BILL ANALYSIS �
SENATE COMMITTEE ON EDUCATION
Carol Liu, Chair
2013-2014 Regular Session
BILL NO: SB 596
AUTHOR: Yee
AMENDED: January 6, 2014
FISCAL COMM: Yes HEARING DATE: January 15, 2014
URGENCY: No CONSULTANT: Lynn Lorber
NOTE : This bill has been referred to the Committees on Education
and Health. A "do pass" motion should include referral to
the Senate Health Committee.
SUBJECT : Student interventions.
SUMMARY
This bill requires the California Department of Education to
establish a pilot program to encourage model practices of
interventions that meet the behavioral, emotional and academic needs
of students.
BACKGROUND
Tiered interventions
Many schools voluntarily follow models of tiered interventions to
address student needs prior to imposing discipline or making
referrals to special education. One model is Response to
Intervention. Typically, the base tier is a schoolwide approach
involving instruction, school climate, etc. The middle tier is
targeted to students who did not respond to the schoolwide efforts
and involved more intense interventions such as tutoring. The top
tier focuses on a smaller group of students who continue to need
support and may include very intense and frequent services such as
counseling.
The Student Success Team, formerly Student Study Team, is a positive
schoolwide early identification and intervention process. Working
as a team, the student, parent, teacher and school administrator
identify the student's strengths and assets upon which an
improvement plan can be designed. As a regular school process, the
team intervenes with school and community support and an improvement
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plan that all team members agree to follow. Follow-up meetings are
planned to provide a continuous casework management strategy to
ensure the needs of students are met.
Community schools are both a place and a set of partnerships between
the school and other community resources. This model integrates
academics, health and social services, youth and community
development and community engagement. Using public schools as hubs,
community schools bring together many partners to offer a range of
support and opportunities to children, youth, families and
communities.
Current status of mental health services for students with
exceptional needs
AB 114 (Committee on Budget, Chapter 43, 2011) among other things,
shifted the "responsible agency" for mental health services for
students with individualized education programs (IEPs) from county
mental health agencies to school districts. One result of this
shift is that mental health services that had been provided outside
of a student's IEP must now be specifically included in a student's
IEP in order for schools to provide and fund those services.
Preliminary information relative to the transition thus far
indicates:
1) Many school districts use a combination of district employees
and contracts with county mental health or non-public agencies.
2) Staffing decisions often depend upon the relationship between a
district and county mental health agency and what
personnel/services are available locally.
3) Larger school districts tend to directly employ staff to
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provide mental health services, while smaller districts tend to
contract with outside agencies.
Relative to services to students with exceptional needs, current law
requires:
1) A child to be assessed in all areas related to the suspected
disability before any action is taken with respect to related
services or designated instruction and services to a child.
(Government Code � 7572)
2) An individual assessment of the student's needs to be conducted
before any action is taken with respect to the initial
placement of the student, and requires tests and other
assessment materials to meet specified requirements. (EC �
56320)
3) Any psychological assessment to be made in accordance with #2
and be conducted by a credentialed school psychologist who is
trained and prepared to assess cultural and ethnic factors
appropriate to the student being assessed. Current law also
requires that any health assessment be made in accordance with
#2 and be conducted by a credentialed school nurse or
physician. (EC � 56324)
Seeking medical services
Current law requires school districts to annually notify students in
grades 7-12, and parents of all students enrolled in the school
district, that schools may excuse students for the purpose of
obtaining confidential medical services without the consent of the
student's parent. (Education Code � 46010.1)
Current law requires the mental health treatment or counseling of a
minor to include involvement of the minor's parent or guardian
unless, in the opinion of the professional person who is treating or
counseling the minor, the involvement would be inappropriate.
Current law authorizes a minor who is 12 years of age or older to
consent to mental health treatment or counseling on an outpatient
basis, or to residential shelter services, if both of the following
requirements are satisfied:
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1) The minor, in the opinion of the attending professional person,
is mature enough to participate intelligently in the outpatient
services or residential shelter services.
2) The minor (a) would present a danger of serious physical or
mental harm to self or to others without the mental health
treatment or counseling or residential shelter services, or (b)
is the alleged victim of incest or child abuse. (Family Code �
6924)
Current law prohibits a student from being tested for a behavioral,
mental, or emotional evaluation without the informed written consent
of the parent, but does not affect a student's right to seek
confidential medical services without parental consent. (EC �
49091.12)
Authority to assess and provide services
Current law requires a psychologist employed by a school district to
hold a school psychologist credential, a general pupil personnel
services credential authorizing service as a school psychologist, a
standard designated services credential with a specialization in
pupil personnel services authorizing service as a psychologist, or a
services credential issued by the State Board of Education or
Commission on Teacher Credentialing. Current law prohibits an
employee of a school district from administering psychological tests
or engage in psychological activities unless specified criteria is
met. Current law further specifies the duties that may be included
in the services provided by a school psychologist.
