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California State Auditor Report Number : 2015-112

Student Mental Health Services
Some Students’ Services Were Affected by a New State Law, and the State Needs to Analyze Student Outcomes and Track Service Costs


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Chapter 1

ASSEMBLY BILL 114 AFFECTED MENTAL HEALTH SERVICES FOR SOME STUDENTS, AND LOCAL EDUCATIONAL AGENCIES SHOULD BETTER DOCUMENT REASONS FOR CHANGES TO SERVICES

Key Points

Some Aggregate Data Allow for Limited Conclusions About How Students Were Affected by AB 114

To assess how the transfer of the responsibility for mental health services to LEAs has affected students, we attempted to identify whether students who were offered mental health services through an IEP before AB 114 took effect subsequently had those services inappropriately reduced or eliminated. However, to draw any definitive conclusions, we would need to review IEPs for students throughout the State who had a mental health service in their IEP prior to the enactment of AB 114 and follow their record of subsequent care after the change in law. In lieu of this cost prohibitive approach, we began our analysis by reviewing aggregate data for four SELPAs for the types of mental health services provided to students, the providers of those services, and the total number of students who had mental health services in their IEPs. Although we did not see any indication from our aggregate analysis that the transfer of responsibility for the provision of mental health services to LEAs negatively affected students, we cannot state with certainty that some students were not affected.

The four SELPAs we reviewed generally continued to offer students the same types of mental health services before and after AB 114 took effect. We identified the three most common types of mental health services in student IEPs during the 2010­–11 school year—the year before AB 114 took effect—and compared those services with the most common service types during the 2014–15 school year for each SELPA we reviewed. Although the rankings changed, Table 3 shows that each SELPA we reviewed continued to provide the most common mental health services before and after the transition in responsibility. For example, at Riverside County Special Education Local Plan Area (Riverside), behavior intervention services dropped from the second to the fourth most common mental health service type in the 2014–15 school year, but Riverside offered that service to more students than it did before AB 114 took effect. The table also notes a decline in residential treatment services at Long Beach Unified School District (Long Beach). We discuss this decline, and Long Beach’s perspective that the decline represents a positive change because it is serving students in a less restrictive environment, later in this chapter.

Additionally, although AB 114 transferred responsibility for the provision of mental health services from county mental health departments to LEAs, the provider of the most common mental health services generally had already been the LEA where the student attended school. We expected that prior to AB 114 taking effect, the county mental health department would be the provider of these services in most instances. However, in the year before the transfer of responsibility to the LEAs, the named provider in student IEPs for the most common mental health services at the four SELPAs generally was the LEA, rather than the county. In contrast, counties and LEAs both appeared as the named provider for less common mental health services in the year before AB 114 took effect. The only exception was Long Beach, where these less common mental health services were provided by the LEA. However, by school year 2014–15, the county was generally not the provider for IEP mental health services at the four SELPAs, regardless of how commonly the service was provided. The predominant provider for services was the LEA or an agency with which the LEA contracted for service provision.



Table 3

Most Common Mental Health Services Offered in School Year 2010–11 and 2014–15

SPECIAL EDUCATION LOCAL PLAN AREA MENTAL HEALTH SERVICE RANKING IN THE 2010–11 SCHOOL YEAR (NUMBER OF TIMES OFFERED IN IEPS)* RANKING IN THE 2014–15 SCHOOL YEAR (NUMBER OF TIMES OFFERED IN IEPS)

Mt. Diablo Unified School District

Individual Counseling
1 (462)
2 (239)
  Counseling and Guidance
2 (275)
1 (445)
  Psychological Services
3 (135)
4 (46)
Comment: Behavior intervention services became the third most common service in the 2014–15 school year.
Long Beach Unified School District Individual Counseling
1 (442)
2 (218)
  Behavior Intervention Services
2 (321)
1 (481)
  Residential Treatment Services
3 (166)
5 (32)
Comment: Psychological services replaced residential treatment services as the third most common service in the 2014–15 school year.
Riverside County Special Education Local Plan Area Individual Counseling
1 (432)
1 (1,549)
  Behavior Intervention Services
2 (385)
4 (672)
  Counseling and Guidance
3 (368)
2 (1,124)
Comment: Psychological services replaced residential treatment services as the third most common service in the 2014–15 school year.
South East Consortium for Special Education Behavior Intervention Services
1 (613)
2 (505)
  Counseling and Guidance
2 (376)
1 (755)
  Individual Counseling
3 (303)
3 (462)

Source: California State Auditor’s analysis of data obtained from the California Department of Education’s California Special Education Management Information System.
* Individualized Education Program.



We also reviewed the number of students with at least one mental health service in an IEP at the four SELPAs. The number of students who require a mental health service to access their free and appropriate public education may fluctuate from year to year depending on student population and the needs of those students in any given year. Therefore, we focused our efforts on whether the data showed a decline in the number of students served since this transfer. As shown in Figure 3, at Mt. Diablo Unified School District (Mt. Diablo), South East Consortium for Special Education (South East), and Riverside, the total number of students who received a mental health service through an IEP did not decline, but rather increased or remained generally consistent after AB 114 took effect in July 2011. In contrast, the number of students at Long Beach whose IEP included a mental health service grew in the 2011–12 school year, the first school year after AB 114 took effect, but dropped in subsequent school years. The district attributes this drop in the number of students receiving mental health services at Long Beach to pre AB 114 levels in part to an early intervention program it implemented to treat students before their mental health affects their education. However, it did not provide us with an analysis or other documentation that supports its claim that the early intervention program it implemented is the cause for the decline in the number of students to whom it provides mental health services through an IEP.



Figure 3

Total Number of Students with a Mental Health Service in an Individualized Education Program at Four Special Education Local Plan Areas for School Years 2010–11 Through 2014–15

Students with a Mental Health Service in an Individualized Education Program at Four Special Education Local Plan Areas for School Years 2010-11 Through 2014-15

Sources: California State Auditor’s analysis of data obtained from the California Department of Education’s (Education) California Special Education Management Information System and data from Education’s California Longitudinal Pupil Achievement Data System.



The Majority of Changes to Services Were Unrelated to AB 114, but LEAs Can Improve Documentation of The Reasons

Because we were able to draw only limited conclusions from the aggregate data, we selected and reviewed the IEPs of 60 students across the four SELPAs to evaluate the impact on students from the transfer of responsibility for special education mental health services from counties to LEAs. It was the practice at all four SELPAs we visited that IEP teams memorialized each student’s IEP on a written form (IEP document) explaining what services, among other items, each student’s IEP included. Most of the reductions in student mental health services that we observed when we reviewed students’ IEP documents were not related to the changes to state law. Instead, most service reductions were due to factors that were independent of AB 114, such as a student graduating or cases in which IEP teams decided that the student had progressed to the point that he or she no longer required the mental health service to be able to access his or her education. However, we found that IEP teams did not always record in the IEP document their rationale for why a service was removed from the student’s IEP. Consequently, we relied in part on explanations from LEAs, which we corroborated by reviewing supporting documentation in order to reach our conclusion about whether the changes were related to AB 114. When IEP teams do not record in the IEP document the reasons why IEP service levels change, they may affect a parent’s ability to participate in the IEP process and create difficulties for subsequent educators and IEP teams in understanding the reasons why a student does or does not receive a particular service.

For the Students We Reviewed, Most Reductions in Mental Health Services Were Not Due to AB 114

Services in a student’s IEP must be designed to meet the student’s goals and educational needs, and therefore it is reasonable to expect that service levels will change from year to year for any given student, including cases in which a student stops receiving mental health services altogether. To determine whether AB 114 affected the rate at which students stopped receiving all mental health services through an IEP, we identified three student groups: students who received a mental health service in school year 2009–10, in 2010–11, and in 2011–12, respectively. We then tracked these groups of students into the next school year to see whether they continued to have a mental health service listed in their IEP documents. Figure 4 shows that each SELPA we reviewed had consistent year to year rates of retention, both before and after AB 114. For example, at South East, 63 percent of the students who received a mental health service in 2009–10 continued getting a service in 2010­–11. This retention rate was similar in the following year: 66 percent of students who received a mental health service in 2010–11 continued getting a service in 2011–12, the year after AB 114 took effect. If AB 114 had negatively affected service rates, we would have expected the student groups from 2010­–11 and 2011–12 to show a lower retention rate in the number of students who retained services. However, this was not the case at the four SELPAs we reviewed, which leads us to conclude that AB 114 did not likely affect the rate at which students experienced a complete end to their mental health services.



Figure 4

The Rate at Which Students at Four Special Education Local Plan Areas Retained Mental Health Services in the Following School Year

The Rate at Which Students at Four Special Education Local Plan Areas Retained Mental Health Services in the Following School Year

Source: California State Auditor’s analysis of data obtained from the California Department of Education’s California Special Education Management Information System
* Assembly Bill 114.



However, as described in the previous section, using aggregate data alone limited our ability to assess how students were affected after AB 114 transferred responsibility to LEAs for the provision of mental health services. To better understand whether and how students were affected by this change in responsibility, we reviewed a total of 60 student files, 15 from each of the four SELPAs we visited, for students who received at least one mental health service in the 2010–11 school year, just before AB 114 took effect. For each student, we tracked the mental health services the student received for two additional school years and found that most of the students experienced some change in the number of mental health services they received, including both increased and decreased service levels.7 In total, 44 of the 60 students we reviewed had one or more mental health services removed from their IEP after the changes AB 114 made to state law. For these 44 students, we reviewed the IEP document to determine why the IEP team removed the service. When the IEP document did not contain explicit reasons why the service was removed, we asked staff at the LEA in which the student attended school to explain why the service was removed. We then attempted to corroborate the statements staff made by reviewing details recorded in the student’s IEP document or with other available information.

