Lee County School District

The School District of Lee County, Florida

2019-2020 Mental Health Allocation Plan

Board Approved on July 30, 2019

Gwynetta S. Gittens, District 5, Chairman

Chris N. Patricca, District 3, Vice Chair

Mary Fischer, District 1

Melisa W. Giovannelli, District 2

Debbie Jordan, District 4

Betsy Vaughn, District 6

Cathleen O’Daniel Morgan, District 7

Dr. Gregory K. Adkins, Ed.D.

Superintendent

Mission: To ensure that each student achieves his/her highest personal potential

Vision: To be a world-class school system

The School District of Lee County

Mental Health Plan

2019-2020

The School District of Lee County utilizes a tiered system of support to address the academic,

behavioral, and social-emotional development of its students. This tiered system approach is the

most effective method of addressing the variety of academic, behavioral, social-emotional,

physical and mental health needs of all students. The goal of the district mental health plan is to

expand the support currently in place and improve the quality and accessibility of mental health

services through direct services and/or referral to outside providers.

The following multi-tiered system of support for mental health and social-emotional initiatives

aligned with state statute are in place to support this effort.

Tier 1: Universal Strategies—focus on promoting social and emotional well-being and

development of all students.

• School Counselors: The school district employs 145 school counselors that serve in the

district K-12 schools based on student population and learning community need. The

school counselor provides tier one services working proactively with students through

social-emotional learning classroom lessons, individual and small-group counseling,

consultation, and collaboration. School counselors recognize students’ mental health

needs and work collaboratively with students, parents, school staff and mental health

agencies to address student needs before escalation to a crisis.

• School Nurses: The school district employs 42 school nurses. Each school in the district is

assigned school nursing services based on need. They provide medication administration

training to staff and are responsible for creating Individual Healthcare Plans (IHCP). School

nurses assess students’ physical health while considering mental health and wellness.

• School Social Workers: The school district employs 49 school social workers. Thirty-nine

(39) are funded by the school district, and 10 additional social workers are funded by the

mental health allocation. Each school in the district is assigned social work services 1-5

days per week based on need. The department utilizes a direct service delivery model to

promote a connection between schools, families, and the community. Social workers

provide consultation and coordinated interventions designed to help students access the

supports they need for mental health and wellness in order to promote student success.

• School Psychologists: The school district employs 36 school psychologists that are

assigned to schools according to need. Thirty-two (32) are funded by the school district,

and four (4) additional school psychologists are funded by the mental health allocation.

School psychologists administer and interpret psychoeducational evaluation instruments

and analyze complex student and school problems.

• Intervention Support Specialists: Each school within the school district has at minimum,

a part-time intervention support specialist. They are responsible for facilitating the

implementation of the Multi-Tiered Systems of Support (MTSS), Early Warning System

(EWS), and Positive Behavior Intervention Support (PBIS) within the school setting. They

coordinate and support targeted student interventions to implement and sustain

MTSS/EWS and PBIS processes at the individual student, classroom, and school-based

levels.

• Prevention Specialists: The school district employs prevention specialists that implement

and coordinate school prevention programs including anti-bullying, alcohol, tobacco, and

other drug use. In addition, they establish school and community partnerships, train and

assist in implementing peer mediation, mentoring, restorative practices, and support

social emotional learning (SEL) through the implementation of evidence-based

curriculum.

• Parent/Family Education: Parent education is provided on the topics of bullying (physical,

verbal, and cyber), social media, sexting, human trafficking, and other issues negatively

affecting student physical, emotional and mental health.

• Training for Staff: Student services personnel offer training to school staff on a variety of

topics that support the social/emotional development and well-being of students as well

as enhance the staff’s ability to identify concerning behaviors. Training topics include, but

are not limited to, Youth Mental Health First Aid, PREPaRE Crisis Prevention and Response

Training, Trauma Informed Care, Trauma Sensitive Schools, CHAMPS, suicide prevention,

LGBTQ, PBIS, SEL, peer mediation, peer mentoring, and Check and Connect.

• Evidence-Based Prevention Programs: The District supports and uses programs that have

demonstrated the highest level of evidence of effectiveness. These programs, when

implemented following the fidelity model, are likely to produce positive youth outcomes.

