care management entity quality collaborative technical assistance webinar series … ·...
TRANSCRIPT
Care Management Entity Quality Collaborative
Technical Assistance Webinar Series
CME Considerations for
Serving Youth in Transition
June 27,2012 2:00 – 4:00 p.m., ET
For audio and to participate, dial: (800) 273-7043
Pass code: 596413
In case of technical difficulties, call (609) 528-8400
This document was developed under grant CFDA 93.767 from the U.S. Department of Health and Human Services, Centers for Medicare & Medicaid
Services. However, these contents do not necessarily represent the policy of the U.S. Department of Health and Human Services, and you should not assume
endorsement by the Federal Government.
.
2
CHCS Priorities
Our work with state and federal agencies, Medicaid health
plans, providers, and consumers focuses on:
2
Integrating Care for People with
Complex and Special Needs
Improving Quality and
Reducing Racial and Ethnic Disparities
Building Medicaid Leadership and Capacity
Enhancing Access to Coverage and Services
Maryland, Georgia and Wyoming Collaborative CHIPRA Grant Project
Goal: Improving the health and social outcomes
for children with serious behavioral health
needs.
Implement and/or expand a Care Management
Entity (CME) provider model to improve the
quality - and better control the cost - of care for
children with serious behavioral health
challenges who are enrolled in Medicaid or the
Children’s Health Insurance Program.
3
Care Management Entity Quality Collaborative
Technical Assistance Webinar Series
CME Considerations for
Serving Youth in Transition
.
Presented by Maryann Davis, PhD
Learning &Working During the Transition to Adulthood
Rehabilitation Research and Training Center
LEARNING AND WORKING DURING THE TRANSITION TO ADULTHOOD REHABILITATION RESEARCH AND TRAINING CENTER University of Massachusetts Medical School, Department of Psychiatry, Center for Mental Health Services Research. Visit us at:
http://labs.umassmed.edu/transitionsRTC/index.htm
The contents of this presentation were developed with funding from the US Department of Education, National Institute on Disability and Rehabilitation Research, and the Center for Mental Health Services, Substance Abuse and Mental Health Services Administration (NIDRR grant H133B090018). Additional funding provided by UMass Medical School’s Commonwealth Medicine division. The content of this presentation does not necessarily reflect the views of the funding agencies and you should not assume endorsement by the Federal Government.
Acknowledgements
Describe important unique characteristics
relative to other age groups
Outcomes during young adulthood
Services that are needed to support movement
into work
Adaptations of existing services models
Peer Services
Factor Relative to Children Relative to Adults
Autonomy More developed –
help with self-
determination skills
Less developed – help
with self-
determination skills
Family Less family role –
help move parents to
passenger seat
More family role –
help include parents
as appropriate
Peer Influence &
Social Life
Greater Greater
Schooling/Training More about
completion & Post
secondary
choices/success
More school
involvement, often
while
needing/wanting
work
Factor Relative to Children Relative to Adults
Working Work becomes a focus;
early career development
support
Need support for EARLY
career development, more
job changing, more
concurrent schooling
Independent
Living &
Housing
Independent living
becomes focus,
increasingly not living at
home, skills need to
develop
More are still living with
family, couch surfing, multi-
roommates age typical,
immature skills
&knowledge
Risks Adult risks more common;
substance use,
homelessness, justice
system, pregnancy, STDs
Higher risk than adults
(peak age of risk)
Factor Relative to Children Relative to Adults
Stigma More aware More felt – yet MH also
more accepted among
peers
Psychosocial
Development
(think, reason,
cognitive control,
identity
formation)
More mature – insight
available, action-
consequence more
connected, evaluate
several ideas
concurrently
Less mature – still not
as organized, more
