Existing law requires the governing board of any school district to give diligent care to the health and physical development of pupils and authorizes the governing board of a school district to employ properly certified persons for the work.

This bill would establish within the State Department of Education the Trauma-Informed Schools Initiative to address the impact of adverse childhood experiences on the educational outcomes of California pupils. The bill would require the department, if it determines appropriate funding is available, to take specified actions, on or before December 31, 2020, to implement the initiative, including developing and posting online an Internet Web site with information regarding the trauma-informed care approach, as defined, and a guide created by the department for public schools, including charter schools, on how to become trauma-informed schools, as defined. The bill would require school districts and charter schools to provide the Internet Web address of that Internet Web site to parents and guardians, as specified. To the extent the bill would impose additional duties on school districts and charter schools, the bill would impose a state-mandated local program. The bill would require the department, with the Student Mental Health Policy Workgroup, to consult with the State Department of Social Services for assistance in implementing the initiative.

The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above.

Existing law requires the governing board of any school district to give diligent care to the health and physical development of pupils and authorizes the governing board of a school district to employ properly certified persons for the work.

This bill would establish within the State Department of Education the Trauma-Informed Schools Initiative to address the impact of adverse childhood experiences on the educational outcomes of California pupils. The bill would require the department department, if it determines appropriate funding is available, to take specified actions, on or before December 31, 2019, 2020, to implement the initiative, including developing and posting online an Internet Web site with information regarding the trauma-informed care approach, as defined, and a guide created by the department for public schools, including charter schools, on how to become trauma-informed schools, as defined. The bill would require school districts and charter schools to provide the Internet Web address of that Internet Web site to parents and guardians, as specified. By imposing To the extent the bill would impose additional duties on school districts and charter schools, the bill would impose a state-mandated local program. The bill would require the department, with the Student Mental Health Policy Workgroup, to consult with the State Department of Health Care Services and the State Department of Social Services for assistance in implementing the initiative.

The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above.

Existing law requires the governing board of any school district to give diligent care to the health and physical development of pupils and authorizes the governing board of a school district to employ properly certified persons for the work.

This bill would establish within the State Department of Education the Trauma-Informed Schools Initiative to address the impact of adverse childhood experiences on the educational outcomes of California pupils. The bill would require the department to take specified actions, on or before December 31, 2019, to implement the initiative, including developing and posting online an Internet Web site with information regarding the trauma-informed care approach, as defined, and a guide created by the department for public schools, including charter schools, on how to become trauma-informed schools, as defined. The bill would require school districts and charter schools to provide the Internet Web address of that Internet Web site to parents and guardians, as specified. By imposing additional duties on school districts and charter schools, the bill would impose a state-mandated local program. The bill would also require the department, on or before December 31, 2019, to work with regional campuses of the University of California and the California State University to coordinate the offering of trauma-informed clinical care hours by students of those campuses at public schools, including charter schools, maintaining kindergarten or any of grades 1 to 12, inclusive, for pupils and their families. The bill would require the department, with the Student Mental Health Policy Workgroup, to consult with the State Department of Health Care Services and the State Department of Social Services for assistance in implementing the initiative.

The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above.

The California Constitution establishes the University of California as a public trust under the administration of the Regents of the University of California. The University of California comprises 10 institutions of higher education, which are located at Berkeley, Davis, Irvine, Los Angeles, Merced, Riverside, San Diego, San Francisco, Santa Barbara, and Santa Cruz.

This bill would express the intent of the Legislature to enact legislation that would create a pilot trauma-informed-care counseling clinic for middle school and high school pupils staffed by University of California students.

GOVERNOR'S VETO

GV Bill Id:AB 2691

Author:(Jones-Sawyer)

As Enrolled Ver:September 5, 2018

2/3 vote

Original Committee Reference: ED.

SUMMARY: Establishes the Trauma-Informed Schools Initiative within the California Department of Education (CDE), contingent upon the availability of funding, and requires CDE to provide information regarding the trauma-informed care approach to school districts and charter schools; to develop a guide for schools on how to become trauma-informed schools; to offer training on the trauma-informed care approach to schools; and to develop and post online a website about the Trauma-Informed Schools Initiative. If the CDE implements the initiative, each school district and charter school must provide the website address of the website developed by CDE to parents and guardians of pupils.

The Senate amendments:

1. Specify that the initiative will be implemented only if CDE determines that appropriate funding is available.
2. Delay the date of implementation to December 31, 2020.
3. Remove the requirement for CDE to consult with the State Department of Health Care Services.
4. Other technical and clarifying changes.

FISCAL EFFECT: According to the Senate Appropriations Committee:

1. While the bill specifies the program will only be implemented if CDE determines that funding is available, there would ongoing cost pressure of approximately $446,000 for CDE to provide information regarding the trauma-informed care approach to school districts, offer related training, and update information about the initiative online.
2. School districts would likely incur minor and absorbable costs to provide the initiative's web address to parents and guardians.

COMMENTS: According to the author,

"Studies now show that nearly every school has children who have been exposed to overwhelming experiences, such as witnessing violence between their caretakers, being the direct targets of abuse, and other kinds of adversity. The Adverse Childhood Experiences (ACE) study found higher levels of traumatic experiences in the general population than previously imagined. Among the approximately 17,000 adults surveyed, just over 50% reported having experienced at least one form of childhood adversity. These included physical, emotional or sexual abuse; witnessing their mother treated violently; having a parent with substance abuse or mental health issues; or, living in a household with an adult who had spent time in prison.

For many children who have experienced traumatic events, the school setting can feel like a battleground in which their assumptions of the world as a dangerous place sabotage their ability to remain calm and regulate their behavior in the classroom. Unfortunately, many of these children develop behavioral coping mechanisms in an effort to feel safe and in control, yet these behaviors can frustrate educators and evoke exasperated reprisals, reactions that both strengthen the child's expectations of confrontation and danger and reinforce a negative self-image."

Background. The Adverse Childhood Experiences (ACE) study investigated the associations between childhood maltreatment and later-life health and well-being. The ACE Study has shown that adverse childhood experiences are major risk factors for the leading causes of illness and death, as well as poor quality of life. Related research has also demonstrated a strong association between high ACE scores and poor performance in school, including a higher risk of learning and behavior problems. Other research into the effects of chronic stress (often caused by ACEs) on children, has identified a profound effect on the developing brain, which in turn affects school performance and behavior.

Recognition of the impact of these childhood experiences has led to the development and increasing use of "trauma-informed" approaches in a variety of fields, including education. Trauma-informed practices in schools are those which involve:

1. A realization of the widespread prevalence and impact of trauma.
2. Recognition of signs of traumatic exposure.
3. Responses grounded in evidence-based practices.
4. Resisting the re-traumatization of students.

Examples of such practices in schools include professional development for educators on the role of trauma in learning, classroom management practices and discipline policies focused on conflict resolution and restorative practices, and instructional modifications which address the specific learning needs of students exposed to trauma.

GOVERNOR'S VETO MESSAGE:

This bill would establish the "Trauma-Informed Schools Initiative" within the Department of Education at state headquarters "to address the impact of ACEs on the educational outcomes of California pupils".

It's a no brainer that our schools should be sensitive to the unique and diverse characteristics of all students. With that goal in mind, I have signed dozens of bills that have sought to ensure that all our students are free from discrimination, bullying, or any other form of disrespect.

While this bill is intended to do good, I am alarmed by the amount of jargon it creates and the inevitable labeling it will encourage. The issues here are best handled by local schools -- and in plain English.

Analysis Prepared by: Debbie Look / ED. / (916) 319-2087 FN: 0005250

CONCURRENCE IN SENATE AMENDMENTS

CSA1 Bill Id:AB 2691

Author:(Jones-Sawyer)

As Amended Ver:August 17, 2018

Majority vote

Original Committee Reference: ED.

SUMMARY: Establishes the Trauma-Informed Schools Initiative within the California Department of Education (CDE), contingent upon the availability of funding, and requires CDE to provide information regarding the trauma-informed care approach to school districts and charter schools; to develop a guide for schools on how to become trauma-informed schools; to offer training on the trauma-informed care approach to schools; and to develop and post online a website about the Trauma-Informed Schools Initiative. If the CDE implements the initiative, each school district and charter school must provide the website address of the website developed by CDE to parents and guardians of pupils.

The Senate amendments:

1. Specify that the initiative will be implemented only if CDE determines that appropriate funding is available.
2. Delay the date of implementation to December 31, 2020.
3. Remove the requirement for CDE to consult with the State Department of Health Care Services.
4. Other technical and clarifying changes.

FISCAL EFFECT: According to the Senate Appropriations Committee:

1. While the bill specifies the program will only be implemented if CDE determines that funding is available, there would ongoing cost pressure of approximately $446,000 for CDE to provide information regarding the trauma-informed care approach to school districts, offer related training, and update information about the initiative online.
2. School districts would likely incur minor and absorbable costs to provide the initiative's web address to parents and guardians.