District schools teach social-emotional learning (SEL) through evidence-based programs

such as Second Step and Sanford Harmony.

Tier 2: Selected, brief strategies to support students at risk of or with mild mental health

challenges.

The staff below provide direct and indirect services to address emerging or mild mental and

behavioral health problems and prevent risky behaviors.

• School Counselor: School counselors address student mental health concerns through a

process of referral and identification generated by school administrators, faculty and

staff, self/peer, parents, guardians, or a community-based care provider. When a referral

is made, school counselors collect quantitative data (e.g. attendance, grades, and/or

number of referrals), qualitative data (e.g. student interview or observation), and

administration of screeners to determine student satisfaction with life and sense of

belonging to the school community. Services include classroom observations,

collaborative intervention planning and implementation, individual and group counseling

and consultation with administration and staff.

• School Nurses: Services include acting as a liaison between home, school, and medical

providers when mental health challenges may be emerging.

• School Social Workers: Services include classroom observations, collaborative

intervention planning and implementation, group counseling services, and assessment of

family needs.

• School Psychologists: Services include classroom observations, assessment and

interpretation of behavioral data to monitor response to interventions, consulting with

school-based teams, identifying and implementing evidence-based interventions.

• Intervention Support Specialists: Continued coordination and support of targeted

academic and behavioral student interventions to implement and sustain problem-

solving processes at the individual student level.

• Community Mental Health Supports: The school district has collaborative agreements

with local community mental health agencies to provide school-based counseling services

as well as office and home-based services. Some of these agencies also provide substance

abuse services.

• Substance Use/Abuse Programs: Teen Intervene is an early intervention program

provided by the Hanley Foundation for 12 to 19-year-olds who display early stages of

alcohol or other drug involvement. The Teen Intervene Program is outpatient and

contains three sessions by a Hanley counselor, offered ten days apart. For more intensive

intervention, Project Success small groups are led by Hanley Foundation group counselors

using the social learning model. These groups focus on substance use/abuse for

adolescents and offer seven different groups based on individual need: Alcohol and Other

Drug Use; Sibling Group for students living with alcohol or drug-abusing siblings; Non-

Users Group for students that are not using but are facing peer pressure to use; Children

of Substance Abusing Parents (COSAP) Group for students that live with an alcoholic or

drug abusing parent/guardian; Abusers Group for students who are abusing alcohol,

tobacco, and other drugs (ATOD) and are motivated to stop; Abuser/COSAP Group for

students who are abusing ATOD and are living with a substance abusing parent/guardian;

and Recovery Group for students who have already been in treatment or have stopped

using on their own.

• SEDNET: Hendry County hosts our regional SEDNET, which facilitates and coordinates

mental health services for youth with/or at-risk of emotional behavioral disabilities.

Tier 3: Intensive, ongoing strategies to support those with significant mental health needs.

The staff below provide direct and indirect services to address significant mental and behavioral

health problems.

• School Counselors and School Social Workers: Services include collaboration with

outside mental health and substance abuse treatment providers, consultation and

collaboration with parents, follow-up with students and families regarding access to

services, classroom observations, and individual and group counseling services.

• School Nurses: Services include acting as a liaison between home, school, and

medical/community mental health providers as needed for students in treatment.

• School Psychologists: Services include working collaboratively with families and

physicians providing direct and indirect mental health services to children with mental

health and psychiatric diagnoses.

• Intervention Support Specialists: Continued coordination and support of targeted

academic and behavioral student interventions to implement and sustain problem-

solving processes at the individual student level. Collaborate with student services staff

regarding potential evaluation for exceptional student education services.

• Community Mental Health Supports: The school district has collaborative agreements

with local community mental health agencies to provide school-based counseling services

as well as office and home-based services. Some of these agencies also provide substance

abuse services.

• Substance Use/Abuse Programs: The small groups provided by the Hanley Foundation as

described in Tier 2 are also available as Tier 3 interventions.

• District Crisis Counseling Response Team: The primary purpose of the District Crisis

Counseling Response Team (CCRT) is to offer support and assistance to students, families,

and staff when a crisis occurs. The CCRT provides both direct and indirect psychological

first aid intervention services. The CCRT coordinates additional follow-up supports

depending on the nature of the crisis.

Mental Health Plan Requirements (§1011.62, F.S.)

