Existing law requires the governing board or body of a local educational agency, defined as a county office of education, school district, state special school, or charter school, that serves pupils in kindergarten and grades 1 to 12, inclusive, to adopt a policy on pupil suicide prevention that specifically addresses, among other things, procedures relating to suicide prevention, intervention, and postvention, and any training on suicide awareness and prevention to be provided to teachers of pupils in all of the grades served by the local educational agency. Existing law requires the governing board or body of a local educational agency that serves pupils in kindergarten and grades 1 to 12, inclusive, to review, at minimum every 5th year, its policy on pupil suicide prevention and, if necessary, update its policy. To assist local educational agencies in developing policies for pupil suicide prevention, existing law requires the State Department of Education to develop and maintain a model policy to serve as a guide for local educational agencies, as provided.

This bill would require, on or before July 1, 2026, the department to update the model policy to address crisis intervention protocols in the event of a pupil suicide crisis, as defined, including the process by which staff and external agencies are deployed to address a pupil suicide crisis, limiting the involvement and notification of law enforcement to situations in which a pupils life is in imminent danger and their needs cannot be addressed by a mental health professional, and the assessment process that law enforcement officers should follow to determine whether the pupil experiencing a suicide crisis is endangered by parental notification. The bill would require, on or after July 1, 2026, the governing board or body of a local educational agency to update their pupil suicide prevention policy to include these crisis intervention protocols, as provided. The bill would encourage, when the governing board or body of a local educational agency reviews its policy on pupil suicide prevention, if the local educational agency does not have a school mental health professional, as defined, or contract with a mental health professional, as defined, the governing board or body to consider whether funding should be identified for purposes of hiring a school mental health professional. By imposing additional duties on local educational agencies, the bill would impose a state-mandated local program.

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 or body of a local educational agency, defined as a county office of education, school district, state special school, or charter school, that serves pupils in kindergarten and grades 1 to 12, inclusive, to adopt a policy on pupil suicide prevention that specifically addresses, among other things, procedures relating to suicide prevention, intervention, and postvention, and any training on suicide awareness and prevention to be provided to teachers of pupils in all of the grades served by the local educational agency. Existing law requires the governing board or body of a local educational agency that serves pupils in kindergarten and grades 1 to 12, inclusive, to review, at minimum every 5th year, its policy on pupil suicide prevention and, if necessary, update its policy. To assist local educational agencies in developing policies for pupil suicide prevention, existing law requires the State Department of Education to develop and maintain a model policy to serve as a guide for local educational agencies, as provided.

This bill would require, on or before July 1, 2026, the department to update the model policy to address crisis intervention protocols in the event of a pupil suicide crisis, as defined, including the process by which staff and external agencies are deployed to address a pupil suicide crisis, limiting the involvement and notification of law enforcement to situations in which a pupils life is in imminent danger and their needs cannot be addressed by a mental health professional, and the assessment process that law enforcement officers should follow to determine whether the pupil experiencing a suicide crisis is endangered by parental notification. The bill would require, on or after July 1, 2026, the governing board or body of a local educational agency to update their pupil suicide prevention policy to include these crisis intervention protocols, as provided. The bill would encourage, when the governing board or body of a local educational agency reviews its policy on pupil suicide prevention, if the local educational agency does not have a school mental health professional, as defined, or contract with a mental health professional, as defined, the governing board or body to consider whether funding should be identified for purposes of hiring a school mental health professional. By imposing additional duties on local educational agencies, the bill would impose a state-mandated local program.

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 or body of a county office of education, school district, state special school, or charter school that serves pupils in kindergarten and grades 1 to 12, inclusive, to adopt a policy on pupil suicide prevention that specifically addresses, among other things, procedures relating to suicide prevention, intervention, and postvention, and any training on suicide awareness and prevention to be provided to teachers of pupils in all of the grades served by the local educational agency. Existing law requires the governing board or body of a local educational agency that serves pupils in kindergarten and grades 1 to 12, inclusive, to review, at minimum every 5th year, its policy on pupil suicide prevention and, if necessary, update its policy. To assist local educational agencies in developing policies for pupil suicide prevention, existing law requires the State Department of Education to develop and maintain a model policy to serve as a guide for local educational agencies, as provided.

This bill would require, on or before July 1, 2026, the department to update the model policy to address crisis intervention protocols that local educational agencies would be required to follow in the event of a pupil suicide crisis, as defined, including the process by which staff and external agencies are deployed to address a pupil suicide crisis, limiting the involvement and notification of law enforcement to situations in which a pupils life is in imminent danger and their needs cannot be addressed by a mental health professional, and the assessment process that law enforcement officers should follow to determine whether the pupil experiencing a suicide crisis is endangered by parental notification. The bill would require, on or after July 1, 2026, the governing board or body of a local educational agency to update their pupil suicide prevention policy to include these crisis intervention protocols, as provided. The bill would require, at each meeting of the governing board or body of a local educational agency encourage, when the governing board or body of a local educational agency reviews its policy on pupil suicide prevention, if the local educational agency does not have a school mental health professional, as defined, or contract with a mental health professional, as defined, the governing board or body to discuss consider whether funding should be identified for purposes of hiring a school mental health professional. By imposing additional duties on local educational agencies, the bill would impose a state-mandated local program.

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 or body of a county office of education, school district, state special school, or charter school that serves pupils in kindergarten and grades 1 to 12, inclusive, to adopt a policy on pupil suicide prevention that specifically addresses, among other things, procedures relating to suicide prevention, intervention, and postvention, and any training on suicide awareness and prevention to be provided to teachers of pupils in all of the grades served by the local educational agency. Existing law requires the governing board or body of a local educational agency that serves pupils in kindergarten and grades 1 to 12, inclusive, to review, at minimum every 5th year, its policy on pupil suicide prevention and, if necessary, update its policy. To assist local educational agencies in developing policies for pupil suicide prevention, existing law requires the State Department of Education to develop and maintain a model policy to serve as a guide for local educational agencies, as provided.

This bill would require, on or before July 1, 2026, the department to update the model policy to also address crisis intervention protocols that local educational agencies are would be required to follow in the event of a pupil suicide crisis, as defined, including the process by which staff and external agencies are deployed to address a pupil suicide crisis, limiting the involvement and notification of law enforcement to situations in which a pupils life is in imminent danger and their needs cannot be addressed by a mental health professional, and the assessment process for informing the parent or guardian of the pupil experiencing the suicide crisis, as provided. that law enforcement officers should follow to determine whether the pupil experiencing a suicide crisis is endangered by parental notification. The bill would require, on or after July 1, 2026, the governing board or body of a local educational agency to update their pupil suicide prevention policy to include these crisis intervention protocols, as provided. The bill would require, at each meeting of the governing board or body of a local educational agency when the governing board or body reviews its policy on pupil suicide prevention, if the local educational agency does not have a school mental health professional, as defined, or contract with a mental health professional, as defined, the governing board or body to discuss whether funding should be identified for purposes of hiring a school mental health professional. By imposing additional duties on local educational agencies, the bill would impose a state-mandated local program.

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 or body of a county office of education, school district, state special school, or charter school that serves pupils in kindergarten and grades 1 to 12, inclusive, to adopt a policy on pupil suicide prevention that specifically addresses, among other things, procedures relating to suicide prevention, intervention, and postvention, and any training on suicide awareness and prevention to be provided to teachers of pupils in all of the grades served by the local educational agency. Existing law requires the governing board or body of a local educational agency that serves pupils in kindergarten and grades 1 to 12, inclusive, to review, at minimum every 5th year, its policy on pupil suicide prevention and, if necessary, update its policy.

This bill would require, on or before July 1, 2026, the policy to also address crisis intervention protocols that local educational agencies are required to follow in the event of a pupil mental health suicide crisis, as defined, including the process by which staff and external agencies are deployed to address a pupil mental health suicide crisis, limiting the involvement and notification of law enforcement to situations in which a pupils life is in imminent danger and their needs cannot be addressed by a mental health professional, and the process for informing the parent or guardian of the pupil experiencing the mental health suicide crisis, as provided. The bill would require, at each meeting of the governing board or body of a local educational agency when the governing board or body reviews its policy on pupil suicide prevention, if the local educational agency does not have a school mental health professional, as defined, or contract with a mental health professional, as defined, the governing board or body to discuss whether funding should be identified for purposes of hiring a school mental health professional. By imposing additional duties on local educational agencies, the bill would impose a state-mandated local program.

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 or body of a county office of education, school district, state special school, or charter school that serves pupils in kindergarten and grades 1 to 12, inclusive, to adopt a policy on pupil suicide prevention that specifically addresses, among other things, procedures relating to suicide prevention, intervention, and postvention, and any training on suicide awareness and prevention to be provided to teachers of pupils in all of the grades served by the local educational agency. Existing law requires the governing board or body of a local educational agency that serves pupils in kindergarten and grades 1 to 12, inclusive, to review, at minimum every 5th year, its policy on pupil suicide prevention and, if necessary, update its policy.

This bill would require, on or before July 1, 2026, the policy to also address crisis intervention protocols that local educational agencies are required to follow in the event of a pupil mental health crisis, as defined, including the process by which staff and external agencies are deployed to address a pupil mental health crisis, limiting the involvement and notification of law enforcement to situations in which a pupils life is in imminent danger and their needs cannot be addressed by a mental health professional, and the process for informing the parent or guardian of the pupil experiencing the mental health crisis, as provided. The bill would require, at each meeting of the governing board or body of a local educational agency when the governing board or body reviews its policy on pupil suicide prevention, if the local educational agency does not have a school mental health professional or contract with a mental health professional but employs or contracts with a security offer or school peace officer, professional, the governing board or body to discuss whether funding should be redirected to identified for purposes of hiring a school mental health professional. By imposing additional duties on local educational agencies, the bill would impose a state-mandated local program.

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 or body of a county office of education, school district, state special school, or charter school that serves pupils in kindergarten and grades 1 to 12, inclusive, to adopt a policy on pupil suicide prevention that specifically addresses, among other things, procedures relating to suicide prevention, intervention, and postvention, and any training on suicide awareness and prevention to be provided to teachers of pupils in all of the grades served by the local educational agency. Existing law requires the governing board or body of a local educational agency that serves pupils in kindergarten and grades 1 to 12, inclusive, to review, at minimum every 5th year, its policy on pupil suicide prevention and, if necessary, update its policy.

This bill would require, on or before July 1, 2026, the policy to also address crisis intervention protocols that local educational agencies are required to follow in the event of a pupil mental health crisis, as defined, including the process by which staff and external agencies are deployed to address a pupil mental health crisis, limiting the involvement and notification of law enforcement to situations in which a pupils life is in imminent danger and their needs cannot be addressed by a mental health professional, and the process for informing the parent or guardian of the pupil experiencing the mental health crisis, as provided. The bill would require, at each meeting of the governing board or body of a local educational agency when the governing board or body reviews its policy on pupil suicide prevention, if the local educational agency does not have a school mental health professional or contract with a mental health professional but employs or contracts with a security offer or school peace officer, the governing board or body to discuss whether funding should be redirected to hiring a school mental health professional. By imposing additional duties on local educational agencies, the bill would impose a state-mandated local program.

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.

 UNFINISHED BUSINESS  

Bill No: SB 1318

Author: Wahab (D), et al.

