CARES Act aid helps Iowa schools shore up mental health services

Principal Chris Myers sought for nearly four years to make mental health counseling available to students in the northwest Iowa rural school district of Graettinger-Terril. But each time he thought he might be close, money — or lack of — got in the way.

Myers’ luck changed in July 2020 when Iowa received $50 million in federal pandemic relief aid through the CARES Act. Of that $50 million, $30 million was allocated per capita — at $9.50 per Iowan — and went to Iowa’s 14 Mental Health and Disability Services regions. It gave Myers’ effort a boost.

School leaders in the 330 public districts and dozens of private schools across the state are in the same boat as Myers — looking to help students with struggling mental health issues. IowaWatch reached out to all 14 mental health regions about where the funds went and how much was used.

Need is real

Teachers and staff took extra social-emotional training over summer 2020 to prepare them for the added demands of the 2020-21 school year, whatever that would look like. New approaches — such as leading classes in yoga poses, breathing techniques and journaling — helped kids and teachers handle the new struggles that come with a pandemic.

“Everybody suffered a trauma of sorts,” said Myers, the principal at Terril Elementary and curriculum director for the Graettinger-Terril and Ruthven-Ayrshire school districts.

Consider this scene from Terril Elementary:

As winter 2021 wound down in March, the lockers belonging to Pennie Klepper’s fourth-grade students started to stink. Klepper told her students it was time to clean. But the mood shifted before the hum of children sorting through outdoor gear, books and papers could even start. Twenty-four pairs of eyes filled with worry above their face masks, and then, for some, even tears.

“One kid starts saying something to another kid, ‘oh we’re cleaning out lockers, this is just like last year,’ and then it kind of was the trickle effect,” Klepper said. “It was just so strange, because the whole vibe in the hall got different. … They just instantly went into a panic mode. It was almost like they were starting to relive the whole pandemic thing all over again.”

Leaving school in March 2020 as the pandemic began created an undercurrent of uncertainty. The one-year mark of the pandemic’s onset caused those memories to be even more palpable.

The 2020-21 school year’s fourth-graders were especially good about sharing and talking out problems, said Klepper, who has taught there for eight years. So, that’s just what they did about cleaning out the lockers on that March day.

“We just stopped in the hall and started talking about it right there. And I thought it was the best, at the time, just to let them get their feelings out, and really talk about it. … And they kind of almost consoled each other a little bit, too,” she said. “Some of them really missed each other (last year). They felt that isolation, and I think that worries them still, and I don’t know how that’s going to affect them going down the road.”

How did aid get to schools?

In August 2020, Iowa’s mental health regions received $30 million in CARES Act funds, with stipulations they were not allowed to use the aid for services they had already in the budget, and that the money could be spent only on services related to the pandemic. Each mental health region invited schools, as well as mental health service providers and other entities such as universities, libraries and day care centers, to apply for funding.

Initially, mental health regions were required to spend each dollar by December 30, 2020, but that was extended until June 2021, said Russell Wood, chief executive officer for the Central Iowa Community Services region.

Regional leaders asked for proposals from providers and school districts they had never worked with. They also reached out to providers they already had relationships with. Within three to four months after receiving the funds, more than $20 million of the $30 million had been allocated. Regional CEOs told IowaWatch they expected all their funds to be spent but any money left over would go to the state.

Nine regions spent all the CARES Act money, with five returning funds.

Eastern Iowa MHDS Region sent back $27,712.15; Central Iowa Community Services returned $30,532.04; Rolling Hills Community Services Region returned $160,000; County Social Services returned an unspecified small amount after an organization didn’t use all the funds allocated to it.

The East Central Region — which includes Linn, Johnson, Benton, Bremer, Buchanan, Delaware, Dubuque, Iowa and Jones counties --- sent back $820,777. But he region is waiting for the Iowa Department of Human Services and the governor’s office to decide if it can have $250,000 of those funds back for a research study to be done with the University of Iowa.

There are 39 school districts in the region. CEO Mae Hingtgen said 33 districts received CARES funds in the first round of funding and 22 received funding in a second round. School districts were all eligible for the same amount in the first round, but did not always access the full $20,000 per district. In the second round, eligibility was based on enrollment. Districts with up to 1,000 students could access $25,000; districts with 1,001 — 5,000 students could access $50,000 and districts over 5,000 could access $75,000. The total amount awarded to schools in both rounds was $967,905

The $30 million was not the only support for Iowa schools’ mental health efforts. Other federal funding, including the American Rescue Plan and aid from the Federal Emergency Management Agency and the U.S. Department of Health and Human Services, has been sent to states as the pandemic has persisted. Some may have gone to schools for mental health services as well.

“The intention in D.C. is to get the money out and provide states with the flexibility on how to spend it,” said Taylor Foy, communications director for Iowa Republican U.S. Sen. Chuck Grassley. How much of that money is funneled to mental health programs is up to state officials.

A spokesman for Iowa Republican Gov. Kim Reynolds did not respond to requests for comment.