distraction, action less
consistent with
knowledge, may be more
concrete
Legal issues more “adult rights”, &
held more accountable
“Rights” less complete
• Eligibility issues are huge • Different definitions of disability for children and
adults
• SSI – no adult ADHD
• State MH Authorities – 65% include PTSD
• SAMHSA – define functional disabilities differently
• Different ages that define adult status
• State services use different definitions of SED
Birth 18-21yrs Death
CHILD SYSTEM ADULT SYSTEM
Child Welfare
Education
Juvenile Justice Criminal Justice
Child Mental Health Adult Mental Health
Medicaid Medicaid
Substance Abuse
Vocational Rehabilitation
Housing
Labor
Health Insurance Health Insurance
Valdes et al., 1990; Wagner et al., 1991; Wagner et al., 1992; Wagner et al., 1993; Kutash et al., 1995; Silver et al., 1992; Embry
et al., 2000; Vander Stoep, 1992; Vander Stoep and Taub, 1994; Vander Stoep et al., 1994; Vander Stoep et al., 2000; Davis &
Vander Stoep, 1997; Newman et al., 2009
Young Adult Functioning Compromised in Many Areas
Functioning
among 18-21 yr olds
SMHC* in Public Services
General
Population/ without SMHC
Graduate High
School 23-65% 81-93%
Employed 46-51% 78-80%
Homeless 30% 7%
Pregnancy (in
girls) 38-50% 14-17%
Multiple Arrests
by 25yrs 44% 21%
*SMHC=Serious Mental Health Condition
Age Group
─ Transition Age (16-30yrs)
─ Adult (31-55yrs)
─ Young Adolescents (13-15yrs)
─ Children (5-12yrs)
Cum
ula
tive %
Rem
ain
ing in T
reatm
ent
Days Since Treatment Initiation
Services to Facilitate ENGAGEMENT are Needed
187 292
350 448
Put youth in the driver’s seat
Family involvement less than children’s services but more than typical adults
Nuances to working with less mature psychosocial development (rejection of authority, self-evaluation skills, making work concrete etc.)
BUILDING SKILLS
COMPREHENSIVE – treatment/rehabilitation and support housing, education, work, community participation
NANA (Not Adolescents Not Adults)
Multisystemic Therapy for Emerging Adults: ◦ Shifts from parent intervention to EA intervention
◦ Extensive engagement component
◦ Teaches planning, coping, problem-solving skills
◦ Teaches specific skills through Life Coach:
Career Development
Work Preparation and Support
School Completion
Parenting Young Children
Relationships with Social Network
◦ Therapists deliver home-based MH, SU, antisocial behavior reduction therapy – place of EA choice
Proportion of each age group
that worked in competitive employment
by study condition.
Interaction of age by condition
Significant (ANOVA; p<.05).
Burke-Miller, J., Razzano, L., Grey, D., Blyler, C., & Cook, J.(2012). Supported employment outcomes for transition
age youth and young adults. Psychiatric Rehabilitation Journal, 35, 171-179.
Individualized Placement and Supports ◦ Add Supported Education to Supported
Employment
◦ Add More Pre- or Concurrent Training About
Working & Career Development
◦ Address Substance Use Issues
◦ Provide the Family Information
◦ Add Peer Mentor
Questions? To submit a question please use one of the following options:
•Ask a Question Online: Click the Q&A icon located in the hidden toolbar at the top of your screen.
•Ask a Question via Phone: Phone lines will now be un-muted.
Slides and a video archive of this event will be
available on our website, at www.chcs.org.
19
Meeting the Unique Needs of Emerging Adults with Serious Mental Health
Conditions:
Challenges, Empirically Supported Approaches, and Implications for Wraparound
CHIPRA CME Collaborative Webinar 27 June 2012
Research & Training Center for Pathways to Positive Futures, Portland State University
Services and Supports for Emerging Adults
with Serious Mental Health Conditions
The age of instability,
uncertainty and exploration…
• Average number of job changes from age 20-29 in U.S. : ~7
• Shifting career goals
• Mobility/changes in residence
• Commitments come and go
• Separation from family
Research & Training Center for Pathways to Positive Futures, Portland State University
…coupled with very high
expectations • “I am very sure that someday I will get to
where I want to be in life.”
