Mental Health Services Update

On November 29, 2010 the California Legislature urged the California Court of Appeal to directly take up California School Boards Association v. Commission on State Mandates, which would otherwise first have to come up on appeal from a trial court.

In the amicus curiae letter, submitted by the California Office of Legislative Counsel, legislative counsel Diane F. Boyer-Vine and Chief Deputy Jeffrey A. DeLand, attorneys for the California Legislature, assert four key points:

1. As a recipient of federal IDEA funding, California is obligated by federal law to provide necessary mental health services to students with exceptional needs.

2. California counties' statutory obligation to provide mental health services is a state mandate that the Legislature is constitutionally directed to either fully fund or suspend each fiscal year.

3. The suspension of a mandate "in a manner prescribed by law" requires that the mandate be identified by the Legislature for suspension in the annual budget act and cannot result from the governor's statement in a veto message.

4. The governor's statement of suspension of mental health services mandates must be declared invalid without further delay, to avoid continuing confusion and harm to local governments and to students with exceptional needs

This lawsuit, filed by the CSBA and two school districts on November 9, was the second filed against Governor Schwarzenegger since he cut the funding for the services on October 8. The lawsuit alleges that the Governor overstepped his authority by vetoing funding for a state school program that provides mental health services to students and that eliminating the program requires a two-thirds legislative vote under Proposition 1A. The school districts involved in the lawsuit are Los Angeles Unified School District and Manhattan Beach Unified School District.

News: Stipulated TRO Issued In AB 3632 Case

Educationally-related mental health services to continue, despite Governor's veto and suspension of mandate

A class action lawsuit was filed last week by the collaborative forces of various public interest law organizations in Los Angeles in response to the Governor's line item veto of funding for mental health services and suspension of the AB 3632 mandate.

More information about this issue:
Our previous blog posts: News: AB3632 Suspended... Mental Health Services in State of Chaos: Part 1... Mental Health Services in State of Chaos: Part 2...
Press Release about the Class Action (on Disability Rights California's webpage)
Public Counsel's story about the class action (on Public Counsel's webpage)
The complaint filed in the class action

As part of the class action litigation, Plaintiffs sought a Temporary Restraining Order (TRO) against various defendants. The Plaintiffs sought an order to require the state department of education (CDE) to take certain actions to monitor and track changes in local policies and practices related to mental health services, exercise its authority under the law to compel local education agencies (i.e. school districts) to ensure that students receive mental health services without delay or interruption, and disburse federal IDEA funds including those specifically delineated for mental health services on the same basis as they were disbursed prior to the Governor's actions on October 8th. Additionally, as to the "local" defendants, including the LA County Department of Mental Health, Plaintiffs sought a TRO requiring the continued provision of mental health services, including assessments, attendance at IEP meetings, and providing services and funding residential placements, at the same level as was previously provided in accordance with the procedures existing prior to the Governor's veto.

State Department of Education (CDE) Action and Agreement to Disburse Funds

On October 29, 2010, Jack O'Connell, State Superintendent of Schools, announced that CDE would be releasing $76 million in federal IDEA funds reserved for state level activities to county offices in order to fund educationally-related mental health services through county mental health agencies. Thus, these funds would be available to ensure the continuation of services mandated by federal law for students with disabilities.

In announcing this action, O'Connell stated "I refuse to let the Governor's misguided action prevent severely disabled students from getting the mental health care they need from qualified providers... The Governor's veto does not override federal law; School districts must still implement the IEP... yet most districts don't have the expertise to provide psychiatric and medical management of necessary medications and other mental health services..." See California Department of Education News Release; October 29, 2010 http://www.cde.ca.gov/nr/ne/yr10/yr10rel122.asp

Stipulated TRO for Provision of Services by LA County DMH

Yesterday, November 2, 2010, the federal judge in the U.S. District Court for the Central District of California signed a stipulated Temporary Restraining Order in this matter. Because of the assurances of disbursement of reserved funding by the CDE, funding would be available to LACDMH to provide services in accordance with the practices and procedures for distribution of funds existing before October 8, 2010. Thus, the stipulated TRO provided that LACDMH would "resume and continue to provide and monitor educationally-related mental health services... attend IEP meetings and authorize services, and complete assessments..." either until the "reserved" funding runs out or until January 14, 2011, whichever occurs first.

What does this mean?