COMMENTS: According to the author,

"Studies now show that nearly every school has children who have been exposed to overwhelming experiences, such as witnessing violence between their caretakers, being the direct targets of abuse, and other kinds of adversity. The Adverse Childhood Experiences (ACE) study found higher levels of traumatic experiences in the general population than previously imagined. Among the approximately 17,000 adults surveyed, just over 50% reported having experienced at least one form of childhood adversity. These included physical, emotional or sexual abuse; witnessing their mother treated violently; having a parent with substance abuse or mental health issues; or, living in a household with an adult who had spent time in prison.

For many children who have experienced traumatic events, the school setting can feel like a battleground in which their assumptions of the world as a dangerous place sabotage their ability to remain calm and regulate their behavior in the classroom. Unfortunately, many of these children develop behavioral coping mechanisms in an effort to feel safe and in control, yet these behaviors can frustrate educators and evoke exasperated reprisals, reactions that both strengthen the child's expectations of confrontation and danger and reinforce a negative self-image."

Background. The Adverse Childhood Experiences (ACE) study investigated the associations between childhood maltreatment and later-life health and well-being. The ACE Study has shown that adverse childhood experiences are major risk factors for the leading causes of illness and death, as well as poor quality of life. Related research has also demonstrated a strong association between high ACE scores and poor performance in school, including a higher risk of learning and behavior problems. Other research into the effects of chronic stress (often caused by ACEs) on children, has identified a profound effect on the developing brain, which in turn affects school performance and behavior.

Recognition of the impact of these childhood experiences has led to the development and increasing use of "trauma-informed" approaches in a variety of fields, including education. Trauma-informed practices in schools are those which involve:

1. A realization of the widespread prevalence and impact of trauma.
2. Recognition of signs of traumatic exposure.
3. Responses grounded in evidence-based practices.
4. Resisting the re-traumatization of students.

Examples of such practices in schools include professional development for educators on the role of trauma in learning, classroom management practices and discipline policies focused on conflict resolution and restorative practices, and instructional modifications which address the specific learning needs of students exposed to trauma.

Analysis Prepared by: Debbie Look / ED. / (916) 319-2087 FN: 0004309

 THIRD READING  

Bill No: AB 2691

Author:

: Senate

Vote:

SENATE EDUCATION COMMITTEE: 7-0, 6/20/18

AYES: Allen, Wilk, Galgiani, Leyva, McGuire, Pan, Vidak

SENATE APPROPRIATIONS COMMITTEE: 7-0, 8/16/18

AYES: Portantino, Bates, Beall, Bradford, Hill, Nielsen, Wiener

ASSEMBLY FLOOR: 76-0, 5/30/18 - See last page for vote

SUBJECT:

SOURCE: Author

DIGEST:

This bill establishes the Trauma-Informed Schools Initiative within the California Department of Education (CDE) to address the impact of adverse childhood experiences (ACE) on the educational outcomes of California pupils.

ANALYSIS:

Existing law:

1) Requires the Superintendent of Public Instruction (SPI) to post, and annually update, on the department’s Web site a list of statewide resources, including community-based organizations, that provide support to youth, and their families, who have been subjected to school-based discrimination, harassment, intimidation, or bullying. The Web site must also include a list of statewide resources for youth who have been affected by gangs, gun violence, and psychological trauma caused by violence at home, at school, and in the community. (Education Code § 234.5)

2) Establishes The Learning Communities for School Success Program to provide grants to local education agencies (LEAs) for planning, implementation, and evaluation of activities in support of evidence-based, non-punitive programs and practices to keep the state’s most vulnerable pupils in school. These may include activities that advance social-emotional learning, positive behavior interventions and supports, culturally responsive practices, and trauma-informed strategies. (EC § 33432)

3) Requires the governing board of a school district to give diligent care to the health and physical development of pupils, and authorizes the district to employ properly certified persons for the work. (EC § 49400)

4) Specifies that the minimum requirements for the services credential with a specialization in pupil personnel services are a baccalaureate degree or higher degree from an approved institution, a fifth year of study, and any specialized and professional preparation that the commission shall require. The services credential with a specialization in pupil personnel services shall authorize the holder to perform, at all grade levels, the pupil personnel service approved by the commission as designated on the credential, which may include, but need not be limited to, school counseling, school psychology, child welfare and attendance services, and school social work. (EC § 44266)

5) Prohibits any person who is an employee of a school district from administering psychological tests or engaging in other psychological activities involving the application of psychological principles, methods or procedures unless the person holds a valid and current credential as a school psychologist or is a psychological assistant or intern performing the testing or activities under the supervision of a credentialed psychologist. (EC § 49422)

6) Specifies that school districts are not precluded from utilizing community-based service providers, including volunteers, individuals completing counseling-related internship programs, and state licensed individuals and agencies to assist in providing pupil personnel services, provided that such individuals and agencies are supervised in their school-based activities by an individual holding a pupil personnel services authorization. (California Code of Regulations, Title 5, Section 80049.1(c))

This bill establishes the Trauma-Informed Schools Initiative within the CDE to address the impact of ACE on the educational outcomes of California pupils. Specifically, this bill:

1. Requires the CDE, in implementing the Trauma-Informed Schools Initiative, to do all of the following by December 31, 2020:
   1. Provide information regarding the trauma-informed care approach to school districts and charter schools.
   2. Develop a guide for public schools, including charter schools, on how to become trauma-informed schools.
   3. Offer training on the trauma-informed care approach to school districts and charter schools, which shall include the guide developed by CDE.
   4. Develop and post online an Internet Web site about the Trauma-Informed Schools Initiative that includes information for public schools, including charter schools, and parents and guardians regarding the trauma-informed care approach and the guide developed by CDE
2. Requires the CDE, with the Student Mental Health Policy Workgroup, to consult with the State Department of Social Services for assistance in implementing the Trauma-Informed Schools Initiative, as specified above.
3. Requires, if CDE implements the initiative, each school district and charter school to provide the Internet Web address of the Internet Web site developed and posted by the CDE to parents and guardians of the pupils of the school district or charter school, and for school districts, to do so at the beginning of the first semester or quarter of the regular school term.
4. Prohibits its provisions from being construed as authorizing or encouraging an employee of a public school, including a charter school, maintaining kindergarten or any of grades 1 to 12, inclusive, to diagnose or treat mental illness unless the employee is specifically licensed and authorized to do so.
5. Provides the following definitions for its purposes:
   1. “ACEs” means adverse childhood experiences.
   2. “Student Mental Health Policy Workgroup” means the workgroup convened in 2012 by the SPI to develop policy recommendations that promote early identification, referral, coordination, and access to quality mental health services for pupils.
   3. “Trauma-informed care approach” means an approach that involves understanding of ACEs and responding to the symptoms of chronic interpersonal trauma and traumatic stress across the lifespan of an individual.
   4. “Trauma-informed school” means a public school, including a charter school, that does all of the following:
      1. Realizes the widespread impact of trauma and understands potential paths for recovery from trauma.
      2. Recognizes the signs and symptoms of trauma in pupils, teachers, and staff.
      3. Responds to trauma by fully integrating knowledge about trauma into the school’s policies, procedures, and practices.
      4. Seeks to actively resist retraumatization.

Comments

1. Need for the bill. According to the author, “Studies show that nearly every school has children who have been exposed to overwhelming experiences, such as witnessing violence between their caretakers, being the direct targets of abuse, and other kinds of adversity. The ACE study found higher levels of traumatic experiences in the general population than previously imagined. Among the approximately 17,000 adults surveyed, just over 50% reported having experienced at least one form of childhood adversity. These included physical, emotional or sexual abuse; witnessing their mother treated violently; having a parent with substance abuse or mental health issues; or, living in a household with an adult who had spent time in prison.

“For many children who have experienced traumatic events, the school setting can feel like a battleground in which their assumptions of the world as a dangerous place sabotage their ability to remain calm and regulate their behavior in the classroom. Unfortunately, many of these children develop behavioral coping mechanisms in an effort to feel safe and in control, yet these behaviors can frustrate educators and evoke exasperated reprisals, reactions that both strengthen the child’s expectations of confrontation and danger, and reinforce a negative self-image.”

2) Student Mental Health Policy Workgroup (SMHPW) and Project Cal-Well. The SPI convened the SMHPW in 2012 to assess the mental health needs of California students and gather evidence to support policy recommendations to the SSPI and the California Legislature. The all-volunteer, unpaid work group is composed of teachers, school counselors, school social workers, school psychologists, school nurses, and school administrators, and state and county mental health professionals. This diverse group has used its combined expertise to develop policy recommendations related to mental health training for educators, youth suicide, student safety, and other mental health-related issues. In addition to its work in providing policy recommendations, the SMHPW now serves as the State Management Team for Project Cal-Well, a five-year federal grant program which serves to foster collaboration between the CDE and LEAs to address critical mental health needs of California's kindergarten through twelfth-grade students. Its policy recommendations include “recommending that the SPI encourage local agencies to work together to develop comprehensive school-based mental health programs. Working together as a team, school staff, school and district boards, county offices of education, and community agencies can be more effective in providing needed assistance to students and their families to support student mental health.”

