Transcript Children’s Integrated System Reform

Continuum Of Care – OMHSAS
and OCYF Coordination
Children’s Commission Meeting
April 9, 2008
Joan Erney, Deputy Secretary OMHSAS
Richard Gold, Deputy Secretary OCYF
Angie Logan, Office of Policy Development
OMHSAS / OCYF Retreat
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On October 4, 2007 the Office of
Children, Youth and Families and
Mental Health and Substance
Abuse Services pulled together a
cross systems team to review
current policies around the use of
residential treatment facilities with
the ultimate goal of reducing
residential placements for children
by 50% over a three year period.
Continuum of Care Providers
 Residential
Treatment
Facilities – 185 licensed
sites with 4,242 beds
 149 Accredited programs
with 2,953 beds
 36 Non-Accredited programs
with 1,289 beds
Utilization Rates
The Commonwealth spent nearly
$234 million on PRTFs (accredited
facilities) in 2006.
 6,848 kids received PRTF services
between CY 2005 and CY 2006
 Philadelphia has the highest
usage; Bucks and Montgomery
had the lowest usage
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OMHSAS / OCYF Retreat VISION
Four work groups were convened to carry
the work forward:
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Continuum of Care Work Group
Screening/Assessment Work
Group
Performance Requirements Work
Group
Center of Excellence (COE) Work
Group
Continuum of Care Work Group
Goals
Define entire ideal service array
for youth currently served in
residential care
 Drill down on utilization rates
 Reduce out of state placements
 No Eject / No Reject policy
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Out of State Placements
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Analyze trends in out of state
placements
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307 children were placed out of state by
CYS or JPO (194 reimbursed by BHMCO) as of November 1, 2007
Most were placed very far from home
Chart reviews on children placed out of
state
CANS data on Philadelphia youth placed
out of state
No reason why these kids could not be
served in state!
Out of State Placements
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Develop policies and
protocols for placing kids in
state
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County survey on current capacity for
serving kids (53 counties responded)
Youth portraits on hard to place kids
(253 portraits includes placement
difficulties for both in and out of
state)
Define Ideal Service Array
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Review current RTF utilization
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Mercer White Paper on RTF utilization
Identify exemplary counties that have low
usage of RTF
Review evidence based practices in
exemplary counties to explain low usage
rates
Develop an ideal service array
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Inventory of OCYF and OMHSAS current
service array
Identify gaps in service
Develop priority recommendations for an
ideal service array
Define Ideal Service Array
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Community-Based Services
Traditional Outpatient
Services
Out-of-Home Care
Define Ideal Service Array
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Identify Current OCYF and OMHSAS Service Array
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Eligibility Basis
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are
are
are
are
MA eligible
involved in voluntary child welfare services
adjudicated dependent
adjudicated delinquent
Needs Based Budget
State / County Funding Mix
Federal
Health Choices Authority to support
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who
who
who
who
OCYF Funding to Support
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Children
Children
Children
Children
State plan
NHRS exception
Supplemental service under waiver
State Plan Amendment Needed
Changes in state-level regulations needed
Identify Gaps in Services and Prioritize needs
Children’s Service Array BH Services
and Supports
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Targeted Case Management
Joint Planning Teams
Service Planning
Crisis Intervention Services
Individual, Group and
Family interventions,
inclusive of both treatment
and coordination
Family-Based Mental Health
Multisystemic Therapy
(MST)
Functional Family Therapy
Transition Life Skills
School-Based Mental Health
Sub acute Day Treatment
Peer Support
Screening and assessment
Transitional Age Youth
Strategies (TAY)
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Autism Service Array
Multidimensional Treatment
Foster Care
Respite
BHRS Exceptions
Physicians Services
Psyc Rehab (residential,
group, host homes)
Licensed Psychologist
Other Licensed Practioneer
of Healing Arts
Hospital Emergency
Drug & Alcohol Outpatient
Drug & Alcohol Residential
Partial Hospitalization
Rehabilitation Services
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Therapeutic Staff Support
Behavioral Specialist
Mobile Therapist
Summer Therapeutic Camp
Children’s CYS Services
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Service Planning / Case
Management
Family Group Decision
Making
Alternate Treatment
Programs – In Home
Information and Referral
Services
Treatment
Mulitsystemic Therapy
(MST)
Functional Family Therapy
(FFT)
Child Protective Services
(CPSL)
General Protective Services
(GPS)
Counseling Intervention
Services
Day Treatment Services
Child Day Care Services
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Homemaker / Caretaker
Services
Life Skills Education
Emergency Shelter
Community Residential
Supervised Independent
Living
Multidimensional Treatment
Foster Care
Therapeutic Foster Services
Family Foster Services
Kinship Foster Services
Respite for children in
foster care
In-home respite for adopted
children
Adoption Services
Adoption Assistance
Screening / Assessment
Work Group
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Develop a coordinated system of
screening and assessment
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Review inventory of screening and
assessments tools for strengths and
weaknesses
Identify training needs and a system for
monitoring
Review the process for Psych evals,
required packets for BHRS and other
current screening and assessment
requirements
Center of Excellence (COE)
Work Group
Implement an integrated COE
strategy across OCYF and
OMHSAS
 Integrate existing groups –
Youth and Family Institute,
PCCD Evidence-based practice,
Child Welfare Training Program,
etc
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Performance Requirements
Work Group
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Develop a practice monitoring
process
Aligning funding
 Aligning regulatory requirements
 Fidelity and quality factors
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Analysis of cross-systems rate
and regulation alignment
Next Steps
Complete research for all
projects
 Present recommendations
through regional forums and redraft based on feedback
 Develop policies, protocols and
timelines for implementation
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