Financing IECMHC

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 essential for 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 is a direct funding request (for example, evaluation data, collaborative partnerships, and communications and messaging, and public policies are all important levers), but when trying to initiate or enhance IECMHC programs, knowing how to access and leverage funding can be important.

Braiding and blending

Braiding funds is when two or more funding sources are coordinated to support the total cost of services to individual children, but revenues are allocated and expenditures are tracked by categorical funding source.

Blending funds is when dollars from two or more separate funding sources are wrapped together within one full-workday, full-year program budget to pay for a unified set of program services to a group of children. In blending, costs are not necessarily allocated and tracked by an individual funding source.

Strategies

These strategies follow the Center’s Financing Guidance. The Guidance helps teams gather what they need before making a funding request, identify strategies for a successful request, and follow up once a request has been presented. Not sure which strategy fits your work? Answer 16 questions in the guide below.

Strategy 1Set the stage for financing IECMHC by identifying the need, the services you aim to fund, and their cost

• Conduct a needs assessment

  Both public and private funders will want to know that you are prepared and are making a serious and well-informed request. Conducting a needs assessment will help you identify exactly why you are making this request.

  A needs assessment is a systematic process for determining and addressing the gaps between current conditions and desired conditions or “wants.” These gaps indicate your needs, and they will be the primary drivers of your financing request. Without performing a needs assessment, you might move in the wrong direction or duplicate existing services.

  Example (Financing Guidance, 2016): As part of Project LAUNCH requirements, Michigan completed a thorough environmental scan of early childhood services within a targeted community. Michigan learned that there was a lack of awareness of what mental health services were available, and families reported that waiting lists, lack of transportation, and excessive paperwork were deterrents to accessing services. When ECMHC services were created, this information informed outreach efforts, evaluation protocols and workforce development.

  Use the Early Childhood Mental Health Consultation Program Needs Assessment Surveys to run one.

• Identify the services you aim to fund

  Once you have identified what the needs are, the next step is to determine what IECMHC services your team hopes to fund to fill the gaps. National studies on effective IECMHC show that the overarching goal of consultation is to improve child well-being by enhancing staff and parent/caregiver ability to meet the social and emotional needs of infants and young children.

  Child- and family-focused consultation

  • In early care and education: when a specific child’s behavior is of concern to parents or early care and education staff, the consultant helps these adults understand, assess, and address the child’s needs by developing an individualized plan with the parents and providers.
  • In home visiting: when a specific child’s behavior is of concern to parents or home visitors, the consultant helps the home visitor understand, assess, and address the child’s needs so the home visitor can facilitate development of an individualized plan with the family. In some cases, the IECMH consultant may do a joint visit with the home visitor to observe and gather information that can further support the home visitor in his or her work.

  Classroom- and group-focused consultation

  • In early care and education: the consultant works with staff to improve the care offered to all children in the classroom by helping to identify and address attitudes, beliefs, practices, and conditions that may be undermining quality relationships between adults and children.
  • In home visiting: the consultant works with home visitors one on one or in a group to provide regular and ongoing reflective consultation to help home visitors identify and address attitudes, beliefs, practices, and conditions that may be undermining quality relationships between adults and children. The larger goal is to improve the care offered to all children and families on their caseloads.

  Programmatic consultation

  • In early care and education: administrators, directors, and other program leaders are supported by the consultant to make changes in their care practices and/or policies to benefit all children and adults in their setting.
  • In home visiting: administrators and other home visiting leaders are supported by the consultant to make changes in their policies to enhance the development of and support provided to home visitors.

  It is important to clearly identify and articulate the types of services you will offer within your program model. This will help to avoid duplication of efforts with other infant and early childhood providers and will help the funder understand exactly what your team intends to provide and what you will not provide.

  Example (Financing Guidance, 2016): The Illinois Children’s Mental Health Partnership developed a model for providing IECMHC within home visiting programs on an ongoing basis for at least two years. It included training for home visitors on mental health topics, group reflective supervision, case consultation, referral to outside mental health services, joint home visits, and support to administrators related to policy and practice.

  See Structure the service for program design documents, logic models, and the program manual.

