First 5 SMC: Systems and Supports for Children with Special Needs Request for Applications (RFA)

Posted At:Tue, Jun 10, 2025 10:36 PMSealed Bid Process:Yes (Bids Sealed / Pricing Sealed)Private Bid:No

Through this Systems and Supports for Children with Special Needs Request for Applications, the Commission intends to solicit applications from qualified agencies and organizations interested in serving as the lead agency to implement the Help Me Grow San Mateo County system with a focus on systems improvement, increasing access to developmental screening and supports, and coordinated care and warm hand-offs to support children with and at-risk for disabilities or developmental concerns, their families, and the providers who serve them. The Help Me Grow San Mateo County system includes four structural components, as well as additional tailored services to support families with children from birth to age 5 and their providers with developmental and behavioral needs.

The upcoming three-year funding term marks an important shift in the Help Me Grow SMC service delivery philosophy. While the intent of Help Me Grow San Mateo County is to serve all children, given the changes in local service provision and the constraints of limited resources, F5SMC is adopting a targeted universalism approach, rooted in the belief that by prioritizing systemic barriers for marginalized and underserved populations, the systems will become more accessible to all. Therefore, applicants should propose how their services and approaches will prioritize support for those with the greatest need while still maintaining a universally available access point. More information on the rationale for this approach and the definition of targeted universalism is contained in the Background section of this document.

This vision for HMG SMC is intended to link to new service delivery and resourcing opportunities, and to broaden beyond the HMG core components to elevate systems building elements to more effectively serve young children with special needs and their families and to promote a more integrated system of care.

We encourage approaches that: 1) support families to more effectively navigate and advocate for care; 2) weave together cross-sector partnerships and services (e.g. partnering to identify and support specific gaps, and leverage existing resources); 3) strengthen system integration, and create greater access to services; and 4) strengthen the capacity of child and family-serving providers to deliver high-quality and culturally responsive services that meet the developmental and behavioral needs of children with special needs.

Eligible Applicants

F5SMC welcomes applications from all qualified service providers. Qualified applicants include local governmental entities, local non-profit agencies with 501(c)(3) status, local pediatric clinics, institutes of higher education, and other local service providers. Applications must be submitted by an identified Lead Applicant. A strong partnership structure with partners/subcontractor applicants is essential to deliver the intended service strategies outlined in this RFA.

Agencies interested in serving as a Lead or Partner Agency for the Systems and Supports for Children with Special Needs Initiative and interested in connecting with other interested partners may, at their discretion, share this intention during the question submittal phase of the process by June 13, 2025. Applicants who do so will agree to their agency name and contact information to be shared via the Open Gov platform with others by June 16, 2025 along with the Posted Answers to submitted questions.

F5SMC may, in its sole discretion, enter into contracts with multiple qualified providers.

Funding Amount and Available Term

First 5 SMC has allocated a maximum of $3,064,800 over a 34-month period beginning September 1, 2025 and ending June 30, 2028 to provide the required activities to meet the goals and objectives detailed in this RFA. This allocation includes $1,394,800 in Sequoia Healthcare District funding and $60,000 in Peninsula Health Care District funding as a supplement to F5SMC’s Prop 10 contribution . Specific details about budget and resource allocation organized by activity and service strategy can be found in Attachment I:

Budget Allocations and Requirements Table.

Evaluation

Successful proposers will be required to participate in F5SMC Evaluation Activities, including (but not limited to) administering surveys to program participants as directed by F5SMC staff and evaluation consultants. Surveys will include items assessing the indicators listed above, as well as items associated with other indicators specified in our 2025-30 Strategic Plan.

First 5 San Mateo County 2025-2030 Strategic Plan

In December 2024, the Commission updated its Strategic Plan for 2025-2030, which will guide the Commission’s priorities and investments. The 2025-2030 Strategic Plan is consistent with the focus and intent of the Children and Families Act, building on what has been learned and accomplished locally and providing a framework for the Commission and the community for how Proposition 10 funds will be strategically invested over the next five years. Central to the success of these investments is a strong foundation that adequately prioritizes early childhood systems and services in San Mateo County.

