The constitutional initiative “dodged” the question of how the vouchers would be funded, failing to mention that “every dollar spent” on a voucher “reduces, dollar by dollar, the funds available” for public schools, the judge wrote. (Getty Pictures)
As the first week of school draws to a close with a shortage of nearly 3,000 teachers in the stateNevada faces another staffing shortage in its education system – mental health professionals.
The state would need 35 times as many school social workers, 3.7 times as many school psychologists and twice as many school counselors to meet the recommended student population ratio, according to a report on improving access to behavioral health care of the Department of Health and Human Services to an Interim Joint Legislative Committee in July.
Staffing shortages are a problem in schools nationwide — no state meets the recommended ratio of social workers to students, for example, and the ratio in Nevada is comparable to that of Iowa, Utah. ‘Idaho, Oregon and Utah, according to the Hopeful Futures Campaign School Mental Health Report Card. But in Connecticut, Illinois, Maine, Minnesota, New Jersey, New Mexico, New York, North Dakota, Rhode Island and Wyoming, the number of students per social worker is less than 1,000.
Mental health staffing shortages limit schools from responding to behavioral health crises and not preventing them, said Christy McGill, director of the Office for a Safe and Respectful Learning Environment at the Nevada Department of Education.
“Really what you want is a system that does prevention and intervention,” she said. “When you do these two things together, you reduce the amount of service required at school.”
Nevada is grappling with two issues that are driving a shortage of mental and behavioral health professionals: a lack of qualified licensed providers and barriers to accessing providers that exist due to affordability, according to the Child and Family Services Division.
“You can’t build a workforce if you don’t have a budget”
The COVID-19 pandemic has exacerbated the need for mental health professionals in schools in a state that, according to the nonprofit Mental Health America’s annual ranking, is last dead in the nation for youth mental health. Rankings are based on higher prevalence of mental illness among young people and lower rates of access to care.
“We are currently in the mental health component of the pandemic and we need to deal with it immediately by putting more hands in the district,” said McGill.
Efforts were underway in the state to establish a better crisis response continuum prior to the pandemic, but the increased need allowed the state to leverage American Rescue Plan Act (ARPA) funding to implement new best practices.
More than $45 million in proposals to support the state’s children’s health care system will be considered at the Interim Legislative Finance Committee meeting Aug. 17, including $3.4 million to mobile teams to crisis response of the Division of Child and Family Services. The mobile teams make it possible to stabilize young people and their families in urgent need of care. The funding would allow teams to support Clark County and Washoe County school districts and the Nevada Department of Education after school hours when school mental health professionals are unavailable.
While the proposal will address the immediate needs of students in crisis, it will not address the larger problem at hand – the Clark County School District (CCSD), the fifth largest in the nation, has approximately 185 school psychologists, 700 school counselors and 195 social workers to support approximately 305,000 students.
The Nevada State Board of Education adopted recommended ratios based on national best standards in April 2020 – these ratios are one school psychologist per 500 students, one school counselor per 250 students, and one school social worker per 250 students.
The CCSD currently has a psychologist for 1,649 students, a school counselor for 436 students, and a school social worker for 1,538 students, based on data provided by the district.
Building a system of care to prevent seizures from happening in schools will take years and increased funding for mental health systems and infrastructure, while simultaneously creating a pipeline to move Nevadans interested in behavioral health professions to the workforce, said McGill.
“You can’t build a workforce if you don’t have a budget, so it seems like an overwhelming issue, but there are some positives,” McGill said. “One of those bright spots is that Nevada is about to start charging Medicaid for those services.”
Two years ago, Nevada expanded its amendment to the state plan allowing Medicaid funding to roll out, but the state must build the infrastructure to obtain parental consent, write care plans and monitor advances in care for students.
The initiative is still in its infancy, but in the meantime, the CCSD plans to pilot a Medicaid billing program for behavioral health this year, McGill said.
The pilot program will allow the state to bill for behavioral health services in eligible schools, instead of relying solely on normal education funding streams.
Districts could then use Medicaid funding to hire more school counselors and other mental health professionals and get closer to recommended staffing ratios, McGill said.
“It will take several years, but there is hope. There is a lot of federal support for Medicaid billing in schools and increasing school health,” she said. “If the kids can’t go to school because of their debates or their mental health or something like that and we don’t have the proper providers and supports in the schools, it becomes an unfair system. ”
Small state = big opportunity?
To address the other side of the labor shortage — getting enough people into the profession — the The Nevada Department of Education contracts with institutions like the University of Nevada, Las Vegas and Nevada State College and school districts, among others, to “develop your own” workforce, said McGill.
Districts are using dual credits for students interested in behavioral and mental health services professions to create a pipeline from Nevada high schools to Nevada universities. Universities and colleges offer paid internships, respecialization plans and more. “We will start building the workforce to meet the needs of the schools,” she said. “We still have a long way to go, but I think we’re a small enough state that we can start making a difference if we start closing those gaps.”
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