Testimony Before the Council of the District of Columbia Committee on Health at the Performance Oversight Hearing on the Department of Behavioral Health

Feb 1, 2023

Good afternoon, Chairperson Henderson and members of the Committee. My name is Rachel Johnston and I am the Senior Director of Operations and School Support at the DC Charter School Alliance, the local non-profit that advocates on behalf of public charter schools to ensure that every student can choose high-quality public schools that prepare them for lifelong success. The DC Charter School Alliance is also an active member of the Strengthening Families Through Behavioral Health Coalition and we fully support the Coalition’s recommendations.

There is no question that isolation and loss from the pandemic have only exacerbated students’ mental health needs. Trauma from instability at home and increased violence in their communities do not simply disappear when students enter their school building and it significantly impacts their ability to learn and succeed. One key way to decrease the violence we are seeing across DC is to ensure every student’s mental health needs are being met. Charter schools are doing all they can to provide these supports and are prioritizing their funds to staff these roles. But this must be supplemented by trained clinicians and resources from community based organizations (CBOs) to help families with issues that fall outside the scope of schools’ services, for example, housing instability and food insecurity.

We understand schools, CBOs, and the Department of Behavioral Health (DBH) are struggling to source qualified clinicians, so I’m here today to share ways DBH can improve students’ mental health supports given existing constraints: (1) providing personalized wrap-around case management services, (2) growing the pool and pipeline of high-quality clinicians for DBH’s school-based mental health program (SBMH), and (3) ensuring all public schools have access to lifesaving overdose drugs.

Providing Personalized Wrap-around Case Management Services

The city has a wide breadth of services that can improve families’ stability and their mental health, but navigating access to these services through a variety of agencies and organizations can be overwhelming and burdensome. While each CBO a school partners with has its own case manager, too often struggling families are directed to agencies through a one-pager, rather than with start-to-finish support. They are expected to figure out complex systems and processes without proper assistance. In the past, the neighborhood based Strengthening Families Collaboratives provided personalized wrap-around case management services, but their funding and scope of services has narrowed over time. We encourage the Council to support provision of additional funding and more widely accessible case management services to the families that need it the most and hold a focused discussion dedicated to the SBMH program to allow schools, students, families, educators, and CBOs to share challenges and opportunities.

Growing the Pool and Pipeline of High-Quality Clinicians

Second, our schools need more staffing support to meet students’ mental health needs. While we’re grateful more schools have access to DBH’s SBMH program than ever before, CBOs are still struggling to staff schools with high-quality clinicians. In fact, there are numerous vacancies across the program right now. To support the goals of the SBHM program, we need more innovative recruitment strategies, such as funding higher education and licensure programs for DC residents to pursue careers in mental health. If enacted and funded, The Pathways to Behavioral Health Degrees Act of 2023 (B25-0055) would support this effort by financing the Master of Social Work degree specifically.

More immediately, though, the city can grow the pool of qualified clinicians by pursuing reciprocity agreements with Maryland, Virginia, and other surrounding jurisdictions. Allowing clinicians licensed in these nearby states to practice in the District has the potential to enhance the pool of providers quickly, and we recommend DBH and related city agencies explore this option.

Additionally, we’re grateful the Council provided the funding for a cost study from DBH last session, and we look forward to seeing the results. We believe the results from this study will be very helpful for the Council and other stakeholders to pinpoint and evaluate the challenges in staffing. Specifically, we’re hopeful the study will provide more information on how to increase the provider pool and stabilize the staffing base of clinicians working in schools.

Providing Naloxone Access to Charter Schools

Finally, charter schools need equitable access to naloxone, commonly referred to by its brand name, Narcan, from DBH to save the lives of students and community members who suffer overdoses on or near school property. Narcan, along with a process for administration, was provided to DCPS schools in November. But systemic access has not yet been provided to public charter schools, and yet we’re aware of several overdose instances at or near charter schools this year. We did hear of one charter school who received a delivery of Narcan last week, for which we are grateful, but in lieu of systematic access, many have had to resort to picking up supplies of the life-saving drug from CVS, as any District resident can do at any time.

We understand from DBH and OSSE that the city is working to develop a template Memorandum of Agreement between DBH and each charter school that will memorialize expectations for the training, administration and storage of Narcan provided to charters. We appreciate cross-agency collaboration to provide charter schools access to this life-saving drug like their counterparts at DCPS, but we’re concerned that schools serving nearly half of the District’s public school students were an afterthought. We’re eager for an update on the issue and would like to work together with the Committee, DME, DBH, OSSE, and other relevant agencies to make sure we have good systems in place going forward to effectively plan for all schools so that all students are equitably served.  As always, the DC Charter School Alliance is available to support this collaborative effort and mitigate the challenges of engaging our 69 charter school organizations individually.

Moving Forward

Ensuring our students’ mental health needs are well cared for is a top priority of our schools, as is ensuring every school has access to life saving overdose drugs. We hope we can work together to provide better coordination on connecting families to services, grow the pool and pipeline of high-quality clinicians, and ensure all public schools get access to Narcan to save lives within their school communities.

Thank you for your time and attention to this matter, and I welcome your questions.