Sharing Jurupa Unified School District's Health Services Journey

Hector Murrieta, principal of Sierra High School, hosts the School Health Connection podcast, featuring Jose Campos, Director of Parent Involvement and Community Outreach at Jurupa Unified School District in Riverside County. Campos discusses the district's expansion of school-based mental health services and leveraging the new Children and Youth Behavioral Health Initiative (CYBHI) fee schedule.

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Transcript

School Health Conn - 20250922

[00:00:00] Hector Murrieta: Hello and welcome to episode five of the School Health Connection Podcast. My name is Hector Murrieta and I am your host. I'm also the proud principal of Sierra High School in the San Bernardino City Unified School District. A deep and heartfelt thank you to the California School-Based Health Alliance and the San Bernardino County Superintendent of Schools for making this podcast possible.

Our Inland Empire School-Based Health Centers Coalition has nearly 300 members. The purpose of the Inland Empire School-Based Health Centers Coalition is to expand and support the San Bernardino school-based Health Center movement and to facilitate greater engagement, investment, and proliferation of school health services, all of which equate to greater access for youth.

In brainstorming topics for this year's slate of episodes, our group wanted to profile a school district currently [00:01:00] leveraging the new fee schedule to strengthen school-based mental health services. One of our own counselors and coalition members, Yesenia Sebas, told me about some incredible work happen at happening at Jurupa Unified School District, and that's how today's guest came to join us.

Jose Campos is here to talk to us about how Jurupa Unified School District is building capacity, expanding services, and making the most of the new funding landscape. Jose is the Director of Parent Involvement and Community Outreach at Jurupa Unified. Jose, welcome to the School Health Connection Podcast.

[00:01:35] Jose Campos: Thank you so very much, Hector. A pleasure to be here today.

[00:01:38] Hector Murrieta: Wonderful. Thank you. Hey, so to help get us started. Just share a little bit about your role at Jurupa Unified School District and the work you've been doing around school-based mental health.

[00:01:49] Jose Campos: Well, as my title suggests, uh, director of Parent Involvement and Community Outreach.

So really two distinguished roles, uh, parent involvement, really working with parents, [00:02:00] empowering parents, and focusing on parent engagement. And then the other aspect of it, the community outreach, bringing in service providers, expanding services and access to services in Jurupa. I started this role, I was the first director for this department at 11 years ago.

Uh, so this is year 11 for all of us. And at that time we, we set out to do exactly as I suggested, you know, really engage parents and bring in and maximize services in our community and Jurupa. And in many communities there's something that is called pent up need, where there really are not a lot of service providers or services, and the need just becomes pent up.

I make an analogy is once you start with services and you turn on the spigot, uh, you can't turn it off, uh, because the demand is there and then they start with the demand. So we launched, um, 11 years ago. Uh, we started with engaging parents, identifying needs, and the most common need from [00:03:00] parents, staff, students, community members was mental health services.

Uh, we were a desert for services. It was hard to get folks connected. Back in that time, um, our most vulnerable students, those that are on Medi-Cal, were ones that had the least access to services. So we focused, and we started years ago, uh, with graduate level interns, bringing in graduate level interns, having external field supervision, and really working with interns to support students, um, at school sites.

We started with a few pilot school sites. We worked with County Behavioral Health to look at how we can expand services. We expanded providers, so we added providers. We were very instrumental in increasing contract amounts for providers, and this again, dates back to about nine years ago. We turned on that water spigot.

The need was there and the demands were growing. We created a [00:04:00] universal, uh, referral system, coordinated and worked with every provider available. And no one could meet the need as we continue to evolve and learn. Uh, we became our own contract provider in 2020, uh, with county, uh, behavioral health, so that's Riverside County University Health System, behavior health.

And in 2020 we became a contract provider. And we all know what happened in 2020. Uh, schools were shut down with the pandemic, and that was our launch. We had two clinicians and we leveraged everything with other grants, other programs, other supports. Uh, so at that time, everything was developed and built off of leveraging and braiding funding that we had, and with two behavioral health therapists, fast Forward schools reopen.

Uh, we have pandemic relief funds, esser funds, and many districts utilize those funds to increase behavioral health services. So we were no different in doing so. [00:05:00] The only difference is that in Jurupa Unified School District, with that leveraging of those onetime esser funds, we built and expanded our contract from what it was back then.

You start that first year at a hundred thousand to our contract is now 3.8 million for specialty. So fast forward to where we're at with school-based mental health. Uh, we have, uh, lots of grants and supports that have allowed us to. Extend our, our services, but more so to really look at how we can embed.

