Early Learning and Care Division
Subject: Early Childhood Mental Health Consultation Services and Adjustment Factors
Number: 19-02
Date: April 2019
Expires: Until Rescinded
Authority: Assembly Bill 2698, Chapter 946, Statutes of 2018; California Education Code Section 8265.2, 8265.5; Assembly Bill 1840, Chapter 426, Statutes of 2018, Education Code Section 8265.5
Attention: Executive Officers and Program Directors of California State Preschool Programs and General Child Care and Development Programs
Purpose
The purpose of this Management Bulletin (MB) is two-fold:
1.
To notify California State Preschool Program (CSPP) and General Child Care and Development Program (CCTR) contractors of a new adjustment factor for children enrolled in classrooms or family child care settings when early childhood mental health consultation (ECMHC) services are provided and provide guidance on what ECMHC services qualify for this adjustment factor, as well as what best practices are available; and
Authority
Assembly Bill 2698, Chapter 946, Statutes of 2018; California Education Code Section 8265.2, 8265.5; Assembly Bill 1840, Chapter 426, Statutes of 2018, Education Code Section 8265.5
Background
The California Education Code (EC) Section 8239.1 requires contractors, in consultation with parents and guardians, take specific steps before expelling or disenrolling a child from a CSPP because of a child’s challenging behavior. Guidance and resources for implementation of this provision were provided in Management Bulletin 18-06 located at: https://www.cde.ca.gov/sp/cd/ci/mb1806.asp.
The California EC Section 8265.5 sets forth adjustment factors to be applied to a contractor’s reported child days of enrollment for any children that meet specific criteria, in order to reflect the additional expense of serving those children.
The AB 1840 (Chapter 426, Statutes of 2018) amended EC Section 8265.5, effective January 1, 2019, to increase and consolidate existing infants and toddlers adjustment factors so the same rate now applies to those children served in a CCTR contract in both center-based or family home settings. These rates are for:
1. Infants aged 0–18 months served in a center-based or family home setting, the adjustment factor is 2.44
2. Toddlers aged 18–36 months served in a center-based or family home setting, the adjustment factor is 1.8.
Additionally, adjustment factors for the following groups of children were increased to:
1. Children aged birth-21 years with exceptional needs from 1.2 to 1.54, and
2. Children aged birth-21 years that are severely disabled from 1.5 to 1.93
In September 2018, California’s Governor signed AB 2698 (Chapter 946, Statutes of 2018), adding the EC Section 8265.2 which defines and clarifies ECMHC services that can be made available to children in: (1) CSPP programs, (2) CCTR programs with children 0–36 months of age and (3) CCTR programs with children 0–60 months of age served in a family child care home education network (FCCHEN) setting.
Additionally, AB 2698 amended the EC Section 8265.5 to add a new adjustment factor of 0.05, which can be claimed in addition to any other single adjustment factor, and would apply to all children within a classroom or family child care setting when ECMHC services are provided. These statutory additions build on a statewide focus to address challenging behaviors in classrooms and family child care home settings by supporting children and families through ECMHC services and to encourage contractors to provide such services through an additional adjustment to the Standard Reimbursement Rate (SRR) to reflect the cost of providing such services.
Policy
Effective January 1, 2019, all CSPP contractors, and any CCTR contractors who care for infants and toddlers in a center-based setting or children 0–60 months in a family child care home setting, who elect to implement ECMHC services to support teaching staff and families by helping to address challenging behaviors in the classroom or family child care home setting, may claim an adjustment factor of 0.05. This adjustment factor can be claimed in addition to any other single adjustment factor, and applies to all children enrolled in the classroom or family child care home setting where services are provided.
Directive
Early Childhood Mental Health Consultation Services
To receive the ECMHC adjustment factor, ECMHC services must be provided, and such services may include, but are not limited to, the following:
1. Consultative support in how to effectively respond to all children in the classroom, including children exhibiting challenging behaviors and individual developmental differences
2. On-site consultation that includes consultative meetings and observations, and training and technical assistance to supply resources and develop teacher capacity
3. Best practices/strategies for promoting positive social-emotional health and addressing problems
4.Developing documentation of a behavior plan by the ECMHC licensed professional outlining steps to maintain a child’s participation in a program, in consultation with the teacher and parent, to support children with persistent and challenging behaviors
The ECMHC services must be provided/supervised by a licensed professional(s) who is(are) qualified to provide ECMHC services:
1. Marriage and family therapist
2. Clinical social worker
3. Professional clinical counselor
4. Psychologist
5. Child and adolescent psychiatrist
Moreover, the licensed professional that provides/supervises ECMHC services is required to have at least three years of experience working with children aged birth–five, be adequately insured, hold a license for at least two years at the time the services are provided, and be in full compliance with all professional continuing education requirements.
