Report 2019-125 All Recommendation Responses

Report 2019-125: Youth Suicide Prevention: Local Educational Agencies Lack the Resources and Policies Necessary to Effectively Address Rising Rates of Youth Suicide and Self‑Harm (Release Date: September 2020)

Recommendation for Legislative Action

To increase students' access to mental health services, the Legislature should provide funding for Public Health to award grants for a pilot program that would establish school health centers at a selection of LEAs located in counties with high rates of youth suicide and self-harm. The Legislature should require Public Health to collaborate with Education to collect data on the pilot program and to provide annual reports on the effectiveness and cost of the program. If the school health center program is deemed affordable and effective, the Legislature should consider expanding it to LEAs throughout the State.

Description of Legislative Action

AB 58 (Salas, 2021) would have stated the Legislature's intent to require Public Health to create a pilot program to establish a school health center at five LEAs located in counties with high rates of youth suicide and self-harm, and it would have required Public Health, in collaboration with Education, to collect data on the pilot program and provide annual reports on the effectiveness and cost of the pilot program. This provision was removed from this bill prior to its enactment.

California State Auditor's Assessment of Annual Follow-Up Status: Legislation Proposed But Not Enacted

Description of Legislative Action

AB 58 (Salas, 2021) states legislative intent to require Public Health to create a pilot program to establish a school health center at five LEAs located in counties with high rates of youth suicide and self-harm, and require Public Health, in collaboration with Education, to collect data on the pilot program and provide annual reports on the effectiveness and cost of the pilot program. This bill is pending in the Assembly Education Committee.

California State Auditor's Assessment of 1-Year Status: Legislation Introduced

Description of Legislative Action

AB 58 (Salas) states legislative intent to require Public Health to create a pilot program to establish a school health center at five LEAs located in counties with high rates of youth suicide and self-harm, and require Public Health, in collaboration with Education, to collect data on the pilot program and provide annual reports on the effectiveness and cost of the pilot program.

California State Auditor's Assessment of 6-Month Status: Legislation Introduced

Description of Legislative Action

As of November 28, 2020, the Legislature has not taken action to address this specific recommendation.

California State Auditor's Assessment of 60-Day Status: No Action Taken

Recommendation #2 To: Education, Department of

To promote the adoption of the best practices that it has identified, Education should remind LEAs of the elements in its model policy. To do so, it should annually send a notice to all LEAs that describes suicide prevention resources, such as the model policy, and encourages their use. Education should also work with external organizations that maintain model policies, including the School Boards Association, to encourage the development of policies that are consistent with state law and best practices by no later than September 2021.

Annual Follow-Up Agency Response From October 2023

Education completed its review of the Model Youth Suicide Prevention Policy (policy) and posted the information on its website in July 2023. Additionally, Education announced the posting of the policy through the Mental Health Listserve that same month.

Education is now working on the notice to all LEAs, which will include: (1) suicide prevention resources; (2) the updated Model Youth Suicide Prevention Policy; and (3) encouraging the use of these resources.

California State Auditor's Assessment of Annual Follow-Up Status: Partially Implemented

We look forward to reviewing evidence that Education has notified all LEAs of the updated policy and availability of other suicide prevention resources. However, we note that Education has not addressed the portion of our recommendation that pertains to working with external organizations, including the School Boards Association, to encourage those organizations to align their model policies with state law and best practices.

Annual Follow-Up Agency Response From October 2022

As previously stated, the California School Boards Association released their sample policy and Education anticipated completing the review and making the Model Suicide Prevention Policy available to LEAs at the end of 2021. However, due to competing workload demands, the Model Suicide Prevention Policy release was delayed and is now expected to be available to LEAs by the end of 2022.

California State Auditor's Assessment of Annual Follow-Up Status: Pending

Education previously stated that it was collaborating with the School Boards Association, but it has not yet provided evidence that it has successfully completed any of the components of our recommendation.

1-Year Agency Response

Education and the California School Boards Association (CSBA) continued collaborating to align suicide prevention policies. CSBA has released their sample policy and Education is in the final stages of review; it is anticipated that the Model Suicide Prevention Policy will be available to LEAs by

November 1, 2021.

Also, Education previously anticipated sending the annual letter to LEAs in June 2021. However, due to additional workload and ongoing demands resulting from the COVID 19 pandemic, the letter will now be sent by November 1, 2021, and include an announcement regarding the updated model policy.

California State Auditor's Assessment of 1-Year Status: Partially Implemented

6-Month Agency Response

In a continuing effort to align policies and request inclusion of the same elements as Education's model suicide prevention policy, Education met with the California School Boards Association (CSBA) in February 2021.The CSBA has agreed to a collaboration with Education and additional meetings will be held to work on reviewing and updating their policies; it is anticipated that their newly aligned suicide prevention policy will be available to their members by September 2021.

Additionally, subject matter experts are continuing to review Education's revised suicide prevention model policy to ensure that it incorporates the necessary language, examples, and resources for LEAs that serve K-6 students and is inclusive of identifying students in need and providing support virtually.

Education previously anticipated sending the annual letter to LEAs in January. However, due to the increased workload and demands on Education staff and its partners resulting from the COVID 19 pandemic, a decision was made to send the letter in June 2021, after the model policy alignment is completed.

California State Auditor's Assessment of 6-Month Status: Pending

60-Day Agency Response

In an effort to align policies and request the inclusion of the same elements as Education's model suicide prevention policy, Education contacted the California School Boards Association and Trevor Project; a tentative date for an initial discussion is scheduled for December 2020.

Education is updating the existing Model Suicide Prevention Policy to ensure it is user friendly and includes best practices for suicide prevention during distance learning. Additionally, in response to Assembly Bill 1767, Education is incorporating language, examples, and resources for LEAs that serve K-6 students. In January 2021, a letter will be sent to LEAs reminding them of their responsibility to adopt, implement, and review their policies. The letter will also provide information on resources, best practices, programs, and trainings related to suicide prevention. Moving forward, Education will send out an annual reminder in June to allow LEAs the opportunity to begin working on their policies prior to the new school year.

California State Auditor's Assessment of 60-Day Status: Pending

Recommendation #3 To: Education, Department of

To encourage LEAs to incorporate elements of suicide prevention training that provide teachers and staff with the knowledge necessary to assist students at risk of self-harm and suicide, Education should remind all LEAs of the statutorily required elements for suicide prevention training.

Annual Follow-Up Agency Response From October 2023

Education completed its review of the Model Youth Suicide Prevention Policy (policy) and posted the information on its website in July 2023. Additionally, Education announced the posting of the policy through the Mental Health Listserve that same month.

Education is now working on the notice to all LEAs, which will include: (1) suicide prevention resources; (2) the updated Model Youth Suicide Prevention Policy; (3) encouraging the use of these resources; and (4) the statutorily required elements for suicide prevention training to provide teachers and staff with the knowledge necessary to assist students at risk of self-harm and suicide.

California State Auditor's Assessment of Annual Follow-Up Status: Pending

Annual Follow-Up Agency Response From October 2022

As previously stated, Education anticipated sending out the annual letter to LEAs by November 1, 2021, which included the announcement regarding the updated Model Suicide Prevention Policy (model policy). However, due to competing workload demands, the model policy release was delayed and is now expected to be available to LEAs by the end of 2022. Once the model policy is approved, Education will send out the annual letter to LEAs and include this information.

