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Ventura Unified weighs Healthy Campus contract to bill insurers for school-based mental-health services amid privacy and opt-out concerns
Summary
District leaders presented a grant-funded partnership with Healthy Campus to implement California's multi-payer fee schedule to sustain counseling and mental-health services. The contract would be largely grant-funded but includes ongoing fees and a 10% claims share; parents and advocacy groups raised questions about data security, consent and insurance limits.
Ventura Unified School District staff presented a proposed partnership with Healthy Campus at the Nov. 19 board meeting to implement California’s multi-payer fee schedule, a state program that allows school districts to bill insurance for certain school-based mental-health services.
Ed Services staff said the district applied for a School Linked Partnership and Capacity Grant to build the necessary digital and administrative infrastructure; the five-year contract under discussion would be funded by that grant for implementation and platform setup (staff cited $1.4 million for setup in discussion), with a $36,000 annual maintenance fee after the grant period and a vendor fee equal to 10% of every processed claim.
Healthy Campus representatives described the platform’s FedRAMP High-level data security pedigree, experience processing millions of claims in other California districts, and an administrative model that collects and verifies insurance information, manages claims and handles dispute resolution. The district said participation in the fee schedule would be voluntary for families and that consent is required to transmit PHI to external partners.
Public commenters and several trustees pressed staff on several points: whether billing school-based services would exhaust a family’s private-plan visit caps; how PHI would be protected and whether it could follow a child across LEAs; whether staff would be trained or incentivized to bill; what frequency limitations apply under the fee schedule; and what indemnity and data-breach protections exist. A parent, Deborah Meer Morris, said her plan has a 60-visit yearly cap and asked whether school billing would reduce that limit.
District and Healthy Campus speakers responded that the fee schedule’s frequency limits are separate from a family’s private plan and that clinical diagnosis codes are not required to bill under the fee schedule; they emphasized that PHI may only be disclosed with signed releases, and that Healthy Campus has FedRAMP High certification and a history of claims experience. The district committed to a multi-channel outreach and explicit opt-out language for families. Legal staff confirmed contract milestones and a cure process to allow the district to hold Healthy Campus to performance standards.
Why it matters: The fee-schedule approach is intended to create sustainable funding for counseling and mental-health staff whose positions were previously grant-funded. Parents’ concerns about PHI and plan limits are common when schools move to insurance billing, and the district acknowledged the need for robust parental outreach and clear consent processes.
Next steps: The Healthy Campus contract was presented at first read and will return to the board for final action. Staff said they will craft community outreach materials, include explicit opt-out language, and lay out operational protocols for how services are offered and documented.
