Bill Text: CA AB1644 | 2015-2016 | Regular Session | Amended

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: School-based early mental health intervention and prevention services.

Spectrum: Moderate Partisan Bill (Democrat 4-1)

Status: (Failed) 2016-11-30 - From Senate committee without further action. [AB1644 Detail]

Download: California-2015-AB1644-Amended.html

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BILL NUMBER: AB 1644	AMENDED
	BILL TEXT

	AMENDED IN ASSEMBLY  APRIL 14, 2016
	AMENDED IN ASSEMBLY  MARCH 8, 2016

INTRODUCED BY   Assembly Member Bonta
   (Principal coauthor: Assembly Member Achadjian)
   (Coauthor: Assembly Member McCarty)
   (Coauthor: Senator Beall)

                        JANUARY 11, 2016

   An act to amend Sections 4370, 4371, 4372, and 4380 of, and to add
and repeal Chapter 4 (commencing with Section 4391) of Part 4 of
Division 4 of, the Welfare and Institutions Code, relating to mental
health.



	LEGISLATIVE COUNSEL'S DIGEST


   AB 1644, as 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  publicly funded elementary school  
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 State Public Health Officer, in consultation with
the Superintendent of Public Schools, the Director of Health Care
Services, and the Attorney General to establish a 4-year 
pilot  program, the  School-Based Early Mental
Health Intervention and Prevention Services   HEAL
Trauma in Schools  Support Program, to provide outreach, free
regional training, and technical assistance for local educational
agencies in providing mental health services at schoolsites. The bill
would require the State Department of Public Health to submit
specified reports after 2 and 4 years. The bill would make the
implementation of the  pilot  program contingent
upon an appropriation in the annual budget act. The bill would repeal
these provisions as of January 1, 2022.
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  The Legislature finds and declares all of the
following:
   (a) California's communities and systems are currently facing
challenges to prevent and address the far-reaching impacts of
childhood adversity, such as Adverse Childhood Experiences (ACEs) and
childhood trauma, which can result in negative educational, health,
social, and economic outcomes for children, youth, families, and
communities across the state.
   (b) In California, 61.7 percent of adults have experienced at
least one ACE and 16.7 percent have experienced four or more ACEs.
Compared to an individual who has not experienced an ACE, an
individual with four or more ACEs is more likely to experience
chronic disease and engage in negative health behaviors. For example,
based on results of the California Behavioral Risk Factor
Surveillance Survey, a person in California with four or more ACEs is
1.6 times as likely to have diabetes, 1.9 times as likely to have
cancer, 2.4 times as likely to suffer from chronic obstructive
pulmonary disease, 2.9 times as likely to smoke, 4.2 times as likely
to be diagnosed with Alzheimer's disease or dementia, 5.1 times as
likely to suffer from depression, 7.4 times as likely to be an
alcoholic, and 12.2 times as likely to attempt suicide. Individuals
are similarly impacted by ACEs, regardless of race and ethnicity.
   (c) From the 1992-93 fiscal year to the 2011-12 fiscal year,
inclusive, the State Department of Mental Health awarded funds each
year in matching grants to local educational agencies to fund
prevention and early intervention programs, including the Primary
Intervention Program, for students experiencing mild to moderate
school adjustment difficulty through the School-based Early Mental
Health Intervention and Prevention Services for Children Program of
1991, known as the Early Mental Health Initiative (EMHI). In the
2011-12 fiscal year, the EMHI received $15 million in state funds.
   (d) School adjustment difficulties that can impede learning, such
as anxiety, withdrawal, and aggressive behaviors, are common symptoms
of chronic or traumatic stress resulting from exposure to ACEs and
childhood trauma.
   (e) Authorizing legislation specified that the EMHI would be
deemed successful if at least 75 percent of the children who complete
the program show an improvement in at least one of the following
four areas: learning behaviors, attendance, school adjustment, and
school-related competencies.
   (f) The EMHI succeeded in meeting these legislative requirements.
According to the 2010-11 Early Mental Health Initiative Statewide
Evaluation Report, of the 15,823 students located in 424 elementary
schools across 66 school districts participating in EMHI-funded
services during the 2010-11 school year, 79 percent exhibited
positive social competence and school adjustment behaviors more
frequently after completing services. Furthermore, the magnitude of
the improvements was exceptional in comparison to evaluations of
other programs, especially given the short-term and cost-effective
nature of the intervention, and improvements were evident across all
demographic subgroups.
   (g) The 2010-11 Early Mental Health Initiative Statewide
Evaluation Report described an unmet demand for EMHI-funded services
at participating schoolsites, as only 37 percent of the students that
scored in the appropriate school adjustment difficulty range were
served with EMHI-funded services due to program capacity and funding
constraints. Based on demographic considerations, similar demand
would be expected at schools that did not receive EMHI grants.
   (h) The Governor's realignment for the 2011-12 fiscal year renamed
the State Department of Mental Health as the State Department of
State Hospitals and limited that department's mission. The Budget Act
of 2012 disbursed Proposition 98 funds, which had been used to fund
the EMHI, directly to local educational agencies in order to provide
local schools with enhanced flexibility to manage their finances and
give greater control of local decisions.
   (i) Multitiered systems and supports, which integrate mental
health, special education, and school climate interventions, have
been developed as a model framework within which to implement these
services. Pilot programs in the Counties of San Bernardino and
Alameda are demonstrating that implementing these services as part of
a multitiered system is cost effective because the cost of the
services is more than fully offset by the reduction in the need for
high-cost, nonpublic school placements.
   (j) The evidence-based, cost-effective services provided by the
EMHI support the "Triple Aim" of better health, better care, and
lower costs. By helping children early on, evidence-based,
cost-effective services also support the recommendations of the Let's
Get Healthy California Task Force, which used the "Triple Aim" as
its foundation and articulated Healthy Beginnings: Laying the
Foundation for a Healthy Life, as a goal that includes reducing
childhood trauma, improving early learning, and improving mental
health and well-being as priorities.
   (k) Providing early mental health service for children exposed to
childhood adversity, such as ACEs and childhood trauma, additionally
furthers the goal of the California Defending Childhood State Policy
Initiative, which is to more effectively align, integrate, and
mobilize multisectoral resources to equitably prevent, identify, and
heal the impacts of violence and trauma on children and youth.
  SEC. 2.  Section 4370 of the Welfare and Institutions Code is
amended to read:
   4370.  This  article   part  shall be
known and may be cited as the Healing from Early Adversity to Level
the Impact (HEAL) of Trauma in Schools Act or the HEAL Trauma in
Schools Act.
  SEC. 3.  Section 4371 of the Welfare and Institutions Code is
amended to read:
   4371.  The Legislature finds and declares all of the following:
   (a) Each year in California over 65,000 teenagers become
adolescent mothers and 230 teenagers commit suicide. Each year more
than 20 percent of California's teenagers drop out of high school.
   (b) Thirty percent of California's elementary school pupils
experience school adjustment problems, many of which are evident the
first four years of school, that is, kindergarten and grades 1 to 3,
inclusive.
   (c) Problems that our children experience, whether in school or at
home, that remain undetected and untreated grow and manifest
themselves in all areas of their later lives.
