Building Infrastructures:

Supporting School-Based Mental Health

Services

National MandatesNational Mandates

Individuals with Individuals with Disabilities Disabilities Education Act Education Act (IDEA)(IDEA)

Districts must provide any Districts must provide any related services to related services to students w/disabilitiesstudents w/disabilities

Counseling services are Counseling services are related services when they related services when they are required to assist are required to assist students with disabilities students with disabilities to benefit from special to benefit from special educationeducation

President’s New President’s New Freedom Freedom Commission on Commission on Mental Health -Mental Health -20042004

Goal 4: Early Mental Health Goal 4: Early Mental Health Screening, Assessment, and Screening, Assessment, and Referral to Services are Referral to Services are Common PracticeCommon Practice

4.2: Improve and Expand 4.2: Improve and Expand School Mental Health School Mental Health ProgramsPrograms

State MandatesState Mandates

OSEP REVIEWOSEP REVIEW ( (1999 –2000) 1999 –2000)

• ADE, SEU cited for not meeting the needs ADE, SEU cited for not meeting the needs of students with mental health counseling of students with mental health counseling needsneeds

• ADE, SEU responsible for over site for all ADE, SEU responsible for over site for all services to services to ALLALL school aged children school aged children

State Response to State Response to MandatesMandates

Medicaid $$ Released to include Schools Medicaid $$ Released to include Schools as Providersas Providers

ADE, SEU began working on state plan to ADE, SEU began working on state plan to address citationsaddress citations

2001 – ADE and DBHS began framing 2001 – ADE and DBHS began framing process for sbmh service delivery; Enter process for sbmh service delivery; Enter into MOUinto MOU

LEAs, Co Ops become active in the LEAs, Co Ops become active in the development of SBMH Networkdevelopment of SBMH Network

OOUR UR MMANDATEANDATE

Schools + Mental Health = SuccessSchools + Mental Health = Success

The mission of schools is to educate all The mission of schools is to educate all students. The mental health of a student students. The mental health of a student underlines how successful he/she will be underlines how successful he/she will be in school. Students with mental health in school. Students with mental health problems that are not adequately problems that are not adequately addressed have higher failure rates.addressed have higher failure rates.

Vision StatementVision Statement

School-Based Mental Health Partners School-Based Mental Health Partners promote quality, accountable and promote quality, accountable and

professional programs by sharing a professional programs by sharing a commitment to working as a team to commitment to working as a team to break through traditional barriers of break through traditional barriers of

service delivery in schools. service delivery in schools.

ADE School-Based Mental ADE School-Based Mental Health Network Program Health Network Program

PrinciplesPrinciplesBuilding School-Based Mental Health Programs with Building School-Based Mental Health Programs with Partnerships that promote Quality, Professionalism and Partnerships that promote Quality, Professionalism and

AccountabilityAccountability

And are Success OrientedAnd are Success Oriented

Emphasis on early interventionEmphasis on early intervention Full integration with community and it’s resourcesFull integration with community and it’s resources Placing students and their families at the center of service Placing students and their families at the center of service

decisionsdecisions Providing services that are culturally competentProviding services that are culturally competent A focus on promoting school attendance and academic successA focus on promoting school attendance and academic success Services and supports validated by research and evidence-based Services and supports validated by research and evidence-based

practicespractices The use of technology, including telecommunicationsThe use of technology, including telecommunications

Partnership GoalsPartnership Goals

Partners Support the Academic and Partners Support the Academic and Mental Health of StudentsMental Health of Students

Open Communication, Shared Agendas, Open Communication, Shared Agendas, Team InterventionsTeam Interventions

Recognize the Value Each Partner Brings Recognize the Value Each Partner Brings to the Tableto the Table

Share Responsibility for Program Share Responsibility for Program ComponentsComponents

Program ModelsProgram Models

Partnerships with local community Partnerships with local community mental health providers – community mental health providers – community mental health centers, independent mental health centers, independent practitioners, private non-profit, and practitioners, private non-profit, and for-profit providersfor-profit providers

School Districts employ mental health School Districts employ mental health providers as part of school/district staffproviders as part of school/district staff

Co Ops work as coordinators for Co Ops work as coordinators for SBMHS SBMHS

Combination Combination

Program AssurancesProgram Assurances Student Supports, Classroom Consultations, Staffing, In-Student Supports, Classroom Consultations, Staffing, In-

Services, Wrap Around ServicesServices, Wrap Around Services Integrated Services – mh and school act as a teamIntegrated Services – mh and school act as a team Pullout Interventions- evaluation, crisis services, diagnosis, Pullout Interventions- evaluation, crisis services, diagnosis,

individual, family group therapy, and day treatmentindividual, family group therapy, and day treatment Comprehensive intake, referral and case management Comprehensive intake, referral and case management

processesprocesses Access to services without regard to student/family Medicaid Access to services without regard to student/family Medicaid

enrollment statusenrollment status Appropriate linkages with community, regional, state and Appropriate linkages with community, regional, state and

natural resourcesnatural resources Participation in Title XIX, Medicaid, either through provider Participation in Title XIX, Medicaid, either through provider

enrollment or purchased services contractsenrollment or purchased services contracts Maximum utilization of alternative funding streams, Maximum utilization of alternative funding streams,

including third party payors, public targeted and competitive including third party payors, public targeted and competitive grants, and private foundation fundsgrants, and private foundation funds