3) Incidence of ACEs among children and youth. A 2011-12 National Survey of Children’s Health identified the prevalence of ACE among children age 0-17 years. Among the study findings related to children in California:

• 44 percent had one or more ACEs.
• 18 percent had two or more ACEs.
• 22 percent had experienced extreme economic hardship.
• 17 percent had experienced family discord leading to divorce or separation.
• 11 percent had lived with someone who had an alcohol or drug problem.
• 8 percent had been a victim or witness of neighborhood violence.
• 7 percent had witnessed domestic violence.

4) California lags in providing social-emotional support to pupils. According to CDE data for 2016-17, there were 5,932 school psychologists and 687 social workers employed in California schools. Further, 29 percent of California school districts have no counseling programs at all. The ratio of students per counselor in this state averages 945 to 1, compared to the national average of 477 to 1, ranking California last in the nation. As of 2016-17, there were only 2,630 credential school nurses, but there are more than 10,000 public K-12 schools in California.

5) Student mental health initiatives. The CDE is engaged in a number of initiatives aimed at improving support for student mental health needs. Among them are:

• Student Mental Health Policy Workgroup established in 2012 to develop policy recommendations that promote early identification, referral, coordination, and access to quality mental health services for students.
• Training Educators Through Recognition and Identification Strategies-Eliminating Barriers to learning (TETRIS-EBL project), a mental health training project funded by the California Mental Health Services Authority and administered through a contract with the Placer County Office of Education.
• A federally-funded "Now is the Time" project to provide support to three LEAs, and CDE training of school staff in a program called Youth Mental Health First Aid.
• Since 2011 an initiative called the Regional K-12 Student Mental Health Initiative, operated through the California County Superintendents Educational Services Association, has provided training designed to build capacity and cross-system collaboration to develop and sustain school-based mental health programs addressing prevention and early identification strategies.

The federal Every Student Succeeds Act (ESSA) also offers support for student mental health through a grant program called Student Support and Academic Enrichment Grants, which may be used, among many other purposes, to “expand access to or coordinate resources for school-based counseling and mental health programs, such as through school-based mental health services partnership programs.” This and other provisions of ESSA are subject to appropriation.

FISCAL EFFECT: Appropriation: Fiscal Com.: Local:

According to the Senate Appropriations Committee:

• While the bill specifies the program will only be implemented if CDE determines that funding is available, there would ongoing cost pressure of approximately $446,000 for CDE to provide information regarding the trauma-informed care approach to school districts, offer related training, and update information about the initiative online.
• School districts would likely incur minor and absorbable costs to provide the initiative’s Web address to parents and guardians.

SUPPORT: (Verified 8/17/18)

Alliance for Children’s Rights

California School Boards Association

California School Nurses Association

California State PTA

County Behavioral Health Directors Association of California

Los Angeles County Office of Education

National Association of Social Workers – California Chapter

SIATech High School

OPPOSITION: (Verified 8/17/18)

None received

ASSEMBLY FLOOR: 76-0, 5/30/18

AYES: Acosta, Aguiar-Curry, Arambula, Baker, Berman, Bigelow, Bloom, Bonta, Brough, Burke, Caballero, Calderon, Carrillo, Cervantes, Chau, Chávez, Chiu, Choi, Chu, Cooley, Cooper, Cunningham, Dahle, Daly, Eggman, Flora, Fong, Frazier, Friedman, Gallagher, Cristina Garcia, Eduardo Garcia, Gipson, Gloria, Gonzalez Fletcher, Gray, Grayson, Harper, Holden, Irwin, Jones-Sawyer, Kalra, Kamlager-Dove, Kiley, Lackey, Levine, Limón, Low, Maienschein, Mathis, Mayes, McCarty, Medina, Melendez, Mullin, Muratsuchi, Nazarian, Obernolte, O'Donnell, Patterson, Quirk, Quirk-Silva, Reyes, Rodriguez, Rubio, Salas, Santiago, Steinorth, Mark Stone, Thurmond, Ting, Voepel, Waldron, Weber, Wood, Rendon

NO VOTE RECORDED: Travis Allen, Chen

Prepared by:

8/19/18 13:34:20

**** END ****

SENATE COMMITTEE ON APPROPRIATIONS

Senator Anthony Portantino, Chair

2017 - 2018 Regular Session

AB 2691 (Jones-Sawyer) - Pupil health: pupil and school staff trauma: Trauma-Informed Schools Initiative

Bill Summary:

This bill establishes the Trauma-Informed Schools Initiative within the California Department of Education (CDE) to address the impact of adverse childhood experiences on the educational outcomes of California pupils.

*********** ANALYSIS ADDENDUM – SUSPENSE FILE ***********

The following information is revised to reflect amendments

adopted by the committee on August 16, 2018

Fiscal Impact:

• While the bill specifies the program will only be implemented if CDE determines that funding is available, there would ongoing cost pressure of approximately $446,000 for CDE to provide information regarding the trauma-informed care approach to school districts, offer related training, and update information about the initiative online.
• School districts would likely incur minor and absorbable costs to provide the initiative’s web address to parents and guardians.

Author Amendments:

Specify that the program will only be implemented if CDE determines appropriate funding is available, remove the Department of Health Care Services from the consulting requirement, and make other changes.

-- END --

SENATE COMMITTEE ON

Senator Anthony Portantino, Chair

2017 - 2018 Regular Session

AB 2691 (Jones-Sawyer) - Pupil health: pupil and school staff trauma: Trauma-Informed Schools Initiative

This bill meets the criteria for referral to the Suspense File.

Bill Summary:

This bill establishes the Trauma-Informed Schools Initiative within the California Department of Education (CDE) to address the impact of adverse childhood experiences on the educational outcomes of California pupils.

Fiscal Impact:

• The CDE indicates ongoing costs of approximately $446,000 to provide information regarding the trauma-informed care approach to school districts, offer related training, and update information about the initiative online.
• School districts would likely incur minor and absorbable costs to provide the initiative’s web address to parents and guardians.

Background:

Existing law requires the Superintendent of Public Instruction to post, and annually update, on the department’s website a list of statewide resources, including community-based organizations, that provide support to youth, and their families, who have been subjected to school-based discrimination, harassment, intimidation, or bullying. The website must also include a list of statewide resources for youth who have been affected by gangs, gun violence, and psychological trauma caused by violence at home, at school, and in the community.

Proposed Law: This bill establishes the Trauma-Informed Schools Initiative within the CDE to address the impact of adverse childhood experiences on the educational outcomes of California pupils. CDE would be required to do the following:

1) Provide information regarding the trauma-informed care approach to school districts and charter schools.

2) Develop a guide for public schools, including charter schools, on how to become trauma-informed schools.

3) Offer training on the trauma-informed care approach to school districts and charter schools, which shall include the guide developed by CDE.

4) Develop and post online an Internet Web site about the Trauma-Informed Schools Initiative that includes information for public schools, including charter schools, and parents and guardians regarding the trauma-informed care approach and the guide developed by CDE

This bill also requires the CDE, with the Student Mental Health Policy Workgroup, to consult with the State Department of Health Care Services and the State Department of Social Services for assistance in implementing the Trauma-Informed Schools Initiative.

This bill requires each school district and charter school to provide the Internet Web address of the Internet Website developed and posted by the CDE to parents and guardians of the pupils of the school district or charter school, and for school districts, to do so at the beginning of the first semester or quarter of the regular school term.

This bill prohibits its provisions from being construed as authorizing or encouraging an employee of a public school, including a charter school, maintaining kindergarten or any of grades 1 to 12, inclusive, to diagnose or treat mental illness unless the employee is specifically licensed and authorized to do so.

The bill make several definitions for its purposes, as specified.

Related Legislation:

AB 2022 (Chu, 2018) would require the CDE to report to the Legislature on the provision of mental health care to students. AB 2022 is pending in the Senate Health Committee.

AB 2686 (Jones-Sawyer, 2018) would require a county office of education, school district, state special school, or charter school to adopt a training policy on pupil mental health for its school administrators and staff and requires the policy to be developed in consultation with school and community stakeholders and school-employed mental health professionals. AB 2686 was held in the Assembly Appropriations Committee.

AB 2315 (Quirk Silva, 2018) would require the CDE, in consultation with the State Department of Health Care Services and appropriate stakeholders with experience in telehealth, to develop guidelines on or before December 31, 2019, for the use of telehealth technology in public schools, including charter schools, to provide mental health and behavioral health services to pupils on school campuses. AB 2315 is pending in this Committee.

-- END --

SENATE COMMITTEE ON EDUCATION

Senator Benjamin Allen, Chair

2017 - 2018 Regular

Bill No: AB 2691 Hearing Date: June 20, 2018

Subject: Pupil health: pupil and school staff trauma: Trauma-Informed Schools Initiative.