As defined in Florida statute, the School District of Lee County (SDLC) will receive a mental health

allocation of $2.09 million to expand school-based mental health care and access to mental

health services. This allocation shall be expended on the following elements:

• Provisions for mental health assessment, diagnosis, intervention, treatment and recovery

services to students with a mental health diagnosis or at-risk for such diagnosis

• Coordination of services with primary care and mental health providers

• Direct employment of mental health service providers (school counselors, school social

workers, school psychologists), and/or contract-based collaborative efforts with mental

health providers to provide school-based mental health services

• Provide training for educators and other school staff in detecting and responding to

children’s mental health issues

Beginning in September 2019, districts will be required to submit a report on the program

outcomes and expenditures for the previous fiscal year based on these plan requirements.

Multidisciplinary School Mental Health Teams

The School District of Lee County developed, implemented, and trained multidisciplinary School

Mental Health Teams. These teams are comprised of the school counselors, school social worker,

school psychologist, and school nurse at each school. The District developed a District School

Mental Health Team Implementation Guide, based on an evidence-based problem-solving model

to be used within a tiered system of supports by the School Mental Health Teams. This

implementation guide also contains a decision tree, district-approved mental health screeners,

parental consent, referral and other related forms for services.

The multidisciplinary School Mental Health Team reviews each student’s presenting factors,

screening results, and other relevant data to determine appropriate evidence-based tier 2 and 3

interventions to be implemented by school-based mental health professionals. When deemed

appropriate for school-based mental health professionals to refer to an outside provider, the

outside provider is responsible for a psychosocial assessment to diagnose, identify treatment

needs and appropriate interventions to ensure a recovery-based model of care.

As members of the school-based multi-disciplinary mental health team, school counselors, social

workers, school nurses, school psychologists, and licensed mental health professionals meet

weekly to discuss students’ needs, services, and effectiveness of interventions. Additional team

members may include parents, teachers, administrators, behavior specialist, ELL specialist, ESE

specialist, and others as determined appropriate for each student. School social workers

coordinate the provision of mental health services with a student’s primary care provider and

with other mental health providers to include case manager, psychiatrist, therapist, and other

mental health professionals when appropriate. To facilitate this collaboration, the school will

ensure that they offer the parent/guardian the opportunity to sign the parental permission for

release of information form. Furthermore, community mental health partners will be encouraged

to have a release signed for SDLC students as part of their intake process. This allows for

communication that meets HIPAA and FERPA guidelines related to confidentiality. Coordination

efforts include case consultation, additional needs assessments, recommendations for school or

home supports, and referral for additional services.

School-Based Mental Health Services Through the Mental Health Allocation

The SDLC utilizes the Mental Health Allocation to supplement support for direct mental health

services for students. These funds do not supplant other funding sources, increase salaries, or

provide staff bonuses.

Current School-Based Mental Health Services:

• For the 2018-2019 school year, the SDLC hired ten (10) additional school social workers

to ensure adequate staff for the provision of school-based mental health services to

students as part of the School Mental Health Team. These services include individual and

small group counseling for students, referrals to outside providers,

consultation/collaboration, and wraparound services with families and other agencies

that may be involved in the student’s continuum of care. Home visits with families are

conducted for gathering information on a student's background. School social workers

were assigned full-time at every high school and three to four days per week at each

middle and elementary school to participate in tier 2 and tier 3 services within the

multidisciplinary school-based mental health teams or with primary care providers and

mental health agencies when additional mental health or substance abuse support is

needed. As appropriate, the SDLC will maximize third-party health insurance benefits and

pursue active consent for Medicaid School Match billing from parents with students

receiving Medicaid. Each of the ten school social workers staffed under the mental health

allocation has a master’s degree in social work and has met the Florida Department of

Education certification requirements.

• The SDLC added four (4) additional school psychologist positions to ensure all school

psychologists are formally assigned to designated schools rather than serving on a

rotational basis. The intent of these extra positions was to provide school psychologists

the opportunity to serve regularly on the School Mental Health Team at each of their

assigned schools. One school psychologist is assigned full-time to the Success Academy,

which is an alternative program for students with serious behavior challenges that

resulted in reassignment to this intensive program. Each of the four school psychologists

staffed under the mental health allocation has a specialist degree in school psychology

and has met the Florida Department of Education certification requirements.

