ABSTRACT. Marchus School's 1261 Project is one of two programs funded by the State of California to establish an education program within a public school setting for elementary and middle school students with emotional or behavioral disorders (E180). The 1261 Project classroom serves students who traditionally have been placed out of public school settings into more restrictive nonpublic school placements. This study details the programmatic design as well as the analysis of the cost effectiveness of this successful program over a 4-year period. Descriptive statistics and case studies demonstrate that not only have costs been avoided but funds have also been saved. Recommendations and directions for further study are addressed
Since 1991, the cost of educating students with emotional or behavioral disorders (E/BD) in nonpublic and out-of-district school sites has doubled in the State of California. The lack of public-school-based programs to serve students with serious emotional disturbances (SED) has resulted in a dramatic increase in state referrals to nonpublic school sites. A report published in 1994 by a special work group convened to study escalating costs of nonpublic school programs serving students with E/BD revealed over an 8-year period (1983-1984 through 1991-1992) that enrollment growth in nonpublic schools (NPSs) and nonpublic agencies (NPAs) grew by about 30% as compared to 7% in public schools. In addition, costs for NPS and NPA placements grew by over 311%, from $31.7 million in 1983-1984 to $130.2 million in 1991-1992 (California Department of Education, 1994).
Currently, over 10,000 California students are being educated in restrictive, nonpublic schools at a cost to the state of over $200 million per year (California Department of Education, 1997a). As a result of these skyrocketing costs, the California legislature passed Assembly Bill 599 on February 22, 1993, which was reauthorized as AB 1261 on June 28, 1997. It encouraged public school districts to establish cost-effective programs for individuals with E/BD who otherwise would be, and currently are, placed in nonpublic schools.
In response to this request, the Contra Costa County Office of Education applied to the State Department of Education for financial support. With the acceptance of Contra Costa County's application, the AB 599/1261 Project (hereafter identified as the 1261 classroom) was placed at the Floyd 1. Marchus School site to provide intervention and services for elementary and middle school aged students with E/BD. The targeted students are those who are imminently at risk of being placed in a nonpublic school or other more restrictive setting. The 1261 Project was designed to provide quality programs and services at a cost to the public that is no greater than that which is incurred in identified nonpublic settings. Marchus School, located in Concord, California, a suburban area east of San Francisco, is one of two sites in the state to establish such an inclusive education program.
This study described powerful social and economic reasons to provide appropriate school district community-based programs for students with E/BD. It also evaluated the costs in providing academic, behavioral, and emotional treatment and appropriate living environments for those students. As a result of the analysis, investigators were able to determine the effectiveness of the 1261 classroom and formulate specific programmatic recommendations based on the project's substantial and significant cost savings and social benefits (California Department of Education, 1997b; MacMillan et al., 1997).
The Marchus School
In Contra Costa County, the Marchus School is an integral component of a far-ranging continuum of services. This continuum includes classrooms for students from kindergarten through grade 12, as well as special education classrooms, in 21 local school districts. These school districts are served by the Contra Costa County Office of Education Special Education Local Planning Agency (SELPA), a service consortium, which operates satellite classrooms within the school districts as well as a special site, Marchus School. in addition to these publicly operated facilities are nonpublic schools with day and residential components. Table 1 details the levels of service within Contra Costa County schools and the locations where various levels of service are provided.
The Marchus School's Counseling and Education Program (CEP) provides special education classes for elementary, intermediate, and middle and senior high school students who are identified as having E/BD and exhibit emotional and behavioral problems. The CEP fosters emotional development and academic achievement. The program is designed to move the student toward self-efficacy (Bandura, 1996, 1997; Schunk, 1991; Sternberg, 1989). Students learn to become more independent through a structured instructional routine. The ultimate goal is to integrate students into less restrictive environments and to help them make the transition to the community as responsible individuals. The program also strives to assist students in developing the social skills and decision-making abilities required to cope with life's difficulties.
The CEP currently serves over 150 students identified as having E/BD. The program is based at the Marchus School and is extended to campuses throughout Contra Costa County through satellite classes on general education school sites. Students are recommended for transition and placement in satellite classes when their behavior is appropriate for district school campuses.
Project Design
The 1261 Project began when the State of California accepted a funding request from the Contra Costa Office of Education. once funding was secured, space was allocated at the Marchus School, a teacher and teacher assistants were hired, wraparound staff was employed, and the process was begun to identify students for the 1261 classroom. A critical feature of the project design was the establishment of a project advisory committee and a school-based intake committee. The 13-member project advisory committee consisted of the project administrator, 1 representative from a nonpublic school, 4 representatives from local school districts, 3 representatives from county mental health agencies, 2 individuals from social service agencies, 1 representative of a psychiatric unit at a local hospital, and 1 representative of higher education who also served as the project evaluator. The two committees were influential in the development of the procedures and processes that guided the project.