California State Auditor's Assessment of Annual Follow-Up Status: No Action Taken

It is not clear why Education has not implemented this recommendation. This recommendation pertains to statutorily required elements for suicide prevention training, and thus there is no reason for the completion of a new model policy to delay the communication of requirements already established in law. Because such information could help ensure that teachers and staff have the appropriate training to assist students at risk of self-harm and suicide, we encourage Education to implement this recommendation immediately.

1-Year Agency Response

Education previously anticipated sending the annual letter to LEAs in June 2021. However, due to additional workload and ongoing demands resulting from the COVID 19 pandemic, the letter will now be sent by November 1, 2021, and include an announcement regarding the updated model policy.

California State Auditor's Assessment of 1-Year Status: Pending

6-Month Agency Response

Education previously anticipated sending the annual letter to LEAs in January. However, due to the increased workload and demands on Education staff and its partners resulting from the COVID 19 pandemic, a decision was made to send the letter in June 2021, after the model policy alignment is completed.

California State Auditor's Assessment of 6-Month Status: Pending

60-Day Agency Response

In January 2021, Education will send all LEAs a reminder letter that includes information regarding the statutorily required elements for suicide prevention training as required by EC Section 215; future reminders will be sent in June each year to allow LEAs the opportunity to begin working on their policies prior to the new school year.

California State Auditor's Assessment of 60-Day Status: Pending

Recommendation #4 To: Education, Department of

To support the provision of suicide prevention education to students at LEAs operating through distance learning, Education should complete and issue to LEAs the resources and guidance it is developing on how to conduct suicide prevention education remotely.

Annual Follow-Up Agency Response From October 2023

Education continues to develop a list of curated resources for LEAs related to distance learning; however, additional research is needed as distance learning is no longer being utilized and students have returned to in-classroom learning. In the interim, Education has updated the resources for youth suicide prevention on its website while working on determining next steps.

California State Auditor's Assessment of Annual Follow-Up Status: Resolved

Education states that students have returned to in-classroom learning and distance learning is no longer being utilized. Thus, there is no longer a pressing need to provide guidance to LEAs on how to provide suicide prevention education in the distance learning environment. For this reason we assess this recommendation to be resolved. However, it is disappointing that Education failed to support LEAs during this challenging period by completing the development and distribution of the resources it claimed it was creating.

Annual Follow-Up Agency Response From October 2022

As previously stated, Education was in the process of finalizing a list of curated resources available to LEAs; however, due to competing workload demands, the list approval was delayed and is now expected to be available to LEAs by the end of 2022.

California State Auditor's Assessment of Annual Follow-Up Status: No Action Taken

Education's failure to implement this recommendation in a timely manner has likely diminished the value that it will provide. Nevertheless, we encourage Education to provide these resources for the benefit of any LEAs that still operate through distance learning.

1-Year Agency Response

Education collaborated with the HEARD Alliance and other partners to finalize the list of curated resources available to LEAs for use as part of their suicide prevention virtual programming; final internal approval is currently in progress and Education anticipates the list will be finalized, posted, and shared with LEAs by November 1, 2021.

California State Auditor's Assessment of 1-Year Status: Pending

6-Month Agency Response

Education is collaborating with the HEARD Alliance regarding guidance and resources for LEAs to use as part of their suicide prevention virtual programming. Final approval is currently in progress for the list of virtual programs that will be shared with LEAs. Education anticipates the list will be finalized, posted, and shared with the field by April 2021, pending final approval by the collaborative partners.

California State Auditor's Assessment of 6-Month Status: Pending

60-Day Agency Response

Education is continuing to develop guidance and resources for LEAs to use as part of their suicide prevention virtual programming, in collaboration with members of the Student Mental Health Policy Workgroup (SMHPW) Suicide Prevention Committee; existing virtual resources are currently being reviewed for future use. With the onset of the pandemic and the continuation of distance learning, many organizations are in the process of updating their in-person programs to a virtual platform. Education and the SMHPW will continue to review programs as they are updated with the goal of creating a list of viable options for LEAs. The list is anticipated to be finalized, posted, and shared with the field by January 2021.

California State Auditor's Assessment of 60-Day Status: Pending

Recommendation #5 To: Health Care Services, Department of

To ensure that LEAs take full advantage of federal funds for Medi-Cal-eligible students, Health Care Services should work with Education to inform LEAs that they may partner with their county offices of education to centralize the administrative responsibilities necessary to obtain reimbursement through the billing option program.

1-Year Agency Response

DHCS has collaborated with CDE to inform LEAs that they may partner with county offices of education to centralize the administrative responsibilities necessary to obtain reimbursement through the billing option program. Specifically, on February 23, 2021, DHCS and CDE hosted a training webinar conducted by the California Children's Trust on Medi-Cal 101 and the Practical Guide for Financing Social, Emotional, and Mental Health in Schools. Offered statewide, this joint training was provided all interested entities (including LEAs) insight on working collaboratively by partnering with one or more of the five School-Medi-Cal models (namely, LEAF, Special Education Local Plan Area, Community Based Organization, County Health Authority, or County Office of Education) to handle Medi-Cal billing and/or hire and supervise staff to provide services to students. The webinar was recorded and posted on the CDE Project Cal-Well webpage (link).

California State Auditor's Assessment of 1-Year Status: Fully Implemented

DHCS and CDE hosted a training webinar to inform LEAs that they may partner with their county offices of education to centralize the administrative responsibilities necessary to obtain reimbursement through the billing option program. The training was offered statewide and invitations were sent to all LEAs.

6-Month Agency Response

November 10, 2020: DHCS distributed Policy and Procedure Letter (PPL) 20-051, titled "Local Educational Agency Medi-Cal Billing Option Program (LEA BOP) Coordination of Mental Health Related Services." Refer to the attachment, titled "PPL 20-051."

November 19, 2020: Sacramento County Office of Education (SCOE) conducted a presentation on SCOE's Medi-Cal model, including partnerships with the County Health Department and the county-operated Federally Qualified Health Center. Refer to the attached presentation documents, titled "Medi-Cal 101" and "Supporting School-Based Mental Health and Wellness" for details.

December 2, 2020: DHCS conducted a training webinar for participating LEAs, covering an LEA BOP overview, navigation of the LEA BOP webpage, resources and State Plan Amendment 16-0001. Refer to the e-mail notification, titled "Advisory Workgroup Meeting."

February 23, 2021: California Department of Education (CDE) hosted a training webinar conducted by the California Children's Trust on Medi-Cal 101 and the "Practical Guide for Financing Social, Emotional, and Mental Health in Schools." The Fresno Collaborative, which included Sierra Unified School District, the County Superintendent of Schools, and the County Behavioral Health Department, provide insight on working collaboratively to expand financing for school-based mental health services. The training was offered statewide and the webinar recording are posted on the Project Cal-Well webpage. Refer to the link for the webinar recording, slide deck, and the shared resources.

LEA outreach and training efforts were fully implemented by February 23, 2021; however, DHCS's collaboration with CDE Project Cal-Well will be ongoing throughout the remainder of the five-year grant period. Efforts by DHCS to provide outreach and technical assistance through the LEA BOP and School-Based Medi-Cal Administrative Activities programs to participating and non-participating LEAs throughout the state will also be ongoing.

