Inside This Issue (click to go directly to the article):



Inside This Issue (click to go directly to the article):

1. The Latest on the DMH FY 2007/08 Mid-Year Budget Deficit

2. ACHSA Responds to the Group Home Contract and Begins Review of the FFA Contract

3. Returning to the Heart of the Matter: Continuing to Serve AB 2034 Clients

4. The Latest on the Title IV-E Waiver

5. Onward March! ACHSA Continues IBHIS Vendor Demonstrations and Work Group Meetings While DMH Recently Resumes CPTT Meetings

6. Homecoming! State Returns Non-Violent Youth Offenders to Their Home County as Part of Juvenile Justice Reform Bill

7. Headed Towards the Right Outcome in 2008? DMH Hosts Informational Meeting on Performance Based Contracting

8. DCFS Youth Development Services (YDS) Presentation to the DCFS Committee

9. DMH Discusses Evidence Based Practices at ACHSA’s Children’s Mental Health Policy Committee Meeting

10. Are You Short on Money? DMH Issues Memo Regarding December Payments

11. ACHSA News

12. Conferences & Events

13. In the News

14. Upcoming ACHSA Meetings

|KEY ISSUES |

• The Latest on the DMH FY 2007/08 Mid-Year Budget Deficit

Consistent with what we reported in our last DMH budget article one month ago, DMH is still projecting a $24 million mid-year budget deficit for FY 2007-08. [At ACHSA's request, an additional $2.5 million in potential outstanding SB 90 claims have been removed from the deficit amount to be addressed.] The three main contributing factors which make up the deficit are:

1) Vehicle License Fees (VLF) are significantly lower than projected.

2) The FY 2006-07 budget mitigation efforts fell short of their targets.

3) The cost of providing services has increased.

In addition, we have acknowledged for some time now that Realignment funding available to support core services has remained flat, not allowing any growth to cover the increased cost of doing business. The current breakdown of the deficit in terms of dollar amounts is as follows: 1) shortfall in VLF revenues -- $14.675 million; 2) unrealized budget mitigation savings -- $4.77 million; and 3) increased cost of providing services (DMH) -- $5.35 million.

Development of Budget Deficit Reduction Principles

ACHSA has participated on a DMH Systems Leadership Team (SLT) budget workgroup which has been developing the Department's plan to address the deficit. A series of budget deficit reduction principles have been developed, which would guide the determination of potential curtailments. The key principles are as follows:

1) Apportioning responsibility for reductions between directly operated programs and contract programs (or shared) is an appropriate strategy.

[As agreed to by the SLT workgroup: a. DMH and contract agencies would share in the $14.675 million reduction caused by reduced VLF growth; b. DMH would be responsible for the following -- unfunded COLA increases, increased medication costs, increased LPS staffing, and unrealized budget mitigation measures, totaling $7.8 million; and c. contract agencies would be responsible for unrealized budget mitigation measures totaling $2.321 million.]

2) Within the apportioned responsibility for reductions above, across-the-board equal percentage reductions in County General Funds is preferable to targeted reductions in specific programs, with EPSDT exempted based on it highly leveraged outside revenue contributions. [ACHSA recommended both parts of this principle.]

3) The specific programs within a contract agency that would be curtailed would be the responsibility of the agencies' CEO, in collaboration with the Service Area District Chief. [ACHSA recommended this.]

4) Indigent care must be preserved at some level in all areas of the County. After much discussion, it was determined that no more than one-third of curtailments within a Service Area should be for indigent care services.

In addition to the above budget reduction principles, ACHSA lobbied the Department's budget workgroup to include a discussion of impact of the proposed curtailments to support recommended Board of Supervisors' funding for the almost $15 million in lost VLF revenues. This $15 million approximates the amount of BOS bridge funding that was provided for FY 06/07 to allow for MHSA transformation.

The Supervisors are expected to get the Department's curtailment recommendations from the CEO's office in a report sometime toward the middle or end of December. The Board will then consider the curtailments at a meeting expected to be held now on January 15th or 22nd of next year.

ACHSA Develops Budget Advocacy Strategy

An ACHSA Board workgroup looking at the DMH budget crisis, consisting of President Lynn Brandstater, DMH Contractual/Administrative Committee Chair Jim Balla, and Dr. Ian Hunter, has developed the following budget advocacy strategy, which will be considered by the ACHSA Board of Directors at its December meeting:

1) Advocate for the BOS retention of the $15 million in prior year bridge funding for MHSA transformation, to be used to cover the State's $14.6 million VLF shortfall. This would mean that contract agencies would be asked to absorb $2.3 million in curtailments and DMH would be asked to absorb $7.8 million in curtailments. It was felt that given the County's and State's current budget situation, the BOS would want to make sure that all parties bore some of the responsibility for the deficit.

2) Organize testimony for the BOS meeting where the proposed curtailment plan will be considered. ACHSA has strongly encouraged participation at the BOS meeting this time from the Mental Health Commission, NAMI, and the Client Coalition.

3) ACHSA staff will talk soon to the remaining three Board offices that have not yet been briefed on the issues, in anticipation of future advocacy activities by ACHSA and individual agencies that will be impacted.

4) Individual agencies will be asked to develop impact statements based on the amounts of their proposed curtailments. [See attached spreadsheet, which lists the individual agency impacts of the proposed $14.6 million VLF reductions alone. A second spreadsheet, which also includes the $2.3 million in curtailments that agencies will be asked to absorb, was to be made available by DMH, but was not ready as of the time of publication. We will email out to the Membership upon receipt.] These proposed curtailment numbers are being provided now only so that agencies can begin to consider the impacts. Individualized letters to Board offices will be encouraged only once the CEO officially submits its curtailment plan to the BOS later in December.

5) ACHSA will utilize the impact sheet it developed for the FY 2006/07 budget hearings, which includes "case scenario" examples of people agencies have been forced to turn away for mental health services.

Please contact Bruce if you have any questions.

