County Office outlines plan to bill insurers for school-based mental-health services

The Santa Cruz County Office of Education presented detailed plans to expand school-based behavioral-health services by using a state-approved school-linked multi-payer fee schedule and enhanced care management.

Lauren Fine, the COE director of behavioral health, told trustees the fee schedule will allow schools, charters and colleges to "bill insurance companies for mental health services, which is fantastic." She described the schedule as a set of agreed prices across payers so families have no co-pay and students up to age 25 can receive services at school or via community providers referred from schools. Fine said starter funding includes a capacity grant and that the county received "$2,500,000" in initial award money to build infrastructure.

The COE said it will act as a regional conduit, providing centralized billing, an electronic health-record approach, technical assistance, and match-making between districts and community providers. Staff described wellness coaches (a certificate-bearing position) and enhanced care management as part of a multi-pronged approach to reach foster youth, students experiencing homelessness and other high-need groups.

Trustees pressed staff on logistics — how services will be distributed across nearly two dozen sites, whether uninsured or undocumented students will still be served, and the sustainability of revenue. Superintendent and staff said the state negotiated insurer participation and a third-party clearinghouse to streamline claims processing; staff named Anthem Blue Cross as the clearinghouse the county will evaluate. Presenters stressed modeling shows the program could generate significant revenue if productivity and billing assumptions hold, while acknowledging risk if Medi-Cal policy or administration changed.

The board did not take formal action on the program at the meeting; staff said they will return with implementation steps and further fiscal modeling.