Amended: 6/17/24

Vote: 21

SENATE EDUCATION COMMITTEE: 5-0, 4/3/24

AYES: Newman, Cortese, Gonzalez, Smallwood-Cuevas, Wilk

NO VOTE RECORDED: Ochoa Bogh, Glazer

SENATE APPROPRIATIONS COMMITTEE: 5-2, 5/16/24

AYES: Caballero, Ashby, Becker, Bradford, Wahab

NOES: Jones, Seyarto

SENATE FLOOR: 32-7, 5/21/24

AYES: Alvarado-Gil, Archuleta, Ashby, Atkins, Becker, Blakespear, Bradford, Caballero, Cortese, Dodd, Durazo, Eggman, Glazer, Gonzalez, Hurtado, Laird, Limón, McGuire, Menjivar, Min, Newman, Padilla, Portantino, Roth, Rubio, Skinner, Smallwood-Cuevas, Stern, Umberg, Wahab, Wiener, Wilk

NOES: Dahle, Grove, Jones, Nguyen, Niello, Ochoa Bogh, Seyarto

NO VOTE RECORDED: Allen

ASSEMBLY FLOOR: 63-10, 8/26/24 - See last page for vote

SUBJECT: .Pupil health: suicide prevention policies: pupil suicide crisis

SOURCE: Santa Clara County Office of Education

DIGEST:

This bill requires the California Department of Education (CDE), by July 1, 2026, to update the model suicide prevention policy to address crisis intervention protocols and requires local educational agencies (LEAs) to update their suicide prevention policies to include crisis intervention protocols on or after July 1, 2026.

Assembly Amendments

1. Remove reference to a trained employee providing “interim care.”
2. Remove requirement that LEAs must follow the model policy and require LEAs to incorporate best practices identified in the department’s model policy.
3. Encourage rather than require that governing boards and bodies consider funding for hiring mental health professionals if the LEA does not employ or contract with such professionals.

ANALYSIS:

Existing law:

1. Requires the governing board of an LEA that serves pupils in grades 7 to 12 to adopt, before the 2017-18 school year, procedures relating to suicide prevention, intervention, and postvention in consultation with school and community stakeholders, school-employed mental health professionals, and suicide prevention experts. (EC § 215(a))
2. Requires the governing board of an LEA that serve pupils in Kindergarten and grades 1 to 6 to adopt, before the 2020-21 school year, a policy on pupil suicide prevention in kindergarten in consultation with school and community stakeholders, school-employed mental health professionals, and suicide prevention experts. (EC § 215 (a)(2)(A))
3. Requires, beginning July 1, 2019, a public school, including a charter school, or a private school, that issue identification cards to pupils grades 7 to 12 to include information to the National Suicide Prevention Lifeline, Crisis Text Line, and local suicide prevention hotline. (EC § 215.5)
4. Require the California Department of Education (CDE) to identify one or more evidence-based online training programs that a LEA can use to train school staff and pupils as part of the LEAs policy on pupil suicide prevention. (EC § 216)

This bill:

1. Requires the CDE, by July 1, 2026, to update the model suicide prevention policy to address crisis intervention protocols in the event of a student suicide crisis, including all of the following:
   1. The process by which staff and external agencies are deployed to address a pupil suicide crisis, including a prioritization of the use of school mental health professionals;
   2. If a school mental health professional is not available, the protocol would suggest that a school employee who has completed youth behavioral health training may be deployed to provide a warm handoff to a mental health professional;
   3. If a trained school employee is not available, the protocol must identify one or more community-based organizations, mobile crisis units, 988 services, or other qualified mental health professionals to be contacted;
   4. Law enforcement to be involved and notified only when a student's life is in imminent danger and their needs cannot be addressed by a mental health professional;
   5. The assessment process that a law enforcement officer should follow to determine whether the student involved in the suicide crisis would be endangered by parental notification; and
   6. The student be informed if their parent or guardian is notified.
2. Requires the governing board or body of an LEA, on or after July 1, 2026, during the next regularly scheduled review of their suicide prevention policy to update the policy to include crisis intervention protocols in alignment with the model policy developed by the CDE.
3. Encourages an LEA governing board or body to consider whether funding should be identified to hire a school mental health professional if they do not employ or contract with a mental health professional.

Comments

1. Need for the bill. According to the author, “The rising suicide rate among California’s children is unprecedented, and it is time to take action. In the first year of the pandemic, intentional self-harm among children aged 13-18 increased by 91%, and without making substantial changes to our youth suicide prevention policies, this statistic will not improve. SB 1318 is a strong step to provide children with the professional mental health support they need in times of crisis. The bill clarifies that the involvement of law enforcement officers, including resource officers, should be the final step to protect a child’s life, and that connection with mental health professionals should be the first. SB 1318 is a lifeline for our most vulnerable youth.”
2. Mental Health Crisis Among Students. Mental health problems can significantly impact various aspects of a student's life. They can reduce the quality of life, academic achievement, and physical health. Additionally, these issues can negatively affect relationships with friends and family members. Furthermore, students may face long-term consequences, including a negative impact on their future employment, earning potential, and overall health.

In a study produced by the Center for Disease Control, “Forty-two percent of high school students in 2021 reported feeling so sad or hopeless for at least two consecutive weeks in the previous year that they stopped engaging in their usual activities, up from 26 percent in 2009.” Moreover, Thoughts of suicide, suicide attempts, and actual suicides among young people have also risen in that period, with Black children nearly two times more likely than their white peers to die by suicide, according to the U.S. Centers for Disease Control and Prevention’s biennial Youth Risk Behavior Survey.

Strong mental health is one of the most critical factors contributing to a student's academic success. When students have a positive mental state, they tend to learn better, retain information more effectively, and realize their full potential more effectively. Their mental health also plays a crucial role in their well-being and social development. Students with good mental health can build stronger relationships, make better decisions, and work collaboratively with their peers. Moreover, students with positive mental health are also more likely to become responsible and productive members of their communities as they transition into adulthood. They have a better sense of self-awareness and are more equipped to navigate the challenges of the transition to adulthood. Therefore, it is essential to prioritize mental health education and promote a positive mental state among students.

1. CDE Youth Behavioral Health Programs. Pursuant to SB 14 (Portantino, Chapter 672, Statutes of 2021), the CDE was required to recommend, by January 1, 2023, best practices and identify evidence-based and evidence-informed training programs for schools to address youth behavioral health, including, but not necessarily limited to, staff and pupil training.

On the CDE’s website, the department has identified the Youth Mental Health First Aid (YMHFA) a research-based curriculum created upon the medical first aid model. It is designed to provide parents, family members, caregivers, teachers, school staff, neighbors, and other caring adults with skills to help a school-age child or youth who may be experiencing emotional distress, the onset of a mental illness, addiction challenge or who may be in crisis. YMHFA participants learn to recognize signs and symptoms of children and youth in emotional distress, initiate and offer help, and connect the youth to professional care through a five-step action plan.

YMHFA also clarifies “that its training is not intended for staff with a mental health background such as school psychologists, social workers, clinicians, etc., due to its basic nature. The ideal audience includes teachers, administrators, nurses, counselors, and any other credentialed staff, classified staff (school secretaries, registrars, yard supervisors, campus monitors, bus drivers, lunch staff, janitors, aides, after school staff, etc.), parents, youth employers, and other community partners that have contact with students.”

1. California Investment In Youth Mental Health Services. Since 2019, California has taken action to address youth mental health. California has enacted grant programs and established initiatives to provide schools proper support to assist students and families.

California Community Schools Partnership Program (CSSP).

A community school is a public school that serves students from pre-kindergarten through grade twelve, and it has partnerships with the local community to support improved academic outcomes, whole-child engagement, and family development.

In response to longstanding inequities exacerbated by the COVID-19 pandemic, California supported CCSPP investments in 2020, 2021, and 2022. In 2020, the California Legislature allocated $45 million in Federal Elementary and Secondary School Emergency Relief (ESSER) to support existing community schools throughout the state. Then, in 2021, the California legislature passed the California Community Schools Partnership Act and in 2022, the Legislature expanded the program by adding funds and extending the program to 2031. Between 2021 and 2022, the Legislature allocated a historic $4.1 billion in state dollars to support new and existing community schools, particularly those serving high concentrations of high-need students.

The partnership strategies of community schools include integrated support services, extended learning time, and collaborative leadership and practices for educators and administrators. Community schools use a community-driven shared decision-making approach to improve access to nurses, counselors, and social workers. This creates community hub campuses where students and families have easy access to the services needed to close opportunity gaps.

Mulitured Systems of Support (MTSS).

MTSS is a comprehensive framework that aligns academic, behavioral, social, and emotional learning and mental health supports in a fully integrated system of support for the benefit of all students. CA MTSS offers the potential to create needed systematic change through intentional design and redesign of services and supports to identify and match all students’ needs quickly. The MTSS framework provides opportunities for LEAs to strengthen school, family, and community partnerships while developing the whole child in the most inclusive, equitable learning environment, thus closing the equity gaps for all students.

In 2015, Assembly Bill 104 (Committee on Budget, Chapter 13, Statutes of 2015), appropriated $10,000,000 for developing, aligning, and improving academic and behavioral support systems. The CDE conducted a competitive grant process and awarded the funds to the Orange County Department of Education (OCDE) for their Scaling Up MTSS Statewide (SUMS) proposal, which included the Butte County Office of Education (Butte COE) as a rural partner. In 2016, an additional $20,000,000, appropriated by SB 828 (Committee on Budget, Chapter 29, Statutes 2016), augmented the original grant award. The Budget Act of 2018 authorized an additional $15,000,000, appropriated by AB 1808 (Committee on Budget, Chapter 32, Statutes of 2018), and SB 840 (Budget Act of 2018, Chapter 29, Statutes of 2018). This phase of the grant focuses on improving the school climate statewide. The total $95,000,000 awarded to date is to encourage LEAs to establish and align schoolwide, data-driven academic and behavioral support systems to more effectively meet the needs of California’s diverse learners in the most inclusive environment.

Comprehensive school mental health programs offer three tiers of support within an MTSS approach:

• Tier 1: Universal mental health promotion activities for all students;
• Tier 2: Selective prevention services for students identified as at risk for mental health problems; and
• Tier 3: Indicated services for students who already show signs of a mental health problem.

Children and Youth Behavioral Health Initiative (CYBHI).

Established as part of the Budget Act of 2021, the CYBHI is a multiyear, multi-department package of investments that seeks to reimagine the systems, regardless of payer, that support behavioral health for all California's children, youth, and their families. Efforts will focus on promoting social and emotional well-being, preventing behavioral health challenges, and providing equitable, appropriate, timely, and accessible services for emerging and existing behavioral health (mental health and substance use) needs for children and youth ages 0-25. CYBHI is grounded in focusing on equity; centering efforts around children and youth voices, strengths, needs, priorities, and experiences; driving transformative systems change; and using ongoing learning as the basis for change and improvement in outcomes for children and youth.

In January 2024, the California Department of Health Care Services (DHCS), in partnership with Kooth and Brightline, is launching two behavioral health virtual services platforms for children, youth, and families. Launching as a part of the state’s CalHOPE program, with funding from the CYBHI a $4.6 billion investment in youth behavioral health, the web- and app-based platforms will offer all California residents, regardless of insurance coverage, free one on one support with a live coach, a library of multimedia resources, wellness exercises, and peer communities moderated by trained behavioral health professionals to ensure the appropriateness of content and the safety of all users. These new CalHOPE platforms will complement existing services offered by health plans, counties, and schools by providing additional care options and resources for parents and caregivers, children, youth, and young adults in California.