Because of the level of funding and commitment from the state (i.e., an operating budget of more than $230,000 each year), the project advisory committee was empowered to make decisions that were based on the best interests of the students of Contra Costa County. Issues of cost containment and other such concerns rarely arose.
The 1261 classroom functions using a model based on Bandura's (1977, 1986) social-cognitive approach, a model that integrates behavioral and cognitive theories in explaining human behavior. A person's behavior, in this model, is viewed as the result of three coexisting factors: the environment, personal and cognitive factors, and behavior. These three factors do not necessarily contribute equally to the outcome behavior, nor are they consistent as determinants of a person's behavior. Rather, the interaction of the factors depends on a number of varying considerations. For most situations, the social and physical environment, personal and cognitive feelings, and the individual's behavior each play a role in human behavior. The significant element in this model is that all factors must be considered in addressing a person's needs, especially the needs of a young person with emotional and behavioral problems (Bandura, 1977, 1986; Kauffman, 1997).
The implications are that no one factor can be linked to the cause of behavioral disturbances; emotional and behavioral disturbances are considered globally, combining behavioral and cognitive theories into a social-cognitive theory. Therefore, the project intervention strategies do not adhere to one specific overriding theory. The classroom combines theory and practice in addressing the needs of the child through global as well as specific interventions. This is done through offering behavior modification techniques and psychoeducational approaches in the classroom. These interventions are also carried over into the home, where they are referred to as wraparound services. These services are coordinated by the educational staff and the on-site school psychologist and mental health professional.
Using the social-cognitive approach, the 1261 Project teaches academic, social, and conflict resolution skills that foster healthy emotional development and academic achievement. The Project's CEP uses a variety of behavior management techniques to facilitate student growth. The project aids each student in meeting his or her social, emotional, and behavioral goals, as well as the academic goals and objectives that are prescribed in the student's individualized education program OEP). Instruction in the program is highly individualized, with whole-class instruction and grouping whenever possible.
The Project encourages the active support and participation of each student's family and/or caregivers. Notably, one of the determining factors for admittance into the 1261 classroom is the strong commitment by parents and/or caregivers to the success of their child and to the overall success of the classroom. The Project staff communicates frequently with families and encourages them to utilize community support services fully. Of special note is the provision of wraparound services by the Contra Costa County Department of Mental Health and other agencies. These wraparound services provide support to the classroom staff as well as the family; they include the services of such professionals as a one-to-one assistant, a mobile therapist who provides therapy in the home and school setting, and a behavioral intervention specialist (Eber 1996; VanDenBerg, 1996). Once a student is successful and stable in the 1261 classroom, the staff assists him or her in the transition to a less restrictive educational environment.
Table 2 compares the Marchus School day program, the 1261 Project, and the program of a typical residential facility within Contra Costa County.
The Project staff consists of one full-time credentialed special education teacher with specific training with students with E/BD, three full-time instructional assistants, one three-fourths time mental health specialist, one half-time school psychologist, and a program evaluator. In addition, students are offered art therapy services through a contract with the local Contra Costa County Mental Health Association. A maximum of 10 students are enrolled in the program at any given time.
After 4 years of operation, 35 students were served by the 1261 Project. The students ranged in age from 8 to 15 years, with an average age of 12 years for students in the 1261 classroom. To give a better understanding of these students when they entered the program and their instructional and behavioral environments, Table 3 compares the Marchus general program students with those served in the 1261 classroom.
Three Case Studies
These studies are presented to illustrate the students, the environments, the program, and the progress to date.
Steve
Steve, 14 years old when he entered the 1261 classroom, lived with his mother. His family had a history of mental illness. There was evidence of physical abuse and neglect as well as reports of Steve's being deprived of food. Child Protective Services had been involved with Steve and his family repeatedly over the years. Steve was tested using the Weschler intelligence Scale for Children (WISC) and had a full-scale score between 80 and 85.
During the summer, the project advisory committee met and decided that Steve should be placed in the 1261 classroom. An IEP team meeting was held, and with the records of his previous school placement, the recommendation of the project advisory team, and the consultation and consideration of his mother, Steve was enrolled in the 1261 classroom.