SUMMARY

This bill establishes the Trauma-Informed Schools Initiative within the California Department of Education to address the impact of adverse childhood experiences on the educational outcomes of California pupils.

BACKGROUND

1) Requires the Superintendent of Public Instruction (SPI) to post, and annually update, on the department’s website a list of statewide resources, including community-based organizations, that provide support to youth, and their families, who have been subjected to school-based discrimination, harassment, intimidation, or bullying. The website must also include a list of statewide resources for youth who have been affected by gangs, gun violence, and psychological trauma caused by violence at home, at school, and in the community. (Education Code § 234.5)

2) Establishes The Learning Communities for School Success Program to provide grants to local education agencies (LEAs) for planning, implementation, and evaluation of activities in support of evidence-based, non-punitive programs and practices to keep the state’s most vulnerable pupils in school. These may include activities that advance social-emotional learning, positive behavior interventions and supports, culturally responsive practices, and trauma-informed strategies. (EC § 33432)

3) Requires the governing board of a school district to give diligent care to the health and physical development of pupils, and authorizes the district to employ properly certified persons for the work. (EC § 49400)

4) Specifies that the minimum requirements for the services credential with a specialization in pupil personnel services are a baccalaureate degree or higher degree from an approved institution, a fifth year of study, and any specialized and professional preparation that the commission shall require. The services credential with a specialization in pupil personnel services shall authorize the holder to perform, at all grade levels, the pupil personnel service approved by the commission as designated on the credential, which may include, but need not be limited to, school counseling, school psychology, child welfare and attendance services, and school social work. (EC § 44266)

5) Prohibits any person who is an employee of a school district from administering psychological tests or engaging in other psychological activities involving the application of psychological principles, methods or procedures unless the person holds a valid and current credential as a school psychologist or is a psychological assistant or intern performing the testing or activities under the supervision of a credentialed psychologist. (EC § 49422)

6) Specifies that school districts are not precluded from utilizing community-based service providers, including volunteers, individuals completing counseling-related internship programs, and state licensed individuals and agencies to assist in providing pupil personnel services, provided that such individuals and agencies are supervised in their school-based activities by an individual holding a pupil personnel services authorization. (California Code of Regulations, Title 5, Section 80049.1(c))

ANALYSIS

This bill establishes the Trauma-Informed Schools Initiative within the California Department of Education (CDE) to address the impact of adverse childhood experiences on the educational outcomes of California pupils. Specifically, this bill:

a) Requires the CDE, in implementing the Trauma-Informed Schools Initiative, to do all of the following by December 31, 2019:

1) Provide information regarding the trauma-informed care approach to school districts and charter schools.

2) Develop a guide for public schools, including charter schools, on how to become trauma-informed schools.

3) Offer training on the trauma-informed care approach to school districts and charter schools, which shall include the guide developed by CDE.

4) Develop and post online an Internet Web site about the Trauma-Informed Schools Initiative that includes information for public schools, including charter schools, and parents and guardians regarding the trauma-informed care approach and the guide developed by CDE

b) Requires the CDE, with the Student Mental Health Policy Workgroup, to consult with the State Department of Health Care Services and the State Department of Social Services for assistance in implementing the Trauma-Informed Schools Initiative, as specified above.

c) Requires each school district and charter school to provide the Internet Web address of the Internet Website developed and posted by the CDE to parents and guardians of the pupils of the school district or charter school, and for school districts, to do so at the beginning of the first semester or quarter of the regular school term.

d) Prohibits its provisions from being construed as authorizing or encouraging an employee of a public school, including a charter school, maintaining kindergarten or any of grades 1 to 12, inclusive, to diagnose or treat mental illness unless the employee is specifically licensed and authorized to do so.

e) Provides the following definitions for its purposes:

1) “Adverse Childhood Experiences (ACEs)” means adverse childhood experiences.

2) “Student Mental Health Policy Workgroup” means the workgroup convened in 2012 by the Superintendent of Public Instruction to develop policy recommendations that promote early identification, referral, coordination, and access to quality mental health services for pupils.

3) “Trauma-informed care approach” means an approach that involves understanding of ACEs and responding to the symptoms of chronic interpersonal trauma and traumatic stress across the lifespan of an individual.

4) “Trauma-informed school” means a public school, including a charter school, that does all of the following:

i) Realizes the widespread impact of trauma and understands potential paths for recovery from trauma.

ii) Recognizes the signs and symptoms of trauma in pupils, teachers, and staff.

iii) Responds to trauma by fully integrating knowledge about trauma into the school’s policies, procedures, and practices.

iv) Seeks to actively resist retraumatization.

STAFF COMMENTS

1. Need for the bill. According to the author, “Studies show that nearly every school has children who have been exposed to overwhelming experiences, such as witnessing violence between their caretakers, being the direct targets of abuse, and other kinds of adversity. The Adverse Childhood Experiences (ACE) study found higher levels of traumatic experiences in the general population than previously imagined. Among the approximately 17,000 adults surveyed, just over 50% reported having experienced at least one form of childhood adversity. These included physical, emotional or sexual abuse; witnessing their mother treated violently; having a parent with substance abuse or mental health issues; or, living in a household with an adult who had spent time in prison.

For many children who have experienced traumatic events, the school setting can feel like a battleground in which their assumptions of the world as a dangerous place sabotage their ability to remain calm and regulate their behavior in the classroom. Unfortunately, many of these children develop behavioral coping mechanisms in an effort to feel safe and in control, yet these behaviors can frustrate educators and evoke exasperated reprisals, reactions that both strengthen the child’s expectations of confrontation and danger, and reinforce a negative self-image.”

2) Student Mental Health Policy Workgroup and Project Cal-Well. The State Superintendent of Public Instruction (SPI) convened the Student Mental Health Policy Workgroup (SMHPW) in 2012 to assess the mental health needs of California students and gather evidence to support policy recommendations to the SSPI and the California Legislature. The all-volunteer, unpaid work group is composed of teachers, school counselors, school social workers, school psychologists, school nurses, and school administrators, and state and county mental health professionals. This diverse group has used its combined expertise to develop policy recommendations related to mental health training for educators, youth suicide, student safety, and other mental health-related issues. In addition to its work in providing policy recommendations, the SMHPW now serves as the State Management Team for Project Cal-Well, a five-year federal grant program which serves to foster collaboration between the California Department of Education (CDE) and local educational agencies to address critical mental health needs of California's kindergarten through twelfth-grade students. Its policy recommendations include “recommending that the SPI encourage local agencies to work together to develop comprehensive school-based mental health programs. Working together as a team, school staff, school and district boards, county offices of education, and community agencies can be more effective in providing needed assistance to students and their families to support student mental health.”

3) Incidence of Adverse Childhood Experiences (ACEs) among children and youth. A 2011-12 National Survey of Children’s Health identified the prevalence of adverse childhood experiences among children age 0-17 years. Among the study findings related to children in California:

• 44 percent had one or more ACEs.
• 18 percent had two or more ACEs.
• 22 percent had experienced extreme economic hardship.
• 17 percent had experienced family discord leading to divorce or separation.
• 11 percent had lived with someone who had an alcohol or drug problem.
• 8 percent had been a victim or witness of neighborhood violence.
• 7 percent had witnessed domestic violence.

4) California lags in providing social-emotional support to pupils. According to California Department of Education (CDE) data for 2016-17, there were 5,932 school psychologists and 687 social workers employed in California schools. Further, 29 percent of California school districts have no counseling programs at all. The ratio of students per counselor in this state averages 945 to 1, compared to the national average of 477 to 1, ranking California last in the nation. As of 2016-17, there were only 2,630 credential school nurses, but there are more than 10,000 public K-12 schools in California.

5) Student mental health initiatives. The CDE is engaged in a number of initiatives aimed at improving support for student mental health needs. Among them are:

• Student Mental Health Policy Workgroup established in 2012 to develop policy recommendations that promote early identification, referral, coordination, and access to quality mental health services for students.

• Training Educators Through Recognition and Identification Strategies-Eliminating Barriers to learning (TETRIS-EBL project), a mental health training project funded by the California Mental Health Services Authority and administered through a contract with the Placer County Office of Education.

• A federally-funded "Now is the Time" project to provide support to three local education agencies, and CDE training of school staff in a program called Youth Mental Health First Aid.

• Since 2011 an initiative called the Regional K-12 Student Mental Health Initiative, operated through the California County Superintendents Educational Services Association, has provided training designed to build capacity and cross-system collaboration to develop and sustain school-based mental health programs addressing prevention and early identification strategies.

The federal Every Student Succeeds Act (ESSA) also offers support for student mental health through a grant program called Student Support and Academic Enrichment Grants, which may be used, among many other purposes, to “expand access to or coordinate resources for school-based counseling and mental health programs, such as through school-based mental health services partnership programs.” This and other provisions of ESSA are subject to appropriation.

6) Related legislation and previous legislation. AB 2022 (Chu, 2018) would require the CDE to report to the Legislature on the provision of mental health care to students. AB 2022 is scheduled to be heard by this committee on June 20, 2018.

