a collaboration between the Centers for Disease Control and
Prevention and Kaiser Permanente's Health Appraisal Clinic in
San Diego.
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The ACE study uses a score to represent the degree to which a
person has experienced traumatic events. One point is recorded
for each type of trauma exposure in the areas of abuse, neglect,
and household dysfunction, and the points add up to a score
ranging from 0 to 10. The higher an ACE score, the greater
one's risk of a broad range of health, mental health, and
at-risk behaviors.
The ACE Study has shown that adverse childhood experiences are
major risk factors for the leading causes of illness and death,
as well as poor quality of life. Related research has also
demonstrated a strong association between high ACE scores and
poor performance in school, including a higher risk of learning
and behavior problems. Other research into the effects of
chronic stress (often caused by ACEs) on children, has
identified a profound effect on the developing brain, which in
turn affects school performance and behavior.
Recognition of the impact of these childhood experiences has led
to the development and increasing use of "trauma-informed"
approaches in a variety of fields, including education. Broadly
speaking, trauma-informed practices in schools are those which
involve 1) a realization of the widespread prevalence and impact
of trauma, 2) recognition of signs of traumatic exposure, 3)
responses grounded in evidence-based practices, and 4) resisting
the re-traumatization of students [definition from the federal
Substance Abuse and Mental Health Agency (SAMHSA)]. Examples of
such practices in schools include professional development for
educators on the role of trauma in learning, classroom
management practices and discipline policies focused on conflict
resolution and restorative practices, and even instructional
modifications which address the specific learning needs of
students exposed to trauma.
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Trauma-informed practices are specifically cited in the new
federal education law, the Every Student Succeeds Act (ESSA).
Several provisions of the law reference staff development "based
on trauma-informed practices that are evidence-based?" and
"effective and trauma-informed practices in classroom
management."
Supporting local decisions to implement a program in the era of
local control. The Local Control Funding Formula (Chapter 47,
Statutes of 2013), eliminated approximately three quarters of
all K-12 categorical programs, and represented a significant
shift away from state control and toward local decision-making.
This bill aims to recast the EMHI program, and to encourage and
support LEAs in administering the program if they determine,
through local decision-making, that the program is a priority
for the use of their resources. The Committee may wish to
consider whether state promotion and support of a program is
contrary to the principle of local control, or whether such
support is necessary to assist LEAs in successfully initiating
and maintaining complex programs, such as ones which require
inter-agency collaboration. Significant lessons were learned in
the design and operation of some categorical programs, and the
Committee may further wish to consider the future role of state
leadership in assisting LEAs in effectively administering
programs which they have determined to be local priorities.
State audit on mental health services provided to students in
special education. AB 114 (Chapter 43, Statutes of 2011), which
took effect in July 2011, transferred the responsibility for
providing mental health services for students with
individualized education programs (IEPs) from county mental
health departments to LEAs. A 2016 state audit on the effect of
AB 114 on mental health services for these students reported,
among other findings:
Although the most common types of mental health services
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offered and the service providers generally did not change,
LEAs removed mental health services from student IEPs in
the two years after AB 114 took effect.
Although most service reductions were not related to AB
114, such as those prompted by a student graduating, IEP
teams did not always record in the IEP document their
rationale of why a service was removed.
.
For 40 percent of the students who had a change to their
mental health services or their educational placement
within two years of AB 114's implementation, the IEP teams
did not document the rationale for the changes.
For 13 of the 44 students reviewed who had a mental
health service removed from their IEPs, either the LEAs
could not satisfactorily explain why the services were
removed or the removal was related to AB 114. In three
cases, the LEA had no assurance that removing services
would not adversely affect access to education.
Student mental health initiatives. The CDE is engaged in a
number of initiatives aimed at improving support for student
mental health needs. Among them are: 1) a Student Mental Health
Policy Workgroup established in 2012 to develop policy
recommendations that promote early identification, referral,
coordination, and access to quality mental health services for
students, 2) the TETRIS-EBL project, a mental health training
project funded by the California Mental Health Services
Authority and administered through a contract with the Placer
County Office of Education, and 3) a federally-funded "Now is
the Time" project to provide support to three LEAs, and CDE
training of school staff in a program called Youth Mental Health
First Aid. In addition, since 2011 an initiative called the
Regional K-12 Student Mental Health Initiative, operated through
the California County Superintendents Educational Services
Association, has provided training designed to build capacity
and cross-system collaboration to develop and sustain
school-based mental health programs addressing prevention and
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early identification strategies.
