BILL ANALYSIS Ó
SENATE COMMITTEE ON EDUCATION
Senator Carol Liu, Chair
2015 - 2016 Regular
Bill No: AB 1644
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|Author: |Bonta |
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|Version: |May 27, 2016 Hearing |
| |Date: June 29, 2016 |
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|Urgency: |No |Fiscal: | Yes |
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|Consultant:|Lynn Lorber |
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Subject: School-based early mental health intervention and
prevention services
SUMMARY
This bill requires the Department of Public Health (DPH) to
establish a four-year program to support local decisions to
provide funding for early mental health support services,
requires DPH to provide technical assistance to local
educational agencies, and requires DPH to select and support
schoolsites to participate in the program.
BACKGROUND
Existing law:
1) Establishes the School-based Early Mental Health
Intervention and Prevention Services for Children Act
(EMHI) and authorizes the Director of the Department of
Mental Health, in consultation with the Superintendent of
Public Instruction, to award 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 students, subject to the
availability of funding each year. (Welfare & Institutions
Code § 4370, et seq.)
2) Defines "eligible pupil" as a student who attends a
publicly funded elementary school and who is in
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kindergarten or grades 1 to 3. (WIC § 4372)
3) Establishes the Primary Intervention Program, using EMHI
funds, to provide school-based early detection and
prevention of emotional, behavioral, and learning problems
in students in kindergarten and grades 1-3, with services
provided by child aides under the supervision of a
school-based mental health professional. (WIC § 4343, et
seq.)
ANALYSIS
This bill requires the DPH to establish a four-year program to
support local decisions to provide funding for early mental
health support services, requires DPH to provide technical
assistance to local educational agencies, and requires DPH to
select and support schoolsites to participate in the program.
Specifically, this bill:
1) Requires the director of the DPH, also known as the Public
Health Officer, to establish a four-year program, in
consultation with the Superintendent of Public
Instruction, the Director of Health Care Services, and the
Attorney General, to encourage and support local decisions
to provide funding for eligible support services.
2) Requires the Department of Public Health (DPH) to provide
outreach to local educational agencies and county mental
health agencies to inform individuals responsible for local
funding decisions of the program established by this bill.
Selection of schoolsites
3) Requires DPH, in providing outreach, training, and
technical assistance, to select and support schoolsites as
follows:
a) Requires DPH, during the first 12
months of the program, to support, strengthen, and
expand the provision of eligible services at
schoolsites that previously received Early Mental
Health Intervention and Prevention Services for
Children Act funding and have continued to provide
eligible support services. This bill requires DPH, in
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working with these selected schoolsites, to develop
methods and standards for providing services and
practices to new schoolsites.
b) Requires DPH to develop a process to
identify schoolsites that demonstrate the willingness
and capacity to participate in the program.
c) Requires 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. This bill requires DPH to
work with these schoolsites to deliver eligible
support services.
4) Requires DPH, in selecting schoolsites and providing
support, to 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 services
for students who have been exposed to childhood
trauma, including but not limited to, foster youth and
homeless children and youth.
c) Geographic diversity, program
effectiveness, program efficiency, and long-term
program sustainability.
Training
5) Requires DPH to provide free regional training on all of
the following:
a) Eligible support services, as
specified.
b) The potential for the eligible support
services to help fulfill state priorities described by
the local control funding formula and local goals
described by local control and accountability plans.
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c) How educational, mental health, and
other funds subject to local control can be used to
finance the eligible support services.
d) External resources available to support
the eligible support services, which may include
workshops, training, conferences, and peer learning
networks.
e) State resources available to support
student mental health and resilience, and positive,
trauma-informed learning environments.
Eligible support services
6) Authorizes eligible support services to 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 students 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 students on a short-term weekly
basis, in a one-on-one setting as in the primary
intervention program.
f) Any other service or activity that will
improve the mental health of eligible students,
particularly evidence-based interventions and
promising practices intended to mitigate the
consequences of childhood adversity and cultivate
resilience and protective factors.
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Student mental health and resilience, and trauma-informed
learning environments
7) Authorizes student mental health and resilience, and
trauma-informed learning environments to 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 multi-tiered systems of
behavioral and academic supports, Schoolwide Positive
Behavior Interventions and Supports, restorative
justice or restorative practices, trauma-informed
practices, social and emotional learning, bullying
prevention, mental health consultation, and
parent-child group supports.
Technical assistance
8) Requires the Department of Public Health (DPH) to provide
technical assistance to local educational agencies that
provide or seek to provide eligible services, and requires
technical assistance to include assistance in any of the
following:
a) Designing programs.
b) Training program staff in intervention
skills.
c) Conducting local evaluations.
d) Coordinating with county mental health
agencies and professionals.
e) Leveraging educational, mental health,
and other funds that are subject to local control and
assisting in budget development.
Report and evaluation
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9) Requires DPH to submit an interim report to the Legislature
at the end of the second year of the program that details
the DPH's work to support the schoolsites and includes an
assessment of the demand and impact of funding for the
program established by this bill. This bill requires DPH
to make the report available to the public and post the
report on its Web site.