AB 2686 (Jones-Sawyer, 2018) would require a county office of education, school district, state special school, or charter school, before the beginning of the 2019–20 school year, to adopt a training policy on pupil mental health for its school administrators and staff and requires the policy to be developed in consultation with school and community stakeholders and school-employed mental health professionals. AB 2686 was held in the Assembly Appropriations Committee.

AB 2315 (Quirk Silva, 2018) would require the California Department of Education (CDE), in consultation with the State Department of Health Care Services and appropriate stakeholders with experience in telehealth, to develop guidelines on or before December 31, 2019, for the use of telehealth technology in public schools, including charter schools, to provide mental health and behavioral health services to pupils on school campuses. AB 2315 is pending in the Senate Health Committee.

AB 2471 (Thurmond, 2018) would require the transfer of funds from the Youth, Education, Prevention, Early Intervention and Treatment Account established through the passage of the Control, Regulate and Tax Adult Use of Marijuana Act to CDE to establish a grant program which would allow schools to provide in-school support services to pupils. AB 2471 was held in the Assembly Appropriations Committee.

SB 191 (Beall, 2017) would have authorized a local educational agency to enter into a contract with a county or qualified mental health service provider to create a partnership for providing mental health services to students. SB 191 would have created a new special fund, from which funding could be provided to support such programs. This bill was held in the Senate Appropriations Committee.

AB 1644 (Bonta, 2016) would have reestablished and renamed the Early Mental Health Initiative as the Healing from Early Adversity to Level the Impact of Trauma in Schools Act, expands the program to serve preschool and transitional Kindergarten students, and establishes an initiative to encourage and support local decisions to provide funding for services offered in that program. This bill was held in the Senate Appropriations Committee.

AB 1025 (Thurmond, 2015) would have required CDE to establish a three-year pilot program in school districts to encourage inclusive practices that integrate mental health, special education, and school climate interventions following a multi-tiered framework.

SB 1396 (Hancock, 2014) would have required CDE, to the extent one-time funding is available in the 2014-15 Budget Act, to designate funds to a county office of education to establish professional development activities to support the development and expansion of multi-tiered intervention and support programs, including but not limited to, schoolwide positive behavior intervention and support. SB 1396 was held on the Assembly Appropriations Committee’s suspense file.

SUPPORT

Alliance for Children’s Rights

California School Boards Association

California School Nurses Association

California State PTA

County Behavioral Health Directors Association of California

Los Angeles County Office of Education

National Association of Social Workers – California Chapter

SIATech High School

OPPOSITION

None received

-- END --

ASSEMBLY THIRD READING

ATR Bill Id:AB 2691

Author:(Jones-Sawyer)

As Amended Ver:April 16, 2018

Majority vote

SUMMARY: Requires the California Department of Education (CDE) to provide information and training to schools on trauma-informed care. Specifically, this bill:

1. Establishes the Trauma-Informed Schools Initiative within CDE and requires the CDE by December 31, 2019 to do all of the following:
   1. Provide information regarding the trauma-informed care approach to school districts and charter schools.
   2. Develop a guide for public schools, including charter schools, on how to become trauma-informed schools.
   3. Offer training on the trauma-informed care approach to school districts and charter schools.
   4. Develop and post online a website about the Trauma-Informed Schools Initiative that includes information for public schools, including charter schools, and parents and guardians regarding the trauma-informed care approach and the guide developed.
2. Requires the CDE and the Student Mental Health Policy Workgroup to consult with the Department of Health Care Services and the Department of Social Services for assistance in implementing the provisions.
3. Requires each school district and charter school to provide the address of the website developed and posted by the CDE to parents and guardians.
4. Specifies that nothing in this section shall be construed as authorizing or encouraging an employee of a public school, including a charter school to diagnose or treat mental illness unless the employee is specifically licensed and authorized to do so.
5. Defines the following terms for the purpose of this initiative:
   1. "Student Mental Health Policy Workgroup" means the workgroup convened by the Superintendent of Public Instruction in 2012 to develop policy recommendations that promote early identification, referral, coordination, and access to quality mental health services for pupils.
   2. "Trauma-informed care approach" means an approach that involves understanding of ACEs and responding to the symptoms of chronic interpersonal trauma and traumatic stress across the lifespan of an individual.
   3. "Trauma-informed school" means a public school, including a charter school, that realizes the widespread impact of trauma and understands potential paths for recovery from trauma; recognizes the signs and symptoms of trauma in pupils, teachers, and staff; responds to trauma by fully integrating knowledge about trauma into the school's policies, procedures, and practices; and seeks to actively resist retraumatization.

FISCAL EFFECT: According to the Assembly Appropriations Committee:

1. One-time general fund (GF) costs of about $300,000 for CDE to develop a guide and develop and post information about the initiative online.
2. Ongoing GF costs of about $200,000 for CDE to provide information regarding the trauma-informed care approach to LEAs, offer training on the trauma-informed care approach, and update information about the initiative online.
3. Minor and absorbable costs to LEAs to provide the initiative's web address to parents and guardians.

COMMENTS: Need for the bill. According to the author:

"Studies now show that nearly every school has children who have been exposed to overwhelming experiences, such as witnessing violence between their caretakers, being the direct targets of abuse, and other kinds of adversity. The Adverse Childhood Experiences study found that among the approximately 17,000 adults surveyed, just over 50% reported having experienced at least one form of childhood adversity. These included physical, emotional or sexual abuse; witnessing their mother treated violently; having a parent with substance abuse or mental health issues; or, living in a household with an adult who had spent time in prison. Experts explain that trauma is not an event itself, but rather a response to one or more overwhelmingly stressful events where one's ability to cope is dramatically undermined. These experiences in childhood can lead to a cascade of social, emotional and academic difficulties. As students get older, exposure to traumatic experiences can also lead to the adoption of self-medicating behaviors such as substance abuse, smoking, and overeating. All of these responses to traumatic events can interfere with a child's ability to learn at school."

Analysis Prepared by: Debbie Look / ED. / (916) 319-2087 FN: 0003200

Date of Hearing: May 9, 2018

ASSEMBLY COMMITTEE ON APPROPRIATIONS

Lorena Gonzalez Fletcher, Chair

ABPCA Bill Id:AB 2691

Author:(Jones-Sawyer) – As Amended Ver:April 16, 2018

Urgency: No State Mandated Local Program: Yes Reimbursable: Yes

SUMMARY: This bill requires the California Department of Education (CDE) to establish, by December 31, 2019, a Trauma-Informed Schools Initiative. It requires CDE to provide information regarding the trauma-informed care approach to local education agencies (LEAs), develop a guide for LEAs on how to become trauma-informed schools, offer training on the trauma-informed care approach to LEAs, and develop and post information about the initiative online. It also requires LEAs to provide the initiative’s web address to parents and guardians.

FISCAL EFFECT:

1. One-time GF costs of about $300,000 for CDE to develop a guide and develop and post information about the initiative online.

1. Ongoing GF costs of about $200,000 for CDE to provide information regarding the trauma-informed care approach to LEAs, offer training on the trauma-informed care approach, and update information about the initiative online.
2. Minor and absorbable costs to LEAs to provide the initiative’s web address to parents and guardians.

COMMENTS:

1. Trauma-Informed Care Approach. A trauma-informed care approach at school means school personnel recognize when a student exhibits symptoms of chronic interpersonal trauma and respond appropriately to that student’s traumatic stress.
2. Staff Comments. CDE staff recommends extending the deadline for their activities by six months, from December 31, 2018, to July 1, 2019, to give staff time to implement the conditions of the bill and make the information available by the 2019-20 school year.
3. Related Legislation. AB 2022 (Chu) requires all schools, including charter schools, to have at least one mental health professional for each 600 pupils. The bill is pending before this committee.

AB 2498 (Eggman) establishes the School Social Worker Pilot Program to provide multiyear grants to school districts in specified counties to fund a social worker at each eligible school. The bill is pending before this committee.

AB 2315 (Quirk Silva) establishes a telehealth pilot program in three school districts, allocates funding from the Mental Health Services Fund for the purchase of telehealth equipment and technology, and specifies that providers would qualify for Medi-Cal reimbursement for mental and behavioral health services provided to a pupil via telehealth. The bill is pending before this committee.

Analysis Prepared by: Natasha Collins / APPR. / (916) 319-2081

Date of Hearing: April 24, 2018

ASSEMBLY COMMITTEE ON HEALTH

Jim Wood, Chair

ABPCA Bill Id:AB 2691

Author:(Jones-Sawyer) – As Amended Ver:April 16, 2018

SUBJECT: Pupil health: pupil and school staff trauma: Trauma-Informed Schools Initiative.