(EC � 49422 & 49424)
Current law authorizes credentialed school nurses to perform
specified duties, including assess and evaluate health and
development, refer students and parents to appropriate community
resources, and counsel students and parents. (EC � 49426)
Pupil Personnel Services credentials authorize individuals to
provide school services in grades 12 and below, including preschool,
as counselors, school psychologists, school social workers, or
school child welfare and attendance regulators, according to the
specific specialization area and service authorization listed on the
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credential.
State-level student mental health programs
The Student Mental Health Initiative is a California Mental Health
Services Authority prevention and early intervention program that
identifies strategies to address student mental health needs across
the K-12 and higher education systems. The California Department of
Education has convened a Student Mental Health Policy Workgroup for
the purpose of assessing the current mental health needs of students
and gather evidence to support its policy recommendations to the
Superintendent of Public Instruction and Legislature:
http://www.cde.ca.gov/ls/cg/mh/smhpworkgroup.asp The California
County Superintendents Educational Services Association has created
a clearinghouse of resources and regional best practices that
promote the mental health and wellness of students in grades K-8,
with linkages to preschool and grades 9-12:
http://www.regionalk12smhi.org/
The Early Mental Health Initiative had the purpose of enhancing the
social and emotional development of K-3 students to minimize the
need for costly services in the future. This grant program was
eliminated in the 2011-12 fiscal year through budgetary action.
The Public School Health Center Support Program is a grant program
to provide technical assistance, and funding for the expansion,
renovation, and retrofitting of existing school health centers, and
the development of new school health centers. It appears this
program has never been funded and therefore not implemented.
(Health & Safety Code � 124174)
ANALYSIS
This bill requires the California Department of Education (CDE) to
establish a voluntary three-year pilot program in four schools to
encourage model practices of interventions that meet the behavioral,
emotional, and academic needs of students. Specifically, this bill:
1) Requires the CDE to establish a three-year pilot program to
encourage inclusive practices that leverage cross-system
resources and offer comprehensive, multi-tiered interventions.
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2) Requires the pilot program to be established in four schools
that volunteer to participate, including two in northern
California and two and southern California, that propose a
model approach that provides preventive, targeted and intensive
interventions that target the behavioral, emotional and
academic needs of students.
3) Requires an applicants school model to include, reflecting the
specific culture and needs of the school:
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) Utilization of a designated percentage of
the school district's existing special education
expenditures to provide services within the school
setting.
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 school-wide
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
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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 therapeutic group interventions, functional
behavioral analysis and plan development, and targeted
reading skills group.
g) Intensive services, such as wraparound,
behavioral intervention, or one-on-one support, that can
serve as school-based alternatives to a youth's placement
in a non-public school setting.
4) Requires the CDE to provide start-up and evaluation funding to
each participating school, as follows:
a) $250,000 in Year One.
b) $200,000 in Year Two.
c) $150,000 in Year Three.
5) Requires participating schools to annually report to CDE the
following:
a) Number of youth referred to the
coordination of services team.
b) Number of youth referred for assessment for
diagnosis of disability.
c) Number of training hours and topics
provided for teachers.
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d) Number and type of parent engagement
activities.
e) Number of youth served with targeted
intervention.
f) Number of youth served with intensive
interventions.
g) Annual teacher and school staff surveys
assessing the impact and satisfaction of services.
h) Annual parent surveys assessing the impact
and satisfaction with services.
i) Annual student surveys, completed by those
participating in intensive and targeted services,
assessing the impact and satisfaction with services.
j) Annual school climate assessments,
including multiple stakeholder feedback.
aa) Number of youth referred to alternative
school placements, such as special day classes or
non-public schools.
bb) Number of school discipline referrals for
the student body as well as for those with disabilities.
cc) Attendance.
dd) Pre- and post-intervention assessments for
students served in targeted and intensive services using
standardized tools appropriate to targeted needs such as
the Child and Adolescent Needs and Strengths Assessment
for social emotional-targeted interventions and the
Developmental Reading Assessment for reading-targeted
interventions.
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ee) Progress made through annual common core
standardized testing.
ff) Progress made among the student body and
specified populations in the Academic Performance Index,
including students with disabilities, foster youth,
low-income students, and students of ethnicities that
experience disproportionate challenges to academic
achievement.
6) Requires the CDE to submit a report to the Legislature at the
end of the three-year period evaluating the success of the
program and further recommendations. The CDE is to make the
report available to the public and post it on the CDE's
website.
7) States legislative intent that the models used by participating
schools and evaluated by CDE can be adopted by additional
schools upon demonstrated success of the pilot program.
8) States legislative findings and declarations that all students
deserve adequate behavioral and academic support, students face
many challenges such as poverty, current funding practices do
not incentivize preventative measures, and collaboration is
needed between schools and county mental health agencies.
