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Fiscal Year 2011 Mental Health Statewide Consultation Services Grant
Context
In FY10 EEC’s mental health initiatives were administered through a two-pronged approach. The
Comprehensive Mental Health in Child Care (CMHCC) Program, funded at $600,000, is an embedded
program which partners early education and care providers with mental health clinics to locate clinicians
on-site at 13 programs that have supportive child care contracts with EEC. The mental health clinicians
provide support and training to staff at the child care program and link families with needed clinical
services through the partnering clinic. Second, the Mental Health Consultation Services Grant, funded at
$900,000, aims to eliminate and/or reduce the number of suspensions and expulsions of children from
EEC funded programs; enhance staff competencies to work with behaviorally challenged children,
thereby benefitting all children enrolled in the program; strengthen parenting skills and parent
involvement; and promote collaboration for better access to services for children and families. This is
done through on-site consultation with staff and parents, observation, crisis intervention support and
case management.
EEV’s Vision and Proposal for Grant Refinement

Vision
EEC envisions expanding to a comprehensive statewide system of mental health supports for children
and families, which will foster the healthy social-emotional development of all children. EEC’s mental
health initiatives are built along a continuum beginning with promotion activities to support positive
relationships and healthy social-emotional development of all children. This includes building child care
program and family capacities to provide quality, nurturing environments for children. The second part
of the continuum is prevention activities, which include individual child-level and program-level service,
such as training and coaching, to identify risks and prevent social-emotional and behavioral problems.
Finally, interventions are implemented when there are multiple risk factors or problems identified, and
can include referrals for clinical and social services or on-site therapeutic interventions.
Running concurrent with EEC initiatives is the Department’s work with the Center on the Social and
Emotional Foundations for Early Learning (CSEFEL). With EEC as the lead, Massachusetts was one of
three states selected in spring of 2009 to participate in a unique early childhood professional
development opportunity designed to build the skills of infant and early childhood practitioners to
nurture young children’s social-emotional development. CSEFEL has been funded by the Office of Head
Start and the Child Care Bureau, Administration for Children and Families, U.S. Department of Health
and Human Services to provide training and technical assistance to selected states. The broad goal of
the intensive training and technical assistance (T/TA) activities is to foster professional development of
the early care and education workforce that enhances knowledge and skills; supports the
implementation and sustainability of evidence-based practices; and increases the size of the workforce
skilled in supporting the social emotional development of young children (birth – 5 years old).
Coordinated by EEC, CSEFEL is working with the Massachusetts Collaborative Planning Team to
accomplish these four specific goals:
1. an enhanced capacity to adopt CSEFEL’s conceptual model of evidence-based practices for
promoting young children’s social and emotional competence and for preventing and addressing
challenging behavior (The Pyramid Model).
2. an increased number of high quality trainers and coaches;
3. a cadre of local demonstration sites; and
4. an evaluation of the three outcomes above.
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
Grant Refinement
Historically, EEC’s Mental Health grants have been awarded to entities able to serve only portions of the
Commonwealth’s children. Approximately 80 cities and towns across the state have had access to EEC
mental health initiatives, leaving many that have not. With CSEFEL professional development being
implemented as the foundational base for support of young children’s social-emotional growth in
Massachusetts, EEC proposes that in FY11 the Comprehensive Mental Health in Child Care Program and
the Mental Health Consultation Services Grant funding is combined into one grant program for a total of
$1.5 million (FY11 funding amount to be finalized). In order to benefit the maximum number of
programs, children and families, the embedded model will be forgone for a statewide consultation
model, which will have further reach for the same amount of funding. Grants will be made available to
entities to build a comprehensive statewide system of mental health supports through a consultation
model which includes access to limited onsite support as needed.
Combining the funding from EEC’s current initiatives into a single statewide consultation model will
allow EEC the opportunity to move its mental health initiatives statewide, helping to create a structural
foundation on which future mental health programs and initiatives can be built.
Grant Purpose
The FY11 Mental Health Consultation Services grant is intended to create a statewide mental health
consultation services model that meets the needs of the early education and care field. The objectives
of the model are 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 children’s 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 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.
System Structure and Target Populations
EEC’s statewide structure will be defined such that all programs and providers in EEC’s mixed-delivery
system across the Commonwealth will have access to consultation services for the purposes listed above
as needed. Programs serving children with EEC supportive contracts will be prioritized with regard to
access to consultation services. As of October, 2009 there were approximately 5,200 children receiving
supportive contracts in the State, who are served by 1,100 programs.
Consultation Services Model Effectiveness
Evidence-based research on early childhood mental health models is beginning to grow, though is
currently scarce. There are, however, certain state models that have shown promising success in their
implementation. Connecticut, for example, works with a budget of roughly $2.0 million dollars annually
to implement a statewide mental health consultation system similar to that which EEC proposes. This
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consultation model has shown promising effects on the number of children who were at risk for
expulsion/suspension being retained in their child care settings, positive results from parents who see
improved outcomes for their children as well as improvements in scores from the CLASS assessment for
participating programs.1
Grant Goals
The three main goals of the program are for selected entities to:
1. Build on success of EEC’s previous models of mental health consultation and services to provide a
system of mental health consultation accessible statewide.