– ~96% of Americans ages 18-24 agree
• Work
– Searching for self-fulfillment… and money
– Career aspirations: arts/creative; own business
• Love : “When you marry, you want to find your soul mate, first and foremost.”
– 94 % of Americans 20-29 agree
Research & Training Center for Pathways to Positive Futures, Portland State University
For all young people…
• Adulthood takes longer to “emerge” than it used to
• Many choices and options are explored: living, working, commitments
• Need to find some kind of compromise between big dreams and possibly harsh realities
• The path is not straight
Research & Training Center for Pathways to Positive Futures, Portland State University
It’s tough on mental health
• Feeling in-between, uncertainty and constant change anxiety
• Becoming independent from family, moving, changing jobs disrupts social support
• Age of possibilities disappointment
• Rates of substance use, sexual risk behavior, are part of peer culture
• Current economic condition adds to stress: high unemployment, job insecurity, costs of education, debt
Research & Training Center for Pathways to Positive Futures, Portland State University
Research & Training Center for Pathways to Positive Futures, Portland State University
What approach to take?
• Our population of young people experiences challenges beyond what is typical
– Existing/newly recognized serious mental health condition
– Multiple areas of need
– Systems experience
• Need service/support approaches that are
– Designed to fit both with these challenges and the unique stage of life
– Attractive to young people and perceived as relevant
– Empirically supported
Research & Training Center for Pathways to Positive Futures, Portland State University
Review of existing information….
• Empirically supported approaches for young people with SMHC – Older youth/young adult MH
– Ongoing research at Pathways RTC and with partners
• Additional literature – Psychosis/early psychosis, trauma, co-occurring
– Empirically supported approaches with high-needs populations: young offenders, youth transitioning from foster care
– Research that provides evidence about how to build key elements: self-efficacy, positive self image, feelings of competence, etc.
• Follow-up interviews with authors – Looking for curricula, specific practices, recommendations
• Other interviews – Leaders in model programs
– Young people
Research & Training Center for Pathways to Positive Futures, Portland State University
… with the aim of… • Determining the extent to which there is consistency
in
– Philosophical underpinnings, principles, theory
– Model for practice (What are the steps? – What’s in the manual?)
– Expectations for communication (How to engage young people? How should interactions go?)
• If so,
– can this be the basis for a “common factors” /”common elements”–type approach
– What are the implications for wraparound specifically
Research & Training Center for Pathways to Positive Futures, Portland State University
Also published as: Walker, J. S. & Gowen, L. K. (2011). Transition for youth with serious mental health conditions. In M.L. Wehmeyer & K. W. Webb (Eds.), Handbook of Adolescent Transition Education for Youth with Disabilities, New York: Routledge.
Positive development
• Our review of empirically supported programs for emerging adults with SMHC universally took a positive development approach
• Focuses on the importance of
– Building assets/capacities appropriate to the developmental stage of life
– Promoting thriving and well-being across the life span , even—or especially—in the face of adversity and challenge
• Growing evidence base and emerging consensus* for youth with highest levels of needs– paradigm shift
• Clinical strategies are in service to positive development *e.g., Altschuler, Stangler, Berkley, & Burton, 2009; Gagnon & Richards, 2008; e.g., Institute of Medicine, 2006
Summary: Model Linking
Empirically Supported
Approaches and Outcomes
Young people experience
Positive Developmental Outcomes
Young people build
Key developmental capacities
Summary: Model Linking
Empirically Supported
Approaches and Outcomes
Young people experience
Positive Developmental Outcomes
Young people build
Key developmental capacities
Providers employ
Specific practices
What do they do?
Summary: Model Linking
Empirically Supported
Approaches and Outcomes
Providers collaborate with young people using a
Primary mode
Young people experience
Positive Developmental Outcomes
Young people build
Key developmental capacities
Providers employ
Specific practices
How?