The issue regarding funding for educationally related mental health services in California is by no means resolved. However, locally in Los Angeles County, the process for providing these services through a student's IEP will theoretically return to the same practices and procedures as before the veto by the Governor, and the subsequent chaos of the past few weeks, occurred. At least for the time being - the "reserved" funding will not last forever, and the long term problem still requires a resolution. For students and families throughout California, Mr. O'Connell's action is a step in the right direction towards ensuring stability in the provision of much needed services during this time of confusion. It means that funds will be disbursed for the provision of services through the counties. Additionally, CDE has continued to remind local school districts of their ultimate responsibility to provide students with a FAPE, and the CDE has agreed to issue directives regarding these obligations in an attempt to ensure and oversee compliance. Within the context of the class action, the Plaintiffs involved have agreed to inform CDE of any information that they obtain regarding non-compliance by a local school district of its obligation to provide or pay for related mental health services when a non-educational agency fails to do so.

For more information, please check out the following links:

Order on Stipulated TRO (as related to local defendants)

Stipulation and Notice of Withdrawal (as related to agreement with state defendants)

News: AB 3632 Mandate Suspended; Mental Health Services in a State of Chaos

Governor’s Line Item Veto Suspends AB 3632 Mandate for Mental Health Services in California

On October 8, 2010, Governor Schwarzanegger signed the state’s budget for fiscal year 2010-2011, while using his line item veto to cut billions of dollars to state funded programs. Among the programs affected are mental health services provided to students with disabilities under what is known as the AB 3632 Mandate. The Governor used his veto to eliminate approximately $133 million in funds apportioned for the state to reimburse County Mental Health agencies for mandated services they have already funded. At the same time, the Governor suspended the AB 3632 mandate going forward.

AB 3632 was enacted in 1984 in order to assign County Mental Health departments the financial responsibility for funding mental health services required pursuant to students’ IEPs. Under AB 3632, County Mental Health departments also funded residential placements for students who were eligible under the category of “Emotionally Disturbed” and required residential placement in order to receive an appropriate special education program.

The Governor’s action has been called “unconscionable” by many, and leaves school districts, SELPAs, County Mental Health departments, providers, residential treatment facilities, and IEP teams in a complete and utter state of chaos. Parents and students are unfortunately likely to be immediately and negatively impacted.

Suspending AB 3632 services does not eliminate mental health services or residential placements, but instead returns the responsibility for these state mandated services to the local education agencies (school districts). However, as each County Mental Health department and each School District reacts to the chaos individually and decides what action to take, there will almost certainly be disruption in services for many students.

Please read more in depth information on this blog at:

Mental Health Services in State of Chaos in California: Part 1 - What Happened? (http://a2zeducationaladvocates.blogspot.com/2010/10/mental-health-services-in-state-of.html)

Mental Health Services in State of Chaos in California - Part 2: What Happens Next? (http://a2zeducationaladvocates.blogspot.com/2010/10/mental-health-services-in-state-of_22.html)

Already, litigation on this issue has begun. On October 21, 2010, in Los Angeles, a class action lawsuit was filed in federal court by Public Counsel, Disability Rights California, Mental Health Advocacy Services, and Gibson, Dunn & Crutcher, in order to "preserve lifeline services for more than 20,000 students." (You can find read the press release on Disability Rights California's website (http://www.disabilityrightsca.org/) as well as the complaint filed in federal court).

Mental Health Services in State of Chaos in California - Part 2: What Happens Next?

On October 8, 2010, Governor Schwarzanegger used his line item veto to cut billions from the state budget for fiscal year 2010-2011, including $133 allocated to County Mental Health agencies for AB 3632 services. Please read Part 1 in this Series on this blog for more information about the suspension of the AB 3632 mandate.

The Governor has made it clear that he intended to suspend the mandate for AB 3632 (mental health services) in California. AB 3632 allocated responsibility for the provision of mental health services pursuant to a child's IEP, as well as residential placements for emotionally disturbed students, to county mental health agencies.

Mental health services under AB 3632 included

• individual or group psychotherapy
• collateral services
• medication monitoring
• intensive day treatment
• day rehabilitation
• case management services

Title 2, California Code of Regulations, Section 60020(i).

Outpatient services are provided at a clinic or public DMH agency, or may be located on a school campus in some circumstances. "Intensive day treatment" and "day rehabilitation" services are intensive mental health services provided in community based or residential treatment program settings.

Additionally, residential placements were funded under the AB 3632 mandate for students who were eligible under the category of "emotional disturbance" and who required a residential educational placement in order to receive an appropriate special education program. (*note: residential placements for students under other categories of eligibility were already the responsibility of the school districts / local education agencies).

Residential placement is an out-of-home placement in a residential treatment facility with a school program certified as a Non Public School (NPS) and appropriate mental health and day rehabilitation services as part of the program. *Residential placements are on the "continuum of placement options" under the California Education Code.

The Governor's suspension of the mandate has caused chaos, confusion, and controversy throughout the state. Because mental health services are mandated by federal law (the IDEA) to be provided as part of a student's IEP if they are required for that student to access an educational benefit, the suspension of the California-specific AB 3632 mandate does NOT eliminate mental health services for students who require them. Nor does the Governor's action mean that residential placements will, as a matter of course, no longer be available for students in California.

