T.R. v. Quigley Final Settlement Agreement Summary Implementation - - PowerPoint PPT Presentation

T.R. v. Quigley Final Settlement Agreement Summary

Implementation of a new mental health program to help youth recover in their communities

Why a Lawsuit? What’s in the Agreement? What is WISe? How do kids access WISe?

Youth who use Medicaid insurance have legal rights to legal rights to legal rights to legal rights to get the treatment get the treatment get the treatment get the treatment they need they need they need they need for healthy minds and bodies.

E E E Early P P P Periodic S S S Screening D D D Diagnostic & T T T Treatment

SERVICES SERVICES SERVICES SERVICES

42 U.S.C. § 1396a(a)(10)(A)

E E E Early P P P Periodic S S S Screening D D D Diagnostic & T T T Treatment

SERVICES SERVICES SERVICES SERVICES

42 U.S.C. § 1396a(a)(10)(A)

Other Other Other Other EPSDT

EPSDT EPSDT EPSDT Mental Health Litigation

Mental Health Litigation Mental Health Litigation Mental Health Litigation

J.K.

J.K. J.K. J.K. (Arizona) (Arizona) (Arizona) (Arizona) – Settled 2001

Settlement agreement committed Arizona to a redevelopment of children’s behavioral health system according to a set of principles that put child and family needs first.

Rosie D

Rosie D Rosie D Rosie D. . . . (Massachusetts) (Massachusetts) (Massachusetts) (Massachusetts) – Won 2006

After trial, district court ordered Massachusetts to develop in-home services, including comprehensive assessments, case management, behavior supports and mobile crisis services.

Katie

Katie Katie Katie A. A. A.

• A. (California

(California (California (California) – Settled 2011

After 9th Circuit affirmed California’s obligation to provide foster youth with effective mental health services, agreement reached for intensive care coordination and home-based services.

Commitments to develop develop develop develop Wraparound with Wraparound with Wraparound with Wraparound with Intensive Services (WISe) program Intensive Services (WISe) program Intensive Services (WISe) program Intensive Services (WISe) program between 2014 to 2018, which will include:

• Intensive Care Coordination
• Direct Services
• Mobile Crisis Intervention and stabilization

For more detailed description of model, see WISe Manual available at: https://www.dshs.wa.gov/sites/default/files/BHSIA/dbh/Mental%20He alth/WISe%20manual%20v%201.6-FINAL-effective%204.1.2016.pdf

Additional Counties Starting WISe: : : :

King Grays Harbor Lewis Pacific Wahkiakum Chelan Douglas Asotin Garfield Spokane

Complete referral contact list available at : https://www.dshs.wa.gov/sites/default/files/BHSIA /dbh/Mental%20Health/WISe%20Referral%20Contac t%20List%20by%20County%20%284.16%29.pdf

Thousands of kids are likely to be eligible for WISe. To be eligible, To be eligible, To be eligible, To be eligible, you must:

Be Medicaid

Medicaid Medicaid Medicaid eligible

Be under the age of 21

under the age of 21 under the age of 21 under the age of 21

Need intensive services

Need intensive services Need intensive services Need intensive services to treat a mental illness or mental mental illness or mental mental illness or mental mental illness or mental health condition health condition health condition health condition that is interfering interfering interfering interfering with your school, family, or community life

Youth with involvement in multiple child

involvement in multiple child involvement in multiple child involvement in multiple child-

• serving

serving serving serving systems systems systems systems (e.g., child welfare, mental health, juvenile justice, developmental disabilities, special education, substance use disorder treatment).

Youth receiving or being considered for restrictive

restrictive restrictive restrictive services services services services, such as psychiatric hospitalizations, residential/foster placement,

Youth at risk of school failure

at risk of school failure at risk of school failure at risk of school failure and/or who have experienced significant and repeated disciplinary significant and repeated disciplinary significant and repeated disciplinary significant and repeated disciplinary issues issues issues issues at school

Youth who have been significantly impacted by

childhood or adolescent trauma trauma trauma trauma.

Youth prescribed multiple or high dosages of

psychotropic psychotropic psychotropic psychotropic medications medications medications medications

Youth with a history of detentions

detentions detentions detentions, arrests arrests arrests arrests, or other referrals to law law law law enforcement enforcement enforcement enforcement

Youth exhibiting risk factors such as suicidal

suicidal suicidal suicidal ideation, danger danger danger danger to self or others.

Youth requesting or whose Youth requesting or whose Youth requesting or whose Youth requesting or whose family family family family is is is is requesting support requesting support requesting support requesting support in meeting the in meeting the in meeting the in meeting the mental/behavioral mental/behavioral mental/behavioral mental/behavioral health health health health challenges. challenges. challenges. challenges.

ANYONE ANYONE ANYONE ANYONE

including youth and family.

When a youth is referred to Children’s Long

Children’s Long Children’s Long Children’s Long-

• Term Inpatient Program (CLIP)

Term Inpatient Program (CLIP) Term Inpatient Program (CLIP) Term Inpatient Program (CLIP) or Behavioral Behavioral Behavioral Behavioral Rehabilitation Services (BRS). Rehabilitation Services (BRS). Rehabilitation Services (BRS). Rehabilitation Services (BRS).