10) Requires DPH to develop an evaluation plan to assess the
impact of the program.
11) Requires DPH to submit a report to the Legislature at the
end of the four-year period evaluating the impact of the
program and providing recommendations for further
implementation, and make the report available to the public
and post the report on its Web site.
Miscellaneous
12) Provides that implementation of this bill is contingent
upon an appropriations in the annual budget act.
13) Renames the School-based Early Mental Health Intervention
and Prevention Services for Children Act (EMHI) as the
Healing from Early Adversity to Level the Impact of Trauma
in Schools Act, or the Heal Trauma in Schools Act.
14) Expands priority for funding for EMHI applicants by adding
local educational agencies that will prioritize services
for children who have been exposed to childhood trauma,
including but not limited to, foster youth and homeless
children and youth.
15) Expands "other service or activity" relative to eligible
supportive services by adding evidence-based interventions
and promising practices intended to mitigate the
consequences of childhood adversity and cultivate
resilience and protective factors.
16) Deletes the prohibition on more than 20% of the grants to
be used for new models of services and the requirement that
at least 80% of the grants awarded to include the basic
components of the primary intervention program.
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17) Expands the definition of "eligible pupil" to include a
student who attends a preschool program at a contracting
agency of the California state preschool program or local
educational agency, and to include students who are in
transitional kindergarten.
18) Modifies the definition of "supportive services" to change
social development to social-emotional development.
19) Expands the definition of "local educational agency" to
include charter schools.
20) Defines "Department" as the State Department of Public
Health.
21) Modifies the definition of "director," from the State
Director of Mental Health to the State Public Health
Officer.
22) States legislative findings and declarations relative to
the need to provide funding to address the mental health
needs of children who have been exposed to childhood
adversity and to prioritize communities that experience
childhood adversity more severely and profoundly.
23) Sunsets the provisions of this bill on January 1, 2022.
STAFF COMMENTS
1) Need for the bill. According to the author, "For 20 years,
the EMHI Matching Grant Program was a highly successful
state program that provided matching grants to local
educational agencies to provide school-based mental health
supports to young pupils 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. Despite its success and the demand
for services, the program was defunded in 2012.
Additionally, with the dissolution of the Department of
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Mental Health, its oversight and agency was eliminated,
effectively ending the program. I believe that restoring
and expanding the EMHI Program is a significant step
towards addressing the harmful and long-lasting effects of
Adverse Childhood Experiences, and will give our children a
better shot at success."
2) Early Mental Health Initiative (EMHI). From 1992 to 2012,
the then-Department of Mental Health awarded matching
grants to local educational agencies to fund prevention and
early intervention programs, including EMHI. In the
2011-12 fiscal year, the EMHI received $15 million in state
funds. At its peak, there were 15,823 students receiving
EMHI-funded services. The Department of Mental Health has
since been dissolved and funding for EMHI was eliminated
beginning in the 2012-13 fiscal year; the state
infrastructure for EMHI was not re-established in another
state agency. It is now a local decision whether to
continue this program without state matching grant support.
The Assembly version of the 2016 Budget included $6
million to fund the former EMHI grant program, but no
funding was included in the final conference committee
report. Therefore, the EMHI program remains unfunded.
This bill creates a framework to support and assist local
educational agencies in implementing early mental health
initiatives at a local level, without the support of a
state infrastructure or funding.
3) Existing statewide student mental health initiatives. The
state is currently engaged in a number of initiatives aimed
at improving support for student mental health needs (none
are specifically targeted to the youngest students). Among
them are:
Student Mental Health Policy Workgroup. In 2012, the
Superintendent of Public Instruction and the California
Mental Health Services Act (CalMHSA) convened a Student
Mental Health Policy Workgroup (workgroup) to develop
policy recommendations that promote early identification,
referral, coordination, and access to quality mental health
services for students. The workgroup is comprised of
teachers, school counselors, school social workers, school
psychologists, school nurses, and school administrators, as
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well as state and county mental health professionals.
The workgroup has noted the connection between mental wellness
and academic achievement, attendance, and behavior. It has
also noted that California's educators acknowledge their
lack of preparedness in addressing pupil mental health
challenges as a major barrier to instruction. The
workgroup found that "most educators and staff lack
training to identify pupils who may be in need of support,
make referrals, and, as appropriate, to help pupils
overcome or manage mental health barriers and succeed in
school." They also noted that mental health challenges
disproportionately impact students who face stressors such
as violence, trauma, and poverty.
Regional K-12 Student Mental Health training. Since 2011,
CalMHSA has funded a Student Mental Health Initiative
through the California County Superintendents Educational
Services Association. This project is designed to build
capacity and cross-system collaboration to develop and
sustain school-based mental health 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 mental health
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. Since 2014, this project has declined
significantly in size as a result of decreased funding.
California Department of Education's training project.