FISCAL EFFECT: Appropriation: No Fiscal Com.: Yes Local: Yes

According to the Assembly Appropriations Committee, “One-time General Fund costs, potentially in excess of $150,000, for staff at CDE to update its model policy to address crisis intervention protocols in the event of a student suicide crisis. One-time Proposition 98 General Fund costs, of a likely minor amount, to LEAs to update their student suicide prevention policies to include the crisis intervention protocols developed by CDE. Potential ongoing costs to the extent following the new protocols increase costs to LEAs. If the Commission on State Mandates determines the bill's requirements to be a reimbursable state mandate, the state would need to reimburse these costs to LEAs.”

SUPPORT: (Verified 8/27/24)

Santa Clara County Office of Education (source)
California Academy of Child and Adolescent Psychiatry
California Association of School Counselors
California Association of School Psychologists
California County Superintendents
California Federation of Teachers
California School Nurses Organization
California State Association of Psychiatrists 
California State PTA
California Teachers Association
CleanEarth4Kids.org
Generation Up
Mental Health Services Oversight and Accountability Commission
National Association of Pediatric Nurse Practitioners 
Santa Clara County School Boards Association
Steinberg Institute

OPPOSITION: (Verified 8/27/27)

None received

ASSEMBLY FLOOR: 63-10, 8/26/24

AYES: Addis, Aguiar-Curry, Alanis, Alvarez, Arambula, Bains, Bauer-Kahan, Bennett, Berman, Boerner, Bonta, Bryan, Calderon, Juan Carrillo, Wendy Carrillo, Connolly, Davies, Flora, Mike Fong, Friedman, Gabriel, Garcia, Gipson, Grayson, Haney, Hart, Holden, Irwin, Jackson, Jones-Sawyer, Kalra, Lee, Low, Lowenthal, Maienschein, McCarty, McKinnor, Muratsuchi, Stephanie Nguyen, Pacheco, Papan, Pellerin, Petrie-Norris, Quirk-Silva, Ramos, Rendon, Reyes, Luz Rivas, Blanca Rubio, Santiago, Schiavo, Soria, Ting, Valencia, Villapudua, Waldron, Ward, Weber, Wicks, Wilson, Wood, Zbur, Robert Rivas

NOES: Megan Dahle, Dixon, Essayli, Gallagher, Hoover, Mathis, Joe Patterson, Sanchez, Ta, Wallis

NO VOTE RECORDED: Cervantes, Chen, Lackey, Ortega, Jim Patterson, Rodriguez

Prepared by: Kordell Hampton / ED. / (916) 651-4105

8/27/24 13:36:59

**** END ****

SENATE THIRD READING

STR Bill Id:SB 1318

Author:(Wahab)

As Amended Ver:June 17, 2024

Majority vote

SUMMARY

Requires the California Department of Education (CDE), by July 1, 2026, to update the model suicide prevention policy to address crisis intervention protocols and requires local educational agencies (LEAs) to update their suicide prevention policies to include crisis intervention protocols on or after July 1, 2026.

Major Provisions

1. Requires the CDE, by July 1, 2026, to update the model suicide prevention policy to address crisis intervention protocols in the event of a student suicide crisis, including all of the following:
   1. The process by which staff and external agencies are deployed to address a pupil suicide crisis, including a prioritization of the use of school mental health professionals;
   2. If a school mental health professional is not available, the protocol would suggest that a school employee who has completed youth behavioral health training may be deployed to provide a warm handoff to a mental health professional;
   3. If a trained school employee is not available, the protocol must identify one or more community-based organizations, mobile crisis units, 988 services, or other qualified mental health professionals to be contacted;
   4. Law enforcement to be involved and notified only when a student's life is in imminent danger and their needs cannot be addressed by a mental health professional;
   5. The assessment process that a law enforcement officer should follow to determine whether the student involved in the suicide crisis would be endangered by parental notification; and
   6. The student be informed if their parent or guardian is notified.
2. Requires the governing board or body of an LEA, on or after July 1, 2026, during the next regularly scheduled review of their suicide prevention policy to update the policy to include crisis intervention protocols in alignment with the model policy developed by the CDE.
3. Encourages an LEA governing board or body to consider whether funding should be identified to hire a school mental health professional if they do not employ or contract with a mental health professional.

COMMENTS

Youth suicide risk. According to the Lucile Packard Foundation for Children's Health, "Youth suicide and self-inflicted injury are serious social and public health concerns. Approximately 157,000 youth ages 10-24 are treated for self-inflicted injuries in emergency rooms every year. Self-inflicted injuries are not necessarily the result of suicide attempts; in fact, self-harm without the intent to die is more prevalent than self-harm with such intent.

Some groups are at a higher risk for suicide than others. Males are more likely than females to commit suicide, but females are more likely to report attempting suicide. Among racial/ethnic groups, American Indian/Alaska Native youth have the highest suicide rates. Research also shows that lesbian, gay, and bisexual youth are more likely to engage in suicidal behavior than their heterosexual peers. Several other factors put teens at risk for suicide, including a family history of suicide, past suicide attempts, mental illness, substance abuse, stressful life events, low levels of communication with parents, access to lethal means, exposure to suicidal behavior of others, and incarceration.

Schools are required to have suicide prevention policies. Current law requires public schools serving students in kindergarten through 12th grade to adopt a suicide prevention policy and to review the policy and update it, if necessary, at least every five years. The policy is to be developed in consultation with school and community stakeholders, school-employed mental health professionals, and suicide prevention experts and at a minimum address procedures relating to prevention, intervention, and postvention.

According to the Author

"The rising suicide rate among California's children is unprecedented, and it is time to take action. In the first year of the pandemic, intentional self-harm among children aged 13-18 increased by 91%, and without making substantial changes to our youth suicide prevention policies, this statistic will not improve. SB 1318 is a strong step to provide children with the professional mental health support they need in times of crisis. The bill clarifies that the involvement of law enforcement officers, including resource officers, should be the final step to protect a child's life, and that connection with mental health professionals should be the first. SB 1318 is a lifeline for our most vulnerable youth."

Arguments in Support

The Santa Clara County Office of Education, a co-sponsor writes, "Under the current student suicide prevention model policy, school staff are required to call 911 when a student is experiencing a mental health crisis. This policy applies regardless of whether the school has behavioral health professionals on campus who could address the crisis. It also does not limit application of the policy to situations where the student presents a physical threat to himself or others. While there may be instances when it is necessary to involve law enforcement, doing so significantly increases the likelihood of student injury, incarceration, or involuntary commitment, and should therefore be the exception, not the default.

SB 1318 would require the CDE to revise their model youth suicide prevention policy to clarify that schools should prioritize the use of behavioral health professionals when responding to a student experiencing a mental health crisis. The bill would also encourage schools to provide more on-campus mental health services by requiring the district governing board to consider the merits of hiring behavioral health professionals every five years."

Arguments in Opposition

None on file

FISCAL COMMENTS

According to the Assembly Appropriations Committee:

1. One-time General Fund costs, potentially in excess of $150,000, for staff at CDE to update its model policy to address crisis intervention protocols in the event of a student suicide crisis.
2. One-time Proposition 98 General Fund costs, of a likely minor amount, to LEAs to update their student suicide prevention policies to include the crisis intervention protocols developed by CDE. Potential ongoing costs to the extent following the new protocols increase costs to LEAs. If the Commission on State Mandates determines the bill's requirements to be a reimbursable state mandate, the state would need to reimburse these costs to LEAs.

VOTES

SENATE FLOOR: 32-7-1

YES: Alvarado-Gil, Archuleta, Ashby, Atkins, Becker, Blakespear, Bradford, Caballero, Cortese, Dodd, Durazo, Eggman, Glazer, Gonzalez, Hurtado, Laird, Limón, McGuire, Menjivar, Min, Newman, Padilla, Portantino, Roth, Rubio, Skinner, Smallwood-Cuevas, Stern, Umberg, Wahab, Wiener, Wilk

NO: Dahle, Grove, Jones, Nguyen, Niello, Ochoa Bogh, Seyarto

ABS, ABST OR NV: Allen

ASM EDUCATION: 6-1-0

YES: Muratsuchi, Addis, Alvarez, Bonta, Flora, McCarty

NO: Hoover

ASM APPROPRIATIONS: 11-3-1

YES: Wicks, Arambula, Bryan, Calderon, Wendy Carrillo, Mike Fong, Grayson, Haney, Hart, Pellerin, Villapudua

NO: Sanchez, Dixon, Ta

ABS, ABST OR NV: Jim Patterson

UPDATED

VERSION: June 17, 2024

CONSULTANT: Debbie Look / ED. / (916) 319-2087 FN: 0003951

Date of Hearing: August 7, 2024

ASSEMBLY COMMITTEE ON APPROPRIATIONS

Buffy Wicks, Chair

SBPCA Bill Id:SB 1318

Author:(Wahab) – As Amended Ver:June 17, 2024

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

SUMMARY:

This bill requires the California Department of Education (CDE) to update its model student suicide prevention policy to include crisis intervention protocols in the event of a student suicide crisis. The bill also requires local educational agencies to update their student suicide prevention policies to include these crisis intervention protocols.

Specifically, this bill:

1. Requires, by July 1, 2026, CDE to update its model policy to address crisis intervention protocols in the event of a student suicide crisis. The protocols are to include the following:
   1. The process by which staff and external agencies are deployed to address a student suicide crisis, including a prioritization of the use of school mental health professionals.
   2. Law enforcement be involved and notified only when a student’s life is in imminent danger and their needs cannot be addressed by a mental health professional.
   3. The assessment process that a law enforcement officer should follow to determine whether the student involved in the suicide crisis would be endangered by parental notification and that the student be informed if their parent or guardian is notified.
2. Requires, by July 1, 2026, each governing board or body of a local educational agency (LEA) to update their student suicide prevention policy to include these crisis intervention protocols.
3. Defines a student suicide crisis as when a student exhibits suicidal thoughts or behaviors, has completed a suicide risk assessment and is determined to be at risk of suicide, or is attempting to physically harm themselves or others.

FISCAL EFFECT:

1. One-time General Fund costs, potentially in excess of $150,000, for staff at CDE to update its model policy to address crisis intervention protocols in the event of a student suicide crisis.
2. One-time Proposition 98 General Fund costs, of a likely minor amount, to LEAs to update their student suicide prevention policies to include the crisis intervention protocols developed by CDE. Potential ongoing costs to the extent following the new protocols increase costs to LEAs. If the Commission on State Mandates determines the bill’s requirements to be a reimbursable state mandate, the state would need to reimburse these costs to LEAs.

COMMENTS:

1. Purpose. According to the author:

The rising suicide rate among California’s children is unprecedented, and it is time to take action...SB 1318 is a strong step to provide children with the professional mental health support they need in times of crisis. The bill clarifies that the involvement of law enforcement officers, including resource officers, should be the final step to protect a child’s life, and that connection with mental health professionals should be the first. SB 1318 is a lifeline for our most vulnerable youth.

1. Background. Current law requires an LEA serving students in kindergarten through 12th grade to adopt a suicide prevention policy containing various elements and to review the policy and update the policy, if necessary, at least every five years. Current law requires CDE to develop and maintain a model suicide prevention policy to serve as a guide for LEAs.

This bill requires CDE update the model suicide prevention policy to address student suicide crisis intervention protocols and requires LEAs update their suicide prevention policies to include these protocols.

