SMMUSD HDQTRS — Health care and its budgetary impacts dominated discussion at the Board of Education meeting Thursday night, with board members grappling with the cost of providing both mental health services and keeping a highly qualified, but expensive, nursing staff.
The board approved a draft memorandum of understanding between the Santa Monica-Malibu Unified School District and the Los Angeles County Department of Mental Health to provide mental health services to certain students that also have individual education programs.
Those services, previously paid for by the state, will cost the district approximately $250,000 a month from Feb. 1 through June 30, which includes the base cost as well as a 20 percent administrative fee for the county department.
A 1984 law called Assembly Bill 3632 mandated that county departments of mental health work with school districts to provide mental health services to students with IEPs that also needed additional support.
In October, outgoing governor Arnold Schwarzenegger cut all state funding for the program, while maintaining the requirement on districts to maintain the same level of care.
Districts made it through until the end of January using $76 million in federal funding, but since that expired, they’ve been on the hook for the full cost of programming.
“The crisis began with the blue lining of the budget allocation,” said Dr. Jeanne Davis, interim director of the Tri City SELPA, or Special Education Local Plan Area. “School districts, by law, are the payor of last resort. We’re campaigning to point out the plight of the district, and request assistance.”
Santa Monica, Culver City and Beverly Hills belong to the Tri City SELPA.
SMMUSD has 15 students placed by the DMH at residential treatment centers, and 59 students receiving outpatient IEP-based mental health services.
The actual cost paid out will depend on the services provided, according to a statement from the Department of Mental Health, with a full reconciliation of costs occurring in 2013.
In some cases, the state will still be on the hook for mental health services. If the students in question are covered under MediCal, California’s low-income health care provider, the state will charge that organization first, and then the school district for the remainder of the health costs, said Margaret Cherene, director of the Santa Clarita Valley SELPA.
Cherene is on the negotiating committee with L.A. County mental health, as well as the interagency committee for state SELPA. She helped draft the MOU the board approved Thursday.
MediCal payments mean that some counties and districts will be paying out a lot more than others on average, depending on how many of their students are covered by MediCal.
“In L.A. County, they say 51 percent of those that qualify for 3632 services are MediCal eligible,” Cherene said.
The MOU passed 5 to 1, with Ben Allen voting no, and Laurie Lieberman absent.
“I have a hard time supporting this,” Allen said. “The terms of this agreement are distressing.”
If board members found themselves “between a rock and a hard place” in terms of mental health, discussing the fate of the nursing program at SMMUSD was no more comfortable of a position.
The board directed staff to return at the next meeting with a full-fledged job description for a Licensed Vocational Nurse at its next meeting in April.
Defining and codifying the LVN position gives the board the flexibility to fill gaps in health care at the schools with LVNs, which receive 12 to 18 months of schooling rather than the Masters degrees required of registered nurses that work in the district.
An ad hoc committee convened by Superintendent Tim Cuneo has been examining different ways to solve what all view as a critical problem — balancing budget-saving measures with the need to provide medical services to school children.
At its March 8 meeting, the district approved 5.6 layoff notices to be sent to nurses in the district as a precautionary measure, giving the board flexibility to layoff or keep on those individuals by May 15.
The ad hoc committee is considering whether or not to hire LVNs or health clerks in their stead. Those positions have fewer requirements, and are consequently less expensive, and may allow more medically-trained workers to be included in the system.
However, there are some tasks that neither LVNs nor health clerks can perform without the supervision of a registered nurse.
District parent Lee Jones spoke at the meeting, pointing out that the committee was given only a month to come to any kind of conclusion on the matter.
“It’s unrealistic to expect a recommendation from the group that is at the level it should be,” Jones said.
While some board members said that including the LVN position in the discussion was merely putting more options on the table, Board Member Ralph Mechur cautioned his colleagues against lowering standards too far, lest the changes become permanent.
“What we’re stuck in is going to last for some time, but not forever,” he said.