• ACHSA Responds to the Group Home Contract and Begins Review of the FFA Contract

On November 27th, DCFS held a Group Home Prospective Contractors Conference to discuss the Group Home RFSQ. All comments related to the Group Home RFSQ were due to DCFS by the date of the prospective contractors’ conference in order for DCFS to respond.

Summary of Key Issues in the Group Home Contract

As stated in the November 15th ACHSA Update, ACHSA formed a small work group of its members to thoroughly review the Group Home RFSQ, which includes the Master Agreement Overview, Terms and Conditions, Statement of Work, and Exhibits. A summary of the workgroup’s concerns and recommendations was shared with DCFS prior to the prospective contractor’s conference. The most significant concerns included:

• The prohibition of co-located DCFS and Probation youth at service delivery sites, included in the Master Agreement Overview on page 10. ACHSA recommended deleting this requirement, as agencies currently operate successfully with dual populations, and it is contradictory with language in the Statement of Work (Section 3.1.2(d) on page 32) and state law (WIC 16514(c)).

• The requirement for a Child Care Licensing Division (CCLD) approved copy of the agency’s program statement. At the prospective contractor’s conference, Out-of-Home-Care managers noted that they also need to approve a contractor’s program statement after CCLD has approved it. ACHSA recommended that DCFS not require contractors to submit a CCLD approved program statement with their Statement of Qualifications, but rather a copy of their program statement simultaneously with its submission to CCLD for approval, since contractors do not have control over CCLD’s timeframe for approving program statements.

• Changes to the Hold, Do Not Refer, and Do Not Use notice requirements. In the Terms and Conditions, DCFS proposes to minimize the previously negotiated notice requirements for placing Contractor on hold status, do not refer status and do not use status rather than increasing the notice provided for administrative holds, as previously agreed upon with ACHSA. ACHSA recommended that the County notify Contractors in writing 15 days prior to DCFS'/Probation's decision to place Contractor on Hold or intention to implement Do Not Refer or Do Not Use Status for Administrative reasons. For Administrative Insurance Provisions, ACHSA recommends that the County notify Contractors in writing 3 days prior to DCFS'/Probation's decision to place Contractor on Administrative Hold or intention to implement Do Not Refer or Do Not Use Status.

• The inclusion of unfunded mandates throughout the Statement of Work, such as: 1) the provision of counseling services to the permanent family by the social worker or mental health therapist; 2) the completion of a CANS assessment every six months; 3) the appointment of a Mentoring Liaison; 4) the provision of intake services 24 hours/7days per week; 5) the provision of computers for the youth; 6) the provision of transportation to ILP classes; and 7) the development of Emancipation services for youth. ACHSA requested that the Department either revise the language to make it more flexible or delete the language.

• The elimination of possible sanctions for not meeting performance measures that are beyond the control of individual agencies, which DCFS has acknowledged by agreeing to only countywide data collection for those measures.

• The inclusion of the Probation population in the performance measures and standards section. ACHSA requested that the performance measures and standards section be specifically defined so that it is DCFS-specific, since at this time Probation has not yet collaboratively developed performance measures for their population and is unable to collect and report appropriate data.

• Separate protocols for DCFS and Probation when reporting Special Incident Reports (SIRs). In the Statement of Work, Probation requires agencies to report a SIR to three different contacts whereas DCFS only requires one point of contact. ACHSA recommended that Probation institute the same protocol for reporting SIRs as DCFS.

The work group is still finishing its review of the Group Home Exhibits. Since DCFS did not provide a track changes version of the Exhibits, ACHSA staff had to spend many hours reviewing the Exhibits to determine the changes. [Attached is a summary of changes to the Group Home Exhibits.] The workgroup is currently reviewing the changes to the Exhibits and plans to share with the Department a summary of ACHSA's concerns and recommendations for changes.

Next Step for the Group Home Contract

ACHSA is currently in a ‘wait and see’ position. DCFS agreed to respond in writing to all questions and comments that were sent to them within two weeks from the prospective contractor’s conference. DCFS plans to internally review the comments with their program managers and will then determine any changes needed to the RFSQ. If changes are made to sections of the Group Home RFSQ, DCFS will post an amendment online at . In the meantime, agencies should work to gather the necessary documents for their Statement of Qualifications, which is due to the Department on Friday, February 29th at 6pm.

FFA Contract Update

In a small victory, at ACHSA’s request, DCFS has agreed to differentiate the timeframe for finalizing the Group Home and FFA contracts by pushing back the FFA prospective contractor’s conference to January 9th at 1pm. Unlike the Group Home RFSQ, DCFS has not provided ACHSA with track changes documents for the FFA RFSQ process. Therefore, ACHSA will have to take additional time to review the documents to determine the changes that were made to the FFA contract.

Similar to the review of the Group Home RFSQ, ACHSA has formed an FFA Contract workgroup to thoroughly review the changes to the FFA RFSQ. Since the Terms and Conditions and the Exhibits are primarily the same for the Group Home and FFA Contracts, the majority of the review will focus on the FFA Statement of Work. ACHSA also plans to host an All FFA meeting for both ACHSA and non-ACHSA member FFAs to specifically discuss the FFA RFSQ. The hosting of an All FFA meeting is designed to show the Department that ACHSA is being inclusive by providing an opportunity to facilitate input from all providers. Once a date and location have been determined, ACHSA plans to notify all FFAs of this critical meeting.

For further information, please contact Bruce or Amanda.

|ISSUE BRIEFS & UPDATES |

• Returning to the Heart of the Matter: Continuing to Serve AB 2034 Clients

In an effort to provide additional resources to assist providers in serving clients enrolled in the de-funded AB 2034 program, State DMH had announced in an October 18th memo of its plans to dedicate one-time MHSA administrative funds totaling $64 million. Since that time, County DMH has considered expanding the number of Full Service Partnership slots as well as increasing the funding to providers that have Wellness or Client Run Centers. While State DMH has not provided further guidelines as to exact date for the release of funds, County DMH is continuing to consider all alternatives for maintaining services to AB 2034 clients.