• Identify the cost

  Have a clear estimate of the cost of the services your team hopes to fund. Be prepared to offer an itemized list explaining the costs of individual parts of the project. The funder should not have to do any work related to identifying costs.

  Consider both direct and indirect costs. For example, line items in a budget might include the following:

  • Consultant’s salary plus fringe benefits
  • Rent or occupancy for the consultant within the organization
  • Telephone/connectivity
  • Supplies and office equipment
  • Travel to and from centers, homes, etc.
  • Training costs
  • General and central administrative supervision
  • Reflective supervision
  • Endorsement or licensure fees for the consultant to maintain credentials

  Be prepared to state your overall target and how you hope to reach it.

  Use the Infant and Early Childhood Mental Health Consultation Cost Calculator (opens in a new tab) from ZERO TO THREE and Georgetown University to estimate costs.

Strategy 2Identify what funds align best with IECMHC services

It is very important to understand the metrics of success for each potential funding source to ensure a “goodness of fit.” One of the most frequent reasons for turning down requests is that they do not mesh with the funder’s interests. Ensure that your team is also aware of who administers the funds, how they are currently being allocated in your state or region, and any eligibility criteria.

States most typically use multiple sources to support IECMHC. The streams below include the eight that the Center’s Financing FAQ lists as most common. Medicaid, federal grants, and state set-aside funds come from the FAQ’s Medicaid answer and the Financing Guidance. Program details from the Financing Guidance are as of July 2016.

• Child Care and Development Fund (CCDF)

  What it is: This block grant provides state-, territory-, or tribe-administered childcare financial assistance to low-income families in the form of subsidies, which help to lessen the financial burden of the cost of childcare so that families (parents) may work or prepare for employment.

  How states used it (Financing Guidance, 2016): Colorado and Arkansas were leveraging federal dollars, primarily Child Care and Development Block Grant (CCDBG) funds, to support ECMHC as a quality-building strategy within childcare programs. Rhode Island was drawing down funds from CCDBG and a combination of Early Childhood Comprehensive Systems grant dollars and Title V dollars. These funds were used for programmatic consultation regarding childcare.

  Administered by: Federal: U.S. Department of Health and Human Services, Administration for Children and Families. Tribal: tribal CCDF grantees. Local: state and territory CCDF grantees.

  Source: Financing Guidance (2016), pages 4, 12. Listed as a common stream in the Financing FAQ (2025), page 2.

• Early Intervention (Part C of IDEA)

  What it is: The Center’s Financing FAQ lists Early Intervention/Part C of the Individuals with Disabilities Education Act among the most common funding streams states use to support IECMHC.

  Learn more: About IDEA (opens in a new tab) (U.S. Department of Education)

  Source: Financing FAQ (2025), page 2.

• Federal grants

  What to consider: Federal grants provide a short-term opportunity to develop or expand services and measure effectiveness. They offer an opportunity to build public awareness and support. They can make it challenging to sustain efforts if sustainability is not discussed from the onset.

  Example (Financing Guidance, 2016): Boone County Project LAUNCH integrated the Early Childhood Positive Behavioral and Support (EC-PBS) program to help early childhood professionals create classrooms that recognize and nurture children’s social and emotional development. Through EC-PBS, consultants with mental health expertise have trained and coached childcare providers across high-need rural and urban areas in preventing, identifying, and reducing the impact of children’s behavioral health challenges.

  Federal grant programs in the Guidance’s table of federal funding sources (as of July 2016):

  • Project LAUNCH (SAMHSA): one of its five strands of service is mental health consultation in early care and education settings.
  • Early Childhood Comprehensive Systems (HRSA): regarding IECMHC, the areas of emphasis are mitigating toxic stress, expanding developmental screening and referral, and incorporating evidence-based standards into system work.
  • Health Center Program (HRSA): eligible public and private nonprofit health care organizations funded under Section 330 of the Public Health Service Act may expand on or establish the delivery of mental health services such as IECMHC.

  Source: Financing Guidance (2016), pages 11, 14, 16, 20.

• Head Start and Early Head Start

  What it is: The goal of Head Start and Early Head Start is to promote the school readiness of children from birth to age 5 and to support pregnant women from low-income families by providing comprehensive services in a variety of areas, including cognitive development, health, mental health, and social and emotional well-being. Early Head Start-Child Care Partnership and Expansion programs allow new or existing Early Head Start programs, including tribal programs, to partner with local childcare centers and family childcare providers who serve infants and toddlers from low-income families.

