Schools, health centers get $30 million in state mental health funding

Originally published by Crain’s Detroit Business

School mental health services are expected to get a boost from new money the Legislature appropriated late last year after a year that saw a number of mass shootings in schools nationally.

Many public school districts and school-based health centers are expected to tap into $30 million in new state mental health funds, funding that Debbie Brinson, as interim executive director of the School-Community Health Alliance of Michigan, says is vitally important to address unmet needs at more than 1,500 schools.

“Lots of kids at schools don’t have access to mental health services,” said Brinson, who also is CEO of Honor Community Health, a federally qualified health center in Pontiac. “Establishing mental health services in school health centers is long overdue.”

Brinson has been working on the issue of expanding school-based health centers, including school nursing and mental health services, in Michigan for the past 10 years. She has worked with such legendary health executives as Gail Warden, the former CEO of Henry Ford Health System, the late Paul Reinhardt, former state Medicaid director, and also former Medicaid director Steve Fitton and interim Medicaid director Kathy Stiffler.

But it was the Florida school shootings in February 2018 at Marjory Stoneman Douglas High School in Parkland that escalated the need for school mental health funding, Brinson said.

“The kids said we need to do something about it, and more than 100 went to the state Legislature for advocacy day” in May 2018, Brinson said. “It won’t prevent school shooters, but it will help identify kids with serious mental health problems. Right now we can’t do anything. It will help to have mental health services available.”

In late December, the Michigan Department of Health and Human Services applied for federal Medicaid matching funds with a state health plan amendment called Caring 4 Students. If approved, another $19 million in federal funds could be provided to the 56 state intermediate school districts and health centers based on the state’s 64 percent federal Medicaid matching rate. Four states have similar plans approved, including most recently Massachusetts, Brinson said.

An additional $5 million will be available to hire additional licensed mental health care providers in the state’s 125 school-based health centers, including those operated by Henry Ford Health System and Ascension Health Michigan.

Besides student mental health services, Michigan schools last year received more than $25 million in school safety grants in the wake of the school shootings in Parkland and Santa Fe, Texas. Nearly $70 million was requested, but it still was more than the $2 million granted in 2017.

Funding will be used to strengthen entrance points in schools; create access control systems, security film or glass and public address systems; install door barricade devices and door locks; and purchase mobile phone communication and safety applications.

Schools with some of the largest grants include Detroit Public Schools, $750,000; Royal Oak Schools, $578,175; Ann Arbor Public Schools, $956,644; Grand Rapids Public Schools, $866,213; Rochester Community Schools, $828,164 and Benton Harbor Area Schools at $928,725.

School mental health funding approach

Under the mental health expansion, health centers and schools would be able to bill Medicaid for services provided to all Medicaid-enrolled students. Currently, only special education students who have an individualized education program can receive the funding.

Officials from Oakland and Wayne public schools told Crain’s they would apply for the funds, which amounts to about $264,000 per ISD. Several other counties, including Kent and Ottawa, also have announced they would use the funds, which were contained in the state’s 2019 K-12 budget.

“Michigan’s shortage of school-based mental health providers and school nurses is one of the worst in the nation, resulting in a serious health crisis for children lacking or with limited access to care outside of school,” said a white paper distributed last July by the School-Community Health Alliance, which received funding from the Michigan Health Endowment Fund for the project.

The report said 27 percent of Michigan youth report symptoms of depression, 16 percent report seriously considered suicide, 25 percent report being bullied at school and 19 percent report electronic bullying. In addition, Michigan’s ratio of 6,607 students for each school nurse is the worst in the nation.

Brinson said ISDs need to apply for the funding, submit a plan for billing, staff and services. When they draw down funding and pay bills, they will get the federal matching dollars, she said.

“Some of the health centers are based in schools, some partner with organizations in the community,” Brinson said.

For example, Henry Ford and Ascension St. John hospitals partner with several individual schools that are part of Detroit Public Schools to operate school-based health centers. Honor Community partners with Waterford and Pontiac school districts in Oakland County.

“School health centers have been around for 30 years, but (comprehensive) mental health services will be a first,” she said.

Maureen Connolly, M.D., medical director for Henry Ford’s school-based and community health program, said Henry Ford’s 10 school and one community-based health centers will apply for about $5 million in funding the state Legislature authorized last December through the Child and Adolescent Health Center Program.

onnolly said Henry Ford operates 11 health centers in Southeast Michigan for school-aged adolescents, mostly located in high schools that include Detroit, Highland, Warren and Mt. Clemens.

“We have full clinical models in high schools and have nurses in three other schools,” she said. “We provide primary care services, including well visits, physicals, sexual health services and a broad range of care for adolescents.”

Connolly said the health centers also do some behavioral health services using clinical therapists. But the additional funding will allow Henry Ford and other school-based providers to expand mental health services.

“It is fantastic. It will help so much, especially working with children and young adults. We can go beyond the physician (to address) trauma or adverse childhood events, help them develop coping skills,” Connolly said.

Sen. Pete MacGregor, R-Cannon Township, and former Sen. Goeff Hansen, R-Hart, co-sponsored the school mental health bill, Senate Bill 149, which includes the following funds for the ISDs:

$16.5 million for intermediate school districts to work with their local school systems to provide mental health services. Statewide it breaks down to $294,500 for each ISD.

$8 million for ISDs will to create school-based behavioral health assessment teams that will focus on providing age-appropriate interventions. The teams will train students to identify behaviors that suggest a student is struggling with mental health challenges for treatment and support.

$500,000 to assist ISDs with administration for school mental health programs.

“In 10 years, I want to look back and see that a system of care has been established within the schools that support access to an array of health services for children and adolescents,” said Brinson, adding that access includes school nursing, mental health services and prevention. “While it will be a challenge to start the process, the potential to expand access and improve the lives of children statewide will have a tremendous impact for our communities.”