July 1st, 2024

How Cherry Creek Public Schools Builds a Sustainable Funding Pathway for a Comprehensive Mental Health Program

This case study is provided directly from the named school district and may not be applicable to every community’s needs. Examples are provided for educational and informational purposes only and do not necessarily reflect the position of SecondMuse or its partners, The Jed Foundation (JED) and the Meadows Mental Health Policy Institute.”

Challenge

Cherry Creek’s mental health task force identified the need for a comprehensive mental health program that included additional telehealth, in-person clinical staff, and life and character-building skills development to support student success.

Approach

Strongly committed to their students’ health and well-being, Cherry Creek made infrastructure investments to leverage multiple funding sources, including general funds, federal and philanthropic grants, and Medicaid grant (School Health Services).

Results

Cherry Creek used a blended and braided funding strategy to support mental health services. Among other successes, they improved understanding of student support needs, increased engagement with mental health referrals, and drastically decreased suicides.

About Cherry Creek Public Schools

Cherry Creek Public Schools is the third largest school district in Colorado serving 53,000 students and more than 300,000 residents. It serves seven municipalities spanning 108 square miles from the heart of Denver out towards the eastern plains. Cherry Creek is a diverse district, with over half the student population identifying as a person of color and/or Hispanic. Over 150 languages are spoken by students across the district.

The district focuses on five core values for empowering students to succeed and achieve a bright future: growth mindset, equity, relationships, engagement, and whole well-being. To achieve these core values, the district acknowledges and promotes the importance of student, teacher, and staff well-being as fundamental to enabling student success.

Cherry Creek’s Challenge

Even before the Covid-19 pandemic exacerbated mental health challenges, Cherry Creek knew that many of its students struggled with mental health concerns. Viewing mental health as fundamental to student success, district leadership was already committed to amplifying mental health supports throughout the school district. As mental health challenges sharply rose during the pandemic, the district knew they needed to do even more to support the mental health needs of students and staff. In 2022, the district’s Superintendent and Chief Health Officer created a stakeholder task force – made up of students, educators, parents and caregivers, district and campus administrators, and community partners – to determine the mental health priorities for the district. The task force identified two priority needs:

  • Increasing the capacity of staff and community partners to provide mental health services to students
  • Improving prevention strategies to better understand and support students’ emotional well-being and development of life and character-building skills

The district was committed to building a comprehensive, Multi-Tiered System of Support to address these needs.

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Student Challenges
From interactions with and reports from students, parents and caregivers, and educators, the district knew many of its students struggled with mental health challenges. The district’s life skills and emotional well-being surveys showed students were struggling primarily with anxiety, followed by depression and family issues. Most drastically, in one year alone, 10 district students, educators, and staff died by suicide.

The mental health task force highlighted what was already known to many in the school community: there were simply not enough mental health services within or outside of the school district to meet student needs. Therefore, students who sought services either presented at an emergency office or had to wait up to six months to receive care, which affected their academic and personal success. 

Middle and high school students also struggled with a sense of belonging and connectedness. The Chief Health Officer partially attributed this to the fact that these secondary schools were larger, and therefore, it was harder for teachers and administrators to know each student in the school.
Existing Programming

Cherry Creek already used a comprehensive mental health model to help students grow and thrive.

  • Its staffing model consisted of both school-based and district-based mental health staff, including counselors and school psychologists on every campus. The staffing model provided for more mental health professionals at each campus than in typical school health models.
  • It partnered with two community-based health clinics to provide students with mental health services.
  • Beginning in 2021, the district began referring students to I-Matter, a state run and funded program that provides six teletherapy sessions for any youth in the state.
  • It conducted regular school climate surveys to assess areas of need related to well-being, life skills, and character development.
Barriers to Change
  • Most of the school-based counselors were focused on career counseling, while the school psychologists dedicated most of their time to assessing and providing services to students with Individualized Education Program plans (IEPs). Consequently, these professionals did not have the capacity to provide clinical mental health services.
  • Despite partnerships with local community behavioral health clinics, the clinics had very limited capacity and did not fully meet student needs.
  • The district regularly referred students to the state tele-therapy program, I-Matter, but many students were unwilling to use the resource. Students didn’t view the state program as a trusted entity in the same way as a program directly coming from the district.  
  • The district could not use climate surveys to drill down to the campus or classroom level, hindering its ability to understand and effectively address the gaps in life and character development skills.
Opportunities for Change

After identifying the most pressing student needs, the Chief Health Officer worked with the task force to identify strategies to meet these needs. The strategies employed and included the following:

  • Partnering with a telehealth provider, Hazel Health, for mental health services for students in grades 6-12. Services are provided within 24 hours, at no cost to students
  • Hiring clinical and other mental health support staff and increasing salaries to retain staff
  • Building a first-of-its-kind school-based mental health day treatment center to provide intensive mental health services in conjunction with academic needs
  • Implementing a student social emotional survey built in concert with Panorama, to understand student needs (e.g. relationship building, character development, resiliency) and better tailor curricula to address gaps
  • Hiring a coordinator to focus on prevention efforts by providing life and character-building skills curriculum and suicide prevention

Strategic Priority: Sustainably Funding a Comprehensive Mental Health Program

To implement these comprehensive and multi-faceted mental health supports, the district had to think big and be creative about how to fund its mental health programming. Specifically, the district had to secure multiple and sustainable funding streams and braid this funding to support a comprehensive mental health program that can be sustained over time.