SUMMARY: Establishes the Trauma-Informed Schools Initiative within the California Department of Education (CDE) to address the impact of adverse childhood experiences (ACEs) on the educational outcomes of California pupils. Specifically, this bill:

1. Requires CDE to establish the Trauma-Informed Schools Initiative, on or before December 31, 2019, and do all of the following:
   1. Provide information regarding the trauma-informed care approach to school districts and charter schools;
   2. Develop a guide for public schools, including charter schools, on how to become trauma-informed schools;
   3. Offer training on the trauma-informed care approach to school districts and charter schools, which shall include the guide developed pursuant to paragraph b) above; and,
   4. Develop and post online an Internet Website about the Trauma-Informed Schools Initiative that includes information for public schools, including charter schools, and parents and guardians regarding the trauma-informed care approach and the guide developed by this bill.
2. Requires CDE, with the Student Mental Health Policy Workgroup, to consult with the State Department of Health Care Services (DHCS) and the State Department of Social Services for assistance in implementing 1) above.
3. Defines the following terms:
   1. “ACEs” means adverse childhood experiences;
   2. “Student Mental Health Policy Workgroup” means the workgroup convened in 2012 to develop policy recommendations that promote early identification, referral, coordination, and access to quality mental health services for pupils;
   3. “Trauma-informed care approach” means an approach that involves understanding of ACEs and responding to the symptoms of chronic interpersonal trauma and traumatic stress across the lifespan of an individual; and,
   4. “Trauma-informed school” means a public school, including a charter school, that does all of the following:
      1. Realizes the widespread impact of trauma and understands potential paths for recovery from trauma;
      2. Recognizes the signs and symptoms of trauma in pupils, teachers, and staff; and,
      3. Responds to trauma by fully integrating knowledge about trauma into the school’s policies, procedures, and practices.
      4. Seeks to actively resist retraumatization.
4. Requires each school district and charter school to provide the Internet Web address of the Trauma Informed Schools Initiative Internet that is developed and posted by CDE to parents and guardians of the pupils of the school district or charter school.
5. Specifies that nothing in this bill is authorizing or encouraging an employee of a public school, including a charter school, maintaining kindergarten or any of grades one to 12, inclusive, to diagnose or treat mental illness unless the employee is specifically licensed and authorized to do so.

EXISTING LAW:

1. Establishes the Medi-Cal program, administered by DHCS, under which qualified low-income individuals receive health care services.
2. Establishes a schedule of benefits under the Medi-Cal program, which includes Early Periodic Screening, Diagnostic, and Treatment (EPSDT) Program for any individual under 21 years of age, consistent with federal Medicaid requirements. Defines, through regulation, “screening services” for purposes of EPSDT to mean:
   1. An initial, periodic, or additional health assessment of a Medi-Cal eligible individual under 21 years of age provided in accordance with the requirements of the Child Health and Disability Prevention (CHDP) program;
   2. A health assessment, examination, or evaluation of a Medi-Cal eligible individual under 21 years of age by a licensed health care professional acting within his or her scope of practice, at intervals other than the CHDP intervals, to determine the existence of physical or mental illnesses or conditions; or,
   3. Any other encounter with a licensed health care professional that results in the determination of the existence of a suspected illness or condition or a change or complication in a condition for a Medi-Cal eligible person under 21 years of age.
3. Requires county mental health plans to provide specialty mental health services to eligible Medi-Cal beneficiaries, including both adults and children. Includes EPSDT within the scope of specialty mental health services for eligible Medi-Cal beneficiaries under 21 years of age pursuant to federal Medicaid law.
4. Requires DHCS, in collaboration with the California Health and Human Services Agency, and in consultation with the Mental Health Services Oversight and Accountability Commission, to create a plan for a performance outcome system for EPSDT mental health services provided to eligible Medi-Cal beneficiaries under 21 years of age.
5. Requires any psychologist employed to provide care to the health and physical development of pupils to hold a school psychologist credential, a general pupil personnel services credential authorizing service as a school psychologist, a standard designated services credential with a specialization in pupil personnel services authorizing service as a psychologist, or a services credential issued by the State Board of Education or Commission on Teacher Credentialing (Commission).
6. Specifies the minimum requirements for the services credential with a specialization in pupil personnel services and the services they are permitted to perform, at all grade levels, as approved by the Commission, which may include, but need not be limited to, school counseling, school psychology, child welfare and attendance services, and school social work.
7. States that the minimum requirements for a services credential with a specialization in health for a school nurse are all of the following: a baccalaureate or higher degree from an accredited institution, a valid California license as a registered nurse, and one year of coursework beyond the baccalaureate degree in a program approved by the Commission.
8. Defines “licensed mental health service provider” as a psychologist licensed by the Board of Psychology, registered psychologist, postdoctoral psychological assistant, postdoctoral psychology trainee, as specified, marriage and family therapist, associate marriage and family therapist, licensed clinical social worker, and associate clinical social worker.

FISCAL EFFECT: This bill has not yet been analyzed by a fiscal committee.

COMMENTS:

1. PURPOSE OF THIS BILL. According to the author, studies now show that nearly every school has children who have been exposed to overwhelming experiences, such as witnessing violence between their caretakers, being the direct targets of abuse, and other kinds of adversity. The ACEs study found higher levels of traumatic experiences in the general population than previously imagined. Among the approximately 17,000 adults surveyed, just over 50% reported having experienced at least one form of childhood adversity. These included physical, emotional or sexual abuse; witnessing their mother treated violently; having a parent with substance abuse or mental health issues; or, living in a household with an adult who had spent time in prison.

The author points out that trauma is not an event itself, but rather a response to one or more overwhelmingly stressful events where one’s ability to cope is dramatically undermined. These experiences in childhood can lead to a cascade of social, emotional and academic difficulties. As students get older, exposure to traumatic experiences can also lead to the adoption of self-medicating behaviors such as substance abuse, smoking, and overeating. All of these responses to traumatic events can interfere with a child’s ability to learn at school.

The author notes that many children who have experienced traumatic events, the school setting can feel like a battleground in which their assumptions of the world as a dangerous place sabotage their ability to remain calm and regulate their behavior in the classroom. Unfortunately, many of these children develop behavioral coping mechanisms in an effort to feel safe and in control, yet these behaviors can frustrate educators and evoke exasperated reprisals, reactions that both strengthen the child’s expectations of confrontation and danger and reinforce a negative self-image.

1. BACKGROUND. There are a number of different funding mechanisms currently available for school districts and LEAs to provide health care services to pupils, as discussed in more detail below. Between 1991 and 2011, the state Department of Mental Health (DMH) also operated a previous version of the Early Mental Health Initiative, which provided schools with approximately $15 million annually to serve children in kindergarten through third grade with mild and moderate mental health problems. With the transfer of responsibilities from the DMH to DHCS in 2012, this program was shifted to local education departments. Many counties also fund on-campus mental health services for non–special education students through EPSDT and Mental Health Services Act-funded early prevention programs.

Schools are the main providers of mental health services for children in California. The federal Individuals with Disabilities Education Act (IDEA) was adopted in 1975 to guarantee children with disabilities a right to public education in the least restrictive setting. In California, the federal IDEA mandate to provide special education services is administered by local school districts and local education agencies. Special education students may be eligible for health care services, including mental health services, in specific IDEA disability categories. Mental health services provided to special education students include counseling and guidance, psychological services, parental counseling and training, and residential placement, among others. While federal law requires mental health services to be provided to students who have been identified for special education services, there are little to no services available to the general student population.

• 1. ACEs. The federal Centers for Disease Control and Prevention and Kaiser Permanente’s Health Appraisal Clinic in San Diego are conducting an ongoing study called the ACEs study. The ACEs Study is one of the largest investigations ever conducted to assess associations between childhood maltreatment and later-life health and well-being. The initial phase of the ACEs Study was conducted at Kaiser Permanente from 1995 to 1997, and more than 17,000 participants had a standardized physical examination. Each study participant completed a confidential survey that contained questions about childhood maltreatment and family dysfunction, as well as items detailing their current health status and behaviors. This information was combined with the results of their physical examination to form the baseline data for the study. The ACEs Study is ongoing and continues to track the medical status of the baseline participants. Participants were asked about 10 types of childhood trauma that had been identified in earlier research literature:
     1. Physical abuse;
     2. Sexual abuse;
     3. Emotional abuse;
     4. Physical neglect;
     5. Emotional neglect;
     6. Mother treated violently;
     7. Household substance abuse;
     8. Household mental illness;
     9. Parental separation or divorce; and,
     10. Incarcerated household member.