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

Date of Hearing: June 12, 2024

ASSEMBLY COMMITTEE ON EDUCATION

Al Muratsuchi, Chair

SBPCA Bill Id:SB 1318

Author:(Wahab) – As Amended Ver:May 16, 2024

SENATE VOTE: 32-7

SUBJECT: Pupil health: suicide prevention policies: pupil suicide crisis

SUMMARY: Requires the California Department of Education (CDE), by July 1, 2026, to update the model suicide prevention policy to address crisis intervention protocols and requires local educational agencies (LEAs) to update their suicide prevention policies to include crisis intervention protocols. Specifically, this bill:

1. Requires the CDE, by July 1, 2026, to update the model suicide prevention policy to address crisis intervention protocols that LEAs must follow in the event of a student suicide crisis, including all of the following:
   1. The process by which staff and external agencies are deployed to address a pupil suicide crisis, including a prioritization of the use of school mental health professionals;
   2. If a school mental health professional is not available, the protocol would suggest that a school employee who has completed youth behavioral health training may be deployed to provide interim care and a warm handoff to a mental health professional;
   3. If a trained school employee is not available, the protocol must identify one or more community-based organizations, mobile crisis units, 988 services, or other qualified mental health professionals to be contacted;
   4. Law enforcement be involved and notified only when a student’s life is in imminent danger and their needs cannot be addressed by a mental health professional;
   5. The assessment process that a law enforcement officer should follow to determine whether the student involved in the suicide crisis would be endangered by parental notification; and
   6. The student be informed if their parent or guardian is notified.
2. Requires the governing board or body of an LEA, on or after July 1, 2026, during the next regularly scheduled review of their suicide prevention policy to update the policy to include crisis intervention protocols in alignment with the model policy developed by the CDE.
3. Requires an LEA governing board or body, at each meeting where they are reviewing their policy on suicide prevention, to discuss whether funding should be identified to hire a school mental health professional if they do not employ or contract with a mental health professional.
4. Defines the following terms for the purpose of this section:
   1. “Local educational agency” as a county office of education (COE), school district, state special school, or charter school.
   2. “Mental health professional” means an individual licensed or registered, or an intern or associate working towards licensure, by the Board of Behavioral Sciences or the Board of Psychology in the Department of Consumer Affairs.
   3. “School mental health professional” means a school employee with a clear or preliminary pupil personnel services (PPS) credential with a specialization in school counseling, school social work, or school psychology, a credentialed school nurse, or a licensed, registered, or associate marriage and family therapist, professional clinical counselor, clinical social worker, educational psychologist, or psychologist under the supervision of a school employee with a PPS or administrative services credential.
   4. “Pupil suicide crisis” means any of the following: a student who is exhibiting suicidal thoughts or behaviors, a student who has completed a suicide risk assessment and is determined to be at risk of suicide, or a student who is attempting to physically harm themselves or others.

EXISTING LAW:

1. Requires the governing board of an LEA that serves pupils in grades 7 to 12 to adopt, before the 2017-18 school year, procedures relating to suicide prevention, intervention, and postvention in consultation with school and community stakeholders, school-employed mental health professionals, and suicide prevention experts. (Education Code (EC) 215)
2. Requires the governing board of an LEA that serve pupils in kindergarten to grade 6 to adopt, before the 2020-21 school year, a policy on pupil suicide prevention in consultation with school and community stakeholders, school-employed mental health professionals, and suicide prevention experts. (EC 215)
3. Requires the CDE to develop and maintain a model suicide prevention policy to serve as a guide for LEAs. (EC 215)
4. Requires the CDE to identify one or more evidence-based online training programs that a LEA can use to train school staff and pupils as part of the LEAs policy on pupil suicide prevention. (EC 216)
5. Requires the CDE to develop model referral protocols for addressing student mental health concerns, in consultation with specified agencies and stakeholders, and authorizes these protocols to be used on a voluntary basis by schools. (EC 49428.1)
6. Requires the CDE, by January 1, 2023, to recommend best practices, and identify evidence-based and evidence-informed training programs for schools to address youth behavioral health, including staff and student training, contingent upon an appropriation for this purpose. (EC 49428.15)
7. Requires, beginning July 1, 2019, a public school, including a charter school, or private school that serves students in grades 7 to 12, and a public or private institution of higher education, that issues student identification cards to have printed on either side of the cards the telephone number for the National Suicide Prevention Lifeline, 1-800-273-8255. (EC 215.5)
   
8. Authorizes, beginning July 1, 2019, a public school or private school that serves students in any of grades 7-12 that issues student identification cards to have printed on either side of the cards:
   
   1. The Crisis Text Line, which can be accessed by texting HOME to 741741; and
      
   2. A local suicide prevention hotline telephone number. (EC 215.5)
9. Authorizes a school district to establish a security department or a school police department. (EC 38000)
10. Requires a school police officer to successfully complete a basic course of training prescribed by the Commission on Peace Officer Standards and Training (POST) before exercising the powers of a peace officer; requires POST to prepare a specialized course of instruction for the training of school peace officers to meet the unique safety needs of a school environment; and requires any school police officer to successfully complete the specialized course of training within two years of first employment. (Penal (PEN) 832.3)
11. Establishes the California Youth Behavioral Health Initiative (CYBHI) to be administered by the California Health and Human Services Agency (CHHSA), to transform California’s behavioral health system in which all children and youth 25 years of age and younger, regardless of payer, are screened, supported, and served for emerging and existing behavioral health needs. (Welfare and Institutions Code (WIC) 5961)
12. Establishes the Mental Health Student Services Act (MHSSA) as a grant program for the purpose of establishing mental health partnerships between a county’s mental health or behavioral health departments and school districts, charter schools, and the COE within a county. Requires the Mental Health Services Oversight and Accountability Commission (MHSOAC) to award grants to fund partnerships, subject to an appropriation being made for this purpose. (WIC 5886)

FISCAL EFFECT: According to the Senate Appropriations Committee, this bill could result in a reimbursable state mandate for school districts to develop mental health crisis intervention protocols, as specified. Costs will vary by LEA but statewide Proposition 98 General Fund costs could be in the hundreds of thousands of dollars on a one-time basis to develop the protocols. This bill could also result in additional, unknown local cost pressures for LEAs to provide training related to youth behavioral health for teachers.

COMMENTS:

Need for the bill. According to the author, “The rising suicide rate among California’s children is unprecedented, and it is time to take action. In the first year of the pandemic, intentional self-harm among children aged 13-18 increased by 91%, and without making substantial changes to our youth suicide prevention policies, this statistic will not improve. SB 1318 is a strong step to provide children with the professional mental health support they need in times of crisis. The bill clarifies that the involvement of law enforcement officers, including resource officers, should be the final step to protect a child’s life, and that connection with mental health professionals should be the first. SB 1318 is a lifeline for our most vulnerable youth.”

Youth mental health crisis intensifying as a result of the COVID-19 pandemic. The American Academy of Pediatrics noted in recent guidance that “emotional and behavioral health challenges were of growing concern before the COVID-19 pandemic, and the public health emergency has only exacerbated these challenges.” Prior to the pandemic, the incidence of youth mental health crises was increasing at an alarming rate. 

Since the pandemic began, rates of psychological distress among young people, including symptoms of anxiety, depression, and other mental health disorders, have increased. Mental health issues are the number one reason that California children are hospitalized. In 2022, 19% of child hospitalizations were due to mental diseases and disorders, up from 9% in 2002. (California Department of Health Care Access and Information)

Youth suicide risk. According to the Lucile Packard Foundation for Children’s Health, “Youth suicide and self-inflicted injury are serious social and public health concerns. Approximately 157,000 youth ages 10-24 are treated for self-inflicted injuries in emergency rooms every year. Self-inflicted injuries are not necessarily the result of suicide attempts; in fact, self-harm without the intent to die is more prevalent than self-harm with such intent.

Some groups are at a higher risk for suicide than others. Males are more likely than females to commit suicide, but females are more likely to report attempting suicide. Among racial/ethnic groups with data, American Indian/Alaska Native youth have the highest suicide rates. Research also shows that lesbian, gay, and bisexual youth are more likely to engage in suicidal behavior than their heterosexual peers. Several other factors put teens at risk for suicide, including a family history of suicide, past suicide attempts, mental illness, substance abuse, stressful life events, low levels of communication with parents, access to lethal means, exposure to suicidal behavior of others, and incarceration.

National and statewide data show suicide to be the third leading cause of death among young people aged 15-24. In California, in 2022 the youth suicide rate was 6.2 per 100,000 for those aged 15-19 years. This varies substantially by geographic region, by race/ethnicity, and gender.

Source: CDPH, 2020-22

In early 2021, emergency department visits in the U.S. for suspected suicide attempts were 51% higher for adolescent girls and 4% higher for adolescent boys compared to the same period in 2019 (Yard, 2021). In California, 15,030 females and 5,119 males aged 10-25 years old visited emergency rooms in 2021 for self-harm. The gender breakdown reverses for deaths as 469 males and 156 females died due to suicides. (Griffin, 2022)

The California Healthy Kids Survey is a research-based assessment of all the major domains of school climate as it affects students, staff, and parents. It measures a multitude of factors including but not limited to, engagement; school safety; mental, behavioral, and physical health, including substance abuse, depression/suicide risk, and other health risks. Results from the 2020-22 survey include the following:

• One-fifth of 5th graders report being sad most or all of the time;
• About one-third of 7th and 11th graders report incapacitating sadness and 15% report contemplating suicide;
• Between 49%–60% of 7th and 11th graders who have been bullied report incapacitating sadness and 30% report contemplating suicide;
• Eleventh graders reported the highest levels of sadness and suicide risk, with 37% reporting incapacitating sadness and 16% reporting that they had contemplated suicide;
• Females in secondary schools had a far greater risk of incapacitating sadness and suicide ideation than males. Among 7th graders, 36% of females report chronic sadness, and 19% report contemplating suicide. This compares to 21% and 10%, respectively, among males; and

• Almost half (46%) of 11th grade females reported chronic sadness and 20% reported contemplating suicide, compared to 27% and 12% of males, respectively.

Schools are required to have suicide prevention policies. Current law requires public schools serving students in kindergarten through 12^th grade to adopt a suicide prevention policy and to review the policy and update it, if necessary, at least every five years. The policy is to be developed in consultation with school and community stakeholders, school-employed mental health professionals, and suicide prevention experts and at a minimum address procedures relating to prevention, intervention, and postvention.

The adopted policy must also specifically address the needs of high-risk groups, including but not limited to: youth bereaved by suicide; youth with disabilities, mental illness, or substance use disorders; youth experiencing homelessness or in out-of-home settings such as foster care; and lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) youth. The policy must address any training provided to teachers on suicide awareness and prevention and ensure school employees act within the authorization and scope of their credential or license. The training should not be interpreted to mean it is authorizing or encouraging a school employee to diagnose or treat mental illness unless the employee is specifically licensed and employed to do so.

The model suicide prevention policy provided by the CDE includes an action plan for suicide attempts in-school or during school sponsored events, including the following steps to be implemented:

• Remain calm, remember the student is overwhelmed, confused, and emotionally distressed;
• Move all other students out of the immediate area;
• Immediately contact the administrator or suicide prevention liaison;
• Call 911 and give them as much information about any suicide note, medications taken, and access to weapons, if applicable;
• Parents/guardians/caregivers/families should be contacted as soon as possible;
• Do not send the student away or leave them alone, even if they need to go to the restroom;
• Listen and prompt the student to talk;
• Review options and resources of people who can help;
• Be comfortable with moments of silence as you and the student will need time to process the situation;
• Provide comfort to the student;
• Promise privacy and help, and be respectful, but do not promise confidentiality; and
• Students should only be released to parents/guardians/caregivers/families or to a person who is qualified and trained to provide help.