   (d) There is a clear relationship between early adjustment
problems and later adolescent problems, including, but not limited
to, poor school attendance, low achievement, delinquency, drug abuse,
and high school dropout rates. In many cases, signs of these
problems can be detected in the early grades.
   (e) It is in California's best interest, both in economic and
human terms, to identify and treat the minor difficulties that our
children are experiencing before those difficulties become major
barriers to later success. It is far more humane and cost-effective
to make a small investment in early mental health intervention and
prevention services now and avoid larger costs, including, but not
limited to, foster care, group home placement, intensive special
education services, mental health treatment, or probation supervised
care.
   (f) Programs like the Primary Intervention Program and the San
Diego Unified Counseling Program for Children have proven very
effective in helping children adjust to the school environment and
learn more effective coping skills that in turn result in better
school achievement, increased attendance, and increased self-esteem.
   (g) To create the optimum learning environment for our children,
schools, teachers, parents, public and private service providers, and
community-based organizations must enter into locally appropriate
cooperative agreements to ensure that all pupils will receive the
benefits of school-based early mental health intervention and
prevention services that are designed to meet their personal, social,
and educational needs.
   (h) ACEs are traumatic experiences that can have a profound impact
on a child's developing brain and body and lasting impacts on a
person's health and livelihood across their lifetime. ACEs include
physical, emotional, and sexual abuse; physical and emotional
neglect; other experiences, such as substance abuse by a household
member and witnessing domestic violence. Other traumatic experiences
can include placement instability for foster youth, homelessness, and
witnessing violence against family and community members.
   (i) The State of California has long recognized the mental health
needs of California's children and the value of addressing these
needs by supporting the provision of evidence-based mental health
services in publicly funded preschools and elementary schools, as
evidenced by the creation in 1981 of the Primary Prevention Project,
now named the Primary Intervention Program, and the creation in 1991
of the School-Based Early Mental Health Intervention and Prevention
Services for Children Program, known as the Early Mental Health
Initiative (EMHI).
   (j) It is in the interest of California's children, families,
schools, and communities that the State of California support local
decisions to provide funding for evidence-based services in publicly
funded preschools and elementary schools to address the mental health
needs of children who have been exposed to childhood adversity.
   (k) In addressing these needs, priority should be given to
children, youth, and communities that experience childhood adversity
more severely and profoundly, including those that experience
socioeconomic disadvantage and historical and contemporary
injustices, vulnerable communities, communities of color, and
culturally, linguistically, and geographically isolated communities.
  SEC. 4.  Section 4372 of the Welfare and Institutions Code is
amended to read:
   4372.  For the purposes of this part, the following definitions
shall apply:
   (a) "Cooperating entity" means a federal, state, or local, public
or private nonprofit agency providing school-based early mental
health intervention and prevention services that agrees to offer
services at a schoolsite through a program assisted under this part.
   (b) "Eligible pupil" means a pupil who attends a preschool program
 at a publicly funded elementary school,   at a
contracting agency of the California state preschool program, as
established by Article 7 (commencing with Section 8235) of Chapter 2
of Part 6 of Division 1 of Title 1 of the Education Code, or a local
educational agency,  or who attends a publicly funded elementary
school and who is in kindergarten, transitional kindergarten, or
grades 1 to 3, inclusive.
   (c) "Local educational agency" means any school district or county
office of education, state special school, or charter school.
   (d) "Department" means the State Department of Public Health.
   (e) "Director" means the State Public Health Officer.
   (f) "Supportive service" means a service that will enhance the
mental health and social-emotional development of children.
  SEC. 5.  Section 4380 of the Welfare and Institutions Code is
amended to read:
   4380.  Subject to the availability of funding each year, the
Legislature authorizes the director, 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 programs that provide school-based early mental health
intervention and prevention services to eligible pupils at
schoolsites of eligible pupils, as follows:
   (a) The director shall award matching grants pursuant to this
chapter to local educational agencies throughout the state.
   (b) Matching grants awarded under this part shall be awarded for a
period of not more than three years and no single schoolsite shall
be awarded more than one grant, except for a schoolsite that received
a grant prior to July 1, 1992.
   (c) The director shall pay to each local educational agency having
an application approved pursuant to requirements in this part the
state share of the cost of the activities described in the
application.
   (d) Commencing July 1, 1993, the state share of matching grants
shall be a maximum of 50 percent in each of the three years.
   (e) Commencing July 1, 1993, the local share of matching grants
shall be at least 50 percent, from a combination of school district
and cooperating entity funds.
   (f) The local share of the matching grant may be in cash or
payment in-kind.
   (g) Priority shall be given to those applicants that demonstrate
the following:
   (1) The local educational agency will serve the greatest number of
eligible pupils from low-income families.
   (2) The local educational agency will provide a strong parental
involvement component.
   (3) The local educational agency will provide supportive services
with one or more cooperating entities.
   (4) The local educational agency will provide services at a low
cost per child served in the project.
   (5) The local educational agency will provide programs and
services that are based on adoption or modification, or both, of
existing programs that have been shown to be effective.
   (6) The local educational agency will provide services to children
who are in out-of-home placement or who are at risk of being in
out-of-home placement.
   (7) The local educational agency  shall  
will  prioritize for receipt of services children who have been
exposed to childhood trauma, including, but not limited to, foster
youth, as defined in subdivision (b) of Section 42238.01 of the
Education Code, and homeless children and youth, as defined in
Section 11434a(2) of the federal McKinney-Vento Homeless Assistance
Act (42 U.S.C. Sec. 11301 et seq.).
   (h) Eligible supportive services may include the following:
   (1) Individual and group intervention and prevention services.
   (2) Parent involvement through conferences or training, or both.
   (3) Teacher and staff conferences and training related to meeting
project goals.
   (4) Referral to outside resources when eligible pupils require
additional services.
   (5) Use of paraprofessional staff, who are trained and supervised
by credentialed school psychologists, school counselors, or school
social workers, to meet with pupils on a short-term weekly basis, in
a one-on-one setting as in the primary intervention program
established pursuant to Chapter 4 (commencing with Section 4343) of
Part 3.  A minimum of 80 percent of the grants awarded by the
director shall include the basic components of the primary
intervention program. 
   (6) Any other service or activity that will improve the mental
health of eligible pupils, particularly evidence-based interventions
and promising practices intended to mitigate the consequences of
childhood adversity and cultivate resilience and protective factors.
   Prior to participation by an eligible pupil in either individual
or group services, consent of a parent or guardian shall be obtained.

