Attachment A12.pdf

ATTACHMENT A12

CATEGORY 4: PREVENTION AND EARLY INTERVENTION

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SCHOOL-BASED EARLY INTERVENTION

SCOPE OF WORK

In addition to Attachment B – Standardized Scope of Work Language, the following applies:

I. Purpose A. The County of Santa Clara (County) Behavioral Health Services Department (BHSD) is seeking statements of qualifications from qualified Offerors interested in the School- Based Early Intervention (SB EI), previously known as Prevention and Early Intervention (PEI) Strengthening Families Program (SFP), under the Early Intervention and School-Based Services Division.

B. Offeror shall provide behavioral health services, to school-aged youth, hereafter refer to as “clients,” primarily in the school setting, although services may also be provided in a variety of settings, such as the clinic, home, community, and community agencies as necessary and as needed by the clients served.

C. Offeror shall partner with identified school district(s) and school site(s), designated to Offeror by BHSD, to fully integrate the SB EI program within the school’s processes, culture, and align with the school’s Multi-Tiered System of Supports (MTSS) framework.

1. The MTSS framework is a proactive and preventative framework to provide targeted supports to address students behavioral, academic, and social-emotional needs through three (3) tiers of support.

a. Tier 1 – Universal support for all or majority students (e.g., 75%+ student enrollment) providing core instructions and basic interventions.

b. Tier 2 – Supplemental support for some students (e.g., 15% student enrollment); includes targeted supports with group interventions.

c. Tier 3 – Intensive support for few students (e.g., less than 10% student enrollment). Clients receive more intensive, individualized support to improve their outcomes.

2. Offeror shall provide Tier 1-2 services through the SB EI program.

II. Background Information

A. The SB EI program was designed to meet the needs of students and their families, by providing early intervention services and supports through culturally and developmentally appropriate practices, and community defined evidence-based practices. Since 2017, the SB EI program has served school-age clients throughout Santa Clara County on school campuses located in high-risk zip codes. In fiscal year (FY) 2023-2024, 1,237 clients were served. Slightly more than half (55%) of clients

RFSQ-BHSD-FY25-0066: Children, Youth, and Family System of Care Services Page 2 of 10 ATTACHMENT A12: School-Based Early Intervention Scope of Work CATEGORY 4: Prevention and Early Intervention served were male, 41% Hispanic or Latino, and 15% of client’s preferred language was Spanish. Majority (95%) of clients served were between the ages of 6 to 15.

Clinical staff indicated 64.5% of clients had a Z code diagnostic code, an encounter of one or more stressful situations, such as problems related to their social environment and problems of adjustment to life cycle transitions, that may have had a negative impact on their mental health.

III. Target Population A. SB EI shall serve clients, in grades Pre-Kindergarten through 8th grade but may also include High School, and their families residing within HRAs and attending targeted school districts and designated school sites.

1. SB EI program shall provide universal early intervention supports and services to all client, regardless of beneficiary status.

a. Short-term individual therapy shall be provided to Medi-Cal beneficiaries only or uninsured individuals, for no more than ten (10) sessions.

b. For on-going moderate therapy or early intervention therapy, Offeror shall refer the client to their Managed Care Plan (MCP), Specialty Mental Health, or other school-based services.

2. Targeted school districts and school sites are identified by but not limited to three (3) criterions:

a. Designated Title 1 school;

b. School located in a high-risk zip code; and

c. School population has greater than 60 percent of students who qualify for Free & Reduced Lunch.

3. School Districts are grouped into four (4) regions in Santa Clara County:

a. Central County: Cambrian, Campbell Union, Campbell Union High, Cupertino Union, Franklin-McKinley, Lakeside Joint, Loma Prieta Joint Union, Los Gatos Union, Los Gatos-Saratoga Joint Union, Luther Burbank, Moreland, Oak Grove Union, San Jose Unified, Santa Clara Unified, Saratoga Union, Santa Clara County Office of Education, Union;

b. East County: Alum Rock Union, Berryessa Union, East Side Union High, Evergreen Elementary, Milpitas Unified, Mount Pleasant Elementary, Orchard;

c. North County: Los Altos, Mountain View-Los Altos, Mountain View- Whisman, Palo Alto Unified, Sunnyvale Elementary, Fremont Union High; and

d. South County: Gilroy Unified, Morgan Hill Unified.

