Purpose

The purpose of this memo is to provide interim guidance to CHVP-funded LHJs regarding the allowable uses of State General Fund (SGF) Evidence-Based Home Visiting (EBHV) funding for mental health supports, including; hiring or subcontracting for a mental health consultant or social worker to support home visiting programs. 

Background

Home visitors work with families who experience multiple stressors, including poverty, food and housing insecurity, intimate partner violence, substance use, and mental illness.¹ The COVID-19 pandemic heightened these stressors.² As a result, home visitors have experienced more burn-out, attrition, and secondary trauma, as they help families navigate through such challenges. 

LHJs have repeatedly expressed to CDPH/CHVP the need for integrating mental health support into CHVP local programs to support staff wellness, stabilize the home visiting workforce, and support families.

Updates

CDPH/CHVP is currently developing policies and procedur​es (P&Ps) regarding allowable uses of funding for mental health supports, starting with hiring or subcontracting with a mental health consultant or social worker using CHVP State General Funds. The upcoming P&P will provide parameters for the scope of work of a mental health consultant or social worker, recommendations, a process for requesting funding for this purpose, and information on limits on the scope and unallowable uses of funding. At this time, a mental health consultant or social worker may not provide any direct mental health care to home visiting participants using CHVP funding. CDPH/CHVP is exploring options for supporting direct services, such as short-term therapy or bridge support as a participant gets connected with longer term treatment and services.

Currently, CDPH/CHVP does not have approval for mental health adaptations or enhancements, as outlined in this memo, from HRSA MIECHV. We will be seeking this approval as we finalize the CHVP P&P. As a reminder, MIECHV grant funding restrictions are clear that funds cannot be used for the delivery or costs of direct medical, dental, mental health, or legal services.

CDPH/CHVP has the goal of broadly supporting LHJs with increased flexibility in use of CHVP funding to meet the needs of home visiting programs and families. We are committed to engaging with department leadership, partners, and model developers to understand local program needs and idenitfy allowable uses of funding for model-approved adaptations and add-ons, as well as other evidence-based home visitng models that may complement the current three CHVP-funded models - Healthy Families America (HFA), Nurse-Family Parentership (NFP), and Parents as Teachers (PAT). As we work to develop parameters around this flexibility and processes for requests and approval we will continue to communicate and gather input and feedback about our plans.

Action

LHJs that would like to request use of funding for hiring or subcontracting with a mental health consultant or social worker to support the home visiting program and staff may do so through the SFY 2023-24 AFA process or by contacting your assigned CDPH/CHVP Program Consultant (PC). PCs may request additional information and LHJs will need to ensure that the EBHV model developer is aware of and agrees with the proposed mental health consultant or social worker scope of work. Requests will be considered on a case-by-case basis with the understanding that once the CHVP P&P governing allowable uses of funding for hiring or subcontracting with a mental health consultant or social worker is finalized, approved, and posted, LHJs may be required to amend the scope of the mental health consultant or social worker’s work to align with the P&P.

Please contact you CDPH/CHVP PC with any questions regarding all other model developer approved add-ons or adaptations to HFA, NFP, or PAT. CDPH/CHVP is working on a process for assessing and supporting requests.

Questions

If you have any questions about this memo, please contact your CDPH/CHVP PC or Jane Troglia (Jane.Troglia@cdph.ca.gov) and Gina Gordon (Gina.Gordon@cdph.ca.gov).

1. Michalopoulos, C., Faucetta, K., Hill, C. J., Portilla, X. A., Burrell, L., Lee, H., Knox, V. (2019). Impacts on family outcomes of evidence-based early childhood home visiting: Results from the Mother and Infant Home Visiting Program Evaluation. (OPRE Report No. 2019-07). Washington, DC: Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services.
2. Campbell A. M. (2020). An increasing risk of family violence during the COVID-19 pandemic: Strengthening community collaborations to save lives. Forensic Science International: Reports, 2, 100089. 10.1016/j.fsir.2020.100089.

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