Youth behavioral health program

(a) As of October 1, 2012, there is established within the Department, and shall be made available to all child development facilities, public schools, and public charter schools, a program that, at a minimum, provides participants with the tools needed to: (1) Identify students who may have unmet behavioral health needs; (2) Refer identified students to appropriate services for behavioral health screenings and behavioral health assessments; and (3) Recognize the warning signs and risk factors for youth suicide and implement best practices for suicide prevention, suicide intervention, and suicide postvention. (b)(1) Starting October 1, 2016, completion of the program shall be mandatory once every 2 years for all: (A) Teachers in public schools and public charter schools; (B) Principals in public schools and public charter schools; and (C) Staff employed by child development facilities, who are subject to training or continuing education requirements pursuant to licensing regulations. (2) In addition to the individuals described in paragraph (1) of this subsection, the Mayor may determine through rulemaking other individuals who shall be required to complete the program. (3) The Department may make the program available to other interested individuals. (c) The Department shall keep a record of all participants who complete the program and shall provide the participants with written proof of completion. (d) If so approved by the Office of the State Superintendent for Education, the program may count towards professional development credits. (e) For the purposes of this section, the term: (1) "Suicide intervention" means specific actions schools can take in response to student suicidal behavior, including: (A) Student supervision; (B) Notification of parents or guardians; (C) Crisis-response protocols; (D) When and how to request an immediate mental health assessment or emergency services; and (E) School re-entry procedures following a student mental health crisis. (2) "Suicide postvention" means planned support and interventions schools can implement after a suicide attempt or suicide death of a member of the school community that are designed to: (A) Reduce the risk of suicide contagion; (B) Provide support for affected students and school-based personnel; (C) Address the social stigma associated with suicide; and (D) Disseminate factual information about suicide. (3) "Suicide prevention" means specific actions schools can take to recognize and reduce suicidal behavior, including: (A) Identifying risk and protective factors for suicide and suicide warning signs; (B) Establishing a process by which students are referred to a behavioral health provider for help; (C) Making available school-based and community-based mental health supports; (D) Providing the location of available online and community suicide prevention resources, including local crisis centers and hotlines; and (E) Adopting policies and protocols regarding suicide prevention, intervention, and postvention, school safety, and crisis response. (f)(1) In Fiscal Years 2026 and 2027, the Department shall, pursuant to part B of subchapter XII-A of Chapter 3 of Title 1, award grants to community-based organizations for the operation of the program at not less than $120,000 per school-based clinician; provided, that the total amount of grants awarded under this subsection shall be not less than $16,320,000 in Fiscal Year 2026 and, except as otherwise provided in paragraph (2B) of this subsection, shall be not less than $13,200,000 in Fiscal Year 2027; provided further, that the Department shall prioritize applicants who previously provided school-based behavioral health services in School Years 2024-2025 or 2025-2026. (2) The Department shall not: (A) Require that any portion of the grant be restricted to supervision expenses; (B) Prohibit the use of any portion of the grant materials for general or specialized therapy for children; (B-i) Reduce the number of participating community-based organization providers except in cases of voluntary withdrawal or substantiated and material performance deficiencies that: (i) Are documented in writing; (ii) Relate directly to a provider's failure to comply with contractual, licensing, billing, clinical, or programmatic requirements that are clearly established in written guidance and made publicly available or available upon request; (iii) Are not based solely on the Department's preference for a different staffing model or increased use of Department-employed clinicians; and (iv) Remain uncured after the provider has been given notice and a reasonable opportunity to remedy the deficiency; (B-ii) Award a grant to an entity for the exclusive provision of telehealth services at a school unless the school agrees to the telehealth model and is also assigned at least one part-time onsite clinician or the school is an adult public charter school. This subparagraph does not preclude a community-based organization from using telehealth services to supplement, but not replace, in-person programmatic services; (C) Condition the disbursement of grant funds on a minimum total billing requirement under the program that exceeds $15,000; or (D) Decrease the grant amount based on reported insurance claims billed or paid for services provided as part of the program. (2A) In Fiscal Year 2027, the Department may utilize prevention specialists in not more than 25 schools. (2B)(A) If the Department reduces the number of participating community-based organization providers consistent with paragraph (2)(B-i) of this subsection, the Department may reduce the total amount of grant funds awarded in Fiscal Year 2027 only to the extent necessary to account for the: (i) Voluntary withdrawal of a community-based organization provider from the program; or (ii) Removal of a provider for documented performance deficiencies pursuant to paragraph (2)(B-i) of this subsection, where the Department is unable to identify a replacement community-based organization provider. (B) The