California State Auditor's Assessment of 6-Month Status: Partially Implemented

Health Care Services did conduct outreach and training webinars to inform some LEAs that they may partner with their county offices of education to centralize administrative responsibilities. However, it communicated only with those LEAs that are already participating in the Medi-Cal Billing Option program. It has not yet collaborated with Education to inform all LEAs about this option.

60-Day Agency Response

LEAs who voluntarily agree to participate in the LEA Billing Option Program (BOP) must directly submit a provider Participation Agreement, a Data Use Agreement, and an annual report to DHCS, which limits the opportunities for centralizing administrative responsibilities to obtain reimbursement through the BOP.

However, opportunities to provide technical assistance to LEAs has been implemented within DHCS under Project Cal-Well. Funded by the Substance Abuse and Mental Health Services Administration, Project Cal-Well raises awareness of mental health, and expands access to school and community-based mental health services for youth, families, and school communities. The project is a collaborative effort through a five year Interagency Agreement between DHCS and Education. Specifically, DHCS coordinates and provides training, education, and resources on youth behavioral health service access to LEAs, and supports the Education-led Student Mental Health Policy Workgroup and related subcommittees. The workgroup provides policy recommendations addressing issues such as youth suicide. Information on Project Cal Well can be found on the website: https://www.cde.ca.gov/ls/cg/mh/projectcalwell.asp. The website includes training information, program evaluations, and additional resources.

DHCS, through involvement in Project Call-Well, is also coordinating with Education to offer several trainings. The following two trainings directly address how LEAs may partner with local county offices of education:

- The Sacramento County Office of Education will present on efforts to partner with a county owned/operated Federally Qualified Health Center to establish school based satellites for the provision of mental health services to students.

- A panel presentation from various County Offices of Education who have experienced success in working collaboratively with County Health Plans, County Behavioral Health, and other community-based providers.

California State Auditor's Assessment of 60-Day Status: Partially Implemented

Notwithstanding Health Care Services' description of the tasks that LEAs must complete, as we describe in the report, Ukiah Unified and the Mendocino County Office of Education stated that their partnership centralized administrative responsibilities and reduced the burden to the LEA of obtaining reimbursement. Although DHCS describes a number of efforts related to youth behavioral health services, its response does not describe a systematic method of implementing our recommendation that will reach all LEAs.

Recommendation #6 To: Public Health, Department of

To support LEAs' efforts to provide mental health services, Public Health should establish the support program for school health centers as state law requires. If Public Health lacks the funding to do so, it should request additional funds as needed. The support program should assist LEAs in establishing school health centers and in identifying and applying for available funding as authorized by law, such as Medi-Cal reimbursement and MHSA funds.

Annual Follow-Up Agency Response From September 2023

Over the past year, the California Department of Public Health (Public Health) continued to learn about the needs of School-Based Health Centers (SBHC) and provided limited technical assistance and data support by leveraging available resources (the Federal Preventive Health and Health Services Block Grant) to support one staff position. Two new positions have been established utilizing Future of Public Health funding, to expand the technical assistance and data collection activities, however there was no funding available to support a program of this size. Public Health has discussed the opportunity for existing SBHC's to bill Medi-Cal and explored this as part of the California Advancing and Innovating Medi-Cal effort, but any resources that would come of both would need to be accessed directly by the SBHC and could not be used to establish a program in Public Health. Therefore, no funding opportunities have been identified to fully establish and administer the Public School Health Center Support Program as required by law. Public Health continues to look for funding opportunities but some options being explored are through the state budget process and are confidential.

California State Auditor's Assessment of Annual Follow-Up Status: Pending

Annual Follow-Up Agency Response From October 2022

Public Health continues to learn about the health care needs of students from the School-Based Health Alliance (SBHA) and evaluate the resources needed to develop a Public School Health Center Support Program. However, no funding opportunities have been identified to establish the program.

California State Auditor's Assessment of Annual Follow-Up Status: No Action Taken

We encourage Public Health to request the funds necessary to establish this support program, as we describe in our recommendation.

1-Year Agency Response

CDPH continues to research opportunities to implement the Public-School Health Center Support Program. Unfortunately, to-date there are no federal or state funding opportunities available.

California State Auditor's Assessment of 1-Year Status: No Action Taken

6-Month Agency Response

CDPH is continuing to assess the resources necessary to implement the Public School Health Center Support Program.

California State Auditor's Assessment of 6-Month Status: No Action Taken

60-Day Agency Response

Since 2017, CDPH has been working to support the School-Based Health Alliance (SBHA) in their efforts to assess and address the health service needs of youth. Specifically, CDPH completed an assessment of technical assistance and resource needs for California school-based health centers; completed the Best Practices for State Program Offices report based on key informant interviews with other states; produced a Resource Guide for School-Based Health Centers; sponsored three School-Based Health Alliance conferences; provided trainings on school-based health centers to CDPH programs, and completed a school-based health center data matrix.

CDPH recognizes that more work is necessary to fully establish and implement the Public School Health Center Support Program (PSHCSP). Over the next six months, CDPH will evaluate the resources necessary to establish and implement the PSHCSP, as written in the Health and Safety Code section 124174-124174.6.

California State Auditor's Assessment of 60-Day Status: Pending

As we state in the report, Public Health has gathered some information that could inform the development of the required program. However, the law requires the program to perform a variety of functions including providing technical assistance to LEAs and other entities on a number of subjects, providing biennial updates to Legislative Committees, and--to the extent funds are appropriated to do so--collecting data from school based health centers on an ongoing basis. We look forward to reviewing Public Health's progress toward establishing the support program and fulfilling these duties, as required by law, in its 6-month response.

Recommendation #7 To: Charter Academy of the Redwoods

To ensure that their teachers and staff have the information necessary to respond consistently, promptly, and appropriately to reduce suicide risk, the six LEAs we reviewed should revise their policies by March 2021 to comply with state law and incorporate the best practices in Education's model policy.

Annual Follow-Up Agency Response From September 2023

The school revised its board policy to include all components required. The staff is trained annually on suicide prevention and intervention.

California State Auditor's Assessment of Annual Follow-Up Status: Partially Implemented

Redwoods Charter's revised board policy contains several elements that were not present in the policy we reviewed during the audit. For example, the revised board policy describes potential postvention strategies and directs the principal to develop prevention strategies that are specific to at-risk populations. However, the revised board policy does not establish specific policies, requirements, or strategies. Rather, it directs the principal or that individual's designee to develop strategies for addressing various aspects of suicide prevention. Further, the direction to create strategies does not address some elements we identified as missing, including the establishment of a postvention response team and a description of how suicide prevention education will be provided to students. Redwoods Charter did not provide the policy, procedures, or strategies that the principal or designee has created; thus, we cannot determine whether that work product aligns with the requirements and best practices described in the audit. We look forward to reviewing those specific policies, procedures, or strategies after Redwood Charter provides them to us.

Annual Follow-Up Agency Response From November 2022

The school revised its board policy to include all components required. The staff is trained annually on suicide prevention and intervention.