STAFF COMMENTS
1) Need for the bill . According to the author, "Unaddressed
student needs frequently result in more profound behavioral and
academic challenges that can necessitate costly, restrictive
interventions. Adding to the difficulty in addressing these
challenges is the fragmentation of the education and mental
health systems designed to serve struggling youth. The school
setting presents an important opportunity to identify and
respond to the comprehensive needs of youth, reducing barriers
to access. 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) Author's amendments . The author has agreed to the following
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amendments to be adopted today in the Senate Health Committee.
a) Delete the requirement that school models include the
designation of a percentage of the school district's
existing special education expenditures.
b) Delete the specific data schools must report to the
California Department of Education (CDE) and instead
require CDE and the Department of Health Care Services to
develop an evaluation plan to assess the impact of pilot
projects and disseminate best practices. The amendments
specify that outcomes and indicators are to include those
already being collected by schools.
c) Clarify that schools that choose to participate must
submit to CDE a proposed model as an application for
funding.
d) Specify that funding is contingent upon the enactment
of an appropriation in the annual Budget Act or another
statute.
e) Broaden language to reference alternatives to
referrals to special education and restrictive settings
rather than referring only to non-public school
placements.
f) Other technical changes.
3) Do schools currently provide mental health services ? Most of
the mental health services provided by schools are within the
context of meeting the requirements specified in a student's
individualized educational program (IEP). Federal and state
law requires the instruction and related services detailed in
an IEP to be provided, irrespective of the internal capacity of
the school to provide the instruction and services. As
indicated in the Background section of this analysis, schools
employ qualified staff directly as well as contract with county
mental health agencies or private providers.
Schools currently have the discretion to provide counseling and
mental health services, or refer to county and community
organizations, to students who do not have an IEP. These
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services may be provided by a school counselor, psychologist or
social worker, or other qualified personnel employed by an
outside entity. Some models used by schools are mentioned in
the Background section of this analysis.
4) How do schools pay for mental health services ? Most of the
mental health services provided by schools are within the
context of meeting the requirements specified in a student's
individualized education program (IEP), and therefore use
special education funding for those services. 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.
Schools may be reimbursed for some costs through Medi-Cal (or even
private insurance) for providing some mental health services to
eligible students:
a) The Medi-Cal Local Billing Option allows schools to
access federal funding for health care services (mostly
used for services provided to students with IEPs).
b) County mental health agencies are responsible for
administering the Early and Periodic Screening, Diagnosis
and Treatment (EPSDT) benefit for children and youth from
birth to age 21 who meet income eligibility and the
medical necessity criteria. Schools are not currently
authorized to seek reimbursement for EPSDT benefits;
schools may be reimbursed with EPSDT funds but only upon
agreement with the county mental health agency.
c) Covering the cost of IEP-based services via private
insurance is only an option if the parent consents, and
the school must provide prior notice to the parent about
potential implications of accessing private insurance,
such as how it might affect lifetime caps.
5) Will kids be assessed or provided services without parental
consent ? Current law prohibits a student from being tested for
a behavioral, mental, or emotional evaluation without the
informed written consent of the parent, but does not affect a
student's right to seek confidential medical services without
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parental consent.
Generally speaking, parental consent is required for a minor's
medical treatment. (American Academy of Pediatrics v. Lungren
(1997)) There are, however, exceptions such as when the public
interest in preserving the health of a minor takes precedence
over the parent's interest in custody and control of the minor.
(Wisconsin v. Yoder (1972)) In addition, a number of "medical
emancipation" statutes allow minors to consent to medical
treatment without parental knowledge, approval or consent, as
detailed in the Background section of this analysis.
Assessment for eligibility for special education and related
services requires parental consent.
6) Fiscal impact . This bill requires the CDE to provide start-up
and evaluation funding to each participating school (up to four
schools), over a three-year period, for a maximum total of $2.4
million. Those funds are for start-up and evaluation only;
participating school districts would be responsible for costs
of the actual services provided to students.
7) Related legislation . AB 1178 (Bocanegra) establishes the
California Promise Neighborhood Initiative to provide funding
to schools that have formalized partnerships with local
agencies and community organizations to provide a network of
services to improve the health, safety, education, and economic
development of a defined area. AB 1178 awaiting hearing by the
Assembly Appropriations Committee.
AB 1367 (Mansoor) among other things, expands existing outreach
about recognition of early signs of potentially severe and
disabling mental illness to include school districts and county
offices of education and charter schools, including funding to
provide training to identify students with mental health issues
that may result in a threat to themselves or others in order to
provide for timely intervention. AB 1367 was referred to the
Assembly Health Committee but was never heard.
SB 561 (Fuller) requires a student who has been expelled to undergo
a mental health evaluation conducted by a licensed clinical
psychologist prior to enrolling in a county community school,
community day school or juvenile court school. SB 561 was
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referred to the Education and Health Committees but was never
heard.
AB 174 (Bonta) would have required the Department of Public Health
to establish a pilot program in Alameda County, to the extent
that funding is made available, to provide grants to eligible
applicants for activities and services that directly address
the mental health and related needs of students impacted by
trauma. AB 174 was vetoed by the Governor, whose veto message
read:
I support the efforts of the bill but am returning it without my
signature, as Alameda County can establish such a program
without state intervention and may even be able to use Mental
Health Services Act funding to do so.
Waiting for the state to act may cause unnecessary delays in
delivering valuable mental health services to students. All
counties - not just Alameda- should explore all potential
funding options, including Mental Health Services Act funds, to
tailor programs that best meet local needs.
SUPPORT
California Association of School Psychologists
Seneca Family of Agencies
OPPOSITION
None on file.