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BILL: SB 201 TITLE: Maryland Medical Assistance and Children's Health Insurance Programs - School-Based Behavioral Health Services - Reimbursement DATE: February 7, 2023 POSITION: Support with Amendments COMMITTEE: Finance CONTACT: Mary Pat Fannon, Executive Director, PSSAM The Public School Superintendents’ Association of Maryland (PSSAM), on behalf of all twenty-four local school superintendents, supports Senate Bill 201 with amendments. This bill requires the Maryland Department of Health to apply to the Centers for Medicare and Medicaid Services for a State Plan amendment that authorizes the State to seek reimbursement for medically necessary school-based behavioral health provided to all individuals enrolled in the program, or the Maryland Children's Health Program, without regard to whether the services are provided under an Individualized Education Plan (IEP) or Individualized Family Service Plan. The bill specifies that certain accredited mental health providers working in a school-based setting within their scope of practice may seek the maximum reimbursement for services under federal law. PSSAM applauds the sponsor’s initiative in sponsoring this legislation. For years, the Maryland Department of Health (MDH) has been asked by stakeholders to seek this State amendment without success. We strongly support this legislation and ask the committee to consider two amendments; (1) extend the same request to the Centers for Medicaid and Medicare for somatic health services, which would create a singular process for both treatment needs; and, (2) be less prescriptive in the bill and allow the Department to work with stakeholders before making the final request to the Centers. Unfortunately, adults and students alike are suffering from symptoms closely associated with the lack of mental and behavioral health treatment. Many of these cases were either spurred by or worsened due to the effect of the COVID-19 pandemic. In the return to school, teachers and administrators are witnessing higher than ever levels of depression and anxiety. In school, this trauma manifests itself within students by cases of classroom disruption, retreat from academic work, and absenteeism. All local school systems in Maryland used part of their federal Covid funds to bring additional mental health support to students, including in-person appointments and telehealth when students could not be in school. As the federal money slows to a halt in 2024, we pivot to the question of sustainability of these efforts, especially in regards to how to afford the continued staffing of these support programs. The Blueprint will provide $125 million to somatic and behavioral health supports, including payments to community providers, but Medicaid is a natural and appropriate option to keep these supportive systems in place. In fact, sixteen states have already implemented Medicaid reimbursement for these services, with another five in the process of requesting the needed amendment. These sixteen states have expanded their programs to cover student populations beyond those with IEPs, similar to the allowances provided by this bill. Some state legislatures have compelled this practice via legislation, while others have gone through the administrative procedural process with their state health departments. This bill gives the Maryland Department of Health the support they need to seek these Medicaid reimbursements. The federal government laid the foundation to support these efforts in 2014 through the reversion of the “free care rule.” This allowed schools to seek some health services, including mental health counselors, for all students enrolled in Medicaid, not just those with IEPs. According to estimates by Georgetown University’s Center for Children and Families, in 2019 about 36% of school-aged children were enrolled in Medicaid and the Children’s Health Insurance Program (CHIP); it is likely that that number is higher today due to the enrollment of more than 50% of all children in the US who were included in Medicaid or CHIP as of January 2022. In Maryland, we have witnessed this increase in the enrollment of our Compensatory Aid student population, which saw an increase of $390 million for FY ‘24. This increase was a result of direct certification of students using Medicaid data, whereas past protocol was to collect family forms only. . The federal government’s reception to these efforts appear to be favorable based on a fact sheet provided with President Biden’s 2022 State of the Union address. The document discussed the U.S. Department of Health and Human Services’ (HHS) efforts to “make it easier for school-based mental health professionals to seek reimbursement from Medicaid.” Additionally, in early March of last year, President Biden announced that he had asked the U.S. Education Department to work with HHS in developing guidance that can help schools offer more mental health support. “And this is going to include enabling schools to use Medicaid funds to deliver those important services.” The Administration’s FY ‘23 budget also included up to $1 billion for more school-based mental health professionals. For these reasons, PSSAM supports Senate Bill 201 and requests a favorable with amendments report.

