“Wraparound Orange”- Addressing the Children’s Mental Health System of Care December 1, 2009

Presentation Outline SAMHSA Grant Existing System New System -"WrapAround Orange" Finance Model Timeline Action Requested

Presentation Outline SAMHSA Grant Existing System New System -"WrapAround Orange" Finance Model Timeline Action Requested

SAMHSA Grant Federal Grant awarded to Orange County through Health and Human Services, Substance Abuse Mental Health Services Administration (SAMHSA) $9M – 6 Years Funds the implementation of a new Children’s Mental Health services model in Orange County Other counties and states have been awarded similar grants Requires community match Requires hiring additional staff

Presentation Outline SAMHSA Grant Existing System New System -"WrapAround Orange" Finance Model Timeline Action Requested

Existing System Fragmented - difficult to navigate for families Lack of collaboration - Silo mentality Lack of coordination and integration Lack of flexibility- agencies have to “chase” the funding Children have to “fit” the system rather than the system fitting the child Florida has many different funding streams for children’s mental health Florida ranks 48 th in the nation in mental health funding

Existing System Emergency Rooms Emergency Rooms Foster Care/ Dependency Foster Care/ Dependency SA/MH Juvenile Justice JAC Juvenile Justice JAC Public Schools Primary Care Clinics – PCAN Primary Care Clinics – PCAN Child Mental Health Substance Abuse Juvenile Justice

Existing System Over 6,500 children in DCF care with a diagnosis of a serious mental health issue Lakeside Behavioral Healthcare provides 8,300 medication clinic appointments to children with mental health issues in Central Florida The national juvenile justice task force indicates 75% of incarcerated juveniles have a mental health disorder. In Orange County last year there were over 4,000 youth in juvenile justice care.

Existing System The OC Juvenile Justice Task force recommended establishing a collaboration between all entities serving children. Marked improvement/outcomes in integrated/ coordinated services –improved school attendance and performance –reduced law enforcement contacts –and reduction in behavioral and emotional symptoms

Existing System Our data shows that 38% of adult mental health consumers brought to the CRC were involved in the Juvenile Justice System Prevention and early intervention diverts from deep end services Collaborative models and positive partnering foster significant positive outcomes with monetary savings and capacity building

Presentation Outline SAMHSA Grant Existing System New System -"WrapAround Orange" Finance Model Timeline Action Requested

“WrapAround Orange” SAMHSA Grant $9M over a 6 year period to develop a system of care A “Central Receiving Center” system of care for children with mental health issues Central point of access (one stop shop) for integrated assessments Streamlined/seamless system of care Ends duplication and fragmentation

“WrapAround Orange” Offers a “Continuity of Care” Focuses on Prevention and Early Intervention Shifts costs from deep-end services Provides access to appropriate services based on proper assessments Centralizes data collection Leverages all funding – state, local, private, philanthropic, etc.

“WrapAround Orange” Comprehensive and Coordinated System of Care Cultural and Linguistic Competence Child Focused and Family Driven Based on Evidence-Based Practice (Georgia, Oregon, Milwaukee) Community Funding for Project

“Wraparound Orange” Governance Model Policy Finance & Sustainability Finance & Sustainability Evaluation Outcomes Evaluation Outcomes Cultural Competency Cultural Competency Clinical Services Clinical Services Family & Consumer Family & Consumer Implementation Team Management Team Orange County Staff, Provider/Child Serving Agency Leadership Management Team Orange County Staff, Provider/Child Serving Agency Leadership Steering Committee or Governing Board Elected officials, Community Leaders Steering Committee or Governing Board Elected officials, Community Leaders

“WrapAround Orange” Department of Children and Families Department of Juvenile Justice Family Services Metro Orlando Florida Hospital and Orlando Health Heart of Florida United Way Orange County Public Schools University of Central Florida Various Child Serving Providers: (CHS, Lakeside, Devereux, UBC etc.) Possible Partnerships:

“WrapAround Orange” Service Intensity Matches Needs Natural Supports Community Based Early Prevention Intervention Individualized Services Team Based Culturally Competent

Presentation Outline SAMHSA Grant Existing System New System -"WrapAround Orange" Finance Model Timeline Action Requested

Finance Model - Existing $700,000 Orange County GR in Children’s Services $1.19 M DCF children’s mental health funding - Crisis Beds in Lakeside Behavioral Healthcare $2.6M DCF funding for children’s substance abuse at the Center for Drug Free Living $500,000 for mental health programs Juvenile Justice funding – (part of the $8M in predisposition costs to DJJ)

Finance Model - Future In-Kind contributions Partner match Systemic shifts of money to mental health services Social Marketing plan Corporate Sponsorship

Finance Model Grant Year Federal Orange County Match Community Match 1 (Actual) $958,664$336,0930 2$1,500,000$336,093$163,907 3$2,000,000$336,093$330,574 4$2,000,000$336,093$1,663,907 5$1,500,000$336,093$2,663,907 6$1,000,000$336,093$1,663,907 70$336,093$1,500,000

Presentation Outline SAMHSA Grant Existing System New System -"WrapAround Orange" Finance Model Timeline Action Requested

TimelineTimeline December ’09 BCC grant approval 2010 –Form Management Team and Implementation Team and develop implementation plan –Select Steering Committee Members –Review Plan and timelines with Steering Committee

Timeline Year One Activities Completion of community-wide assessment, strategic plan and logic model Development and implementation of cultural and linguistic competence model Identify service gaps and barriers Recruit and hire project staff

Timeline Orange County staff lead the project – Syd McCallister, Donna Wyche, and Anne Marie Sheffield Hire additional positions Year 1 and 2 – –Business/Finance Advisor –Lead Family Advocate –Family Advocates (5) –Youth Coordinator –Technical Assistance Coordinator/Program Manager –Social Marketing- Communications Manager

Presentation Outline SAMHSA Grant Existing System New System -"WrapAround Orange" Finance Model Timeline Action Requested

Approval of Substance Abuse Mental Health Services Administration (SAMHSA) Grant and Approval to add ten positions to the manning table for grant funded positions to carry out the provisions of the grant

“Wraparound Orange”- Addressing the Children’s Mental Health System of Care December 1, 2009