Financing IECMHC

Financing IECMHC

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Overview

Sources of funding for IECMHC vary across the nation, depending on political and economic context. States differ in their financing approaches, but no matter how creative or successful they are in their approaches to funding, advocacy is critical (or essential) both in terms of using existing funding streams and for  bringing in new funding to support an IECMHC system.

Not every strategy for sustaining infant and early childhood mental health consultation requires funding, but when trying to initiate or enhance prevention, wellness, and mental health services and supports for young children and their caregivers, knowing how to access and leverage funding can be important.

Financing Tip: When considering which funding sources to use, the following questions can help guide your planning:

  1. Is the funding source time-limited? For how long?
  2. Can the funding from this source be leveraged to bring in other funding?
  3. Are these funds renewable or one-time?

Depending on the size and scope of the IECMHC initiative or component you are funding you might pursue opportunities through:

  • National, state, and local public grants
  • Your state’s legislature
  • Local property taxes
  • Ballot measures (local or state)
  • Philanthropy
  • Re-prioritizing existing early childhood or mental health budgets

Financing tip: Leverage funds from other programs that have intersecting missions.

Financing strategies can be about dollars but they can also be about getting a needed service or support in ways that use other community resources “in-kind,” such as clinical services from a partner organization or sharing staff or administrative time. In this section we address funding as well as saving on costs through shared resources.

 New or emerging IECMHC programs can start by completing the checklist in Strategy 1.

Strategies

If you are a new or emerging IECMHC program, we recommend you start with the checklist in Strategy 1.

Organizational readiness

Yes

No

In process

Can you identify your main objectives and population served?

Is it clear to funders what outcomes you want to achieve?

Financial management

Yes

No

In process

Do you have a clear and realistic budget?

Do you have a way of tracking and managing your budget?

Are you clear about funding needs/gaps?

Do you have a fundraising strategy?

Communication

Yes

No

In process

Do you regularly communicate with current funders?

Do you know what your funders think of the work that you do?

Do you believe your funders would provide future funding for your program?

Program implementation

Yes

No

In process

Is your program clearly defined for funders?

Do you have adequate human resources to implement your program?

Do you measure program impact?

Do you collaborate with other partners?

What is it: A ballot initiative, referendum, or measure, puts an issue, law, or question on a state or local proposal to eligible voters. These are typically citizen-initiated, and rooted in the needs of the community, giving voters a closer connection to the proposed policy

Considerations: Ballot initiatives can be intensive. Typically, petitions are circulated and require enough signatures to get on the ballot. Twenty-four states have an initiative process – so not all states have this option in place. This link (Opens in new tab) (Opens in new tab) shows which states have initiative or referendum processes in place

What can be funded? Ballot initiatives can be used for purposes outlined in the initiative, and could include dedicated mental health prevention and early intervention programs, education and training, or early childhood programs among many other possibilities.

Additional resources or examples: To gain a more comprehensive understanding of types of initiatives, the National Conference of State Legislatures has put together this guide (Opens in new tab) (Opens in new tab).

What is it: Property taxes (residential and commercial) help to cover the costs of basic societal functions. Cities, municipalities, counties and school districts rely on property taxes to raise money for their budgets.

Considerations: Property taxes are based on a percentage of the value of owned property in the city, municipality, or county. But when municipalities depend largely, and sometimes exclusively, on property taxes for revenue, it creates inequities between rich and poor communities.

What can be funded? Funding can be directed to a variety of services or supports, depending on the language used to identify how the funds will be used. Services not covered through other funding streams, capital construction, and innovative programs are just some examples.

Additional resources or examples: Research has demonstrated the staying power and resiliency of property taxes during economic downturns when other taxes (such as sales or income) are more volatile.

What is it: A sales tax is a consumption tax imposed by the government on the sale of goods and services.

Considerations: There is often a gap between taxpayers wanting more funding for services and being willing to pay for it.

What can be funded? Most states/localities put sales tax revenue into a general state/local fund to support a variety of public services. Sometimes states/localities earmark portions of sales tax revenue for a particular purpose or initiative.

Additional resources or examples: In 2018, Denver, CO voters approved Caring 4 Denver (Opens in new tab) (Opens in new tab), a ballot measure that implements a small sales tax increase, .25 percent, to fund mental health services.

What is it: Philanthropic funding includes funding from private, community, or corporate foundations for high-impact initiatives in communities of interest.

Considerations: Funding through philanthropy is typically short-term and not sustainable. Many donors want to avoid being reactive and piecemeal in their giving and need ideas, examples, and history to make them more informed grantmakers.

What can be funded? Short term initiatives or innovative projects that can be used to demonstrate effectiveness or outcomes.

