Mark Lane Bay Area Consortium RBS Local Implementation Coordinator Transforming Bay Area Residential Services

Planning Process 5 Counties x 3 Departments = Chaos

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.

Guiding Principles Service-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

DEVELOPING THE MOU Nature of the Relationship Vision Shared expectations Roles and Responsibilities

ENGAGING THE PROVIDERS THROUGH AN RFQ Refining the Target Population Restating the Guiding Principles Outlining the Program Design Defining the Criteria to Deliver Services

KEY INNOVATIONS for TRANSFORMING BAY AREA RESIDENTIAL SERVICES

Provider Innovations Flexible 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

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.

County Worker Innovations RBS is seen as an affirmative choice Use of RBS should be a decision of first resort, rather than last resort

Next Steps Issue the RFQ Engage the qualified providers Complete the funding model Outline the Waiver Requests Plan for Implementation

Target Populations Bay Area Consortium Residentially Based Services Lois Rutten, Contra Costa County

Who Are These Youth?

Phase 1 Target Populations n Family Reattachment –Younger children who are in placement due to a combination of family disruption, abuse and/or dangerous behaviors that can’t be managed in other settings n Pathways to Permanency –Children and youth who are growing up in placement and do not have a permanent plan

Phase 2 Target Populations n Bridge to Success and Safety –Youth with complex needs who are mandated to out of home placement in the juvenile justice system but are currently in detention n Reconnecting and Reconstructing –Sexually exploited girls who are unable to stay in placement using current approaches

How Many Youth? n All youth/children in this pilot must be: –A dependent or ward of the court described in section 300 or 602 of the Welfare & Institutions Code and/or, –Receiving services under AB 3632 n Family Reattachment – 100 n Pathways to Permanence – 600

Criteria for Determining Target Population n Statistical case review – CWS/CMS n Individual case review – look for common characteristics n Optimal volume to sustain population? n Is there an existing cross-system partnership? n Can a program be regionally implemented?

Common Characteristics n Age and Gender –Male –12-16 years old n Ethnicity –African American n Average length of placement in group care –More than 2 years n Average number of placements –5-7 –Out of county n Minimal family and community connections n Multiple psychotropic medications n Multiple assessments/evaluations for treatment –Diagnosis?

Next Steps n RFQ response n Intake & referral process n Project entry/exit/capacity n Training –Providers –Staff –Community n Measure results

Residentially Based Services Proposed Funding Streams BAY AREA CONSORTIUM Presented by: Liz Crudo, San Fransisco County and Ellen Bucci, San Mateo County

Objective To provide an overview of potential funding streams; Discuss potential funding model; Next steps.

Current funding sources Residential stay  AFDC-FC  Medi-cal / EPSDT Community stay  AB 163 Wraparound Funding  Medi-cal / EPSDT

Potential Funding Streams EPSDT –Case mgmt –Medication support –Therapy SB 163 Wraparound AFDC Residential Rate –Monthly bed rate board and care –In house stabilization

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

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;

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

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?

Next Steps Complete RFQ; Hold discussions with providers; Create funding model.