   (i) Each local educational agency seeking a grant under this
chapter shall submit an application to the director at the time, in a
manner, and accompanied by any information the director may
reasonably require.
   (j) Each matching grant application submitted shall include all of
the following:
   (1) Documentation of need for the school-based early mental health
intervention and prevention services.
   (2) A description of the school-based early mental health
intervention and prevention services expected to be provided at the
schoolsite.
   (3) A statement of program goals.
   (4) A list of cooperating entities that will participate in the
provision of services. A letter from each cooperating entity
confirming its participation in the provision of services shall be
included with the list. At least one letter shall be from a
cooperating entity confirming that it will agree to screen referrals
of low-income children the program has determined may be in need of
mental health treatment services and that, if the cooperating entity
determines that the child is in need of those services and if the
cooperating entity determines that according to its priority process
the child is eligible to be served by it, the cooperating entity will
agree to provide those mental health treatment services.
   (5) A detailed budget and budget narrative.
   (6) A description of the proposed plan for parent involvement in
the program.
   (7) A description of the population anticipated to be served,
including number of pupils to be served and socioeconomic indicators
of sites to receive funds.
   (8) A description of the matching funds from a combination of
local education agencies and cooperating entities.
   (9) A plan describing how the proposed school-based early mental
health intervention and prevention services program will be continued
after the matching grant has expired.
   (10) Assurance that grants would supplement and not supplant
existing local resources provided for early mental health
intervention and prevention services.
   (11) A description of an evaluation plan that includes
quantitative and qualitative measures of school and pupil
characteristics, and a comparison of children's adjustment to school.