The State of Chaos for County Departments of Mental Health

On October 12, 2010, the Executive Director of the state Mental Health Directors Association sent a memo to all County Mental Health agencies regarding the current state of AB 3632 services. The memo addresses questions arising from the suspension of the mandate, such as whether the Governor actually had the legal authority to suspend a mandate. Additionally, it indicated that there was uncertainty about factors such as the date on which the suspension was effective (October 8th or retroactive to the start of the fiscal year), whether / how counties will ever be reimbursed for the costs incurred from 2004 forward for providing services, and how funding will be accessed / provided for transition of services to school districts.

The Memo set forth "Issues/Actions" for counties to consider, discussing the pros and cons of each action. Subsequently, County Mental Health agencies across the state have each interpreted / implemented these "actions" individually, giving rise to a true state of confusion across California.

It appears to be fairly consistent that most County Mental Health agencies in Southern California are no longer accepting any new IEP referrals from school districts, stating that they do not have the legal right or responsibility to be involved in the IEP process. Los Angeles County Department of Mental Health (LACDMH) and San Diego County Department of Mental Health have reportedly taken this position. Additionally, counties that have taken this action are in most cases refusing to attend IEP meetings or participate any further in cases in which the DMH assessment had already occurred but the IEP meeting had yet to be held.

Reportedly, County Mental Health agencies have also been communicating with school districts, SELPAs, and contracted-residential placement staff, with inconsistent statements made. In some reports, Counties have indicated that students already in residential placements will continue to be funded through the end of this year, but in other reports, Counties have indicated that students will no longer be funded in residential placements effective immediately.

What is truly the "unknown" is what action County Mental Health agencies have taken / are taking to work with SELPAs and school districts to determine how to effectively transition students' services to the school districts.

The State of Chaos for School Districts / Local Education Agencies

Related services and appropriate placements (even residential placements) must be provided to a student as part of a Free Appropriate Public Education in order to meet the child's unique needs and provide them with educational benefit. If mental health services are required as a part of FAPE, they must be provided. It has always been the case that even though California allocated funding-responsibility to county mental health agencies under the AB 3632 mandate, the state education agency (CDE) through the school districts / local education agencies remained ultimately responsible for ensuring that the child was provided with a FAPE. See 20 U.S.C. sections 1400(8), 1401(22); 1412(a)(11)&(12); 34 C.F.R. sections 300.341, 300.360; California Education Code section 5600 & 56031; California Government Code sections 7570 et seq.

As courts have stated;

When disputes between agencies over funding arise, the school district must "ensure that the placement is at no cost to Parent, as provided for in 20 U.S.C. section 1412(a)(10)(B)(i). In other words, if there is to be a fight over payment, it is to be between the [school district] and [the other public agency], not between the parent and the [agency]."

School Board of Lee County Florida v. E.S., 561 F. Supp. 2d 1282 (M.D. Fl. 2008).

"Compliance with duties under the IDEA is a serious matter... Thus, it is not surprising that Congress would impose a duty on local education agencies to continue services to students if local a mental health agency refused to do so."

County of Tuolumne v. Special Education Hearing Office, James G, et al, 45 IDELR 15 (C. Ct. App. 2006) (citing 20 U.S.C. section 1412(a)(12)(B)(ii)).

All related services necessary for a child to benefit from special education / required for the child to make progress towards IEP goals, are the responsibility of the child's school district. Provision of an appropriate placement, including, when required, a residential placement, is also the responsibility of the child's school district. These responsibilities fall within the general duty of the school district to make a FAPE available to each child within its jurisdiction.

Thus, school districts in California are now left with the obligation and responsibility to continue to provide mental health services and residential placements, even though just a few weeks ago the funding responsibility fell on another agency. School districts are not permitted to refuse to provide services pursuant to an IEP, or to refuse to include services that are necessary in the IEP when it is developed, simply because a funding source is not identified. If the county mental health agency refuses to fund services, or ceases funding previously funded services, for any reason (such as the current suspension of the mandate), the school district must assume responsibility.

On October 18, 2010, the California Department of Education, Special Education Division, issued a memorandum to all SELPAs, County Offices of Education, the Advisory Committee on Special Education, Nonpublic School Administrators, and "Interested Individuals, Agencies and Organizations" addressing the present issues. In that memo, CDE called the Governor's actions "unconsionable" and indicated that the suspension of the mandate had created a "state of chaos" in California.

