COMPREHENSIVE COMMUNITY MENTAL HEALTH SERVICES FOR CHILDREN WITH SERIOUS EMOTIONAL DISTURBANCES (SED)

Transcription

1 APRIL COMPREHENSIVE COMMUNITY MENTAL HEALTH SERVICES FOR CHILDREN WITH SERIOUS EMOTIONAL DISTURBANCES (SED) State Project/Program: NC SYSTEM OF CARE NETWORK U. S. Department of Health and Human Services Federal Authorization: #SM / Part E, Title V Section of Public Health Services Act Amended (42 U.S.C. 290ff et seq.) N. C. Department of Health and Human Services Division of Mental Health, Developmental Disabilities and Substance Abuse Services Agency Contact Person Program Maria E. Fernandez, Project Administrator Community Policy Management-Early Intervention/Prevention Team NC Division of MH/DD/SAS 3021 Mail Service Center Raleigh, NC (919) Maria.Fernandez@ncmail.net Agency Contact Person Financial Katrina Blount Budget and Finance NC Division of MH/DD/SAS 3012 Mail Service Center Raleigh, NC (919) Katrina.Blount@ncmail.net N. C. DHHS Confirmation Reports: SFY 2008 audit confirmation reports for payments made to Local Management Entities/Area Authorities, Councils of Government and District Health Departments will be available by around late August to early September at the following web address: At this site, page down to Letters/reports/forms for ALL Agencies and click on Audit Confirmation Reports (State Fiscal Year ). Additionally, audit confirmation reports for Nongovernmental entities receiving financial assistance from the DHHS are found at the same website except select Non-Governmental Audit Confirmation Reports (State Fiscal Years ). The auditor should not consider the Supplement to be safe harbor for identifying audit procedures to apply in a particular engagement, but the auditor should be prepared to justify departures from the suggested procedures. The auditor can consider the Supplement a safe harbor for identification of compliance requirements to be tested if the auditor performs reasonable procedures to ensure that the requirements in the Supplement are current. The grantor agency may elect to review audit working papers to determine that audit tests are adequate. I. PROGRAM OBJECTIVES The NC System of Care Network (SOC Network) Project, initiated in 1999 through a six year/$8.75 million federal award from CMHS to NC DMH/DD/SAS builds upon lessons learned from previous NC Child Mental Health initiatives. B

2 The NC SOC Network Project attempts to advance the NC child mental health system to one that demonstrates a full understanding that family members and others defined by the family are the experts regarding their children s strengths and needs, and that neighborhoods and communities provide the most enduring and culturally sensitive/appropriate source of support for the future. NC SOC Network acknowledges that including families as full partners in planning, evaluation, and policy-making improves services; and, that children gain most when they live, work and play in their home communities, in living arrangements that are stable, safe and free from imminent risk of disruption. Best practices will be shaped when families and professionals work together, drawing upon the substantial strengths and resources of families, neighborhoods, and communities to assist children and families in reaching their full potential. The primary intent is to demonstrate that community-based, family-driven Systems of Care (SOC) can be simultaneously developed in diverse sites, can integrate cost effective, high quality services among a variety of child serving agencies, and can involve consumers and families in developing and directing how services are delivered. Outcome measures include: 1. Improve school attendance/achievement. 2. Decrease out of home placements. 3. Decrease rates of child abuse/neglect. 4. Decrease juvenile arrests for the target population. Consistent with these priorities, the NC SOC Network will further demonstrate that (1) children with SED and their families can receive timely, effective care in communities where services and community supports, including medical services, are integrated into one SOC, (2) a unified effort of child-serving agencies and practitioners provides a viable approach to meeting the goals of systems reform which can be 'taken to scale, (3) full, sustained family partnerships add value and improve the development and implementation of SOC; and, (4) participatory learning and knowledge management will result in replicable best practices that can be directly attributed to the SOC and incorporated into training curricula for state and national dissemination. II. PROGRAM PROCEDURES Funds are made available to DMH/DD/SAS, through a six year grant for the U. S. Dept. of Health and Human Services #HSS SM Child Mental Health Initiative GFA SM Grant funds were available beginning October 1, 1999 through August 31, Awards are limited to the counties participating with the participating Local Management Entities/Area Authorities (LME/AA) with the possibility of providing limited incentive funds to other LME/AA on a limited basis. Funds are then allocated to specific LME/AA (i.e. Orange-Person-Chatham Area Authority, Five County, and Smoky) and/or Community Collaboratives identified in the Grant. A base amount of funds on a non-competitive basis are allocated to each participating LME/AA to cover: required positions such as 1 FTE local site director, a.75 FTE data director, travel, supplies, equipment, and related service/service coordination costs as specified in the grant application. An additional proportion of funds is held aside for independent communitybased family and/or youth advocacy and support organizations (note: these funds typically are allocated to the LME/AA which then contracts with the family organization). All these funding arrangements are described in detail in the approved grant application. Funds are utilized to meet the service, training, family support/advocacy, and Project governance requirements described in the grant application. Service-related positions funded consist primarily of case managers/service coordinators. Funds are also provided for Flexible B