  How it supports IECMHC: Head Start and Early Head Start require that mental health services include onsite mental health consultation.

  Administered by: Federal: U.S. Department of Health and Human Services, Administration for Children and Families, Office of Head Start. Tribal and local: ACF Regional Offices and the American Indian-Alaska Native and Migrant and Seasonal Program Branches.

  Learn more: Early Head Start Programs (opens in a new tab) (HeadStart.gov)

  Source: Financing Guidance (2016), page 15. Listed as a common stream in the Financing FAQ (2025), page 2.

• Human services and child welfare funding (including TANF)

  What it is: The Center’s Financing FAQ lists human services and child welfare funding (including child welfare and Temporary Assistance for Needy Families, or TANF) among the most common funding streams states use to support IECMHC.

  How TANF can support IECMHC: TANF helps families in need achieve economic self-sufficiency. States can reallocate up to 30% of these funds to their Child Care and Development Fund. IECMHC can be implemented and supported under that fund.

  Administered by: Federal: U.S. Department of Health and Human Services, Administration for Children and Families.

  Source: Financing FAQ (2025), page 2; Financing Guidance (2016), page 21.

• Maternal, Infant, and Early Childhood Home Visiting (MIECHV)

  What it is: 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.

  How it supports IECMHC: IECMHC can be incorporated into home visiting models by training home visitors. In home visiting, the consultant works with home visitors one on one or in a group to provide regular and ongoing reflective consultation. The larger goal is to improve the care offered to all children and families on their caseloads.

  Administered by: Federal: Health Resources and Services Administration, Maternal and Child Health Bureau. Tribal: Administration for Children and Families. Local: state mental health systems or health agencies, and county-based mental health systems.

  Learn more: Home Visiting (opens in a new tab) (Administration for Children and Families)

  Source: Financing Guidance (2016), pages 6, 16. Listed as a common stream in the Financing FAQ (2025), page 2.

• Medicaid

  What to consider: Unlike clinically based mental health treatment that requires a diagnosis, IECMHC is not a widely billable service. Medicaid is a source of funding in every state. It may require a diagnosis for the child or family member to draw down the funds.

  Example (Financing Guidance, 2016): Michigan’s Department of Health and Human Services, Division of Mental Health Services to Children and Families, identified the Child Care Expulsion Prevention (CCEP) program as a Medicaid-covered prevention and direct service model: a program using individual, family, and group interventions designed to reduce the incidence of behavioral, emotional, or cognitive dysfunction. CCEP was one of five direct prevention models that could be made available statewide by the Prepaid Inpatient Health Plan or its provider network for children with Medicaid who are under six years of age and are experiencing behavioral and emotional challenges in their childcare setting.

  Medicaid options in the Guidance’s table (as of July 2016):

  • State plan amendments, which give states an opportunity to modify and expand the services delineated in their original Medicaid plan, such as the inclusion of IECMHC, as well as eligibility criteria.
  • Section 1115 and Section 1915(b) Managed Care Waivers. The former allows states to offer services not typically covered by Medicaid, and the latter supports states in allocating funds saved through the managed care delivery system to cover other services.
  • Administrative funds, which provide opportunities for infrastructure building (such as training) that may support and impact consultation efforts.
  • Early and Periodic Screening, Diagnostic, and Treatment (EPSDT). Children enrolled in this program must receive treatment deemed necessary by their providers, whether or not it is traditionally covered in the state’s Medicaid plan. Children may benefit from IECMHC through this provision.

  Current questions: See Can Medicaid be used for funding IECMHC? in the FAQ below.

  Administered by: Federal: Centers for Medicare & Medicaid Services. Local: state Medicaid programs.

  Source: Financing Guidance (2016), pages 3, 10, 17, 18; Financing FAQ (2025), pages 2 and 3.

• Philanthropic, foundation, and private grant funding

  What it is: The Center’s Financing FAQ lists philanthropic, foundation, and private grant funding among the most common funding streams states use to support IECMHC.