Clarification Sought on the AB 2034 Slot Maintenance Issue

At the most recent ACHSA Board of Directors’ meeting on November 7th, DMH Director Dr. Southard stated that the number of AB 2034 client slots would not necessarily translate to an exactly equivalent number of additional Full Service Partnership slots. For example, a contract provider with 10 clients enrolled in its AB 2034 programs and 10 Full Service Partnership slots would not necessarily receive an additional 10 FSP slots. Since there continued to be a lack of clarity as to how the State's administrative funds would be allocated, ACHSA contacted CCCMHA and Mental Health Advocacy Services, a public interest organization that is in the process of filing a lawsuit challenging the Governor’s elimination of AB 2034. Both parties stated that there was no legal requirement that County DMH augment the number of FSP slots equivalent to the number of lost AB 2034 client slots at the current time. At the same time, ACHSA has advocated that DMH recommend to its Stakeholder's Group that the highest priority use of MHSA growth funds should be for former AB 2034 providers to be able to add FSP slots in the same number that they lost with the de-funding of the AB 2034 program. This would allow agencies to continue providing services into the future for those highest in need of services.

Concerns Regarding DMH Transition of Current AB 2034 Clients

With respect to the transition of current AB 2034 clients, several ACHSA members have articulated their concerns about what will happen to individuals who were enrolled in the AB 2034 program but who do not meet the FSP criteria. Furthermore, parolees enrolled in the AB 2034 program are ineligible for FSPs. Contract providers are also concerned about the future of AB 2034 clients who do not meet FSP criteria but are not ready to transition into the Wellness/Client Run Centers. In order to ensure that AB 2034 clients are not going to “fall through the cracks,” ACHSA has requested a meeting with DMH to discuss these operational issues. DMH has agreed to arrange a meeting with AB 2034 providers in the next week or so.

For additional information, please contact Bruce or Wendy.

• The Latest on the Title IV-E Waiver

On November 29th ACHSA participated in its second meeting with DCFS, Probation, and two Board offices (the Children's Deputies for Supervisors Knabe and Antonovich) to discuss the status of the County’s Title IV-E Waiver Demonstration Project. The discussion at the meeting focused on the following topics: 1) financial status update; 2) DCFS and Probation waiver project status reports; and 3) opt out status.

Financial Status Update

Prior to the meeting, ACHSA had shared with DCFS a one-page document outlining the key Waiver financial components that ACHSA had identified which DCFS agreed to report on over time. Susan Kerr shared that the two main financial components that the Department is tracking for the Waiver include: 1) staffing and salary expenses, and 2) assistance payments (i.e.., foster care payments). For the first year of the Waiver, the Department budgeted $367,522,000 in staffing and salary expenses and is currently projecting that it will actually spend $343,984,000, which includes a projected 3% salary increase for its staff in January. A portion of its decrease in staffing and salary costs can be attributed to the delayed hiring for positions and open vacancies.

For the foster care assistance payments, the Department budgeted $417,650,000 in expenses, based on an estimated 2% decrease in the out-of-home care population. It is currently projecting that it will actually spend $430,694,000 in foster care payments, so its estimation of a 2% decline in out-of-home care population is not likely to be realized. The projected actual cost for foster care payments ($430,694,000) includes the 5% provider rate increase beginning in January. Since the staffing and salary expenses are currently projected to be about $20 million less than anticipated and the foster care payments about $13 million more than budgeted, the County believes that it is on track to cover its costs and perhaps realize some savings.

Waiver Project Status Reports

DCFS acknowledged that it has been slow to begin implementing its Waiver activities:

1) Expansion of TDM Facilitators: DCFS has hired 12 of 14 new TDM facilitators assigned to specifically have permanency planning conferences for children placed in RCL 7-9 congregate care facilities. Lisa Parrish noted that DCFS plans to assess the appropriateness of the current placements for this population and hopefully identify alternative family based placements, such as with a relative, in a foster home, or possibly in a Wraparound program. Lisa also noted that the Department is working on drafting a specific protocol for these specialized TDM facilitators to use and agreed to share a copy of the draft with ACHSA for review. DCFS plans to begin utilizing these new TDM facilitators in January.

2) Specialized Permanency Units: DCFS is having conversations with the union about lowering caseloads for a specialized permanency unit in two offices: Metro North and Pomona. DCFS plans to have this specialized unit work with the hardest to place youth, those youth with the most number of previous placements, AWOLs, and hospitalizations. Lisa stated that DCFS plans to train the staff on family finding and engagement techniques, so that it can work to locate permanent connections for these disconnected youth.

3) Expansion of Up-Front Assessments: DCFS plans to duplicate the SHIELDS' up-front assessment model project, currently in use in the DCFS Compton office, in two other offices. Lisa noted that up-front assessments would occur for families pre-detention, without an open case, to assess for possible domestic violence and substance abuse issues and make appropriate as well as immediate referrals in the community. DCFS is waiting to hear from the Margaret E. Casey Foundation to determine if it will receive funding to model this program beyond the Compton office, which it projects will cost about $500,000 per office. Without this external funding, DCFS is unsure about the expansion of this program.

Probation briefly summarized its two Waiver activities:

1) Expansion of MST and FFT Programs: Carol Sanchez stated that Probation has transitioned approximately 80 youth from group home facilities to one of the MST, FFT, or Family Preservation programs. Probation shared that it has been working more collaboratively with providers to gain feedback on appropriate youth to refer into one of these programs. Probation has been able to fund this initiative through external funding to date.

2) Development of a Comprehensive Case Assessment: Probation has started to gain traction in moving forward to develop and implement a comprehensive case assessment for all Suitable Placement youth in each of the three juvenile halls. DMH has identified three therapists to complete a mental health assessment for youth across the three halls. Jitahadi Imara noted that he is working with LACOE to identify three educational specialists to work with the DMH staff to complete these multi-disciplinary assessments in the juvenile halls. Jitahadi also mentioned that Casey Family Programs has provided Probation with educational consultants to share educational assessment tools and instruments to use in their overall assessment process. Jitahadi shared that for FY 2008/09 Probation will be looking at additional priorities for aftercare (focused on RBS providers as the deliverers of service) and MAT-like assessments.