California State Auditor's Assessment of Annual Follow-Up Status: Partially Implemented

Although the Charter Academy of the Redwoods has revised its suicide prevention policy in an effort to comply with state law, and it has incorporated some of the best practices from Education's model policy, it still lacks crucial elements. Among other things, the policy does not outline how suicide prevention education will be provided to students; include a provision to share the policy and other information with parents, guardians, and caregivers; or include action plans for in-school and out-of-school suicide attempts.

1-Year Agency Response

The school revised its board policy to include all components required. The staff is trained annually on suicide prevention and intervention.

California State Auditor's Assessment of 1-Year Status: Pending

The revised policy that the Charter Academy of the Redwoods provided does not establish specific policies related to suicide prevention. Rather, it directs the principal or designee to develop strategies for addressing various aspects of suicide prevention. The policy describes elements that these strategies may include but does not establish requirements. Further, the direction to create strategies does not address some elements we identified as missing, including the establishment of a postvention response team and a description of how suicide prevention education will be provided to students. We look forward to reviewing specific policies and strategies once Redwoods Charter establishes them.

6-Month Agency Response

Charter Academy of the Redwoods did not submit a response to this recommendation.

California State Auditor's Assessment of 6-Month Status: No Action Taken

Charter Academy of the Redwoods did not assert or provide evidence that they have taken any steps to date to revise their policies.

60-Day Agency Response

The LEA will revise the policy to reflect the outlined deficiencies in the report.

California State Auditor's Assessment of 60-Day Status: No Action Taken

Charter Academy of the Redwoods did not assert or provide evidence that they have taken any steps to date to revise their policies.

Recommendation #8 To: Gateway Public Schools

To ensure that their teachers and staff have the information necessary to respond consistently, promptly, and appropriately to reduce suicide risk, the six LEAs we reviewed should revise their policies by March 2021 to comply with state law and incorporate the best practices in Education's model policy.

Annual Follow-Up Agency Response From October 2023

Based on the feedback we received from the audit as well as reviewing the sample best practices to ensure our policies is reflected of all of those updates. The policy was last reviewed and updated in October 2021 and has been shared with staff for the 2023-24 school year.

California State Auditor's Assessment of Annual Follow-Up Status: Partially Implemented

Gateway did not demonstrate that it revised its suicide prevention policy in consultation with community stakeholders, as required by state law. Although Gateway revised its suicide prevention policies to address the needs of at-risk groups, such as LGBTQ youth and youth in foster care it should, at a minimum, provide its suicide prevention policy to the community stakeholders described in law and consider incorporating any feedback they provide.

Annual Follow-Up Agency Response From November 2022

Based on the feedback we received from the audit as well as reviewing the sample best practices to ensure our policies is reflected of all of those updates. The policy was last reviewed and updated in October 2021 and has been shared with staff for the 2022-23 school year.

California State Auditor's Assessment of Annual Follow-Up Status: Partially Implemented

Gateway Public Schools' (Gateway Charter) revision of its suicide prevention policy did not meet all of the requirements specified in state law. The policy now includes language addressing the needs of at-risk groups, such as LGBTQ youth and youth in foster care. However, state law also requires that local educational agencies consult with school and community stakeholders, school-employed mental health professionals, and suicide prevention experts when adopting these policies. Gateway Charter did not provide any evidence that it met with these stakeholders when it adopted its policy.

1-Year Agency Response

The policy has been updated to incorporate best practices based on recommendations from the audit.

California State Auditor's Assessment of 1-Year Status: Partially Implemented

Although Gateway revised its suicide prevention policies to address the needs of at-risk groups, such as LGBTQ youth and youth in foster care, it did not demonstrate that it revised its suicide prevention policy in consultation with community stakeholders.

6-Month Agency Response

Gateway Public Schools did not submit a response to this recommendation

California State Auditor's Assessment of 6-Month Status: No Action Taken

60-Day Agency Response

Gateway Public Schools did not submit a response to this recommendation

California State Auditor's Assessment of 60-Day Status: No Action Taken

Recommendation #9 To: Heartland Charter Schools

To ensure that their teachers and staff have the information necessary to respond consistently, promptly, and appropriately to reduce suicide risk, the six LEAs we reviewed should revise their policies by March 2021 to comply with state law and incorporate the best practices in Education's model policy.

Annual Follow-Up Agency Response From October 2022

Heartland Charter School has fully implemented suggestion 9. We have a new board-approved Suicide Prevention Policy. We have a new flowchart for staff, and an intervention website for staff to have all mental health support in one location. We have also provided resources to teachers in their Handbook. Our goal was to make sure all staff had quick easy access to the policy and the knowledge that is included in their training at the click of a button.

California State Auditor's Assessment of Annual Follow-Up Status: Fully Implemented

Heartland Charter School's suicide prevention policy now complies with state law and incorporates the best practices in Education's model policy.

1-Year Agency Response

Although we contacted Heartland to remind it to submit responses to our recommendations, it did not provide an update regarding this recommendation.

California State Auditor's Assessment of 1-Year Status: Partially Implemented

As we stated in our assessment of Heartland's 60-day response, Heartland Charter's guidelines for post suicide-attempt school reentry and suicide postvention does not include a provision describing how this and related information will be shared with parents, guardians, and caregivers; nor does it describe how suicide prevention education will be provided to students. Until Heartland Charter addresses these elements this recommendation is not considered fully implemented.

6-Month Agency Response

No additional information

California State Auditor's Assessment of 6-Month Status: Partially Implemented

As we stated in our assessment of Heartland's 60-day response, Heartland Charter provided a document describing guidelines for post suicide-attempt school reentry and suicide postvention; however, the document still lacks some elements of a robust suicide prevention policy. Specifically, Heartland's document does not include a provision describing how this and related information will be shared with parents, guardians, and caregivers; nor does it describe how suicide prevention education will be provided to students. Until Heartland Charter addresses these elements this recommendation is not considered fully implemented.

60-Day Agency Response

We have implemented additional suicide prevention training for our staff now implementing local resources and taking into consideration our regions' data points.

We have sought local health care professionals (via Kern County Health Department) as well as reaching out to the San Luis Obispo suicide hotline in the creation of our training.

California State Auditor's Assessment of 60-Day Status: Partially Implemented

Heartland Charter provided a document describing guidelines for post suicide-attempt school reentry and suicide postvention; however, the document still lacks some elements of a robust suicide prevention policy. Specifically, Heartland's document does not include a provision describing how this and related information will be shared with parents, guardians, and caregivers; nor does it describe how suicide prevention education will be provided to students. Until Heartland Charter addresses these elements we do not consider the recommendation to be fully implemented.

Recommendation #10 To: Kern High School District

To ensure that their teachers and staff have the information necessary to respond consistently, promptly, and appropriately to reduce suicide risk, the six LEAs we reviewed should revise their policies by March 2021 to comply with state law and incorporate the best practices in Education's model policy.

60-Day Agency Response

Based on the recommendation of the auditors, Kern High School District has updated Administrative Regulations regarding Suicide Prevention. Additionally, at the recommendation of the auditors, Kern High School District has updated and supplemented the training resources to include: contact list for local resources, and current trend data regarding suicide.

California State Auditor's Assessment of 60-Day Status: Fully Implemented

Kern High School district updated its suicide prevention policy to address the element we identified as missing.