California lags in providing critical mental health support to students. Recent research on access to comprehensive school-based mental health services in California (Romer, 2022) includes the following key findings:

• Students in California had significant mental health and related support needs prior to the pandemic that have only further increased;
• Despite growing student mental health needs, critical school and community behavioral and mental health staffing shortages persist;
• School-based mental health referral pathways are not always aligned and coherent, and approaches to service delivery vary greatly across the state;
• Limited funding flexibility and varied understanding of how to navigate, maximize, and plan for sustainability of available funding sources constitute a key barrier to expanding access to mental health services for students; and
• A limited understanding of complex privacy laws and regulations by educational leaders and community partners can be a barrier to providing school-based mental health services.

Schools offering mental health services may provide services with credentialed school staff trained to address student mental health needs, and/or may rely on partnerships with community systems, such as county behavioral health agencies, community mental health providers or centers, hospitals, and universities.

Credentialed school counselors, psychologists, social workers, and nurses provide critical health and mental health services to students. The distribution of support personnel in schools differs significantly from one school district to another throughout the state, but California lacks sufficient numbers of trained personnel in our schools to meet the mental health needs of over six million students.

A 2022 report by the California Future Health Workforce Commission notes that California has a severe workforce shortage, with too few of the right types of health workers in the right places to meet the needs of the population. Millions of Californians struggle to access the care they need, and the COVID-19 pandemic has made it clear that under-resourced communities and communities of color are hit hardest by an inadequate workforce. The aging of a generation of baby boomers will exacerbate the shortages in primary care, behavioral health care, and among workers who care for older adults.

This shortage holds true for the public education system in California as well. Schools are facing a severe workforce shortage across multiple job classifications, including the Pupil Personnel Service (PPS) credentialed professionals.

Pupil Personal Service (PPS) Credential. This bill would require the protocols to specify that school employees who hold a PPS credential be prioritized for interactions with youth experiencing a suicide crisis before engaging community-based organizations and law enforcement, in that order, as specified.

PPS credential holders may work with individual students, groups of students, or families to provide the services authorized by their credentials to address the needs of all students by providing a comprehensive PPS program. PPS credential covers services for individuals who serve as counselors, school psychologists, school social workers, school nurses, and school child welfare and attendance regulators.

Statewide investments in youth mental health. In recognition of the crisis in youth mental health due in part to the COVID-19 pandemic, coupled with the state’s unprecedented budget surplus in recent years, the State funded, one-time investments in counties, districts, schools, and health plans that are eligible to receive dollars to implement various student mental health projects. The table below outlines some of the more than $5 billion in one-time investments made available since 2020 for California students to address mental health staffing, service delivery, and interagency linkages.

Many of these programs are a part of the CYBHI. As noted on the Department of Health Care Services (DHCS) website, the CYBHI is a $4.6 billion investment in youth behavioral health designed to focus on promoting social and emotional well-being, preventing behavioral health challenges, and providing equitable, appropriate, timely, and accessible services for emerging and existing behavioral health (mental health and substance abuse) needs for children and youth ages 0-25 years. The CYBHI initiatives offering school-linked services include:

• Statewide multi-payer school linked fee schedule;
• School-linked partnerships and capacity grants;
• Mindfulness, resilience, and well-being supports;
• Youth peer-to-peer support program;
• School behavioral health incentive program (SBHIP); and
• CalHOPE student support.

​In addition to these, in January 2024, the DHCS, in partnership with Kooth and Brightline, launched two behavioral health virtual services platforms for children, youth, and families. Launching as a part of the state’s CalHOPE program, with funding from the CYBHI, the web- and app-based platforms will offer all California residents, regardless of insurance coverage, free one-on-one support with a live coach, a library of multimedia resources, wellness exercises, and peer communities moderated by trained behavioral health professionals to ensure the appropriateness of content and the safety of all users. These new CalHOPE platforms will complement existing services offered by health plans, counties, and schools by providing additional care options and resources for parents and caregivers, children, youth and young adults in California.

*Component of the Children & Youth Behavioral Health Initiative (CYBHI)

Source: One-Time Investments for School Mental Health, Children Now, January 2023

Youth behavioral health training and support. SB 14 (Portantino, Chapter 672, Statutes of 2021) required the CDE to recommend, by January 1, 2023, best practices and identify evidence-based and evidence-informed training programs for schools to address youth behavioral health, including, but not necessarily limited to, staff and pupil training. The CDE has identified Youth Mental Health First Aid (YMHFA), a research-based curriculum created upon the medical first aid model, to meet this requirement. It is designed to provide parents, family members, caregivers, teachers, school staff, neighbors, and other caring adults with skills to help a school-age child or youth who may be experiencing emotional distress, the onset of a mental illness, addiction challenge or who may be in crisis. YMHFA participants learn to recognize signs and symptoms of children and youth in emotional distress, initiate and offer help, and connect the youth to professional care through a five-step action plan. The ideal audience for this training includes teachers, administrators, nurses, counselors, and any other credentialed staff, classified staff (school secretaries, registrars, yard supervisors, campus monitors, bus drivers, lunch staff, janitors, aides, after school staff, etc.), parents, youth employers, and other community partners that have contact with students.

The CDE has also convened a Statewide Suicide Postvention Response Team (SSPRT) to support districts in navigating the journey after a youth or staff suicide. The primary goal of the SSPRT is to offer support and guide a district affected by a suicide. The CDE website notes that the SSPRT will serve as a support with whom districts can discuss the postvention process. The team will help affected LEAs receive accurate and timely information, resources to fill in identified gaps; assistance with messaging to staff, parents, students, and the media; and help them find ways to support staff, parents, families, and students. The SSPRT is also designed to help LEAs build their capacity and connect them to their local resources, including their COE, county behavioral health department, and community mental health and suicide prevention and postvention resources

Recommended Committee amendments. Staff recommend that the bill be amended as follows:

1. Remove reference to a trained employee providing “interim care”.
2. Remove requirement that LEAs must follow the model policy and require LEAs to incorporate best practices identified in the department’s model policy.
3. Encourage rather than require that governing boards and bodies consider funding for hiring mental health professionals if the LEA does not employ or contract with such professionals.

Arguments in support. The Santa Clara County Office of Education, a co-sponsor writes, “Under the current student suicide prevention model policy, school staff are required to call 911 when a student is experiencing a mental health crisis. This policy applies regardless of whether the school has behavioral health professionals on campus who could address the crisis. It also does not limit application of the policy to situations where the student presents a physical threat to himself or others. While there may be instances when it is necessary to involve law enforcement, doing so significantly increases the likelihood of student injury, incarceration, or involuntary commitment, and should therefore be the exception, not the default.

SB 1318 would require the CDE to revise their model youth suicide prevention policy to clarify that schools should prioritize the use of behavioral health professionals when responding to a student experiencing a mental health crisis. The bill would also encourage schools to provide more on-campus mental health services by requiring the district governing board to consider the merits of hiring behavioral health professionals every five years.”

Related legislation. SB 1063 (Grove) of the 2023-24 Session would require public and private schools serving students in grades 7 to 12 to print on the student identification (ID) card the uniform resource locator (URL) for the local county mental health agency or a quick response (QR) code that links to the website.

AB 2072 (Gabriel), Chapter 909, Statutes of 2022, requires, by November 1, 2024, COEs, in consultation with the CDE and other relevant state and local agencies, to coordinate agreements between school districts and charter schools within the county to develop a system for rapidly deploying qualified mental health professionals and other key school personnel employed by individual school districts and charter schools throughout the county to areas of the county that experienced a natural disaster or other traumatic event.

AB 58 (Salas), Chapter 428, Statutes of 2022, requires an LEA, on or before January 1, 2025, to review and update its policy on pupil suicide prevention, and encourages LEAs to provide suicide awareness and prevention training to teachers, beginning with the 2024-25 school year. Requires the CDE to develop and issue resources and guidance to LEAs on how to conduct suicide awareness and prevention training remotely, by June 1, 2024.

AB 309 (Gabriel), Chapter 662, Statutes of 2021 requires the CDE to develop model pupil mental health referral protocols, in consultation with relevant stakeholders, subject to the availability of funding for this purpose.

SB 224 (Portantino), Chapter 675, Statutes of 2021, requires LEAs and charter schools that offer courses in health education to students in middle school or high school to include in those courses instruction in mental health that meets specified requirements and requires the CDE, by January 1, 2024, to develop a plan to increase mental health instruction in California public schools.

SB 14 (Portantino), Chapter 675, Statutes of 2021, requires a student's absence related to pupil mental or behavioral health to count as an excused absence for school attendance reporting and, subject to appropriation, requires the CDE, by January 1, 2023, to recommend best practices and identify evidence-based and evidence-informed training programs for schools to address youth behavioral health, including staff and student training.

AB 1767 (Ramos), Chapter 694, Statutes of 2019, requires LEAs serving students in grades K-6 to adopt and periodically update a policy on student suicide prevention that is appropriate for that age group.

SB 972 (Portantino), Chapter 460, Statutes of 2018, requires schools that serve students in any of grades 7-12, and institutions of higher education, that issue student identification cards to have printed on either side of the identification card the number for a suicide hotline.

AB 2639 (Berman), Chapter 437, Statutes of 2018, requires the CDE to identify and make available an online training program in suicide prevention that an LEA can use to train school staff and pupils, consistent with the LEA’s policy on suicide prevention.

AB 2022 (Chu), Chapter 484, Statutes of 2018, requires each school of a school district or COE, and each charter school, to notify students and parents or guardians of students, at least twice per school year, about how to initiate access to available student mental health services on campus or in the community.

AB 2246 (O’Donnell), Chapter 642, Statutes of 2016, requires LEAs to adopt policies for the prevention of student suicides, and requires the CDE to develop and maintain a model suicide prevention policy.

REGISTERED SUPPORT / OPPOSITION:

Support

California Association of School Counselors

California Association of School Psychologists

California County Superintendents

California Federation of Teachers

California School Nurses Organization

California State Association of Psychiatrists

California State PTA

California Teachers Association

Cleanearth4kids.org

Generation Up

Mental Health Services Oversight and Accountability Commission

National Association of Pediatric Nurse Practitioners

Santa Clara County Office of Education

Santa Clara County School Boards Association

Steinberg Institute

Opposition

None on file

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

 THIRD READING  

Bill No: SB 1318

Author: Wahab (D), et al.

Amended: 5/16/24

Vote: 21

SENATE EDUCATION COMMITTEE: 5-0, 4/3/24

AYES: Newman, Cortese, Gonzalez, Smallwood-Cuevas, Wilk

NO VOTE RECORDED: Ochoa Bogh, Glazer

SENATE APPROPRIATIONS COMMITTEE: 5-2, 5/16/24

AYES: Caballero, Ashby, Becker, Bradford, Wahab

NOES: Jones, Seyarto

SUBJECT: Pupil health: suicide prevention policies: pupil suicide crisis

SOURCE: Santa Clara County Office of Education

DIGEST:

This bill requires, on or before July 1, 2026, the California Department of Education (CDE) to develop a model protocol, and for a local educational agencies (LEA) to adopt, a mental health crisis intervention protocol in the event of a pupil having a mental health crisis, as defined, including the process by which staff and external agencies are deployed to address a pupil mental health crisis, as specified.