The intention of the memo was to "remind all special education local planning areas (SELPAs), county offices of education (COEs), and local education agencies (LEAs) [school districts] of their responsibility to provide mental health services to students with disabilities." The CDE cited to California Government Code sections and the IDEA. It stated "If a public agency other than an educational agency fails to provide or pay for the special education and related services... the LEA (or State agency responsible for developing the child's IEP) must provide or pay for these services to the child in a timely manner." (quoting 34 C.F.R. section 300.154(b)(2).

Despite this reminder, and the clear legal mandate from the federal law, a state of confusion has definitely ensued, and many school districts are reportedly telling parents that residential placements will no longer be offered, IEP meetings will not be held to discuss needed mental health services, etc.

The State of Chaos for Parents, Students and the Community

Many strange things have happened since the Governor's actions on October 8th. Some parents have been told by school districts (or by residential school staff, who were told by school districts or mental health agencies) that all residential placements would cease to be funded immediately. Other parents have reported that they have heard that the school districts won't continue to fund the residential placements if the child can "survive" outside of that setting. IEP meetings that were scheduled to review assessments by County Department of Mental Health professionals, and thus to determine necessary mental health services, are reportedly being canceled across the state.

School districts and IEP teams in California are so used to having the AB 3632 mandate, that they have forgotten the fact that residential placements and mental health services are not something "special" or "unique" to California. Thus, some school districts are understandably confused about how to make the determination of necessary services and placement under the genre of "mental health."

The community as a whole is certainly affected by the chaos, and litigation on these issues will likely be plentiful. It will take the collaborative efforts of non-profit legal services offices and the community of special education attorneys, advocates and parents, likely working with school districts, mental health agencies, etc, to address this issue in the long term. On October 21, 2010, in Los Angeles, a class action lawsuit was filed in federal court by Public Counsel, Disability Rights California, Mental Health Advocacy Services, and Gibson, Dunn & Crutcher, in order to "preserve lifeline services for more than 20,000 students." (You can find read the press release on Disability Rights California's website, as well as the complaint filed).

Here are some final points to keep in mind if you are being told that services are going to stop, that placement is going to end, etc:

1. Most importantly, remember that ANY change to your child's IEP, including the placement and services he/she receives, cannot be done unilaterally / outside of the IEP process. At the least, an IEP meeting should be held and/or you should be given prior written notice of any proposed changes, after which you have the right to disagree with the proposal. You shouldn't sign an "administrative addendum" or other IEP document that is simply sent to you stating that residential placement is no longer available.

2. If a service is listed in an IEP already (i.e. outpatient mental health services, residential placement), that service / placement is, by definition, related to the student's education. No matter what agency was funding them before, services that were not related to a child's education and necessary for the child to make progress should not have been listed in the IEP. Thus, the school district's should not be able to argue that they are not responsible for mental health services or residential placement because those things were not "educationally related."

3. If a school district has made a referral for assessment by County Mental Health under AB 3632, and now that assessment will not go forward because of suspension of the mandate, the obligation to evaluate the child in this area falls back onto the District. The school district is obligated to evaluate a child in all areas of suspected disability, and the referral can be argued to be indication that the district acknowledges this as an area of suspected disability / an area that needs to be assessed.

4. A district's unilateral determination to stop services or placement due to the lack of funding through the department of mental health may give rise to a compliance issue, which can be addressed through a compliance complaint filed with the CDE, or to due process issues, which can be addressed by requesting a due process hearing with the Office of Administrative Hearings. Likely, there will be an influx of these types of cases in the coming weeks.

Finally, this is certainly all confusing and chaotic, and school districts, mental health agencies, providers, and parents are left to figure out on a case by case basis what will happen next. If you are impacted by this and fear that services will be eliminated, you should consult with a special education attorney for assistance.

Mental Health Services in State of Chaos in California: Part 1 - What Happened?

The Individuals with Disabilities Act (“IDEA”) requires that students with disabilities be provided with a “free appropriate public education,” which includes provision of related services necessary for a child to benefit from his or her special education. Related services includes “mental health services,” and since “FAPE” must be provided at “no cost to parents,” this obligates the educational agency to fund mental health services required to allow the student to benefit from their education.

In California, prior to 1984, concerns arose that the federal mandate for provision of appropriate mental health services as a part of a student’s IEP was not being implemented effectively. The mental health needs of students with disabilities were largely ignored, sometimes until more extreme interventions, like the juvenile justice system or hospitalization, were required. There was also a concern regarding the lack of coordination of services between school districts and other public agencies. Based on these concerns, the state legislature enacted what is known as AB3632, assigning the responsibility for mental health services to the state department of mental health, through the county departments of mental health. Thus, AB3632 assigned responsibility for mental health goals on a child’s IEP, mental health services, and even residential placements for seriously emotionally disturbed students, to an agency other than the local educational agency (i.e. school district) even though these components of the IEP are related to the student’s receipt of FAPE.