As outlined in its 2025-2030 Strategic Plan, First 5 San Mateo County is prioritizing partnerships with entities that are achieving both direct impact and positive systemic change. This approach fosters sustainable improvement within agencies and systems, and allows families beyond the direct service reach to benefit. Many of our investments serve present needs as well as examining and improving the underlying systems.

The First 5 San Mateo County Commission (F5SMC) adopted the following desired outcomes to guide its efforts during the 2025-2030 Strategic Plan:

1. San Mateo County leaders and partners fully invest in young children and their families.

2. Communities provide a safe and healthy environment for young children.

3. Children have timely and affordable access to high-quality early care and education settings.

4. Families feel connected to and supported by their community and able to nurture their children’s health and development.

5. Children have healthy relationships and stable attachments to their primary caregivers.

6. Children have access to and are utilizing appropriate health care services to meet their health and developmental needs.

7. Families have agency and voice to direct policies and systems that impact their children.

To achieve our desired outcomes, F5SMC has identified the following five strategies with the goal of impacting children and families across our four core domains:

1. System Navigation and Care Coordination for Families

2. Capacity and Network Building for Child-Serving Systems and Providers

3. Weaving Partnerships and Innovative Initiatives for Transformational Change

4. Family Connectivity and Leadership

5. Policy, Advocacy, and Community Education

To maximize our resources and the expertise that exists in our county, these strategies will be implemented in collaboration and coordination with other funding partners, systems, and community organizations, as F5SMC has done for 25 years. Guided by our understanding of the interdependencies and interrelatedness of early childhood systems, F5SMC recognizes that these strategies may directly impact and/or have ripple effects beyond one singular domain area.

Foundational improvements will be furthered with investments, leadership, and partnerships that target four core domains:

• Healthy Children

• Resilient Families

• Quality Care and Education

• Systems Change

Background and Research

Early identification and treatment of developmental concerns is an important element of preventive care for children during the first five years of life because this is the time when a child’s brain, body, and behavior are most malleable. Early detection is critical for the 16.9% percent of all children ages 0-5 in California who have special health care needs. However, in 2021, only 45% of children with Medi-Cal in San Mateo County received an annual preventive checkup.

Screening for developmental delays using a validated tool has been shown to detect credible concerns that are otherwise missed by primary care physicians and other child-serving professionals who rely instead on surveillance methods. The American Academy of Pediatrics recommends that pediatricians implement universal screening for their patients three times before a child’s third birthday. In San Mateo County, 64.8% of children receive timely developmental screenings, suggesting that there are still many children who may not be identified early enough. Although developmental delays pose risks for all children, delays for low-income children are more likely to be missed.

Once a health or developmental concern has been identified, families and providers need support to understand and navigate the complex array of community-based services and supports available to promote children’s optimal health and wellness. Navigating numerous and sometimes disconnected systems to access vital health care services can be challenging for any family, but especially for working families, families with limited English proficiency, and families from marginalized and disenfranchised communities.

When families are supported through coordinated care, case management, system navigation, and warm hand-offs, they may be able to more easily access health services that their children need to develop and lead healthy lives. However, California ranks 43 ^rd in the nation on effective care coordination for children with special health care needs. In 2024, F5SMC gathered qualitative and survey data from families through a number of initiatives. Across these insight gathering efforts, systems navigation and care coordination consistently rose to the surface as a key need.

​​History of F5SMC Special Needs Initiatives

First 5 San Mateo County (F5SMC) has directly invested in supporting children with or at-risk of disabilities or developmental concerns for many years. These investments have evolved over time to reflect emerging needs and research. Starting in 2007, F5SMC funded Watch Me Grow, an Early Identification and Special Needs Initiative for Young Children and their Families. This collaborative initiative partnered with 15 agencies that serve young children with or at-risk of special needs to improve the system of care for these children and to optimize their development. Then, in 2013, Watch Me Grow participated in the 5Cs (California Community Care Coordination Collaborative) funded by Lucile Packard Foundation for Children’s Health to improve systems of care for children with special health care needs and their families. These collaborative systems change efforts, which included a landscape analysis, informed the 2016 investment in developing a local Help Me Grow system, which would address the need for centralized access for children and families.