ANALYSIS:

Existing law:

1. Requires the governing board of an LEA that serves pupils in grades 7 to 12 to adopt, before the 2017-18 school year, procedures relating to suicide prevention, intervention, and postvention in consultation with school and community stakeholders, school-employed mental health professionals, and suicide prevention experts. (EC § 215(a))
2. Requires the governing board of an LEA that serve pupils in Kindergarten and grades 1 to 6 to adopt, before the 2020-21 school year, a policy on pupil suicide prevention in kindergarten in consultation with school and community stakeholders, school-employed mental health professionals, and suicide prevention experts. (EC § 215 (a)(2)(A))
3. Requires, beginning July 1, 2019, a public school, including a charter school, or a private school, that issue identification cards to pupils grades 7 to 12 to include information to the National Suicide Prevention Lifeline, Crisis Text Line, and local suicide prevention hotline. (EC § 215.5)
4. Require the CDE to identify one or more evidence-based online training programs that a LEA can use to train school staff and pupils as part of the LEAs policy on pupil suicide prevention. (EC § 216)

This bill:

1. Requires the CDE, on or before July 1, 2026, to adopt a policy that establishes a crisis intervention protocol in the event a pupil experiences a mental health crisis that includes all of the following while prioritizing the use of school mental health professionals when addressing a pupil mental health crisis:
   1. A process by which staff and external agencies are deployed to address a pupil’s mental health crisis and prioritizes the use of school mental health professionals when addressing a pupil’s mental health crisis.
      1. Specifies if a school mental health professional is not available, the protocol may identify a school employee who has completed training related to youth behavioral health to provide interim care and a warm handoff to a mental health professional.
      2. Specifies that if a trained school employee is not available to address the pupil’s mental health crisis, the protocol shall identify one or more community-based organizations, mobile crisis units, 988 services, or other qualified mental health professionals who shall be contacted in the event of a pupil mental health crisis.
   2. Limits involvement and notification of law enforcement, including peace officers and school resource officers, to situations in which a pupil’s life is in imminent danger and their needs cannot be addressed by a mental health professional.
   3. A process to inform the parent or guardian of the pupil experiencing the mental health crisis, including the process for assessing whether the pupil is endangered by parental notification and requires that notification to the pupil if the parent or guardian of the pupil is informed.
2. Requires, on or after July 1, 2026, the governing board or body of a LEA to update its pupil suicide prevention policy to include crisis intervention protocols in alignment with
3. Requires the governing board or body of a LEA, when the governing board or body reviews its policy on pupil suicide prevention, to discuss whether funding should be redirected to hiring a school mental health professional if the LEA does not have a school mental health professional or contract with a mental health professional.
4. Defines “Local educational agency” means a county office of education, school district, state special school, or charter school.
5. Defines “Mental health professional” means an individual licensed, licensed or registered, or an intern or associate working towards licensure, by the Board of Behavioral Sciences or the Board of Psychology in the Department of Consumer.
6. Defines “Pupil mental health crisis” means any of the following:
   1. A pupil who is exhibiting suicidal thoughts or behaviors.
   2. A pupil who has completed a suicide risk assessment and is determined to be at risk of suicide.
   3. A pupil who is attempting to physically harm themselves or others.
7. Defines “School mental health professional” means a school employee with a clear or preliminary pupil personnel services credential with a specialization in school counseling, school social work, or school psychology or a credentialed school nurse or a licensed, registered, or associate therapist, social worker, or psychologist under the supervision of a school employee with a pupil personnel services or administrative services credential.

Comments

Need for the bill. According to the author, “The rising suicide rate among California’s children is unprecedented, and it is time to take action. In the first year of the pandemic, intentional self-harm among children aged 13-18 increased by 91%, and without making substantial changes to our youth suicide prevention policies, this statistic will not improve. SB 1318 is a strong step to provide children with the professional mental health support they need in times of crisis. The bill clarifies that the involvement of law enforcement officers, including resource officers, should be the final step to protect a child’s life, and that connection with mental health professionals should be the first. SB 1318 is a lifeline for our most vulnerable youth.”

Mental Health Crisis Among Students. Mental health problems can significantly impact various aspects of a student's life. They can reduce the quality of life, academic achievement, and physical health. Additionally, these issues can negatively affect relationships with friends and family members. Furthermore, students may face long-term consequences, including a negative impact on their future employment, earning potential, and overall health.

In a study produced by the Center for Disease Control, “Forty-two percent of high school students in 2021 reported feeling so sad or hopeless for at least two consecutive weeks in the previous year that they stopped engaging in their usual activities, up from 26 percent in 2009.” Moreover, Thoughts of suicide, suicide attempts, and actual suicides among young people have also risen in that period, with Black children nearly two times more likely than their white peers to die by suicide, according to the U.S. Centers for Disease Control and Prevention’s biennial Youth Risk Behavior Survey.

Strong mental health is one of the most critical factors contributing to a student's academic success. When students have a positive mental state, they tend to learn better, retain information more effectively, and realize their full potential more effectively. Their mental health also plays a crucial role in their well-being and social development. Students with good mental health can build stronger relationships, make better decisions, and work collaboratively with their peers. Moreover, students with positive mental health are also more likely to become responsible and productive members of their communities as they transition into adulthood. They have a better sense of self-awareness and are more equipped to navigate the challenges of the transition to adulthood. Therefore, it is essential to prioritize mental health education and promote a positive mental state among students.

CDE Youth Behavioral Health Programs. Pursuant to SB 14 (Portantino, Chapter 672, Statutes of 2021), the CDE was required to recommend, by January 1, 2023, best practices and identify evidence-based and evidence-informed training programs for schools to address youth behavioral health, including, but not necessarily limited to, staff and pupil training.

On the CDE’s website, the department has identified the Youth Mental Health First Aid (YMHFA) a research-based curriculum created upon the medical first aid model. It is designed to provide parents, family members, caregivers, teachers, school staff, neighbors, and other caring adults with skills to help a school-age child or youth who may be experiencing emotional distress, the onset of a mental illness, addiction challenge or who may be in crisis. YMHFA participants learn to recognize signs and symptoms of children and youth in emotional distress, initiate and offer help, and connect the youth to professional care through a five-step action plan.

YMHFA also clarifies “that its training is not intended for staff with a mental health background such as school psychologists, social workers, clinicians, etc., due to its basic nature. The ideal audience includes teachers, administrators, nurses, counselors, and any other credentialed staff, classified staff (school secretaries, registrars, yard supervisors, campus monitors, bus drivers, lunch staff, janitors, aides, after school staff, etc.), parents, youth employers, and other community partners that have contact with students.”

California Investment in Youth Mental Health Services. Since 2019, California has taken action to address youth mental health. California has enacted grant programs and established initiatives to provide schools proper support to assist students and families.

California Community Schools Partnership Program (CSSP). A community school is a public school that serves students from pre-kindergarten through grade twelve, and it has partnerships with the local community to support improved academic outcomes, whole-child engagement, and family development.

In response to longstanding inequities exacerbated by the COVID-19 pandemic, California supported CCSPP investments in 2020, 2021, and 2022. In 2020, the California Legislature allocated $45 million in Federal Elementary and Secondary School Emergency Relief (ESSER) to support existing community schools throughout the state. Then, in 2021, the California legislature passed the California Community Schools Partnership Act and in 2022, the Legislature expanded the program by adding funds and extending the program to 2031. Between 2021 and 2022, the Legislature allocated a historic $4.1 billion in state dollars to support new and existing community schools, particularly those serving high concentrations of high-need students.

The partnership strategies of community schools include integrated support services, extended learning time, and collaborative leadership and practices for educators and administrators. Community schools use a community-driven shared decision-making approach to improve access to nurses, counselors, and social workers. This creates community hub campuses where students and families have easy access to the services needed to close opportunity gaps.

Mulitured Systems of Support (MTSS). MTSS is a comprehensive framework that aligns academic, behavioral, social, and emotional learning and mental health supports in a fully integrated system of support for the benefit of all students. CA MTSS offers the potential to create needed systematic change through intentional design and redesign of services and supports to identify and match all students’ needs quickly. The MTSS framework provides opportunities for LEAs to strengthen school, family, and community partnerships while developing the whole child in the most inclusive, equitable learning environment, thus closing the equity gaps for all students.

Children and Youth Behavioral Health Initiative (CYBHI). Established as part of the Budget Act of 2021, the CYBHI is a multiyear, multi-department package of investments that seeks to reimagine the systems, regardless of payer, that support behavioral health for all California's children, youth, and their families. Efforts will focus on promoting social and emotional well-being, preventing behavioral health challenges, and providing equitable, appropriate, timely, and accessible services for emerging and existing behavioral health (mental health and substance use) needs for children and youth ages 0-25. CYBHI is grounded in focusing on equity; centering efforts around children and youth voices, strengths, needs, priorities, and experiences; driving transformative systems change; and using ongoing learning as the basis for change and improvement in outcomes for children and youth.

In January 2024, the California Department of Health Care Services (DHCS), in partnership with Kooth and Brightline, is launching two behavioral health virtual services platforms for children, youth, and families. Launching as a part of the state’s CalHOPE program, with funding from the CYBHI a $4.6 billion investment in youth behavioral health, the web- and app-based platforms will offer all California residents, regardless of insurance coverage, free one on one support with a live coach, a library of multimedia resources, wellness exercises, and peer communities moderated by trained behavioral health professionals to ensure the appropriateness of content and the safety of all users. These new CalHOPE platforms will complement existing services offered by health plans, counties, and schools by providing additional care options and resources for parents and caregivers, children, youth, and young adults in California.

FISCAL EFFECT: Appropriation: No Fiscal Com.: Yes Local: Yes

According to the Senate Appropriations Committee, “This bill could result in a reimbursable state mandate for school districts to develop mental health crisis intervention protocols, as specified. Costs will vary by LEA but statewide Proposition 98 General Fund costs could be in the hundreds of thousands of dollars on a one-time basis to develop the protocols. This bill could also result in additional, unknown local cost pressures for LEAs to provide training related to youth behavioral health for teachers.”

SUPPORT: (Verified 5/17/24)

Santa Clara County Office of Education (source)
California Association of School Counselors
California Association of School Psychologists
California County Superintendents
California Federation of Teachers
California School Nurses Organization
California State Association of Psychiatrists 
California State PTA
California Teachers Association
CleanEarth4Kids.org
Generation Up
Mental Health Services Oversight and Accountability Commission
National Association of Pediatric Nurse Practitioners 
Santa Clara County School Boards Association
Steinberg Institute

OPPOSITION: (Verified 5/17/24)

None received

ARGUMENTS IN SUPPORT: According to the Santa Clara County Office of Education, “In the first year of the pandemic, intentional self-harm among 13 to 18-year-olds increased by 91%, overdoses increased by 95%, and diagnoses of major depressive disorders increased by 84%. A 2021 report from 50 school districts across California found that two-thirds of students reported that their mental health was negatively impacted by the pandemic. Despite the severity of youth mental health needs, there are 1,873,624 students in schools with police but no school counselor, psychologist, social worker, or nurse. Under the current student suicide prevention model policy, school staff are required to call 911 when a student is experiencing a mental health crisis. This policy applies regardless of whether the school has behavioral health professionals on campus who could address the crisis. It also does not limit application of the policy to situations where the student presents a physical threat to himself or others. While there may be instances when it is necessary to involve law enforcement, doing so significantly increases the likelihood of student injury, incarceration, or involuntary commitment, and should therefore be the exception, not the default. SB 1318 would require the California Department of Education (CDE) to revise their model youth suicide prevention policy to clarify that schools should prioritize the use of behavioral health professionals when responding to a student experiencing a mental health crisis. The bill would also encourage schools to provide more on-campus mental health services by requiring the district governing board to consider the merits of hiring behavioral health professionals every five years. We are proud to sponsor SB 1318 and want to thank you for authoring this important bill that encourages the adoption of anti-racist, pro-social interventions for youth in crisis.”

