Dear Friends and Allies

California schools are slowly beginning to reopen and billions of dollars in federal and state funds have been committed to support the long road of not only getting our kids in school but helping close the learning gap and address the social-emotional stress of the past 12 months. The specifics, as reported by EdSource, include:

• $15.3 billion in assistance to California’s K-12 schools from the American Rescue Plan.
• An additional $6.6 billion appropriated by Gov. Gavin Newsom and the Legislature to help districts recover from the pandemic’s impact.

Adding in previous relief funds, this totals about $33 billion in one-time state and federal aid since the start of the pandemic a year ago. A portion of these funds is earmarked for social-emotional support and mental health services in schools. But is it enough?

The fact is that California continues to experience a significant spike in youth suicides and suicide ideation, while at the same time ranking at the bottom nationally for children who did not receive needed mental health care. If we are to ensure that these new funds meet the needs of our young people and their families, we need to address the significant flaws in our financing and service models by directly and specifically acknowledging the impact of structural racism and poverty on the social and emotional well being of children.

As welcome as these new funds are, they are almost all one-time, and they reflect both the fragmentation of California’s Medicaid program (Medi-Cal), and our continued imprisonment in diagnosis-driven models that pathologize children of color. We must chart a new course at the nexus of public health and education, and it must be informed by principles of anti-racism and health equity.

To fully leverage federal matching funds coming through Medi-Cal, school districts need support in understanding and building their capacity to partner with Medi-Cal payers and providers. These one-time investments must be used to build sustainable programs and partnerships that bring new resources and strategies to children and their families in schools.

The state has proposed that Medi-Cal Managed Care Organizations (MCOs) oversee the distribution of some of these funds to schools. Unfortunately, MCOs are not experienced with school budget structures or student needs, they do not support services under the mild to moderate benefit, and their financial incentives are misaligned with principles of equity and social justice. Despite these challenges, MCOs are the sleeping giant of children’s mental health financing, and their engagement and partnership are necessary to bring any solution to scale. While MCOs seem unlikely partners for schools and advocates, and no doubt this process will be messy and difficult, we strongly support these efforts as the only viable path forward.

Although we would all like to take a sigh of relief as schools reopen, now is the time to press hard on the accelerator to ensure these one-time state and federal funds are invested to lay the foundation for sustainable change. We call on our allies and friends to help lead the way for MCOs, Mental Health Plans, and schools to break the traditional medical model and build a just and equitable approach to children's mental health care.

See Alex Briscoe’s comment in this March 16 EdSource article on adopting permanent changes in the way schools address students’ mental health:

I think the universal consensus now is that children, especially Black and brown children, have been suffering greatly during the pandemic, and our system of delivering services is broken. Everyone knows we need to make changes. Will this be a game changer? Maybe. Is it important that we do it? Hell yes.

Raise Awareness

In case you missed it: Navigating the Intersection of MCOs and Schools
On March 4, CCT hosted a webinar with youth advocates and partners from the School-Based Health Association, California Coalition for Youth and Davis Health Strategies to discuss the role of Medi-Cal and Managed Care Organizations in funding school-based mental health services. The webinar recording and materials are a resource for school districts, advocates, and providers to understand how to work across MCOs and schools.

Check out and share this essential guide for education leaders to claim millions of dollars of Medicaid funding
More than 60% of California’s children in public schools rely on Medi-Cal for their healthcare needs—physical, mental, and social and emotional. The Practical Guide for Financing Social, Emotional and Mental Health in Schools presents 5 models and a step-by-step guide for investing in children’s mental health by leveraging Medicaid.

Follow the lead of our youth who use and trust school-based health services
Stay tuned for a CCT snapshot with findings from interviews with youth covered by Medi-Cal. A preview of their comments supports the focus on schools, and confirms the potential to bridge MCOs and schools.

I've used my school-based health center; I used it to get papers signed so I could participate in sports and activities. If they sent me something to fill out to get free counseling via Zoom, I’d do that.
—A, 17, Stockton, African-American

My school counselor has reached out when I struggled in class, and reminded me to take it one step at a time. I like that I can talk to my counselor and teacher directly; I just reach out through the school email/Canvas platform, it’s like any other messaging I do with my friends.
-- S, 17, Ontario, Hispanic

Take Action

CCT influences Managed Care Plan re-procurement process
In the coming weeks, DHCS will release a draft MCP Request for Proposal and contract template—the next step in the re-procurement process, the first in nearly 17 years. CCT, our partners, including youth advocates, will provide input during the public comment period. CCT has also released a primer on Medi-Cal managed care and mental health services to inform advocates and increase support.

Resources for Advocacy and Action
CCT developed a list of actions that all advocates can take to help ensure school funding is invested to increase student mental health services.

Advocate for the passage of AB586—the “School Health Demonstration Project”
The bill, introduced by Assembly Members O’Donnell and Wood, would enact legislation to develop a two-year grant program to assist local educational agencies in building infrastructure and partnerships to secure ongoing federal Medi-Cal funding for mental health services.

Sign Up for Action Alerts no AB 586