In some cases, students who had been receiving mental health services before the transfer of responsibility stopped receiving all of their mental health services. Twenty nine of the 44 students who had a mental health service removed stopped receiving all mental health services within this period. For 21 of these students, the LEAs stopped providing services for reasons unrelated to the change in responsibility created by AB 114. Specifically, these students graduated from high school or stopped attending school, their IEP teams determined that they had improved in their performance and no longer required the service to be able to access a free and appropriate public education, or the IEP teams determined a different mix of services that did not include mental health services was more appropriate. For example, at Mt. Diablo one student file we reviewed showed that the student received mental health services in school year 2010–11 and then met her associated goal in 2011–12. Due to her progress, the student no longer received mental health services, although she continued in special education to meet other needs. However, for eight of these 29 students, either the LEAs could not explain why they removed all mental health services or the removal of all mental health services from the student’s IEP appeared connected to AB 114. We discuss these students in greater detail in the next section.

The remaining 15 students of the 44 who had a mental health service removed had some but not all of the mental health services on their IEP removed. Similar to the students who had all of their mental health services removed, we determined that some of these service removals were attributable to positive outcomes, such as a student meeting the behavior and social skills goals contained in their IEP. In other cases, we saw evidence that an IEP team determined that a different combination of mental health services would better benefit the student than the existing array of services, which led the IEP team to remove some mental health services from the student’s IEP. However, for five of these 15 students, either the LEAs could not explain why they removed the services or the reason appeared related to AB 114.

AB 114 Was the Reason for Some Changes to Mental Health Services, but the Effect on Students Is Unclear

For 13 of the 44 students we reviewed who had a mental health service removed from their IEPs, either the LEAs could not explain the reason, there was no evidence to support their explanation for removing the services, or the removal was related to AB 114. For seven of these 13 students, five from Riverside and one each from Mt. Diablo and Long Beach, the LEA could not satisfactorily explain why the services were removed. In all but one of those cases, staff at the LEAs where the students attended school offered an explanation for why services were removed from student IEPs, but there was no evidence supporting the explanations. For example, for three students at Riverside, LEA staff indicated that it was possible services changed because of county mental health department recommendations. However, we could not corroborate the reasons we were provided with any information presented in these students’ IEP documents. Because the IEP team for these students did not document the reasons why they removed services from students’ IEPs, neither we nor these LEAs can know whether the removal was related to AB 114. Therefore, it is possible that these students were negatively affected by the transfer of responsibility that AB 114 created. We address this lack of documentation in the next section.

After reviewing the students’ IEP documents and discussing service changes with the LEAs in which the students attended school, we concluded that each of the six remaining students had a service removed for reasons related to AB 114. Specifically, three of these students’ services changed because the IEP team believed that the county mental health department had previously included services on the IEP that were not educationally related. Two of these students were from Long Beach and one was from an LEA within South East. Before AB 114 took effect, state law required that the LEA adopt the recommendation of the county mental health department after the IEP team reviewed and discussed the recommended services. IEP team meeting notes and statements from the special education directors where these three students attended school indicated that the students stopped receiving specific mental health services because the LEA did not believe those services were related to the students’ ability to access a free and appropriate public education. Long Beach’s special education director stated that the IEP team removed the services from student IEPs because the county had used medical criteria to determine the student’s need instead of assessing the student’s educational needs. However, we saw no evidence in the IEP documents we reviewed that either Long Beach or South East’s LEA had reassessed the students’ needs to determine that removing these services would not affect their ability to access their education. Therefore, in these three cases the LEAs lacked assurance that the services they removed would not negatively affect the students’ access to a free and appropriate education.

Finally, the remaining three students affected by AB 114, all of whom were from LEAs within South East, lost services from their IEPs for reasons connected to their eligibility for the California Medical Assistance Program (Medi Cal). In the first two cases, notes included in the students’ IEP documents show that in the year after AB 114 took effect, IEP teams decided that the students would obtain the mental health services that had previously been on their IEPs through the Medi Cal program. As a result, the IEP teams for these students removed these services from the students’ IEPs. Although we found no evidence in these first two cases that the LEA encouraged the family to seek their services through Medi Cal instead of leaving them on the IEP, this was not true for the third student. In this case, the IEP team removed individual counseling from the student’s IEP and noted that the parent would follow up with a local nonprofit that provides services to children who are Medi Cal eligible. The student services director where the student attended school stated that this student had been receiving services from an outside provider for many years before this change. She also stated that after AB 114 transitioned responsibility for mental health services, it was her LEA’s practice to remove mental health services from IEPs if students were receiving the same mental health services from outside providers who worked with Medi Cal and if those students were eligible for or enrolled in Medi Cal.

This school district’s practice does not align with federal requirements for which services should be included in an IEP. Federal criteria for which services LEAs should incorporate on a student’s IEP do not include whether the student is eligible to receive the service through other public programs. Instead the Individuals with Disabilities Education Act (IDEA) directs LEAs to include and consider several factors when determining which services a student requires to access a free and appropriate public education. These factors are advancement toward attaining the student’s annual goals, the student’s ability to be involved and make progress in the general education curriculum, and the student’s ability to be educated and participate with other children. However, these factors do not include consideration of who will provide the service or how the LEA will pay for the cost of the service. As mentioned earlier, student educational needs are the primary factor in determining whether a service should be included in an IEP. Although LEAs are allowed to seek reimbursement for the cost of IEP services from public benefit programs, that is a financial matter and should not affect whether the service is included in the student’s IEP.

The effect on these students from having these mental health services removed is not clear. All six of these students continued to receive mental health services, from either their county mental health department or their LEA, after these services were removed from their IEPs. The most recent records we were able to obtain for these students show that five of the six students either had graduated high school or were continuing in special education, and the other student left special education after entering high school. However, none of these outcomes is complete assurance that these students were not affected negatively when, because of AB 114, LEAs removed at least one of their mental health services from the students’ IEPs.

LEAs Did Not Always Ensure That IEP Documents Included the Reasons for Changes to Student IEPs

IDEA requires IEP teams to share information based on each team member’s understanding of the student’s needs; determine goals for the student that, if met, would support the student’s education; determine what services the LEA should provide the student to ensure that he or she obtains a free and appropriate public education; and create an IEP document that details the services and goals for that student. Federal law also requires LEAs to give prior written notice to a child’s parents whenever the IEP team proposes to initiate or change the educational placement or the provision of a free and appropriate public education to the child, which includes the services the LEA is offering the student. The notice must contain a description of the proposed action, an explanation of why the agency proposes the action, and any assessments, results, records, or reports used as a basis for the change. Reflecting the federal requirement, Education issued a letter in July 2012 to SELPA directors, LEA superintendents, and school principals, among others, which stated that changes to services in an IEP require documentation that the student’s needs have changed, resulting in the need to adjust the related services. Education also reviews compliance with this federal requirement in its verification reviews, and its policy is to create a corrective action plan if it finds the LEA has not met legal requirements.

Earlier in this section, we described how in some cases we could not find explicit reasons for reductions to student services in the students’ IEP documents and instead asked LEA staff why a service was changed. In many of those cases, the staff provided plausible explanations for why services were removed that we could corroborate with other information contained in the students’ IEP documents or other supporting documents to which they pointed us. However, we believe that it is important for the student’s IEP document to stand on its own and contain clear reasons why services are removed instead of relying on staff knowledge to connect various areas of the IEP document or other supporting documents to service reductions. Almost all—54 of the 60—students we reviewed had a change to their mental health services or their educational placement in the two years after AB 114 took effect. For 22 of these 54 students, the IEP team did not document the rationale for changes in mental health services or educational placements offered to students in the two years after AB 114 took effect. For 17 of those 22 students, the IEP document did not include the reason the IEP team reduced the student’s placement in the regular classroom or the mental health services the student received. For the remaining five students, the IEP teams increased the student’s placement in the regular classroom or the mental health services that the LEA provided. The educational and placement outcomes for these 22 students were mixed, but 14 of the students graduated or were still in school and receiving mental health services.

Although Education stated that it directs two review processes to ensure that LEAs follow the federal requirement related to documenting the reason for changes to student placement and services, its oversight could use improvement. Education requires LEAs to review their compliance with this federal requirement once every four years during their special education self reviews, which address student progress, goals, and services contained in IEP documents. Further, the associate director stated that Education also monitors LEAs’ processes for making changes to IEPs as part of the verification reviews it performs. However, Education only ensures that LEAs meet the legal requirements for completing IEPs and providing prior written notice, none of which specify that IEP teams must include reasons for changes in the IEP document. The associate director noted that Education expected that LEAs’ documentation of reasons for changes would improve after the transition to AB 114, as they would be responsible for the entire process instead of sharing responsibility with other entities. However, despite Education’s expectations and prior communication, LEAs have not always included clear reasons in IEP documents for the changes IEP teams make. Therefore, we believe Education could do more to remind LEAs about this federal requirement, communicate its expectations for how LEAs will meet it, and monitor their compliance.

Changes to IEP documents need to be well documented for various reasons, most significantly so that parents have an adequate understanding of the process. Federal law requires LEAs to obtain a parent’s agreement to amendments to IEPs. Further, the law gives parents the right to examine all records relating to their child, to participate in IEP meetings, and to obtain an independent evaluation. Failure to document relevant information could prevent parents from exercising these important rights and may place them at a disadvantage when considering whether to agree to the amendments. Although IEP teams discuss the provision of services for the student with parents during IEP meetings, if this information is not recorded in the IEP document, parents cannot easily reference it at a later date. In addition, educators and future IEP teams need to be able to readily understand why changes were made to students’ IEPs, particularly in those situations where students move between schools or LEAs.