Prepared by: Kordell Hampton / ED. / (916) 651-4105

5/18/24 12:31:10

**** END ****

SENATE COMMITTEE ON

Senator Anna Caballero, Chair

2023 - 2024 Regular Session

SB 1318 (Wahab) - Pupil health: suicide prevention policies: pupil suicide crisis

Bill Summary:

This bill would require, on or before July 1, 2026, a local educational agencies (LEA) to adopt a mental health crisis intervention protocol in the event of a pupil having a mental health crisis, as defined, including the process by which staff and external agencies are deployed to address a pupil mental health crisis, as specified.

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

The following information is revised to reflect amendments

adopted by the committee on May 16, 2024

Fiscal Impact:

This bill could result in a reimbursable state mandate for school districts to develop mental health crisis intervention protocols, as specified. Costs will vary by LEA but statewide Proposition 98 General Fund costs could be in the hundreds of thousands of dollars on a one-time basis to develop the protocols. This bill could also result in additional, unknown local cost pressures for LEAs to provide training related to youth behavioral health for teachers.

Author Amendments:

Provide that the adoption occur during the next regularly scheduled review of a school district’s suicide prevention policy.

-- END --

SENATE COMMITTEE ON APPROPRIATIONS

Senator Anna Caballero, Chair

2023 - 2024 Regular Session

SB 1318 (Wahab) - Pupil health: suicide prevention policies: pupil suicide crisis

Bill Summary:

This bill would require, on or before July 1, 2026, a local educational agencies (LEA) to adopt a mental health crisis intervention protocol in the event of a pupil having a mental health crisis, as defined, including the process by which staff and external agencies are deployed to address a pupil mental health crisis, as specified.

Fiscal Impact:

This bill could result in a reimbursable state mandate for school districts to develop mental health crisis intervention protocols, as specified. Costs will vary by LEA but statewide Proposition 98 General Fund costs could be in the mid to high hundreds of thousands of dollars on a one-time basis to develop the protocols. This bill could also result in additional, unknown local cost pressures for LEAs to provide training related to youth behavioral health for teachers.

Background:

Existing law requires the governing board of an LEA that serves pupils in grades 7 to 12 to adopt, before the 2017-18 school year, procedures relating to suicide prevention, intervention, and postvention in consultation with school and community stakeholders, school-employed mental health professionals, and suicide prevention experts.

Existing law requires the governing board of an LEA that serve pupils in Kindergarten and grades 1 to 6 to adopt, before the 2020-21 school year, a policy on pupil suicide prevention in kindergarten in consultation with school and community stakeholders, school-employed mental health professionals, and suicide prevention experts. The policy shall specifically address the needs of high-risk groups, including, but not limited to the following: youth bereaved by suicide, youth with disabilities, mental illness or substance abuse disorders, youth experiencing homelessness or in out-of-home settings, such as foster care, and lesbian, gay, bisexual, transgender, or questioning youth.

Existing law requires, beginning July 1, 2019, a public school, including a charter school, or a private school, that issue identification cards to pupils grades 7 to 12 to include information to the National Suicide Prevention Lifeline, Crisis Text Line, and local suicide prevention hotline. The law also require the California Department of Education (CDE) to identify one or more evidence-based online training programs that a LEA can use to train school staff and pupils as part of the LEAs policy on pupil suicide prevention.

Proposed Law:

This bill requires a LEAs, on or before July 1, 2026, to adopt a policy that establishes a crisis intervention protocol in the event a pupil experiences a mental health crisis. The policy shall include the following while prioritizing the use of school mental health professionals when addressing a pupil mental health crisis:

• 1. A process by which staff and external agencies are deployed to address a pupil’s mental health crisis and prioritizes the use of school mental health professionals when addressing a pupil’s mental health crisis. If a school mental health professional is not available, the protocol may identify a school employee who has completed training related to youth behavioral health to provide interim care and a warm handoff to a mental health professional. If a trained school employee is not available to address the pupil’s mental health crisis, the protocol shall identify one or more community-based organizations, mobile crisis units, 988 services, or other qualified mental health professionals who shall be contacted in the event of a pupil mental health crisis.
  2. Limits involvement and notification of law enforcement, including peace officers and school resource officers, to situations in which a pupil’s life is in imminent danger and their needs cannot be addressed by a mental health professional.
  3. A process to inform the parent or guardian of the pupil experiencing the mental health crisis, including the process for assessing whether the pupil is endangered by parental notification and requires that notification to the pupil if the parent or guardian of the pupil is informed.

This bill requires the governing board or body of a LEA, when the governing board or body reviews its policy on pupil suicide prevention, to discuss whether funding should be redirected to hiring a school mental health professional if the LEA does not have a school mental health professional or contract with a mental health professional.

This bill defines “mental health professional” means an individual with a behavioral health license, and may include an intern, community health worker, peer counselor, or wellness coach, and also defines pupil mental health crisis” means any of the following: a pupil who is exhibiting suicidal thoughts or behaviors, a pupil who has completed a suicide risk assessment and is determined to be at risk of suicide, and a pupil who is attempting to physically harm themselves or others.

This bill defines “school mental health professional” as a school employee with a clear or preliminary pupil personnel services credential, or school nurse services credential, or a licensed or associate therapist, social worker, or psychologist.

Related Legislation:

AB 58 (Salas, Chapter 428, Statutes of 2022) requires an LEA, on or before June 1, 2024, to review and update its policy on pupil suicide prevention, and encourages them to provide suicide awareness and prevention training to teachers.

SB 14 (Portantino, Chapter 672, Statutes of 2021) requires the CDE to recommend, by January 1, 2023, best practices and identify evidence-based and evidence-informed training programs for schools to address youth behavioral health, including, but not necessarily limited to, staff and pupil training.

AB 309 (Gabriel, Chapter 662, Statutes of 2021) requires the CDE to develop model pupil mental health referral protocols, in consultation with relevant stakeholders, subject to the availability of funding for this purpose.

AB 2639 (Berman, Chapter 437, Statutes of 2018) requires the CDE to identify and make available an online training program in suicide prevention that an LEA can use to train school staff and pupils, consistent with the LEA’s policy on suicide prevention.

Staff Comments:

This bill defines an LEA as a county office of education, school district, state special school, and charter school. Under this definition, there are approximately 1,100 LEAs affected by this bill. To the extent it took 20 to 40 hours of staff time to develop a mental health crisis intervention protocol as specified in the bill for each LEA, the one-costs would range between about $480,000 and $960,000. Though some LEAs may already have such protocols in place, they may be required to amend their policies to bring it into conformity with the requirements of this bill. In these circumstances, costs to those LEAs would likely be less than LEAs without a policy in place. To the extent LEAs use existing available resources, less staff time would be needed, and less costs would be incurred in developing the protocols.

-- END --

SENATE COMMITTEE ON EDUCATION

Senator Josh Newman, Chair

2023 - 2024 Regular

Bill No: Hearing Date: April 3, 2024

Subject: .

SUMMARY

This bill would require, on or before July 1, 2026, a local educational agencies (LEA) to adopt a mental health crisis intervention protocol in the event of a pupil having a mental health crisis, as defined, including the process by which staff and external agencies are deployed to address a pupil mental health crisis, as specified.

BACKGROUND

Existing Law:

Education Code (EC)

1. Requires the governing board of an LEA that serves pupils in grades 7 to 12 to adopt, before the 2017-18 school year, procedures relating to suicide prevention, intervention, and postvention in consultation with school and community stakeholders, school-employed mental health professionals, and suicide prevention experts. (EC § 215(a))
2. Requires the governing board of an LEA that serve pupils in Kindergarten and grades 1 to 6 to adopt, before the 2020-21 school year, a policy on pupil suicide prevention in kindergarten in consultation with school and community stakeholders, school-employed mental health professionals, and suicide prevention experts. (EC § 215 (a)(2)(A))
3. Requires, beginning July 1, 2019, a public school, including a charter school, or a private school, that issue identification cards to pupils grades 7 to 12 to include information to the National Suicide Prevention Lifeline, Crisis Text Line, and local suicide prevention hotline. (EC § 215.5)
4. Require the California Department of Education (CDE) to identify one or more evidence-based online training programs that a LEA can use to train school staff and pupils as part of the LEAs policy on pupil suicide prevention. (EC § 216)

ANALYSIS

This bill:

1. Requires a LEAs, on or before July 1, 2026, to adopt a policy that establishes a crisis intervention protocol in the event a pupil experiences a mental health crisis that includes all of the following while prioritizing the use of school mental health professionals when addressing a pupil mental health crisis:
   1. A process by which staff and external agencies are deployed to address a pupil’s mental health crisis and prioritizes the use of school mental health professionals when addressing a pupil’s mental health crisis.
      1. Specifies if a school mental health professional is not available, the protocol may identify a school employee who has completed training related to youth behavioral health to provide interim care and a warm handoff to a mental health professional.
      2. Specifies that if a trained school employee is not available to address the pupil’s mental health crisis, the protocol shall identify one or more community-based organizations, mobile crisis units, 988 services, or other qualified mental health professionals who shall be contacted in the event of a pupil mental health crisis.
   2. Limits involvement and notification of law enforcement, including peace officers and school resource officers, to situations in which a pupil’s life is in imminent danger and their needs cannot be addressed by a mental health professional.
   3. A process to inform the parent or guardian of the pupil experiencing the mental health crisis, including the process for assessing whether the pupil is endangered by parental notification and requires that notification to the pupil if the parent or guardian of the pupil is informed.
2. Requires the governing board or body of a LEA, when the governing board or body reviews its policy on pupil suicide prevention, to discuss whether funding should be redirected to hiring a school mental health professional if the LEA does not have a school mental health professional or contract with a mental health professional.
3. Defines “Local educational agency” means a county office of education, school district, state special school, or charter school.
4. Defines “Mental health professional” means an individual with a behavioral health license, and may include an intern, community health worker, peer counselor, or wellness coach.
5. Defines “Pupil mental health crisis” means any of the following:
   1. A pupil who is exhibiting suicidal thoughts or behaviors.
   2. A pupil who has completed a suicide risk assessment and is determined to be at risk of suicide.
   3. A pupil who is attempting to physically harm themselves or others.
6. Defines “School mental health professional” means a school employee with a clear or preliminary pupil personnel services credential, or school nurse services credential, or a licensed or associate therapist, social worker, or psychologist.

