New Actions to Strengthen School-Based Mental Health Services

On July 29, the White House announced two actions to strengthen school-based mental health services. The first is a set of grant programs from the Department of Education that will increase the number of school-based mental health providers. The second is a joint letter to Governors from U.S. Secretary of Health and Human Services (HHS) Xavier Becerra and U.S. Secretary of Education Miguel Cardona highlighting current federal resources and previewing upcoming guidance from HHS to help states better utilize Medicaid for school mental health services.

The Department of Education started the process of distributing the mental health professional grants on August 2 by soliciting comments on the design of the grant programs. AOTA is reviewing these programs for opportunities to include OT.

• The Mental Health Service Professional (MHSP) Demonstration Grant Program will fund more than $140 million in partnerships between local school districts and institutions of higher education to create mental health career pathways, including fieldwork or other training opportunities for graduate students in school-based mental health fields.
• The School-Based Mental Health (SBMH) Services Grant Program will provide more than $140 million to address staff shortages with recruitment and retention incentives and programs to help existing mental health providers get the additional training or certification they need to work in schools.

The letter to Governors from Secretaries Becerra and Cardona describes steps their agencies have already taken to support school-based mental health services and announces guidance that will be released soon to help states improve their Medicaid programs to better support student mental health. These guidance documents were mandated by the Bipartisan Safer Communities Act (the Safer Act). AOTA Federal Affairs staff have written an analysis of the Safer Act and its potential to create new opportunities for OT in community mental health, Medicaid, and schools.

• Upcoming guidance will encourage states to take up Medicaid’s existing “free care” policy, which allows schools to receive Medicaid reimbursement for services provided to all children covered by Medicaid, not just those with an individualized education program (IEP) or individualized family service plan (IFSP), and reduce administrative burdens to make it easier for schools to bill Medicaid. School districts can use reimbursement for services provided to Medicaid-eligible children to employ more occupational therapy practitioners and other specialized instructional support personnel (SISP).
• HHS will also issue guidance to help states improve coverage under the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit, the Medicaid program’s benefit for infants, children, and adolescents under the age of 21. They will provide ongoing technical assistance to states to identify and correct gaps and deficiencies in EPSDT, including in the provision of OT services.

The White House announcement also highlights additional mental health provisions of the Safer Act, including the nationwide expansion of Certified Community Behavioral Health Clinics (CCBHCs). When CCBHCs were launched as a demonstration program in select states, AOTA worked with OT advocates from across the country to ensure that occupational therapy practitioners were listed in the suggested staffing guidelines. This expansion, which will roll out in 10-state increments, will provide an opportunity to again advocate for OT as a core part of the program.

Advocacy at the federal, state, and local levels will be needed, and AOTA will collaborate with federal agencies and state associations to advance OT in school mental health. Learn more about our advocacy efforts at www.aota.org/advocacy.