Education Lacks Adequate Information About the Frequency of Mental Health Services

We attempted to analyze whether the frequency with which students received mental health services was affected by AB 114. However, for one SELPA we reviewed, South East, there were a significant number of students for whom frequency data were not available in Education’s California Special Education Management Information System (CASEMIS). Federal law requires that student IEPs include the frequency with which a student will receive the services. For example, the IEP must indicate whether the student will receive individual counseling services daily, weekly, monthly, or annually. However, Education does not require LEAs to report this information, either in aggregate or by student. Education’s associate director for special education stated that the department does not collect data about the frequency of services because Education is not required to do so in order to meet its reporting obligations under federal or state special education law. He also stated that he believes the information by itself would lack the required context that examining a student’s full record can provide.

However, collecting and analyzing data about the frequency of services would provide Education with information it could use as it oversees the special education program. Although the context of a student’s full record could be helpful for determining why the frequency of an individual student’s services changed, aggregated information about the overall occurrence of services could also be beneficial. For example, if Education collected and analyzed aggregate data about the frequency of mental health services, it could compare the frequency of counseling services a LEA offers students in one year to the frequency in the following year. If, after performing this analysis, Education observed that a LEA had an overall trend toward offering a particular counseling service less frequently, it could then follow up with the LEA and ask further questions about the reasons for the changes in service levels.

For the SELPAs we reviewed, we identified all students who received a mental health service in the 2010–11 school year where these specific services continued in 2011–12. We then compared the frequency with which the student’s IEP continued to include these specific services between the two years. We were able to analyze the frequency of these services at Mt. Diablo, Riverside, and Long Beach and found that for most of these services the frequency did not change in 2011–12. However, frequency data were available for fewer than 10 percent of these services in South East. Therefore, we do not present a conclusion related to that SELPA.

County Mental Health Departments Continue to Provide Additional Services to Students Outside the IEP Process

Counties continue to provide to special education students mental health services that are not required by the students’ IEPs. As discussed in the Introduction, county mental health departments can provide mental health services to children outside of the IEP process through the Early and Periodic, Screening, Diagnostic, and Treatment program. We reviewed 60 students in four counties and found that 40 students, or 67 percent, had received additional services from county mental health departments, beyond those related to special education, during the two years after AB 114 took effect. For example, we noted an instance in which a county mental health department provided five different services to a student during the 2012–13 school year that were outside the services indicated in the student’s IEP document, as shown in Figure 5.



Figure 5

The Rate at Which Students at Four Special Education Local Plan Areas Retained Mental Health Services in the Following School Year

The Rate at Which Students at Four Special Education Local Plan Areas Retained Mental Health Services in the Following School Year

Sources: California State Auditor’s analysis of student records from local educational agency within the South East Consortium for Special Education and patient records from the Santa Clara County Department of Behavioral Health Services.
Note: From our review of the mental health services students received through an IEP, we determined that the services students receive can change over time based on the student’s need for the services. Therefore, changes in the overall number of services this student received do not necessarily reflect a failure of any agency to provide an adequate level of service to the student.
* According to state regulations, collateral services are provided to a significant support person in the beneficiary’s life for the purpose of meeting the needs of the beneficiary in terms of achieving the goals of their client plan. Collateral services may include consultation and training of the significant support person(s) to assist in better utilization of specialty mental health services by the beneficiary and to assist in better understanding of mental illness, and family counseling with the significant support person(s).



Only one of the four SELPAs we reviewed continued to work with the county mental health department after the law changed, but students from all four SELPAs we reviewed received non-IEP mental health services from all of the counties we reviewed after AB 114 took effect. Specifically, Mt. Diablo continues to contract with the Contra Costa County mental health department to provide IEP-related mental health services to its Medi-Cal-eligible students. In contrast, Long Beach, Riverside, and South East do not have similar contracts with their respective county mental health departments as service providers. However, the county mental health departments that correspond to these three SELPAs continued to provide non‑IEP mental health services to the majority of the special education students we reviewed.

As discussed earlier, many of the students we reviewed stopped receiving mental health services from their LEAs for a variety of reasons. The reasons services stopped often related to common occurrences, such as students’ improved performance, completion of high school, or adjustments to the mix of services to better address the student’s needs. Similarly, nearly half of the students we reviewed who received a non-IEP service from their county in 2010–11 had experienced a complete end to their non-IEP mental health services by the 2012–13 school year. The decline in county mental health services not listed on IEP documents indicates that the two types of entities, LEAs and county mental health departments, which have different mandates to provide care to students, were both decreasing services to many of these students at the same time.

Fewer Students are Receiving Residential Treatment Services, but LEAs Do Not Always Clearly Document Their Decisions Regarding This Treatment in Students’ IEP Documents

After AB 114 took effect, LEAs began reassessing student placements in residential treatment as part of the transfer of responsibility for mental health services. Education and LEAs believe that LEAs can often better serve students in a less restrictive environment, which has resulted in fewer students being placed into residential treatment. However, LEAs are not always clearly recording in students’ IEP documents their decisions regarding residential placement or their considerations of the potential harmful effects of a more restrictive environment.

LEAs Are Reassessing Placement of Students in Residential Treatment, With a Focus on Serving Them in the Least Restrictive Environment

We reviewed the number of students receiving residential treatment services—which requires one of the most restrictive educational placements—before and after AB 114 and found that the total number of students receiving residential treatment services has dropped since AB 114 took effect. Education’s CASEMIS manual defines residential treatment as a 24-hour, out-of-home placement that provides intensive therapeutic services to support students’ educational programs. The number of students throughout the State whose IEP contained residential treatment services—including students at the four SELPAs we reviewed—decreased from the 2010–11 school year to the 2014–15 school year, as shown in Table 4. Among the SELPAs we reviewed, Long Beach and Riverside showed the steepest declines in the number of students receiving residential treatment services. The results of this analysis suggest that AB 114 had an effect on the total number of students who received residential treatment services.



Table 4

Approval Rates for Reimbursement Claims Submitted Under the Reasonableness Test Criteria Review Process, Which Was in Place From October 28, 2013, Through October 7, 2014

SCHOOL YEAR
  2010–11 Pre-Assembly Bill 114 2011–12 2012–13 2013–14 2014–15

Mt. Diablo Unified School District

18
12
≤10
≤10
≤10
Long Beach Unified School District
166
179
166
101
30
Riverside County Special Education Local Area Plan
30
31
22
≤10
≤10
South East Consortium for Special Education
≤10
≤10
≤10
≤10
≤10
All other special education local plan areas
1,024
1,022
845
811
772

Source: California State Auditor’s analysis of data obtained from the California Department of Education’s California Special Education Management Information System

Note: The count of the number of students with residential treatment services included in their individual education program may include the same student being tallied in more than one special education local plan area (SELPA) during a given school year. This condition would result if the student transferred between SELPAs during a school year. Also, to protect student privacy, the table presents numbers of 10 or less with the notation ≤10.



When presented with the analysis regarding the reduction in residential placements, Education and the SELPAs we reviewed provided several possible explanations for the decline. In general, the reasons were related to compliance with the federal requirement to provide special education and related services within the least restrictive environment that still allows students to access a free and appropriate public education. As discussed in the Introduction before AB 114 took effect, county mental health departments made all recommendations about the mental health services that would appear in a student’s IEP, which would result in decisions to provide a student residential treatment services. However, Education explained that after AB 114 took effect, IEP teams made decisions about how individual students’ needs could best be met, and in some cases decided that the student could be better served in a nonresidential environment with additional assistance. All four SELPAs agreed that LEAs can now better serve students in less restrictive environments because they now have complete control in tailoring students’ IEPs to meet their needs. In addition, the special education director at Long Beach believes that data entry errors, wherein students were incorrectly reported as being in residential treatment, could be contributing to the apparent reduction in residential placements. The explanations provided by Education and the LEAs could conceivably result in a decline in residential placements. However, simply examining the aggregate number of students in those placements cannot corroborate these explanations.

To further understand LEA decisions to remove students from residential treatment, we reviewed the files for a selection of students across the four SELPAs who were receiving or had received residential treatment services. Specifically, we reviewed records for 18 students who were receiving residential treatment services in school year 2010–11 and continued receiving special education services in school year 2011–12—five each from Long Beach, Riverside, and Mt. Diablo, and three from South East. We reviewed each student’s placement in school years 2010–11 through 2012–13. Our review showed that some students transitioned out of residential treatment for a variety of reasons, including when IEP teams determined that the student had shown improvement and no longer needed that level of treatment. Six of these 18 students were transitioned into a less restrictive environment, and for five of these six students, the IEP team recorded in the IEP document that the student’s improvement was the reason for the student’s transition out of residential treatment. For example, an IEP team at Riverside transitioned a student out of residential treatment and into a less restrictive day treatment program after the IEP team noted that the student had measurably improved, followed direction from staff, and gone three months without a behavioral incident. Because the IEP documentation was so poor for the sixth student, who was from Long Beach, we were unable to determine whether that student was removed due to an improvement. Another four of the 18 students graduated from high school while in residential treatment and exited the IEP process entirely, one student dropped out of school while in the residential setting, and another moved and did not continue receiving residential treatment services at the student’s new SELPA. The remaining six students we reviewed stayed in residential treatment through the 2012–13 school year.