Additional resources or examples: A useful resource to better understand considerations with relying on philanthropic funding can be found here: Fixing Problems via Philanthropy vs. Government. (Opens in new tab) (Opens in new tab)

What is it: Early and Periodic Screening, Diagnostic, and Treatment (Opens in new tab) (Opens in new tab) (EPSDT) is Medicaid’s comprehensive, preventive child health benefit. School health services can be provided in schools. Medicaid’s role in schools goes beyond ensuring that students with disabilities have access to the medical services they need to succeed. Medicaid provides support for health care services delivered in school, which benefit all children — not just those enrolled in Medicaid.

Considerations: Services must be provided to a child who is enrolled in Medicaid, and services must be deemed medically necessary for the child. In many states, children must have an IEP or IFSP to be eligible. To receive Medicaid payment for health and related services, schools, providers in schools, or school based health centers must meet federal and state requirements for Medicaid providers and any state-specific Medicaid State Plan Amendment must be considered.

What can be funded? Depending on the interventions that the individual child needs, services that can be covered as rehabilitative services are inclusive of individualized mental health and substance use treatment services, including in non-traditional settings such as a school, a workplace or at home.

Additional resources or examples: The Centers for Medicaid and Medicare Services (CMS) issued guidance that allows school districts to expand their school based Medicaid programs to cover more students than just those who have IEPs or IFSPs, and potentially bring in additional, sustainable federal funding for states. Many states have or are considering expanding school based Medicaid programs to include all Medicaid-enrolled students—and to add additional covered services and provider types. This presents an opportunity to expand access to and resources for school health services when ECMHC is provided in a school setting, such as a public preschool program.

What is it: The Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program gives pregnant women and families, particularly those considered at-risk, necessary resources and skills to raise children who are physically, socially, and emotionally healthy and ready to learn.

Considerations: As mandated by the Patient Protection and Affordable Care Act, the home visiting program aims to improve maternal and child health and outcomes, children’s development, and the economic self-sufficiency of families through support and education.

What can be funded? IECMHC can be incorporated into home visiting models by providing consultation to home visitors

Additional resources or examples: Iowa began providing funding for mental health consultation in their MIECHV contract after writing IECMHC into their MIECHV request. The MIECHV program has provided funding to each of their contractors to secure a mental health consultant in their service area to provide consultation services to their family support supervisors and family support staff. Mental health consultation orientation was provided to each program. Facilitated monthly calls occur for resource sharing, problem solving, and overall support. “This project has been incredible. What an amazing time, especially through a pandemic, to be a family support professional and have the support of a mental health consultant.” -- Iowa MIECHV Program Manager

What is it: The Program for Infants and Toddlers with Disabilities (Part C of IDEA) is a federal grant program that assists states in operating a comprehensive statewide program of early intervention services for infants and toddlers with disabilities, ages birth through age 2 years, and their families.

Considerations: Part C services and planning are only available to children under the age of 3 who meet eligibility criteria in their state. Programming is based on measurable results or outcomes for the individual child and their family.

What can be funded? Services and supports funded must meet the individualized needs of the child and family.

Additional resources or examples: In Louisiana, IECMH consultation services are offered to early intervention service providers, including speech and language therapists, occupational therapists, physical therapists, special instructors, family service coordinators, and program administrators. Providers were reported to have increased their use of informed clinical opinion about social-emotional concerns in eligibility determinations; increased social-emotional screening of children in foster care, and increased focus among early interventions providers on family relationships as observed in focus groups.

What is it: Title V is a key source of support for promoting and improving the health and well-being of the nation’s mothers, children (in particular children with special needs) and their families.

Considerations: States and territories have discretion in the use of Title V Maternal and Child Block Grant funds to address their unique needs through gap-filling direct services, and enabling public health services and systems.

What can be funded? Many state Title V programs collaborate with other state agencies to establish mental health consultation services for child care providers. Title V programs also provide health and safety consultation to child care providers through the Healthy Child Care America program, a collaborative effort of MCHB, the Child Care Bureau of the Administration for Children and Families (ACF), and the American Academy of Pediatrics.

Additional resources or examples: Many states such as Kentucky (Opens in new tab) (Opens in new tab) specifically incorporate early childhood mental health in their Maternal and Child Health Services Title V Block Grant planning, ensuring ECMH is embedded rather than an add-on when considering critical state maternal and child health services.

What is it: Grants to states, territories, tribes, and tribal organizations for child care assistance for low-income families, including quality enhancement in child care and provider training.

Considerations: States can use CCDF funds set aside for quality improvements and for infants and toddlers, to support I-ECMHC.

What can be funded? Activities may include professional development enhancements that target behavioral management strategies and training that promote positive social and emotional development, reduce challenging behaviors and reduce expulsion practices.

Additional resources or examples: A review of Child Care and Development Fund plans (Opens in new tab) (Opens in new tab) indicates that more states are using Quality Set Aside funds to support IECMHC services. Many states are directly linking the need for IECMHC to the goal of preventing suspension and expulsion for early learning programs.

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This product was developed [in part] under grant number 1H79SM082070-01 from the Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services (HHS). The views, policies and opinions expressed are those of the authors and do not necessarily reflect those of SAMHSA or HHS.