The new federal education act, ESSA, also appears to offer
support for student mental health through a new grant program
called Student Support and Academic Enrichment Grants, which may
be used, among many other purposes, to "expand access to or
coordinate resources for school-based counseling and mental
health programs, such as through school-based mental health
services partnership programs." This and other provisions of
ESSA are subject to appropriation.
Related legislation this Session. AB 1133 (Achadjian) of this
Session would have established a program substantially similar
to the one proposed by this bill. It would have established 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
LEAs in providing mental health services at school sites.
AB 1025 (Thurmond) of this Session, would require the CDE to
establish a 3-year pilot program to encourage inclusive
practices that integrate mental health, special education, and
school climate interventions following a multitiered framework.
AB 1025 was held in the Senate Appropriations Committee.
SB 463 (Hancock) of this Session requires the CDE 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 104 (Committee on Budget), Chapter 13, Statutes of 2015,
among other things, appropriates $10 million to the SPI to be
apportioned to a designated COE to provide technical assistance
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and develop statewide resources to assist local educational
agencies to establish and align systems of learning and
behavioral supports.
Technical amendments. Staff recommends the following technical
and clarifying amendments:
1.Broaden the reference to students enrolled in preschool
programs to include those not operated on school sites.
2.On page 10, line 3, delete the sentence beginning with "A
minimum of 80 percent?"
3.On page 12, change the Chapter title to "The HEAL Trauma in
Schools Support Program."
4.On page 12, line 15, page 14, line 34, and 15, lines 4 and 7,
strike the word "pilot."
REGISTERED SUPPORT / OPPOSITION:
Support
California Attorney General Kamala D. Harris (sponsor)
Children Now (sponsor)
Time for Kids, Inc. (sponsor)
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Abriendo Puertas/Opening Doors
Alameda Unified School District, Woodstock Child Development
Center
Alliance for Education Solutions
American Academy of Pediatrics
Amethod Public Schools
BANANAS
Bay Area Urban Debate League
Beats Rhymes and Life
Bicycle Coffee
Brighter Beginnings
California Alliance of Child and Family Services
California Black Health Network
California Center for Public Health Advocacy
California Council of Community Mental Health Agencies
California Pan-Ethnic Health Network
California School Nurses Organization
California School-Based Health Alliance
California State PTA
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Californians for Safety and Justice
Center for Leadership, Equity, and Research
Center for Youth Wellness
Center Joint Unified School District
Chico Unified School District
Children's Specialty Care Coalition
Children's Defense Fund-California
Children's Partnership
Common Sense Kids Action
Early Edge California
East Bay Agency for Children
East Bay Asian Youth Center
Family Voices of California
Fight Crime: Invest in Kids California
First Place for Youth
Folsom Cordova Unified School District
Full Court Press Communications
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Futures Without Violence
Girls Leadership Institute
Human Impact Partners
Inland Congregations United for Change
Lemonade Creative Consulting
Liberty School District
Los Angeles County Office of Education
Los Angeles Trust for Children's Health
Lucile Packard Children's Hospital Stanford
Mental Health America of California
Mental Health and Autism Insurance Project
Mental Health Association of California
Montclair Physical Therapy
National Alliance on Mental Illness California
National Association of Social Workers, California Chapter
Nonprofit Communications
Nurse-Family Partnership
Oakland City Council
Oakland Natives Give Back
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Playworks
Public Counsel
Rape Counseling Services of Fresno
Regional Asthma Management and Prevention
Resource Development Associates
Sacramento Area Congregations Together
Santa Clara County Board of Supervisors
Santa Cruz City Schools
Street Level Health Project
The Children's Partnership
The MADE
ThriveSF Fitness
Time for Kids, Inc.
United Ways of California
Violence Prevention Coalition of Greater Los Angeles
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Waugh School District
Wellness Together
Western Center on Law and Poverty
Young People's Policy Solutions
Youth UpRising
Numerous individuals
Opposition
California Right to Life Committee, Inc.
Analysis Prepared by:Tanya Lieberman / ED. / (916) 319-2087
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