THE HELP ME GROW (HMG) SYSTEM MODEL

Help Me Grow (HMG) is a nationally recognized model to advance developmental promotion, early detection and linkage to services to support healthy development of all young children. Since 2005, the HMG system has been adopted by 99 affiliates in 31 states across the US, including 32 counties within California. The Help Me Grow model is designed to help communities leverage existing resources to provide information on child development, link families to community-based services, identify vulnerable children, and empower families to support their children’s healthy development through the implementation of four core components.

Four Core Components

Child Health Provider Outreach supports community-based pediatricians by enhancing their developmental promotion and early detection activities for all children and families. Child health care providers are charged with supporting the health and safety of children. They are uniquely positioned to identify developmentally vulnerable children as collectively they have near universal access to the population of young children. However, child health care providers often face challenges providing the ongoing monitoring of children’s developmental status, including identifying early signs of developmental or behavioral concerns. Even when needs are recognized, keeping comprehensive and updated information on community-facing services is difficult and successful connection to those programs is time-consuming.

Family & Community Outreach promotes the HMG system, facilitates provider networking, and bolsters children’s healthy development by supporting families. Family & Community Outreach is key to promoting the use of HMG and providing networking opportunities among families and community-based service providers. Family & Community Outreach staff work to engage families by participating in community meetings, forums, public events, fairs, and facilitating sessions that help families learn about child development and the role of HMG. These staff also establish and maintain relationships with community-based service providers and maintain a community resource directory.

Centralized Access Point typically takes the form of a call center and, more recently, an accompanying virtual service, that serves as the “go-to” place for family members, child health care providers, and other professionals seeking information, support, and referrals for children and early development. Telephone and web-based services have proven to be effective primary points of access to community resources. They are cost-effective, easy to promote, efficient in identifying needs, and effective in supporting callers and triaging to appropriate services.

Data Collection and Analysis ensures ongoing capacity for continuous system improvement. Data is collected throughout all components of the HMG system, including child health provider outreach, family and community outreach, and within the centralized access point. The collection of shared metrics across the HMG National Affiliate Network enables HMG affiliates to benchmark progress, identify areas of opportunity and systemic gaps, determine potentially advantageous partnerships, and guide strategic quality improvement projects.

The HMG model also depends on three Structural Requirements to provide the foundation for building and managing the components of a HMG System effectively over time: Organizing Entity, Scale and Spread, and Continuous Systems Improvement. In San Mateo County, the Organizing Entity is F5SMC; while Scale and Spread and Continuous Systems Improvement will be held in partnership with the successful lead applicant and will be driven by data collection and evaluation efforts.

HELP ME GROW SAN MATEO COUNTY

In 2016, First 5 SMC began local implementation of the Help Me Grow model. Help Me Grow San Mateo County (HMG SMC) aims to develop a system to provide universal access for parents and providers to information and resources about early development and support linkage to services. HMG SMC is a collective effort led by F5SMC with partners who are invested in ensuring that all children and their parents receive the information and support they need as early as possible in order to realize their child’s greatest potential.

Since 2016, F5SMC has:

• Engaged a lead partner to implement the HMG Centralized Access Point and the HMG Family and Community Outreach components, which officially launched in 2019

• Developed a HMG SMC Leadership Advisory Team composed of high-level leaders and decision-makers from several of the most prominent child-serving institutions to provide strategic visioning and feedback on the rollout of this model

• Engaged a consultant to support outreach strategies, messages, and the launch of the bilingual HMG SMC website

• Identified a HMG SMC Physician Champion who convenes a HMG Physician Advisory Group to inform and guide efforts in partnership with the medical community

• Subcontracted to implement the HMG Child Health Provider Outreach Component, which involved developing outreach and training materials, conducting a needs assessment, and provided outreach to pediatric practices and trainings on screening tools, billing and referral pathways

In 2021, F5SMC funded a landscape scan to identify systemic barriers and opportunities to better serve children with or at-risk of developmental delays and disabilities. Through The Early Identification and Intervention System in San Mateo County Environment Scan the following systemic challenges were identified: 1) Many children with delays are still not being identified through developmental screening and referred for early intervention services; 2) The current model of care often overlooks other community-based interventions that could serve children and families in an inclusive way, especially for children with mild to moderate concerns; 3) Families continue to struggle with navigating a confusing referral process and system; 4) The assessment process for early intervention often extends beyond the mandated 45-day timeline; 5) Lack of data transparency and data sharing is preventing the identification of systemic opportunities.

