Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise F. Rogers, Chief, San Mateo County Health
Scott Gilman, Director, Behavioral Health and Recovery Services
Subject: Measure K: Amendment to the Agreement with TALK: Teaching and Assessing Language for Kids for Alternative Therapy Services
RECOMMENDATION:
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Measure K: Adopt a resolution authorizing an amendment to the agreement with TALK: Teaching and Assessing Language for Kids for alternative therapy services, reducing Measure K funding and adding Mental Health Services Act funding, decreasing the amount of the agreement by $112,500 to $397,500, with no change to the agreement term.
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BACKGROUND:
On June 2, 2020, this Board approved an agreement with TALK: Teaching and Assessing Language for Kids, to provide alternative therapy services, for the term July 1, 2020 through June 30, 2022, in an amount not to exceed $510,000.
DISCUSSION:
Many children receiving speech and language services have experienced multiple adverse childhood experiences (ACE) that may not be recognized or addressed by traditional mental health service providers. When a child experiences strong, frequent, and/or prolonged adversity-such as physical or emotional abuse, chronic neglect, caregiver substance abuse or mental illness, exposure to violence, and/or the accumulated burdens of family economic hardship-without adequate adult support, the development of brain architecture and other organ systems can be disrupted, resulting in increased risk for stress-related disease and cognitive impairment throughout the lifespan. Young children exposed to five or more significant ACEs in the first three years of childhood face a 76% likelihood of having one or more delays in their language, emotional, or brain development. The Neurosequential Model Therapy (NMT) Program is able to identify children with speech and language sensory deficits, making it easier for staff to issue the necessary referrals. TALK provides intensive and individualized alternative therapy services up to four times per week, to children with speech, voice, social, and developmental disorders. Because these services are not provided by schools through an Individualized Education Plan or covered by insurance; they can be unaffordable to most families.
During the COVID-19 health crisis, TALK has continued to provide services to clients through Telehealth for those clients who have access to WiFi and a device such as a laptop, tablet or smart phone. When in-person services are required, staff wear Personal Protective Equipment (PPE) at all times. In some cases, clients with sensory or behavioral problems are not able to wear PPE due to the extreme discomfort felt or to limited cognitive understanding, but PPE is worn by the speech therapist at all times. The speech therapy team communicates internally and with the families prior to providing services to clients who are unable to wear PPE.
The County implemented a 3% reduction in Measure K funding to ensure a continuation of services and the ability to meet budgetary needs. In addition, the Mental Health Services Act (MHSA) Innovation funding was approved to complete a four-year pilot of the NMT Program in the BHRS adult system of care. Due to the positive outcomes for youth and adult, NMT was prioritized for funding as part of the MHSA 3-year plan. Through this amendment: 1) Measure K funding will be reduced by $212,500; and 2) MHSA will add $100,000; resulting in an overall funding reduction of $112,500.
The resolution contains the County’s standard provision allowing amendment of the County’s fiscal obligations by a maximum of $25,000 (in aggregate).
The amendment and resolution have been reviewed and approved by County Counsel as to form.
The goals of Individualized Treatment Plans (ITP) are reviewed and updated bi-monthly based on the progress of the child and continued developmental needs identified by the contractor. It is anticipated that 95% of the clients will show improvement in at least three goals identified in their ITP.
PERFORMANCE MEASURE:
|
Measure |
FY 2019-20 Actual |
FY 2020-21 Projected |
|
Percentage of clients who show improvement in at least three goals identified in their ITP |
95% 6-10 clients |
95% 6-10 clients |
FISCAL IMPACT:
The term of the agreement is July 1, 2020 through June 30, 2022. The amount of the amended agreement is not to exceed $397,500. The amendment decreases the contract maximum by $112,500 and is included in the BHRS FY 2020-21 Adopted Budget. Of the decrease, Measure K funding will be reduced by $212,500 and $100,000 of MHSA funding will be added.