Recommendation #11 To: San Francisco Unified School District

To ensure that their teachers and staff have the information necessary to respond consistently, promptly, and appropriately to reduce suicide risk, the six LEAs we reviewed should revise their policies by March 2021 to comply with state law and incorporate the best practices in Education's model policy.

6-Month Agency Response

The amendments to BP 5141.52 related to out of school attempts and a single point of contact to assist sites with suicide prevention procedure and policy were adopted by the Board of Education on December 8, 2020.

California State Auditor's Assessment of 6-Month Status: Fully Implemented

SFUSD has fully implemented the recommendation by revising its policies to comply with state law and incorporate the best practices in Education's model policy. Specifically, SFUSD revised its policy in consultation with community stakeholders. Further, the revised policies included a requirement that the district appoint an individual to serve as a suicide prevention point of contact to assist other staff and an action plan for out-of-school suicide attempts.

60-Day Agency Response

BP 5141.52 was amended to add language to the crisis response plan to specify "including out of school attempts" to make this clear, although the crisis response plan already did apply to those situations. The BP also adds language to appoint a single point of contact in the AR to assist sites with suicide prevention procedure and policy. This amendment went for first reading on October 20, 2020, and is scheduled to go to Rules Committee on November 30, 2020 and for final vote on December 8, 2020.

California State Auditor's Assessment of 60-Day Status: Pending

Recommendation #12 To: Ukiah Unified School District

To ensure that their teachers and staff have the information necessary to respond consistently, promptly, and appropriately to reduce suicide risk, the six LEAs we reviewed should revise their policies by March 2021 to comply with state law and incorporate the best practices in Education's model policy.

6-Month Agency Response

Ukiah Unified School District revised the UUSD Suicide Prevention Policy after consulting with community partners. Consultation with community partners was previously reported in the 60 day response. The UUSD Board conducted a first reading on December 14, 2020 and a final reading for policy adoption on January 14, 2021. Evidence of compliance will be submitted as requested via email.

California State Auditor's Assessment of 6-Month Status: Fully Implemented

Ukiah Unified has revised its suicide prevention policy to comply with state law and has incorporated the best practices in Education's model policy. Specifically, the district now requires its policy to be updated annually in conjunction with community stakeholders. Further, the policy appoints the director of students services to serve as a suicide prevention point of contact, requires annual training, creates a postvention response team, and establishes a plan for out-of-school suicide attempts.

60-Day Agency Response

Ukiah Unified School District ("UUSD") is currently in the process of revising its Suicide Prevention Policy. The revised policy is based on the CDE Model Suicide Prevention Policy with input from mental health professionals who have expertise in suicide prevention, intervention, and postvention. To date, the policy has been reviewed and approved by the District Health Advisory Committee (Date:10/16/2020), the UUSD Counselor Network (Date: 10/14/2020), and three community partners: Redwood Community Services, Tapestry Family Services, and the Mendocino County Youth Project.

The UUSD Board will conduct a first reading of Board Policy 5141.52 Youth Suicide Prevention on December 14, 2020, and second reading and, unless there are further modifications, adoption on January 14, 2021.

California State Auditor's Assessment of 60-Day Status: Pending

We look forward to reviewing Ukiah Unified School District's revised policies.

Recommendation #13 To: Charter Academy of the Redwoods

To ensure that their teachers and staff have the knowledge necessary to identify and assist students at risk of self-harm and suicide, the six LEAs we reviewed should do the following:

- Revise their suicide prevention training materials by June 2021 to align with state law and incorporate the best practices in Education's model policy.

-LEAs that provide suicide prevention training should conduct it at the beginning of the school year.

1-Year Agency Response

The school uses LivingWorks suicide prevention training to train staff every August.

California State Auditor's Assessment of 1-Year Status: Fully Implemented

Charter Academy of the Redwoods staff attended the Living Works training in August 2021. Past versions of this training that we reviewed align with state law and incorporate the best practices in Education's model policy.

6-Month Agency Response

Charter Academy of the Redwoods did not submit a response to this recommendation

California State Auditor's Assessment of 6-Month Status: No Action Taken

60-Day Agency Response

The LEA provided the Living Works Start training provided by the CDE in conjunction with San Diego County Office of Education prior to school starting. All staff participated in the training.

California State Auditor's Assessment of 60-Day Status: Partially Implemented

Redwoods Charter did not provide evidence that its suicide prevention training for teachers and staff discussed trends in data on self-harm incidents and suicides within its region, as Education recommends. Further, Redwoods Charter did not provide evidence that it provided its suicide prevention training at the beginning of the 2020-21 school year.

Recommendation #14 To: Gateway Public Schools

To ensure that their teachers and staff have the knowledge necessary to identify and assist students at risk of self-harm and suicide, the six LEAs we reviewed should do the following:

- Revise their suicide prevention training materials by June 2021 to align with state law and incorporate the best practices in Education's model policy.

-LEAs that provide suicide prevention training should conduct it at the beginning of the school year.

1-Year Agency Response

Suicide prevention training materials have been updated and all staff have been trained in September 2021

California State Auditor's Assessment of 1-Year Status: Fully Implemented

Gateway revised its suicide prevention training materials which now align with state law and incorporate the best practices in Education's model policy. Gateway also held its training at the beginning of the school year.

6-Month Agency Response

Gateway Public Schools did submit a response this recommendation

California State Auditor's Assessment of 6-Month Status: No Action Taken

60-Day Agency Response

Gateway Public Schools did not submit a response to this recommendation.

California State Auditor's Assessment of 60-Day Status: No Action Taken

Recommendation #15 To: Heartland Charter Schools

To ensure that their teachers and staff have the knowledge necessary to identify and assist students at risk of self-harm and suicide, the six LEAs we reviewed should do the following:

- Revise their suicide prevention training materials by June 2021 to align with state law and incorporate the best practices in Education's model policy.

-LEAs that provide suicide prevention training should conduct it at the beginning of the school year.

Annual Follow-Up Agency Response From October 2022

Heartland Charter School has fully implemented suggestion 15. We have created a new Suicide Prevention Training complete with all of the necessary components. This training is required at the beginning of every school year. We have also implemented a Mental Health screener and school-wide SEL curriculum. We have all supports listed on our Heartland website heartlandcharterschool.com We also have all resources listed for our staff in their Handbook including our Intervention Website, Mental Health Screeners, Mental Health Contacts, Flowcharts for Process, and parent communication.

California State Auditor's Assessment of Annual Follow-Up Status: Partially Implemented

Heartland Charter School's suicide prevention training now describes school-based and community-based mental health services and when and how to refer students to them, as required by state law. However, the California Department of Education recommends that trainings also discuss regional trends identified in data on self-harm incidents and suicides, which Heartland Charter did not include.

1-Year Agency Response

Although we contacted Heartland to remind it to submit responses to our recommendations, it did not provide an update regarding this recommendation.

California State Auditor's Assessment of 1-Year Status: Partially Implemented

The training materials Heartland Charter provided in its 60-day response did not incorporate information on trends identified in data on self-harm incidents and suicides within its region, as recommended by Education. Further, Heartland did not provide evidence that it conducted this training at the beginning of the school year.

6-Month Agency Response

This was fully implemented by November2020. Documentation was presented to California State Auditor in November.

