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Episode 5: Solving for X - The School Mental Health Funding Equation
318 Plays1 year ago
Communities and schools seeking mental health solutions for students are true math whizzes - “blending and braiding” funding from philanthropy, local levy, state & federal grants and insurance to deliver the right answer for success.
In the fifth episode, Coalition Board Chair Julie Hueller (Manager, Racine Collaborative for Children's Mental Health) welcomes guests Kristen Waters Guetschow PhD, Director of Mental Health, Madison Metropolitan School District and Scott Radke, Chief Clinical Officer, Catalpa Health for a dialogue on lessons learned and challenges ahead. Kristen and Scott share the unique, problem-solving approaches that have emerged in their communities to provide a full range of mental health supports to students. Their conversation sheds light on the complexity and fragility of current funding structures and the importance of continued efforts to find solutions and bring sustainable services into Wisconsin’s future.
Show Notes
Coalition for Expanding School-Based Mental Health in Wisconsin
Wisconsin Department of Public Instruction - Comprehensive School Mental Health
Wisconsin School Mental Health Framework
Wisconsin Office of Children’s Mental Health
Madison Metropolitan School District
CBITS - Cognitive Behavioral Intervention for Trauma in Schools
Connections for Mental Wellness - NE Wisconsin MH Collective Impact
Recommended
Transcript
Introduction and Podcast Overview
00:00:00
Speaker
Welcome to School Mental Health Works, a Quick Dip monthly podcast presenting dialogues on school mental health in Wisconsin as viewed through the lens of the array of stakeholders who play a role in comprehensive model of school mental health services in Wisconsin.
00:00:18
Speaker
Our mission is to share the successes and challenges experienced by a wide range of partners in Wisconsin as communities continue to collaborate and show that school mental health works. This series is a product of the Coalition for Expanding School-Based Mental Health in Wisconsin, a statewide coalition with a mission to advance and support expanded
00:00:39
Speaker
comprehensive and integrative mental health services within the school setting through school, home and community partnerships.
Introducing Guests and Roles
00:01:06
Speaker
My name is Julie Hiller. I'm the manager of the Racine Collaborative for Children's Mental Health, and I'm also the chair of the board for the Coalition for Expanding School Mental Health in Wisconsin. And today I am honored to have with me Kristin Getchow, a director of mental health for Madison Metropolitan School District, and Scott Racke, chief clinical officer with Catala Health headquartered in Appleton.
00:01:30
Speaker
So thank you both for being here with me today to share your perspective on how different communities across the state are blending and braiding funding to support mental health services and supports for your students.
00:01:43
Speaker
I'm really looking forward to our conversation to really ground our understanding of where things stand today and where we hope we are headed to advance sustainable funding in the future. And I think when we talk about funding, this is a hot topic across the state. A lot of school districts are still trying to figure this out with our community mental health partner. So I think having both the perspective of a community mental health partner and a school district person in the room today is gonna bring a really robust conversation.
00:02:12
Speaker
Let's just start off like doing some brief introductions. Can you just tell me a little bit more about yourself and your brief history of your program and services in support of student mental
History and Expansion of Mental Health Programs
00:02:24
Speaker
health? And Christian, I'm gonna start with you.
00:02:27
Speaker
Thanks, Julie. Thanks for having me today. And I also agree, I'm thrilled to be here with Scott as we have to have our agency partners along with school districts in this conversation. So as you mentioned, my current position is that I'm the director of mental health for Madison Metropolitan School District. I've served over before in this position, I served over 20 years as a school psychologist in MMSD.
00:02:51
Speaker
As far as a brief history of our program, it's hard to know where to start to highlight a few things. MMSD really has a long history of partnering with community agencies for expanded school-based mental health services. A few examples, back when I was starting as a school psychologist, so almost 20 years ago, we started working with community partners to screen our students for trauma.
00:03:17
Speaker
and trauma exposure and symptoms and then really worked to bring in community therapists to support evidence-based interventions through our CBITS program to support all of our sixth graders. So that's been a long time in the making of long-term partners and that's still going strong today.
00:03:37
Speaker
A few other examples, we're in our eighth year of sometimes what you think of a more traditional school-based mental health service. So that's our BHS or Behavioral Health in Schools program. We also partner there with local community agencies to provide at least a baseline of a halftime school therapist in 16 of our elementary and middle middle schools.