BILL: SB 120 TITLE: Public Schools - Anaphylactic Food Allergies - Guidelines DATE: February 2, 2023 POSITION: Oppose COMMITTEE: Education, Energy, and the Environment CONTACT: Mary Pat Fannon, Executive Director, PSSAM The Public School Superintendents’ Association of Maryland (PSSAM), on behalf of all twenty-four Maryland local school superintendents, opposes Senate Bill 120. Senate Bill 120 requires each county board of education to adopt, implement, and publish certain guidelines in accordance with the Maryland State School Health Service Guidelines to reduce the risk of exposure to anaphylactic causative agents in classrooms and common areas. Further, it requires that each county board publish guidelines on its website, and that each public school develop a system to disclose the food to be served each school day and the major allergens contained in the food in advance of the school day. The Public School Superintendents’ Association of Maryland, PSSAM, respectfully opposes House Bill 154. Under current law and regulations, public schools provide nutritional information on food that is served and provide peanut free tables in each school. Also, children with known allergens are trained to work with school health personnel if they have an allergic episode. One of the more troubling aspects of this bill is the requirement that schools ensure that students with allergies are fully able to participate in field trips and after school activities. This is certainly something school administrators and health staff strive for with families and students with known allergies, but should not be mandated under state law. Further, the bill requires that school personnel monitor private food providers to ensure they are complying with this legislation. This is an overly burdensome mandate that would be very difficult to comply with, especially with the number of outside organizations that use our schools. Lastly, the requirement to provide epi-pens in the cafeteria, in addition to the health suites, is inappropriate and has practical difficulties. This medicine is most appropriately handled by school health personnel and should not be an obligation of cafeteria staff. Teachers, school administrators, and all school staff are currently operating in an extremely stressful Covid environment, taxed beyond their normal duties; therefore, we cannot endorse any additional mandates for our school personnel at this time. For the reasons stated above, PSSAM opposes Senate Bill 120 and requests an unfavorable report.

BILL: HB 69 TITLE: Education - Student Behavior - Parent and Guardian Notice and Required Counseling (Parent and Guardian Accountability Act) DATE: February 1, 2023 POSITION: Oppose COMMITTEE: Ways and Means CONTACT: Mary Pat Fannon, Executive Director, PSSAM The Public School Superintendents’ Association of Maryland (PSSAM), on behalf of all twenty-four Maryland local school superintendents, opposes House Bill 69. HB 69 would establish parental notification requirements for school administration in response to multiple violent and disruptive incidents by a student. This bill also establishes criminal penalties for parents who fail to seek either school-based or private counseling as a result of their child’s behavior. Local superintendents strongly support high levels of parental engagement in childrens’ education, and in response, highly prioritize the establishment of policies and procedures concerning student discipline. However, the positive outcomes resulting in parental engagement are not met by the approach proposed in this legislation. State law reflects the Legislature’s long standing recognition that principals and superintendents have broad discretion to make student discipline decisions “as warranted” (Section 7-305 of the Education Article). State regulations mirror this deference to local decision making, as well as place a clear emphasis on maintaining a safe learning environment for all students. Local school systems take very seriously the need for strict and comprehensive student discipline and school safety policies that focus on controlling and/or preventing bullying, verbal threats, student fights, and numerous other actions that can disrupt effective classroom environments. In line with State regulations and local decision making, PSSAM strongly supports the implementation of restorative approaches to discipline -- approaches that were mandated by the legislature in 2019 for all Maryland public school systems, but that are not apparent in this legislation. The law defines “restorative approaches” as a relationship-focused student discipline model that: is preventative and proactive emphasizes building strong relationships and setting clear behavioral expectations that contribute to the school community well-being in response to behavior that violates clear behavioral expectations, focuses on accountability for any harm done by the problem behavior; and addresses ways to repair the relationships affected by the problem behavior with the voluntary participation of an individual who was harmed. While this legislation aims to provide a response and accountability measure for student discipline, it fails to meet other outlined objectives that are essential parts of a restorative approach. Proactive practices that are implemented following appropriate professional development and training of all teachers, board members, superintendents, students, parents, and the larger community can make significant improvements in school climate and learning conditions. In conjunction with local discretion, proactive and restorative student discipline approaches allow positive parental and student engagement in the discipline process without threat of criminal penalties. For these reasons, PSSAM opposes House Bill 69 and requests an unfavorable report.

