Sample Contract

Head Start Program Mental Health Consultation

Terms Of Agreement

1. General Provisions
   1. This Agreement will cover children currently enrolled in Head Start program.
   2. Contractor shall provide an itemized monthly invoice.
2. Scope of Services
   1. General Classroom Consultation and Coaching
      1. Visit each classroom at least once per month.
      2. Provide child development information related to social and emotional development and mental health.
      3. Provide guidance and model developmentally appropriate activities for children and effective ways to work with and support young children.
      4. Provide staff’s written and oral observations and strengths-based feedback to classrooms on an annual basis.
      5. Meet with classroom teams to review and explore staff’s observations and develop and implement plans as needed.
   2. Staff Training
      1. Support, coordinate, and provide staff trainings related to social and emotional and mental health issues at least once per quarter.
   3. Programmatic Consultation
      1. Participate in weekly staff team meetings.
      2. Participate in the development and implementation of the program’s mental health program and policy.
   4. Family Training
      1. Recruit participants for at least one family group and one child group per year.
      2. Coordinate and facilitate family groups and child groups.
   5. Individualized Child- and Family-centered Consultation
      1. Meet with the teachers to discuss and explore concerns, as well as child and family needs and strengths. Review ideas and strategies to meet individual children’s needs. Conduct observations of individual children as appropriate.
      2. Meet with families to consult on child and family needs and create or follow up on plans to support these needs.
   6. Individual Child Screening, Assessment, and Referral
      1. Provide guidance to staff on selecting, implementing, and interpreting social and emotional screening and assessment tools and findings.
      2. Conduct standardized developmental, behavioral, and social and emotional screens and assessments for individual children as assigned or referred for consultation.
      3. Provide child and family referral and follow-up to community services.
   7. Home Visiting
      1. Conduct home visits to support the mental health needs of families and children.
      2. Provide guidance and model developmentally appropriate activities for children and effective ways to work with and support young children.
   8. Other
      1. Participate in regular supervision with Administrator and clinical supervisor.
      2. Contribute to federal, state, and local reporting requirements.
3. Responsibilities and Duties of Contractor
   1. To provide Head Start program with proof of licensure, if applicable, through the duration of this Agreement.
   2. To provide Head Start program with a single point of contact for scheduling, receiving services, billing, and the fiscal component of this Agreement.
   3. To provide Head Start program with documentation of biweekly clinical supervision, including name and contact information of supervisor.
   4. To participate in planning for the execution of services listed as well as participating in program planning when expertise in mental health is needed or required.
   5. To make every effort to follow up with families referred for services within one week and provide documentation of these efforts.
   6. To submit monthly invoices by the 5th of the following month for service performed in the prior month, allowing enough time for appropriate documentation of services.
   7. To ensure that all invoices include:
      1. Date of Service
      2. Category of Service
      3. Number of hours billed for each category
      4. Any correlating in-kind amount for billing services
   8. To ensure that staff, families, and children receive appropriate referrals when they need additional services and evaluations beyond the scope of what the contractor can provide.

   9. To provide the following services in an ethical as well as culturally and linguistically appropriate manner:

      Service	Maximum Number of Hours Allotted*
      General Classroom Consultation, and Coaching	832
      Staff Training	208
      Programmatic Consultation	104
      Family Training	104
      Individualized Child- and Family-Centered Observations and Consultation	416
      Individual Child Screening and Assessment as Assigned or Referred for Consultation, and Referral to Community Services	104
      Home Visiting	208
      Other, Including Supervision and Reporting	104

      *Maximum number of contractor hours for this term is 2,080 across 12 months.

   10. Cost or Pricing
       1. Contractor Hourly Service Rate
       2. Contractor Service Hours for This Period
       3. Subtotal
       4. Estimated Travel Costs for This Period
       5. Maximum Amount for This Period (iii + iv)
   11. Head Start Program Responsibilities
       1. Provide contractor with an orientation to Head Start program.
       2. Provide contractor with a single point of contact for scheduling.
       3. Provide regular meetings between Head Start administrator and contractor for program supervision and contract monitoring.
       4. Provide an annual performance evaluation for contractor based on the Scope of Services and the responsibilities and duties outlined in this Agreement.
       5. Work with the contractor to develop an appropriate referral process.
       6. Support contractor with contacting families if contractor is having difficulties setting up appointments with families.
       7. Arrange logistics (e.g., room reservations and setup of area) for trainings conducted by contractor with adequate notice of these needs.

       8. Agree to pay contractor $[ ] per hour for all services provided under this Agreement.
          Hours to include:

          1. aa. Time spent at Head Start program.
          2. bb. Time spent meeting with families in their homes.
          3. cc. Time allotted for writing reports and supervision.

          NOTE: This is not an all-inclusive list but provides a guideline for payment made to contractor for certain activities.

       9. When required by Head Start program, Head Start program agrees to reimburse contractor for mileage expenses. Such mileage reimbursements will be made at the prevailing rate per mile as outlined in Head Start program travel policies.

Last Updated: August 6, 2025