THERAPEUTIC FOSTER CARE (TFC) SERVICE MODEL

Transcription

1 THERAPEUTIC FOSTER CARE (TFC) SERVICE MODEL Teresa Castillo Department of Health Care Services Kimberly Mayer California Institute for Behavioral Health Solutions Bay Area, CCR RITE, August 19, 2016

2 CALIFORNIA INSTITUTE FOR BEHAVIORAL HEALTH SOLUTIONS (CIBHS) Background and Role: Established in 1994 as California Institute for Mental Health (CiMH) Currently run a range of statewide, regional and local projects, plus conferences. Some examples: Statewide: DHCS Care Coordination Learning Collaborative; Small County TA; Pathways to Wellbeing; Drug/Medi-Cal TA Regional: Regional Partnerships in the Greater Bay Area and Central Region (OSHPD) Counties/CBOs: Implementation of Evidence-based Practices, customized implementation; training and TA Foundations: Developing SUD curriculum for graduate programs

3 CIBHS ROLE IN THE TFC SERVICES MODEL Provide support and technical assistance in the development and implementation for the TFC Service Model Pathways to Wellbeing technical assistance

4 To provide an overview and status of California s TFC Service Model PURPOSE

5 PRESENTATION OVERVIEW Key Areas: TFC Service Model TFC Parent Qualifications Questions and Answers

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7 TFC SERVICE MODEL DEFINITION Individualized Medi-Cal Specialty Mental Health Service (SMHS) Short-term and intensive Highly coordinated and trauma informed Child/youth placed with trained, intensely supervised and supported TFC Parents

8 TFC SERVICE MODEL The TFC Service Model is intended for children and youth who require intensive and frequent mental health support in a one-on-one environment. It allows for the provision of certain Medi-Cal Specialty Mental Health Services (SMHS) components available under the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) benefit as a home-based alternative to high level care in institutional settings such as groups homes, and in the future, as an alternative to Short Term Residential Treatment Placements (STRTPs). TFC homes may also serve as a step down from STRTPs. This service model is but one service option in the continuum of care for eligible children and youth.

9 ELIGIBILITY CRITERIA Available as an EPSDT benefit to: Full scope Medi-Cal children & youth (up to age 21) who have more complex emotional and mental health needs; AND Who meet medical necessity criteria for SMHS per California Code of Regulations (CCR), Title 9, Chapter 11, Section or Section *DHCS in process of establishing specific service criteria

10 SERVICE COMPONENTS Plan Development (limited to when it is part of CFT) Rehabilitation Collateral

11 SERVICE LIMITATIONS The TFC Service Model does not include: Reimbursement for room and board costs Other foster care program related services Assessing adoption placements Serving legal papers Home investigations Administering foster care subsidies Parenting functions (e.g., providing food, transportation, etc.)

12 SERVICE LOCKOUTS Psychiatric Inpatient Hospital Services Psychiatric Health Facility Services Psychiatric Nursing Facility Services

13 ROLES AND RESPONSIBILITIES TFC Service Model Program Agency TFC Parent Primary Entities

14 TFC PARENT ROLE KEY PARTICIPANT Key participant in the provision of trauma-informed, therapeutic treatment The TFC parent will operate under the direction of a LMHP Provide therapeutic services and support and be available 24 hours/7 days per week so that services are timely and meet the individual needs of the child or youth The TFC parent will receive extensive training prior to rendering services under the TFC Service model, and will receive extensive support under the direction of a LMHP

15 TFC PARENT ROLE KEY PARTICIPANT As a Medi-Cal provider, TFC Parents will provide: Plan development Rehabilitation Collateral

16 QUALIFICATIONS FOR THE TFC SERVICE MODEL PROGRAM AGENCY Must be both: A California Foster Family Agency (FFA) AND A Medi-Cal Specialty Mental Health Services Provider

17 TFC SERVICE MODEL PROGRAM AGENCY ROLE The TFC Service Model Program Agency is responsible for ensuring that TFC parents meet both Resource Family Approval (RFA) Program standards and meet the required qualifications as a TFC Parent. TFC parents will work under the direction of that agency.

18 TFC SERVICE MODEL PROGRAM AGENCY ROLE Employs a Licensed Mental Health Professional (LMHP) to: Provide direction of the TFC parent Ensure the TFC parent is following the client plan Act as the team leader Provide ongoing direction of service delivery or the review and approval of individual client plans

19 TFC SERVICE MODEL PROGRAM AGENCY ROLE - MANAGEMENT OVERSIGHT OF PARENTS Recruits, approves and annually re-approves foster parents (following Resource Family Approval (RFA) process and Medi-Cal SMHS requirements) Actively participates on Child & Family Team (CFT) Provides training, direction & support Monitors child s/youth s progress Maintains progress note documentation Provides Medi-Cal related reports to county MHP, as appropriate

20 TFC SERVICE MODEL PROGRAM AGENCY ROLE - CARE OF THE CHILD/YOUTH Provides or arranges for provision of non-tfc SMHS (if included in their contract with MHP and as set forth in the client plan) Incorporates evidence informed practices in training of TFC parents

21 MEDI-CAL DOCUMENTATION REQUIREMENTS At a minimum, must be consistent with the County MHPs policies and procedures and contract between DHCS and County MHP TFC Parents must write and sign a Daily Progress Note Program Agency s Licensed Mental Health Professional (LMHP) must review and co-sign the Daily Progress Note Program Agency s must comply with mental health documentation requirements TFC services provided must be reflected in child/youth s client plan

22 REIMBURSEMENT METHODOLOGY SMHS service components provided through the TFC Service Model will be reimbursed at a per diem rate.

23 PARENT QUALIFICATIONS The following slides outline the additional requirements for TFC Parents beyond the Resource Family Approval Standards effective January 1, 2017

24 GENERAL TFC PARENT REQUIREMENTS Must be 21 years of age Must meet California s Medicaid rehabilitation provider qualifications for other qualified provider (i.e., has a high school degree or equivalent) Must meet provider qualifications and other requirements and oversight as established by the MHP

25 HOME STUDY PROCESS & INSPECTION A thorough psychosocial evaluation for the TFC parent A minimum of 2-3 pre-approval home visits Individual interviews with every adult in home Group interview session with all family members A comprehensive written report

26 INITIAL TRAINING REQUIREMENTS 40 hours of initial training Must be completed prior to parent being eligible to provide TFC services

27 ONGOING TRAINING 24 hours of annual ongoing training Related to providing TFC services Emphasis on: Skill development and application SMHS knowledge

28 OVERSIGHT AND SUPPORT TFC Provider Agency Licensed Mental Health Professional TFC Parent

29 TFC PARENT EVALUATIONS CFT Input TFC Parent Selfevaluation Home Visit Elements of the Annual Evaluation and Renewal Process

30 NEXT STEPS Finalize and release the TFC Service Model, TFC Parent Qualifications and other resources (frequently asked questions) Update Medi-Cal Manual for ICC and IHBS to include TFC Trainings

31 HELPFUL RESOURCES References: Joint Information Notices: CDSS ACIN # /MHSUDS IN # CDSS ACIN # I-52-16E/MHSUDS IN #16-031E MHSUDS IN # CDSS Resource Family Approval Fact Sheet

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33 Thank you!