Over the past several years, much talk has occurred regarding the funding for AB3632 services. It has almost always been known to be an “underfunded” mandate. Counties estimate an amount in the hundreds of millions in terms of the money that has been spent on mandated services that has not been reimbursed by the state in accordance with the provisions of AB3632.

Enter Governor Schwarzenegger.

In 2005, the Governor’s budget proposed to suspend the AB3632 mandate. Advocacy groups, school districts, and even county mental health agencies argued against suspension noting that confusion and chaos would ensue if the obligation to fund and provide mental health services suddenly was shifted back to school districts without an appropriate transition. It was noted that school districts were not prepared to take on this obligation, that they did not employ the appropriate mental health professionals to provide these services, and that there was an “institutional disincentive for school districts to identify children as having complex and potentially costly mental health service needs if schools become the only agency responsible for meeting those needs.” See “AB3632,” Adolescent Mental Health Policy News, California Adolescent Health Collaborative, April 2005 (www.californiateenhealth.org).

In 2010, the issue arose again. In May 2010, a proposal to revise the AB3632 mandate was contemplated in the California General Assembly. Again, advocates argued that “suspension of AB3632 would most likely result in complete disarray and gaps in services for children as shifts in responsibility for and funding of the services occur.” See Letter to Honorable Dave Jones, AB3632 May Revision Proposal – Oppose, Disability Rights California (www.disabilityrightsca.org).

On October 8, 2010, Governor Schwarzenegger utilized his “line item veto” to veto approximately $133 million within the state budget package for reimbursement to County Mental Health for “back claims” of amounts owed to them for providing mandated AB3632 services. At the same time, Governor Schwarzenegger stated that he was “suspending the AB3632 mandate.” Thus, effectively as of that date, county Mental Health is no longer required to provide mental health services to students pursuant to their IEPs, and school districts will now be required to provide these services and placements. No additional funding was allocated in the budget to cover the expenses that will be occurred in order to meet these obligations. (*there is debate regarding whether the Governor could use a "line item veto" to effectively eliminate an entire mandate, which will likely be one subject of litigation in the coming days, weeks and months. Meanwhile, what we know is that in fact, the Governor's intention with this action was to suspend the mandate).

The action has been called by many “unconscionable” and certainly creates a state of chaos for school districts, county mental health agencies, parents, and students. See, e.g., “Governor’s proposal puts kids’ mental health services at risk,” Michael C. Watkins (www.santacruzsentinel.com); “CDCAN Report #190-2010” (www.cdcan.info/node/1357). It is uncertain what the Governor could have possibly believed he was accomplishing by this action. Ultimately, it will not save the state any money to cut out of the budget funding for “mental health services” through AB3632 specifically, as these services are still mandated to be funded. The financial burden will simply shift to the already over-burdened school district, and the state as well as local educational agencies will also likely incur expensive legal fees because of issues arising out of this state of chaos.

Stay tuned to the blog for more information. Tomorrow's postings will cover "What happens next after the Governor's veto?"(the all important question, with somewhat speculative answers).

Related Services: Counseling

Under the IDEA Counseling is a related service, defined as services provided by qualified social workers, psychologists, guidance counselors, or other qualified personnel. See CFR 300.34(c)(2).

Related services include psychological counseling when it is required for a student to receive FAPE. See 34 CFR 300.34(c)(10). A school district, however, may be required to provide psychological counseling services even in situations where counseling is not needed primarily for educational purposes. In Doe v. Anring, the court found that psychotherapy and group therapy were required to assist the student to benefit from special education and were therefore "related services" under federal law. See Doe v. Anrig, 558 IDELR 278 (D. Mass. 1987).

If a student has emotional and behavioral disorders they may be entitled to receiving counseling services for therapeutic as well as educational benefit. If a student is emotionally or behaviorally disturbed, the connection between improving emotional difficulties, coping skills or social skills and increasing a student's ability to benefit from special education is fairly clear. In Sacramento City Unified School District, the student in question had intellectual abilities in the high average range but his classroom performance was below his ability. He displayed little to no behavior issues within the confines of the structured classroom setting but out of the classroom his behaviors included physical abuse of other children. The court found that he qualified for special education and related services, including counseling. See Sacramento City Unified School District, 509 IDELR 171 (SEA CA 1987).

Psychotherapy can either be a related service or a medical service, for which the LEA would not be responsible. The distinction is drawn based on the identity of the provide and the relation of the therapy to the child's educational needs. Typically, services that can only be provided by a psychiatrist are classified as medical services. If the psychotherapy services can be provided by other professionals, such as social workers, psychologists or guidance counselors, then those services will be considered related services if they are required to assist a child benefit from his or her special education.

