NEW CASTLE – House Majority Leader Valerie Longhurst unveiled a package of new measures on Monday that would encompass a holistic approach to improving the way mental health care is delivered and addressed for children in Delaware.
Collectively known as the 2023 Delaware Behavioral Health Package, the measures include proposals designed to improve access to mental health services in schools, provide support for students in the aftermath of traumatic events, and help children prioritize mental health as a key component of overall well-being.
“Our kids are struggling with their mental health in ways many of us can’t even begin to understand, and if we don’t act quickly to address this crisis, the long-term consequences could be dire,” said Rep. Longhurst. “The 2023 Delaware Behavioral Health Package reflects our ongoing commitment to addressing this crisis head-on, destigmatizing mental illness, and providing proactive solutions to improve the mental well-being of students in Delaware.”
Building on earlier efforts to increase mental health professionals in school elementary and middle school settings, House Bill 200 would create new positions for school counselors, social workers, and school psychologists in Delaware high schools. HB 200 would effectively lower the ratio of students to mental health practitioners in high schools by requiring one school counselor, school social worker, licensed clinical social worker, or other mental health services provider for every 250 students.
Recognizing the need for more qualified mental health professionals in schools, the bill would also create a reimbursement program to encourage current school employees to gain certifications or professional licensure in critical need mental health areas.
“Our educators wholeheartedly support legislation to extend the unit funding for mental health professionals to high schools. Suicide is the second leading cause of death among teenagers. Until we give all students access to the mental health support they need, we cannot save young lives,” said Stephanie Ingram, President of the Delaware State Education Association. “This legislation will add the needed mental health positions to our schools without taking funding for other needed staff positions and give our students access to the support they deserve. Delaware has led the way on funding these positions in our schools, but until we can help students at all levels, the job isn’t done.”
Half of all lifelong cases of mental illness begin by age 14, and 37% of students with a mental health condition at age 14 and older drop out of school which is the highest school dropout rate of any group of students with a disability. However, youth with access to mental health services in school-based health centers are 10 times more likely to seek care for mental health or substance abuse than youth without access.
A companion measure to HB 200, House Bill 6 would help districts and charter schools identify and treat students struggling with mental health issues by providing funding for a District Mental Health Professional and District Mental Health Coordinator beginning in the 2024-2025 school year.
These coordinators would be responsible for developing partnerships with families, community-based organizations, school-based mental health professionals, and community behavioral health providers to further expand access to mental health services and better support students. The mental health coordinators would also be tasked with developing a district implementation plan that includes a screening process to identify students in need of services and a response plan for students experiencing distress or exhibiting warning signs of mental illness.
“As young people deal with trauma at home or undiagnosed mental, behavioral and developmental disorders, it has become clearer than ever that mental health workers should be as commonplace in our schools as nurses have been for generations,” said Sen. Marie Pinkney, the Senate prime sponsor of HB 200 and HB 6. “Over the last three years, Rep. Longhurst and I have worked together to fund close to 300 counselors and social workers, and 135 school psychologists in our elementary and middle schools. Today, we are continuing that work by bringing mental health professionals to all of Delaware’s high schools and making sure every district has the resources they need to help their students.
“This legislation will add the needed mental health positions to our schools without taking funding for other needed staff positions and give our students access to the support they deserve. Delaware has led the way on funding these positions in our schools, but until we can help students at all levels, the job isn’t done.”
While the data showed a decline in student mental health years prior to the COVID-19 pandemic, it is clear that the pandemic created severe mental health challenges and stressors. Research shows that the impacts of stress and trauma can disrupt a student’s behavior, emotional wellbeing, academic success, and health. Even more concerning, suicide is now the second leading cause of death for people ages 10 to 14 and 25 to 34.
House Bill 3 would help students prioritize their mental health by providing them up to three excused absences per school year for mental or behavioral health reasons. To ensure that students struggling with their mental health get the help they need, this bill would require that any student taking more than two of these excused absences be referred to an appropriate behavioral health specialist.
Another measure, House Bill 4, would ensure that students have access to behavioral health support in their schools in the aftermath of a school-connected traumatic event, defined as the death of any student, educator, administrator, or other building employee of a public school.
Under HB 4, the Delaware Department of Education (DOE) would be tasked with developing guidance, best practices, and written resources for schools dealing with a school-connected traumatic event. DOE would also be responsible for covering the costs of grief counseling offered to students for up to 30 days after a school-connected event.