Next Steps

Based on the Departments’ financial status, Susan Kerr noted that she anticipates the County completing at least the first year of the Waiver. At this time, she is uncertain about year two. Susan ackonwledged that the County is basically assessing the projected expenses versus projected revenue to determine the feasibility of remaining in the Waiver. For this year, it seems that the County actually benefited financially from participating in the Waiver. If the County considers opting out of the Waiver, there could be some significant budget impacts that the Departments may have to consider.

Until then, the two Departments will be providing regular reports to the CEO’s office and the Board of Supervisors at 5-month, 9-month, 11-month, and year-end closing intervals. Susan Kerr agreed to share a copy of the 5-month report with ACHSA, which should be available at the end of December. In addition to these regular reports, the Waiver has a State-issued evaluation component. The State evaluation, contracted to Sonoma State University, will consist of a pre/post analysis based on eight Federal measures. The baseline data for the pre-Waiver outcomes should be available in January on Berkley’s website. The County is also discussing the possibility of a county-specific evaluation with Casey Family Programs to assess the specific Waiver activities and determine any lessons learned for future practice. ACHSA plans to have another meeting with DCFS, Probation, and the two Board offices within a few months to receive another status report.

For additional information, please contact Amanda.

• Onward March! ACHSA Continues IBHIS Vendor Demonstrations and Work Group Meetings While DMH Recently Resumes CPTT Meetings

ACHSA IBHIS Work Group

At the most recent ACHSA IBHIS Work Group meeting on November 27th, the discussion focused on requirements that contract providers believe vendor systems need to meet for an effective EHR-system. Facilitated by Keely McGeehan, ACHSA’s IBHIS consultant, the work group focused on the minimum requirements for a vendor system related to different aspects of an agency’s operations. Keely outlined five different options for third party interface. The optimal solution is for an agency to have all client related data in its internal system in order to correlate outcomes and other goals (i.e. interventions, medications, etc.) This being said, with the exception of the required interfacing with PATS, an agency has the following options regarding third party interface: 1) double data entry into agency’s new EHR system and third party system; 2) no data entry into an agency’s EHR system; 3) EDI transmission to a third party database; 4) data dump into a separate data warehouse and then export the data to the agency’s new EHR system; and 5) EHR-S interface built with vendor to import data into an agency’s system. Work group members agreed that it would be important for County DMH to provide further technical assistance on each one of the above options.

ACHSA Vendor Demonstration #2

ACHSA recently hosted its second IBHIS vendor demonstration on November 29th at Phoenix House. The demonstration featured three vendors: DeFran, Sigmund, and Askesis. While each of the vendors followed a scripted demo prepared by Keely McGeehan, the products presented were vastly different. Each of the vendors had innovative formats and layouts for screens pertaining to different staff roles and functions.

DMH Contract Provider Transition Team Meeting

DMH resumed its first Contract Provider Transition Team (CPTT) meeting since the summer months on November 20th. The hiatus was attributed to administrative delays in the Department’s renewal of the Integrated Behavioral Health Information System (IBHIS) consulting contract with Karen Bollow. As detailed in the November 15th ACHSA Update, the CPTT meeting featured a new format that included break-out sessions.

The meeting began with a short presentation by DMH Chief Information Officer Bob Greenless on the status of the MHSA Capital Facilities and Technology guidelines. Not surprisingly, Bob shared that the State has yet to finalize the Capital Facilities and Technology guidelines. It is his understanding that the delay relates to the capital facilities component. Even though these two components are currently linked, the California Mental Health Directors Association (CMHDA) has requested that the State DMH release the Technology guidelines first.

According to initial estimates, there will be approximately $350-$450 million dedicated to the MHSA Capital Facilities and Technology Plan statewide. If this is accurate, Los Angeles County would receive approximately $100-$125 million across a three-year span. Bob stated that the proportion of the funding for each of the two components will be decided by each County.

The participants spent the majority of the meeting divided into four different groups: 1) agencies that have not started the EDI process; 2) agencies that are preparing for EDI or are in the EDI selection phase; 3) agencies that are in the EDI implementation phase, the EDI certification process or the EDI production phase; and 4) agencies that have been using EDI for awhile. Following the break out sessions, each group reported back to the larger group regarding their respective priorities and concerns.

For more information on upcoming events, please refer to the full list of IBHIS Seminars, Workgroups, and Vendor Demonstrations. For more comprehensive discussion on EHR-S issues, click on the following blog: .

For further information, please contact Wendy.

• Homecoming! State Returns Non-Violent Youth Offenders to Their Home County as Part of Juvenile Justice Reform Bill

On August 24 2007, Governor Swarzenegger signed SB 81, which shifts non-violent juvenile offenders out of secure facilities operated by the state Division of Juvenile Justice (DJJ), formerly known as the California Youth Authority, to their home county facilities and/or community-based programs. The Chief Probation Officers of California (CPOC) and counties were not involved in the planning process for SB 81 which resulted in some inconsistencies and lack of clarity with regard to the legislation. In addition, SB 81 had set an implementation date of September 1, 2007, which did not allow the counties sufficient time for planning and preparation. Therefore, on September 29th the Governor signed AB 191, a trailer bill with language clarifying SB 81.

Nuts and Bolts of the Legislation – What it Says and Does

The target population for this initiative includes non-violent 707(b) juvenile offenders. Initially all gang and sexual offenders were included in the SB 81 bill, but that was amended in AB 191. Under DJJ, counties utilized multiple placements for these youth in their county (e.g., juvenile halls and camps) before sending them to DJJ for placement. With this new legislation, the county will now be responsible for keeping these youth in county.

The reform bill provides counties with block grant funds to pay for local alternatives for these youth, at an average of $130,000 per ward. Los Angeles County should receive approximately $5 million for the first year, $10 million for the second year and $15 million the third year. The block grant is based on a formula dependent on the county’s share of all annual state felony juvenile adjudications (50% factor) and their share of the statewide at-risk youth population, ages 10-17 (50% factor). Counties will also receive start-up funds.