00:04:01
Speaker
And then lastly, we've been expanding that model most recently into our high schools, we're looking to build more of a school based health center model in our four comprehensive high schools and expanding beyond. And that would also include behavioral health therapists. So lots of different streams of types of supports and partnerships, but all about in the interest of providing services and well being for all of our students.
00:04:29
Speaker
Well, that is going to be a great conversation, and we're going to dive deeper into some of the work that's being done. But Scott, can you just take a few minutes to introduce yourself?
Challenges in Mental Health Funding
00:04:39
Speaker
Absolutely, Julie, and thanks for the opportunity to talk today. My name is Scott Radke, and I'm the chief clinical officer at Catelpa Health. Catelpa is a pediatric mental health agency headquartered in the Fox Valley.
00:04:54
Speaker
in Northeastern Wisconsin, typically seeing kids ages two to 18. We're a one of a kind organization as we receive support from three different health systems. Ascension Wisconsin, ThetaCare, and Children's Wisconsin. Catelpa typically serves around 8,000 or 8,500 families every year.
00:05:20
Speaker
for services that include psychiatry, such as medication management, psychological and neuropsychological testing, as well as therapy services, including in our clinics in Appleton, Waupaca, and Oshkosh, as well as over 40 schools within the Fox Valley region. We've been open for 10 years now.
00:05:46
Speaker
And soon after opening, we started getting into school-based mental health services. At the height of our involvement, we were in over 50 schools, but that has come down some, largely due to what we're talking about today, which is some of the challenges in finding funding to support these collaborations on an ongoing basis.
00:06:09
Speaker
Awesome. And I'm looking forward from a community mental health partner to really talk about your perspective in the funding world and kind of where do we go from here. So having both of you with your expertise today is going to be a great conversation. So to kick things off.
00:06:25
Speaker
more about how you see the comprehensive school mental health model being implemented. And I'm gonna say, Kristin, your school district, and then for you, Scott, I'm gonna go in your region, but also within schools. So Kristin, let's just start with you on that, comprehensive school mental health systems.
00:06:42
Speaker
You know, it's interesting when Scott was talking about what was and what is now, as I was reflecting on this, I think it's very interesting to think about what our recent history is, right? I mean, we are coming from a position currently within MMSD to really work to rebuild our strong foundation for mental health programming post COVID.
00:07:01
Speaker
We know we spent a lot of time the last few years really pivoting to manage our day-to-day operations in schools and it took tons of creative thinking to just keep programs alive during times of remote learning and then upon returning to school.
00:07:17
Speaker
You know, some people are feeling like COVID is over, but I have to tell you, schools are still rebuilding to figure out getting back into school full time and really managing some major issues like staffing shortages, both at the school district and at the community partner levels. So there's a lot that we're talking about with funding today, but there's also sort of a very unique landscape that we're having this conversation in today.
00:07:45
Speaker
When you say sort of what's the landscape looking like right now, I really see MMSD and surrounding districts trying to expand programming. We are in a really unique time where we're having a national conversation about mental health challenges.
00:08:02
Speaker
which is amazing. And there's been some short-term funding available, which is also amazing, but also very hard to build a sustainable long-term model based on short-term infusion of money. So the grateful for the ongoing conversation and the recognition of the significant needs that are out there and working to figure out how to use that kind of
00:08:30
Speaker
amplified attention, both with conversation and money to build really something that we can build on for the long-term sustainable future.
Support for Families and Community Involvement
00:08:40
Speaker
And also just recognizing those current conditions of staffing challenges and things like that, that those are also real.
00:08:48
Speaker
You know, a few things that we can talk about about like what when I talk about building our foundation. That was some of the examples that I gave already about making sure that we've got screening programs available. We do have screening programs available currently at around the third, sixth and ninth grade. So that we make sure we're doing a point of touching base with our students on a regular cadence within our schools.
00:09:13
Speaker
We really also are working hard to create stable people. You need people to do in schools to do all of these things, right? So how are we making sure that we're hiring the right folks, keeping any leaves filled, right? We can have all great partnerships, but if we don't have the staffing to fulfill those on either side of the aisle between schools or community,
00:09:40
Speaker
doesn't really help to have shiny programs that no one is implementing. And we also, you know, a few of the other things that we're really doing is thinking about what does it mean to access programs. So some of those programs are housed in our school, but we've also most recently been working on hiring mental health navigator. In our case, we were able to hire a bilingual mental health navigator.