• The school district developed new cooperative agreements with several mental health

agencies. These agencies provide mental health, substance abuse, behavior analysis, and

case management services to students with parental consent.

• Collaborative partnerships with community mental health professionals are supported

through monthly meetings of The School District of Lee County Interagency Council,

monthly meetings of the Healthy Lee Behavioral Health Task Force; and bi-annual

meetings with community and mental health partners.

• Through contracted services with SalusCare, the largest local community behavioral

health care agency, a full-time licensed mental health counselor is staffed at the Success

Academy, including vacations and summer break, for students determined in need of

therapeutic mental health and/or substance abuse intervention and services. The full-

time licensed mental health counselor staffed under the mental health allocation has a

master’s degree in mental health counseling and clear and active licensure as a licensed

mental health counselor with the State of Florida.

• Through contracted services with SalusCare, the school district funds an intake and

assessment specialist dedicated to serving the needs of SDLC students in a timely manner

that are referred for services, including assessments required as a result of the school-

based threat assessment teams and designated student code of conduct infractions that

require referrals for assessment. Each of the two intake and assessment specialists

funded under the mental health allocation has a master’s degree.

• Formal communication pathways between local law enforcement agencies and the

school district have been established regarding out-of-school involuntary hospitalization

via Baker Act to ensure a re-entry plan is developed by the School Mental Health Team

upon return to school.

• The district established, via memorandum of understanding, a partnership with the

Center for Progress and Excellence for utilization of the new Circuit 20 Mobile Crisis

Response Team by district schools.

2019-2020 Expansion:

For the 2019-2020 school year, the SDLC will hire six (6) Licensed Mental Health Professionals

that will work in collaboration with School Mental Health Team members and community

agencies to provide consultation and services related to the delivery of tiered mental health

supports to students enrolled in district K-12 schools. The full-time district-employed licensed

mental health professionals staffed under the mental health allocation will have a master’s

degree in a mental health area and clear and active licensure as a licensed mental health

professional with the State of Florida.

The district will continue developing additional cooperative agreements with community mental

health agencies. These agencies provide mental health, substance abuse, behavior analysis, and

case management services to students with parental consent.

Strategies for Increasing School Mental Health Professionals’ Time Spent on Mental Health

Services and Improving Ratios:

• School Counselors: In an effort to reduce ratios and increase time spent on direct mental

health services to students, the SDLC implemented minimum/maximum staffing

guidelines based on 2019-2020 projected student enrollment at each district school for

the staffing of school counselors.

• School Social Workers: Ten (10) school social workers were added to current staffing

inputs using the 2018-2019 mental health allocation and will continue to be funded using

the 2019-2020 allocation. These additional staffing inputs reduced ratios and increased

direct mental health services to students.

• School Psychologists: Four (4) school psychologist positions were added to current

staffing inputs using the 2018-2019 mental health allocation and will continue to be

funded using the 2019-2020 allocation. These additional staffing inputs reduced ratios

and increased direct mental health services to students.

Multi-Year Training Initiatives:

• PREPaRE Crisis Intervention and Recovery Training: To be better prepared for supporting

students, parents, and staff in the event of a crisis, multidisciplinary school-based mental

health teams will be trained in PREPaRE, an evidence-based school crisis prevention and

response model. To build capacity of staff and perpetuate this training in upcoming years,

the SDLC will follow a train-the-trainer model for Workshop Two, Crisis Intervention and

Recovery: The Roles of School-Based Mental Health Professionals. This training will not

only prepare district trainers to train multidisciplinary school-based mental health teams,

it will also ensure all members of the School District Crisis Counseling Response Team are

trained in the PREPaRE prevention and intervention model as they serve schools through

a district response when required.

• Youth Mental Health Training: Beginning in 2018-19, all school personnel began

receiving youth mental health awareness and assistance training to help them understand

the signs and symptoms of mental health challenges and how to assist a student who may

be in distress or crisis. The SDLC will continue providing Youth Mental Health First Aid

Training for teachers and other school staff until all school staff are trained.

• Question, Persuade, and Refer (QPR) Gatekeeper Training for Suicide Prevention: This

training teaches lay and professional “gatekeepers” the warning signs of a suicide crisis

and how to respond.