ACHSA has begun to engage the Probation Department to determine its plans for moving forward with implementation of this reform bill. Probation’s Juvenile Special Services Bureau, headed by Felicia Cotton (who reports directly to Jitahadi Imara), is responsible for overseeing this legislation. At this time, the Department is trying to develop the components of their county plan, which is due to the state by January 2008.

A specific area of the legislation that ACHSA has offered assistance to the Department on is developing the service component for these youth. Felicia identified that the types of services they anticipate this population needing include: 1) vocational, 2) educational, 3) transitional housing, 4) mental health, 5) and substance abuse. Felicia also noted that the initial population served from DJJ should be approximately 150-200 juvenile offenders. Of that population, they expect about 10-15% being under 18 years of age, with the majority of the population in the 18-25 year old age range. Felicia was eager to learn about the opportunities in partnering with ACHSA agencies and agreed to follow-up with ACHSA to discuss the next steps in moving forward.

For further information, please contact Amanda.

• Headed Towards the Right Outcome in 2008? DMH Will Host Informational Meeting on Performance-Based Contracting

At the most recent DMH Performance-Based Contracting Work Group meeting on November 21st, the members reviewed the latest draft of the operational measures matrix. Work Group members continued to voice their concerns about the use of the State Outcome Survey and its implications for contract agencies. In particular, one individual pointed out that the survey response rate would be drastically lower for agencies that offer primarily field based services, due to the fact that existing state guidelines on the dissemination of the State Outcome Survey prohibits clinicians from administering the surveys while providing field based services. Lead DMH PBC staff, Gurubanda Singh-Khalsa agreed to bring this concern to the attention of DMH’s Executive Management Team. Gurubanda reminded the Work Group that the survey response rate will be an issue that the Work Group will need to address when it resumes meeting in 2008.

Work Group members also discussed the format and content of the upcoming DMH informational meeting on December 5th. DMH had distributed a memo dated November 20th notifying providers about the location of the meeting. The information meeting will include a short narrative of how performance measures have evolved in the last two years. Then, DMH staff will make a presentation on the operational measures matrix, the data collection process, and the documentation requirements. ACHSA has requested that DMH allot some time during the informational meeting for a question and answer session.

DMH queried Work Group members about whether the operational measures matrix should be included in the Negotiation Package or as an exhibit in the Legal Entity Agreement (similar to the Financial Responsibility Requirements). Members held diverging views about where the operational measures matrix should be inserted. Some individuals felt that inserting the matrix into the negotiation package would give contract providers the idea that the outcome measures were optional or negotiable. Gurubanda will report back to the DMH Executive Management Team that there was no agreement on this issue.

For additional information, please contact Wendy.

• DCFS Youth Development Services (YDS) Presentation to the DCFS Committee

 

ACHSA invited DCFS Youth Development Staff (YDS) staff to the November DCFS Committee meeting to answer member questions and share information regarding the recent changes that have occurred within the program, formally known as Emancipation/Independent Living Program (ILP).  Otho Day, DCFS Transitional Housing Program (THP) Manager and Luvirda Carter, DCFS Independent Living Skills Program Manager, attended the Committee meeting with some of their staff to discuss the following issues: 1) ILP eligibility requirements; 2) available ILP services; 3) ILP referral process; 4) post-secondary education and vocational training; 5) transitional housing; and 6) YDS contract and contractors.

 

ACHSA distributed the most recent DCFS YDS Organizational Chart and later obtained directories for DCFS ILP and THP staff.  DCFS YDS distributed an informational packet, which included the following materials: 1) brief overview of the YDS program; 2) ILP eligibility guidelines; 3) informational bulletin on ILP services; 4) ILP Services Request form; 5) YDS referral guide specific by age group; 6) sample copy of the Transitional Independent Living Plan (TILP) and the 5557 Form; 7) THP informational flyer; and 8) and a step-by-step guide for assistance with post-secondary education and vocational training.  YDS also provided ACSHA with the 2007 Resource Directory for Transition-Age Young Adults, published by the Los Angeles County Emancipation Program (please contact Adam to obtain a copy of the Resource Directory).

 

The most critical issue for members that was discussed was the receipt of TILPs.  YDS managers clarified that it is the responsibility of the CSW to share the TILP with providers.  In fact, CSWs are supposed to complete the TILP in collaboration with the caregiver and youth.  YDS staff also noted that the TILP is to be updated every six months by the CSW.  If providers are not receiving a copy of the TILP, then Luvirda strongly encouraged providers to go up the chain of command in the Regional Office by first contacting the CSW, followed by the SCSW, the ARA, and finally the RA until the issue is resolved.  Otho noted that the State has plans to modify the TILP form, which is a statewide requirement, by developing a software tool that will allow for the TILP information to be included in a youth’s court report in a shorter, condensed version and subsequently be readily available for CSWs by the spring of 2008.

 

Since the receipt of the TILPs is such a prominent issue for providers and, ultimately, youth, ACHSA recently issued a survey to its members to determine the percentage of youth in care that actually have a copy of their TILP.  Once ACHSA has determined the actual number, then it can utilize this information to demonstrate the need for both DCFS and Probation to resolve this outstanding issue.  If you haven’t already submitted your agency’s data, please email the information to Adam ASAP.  

 

Other issues clarified by DCFS included transitional housing and vocational resources.  DCFS clarified the process for youth receiving funds for specific ILP services.  Once the youth completes the ILP Services Request form, DCFS stated that it usually takes three to four weeks for YDS staff to follow-up with the youth.  If youth haven’t received a response during this timeframe, then DCFS encouraged caregivers to contact a YDS Transition Coordinator, who is a critical link to assisting the youth in accessing the ILP services.  ACHSA also asked for clarification as to why the County has only requested THP-Plus funding for just 48 beds when the State budget, as of January 2007, allocated a total of $35.5 million for THP-Plus programs.  Otho stated that DCFS plans to post an RFSQ by the end of this year to expand the THP-Plus program to more providers and implement new programs in October of 2008.  Otho also stated that in Los Angeles County there are multiple transitional housing beds available for the Emancipation population in addition to the THP-Plus program.

