BOARD OF EDUCATION Attachment: Discussion 10. PALO ALTO UNIFIED SCHOOL DISTRICT Date:

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BOARD OF EDUCATION Attachment: Discussion 10 PALO ALTO UNIFIED SCHOOL DISTRICT Date: 02.09.16 TO: FROM: SUBJECT: Glenn Max McGee, Superintendent Holly Wade, Chief Student Services Officer A Coordinated School Health and Approach to Student Success Mental Health Expenditures 2011-2016 STRATEGIC PLAN INITIATIVE Governance and Communication RECOMMENDATION The Board of Education will review and discuss mental health expenditures in order to consider providing additional funding to student health and wellness programs. This item is presented for discussion and pending approval of increased funding FY 2015 to address the development of a coordinated student health and wellness approach to benefit all students and staff. The total cost for approval at this time is $56,800. BACKGROUND In the past five years the Palo Alto Unified School District has invested in mental health services across the district to increase K-12 direct supports to students, staff, and families. Each year the costs have risen to address the needs of our community. We have both initiated and deepened partnerships with community agencies and increased staffing of school psychologists, a social worker, licensed therapists, and certified interns. Last year, the Board approved adding a mental health specialist at each of the two high schools to address a wide range of student needs. After five years of increased spending and focused goals in the areas of student and staff wellness and a consistent request to increase student connectedness, the District Committee and site level teams at the high schools, as well as high school Single Plans for Student Achievement (SPSAs) and Western Association of Schools and Colleges (WASC), have articulated a need to coordinate the critical resources we have directly to students. Both high school SPSAs and WASC plans support BOE goals to develop comprehensive approaches to student wellness. Plans have called for site plans to include physical space to provide Centers on campuses. Current resources have allocated staff to contribute to this model, however there is no infrastructure at this time to coordinate, maintain, and monitor effective direct services to students. According to the 2011-2016 budget for mental health costs we have increased spending each year in both PAUSD staffing and our contract agency services. Last year, we increased staffing expenses in three key areas: 1) added an additional district nurse, 2) added two mental health specialists and 3) increased contracted services. Last year specifically we increased spending in PAUSD personnel by 50% of the total additional allocation and realized organic growth in all other areas, or less than 10% growth to overall costs. 1

We are recommending a strategic and comprehensive plan to develop a wellness continuum of integrated supports to coordinate and minimize duplication of services, and increase direct service to students. Prioritization is given to the high schools at this time, with the benefit of building a replicable model to be used as a unified approach across the district over time. Therefore, we ask for the Board s approval to extend the contract with Asian Americans for Community Involvement (AACI) for the reminder of the year to increase services to Mandarin and Korean speaking families for parent classes ($21,800), and to consider an additional agency for more support to Spanish speaking families ($10,000). In addition, we request $25,000 to be allocated immediately to support the exploration of Model programs for students and staff. This will allow us to invest in best practice coordinated efforts to provide direct services to students, and explore data management/evaluation resources in order to maintain and monitor these most important efforts To address the documentation of Efforts, tools will be identified to consider evaluation approaches that will allow practitioners to document all services provided at the individual student level and if possible integrate with our current student information system. 2

Student WELLNESS A Coordinated Approach for Success Presentation to the Board of Education Palo Alto Unified School District` February 9, 2016 Holly Wade, Assistant Superintendent, Student Services Brenda Carrillo, Director of Student Services

Presentation Goals Current overview of services and costs provided for students from 2011-2016 Identified gaps Recommendations for increased funding for short and long term needs

Actuals Actuals Actuals Actuals Budget ` 2011-2012 2012-2013 2013-2014 2014-2015 2015-2016 $6,005,885 $6,837,274 $7,796,963 $8,981,287 $10,004,407 PAUSD STAFF: Psychologists $1,836,963 $2,074,765 $2,456,540 $2,672,501 $2,899,459 Counselors $2,576,275 $2,812,798 $3,135,901 $3,445,469 $3,512,320 Educational Related Mental Health/Sp Ed $811,639 $1,088,905 $1,160,619 $1,584,412 $1,841,351 Mental Health Specialists $199,747 Nurses $141,138 $160,726 $167,772 $171,190 $231,190 Health Technicians $452,685 $446,478 $483,000 $465,738 $470,065 Social Worker $99,809 $116,350 Parent Outreach $48,838 Contract Agency Services: Lucile Packard Childrens Group $34,785 $29,403 $39,331 $50,888 $64,704 Counseling contracts $152,400 $224,200 $353,800 $491,280 $620,383 Total $6,005,885 $6,837,274 $7,796,963 $8,981,287 $10,004,407 2015-2016 Key Takeaways: - 3 New FTE Additions (Psychologist, Mental Health Specialist, Nurse) - All Other Areas Had Organic Growth ~ 10% / <$15K