 Grantees must have the capacity to provide direct services and consultation at the child,
family and program levels.
2. Meet needs identified by EEC.
Grant funding will be prioritized for proposals that demonstrate the ability to:
 Provide services widely accessible within a set region;
 Benefit the greatest number of at-risk children;
 Serve children from birth through age 14, with a particular emphasis on working with
children and families as early as possible (infant/toddler capacity);
 Address cultural and linguistic needs of children, families, and providers;
 Work in partnership with families;
 Provide referral options for children with intensive mental health needs;
 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 Learning’s (CSEFEL) Pyramid Model); and
 Build field and program capacity through train the trainer models to enable program staff to
respond quickly and appropriately to children and families in need of support.
3. Create efficiencies by building on the current system of collaboration with partners and use of 3rd
party billing without duplication.
 Build linkages to other available and appropriate community resources, social services, and
mental health agencies including referrals to public school Special Education, Early
Intervention programs, and other family support programs and services, in order to
promote the coordination and continuation of mental health services for children and
families; and
 Make referrals for more intensive therapeutic services for children and families, including
services provided for MassHealth eligible children through CBHI.
Required Services
Grantees will be required to perform the following services:
1. Provide on-site mental health consultation and support services by a qualified behavior
specialist/mental health consultant. These services consist of Individual-level services to address
the particular needs of a child or family; and Program-level services to help educators promote
1
Duran, F., Hepburn, K., Irvine, M., Kaufmann, R., Anthony, B., Horen, N., et al. (2009). What Works? A Study of
Effective Early Childhood Mental Health Consultation Programs. Georgetown University Center for Child and
Human Development.
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emotional well-being and serve children with behavioral challenges; including, but not limited,
to the following:
 On-site observation of classrooms and on-site observation and assessment of individual
children’s social-emotional and behavioral skills;
 Guidance for educators and families on understanding and responding to children’s
social- emotional and behavioral needs;
 Modeling of appropriate responses to children’s challenging behaviors for educators,
and modeling positive interactions with families;
 Guidance and referrals for educators and families on coping with stress and mental
health issues;
 Consultation with program staff and director around program strengths and needs;
 Consultation with educators and parents around children’s strengths and needs; and
 Development and implementation of individualized behavior plans for children with
input from program staff and parents.
2. Strengthen the involvement of parents by encouraging them to access needed services;
supporting their participation in the development of individualized behavior plans for their
children; and providing support to parents through on-site consultation, technical assistance on
behavioral strategies and interventions, modeling of positive interactions, translation services
and referrals, as needed; and
3. Provide crisis intervention planning and on-site crisis support in a timely manner for early
education and care programs in the target area, in order to:
 Stabilize children at risk of suspension and expulsion due to their challenging behaviors;
and
 Provide support, resources, and referrals to children, families, and staff of early
education and care programs impacted by a traumatic event such as an accident or
death that affects program staff and children.
4. Complete required documentation and reporting including, but not limited to, number of sites
and classrooms visited; ages and numbers of children observed and served; outcomes, including
the number of children who risk suspension or expulsion due to their challenging behaviors,
types and frequency of behavioral issues observed, and analysis of the most effective
intervention strategies.
5. Provide trainings to programs, and utilize train the trainer models when possible, to build selfsufficiency 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.
6. Provide on-site, clinical mental health interventions (including diagnostic evaluation; individual,
group and family counseling; family and case consultations; collateral contacts) utilizing 3rd party
billing for services. Clinicians will:
 Directly bill insurance, including MassHealth/MBHP, for allowable, medically-necessary
services;
 Receive appropriate clinical supervision/oversight;
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

Follow appropriate confidentiality protocol regarding sharing of clinical information with
child care staff and other parties, maintaining all necessary releases of information in
order to provide services; and
Regularly communicate with and work in collaboration with parents/guardians
regarding their children’s treatment – providing translation services and written
materials in the primary language of the child’s family whenever possible.
7. Conduct outreach and elicit referrals from EEC-funded programs and providers located within
the service area.
8. Support continuity of services provided to programs. Grantees must :
 Ensure that clinicians visit the same programs whenever possible and track clinicians
lengths of tenure with programs;
 Match programs with mental health providers who speak the language and understand
the diversity of the population to which they are consulting; and
 Survey programs/providers to determine the effectiveness of mental health
consultation services provided through this grant.
Data Reporting and Evaluation - TBD: EEC will be developing a data reporting and evaluation plan for
the FY11 Mental Health Consultation Services Grant as planning moves forward.
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