 

YDS informed ACHSA that the County's Internal Services Department (ISD) is interested in linking DCFS and Probation youth with representatives who may be able to provide vocational training.  The ISD has released a list of the various industries throughout the County that offer apprenticeships and training programs.  Since each program tends to have different eligibility requirements, the youth are encouraged to call the Apprenticeship Coordinators themselves to find out more.  At the October YDS Partnership meeting, DCFS distributed a matrix of vocational resources that are available throughout the County.  The matrix includes a breakdown of each contract by service area, target population, focus, participation, outcome, and program components. Providers should encourage youth to contact their CSW and/or Transition Coordinator for additional information. 

 

DCFS recently revised its YDS procedural guide, which outlines the responsibilities of both CSWs and YDS staff when referring eligible foster youth to independent living skills training.  The policy includes a detailed appendix of step-by-step instructions for CSWs and YDS staff to follow throughout the ILP referral process.

 

The county has an extensive website that summarizes the available YDS resources and contact information at .  In addition, ACHSA has a peer support group for staff who work with the Emancipation/ILP program at their individual agency.  The next peer support group meeting is Wednesday, February 6th at 1:30 p.m. at the ACHSA office.

 

For further information, please contact Amanda or Adam.

• DMH Discusses Evidence-Based Practices at ACHSA’s Children’s Mental Health Policy Committee Meeting

The November 14th ACHSA Children’s Mental Health Policy Committee meeting featured three DMH clinicians: Dr. Heidi Rotheim, of the Juvenile Justice Mental Health-Evidence Based Programs and Drs. Ilda Aharonian and Gail Blesi of Intensive In-Home/Specialized Foster Care Services. Heidi began the presentation by defining evidence-based practices (EBPs) as “interventions and treatment approaches that have been proven effective through a rigorous scientific process.” She encouraged contract providers to keep fidelity in mind when thinking about implementation and to be proactive in order to avoid drift, a result of model adherence not being met.

Incredible Years (IY)

Several examples of EBPs models are found under the Intensive In-Home Mental Health Services Program (IIHMHSP), including Incredible Years (IY). IY focuses on 2-12 year olds with behavioral problems and aggressive tendencies. IY currently includes Beginning Parenting, Advanced Parenting, and Child Therapy programs. In both Beginning and Advanced IY Parenting groups, the emphasis is on hands-on practice, with rewards given to parents for homework completion. The Child Therapy Program, which will be implemented in the near future, promises to help group members understand and communicate feelings and facilitate problem solving. Outcomes for the Child Therapy Program are improved child behavior, decreased maternal/paternal stress, and increased parent-teacher and parent-child relationships.

Trauma-Focused Cognitive Behavioral Therapy (TFCBT)

Trauma-Focused Cognitive Behavioral Therapy (TFCBT) combines trauma interventions with classic cognitive behavioral therapy, helping children ages 4-18 who have experienced a traumatic life event gain control and make sense of the trauma. The treatment focuses on client engagement, with the end treatment result being “The Narrative,” a story the child writes about his/her trauma. TFCBT helps reduce Post Traumatic Stress Disorder symptoms, acting out behavior, self-blame, and externalizing in children who have experienced trauma.

Functional Family Therapy (FFT)

Functional Family Therapy (FFT), a “relationally based” family therapy treatment, targets at-risk adolescents ages 10-17. FFT is a goal-oriented, phase-based, and strength-based model. During the Engagement/Motivation Phase, the therapist attempts to gain a balanced alignment wherein every family member feels the therapist is on his/her side, while during the Generalization phase families are encouraged to apply learned skills. Outcomes for FFT include increased positive family interaction, increased positive behavior in youths, increased stability in the home, and decreased risk factors for younger siblings.

Multidimensional Treatment Foster Care (MTFC)

Multidimensional Treatment Foster Care (MTFC) was designed as an alternative to institutionalization for 12-18 year olds with severe behavioral issues. The program is available to adolescents who have been in two or more out-of-home placements, and provides short-term placement only (6-9 months). Foster families who participate in MTFC are specially trained, take only one foster child at a time, and receive intense support from a treatment team. This treatment team will follow foster youth from their temporary placement into a permanent transition, and family therapy is provided for permanent caregivers both before and after the youth is placed with them.

Multisystemic Therapy (MST)

Multisystemic Therapy (MST) is aimed primarily at conduct-disorder adolescents aged 12-17 with severe delinquent and antisocial issues and an invested caregiver. MST is a goal-oriented 3-5 month long program that works to empower these caregivers, conducting all interventions through them. Outcomes for MST include decrease in final placement instability and a 25-70% decrease in recidivism, with one study finding an average of 59% fewer arrests and 58% fewer days of adult confinement for adolescents who had completed the program compared to those who had not.

For more information regarding EBPs, contact: Dr. Ilda Aharonian (IY, TFCBT, FFT); Dr. Gail Blesi (MST, MTFC); Dr. Heidi Rotheim (General EBPs).

For further questions, please contact Brianne or Wendy.

• Are You Short on Money? DMH Issues Memo on December Payments

ACSHA has recently been informed that DMH is experiencing difficulties in extracting data in order to process December payment checks for contract providers. The Department is currently trying to rectify the technical issue. If there are discrepancies resulting from this technical issue, DMH will issue a supplemental payment check. In the event that a contract agency does not receive the anticipated full amount of their December payment, please contact your District Chief immediately.

Please click on December Payments to view the November 30th DMH memo.

For more information, please contact Wendy.

|ACHSA NEWS |

• ACHSA Welcomes New Mental Health Policy Assistant

ACHSA extends its warmest welcome to Brianne Amato, the new Mental Health Policy Assistant. Brianne is a graduate of Brown University, with a degree in both Psychology and English. Since moving to California, Brianne has worked in various capacities at UCLA, most recently as the Outreach Coordinator and Assistant to the Director at UCLA’s Student Psychological Services. We are very pleased that Brianne has joined the ACHSA staff!