30. 22.5 15. 7.5 Psychologists Counselors Special Education MH Mental Health Specialists Nurses Health Techs Social Worker Parent Outreach 0. 2011-2012 2012-2013 2013-2014 2014-2015 2015-2016

Service Trends Each year our expenditures have increased Better coordination of services continues to be an identified need Gaps in current system identified to meet the needs of all students

Current Data Used Alcohol: 18%/43% Used Marijuana: 10%/26% Sad/Hopeless: 17%/24% Considered Suicide:12%/12% CHKS Data 2013-14

Services Lack Coordination

Defined To enhance the delivery of comprehensive and coordinated health, mental health and other support services within the school environment so that STUDENTS can THRIVE.

Students Thrive When Services are Coordinated

Why a Coordinated Approach? Mental Health Over 70 % of students receiving mental health services are getting them at school (National Assembly on School Based Care). 90% of teens who attempt suicide have a diagnosable mental health disorder that could have been addressed with early intervention (US Department of HHS).

CSH Approach Academics/Attendance 81 % of students receiving individual counseling report coming to school more often and nearly 70% report doing better in school School Climate 79% of teachers reported improvement in attention, behavior and motivation among referred students 75% of teachers surveyed reported increase in academic performance among referred students SF Unified Results Students receiving group and individual services report a higher percentage of school assets (10-13 points) (caring relationships, meaningful participation)

Student Improves students' health and their capacity to learn through the support of families, schools, and communities working together. Recommended by the Center for Disease Control and Prevention, the Association for Supervision and Curriculum Development

Benefits of Coordinated Approach for Students Improved student performance & test scores Decrease in risk behaviors Reduced absenteeism and drop out rates Improved rates of physical activity schools Improved Allocation of Resources Reduced duplication of services Improved staff morale

Youth When students receive instruction in social emotional concepts, standardized test scores increase an average of 11-17 points (Barrett, et al). 13-20% of youth have mental health needs, but over 70% do not get treatment, even those with insurance. Schools provide increased access, decreased stigma and early intervention services that are less expensive and can prevent the need for more intensive services later on (CDC & California Health Interview Survey).

Students who feel connected to school are: More likely to attend school regularly, stay in school longer, and have higher grades & test scores. Less likely to smoke cigarettes, drink alcohol, or have sexual intercourse. Less likely to have emotional problems, suffer from eating disorders, or experience suicidal thoughts or attempts.

Centers Defined Strategically coordinate resources within wellness centers so students can access effective and appropriate services In line with BOE, WASC & SPSA School Goals In line with best practice (CDC & ASCD) Successful results in other districts Approach serves all students

Student Centers Counseling (individual and group) Services Drug and Alcohol Education and Counseling Crisis Support and Intervention Case Management Nursing and Individual and group) Reproductive Health Services Drug and Alcohol Education and Counseling Crisis Support and Intervention Case Management Nursing and Health Services Mentoring Youth Development Programs

Centers Serve ALL Students Lead prevention programs, education & activities for whole school. Provide safe and welcoming spaces to receive support. De-stigmatization of behavioral health services & reduced barriers to access. Provide coordinated health, mental health, substance use/abuse & reproductive health services.

Student Centers Model 2016-17 Counselors (Mental Health Clinicians) Coordinator (MH Specialists) Outreach Specialist Nurse Center Team School Counselors & School Psychologists Community Partners (YCS, Dairy Council, PAMF, Stanford, etc.) Interns (social work, counselor, etc. ) Peer Supports and Resources (ROCK, SOS, etc.)

Recommendations for Funding Hire contractor(s) to develop proposal for Student and Staff Models ($25,000) Begin Community Needs Assessment (Data) Add Contract Services from AACI to address the direct service needs of Mandarin and Korean ($21,800) Services for Spanish speaking families ($10,000)

Every Student, Every Day Thank you to the Board for their continued and intentional support toward building communities in our schools that support the whole child, everyday.