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State Executive Council / State & Local Advisory Team

DRAFT MINUTES March 5, 2009
STATE & LOCAL ADVISORY TEAM (SLAT)
COMPREHENSIVE SERVICES FOR AT-RISK YOUTH & FAMILIES
Richmond Room
1604 Santa Rosa Road, Richmond

Members Present: Mike Mastropaolo, SLAT Chair, Association of Court Service Directors; Randy Blevins, Association of Court Service Directors; Mark Hinson, Parent Representative; Vicki Hardy-Murrell, Parent Representative; Buz Cox, League of Social Services Executives; Gail Schreiner, CSA Coordinators Network; Penny Combs, VCOPPA; Karen Tompkins, VCOPPA; Paul Raskopf, DOE; Susan Cumbia, DOE; Catherine Hancock, DMAS; Katharine Hunter, DMHMRSAS; Paul McWhinney, DSS

Members Absent: The Honorable Sharon Will, Virginia Council of J& DR Judges; Janet Lung, DMHMRSAS; Scott Reiner, DJJ; Kim Barnes, VDH

Guests and OCS Staff: Rebecca Paris, Saniyyah Turner, Scott Cook, Wanda Sadler, Crystal Bell, Karen Reilly-Jones, Helen Curtis, Jeannie Decker, Janet Fuller-Holden, Pam Fisher, Charlotte McNulty, Alan Saunders, Dave Nichols, Dawn Howard, Marsha Mucha

Call to Order: Mike Mastropaolo, Chair called the meeting to order at 9:40 a.m. and asked for introductions. SLAT members agreed by consensus to begin meeting every other month with the next meeting scheduled for May 7, 2009. Also, for purposes of voting, SLAT members were asked to seat only the primary member and one alternate at the table.

Approval of Minutes: The minutes of the January 8, 2009 meeting were approved on a motion from Catherine Hancock, seconded by Gail Schreiner and carried.

Public Comment:
There were no public comments.

Election of SLAT Vice-Chair
Mike reported that, since Charlotte’s selection as the Office of Comprehensive Services (OCS) Executive Director and his assuming the position of SLAT Chair, it was necessary to elect a vice-chair to serve in his previous position of Vice-Chair. A motion was made by Catherine Hancock, seconded by Mark Hinson and carried that Gail Schreiner serve as the new SLAT Vice-Chair.

Report on the 2009 Legislative Session
Alan Saunders reported on the relevant legislation and budget amendments for the Comprehensive Services Act (CSA):

Legislation
SB 1179A (Hanger) – Expands State Executive Council (SEC) membership by four. The bill provides for one additional local government member (currently there are 2); two additional private provider members (currently there is 1); and includes the Special Advisor on Children’s Services Reform as an ex-officio member. Additional memberships will be appointed by the Governor for three-year terms with a two-term limit.
SB 1180 (Hanger) – Requires the SEC to report and analyze expenditures associated with children who do not receive pool funding and have emotional and behavioral problems. The bill also requires the Council to identify funding streams used to purchase services in addition to pooled, Medicaid, and Title IV-E funding. Both reporting requirements would be included in the biennial state progress report on comprehensive services to children, youth and families delivered to the General Assembly and Community Policy and Management Teams (CPMTs).
SB 1181 (Hanger) – Requires the Executive Director of OCS to report to the SEC all expenditures associated with serving children who receive pool-funded services. The report shall include expenditures for (i) all services purchased with pool funding; (ii) treatment, foster care case management, and residential care funded by Medicaid; and (iii) child-specific payments made through the Title IV-E program. (SBs 1181, 1182, 1183 and 1184 were incorporated into SB 1181.)
SB1506A (RB) (Hanger) – Provides that in cases of judicial assignment of services for children under the CSA program where a party requests a level of service not identified or recommended in the report submitted to the court by the Family Assessment and Planning Team (FAPT), the court shall request the CPMT to submit a second report characterizing comparable levels of service to the requested level of service.