• ACHSA Hosts Holiday Party at Westin Hotel in Pasadena

December 11th

Please join us on December 11th for ACHSA’s annual party, with member agencies, DMH, DCFS, Probation staff and the Board Deputies all invited. Come relax and mingle with colleagues as we celebrate the holidays with light appetizers and drinks at the Westin Hotel in Pasadena from 3:30 p.m. to 7 p.m.

Please send RSVPs to mailbox@.

|CONFERENCES & EVENTS |

• Southeast Communities Prevention and Intervention Program's (SCPIP) Presents Foundation Roundtable 2007

December 3rd: RSVP Deadline

December 7th: Event Date

SCIPS’s Executive Support Network (ESN) provides management training to executive directors of community based organization in South Los Angeles and the surrounding areas. The ESN will be leading this roundtable discussion at the California Endowment right here in Los Angeles. Late registration costs $65 while on-site registration runs $75. Hot Breakfast Served! For additional information contact: Eddie Mae Williams at (323) 290-3593 or refer to the event flyer and registration form.

• DMH Presents Understanding How and Why the Private Sector Hires!

November 26th or until space is filled: Registration Deadline

December 17th: Event Date

DMH has coordinated a training designed to assist mental health staff in helping consumers obtain a job in the private sector. The goal of the workshop is to train staff to give consumers the behind the scenes truth about the hiring process to build their confidence. This is intended to increase clients’ motivation to job hunt and become employed. This all-day training features hidden hiring agendas and concepts in regards to different hiring models. The presenter will discuss skill building ideas to will help consumers with the application and interview process, and provide choices and strategies for mental health disability disclosure in the hiring process. The three main course objectives are to help training participants identify hidden hiring agendas, talk about different hiring models and utilize strategies for mental health disability disclosure in the hiring process. The training will take place on Monday, December 17th, from 9:00AM to 4:00PM at the Wilshire Grand Hotel, 930 Wilshire Blvd. Parking is $12.00. Click for a training application form and contact jfriend@dmh. for more information.

• Parent-Infant & Child Institute Offering 15-month Infant Parent Mental Health Post-Graduate Certification Program

December 3rd until space is filled: Application Deadline

January 2008 – April 2009: Program Duration

The Parent-Infant & Child Institute is offering a 15-month Infant-Parent Mental Health Post-Graduate Certificate Program being held in Napa from January 2008 - April 2009. The program meets one weekend each month (Friday, Saturday & Sunday) and is overseen by the Faculty Chief, Dr. Ed Tronick, University Distinguished Professor University of Massachusetts Boston, Director of the Child Development Unit at Children's Hospital Boston, and internationally renowned researcher, author and trainer on the infant-parent relationship. This program is open to licensed or credentialed professionals working with children age 0-5, their families and other caregivers. The first round of application review and offers will occur the week of December 6, 2007, then will continue until a class of 30 is seated. The tuition is $5,500 per person. Applicants in California are encouraged to talk to their First 5 and MHSA coordinators to explore any scholarship options from these funding sources. For further details, please refer to the application, course description, faculty description and schedule. Contact Dr. Kristie Brandt with any questions.

• DMH Presents COS Training for Wellness and Client-Run Center Staff

December 14th: Registration Deadline

December 19th: Event Date

Friday December 21st: Event Date

DMH will host a workshop for two dates in December to address the issue of COS Training. This workshop will be a step-by-step training on completing the COS forms and will include a section on entering the COS into the IS. The workshop will take place on Wednesday, December 19th from 10:00am to Noon at 550 S. Vermont Ave, 9th floor and on Friday, December 21st from 1:00PM to 3:00PM at 550 S. Vermont Ave, 10th floor. Interested parties need only attend one date, and should RSVP to Krista Scholton at kscholton@dmh. or (213) 738-4746 by December 14th. Space is limited.

• New Ways to Work Presents 2008 Foster Youth Career Development and Employment Summit

December 14th: Registration Deadline

January 8th and 9th: Event Date

California’s first Foster Youth Career Development and Employment Summit will bring together representatives from all systems that touch the lives of foster youth. You are invited to attend this two-day, solution-focused summit in Sacramento that will build on recent and innovative work at the national, state, and local levels that has demonstrated effective practices to ensure certain outcomes. A limited number of Youth Scholarships are available.  More information regarding the summit as well as youth scholarships can be found in the Current Happenings section of the New Ways to Work Website. If you have any questions, please contact Lisa Elliott (707) 824-4000 or email lelliott@. The summit flyer is also available for additional information.

• Certificated Training in Older Adult Mental Health Services

Various Dates in January 2008

The Los Angeles County DMH will host a series of training courses in Older Adult Mental Health Services in January of next year. The training is targeted toward staff of DMH operated or contracted agencies who are presently serving older adults, or are interested in working with this population. For details regarding course description, training agencies, instructors, and application deadlines, please refer to the attached brochure, training application form, and supplemental application form part I and part II. For additional information, please contact James Cunningham, Ph.D. at jcunningham@dmh. or (213) 351-7254.

• United Friends of the Children Presents College Sponsorship Program

January 16th: Application Deadline

United Friends of the Children is seeking referrals for the College Sponsorship Program through which graduating foster and probation youth are eligible for $15,000 for college. Students should have around a 3.0 GPA and plan to attend a four year college or university in fall 2008. Students transferring from community colleges to four-year schools are also eligible. For additional information, please refer to the event flyer or contact Falon with referrals or any questions you may have at (213) 580-1857. Completed applications are due January 16, 2008.

• Foster Parents: This Holiday, Give Your Teen the Gift of Art Lessons!