Summary: Model Linking
Empirically Supported
Approaches and Outcomes
Providers collaborate with young people using a
Primary mode
Young people experience
Positive Developmental Outcomes
Organizational support
Training and coaching
Young people build
Key developmental capacities
Providers employ
Specific practices
Positive Developmental
Outcomes:
• Meet basic needs, carry out daily
living
• housing, health, safety
• shopping, cooking, managing
finances,
• Have skills and knowledge for adult
roles
• social skills
• intrapersonal skills
• skills for managing specific
challenges
• education/ vocational skills
• Have a pro-social, satisfying place
in community and society:
• employment/career/ occupation
• relationships
• “play”
Developmental
Capacities, learn to …
• Take action– be
proactive/intentional in
moving toward desired
outcomes
• Maintain “fortitude”
• Engage with resources
and support in different
contexts (people,
organizations, institutions,
systems)
Central Developmental Challenge
Become the primary person responsible for achieving developmental outcomes
– Be proactive in moving toward goals • Be motivated and capable of developing plans connected to
personally meaningful goals
• (failing, refocusing, trying again)
– Maintain “fortitude”/psychological resilience in the face of challenge, uncertainty and failure/ “failure”
• Making compromises between high hopes and hard realities
• Maintaining a positive sense of self in the face of cultural messages and depictions
– Engage with “contexts” that offer help, support, belonging, opportunity
• Family, friends, romantic partners, organizations, institutions
Research & Training Center for Pathways to Positive Futures, Portland State University
Why our young people need extra
support …
… for acquiring developmental capacities and achieving outcomes
– Specific challenges related to MH conditions
– Past history of instability in care giving, relationships, place of residence, school
– History of trauma, including trauma from services and systems
– Services may be experienced as punitive, oppressive; providers not trustworthy
– Young people often respond by being overly compliant and/or oppositional
– Exaggerated sense of self-sufficiency or dependency/ combination of the two
– Main modality is reactive
– Heightened sensitivity to stigma
Research & Training Center for Pathways to Positive Futures, Portland State University
How much does wraparound need to
change? • Wraparound is in theory entirely consistent with
supporting the developmental capacities
– Actual practice often does not live up to the aspiration
• What are the options?
– Wraparound as is
– Enhanced wraparound– more specific practice, enhance mode of interaction
– Significantly adapted wraparound– practice is significantly tweaked
– Not wraparound– differences are more than tweaks, don’t fall under principles any more
Research & Training Center for Pathways to Positive Futures, Portland State University
Recently published findings (Psychiatric Rehabilitation Journal, January 2012)
– Perceptions of participation among matched pairs of young people 16-21* and their caregivers
– Using items from WFI and other assessments
– Young people overall slightly lower perceptions of participation than caregivers (did not increase with age)
– No evidence of “crowding out” with age
– Supported idea that higher ratings from both related more to quality of facilitation
Research & Training Center for Pathways to Positive Futures, Portland State University
Intentional enhancement
• Achieve My Plan– be more intentional about the “what” and the “how”– improve youth participation and team satisfaction (PRJ, 2010)
• What: Engagement on par with what wraparound expects with caregivers
– Find out what the young person really cares about, tap that motivation
– Find out what the young person enjoys, is good at: reinforce and build on competence
– Prepare the young person for the strange situation of being in a meeting with a bunch of providers
– Facilitate communication with caregivers so they are on the same page with the young person
Intentional enhancement (cont.)
• What: Impact on what gets planned
– Young person places own items on the agenda, asks team support– typically leads this section of the meeting with facilitator/coach back-up
– Include activities for which the young person is the primary driver
– Young person prepares with the coach to speak on all agenda items
Intentional enhancement (cont.)
