Comprehensive Statewide System of Mental Health Supports for Children & Families Mental Health Consultation Grant (Fund Code 700) Mental Health Services Procurement – Discussion and Vote EEC Board Meeting - October 16,

Comprehensive Statewide System of Mental Health Supports 2 The statewide system of mental health supports for children and their families include a variety initiatives that are aligned with several of the goals and priorities of EECs Indicators of Success under the Quality, Family Support, Workforce, Communications and Infrastructure sections of the EEC Strategic Plan. In addition, there are many key provisions under M.G.L Chapter 15D specific to supporting childrens healthy social emotional development, the availability of mental health consultation services designed to prevent expulsions and suspensions of preschool-age children in Massachusetts. Additional Details offered in Appendix

V ISION AND F UTURE : Massachusetts Early Childhood Mental Health System of Supports For Early Childhood Mental Health Consultation (ECMHC) 3

Vision and Future: Massachusetts Early Childhood Mental Health System of Supports For Early Childhood Mental Health Consultation (ECMHC) System of mental health supports, strategies, and services which addresses the developmental, emotional, and behavioral challenges of infants, young children and their families complementing the CSFEL Pyramid Model promoting school readiness and healthy social-emotional development Part of a larger, community-based system of metal health services and supports for young children and their families based in early education and care settings with connections and referrals for consultation, screening, assessment, and treatment made within the mental health systems and services. System of collaborative, developmentally based strategies, attentive to the needs and effective care of culturally and linguistically diverse populations within early childhood programs, staff, families, and communities collaborative effort of EEC, DMH, and ECMHC providers increasing access to consultation through a centralized intake system and brief intervention model. Competent mental health consultants whose knowledge, skills, and interventions are informed by evidenced-based and emerging practices and who are provided professional development opportunities, support, guidance, and technical assistance. Evaluation and monitoring to promote continuous quality improvement, sustainability, and progress in reducing expulsion rates 4

Vision and Future: Massachusetts Early Childhood Mental Health System of Supports For Early Childhood Mental Health Consultation (ECMHC) Family centered, interdisciplinary, collaborative, high quality service for infants, young children, and their families provided across educational, health, mental health, child welfare, and other community-based services. Strategies committed to family engagement within EEC programs and its network of community and family supports. Individualized services and strategies for the program, staff and families. Programs and staff function with new perspectives, confidence, knowledge, skills and strategies to promote infant and early childhood mental health, address current problems and prevent future concerns that might arise. Receive the ongoing support and technical assistance needed to succeed in their work with children and families. 5

P ROCUREMENT : Mental Health Consultation Services Grant (Fund Code 700) 6

FY14 Mental Health Consultation Grant Proposed Purpose The objectives of the model remain as follows: Promote the healthy social and emotional development of all children, particularly those children whose emotional development is compromised by poverty, biological or family risk factors, or other circumstances which may contribute to toxic levels of stress; Build the capacity of early education and care program staff to enhance childrens learning through positive, nurturing interactions with children and with their families and to address the needs of children who exhibit behavioral challenges; Attend to social-emotional needs of children so they are ready to learn and be successful in their early education; Reduce the number of children who are suspended or expelled from EEC-funded programs; Promote collaboration for better access to services for children and their families; and Maximize resources by ensuring that certain mental health interventions are funded, when appropriate, through insurance payments. 7

Benefit the greatest number of at-risk children and children and families identified as high needs (Expanded); Address cultural and linguistic needs of children, families, and educators, programs and communities; and measure effectiveness of interventions (Expanded); Work in partnership with programs, educators, families, and other community supports using collaborative approaches (Expanded); Provide referral options for children and families with behavioral, emotional, developmental, and /or neurodevelopment difficulties, (refined); Build program capacity through training and coaching on models that promote positive social emotional development and prevent challenging behaviors (e.g. the Center on Social Emotional Foundations for Early Learnings (CSEFEL) Pyramid Model, Strengthening Families, etc.) in the context of the provision of specific on-site consultation service (Amended for clarification); 8 Summary: Proposed enhancements for FY14 Grant Priorities