California State Auditor's Assessment of 6-Month Status: Partially Implemented

Heartland Charter's training material now includes information on community-based and school-based mental health services, and when and how to refer students to them. However, it does not incorporate information on trends identified in data on self-harm incidents and suicides within its region, as recommended by Education. Further, Heartland did not provide evidence that it conducted this training at the beginning of the school year.

60-Day Agency Response

We have implemented additional suicide prevention training for our staff now implementing local resources and taking into consideration our regions' data points.

*We have sought local health care professionals (via Kern County Health Department) as well as reaching out to the San Luis Obispo suicide hotline in the creation of our training.

*We have added Heartland mental health professionals including three counselors, two nurses, four school psychologists, and one Heartland social worker.

We have appointed a primary and secondary suicide prevention liaison. She is overseeing our entire process from the initial recommendation to the postvention response team.

The mental health and safety of our students is of utmost importance at Heartland Charter School.

California State Auditor's Assessment of 60-Day Status: Partially Implemented

Heartland Charter's training material now includes information on community-based and school-based mental health services, and when and how to refer students to them. However, it does not incorporate information on trends identified in data on self-harm incidents and suicides within its region, as recommended by Education. Further, Heartland did not provide evidence that it conducted this training at the beginning of the school year.

Recommendation #16 To: Kern High School District

To ensure that their teachers and staff have the knowledge necessary to identify and assist students at risk of self-harm and suicide, the six LEAs we reviewed should do the following:

- Revise their suicide prevention training materials by June 2021 to align with state law and incorporate the best practices in Education's model policy.

-LEAs that provide suicide prevention training should conduct it at the beginning of the school year.

1-Year Agency Response

The suicide prevention training was updated according to specifications and staff is required to complete training within 30 days of either the beginning of the school year or their employment date. Mental health services available at school sites, as well as, the process for staff to refer students in need of services are reviewed annually and staff can access the referral form by visiting their school webpage.

California State Auditor's Assessment of 1-Year Status: Fully Implemented

Kern High School District's updated suicide prevention training materials now align with state law and incorporate the best practices in Education's model policy. This training was required at the beginning of the 2021-2022 school year.

6-Month Agency Response

Kern High School District did not submit a response for this recommendation.

California State Auditor's Assessment of 6-Month Status: No Action Taken

60-Day Agency Response

At the recommendation of the auditors, the Kern High School District has included supplemental training resources for all staff training in suicide prevention that includes: Community Resources, and Suicide Trend Data.

California State Auditor's Assessment of 60-Day Status: Partially Implemented

Kern High School District updated its suicide prevention training to identify community-based mental health services. In addition, it provided information on self-harm and suicide trends within the State. However, it did not include information on school-based mental health services and when and how to refer those services. Until it does so, teachers and staff may not know where to refer students in crisis. Further, it did not identify self-harm and suicide trends within its region, as Education recommends.

Recommendation #17 To: San Francisco Unified School District

To ensure that their teachers and staff have the knowledge necessary to identify and assist students at risk of self-harm and suicide, the six LEAs we reviewed should do the following:

- Revise their suicide prevention training materials by June 2021 to align with state law and incorporate the best practices in Education's model policy.

-LEAs that provide suicide prevention training should conduct it at the beginning of the school year.

Annual Follow-Up Agency Response From October 2023

Please see previous explanation submitted in September 2022.

California State Auditor's Assessment of Annual Follow-Up Status: Partially Implemented

In its 1-year response submitted in September 2021, SFUSD demonstrated that it had revised its suicide prevention training materials to align with state law and the best practices in Education's model policy. However, SFUSD has not yet submitted documentation demonstrating that it conducted those trainings at the beginning of the school year in either 2021-2022 or 2022-2023. For this reason, we continue to consider this recommendation to be only partially implemented.

Annual Follow-Up Agency Response From November 2022

The District did amend its training materials as recommended in the auditor's report, and will continue to provide the annual suicide prevention training as early as practicable in the first semester, to give a refresher to existing staff and to inform new staff. The District will not implement the recommendation to the extent that it requires the training to be completed by a particular date in fall semester.

California State Auditor's Assessment of Annual Follow-Up Status: Partially Implemented

During our last evaluation of San Francisco Unified School District's implementation of this recommendation, we found that the district's training included the elements recommended by the California Department of Education. San Francisco Unified appears to be confused as it states that it will not implement the recommendation to the extent that it requires the training to be completed by a particular date; however, our recommendation did not require that it do so. We look forward to reviewing documentation from San Francisco Unified in its next response showing that it provided the training at the beginning of the 2022-23 school year, as we recommended.

1-Year Agency Response

The suicide prevention training materials were revised as recommended, as indicated in an earlier submission. During the academic year 2020-2021, the district provided suicide prevention training during the first semester but plans to offer these trainings in October during the 2021-2022 school year.

California State Auditor's Assessment of 1-Year Status: Partially Implemented

San Francisco Unified School District's training includes the elements recommended by the California Department of Education. We look forward to reviewing documentation after the 2021-22 school year begins showing that San Francisco Unified offered the training at the beginning of the school year.

6-Month Agency Response

San Francisco Unified School District did not submit a response to this recommendation.

California State Auditor's Assessment of 6-Month Status: No Action Taken

60-Day Agency Response

The suicide prevention training materials have been revised to include protective factors.

California State Auditor's Assessment of 60-Day Status: Partially Implemented

San Francisco Unified addressed the missing element in its suicide prevention training, a discussion of all three elements of suicide identification: risk factors, warning factors, and protective factors. However, San Francisco Unified's response did not establish that it provided the suicide prevention training at the beginning of the school year.

Recommendation #18 To: Ukiah Unified School District

To ensure that their teachers and staff have the knowledge necessary to identify and assist students at risk of self-harm and suicide, the six LEAs we reviewed should do the following:

- Revise their suicide prevention training materials by June 2021 to align with state law and incorporate the best practices in Education's model policy.

-LEAs that provide suicide prevention training should conduct it at the beginning of the school year.

1-Year Agency Response

Ukiah Unified implemented staff training in August 2021 that is compliant with all five areas referenced in Table 2 on page 22 of the Youth Suicide Prevention report issued on September 29, 2020.

UUSD adopted a comprehensive suicide prevention and intervention training program that is delivered online through Keenan and Associates. The Keenan training includes two components of state law and California Department of Education recommendations: covering high-risk groups and the three elements of suicide identification: risk factors, warning factors, and protective factors. As this training is provided online, UUSD is able to track who has completed the training. A follow-up contact is conducted for all staff who did not complete the training, until the district is 100% completion.

Additionally, in August 2021, prior to students attending school, staff received training under the direction of a school-employed mental health professional (e.g., school counselor, psychologist). This training covered school-based mental health services and when and how to refer students to them, community-based mental health services when and how to use them, along with trends in our local area. This training will be conducted annually for all staff. UUSD submitted a copy of the training materials following the Month 6 Response.

Complaince Chart to be attached in an email.

California State Auditor's Assessment of 1-Year Status: Fully Implemented

Ukiah Unified used a suicide prevention training that aligns with state law and incorporates the best practices in Education's model policy. In addition, Ukiah Unified provided evidence that it provided the training to all teachers and staff at the beginning of the school year.

6-Month Agency Response

Ukiah Unified has identified training for August 2021 that is compliant with all five areas referenced in Table 2 on page 22 of the Youth Suicide Prevention report issued on September 29, 2020.