  Sample ask from the Guidance: A foundation commitment supports a specialized mental health training series for all home visitors, while federal funds cover the cost of providing expert onsite support to home visitors on a weekly basis.

  Source: Financing FAQ (2025), page 2; Financing Guidance (2016), page 9.

• State general funds

  What it is: Many states are accessing their general funds to support IECMHC. The Center’s Financing FAQ lists state general funds among the most common funding streams states use to support IECMHC.

  Examples (Financing Guidance, 2016): Connecticut’s statewide Early Childhood Consultation Partnership program was funded primarily by the Connecticut Department of Children and Families’ Early Intervention Prevention Unit, with supplementary funding from the State Department of Education. Maryland’s statewide Early Childhood Mental Health Consultation Project was funded through the Maryland State Department of Education, Division of Early Childhood Development, Office of Child Care.

  Source: Financing Guidance (2016), page 4. Listed as a common stream in the Financing FAQ (2025), page 2.

• State set-aside funds

  What to consider: State set-aside funds offer flexibility to finance programmatic work that is often more difficult to fund than child-focused intervention.

  Example (Financing Guidance, 2016):

  “Louisiana has been using ‘quality set-aside funds’ as another way to fund IECMHC. Sometimes there is leeway in this funding stream, and you can find ways to connect with that allotment of funds. Our state looks at IECMHC, along with coaching, as two of the key quality improvement services available to staff, families, and children.”

  Allison Boothe, Ph.D., Associate Professor of Psychiatry, Tulane University School of Medicine

  Source: Financing Guidance (2016), page 10.

• Tax levies and ballot initiatives

  What it is: The Center’s Financing FAQ lists tax levies and ballot initiatives among the most common funding streams states use to support IECMHC.

  Example (Financing Guidance, 2016): Arizona’s ECMHC program Smart Support received funding through First Things First. First Things First was funded by a voter-enacted tax on tobacco products. Smart Support team members developed a white paper on IECMHC that was a foundation for the state’s development of a Request for Proposals (RFP) for IECMHC funded with tobacco tax dollars.

  What to consider: Public funds often offer the ability for innovation in practice, can be influenced by advocacy efforts, and are often longer-term funding options that can still be at risk due to changing rules and regulations.

  Source: Financing FAQ (2025), page 2; Financing Guidance (2016), pages 4, 11, 27.

Strategy 3Choose your messenger, make the request, and follow up

• Identify your messenger

  A funding request is much more likely to have success when the person making the appeal has an established relationship with the potential funder. The person making the connection should know the funder’s interests, areas of focus, and previous investments.

  Consider:

  • Who has positive, established, and ongoing relationships with the identified funder?
  • Is this person a clear and concise speaker?
  • Is this person passionate about the services that you aim to provide?

  It may not always be the person who is the most knowledgeable or is leading current efforts.

  Examples (Financing Guidance, 2016): In Arizona, Ginger Ward, CEO of Southwest Human Development, had decades of long-standing relationships within the state. She cultivated them as an ongoing process rather than only in a time of need. In Colorado, the state’s early childhood mental health director met funders, learned their priorities, and became part of the regular conversation about the needs of children and families before making an ask.

• Develop and schedule your ask

  Organize all the data you have gathered into a simple, easy-to-digest one- or two-page document that you will share with potential funders. Offer enough information to orient someone who is completely new to the issue, but not so much that you are at risk of overwhelming the funder. Ensure that your plan is free of jargon and typos.

  Prepare talking points from your data. Be sure to include the short- and long-term benefits of investing in this work. Consider having someone outside your team read your plan and talking points to look for errors and inconsistencies and to point out sections where you need more clarity.

  Identify the lead person(s) you want to reach out to for a funding discussion and make the appointment. Or, if your request is to be part of a discussion or meeting with an established group, such as an early childhood advisory council, make sure that you are on the agenda.

  See Communications and Messaging for help with messages.

• Prepare and practice

  Practice your request before the meeting. Review possible policy changes that might support IECMHC, as well as state plans, such as your state Medicaid plan. Go over all the data you’ve gathered, and try to anticipate what questions the funder might have. Make sure you can answer at least the following questions:

  • What is the issue?
  • Why is it a problem?
  • What will your team do to address it?
  • What will your team not be able to do?
  • How much funding will it take to support what your team will do? (Be prepared to provide details.)
  • What difference will the funding make?
  • How will your team measure success?
  • What is an example of how this work has been influential to a child and/or a family?