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B. A typical client in the SB EI program may have, but not limited to some of the below characteristics:

1. Functional Impairment: Some difficulties observed in family interactions, peer, and social interactions. Difficulties in school functioning that is impacting their school behavior, achievement, and attendance. Moderate emotional and behavioral regulation needs that may require occasional external support.

2. Common Diagnoses and Presenting Behaviors: Anxiety disorders, depressive disorders, adjustment disorders. Internalizing or externalizing behavioral issues causing moderate impact on relationships and functioning. Some challenges with attention and concentration.

3. Support System: Access to social and environmental support but may benefit from strengthening and buffering.

4. Types of Treatment and Timeline: Clients and their families typically require support for 2.5 months or ten (10) sessions. Treatment includes individual, family, group therapy, and case management.

5. Crisis Intervention: Clients are generally stable and unlikely to need immediate crisis intervention. However, a plan should be in place for potential exacerbation of symptoms.

6. Care coordination: Simple and occasional communication with other providers, focusing on transitions and continuity of care.

IV. Program Goals and Objectives A. SB EI program shall be aligned to achieve the following goals and objectives:

1. Short-term goals shall include, but not be limited to:

a. Increase mental health awareness and knowledge;

b. Maintain or improve school functioning in areas such as school behavior, attendance, and achievement; and

c. Increase access to behavioral health services and community resources.

2. Long-term goals shall include, but not limited to:

a. Increase high school graduation rates;

b. Reduce chronic absenteeism; and

c. Improve overall school climate.

B. Objectives shall be achieved through:

1. MTSS Tier 1 services and supports include but not limited to:

a. Mental Health Promotion;

b. Psychoeducation;

c. School-wide and/or classroom skill building;

d. Mental Health Screening/Universal Screening;

e. Outreach;

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f. Touch and refer/ light case management;

g. Evidence Based Practices (EBPs), Promising Practices, and Community

Defined Evidence Practices (CDEP); and

h. Fundamental trainings for parents, faculty, and students.

2. MTSS Tier 2 supports and services include but not limited to:

a. Group skill building for students and parents to address moderate behavioral and emotional needs;

b. Paraprofessional support for critical incidents that occur within the designated school or surrounding community of the designated school;

c. Short-term individual therapy for Medi-Cal beneficiaries, no more than ten (10) therapeutic sessions; and

d. Evidence Based Practices (EBPs), Promising Practices, and Community Defined Evidence Practices (CDEP).

V. Reporting and Data Collection Requirements A. Data collection requirements

1. Data required per BHSD guidelines include but not limited to:

a. Client demographics;

b. Number of clients served;

c. Outreach activities;

d. Number of clients referred to treatment;

e. Number of group services provided and number of attendees;

f. Detailed outcome data; and

g. Evaluation summary

i. Successes;

ii. Challenges;

iii. Lessons Learned; and

iv. Implementation barriers, if applicable.

2. Data collection required by the EBP or program:

a. Administered pre and post or admit and discharge.

b. Data collection and reporting informs clinical practices, service quality, and Continuous Quality Improvement (CQI).

3. Data collection may also include but not limited to:

a. Client or Attendee satisfaction;

b. Teacher input; and

c. Parent or caregiver input.

B. Data reporting requirements

1. Narrative reporting requirements required per funding or BHSD guidelines.

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2. Cumulative, fiscal year report submitted after the fiscal year ends.