BILL: HB 85 TITLE: Education - Collective Bargaining - Certificated Employees - Class Size DATE: February 1, 2023 POSITION: Oppose COMMITTEE: Ways and Means CONTACT: Mary Pat Fannon, Executive Director, PSSAM The Public School Superintendents’ Association of Maryland (PSSAM), on behalf of all twenty-four Maryland local school superintendents, opposes House Bill 85. House Bill 85 aims to add the complex and costly topic of class size to the permissible topics that may be included in collective bargaining agreements. The agreements are negotiated annually through a highly regulated process and with an established dispute resolution process. Adding class size to the permissible negotiating topics would introduce an unanticipated complicating factor in the implementation of the Blueprint for Maryland’s future. The Blueprint is based on equity and adequacy; this legislation could result in 24 different agreements could actually create regarding nor the current process for resolving teachers’ contract disputes are aligned with adding class size to the types of matters w The quasi-judicial body created by the legislature to resolve collective bargaining disputes would be ill-equipped to resolve disputes on the complex topic of class size. Because none of the current bargaining agreements contain provisions on class size, the body responsible for hearing and deciding on cases in dispute, the Public School Labor Relations Board (PSLRB), would have no experience in this area. Foremost among the challenges would be the timing of decision-making relative to the end of one fiscal year, and contract term, and the impending July 1 day for the beginning of the new year. The annual negotiations cycle is already contentious. Adding class size to the scope of bargaining would only make an already complex and time-sensitive process more likely to bog down in irreconcilable disputes. It is reasonably foreseeable that the PSLRB would be unable to make final decisions in a timely manner on contract disputes on the topic of class size. Class size disputes will, unavoidably, involve school facilities issues not contemplated when bargaining laws and procedures were adopted. This is because class size is inherently a question of physical space. MABE opposes class size a topic of bargaining because reducing class size is so closely tied to the planning, timing and funding of school construction projects. As desirable as smaller class sizes may be to both the school system and teachers, state and local investments in expanding school facilities to provide more space are completely outside the control of the parties negotiating at the bargaining table. For these reasons, PSSAM respectfully opposes House Bill 85 and urges an unfavorable report.

BILL: SB 21 TITLE: Criminal Law - Person in a Position of Authority - Sexual Offenses With a Minor DATE: February 1, 2023 POSITION: Support COMMITTEE: Judicial Proceedings CONTACT: Mary Pat Fannon, Executive Director, PSSAM The Public School Superintendents’ Association of Maryland (PSSAM), on behalf of all twenty-four Maryland local school superintendents, supports Senate Bill 21. Since the passage of the State’s initial “person in a position of authority” legislation in 2004, which prohibits certain persons employed in public or private schools from engaging in a sexual act with a minor enrolled at the school that employs the perpetrator, PSSAM continues to strongly support the criminalization of sexual activity between minor students and educators not prohibited under other provisions of state law. In the absence of the “person in position of authority” law, a school employee may be charged with child abuse if the conduct occurs on school property or while the student is engaged in school activities. However, sexual conduct occurring outside this custodial relationship would not constitute a charge of child abuse and no other criminal charge may be available. Per the legislation passed in 2004, violators can be found guilty of the misdemeanor of fourth degree sexual offense and subject to maximum penalties of a fine of $1,000 and imprisonment for one year. Maryland statute defines “person in a position of authority” as a person who is employed by or works as a volunteer in a public or private school and, because of the person’s position or occupation, exercises supervision and influence over a minor who attends the school. The law further clarifies that this definition includes a principal, vice principal, teacher, or school counselor. School systems are more suited to administer internal discipline and discharge educators engaging in sexual conduct with students; however, outside of public schools, communities are not fully protected from perpetrators without the assurance that criminal penalties are available to prosecutors. Criminal penalties also better ensure that a record of the employee’s conduct will be available to future prospective employers, thereby more effectively protecting the safety and welfare of all students. The same rationale that garnered support for the “person in position of authority” law described above should support the updating and expansion of this approach to criminalizing sexual activities between adults and the youth they supervise in other service sectors. Just as school employees, these adults that are entrusted to supervise youth should be held criminally responsible for engaging in sexual conduct with the minors in their care. For these reasons, PSSAM supports Senate Bill 21 and requests a favorable report.