Related Services Hiatus

Due to some circumstances beyond my control - namely that I stayed up late baking a fabulous rainbow birthday cake - I'm going to have to delay the post by one day. Check back tomorrow for a post on Counseling.

Switzer Learning Center

Yesterday, I visited and toured the Switzer Learning Center, a Nonpublic School (NPS) (for more about NPS placements - read our previous blog post from April 2009) in Torrance, California. Switzer if a specialized school for students grades 3 through 12 with learning disabilities, emotional disabilities, attention deficit disorders and behavioral disorders. It is an extremely small school, with currently around 92 students total.

Overview of the Program:

Switzer incorporates a clinical treatment program and behavior management throughout the school program. All students at all grade levels are on a behavior program that is based on reinforcement for positive behaviors, meaning that the students earn points for appropriate behaviors in each period of the school day. Additionally, the school keeps data on both negative or inappropriate behaviors and positive or "involvement" behaviors for every student, and utilizes a computer program to track progress and compare the student to the overall population of the school. The clinical treatment component also includes DIS counseling services for all students on a weekly basis, and availability of the counselors in the moment on an as needed basis.

There is one elementary school classroom, with students ranging from third through sixth grade, and one middle school class, with students from sixth through eighth grade. The high school classrooms are separate from the lower grade levels. The high school program includes six periods per day with the students changing classes and teachers for each class, similar to a traditional high school schedule. High school students can also be dually enrolled, either in a public high school in their home district, at the Southern California Regional Occupational Center (SCROC) in Torrance.

Other Things to Note:

Switzer is a good option for students who have behavior difficulties related to their disability.

It provides modified and individualized instruction within grade level curriculum standards, and also utilizes a specialized reading program, SRA-reading, to provide specialized intervention.

The behavior system is very positive and seems to be implemented consistently.

Switzer offers a diploma-bound curriculum, but does not provide the necessary classes and credits for a student to go straight into a 4-year university.

For more information about Switzer, visit their site directly at www.switzercenter.org. We can also help you with specific information about Non Public School placements.

Residential Placements

What is a residential placement? When is it required? Who pays for the room and board cost? This blog will cover a basic overview of residential placements. Because often is is the student with mental health needs that need a therapeutic program like a residential school, this blog is part of our series for Children's Mental Health Awareness Day.

Residential schools can provide students with much needed consistency and intensity in their program, and can provide a therapeutic environment that may not be available in other settings. They exist on the "continuum of placements" under the IDEIA and state special education laws. Generally, residential placements are very restrictive settings, are very expensive, and are burdensome on the family unit, as the child has to be out of the home. Therefore, they are only appropriate as a consideration of the IEP team in situations where it is shown that they are required for that student.

Overview and Definitions:

A "residential placement" is a facility in which the student essentially lives at the school site and is in 24 hour custody. Residential schools are a type of therapeutic placement, and they provide a therapeutic component to address the student's mental health needs in conjunction with addressing the core educational curriculum and academics.

Students require residential placements for a variety of reasons and in a variety of situations. Residential placement is deemed appropriate when the therapeutic and residential components of the program are necessary in order for the student to receive an educational benefit. If placement in a residential program is necessary for the appropriate provision of special education and related services to the student, the program (including both therapeutic and educational components) must be provided at no cost to parents. Students who require residential programs are those for whom the educational needs and emotional needs are "intertwined" or "inseparable" from emotional needs, and a determination is made by the IEP team that the child requires therapeutic and habilitation services in order to "benefit from special education."

Some Basic Examples:

Student with extreme behavioral difficulties, who has been unable to learn appropriate behaviors in the school and community settings, or who is unable to generalize learned behaviors across settings to the extent that they are not able to benefit from the general education campus placement.

Students who require intensive 24-hour supervision and interventions to address aggressive, assaultive, destructive or self-injurious behaviors.

Students whose mental health needs are so significant that they impact their ability to participate in the school environment, attend school regularly, and function on a regular campus.

Students who have not made any progress in their emotional and behavioral goals in a less restrictive setting, and who require interventions across settings and in a therapeutic environment in order to benefit.

Payment for Residential Programs:

If a residential program is required for the student to receive FAPE, then it must be provided at no cost to parents. This does not mean, necessarily, that your school district will be paying the entire cost. Rather, states are permitted to have specific procedures and mechanisms in place to deal with funding for residential schools. In many states, there are cost-sharing arrangements between school districts (or "local education agencies" - LEAs), the state department of education (or "state education agencies" - SEAs), and / or other local or state government agencies. For example, in California, there are state-specific cost provisions that require the Department of Mental Health to fund the residential and therapeutic components of the program, if the child is eligible to recieve mental health services under the state's AB3632 provision.