   (k) Matching grants awarded pursuant to this article may be used
for salaries of staff responsible for implementing the school-based
early mental health intervention and prevention services program,
equipment and supplies, training, and insurance.
   (  l  ) Salaries of administrative staff and other
administrative costs associated with providing services shall be
limited to 5 percent of the state share of assistance provided under
this section.
   (m) No more than 10 percent of each matching grant awarded
pursuant to this article may be used for matching grant evaluation.
   (n) No more than 10 percent of the moneys allocated to the
director pursuant to this chapter may be utilized for program
administration and evaluation.
   Program administration shall include both state staff and field
staff who are familiar with and have successfully implemented
school-based early mental health intervention and prevention
services. Field staff may be contracted with by local school
districts or community mental health programs. Field staff shall
provide support in the timely and effective implementation of
school-based early mental health intervention and prevention
services. Reviews of each project shall be conducted at least once
during the first year of funding.
   (o) Subject to the approval of the director, at the end of the
fiscal year, a school district may apply unexpended funds to the
budget for the subsequent funding year.
   (p) Contracts for the program and administration, or ancillary
services in support of the program, shall be exempt from the
requirements of the Public Contract Code and the State Administrative
Manual, and from approval by the Department of General Services.
  SEC. 6.  Chapter 4 (commencing with Section 4391) is added to Part
4 of Division 4 of the Welfare and Institutions Code, to read:
      CHAPTER 4.   SCHOOL-BASED EARLY MENTAL HEALTH
INTERVENTION AND PREVENTION SERVICES   HEAL TRAUMA IN
SCHOOLS  SUPPORT PROGRAM


