AGENDA STAFF REPORT

Agenda Item AGENDA STAFF REPORT ASR Control 21-000282
MEETING DATE:	07/27/21
legal entity taking action:	Board of Supervisors
board of supervisors district(s):	All Districts
SUBMITTING Agency/Department:	Health Care Agency (Approved)
Department contact person(s):	Annette Mugrditchian (714) 834-5026
	Jeff Nagel (714) 834-7024

Subject: Amendment No. 3 for Early Childhood Mental Health Consultation Services

ceo CONCUR

County Counsel Review

Clerk of the Board

Concur

Approved Agreement to Form

Discussion

3 Votes Board Majority

Budgeted: Yes

Current Year Cost: FY 2021-22 $140,302

Annual Cost: N/A

Staffing Impact:

# of Positions:

Sole Source: No

Current Fiscal Year Revenue: N/A

Funding Source: State: 100% (Mental Health Services Act/Prop 63)	County Audit in last 3 years: No

Prior Board Action: 02/11/2020 #12

RECOMMENDED ACTION(S):

Approve Amendment No. 3 to the Contract with Charitable Ventures of Orange County, for provision of Early Childhood Mental Health Consultation Services, to increase the contract amount not to exceed by $140,302, effective July 28, 2021, through June 30, 2022, for a revised cumulative Contract total amount not to exceed $2,140,301.

Authorize the County Procurement Officer or authorized Deputy to execute Amendment No. 3 to the Contract with Charitable Ventures of Orange County, as referenced in the Recommended Action above.

SUMMARY:

Approval of Amendment No. 3 to amend the Contract with Charitable Ventures of Orange County for Early Childhood Mental Health Consultation Services will expand services to reach five to eight year old children and continue to help Orange County providers effectively manage the challenging behaviors exhibited by infants and pre-school children in early childhood settings.

BACKGROUND INFORMATION:

Your Honorable Board of Supervisors (Board) approved the Contract with Charitable Ventures of Orange County (Charitable Ventures) for provision of Early Childhood Mental Health Consultation (ECMHC) Services and the below additional actions have been executed pursuant to appropriate authorities.

Table 1: Prior Board Actions

Board Date	Contract/Amendment	Action	Term
February 11, 2020	Contract	Board Approved Contract	March 15, 2020 – June 30, 2022
	Amendment No. 1	Deputy Purchasing Agent Authority - Administrative Revision	March 15, 2020 – June 30, 2022
	Amendment No. 2	Deputy Purchasing Agent Authority - Administrative Revision	July 1, 2020 – June 30, 2021

ECMHC Services are new services implemented in March 2020 that seek to support and provide consultation to staff in the early childcare settings in Orange County. The proposed Amendment is requesting an increased amount of $140,302 over the original budgeted maximum obligation for the FY 2021-22 term, for a revised cumulative contract total amount not to exceed $2,140,301. The COVID-19 pandemic has placed additional stressors on young children and their families. Demand for similar services has increased during the past year. The proposed amendment will increase the ability of Charitable Ventures to support community needs for services to families with children from birth to eight years old. Charitable Ventures will provide ECMHC to early childcare providers serving infants and young children and particularly build their capacity to serve children who exhibit challenging behaviors and are at risk of mental illness.

Scope of Services:

ECMHC Services are designed to improve the mental health outcomes of young developing children, particularly those exhibiting challenging behaviors in early childhood and education (ECE) settings as these children are expelled at three times the rate of school children in kindergarten through grade 12. The increase in funding will allow the provider to expand the program’s capacity and include providers in educational setting such as before-and-after school programs serving children five to eight years old. Currently, the program serves the age groups infants to five years old only and does not include the before-and after-school programs.

The services are intended to educate and build knowledge of early childhood providers throughout Orange County so that they are able to: 1) promote social and emotional development of young children in order to prevent challenging behaviors, 2) provide appropriate support for those children exhibiting ongoing challenging behaviors and 3) support the development of healthy identities in young children throughout Orange County.

ECMHC Services include mental health consultation, training, education, coaching and support services to build capacity and increase the knowledge of early childcare providers. ECMHC Services will be available to any provider in ECE settings such as licensed and licensed exempt childcare centers, family and faith-based childcare programs, ECE programs including non-state or non-federally funded and before-and-after school programs.