Ultimately, it is the school district's responsibility to provide individual students with a free appropriate public education (FAPE). And the bottom line, therefore, is that if the student requires residential placement to recieve a FAPE, the District bears the burden of ensuring that it is provided at no cost to parents. There are certainly instances where a child may not qualify for eligibility under AB3632 or whatever program/agency the state has for mental health services, but still requires residential placement as part of their educational program. In those situations, the District must fund the placement, including the residential component, because to fail to do so would be a denial of FAPE to the student.

Eligibility under the category of Emotional Disturbance ("ED")

Mental health issues, as described in the previous post, are important components of the special education maze for many special needs kids. While mental health concerns arise in every eligibility category, there is one obvious category where they are a centralized concern, and that is the category labeled "Emotional Disturbance".

To qualify for eligibility for special education and related services as someone with an emotional disability, a student must exhibit one of the following five criteria "to a marked degree" over "a long period of time".

These criteria are:

(1) An inability to learn that cannot be explained by intellectual, sensory or health factors.
(2) An inability to build or maintain satisfactory interpersonal relationships with peers and teachers.
(3) Inappropriate types of behavior or feelings under normal circumstances.
(4) A general pervasive mood of unhappiness or depression
(5) A tendency to develop physical symptoms or fears associated with personal or school problems.

What is "to a marked degree" over "a long period of time"? Well, to keep things interesting, the IDEA does not define these terms for us. To provide some guidance, the Office of Special Education Programs ("OSEP") has stated that a "generally acceptable definition" of "a long period of time" is a range of time from two to nine months - assuming preliminary interventions have been implemented and proven ineffective during that period. Letter to Anonymous, 213 IDELR 247 (OSEP 1989). As to the requirement that the behavior be to a "marked degree," OSEP has stated that this refers to the "frequency, duration or intensity of a student's emotionally disturbed behavior in comparison to the behavior of his peers and can be indicative of either degree or acuity or pervasiveness." Letter to Anonymous, 213 IDELR 247 (OSEP 1989).

My child meets this criteria, so now what? If your child meets the criteria for ED, then he or she should receive special education and related services that are appropriate for his or her unique educational needs in this area. If your child is not receiving services to meet these needs, then that means it is time for the IEP team to come together to discuss these unique needs, keeping in mind that "educational" needs can include BOTH academic and non-academic areas - so don't be afraid to explain how the emotional disability affects the needs of your child in both of these areas. The bottom line is that your child's IEP should reflect a program that is appropriate to meet your student's unique needs and enable him/her to receive an educational benefit.

How do I get Mental Health Services? Special education students in any disability category may receive services from county mental health programs. To receive these services, it all goes back to the basics of special education- FAPE - if mental health services are appropriate [the "A" in FAPE] to meet your child's unique educational needs [the "E" in FAPE], then those services must be provided at no cost to the parent [the "F" in FAPE].

National Children's Mental Health Awareness Day

Today, May 7, 2009, is National Children's Mental Health Awareness Day. This year's theme is "Thriving in the Community," and the awareness campaign has a special emphasis on how high school youth who receive the services they need are more likely to have positive outcomes, such as better grades, and less likely to have negative outcomes, such as involvement with the juvenile and criminal justice systems.

So many students who receive special education and related services require mental health services to address behavioral, social and emotional needs. We see a wide range of these issues, from kids who need school based counseling services to address their social skills deficits, to kids who require outside therapies to address their mental health needs, to kids who require residential placements because of the severity of their needs.

Here in California, we have what is referred to as AB3632 services, which are services and supports provided by the Department of Mental Health when a child on an IEP requires mental health services in order to access their curriculum. Read more about AB3632 here: http://www.dmh.ca.gov/Services_and_Programs/Children_and_Youth/AB3632.asp

Mental health issues need to be destigmatized-especially for kids and within the special education system. Why is it that parents are so reluctant to accept special education eligibility if the "category" is Emotional Disturbance (ED)? It's because of the stigma attached to these types of disabilities, the stigma that follows the child and unfortunately leads to misunderstanding by teachers and others who then often just assume "this is a bad kid." These issues can only be addressed by increased awareness on a large scale within school systems and communities.

One problem with mental health disabilities is that there are kids who are never identified as having a disability, but are merely "labelled" as being a disipline problem, so they never recieve the supports and services that they need. It is so true that if kids recieve the supports and services they need, they are more likely to have positive outcomes and less likely to end up on the juvenile or criminal system. As advocates, parents and educators, we have a "window of opportunity" to push for interventions and services for these students so that they can succeed and become productive participants in society.