BILL: HB 99 TITLE: Education - Public High Schools - Financial Literacy Curriculum DATE: February 1, 2023 POSITION: Oppose COMMITTEE: Ways and Means CONTACT: Mary Pat Fannon, Executive Director, PSSAM The Public School Superintendents’ Association of Maryland (PSSAM), on behalf of all twenty-four Maryland local school superintendents, opposes HB 99. House Bill 99 requires the State Board of Education to develop curriculum content for a half-credit course in financial literacy. This bill also requires that each county board of education implement the financial literacy curriculum content developed by the State Board in every public high school. Maryland educational leaders have a longstanding track record of supporting the integration of financial literacy content into already existing core curriculum. While PSSAM supports the concept of providing all students with a strong foundation in financial literacy education prior to graduation, we continue to have concerns regarding the assigning of additional instructional staff and designated classroom space in order to meet the requirements prescribed by the bill’s current language. This burden would substantially increase the already existing teacher retention challenges and budgetary constraints that Maryland’s public schools have faced since the onset of the COVID-19 pandemic. The State Board’s current approach of mandating that financial literacy instruction be emphasized within existing courses significantly alleviates these burdens. In addition, PSSAM would like to highlight the significant ongoing efforts to emphasize financial literacy education in every public school across Maryland. State regulations already require financial literacy education as a requirement in all Maryland public schools, including elementary, middle, and high schools. Maryland prepares students to be financially literate by implementing Personal Financial Literacy Education Standards in grades 3-12 in every public school. Further, many school systems have partnered with financial institutions and other organizations to provide ongoing professional development for teachers, as well as create public and private partnerships to fund financial literacy initiatives in local schools. PSSAM champions the integration of financial literacy curriculum into already existing subjects in every public school, and we continue to take concerns from legislators, parents, and the business community very seriously as they raise concerns regarding the quality and implementation of sound financial literacy curriculum. Maryland’s superintendents are committed to working with MSDE and local boards of education in order to provide a well-rounded curriculum that emphasizes the essential education of financial literacy topics such as responsible financial decisions, money management, career income, risk management, wealth preservation, and other essential topics already mandated by COMAR 13A.04.06.01. However, due to the logistical and staffing challenges this bill would create for local systems, as well as our historic track record of opposing all curricular mandates or graduation requirements, PSSAM respectfully opposes House Bill 99 and urges an unfavorable committee report.

BILL: HB 119 TITLE: Primary and Secondary Education - Comprehensive Health Education Framework - Established DATE: February 1, 2023 POSITION: Oppose COMMITTEE: Ways and Means CONTACT: Mary Pat Fannon, Executive Director, PSSAM The Public School Superintendents’ Association of Maryland (PSSAM), on behalf of all twenty-four Maryland local school superintendents, opposes House Bill 119. House Bill 119 requires that local school systems create age-appropriate health curriculum based on the comprehensive health education framework created through a partnership by the Maryland State Department of Education and the Maryland Department of Health. This bill also requires local school systems to establish methods by which parents would be able to opt out of topics contained within the health curriculum. PSSAM champions the localized approach to implementation of health curriculum consistent with State guidelines. However, PSSAM shares concerns with local school boards and other advocacy organizations regarding legislative efforts to codify standardized curriculum, assessments, or standards. PSSAM maintains our longstanding position regarding curricular mandates, which highlights the critical nature of preserving local authority and oversight concerning matters such as curriculum and assessments. Each of Maryland’s local school systems must be granted flexibility in developing curriculum that best reflects the specific, and diverse needs of their student population and local community. Again, local superintendents support robust and comprehensive instruction in health education, and believe that this objective is best accomplished by preserving local flexibility in implementing health curriculum. PSSAM firmly maintains that the role of curriculum development belongs solely to local school boards and superintendents, in partnership with the State Board of Education. For these reasons, PSSAM opposes House Bill 119 and kindly requests an unfavorable committee report.