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DATE: |
November 18, 2025 |
04 |
SUBJECT
Title
AUTHORIZE COMPETITIVE SOLICITATION FOR INTEGRATED PREVENTION AND EARLY INTERVENTION SERVICES FOR CHILDREN AGES 0 TO 5 YEARS (DISTRICTS: ALL)
Body
OVERVIEW
The County of San Diego (County) provides early intervention and prevention services through programs that are designed to meet the developmental and/or behavioral needs for children ages 0 to 5 years of age and their families and caregivers. These programs include the First 5 Commission of San Diego (Commission) Healthy Development Services and KidSTART Center, as well as the Child and Family Well-Being (CFWB) Developmental Screening and Enhancement Program.
This item brings together CFWB and the Commission to leverage available resources that include funding from the California Department of Social Services and Proposition 10 revenue to support the ongoing continuum of care that supports our most vulnerable children ages 0 to 5 years of age and their families and caregivers. For over 20 years, CFWB and the Commission have funded separate programs that aim to reach this focus population. The Commission’s declining revenue has impacted these safety net programs, and in anticipation of a greater reduction in funding in 2026, the opportunity to partner with CFWB and integrate funding will help mitigate the projected reduction in services available. Furthermore, bringing these programs together into one procurement provides an opportunity to improve fiscal and contract efficiency while enabling an optimal, integrated continuum of care for developmental, behavioral, and social-emotional interventions. This endeavor will build upon the foundation of the aforementioned programs to continue serving children with developmental and behavioral needs for children ages 0 to 5 and their families/caregivers.
Today’s action requests the Board authorize the Director, Department of Purchasing and Contracting, to issue a competitive solicitation for Integrated Prevention and Early Intervention Services. This item supports the Commission's vision that all children ages 0 to 5 are safe, healthy, actively learning, and embraced by loving families and caregivers in supportive communities. It is also in alignment with CFWB’s commitment to empowering children, youth, families and caregivers to have the support, connections and resources to live healthy, be safe and remain together. Additionally, this item supports the County vision of a just, sustainable, and resilient future for all, specifically those communities and populations in San Diego County that have historically been left behind, as well as an ongoing commitment to the regional Live Well San Diego vision of healthy, safe, and thriving communities by supporting families and caregivers in making healthy lifestyle choices, developing resiliency, and enjoying the highest quality of life.
RECOMMENDATION(S)
CHIEF ADMINISTRATIVE OFFICER
In accordance with Board of Supervisors Policy A-87, Competitive Procurement, authorize the Director, Department of Purchasing and Contracting, to issue a Competitive Negotiated Procurement for integrated prevention and early intervention services, and upon successful negotiations and determination of fair and reasonable price, award one or more contracts for a term of one year, with four option years and up to an additional six months if needed; and to amend contracts as needed to reflect changes to services and funding.
EQUITY IMPACT STATEMENT
The County of San Diego (County) Health and Human Services Agency (HHSA) has been instrumental in supporting integrated prevention and early intervention services for over 20 years, with the goal of improving the health and well-being of children ages 0 to 5 and their families and caregivers. This includes making developmental and behavioral services available to eligible families and caregivers throughout the county that support children in reaching their developmental milestones and school readiness. Children with developmental and behavioral delays face a wide range of social inequities that hinder access to resources and can negatively impact their quality of life through adulthood. Furthermore, social stigma and deficient support systems create barriers to optimal education, employment opportunities, and access to healthcare, which can lead to higher rates of poverty, unemployment, housing insecurity, incarceration, and disease risk. Therefore, early prevention and intervention services play a vital role in identifying and working to address mild to moderate developmental and behavioral delays in children ages 0 to 5. By focusing on integrated prevention and early intervention services, the County can support children with mild to moderate developmental and behavioral delays to meet their developmental milestones. This support system can lead to improved quality of life outcomes and mitigate negative socioeconomic outcomes.
SUSTAINABILITY IMPACT STATEMENT
Today's proposed action supports the County of San Diego Sustainability Goal #1 to engage the community in meaningful ways; Sustainability Goal #2 to provide just and equitable access; and Sustainability Goal #4 to protect the health and well-being of everyone in the region. The integrated prevention and early intervention approach meets families and caregivers where they are and collaboratively formulates service plans that support their well-being. Through multiple evidence-based, family-focused models, this approach fosters positive parenting, promotes child health and development, and facilitates family strengthening and overall well-being.
FISCAL IMPACT
Funds for this request are included in the Fiscal Year (FY) 2025-27 Operational Plan in the Health and Human Services Agency, as well as the First 5 Commission of San Diego Operating Budget for FY 2025-26. If approved, this will result in no costs and revenue in FY 2025-26, and an estimated annual cost and revenue of up to $13 million in FY 2026-27. The funding sources are $9.0 million from Proposition 10 from First 5 Commission, $1.7 million from Social Services Administrative revenue, and $2.3 million from existing Realignment. There will be no change in net General Fund costs and no additional staff years.
BUSINESS IMPACT STATEMENT
N/A
Details
ADVISORY BOARD STATEMENT
The First 5 Commission of San Diego met on October 30, 2025, and approved the integrated prevention and early intervention competitive procurement.
BACKGROUND
Since 2006, the First 5 Commission of San Diego (Commission) has made a significant investment to create and implement accessible prevention and early intervention services through its Healthy Development Services (HDS). HDS is a groundbreaking program that promotes young children’s optimal development and learning by identifying and addressing developmental and/or social emotional problems early. Furthermore, HDS focuses on children ages 0 to 5 who present mild to moderate developmental and behavioral concerns and who, based on eligibility requirements set forth by the California Department of Social Services, do not qualify for services through California Early Start, school-provided services, special education services, or traditional health insurance services. HDS is designed to complement the existing ecosystem serving children with the most severe developmental and/or behavioral delays.