LEAs Did Not Always Note on the IEP Document the Reasons for Residential Treatment or the Potential Harms of the Placement

Although LEAs most often had evidence demonstrating the reasons why they removed students from residential treatment, we found that LEAs did not clearly document the reasons for placement into residential treatment. State regulations require the IEP team to document its rationale for placing the student in a setting other than the school and classroom that the student would otherwise attend if he or she did not have a disability, also referred to as the least restrictive environment. We expected that LEAs would include the rationale on the student’s IEP document but found this was not the case. The IEP documents we reviewed generally contained a section related to the educational setting of the student and provided space for the IEP team to describe why the student would not participate in the regular classroom and extracurricular and nonacademic activities, as shown in the example in Figure 6. However, we found that none of the IEP documents we reviewed for the 18 students we selected contained a statement in this part of the IEP document that met the requirement. For example, the IEP document for one student from Mt. Diablo merely stated that the student was placed outside of a regular classroom because the student was benefiting from services received from the nonpublic school program. In this case, we concluded that the IEP team was using the circular argument that the student required residential placement simply because that student was currently benefiting from that specific residential placement. We would have expected that the IEP team would include a statement explaining how the student’s disability affected his or her ability to participate in the regular education environment, the additional services that the student would require to access his or her education, and a conclusion that the services the student required were not available in a less restrictive environment than the residential setting. We found similarly vague or incomplete statements in the other IEP documents we reviewed at each SELPA we audited.

When we asked LEA staff why the rationale for placement was not clearly written into this section in the IEP documents, they suggested that the rationale could be evidenced in different places in the document, and Mt. Diablo’s special education director further suggested that the rationale could be found in additional documentation in the student file. However, none of the locations within the IEP document that the LEAs directed us to and none of the additional documentation within the student files that staff at LEAs provided for review contained an appropriate rationale for placing the 18 students we reviewed in residential treatment. In some cases, staff at LEAs pointed to descriptions of the student’s behaviors, such as aggression or disobedience, but these descriptions lacked an explanation as to why the student’s behaviors created a need for residential placement or why the student’s needs could not be met in a less restrictive environment.



Figure 6

Example of Individualized Education Program Educational Setting Page From Mt. Diablo Unified School District

Example of an Individualized Education Program Setting Page from Mt. Diablo Unified School District

Source: Student file at Mt. Diablo Unified School District.
* FAPE: Free and Appropriate Public Education.
† APE: Adapted Physical Education.



In addition to not adequately recording the rationale for placement decisions in the IEP document, LEAs did not always properly note their consideration of the potentially harmful effects resulting from the student’s placement in residential treatment. Federal regulations require that, when selecting the least restrictive environment, LEAs must consider any potentially harmful effect on the child or on the quality of services that he or she receives. In a review of the 18 files previously described, we found that Long Beach, South East, and Mt. Diablo did not include the required consideration of the potential harmful effects of placement decisions in any of the IEP documents we reviewed at those LEAs. At Riverside we found that IEP teams included their consideration of the potential harmful effects in the IEP documents for three of the five students we reviewed, and in all but one IEP document for each of the other two students. Long Beach’s special education director stated that the LEA’s consideration of potential harmful effects was not included within the IEP documents because federal regulation requires only that they be considered, not specifically recorded within the student’s IEP document. However, we believe it is prudent for LEAs to include this information directly in the IEP document to avoid any confusion and minimize the research needed to answer questions about IEP team decisions in this area if a student moves or IEP team members change. In another instance, a director of special education at an LEA in South East explained that the IEP team did not have a clear understanding of what would be appropriate documentation for its consideration of potential harmful effects.

All four SELPAs claimed that in 2010–11, when the county was responsible for placing students into residential treatment, the IEP teams had difficulty in obtaining information from the county regarding the reasons why residential treatment was the most appropriate placement for the student. According to the SELPAs, this resulted in the IEP teams lacking the information necessary to appropriately record in the IEP document the rationale for the student’s placement. Nevertheless, we would expect to find that in subsequent years when IEP teams became responsible for placement decisions, they would have appropriately documented the rationale for those decisions. However, as discussed previously, this did not occur. Without clearly indicating in the IEP document the rationales and the potential harmful effects of placement in residential treatment, IEP teams cannot easily demonstrate that they are addressing the legal requirements when placing students in a more restrictive environment. Moreover, if the student moves to another LEA or SELPA, the new IEP team may not fully understand the prior team’s decisions or the student’s needs. Therefore, it is important that as LEAs continue to consider the most appropriate educational placement for their special education students, they clearly indicate in the student’s IEP their rationale for the placement decisions and the harmful effects that they have considered may result from those placements.

Selected Indicators and Targets From the California Department of Education Individuals with Disabilities Education Act Annual Performance Report

INDICATOR TARGET

Graduation rate

73 percent graduate with a regular diploma
Dropout rate Less than 22 percent
Statewide assessment 95 percent participation with approximately 89 percent proficient, depending on subject and grade
Suspension
and expulsion
Less than 10 percent of LEAs with significant discrepancies in the rate of suspensions or expulsions for more than 10 days for children with individualized education programs
Participation in general education classes 76 percent of students participate for more than 80 percent of the day
Post-school outcomes 69 percent of students enrolled in any post secondary education, training program, or employment within one year of leaving high school

California Department of Education’s federal fiscal year 2013 Individuals with Disabilities Education Act Annual Performance Report.

LEAs Could Improve Their Monitoring of Special Education Student Outcomes

California has established performance targets for its special education program to comply with federal requirements. IDEA requires each state to establish targets for indicators of special education performance and to report annually to the U.S. Department of Education and the public on these targets. To comply with these requirements, Education has established 17 performance indicators with targets for its annual performance reports. The text box shows the six indicators that we determined could be used to measure the educational outcomes of special education students who receive mental health services, as listed in the annual performance report Education submitted to the U.S. Department of Education in 2015.8 SELPAs are required by state law to forward LEA data on individual students to Education, which in turn compiles aggregate data for its annual performance report.

Although LEAs collect data on their students as part of Education’s reporting process, the LEAs we reviewed varied in the extent to which they use those data to track the educational outcomes of special education students who receive mental health services. For example, Education has established a graduation target for special education students, but East Side Union High School District (East Side) does not use the graduation rate information for the subset of special education students who receive mental health services to monitor its program. Instead, its director of assessment and accountability noted that the IEP team is responsible for ensuring that special education students achieve optimal outcomes. Specifically, she noted that East Side’s IEP teams have primary responsibility for tracking student outcomes related to graduation, as the transition plan they create includes a target graduation date and the teams meet at least annually to review student progress in transitioning out of high school. However, when LEAs do not review aggregate outcomes for special education students who receive mental health services, they are unable to determine whether significant changes to special education services, such as changes in mental health service contractors, negatively affected their students systematically. For example, if a contractor ceased operations and an alternative provider was selected by East Side, it would not evaluate whether fewer students were graduating after they received services from the new provider, or whether more students were being suspended as a result of the change.

The special education director at Long Beach informed us that Long Beach performs routine analyses of the aggregate educational outcomes of the LEA’s special education students. These analyses focus on better understanding the development of special education students and identifying any negative trends. Similarly, he stated that these analyses can determine whether a school site places a disproportionate percentage of its special education students in residential treatment. However, the Long Beach director told us that his LEA has not performed specific analyses related to special education students who receive mental health services because there have not been any specific concerns within Long Beach that would require the LEA to disaggregate those students from other high-risk populations.

The other two LEAs we reviewed either are performing analyses on their students who receive mental health services or plan to do so. The executive director of special education at Murrieta Valley Unified School District (Murrieta Valley), part of Riverside, confirmed that for the past several years, her LEA has been reviewing outcome data published by Education. She provided a presentation she created for the LEA’s staff comparing student educational outcomes at Murrieta Valley and associated targets. She stated that the LEA is in the process of analyzing its data in a more comprehensive manner for students receiving mental health services and informed a parent stakeholder group about this effort. Mt. Diablo performs an analysis of special education student outcomes that comes the closest to looking at the outcomes for students receiving mental health services among the LEAs we reviewed. Specifically, it runs reports on the graduation rates for its various school sites and programs over the last five years, some of which are specific to special education students who receive mental health services. However, Mt. Diablo did not provide us any information related to the collective group of students receiving mental health services. None of the LEAs we reviewed measure the outcomes in all six areas described in the text box for the subset of their special education students who receive mental health services, nor do they examine how those outcomes change over time for these students.

From a statewide perspective, Education does not perform any analysis of the outcomes of students who receive mental health services. According to the associate director of its special education division, Education does not analyze the statewide performance indicators for any subsets of populations, such as special education students receiving mental health services, unless responding to a specific request. The associate director noted that Education has the data on these students and can run specialized reports if requested, but that it is not required to do so and has limited resources to perform such an analysis. Specifically, he noted that IDEA establishes a single category for special education that includes all related services, and that IDEA does not establish any special classification or place additional expectations or requirements on Education concerning mental health services. Consequently, Education produces its annual IDEA performance report with the outcome measures for all special education students in the State rather than focusing specifically on those students receiving mental health services.

Education and LEAs could significantly improve the quality of mental health programs by performing data analysis and follow-up. As we mentioned in the Introduction, the governor expected that the passage of AB 114 would strengthen the connection between student services and educational outcomes. However, as we discussed earlier, this connection does not currently exist outside of the IEP teams. Given that the Legislature separately funds mental health services for special education students in the State’s budget, indicating an emphasis on students receiving these services, we would expect Education to take the lead in performing analyses and follow-ups. By tracking and analyzing this information, Education would be able to demonstrate to the Legislature how its investment in these mental health services affects special education student outcomes, and it could intervene to address any negative trends it identifies. Similarly, LEAs would be able to identify whether service trends, such as changes in providers or reductions in mental health services over time, are associated with improving or deteriorating educational outcomes for students and could then alert IEP teams concerning problems or negative trends they identify. For these reasons, we believe it is important that Education and LEAs improve their tracking of outcomes for students who receive mental health services through IEPs.