CSA Budget Amendments
Item 283 #1c – Reduces by $2 million the first year and $1million the second year from the general fund to reflect slower caseload growth in CSA. This amendment reflects slower then expected growth in children entering CSA through parental agreements.
Item 283 #2c – Adds language to require local CPMTs and Community Services Boards (CSBs) to work collaboratively on developing local plans for intensive care coordination (ICC) for children placed in, or at risk of placement in, residential care and to determine the service provider for these services according to guidelines adopted by the SEC. Also, requires the SEC and OCS to develop guidelines for reasonable rates for ICC services and provide training and technical assistance for these services.
Item 283 #3c – Requires OCS to develop a plan for conducting training sessions during the fiscal year. Language also requires reporting on training session dates, programs, trainers, evaluations and funds expended beginning December 1 of each year.
Item 283 #4c – Adds language to CSA to clarify that local match rates for Medicaid-funded services provided through the CSA program are not reduced during the 2008-10 biennium. Any increases in local Medicaid match rates would violate local cost sharing requirements included within the federal American Recovery and Reinvestment Act of 2009, thus jeopardizing $962 million in federal Medicaid revenue to the Commonwealth.
Item 283 #5c – Adds language directing the SEC to work with the Department of Education (DOE) to make sure that funding is sufficient to pay for the educational services of children placed in state or privately operated facilities. (DOE SLAT members provided additional information to SLAT on the background of this amendment).

Report on FY 08 CSA Critical Service Gaps Report
Dave Nichols reported that the 2006 Virginia General Assembly amended Chapter 781 of the Code of Virginia to require that, on an annual basis, CPMTs report to OCS on gaps and barriers in services need to keep children in the local community. The 2008 report reflects the third year that this data has been collected.

Eighty percent of CPMTs participated in the FY 08 assessment. These localities represent approximately 87% of youth served under the CSA. Localities were asked to rank their top 5 service gaps from the list of services from previous surveys. They were asked to indicate which of a list of barriers were impacting their ability to develop community-based services. A new community services availability section was added with items relating to increased services, strategies and needs. Space was provided for anecdotal descriptions of increased services and strategies utilized to increase service capacity.

Dave highlighted the following areas of the report:
Increased reported needs for ICC and parenting/family skills training - The need for these services rose significantly in FY08.
Decreased reported needs for group home care and residential treatment - These needs were in the top 10 for the previous 2 years but fell from the top 20 list in FY08.
Increased community-based service capacity for school-based mental health day treatment
Strategies for increasing service capacities include annual CPMT/stakeholder retreats and working with existing providers to modify/customize services
Respite and transportation are more highly reported needs in rural than metropolitan areas of the state
Intensive Substance Abuse services are very highly reported needs for the Northern and Western regions of the state.

The top three barriers to community service availability were:
Access to grant or flexible funding for program start up
Need to pool resources and funding across multiple community partners and funding sources for the service
Need for greater collaboration amount community stakeholders

As reported in the new community services availability section:
65% of localities reported an increase of community services
61% of localities reported an increased array of services
81% of localities reported they had taken steps to expand services

The most commonly reported new community services included:
School-based mental health day treatment
Parent and family mentoring
Parent/family skills training
Wraparound services
Intensive in-home services

Strategies for expanding community services included:
CPMT led initiatives – i.e. retreats, case worker training, regional meetings of CSA programs
Juvenile court led initiatives – i.e. stakeholder conference on community services and cross agency school/court service unit trainings on truancy
Funding strategies – i.e. access regional grant funds and strategically coordinating private funds, Safe and Stable Families, VJCCCA and CSA non-mandated funds

Update on the Transformation Initiative and CORE
Charlotte provided a brief update on the Transformation Initiative. During the month of February, several Transformation Academy Kickoff trainings were held. These trainings provided state staff from across Virginia’s child serving agencies an opportunity to learn more about the Transformation Initiative. These trainings are being followed up in March with a series of Transformation Kickoff Forums across the state.