Steve displayed behaviors such as slow speech, a schizoid affect, and extremely poor hygiene. His medications included lithium, haloperidol, and imipramine. He appeared to have mental disabilities, with slow speech and an awkward body posture.
In November, Steve was removed from his family and placed in a group home. During the time he was enrolled in the 1261 classroom, it was determined that he was inappropriately and overly medicated, and he was taken off all medication. He was recognized within the classroom and the larger school as an exceptional artist and musician. His hygiene improved. He was discharged from the 1261 classroom 1 year later. Upon discharge, and 2 years after he was initially tested, his WISC full-scale score was reported as 118.
In June Steve left the group home to move to San Diego to live with his father. His leaving the group home saved social service agencies more than $36,000. In August he enrolled in a public high school and received resource-room-level special education services only. His IEP stipulated the discontinuation of special education services once his transition to a new school was successfully completed. it is likely that
Without 1261 services, Steve may have been placed in a nonpublic school August through June at a cost of $20,000.
Without 1261 interventions (and improved social and emotional behaviors), Steve may not have been able to move to San Diego to reunite with his father.
Given that Steve was able to move into a resource classroom, there was an annual cost savings of over $36,000.
Finally, without 1261 services, Steve may have remained in Contra Costa County, possibly moving to a residential facility. If in fact he had moved to San Diego without participating in the 1261 classroom, it is possible that Steve may have required significant and very restrictive services there.
Matt S.
Formerly enrolled in the Marchus School in a special education classroom, Matt moved to a less restrictive district special education special day class in October. Due to lack of academic progress and the display of inappropriate behaviors, Matt returned to the Marchus School in January. In September he enrolled in the 1261 classroom located within the Marchus School. In November, as his schizophrenia became more severe, Matt was hospitalized. He was discharged from the hospital with a prescription for 250 mg of haloperidol to be taken twice daily to control his outbursts of anger. In late January he returned to the 1261 classroom. He maintained control of his anger reasonably. Unfortunately, as Matt grew older and was no longer able to be served by the 1261 Project because of his grade placement, he exited the program and enrolled at LaCheim Day Treatment, a nonpublic school. it is likely that
Without 1261 classroom intervention, Matt may have gone directly to a nonpublic school program in January and then again in the following January. Those months spent in the 1261 classroom represent a cost avoidance of more than $14,000.
If a program similar to the 1261 Project had existed for older students, Matt might have remained in such a program at cost savings of $21,000 annually.
Dave M.
Dave, best described as a moody 12 year old, arrived at the 1261 classroom in 1995 from the Marchus general program. His records revealed that he suffered from a chronic lowgrade depression and paranoid-like behaviors. He often accused people of talking about him. At times he was talkative, and he tended to embellish the truth. He was reported to have a history of stealing. His family disliked the "system" and was very defensive toward professional, institutional interventions. He did not take any medication. On the plus side, Dave enjoyed cooking.
With interventions that the 1261 staff described as "serious," strict limits were set for Dave. As his academic performance and behavior improved, the family became more supportive of him and the 1261 classroom. During this time, his mother left her abusive boyfriend. His grandfather, an alcoholic, was incarcerated. When he came home from prison he was sober, and he has remained sober. Dave's grandmother had been in ill health, but as a result of surgery her health and ability to function improved. Thus, the home environment became much more stable. Dave became increasingly more motivated at school through his continued success and stabilized family situation.
Ten months after entering the 1261 classroom, Dave enrolled in a special day class for students with mild learning disabilities in a fully integrated public school at annual savings of $35,500. It is likely that
Without 1261 classroom intervention, Dave would have been placed in a nonpublic school at $4,000 per month versus $2,000 per month at 1261; over $20,000 in costs were avoided.
Evaluation Design and Intent
Given that the 1261 Project was mandated by the legislature, the question of accountability was paramount. To validate the program, the project staff sought to determine project effectiveness. They determined that although the study was of value, a study of more depth was needed. This longitudinal study is the result of this effort.
To determine the effectiveness of the 1261 Project, a study was conducted examining the first years of the project's operation. A total of 24 students were identified by the project advisory committee as eligible for admittance into the 1261 classroom. All of the identified students were considered to be at great risk for referral to nonpublic day and residential programs. All of these students were exhibiting significant behavioral problems within their local district special education programs. Of the 24 students, 14 were randomly identified as the control group. These students were placed in programs throughout the county. The other 10 students were enrolled in the 1261 classroom. The students were tracked during the first 2 years of the project by an educational diagnostic specialist employed by the Contra Costa County Office of Education who worked as a member of the Youth Interagency Contact Team (YIACT) and the project evaluator. Of the 14 students in the control group, 7 moved to more restrictive nonpublic school settings (i.e., a 50% success rate). Of the 10 students initially served by the 1261 classroom, 3 moved to more restrictive settings while the remainder were maintained in the 1261 program or went to less restrictive settings (i.e., a 70% success rate).
