PCCYFS
Children’s Services Policy Day
Friday, October 18, 2013
OMHSAS Presentation
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Topics for Discussion
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Environmental Overview
Cross-systems Activities
Future of BHRS
Status and Updates on OMHSAS Activities, Initiatives
and Guidance
• Other potential items for discussion – Psychotropic Medication
– Family-Based Mental Health Services Update
– Residential
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ACA/Healthy PA
• The decision on whether to move children
from CHIP to MA has not been resolved
• CHIP 6 month waiting list has been eliminated
• ACA appears not to impact children who are
eligible for Medicaid due to disability
• Likewise, Healthy PA is focused on MA
eligibility due to income
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Block Grant Implementation
• There are now 30 counties that are part of the
Human Service Block Grant
• These counties have some flexibility in the
way they use their State allocations
• The impact on children’s behavioral health is
primarily on Student Assistance Programs,
Respite, and to some degree, CASSP
Coordinators and case management.
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Cross-systems activities
• System of Care, 2009, working with 15
counties
• Expansion Planning Grant, 2011
• System of Care Expansion Implementation
Grant, to expand system of Care throughout
the Commonwealth
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System of Care Standards
1. System of Care governance at state and local levels
2. Youth Involvement in their own services and in system
decision-making
3. Family Involvement
4. Comprehensive, individualized planning process for
youth and families - in partnership with systems staff
5. Focus on natural and community supports
6. Integration of services
7. Cultural and Linguistic Competence
8. Continually evaluate and improve the structures,
services and supports
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Safe Schools/Healthy Students
• OMHSAS, in conjunction with PDE, has received a
4 year grant to develop exemplary safe and
supportive schools and communities in 3 local
education agencies (LEAs), and ultimately
throughout Pennsylvania.
• Local, and state, planning will identify ways to
decrease bullying, youth violence and criminal
behavior as well as to promote the healthy
development, social and emotional learning, and
academic achievement of all students.
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BHRS Work Group
• There is a new Draft BHRS Bulletin that
addresses recent issues
• Summer Therapeutic Activities Programs
• Family Guide to BHRS
• Best Practice Guidelines, Training, etc.
– Evaluation
– ISPT
– Titration
– School Based BHRS
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Algorithm/Outcome Initiative
• BHRS is a high volume, labor intensive process for
providers and BH-MCOs, an administrative burden that
significantly affects the quality of clinical documentation
and care management.
• Testing a data-driven approach to care management:
•Refocuses care manager resources to quality of care issues with
individual case and provider-level outliers.
•Allows flexibility for submission of clinical documentation to support
medical necessity reviews (e.g., online forms, telephone reviews).
•Allows flexibility in timing of ISPT meetings to match needs of child and
family rather than every 120 days.
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Behavior Specialist Licensure
As of 10/3 the BoM reports:
– 2294 applications received
– 696 licenses issued
– 1659 applications with discrepancies
• At this point the MCOs are not hearing from
providers about concerns with staffing cases or
having a sufficient number of qualified staff.
• We are interested in ideas about how to
proactively address the need for future licensed
staff.
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FBMHS
• Create Consistency/uniformity in training statewide.
• Emphasize role of clinical supervision
• Technical assistance– Resolve outstanding questions and concerns
• Survey of FB providers:
– Asked for ‘Point in time’ data regarding the progress towards
implementing the changes
– The majority of respondents/providers are compliant or in the process of
implementing and complying with training and supervision requirements
• Next areas of focus:
– Standard outcome measures for family and child
– On line/web learning availability
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FASD
• Children’s Bureau training- provided several
presentations to groups at
conferences/trainings/meetings.
• Focus is on stakeholder awareness.
• Prevalence (1 in 100) of people with an FASD.
• Identification and effective treatment
– ‘It’s not that the child won’t, it’s that the child can’t’.
– Understanding that the child is not willfully disobeying
– Individualized treatment
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Attachment Disorder
• The Children’s Bureau cross-systems
workgroup is making progress in developing a
best practice policy.
• Current focus of discussion of workgroup is
meeting the needs of children diagnosed with
RAD in out of home placements and adoptive
families.
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Psychotropic Medication
• DPW/OCYF Healthcare Psychotropic Medication Subcommittee.
– Cross-system workgroup dedicated to improving physical/behavioral
health outcomes for youth in foster care.
• Resources developed by Children’s Bureau and located on PA Recovery
website
– Psychotropic Medication and CASSP Principles
(parecovery.org/documents/Meds_CASSP_Hodas.pdf)
– Psychotropic Medication in Foster Care: Understanding the Youth Voice
(parecovery.org/documents/CMHM_Hodas_082012.pdf )
• Additional Resource
– A Guide on Psychotropic Medications for Youth in Foster Care 2012
(www.nrcyd.ou.edu/publication-db/documents/psychmedyouthguide.pdf)
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6 Year RTF Data
SFY 06-07
RTF Accredited
SFY 07-08
SFY 08-09
SFY 09-10
SFY 10-11
SFY 11-12
$158,808,341 $142,231,628
$239,210,127
$232,159,650
$218,225,436
$187,750,643
$48,582,516
$41,850,650
$43,781,935
$37,354,310
$36,048,843
$37,777,855
RTF Accredited
5,058
4,632
4,213
3,691
3,237
2,874
RTF Non-Accredited
1,593
1,320
1,301
1,098
1,018
1,030
RTF Non-Accredited
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RTF Provider Survey
• For 2012 Calendar year
• Providers that responded 35 (88%)
– Accredited Providers-28
• JCAHO-22
• CARF-2
• COA-4
– Non-Accredited-13
• Total Bed Capacity-2,552
– Female-732
– Male-1820
• Average Daily Census 71.3% of capacity (2011-77.4%)
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Audience Response System
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