Alaska s FASD

1. BETA Training October 8, 2007 1 Alaska�s FASD/RPTC Medicaid Demonstration ProjectMODEL Implementation �3-M� Service Delivery Focus: Modeling, Mentoring, and Monitoring Home and Community Based (HCB) Services for Children with SED and FASD Michelle Lyons-Brown, Acting Project Director

2. 2 Alaska�s FASD/RPTC Medicaid Demonstration Project Why should NAME care? Or its members??? Youth going to and from treatment move in an out of school districts, often without notice or a treatment plan that includes educational supports Schools are important �natural supports� in a child�s life School-wide Postive Behavioral Supports

3. 3 Demonstration Requirements Children under age 21 meeting RPTC level of care RPTC�s become recognized facilities under demo Enables children to meet an RPTC-institutional level of care rather that skilled nursing or ICF/MR Enables children to remain financially eligible outside the institution; if they get disability determination and income is under 300% SSI �Demonstration Project� like traditional HCB 1915c Waivers in some ways: mostly same parameters and federal rules same federal application and approval process

4. 4 Demonstration Financing $210 million to 10 states over 5 years $15 million federal match to Alaska for life of project=approx 30 mill total computable Regular FMAP reimbursement Administrative activities @ 50/50 No extra money for additional start-up/IT system changes (MMIS/EIS) Alaska must reapply every year of project for continued qualification No new money overall! Allows Alaska to reallocate funds from RPTC to Home and Community Based services

5. 5 Alaska�s Project Target group: 14-21 year olds placed in or at risk of placement in Residential Psychiatric Treatment Centers (RPTCs) with diagnosed or suspected Fetal Alcohol Spectrum Disorder (FASD) Youth we currently treat least effectively yet at great monetary and social cost.

6. 6 Alaska�s Project Problem: Target group is underserved and experiences negative health and social outcomes. Children with Serious Emotional Disturbance (SED) and FASD have more difficulty than others transitioning to adulthood, independent living and adult support systems. Data on specialized treatment interventions is needed to provide evidence of effective practice Kids coming home need community and natural support involvement part of transition plan success �Practice Based Evidence� to support 3-M Model and interventions.

7. 7 Alaska�s Project Current Issues: Inappropriate placements for this population lead to ineffective interventions Youth with an FASD learn by modeling behaviors. Point systems rely on understanding �cause and effect� Increased service capacity in home communities will lead to better outcomes Building natural supports will serve youth into adulthood

8. 8 3M Design and Development Values No child will fail Stability for child and family Predictable, responsive environment Plan for transition and sustainability Establish and enhance natural supports Simple, lean program design Mentor to independence vs. co-dependence Epochs Recruitment/Acceptance Service Delivery Service to Transition

9. 9 3M Design and Development State Involvement DHSS- 32 members on 9 workgroups DBH, DHCS, DJJ, DPH, DPA, DSDS, FMS, OCS, Commissioner� Office Alaska Mental Health Trust Authority Governor�s Council on Disabilities and Special Education UAA-CHD: Training design & syllabus development Accreditation & workforce development Federal Involvement SAMHSA/ FASD Center for Excellence Centers for Medicare and Medicaid Services Stakeholders BTKH Committee Alaska Mental Health Trust Authority SESA Anchorage School District UAA-CHD Stone Soup Alaska Mental Health Board Alaska�s Youth and Family Network SE FASD Diagnostic Team Family members