EARLY CHILDHOOD MENTAL HEALTH INTEGRATION

Early Childhood Mental Health Hub

A common theme that has emerged through F5SMC’s work with families and through the recent Strategic Planning process is the need for navigation support for young children with mental health concerns. Families and family-serving providers are often unclear about service availability, eligibility, and access. With support from Sequoia Healthcare District, F5SMC aims to strengthen countywide coordination with the addition of a specialized early childhood mental health coordinator embedded within Help Me Grow SMC to ensure families receive timely mental health referrals and strengthened collaborative linkages. This position will also provide enhanced support and training to build capacity for care coordinators to identify families at risk for early mental health needs, and to be prepared with strategies to support them to successfully access services.

ECMH Embedded Services

This year, with leveraged mental health funding from the DHCS Children and Youth Behavioral Health Initiative (CYBHI), F5SMC has begun training 60 local mental health clinicians in Child-Parent Psychotherapy, an evidence-based therapeutic practice tailored to address early traumatic experiences in the lives of young children. In the next 9 to 18 months, this cohort of clinicians will have completed their training, resulting in a significant expansion of our early childhood mental health workforce in San Mateo County. With Sequoia Healthcare District support, F5SMC aims to embed CPP-trained clinicians within trusted community-based programs, to help reduce barriers to access and provide therapeutic services within Sequoia Healthcare District boundaries.

SHIFTS IN THE LOCAL SERVICE PROVIDER LANDSCAPE

Despite F5SMC’s investment and progress, much work still remains to be done in order to meet the needs of young children with special needs and their families, as well as their service providers, in a coordinated and comprehensive way. Through the upcoming funding cycle (2025-2030), F5SMC intends to build upon the progress made to-date to continue bolstering the system of care for young children with special needs in San Mateo County, as well as continuing to support all families of young children and their providers with resources and information to promote their development and connect them to needed services.

F5SMC and our partners recognize that the priorities of our work are shared by other partners and systems, and we anticipate that recent shifts in service delivery and resources will contribute to an increase in the ability for many families with questions or concerns about their children’s development to receive support, particularly in the following ways:

• Recontracting of Medi-Cal Managed Care Contracts has resulted in the addition of Kaiser as a Medi-Cal Managed Care Plan that now covers a share of the County’s Medi-Cal beneficiaries. Kaiser patients with developmental concerns are generally referred internally for these needs rather than out to Help Me Grow SMC or other external resources.

• F5SMC, along with other partners, recently launched the Baby Bonus project, which aims to provide a monthly cash gift and care coordination for the first three years of a baby’s life for select families who receive their Medi-Cal coverage through the Health Plan of San Mateo. Over the next four to five years, 600 children ages 0-36 months will receive support from dedicated Community Health Workers at Health Plan of San Mateo for their child’s needs, including assistance with referrals for concerns or questions about development.

• Other community programs such as SMC Family Health Services are increasing their capacity for home visiting with the launch of a relatively new evidence-based model, Promoting First Relationships. This model, alongside the other home visiting models offered throughout the county, offer intensive service delivery and the ability to support families with developmental screening, questions or concerns.

• Since the last funding term for the Help Me Grow SMC system, Medi-Cal Transformation has led to new opportunities for billable services for Medi-Cal recipients, including for Enhanced Care Management and Community Health Worker services. These opportunities offer a chance to explore more sustainable financing for services such as care coordination.

With the responsibility for supporting the developmental needs of children shared across several entities and providers, Help Me Grow SMC has an opportunity to adapt to prioritize service to children and families who may not have access to additional intensive supports. This aligns to the targeted universalism philosophy, which "supports the needs of the particular while reminding us that we are all part of the same social fabric"; supporting an approach that is "universal yet captures how people are differently situated" and "inclusive yet targets those who are most marginalized. (powell, john, Stephen Menendian and Wendy Ake, Targeted universalism: Policy & Practice, 2019)