3. Outcome measure, client level, data submission is due to BHSD quarterly in an approved Microsoft Excel template.

a. Data at client level includes but not limited to:

i. Outcome measure scores at pre and post or admit and discharge or other timeframes as indicated by BHSD.

VI. Outcomes and Measurements A. Offeror shall achieve the following outcomes:

1. Demonstrate program and EBP effectiveness;

2. Client and parent satisfaction;

3. Demonstrate an increase in knowledge and mental health awareness among large groups and small groups;

4. Demonstrate change in behavioral and emotional needs; and

5. Demonstrate an increase in skill building to improve family, school, relationship, and recreational functioning.

B. Offeror shall administer standardized, reliable, and valid measurements identified by the EBP at pre- and post-EBP or identified by BHSD at specified time periods such as admission and discharge. Offeror is responsible for training staff on the use, scoring, and interpretation of the measurements.

1. EBP and outcome measures include but not limited to:

a. Participant satisfaction questionnaire;

b. Eyberg Child Behavior Inventory (ECBI), a parent/caregiver report to assess the frequency and severity of disruptive behaviors that occur at home;

c. Sutter-Eyberg Student Behavior Inventory-Revised (SESBI-R), a teacher report to assess the frequency and severity of disruptive behaviors that occur at school;

d. Teacher survey related to SkillStreaming;

e. Parenting Scale; and

f. Revised Child Anxiety and Depression Scale (RCADS-25), a brief, youth self-report questionnaire focusing on areas such as anxiety and depression.

VII. Program Description A. Service Description

1. Services shall be provided to clients who need support to address behavioral health challenges that impact their education, wellbeing, families, relationships, and other domains of functioning.

2. Offeror shall provide early intervention services by providing MTSS Tiers 1

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a. MTSS Tier 1 supports and services include but not limited to:

i. Mental Health Promotion;

ii. Psychoeducation and workshops for parents/caregivers, students, community, and faculty on specific topic areas such as:

1) Youth Mental Health First Aide, Mental Health 101, Mental Health Awareness;

2) Substance Use: Narcan Training, Vaping Prevention, etc.;

3) Suicide Prevention; and

4) Trauma Informed Systems 101.

iii. School-wide and/or classroom skill building through SkillStreaming curriculum, an evidence-based prosocial skills training program that builds social-emotional competence through approaches such as modeling, role-playing, performance feedback, and generalization;

Mental Health Screening/Universal Screening at transitional periods in a child’s developmental journey such as 3rd, 6th, and 9th grades;

Outreach to targeted populations and populations as identified by Mental Health Services Act (MHSA);

Case management – Touch and refer; and Positive Parenting Program (Triple P) Level 2, a "light touch" intervention providing brief one-time assistance to parents who are generally coping well but have one (1) or two (2) concerns with their child's behavior or development.

b. MTSS Tier 2 supports and services include but not limited to:

i. Group skill building for students and parents, to reduce or prevent behavioral and emotional needs, in areas that include but not limited to:

1) Enhancing skills such as communication, problem-solving, coping strategies;

2) Relational skills such as anger management, conflict resolution; and

3) Self-regulation, self-esteem, self-worth.

ii. Case Management – Navigation support;

iii. Critical incident paraprofessional support for critical incidents

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1) Total hours of support will be determined with BSHD based on school district size.

Student Enrollment Range School District Size

Less than 4,000 Small

4,000-9,000 Medium

9,000 or greater Large

iv. Short-term individual therapy, no more than ten (10) sessions, for Medi-Cal beneficiaries or uninsured students; and

v. EBPs include but not limited to:

1) Triple P Level 3, targeted counseling for parents of a child with mild to moderate behavioral difficulties, available for parents of children from birth to 12 years and for parents of teenagers. Level 3 interventions deal with a specific problem behavior or issue.

2) SFP, an evidence-based family skills training program for high-risk and general population families in which parents and their youth attend weekly SFP skills classes together, learning parenting skills and youth life and refusal skills. Program includes separate class training for parents and youth the first hour, followed by a joint family practice session the second hour.