Recommendations

Legislature

The Legislature should amend state law to require Education to report annually, beginning March 2017, regarding the outcomes for students receiving mental health services in the six key areas we identified. The report to the Legislature should include outcome data for the most recently completed school year and should compare the outcomes for students receiving mental health services with the outcomes for other special education students. Subsequent reports should also identify any trends in outcome data from one year to the next. Education should also provide comments in the report on the trends that it identifies and any actions it plans to take to improve the outcomes for students who receive mental health services.

Entities We Reviewed

To ensure that it provides mental health services through an IEP to all students who require such services, Long Beach should analyze the number of students to whom it provides these services and determine whether the annual decline can be attributed to its early intervention program. If the decline cannot be attributed to the early intervention program, Long Beach should reassess its process for determining whether students require mental health services through an IEP and make any necessary improvements to that process.

To ensure that all LEAs comply with federal special education requirements, Education should require them to include directly in a student’s IEP document reasons for any changes to student placement or services.

To better communicate this information to parents and future IEP teams, each SELPA we visited should develop a process to ensure that IEP teams record, in student IEP documents, the reasons for any changes to services, including changes to mental health services, and student placements.

To enable it to review additional areas of its special education program for quality assurance, Education should collect information about the frequency of the provision of each service contained in all students’ IEPs. Education should then use this information to annually review the frequency of mental health services and follow up with SELPAs when it observes a significant reduction in the frequency of services.

To ensure that LEAs comply with federal and state requirements, Education should require all LEAs to use the IEP document to communicate the rationale for residential treatment and any potential harmful effects of such placement. To ensure that they comply with federal and state requirements, each SELPA we visited should develop a process to ensure that IEP teams record, in student IEP documents, the rationale for residential treatment and any potential harmful effects of such placement.

To better understand the effectiveness of the mental health services in their special education programs, the LEAs we reviewed should use the six performance indicators we identified to perform analysis annually on the subset of students receiving mental health services.

Education should analyze and report to the Legislature, by May 30, 2016, on the outcomes for students receiving mental health services statewide, including outcomes across the six performance indicators we identified, in order to demonstrate whether those services are effective. Once it has reported this statewide information, Education should provide each LEA throughout the State a report regarding the outcomes for the students the LEA served.

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Chapter 2

THE STATE CAN IMPROVE FISCAL OVERSIGHT BY TRACKING THE TOTAL COST TO PROVIDE MENTAL HEALTH SERVICES TO STUDENTS

Key Points

LEAs Do Not Track How Much They Spend to Provide Mental Health Services to Special Education Students

Each of the four LEAs we reviewed—Mt. Diablo, East Side Union High School District (East Side), Murrieta Valley, and Long Beach Unified School District (Long Beach)—used more than one source of revenue to provide students with mental health services through an IEP. As discussed in the Introduction, LEAs receive funding from a few different sources that can be used to provide the mental health services included in student IEPs. The most restricted funding that Education distributes to LEAs is federal and state mental health funding, which can be used only to provide mental health services called for in student IEPs (mental health funding). However, LEAs can also use their general special education funding (special education funding) for any purpose related to special education, including for mental health services. LEAs can also pay for mental health services using money from the unrestricted portion of their general fund (unrestricted funding), which is not specific to the special education program. At all four LEAs we reviewed, special education directors and fiscal analysts stated that in addition to spending their mental health funding, they also used their special education funding or unrestricted funding to provide mental health services to students.

Although LEAs use multiple funding sources to provide the mental health services in student IEPs, they are not required to track or report to Education the total cost of providing these services. State law requires LEAs to follow the definitions, instructions, and procedures published in the California School Accounting Manual (accounting manual). The accounting manual, which is published by Education, does not define a unique code or identifier for tracking mental health expenditures. Although Education requires LEAs to report how much of their mental health funding they spend, it does not require them to track or report total expenditures for mental health services. For example, if an LEA spends $100,000 of mental health funding, it must report that expenditure to Education. However, an LEA that spends $100,000 of its unrestricted funding on mental health services is not required to report that spending to Education as money spent on mental health services. Therefore, no statewide information exists that summarizes the total amount spent to provide the mental health services in student IEPs.

At the local level, none of the four LEAs we reviewed followed a formal process for tracking all IEP mental health expenditures, although Long Beach and Mt. Diablo had taken steps to attempt to quantify the amount they spend on mental health services. Specifically, Long Beach tracked the amount of unrestricted funding it transferred from its general fund to pay for mental health services—roughly $1.4 million in total from fiscal year 2011–12 through 2014–15. However, according to its director of fiscal services, Long Beach also used its special education funding to pay for some mental health services, but she was unable to determine the amount spent. Similarly, Mt. Diablo’s fiscal analyst informed us that his LEA used its own accounting codes to track the mental health expenditures it used special education funding to pay for. Based on the information he provided, for fiscal years 2011–12 through 2014–15, the LEA’s total mental health expenditures from special education funding were $22.5 million. However, the fiscal analyst stated that Mt. Diablo also uses Medi‑Cal funding to provide mental health services to both special education and general education students but he could not determine the amount spent to provide IEP mental health services. Consequently, none of the LEAs we reviewed could easily determine the total cost of providing mental health services to students in special education.

Without a statewide requirement for LEAs to track and report mental health expenditures, the State cannot determine the fiscal impact AB 114 has had on LEAs, or whether AB 114 has resulted in cost savings, as was discussed at the time the Legislature was considering the bill. Before AB 114 took effect, the Legislature annually appropriated a specific amount of funding for mental health services in student IEPs, and counties could submit reimbursement claims for state‑mandated costs that exceeded the appropriation—with no apparent limit on the amounts counties could request. Through this process, the State could track the amount that was spent on these services. However, since AB 114 took effect in July 2011, Education has not required comprehensive tracking of mental health expenditures.

When we discussed the tracking and reporting of mental health‑related expenditures with Education, the associate director of special education explained that neither state nor federal law requires Education to track expenditures related to specific special education services. Nevertheless, this information would be valuable for policy and funding decisions about the mental health services provided by LEAs and SELPAs. Because Education is responsible for distributing mental health funding and overseeing the special education program, it is important for it to collect this information and make it available to policymakers, even though Education informed us that there is no legal requirement for it to do so.

The associate director also explained that there would be a need to create guidelines to define what is considered a mental health service expenditure, because definitions of these services are not specified in state law and the definitions of mental health services in federal regulations are not considered to be an exhaustive list. However, in January 2012, Education issued guidance to LEAs that describes the allowable uses for mental health funding. Specifically, this guidance describes the general categories of expenses for which LEAs can use mental health funding and establishes that the expenditures must be related to services in a student’s IEP. With this existing guidance as a foundation, we do not believe it would be a difficult task for Education to establish instructions for LEAs about which expenditures to track using a newly developed mental health expenditure code.

Finally, the director of Education’s fiscal services division (fiscal services director) raised several concerns with tracking IEP‑related mental health expenditures. The fiscal services director stated that Education cannot add a new accounting code for IEP mental health expenditures to its existing accounting structure without losing the specificity of its accounting for other costs. For example, if some of the existing costs an LEA incurs under the accounting code for nonpublic school spending are related to IEP mental health services, a new accounting code to track spending for those services would reduce Education’s ability to track other types of nonpublic school spending. He further believed that placing responsibility on LEAs to track these mental health services costs would be burdensome and that, following Education’s normal practice for updating its accounting manual, it would take over a year to implement a new accounting code. Despite these challenges, we believe it is important for Education to be able to explain how much LEAs spend on IEP mental health services. Without this information, the Legislature and the public cannot know whether the transfer of responsibility brought by AB 114 has reduced the cost to provide these services.

Two LEAs We Reviewed Have Not Spent All of the Mental Health Funding They Received

LEAs can choose to spend all or only a portion of the mental health funding they receive annually. The State has not established a deadline by which LEAs must spend the mental health funding they receive from state sources. In effect, this allows LEAs to carry over all or a portion of their state mental health funds indefinitely. In contrast, LEAs must spend federal mental health funding by the end of the second federal fiscal year after receipt. Both East Side and Long Beach spent most or all of their state and federal mental health funding in fiscal years 2010–11 through 2014–15. However, Mt. Diablo and Murrieta Valley retained larger cumulative balances of their restricted mental health funds at the end of each fiscal year, although Mt. Diablo spent more than it received in three of the past five fiscal years. Figure 7 shows the mental health budget, revenues, and expenditures at each of the four LEAs we reviewed.



Figure 7

Budget, Revenues, and Expenditures for Restricted Mental Health Funding at Four Local Educational Agencies

Budget, Revenues, and Expenditures for Restricted Mental Health Funding at Four Local Educational Agencies

Source: California State Auditor’s analysis of district mental health budget, revenue, and expenditure reports for fiscal years 2010–11 through 2014–15.

Note: Expenditures may be higher than revenues for some years because local educational agencies can carry over unspent federal mental health funding for a limited time period and unspent state mental health funding indefinitely. Also, local educational agencies may transfer less restricted funding and spend that funding as mental health funding.

* Mt. Diablo Unified School District’s budgeted expenditures for fiscal years 2011–12 and 2012–13 were significantly higher than its actual revenues and expenditures because the district budgeted revenues along with its prior unspent revenues to arrive at budgeted expenditure amounts.

† Murrieta Valley Unified School District (Murrieta Valley) did not budget any expenditures for its restricted mental health funding for fiscal years 2010–11 and 2011–12. Murrieta Valley’s director of special education stated that in 2010–11 the district’s special education local plan area was responsible for managing the district’s mental health funding, and therefore the district did not develop a budget for this funding. She further stated that in 2011–12 the district used other resources to provide mental health services to students instead of its mental health funding because the district was concerned that the dedicated mental health funding would not be permanent.