• How: Impact on interactions
– Video-based training and coaching: youth-driven and “transparent”/non-coercive, sensitive to what youth finds meaningful, alert to connections to context, alert to examples of competence, “motivated” toward positive development
– Ground rules and strong facilitation keep the meeting from turning negative or getting off track
– Shift in balance of emphasis from outcomes to process
Further enhancement • Use of peer as coach, not just for engagement, but as
ongoing support
– Unique advantages of this, when provided in a high quality manner
• Overall shift of focus away from diagnosis-driven to functioning/wellness
– Employment, housing, etc., can be the main focus
– Non-traditional and wellness services/supports can be main strategies
– Clinical services are accessed when young person sees the need and for specific purposes; coordinated with the needs/goals that young person has prioritized
Adaptation
• Explicit shift to young-adult driven
– Young person takes the lead in choosing the team
• With coaching/support about the usefulness of including specific people
• Decides who is “family”
– Young person takes lead on needs, goals, service/support strategies
– Lots of flexibility about what a “team” is and which team members are “core”; as well as the nature of team collaboration
Research & Training Center for Pathways to Positive Futures, Portland State University
For any approach…
• Strategies for initial engagement and retention
• Keep young person engaged with immediate benefits or incentives
• Acknowledge not only young person’s accomplishments often but the process
• Immediate establishment/contributions of roles of each team member
Research & Training Center for Pathways to Positive Futures, Portland State University
Research & Training Center for Pathways to Positive Futures, Portland State University
www.pathwaysrtc.pdx.edu
Acknowledgments/Funders
The development of the contents of this presentation were supported by funding from the National Institute of Disability and Rehabilitation Research, United States Department of Education, and the Center for Mental Health Services Substance Abuse and Mental Health Services Administration, United States Department of Health and Human Services (NIDRR grant H133B090019). The content does not represent the views or policies of the funding agencies. In addition, you should not assume endorsement by the Federal Government.
Questions? To submit a question please use one of the following options:
•Ask a Question Online: Click the Q&A icon located in the hidden toolbar at the top of your screen.
•Ask a Question via Phone: Phone lines will now be un-muted.
Slides and a video archive of this event will be
available on our website, at www.chcs.org.
50
Transitioning Youth to Adulthood: Wraparound Milwaukee’s Healthy Transitions Initiative
CHIPRA CME Collaborative Webinar
June 27, 2012
Bruce Kamradt, MSW
Administrator of Children’s Mental Health Services for Milwaukee County
Director, Wraparound Milwaukee
Brian McBride
Project Coordinator for Milwaukee County & Wraparound Milwaukee’s Transitions Initiative (Project O-YEAH)
Why Develop a Specialized Program for Transitional Age Youth with Serious Emotional and Mental
Health Needs
Transitional age youth (18 – 24), were experiencing poor outcomes:
not finishing school
higher likelihood of involvement in criminal justice system
high rate of homelessness
high rates of unemployment
The Adult Services System was focused on serving adults with chronic, persistent mental illness but was not focused on the transitional age youth with SED. Many young adults would simply not qualify for adult services
While many of these young adults had qualified for Medicaid as youth, they began facing loss of their health care coverage at a time they still had physical health needs and needed access to critical mental health & alcohol and other drug addiction services.
