Answers to Questions relating to Management Bulletin (MB) 19-02
Return to Management Bulletin 19-02
Early Childhood Mental Health Consultants
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Can the California Department of Education approve a waiver for a consultant who is in the process of obtaining a license, but does not have one yet?
No. There is no statutory provision allowing for a waiver of the qualifications.
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Can an unlicensed individual that is supervised by a licensed individual provide the services?
No. California Education Code (EC) Section 8265.2 (b)(2) states the services should be provided by a licensed marriage and family therapist, a licensed clinical social worker, a licensed professional clinical counselor, a licensed psychologist, a licensed child and adolescent psychiatrist, or others as determined by the department. The department has not added other individuals to the list of qualified service providers.
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What type of duration and intensity of service is needed to qualify for the adjustment factor?
The early childhood mental health consultation service (ECMHCS) must be provided on a schedule of sufficient and consistent frequency to ensure that a mental health consultant is available to partner with staff and families in a timely and effective manner. The minimum standard of practice is one hour a week, although the frequency of services can vary depending on the number of staff and classrooms being served. These services can also vary based on financial resources and the scope of consultation needs. Whatever service is being performed must be documented and on file with the contractor.
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How does an agency ensure fulfillment of the timely manner requirement?
Agencies receiving an adjustment factor for ECMHCS must take affirmative steps when selecting and working with mental health consultants to ensure that services are provided on a sufficient and consistent enough basis to meet the goals of the services, which are set forth in EC Section 8265.2(a)(2). The services should be provided on a schedule of sufficient and consistent frequency to ensure that a mental health consultant is available to partner with staff and families in a timely and effective manner.
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How will the Executive Director/Program Director from a contracting agency set up agreements with a mental health consultant?
Contractors need to have evidence that the mental health consultants meet the criteria set forth in EC Section 8265.2(b)(2) by obtaining a copy of the consultant’s insurance coverage, their professional license, and any documentation that proves the consultant meets the experience requirements, such as a resume or curriculum vitae or references with contact information. The contractor shall also provide a form for the consultant to sign stating they have met all criteria under penalty of perjury.
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What role would a mental health consultant play in working directly with the child and parent, versus what role will they have working with the staff? Can the ECMHCS be used as one-on-one therapy for a specific child?
The mental health consultant will work directly with the staff at the agency on best practices to help all children in the classroom with their behaviors, including those exhibiting challenging behaviors. While they observe children in the classroom, they do not work directly with the child, so no, this service is not meant to be a one-on-one therapy for a child. The consultant’s role with the child and their parent would be indirect; they would help support and facilitate all families’ participation, collaboration, and promotion of children’s mental health, cognitive development, and social-emotional learning.
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If an agency is utilizing the ECMHCS to help maintain a child’s participation in the program, can the agency apply the new adjustment factor for all children in the classroom when the specific child is not enrolled every day?
The intent is that the mental health adjustment factor provides reimbursement to cover the cost of the early mental health consultation service. The early childhood mental health consultation services are not a direct service or therapy for a child or family. Providing this service with the intent of supporting all children’s ability to participate fully in a classroom, including those with behavioral challenges, benefits all children in the classroom, regardless of which children are present or not present. Therefore, the mental health adjustment factor should be applied to all children in classrooms benefitting from early childhood mental health consultation services.
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When can an agency begin reporting children under the mental health adjustment factor and receiving a higher reimbursement for that classroom?
If an agency was already providing mental health services on or before January 1, 2019, and the agency is using early learning and care contract funds to pay for the service, the agency could have begun reporting the child days of enrollment under the mental health adjustment factor categories back to January 1, 2019. However, if the agency hired the mental health consultant after January 1, 2019, the agency can only include the child days of enrollment under the mental health adjustment factor category back to when services began.
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If the early childhood mental health consultation services are no longer provided, can an agency still claim the adjustment factor?
No. In this case, the last day services are provided is the last day that the agency can report the days of enrollment for the whole classroom under the mental health adjustment factor.
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If an agency has another fund source to cover the expense of the mental health service, can they still report children under the mental health adjustment factor?
Yes. If an agency that has another fund source to cover the expense of the mental health service, they can still utilize the mental health adjustment factors. The agency must also report the total expense related to the mental health consultation service as well as the revenue received from the other fund source. Per California Code of Regulations, Title 5, Section 18054, reimbursement will be limited to the lesser of the contract’s maximum reimbursable amount, the new reimbursable program costs, or service earnings.
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Can contractors use reserve funds?
Yes. Contractors may use reserve funds for any mental health consultation service expenses that exceed contract reimbursement, as these expenses are reimbursable program expenses.
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Can contractors begin working with a mental health consultant and claim ECMHCS adjustment factors before a specific child or group of children are enrolled in the program?
Yes. Under EC Section 8265.2(a)(2), early childhood mental health consultation services include but are not limited to, support to respond effectively to all children, aid to providers in developing skills and tools, and development of strategies for addressing prevalent child mental health concerns. These can begin in anticipation of a specific child or group of children beginning at a program and be claimed with the adjustment factor for that particular classroom. If utilizing the factors in this way, the adjustment factors should be claimed within a reasonable amount of time.
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Can contractors use the ECMHCS adjustment factors for a classroom where non-certified children are served?
The adjustment factor can be used for children who are served in a California State Preschool Program, infants and toddlers who are 0 to 36 months of age and are served in General Child Care Fund programs, or children who are 0 to 5 years of age and are served in a Family Child Care Home setting. When certified and non-certified children are commingled in one classroom, contractors must report the certified and non-certified child days of enrollment on the Child Development and Nutrition Fiscal Services (CDNFS) report forms. If the commingled classroom has one child who is receiving a mental health consultative service, then the contractor may utilize the mental health adjustment factors to record the child days of enrollment for certified and non-certified children. Contractors are also required to report all revenue and expenses related to the commingled classroom. The CDNFS calculates a percentage of certified children served in a given program and prorates the total expenses reported accordingly.
When certified and non-certified children are co-located, i.e. certified and non-certified children are not served in the same classroom but at the same site, and the non-certified classroom received mental health services, contractors may not utilize the mental health adjustment factors. Contractors with co-located programs do not report the child days of enrollment related to the non-certified classroom and must have a cost allocation plan to accurately report the appropriate costs related to the program.
Return to Management Bulletin 19-02