Mt. Diablo initially built up a balance of mental health funding, but the balance has since decreased. Mt. Diablo’s special education director stated that the LEA used some of its special education funding and unrestricted general funding to pay for mental health services, rather than using its mental health funding. Although she was not with the LEA at the time, the director believes that it may have wanted to keep a balance of mental health funding to help lessen the impact of any potential future funding shortfall and to help Mt. Diablo pay for mental health services that it had not previously been directly billed for. She anticipates that the LEA will use up the remaining accumulated balance by the end of fiscal year 2015­–16 and will use all of its mental health funding allocation in subsequent fiscal years. Table 5 shows the accumulated balance of mental health funding at Mt. Diablo and Murrieta Valley over time.



Table 5

Balance of Restricted Mental Health Funding at End of Fiscal Year for Two Local Educational Agencies

FISCAL YEAR MT. DIABLO UNIFIED SCHOOL DISTRICT MURRIETA VALLEY UNIFIED SCHOOL DISTRICT

2010–11

$1,763,645

2011–12
1,354,870
$782,487
2012–13
150,002
1,090,433
2013–14
586,321
1,248,399
2014–15
504,650
1,347,929

Source: California State Auditor’s analysis of information from the California Department of Education website.



Murrieta Valley has increased its balance of mental health funding during the past several years, although the rate of increase has recently tapered off. In contrast to Mt. Diablo, Murrieta Valley has added to its balance of funding each fiscal year since 2011–12. In recent years, the LEA has annually received about $1.4 million in mental health funding, and its accumulated surplus as of June 2015 is more than $1.3 million. According to the executive director of special education at Murrieta Valley, the LEA took some time to fully ramp up its mental health program after AB 114 took effect. The LEA informed us that since it took over responsibility for mental health services, the number of students it has assessed as needing mental health services has increased, and because it now has a history of budgets to better understand its mental health costs, it will be better able to match its spending to its funding.

LEAs may create an unnecessary hardship on their school districts’ budgets by spending other sources of funding while accumulating a balance of mental health funding. Both Mt. Diablo and Murrieta Valley informed us that they spent their special education or unrestricted funds for some of their mental health services. As discussed in the previoius section, Mt. Diablo has spent about $22 million of its special education funding to provide mental health services. However, Mt. Diablo could have lessened the effect on its overall special education program by spending its mental health funding first before it resorted to other funding sources. Additionally, Murrieta Valley did not track the expenditures for mental health services that it made using its special education funding or unrestricted funding. Consequently, Murrieta Valley does not know the degree to which those mental health services are affecting its ability to spend funds in other areas.

When we discussed LEA funding balances with representatives at Education, they were not concerned about these balances except under certain conditions. Education’s associate director for special education stated that he would not be concerned about an LEA maintaining a surplus of mental health funding unless the LEA experienced a corresponding drop in service levels. The associate director and his staff informed us that in fall 2013, Education analyzed service levels at LEAs that had mental health funding balances in fiscal years 2011–12 and 2012–13. However, when they contacted these LEAs, they discovered that there were multiple reasons for spending or service patterns, with no consistent theme. Although it concluded that this area deserves further inquiry, Education has not yet completed the protocol for this type of monitoring activity. Because an accumulated balance of funding could be an indicator that an LEA is not fulfilling its obligations to provide mental health services to students, it is important that Education regularly perform this monitoring activity and follow up with LEAs that show both a balance of mental health funding and a decline in mental health service levels to determine whether accumulated balances are a cause for concern.

LEA and County Collaboration Could Allow LEAs to Access Medi‑Cal Funding to Provide Additional Mental Health Services

As discussed in the Introduction, LEAs can access Medi-Cal funding through the LEA Medi-Cal Billing Option program for certain special education mental health services. In addition to this program, one of the four LEAs we reviewed, Mt. Diablo, has been able to access roughly $1.3 million in federal funding per year through Medi-Cal, along with other related funds it receives from its county, to provide services over the past few years. Mt. Diablo’s special education director informed us that her LEA contracted with the county in order to become a provider of EPSDT services to students and to receive EPSDT Medi-Cal funding from the county. As discussed in the Introduction, EPSDT is a program that provides children under 21 who are eligible for full-scope Medi-Cal with early detection and care, including mental health services, so that health problems are averted or diagnosed and treated as early as possible. Mt. Diablo’s agreement with Contra Costa County provides it with an additional source of federal funding to pay for mental health services for its Medi-Cal-eligible students. The special education director at Long Beach and the executive director of special education at Murrieta Valley stated that although they used the LEA Medi-Cal Billing Option program, they were unable to reach an agreement with their respective counties to access EPSDT funding. Because she had only been in her position since July 2015, the special education director at East Side did not know why her LEA had not pursued any Medi-Cal funding.

Under state law, counties are responsible for providing certain mental health services and can receive federal reimbursements for these services by submitting claims through the California Department of Health Care Services (Health Care Services). Through the EPSDT program, the federal government provides reimbursement for generally half of the allowable expenditures for mental health services, and the State must provide the other matching portion. Since legislation in 2011 authorized the realignment of various programs, counties became responsible for funding the entire state match for EPSDT mental health services and may use a variety of funding sources to match it. County mental health plans can choose whether to provide certain EPSDT services directly or contract with outside service providers, which could include LEAs. The counties that correspond to the LEAs we visited informed us that prior to AB 114 they accessed EPSDT funding to provide mental health services to Medi-Cal-eligible students. However, because state law assigns counties responsibility for providing certain mental health services and seeking reimbursements, LEAs cannot access funding for those EPSDT services unless they contract with their respective counties.

This type of collaboration between LEAs and counties could improve access to mental health services for all Medi-Cal-eligible students by ensuring that all mental health services for these students are coordinated. LEAs are responsible for ensuring that students receive the mental health services specified in their IEPs, but counties are responsible for providing other mental health services to students. If LEAs contract with counties as mental health service providers, more Medi-Cal-eligible students than just those in special education could receive a wider range of EPSDT mental health services through their schools, including both mental health services related to a student’s IEP and those that are not related. By providing a common access point for some Medi-Cal-eligible students to receive certain mental health services, responsibilities for services and coordination of care could potentially be improved.

Although county collaboration with SELPAs or LEAs as mental health service providers could improve student access to mental health services by helping ensure coordination of care, not all SELPAs or LEAs may be able to immediately become mental health service providers. State law requires county mental health plans to ensure that their contracted mental health service providers meet certain requirements in order to provide services. For example, the head of service must be a licensed mental health professional or mental health rehabilitation specialist. Because these professional requirements are different from those that SELPA and LEA staff are required to possess to provide related services under IDEA, these entities may not currently have staff with the necessary qualifications to meet these requirements. However, county guidance and assistance to SELPAs and LEAs included as part of a contractual arrangement could help ensure that these entities meet the requirements specified in state law.

Contractual arrangements between counties and SELPAs could also ensure that these entities are maximizing the amount of federal funding to provide mental health services. In an October 2011 presentation hosted by Education related to the transition to AB 114, the director of the Children’s Center at the Desert Mountain SELPA (Desert Mountain) highlighted her SELPA’s collaboration with San Bernardino County (San Bernardino) as financially beneficial for both the SELPA and the county. Specifically, the director stated that the SELPA contributes to the county’s effort to match the federal reimbursements. Under this arrangement, San Bernardino does not need to provide the full amount of the federal match that the State expects local entities to contribute, and Desert Mountain receives EPSDT funding that it uses to provide mental health services to Medi-Cal-eligible students with and without IEPs. According to financial information provided by Desert Mountain SELPA, for fiscal year 2014–15, its agreement with the county allowed it to access almost $4 million in federal funds through Medi-Cal. In the absence of this agreement, the SELPA would need to find another source of revenue in order to provide the same level of services. If California’s other SELPAs established agreements with their county mental health plans, these entities in total could potentially receive millions of dollars in federal reimbursements for mental health services provided to Medi‑Cal‑eligible children.

Other counties have also begun working with LEAs as mental health service providers to allow them to access EPSDT funding. We spoke with staff at the Riverside University Health System—Behavioral Health, the former Riverside County Mental Health Department, who informed us that they are currently collaborating with one LEA, Palm Springs Unified School District, to allow it to become a mental health service provider and access EPSDT funding. They also stated that they are currently discussing collaboration with Riverside for the SELPA to provide mental health services and receive EPSDT funding. We also spoke with the deputy director of Children’s System of Care at the Los Angeles County Mental Health Department, who stated that although his department conducted some outreach to LEAs after AB 114 took effect to discuss collaboration, no SELPAs or LEAs contacted the department to become specialty mental health service providers. However, the deputy director informed us that his county has contracts with the Los Angeles Unified School District and Pasadena Unified School District that make these districts specialty mental health service providers and allow the districts to access EPSDT funding.

The LEA Mental Health Staff and the Contractors We Reviewed Were Qualified, but LEAs Should Improve Some Hiring and Contracting Practices

All of the LEA staff and contracted mental health providers we reviewed met the minimum requirements in state regulations to provide mental health services to students. However, the minimum qualifications contained in the job descriptions for some positions we reviewed at Mt. Diablo and Long Beach did not meet the requirements in state regulations at the time we began our review. Additionally, Mt. Diablo did not have a formal, written process for verifying employee mental health licenses at the time of hire or throughout employment. Finally, at each LEA we reviewed we found that the LEA or its SELPA had not retained copies of all contractor qualifications and therefore could not demonstrate that it had verified its contractors’ qualifications.