HDS makes these essential arrays of services available for eligible children ages 0 to 5 and families and caregivers:
• Developmental screening, assessment, classes, consultation, and treatment (e.g., speech therapy, occupational therapy, physical therapy)
• Behavioral and social emotional screening, assessment, consultation, and treatment
• Referrals to higher levels of care
• Screening, referrals, and treatment for caregiver mental health
• Care coordination and case management
Over time, HDS has provided a system of care for children ages 0 to 5 and their families and caregivers, thereby building and maintaining rapport within the early childhood network. Central to HDS is the focus on building relationships with families and caregivers, which is achieved through care coordination. Care coordination is instrumental to support families and caregivers to navigate and engage in services. Care coordination supports families’ and caregivers’ understanding of their child’s needs, how to support their child’s needs at home, and how to access and advocate for appropriate services. HDS also performs behavioral health screening and referrals for parents and caregivers, allowing parents to engage in HDS services with their children and improve outcomes. Families and caregivers are supported by a family-centered, trauma-informed approach where care coordinators and service providers work together to address social determinants of health and barriers to services. Resources may include basic needs, education, employment, health care and social connectedness, and warm hand-offs with community partners to ensure continuity of care. Using these strategies and resources helps mitigate the effects of marginalization, trauma, mistrust of systems, perceived stigma of accessing services, and a parent and caregiver’s own attachment experiences, which can influence willingness and readiness to enroll and receive services through HDS. When children in HDS require a higher level of intervention based on complex needs, HDS works in tandem with another Commission integrated program, KidSTART. Children who complete early intervention services through HDS and KidSTART are likely to reach their typical developmental trajectory by the time they enter kindergarten.
KidSTART and Developmental Screening and Enhancement Program (DSEP) provide prevention and early intervention supportive services to children ages 0 to 5. KidSTART, launched in 2012, provides comprehensive triage, assessment, referral and treatment of children ages 0 to 5 with complex needs. Complex care is indicated by needs in multiple domains where multiple providers are required to adequately address the child and family and caregiver needs. Early identification of developmental delays in any domain (cognitive, communication, adaptive, motor, and social-emotional), followed by appropriate interventions and support, will yield the highest levels of improvement. Treatment includes individual and group therapy for behavioral health, occupational, physical and speech and language. KidSTART services are provided to over 200 children in alignment with current best practices. Furthermore, since 1997, DSEP provides prevention and early intervention services including screening, development of care plans, and case management. These services are provided to children ages 0 to 5 who are referred from County of San Diego, Health and Human Services Agency, Department of Child and Family Well-Being (CFWB), typically with complex and high-need cases. DSEP serves over 1,400 children annually.
In Fiscal Year 2024-25, these programs collectively reached 6,840 children ages 0 to 5 and 5,486 families and caregivers countywide through prevention and early intervention services. Behavioral and developmental outcomes include:
• 86.1% of children who were identified with behavioral concerns and received behavioral treatment showed improvement in the areas of initiative, self-regulation, and attachment/relationships;
• 79.1% of children receiving treatment for a developmental concern showed gains in at least one developmental domain;
• Through DSEP, 295 children received behavioral intervention and 181 received developmental enrichment;
• DSEP provided 504 developmental enrichment sessions that offered behavioral and developmental caregiving coaching across all developmental domains (cognition, communication, gross motor, fine motor, social emotional, and self-help skills).
Building upon the outcomes of these programs, there is an opportunity to merge HDS, KidSTART, and DSEP to create a more comprehensive continuum of care that will maximize resources and continue to support children ages 0 to 5 and their families and caregivers with high-quality services.
For over 20 years, CFWB and the Commission have serviced children ages 0 to 5 and their families and caregivers through separate programs and limited resources. Integrating efforts into one procurement provides an opportunity to enhance service outcomes and fiscal efficiency within the framework of an optimal continuum of care for developmental, behavioral and social-emotional interventions. Furthermore, continued declines in the Commission’s revenue offer an opportunity to partner with CFWB to mitigate projected reductions in service capacity. If approved, this partnership will help secure critical integrated prevention and early intervention services for children ages 0 to 5 with developmental and behavioral health needs.
Today’s action requests the San Diego County Board of Supervisors authorize the Director, Department of Purchasing and Contracting to issue a competitive solicitation for Integrated Prevention and Early Intervention Services. If approved, this action will maximize serving capacity, improve efficiency, provide timely service, and centralize and streamline program access with the goal of increasing the number of children and families and caregivers served over time.
LINKAGE TO THE COUNTY OF SAN DIEGO STRATEGIC PLAN
Today’s proposed action supports the County of San Diego (County) 2025-2030 Strategic Plan initiatives of Sustainability (Economy and Resiliency), Equity (Health), and Community (Engagement, Quality of Life, Communications, and Partnership) as well as the regional Live Well San Diego vision of healthy, safe and thriving communities. This is accomplished by delivering services to children who are at risk for adverse childhood experiences and their families and caregivers. These efforts also empower County workforce by fostering innovation to implement evidence-based practices in early intervention and prevention services to increase the well-being of families/caregivers and their children.
Respectfully submitted,
ebony n. shelton
Chief Administrative Officer
ATTACHMENT(S)
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