- Posted by Famcare
- On March 21, 2017
- 0 Comments
I like to view the growth of Family Care Network as the placement of essential “building blocks” which make up the foundation of our organization and enable us to provide a broad continuum of effective programs. Our history is a story of identifying community needs and then assembling the “blocks” necessary to meet that need. These “blocks” include important relationships and partnerships, skills, methods and interventions, funding and resources, infrastructure and key personnel.
One of the most important “blocks” to be added to our foundation has been the ability to provide MediCal funded Specialty Mental Health services to children and youth. Since our first year, FCNI had been delivering mental health services by very skilled, licensed clinicians but without a specific funding stream. Our Social Work staff were expected to do provide these services as part of their regular case management requirements, but this created a substantial workload burden, requiring more time without the luxury of having smaller caseloads. However, this situation was about to change.
In 1989, federal law was established requiring all states to provide Early and Periodic Screening, Diagnosis and Treatment (EPSDT) to children to “correct or ameliorate defects, physical and mental illnesses, and conditions discovered by screening services” under the federal Medicaid (California MediCal) program. In 1993, a collection of health advocacy attorneys sued California alleging that the state was not providing EPSDT Specialty Mental Health services to children, and California lost. In 1997/98, the state required all counties to provide EPSDT expanded mental health services to eligible children, and 1998 California lost another lawsuit which required it to provide “Therapeutic Behavioral Services” (TBS) to all medical eligible children.
I had been following these developments through my participation in a statewide provider organization. Building on the relationships we had formed with our County Mental Health Department, I approached them about providing TBS and other Specialty Mental Health services. They were very amenable to the idea, and a long-term partnership was formed.
After several months of training, learning the requirements and procedures for delivering EPSDT services, MediCal billing, internal auditing and the likes, the Family Care Network became a state certified Specialty Mental Health Services provider.
Our first order of business was to open mental health cases for the foster youth in our care who met all of the eligibility requirements. This allowed us to balance Social Worker caseloads between providing FFA case management and EPSDT funded mental health. Second, we began hiring personnel to provide TBS services, a one-on-one, intensive behavioral intervention designed to prevent children from being removed from their home for placement in a group home. Another strategic planning objective coming to fruition.
The FCNI program most substantially benefitting from Specialty Mental Health services, was our newly implemented Intensive Treatment Foster Care (ITFC) program. We were able to bifurcate services into those funded by our ITFC rate and those funded through EPSDT. Thus, we were able to develop a very robust constellation of therapeutic, treatment, intensive supervision and community linked services; creating one of the most unique and effective TFC models in the state.
Another exciting development this year, and significant “building block” for Family Care Network, was the Transitional Housing Placement Program (THPP). THPP was first started in 1994 as a pilot project, allowing foster youth, 16-18, to live in their own housing with supervision and intensive life skill development services. In 1998, the program became available statewide.
Again, under the umbrella of CSN and led by Social Services Supervisor, Patrick Considine, a workgroup formed to develop a THPP model. I offered to take the information we learned from the state and write up a THPP proposal which was quickly approved by the County Board of Supervisors and sent to the state for their approval. Unfortunately, the state did not have the project properly staffed and it took considerable time to receive their official blessing. By the end of 1998/99, the Family Care Network was ready to apply for a THPP license, the first under the new legislation.
THPP would fulfill another FCNI strategic objective and fill a huge services gap; to establish the ability to effectively transition foster youth out of the foster care system to successful independence and self-sufficiency. We were very eager to get started as soon as the state was ready to roll.
Another service was launched this year in partnership with County Probation, the Juvenile Accountability Grant (JAG). This program was designed as a pilot project to reduce truancy and improve school attendance for at-risk youth involved in the Juvenile Justice system. We were able to hire two full-time JAG workers, one each for North and South counties. These workers would contact youth who didn’t show at school, or their parents, and developed plans, in concert with the school and Probation, to ensure attendance. We were fortunate to hire several really great employees, and JAG got off to a great start.
By the end of this year, the Family Care Network was operating nine separate programs, including the newly implemented Therapeutic Behavioral Services. Our foster care services remained steady while we experienced growth in other service areas. For the year, we served 426 clients with a 91% success rate.