Although the Staff We Reviewed Were Qualified Under State Requirements, Some LEAs Could Improve Their Hiring Practices

State regulations require persons providing mental health services in a special education setting to hold specific credentials or licenses based on the type of service they provide. In general, the regulations allow an individual to hold one of several different licenses or credentials to meet the requirements for a specific type of mental health service. For example, individuals who provide counseling and guidance services can meet the requirements by holding one of six different types of licenses or credentials. The qualifications required to provide mental health services range from licenses that require higher levels of education and experience, such as a marriage and family therapist license, to credentials that require less education and experience, such as a pupil services credential. To obtain a marriage and family therapist license, applicants must complete an advanced degree and 3,000 hours of supervised work experience. In contrast, to obtain a pupil services credential, applicants generally must obtain a bachelor’s degree; complete some postgraduate course work, including a practicum with school‑aged children; and pass a state‑administered basic skills exam.

We judgmentally selected five staff members at each of the four LEAs we reviewed and determined that all 20 individuals met the requirements in state regulations for the mental health services they provide to students. We interviewed the special education director at each LEA to identify the mental health services those staff provide to students and found that all staff possessed a license, credential, or the education that permitted them to provide the services the LEA special education director indicated they were responsible for providing. Some LEA staff members were qualified because of licenses, such as marriage and family therapist or clinical social worker licenses, and others were qualified because of pupil services credentials.

Although all staff members we reviewed met the minimum requirements, not all of the LEAs we reviewed established minimum qualifications for their mental health staff that would ensure that staff members were properly qualified when hired. The minimum qualifications for all positions we reviewed at East Side and Murrieta Valley met the minimum qualifications outlined in state regulations. However, this was not the case at Mt. Diablo and Long Beach. Specifically, at Mt. Diablo the minimum qualifications for the LEA’s behavioral health specialist positions allowed staff in these positions to perform counseling and guidance services if they were eligible for one of two mental health professional licenses. However, state regulations require that individuals who provide counseling and guidance be fully licensed or registered and under the supervision of a license‑holder, which is different from being license eligible. At Long Beach, the minimum qualifications for an autism supervisor position do not require a license or credential, and the minimum level of education required is a bachelor’s degree. However, state regulations require all persons who design or plan behavioral interventions, which this autism supervisor position does, to possess at least a master’s degree if the individual is not licensed or credentialed.

Both Mt. Diablo and Long Beach acknowledged that the minimum qualifications for their positions did not meet the requirements of state regulations. The special education director at Mt. Diablo stated that the minimum requirements for the behavioral health specialist positions we reviewed were outdated and that she would never hire someone into these positions without a license. In September 2015, after we discussed this issue with Mt. Diablo, it updated the minimum requirements for the two behavioral health specialist positions to comply with the requirements in state regulations. At Long Beach, a personnel analyst acknowledged that the minimum qualifications for the autism supervisor position do not meet the requirements of the regulations but informed us that no one has been hired into that position since the regulation that established the minimum requirements took effect in July 2014. The personnel analyst stated that Long Beach is in the process of updating the minimum requirements for this position and that it expects to be done with this process by January or February 2016.

Murrieta Valley, East Side, and Long Beach were able to demonstrate that they verified that all selected staff members possessed the required qualifications for their positions; however, Mt. Diablo did not have formal, written procedures in place to verify that staff had the licenses required for their position, both at the time of hire and during the course of their employment. We reviewed qualifications for five mental health staff at Mt. Diablo and found that Mt. Diablo did not verify that one of these staff members possessed a current, valid license at the time of hire. We also found that Mt. Diablo did not verify that another staff member’s license remained current during her employment. In both cases, there was no direct negative effect on students because the staff members held current, valid licenses at the time of hire and continue to maintain their licenses. However, Mt. Diablo did not have a record of current licensure for either employee.

Mt. Diablo’s personnel director stated that the district has a process to ensure that all licenses are verified before the date of hire. However, this process was not documented, and the personnel director, who was not in her position at the time this staff member was hired, did not know how Mt. Diablo hired the staff member mentioned previously without first verifying her license. Further, the personnel director acknowledged that Mt. Diablo did not have a process to verify that staff members keep their licenses current after they are hired. Mt. Diablo’s lack of a formalized, systematic process for ensuring that mental health staff members possess current, valid licenses at the time of hire and during the course of their employment created a risk that Mt. Diablo could have unlicensed staff members providing mental health services to students. After we discussed this issue with the personnel director, the Mt. Diablo personnel department implemented a procedure for verifying staff licenses both at the time of hire and during the course of employment. According to the personnel director, Mt. Diablo has since reviewed personnel records to verify that all employees requiring licenses have current, valid licenses.

LEAs Generally Use Contractors to Provide Higher‑Level or Different Services to Students, but Do Not Always Obtain Documentation of Contractor Qualifications

The special education directors at the LEAs we reviewed indicated that they typically use contractors to provide either higher‑level mental health services or different types of mental health services than LEA staff provide. As characterized by one special education director, higher‑level services include services that are more intensive or of longer duration than services provided by school psychologists. Murrieta Valley and Mt. Diablo use contractors to provide higher levels of services than those provided by LEA staff. According to the executive director of special education at Murrieta Valley, after it first attempts to address student needs using its staff, the LEA uses contractors hired by its SELPA to provide services to students who need a higher level of intervention. Similarly, the special education director at Mt. Diablo stated that the contractors her LEA uses provide a higher‑intensity level of service than her staff school psychologists provide. The special education director at East Side stated that the LEA uses contractors to provide different, but not necessarily a higher level of services than East Side staff members provide, such as behavioral intervention services. The LEA also uses contractors to supplement its staff when the workload is high. Finally, at Long Beach the special education director stated that contractors are most often retained to provide the same types of services that LEA staff provide when LEA staff members are not available, although they also sometimes provide specialized services that LEA staff members cannot provide, such as counseling for special education students undergoing gender transformation.

We judgmentally selected five contracted personnel at each LEA and determined that these contractors were qualified to provide the specific types of mental health services received by students.9 We determined that each contracted individual possessed the license, credential, or educational background that state regulations required to provide the mental health services that the LEA or SELPA special education director indicated they provided. In some cases, this meant that the contractor held a bachelor’s degree, which exceeded the minimum education required for certain services, such as implementing a behavior intervention plan, while in other cases the contractor possessed a marriage and family therapy license, permitting the individual to provide a variety of services, including psychological services and counseling and guidance.

We noted that the contracted personnel we reviewed maintained licenses that require higher levels of education and experience more often than LEA staff did. Our selection of both staff and contractors was not a statistical sample, and therefore our comparison of the qualifications cannot be projected to all staff and contractors at the LEAs we reviewed. Nevertheless, 13 of the 20 contracted personnel we reviewed held a mental health professional license or license internship, whereas only five of the 20 LEA staff we reviewed held licenses or license internships that qualified them to provide mental health services. The remainder were qualified to provide the particular mental health service because of a credential or education status.

Despite using contractors to provide mental health services to special education students, the LEAs we visited did not always maintain documentation of the qualifications of the contracted personnel who served their students. State regulations require contractors to provide LEAs with copies of qualified personnel’s credentials or licenses that allow them to perform the services they provide. However, East Side, Mt. Diablo, and Long Beach did not have contractor qualifications on file for any of the contractors we selected for review when we began our work in June 2015. At Murrieta Valley, we reviewed contractor qualifications from three of its SELPA’s contractors. The SELPA had lists of the contractor’s mental health personnel for all three contractors and copies of licenses and credentials for two of the contractors, which they were able to provide upon request. The executive director at Riverside stated that the SELPA does not have copies of licenses and credentials for the third contractor because that contractor has multiple sites with a central location that maintains copies of personnel qualifications, which she can easily access. She indicated that the SELPA retains copies of most contracted personnel’s qualifications to ensure that they are qualified to provide the services they offer, and that Riverside would be willing to implement a policy to retain copies of credentials and licenses for all contractors. After our conversation with the executive director about this issue, Riverside provided us with a copy of a spreadsheet it stated it would use to track the receipt of copies of contracted personnel’s qualifications.

By not having copies of qualifications on hand, the LEAs we reviewed cannot demonstrate that they have ensured that the individuals their contractors hired to serve their students are qualified. After we requested evidence their contracted personnel were qualified, all entities we reviewed were able to obtain this evidence from their contractors. When asked about their processes for verifying that contracted personnel are qualified, the special education directors stated that it is the contractor’s responsibility to hire qualified individuals. While it is true that contractors are required to demonstrate that their personnel are qualified, it is important that LEAs hold their contractors accountable for doing so. After we discussed this concern with the special education director at Mt. Diablo, it implemented a practice requiring contractors to provide Mt. Diablo with personnel lists and copies of their credentials and licenses. The director of special education at East Side informed us that her LEA would retain contractor qualifications in the future. In contrast, the director at Long Beach agreed with the concept of retaining contractor qualifications but stated that it is not legally required to maintain such files and does not currently have the personnel to do so.

Education does not believe that LEAs should be required to retain copies of contractor qualifications. According to Education’s director of special education, LEAs should receive and review contractor personnel lists, verify that contractors have valid credentials or licenses for each of the individuals on the lists, and ensure that the contracted personnel on the lists are qualified to provide the services they provide to the LEA by checking their credentials and licenses against the minimum qualification requirements established in state regulations. However, he stated that after this process is complete, LEAs should not be required to retain the personnel lists, credentials, or licenses, because such a requirement would be overly burdensome and the information is available through other sources, such as the agencies responsible for issuing licenses and credentials. We believe the benefit of retaining contractor qualifications outweighs any potential burden on the LEAs because it would allow LEAs to defend the use of specific contracted personnel. This would be especially important in cases in which the LEA staff receive an inquiry from members of IEP teams, such as parents or other interested parties that are not those involved in the initial review of the contractor qualifications.