   4391.  (a) The director shall establish a four-year  pilot
 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 the eligible support services as provided in this section.
   (b) The department shall provide outreach to local educational
agencies and county mental health agencies to inform individuals
responsible for local funding decisions of the program established
pursuant to this section.
   (c) The department shall provide free regional training on all of
the following:
   (1) Eligible support services, which may include any or all of the
following:
   (A) Individual and group intervention and prevention services.
   (B) Parent engagement through conference or training, or both.
   (C) Teacher and staff conferences and training related to meeting
project goals.
   (D) Referral to outside resources when eligible pupils require
additional services.
   (E) Use of paraprofessional staff, who are trained and supervised
by credentialed school psychologists, school counselors, or school
social workers, to meet with pupils on a short-term weekly basis, in
a one-on-one setting as in the primary intervention program
established pursuant to Chapter 4 (commencing with Section 4343) of
Part 3.
   (F) Any other service or activity that will improve the mental
health of eligible pupils, particularly evidence-based interventions
and promising practices intended to mitigate the consequences of
childhood adversity and cultivate resilience and protective factors.
   (2) The potential for the eligible support services defined in
this section to help fulfill state priorities described by the local
control funding formula and local goals described by local control
and accountability plans.
   (3) How educational, mental health, and other funds subject to
local control can be used to finance the eligible support services
defined in this section.
   (4) External resources available to support the eligible support
services defined in this section, which may include workshops,
training, conferences, and peer learning networks.
   (5) State resources available to support student mental health and
resilience, and positive, trauma-informed learning environments,
which may include any of the following:
   (A) Foundational aspects of learning, childhood social-emotional
development, mental health and resilience, toxic stress, childhood
trauma, and Adverse Childhood Experiences.
   (B) Inclusive multitiered systems of behavioral and academic
supports, Schoolwide Positive Behavior Interventions and Supports,
restorative justice or restorative practices, trauma-informed
practices, social and emotional learning, and bullying prevention.
   (d) The department shall provide technical assistance to local
educational agencies that provide or seek to provide eligible
services defined in this section. Technical assistance shall include
assistance in any of the following:
   (1) Designing programs.
   (2) Training program staff in intervention skills.
   (3) Conducting local evaluations.
   (4)  Coordination   Coordinating  with
county mental health agencies and professionals.
   (5) Leveraging educational, mental health, and other funds that
are subject to local control and assisting in budget development.
   (e) In providing outreach pursuant to subdivision (b), training
pursuant to subdivision (c), and technical assistance pursuant to
subdivision (d), the department shall select and support schoolsites
as follows:
   (1) (A) During the first 12 months of the program, the department
shall support, strengthen, and expand the provision of eligible
services at schoolsites that previously received funding pursuant to
the  HEAL Trauma in Schools Act (Chapter 2 (commencing with
Section 4380))   former   School-Based Early
Mental Health Intervention and Prevention Services Matching Grant
Program  and have continued to provide eligible support
services. In working with these selected schoolsites, the department
shall develop methods and standards for providing services and
practices to new schoolsites.
   (B) The department shall develop a process to identify schoolsites
that demonstrate the willingness and capacity to participate in the
program.
   (2) During the subsequent 36 months of the program, the department
shall select new schoolsites that are not providing eligible support
services but that demonstrate the willingness and capacity to
participate in the program. The department shall work with these
schoolsites to deliver eligible support services.
   (3) In selecting schoolsites and providing support, the department
shall prioritize the following:
   (A) Schoolsites in communities that have experienced high levels
of childhood adversity, such as Adverse Childhood Experiences and
childhood trauma.
   (B) Schoolsites that prioritize for receipt of services children
who have been exposed to childhood trauma, including, but not limited
to, foster youth, as defined in subdivision (b) of Section 42238.01
of the Education Code, and homeless children and youth, as defined in
Section 11434a(2) of the federal McKinney-Vento Homeless Assistance
Act (42 U.S.C. Sec. 11301 et seq.)
   (C) Geographic diversity, program effectiveness, program
efficiency, and long-term program sustainability.
   (f) The department shall submit, in compliance with Section 9795
of the Government Code, an interim report to the Legislature at the
end of the second year of the  pilot  program that
details the department's work to support the schoolsites selected
pursuant to paragraph (1) of subdivision (e) and includes an
assessment of the demand and impact of funding for the HEAL Trauma in
Schools Act established pursuant to  Chapter 3 (commencing
with Section 4380).  this part.  The department
shall make the report available to the public and shall post the
report on its Internet Web site.
   (g) The department shall develop an evaluation plan to assess the
impact of the  pilot  program. The department, in
compliance with Section 9795 of the Government Code, shall submit a
report to the Legislature at the end of the four-year period
evaluating the impact of the  pilot  program and
providing recommendations for further implementation. The department
shall make the report available to the public and shall post the
report on its Internet Web site.
   4392.  Implementation of this chapter is contingent upon an
appropriation in the annual budget act.
   4393.   This chapter shall remain in effect only until January 1,
2022, and as of that date is repealed, unless a later enacted
statute, that is enacted before January 1, 2022, deletes or extends
that date.