• Trauma Informed Care Training for School Mental Health Teams: This four-part training

will teach the role of trauma in schools; the role of safety (trauma and attachment

theory); the role of mindfulness (neuro-biology); and the role of compassion in cognitive

disorders.

• Trauma Sensitive Schools Training: This on-site school-wide training is offered to

interested schools. The training leads schools through identifying strategies to create

trauma-sensitive, safe and supportive schools. Three levels of progressive training are

available.

Processes for Documenting Outcomes

The following processes are currently in place to collect data regarding the number of students

screened/assessed, number of students referred for internal mental health services, and number

of students referred to an outside mental health provider:

• For any student being referred to the multidisciplinary School Mental Health Team for a

mental health or substance use concern, a school-based referral form is completed. The

School Mental Health Team reviews the concerns detailed on the referral using the

problem-solving model as a guide to determine next steps for the student. Based on the

paths taken via the problem-solving model, appropriate student and parental consent is

obtained. School-based mental health services must be initiated within 15 days after

identification and assessment, as specified in s. 1011.62, F.S. Required timelines from

referral to assessment and from assessment to commencement of school-based services

will be documented and monitored by the school mental health team and district mental

health leadership team.

• When referring to an outside mental health agency, school counselors, social workers, or

school psychologists complete the SDLC referral consent form. Required data is entered

into the confidential student information system for tracking and reporting. Support by

community-based mental health service providers for students who are referred for

community-based mental health services must be initiated within 30 days after the school

or district makes a referral, as specified in s. 1011.62, F.S. The school social worker is

responsible for reporting the outcome of the referral and working with the family and

agency to remove barriers that may impede access to services.

• SDLC social workers provide wraparound services to families of students. They provide a

combination of direct service support and referrals to district and community mental

health providers to meet the unique needs of each student based on the assessment

outcomes and collaboration with parents. They communicate outcomes and progress

with the School Mental Health Team and support the reporting process as outlined in

state statute.

• The SDLC uses a secure electronic record system for tracking documentation of mental

health services provided by district personnel, including referrals to outside agencies. The

system tracks mental health assessments, screening results and progress notes. The SDLC

ensures confidentiality of student information, as required by FERPA.

Program Oversight and Training for Schools

The School District Mental Health Leadership Team provides ongoing and progressive mental

health trainings for school mental health professionals and supports each School Mental Health

Team. The district team schedules bi-annual meetings with each approved mental health

provider. Additionally, this team evaluates district policy and procedures that support the mental

health services in the district. Data reporting related to state statutory requirements will be

reported by District Mental Health Leadership Team to the FL DOE beginning September 2019

and annually thereafter.

Proposed Expenditures for 2019-2020

Please note that funding totals are approximate, and funds may be adjusted between categories

as determined by the SDLC and technical assistance from the Florida Department of Education.

Note: Mileage and associated costs line item pays for the mileage, required equipment, training,

and supplies for the district mental health coordinator, ten school social workers, four school

psychologists, and six licensed mental health professionals staffed using the mental health

allocation.

Proposed Mental Health Allocation FY20

Allocation 2,090,716.00

FTE Average Cost Line Item Total

Staff

Director, School Counseling and Mental Health Services 0.2 2 7,382.00 27,382.00

Coordinator, Mental Health Services 1 104,707.00 104,707.00

School Psychologist 4 85,537.00 342,148.00

School Social Worker 10 6 9,828.00 698,280.00

Licensed Mental Health Professional 6 8 0,000.00 480,000.00

Mileage and Associated Costs 30,000.00 3 0,000.00

Extended School Year for Some School-Based Mental Health

Professionals to Continue Support for Students in Need 3 4,000.00 3 4,000.00

Contracts

Mental Health Counselor for Success Academy 1

Threat Assessment Mental Health Assessment Intake Clinician(s) 2 271,916.00

Mental Health Training and Implementation Support

Training for Mental Health Professionals, School Staff, and

Administrators; Supplies; Counseling Materials 102,283.00 102,283.00

Total Expenses 2 ,090,716.00

Balance Remaining 0.00

This proposed budget contains approximate amounts based on current information and technical assistance

from the Florida Department of Education. Proposed amounts and categorical funding assignments subject

to change.