ECMHC Services will be provided by mental health consultants who have advanced training in mental health or early childhood development including expertise in all required evidence-based practices. ECMHC Services will be provided for a period of three to six months, during which time a mental health consultant will be paired with each ECE provider staff for practice-based individual coaching, training and feedback. Training will be offered at ECE sites, community-based organizations, as well as online and will cover a variety of topics including trauma-informed practices, adverse childhood experiences, topics related to social and emotional skills development, challenging behaviors, screening and assessment and referral to community resources. When necessary, linkages to behavioral health services will be made. Charitable Ventures will conduct outreach to ECE providers, school districts, the Regional Center of Orange County and other organizations who intersect with ECE providers throughout Orange County.

Performance Outcomes:

Program performance outcomes for the proposed Amendment will measure the impact of services to increase the ability of ECE providers to manage challenging behaviors of children and promote healthy prosocial behaviors. The contracted goals for FY 2019-20 were prorated as the program was implemented in March 2020. Soon after, the county was placed under a public health emergency and, consequently, Charitable Ventures was unable to meet one of the contracted goals for childcare sites. However, they were successful in their outreach to the ECE providers who signed up and received services, both virtually and in person. FY 2021-22 contracted goals will be increased proportionately to the proposed increase in funding (See Table 2 for contracted goals).

Table 2: Contracted Goals

Service Category	FY 2019-20 Contracted Goals (Prorated March 15 - June 30, 2020)	FY 2019-20 Annual Contracted Goals Achieved	FY 2020-21 Annual Contracted Goals	FY 2020-21 Contracted Goals Achieved (July - April 2021)	FY 2021-22 Proposed Annual Contracted Goals
Childcare Sites	30	12	100	35	115
Provider Staff at Childcare Sites	75	148	250	401	300
Children Served	400	691	2,500	1,594	3,000

Program performance outcomes for the proposed Amendment are consistent with current year goals and will be measured by data collected through pre- and post-surveys, consultation logs and assessment tools. Preliminary outcome data for FY 2020-21, available through April 2021, indicates that a majority or participants reported improvements in all areas measured and the program has demonstrated success in achieving its overall goals (See Table 3 below).

Table 3: FY 2020-21 Program Outcomes

Goal	Outcomes
ECE providers will demonstrate increase in ability to manage challenging behaviors in children.	63 percent of ECE providers reported increased confidence and knowledge to address challenging behaviors among young children.
ECE providers will report fewer children who engage in ongoing, persistent challenging behaviors.	Percentage of children who engage in ongoing challenging behaviors dropped from 25 percent at baseline to 13 percent at follow-up.
Participating children will demonstrate an increase in pro-social behaviors.	67 percent of children showed improvement in pro-social behaviors.
Participating children will demonstrate improved engagement in tasks/activities.	100 percent of children showed improved engagement in tasks/activities.

The Contractor's performance has been confirmed as satisfactory. The Health Care Agency (HCA) has verified there are no concerns that must be addressed with respect to Contractor's ownership/name, litigation status or conflicts with County interests. The Orange County Preference Policy is not applicable to this contract award.

The proposed Amendment with Charitable Ventures for ECMHC Services includes subcontractors. See Attachment B for information regarding subcontractors and Contract Summary Form.

The Amendment is presented to the Board less than 30 days from the start date of the contract term due to the additional time needed to negotiate the terms of the contract for services expansion to age group five to eight years.

HCA requests that the Board approve Amendment No. 3 to the Contract for provision of ECMHC Services with Charitable Ventures of Orange County, as referenced in the Recommended Actions.

FINANCIAL IMPACT:

Appropriations for this Contract are included in Budget Control 042 FY 2021-22 Budget.

Should services need to be reduced or terminated due to lack of funding, the Contract contains language that allows HCA to give a 30-day notice to either terminate or renegotiate the level of services to be provided. The notice will allow HCA adequate time to transition or terminate services to clients, if necessary.

STAFFING IMPACT:

N/A

ATTACHMENT(S):

Attachment A - Amendment No. 3 to Contract MA-042-20010886 for Early Childhood Mental Health Consultation Services with Charitable Ventures of Orange County
Attachment B - Contract Summary Form
Attachment C - Redline Version to Attachment A