STAFF COMMENTS

1. Need for the bill. According to the author, “The rising suicide rate among California’s children is unprecedented, and it is time to take action. In the first year of the pandemic, intentional self-harm among children aged 13-18 increased by 91%, and without making substantial changes to our youth suicide prevention policies, this statistic will not improve. SB 1318 is a strong step to provide children with the professional mental health support they need in times of crisis. The bill clarifies that the involvement of law enforcement officers, including resource officers, should be the final step to protect a child’s life, and that connection with mental health professionals should be the first. SB 1318 is a lifeline for our most vulnerable youth.”
2. Mental Health Crisis Among Students. Mental health problems can significantly impact various aspects of a student's life. They can reduce the quality of life, academic achievement, and physical health. Additionally, these issues can negatively affect relationships with friends and family members. Furthermore, students may face long-term consequences, including a negative impact on their future employment, earning potential, and overall health.

In a study produced by the Center for Disease Control, “Forty-two percent of high school students in 2021 reported feeling so sad or hopeless for at least two consecutive weeks in the previous year that they stopped engaging in their usual activities, up from 26 percent in 2009.” Moreover, Thoughts of suicide, suicide attempts, and actual suicides among young people have also risen in that period, with Black children nearly two times more likely than their white peers to die by suicide, according to the U.S. Centers for Disease Control and Prevention’s biennial Youth Risk Behavior Survey.

Strong mental health is one of the most critical factors contributing to a student's academic success. When students have a positive mental state, they tend to learn better, retain information more effectively, and realize their full potential more effectively. Their mental health also plays a crucial role in their well-being and social development. Students with good mental health can build stronger relationships, make better decisions, and work collaboratively with their peers. Moreover, students with positive mental health are also more likely to become responsible and productive members of their communities as they transition into adulthood. They have a better sense of self-awareness and are more equipped to navigate the challenges of the transition to adulthood. Therefore, it is essential to prioritize mental health education and promote a positive mental state among students.

1. CDE Youth Behavioral Health Programs. Pursuant to SB 14 (Portantino, Chapter 672, Statutes of 2021) the CDE was required to recommend, by January 1, 2023, best practices and identify evidence-based and evidence-informed training programs for schools to address youth behavioral health, including, but not necessarily limited to, staff and pupil training.

On the CDE’s website, the department has identified the Youth Mental Health First Aid (YMHFA) a research-based curriculum created upon the medical first aid model. It is designed to provide parents, family members, caregivers, teachers, school staff, neighbors, and other caring adults with skills to help a school-age child or youth who may be experiencing emotional distress, the onset of a mental illness, addiction challenge or who may be in crisis. YMHFA participants learn to recognize signs and symptoms of children and youth in emotional distress, initiate and offer help, and connect the youth to professional care through a five-step action plan.

YMHFA also clarifies “that its training is not intended for staff with a mental health background such as school psychologists, social workers, clinicians, etc., due to its basic nature. The ideal audience includes teachers, administrators, nurses, counselors, and any other credentialed staff, classified staff (school secretaries, registrars, yard supervisors, campus monitors, bus drivers, lunch staff, janitors, aides, after school staff, etc.), parents, youth employers, and other community partners that have contact with students.”

1. Pupil Personal Service (PPS) Credential. PPS credential holders may work with individual students, groups of students, or families to provide the services authorized by their credentials to address the needs of all students by providing a comprehensive PPS program. PPS credential covers services for individuals who serve as counselors, school psychologists, school social workers, and school child welfare and attendance regulators. Holders of these credentials perform, including, but not limited to, the following duties:

School Counseling: Develop, plan, implement, and evaluate a school counseling and guidance program that includes academic, career, personal, and social development; advocate for the high academic achievement and social development of all students; provide schoolwide prevention and intervention strategies and counseling services; and provide consultation, training, and staff development to teachers and parents regarding students’ needs.

School Social Work: Assess home, school, personal, and community factors that may affect a student’s learning; identify and provide intervention strategies for children and their families, including counseling, case management, and crisis intervention; consult with teachers, administrators, and other school staff regarding social and emotional needs of students; and coordinate family, school, and community resources on behalf of students.

School Psychology: Provide services that enhance academic performance; design strategies and programs to address problems of adjustment; consult with other educators and parents on issues of social development and behavioral and academic difficulties; conduct psycho-educational assessment for purposes of identifying special needs; provide psychological counseling for individuals, groups, and families; and coordinate intervention strategies for management of individuals and schoolwide crises.

Child Welfare and Attendance: Access appropriate services from both public and private providers, including law enforcement and social services; provide staff development to school personnel regarding state and federal laws pertaining to due process and child welfare and attendance laws, address school policies and procedures that inhibit academic success, implement strategies to improve student attendance; participate in schoolwide reform efforts; and promote understanding and appreciation of those factors that affect the attendance of culturally-diverse student populations.

This bill would prioritize school employees, who hold a PPS credential, to interact with youth experiencing a mental health crisis before engaging community based organizations and law enforcement, in that order, as specified.

1. California Investment In Youth Mental Health Services. Since 2019, California has taken action to address youth mental health. California has enacted grant programs and established initiatives to provide schools proper support to assist students and families.

California Community Schools Partnership Program (CSSP).

A community school is a public school that serves students from pre-kindergarten through grade twelve, and it has partnerships with the local community to support improved academic outcomes, whole-child engagement, and family development.

In response to longstanding inequities exacerbated by the COVID-19 pandemic, California supported CCSPP investments in 2020, 2021, and 2022. In 2020, the California Legislature allocated $45 million in Federal Elementary and Secondary School Emergency Relief (ESSER) to support existing community schools throughout the state. Then, in 2021, the California legislature passed the California Community Schools Partnership Act and in 2022, the Legislature expanded the program by adding funds and extending the program to 2031. Between 2021 and 2022, the Legislature allocated a historic $4.1 billion in state dollars to support new and existing community schools, particularly those serving high concentrations of high-need students.

The partnership strategies of community schools include integrated support services, extended learning time, and collaborative leadership and practices for educators and administrators. Community schools use a community-driven shared decision-making approach to improve access to nurses, counselors, and social workers. This creates community hub campuses where students and families have easy access to the services needed to close opportunity gaps.

Mulitured Systems of Support (MTSS).

MTSS is a comprehensive framework that aligns academic, behavioral, social, and emotional learning and mental health supports in a fully integrated system of support for the benefit of all students. CA MTSS offers the potential to create needed systematic change through intentional design and redesign of services and supports to identify and match all students’ needs quickly. The MTSS framework provides opportunities for LEAs to strengthen school, family, and community partnerships while developing the whole child in the most inclusive, equitable learning environment, thus closing the equity gaps for all students.

In 2015, Assembly Bill 104 (Committee on Budget, Chapter 13, Statutes of 2015), appropriated $10,000,000 for developing, aligning, and improving academic and behavioral support systems. The CDE conducted a competitive grant process and awarded the funds to the Orange County Department of Education (OCDE) for their Scaling Up MTSS Statewide (SUMS) proposal, which included the Butte County Office of Education (Butte COE) as a rural partner. In 2016, an additional $20,000,000, appropriated by SB 828 (Committee on Budget, Chapter 29, Statutes 2016), augmented the original grant award. The Budget Act of 2018 authorized an additional $15,000,000, appropriated by AB 1808 (Committee on Budget, Chapter 32, Statutes of 2018), and SB 840 (Budget Act of 2018, Chapter 29, Statutes of 2018). This phase of the grant focuses on improving the school climate statewide. The total $95,000,000 awarded to date is to encourage LEAs to establish and align schoolwide, data-driven academic and behavioral support systems to more effectively meet the needs of California’s diverse learners in the most inclusive environment.

Comprehensive school mental health programs offer three tiers of support within an MTSS approach:

• Tier 1: Universal mental health promotion activities for all students;
• Tier 2: Selective prevention services for students identified as at risk for mental health problems; and
• Tier 3: Indicated services for students who already show signs of a mental health problem.

Children and Youth Behavioral Health Initiative (CYBHI).

Established as part of the Budget Act of 2021, the CYBHI is a multiyear, multi-department package of investments that seeks to reimagine the systems, regardless of payer, that support behavioral health for all California's children, youth, and their families. Efforts will focus on promoting social and emotional well-being, preventing behavioral health challenges, and providing equitable, appropriate, timely, and accessible services for emerging and existing behavioral health (mental health and substance use) needs for children and youth ages 0-25. CYBHI is grounded in focusing on equity; centering efforts around children and youth voices, strengths, needs, priorities, and experiences; driving transformative systems change; and using ongoing learning as the basis for change and improvement in outcomes for children and youth.

In January 2024, the California Department of Health Care Services (DHCS), in partnership with Kooth and Brightline, is launching two behavioral health virtual services platforms for children, youth, and families. Launching as a part of the state’s CalHOPE program, with funding from the CYBHI a $4.6 billion investment in youth behavioral health, the web- and app-based platforms will offer all California residents, regardless of insurance coverage, free one on one support with a live coach, a library of multimedia resources, wellness exercises, and peer communities moderated by trained behavioral health professionals to ensure the appropriateness of content and the safety of all users. These new CalHOPE platforms will complement existing services offered by health plans, counties, and schools by providing additional care options and resources for parents and caregivers, children, youth, and young adults in California.

This bill stipulates that the governing board or body of a LEA, when the governing board or body reviews its policy on pupil suicide prevention, is required to discuss whether funding should be redirected to hiring a school mental health professional if the LEA does not have a school mental health professional or contract with a mental health professional.

1. Committee Amendments. Committee staff recommends, and the author has agreed to accept, the following amendments:
   1. Redefine “Mental health professional” to mean any individual licensed by the California Board of Behavioral Sciences or the California Board of Psychology and any intern or associate working towards licensure, and may include a peer counselor, certified wellness coach, and community health workers trained in behavioral health conditions.
   2. Replace “youth mental health crisis” with “youth suicide crisis”, to match the intent of the bill.
   3. Clarify “school mental health professional” to mean a school employee with a clear or prelimniary pupil personnel services credential with a specialization in school counseling, school social work, or school psychology or a credentialed school nurse or a licensed or associate therapist, social worker, or psychologist under the supervision of a school employee with a pupil personnel services or administrative services credential.
   4. Makes technical changes.
2. Related Legislation.

AB 309 (Gabriel, Chapter 662, Statutes of 2021) requires the CDE to develop model pupil mental health referral protocols, in consultation with relevant stakeholders, subject to the availability of funding for this purpose.

AB 2639 (Berman, Chapter 437, Statutes of 2018) requires the CDE to identify and make available an online training program in suicide prevention that an LEA can use to train school staff and pupils, consistent with the LEA’s policy on suicide prevention.

AB 2246 (O’Donnell, Chapter 642, Statutes of 2016) requires LEAs to adopt policies for the prevention of student suicides, and requires the CDE to develop and maintain a model suicide prevention policy.

SB 224 (Portantino, Chapter 675, Statutes of 2021) requires LEAs and charter schools that offer courses in health education to students in middle school or high school to include in those courses instruction in mental health that meets specified requirements, and requires the CDE, by January 1, 2024, to develop a plan to increase mental health instruction in California public schools.

SB 14 (Portantino, Chapter 672, Statutes of 2021) requires a student's absence related to pupil mental or behavioral health to count as an excused absence for school attendance reporting and, subject to appropriation, requires the CDE, by January 1, 2023, to recommend best practices and identify evidence-based and evidence-informed training programs for schools to address youth behavioral health, including staff and student training.

SUPPORT

Santa Clara County Office of Education (sponsor)

California Association of School Psychologists

California County Superintendents

California Federation of Teachers

California State Association of Psychiatrists

California Teachers Association

Generation Up

National Association of Pediatric Nurse Practitioners

Steinberg Institute

OPPOSITION

None received

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