So we started establishing wellness centers, building net wellness centers in our secondary sites. We had school-based mental health dollars and partnership with Riverside County Office of Ed, and we had community schools dollars. We were part of cohort one. And in leveraging funds we were building out wellness centers at all of our comprehensive middle and high schools.

At this moment, uh, we have the top five of our six. And then are working on building out our sixth [00:06:00] wellness center. So every year we keep learning and evolving and building that base of school-based mental health.

[00:06:06] Hector Murrieta: That's awesome. Yeah. You answered a question that I was thinking of asking, but you've answered it.

So, you know, you now have them at, at five of your six, uh, uh, secondary sites, right? The wellness centers. Yeah. I was gonna, uh, you've probably, you can probably relate to this, that when, when the services aren't at the site. We tell students or parents, oh yeah, go over there to receive the services. You know, we lose, we lose them.

You know, they either don't go, or for whatever reason they don't get the service. So yeah, we learned that lesson at Sierra high school that you need to offer it, you know, on site. So, congratulations. That's,

[00:06:42] Jose Campos: Thank you.

[00:06:42] Hector Murrieta: That's very comprehensive. And I'm sure others, uh, might share this. I'm not too familiar with the C-Y-B-H-I, the fee schedule, and how to get it going? I mean, how did you guys do that? I mean, walk us through that.

[00:06:57] Jose Campos: So the Children Youth Behavioral Health Initiative, uh, [00:07:00] C-Y-B-H-I, it launched to support school districts in being reimbursed for services they already provide first and foremost. Uh, secondly, it's established to hold our commercial insurance and managed care plans, um, accountable for reimbursing for services they're already accountable for.

So they're already charged to providing these services. We all know that as, as you stated, it needs to happen in the school site where folks are present and available. When we look at doing mental health services, we talk about no adverse effects. While when we're only offering offsite, we're having to check the student out, miss more school, increase their anxiety, 'cause now they're having to drive to the clinic and they've now missed not just a period, but half a day of school.

Think about the adverse effects. Think of where students and families are available schools. Um, and so for years, research has said this is where services need to happen. You know, back prior we had frameworks such as coordinated school health, which [00:08:00] then, you know, became known as wisc, the whole school, whole childhood community model.

Now we know 'em as community schools frameworks. So the framework has always been there. To embed services and for services to be at the school sites. So C-Y-B-H-I just helps us realize that with behavioral health, so going back to start where we're at, we were already providing services. If they were County Medi-Cal, we were able to bill our specialty mental health.

However, if they were commercial insurance or out of county Medi-Cal, we provided the service at no cost. So last year as part of cohort one, we started collecting all the insurance information for our. Commercial Anthem, uh, blue Cross Kaiser, and we're ready to start billing as soon as the fee schedule was ready.

So we started in January of 2024. As of July, we're able to get reimbursed for those services. We started where we were, we were already providing treatment services. Now. With wellness coaches, those grants came out that was still [00:09:00] evolving. What were the codes for billing? What were the services between, um, H Chi and California Department of Healthcare Services?

Uh, so we applied and we're one of three applicants in the county Riverside, to receive the Wellness Coach Grant so that we can certify existing staff into that role and expand their capacities. Likewise, on that fee schedule, there's psychoeducation. Psycho education is coming and we're presenting to the entire class or a group skill sets, uh, coping skills, uh, supports.

We often had requests to provide such presentations, but because we're self-sustaining, meaning if we're not providing a reimbursable services, I can't pay for the staff. So we oftentimes shied away from those psychoeducation presentations because in the past, there was no reimbursement that would be time away from direct service to students.

Now this opens up the door to where we're providing psychoeducation. So for example, by [00:10:00] law we have to provide suicide prevention, uh, workshops to students. So as we launch that, we are now able to document that and receive some reimbursements for that time that it took our staff to do that. And now we're able to open up the door to the school sites as to what psychoeducation, what presentations, how can we support.

Based on what's taking place in the classroom, at the school site, in the community to really support the, the, the school and the school community as a whole. That supports us this year. Moving to the next step, psychoeducation, where it's always happened, we were just limited. Now we can increase the availability.

Two with wellness coaches, we provided preventative service student check-ins at the wellness centers. We have students checking in. They were never reimbursable services, so we had to really leverage how we do it, how many hours the wellness center was open for check-ins because again, we're leveraging against our sustainability of [00:11:00] we, we have that business model of this is how many services we have to provide for reimbursement.

Now that's opened that up where that is now also reimbursable. So our check-ins, uh, so our wellness coaches can support with student check-ins, they can support with certain screenings, um, under a licensed, uh, clinician. And we've had a program, a mentoring program where we're taking our at-risk students and we have been providing skill-based supports for the semester to really look at addressing those barriers to success.