Many of these young adults no longer had their family support system or chose themselves not to avail themselves of those systems – “they wanted to be on their own”
Employment & Housing services were particularly difficult for youth/young adults with serious emotional needs to identify, access and maintain
Healthy Transitions Initiative (HTI) and Wraparound Milwaukee’s Implementation of the Transitional
Care Model
Federally funded (5 year/$2.5 million SAMHSA), grant to help states and communities create developmentally appropriate and effective youth guided local systems of care to improve outcomes for youth and young adults with serious mental health conditions in areas such as education, employment, housing, mental health and co-occurring disorders
State of WI Dept. of Health, Bureau of Mental Health was recipient
Milwaukee County Behavioral Health – Wraparound Milwaukee was the site selected to develop the local transitional model in Milwaukee County
Design of Milwaukee’s HTI Program (Project
O-YEAH): Assumptions Underlying
Better outcomes for youth & young adults transitioning to adult roles can occur by providing four interventions:
1. Form trusting and strength-based relationships with them in their roles as young adults and with the circles of support they choose to build around themselves
2. Help them develop and embrace hope and their dreams through the development of person-centered, future-oriented plans
3. Provide access to the resources, support and assistance needed to implement their plans
4. Offer one-on-one coaching to help them develop the knowledge, skills and insights that will help them find success as adults
Components of Project O-YEAH
Service Tiers
Person-Centered Planning Curriculum Wraparound model/Transition to Independence process
Transitional Specialists
Club House Model
Partnerships/Satellite Centers established with homeless youth/young adult provider (Pathfinders) & with agency servicing youth aging out of foster care (Lad Lake)
Collaboration with county adult community services agency through MOUs
Components Project O-YEAH (cont’d)
Program Evaluation that is Youth/Adult Friendly
Creation of Peer Specialists
Expansion of Provider Network System to Include Specialized Providers
Housing
Employment
Emerging shelter
Expanded Eligibility for Pooled Funding (by covering the 18-
21 year olds aging out of foster care )
Family Involvement
Three Tiers of Support for Young Adults
Transitioning to Adulthood
Tier One – youth/young adults with emotional needs who need some help with resources & support which they can get with membership or participation in Club House Program and from club house staff
Tier Two – youth/young adults with serious emotional & mental health needs who need the help & support of a Transitional Specialist with their mental health, education, employment or housing needs and need the help of the Transitional Specialist to facilitate a person-centered plan & coaching as they navigate the adult system/adult roles
Tier Three – youth /young adults with serious and potentially long-term mental health issues and challenges who need help accessing the adult community mental health system and enrollment in Community Support Programs (CSP) or other services provided by adult system
Person-Centered Planning
Tailored to the individual based on their needs and desires
Incorporates the wraparound process (i.e. strength based, individualized)
Individualized
Engages through relationship building (trust)
Uses young adult’s “vision” for what it means to be successful
Transitional specialist is advocate and works with young adult’s identified strengths
Assists young adult to meet needs but doesn’t do it for them, build supports around them
Personal choice and tailored services to work towards independence
Uses their chosen support network
Needs driven and outcome based
Allows for and embraces failure while modeling positive responses
Needs and Barriers That Youth & Young
Adults Need Help With
Employment
Housing – do I have somewhere to sleep that is safe, affordable?
Transportation – even in big city how do I get around?
Educational – College? GED? High School?
Financial/ money management - How do I survive on minimum wage or SSI?
Continuation of service providers
Pregnancy/child
Support of family
Insurance/medical care
Role of Transitional Specialist
Partner with young adult to identify strengths and needs
Be a trusted advocate for young adults
Help create an individualized future plan
Motivate and coach on knowledge, skills and appropriate adult roles
Connect young adult with appropriate services both formal and informal
Monitor futures plan with young adult
Connect the young adult with adult community mental health systems as needed
Be there as needed
Creating Transitional Centers/Specialists
through Partnerships
Local Project Coordinator, three Transitional Specialists housed together at Wraparound Milwaukee
One Transitional Specialist at each of two satellite transitional centers created at: Pathfinders - largest provider of services to homeless young & young adults
Lad Lake, Inc. - contractor to provide services to the Bureau of Milwaukee Child Welfare for youth aging out of foster care
Satellite centers use person centered, HTI curriculum and Wraparound Milwaukee’s IT system but generate own referrals and maintain on site supervision of staff
70 young adults currently being served, caseload 1:15 to 1:20
Plan is to expand to one or two additional satellite sites in 2013
Clubhouse Model to Support Youth/Young Adults
Gathering place to socialize
Resource center Employment resources
Housing resources
Practice daily living skills
Food & meals available, showers, laundry, etc.
