Transforming Together: Implementation Guide
Please see below for a vignette from Fresno County, amplifying the benefits and impact of ecosystem work.
Fresno County: Building Access Through Trust and Integration
Fresno County Superintendent of School’s (FCSS) journey toward an ecosystem of care began with a stark reality: rural communities on the county’s west side had virtually no access to behavioral health services. “We knew there was a lack of services for all students,” recalls Trina Frazier from the office of the Fresno County Superintendent of School. FCSS partnered with the Department of Behavioral Health to bring services directly into schools, homes, and communities— laying the foundation for trust and shared responsibility. Over time, FCSS shifted from offering only specialty mental health (tier three) to offering tier one and tier two services now includes prevention and early intervention supports, and mild mental health services with 12 wellness centers strategically placed in high need areas and mobile therapy units serving as regional hubs. FCSS now has a full behavioral health continuum of care. Key milestones along the way included blending funding streams, piloting billing through the statewide fee schedule, and creating a consortium with districts to close gaps for students with private insurance. “Our goal was to remove as many barriers as possible so families could have a choice where they obtain services,” adds Tammy Frates. Wellness Coaches, clinicians, and family partners now provide care through a “no wrong door” approach, ensuring families are connected to support no matter where they enter the system.
The work has not been without challenges— navigating two different systems (medical and educational) required patience, training, and new language. But FCSS is seeing results: waitlists have shortened, more youth in rural areas are accessing care, attendance has improved, and suspensions have declined. For FCSS, the most inspiring outcome is simple: children receiving mental health services they never had before. As Trina explains, “It can change the trajectory of a student’s life—teaching them how to cope with what’s going on at home, so they can show up ready to learn.”
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