The CDE’s Early Learning and Care Division (ELCD) encourages the use of ECMHC services to ensure nurturing responsive environments for all children, particularly those children with challenging behaviors in the classroom or family child care home setting. The services provided should ideally:
1. Promote a multi-level, prevention-oriented approach that benefits young children in early care and education settings by building the capacity of staff, families, programs, and systems to prevent, identify, treat, and reduce the impact of social-emotional or developmental mental health problems
2. Involve consultation and training that enables teaching staff and caregivers/families to build positive learning environments, support the social-emotional health and development of all children in their classroom or home, and work effectively with children with mental health and social-emotional behavioral challenges
3. Aim to enhance relationships within classrooms and family child care home settings, create nurturing and emotionally responsive environments, strengthen adults’ effectiveness in interactions with young children, and families and each other, address and/or prevent challenging behaviors, and foster social-emotional competencies
The CDE encourages early learning and care settings partnering with their local First 5 County Commission, County Office of Education, and Quality Counts Consortia (local Quality Rating and Improvement System) to leverage existing behavioral health resources and connect children and families to a system of care when possible.
Claiming Reimbursement for the new ECMHC Services Adjustment Factor:
1. The CSPP contractors may claim the adjustment factor for all children served in a classroom or family child care setting serving age-eligible CSPP children.
2. The CCTR contractors may claim the adjustment factor for all children served in a classroom serving infants and toddlers aged 0–36 months.
3. The CCTR contractors operating a family child care home education network (FCCHEN) serving children aged 0–60 months may claim the adjustment factor.
NOTE: Since the adjustment factors are only applicable where providers are reimbursed at the SRR, in the case of FCCHEN’s, the mental health adjustment factor would apply to those contractors funded pursuant to a CCTR contact, and not to those contractors funded pursuant to a CFCC contract as those contracts reimburse at the regional market rate.
The adjustment factor for ECMHC services may be claimed for all children enrolled in the classroom or family child care home setting and is in addition to any single adjustment factor used for a particular child. For example, if there is a classroom of 24 children and ECMHC services are provided in order to assist the contractor with the behaviors of a particular child or group of children, all 24 children should be reported under the new ECMHC adjustment factor categories as it is assumed that the ECMHC services being provided will benefit the entire classroom or family home child care setting. For the purposes of reporting child days of enrollment, non-subsidized children served in the same classroom will also have the 0.05 adjustment factor applied to their single adjustment factor.
The ECMHC service should be provided on a schedule of sufficient and consistent frequency to ensure that a mental health consultation professional is available to partner with staff and families in a timely and effective manner.
If a contractor is claiming the additional adjustment factor, the ELCD will request that all of the following documents be on file during the Contract Monitoring Review process:
1. Detailed documentation of the specific early mental health consultation services that the licensed professional is providing, including the types of challenging behaviors or problems in the classroom or family child care home setting
2. Contractor plan to provide ECMHC services, including the frequency of services to be provided
3. License of the ECHMC professional and the contract/agreement or job description for the ECMHC professional
Contractors must use the new Attendance and Fiscal Report forms when submitting a report in relation to AB 2698. To locate this information, please see the current report forms and blended adjustment factor table located on the CDE Reporting Forms Fiscal Year 2018–19 web page at https://www.cde.ca.gov/fg/aa/cd/cdnfsforms18.asp [Link no longer available].
The CDE anticipates the forms reflecting the mental health adjustment factor will be available in May 2019. These include the CDNFS 9500MHCS form for CCTR programs providing ECMHC services and the CDNFS 8501MHCS form for CSPP programs providing ECMHC services.
Increases to Existing Adjustment Factors for All Center-Based Contracts
Because the adjustment factor increases were effective January 1, 2019, the applied adjustment factors for the 2018–19 fiscal year are a blend of the factors in effect January 1, 2019, and those in effect December 31, 2018. The attendance and fiscal reports have been revised to reflect the blended rates. These forms can be found on the CDE Reporting Forms Fiscal Year 2018–19 web page at https://www.cde.ca.gov/fg/aa/cd/cdnfsforms18.asp [Link no longer available].
Resources
Within the guidelines set forth, contractors are able to use whatever ECMHC model meets their needs. Some resources to consult when determining the best implementation approach are:
1. The Georgetown Model of ECMHC web document at https://www.ecmhc.org/documents/FCC_SB%20ECMHC%20Manual.pdf
2. Zero-to-Three ECMHC Policies and Practices to Foster the Care at https://www.zerotothree.org/resources/1694-early-childhood-mental-health-consultation-policies-and-practices-to-foster-the-social-emotional-development-of-young-children
More information is available at the Management Bulletin 19-02 Frequently Asked Questions (FAQ) Web page at https://www.cde.ca.gov/sp/cd/ci/mb1902faq.asp.
If you have any questions regarding ECMHC program information in this management bulletin, please contact your assigned ELCD Field Services Consultant. A list of consultants can be found at https://www.cde.ca.gov/sp/cd/ci/assignments.asp or by phone at 916-322-6233.
This Management Bulletin is mandatory only to the extent that it cites a specific statutory and/or regulatory requirement. Any portion of this Management Bulletin that is not supported by a specific statutory and/or regulatory requirement is not prescriptive pursuant to California Education Code Section 33308.5.