‘A springboard’

An influx of cash through the CARES Act forged new relationships among mental health providers and schools and their mental health regions.

“It’s unfortunate that we’ve limited it to the fact that we have a pandemic, but for us we’re looking at it as a springboard,” Hingtgen said. “People know who we are as an MHDS region now (and) we can use that with the ongoing funding that we have all committed in each of our regions to provide support in a little bit more of a comprehensive system for children’s brain health needs.”

Hingtgen said some districts in the region received enough federal dollars directly from the CARES Act and didn’t need the funds allocated to mental health regions instead.

In the Southwest Iowa Region, CEO Suzanne Watson provided funding to 33 of her region’s 36 school districts. Those funds went to helping schools purchase mental health curricula, sensory items such as texturized or brightly colored toys, creating outdoor sensory paths and quiet, self-care rooms or areas within classrooms to give students feeling anxiety a safe place to go, among other things, she said.

In some of the Heart of Iowa Region’s more rural school districts, region leaders already helped fund therapists in the school, said Darci Alt, the Heart of Iowa CEO. But in larger, more suburban school districts, like those in Dallas County, some district leaders asked for additional funding to increase how frequently therapists or counselors visited their school buildings.

But not everything that is tied to children’s mental health starts with therapy or sensory items.

Personal protective equipment and plexiglass dividers helped children’s brain health just by helping to get them back into the classroom, Central Iowa’s Wood said.

“I think what we’ve learned from this is that kids need other kids. They need to be around each other, and to take them out of that environment is going to cause a significant amount of stress,” Southwest Iowa’s Watson said. “So I think any of these supports we were able to provide to keep them in the classroom, and to give them some idea that everything is going to be OK and to provide hope, I think that was one of the biggest things we were able to do for the kids and the teachers.”

Access ‘makes all the difference’

A counselor from Plains Area Mental Health began visiting once a week for appointments with Ruthven-Ayrshire and Graettinger-Terril students starting in March 2021, thanks to the CARES Act dollars.

“We literally turned around within a two-week time frame and set up a space to work and did all of those kind of things, so the person can come in once a week,” Myers said.

Being a rural district is a factor in having such a hard time getting access to mental health care, said Marshall Lewis, superintendent of the district and elementary principal at Ruthven-Ayrshire.

“For us, we’re traveling one way an hour sometimes to get the same services, and so you just put a three-hour period of time together, that somebody’s off work, out of school, and (Myers) has been able to bridge that by creating maybe a 30- to 40-minute window for one individual to get a half-hour session out of it, and wow, that makes all the difference in the world. If we were in a community that, 15 minutes or less I’m there, that’s a lot easier,” Lewis said.

Last summer, one family in the district was trying to access a mental health care provider for their child and was on a waiting list for three months — followed by another waiting list for four months.

“I think maybe in January they finally got some connections. And we had to facilitate that a little bit by calling in and pleading, saying ‘hey this is a family that’s really wanting to reach out,’” Lewis said. A few other families connected with another service just before the in-school opportunity was available, which was also a very difficult process. “If it had been a month later that we were looking for these families, I think we would’ve had a lot easier time making it happen.”

The bar for accessing counseling in school buildings is lower in more populous places like Cedar Rapids and the surrounding area, where mental health provider Tanager Place offers counseling and therapy in schools, clinics and even a camp. Tanager Place counselors visit about 60 school buildings in eight districts and a private school in Iowa City, Faith Academy, said Maggie Hartzler, school-based program manager for the organization and a licensed independent social worker.

Tanager Place received CARES Act funds through the region’s mental health districts, and used that to offer help to children in Cedar Rapids and Linn County and to offer more support to children and families via virtual care.

Part of clinicians’ roles is to provide therapy for children individually, and the other part of their jobs is prevention. That includes things like sitting in on meetings to offer a mental health perspective, training teachers about mental health and trauma, offering self-care sessions for teachers and identifying mental health needs for kids, families and educators.

But as more students have access to mental health care, that individual support also will help things run more smoothly both in and out of classrooms. Schools that have been able to add counselors, even if it’s only part-time, will start seeing benefits, Peggy Huppert, executive director of the National Alliance for Mentally Ill-Iowa, said. “Once you start something, it’s a lot harder to not do it or to take it away.”

‘It’s like ‘Field of Dreams’

In Terril, just having a counselor visiting the school regularly since the second week of March helped to cut through the stigma around mental health care. Three families started sessions in March 2021, and several others have shown interest and are working with scheduling issues.

“It’s like ‘Field of Dreams’ — if you build it, they will come,’” Myers said.

And although CARES Act funding is one-time, and the service is hoped to be perpetual, connecting therapists with clientele means a continuing funding stream even after federal dollars run out.

“We might come to rely on it in some ways, and it’s a no differencing cost,” Lewis said. “The school would love that, 100 percent, I’m sure that the providers would love that, and I know our families would love that. So beyond a win-win, we’re talking about a triple win here, as well as for our community.”

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