These forums will provide localities with an opportunity to learn more about the Transformation work to date, plans for implementation statewide, and how localities could benefit, and become involved, in the Transformation. These forums will also serve as an opportunity for people to provide valuable input on the process. Additional trainings are planned in the areas of family engagement and resource family development.

Charlotte also reported that CORE is meeting on a quarterly basis. These meetings will provide the implementation teams from the original 13 CORE localities the opportunity to share their technical assistance expertise, problem solve and support a mechanism for mutual accountability.

Several additional meetings have been convened in the areas of flexible funding and community-services development. A CSA/Community Service Development Steering Committee is working, in conjunction with several smaller workgroups, to determine how to develop Virginia’s Children’s Services Practice Model in a way that creates alignment across child-serving agencies through more family-focused and community-based practices, more consistently employed across agencies and localities. The Steering Committee’s work includes the creation and dissemination of several sets of deliverables by the summer of 2009. These deliverables will include guidance and practice documents and updates to key CSA policies.

Charlotte, Dave Nichols, Dawn Howard, Stacie Fisher and Brady Nemeyer from OCS will be coordinating the smaller workgroups and will report back on a regular basis to the full Steering Committee. SLAT members were invited to participate and to let Charlotte know if they would like to do so.

Update on Intensive Care Coordination
Pam Fisher reported in Janet Lung’s absence. Pam reported that the Intensive Care Coordination Toolkit had been posted to the DMHMRSAS and CSA websites.

The first Intensive Care Coordination Network meeting has been held. Pam reported that the meeting was well attended by those interested in learning more about ICC. Because of the interest generated by the first meeting, regional meetings may be held to provide additional information on ICC. The next ICC Network meeting is being planned for sometime before the middle of May. That meeting will be held in southwest Virginia.

Update on CANS
Carol Wilson provided a brief update. Carol reported that representatives from RCR Technology are in Richmond conducting testing and training on the on-line CANVaS software. Certified CANS super users are assisting with the testing.

Currently 2,225 people have completed the on-line training and are certified CANS users. Through the regional Super User trainings, Dr. Lyons has trained and certified 170 CANS super users. All of the regional Super User Trainings have been completed except for training in early April that was rescheduled due to bad weather.

Carol reported that she continues to receive positive comments about CANS. The on-line CANVaS software is tentatively scheduled to be rolled-out in certain localities on March 16.

Other Business
Nominating Committee
Because there will be no April SLAT meeting, Mike appointed a Nominating Committee to bring a slate of SLAT officers for election at the May meeting. Catherine Hancock, Mark Hinson and Penny Combs agreed to serve as the Nominating Committee.

2009 Spring DOE/CSA Trainings
Over the past year, the SEC created a charge to improve communication and coordination between schools and CSA programs. A workgroup comprised of a wide range of stakeholders examined these issues and conducted a statewide survey of local schools, private providers and CSA coordinators. One recommendation of the workgroup was to conduct cross trainings for school and CSA staff to better understand their program responsibilities.

This year DOE and OCS are partnering to provide regional training sessions regarding CSA and special education. The trainings will provide an opportunity to clarify roles, responsibilities and mandates for special education within the context of CSA. Local CSA representatives have been invited to attend the training sessions that will be held in eight locations across the state.

Strong Roots for a Healthy Future Conference
Vicki Hardy-Murrell reported that the Fourth Annual Statewide “Strong Roots for a Healthy Future” Conference would be held on July 11, 2009 at the Hotel Roanoke. The keynote speaker will be Dr. Michael Manos, Chief of Pediatric Behavioral Medicine at the Cleveland Clinic.

Adjournment
The meeting was adjourned at 11:10 a.m. on a motion from Catherine Hancock, seconded by Penny Combs and carried.

 

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