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Kirwan Commission’s Impact on School Health August 12, 2019. Agenda. Introductions Commission Background Recommendations Legislative Actions & Funding Implementation & Next Steps Questions & Comments. Introductions. Patryce Toye, MD President
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Agenda • Introductions • Commission Background • Recommendations • Legislative Actions & Funding • Implementation & Next Steps • Questions & Comments
Introductions Patryce Toye, MD President Maryland Assembly on School-Based Health Care Mary C. Backley Executive Director Maryland Dental Action Coalition Mary Kay DeMarco, PhD, RN, CNE President Maryland Nurses Association Rachael Faulkner, MSW Director of Research and Policy Development Public Policy Partners
Background – SHS & SBHC School health services School-based health centers Interdisciplinary Team led by a nurse practitioner or a physician Provide primary health care; and may include dental and behavioral health services Part of the larger health system and contributes to larger data and quality reporting systems • Services provided by a Nurse or combination Nurse and Health Aide • Provide oversight for the health and safety of the students through school health policies and programs • Responsible for the health expertise in Individualized Health Plans and Emergency Care Plans
Background – Kirwan Commission The Commission on Innovation and Excellence in Education was established in 2016 as a result of legislation (HB 999/SB 905). Charge: • Review and recommend any needed changes to update the current education funding formulas (known as the Thornton formulas); and • Make policy recommendations that would enable Maryland’s preK-12 system perform at the level of the best-performing systems in the world.
Commission Background – Focus on Health Services In Spring 2018, the Commission directed its focus to school health services in an effort to understand the connection between improved health and academic success. • Focus on schools with high concentrations of poverty • Discussion of somatic and mental health services
Recommendations • Schools with at least 55% FRPM students* will receive funding for: • Community school coordinator; • Health services practitioner (under school health or school-based health center); and • Per pupil allocation on a sliding scale based on the concentration of students living in extreme poverty for wraparound services (schools with 55% of its students living in poverty will receive 0% of the per pupil amount increasing to 100% for schools with at least 80% of its students in poverty). • *2017-2018 school year data shows 557 schools with at least 55% FRPM students.
Recommendations • School–Based Health Centers (SBHC) should be established or enhanced in schools with high poverty rates. • Scaling of school behavioral health service availability to ensure that all students have some exposure and access to behavioral health programming and services and to ensure that schools without a SBHC will organize response plans to connect all students to community–partnered school based or community behavioral health and other services, as needed. • Needs assessment for SBHCs is needed to determine the need to expand capacity through existing SBHCs and new SBHCs and the amount of funding needed to expand based on the assessment. • In addition, it is being recommended that State funding for school-based health centers be increased to $9 million beginning in fiscal 2021. This is an additional $6.5 million over the current FY 2019 allocation ($2.5 million).
Legislative Actions & Funding • Concentration of Poverty Grants: $54.6 million in fiscal years 2020 and 2021 for concentration of poverty grants for 206 schools that meet the 80% eligibility threshold set by the bill. The number of schools is based on school year data for Free and Reduced-Price Meals.
Legislative Actions & Funding • Concentration of Poverty Grants: • Each county board shall distribute directly to each eligible school $248,833. • Each eligible school must: • Employ one community schools school coordinator staff position; and • Provide full-time coverage of at least one professional health care practitioner during school hours, including extending learning time, who is a licensed physician, licensed physician’s assistant, or a licensed registered nurse. • If a local school system has at least 40 eligible schools, the county board may, on behalf of the eligible schools, expend the funds distributed by the State • If a county board expends the funds, it must develop a plan in consultation with the eligible schools in that jurisdiction.
Legislative Actions & Funding • Health Care Practitioners: • A health care practitioner providing coverage may work under a school health services program, a county health department, or a school-based health center. The legislation does not: • Require eligible schools to hire a full-time health care practitioner; or • Preclude the hiring of any other health care practitioners that meet the needs of students.
Legislative Actions & Funding • School Needs Assessment: The Community Schools School Coordinator is responsible for completing an assessment by July 1, 2020 of the needs of the students in the school for appropriate wraparound services to enhance the success of all students in the school. • Must be done in collaboration with the principal, school health care practitioner, parent-teacher organization or a school family council. • Must include an assessment of the physical, behavioral, and emotional health needs of students, their families, and their communities.
Legislative Actions & Funding • Wraparound Services: • Dollars not used to staff a community schools coordinator and provide full-time coverage of health care services may only be used to provide wraparound services* including: • Establishing and expanding school-based health center services; • Additional school-employed mental health professionals such as social workers and psychologists; and • Enhancing behavioral health services such as access to mental health practitioners and professional development to school staff to provide trauma-informed interventions. • *A full list of wraparound services is included under §5-203(A)(7) of the Education Article.
Legislative Actions & Funding • Additional Items of Interest: • Mental Health Services Coordinators: $83,333 per local school system ($2 million total) to fund a full–time mental health services coordinator staff position as required under § 7–1511 of the Education Article. • Expanding SBHC Sponsors: The bill requires the Maryland Department of Health and the State Department of Education to consult with the Council on Advancement of School–Based Health Centers and other interested stakeholders on a plan to build a sustainable sponsorship model by expanding the type of organizations that can sponsor school–based health centers. Recommendations are due November 1, 2019. • Teacher Salary Incentive Grant Program: The State must provide a grant to a local boards of education if the local board provides a negotiated and funded average salary increase for teachers of at least 3.0% in fiscal 2020. • “Teacher” means a certificated public school employee who: (i) is not an administrator; and (ii) as of April 1, 2019, is part of a collective bargaining unit that includes classroom teachers. • Special Education: For each fiscal year (2020 and 2021), an additional $65.5 million is provided for special education services (specified amounts to each local school system are included in the bill). • If any of this funding is not needed to fully implement IEPs and 504 plans for students with disabilities, each local board of education must use the remaining funding to implement other recommendations made in the Commission’s January 2019 Interim Report.
Implementation & Next Steps • Summer 2019: Local school systems should have received notification and funding for 2019-2020 school year. • Currently developing plans for meeting requirements • Fall 2019: Kirwan Commission will release additional recommendations on redesigning the funding formulas, including local share of comprehensive education funding • Winter 2020: Additional legislation and funding will be debated. Of interest to school health: • Protecting funding in FY 2021 for school health services • Dedicated funding for wraparound services • Additional $6 million for SBHCs
Contact Information • Rachael Faulkner, MSW • Director of Research and Policy Development • Public Policy Partners • rfaulkner@policypartners.net