While a youth is enrolled in BRS or receiving

CLIP services: no less frequently than every every every every six months, and during discharge planning six months, and during discharge planning six months, and during discharge planning six months, and during discharge planning.

Prior to a youth discharging from a

discharging from a discharging from a discharging from a psychiatric hospital. psychiatric hospital. psychiatric hospital. psychiatric hospital.

When a step

step step step-

• down request

down request down request down request has been made from institutional or group care.

When a youth receives crisis intervention or

crisis intervention or crisis intervention or crisis intervention or stabilization services, stabilization services, stabilization services, stabilization services, and there are past and/or current functional indicators of need for intensive mental health services

Youth will receive a WISe Screen WISe Screen WISe Screen WISe Screen that:

Must be offered within 10 working days of

10 working days of 10 working days of 10 working days of referral referral referral referral

Will gather information from referent and

youth/family or others directly involved

Will complete a 26 question Child and

Child and Child and Child and Adolescent Needs and Strengths (CANS) Adolescent Needs and Strengths (CANS) Adolescent Needs and Strengths (CANS) Adolescent Needs and Strengths (CANS) screen

Youth should be offered

• ffered
• ffered
• ffered WISe if:

Enrolled or eligible to be enrolled* with a

Behavioral Health Organization (BHO, formerly known as Regional Support Networks or RSNs); and

The CANS screen score meets the WISe Algorithm,

• r screening clinician determines WISe is medically

necessary.

*Youth who screen into WISe should generally be BHO eligible.

Participation in WISe is voluntary

voluntary voluntary voluntary for youth* and families and is NOT NOT NOT NOT a prerequisite a prerequisite a prerequisite a prerequisite for other medically necessary services.

Who decides whether dependent youth will

participate in WISe?

Offering WISe does not eliminate obligation to

Offering WISe does not eliminate obligation to Offering WISe does not eliminate obligation to Offering WISe does not eliminate obligation to provide other medically necessary services. provide other medically necessary services. provide other medically necessary services. provide other medically necessary services.

*Age of consent is 14 and older.

These services generally cannot be delivered simultaneously with WISe:

• Behavioral Rehabilitation Services (BRS)*
• Children’s Long-Term Inpatient Program (CLIP)

Admission*

• State Hospital Admission (over 18 years old)*
• Non-BHO mental health therapy covered by regular

mental health Medicaid benefit **

*WISe is considered a less restrictive alternative to these services, but may be engaged during discharge planning and transition phases. ** Possible difference for beneficiaries in Clark/Skamania Counties

Youth may access WISe along with services from other child and family service systems, including but not limited to:

• Family Preservation services
• Foster Care
• Developmental Disabilities Administration (DDA) services, such

as respite, personal care, or case management

• Medical care
• Specialized therapies
• IEP or Section 504 Services
• Probation services or other juvenile justice services
• Evidence Based Practices
• Services for Homeless Youth
• Services from various community organizations serving youth

and families

• Advise youth and families about how to request

a WISe screen.

• Educate system partners about using WISe as a

less restrictive alternative to institutionalization

• r out of home placement.
• Monitor whether essential referrals are being

made for youth.

• As appropriate, participate in Child and Family Teams (CFT) to

help engage youth and family, identify child and family strengths, or plan your role in addressing other system service barriers

• Advocate for system partners such as schools or county

juvenile justice staff to participate in CFT meetings

• Participate and/or encourage your clients to participate in

monthly Regional Family Youth System Partner Round Table (FYSPRT) meetings.

• Call DRW with questions or concerns.

BELIEVE in your client’s recovery!

WISe Implementation Page: https://www.dshs.wa.gov/bha/division- behavioral-health-and- recovery/wraparound-intensive-services- wise-implementation

Includes WISe information sheets, referral contact information, implementation planning and reports, screening and outcome data, trainings, and links to FYSPRT information

Contact Contact Contact Contact

www.disabilityrightswa.org/kids-community-based-mental-health

Call Toll Free Call Toll Free Call Toll Free Call Toll Free

1-800-562-2702

Write or Visit Write or Visit Write or Visit Write or Visit

315 5th Ave. South Suite 850 Seattle, WA 98104

NATIONAL CENTER FOR YOUTH LAW NATIONAL CENTER FOR YOUTH LAW NATIONAL CENTER FOR YOUTH LAW NATIONAL CENTER FOR YOUTH LAW 405 14th Street, 15th Floor Oakland, CA 94612 Telephone: (510) 835-8098 Facsimile: (510) 835-8099 NATIONAL HEALTH LAW PROGRAM NATIONAL HEALTH LAW PROGRAM NATIONAL HEALTH LAW PROGRAM NATIONAL HEALTH LAW PROGRAM 3701 Wilshire Blvd., Suite #750 Los Angeles, CA 90010 Telephone: (310) 204-6010 Facsimile: (213) 368-0774 YOUNG MINDS ADVOCACY PROJECT YOUNG MINDS ADVOCACY PROJECT YOUNG MINDS ADVOCACY PROJECT YOUNG MINDS ADVOCACY PROJECT 275 5th St San Francisco, CA 94103 Telephone: (415) 466-2991

Additional Plaintiffs’ Counsel Additional Plaintiffs’ Counsel Additional Plaintiffs’ Counsel Additional Plaintiffs’ Counsel