Program ComponentsProgram ComponentsBest Practice ModelBest Practice Model

Fully integrated partnerships – mental health provider is Fully integrated partnerships – mental health provider is part of the school teampart of the school team

Each school has a dedicated full time therapist to serve Each school has a dedicated full time therapist to serve ALL studentsALL students

Therapist is integrated into school and its cultureTherapist is integrated into school and its culture School Staff and Mental Health Provider work together School Staff and Mental Health Provider work together

to develop student treatment plans, education plans etc. to develop student treatment plans, education plans etc. Schools and Providers share information and provide for Schools and Providers share information and provide for

this in the framework of their contracts, MOUs – HIPAA, this in the framework of their contracts, MOUs – HIPAA, FERPA guidelinesFERPA guidelines

Interventions are EVIDENCE BASEDInterventions are EVIDENCE BASED Data Collection Data Collection Outcome Measurements Outcome Measurements Funding is joint venture between provider, schools and Funding is joint venture between provider, schools and

communitycommunity

Program ImplementationProgram Implementation

Completion of SBMHS Applications (ADE and Completion of SBMHS Applications (ADE and Medicaid)- includes technical assistanceMedicaid)- includes technical assistance

Review of Application – Includes Site VisitReview of Application – Includes Site Visit Finalization of Agreements, MOUs, ContractsFinalization of Agreements, MOUs, Contracts Development of Processes, Forms, PoliciesDevelopment of Processes, Forms, Policies In-service to both school and mh staff In-service to both school and mh staff

regarding processes – referrals, service regarding processes – referrals, service delivery, team workdelivery, team work

Establish start dateEstablish start date

DBHS and Special Education DBHS and Special Education combining efforts to achieve:combining efforts to achieve:

Quality Quality

ConsistencyConsistency

Positive OutcomesPositive Outcomes

AccountabilityAccountability

Collaboration is the KeyCollaboration is the Key

O.U.R. Educational O.U.R. Educational CooperativeCooperative

What is an Educational What is an Educational Cooperative?Cooperative?

ProcessProcess

TeamingTeaming

Evaluations & OutcomesEvaluations & Outcomes

Internal and external evaluation Internal and external evaluation methodologymethodology

Network Evaluation TeamNetwork Evaluation Team SARA Data BaseSARA Data Base Satisfaction SurveysSatisfaction Surveys

Program EvaluationProgram Evaluation On-going process from planning to service On-going process from planning to service

deliverydelivery Site Visits pre and post program implementationSite Visits pre and post program implementation Site Visits mirror accreditation standardsSite Visits mirror accreditation standards Monitor both educational and mental health Monitor both educational and mental health

outcomesoutcomes Quality Service DeliveryQuality Service Delivery PartnershipPartnership AccountabilityAccountability Student Improvements: attendance, grades, discipline, Student Improvements: attendance, grades, discipline,

self-esteem, wellness, decrease in symptoms self-esteem, wellness, decrease in symptoms

ARKANSAS DEPARTMENT OF EDUCATIONARKANSAS DEPARTMENT OF EDUCATIONSCHOOL-BASED MENTAL HEALTH PROGRAMMINGSCHOOL-BASED MENTAL HEALTH PROGRAMMING

FISCAL YEAR 2005-06FISCAL YEAR 2005-06

Total Number of Network Districts: 47Total Number of Network Districts: 47 Total Number of Covered Students: 112,950Total Number of Covered Students: 112,950 Total Unduplicated Service Cases: 3,500 as Total Unduplicated Service Cases: 3,500 as

reported onreported onthe ADE Student Assessment and Referral the ADE Student Assessment and Referral

Database (SARA)Database (SARA)

Anticipated Expenditures by Source:Anticipated Expenditures by Source: Department of Education $1,500,000Department of Education $1,500,000 Local Cash/In-kind 250,000Local Cash/In-kind 250,000 RSPMI Medicaid 7,500,000RSPMI Medicaid 7,500,000 Private Insurance 50,000Private Insurance 50,000 TOTAL $9,300,000TOTAL $9,300,000

Contact InformationContact Information

Ruth Fissel, LCSWRuth Fissel, LCSW ruthfissel@aristotle.netruthfissel@aristotle.net

Betsy Moore, MSEBetsy Moore, MSEbetsyandgrace@yahoo.combetsyandgrace@yahoo.com

Monica Pruitt, SPSMonica Pruitt, SPSmpruitt@greenwood.k12.ar.usmpruitt@greenwood.k12.ar.us

Valorie Williams, LPE Valorie Williams, LPE valorie@tcworks.netvalorie@tcworks.net

http://arksped.k12.ar.ushttp://arksped.k12.ar.us