San Francisco Unified School District and County Office of Education

 Board Policy 5141.51

 Behavioral Health Referrals

This Board Policy applies to the San Francisco Unified School District and the County Office of Education.

This policy outlines referral protocols for addressing pupil behavioral health concerns in grades 7–12. This policy has been developed in consultation with school and community stakeholders and school-linked behavioral health professionals and establishes the adopted procedures relating to referrals to behavioral health professionals and support services. (EC Section 49428.2(b)(1))

Addressing the Needs of High-Risk Groups (EC Section 49428.2(b)(3))

The Governing Board recognizes the importance of ensuring equitable access to behavioral health supports for all students. The Governing Board hereby adopts this policy to address the needs of high-risk pupil groups, which include but are not limited to the following:

• Pupils with disabilities, mental illness, or substance use disorders.
• Foster youth and youth placed in out-of-home settings.
• Homeless youth.
• Pupils experiencing bereavement or loss of a close family member or friend.
• Pupils for whom there is a concern due to behavioral health disorders, including common psychiatric conditions and substance use disorders such as opioid and alcohol abuse.
• Lesbian, gay, bisexual, transgender, or questioning pupils.

The District staff who oversees the mental and behavioral health needs of students is responsible for coordinating implementation of these group-specific referral protocols, in collaboration with the Director of Special Education (IEP/504), Foster Youth Liaison, Homeless Liaison, and Schoolsite administrators.

District leadership may also identify additional pupil groups, such as English Learners or recently immigrated students, if local data or partner input show increased behavioral health risks.

Student Privacy

The District recognizes and agrees to abide by the variety of federal and state student data privacy laws and regulations (including but not limited to the Family Educational Rights and

Privacy Act [FERPA], EC Section 49073, et seq., etc.) with which the District must comply in connection with its policy on referral protocols for addressing pupil behavioral health concerns and in connection with implementation of its policy and protocols, including but not limited to any of subsets of its policy, such as those listed below.

Referral Protocols and Procedures

The Governing Board hereby adopts the following referral protocols and procedures relating to referrals to behavioral health professionals and support services:

Needs Assessment

• The Superintendent or designee shall conduct an annual needs assessment to:
  • Identify behavioral health trends;
  • Review available resources; and
  • Detect service gaps within the school community.

• Each school site shall review referral volume, and outcomes and shall submit findings to the District for continuous improvement.

Capacity Building

• The District shall:
  • Provide professional development on referral pathways and staff roles;
  • Clarify responsibilities among certificated and classified staff; and
  • Maintain partnerships with school-linked behavioral health professionals and community providers

Planning

• The Superintendent or designee shall:
  • Define referral pathways for crisis and non-crisis concerns;
  • Establish goals and assign responsible roles for each step in the referral process; and
  • Enter into memoranda of understanding with external partners, where appropriate, to support referral handoffs and information-sharing.

Implementation

• The District shall establish step-by-step procedures to:
  • Initiate referrals;
  • Document concerns;
  • Notify parents/guardians consistent with law;
  • Triage level of need;
  • Link pupils to appropriate services; and

• • Schedule follow-up checks.

Evaluation and Continuous Improvement

• The District shall conduct an annual evaluation of referral protocols that includes:
  • Data collection and analysis;
  • Input from staff, families, and community stakeholders; and
  • Targeted improvements based on results.

• A summary of results is reported to the Governing Board annually to support transparency and continuous improvement.

Training (EC Section 49428.2(b)(4), (c)-(e))

The District shall ensure that teachers of pupils in grades 7–12 receive training on pupil behavioral health. Training materials approved by the District shall include:

• How to identify appropriate contacts for behavioral health evaluation, services, or both evaluation and services, at both the school site and within the larger community; and
• When and how to refer pupils and their families to those services. Optional elements may also include:
• Recognizing the signs and symptoms of youth behavioral health disorders.

Subject to EC Section 49428.2(d), the District shall certify, on or before July 1, 2029, to the CDE that 100 percent of its certificated employees and 40 percent of its classified employees who have direct contact with pupils in grades 7–12 have received youth behavioral health training at least once, in accordance with EC Section 49428.2(c)(1)–(5).

The District may use the evidence-based and evidence-informed training program(s) identified by CDE as required by EC 49428.15 to meet the training requirements of this policy. The training will provide instruction around the unique risk factors and warning signs of behavioral health problems in adolescents, build understanding of the importance of early intervention, and teach classified and certificated employees how to help an adolescent in crisis or experiencing a behavioral health challenge, including guidance on when to make referrals consistent with this policy.

Authorization and Scope of Practice (EC Section 49428.2(b)(5))

In order to ensure that all school employees act only within the authorization or scope of their credential or license, the District shall: