June 16, 2023

Dear Governor,

Over the last several years, our nation's young people have faced unprecedented challenges and disruptions in school and in their communities. These challenges – including increased gun violence, social isolation, and other repercussions from a once-in-a-lifetime pandemic – have devasting effects on students' mental health and well-being, which in turn have profound implications for their academic progress and their overall success. No young person should face these challenges alone, and no parent or child should have to live in fear of gun violence. As a result of these challenges, our students need our support in addressing their mental health needs at this critical moment. We know that youth facing mental health and substance use challenges are more likely to receive services if they are offered in school-based settings. Therefore, the Biden-Harris Administration stands ready and willing to partner with you and the leaders in your state to tackle this crisis by making mental health resources and supports more widely available to children and young people.

One of the most concerning challenges facing young people today is gun violence. This is both a public health and a public safety epidemic that impacts the lives of Americans every day. To address this epidemic and prevent and reduce the high rates of gun violence in this country, leaders in both political parties worked together to pass the Bipartisan Safer Communities Act (BSCA), which President Biden signed into law one year ago. BSCA is the most comprehensive gun safety legislation passed in nearly three decades. It brought crucial new resources and protections to help curb gun violence in our communities through prevention, intervention, and enforcement, and to provide the mental health supports that young people need to learn freely and safely.

We write today to reaffirm our commitment to working with you to promote a whole-of-government approach to enhance supportive services for young people impacted by gun violence, and to ensure every young person feels safe, supported, and welcome in their community and school. Together, we can improve the mental health and well-being of every child and young person, no matter where they live, with access to resources, services, and professionals. These resources can help address the trauma of gun violence and ultimately save lives. To that end, we are providing the following federal resources and opportunities from the U.S. Departments of Health and Human Services (HHS) and Education (ED) to help you better advance the mental health and well-being of students and young people in your state, including for those facing trauma and grief resulting from victimization by or exposure to gun violence:

