Creating Linkages Between Child and Adolescent Services

Transcription

1 Creating Linkages Between Child and Adolescent Services Lynn Thull, PhD of Child & Family Services 1

2 Publically Funded Children s Mental Health Services Hospital Association Lynn Thull, PhD December 7 th, Agenda Overview of Children s Mental Health Services Medi Cal funded services School funded services MHSA funded services Special populations County Dependents Child Welfare Probation Autism 4 2

3 We will also discuss: Eligibility Access Advocacy Potential Partners Current/Future Initiatives 5 Children s Mental Health Services History in Delivered in silos Minimal until 1980s 1990s 1915(b) waiver Litigation driven 6 3

4 Litigation Driven Christopher T v. San Francisco Unified School District Resulted in AB3632 T.L. v. Belshe Requiring that all federally mandated Medi Cal programs be funded Emily Q. v Bonta Among other things, the state was ordered to include therapeutic behavioral services (TBS) in the Medi Cal program Katie A. v. Bonta Improve the provision of mental health and supportive services for children and youth involved in foster care 7 Oversight Department of Mental Health Department of Health Care Services Department of Managed Health Care County Mental/Behavioral Health Plans County Offices of Education 8 4

5 Medi Cal/EPSDT SMHS EARLY, PERIODIC, SCREENING, DIAGNOSIS, TREATMENT SPECIALTY MENTAL HEALTH SERVICES Federal Entitlement 50/50 Funding Shared responsibility CHDP (Child Health and Disability Prevention Program) Mental/Behavioral Health Plans Medi Cal Managed Care Plans 9 EPSDT SMHS Eligibility Full scope Medi Cal* Medical necessity Included diagnosis Functional impairment Anticipated improvement with treatment *SB75 will expand full scope Medi Cal for all children who are now on restricted scope Medi Cal or undocumented 10 5

6 EPSDT Specialty Mental Health Services Assessment Plan development Rehabilitation Collateral Individual or group therapy Crisis intervention and stabilization Day treatment intensive services Medication support Case management Therapeutic behavioral services Katie A. Specialized services (ICC, IHBS, and TFC) 11 EPSDT SMHS Additional Information County access teams v. Medi Cal managed care Penetration rates Intensity County variances Staffing 12 6

7 Educationally Related Mental Health Services AB 3632/26.5 Discontinued in 2012 AB 114 Replaced 3632 Must meet criteria for special education Access through IEP Progress Local Control Funding Formula Services determined by local stakeholder process Most often counseling rather than therapy 13 Mental Health Services Act 2004 Prop 63 Funded by millionaires tax Developed to fill gaps in continuum of mental health care Several Components Community services and supports Prevention and early intervention Workforce education and training Innovation Capital facilities 14 7

8 MHSA Eligibility and Access Required community planning process Cannot be used to supplant other funding 15 Special Populations County dependents Autistic/developmentally delayed 16 8

9 County Dependents Child welfare Probation EPSDT eligible Increased need Lock outs Children s system of care Out of county issues Psychotropic medications Health passports JV Autistic/Developmentally Delayed Applied behavioral analysis benefit Regional centers roles and responsibilities 18 9

10 Children s Mental Health Services Trends Evidence based practices Integrated services Family and youth driven Community based Accountability 19 Potential Partners County mental health plans Medi Cal managed care plans Organizational community based providers Schools Probation officers Developmental centers Youth Family members Advocates 20 10

11 Individual Advocacy Learn to speak the language of other systems Engage natural supports Coordinate with other paid supports Attend/inform IEP process Refer to county mental health plan Local MHSA LCFF Mental health board Board of Supervisors State Legislative hearings Policy development/ support 21 Current/Future Initiatives Current Bills: AB 403 (Stone) Continuum of Care Reform AB 1299 (Ridley Thomas) Out of County Mental Health AB 741 (Williams) Children s Crisis Residential SB 75 Full Scope Medi Cal for All Children Current/Future Litigation: Full access to all EPSDT services Crisis services Out of county mental health services for dependents DHCS Efforts: Performance outcome system Call for statewide mental health policy 22 11

12 Top 10 Take Aways: 1. Educate/empower youth and caregivers 2. Use your statewide associations 3. Identify local advocates to help access services 4. All systems have community participation components use it 5. Not all funding is accounted for 6. Learn the basic language of each system 7. Know the access criteria 8. Schools and counties are paid at least partially in advance 9. Most programs are federal entitlements or state mandates 10. Systems are siloed 23 Questions? 12

13 Lynn Thull, PhD Mental Health Policy and Practice Improvement Consultant of Child and Family Services (916)