B. Staffing Requirements

1. Offeror shall staff the SB EI program with paraprofessionals that can provide individual and group support and services as indicated in the Service Description.

a. Paraprofessionals may include but not limited to:

i. Behavior Specialist;

ii. Peer Support Worker;

iii. Family Specialist;

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iv. Rehabilitation Counselor; and

v. Parent Partner.

2. Offeror shall staff the SB EI program with direct service staff, such as Licensed Practitioner of the Healing Arts (LPHA), including waivered staff.

3. Offeror is responsible for training for staff to meet fidelity of the EBP along with supervision.

a. Offeror is responsible for certification and re-certification of the EBP if required by the EBP.

4. Offeror must ensure program staff and services are integrated in the designated school site.

C. Referrals and Admissions

1. Offeror shall promote MTSS Tier 1 services and supports to all students from designated school sites, and school district, if applicable.

2. Offeror shall promote and recruit students and parents for MTSS Tier 2 services and supports to selected students from the designated school sites.

a. Offeror shall receive referrals and admit clients, if applicable, into the SB EI program throughout the fiscal year (twelve months), including all scheduled school breaks such as winter break, spring break, and summer break.

3. Offeror shall accept referrals for students from identified, designated school sites.

4. Offer shall accept referrals from School Linked Services (SLS) Coordinator, School-based Wellness Center, and school site designee.

5. Offeror shall participate and be integrated within school’s existing referral system, process, and pathway.

a. If school site does not have a referral process, Offeror shall collaborate with school site to establish a referral process to receive referrals and triage referrals to appropriate level of care.

D. Care Coordination

1. Offeror shall be knowledgeable of existing supports and services within the school site and within the school community to coordinate care.

a. Step down to existing school services at the wellness center or school district resources;

b. Primary Care Provider referral;

c. Managed Care Plans or Commercial Plans; and

d. Coordinate to higher level of care.

2. Offeror shall coordinate services and collaborate with school staff, RFSQ-BHSD-FY25-0066: Children, Youth, and Family System of Care Services Page 9 of 10 ATTACHMENT A12: School-Based Early Intervention Scope of Work CATEGORY 4: Prevention and Early Intervention partnering agencies, and other organizations to connect families and children to key services outside the scope of SB EI program, when services are appropriate and available. Interagency collaborative efforts with other community partners and agencies are essential to reduce duplication of services, close service gaps, increase accessibility of services to the targeted population, continuity of services during the summer break, and establish family engagement services.

3. Offeror shall effectively link clients and their families’, including siblings ages Birth to 5, to appropriate services within the County’s Children, Youth, and Family System of Care Services.

a. Offeror shall partner with SLS Coordinator or school site providers such as Wellness Center staff, academic counselor, etc. to provide linkage to resources at school and services and supports that complement the MTSS Tiers 1-2 services provided by the SB EI program.

b. This service shall include connecting families to appropriate services if their needs for behavioral health services are beyond the scope of the SB EI program.

c. Offeror shall coordinate services with the SLS Coordinator.

E. Program Hours of Operations

1. Offeror shall provide services on a year-round basis including during school breaks such as winter, spring, and summer breaks.

2. Offeror shall provide services, Monday through Friday, before, during, and after school hours as well as times as family and student requests.

a. Services shall not impede students’ academic time and their right to an education.

3. Offeror shall provide services on designated school sites, according to a schedule determined in collaboration with the school districts.

F. Flex Funding

1. Flex funds is available to Offeror to promote, engage, and support students and their families attending MTSS Tier 1 and Tier 2 activities and events.

2. Flex funds are approved for:

a. Food/refreshments at the activity or event;

b. Childcare;

c. Program or EBP materials and supplies;

d. Incentives for completion of the activity or event; and

e. Transportation to the activity or event.

3. All other needs for flex funding must be requested to and approved by

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BHSD Program Monitor.