California Mental Health Services Act (CalMHSA) has also
funded mental health training through the California
Department of Education (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 mental health issues
early on. To accomplish this goal, the CDE subcontracted
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with the Placer County Office of Education to deliver 11
TETRIS EBL workshops annually through 2019. The curriculum
used for the TETRIS EBL workshops was developed by the
United States Department of Health and Human Services'
Substance Abuse and Mental Health Services Administration
(SAMHSA). Kognito Interactive Online Simulation Program is
also used as an outside source to help support school staff
in initiating conversations with students around the
subject of mental health and suicidal ideation.
SAMHSA "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 mental health services.
California received $9.7 million from the "Now is the Time
Project Advancing Wellness and Resilience in Education"
(NITT AWARE) grant in 2014. According to the CDE, the
grant has two components. Three local educational agencies
(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 mental health services. If
successful, the models developed by these LEAs can be
shared statewide. The second component utilizes a training
program called Youth Mental Health First Aid. The training
teaches school staff how to help youth experiencing mental
health or addictions challenges, or are in crisis.
4) Heard by the Senate Health Committee. This bill was heard
by the Senate Health Committee on June 15, where it passed
on a 9-0 vote.
5) Fiscal impact. This bill provides that its implementation
is contingent upon an appropriation in the annual budget
act. Funding for the purposes of this bill was not
provided in the 2016 Budget Act.
According to the Assembly Appropriations Committee, this bill
imposes the following costs:
a) General Fund administrative costs to the
Department of Public Health (DPH) of approximately
$300,000 to oversee the program, provide outreach,
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free regional training, and technical assistance to
school sites
over four years. Department of Public Health (DPH)
would also incur costs related to interim reporting
requirements and final evaluation of the program.
b) Proposition 98 General Fund (GF) cost pressure,
in the millions of dollars, to fund grants pursuant to
the Healing from Early Adversity to Level the Impact
Trauma in Schools Act. Grants are contingent upon an
appropriation in the annual budget act.
6) Related legislation. SB 1113 (Beall) authorizes local
educational agencies to enter into partnerships, as
specified, with county mental health plans for the
provisions of Early and Periodic Screening, Diagnosis, and
Treatment mental health services, and to expand the
allowable uses of specified mental health funds. SB 1113
is pending in the Senate Appropriations Committee.
AB 2017 (McCarty) requires the Department of Health Care
Services to create a grant program for public postsecondary
education institutions to access mental health services,
and appropriates $40 million for this purpose. AB 2017 is
scheduled to be heard by this Committee on June 29.
7) Prior legislation. AB 1133 (Achadjian, 2015) established a
four-year pilot program, the School-Based Early Mental
Health Intervention and Prevention Services Support Program
(EMHI Support Program), to provide outreach, free regional
training, and technical assistance for local educational
agencies in providing mental health services at school
sites. AB 1133 was held in the Assembly Appropriations
Committee.
AB 1025 (Thurmond, 2015) required California Department of
Education (CDE) 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.
AB 1025 was held in the Senate Appropriations Committee.
AB 1018 (Cooper, 2015) required the Department of Health Care
Services and CDE to convene a joint taskforce to examine
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the delivery of mental health services to children. AB
1018 was held in the Senate Appropriations Committee.
AB 580 (O'Donnell, 2015) required the CDE to develop model
referral protocols for voluntary use by schools to address
the appropriate and timely referral by school staff of
students with mental health concerns. AB 580 was vetoed by
the Governor, whose veto message read:
California does not currently have specific model
referral protocols for addressing student mental
health as outlined by this bill. However, the
California Department of Education recently received a
grant from the federal Department of Health and Human
Services, Substance Abuse and Mental Health Services
Administration to identify and address critical
student and family mental health needs.
It's premature to impose an additional and overly
prescriptive requirement until the current efforts are
completed and we can strategically target resources to
best address student mental health.
SUPPORT
Alameda County Board of Supervisors
Attorney General Kamala Harris
California Academy of Child and Adolescent Psychiatry
California Association for Licensed Professional Clinical
Counselors
California Black Health Network
California Children's Hospital Association
California Council of Community Behavioral Health Agencies
California Federation of Teachers
California Medical Association
California Pan-Ethnic Health Network
California School-Based Health Alliance
California School Nurses Organization
California State PTA
Center for Youth Wellness
Children Now
Children's Defense Fund - California
Children's Specialty Care Coalition
Common Sense Kids Action
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Disability Rights California
East Bay Agency for Children
Family Paths
Fight Crime: Invest in Kids
First 5 California
First 5 LA
Foster Care Alumni of America, California Chapter
Lemonade
Los Angeles County Office of Education
Los Angeles Trust for Children's Health
Mental Health America of California
National Association of Social Workers, California Chapter
Public Health Advocates
Santa Clara County Board of Supervisors
Santa Clara County Office of Education
The Children's Partnership
United Ways of California
Western Center on Law & Poverty
OPPOSITION
None received.
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