00:10:02
Speaker
to support families in accessing programs both in schools and out in the community, as we just know what a complex system it is for anyone to navigate any of those systems and to just allow a little bit more support than what our day-to-day school staff can do sometimes in a more sort of intensive, targeted way.
00:10:23
Speaker
There's so much more to say, but I think I will just say that with all of this, it's taken district level support as well, right? So my role has really changed over the last few years to manage the changes in the budget landscape, to manage the complexities in our partnerships, and just to make sure that we have those implementation resources in place so that what we're doing is high quality and that schools and
00:10:52
Speaker
families can rely on them to be here now and into the future. So Kristen, just as a recap, as I'm listening to this conversation around building your comprehensive mental health system, really starting with that platform and really looking at screening.
00:11:09
Speaker
And it sounded like you guys really started at a screening tool process. As you begin to understand the needs of your students, then you're able to kind of grow your comprehensive mental health system. And I also like how you are tying different aspects of a comprehensive mental health system together. And even including that initial conversation, you kind of blew by it, but I do want to talk just a minute
00:11:34
Speaker
about that kind of role of a behavioral health navigator, and the importance of how you help support families. And can you tell me a little bit just a little bit why we landed on a bilingual? I love that. Tell me more about that.
00:11:50
Speaker
Yeah, we really, when we looked at what services that we were able to provide to our students and families and where some of the gaps were, we really realized that just a conversation about accessing services both in our schools and outside of our schools was important.
00:12:05
Speaker
We've heard from our students and our families this year that they weren't, actually in recent years, but this year in particular, that they really weren't certain about what some of our programs were or how they could access them. And we know that's true both internally in our schools as well as externally. So some of it was that we had a bit of a PR problem ourselves about letting people know
00:12:28
Speaker
I also think there was so much information coming to people all during COVID that whatever was out there, if people are anything like me, that it went in one ear and out the other. So sometimes what was told once maybe needed to be told twice or three or five or 10 times. So that's part of what we're really realizing is that we need to do a better job of promoting all the great work we're doing and making sure people can access it.
00:12:52
Speaker
And within that point of access, we know that language can be a barrier. So we really needed to make sure that we had accessible, culturally relevant, language accessible services for our families. And some of that we can do sort of school by school, but that was a nice place of efficiency was to move that position district-wide and make sure that we can support our great school teams who are doing this work to have one more layer of support and access for all of our families.
00:13:22
Speaker
Great. And then Scott, I want to turn it over to you because you bring a great and an interesting perspective on Appleton area, what they have really done to help support a comprehensive mental health system, you know, as a community mental health provider, being that expert coming to help school districts. So I really want to hear from the provider side about your journey.
00:13:44
Speaker
Yeah, I thought I'd start with just talking about the need in general and bringing it back to when we started as an organization. One of the original arguments for Catelpa came about after a community life study was done, which showed that one in four kids in the Fox Valley felt sad or hopeless nearly every day for a two-week period of time.
00:14:10
Speaker
If I, you know, upon preparing for today, I was reviewing the Wisconsin Office of Children's Mental Health annual report, which showed that anxiety, depression, and suicide are up again with the percent of students feeling sad and hopeless almost every day jumping to nearly 34%. So in a 10-year period, you know, we've gone from one in four to one in three.
00:14:35
Speaker
So we should start by talking about like the demand continues to go up. And I think we need to consider that the way we deliver services needs to change as well. Like we can't just rely on people coming to us in our brick and mortar buildings.
00:14:54
Speaker
Now, one of the benefits of the pandemic, if we can talk about benefits of the pandemic has been telehealth services and our ability to do remote care where families can be at home, what's convenient for them and our providers can be in their offices or be at home, creating better access. But still, there are many families that struggle to get to appointments and that may be due to unreliable transportation,
00:15:22
Speaker
or work responsibilities or other barriers that we need to continue to evolve and have it evolve to meeting kids where they're at. Why we partner with schools is for a couple of reasons. One, kids are with their teachers and staff for more hours per day than they are with their parents during the week.