Initial results of the ACEs Study found the following:

• • 1. A child with four or more ACEs is 32.6 times as likely to have a learning or emotional problem;
    2. A strong correlation exists between the number of ACEs and a person’s risk for disease and negative health behaviors; and,
    3. A person with four or more ACEs is 2.4 times as likely to have a stroke, 1.9 times as likely to have cancer, 10.3 times as likely to use injection drugs, and 7.4 times as likely to be an alcoholic.
  1. Student mental health initiatives. The CDE is engaged in a number of initiatives aimed at improving support for student mental health needs. Examples of these initiatives are:
     1. Student Mental Health Policy Workgroup established in 2012 to develop policy recommendations that promote early identification, referral, coordination, and access to quality mental health services for students;
     2. The CDE Training Educators through Recognition and Identification Strategies Eliminating Barriers to Learning project, a mental health training project funded by the California Mental Health Services Authority and administered through a contract with the Placer County Office of Education;
     3. A federally-funded "Now is the Time" project to provide support to three local education agencies, and CDE training of school staff in a program called Youth Mental Health First Aid;
     4. Since 2011 an initiative called the Regional K-12 Student Mental Health Initiative, operated through the California County Superintendents Educational Services Association, has provided training designed to build capacity and cross-system collaboration to develop and sustain school-based mental health programs addressing prevention and early identification strategies; and,
     5. The federal Every Student Succeeds Act (ESSA) which offers support for student mental health through a grant program called Student Support and Academic Enrichment Grants, which may be used, among many other purposes, to “expand access to or coordinate resources for school-based counseling and mental health programs, such as through school-based mental health services partnership programs.” This and other provisions of ESSA are subject to appropriation.

1. SUPPORT. The California State Parent Teacher Association (CA PTA) states in support of the bill that it believes in securing laws for the care and protection of children in the home, school, and community. CA PTA also seeks to prevent, control or eliminate hazards to the safety and well-being of children. Children who have been exposed to violent experiences may become mistrustful, depressed, socially isolated and fail to progress in school. CA PTA concludes that any effort to mitigate the effects of ACEs and help traumatized children reach their highest potential is worthwhile.
2. OPPOSITION. The California Right to Life Committee, Inc. states in opposition to the bill that this bill would develop a history of data collection tracking the effects of trauma on learning through the addition of another layer of government. CRLC is concerned that this on-going collection would be using students for its research; however, not to benefit the students who are suffering trauma but to benefit medical records for national data collection efforts.
3. RELATED LEGISLATION.
   1. AB 2022 (Chu) requires schools, as specified, to have at least one mental health professional for every 600 pupils by December 31, 2021. AB 2022 is pending in the Assembly Health Committee.
   2. AB 2686 (Jones-Sawyer) requires a county office of education, school district, state special school, or charter school, before the before the beginning of the 2019–20 school year, to adopt a training policy on pupil mental health for its school administrators and staff and requires the policy to be developed in consultation with school and community stakeholders and school-employed mental health professionals. AB 2686 is pending in the Assembly Health Committee.
   3. AB 2315 (Quirk Silva) establishes a telehealth pilot program in three school districts, allocates funding from the Mental Health Services Fund for the purchase of telehealth equipment and technology and specifies that providers would qualify for Medi-Cal reimbursement for mental and behavioral health services provided to a pupil via telehealth. AB 2315 is pending in the Assembly Health Committee.
   4. AB 2471 (Thurmond) requires the transfer of funds from the Youth, Education, Prevention, Early Intervention and Treatment Account established through the passage of the Control, Regulate and Tax Adult Use of Marijuana Act to CDE to establish a grant program which would allow schools to provide in-school support services to pupils. AB 2471 is pending in the Assembly Health Committee.
4. PREVIOUS LEGISLATION.
   1. SB 191 (Beall) of 2017 would have authorized a local educational agency to enter into a contract with a county or qualified mental health service provider to create a partnership for providing mental health services to students. SB 191 would create a new special fund, from which funding could be provided to support such programs. This bill was held in the Senate Appropriations Committee.
   2. AB 1644 (Bonta) would have reestablished and renamed the Early Mental Health Initiative as the Healing from Early Adversity to Level the Impact of Trauma in Schools Act, expands the program to serve preschool and transitional Kindergarten students, and establishes an initiative to encourage and support local decisions to provide funding for services offered in that program. This bill was held in the Senate Appropriations Committee.
   3. AB 1025 (Thurmond) of 2015 would have required CDE to establish a three-year pilot program in school districts to encourage inclusive practices that integrate mental health, special education, and school climate interventions following a multi-tiered framework.
   4. SB 1396 (Hancock) of 2014 would have required CDE, to the extent one-time funding is available in the 2014-15 Budget Act, to designate funds to a county office of education to establish professional development activities to support the development and expansion of multi-tiered intervention and support programs, including but not limited to, schoolwide positive behavior intervention and support. SB 1396 was held on the Assembly Appropriations Committee’s suspense file.

REGISTERED SUPPORT / OPPOSITION:

Support

California School Nurses Organization

California State Parent Teacher Association

Los Angeles County Office of Education

Opposition

California Right to Life Committee

Analysis Prepared by: Paula Villescaz / HEALTH / (916) 319-2097

Date of Hearing: April 11, 2018

ASSEMBLY COMMITTEE ON EDUCATION

Patrick O'Donnell, Chair

ABPCA Bill Id:AB 2691 (

Author:Jones-Sawyer) – As Amended Ver:March 20, 2018

[Note: This bill is doubled referred to the Assembly Health Committee and will be heard by that Committee as it relates to issues under its jurisdiction.]

SUBJECT: Pupil health: pupil and school staff trauma: Trauma-Informed Schools Initiative

SUMMARY: Requires the California Department of Education (CDE) to provide information and training to schools on trauma-informed care and to work with specified higher education institutions to coordinate trauma-informed care on K-12 school campuses by higher education students. Specifically, this bill:

1. Establishes the Trauma-Informed Schools Initiative.
2. Defines the following terms for the purpose of this initiative:
3. “ACEs” means adverse childhood experiences.
4. “Student Mental Health Policy Workgroup” means the workgroup convened in 2012 by Superintendent of Public Instruction, Tom Torlakson, to develop policy recommendations that promote early identification, referral, coordination, and access to quality mental health services for pupils.
5. “Trauma-informed care approach” means an approach that involves understanding of ACEs and responding to the symptoms of chronic interpersonal trauma and traumatic stress across the lifespan of an individual.
6. “Trauma-informed school” means a public school, including a charter school, that does all of the following:
7. Realizes the widespread impact of trauma and understands potential paths for recovery from trauma.
8. Recognizes the signs and symptoms of trauma in pupils, teachers, and staff.
9. Responds to trauma by fully integrating knowledge about trauma into the school’s policies, procedures, and practices.
10. Seeks to actively resist retraumatization.
11. Establishes the Trauma-Informed Schools Initiative within CDE and requires the CDE by December 31, 2019 to do all of the following:
12. Provide information regarding the trauma-informed care approach to school districts and charter schools.
13. Develop a guide for public schools, including charter schools, on how to become trauma-informed schools.
14. Offer training on the trauma-informed care approach to school districts and charter schools, which shall include the guide developed.
15. Develop and post online a website about the Trauma-Informed Schools Initiative that includes information for public schools, including charter schools, and parents and guardians regarding the trauma-informed care approach and the guide developed.
16. Work with regional campuses of the University of California and the California State University to coordinate the offering of trauma-informed clinical care hours by students of those campuses at school sites of public schools, including charter schools, maintaining kindergarten or any of grades 1 to 12, inclusive, for pupils of those schools and the families of those pupils.
17. Requires the CDE and the Student Mental Health Policy Workgroup to consult with the Department of Health Care Services (DHCS) and the Department of Social Services (DSS) for assistance in implementing the provisions in (3) above.
18. Requires each school district and charter school to provide the address of the website developed by the CDE pursuant to (3) (d) above to parents and guardians of the pupils of the school district or charter school within the content required to be provided at the beginning of the first semester or quarter of the school year, as per EC 48980.
19. Specifies that nothing in this section shall be construed as authorizing or encouraging an employee of a public school, including a charter school, maintaining kindergarten or any of grades 1 to 12, inclusive, or a student of the University of California or California State University to diagnose or treat mental illness unless the employee or student is specifically licensed and authorized to do so.

EXISTING LAW:

1. Requires the Superintendent of Public Instruction (SPI) to post, and annually update, on the department’s website a list of statewide resources, including community-based organizations, that provide support to youth, and their families, who have been subjected to school-based discrimination, harassment, intimidation, or bullying. The website must also include a list of statewide resources for youth who have been affected by gangs, gun violence, and psychological trauma caused by violence at home, at school, and in the community (EC 234.5).
2. Establishes The Learning Communities for School Success Program to provide grants to local education agencies (LEAs) for planning, implementation, and evaluation of activities in support of evidence-based, non-punitive programs and practices to keep the state’s most vulnerable pupils in school. These may include activities that advance social-emotional learning, positive behavior interventions and supports, culturally responsive practices, and trauma-informed strategies (EC 33432).
3. Requires the governing board of a school district to give diligent care to the health and physical development of pupils, and authorizes the district to employ properly certified persons for the work (EC 49400).
4. Specifies that the minimum requirements for the services credential with a specialization in pupil personnel services are a baccalaureate degree or higher degree from an approved institution, a fifth year of study, and any specialized and professional preparation that the commission shall require. The services credential with a specialization in pupil personnel services shall authorize the holder to perform, at all grade levels, the pupil personnel service approved by the commission as designated on the credential, which may include, but need not be limited to, school counseling, school psychology, child welfare and attendance services, and school social work (EC 44266).
5. Prohibits any person who is an employee of a school district from administering psychological tests or engaging in other psychological activities involving the application of psychological principles, methods or procedures unless the person holds a valid and current credential as a school psychologist or is a psychological assistant or intern performing the testing or activities under the supervision of a credentialed psychologist (EC 49422).
6. School districts are not precluded from utilizing community-based service providers, including volunteers, individuals completing counselling-related internship programs, and state licensed individuals and agencies to assist in providing pupil personnel services, provided that such individuals and agencies are supervised in their school-based activities by an individual holding a pupil personnel services authorization (California Code of Regulations, Title 5, Section 80049.1(c).