Hosts classes in
Health
Banking
Cooking
Employment preparation
Learning about Medicaid, SSI, social security
Clubhouse Model to Support Youth/Young Adults – cont’d
Recreation Availability of gym and other physical activities
Connect with peer specialists, mentors
Work on “portfolio” of things that need to get done in order to move toward independence
Connect youth/young adults who need & desire more help with a transitional specialist
Peer Specialists
Young adults who are or have been recipients of services who support other youth/young adults who are currently enrolled in the program
Must be at least 18 years of age
Can be certified in Wisconsin and are eligible for Medicaid reimbursement under the state’s Comprehensive Community Services (CCS) benefit (1915(i)), and crisis benefit
Engage and encourage current young adults in HTI/Project O-YEAH and promote independent living and self-direction
Help other young adults through their own experience to identify resources in the community and to “navigate” the system of care
Provide counsel and support in crisis, facilitate groups, and advocate on behalf of youth/young adults
Creating Avenues of Collaboration with Adult
Community Services Related to Transitional Services
Written memorandums of understanding (MOUs)
Identified liaisons/contact people to enhance a coordinated approach from Wraparound Milwaukee/HTI project and from adult services
Written criteria/flow chart for how youth/young adults are referred, assessed and services provided by each system
Enhancement of provider network through identification of shared providers between adult and youth serving systems, particularly around targeted case management, community-support providers (CSP) and housing, etc.
Protocol for information sharing and single release of information form
Able to overlap services between systems to improve transitions and prevent “gaps”
Regularly scheduled collaborative meetings
Joint initiatives Comprehensive community services/1915(i) Peer specialists Congregate housing
Provider Network Services Needed by Transitional Population
Care Coordinator/Transitional Specialists Peer Specialists Housing Employment Crisis Housing/Emergency Shelters Crisis 1:1 Medication Management Daily Living Skills/Independent Living Health Care Coverage and Advocacy Therapy Medical Home (Coordination & Primary Care Providers)
Information Technology Considerations
One information system, Synthesis, is used for both child (Wraparound) and youth/young adults in transition:
Crisis plans
Person-centered planning
Service authorization
Electronic medical record
Reports
No need for separate data systems
Funding The Healthy Transitions Initiative
Five year, $2.5 million SAMHSA grant
Expanded eligibility under 1915a agreement with WI Medicaid for Wraparound Milwaukee (as special managed care entity) to cover youth/young adults, 18 – 21 years old, who are aging out of foster care (now covered by capitation payment)
Utilizing pooled funding from Medicaid, Child Welfare, and Juvenile Justice – funding pool currently at $47 million
Expanding service benefit covered under Medicaid to include peer supports, employment and other services by applying for Wisconsin’s Comprehensive Community Service (CCS) under the 1915(i) Home and Community Services State Plan benefit
Working with adult services to “fast track” eligible youth to Family Care or Community Support programs
Benefit advocacy with Medicaid
Wraparound Milwaukee Pooled Funds
CHILD WELFARE Funds thru Case Rate
(Budget for Institutional
Care for CHIP Children)
JUVENILE JUSTICE (Funds Budgeted for
Residential Treatment and
Juvenile Corrections Placements)
MEDICAID CAPITATION ($2052per Month per Enrollee)
MENTAL HEALTH •CRISIS BILLING
• HTI GRANT
• HMO COMMERCIAL INSUR
WRAPAROUND MILWAUKEE
CARE MANAGEMENT ORGANIZATION
(CMO)
$46.5 M
CHILD & FAMILY TEAM OR
TRANSITION TEAM
PLAN OF CARE
OR
$10.0M $10.0M $19.5M $7.0 M
FUTURE PLAN
Program Evaluation
Purpose of evaluation model is to observe and assess change related to:
Identification of needs
Feelings of empowerment
Overall accomplishments within the developmental domains
Management of crisis
as young adults participate in the HTI Program (Project O-YEAH)
Questions? To submit a question please use one of the following options:
•Ask a Question Online: Click the Q&A icon located in the hidden toolbar at the top of your screen.
•Ask a Question via Phone: Phone lines will now be un-muted.
Slides and a video archive of this event will be
available on our website, at www.chcs.org.
71