00:15:43
Speaker
Teachers are child development experts and can give key signs for us and their great partners to work with when they're seeing difficulties. And it gives us the opportunity to collaborate with them on how these kids are doing. Because hopefully, if we are addressing the mental health issues of kids, they're also doing better in school.
00:16:07
Speaker
So it's a key partnership and we really value that and the opportunities that we can provide services in those spaces with them as partners. I want to take a couple minutes to talk about Catelpa's involvement and how we started.
00:16:28
Speaker
It was the United Way Fox Cities was the first organization that stepped up for us in creating what's called the PATH program, which stands for Providing Access to Healing. PATH was started as a pilot project in the Menasha Joint School District, offering services to elementary, middle school, and high school students experiencing barriers to care.
00:16:50
Speaker
In 2011, that was expanded to nine other school districts, and Catelpa at that point became involved in providing those services and continues today. So we are in the majority of the schools in Outagamie County providing those same mental health services and working alongside our educational partners in that way.
Evolution and Management of Funding Sources
00:17:13
Speaker
But in addition to that, school districts have had to be creative at creating these opportunities alone, especially those school districts that don't have a PATH program to rely on. So certainly looking to community resources such as community foundations and other private groups as well. And at times, once those dollars run out, they have to figure out how they can work the costs of those services into their budgets.
00:17:41
Speaker
or seek funding in other places. So the Oshkosh School District is a key partner for us. So they've been successful at finding resources to be able to continue our partnership year after year. But it is a challenge for those school districts to continue to source those dollars to make programs like this successful.
00:18:06
Speaker
The demand is there, certainly. That's without question, but there is a cost to providing these services in this way and meeting kids where they are at.
00:18:15
Speaker
Great. Awesome. And a lot of great work coming out of the Appleton-Fox Valley area around student mental health and a lot to learn. So I really appreciate you bringing your expertise today on the funding side. So Kristen, back to you. Because you have a journey. I'm going to say you're what? You're eight into the journey. So I don't want to make people who are just starting this work going, oh my goodness, this is a lot.
00:18:43
Speaker
Let's just take a few minutes and really talk about that funding piece, about how you have been able to build a comprehensive mental health system using a variety of different funding resources. It really kind of get into kind of the meat and potatoes, how you started and how did you grow to where you are today and what does that funding underneath that look like?
00:19:07
Speaker
Yeah, when I've been thinking about funding and talking with people about funding in the last few years, one of the things that I really bring to the front of this is that when I first started doing this work and this position like five years ago, I was managing two funding sources.
00:19:24
Speaker
There was a grant and there was our local school district funding. My last count was 11 and I think we're in the process of writing three grants as we speak. Some of those are probably already in that 11 because they're kind of ongoing grants. But it really is a significant amount of my time right now as a district of really working to
00:19:50
Speaker
You know, manage all of those funding sources. They all have different time frames. They all have different restrictions on spending. They all have different reporting criteria. And that's just on the school side. We know our partners also are coming in with a whole blend of funding options themselves with their own grants.
00:20:08
Speaker
you know, billing insurance and things like that. And with each of our community partners, it's a little bit of a different blend, right? So some of it is a 100% school-based local budget. Some of them is that is 100% paid for with the community partner because they have a grant that's paying it and they said, you know, hey, we'd love to come into your school and provide X, Y, or Z. And then we have a conversation and
00:20:34
Speaker
and create an agreement about that. And then there's all kinds of blended models of some funding that comes from the school district in multiple, like either local funds, grants,
00:20:50
Speaker
you know, grants that we've applied for, just donations, right? And some of our partnerships in a really short amount of time change pretty quickly, right? Like long standing funding from some community agencies that supported countywide programs that have changed. And so now each school district is trying to like create funding for this long-term program that we had relied on before in ways that were paid for by our community partners. So I think that
00:21:20
Speaker
I spend a lot of time rearranging puzzle pieces to try to just keep that foundation as solid as possible. Sometimes this funding comes in with a very specific program or add
00:21:38
Speaker
this is sort of the program of the day and I've been you know longer I do this work I realize that that is not always helpful. I always say like more is not always more right if we're creating more silos or adding on programs that schools aren't ready for or take away from the tension of some of our other foundational practices we really have to do some deep thinking about what expansion can and should look like.