Now we're able to increase that, so in the past, we limited that program to our interns because we received no reimbursement. Now, as we're bringing on wellness coaches that we're expanding that program so that. This year, our goal is to serve 300 students under our mentoring program, providing those skill-based services through our wellness coaches.

[00:11:51] Hector Murrieta: Fascinating. I'm, I'm gonna get to wellness coaches, I promise, because, uh, uh, also we're also intrigued by that. Yeah, I know. I can certainly understand. [00:12:00] Uh, you know, how the whole fee schedule works, but from a site perspective or, uh, you know, a principal or a counselor or a teacher somewhere, even a parent that says, well, hey, I want our school to be doing this.

What does it take like on the backend to get all this fee schedule working? So for example, did you have to work with fiscal, did you have to work with HR? How did all that work, you know, to, to get to, you know, to start charging?

[00:12:28] Jose Campos: For us, the infrastructure was there for somebody starting, they have to be Medi-Cal certified.

School districts, you're either already providing LEA billing option or you have to become Medicare certified to, to enroll in the fee schedule With the Department of Healthcare Services, there are applications for cohorts. So they take you through an onboarding process. Um, so the players, if you will, or Department of Healthcare Services, and they have a contract provider called the third party administrator, which is Care along Behavioral Health.

Those are the two entities that you engage [00:13:00] with and work with the billing. Um, on the back end, you're either gonna work with a vendor, uh, to support you in doing so, uh, which obviously comes at a cost or you're gonna look at a, uh, doing it yourself or a hybrid of a vendor and yourself. I think the key for us was we already had an electronic health record in place to help us capture services. The difficulty or complexity is this is new, and so as this launch, it's identifying systemic ways for billing the fee schedule. You know, it definitely is a complex system. It's understanding all the requirements, all the systems. However, as indicated, there's an onboarding process to educate, support, and, and navigate. This is truly where education and healthcare merge.

And so there has to be a full understanding and, and what I like to share with folks that, if not us, then who then who I shared our, our experience, I shared [00:14:00] how we developed and how we evolved. It was because we asked ourselves, if not us, then who, because there was no one there to provide the services and during the pandemic it was less of a question of should school districts be involved in this work?

For many school districts, it was more of a question of. How can we establish systems so that school districts can be involved in this work? Uh, because the need was vast and the resources scarce, it was just not at all available in many locations. So as we ask ourselves that we have to invest the time, the energy to educate ourselves on how to do this, the support is there. We need to allow for the time.

[00:14:42] Hector Murrieta: Right? Get that infrastructure that you talked about and align it. So that, you know, if the services are happening, then, um, like in your case they were already happening. Yeah. How you could, uh, you know, rightfully bill for them and, and, and expand these services. Uh, especially in these [00:15:00] times when, uh, at the time of this recording, you know, there's, uh, you know, a lot of talk of, of cuts here and there and districts are, are looking to, to do that.

So that would, that would benefit all of us.

[00:15:11] Jose Campos: You know, as you talk about cuts, I like to add a point because, uh, on the tip of everybody's tongue is Medi-Cal cuts. How are Medi-Cal cuts impacting services? And so what I'm sharing with folks is, you know, as we look at the restrictions for Medi-Cal now versus documentation status, the fear, um, and whatnot, you know, and now you have to also with the new legislation, the new tax bill.

With Medi-Cal, I believe you have to now reverify twice a year. So undoubtedly we will probably see fewer students qualifying. There'll be an impact. What is that impact gonna be? We don't yet know. However, um, as we talk about Medi-Cal, the ability to Bill [00:16:00] Medi-Cal has not been cut. The ability to access those reimbursements has not been cut.

That is there. And so when we look at the Children Youth Behavioral Health Initiative. We are billing managed care, which is Medi-Cal. Managed care is who, those are the plans that manage that Medi-Cal. So it's not just commercial insurance, it's still Medi-Cal. So we still have that opportunity. And for others that we're billing Medi-Cal, maybe if they're looking that they might lose some revenue because this is a way to offset that because we still have that capacity to do so.

So there, as we talk about cuts, is that we look at cuts. Let's look at opportunities within the systems that have been created to offset potential cuts.

[00:16:40] Hector Murrieta: Sure. Yeah. Fascinating stuff. And speaking of fascinating, some that caught my attention, um, and I'm sure of our listeners is the wellness coach model.

And I know, I mean, you, you just said that that's an i, you know, important piece of yours. You're, you've got, uh, you said 16 certified, uh, wellness coaches. I know, uh, me [00:17:00] personally, I know we took a look into that. You'll see our high school, when I say we, when, when the wellness coach description, uh. A job description came out and it was gonna be approved at the state level.