One understandable and powerful method of documenting success (i.e., students maintaining and/or progressing toward a less restrictive setting) is to compare the costs of specific programs. This analysis was undertaken with the understanding that programs that are less restrictive tend to be less expensive than those serving students in more restrictive environments. The examination of specific programs for individual students led to a determination of the cost implications of programmatic decisions (MacMillan & Grimes, 1996).
As mandated by the legislature, the 1261 Project was to evaluate individual student and class progress. Although many different evaluation processes and procedures were considered, Marchus staff decided that project success could be determined through the development of a detailed analysis of the cost savings and/or cost avoidance to school and public agencies as a result of 1261 classroom intervention.
To determine programmatic success, the staff set out to examine specific costs of services. The analysis sought to identify the effect of 1261 Project services in the following terms:
Cost avoidance: occurs when a more restrictive and costly placement is avoided due to appropriate placement in the 1261 classroom.
Cost savings: occur when the student, as a result of 1261 classroom interventions, is able to move to a less costly, less restrictive educational placement. Savings are determined based on service cost 1 year after leaving the 1261 classroom.
Social savings: occur when the student, as a result of 1261 classroom and wraparound interventions, is able to make the transition from a more costly foster home, group home, or residential care setting to a living situation that is less restrictive (and costly) than their previous setting.
To begin such an analysis, the costs of specific social, behavioral, residential, and instructional services throughout the service delivery continuum were determined. For example, the Contra Costa County SELPA annual average cost for 1261 classroom placements at Marchus School is $23,000 per student for an extended school year program. Project funding is sufficient to provide basic instructional services as well as additional services and staff support to the 1261 classroom. The following analysis of the costs avoided, costs saved, and social savings is based on the cost of providing instructional service to this population. Table 4 compares the costs for all programs along the continuum of services listed earlier in Table 1.
As a result of 1261 classroom intervention from September 1994 to August 1998, costs of more than $767,688 have been avoided. Without this program, the 1261 Project students would have been placed in more restrictive and costly educational settings.
Furthermore, of the 29 students who exited the project, 22 students (76%) enrolled in less restrictive academic environments. Of these 22 students, 11 have entered the Marchus program, 8 were placed in district special education programs, and 1 was totally integrated into general education. Serving these students in less restrictive and less costly programs saved local, state, and federal agencies more than $610,205.
As the students' academic performance and behaviors improved, so did their social skills and socially appropriate behaviors. Of the 29 students who exited the project, 8 moved to more normal living situations ( i.e., from residential/group home settings to living with family members), resulting in an estimated social saving of $234,000. Not only has this intervention saved governmental agencies money, there have also been notable human benefits for all involved-the students as well as their families. Figure 1 details the specific cost benefits in each of the three identified categories.
Currently, eight 1261 Project students are maintaining their improved behaviors and progressing toward less restrictive settings. The savings from avoiding placement in more costly nonpublic programs and the savings as a result of 1261 classroom interventions, taken together, have saved the taxpaying public an average of more than $48,000 per student served.
These savings are a direct result of the effectiveness of the 1261 Project. Students have been able to improve their classroom and social behaviors to the extent that they have been able to move to less restrictive and less expensive classes. The total savings (and costs avoided) as a result of the 1261 Project for the 4 years studied amounted to $1,611,893 (see Figure 2).
As previously mentioned, the students in the 1261 classroom exhibited extremely difficult behaviors. Unfortunately, in spite of the 1261 classroom interventions, seven students (24%), within a year of leaving the 1261 classroom, required more restrictive settings. Three students moved to nonpublic day programs, three to residential placements, and one to a hospital.
Recommendations and Summary
More quantitative research is needed to determine the success rates of comprehensive, individualized service models, particularly in public school settings (Jones, 1992; Kauffman, 1997; Rivera & Kutash, 1994). In a recent review of literature on the issue of program effectiveness and cost effectiveness for students with E/BD, other states reported success with similar projects that encouraged wraparound, integrated, comprehensive services. Rivera and Kutash (1994) reported that comprehensive, individualized care programs in several states demonstrated success in reducing hospitalizations and returning the children involved to their primary caregivers. The outcome clearly indicates that these interventions are more cost effective because they avoid the large costs of residential treatment and/or hospitalization.