00:22:02
Speaker
And, you know, also just a lot of creative thinking. I have the mental health navigator that we were talking about before, Julie. She's been in this position since last January, and I think we're on her fourth or fifth budget source to keep her funding going. And she's just key to supporting our families that need access to care.
00:22:25
Speaker
you know, for many reasons. So I think that it really is taking a lot of time and attention to manage really complex and increasingly complex financial puzzle. We spend, and then with each of those
00:22:40
Speaker
different packages, right? Then we're also working with our community partners to just spend the time. It's a lot of just face to face time of meeting and talking and creating MOUs or MOAs to make sure that we're clear about where funding is coming from, what are the services that are available, what it takes
00:23:00
Speaker
you know, for a community agency to come in, in a way that we feel the robustness of that service, right? So that we're really implementing it in a strong way. You know, it's not, it's, for me, it's like, it's one thing to manage the money that's coming in, but I want to do it in a way that's like creating really high quality programming and supports for our students, right? So that takes time and attention. You know, both on the funding side, but also making sure that we're creating really strong implementation practices.
00:23:29
Speaker
that are going to last us a while. And I also hear, and I want to just call this out, a pivotal piece for me is around sustainable funding. But what I also see in our conversation, Kristen, is that you're the person kind of managing all those pieces. Like there is a point person at a school district. And what I have found that that works a lot better when there is one person who is able to
00:23:56
Speaker
kind of look at here is the grant landscape and these are all the grants we need to write for and starts writing for those grants and then managing those pieces and having the time and not an add-on position like you're going to do this on top of your regular duties. And so I really wanted to call that piece out for our listeners so that they can start to think about how does that work with
00:24:17
Speaker
within their school district, because I think that also has leveraged, I can balance 11 different grants and kind of know what each grant is requiring of me. And I also, I think also a good piece that you talked about.
00:24:30
Speaker
is that bucketing approach of, you know, I have my community funding sources, I have a school district that's putting funding into this, as well as looking at what our state, maybe federal grants as well as, and I love that donation piece, you know, families feeling passionate about student mental health and donating to those programs. And so,
00:24:50
Speaker
Awesome job you guys are doing in Madison. And I think balancing a lot of balls all at once to make it happen and you're making it happen. So thank you for sharing that perspective. And Scott, I want to give you a minute here too, because I think you bring in a great perspective, one that I'm always in a bit of a conversation with my mental health partners on as well.
00:25:14
Speaker
As you know, you come into the school, you really are our community partner. You're our mental health expert. We really look at our, you know, our partners and to come in and kind of helping set up that comprehensive mental health system. You know, even working on, like you talked about, that one-to-one, doing some group interventions. We'd love to hear from you how you're able to work on going from the mental health provider perspective.
Challenges for School-Based Mental Health Providers
00:25:38
Speaker
coming into the school setting and talking about your experience and making sure that first of all that you come into the school building they're ready for a community mental health provider to be in their building and also looking at I'm going to talk from a mental health provider
00:25:56
Speaker
having enough students or what I would call a volume of kids that need to be seen during the course when that therapist is there. So I want to talk more about that from your perspective just the challenges and successes that you've seen coming into from a traditional clinic setting to a school-based mental health setting. Yeah so absolutely I think it's a great question. You know so I do want to step back and talk about how
00:26:22
Speaker
It really takes the blend of the work that Kristin is doing in finding those funding sources and also pairing that with what we as providers are able to build for services, right? So the math needs to work together to have this work out, right? So in the 40 plus schools that we are in, we actually license
00:26:46
Speaker
the locations in those schools as mental health clinics, the same as as our main campus here in Appleton. So that allows us to bill out for those services. Now, when schools come to us and say, hey, we really would love to partner with you coming into our district or if we're already in a district about expanding, you know, it's a real deep conversation about how much demand there is.
00:27:14
Speaker
you know, certainly from a school's perspective, they see kids with needs and they don't want to see kids waiting for those services. So having a provider in the building to be able to see those kids is really beneficial for the school, for the families, for the kids themselves. But there really needs to be enough volume to keep that provider full
00:27:38
Speaker
for that period of time, and most of our work is coming into a school like, let's say, one day per week for the entire school year. If the school is not able to keep that provider full throughout the year, then it turns that formula a bit upside down, and we really rely on needing to keep that provider full.