3 Funds. Funds are earned on an expenditure basis at the local level. Reporting on progress in meeting each goal and objective is obtained from the local sites quarterly and annually. Local sites also provide data for monthly evaluation reports from 20 different instruments measuring changes in functioning of the child/family, satisfaction with services, changes in living circumstances, etc. These data are submitted to the (state office) Project Research Director for compilation for submission to the national data contract entity (MACRO International). Data are submitted monthly. Services provided/facilitated through local Memoranda of Agreement (but not necessarily funded) through the Project include: access to services available through the LME/AA and their sister agencies (public schools, DSS, Juvenile Justice, etc.) according to the particular strengths and needs of each individual child and family. The Care Coordinator works in partnership with the family to ensure service access and appropriateness. The resources of these various agencies, along with neighborhood and community resources/supports comprise a menu of options that can be built around each child and family as a Child and Family Team. A portion of funds allocated to the LME/AA is designated for Flex Funds to be utilized by each Child and Family Team to fund non-traditional services/resources not available through existing agencies, e.g., funds to assist a child s participation in a karate class. Policies and procedures specific to the use of Flex Funds are utilized to monitor expenditures. The LME/AA and Community Collaborative (see below) also monitor these expenditures. Each Child and Family Team is different, according to the unique and changing needs of each child and family. To support the changes in practice and administration necessary for the successful implementation of the Project, intensive training and technical assistance is provided to frontline providers, administrators, and to families. The Division uses a portion of grant funding to contract with Western Carolina University and University of North Carolina at Greensboro to support training and technical assistance efforts in the grant sites. Additionally, family advocacy and support organizations have the important role of helping parents of children enrolled in the Project to become better informed and able to participate as partners in the treatment of their children. A core value of the Project promotes parent involvement in all levels of project management, training, monitoring and service delivery. Grant funding is also used to contract with the Exceptional Children s Assistance Center to provide workshops, on-site technical assistance, and training materials to the family advocacy and support organizations that have been established in each of the SOC grant sites. A collaborative governance structure (the Community Collaborative) comprised of parents, agency representatives, neighborhood and community representatives pool resources, unify efforts, oversee implementation and monitoring of the Project in each site. As children and families move though the Project (which increases service unification and responsiveness across provider groups/agencies), it is expected that their ongoing need for high-end services will decrease, their self-reliance and reliance on more informal community resources will increase. However, the nature of the population served requires an understanding and readiness to meet complex and changing needs over time. As funds were not completely expended by the end of the grant period, a 12-month extension was requested from the Center for Mental Health Services Division of Grants Management was requested and subsequently granted. The carry-forward amount is intended to support additional flexible support of children with serious emotional disturbances in settings as part of their Child and Family Plans, to support the continued development of local family B