  Example (Financing Guidance, 2016): In Arkansas, the team aligned its request with the priorities of the state and with Child Care and Development Fund changes and new plan requirements. It brought federal documents and recent policy papers supporting the importance of social and emotional development and reducing expulsion. It did not open with an ask to expand its consultant base. It asked the state, “What is your response to these challenges? How can we be helpful and be a part of this discussion?” Once the discussion was going, the team put more energy into expansion funding.

• Make the request

  Once the initial greeting is out of the way, make a transition so the funder knows that the topic has changed to something far more critical. Remind the funder of your personal connection to the organization.

  Demonstrate the impact of your work with a real-life story. In the Financing Guidance (2016), Colorado’s early childhood mental health director advised striking a balance between a story and some quantifiable data and linking both to what is happening more broadly.

  Be concrete and specific. Share:

  • The needs identified from your needs assessment
  • The type of services you want to provide and the identified costs
  • How these services align with the funder’s metrics of success
  • What difference the funding will make

  Don’t expect an answer right away. Leave plenty of space for dialogue and questions. Offer to follow up within 24 hours to answer any questions the funder may have or to offer additional resources.

• Follow up

  • Debrief with your team. Share what worked and what did not work and come up with a plan for refining your request right away while the experience is fresh.
  • Follow up with the funder within 24 hours. Thank the person for their time, answer any questions the funder still has, and ask how you might communicate in the future.
  • Find out why a request was not accepted. Ask for reviewer comments on grant proposals.
  • Continue to champion IECMHC. For example, the Financing Guidance (2016) describes leaders and staff of Arizona’s Smart Support program presenting at state, community, and national conferences and serving on local and statewide early childhood committees to ensure that a mental health lens is at the table.
  • Prepare for the next ask. Obtaining funds is a long-term and ongoing process. It involves building and fostering relationships and showing the success of your efforts over time. Engage in small-scale pilots that demonstrate success as a stepping-stone to larger scale projects.

  Examples (Financing Guidance, 2016): Colorado opened its network to everyone involved with IECMHC in the state and not only to the consultants it funded. It invited Head Start, private childcare and preschool programs, Project LAUNCH, and philanthropies to attend its trainings, enter their data in the state database, and participate in its learning collaborative. In Arkansas, the team started with pilot sites, had a strong evaluation component, and made a substantial up-front investment in looking at outcomes and impacts at the teacher and child levels. This helped the team make a bigger ask and maintain its funding.

Find your funding strategies

Answer 16 questions to see which funding strategies to look at first and how ready your program is to plan for new funding. The last 13 questions cover four areas: organizational readiness, financial management, communication, and program implementation.

• Disclaimer

  This guide points to funding strategies described in the Center’s Financing Guidance (2016) and Financing FAQ (2025) and to resources on this site. It does not determine eligibility for any funding stream. Requirements vary by state. The Guidance’s federal funding details are as of July 2016.

Frequently asked questions

• Why is funding Infant and Early Childhood Mental Health Consultation (IECMHC) challenging?

  IECMHC is a unique practice, as it is the intersection of multiple professional domains: early childhood, mental health, adult learning, and consultative practice. There are several considerations as states, tribes, and territories review funding options for IECMHC.

  1. Domain-Specific Funding System: Many funding sources have a specific set of criteria for the scope of use of the funding, or the population to be served by it. A cross-disciplinary practice such as IECMHC is often limited by the inability of government entities to braid funding sources together.
  2. Competing Needs Within Systems: Funding for early childhood programs often prioritizes basic needs like child care access or educational resources, leaving less room for specialized services like IECMHC. Additionally, mental health funding might be directed towards clinical mental health services for youth and adults, with less focus on preventive programs like IECMHC for young children.

• Is there a state that is using a single dedicated funding source for statewide IECMHC?