We took a look at that, but it kind of stayed there. So, um, so tell us, I mean, how, how did you get that piece going with the wellness coach and how does that fit into the, you know, your broader student wellness strategy?

[00:17:26] Jose Campos: So, going back to the fact that we're a specialty mental health provider that comes with certain wraparound types of services, one of those services is out of a behavioral health.

Peer specialist and we call it a TAY partner, transition aged youth. So during eser, during that time, we, we placed a behavioral health peer specialist at every middle and high school. So we already had staff that through the job description and their roles, in essence, were performing all the duties at a wellness coach would be doing.

The only difference is who we billed. [00:18:00] So we have an existing position, have had an existing position. We took those individuals. That met the degree requirements and had them certify as part of our, uh, wellness coach grant as wellness coaches. Um, we then looked, um, we have another contract where we have home visitors.

So we have a home visitation program with, uh, first five of Riverside, a very robust home visitation program. So we took our outreach workers and had them certify as wellness coaches. So when we look at, again, where are we at, we had two job descriptions in place that kind of fit the standard of the role of a wellness coach.

So we didn't necessarily need to create a different job description. So I think that's where we had advantage over the, uh, the role. If we look at the continuum of nonclinical behavior health staff in that continuum, you have now wellness coach, community health worker, and a TAY [00:19:00] specialist. I identify those as roles that fall under behavioral health.

So therefore, our staff that meet the qualifications under the fee schedule, if they have a degree and we're able to certify 'em as a wellness coach, they can bill as a wellness coach. Now, what's developing for school districts under the fee schedule is out of a community health worker. So now, if they don't have a degree, but yet they have the experience, we're looking at them, them having to be able to provide certain services as a community health worker.

In essence, we look at what services we have been providing and, and this Wellness Coach role allows us to bill for the services we couldn't bill for before increasing sustainability increasing. I, I like using the, the word, um, two I's, improve and increase. So we're looking at how are we improving services and how are we increasing services?

Just like C-Y-B-H-I is very complex. Our system is very complex. Um, we have, uh, half a [00:20:00] dozen school districts that come and visit, um, each year. So we had one district last year, Coachella Valley. There were community schools or high school. There were community schools, uh, funded. They came out twice and then used an entire day as a planning day.

Um, we like to call ourselves the teaching district. Because of the complexities. We ensure also that our clinical supervisors, our management level as we built out these wellness centers, that they're staffed at the sites. Um, imagine that centralized support being, uh, at the school sites. So that's one of the things we've been able to expand and, and as folks looking puzzlement and say, Hey, uh, we have expanded over 3000 square feet of services in the last two years.

Um, and that's where I like to share with folks as we look at all of our wellness center, actually not even 3000, I'd say it's closer to 9,000 square feet. Um, so if you look at those expansion pieces, so we are a very complex system, and when folks do come out and visit, we say, Hey, take one [00:21:00] piece, one aspect that you can replicate.

We're here for you. We're here to support, you know, to look at that greater system. But we ask everyone to just look and take one piece. So we invite any, any listeners that, you know, if their school district wants to come out and visit, uh, please do so, uh, reach out and we'll schedule it for you.

[00:21:21] Hector Murrieta: Yeah, and that's definitely the intent, uh, of this podcast. Is, uh, is that so that people, uh, members in the coalition and beyond, they could learn from each other. And in this case, you know, visit. Yeah, because it sounds like. You guys were very intentional and very intelligent about it. So you, you didn't necessarily create positions. You took what you had and, you know, here's this new, uh, description of, of a wellness coach and it fits.

Congratulations on that. So, I mean, and you talked about it being complex, so yeah, I wanted to touch on that. So how, um, how do you manage all that? How, how [00:22:00] does, uh, I mean, I mean, you have your role obviously. You know, you have a lot of touch points for kids at all the different sites, so how is that managed, you know, the day-to-day reality?

How is that, how do you, how do you deal with that? How do you manage that?

[00:22:15] Jose Campos: With that intentionality of care? You know, we talk about intentionality. We, we look at coordination of care, and really what we're here to do is, is to ensure that students are receiving the care. In doing so, we have to be methodical.

Uh, so we don't miss points, uh, because that can be devastating, uh, for, for anyone, right? If somebody indicates that there's a risk and somehow you missed it, and that complexity. So we have to be sure that we have systems in place that we're responsive to risk. Back to the point I made, you know, previously, is to ensure that we have our therapists or clinical supervisors at the site really supporting that was, [00:23:00] uh, very intentional as to, hey, we've now expanded we can now make sure that their officed out of there. Two, as we look at the flow, ensure that we have documentation, case management and documentation for students that need to have check-ins.

