Download - Transforming Bay Area Residential Services
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Mark LaneBay Area Consortium
RBS Local Implementation Coordinator
TransformingBay Area
Residential Services
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Planning Process
5 Counties
x 3 Departments
= Chaos
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Developing consensus(July 11 TA meeting)
How are we going to work together?
Lead County vs. Shared Coordination vs. Shared Purchase ….
Who decides?
What approach makes sense?
Mission: To work together to help the children and families in our target populations build and sustain whole lives.
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Guiding PrinciplesService-based, rather than place-based
Families will be part of the team and the decision-making process
Locally provided continuity of care and services
Culturally competent and strength-based services
Minimal disruptions in connections for youth and families
Focus on safe, stable, permanent living environment
Services customized to meet the family’s unique situation
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DEVELOPING THE MOU
Nature of the Relationship
Vision
Shared expectations
Roles and Responsibilities
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ENGAGING THE PROVIDERSTHROUGH AN RFQ
Refining the Target Population
Restating the Guiding Principles
Outlining the Program Design
Defining the Criteria to Deliver Services
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KEY INNOVATIONS forTRANSFORMING BAY AREA
RESIDENTIAL SERVICES
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Provider InnovationsFlexible use of staff resources
Flexible use of facility-based interventions
Increased trend of community-based interventions
Ongoing and flexible decision-making
Balance between place-based and community-based activities
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Funder Innovations
Building contracts with an assumption of trust and based on anticipated transactions throughout the duration of the project.
Family involvement as a key business practice.
Process-based contracting in which key actions are outlined, agreed-upon, and monitored.
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County Worker Innovations
RBS is seen as an affirmative choice
Use of RBS should be a decision of first resort, rather than last resort
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Next Steps
Issue the RFQ
Engage the qualified providers
Complete the funding model
Outline the Waiver Requests
Plan for Implementation
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Target PopulationsTarget PopulationsBay Area ConsortiumBay Area Consortium
Residentially Based ServicesResidentially Based Services
Lois Rutten, Contra Costa County
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Who Are These Youth?Who Are These Youth?
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Phase 1 Phase 1 Target PopulationsTarget Populations
Family ReattachmentFamily Reattachment– Younger children who are in placement Younger children who are in placement
due to a combination of family due to a combination of family disruption, abuse and/or dangerous disruption, abuse and/or dangerous behaviors that can’t be managed in behaviors that can’t be managed in other settingsother settings
Pathways to PermanencyPathways to Permanency– Children and youth who are growing up Children and youth who are growing up
in placement and do not have a in placement and do not have a permanent planpermanent plan
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Phase 2 Phase 2 Target PopulationsTarget Populations
Bridge to Success and SafetyBridge to Success and Safety– Youth with complex needs who are Youth with complex needs who are
mandated to out of home placement mandated to out of home placement in the juvenile justice system but are in the juvenile justice system but are currently in detentioncurrently in detention
Reconnecting and ReconstructingReconnecting and Reconstructing– Sexually exploited girls who are Sexually exploited girls who are
unable to stay in placement using unable to stay in placement using current approachescurrent approaches
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How Many Youth?How Many Youth?
All youth/children in this pilot must All youth/children in this pilot must be:be:– A dependent or ward of the court A dependent or ward of the court
described in section 300 or 602 of the described in section 300 or 602 of the Welfare & Institutions Code and/or,Welfare & Institutions Code and/or,
– Receiving services under AB 3632Receiving services under AB 3632
Family Reattachment – 100Family Reattachment – 100 Pathways to Permanence – 600Pathways to Permanence – 600
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Criteria for Determining Criteria for Determining Target PopulationTarget Population
Statistical case Statistical case review – review – CWS/CMSCWS/CMS
Individual case Individual case review – look for review – look for common common characteristicscharacteristics
Optimal volume to Optimal volume to sustain population?sustain population?
Is there an existing Is there an existing cross-system cross-system partnership?partnership?
Can a program be Can a program be regionally regionally implemented?implemented?
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Common CharacteristicsCommon Characteristics
Age and GenderAge and Gender– Male Male – 12-16 years old12-16 years old
EthnicityEthnicity– African AmericanAfrican American
Average length of placement in group careAverage length of placement in group care– More than 2 yearsMore than 2 years
Average number of placementsAverage number of placements– 5-75-7– Out of countyOut of county
Minimal family and community connectionsMinimal family and community connections Multiple psychotropic medicationsMultiple psychotropic medications Multiple assessments/evaluations for Multiple assessments/evaluations for
treatmenttreatment– Diagnosis?Diagnosis?
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Next StepsNext Steps
RFQ responseRFQ response Intake & referral processIntake & referral process Project entry/exit/capacityProject entry/exit/capacity TrainingTraining
– ProvidersProviders– StaffStaff– CommunityCommunity
Measure resultsMeasure results
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Residentially Based Services Proposed Funding Streams
BAY AREA CONSORTIUM
Presented by: Liz Crudo, San Fransisco County and Ellen Bucci, San Mateo
County
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Objective
• To provide an overview of potential funding streams;
• Discuss potential funding model;
• Next steps.
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Current funding sources
• Residential stay AFDC-FC Medi-cal / EPSDT
• Community stayAB 163 Wraparound FundingMedi-cal / EPSDT
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Potential Funding Streams
• EPSDT
– Case mgmt
– Medication support
– Therapy
• SB 163 Wraparound
• AFDC Residential Rate
– Monthly bed rate board and care
– In house stabilization
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Potential Funding Streams (con’t)
• Other Wrap Dollars
– New or unused slots
– Wrap Savings
• Mental Health Services Act (MHSA)
• PSSF / CAPIT / STOP / TANF/Family Preservation/TCM/CALWORKS
• County General Fund
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New Funding Model Assumptions
No new moneys;
Impact of State budget;
Providers will need to be Medi-cal certified for billing and leverage purposes;
Will require waivers and utilization of multiple funding streams;
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New Funding Model Assumptions (con’t)
Need to build service model first, then funding structure (What do we want to achieve, rather than how much money do we have?);
Providers need to be WRAP eligible; and
Counties will need to apply for additional WRAP slots.
Counties would each need to contract with the provider for Medi-cal
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New Funding Model Questions to be answered
• Service Model needs to be discussed and explored with Providers (Providers have knowledge re:making funding work);
• Need cost information from Providers; – Cost per individual youth will vary greatly?– Price Point? (average fair price)– Existing staff to be utilized or new staff?– How will youth without Medi-Cal be served?
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Next Steps
• Complete RFQ;
• Hold discussions with providers;
• Create funding model.
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