Report 2019-125 Recommendation 5 Responses

Report 2019-125: Youth Suicide Prevention: Local Educational Agencies Lack the Resources and Policies Necessary to Effectively Address Rising Rates of Youth Suicide and Self‑Harm (Release Date: September 2020)

Recommendation #5 To: Health Care Services, Department of

To ensure that LEAs take full advantage of federal funds for Medi-Cal-eligible students, Health Care Services should work with Education to inform LEAs that they may partner with their county offices of education to centralize the administrative responsibilities necessary to obtain reimbursement through the billing option program.

1-Year Agency Response

DHCS has collaborated with CDE to inform LEAs that they may partner with county offices of education to centralize the administrative responsibilities necessary to obtain reimbursement through the billing option program. Specifically, on February 23, 2021, DHCS and CDE hosted a training webinar conducted by the California Children's Trust on Medi-Cal 101 and the Practical Guide for Financing Social, Emotional, and Mental Health in Schools. Offered statewide, this joint training was provided all interested entities (including LEAs) insight on working collaboratively by partnering with one or more of the five School-Medi-Cal models (namely, LEAF, Special Education Local Plan Area, Community Based Organization, County Health Authority, or County Office of Education) to handle Medi-Cal billing and/or hire and supervise staff to provide services to students. The webinar was recorded and posted on the CDE Project Cal-Well webpage (link).

California State Auditor's Assessment of 1-Year Status: Fully Implemented

DHCS and CDE hosted a training webinar to inform LEAs that they may partner with their county offices of education to centralize the administrative responsibilities necessary to obtain reimbursement through the billing option program. The training was offered statewide and invitations were sent to all LEAs.

6-Month Agency Response

November 10, 2020: DHCS distributed Policy and Procedure Letter (PPL) 20-051, titled "Local Educational Agency Medi-Cal Billing Option Program (LEA BOP) Coordination of Mental Health Related Services." Refer to the attachment, titled "PPL 20-051."

November 19, 2020: Sacramento County Office of Education (SCOE) conducted a presentation on SCOE's Medi-Cal model, including partnerships with the County Health Department and the county-operated Federally Qualified Health Center. Refer to the attached presentation documents, titled "Medi-Cal 101" and "Supporting School-Based Mental Health and Wellness" for details.

December 2, 2020: DHCS conducted a training webinar for participating LEAs, covering an LEA BOP overview, navigation of the LEA BOP webpage, resources and State Plan Amendment 16-0001. Refer to the e-mail notification, titled "Advisory Workgroup Meeting."

February 23, 2021: California Department of Education (CDE) hosted a training webinar conducted by the California Children's Trust on Medi-Cal 101 and the "Practical Guide for Financing Social, Emotional, and Mental Health in Schools." The Fresno Collaborative, which included Sierra Unified School District, the County Superintendent of Schools, and the County Behavioral Health Department, provide insight on working collaboratively to expand financing for school-based mental health services. The training was offered statewide and the webinar recording are posted on the Project Cal-Well webpage. Refer to the link for the webinar recording, slide deck, and the shared resources.

LEA outreach and training efforts were fully implemented by February 23, 2021; however, DHCS's collaboration with CDE Project Cal-Well will be ongoing throughout the remainder of the five-year grant period. Efforts by DHCS to provide outreach and technical assistance through the LEA BOP and School-Based Medi-Cal Administrative Activities programs to participating and non-participating LEAs throughout the state will also be ongoing.

California State Auditor's Assessment of 6-Month Status: Partially Implemented

Health Care Services did conduct outreach and training webinars to inform some LEAs that they may partner with their county offices of education to centralize administrative responsibilities. However, it communicated only with those LEAs that are already participating in the Medi-Cal Billing Option program. It has not yet collaborated with Education to inform all LEAs about this option.

60-Day Agency Response

LEAs who voluntarily agree to participate in the LEA Billing Option Program (BOP) must directly submit a provider Participation Agreement, a Data Use Agreement, and an annual report to DHCS, which limits the opportunities for centralizing administrative responsibilities to obtain reimbursement through the BOP.

However, opportunities to provide technical assistance to LEAs has been implemented within DHCS under Project Cal-Well. Funded by the Substance Abuse and Mental Health Services Administration, Project Cal-Well raises awareness of mental health, and expands access to school and community-based mental health services for youth, families, and school communities. The project is a collaborative effort through a five year Interagency Agreement between DHCS and Education. Specifically, DHCS coordinates and provides training, education, and resources on youth behavioral health service access to LEAs, and supports the Education-led Student Mental Health Policy Workgroup and related subcommittees. The workgroup provides policy recommendations addressing issues such as youth suicide. Information on Project Cal Well can be found on the website: https://www.cde.ca.gov/ls/cg/mh/projectcalwell.asp. The website includes training information, program evaluations, and additional resources.

DHCS, through involvement in Project Call-Well, is also coordinating with Education to offer several trainings. The following two trainings directly address how LEAs may partner with local county offices of education:

- The Sacramento County Office of Education will present on efforts to partner with a county owned/operated Federally Qualified Health Center to establish school based satellites for the provision of mental health services to students.

- A panel presentation from various County Offices of Education who have experienced success in working collaboratively with County Health Plans, County Behavioral Health, and other community-based providers.

California State Auditor's Assessment of 60-Day Status: Partially Implemented

Notwithstanding Health Care Services' description of the tasks that LEAs must complete, as we describe in the report, Ukiah Unified and the Mendocino County Office of Education stated that their partnership centralized administrative responsibilities and reduced the burden to the LEA of obtaining reimbursement. Although DHCS describes a number of efforts related to youth behavioral health services, its response does not describe a systematic method of implementing our recommendation that will reach all LEAs.

All Recommendations in 2019-125

Agency responses received are posted verbatim.