We want that documented in our student system. We want that documented in our electronic health record or our tracking system that we have. We within our team, once a week we meet as a management team. I meet with my team and part of that team meeting is we're looking at, okay, let's identify risk factors or students at risk.

Let's look at our system. Is there anybody that got missed it? It takes a lot of diligence because there's a lot of systems in place to be sure no one has missed The O uh, was missed. The other aspect is redundancy. We have systems with redundancy. Um, and the reason we create redundancy is back to we don't wanna miss anything.

We don't wanna miss students at risk. And I, and I'll give an example, we have a referral system. We have an admissions tracker, and then we have a [00:24:00] caseload tracker. We have a lot of tracking systems, um, and all of it is meshed together, uh, into the system. And we also have check-in trackers for students that are checking in.

Students come into the wellness center, they're checking in. So a lot of redundancy to be sure that we're providing the best care and that we don't miss any students. And then coordination and collaboration with our site admin, I mean at the secondary sites with the site counselors as well. Two years ago we launched coordination of service team meetings.

That was actually as part of our community of schools, um, initiative. We launched that at our secondary sites. Um, and again, every year improving and, um, enhancing it. This year we're expanding it to our elementary sites. Uh, 'cause the other part of the complexity is how do you avoid duplication? So we're in an era where depending on where you're at, um, you can have duplication.

Um, in our district, we're in an era where, uh, we have a multitude of service because we're so successful at bringing in [00:25:00] partners. We're so successful, have expanded our services. That we've had some duplication take place. So part of the coordination of service team meeting as we look at that framework to avoid that duplication.

So a lot of moving parts, but they do all synchronize in time, uh, with one another. And again, message to others is it takes time. You know, don't be overwhelmed. Start with something.

[00:25:25] Hector Murrieta: Right. That's wonderful. And, and, uh, speaking of starting. We'll, we'll, we'll end with giving you an opportunity to share, uh, anything else that I may have not covered, you know, any next steps for Jurupa Unified that, you know, you haven't had a chance to discuss, that you're able to, and then we'll get to, um, yeah, that, that piece of a starting.

[00:25:49] Jose Campos: For Jurupa Unified, as I've indicated we're constantly evolving. So you have to take into consideration, uh, political climate, social climate, economic [00:26:00] climate, and you're, you have to be responsive to the needs of the community. Based on the three, the political climate in California, children, youth Behavioral health initiative, op, a lot of opportunity, the political climate nationwide, as we have students with a lot more need and support.

So therefore we have to capitalize on C-Y-B-H-I to be able to provide for students and always having to pivot, always having to evolve when with Jurupa, because it is an ecosystem, right? Uh, the, we've established an ecological system that's very responsive. We can be very responsive where if there are budget cuts at the state level for school districts, our funding doesn't necessarily come, uh, from LCAP or from other funds, we've established the systems where they're sustainable. We're still able to continue to expand and evolve, and I think that's been the beauty of [00:27:00] Jurupa, that we've had that trust and that direction from our leadership to provide those supports that over the last decade, every time, as you talk about cyclical, every time budgets have decreased, we haven't been impacted.

We've been continuously been expanding services. Uh, so I think that's, uh, one of the keys, uh, to note, uh, I hope others can arrive there. Um, it's definitely possible, and I think as lessons learned is Children Youth Behavioral Health Initiative is here. It will continue to be here. Um, again, going back to that initial message, we're holding our commercial insurance and managed care plans accountable for the services.

They're already legally obligated to reimburse for. So the fact that it's here, it's a question of when are you gonna start and when are you gonna bring in resources through the C-Y-B-H-I?

[00:27:58] Hector Murrieta: Well, that's a great, [00:28:00] uh, segue to our, to our ending. We'll, we will leave with that reflection question for our listeners.

And Jose, I want to thank you for taking the time today to come and share your wisdom, your knowledge, your experience. I'm, I'm sure we can keep going. But, um, and to our listeners, I also wanna extend, uh, an immense thank you for joining us and listening. And speaking of, of continuing the conversation, I'll throw in a little plug for our, uh, second annual Inland Empire School Health Symposium that will take place Monday, October 6th.

And as a spoiler alert, you, our listeners will be able to continue the conversation with Jose. He will be one of our presenters. At the symposium, the Inland Empire School-Based Health uh, coalition will put out more information, uh, shortly so you'll be able to view it in the show notes. And until then, we'll see you in the next episode of the School Health [00:29:00] Connection.