UUSD adopted a comprehensive suicide prevention and intervention training program that is delivered online through Keenan and Associates. The Keenan training includes two components of state law and California Department of Education recommendations: covering high-risk groups and the three elements of suicide identification: risk factors, warning factors, and protective factors.

At the beginning of the 2020-21 school year, all UUSD employees were notified that they must complete the Keenan suicide prevention and intervention training. As this training is provided online, UUSD is able to track who has completed the training. A follow-up contact is conducted for all staff who did not complete the training, until the district is 100%.

Starting in August 2021, prior to students attending school, staff will receive training under the direction of a school-employed mental health professional (e.g. school counselor, psychologist) who has received advanced training specific to suicide prevention, intervention, and postvention. This training will cover school-based mental health services and when and how to refer students to them, community-based mental health services and when and how to use them, and trends in data on self-harm incidents and suicides with the Ukiah Unified region. This training will be conducted annually for all staff and addresses all five areas referenced in Table 2 on page 22 of the Youth Suicide Prevention report issued on September 29, 2020.

California State Auditor's Assessment of 6-Month Status: Pending

We repeatedly reached out to Ukiah Unified to obtain the supporting documentation necessary to substantiate the information included in its response. However, it did not provide any additional documents and thus we could not determine whether it fully implemented the recommendation.

60-Day Agency Response

Ukiah Unified is in the process of identifying training for August 2021 that is compliant with all five areas referenced in Table 2 on page 22 of the Youth Suicide Prevention report issued on September 29, 2020. We will have the training identified by June 2021.

California State Auditor's Assessment of 60-Day Status: Pending

We look forward to reviewing Ukiah Unified School District's new training after the school adopts and provides it.

Recommendation #19 To: Charter Academy of the Redwoods

To improve their students' access to mental health professionals, Kern High School District, Ukiah Unified, Gateway Charter, Redwoods Charter, and Heartland Charter should coordinate with their respective counties to request MHSA funding to employ additional school counselors, school nurses, school social workers, and school psychologists.

Annual Follow-Up Agency Response From September 2023

The MHSA funding is used by the county to administer programs. The funding is not something we can receive directly. We have participated in some of their suicide prevention training as well as the Youth Mental Health First Aid, but have since started using a different source for training. We partnered with local agencies to provide part-time counselor and additional mentor support. We provide 16 hours of counseling and 8 hours of mentor to support students.

California State Auditor's Assessment of Annual Follow-Up Status: Resolved

Redwoods Charter states that it is not eligible to receive MHSA funds because of the way in which its county uses them. Thus, we consider this recommendation resolved. However, Redwoods Charter's response does not indicate that it has hired the recommended number of psychologists, nurses, or social workers. Until it does so, we encourage Redwoods Charter to pursue other methods for employing the recommended number of individuals in those positions.

Annual Follow-Up Agency Response From November 2022

The school employees a part-time counselor through an outside agency.

California State Auditor's Assessment of Annual Follow-Up Status: Partially Implemented

Although the Charter Academy of the Redwoods does receive some funding from the Mendocino County Youth Project for mental health services, it has not provided any evidence that it has requested MHSA funding to employ additional school counselors, school nurses, school social workers, and school psychologists. We still believe that it should attempt to obtain MHSA funding to employ sufficient professionals of these types to meet the State's recommended staffing levels.

1-Year Agency Response

The school employees a part-time counselor through an outside agency.

California State Auditor's Assessment of 1-Year Status: Partially Implemented

Although Redwoods Academy has retained a part-time counselor, its response does not indicate that it has hired the recommended number of psychologists, nurses, or social workers. Thus, Redwoods Academy should coordinate with Mendocino County to request MHSA funding to employ individuals in those positions.

6-Month Agency Response

Charter Academy of the Redwoods did not submit a response for this recommendation.

California State Auditor's Assessment of 6-Month Status: No Action Taken

60-Day Agency Response

The LEA has not contact the county office of education regarding MHSA funding. An LEA representative will reach out to the county in the spring.

California State Auditor's Assessment of 60-Day Status: No Action Taken

Recommendation #20 To: Gateway Public Schools

To improve their students' access to mental health professionals, Kern High School District, Ukiah Unified, Gateway Charter, Redwoods Charter, and Heartland Charter should coordinate with their respective counties to request MHSA funding to employ additional school counselors, school nurses, school social workers, and school psychologists.

Annual Follow-Up Agency Response From October 2023

We were told by the County that we don't have access MHSA funding. We continue to pursue other ways to bring mental health service to our campuses. That includes applying for grants, an expanded MFT partnership with University of San Francisco, additional school based services in collaborations with SFUSD.

California State Auditor's Assessment of Annual Follow-Up Status: Pending

Gateway Charter stated that the San Francisco Unified School District (SFUSD) verbally informed it that it was ineligible for MHSA funds. However, SFUSD's leadership team could not recall any conversations with anyone at Gateway Charter about MHSA funding. SFUSD also stated that Gateway Charter's eligibility for MHSA funding is a decision to be made by the San Francisco Department of Public Health (SFDPH). We encourage Gateway Charter to contact SFDPH to determine whether it may apply for MHSA funding to employ additional school counselors, school nurses, school social workers, and school psychologists.

Annual Follow-Up Agency Response From November 2022

We were told by the County that we don't have access MHSA funding. We continue to pursue other ways to bring mental health service to our campuses. That includes applying for grants, an expanded MFT partnership with University of San Francisco, additional school based services in collaborations with SFUSD.

California State Auditor's Assessment of Annual Follow-Up Status: Pending

Although Gateway Charter is legally allowed to apply for this funding, its response indicates that the county has identified different priorities for these funds. Because Gateway Charter attempted to coordinate with the county to obtain access to these funds, we consider this recommendation to be fully implemented.

1-Year Agency Response

We have increased access to mental health professionals through partnerships with universities and local programs. We have not been able to receive funding. We have also inquired about the funding and we were informed we were not eligible. However, our students are benefiting from increased access to mental health professionals. Thanks for the suggestion however.

California State Auditor's Assessment of 1-Year Status: Pending

Gateway staff indicated that the San Francisco Unified School District (SFUSD) verbally informed them that Gateway was ineligible for MHSA funds. We contacted SFUSD to confirm that it told Gateway that it was ineligible for MHSA funds, but SFUSD did not respond to our request for clarification. Gateway should continue to request MHSA funding or provide documentation showing that it has been informed that it is ineligible.

60-Day Agency Response

Gateway Public Schools did not submit a response to this recommendation.

California State Auditor's Assessment of 60-Day Status: No Action Taken

6-Month Agency Response

Gateway Public Schools did not submit a response to this recommendation.

California State Auditor's Assessment of 6-Month Status: No Action Taken

Recommendation #21 To: Heartland Charter Schools

To improve their students' access to mental health professionals, Kern High School District, Ukiah Unified, Gateway Charter, Redwoods Charter, and Heartland Charter should coordinate with their respective counties to request MHSA funding to employ additional school counselors, school nurses, school social workers, and school psychologists.

1-Year Agency Response

We hired 2 ERMHS psychologists to support school wide mental health needs. Additionally began running Tier1 and Tier 2 social/emotional/behavioral intervention groups as well as tier 3 one on one short term intervention.