HB 4 will be called Nolan’s Law, in honor of Wendy Eastburn-Teal’s son Nolan, who died by suicide last year.
“During my 25-year tenure as a public-school teacher, there were many devastating losses of young people and of building staff that my students, my colleagues, and I experienced together. I saw the lasting impact this had on my students and was grateful when they were able to access counseling for their grief and for the other emotions that such a loss triggered for them” said Senate Education Committee Chair Sen. Laura Sturgeon, Senate prime sponsor of HB 4 and HB 3. “I am proud to join with Rep. Longhurst to make sure all of our schools are providing consistent and quality support to students in the wake of crisis, and our students have the flexibility to take a day or two for their own mental health when the need arises.”
“We know that early intervention and treatment of mental health conditions in young people can have a profound impact on their academic, social, and physical well-being,” said Rep. Longhurst. “I’m proud that Delaware has been at the forefront of behavioral health policy, and these bills represent another bold step to address the disparity and shortfalls of mental health care in our state. By building the mental health infrastructure necessary to support these policies, we are not only setting an example for the rest of the nation, but we are also ensuring that our schools and students have access to the resources they need and deserve.”
According to the National Academies of Sciences, Engineering and Medicine, every dollar invested in mental health can yield up to 10 times the savings in health care, criminal and juvenile justice, and lost productivity,
For example, detecting and effectively treating mental illness at an early age can alleviate suffering for young people and allows them to adopt lifelong healthy coping strategies. But mental health needs that go unmet in children could lead to more costly treatment services down the road and could increase the likelihood of school dropout, unemployment, substance use, and incarceration.
House Bill 5 would address a critical barrier that prevents students covered under Delaware’s Medicaid plan from receiving behavioral health services in a school setting. Currently, the reimbursement of Medicaid-covered, school-based behavioral health services are limited only to those provided under an Individualized Educational Program (IEP) or Individualized Family Service Plan (IFSP).
HB 5 charges the Department of Health & Social Services to apply to the Centers for Medicare and Medicaid Services for a state plan amendment, which would allow for reimbursement of medically necessary behavioral health services without the need for IEP or IFSP documentation. Local education agencies would be required to use the reimbursed funds to further invest in school-based behavioral health supports.
“This year, thanks to Majority Leader Longhurst, Delaware has an opportunity to show national leadership in addressing the youth mental health crisis with this package,” noted Angela Kimball, Senior Vice-President of Advocacy & Policy at Inseparable, a coalition that fights for stronger mental health policies. “These bills fill critical policy gaps and will not only support the mental health care youth need and deserve, they will be lifechanging and lifesaving.”
Another measure, House Bill 7, would provide Medicaid enhancements for pediatric behavioral health inpatient admissions. The enhancement fees, ranging between 10%-25% of the total per diem rate for the patient’s length of stay, would be determined by categories such as the patient’s age, the days of the week that the patient is staying, access to department resources, and behavioral health intervention requirements.
By incentivizing facilities to admit pediatric patients who need emergency care and increasing the availability of beds available for these patients, this bill would address the urgent need for access to behavioral health care for children in Delaware.
“At a time when children and teens across our nation are facing a mental health crisis, House Majority Leader Valerie Longhurst has stepped up time and time again to give them the care they need,” said Sen. Nicole Poore, D-New Castle. “I am proud to stand beside her as she continues that work by serving as the Senate prime sponsor of HB 5 and HB 7. “Together, these bills will help families experiencing mental health struggles to focus on the needs of their child without having to worry if that care will break the bank, regardless of whether that help is provided in a school or hospital.”
“Delaware is experiencing a youth mental health crisis with a significant increase of pediatric mental health emergency department visits,” said Kara Walker, MD, MPH, MSHS, Executive Vice President, Chief Population Health Officer, Nemours Children’s Health.
“House Bill 7 provides a Medicaid enhancement targeting resources to acute psychiatric treatment facilities for the most complex patients,” Dr. Walker added. “Additionally, the proposed Quality Oversight Committee, will provide recommendations ensuring children get the quality acute care they need to avoid emergency department visits, decrease patient rejections, and readmissions. Nemours Children’s Health applauds the “Smile” package and its sponsors for their continued partnership, as we work together to strengthen the resources that are critical to supporting the health and well-being of Delaware’s children.”
The 2023 Delaware Behavioral Health Package bills will be filed on Tuesday, April 25.
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