Transforming Bay Area Residential Services

2. TransformingBay Area Residential Services Mark Lane Bay Area Consortium RBS Local Implementation Coordinator

3. Planning Process 5 Counties x 3 Departments = Chaos

4. 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.

5. 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

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

7. ENGAGING THE PROVIDERSTHROUGH AN RFQ • Refining the Target Population • Restating the Guiding Principles • Outlining the Program Design • Defining the Criteria to Deliver Services

8. KEY INNOVATIONS forTRANSFORMING BAY AREARESIDENTIAL SERVICES

9. 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

10. 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.

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

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

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

14. Who Are These Youth?

15. Phase 1 Target Populations • 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 • Pathways to Permanency • Children and youth who are growing up in placement and do not have a permanent plan

16. Phase 2 Target Populations • 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 • Reconnecting and Reconstructing • Sexually exploited girls who are unable to stay in placement using current approaches

17. How Many Youth? • 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 • Family Reattachment – 100 • Pathways to Permanence – 600

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

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

20. Next Steps • RFQ response • Intake & referral process • Project entry/exit/capacity • Training • Providers • Staff • Community • Measure results

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

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

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

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

26. 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

27. 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;

28. 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

29. 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?

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