January 19th – 21st

You can give your interested teen a gift of over fifteen hours of group art lessons plus a bunch of fun – at no cost to you! Apply now to send your teen (aged 14-18) to the Eighth Annual Animagination Art Camp, to be held Martin Luther King Weekend, January 19-21, 2008, at nearby Camp Gilmore in Malibu Canyon. Presented by Youth Opportunities United, this 3-day overnight camp will give your child over fifteen hours of art instruction. In addition to large group sessions on basic design elements, students will select a focus in drawing, painting, or sculpture, and will receive some art supplies to go with that medium, so they can practice at home. Each student will return with their own creative work to inspire and enjoy for the rest of their lives. Apply today by contacting Michael Wrice, DCFS, at 213-739-6202 or WRICEM@dcfs.. Michael will send you an application to complete and if accepted, you’ll get a GIFT CERTIFICATE and a list of suggested token art supplies you can enclose with your gift certificate for your teen to unwrap on Christmas, Hanukah, or other holiday.

• St. Anne’s Presents “Pathways to Brighter Futures – A Values Based Approach to Serving Teenage Girls and their Babies” 

January 30th

St. Anne’s will host its Centennial Conference on “Pathways to Brighter Futures,” which will focus on serving teenage girls and their babies through a values based approach.  The keynote speaker will be Dr. Larry Brendtro of Reclaiming Youth International, and participants may earn up to six hours of continuing education credits for MFT’s and LCSW’s as required by the California Board of Behavioral Sciences.  Online registration and additional details on conference presenters are available here.  For more information, please contact Sonya Steele at (213) 381-2931 ext. 218 or ssteele@.

• LA County Helps: The Free and Easy Way to Find Help

This easy-to-use website offers many helpful programs and services to assist County residents, from helping you buy nutritious food for your family, to assistance with health coverage, child care, and more. The answers are anonymous and the website does not ask you who you are and will not share your information with anyone. For additional information, please visit or contact David Zippin at (213) 738-4614. Click here to access the informational flyer.

 

|IN THE NEWS |

• Bush Signs Vets' Mental Health Bill, Associated Press, 11/6/2007

• Schwarzenegger Orders Plan for 10% Budget Cuts, Los Angeles Times, 11/6/2007

• Supervisors Urge Firings over DCFS Spending, L.A. Daily News, 11/7/2007

• Firings are Urged over Misuse of Foster Kids' Money, Los Angeles Times, 11/8/2007

• Latest DCFS Scandal is a Crime against Children, L.A. Daily News, 11/8/2007

• Nearly 200 Children will be Adopted during Adoption Saturday, Whittier Daily News, 11/9/2007

• L.A. County Prosecutors Review Child Welfare Audit, Los Angeles Times, 11/9/2007

• A Small Triumph for Children in Foster Care, Los Angeles Times, 11/10/2007

• Probation Officer Accused of Child Abuse, Los Angeles Times, 11/10/2007

• A Helping Hand - and a Home - for Youth, San Francisco Chronicle, 11/11/2007

• Urgent Action Needed on State Budget, Los Angeles Times, 11/14/2007

• After a Day in Court, Hundreds of Kids Have Homes, Los Angeles Times, 11/18/2007

• Angie Harmon Shares Thanksgiving Tradition with Foster Youth, People, 11/19/2007

• California a Leader in Number of Youths in Prison for Life, Los Angeles Times, 11/19/2007

• Bitter Battle over Children's Health Care Starts to Hit California, San Francisco Chronicle, 11/25/2007

• Medi-Cal Faces New Fed Cut, Sacramento Bee, 11/25/2007

• Toys for Tots Program Helps Needy Children, Paradise Post, 11/27/2007

• Foster Care Charity Needs Help with Adopt-a-Family Program, Open Press, 11/30/2007

|UPCOMING MEETINGS & EVENTS |

|DECEMBER |

|5 |ACHSA Board of Directors Meeting |ACHSA |9:30 AM – 11:30 AM |

|6 |FFA Program Directors’ Peer Support Group |CANCELLED |

|6 |IBHIS Seminar #4: “Preparing for an EHR-S” |Phoenix House |9:30 AM – 4:00 PM |

| | |11600 Eldridge Ave | |

| | |Sylmar, CA 91342 | |

|7 |Foster Care Performance Measures Task Group Meeting |ACHSA |10:00 AM – 12:00 PM |

|7 |Residentially Based Services Performance Measures |ACHSA |12:30 PM – 2:30 PM |

| |Task Group Meeting | | |

|11 |IBHIS Vendor Demonstration #3: |Phoenix House |9:00 AM -4:00 PM |

| |UniCare 9:00 AM – 11:00 AM |11600 Eldridge Ave | |

| |Netsmart 11:30 AM – 1:30 PM |Sylmar, CA 91342 | |

| |Anasazi 2:00 PM – 4:00 PM | | |

|12 |Children’s Mental Health Committee |Hathaway-Sycamores |1:30 PM – 3:30 PM |

| | |210 South de Lacey Ave | |

| | |Pasadena, CA 91105 | |

|13 |IBHIS Work Group #3 |ACHSA |1:30 PM – 3:30 PM |

|17 |Family Based Services Subcommittee Meeting |ACHSA |10:00 AM – 12:00 PM |

|18 |IBHIS Steering Committee Meeting |ACHSA |1:30 PM – 3:30 PM |

|19 |FFA Strategic Planning/Policy Committee Meeting |ACHSA |10:00 AM – 12:00 PM |

|19 |Contractual-Administrative |Conference Call |1:30 PM – 3:30 PM |

| |Steering Committee | | |

|24-25 |CHRISTMAS HOLIDAY |OFFICE CLOSED |

|28 |Adult Mental Health Committee |CANCELLED |

|31 |NEW YEAR’S DAY HOLIDAY |OFFICE CLOSED |

Association of Community Human Service Agencies

1200 Wilshire Boulevard, Suite 302, Los Angeles, CA 90017

Tel: 213-250-5030 / Fax: 213-250-5040

E-mail: mailbox@ / Web: [pic][pic]

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December 1, 2007

Volume 4, Issue 21

ACHSA UPDATE

A bi-weekly briefing of the Association of Community Human Service Agencies

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