00:28:05
Speaker
to be able to offset those costs. So it is a dance and really important to kind of collaborate with the Christens in all of the districts that we have to make sure we're identifying kids, we're talking to the families about services, and seeing if they're interested in getting services while they're in school.
00:28:26
Speaker
Certainly, there are some challenges for us as a provider to do this work. Schools are shorter than clinic days, so we wouldn't want to start a kid in a therapy session, let's say after two o'clock. Because the school day is going to end and the kid may have to get on a bus or get on a ride, especially if it's a crisis situation.
00:28:49
Speaker
And there's certainly other logistical things that we need to work through. It is a bit of a puzzle for us to do that work, but we work with the schools to create those
00:29:05
Speaker
You know, to provide that support for those funding applications about kids we serve. We identify symptoms every single visit. We measure that so they can report out that this program works. You know, it works to see kids as soon as there's an identified mental health crisis.
00:29:27
Speaker
whether it is at home or in the school, because the sooner we can apply that treatment, the sooner they can recover, the sooner they can get back to their priority of being a kid.
00:29:37
Speaker
And I like how you put it as a dance, and I absolutely 100% agree it is a dance, because you do have to have enough kids to be seen per day to make it work. And I think balancing both pieces, I think school districts leaning into their community mental health provider to understand what that looks like and what that truly needs to be a sustainable model on the billing side too, is a great conversation. And I'm glad you also called that out.
00:30:07
Speaker
So as we had our conversations today, both of us, you know, it's complicated, right? It's really a difficult maneuvering. But I have two people on our conversation today that really understand the dance. And so really looking at, you know, there are challenges. And this work is I want to validate this work is hard work. This is not simple work. This isn't like, hey, here we are, we can do this really easily. It takes time and attention to do that.
00:30:34
Speaker
So I actually talk a little bit more about sustainability and I always like the concept of, you know, how do we build long term success? So kind of what is our wish list? What's that ideal and how do we get there?
Strategies for Sustainable Funding Models
00:30:46
Speaker
And I'm just going to start with you, Kristin, just on a few thoughts about, you know, what's the ideal and how do we get there?
00:30:53
Speaker
Yeah, my magic wand definitely leads to predictable, stable funding with as few strings attached as possible and as few grant applications as possible. And a crazy amount of time goes into some of this work. And I just truly believe that if this is a universal need, we shouldn't be setting this up as a competition. We really should be finding ways to meet the needs of our students, you know, where they are, as Scott said so beautifully.
00:31:20
Speaker
And I also just think that the other part that happens sometimes is that there'll be funding associated for the stuff, you know, to bring in this program. And we have to make sure that there's funding for the related staffing. And as you were talking about, Julie, sometimes that's staffing in the schools. And of course, that's first and foremost. But it also takes staffing to do implementing at the district level or
00:31:44
Speaker
um you know county level or wherever else you know so we need to tend to an implementation plan um because otherwise just you know sending materials into schools um isn't high quality intervention um and also can contribute to staff burnout as we're trying to just chase the next new shiny thing right without sort of the sufficient people on all levels of implementation um
00:32:08
Speaker
You know, and I just, you know, Scott just said this, I think when we're talking about the dance analogy, right? That strong partnerships take time and attention, right? And we have both, we need that, we talk about braided funding, we need funding on both sides, so that we're all creating stable positions to build this work together. And I think we also think about efficiencies, right? You know, each school
00:32:31
Speaker
can't do this on their own. I mean they can and they try and they do amazing work and it's just not, we're spending a lot of resources kind of recreating the wheel school by school or even school district by school district. I think what are some of those ways that we can build some efficiencies into this model so that you know we have predictable funding in ways that gets as directly to students as possible without all of these other challenges that we've been speaking about so far.
00:33:02
Speaker
Great, yeah, I love that. And I love predictable, stable, and not so much grant writing. I love that. Scott, from your perspective, coming from the mental provider perspective, and I know you bring in the completely different perspective on just what kind of long-term sustainability, how do we get this to work? Yeah, Kristen can pass me the magic wand. I'll offer my thoughts also. I have a couple of them.
00:33:32
Speaker
We really need to really consider reimbursement rates and how, as an industry, we can provide some more fair reimbursement rates for services provided.