4 advocacy and support systems and a statewide family network, the development of local Child and Family Team trainers of the System of Care model, expansion of community-based treatment to counties in the Orange/Person/Chatham Local Management Entity, and continued service delivery capacity-building in the Halifax site. III. COMPLIANCE REQUIREMENTS Crosscutting Requirements The DHHS/Division of Mental Health, Developmental Disabilities and Substance Abuse Services (DMHDDSAS) mandates that all the testing included within the crosscutting section be performed by the local auditors. Please refer to that section, which is identified as DMH-0 for those mandated requirements. A. Activities Allowed or Unallowed Services activities and expenditures as specified in the grant application and per the GFA are allowed: salaries, wages, fringe benefits of professional and other supporting staff engaged in the Project; travel in-state and out-of-state to carry out activities; supplies, communications, rental of equipment and space related to Project; contracts for performance of activities under the Project; training related specifically to goals of the Project, other such items necessary to support Project activities. Funds cannot be used for purchase, renovation, or construction of a facility to house any portion of the Project; room and board in any residential setting; room and board or other services/expenditures associated with care of children in residential treatment centers serving more than 10 children or in inpatient hospital settings, except intensive home-based services and other services provided on an ambulatory or outpatient basis; non-mental health services including: medical, education, vocational counseling and rehabilitation, Protection and Advocacy, i.e., those services already funded through their respective mandates to provide said service. B. Allowable Costs/Cost Principles All grantees that expend State funds (including federal funds passed through the N. C. Department of Health and Human Services) are required to comply with the cost principles described in the N. C. Administrative Code at 09 NCAC 03M E. Eligibility Children with Serious Emotional Disorders (SED), ages 5 to 17, who experience functional difficulties in a variety of areas: home, school, community, vocational, and recreational; who need more than one source for services and who are at risk of removal from the home and who live in the catchment area. B

5 G. Matching, Level of Effort, Earmarking Matching level specified in the grant application includes years One through Three as 3 to 1 match (federal : State), year Four as a 1 to 1 match and years Five and Six as a 1 to 2 match. In-kind match provided by the local agency sites combined with LME/AA new per capita allocations for child mental health services and state and local dollars in the amount equal to revenues generated by the project will account for the required match. H. Period of Availability of Federal Funds This requirement does not apply at the local level. I. Procurement and Suspension and Debarment Procurement All grantees that expend federal funds (received either directly from a federal agency or passed through the N. C. Department of Health and Human Services) are required to conform to federal agency codifications of the grants management common rule accessible on the Internet at All grantees that expend State funds (including federal funds passed through the N. C. Department of Health and Human Services) are required to comply with the procurement standards described in the North Carolina General Statutes and the North Carolina Administrative Code, which are identified in the State of North Carolina Agency Purchasing Manual accessible on the Internet at Nongovernmental subrecipients shall maintain written Procurement policies that are followed in procuring the goods and services required to administer the program. Suspension and Debarment All grantees awarded contracts utilizing Federal dollars must be in compliance with the provisions of Executive Order 12549, 45 CFR Part 76 and Executive Order L. Reporting Program progress reports are due quarterly and annually to DMH/DD/SAS as specified by the Center for Mental Health Services National Project Office. Additionally, Financial Status Reports (FSR s) are due by the 10 th of each month for reimbursement of the previous month s expenditures. M. Subrecipient Monitoring Monitoring is required if the agency disburses or transfers any State funds to other organizations, except for the purchase of goods or services, the grantee shall require such organizations to file with it similar reports and statements as required by G.S and the applicable prescribed requirements of the Office of the State Auditor s Audit Advisory #2 (as revised January 2004) including its attachments. If the agency disburses or transfers any pass-through federal funds received from the State to other organizations, the agency shall B

6 require such organizations to comply with the applicable requirements of OMB Circular A Accordingly, the agency is responsible for monitoring fiscal compliance of subcontractors as described above. B

7 N. Special Tests and Provisions The agency must comply with any additional requirements specified in the contract or to any other performance-based measures or agreements made subsequent to the initiation of the contract including but not limited to findings requiring a plan of correction or remediation in order to bring the program into compliance. Suggested Audit Procedures Review contract/grant agreement, identify any special requirements; and Verify if the requirements were met. Conflict of Interest All non-state entities (except those entities subject to the audit and other reporting requirements of the Local Government Commission) that receive, use or expend State funds (including federal funds passed through the N. C. Department of Health and Human Services) are subject to the financial reporting requirements of G. S. 143C-6 effective July 1, These requirements include the submission of a Notarized Conflict of Interest Policy (see G. S (b1)) and a written statement (if applicable) that the entity does not have any overdue tax debts as defined by G. S at the federal, State or local level (see G. S (b2)). All non-state entities that provide State funding to a non-state entity (except any non-state entity subject to the audit and other reporting requirements of the Local Government Commission) must hold the subgrantee accountable for the legal and appropriate expenditure of those State grant funds. B