Board backs pilot for billing mental‑health services under state CYBHI fee schedule

The San Rafael City Schools Board on Nov. 18 heard a presentation from Marin County Office of Education officials about a statewide effort to help schools bill insurance for certain behavioral‑health services and voted to proceed with local pilot steps.

Dr. Lisa Miller, assistant superintendent for Marin County, told trustees the Children and Youth Behavioral Health Initiative, launched by Gov. Gavin Newsom in August 2022, includes a fee‑schedule strategy meant to sustainably fund mental‑health services in schools. "Schools are a place where students can access care," Miller said, summarizing the statewide rationale for the approach.

Scott Ostendorf, project director for health, safety and support, described how the fee schedule works: roughly 50 billing codes cover assessments, psychoeducation, counseling/treatment and case management; the schedule already defines eligible provider types and rates, meaning districts do not need to negotiate fees with insurers. Ostendorf said special‑education services are exempt and continue to be billed through existing Medi‑Cal special‑education pathways.

County staff presented statewide early results and operational details. They said 56 local educational agencies had submitted about $2.25 million in claims as of Nov. 4 and that roughly $2.2 million had been reimbursed, covering services for more than 5,600 students across 33 insurers in the dataset presented. County staff emphasized that implementing the fee schedule requires new workflows—collecting insurance information, obtaining parental consent for billing and training school staff on documentation and privacy rules.

"This is going to be a lot of training for school staff," Ostendorf said, adding that the district is the pilot in Marin County and that initial trainings for counselors begin the day after the board meeting. Presenters also warned trustees that the work crosses FERPA and HIPAA boundaries and will require careful procedures and state/federal approvals.

Trustees asked about operational impacts and communications with families. Trustee Kerner, who moved the motion to accept the presentation and proceed, asked whether the district’s counseling and nursing staff would be eligible to bill; presenters confirmed counselors, psychologists, nurses and licensed therapists can be eligible providers under the fee schedule if they meet the program requirements.

The board approved the motion to proceed with local onboarding (motion moved by Trustee Kerner, seconded and passed by voice vote). District staff and county partners will develop a communication plan for families and begin staff trainings required to submit claims.

What happens next: Marin County Office of Education will support the district as the county billing consortium hub, provide necessary trainings and assist with consent‑and‑billing procedure development. Presenters and trustees noted the approach aims to bring sustainable funding for school wellness positions and services, but implementation timelines will depend on state and federal approvals and the district’s ability to operationalize consent and information collection.