Objective 1:

Get community and leadership buy-in to prioritize allocating funding for innovative mental health strategies

Why:

The major investment of time and resources needed to support the district’s mental health programming required the full support and buy-in of district leadership and the broader school community, especially since funding had to be revisioned.

What it Took: 

  • The superintendent believed that to achieve the school’s mission of each student finding a pathway to a fulfilling future, (their “Pathway of Purpose”), students must first have their fundamental needs met, including mental health. This ethos acted as a north star.
  • The district assessed student needs and mapped existing resources in the district and community. The mental health task force, discussed above, was key to this process.
  • The Chief Health Officer collected qualitative and quantitative data to make her case to district leadership. Throughout this process, she engaged the chief financial officer, who was instrumental in reallocating funds in the budget to enable expanded mental health programming.

Objective 2:

Invest in infrastructure needed to finance health programs sustainably.

Why:

Colorado has a very low per-pupil funding ratio, creating funding constraints. A limited number of funding streams are dedicated to mental health in schools. To build sustainable mental health supports, Cherry Creek knew that it could not rely on short term funding, such as Elementary and Secondary School Emergency Relief (ESSER), American Rescue Plan Act (ARPA) or other grants. Thus, it would need to invest in its infrastructure and partnerships to support programming sustainability.

What it Took: 

  • In 2021, the district combined its physical and mental health services divisions to create the Office of Student Health, which focuses on supporting students and educators’ mental, physical, emotional, and social needs. Combining health and mental health under one umbrella not only helped them better serve students, but facilitated grant applications, collaboration, and pooled funding.
  • Cherry Creek enrolled in the Medicaid School Health Services program to recoup funds for Medicaid-covered services delivered in the school setting. It invested in hiring a couple of administrative staff members to do the work required to realize the full extent of this reimbursement. While this required initial investment, the funds generated through Medicaid cover administrative staff time while also providing a more sustainable funding source for mental health supports.
  • The district built up their grant team from one person to three people so they could increase their capacity to apply for grants.
  • The district used a Request for Proposal (RFP) process that included a team of eight to nine district staff who made sure the companies chosen could provide customizable services that fit with the district’s culture and that each company chosen was well-established and sustainable. Additionally, district administrators negotiated contracts to make sure that they met their students' needs and fit within their budget.

Objective 3:

Blend and braid funding together to sustain a comprehensive mental health program

Why:

By putting the infrastructure into place to blend and braid multiple funding sources, the district was able to pay for its priority initiatives, including Hazel Health and Panorama.

What it Took: 

Cherry Creek pulled together a number of funding sources to support its mental health programming. Some of these included:

  • Reallocation of existing funding streams to prioritize mental health initiatives. For instance, the district focused more on mental health during the pandemic when youth nationwide were experiencing heightened mental health concerns. The district aligned various funding sources for prevention and mental health purposes that were previously allocated to other programs.
  • Cherry Creek’s participation in the Medicaid School Health Services program allowed it to claim for Medicaid-covered services it was already providing and created a new and sustainable funding stream that enabled them to contract with Hazel Health.
  • The district was successful in obtaining various federal, state, and philanthropic grants to support specific components of its mental health programming. For example, they received a federal grant to hire substance use counselors for each middle school.
  • The district used money from a bond measure approved by voters in 2020 to build a school-based day treatment center, Traverse Academy. This first-in-the-nation treatment center was also enabled by the vision of the district Board of Education and staff leaders in partnership with the University of Colorado Psychiatry Department and Children’s Hospital.
  • Supported largely through community donations, The Cherry Creek Schools Foundation established the Cherry Creek Schools Mental Health Relief Fund which provided funds for mental health services and directly assisted students and families accessing these services.

District and Student Outcomes

From the school year 2020-2021 to 2023-2024, the number of students and staff that died by suicide was reduced from ten to zero.  
Telehealth referrals with Hazel Health, the digital counseling product the district partnered with, doubled from the first to the second year. 
By hiring two additional staff to support Medicaid recoupment, the district tripled its compliance with the state Medicaid program and increased its reimbursement.

Key takeaways and learnings

Insight #1

Upfront investment can yield long-term gain

In the short term, Cherry Creek strategically decided to spend money to implement a variety of mental health strategies knowing that the long-term gain was healthy, successful students.
Insight #2

Don’t overlook Medicaid as a funding source

Districts might be missing out on sustainable funding for school health services because they are not seeking Medicaid reimbursement for services they already deliver. Cherry Creek learned that hiring dedicated administrative staff paid for itself when the district was able to maximize its Medicaid reimbursement. 
Insight #3

Invest time in negotiating your contracts

Negotiating contracts with companies, such as Hazel and Panorama, takes time and effort. It is important to keep in mind and advocate for your district’s interests when negotiating with a company to deliver services to your students and staff.

Next Steps for the District

Cherry Creek is scaling implementation of Panorama and will roll it out to the entire district in the next school year to demonstrate to stakeholders the benefits of checking in with students to see how they’re feeling. The district will also leverage data from Panorama to identify student and school needs, and target program supports where needed.

Conclusion

With strong support from district leadership and the school community at large, Cherry Creek Schools funded a multi-faceted mental health strategy. They did this by making long-term investments and blending and braiding their funding streams to support health services.