  While there is no single dedicated federal funding source for IECMHC, there are several states who have dedicated state funding to support IECMHC as part of a combination of funding sources, however currently there are no known states with single source dedicated funding for IECMHC. States most typically use multiple sources to support IECMHC initiatives, with the most common funding streams including:

  • Child Care and Development Fund
  • Early Intervention/Part C of the Individuals with Disabilities Education Act (opens in a new tab)
  • Head Start/Early Head Start (opens in a new tab)
  • Human Services/Child Welfare Funding (including Child Welfare and Temporary Assistance to Needy Families)
  • Maternal Infant Early Childhood Home Visiting (opens in a new tab)
  • Philanthropic/Foundation/Private Grant Funding
  • State General Funds
  • Tax Levies and Ballot Initiatives

• Can Medicaid be used for funding IECMHC?

  States have reported Medicaid efforts in progress for billing and reimbursement for IECMHC (NCCP 2017 Report (opens in a new tab), NCCP 2023 Report), however, it is unclear if these states are truly reporting on IECMHC as a consultative model, and while research indicates Michigan is the only state that includes IECMHC as a Medicaid covered service, no state that we have found has released information on its success or return on investment to date. The Center of Excellence worked with one state to explore options for potential use of Medicaid, which included a review of child-focused cases served by the state funded IECMHCs, the potential pool of IECMHCs that would be Medicaid-eligible service providers, and the potential number of children in programs receiving IECMHC services that might be Medicaid eligible. The COE identified that analysis of child eligibility and service delivery should be collected to help in decision making, including the following information:

  1. Capacity of sites: Is the program/site equipped to bill Medicaid? While some programs currently not set up for Medicaid billing might not be excluded from billing Medicaid, setting-up a structure for consultation teams to bill Medicaid will take additional time and resources.
  2. Qualifying providers: In order to bill Medicaid, providers must meet the state’s qualifications. As such, not all employed IECMH consultants would necessarily meet these qualification requirements.
  3. Child-focused cases: Generally, Medicaid billing is for an individual member. It is worth noting that most IECMHC models encourage consultants to provide classroom- or program-level services, when appropriate, to build the capacity of the adult to support a group of children, rather than one specific child at a time. Additionally, while the Centers for Medicare and Medicaid Services issued guidance in August 2022 (opens in a new tab) encouraging states to avoid requiring a behavioral health diagnosis for some service, there is not a definitive and up-to-date list of states that waive a behavioral health diagnosis, as each state has the flexibility to design its own Medicaid program within federal guidelines. This means requirements for behavioral health coverage can vary by state. Colorado is one example of a state that has passed legislation and signed into law through Senate Bill 23-174 (opens in a new tab) the ability to cover limited behavioral health services for children with no diagnosis.
  4. Medicaid or Medicaid-Eligible Child: IECMHC programs would need to have a method with which to identify the number of children served through child-focused cases that are Medicaid eligible. It is safe to assume that not all of the children served through child-focused IECMHC would be Medicaid eligible, as IECMHC is typically available at no-cost to any adult caring for a child age birth to age 6, regardless of eligibility status.

• What are some ways that funding IECMHC can be most successful?

  Here are three ways:

  1. Collaboration: Collaboration among early childhood, mental health, child welfare, and health care agencies can strengthen funding requests by demonstrating a unified approach.
  2. Cost-Benefit Analysis: Developing a strong cost-benefit analysis that highlights potential cost savings from IECMHC can be helpful in securing funding.
  3. Demonstration Projects: States might be more willing to fund pilot programs or demonstration projects to showcase the effectiveness of IECMHC before committing to larger-scale funding.

• What are we requesting funding for?

  ZERO TO THREE, in partnership with Georgetown University, introduced a new Infant and Early Childhood Mental Health Consultation Cost Calculator (opens in a new tab). It is a tool for identifying and calculating costs associated with IECMH consultation programs. The IECMHC cost calculator is for IECMHC professionals, program managers, and administrators and those supporting, designing and managing IECMHC programs. This tool helps determine the true costs of services and supports for infants, toddlers, young children and families and provides evidence-based estimations for infant and early childhood mental health consultation.

  Learn about the tool (opens in a new tab) and how it can be used in program budget planning and grant proposal development. Hear from developer Jordana Ash of Colorado and Dr. Angela Keyes of Louisiana about costs associated with high-quality consultation and how this tool can be applied to program planning and development.

Resources