00:33:47
Speaker
maybe many on the call or listening to this, but not everyone. They may not understand how healthcare works, that there is a variable cost for services depending on who your insurance payer is. And the example I use is, if you go into a restaurant and two people order the same thing off an entree, one person may pay $20 for that entree and another person pays five.
00:34:15
Speaker
The person that pays five, it still costs the restaurant $20 or whatever it costs to make the entree, but they're getting less for the service. So that's what makes healthcare different or different and challenging for us is, you know, based on that payer mix and the schools we're in, if we get
00:34:39
Speaker
If we're getting reimbursed too many times at $5, you know, then we are looking for more of that funding. So, you know, we'd love to see reimbursement rates change, especially for those insurance payers that pay the least. You know, one of the challenges we're facing right now with the demand for services is not all agencies contract with all insurance companies.
00:35:07
Speaker
So a family, let's say that's on Medicaid, for instance, will have more barriers to finding a provider group to take them and may have to travel farther to have that happen. And that's really not fair to that child. It's not fair to that family. You know, living in Wisconsin my whole life, I want to live in a state where everyone has equal access to care.
00:35:34
Speaker
period. So would love to see that happen. The second wish list I wish I might have is, you know, being able to do more preventative work. You know, when I think about me seeing my primary care doctor every year and how critical that is,
00:35:53
Speaker
for a child or for an adult would, you know, wonder what would that be like if we could provide that for behavioral health services, if Kristin would identify for someone, you know, someone that the family wouldn't have a cost for them to do that. And if we could do more of that preventative work, and sometimes families shy away from seeing a provider because of that cost, and then,
00:36:20
Speaker
you know, those problems grow into more crises. And it's just harder to manage those crises. And, you know, if a crisis has been going on long enough, there's greater impairment. There's impairment in school. There's impairment for the family. So I think we need to really think about that as well. And, you know, I guess finally I wanted to point out that it's important that we understand
00:36:46
Speaker
the value of this preventative work. There is a cost to doing nothing different. I mentioned earlier that in my time, we've seen the rates of depression in kids being reported from one to four go down to one to three. What's the cost to this community if it goes down to one to two? We need to do more to turn the curve with those numbers.
00:37:16
Speaker
because it impacts not only that child, not only the school, but it affects the entire family. It affects every employer because if a parent of a child with a mental health issues has to miss work in order to go to appointments or to keep their child safe at home, that impacts
00:37:38
Speaker
everyone. What would it mean for us as a state to put our foot forward to making this a healthier community for every child and talk about what an investment in programs within schools could mean for kids, for teachers, and for the next generation coming up who will become adults?
00:38:03
Speaker
And I so love that you brought up some excellent points in just looking at that need, access, having equitable access, and really honing in on those reimbursements and what that really needs to look like for a healthcare provider. So as we talk about the dance, the dance is complex. So I want to thank you both for joining me today.
Collaboration and Conclusion
00:38:28
Speaker
We heard a lot about collaboration, which really lies at the center of our funding piece discussion. And this does not work without someone taking the responsibility to get grants. We talked a lot about that. Managing those community relationships in a way that continuously draws in families.
00:38:48
Speaker
our philanthropic funders, local businesses, our state and federal funding resources, you think about grants, our county programs, even our school boards and our local levies and our community mental health providers, plus our public and commercial insurance payers. So you look at the amount of things that
00:39:08
Speaker
We are kind of dancing with right now and bringing those all together to help support meeting the needs of our students in the school setting. So, you know, while our districts are really finding their way to a path to better mental health supports for their students, we know that, you know, sustainability
00:39:27
Speaker
And having a continuous, reliable funding source is going to be very pivotal. So first of all, I want to thank you both for all that one of your guys are doing every day and each day for our students and families and communities in Wisconsin. This has been a great conversation on sustainability of funding. I hope that our listeners have taken away some key points that they can go back to their districts and their community mental health providers to start having those collaborations.
00:39:53
Speaker
And until next time, keep working at School Mental Health because School Mental Health works. Looking forward to future episodes? Make sure to subscribe on the podcast platform of your choice and leave us a rating so that others invested in better mental health for Wisconsin students can find us. We welcome your questions. You can find resources and learn more by checking out today's show notes and by visiting the Coalition's website at schoolmentalhealthwisconsin.org. Until next time,