FISCAL EFFECT: The Office of Legislative Counsel has keyed this bill as a state-mandated local program.

COMMENTS: Need for the bill. According to the author,

“Studies now show that nearly every school has children who have been exposed to overwhelming experiences, such as witnessing violence between their caretakers, being the direct targets of abuse, and other kinds of adversity. The Adverse Childhood Experiences (ACE) study found higher levels of traumatic experiences in the general population than previously imagined. Among the approximately 17,000 adults surveyed, just over 50% reported having experienced at least one form of childhood adversity. These included physical, emotional or sexual abuse; witnessing their mother treated violently; having a parent with substance abuse or mental health issues; or, living in a household with an adult who had spent time in prison.

Experts explain that trauma is not an event itself, but rather a response to one or more overwhelmingly stressful events where one’s ability to cope is dramatically undermined. These experiences in childhood can lead to a cascade of social, emotional and academic difficulties. As students get older, exposure to traumatic experiences can also lead to the adoption of self-medicating behaviors such as substance abuse, smoking, and overeating. All of these responses to traumatic events can interfere with a child’s ability to learn at school.

For many children who have experienced traumatic events, the school setting can feel like a battleground in which their assumptions of the world as a dangerous place sabotage their ability to remain calm and regulate their behavior in the classroom. Unfortunately, many of these children develop behavioral coping mechanisms in an effort to feel safe and in control, yet these behaviors can frustrate educators and evoke exasperated reprisals, reactions that both strengthen the child’s expectations of confrontation and danger and reinforce a negative self-image.”

The Adverse Childhood Experiences study and trauma-informed practices. The Adverse Childhood Experiences (ACE) study, a collaboration between the Centers for Disease Control and Prevention and Kaiser Permanente, investigated the associations between childhood maltreatment and later-life health and well-being. The ACE study uses a score to represent the degree to which a person has experienced traumatic events. One point is recorded for each type of trauma exposure in the areas of abuse, neglect, and household dysfunction and the points add up to a score ranging from 0 to 10. The higher an ACE score the greater one’s risk of a broad range of health, mental health, and at-risk behaviors.

The ACE Study has shown that adverse childhood experiences are major risk factors for the leading causes of illness and death, as well as poor quality of life. Related research has also demonstrated a strong association between high ACE scores and poor performance in school, including a higher risk of learning and behavior problems. Other research into the effects of chronic stress (often caused by ACEs) on children, has identified a profound effect on the developing brain, which in turn affects school performance and behavior.

Recognition of the impact of these childhood experiences has led to the development and increasing use of “trauma-informed” approaches in a variety of fields, including education. Trauma-informed practices in schools are those which involve:

• A realization of the widespread prevalence and impact of trauma.
• Recognition of signs of traumatic exposure.
• Responses grounded in evidence-based practices.
• Resisting the re-traumatization of students.

Examples of such practices in schools include professional development for educators on the role of trauma in learning, classroom management practices and discipline policies focused on conflict resolution and restorative practices, and instructional modifications which address the specific learning needs of students exposed to trauma.

Trauma-informed practices are specifically cited in the new federal education law, the Every Student Succeeds Act (ESSA). Several provisions of the law reference staff development “based on trauma-informed practices that are evidence-based…” and “effective and trauma-informed practices in classroom management.”

Incidence of ACEs among children and youth. A 2011-12 National Survey of Children’s Health identified the prevalence of adverse childhood experiences among children age 0-17 years. Among the study findings related to children in California:

• 44 percent had one or more ACEs
• 18 percent had two or more ACEs
• 22 percent had experienced extreme economic hardship
• 17 percent had experienced family discord leading to divorce or separation
• 11 percent had lived with someone who had an alcohol or drug problem
• 8 percent had been a victim or witness of neighborhood violence
• 7 percent had witnesses domestic violence

Research finds that California children with ACEs are less engaged in school, miss more days of school, and are more likely to repeat a grade than children who have not suffered such trauma.

Student mental health initiatives. The CDE is engaged in a number of initiatives aimed at improving support for student mental health needs. Among them are:

• Student Mental Health Policy Workgroup established in 2012 to develop policy recommendations that promote early identification, referral, coordination, and access to quality mental health services for students.
• TETRIS-EBL project, a mental health training project funded by the California Mental Health Services Authority and administered through a contract with the Placer County Office of Education.
• A federally-funded "Now is the Time" project to provide support to three LEAs, and CDE training of school staff in a program called Youth Mental Health First Aid.
• Since 2011 an initiative called the Regional K-12 Student Mental Health Initiative, operated through the California County Superintendents Educational Services Association, has provided training designed to build capacity and cross-system collaboration to develop and sustain school-based mental health programs addressing prevention and early identification strategies.

The federal Every Student Succeeds Act (ESSA) also offers support for student mental health through a grant program called Student Support and Academic Enrichment Grants, which may be used, among many other purposes, to “expand access to or coordinate resources for school-based counseling and mental health programs, such as through school-based mental health services partnership programs.” This and other provisions of ESSA are subject to appropriation.

This bill would require the CDE to develop materials and provide information and training to schools, including charter schools, on becoming trauma-informed schools. Committee staff recommends that the bill be amended to require the training provided by CDE to comprise an online training module developed by CDE, in consultation with DHCS and DSS, and posted on their website for schools to access.

This bill also requires CDE to work with regional campuses of the University of California and the California State University to coordinate the offering of trauma-informed clinical care hours by students of those campuses at K-12 schools, including charter schools, for pupils and their families. The bill does not clarify the education or training requirement of the post-secondary students who would be providing such care nor does it provide any protection for K-12 pupils by requiring fingerprint clearances or background checks of the student providers, or other procedures to protect the safety and privacy of pupils receiving services. The committee recommends that this requirement be removed from the bill.

Similar and prior legislation. AB 2022 (Chu) of this Session requires all schools, including charter schools, to have at least one mental health professional for each 600 pupils. This bill is pending before this committee.

AB 2498 (Eggman) of this Session establishes the School Social Worker Pilot Program to provide multiyear grants to school districts in specified counties to fund a social worker at each eligible school. This bill is pending before this committee.

AB 2315 (Quirk Silva) establishes a telehealth pilot program in three school districts, allocates funding from the Mental Health Services Fund for the purchase of telehealth equipment and technology and specifies that providers would qualify for Medi-Cal reimbursement for mental and behavioral health services provided to a pupil via telehealth. This bill is pending before this committee.

AB 2471 (Thurmond) requires the transfer of funds from the Youth, Education, Prevention, Early Intervention and Treatment Account established through the passage of the Control, Regulate and Tax Adult Use of Marijuana Act to the California Department of Education (CDE) to establish a grant program which would allow schools to provide in-school support services to pupils. This bill is pending before this committee.

ACR 8 (Jones-Sawyer) Chapter 139, resolutions of 2017 recognizes adverse childhood experiences (ACEs), also known as post-traumatic “street” disorder in communities of color, as having lasting negative outcomes to both physical and mental health with growing implications for our state.

SB 191 (Beall) of this Session authorizes a local educational agency to enter into a contract with a county or qualified mental health service provider to create a partnership for providing mental health services to students. The bill would create a new special fund, from which funding could be provided to support such programs. This bill was held in the Senate Appropriations Committee.

AB 580 (O’Donnell) of the 2015-16 Session requires the CDE to develop model referral protocols for voluntary use by schools to address the appropriate and timely referral by school staff of students with mental health concerns. This bill was vetoed by the Governor.

AB 1014 (Thurmond) Chapter 397, Statutes of 2016 establishes the Learning Communities for School Success Program for the purpose of implementing the K–12 education portion of the Safe Neighborhoods and Schools Act, approved as Proposition 47 by the voters at the November 4, 2014, statewide general election.

AB 104 (Committee on Budget), Chapter 13, Statutes of 2015, among other things, appropriates $10 million to the Superintendent of Public Instruction to be apportioned to a designated county office of education to provide technical assistance and develop statewide resources to assist local educational agencies to establish and align systems of learning and behavioral supports.

REGISTERED SUPPORT / OPPOSITION:

Support

Children NOW

Opposition

California Right to Life Committee

Analysis Prepared by: Debbie Look / ED. / (916) 319-2087