California State Auditor's Assessment of 1-Year Status: Partially Implemented

Although Heartland has hired two psychologists, its response does not indicate that it has hired the recommended number of counselors, nurses, or social workers. Thus, Heartland should coordinate with Kern County to request MHSA funding to employ individuals in those positions.

6-Month Agency Response

Heartland Charter school requested training from our SELPA on applying for MHSA funding. The SELPA has organized a training that we are planning on attending. We plan to apply for funding by 6/2021 and are in the process of gathering data needed for the application.

California State Auditor's Assessment of 6-Month Status: Pending

60-Day Agency Response

*We are in the application process for MHSA funding and will use this revenue for additional mental health professionals should we be accepted.

*We have appointed a primary and secondary suicide prevention liaison. She is overseeing our entire process from the initial recommendation to the postvention response team.

California State Auditor's Assessment of 60-Day Status: Pending

Heartland has not yet provided evidence of its application for MHSA funds.

Recommendation #22 To: Kern High School District

To improve their students' access to mental health professionals, Kern High School District, Ukiah Unified, Gateway Charter, Redwoods Charter, and Heartland Charter should coordinate with their respective counties to request MHSA funding to employ additional school counselors, school nurses, school social workers, and school psychologists.

Annual Follow-Up Agency Response From October 2022

A memorandum of understanding (MOU) between the Kern High School District and the Kern County of Superintendent of Schools Office was approved by their Governing Board at the October 2021 board meeting. The MOU provides the mental health support of licensed clinicians (e.g., Marriage and Family Therapists or Clinical Social Workers) two days a week at two different KHSD sites (Bakersfield High School and South High School) through August 2024. The Director of Student Behavior and Support, Stephen Granucci, is the person in charge of implementation for the Kern High School District, working with both the County office and school sites.

California State Auditor's Assessment of Annual Follow-Up Status: Fully Implemented

The grant that Kern High School District describes is funded by the Mental Health Student Services Act (MHSSA) rather than the Mental Health Services Act (MHSA). Although this is not the funding source we recommended, the grant agreement between Kern High School District and the Kern County Superintendent of Schools will increase students' access to mental heath services. Among other things, the grant provides psychologists to conduct assessments and make available individualized school-based mental health services.

1-Year Agency Response

The Kern High School District is part of a four-year grant awarded to the Kern County Superintendent of Schools, which will increase mental health services within the high school district. A memorandum of understanding between the district and county was approved by the KHSD Board in September 2021 and is expected to be presented to the County Board in October 2021.

California State Auditor's Assessment of 1-Year Status: Partially Implemented

The grant that Kern High School District describes is funded by the Mental Health Student Services Act (MHSSA) rather than the Mental Health Services Act (MHSA). Although this is not the funding source we recommended, the grant agreement between Kern High School District and the Kern County Superintendent of Schools will increase funding for mental heath services. Among other things, the grant provides psychologists to conduct assessments and individualized school based mental health services. Our final assessment is pending documentation that the grant received all necessary approvals.

6-Month Agency Response

Kern High School District did not submit a response to this recommendation.

California State Auditor's Assessment of 6-Month Status: No Action Taken

60-Day Agency Response

The Kern High School District will continue to pursue MHSA funding through the county.

California State Auditor's Assessment of 60-Day Status: Pending

Recommendation #23 To: Ukiah Unified School District

To improve their students' access to mental health professionals, Kern High School District, Ukiah Unified, Gateway Charter, Redwoods Charter, and Heartland Charter should coordinate with their respective counties to request MHSA funding to employ additional school counselors, school nurses, school social workers, and school psychologists.

Annual Follow-Up Agency Response From October 2022

In regards to utilizing MHSA funds, we attended the presentation and participated in the forum, and in doing so became aware that we are not eligible to receive these funds. Ukiah Unified is part of a coalition of schools receiving services through MHSSA (Mental Health Student Services ACT) funds.. We had discussions with the project coordinator and had her put it in writing. "MHSA is a non-supplanting fund. While our services can and do pay for mental health services that can be directed to schools, at this time, Mendocino County is a recipient of the MHSSA grant (Mental Health Student Services Act), whereby mental health services are provided to students through on campus services. It would be supplanting to utilize MHSA funds to do what MHSSA is currently doing." (Attached email from MHSA Project Coordinator Rena Ford).

All slides and documents from the MHSA presentation and forum are included in this file.

However, we have been able to increase mental health services through MHSSA funds (Student referral program to local providers) along with various other sources. We have also increased our counseling positions by 2.0 FTE from our last report.

Additionally, we have reached out to our county office of education and are one of two districts in our county participating in the Student Behavioral Health Incentive Program (SBHIP). We have received our initial funds and have submitted our District Project Assessment Proposal. Our project is the implementation of Universal Mental Health Screeners and using the BIMAS-2 system data collection system to improve our student mental health program.

Exhibit A - Email from Rena Ford, Senior Department Analyst, County of Mendocino

Exhibit B - Documents from August 30 MHSA/QIC Joint Forum

Exhibit C - Documents from MHSA Stakeholder Forum June 1, 2022

California State Auditor's Assessment of Annual Follow-Up Status: Fully Implemented

Ukiah Unified School District is using Mental Health Student Services Act funds to provide additional mental health services in schools. Although this is not the funding source we recommended, we consider this recommendation to be implemented.

1-Year Agency Response

UUSD's Superintendent requested information from the Mendocino County Health and Human Services ("MCHHS") regarding MHSA funds on October 12, 2020. HHSA Acting Deputy Director Karen Lovato advised that the MHSA expenditure plan runs in three-year cycles and that the period for proposal submittals for the next-three year cycle had closed but that UUSD would be placed on the MCHHS email list-serve for the next cycle. The District cannot submit a proposal for the 2020-2023 plan, but will receive notice when the next proposal period is open.

The Superintendent has verified that UUSD is now on the MHSA list serve so UUSD will be notified when the new three year plan is developed. The current plan is for 2020-2023.

California State Auditor's Assessment of 1-Year Status: Pending

We look forward to reviewing Ukiah Unified's request for MHSA funding when it is next able to request those funds.

6-Month Agency Response

There is nothing new to report from 60 day submission.

California State Auditor's Assessment of 6-Month Status: Pending

We will continue to monitor Ukiah Unified School District's efforts to obtain MHSA funding to employ additional school counselors, school nurses, school social workers, and school psychologists.

60-Day Agency Response

UUSD's Superintendent requested information from the Mendocino County Health and Human Services ("MCHHS") regarding MHSA funds on October 12, 2020. HHSA Acting Deputy Director Karen Lovato advised that the MHSA expenditure plan runs in three-year cycles and that the period for proposal submittals for the next-three year cycle had closed but that UUSD would be placed on the MCHHS email list-serve.

The Superintendent will follow up in 18 months to ensure that UUSD is informed of MCHHS's planning and application process so that UUSD can request available funding for school counselors, school nurses, school social workers, and school psychologists.

California State Auditor's Assessment of 60-Day Status: Pending

We will continue to monitor Ukiah Unified School District's efforts to obtain MHSA funding to employ additional school counselors, school nurses, school social workers, and school psychologists.

All Recommendations in 2019-125

Agency responses received are posted verbatim.