State and Federal Legal Requirements and Best Practices for Child Find

Federal legal requirements

  • Develop policies and procedures to identify, locate, and evaluate all children with disabilities residing in the state who need special education and related services.
  • State legal requirements

  • Each special education local plan area shall establish written child find policies and procedures for use by its local educational agencies (LEAs).
  • Child find policies and procedures must reach students attending private school.
  • Child find policies and procedures must reach homeless children and wards of the state.
  • Best practices

  • Child find outreach should include the following:
  • LEAs should do the following:
  • Sources: Title 20 United States Code, Section 1414.

    LEAs and SELPAs Have Developed Child Find Processes That Meet Legal Requirements and Incorporate Best Practices

    A recent health care study indicates that more children in the State suffer from a severe emotional disturbance than the number of students receiving mental health services in special education. In 2013 the California HealthCare Foundation (foundation) issued a report in which it stated that 7.6 percent of children in California suffer from a severe emotional disturbance. Using this information and 2013 population projections from the 2010 census, we calculated that, according to the foundation’s estimate, approximately 700,000 children in the State suffer from a severe emotional disturbance. Using data obtained from Education’s California Special Education Management Information System (CASEMIS), we found that between more than 104,000 and 120,000 students in California received mental health services in an IEP for the period from July 2010 through June 2015.

    LEAs are not required to provide mental health services for all children as part of an IEP. Instead, LEAs are required to locate and evaluate students with disabilities to determine their needs, and then provide special education and related services including mental health services to those students with disabilities who require the services to receive a free and appropriate public education. Therefore, not all students who have a disability, such as an emotional disturbance, will qualify for special education or related services, including mental health services. However, we believe that this factor alone appears insufficient to explain why such a wide gap exists between the number of students the foundation’s estimate suggests struggle with a severe emotional disturbance and the number of students receiving a mental health service through an IEP. Therefore, it is important that Education investigate whether California is providing special education and related services to all eligible students.

    To identify children who may benefit from special education, federal and state law require the State and LEAs to develop policies and procedures known as child find. Each of the four SELPAs we visited has developed policies and procedures for child find, and the LEAs we reviewed have adopted the policies and procedures of their respective SELPAs. The four LEAs we reviewed had child find policies and procedures that met legal requirements and included best practices that we identified, as shown in the text box. The LEAs also provided documentation illustrating how they generally performed the steps or actions included in their child find procedures. As a result, we believe LEAs are well positioned to identify children with mental health needs who may qualify for special education and related mental health services.

    Selected State and Federal Compliance, Due Process, and Mediation Complaint Requirements

    Compliance Complaints

    Due Process Complaints

    Mediation Complaints

    Sources: Title 20 United States Code section 1415; Title 34 Code of Federal Regulations sections 300.152 and 300.515; Title 5 California Code of Regulations sections 4660, 4662, and 4664; California Education Code sections 5600.3 and 56043; California Department of Education complaint investigation procedures; and Office of Administrative Hearings mediation and due process request procedures.

    * Extensions may be granted.


    LEAs Properly Notified Parents of Complaint Options, and Education Addressed Parents’ Complaints

    Education and LEAs are required to provide parents with procedural safeguards—sometimes referred to as educational rights under IDEA—that include information on filing complaints to address parents’ concerns regarding their child’s education. IDEA requires Education and LEAs to establish and maintain procedures to ensure that students with disabilities and their parents are guaranteed their procedural safeguards. Among other things, the procedural safeguards must include information about the opportunity for any party to present a complaint with respect to the identification, evaluation, or educational placement of the student or the provision of a free and appropriate public education. The ability to present a complaint regarding their students’ services enables parents to address concerns they may have regarding their children’s education. LEAs are required to inform parents of these rights in specific instances, such as at each IEP meeting, but at least annually.

    The four LEAs we visited use various methods to notify parents of their complaint resolution options, as required by law. For instance, we found that LEAs informed parents of their complaint resolution options through the procedural safeguard notice at IEP meetings. By presenting this notice, LEAs ensure that at least annually parents are reminded of their complaint resolution options. SELPAs and LEAs also made complaint resolution information available through their websites and presented the information at their community advisory committee meetings or included it within the committees’ parent handbooks. The presentation of complaint resolution options to parents through these means provides assurance that parents are made aware of their ability to address concerns regarding their children’s education.

    To resolve parents’ complaints, Education has developed systems and procedures that meet federal and state requirements. Federal law requires Education to provide due process complaint and mediation systems, and federal regulations require it to provide a state complaint system. Education satisfies the requirement to provide due process complaint and mediation systems by contracting with the Office of Administrative Hearings (Administrative Hearings) for the provision of due process hearings and mediations. Due process hearings and mediations primarily address disputes between parents and LEAs regarding the determination of a student’s special education needs and placement. Education fulfills the requirement to provide a state complaint system by having its staff investigate compliance complaints—complaints alleging that an LEA has not adhered to specific IDEA requirements, such as failing to hold an IEP team meeting within 30 days of a parent’s request. Additionally, state and federal laws and regulations specify procedural requirements that must be adhered to while resolving complaints. We reviewed a total of 20 compliance complaints, six due process complaints, and two mediation complaints pertaining to the LEAs at the four SELPAs we visited that were submitted during the period from July 2012 through June 2015. We found that Education and Administrative Hearings followed their respective procedures and met the relevant state and federal requirements shown in the text box. Because Education and Administrative Hearings are providing these services and processing complaints appropriately, parents are able to address concerns they may have regarding their students’ free and appropriate public education.

    Recommendations

    Legislature

    The Legislature should amend state law to require counties to enter into agreements with SELPAs to allow SELPAs and their LEAs to access EPSDT funding through the county mental health plans by providing EPSDT mental health services. If individual counties can demonstrate good reason why this type of arrangement is not possible or beneficial, the amended law should allow the counties to opt out of the collaboration by seeking a time-limited waiver from Health Care Services. The Legislature should require Health Care Services to make a final determination as to whether counties will be allowed to opt out of the required collaboration. The Legislature should require counties seeking a waiver to specify what barriers exist to working with SELPAs and their LEAs and how the county is attempting to remove those barriers.

    Entities We Reviewed

    To ensure that the State knows the amount LEAs spend to provide mental health services for student IEPs, before the start of the 2017–18 fiscal year, Education should develop, and require all LEAs to follow, an accounting methodology to track and report expenditures related to special education mental health services.

    To ensure that LEAs provide mental health services as required, Education should, on an annual basis, identify LEAs with accumulated balances of mental health funding and analyze whether the LEA has had a corresponding drop in mental health service levels. For all LEAs that Education determines have both an accumulated balance and a corresponding drop in services, Education should follow up with the LEA to determine whether the LEA is meeting its obligations to provide mental health services to students as part of the special education program.

    To ensure that all staff it hires are qualified to provide mental health services, Long Beach should update its minimum qualifications for the autism supervisor position to comply with state regulatory requirements no later than March 2016.

    To ensure that the licensed staff it hires are qualified at the time of hire and throughout their employment, Mt. Diablo should follow its formal procedures to ensure that staff possess required licenses when hired and that their licenses remain current while employed.

    To ensure that they can demonstrate that the contracted personnel who provide mental health services are qualified, the LEAs and SELPAs we reviewed that hold contracts for mental health services should annually obtain and retain copies of contractor personnel lists and the credentials or licenses for personnel who provide mental health services to students in the LEA or SELPA. Further, Education should require all LEAs and SELPAs that hold such contracts to annually obtain and retain copies of contractor personnel lists and the credentials or licenses for contractor personnel who provide mental health services to students in their respective LEA or SELPA.

    To ensure that the State provides special education and related services to all eligible students, Education should investigate the difference between the estimated number of school aged children statewide who have a severe emotional disturbance and the number receiving mental health services through an IEP and determine the reason for such a discrepancy. Education should then take any steps necessary to assist LEAs in identifying and providing services to children who are severely emotionally disturbed.


    We conducted this audit under the authority vested in the California State Auditor by Section 8543 et seq. of the California Government Code and according to generally accepted government auditing standards. Those standards require that we plan and perform the audit to obtain sufficient, appropriate evidence to provide a reasonable basis for our findings and conclusions based on our audit objectives specified in the Scope and Methodology section of the report. We believe that the evidence obtained provides a reasonable basis for our findings and conclusions based on our audit objectives.

    Respectfully submitted,

    ELAINE M. HOWLE, CPA
    State Auditor

    Date: January 19, 2016

    Staff:
    Linus Li, CPA, CIA, Audit Principal
    Vance W. Cable
    Bob Harris, MPP
    Jim Adams, MPP
    Brian D. Boone, CIA, CFE
    Nisha Chandra
    Matthew Hayes
    Sean D. McCobb, MBA
    Amanda Millen, MBA

    Legal Counsel:
    Joseph L. Porche, Staff Counsel

    IT Audit Support:
    Michelle J. Baur, CISA, Audit Principal
    Ben Ward, CISA, ACDA
    Richard W. Fry, MPA, ACDA

    For questions regarding the contents of this report, please contact Margarita Fernández, Chief of Public Affairs, at 916.445.0255.




    Footnotes

    7Five students we reviewed moved out of the SELPAs we selected for this audit before the 2012–13 school year (the second year after AB 114 took effect). For those students, we reviewed only changes to mental health services that occurred in the school year immediately following when AB 114 took effect.Go back to text

    8The U.S. Department of Education required the California Department of Education to submit its annual performance report in February 2015 using data from the 2013–14 school year.Go back to text

    9For Murrieta Valley, we reviewed contractors hired by its SELPA office, Riverside, because, according to the special education director at Murrieta Valley, the LEA does not hire its own contractors but instead uses those hired by its SELPA.Go back to text


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