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Counties and districts warn CYBHI fee schedule delays risk layoffs and service cliffs for school‑based mental health
Summary
County offices and large school districts told the subcommittee that delays in implementing the Children and Youth Behavioral Health Initiative fee schedule have hampered claims submission and forced layoffs or pink slips for staff hired to provide school‑based behavioral health services.
Multiple local educational agencies (LEAs) and county offices told the Assembly Subcommittee 1 on Health that implementation delays for the Children and Youth Behavioral Health Initiative (CYBHI) fee schedule threaten a near‑term service cliff for school‑based behavioral health.
Tyler Sedwith, the state Medicaid director at DHCS, described the CYBHI fee schedule as a “first‑of‑its‑kind” effort to allow LEAs and institutions of higher education to bill insurers and managed‑care plans for outpatient behavioral health services provided to students under age 26. DHCS said it awarded $400 million in one‑time grants to help LEAs onboard and expand capacity and that cohort 1 participants would be able to submit claims and obtain reimbursements. DHCS said it has built an onboarding process, is providing one‑on‑one technical assistance and is working with the third‑party administrator Carillon Behavioral Health to resolve claim submission errors.
But Fresno County Superintendent Trina Frazier and Los Angeles Unified School District Executive Director Joel Cisneros told the panel that timeline slips and staggered release of implementation materials have delayed onboarding. Fresno said it applied to cohort 1 in October 2023 and was accepted in December 2023 but had submitted only a single claim by late February 2025; Fresno said that workforce hired as wellness coaches in October 2024 are being given layoff notices because rates for those services have not been established and districts cannot bill for them.
LAUSD said it has decades of experience billing for school‑linked medical services, described the internal steps it took to map services to the fee schedule and said it expects to submit its first claim in the month following the hearing. Both districts urged the Legislature and DHCS to consider short‑term bridge funding to avoid cutting staff as the fee schedule ramps up.
Members asked about privacy questions at the intersection of FERPA and HIPAA and data‑sharing needs for billing. DHCS said it is developing a simple toolkit for districts explaining privacy requirements and said the department is not proposing statutory changes to federal privacy laws but will use technical assistance and guidance to address school questions.
Several LEAs and county offices said onboarding support from the third‑party administrator came late and that additional, clearer guidance and faster helpdesk support would have prevented delays. Multiple public commenters and county superintendents urged the subcommittee to consider bridge funding to sustain staff hired for CYBHI until claims flow through the fee schedule.
Public commenters representing school districts, county offices of education, and community organizations described the program as an essential pathway to long‑term funding for school‑linked behavioral health but said the current implementation timeline risks losing staff and curtailing services for students when COVID‑era funds expire.