The following are suggested underpinnings for the successful replication of this model.
For Parents or Primary Caregivers
An understanding that their support of their child and the local school district is critical for the success of their child and the program.
An acknowledgment that their involvement in the placement decision in order to identify the most appropriate program for their child is critical to their child's eventual success.
Inclusion and participation in the ongoing instructional and behavioral treatment plan for their student who is in local district programs.
For Local School Districts
An operational continuum of services that provides viable placement options for students.
Overall vertical commitment; that is, a commitment from district administration, school site administration, school site staff, project staff, parents (caregivers), students, and support personnel.
Creation of a school site project advisory committee that consists of, but is not limited to, an integrated group that represents local school districts, child welfare agencies, local nonpublic schools, and the courts.
Adequate funding to support the commitment (i.e., creation of a desirable, staffintensive, community-based instructional program).
Commitment by project school site staff to include and integrate the project classroom into appropriate school site and local school district activities.
Conceptual ization, prior to the establishment of the 1261 Project, of a delivery system model that will provide the framework for programmatic success.
Establishment of a working cross-disciplinary team of teachers and assistants, social workers, mental health professionals, psychologists, and evaluators.
An acknowledgment of the importance of family/caregiver involvement.
An extensive inservice education program that provides not only training but also support to all school district personnel in order to make appropriate placement decisions.
A collaboration of regional educational, mental, and child welfare agencies to combine and integrate budgets, personnel, and experiences. This will create a vehicle to provide comprehensive family interventions for students with E/BD and allow for new training opportunities for teachers and child care workers.
Recognition that the student's return to the local school district is educationally easier if the student is returning from a local (which includes the consortium) educational setting rather than from a more restrictive and somewhat "foreign" nonpublic school setting.
For the State Education Agency and Legislature
Establishment of a comprehensive and cohesive policy to serve students with SED and BID in community-based settings.
Legislative incentives to local school districts to explore options and establish community-based programs to serve students with E/BD.
A commitment by the state to financially support districts in securing out-of-district programs when appropriate.
Support for the creation of treatment options that are family centered and in the least restrictive environment through grants and/or alternative funding.
Establishment of a comprehensive system of student identification and monitoring of student and programmatic costs.
Monitoring of school districts' budgets for students with E/BD, which would allow for per-pupil cost analysis and comparisons between the costs of serving students in nonpublic settings versus public school settings.
I believe that these underpinnings are essential to decrease the number of students referred for and served in restrictive nonpublic placements and contain the costs of providing those services.
Conclusion
There is a clear need to contain the costs of providing services to students with E/BD. Not only do local and federal agencies need to be committed to serving students in local settings, they need to act on that commitment by establishing, supporting, and funding local school district alternatives to nonpublic day and residential settings. Educational and treatment programs such as the 1261 Project classroom operated by the Contra Costa County Office of Education have been successful in both human and monetary terms. We invite legislators, governmental officials, administrators, and teachers to review this study.
As others review this work, we encourage the replication of the conceptual framework, project design, and wraparound features of the 1261 Project. We also urge transporting this project to similar programs and populations within local school districts in order to intervene with students before behaviors become so inappropriate that more restrictive placements are needed. Upon review, we are confident that legislators, educators, and parents will understand the need to establish community-based public school programs for students with E/BD.
Finally, this longitudinal study suggests the need for educators, legislators, and the general public to understand not only the services to be provided to students with E/BD, but also the cost of such services. The ultimate success of students with E/BD (i.e., their ability to live as independently as possible) is a community responsibility, involving the services of local schools, mental health agencies, and child welfare agencies. Alternative placements should take into consideration the needed services of community agencies to increase cost effectiveness and ensure student success. Under the federal regulations in the Individuals with Disabilities Education Act Amendments (IDEA; 1997), effective educational systems "promote service integration, and the coordination of state and local education, social health, mental health, and other services, in addressing the full range of student needs to maximize their participation and learning in school and in the community" (Section 651, a). The success of students with E/BD requires the cooperation of child agencies and local schools in providing needed services to this population. State legislatures and state educational agencies need to provide a framework of support and financial incentives to districts in order to educate students with E/BD in community-based school district settings.
[Reference]
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[Author Affiliation]
Robert C. MacMillan
Bridgewater State College
[Author Affiliation]
AUTHOR:
ROBERT C. MACMILLAN, Assistant Professor, Department of Special Education, Bridgewater State College, Bridgewater, Massachusetts. E-mail: RMacMillan@bridgew.edu
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