• Updated Medicaid and CHIP guidance to deliver mental and physical health services in school-based settings: Last month, HHS and ED collaborated to release a comprehensive guide for filing Medicaid claims to enable school-based providers to receive payment for mental and physical health services eligible students receive at school. This guide outlines flexibilities states, including for simplified billing, can adopt to expand and sustain critical school-based health services delivered to children enrolled in Medicaid and the Children's Health Insurance Program (CHIP). These changes will make it easier for schools to deliver and receive payment for health care, including mental health care services, to millions of eligible students. More than half of all children in the United States receive health coverage through these two programs, and this guidance will help schools receive Medicaid payment to provide critical services to their students. All states and school-based providers can take advantage of Medicaid payment to support eligible students with disabilities, with the option to go further and adopt policies that will allow them to bill Medicaid for school-based services for all Medicaid-enrolled students. To date, 21 states have adopted these policies to broadly allow Medicaid payment for covered services furnished to all eligible students in schools, and we encourage the remaining states to adopt similar policies to expand access to Medicaid payment for school-based services. We also encourage all schools to take advantage of additional federal resources for school-based services through a new federal technical assistance center, which HHS and ED will launch later this month. Our teams stand ready to support states as they consider additional steps to expand their Medicaid school-based health programs.
• Investments in safe and supportive learning environments and student well-being in high-need school districts through the Stronger Connections Grant Program: Last fall, ED provided states with $1 billion to invest in improving school climate and safety and supporting student mental health and well-being through the new Stronger Connections Grant Program, funded through BSCA. This funding must be allocated to high-need school districts on a competitive basis and may be used for a variety of strategies, including school-based mental health services, safety and violence prevention and intervention programs, and physical security measures. You can find your state's allocation here. Since funds were released, all states have taken action to implement this new funding stream, including launching state competitions, making awards, and engaging the public and communities on funding priorities. We strongly encourage all states to complete their grant competitions as quickly as possible as they head into the 2023-24 school year, so we can ensure these crucial funds are available for schools and students as soon as possible. To provide support and resources to states and school districts in using BSCA funds, ED published nonregulatory guidance, a letter to Chief State School Officers, and extensive technical assistance. In addition, ED is planning to fund a technical assistance center using BSCA technical assistance and capacity building funds. This center will provide direct support to Stronger Connections grantees to assist in implementing strategies to student health and well-being.
• Enhancing supportive services for students and youth impacted by gun violence trauma: We encourage states and schools to utilize resources developed by HHS grantees to improve supports for students and youth impacted by gun violence. This includes Talking to Teens about Violence, which offers guidance for adults and peers on how to prepare to talk to teens after frightening events occur; Coping After Mass Violence, which provides common reactions children and families may experience as well as what they can do to take care of themselves, after a mass violence event; and The Dialogue: Mass Violence, Community Violence, and Hate Crimes, which discusses the impact of exposure to events that may be traumatic, such as mass shootings, and what communities may do to cope, enhance resilience, and recover.
• Additional funding to build out your pipeline of mental health professionals serving in schools: With funding provided by BSCA, ED is investing more than $1 billion to help high-need school districts hire and train school-based mental health professionals over the next five years. To date, ED has awarded $286 million across 264 grantees in 48 states and the District of Columbia as part of the School-Based Mental Health Services and the Mental Health Service Professional programs to boost the training, hiring, and diversity of mental health professionals in schools. Grantees estimate that these funds will collectively support the preparation and placement of more than 14,000 new mental health professionals to serve America's school children. For the next five years, ED will use the remainder of the $1 billion provided by BSCA to continue to support these grantees. Other federal funds including Elementary and Secondary School Emergency Relief (ESSER) and State and Local Fiscal Recovery Funds (SLFRF) may also be used to support these efforts. We encourage you to extend the reach of federal funds by fostering efforts among public health, K-12, and higher education leaders in your state to expand pipeline programs preparing school-based mental health professionals, like school counselors, school psychologists, and school social workers, and to consider additional state investments and supports in your school-based mental health workforce. ED is also investing BSCA funds in a new technical assistance center, Mental Health Personnel Technical Assistance Center, to support grantees and disseminate best practices, resources, and information related to preparation of school-based mental health services providers.
• Enhancing public safety by supporting community violence interventions and providing wraparound supports: In addition to the supports provided through BSCA, ED provides additional grant opportunities on a competitive basis that can be used by local communities to enhance public safety by supporting student health and well-being and community violence interventions. These opportunities include:
• The Full Service Community Schools program, which is currently accepting applications from school districts for $74 million in federal funding to improve the coordination, integration, accessibility, and effectiveness of in-school services like those that address out-of-school barriers to learning (e.g., medical care and assistance with housing, transportation, or nutrition) in partnership with states, local nonprofits, the private sector, and government agencies;
• The Project Prevent program, which expands local capacity to implement community- and school-based strategies to prevent and reduce community violence and mitigate the impacts of exposure to community violence; and
• The Promise Neighborhoods program, which provides coordinated support services and programs to students from low-income backgrounds at every stage of their educational development. We invite you to learn more about our grant opportunities here and to apply in advance of program deadlines.
• Supporting youth mental health and help the health care workforce meet families' mental health needs: Earlier this year, HHS announced nearly $245 million in BSCA grant opportunities to support youth mental health, help the health care workforce address mental health needs, and fund other critical mental health supports. This funding will reach more than 300 grantees and impact communities in more than 200 cities across the country. It includes $70 million to help develop and support school-based mental health programs; almost $60 million to prepare and train school personnel, emergency first responders, law enforcement, and others to recognize the signs and symptoms of mental health challenges, including those resulting from gun violence; nearly $60 million to support primary care providers to treat the mental health needs of children and adolescents; and almost $55 million to increase treatment and support services for individuals and communities affected by trauma, including trauma resulting from victimization by or exposure to gun violence. In the coming months, HHS will also provide almost $60 million to states and territories for the second of four opportunities in supplemental funding for the Community Mental Health Services Block Grant for mental health treatment and recovery services, including crisis services and early serious mental illness treatment programs.

BSCA enabled historic investments and efforts that will change lives by building a mental health services infrastructure in schools and communities across the country to better support our youth, especially those affected by gun violence and trauma. BSCA represents an unprecedented opportunity to enhance the safety of our communities by: investing in strategies to prevent, reduce, and respond to the trauma of gun violence; raising the bar in support of our students; improving learning conditions in our schools; expanding access to school-based mental health care; and dramatically accelerating efforts across the country to train and hire a pipeline of professionals to better meet the mental health needs of young people.

The Biden-Harris Administration will continue to ensure we are doing all that we can to support student well-being, mental health, and safety. In addition to the important work underway at ED and HHS, our colleagues at the Department of Justice are conducting important work on safe gun storage campaigns. We look forward to working with you to advance all of these aims on behalf of our students. We are ready and able to meet with your state teams to discuss how these resources can support your state. Please reach out to Zach Kahan at zach.kahan@hhs.gov and Lauren Mendoza at lauren.mendoza@ed.gov to request a follow-up meeting.

Sincerely,