Build linkages to other available and appropriate community resources, social services, and mental health agencies including Mass 211, pediatricians, pediatric medical home, MCPAP, referrals to Early Intervention programs, public school Special Education, and other family support programs and services in order to promote the coordination and continuation of mental health services for children and families (Expanded); Make referrals for screening, assessment, diagnosis, and mental health services for children and families including services provided for MassHealth eligible children through the Childrens Behavioral Health Initiative (CBHI), and other appropriate third party billing sources (Expanded); Notify EEC/DMH of areas of the state where third party mental health services are not available in a community or for a specific family (Expanded); Utilize a centralize program referral/intake system (New), and Improve the integration of ECMHC services with other systems of support though the participate in on-going technical assistance opportunities and work collaboratively with community partners to strengthen the infrastructure of the statewide system of mental health supports and further enhance the quality of ECMHC services (DMH Technical Assistance) (New). 9 Summary: Proposed enhancements for FY14 Grant Priorities (cont)

Use centralize intake system to manage and track success of ECMHC outreach, programs requests for consultation, presenting concerns, and utilization for program-level and classroom level mental health services, (i.e. purpose, program characteristics, frequency, duration, and intensity) (Expanded); Manage referrals, and track utilization of clinical and social services or on-site therapeutic interventions and the 3rd party billing source (Access, Availability, and Utilization) (Expanded); Use of a standard measurement tool to gather and analyze information about the effectiveness of the mental health consultation services used statewide that will provide demographic, process, and outcome data and provide pre- and post assessment information to EEC and DMH (Expanded); Program-level and classroom-level to measure changes in the program/classroom environment, Program administrators, educators and families 10 Summary Proposed enhancements for FY14 Required Services

Complete required documentation and reporting requirements monthly, and as requested by EEC/DMH (Expanded/ Refine to align with required services and additional data collection elements) Provide focused training to programs to build self-sufficiency of staff to respond to the social-emotional needs of children. Also, incorporate training and resources to allow programs to create and build their own relationships with local mental health providers. Training should be provided only in the context of a specific program level consultation services (Amended for clarification); Provide on-site, clinical mental health interventions (including diagnostic evaluation; individual, group and family counseling; family and case consultations; collateral contacts) utilizing 3 rd party billing for services, when available. Also, maintain a wait list of children, families, and/or programs waiting more than 3 days to receive consultation services; and provide notification to EEC/DMH of areas of the state where third party mental health services are not available in a community or for a specific family (Expanded). 11 Summary Proposed enhancements for FY14 Required Services

Conduct outreach to programs/ providers and expanded network of community supports included Mass 211, and elicit request for ECMH consultation services from EEC-funded programs/providers located within the service using a centralized intake system (Expanded); Participate in meetings as scheduled by EEC/DMH to offer feedback to support the enhancement of the early childhood mental service delivery model and structure (New); Participate in on-going technical assistance opportunities and working collaboratively with community partners to strengthen the infrastructure of the statewide system of mental health supports and to further enhance the quality of ECMHC services (DMH Technical Assistance) (New). 12 Summary Proposed enhancements for FY14 Required Services

EEC and DMH will continue to meet to: Design & develop a centralized intake system, technical assistance protocols and stream-line ECMHC program evaluation tools for FY13 to inform the development of anticipated FY14 grant opportunities. Proposed Procurement EEC will develop and issue a Request for Responses (RFR) for the FY14 Mental Health Consultation Services Grant as a Competitive Procurement in November 2012 with a start date effective, July 1, 2013 FY14 Anticipated Appropriation $1.25 M 13 FY14 Mental Health Consultation Grant Next Steps

D ISCUSSION & V OTE : PROCUREMENT MENTAL HEALTH CONSULTATION SERVICES GRANT 14