Another equally concerning problem, however, is the overidentification of students as having "ED." In many instances, students with other disabilities, such as Learning Disabilities, Autism, etc, have related mental health needs, like anxiety or depression. Sometimes these needs are exasperated in situations where these children have not recieved the appropriate educational interventions or supports, and so they are flailing in a program where they are overwhelmed or feel "stupid." More awareness and education needs to take place to truly help parents and educators understand the existence of mental health needs that are related to other disabilities. The core disability may not be ED, but the child still may require mental health services in order to meet their needs.

There are also issues with systemic problems within school systems in terms of placing and servicing children with an "ED" label. Organizations all over the country are attempting to fight the "schoolhouse to jailhouse pipeline" by advocating for systemic changes in how students with emotional and behavioral difficulties are served within the special education system. (read: http://www.splcenter.org/news/item.jsp?aid=282) Too often, these kids have been "wharehoused" into special day classes without true individualization of their programs. Too often, comprehensive behavioral evaluations have not been conducted, or behavior plans have not been based on positive interventions, or haven't been approrpiately implemented. These systemic issues need to be addressed if the educational system is truly going to meet the needs of these kids, increase their positive outcomes and decrease the negative outcomes. An interesting article about these systemic issues can be found at the Southern Poverty Law Center's website at http://www.splcenter.org/legal/news/article.jsp?aid=189&site_area=1.

National Children's Mental Health Awareness Day is a good step in the right direction for addressing the issues that face children with mental health needs. Awareness, community education, decreased stigmatization, and systemic change are all necessary to truly begin to meet the needs of these kids so that they really can thrive in their communities.

Two Schools in Two Days

A2Z is often invited to open house events in Southern California to learn about and tour local non public schools. As these opportunities are made available to us, we will post to let you know about schools in your community and how they may be appropriate for your child.

Last week, I had the pleasure of touring two different schools in Los Angeles County: The Pacific Schools & Aviva High School

1. The HELP Group's Pacific Schools



Where: 15339 Saticoy Street, Van Nuys, California

What makes it unique: The Help Group's Pacific Schools are actually made up of 3 specialized programs: Pacific Ridge, Pacific Harbor and Project Six. In the Pacific Ridge and Pacific Harbor program, which are therapeutic day programs, the class size averages about 10 students with 2 adults. Various services, including family therapy, psychiatric services, counseling, speech and language services and Occupational Therapy are available on site. The Pacific Schools serve elementary, middle and high school aged students.

• Pacific Ridge is a day program serving children and adolescents with special needs in the areas of emotional, behavioral and neurological challenges.
  

• Pacific Harbor is for students who internalize their feelings, such as depression and anxiety, and may display mild behaviors. This program is also appropriate for students with emotional disturbances that require more intensive and comprehensive mental health services.
  

• Project Six is a residential treatment center for adolescents with emotional and behavioral challenges.
  

Is it appropriate for your child? The Pacific Schools may be appropriate for your child if he/she has emotional disabilities, behavioral disabilities, autism spectrum disorder, significant behavioral challenges or internalizing disorders. It provides a safe environment for students who were previously bullied at a typical school due to their differences, and who now show internal or external behaviors.

What I love about this school: The staff at the Pacific Schools place a strong emphasis on finding individualized incentives that are of interest to its students and using those things to help the student access his/her education. For instance, if your child is interested in playing instruments, sewing or guitar hero, these things would be made available as an incentive. For each program, there were "reward lounges" where students could play games, watch TV or use the computers. The importance of incorporating a child's interests into his/her program was a universal message across all three programs at the Pacific Schools. I believe that it was for this reason that the Pacific Schools had a personal touch where the personalities of the children were very evident.

2. Aviva High School




Where: 7120 Franklin Ave., Los Angeles, CA 90046

What makes it unique: Aviva High School is one of the few all girl, non public schools in Los Angeles County. Aviva also has a residential treatment program that has 42 students enrolled in the high school. Aviva provides a range of on-site clinical and educational services. Aviva also offers a mandatory 6 week summer school program designed to enrich and broaden the students' reading, writing, and math skills and prepare them to pass the California HIgh School Exit Exam (CAHSEE). Aviva High School has a maximum enrollment of 84 students. The maximum student:teacher ratio in class is 6:1. Over 95% of its students go on to post secondary programs, including universities and junior college.

Is it appropriate for your child? Aviva High School is appropriate for girls in grades 7 through 12 who need special academic, emotional, or behavioral support to maximize their educational potential. If your daughter requires a dual enrollment program, then Aviva may be the appropriate placement for her.

What I loved about this school: It was very clear that the staff at Aviva were dedicated not only to its students, but were also dedicated to working on improving the bureaucratic system that can often be an impediment to special education students. The staff at Aviva have forged relationships with individuals in the LAUSD system that are in charge of making important decisions, and are working with them to try to evoke a change in the system. This passion was not only present at the administrative level of Aviva, but was also apparent through the teachers, aides, and even hallway monitors at the school.