Department shall not reduce community-based organization provider grant funding for the purpose of increasing the number of Department-employed clinicians or increasing the proportion of services delivered directly by the Department. (3) A grantee shall report to the Department on activities, services provided, and individuals served in a manner and form to be prescribed by the Department; provided, that the report shall include the salary information for each clinician and supervisor funded by the program, including the employee's salary from the previous 2 school years. (f-1) Notwithstanding subsection (f) of this section, in Fiscal Year 2027, the Department shall permit not more than 4 public charter schools to directly hire behavioral health clinicians where the school demonstrates the capacity, willingness, and ability to support and implement behavioral health services; provided, that each clinician shall receive onsite clinical supervision and shall perform duties exclusively related to the School-Based Behavioral Health program. (g) By October 15, 2025, the Department shall submit to the Council and the Mayor a comprehensive plan outlining the Department's strategy for strengthening and improving the program, which shall include: (1) An overview of the strategic vision for the program, including a description of how the program will align with a public health approach to prevention, early intervention, and treatment in public and public charter schools; (2) A summary of findings from an environmental scan of behavioral health resources in public and public charter schools, and an explanation of how this data will inform school assignments, staffing models, and risk-based resource allocation; (3) A billing and funding sustainability strategy, including an assessment of the current program funding model, proposed changes to the community-based organization clinician subsidy structure, and specific actions the Department will take to identify and remove barriers to Medicaid and private-insurance billing, support provider compliance, and promote the long-term financial sustainability of school-based services; (4) A detailed evaluation of all pilot programs implemented by the Department in Fiscal Years 2023, 2024, and 2025, including analysis of outcomes, challenges, and lessons learned to inform future program design; (5) A workforce development strategy, including a plan to address supervision needs, clinician licensure levels, recruitment and retention challenges, the incorporation of non-licensed staff, professional development opportunities for Department and community-based organization clinicians, and an evaluation of the current staffing model, including the Department clinicians compared to clinicians employed through grant-funded partnerships with community-based organizations; (6) An integration framework for behavioral-health and school-health services, developed in consultation with the Department of Health, to support collaboration between school-based behavioral-health clinicians and public-school and public-charter-school nurses; (7) A review of performance metrics, curriculum standards, and quality assurance protocols for clinicians assigned to public and public charter schools, with proposed updates to strengthen accountability and service delivery outcomes; (8) An assessment of the need for, and feasibility of, a common electronic health record platform or data-sharing interface between the Department and its contracted providers to support documentation, billing, and care coordination; (9) A summary of input received from Department clinicians and community-based organization employed clinicians, including feedback on service-delivery challenges and recommendations for program improvement; (10) A proposed structure and function for the program's advisory council, including any changes to membership, scope, and meeting frequency to ensure the advisory council can effectively support implementation and accountability; (11) A plan for how the Department will support the creation and maintenance of a comprehensive inventory of behavioral health resources in public and public charter schools, pursuant to § 7-731.02, and subchapter I of Chapter 8A of Title 38, by partnering with school behavioral health coordinators to identify resource gaps and guide resource allocation and development; and (12) A timeline and implementation plan, including short- and long-term actions, milestones, responsible parties, and any budgetary or legislative changes needed to support improvements to the program. [(h)] By March 1, 2027, the Department shall, in collaboration with at least 2 leaders from community-based organizations awarded grants under subsection (f) of this section, at least 4 program clinicians, including at least 2 clinicians employed by community-based organizations, the Strengthening Families Through Behavioral Health Coalition, and The Center for Health and Health Care in Schools at the Milken Institute School of Public Health at the George Washington University, develop, and publish on the Department's website and submit to the Council: (1) Uniform, publicly available standards, protocols, and assignment criteria for all clinicians participating in the program, including standardized roles, responsibilities, supervision expectations, performance expectations, and evaluation processes applicable equally to Department and community-based organization-employed clinicians performing comparable functions; (2) A standardized evaluation framework for program clinicians that includes objective measures related to service delivery, documentation compliance, timeliness of services, school engagement, and student and family responsiveness, and requires evaluations on a consistent schedule using the same criteria, metrics, and review processes; and (3) A methodology for tailoring program services to the individual needs of schools, including consideration of student population, service utilization, community needs, language access, and existing provider relationships.