July 2019 Resources of the Month
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Dear UCCCN members and interested parties,
Here are your July 2019 Resources and meeting summary.
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Announcements:
From Mindy – The Portal needs help identifying parents of children and youth with special health care needs to help us improve the experience of visiting our website. Please help spread the word in your clinic by taking some fliers back with you.
From Eric Christensen - Heather Carlson is leaving Ogden’s ISP team to direct the Weber-Morgan
Early Intervention program
, now a contracted position through the State Health Department. Utah's EI programs will be doing a 5-year cycle for contracts (alternating years) – a change from the last 30 years.
From Greg Hawkes – Intermountain has announced that it has purchased land in Lehi to build another behavioral health facility, similar to Wasatch Canyons in Taylorsville, perhaps by 2023, and likely co-located with the current PCH campus in Lehi (Utah Valley Hospital).
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Brainstorming:
Case #1
from Mindy Buttars: Is the Health Dept doing CSHCN clinics in Provo? Eric: smaller, becoming more a niche clinic around ASD at the State building on Center Street. There is a wait list because they have only one psychologist. They refer to other providers when possible, including private (based on geography). Currently 2 - 3 months for full assessment results afer the visit. Schools will take the ISP assessment. Jan: quality of assessment varies so much in the schools; she’s been shocked. Eric: has seen full ADOS done in schools. Angee: What is the fee? Eric: had been using block grant (thus free for families) but will be billing large insurance providers in coming months, with a sliding fee scale. Cash price? Price is based on the # of hours the psychologist spends. With sliding fee scale, consider family’s gross income, other medical fees. Gina: schools, if they have the capacity, will assess for the local school services placement, educational needs and specialized instruction (for IDEA). Families need a medical diagnosis for other outside services. Schools will take the medical assessment into account. Autism is very individual, learning capacities vary across the spectrum relative to instructional needs.
Lana – mentioned Matt’s Place where they test for autism, have a full staff of therapists and clinicians. They have purchased land in St. George to build a new facility.
- Health Clinics of Utah – Provo Medical clinic offering quality medical care to people of all ages. Autism testing offered by a psychologist, aiming for one-month turnaround. Sliding scale. MHP 10419
- Matt’s Place Centerville. Helps families and individuals ages 3 to 21, with behavioral disorders, and those on the autism spectrum, in a day treatment setting. Autism Spectrum Disorder assessment MHP 23918
Disclaimer: These resources come from our members as part of the meeting brainstorming session; please check with your providers to make sure they are appropriate for your patient/families.
You can find a custom list of these service providers that can be printed, emailed, and more, here
:
UCCCN Resources July 2019
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Presentation: “Partnering for Stronger Children, Youth and Families” - Lana Stohl, LCSW, MBA, Deputy Director, Utah Dept of Human Services, and Director of System of Care
Presentation slides
. Lana has been in the behavioral health field for 40 years. She grew up in eastern Kentucky.
Human services systems are often very fragmented, across agencies and within agencies. Systems include child welfare, DCFS, DSPD, Juvenile Justice, DMHSA; responses inconsistent. Address gaps with “System of Care” (SoC) a coordinated network, that builds meaningful partnerships with families, cultural and linguistic competence, to function better at home, school, and in communities.
Values - trying to infuse these into everything the agencies do.
- Family Driven - they are the primary decision makers
- Culturally Competent
- Youth Guided - value and respect youth voices, treat them as equal partners
- Community-Based
- Trauma Informed
- Strengths-Based
- Individualized - if a child and family isn’t ready for therapy, shouldn’t force it
Since 1989 Utah’s Department of Human Services has been evolving towards today’s System of Care. Now a state-funded statutory program (not dependent on federal grants for sustainability). Using System of Care concept to reshape the department, underway for four years so far; it took New Jersey 20 years to feel they made it. Workforce development for ongoing training, technical assistance and coaching. Limited funding, low salaries, high turnover in staff has always been a problem. Three partners: State, Local, Tribal.
State level Integrated Services Delivery Advisory Committee - on which Gina Pola-Money serves.
Locally: need more youth peer support. Teams are in-home. 4 levels of wraparound. Regional Coordinators cover large geographic areas, very challenging. For example, child welfare may need a plan for court, which needs to be integrated with the kid’s needs.
Who: children and youth under 22 and at risk of receiving services from two or more of the DHS agencies. Many have not had autism diagnosed but it’s clear they are on the spectrum. Behavioral supports are a big success for this population. Others in the program were exposed to in-utero drugs and alcohol and lack executive functioning skills. Respite for families is greatly needed.
Juvenile competency
: if a child doesn’t have the capacity to understand the system and consequences, they don’t go into JJS.
Stabilization and Mobile Response program in Salt Lake will eventually be statewide.
Referrals are not limited to state custody. Referrals have to be by choice (the child’s). Referrals come in from schools, DCFS, JJS. Local advisory councils ultimately select. Any of our care coordinators can refer:
https://hs.utah.gov/soc-refer
; there is a triage process. Once in the program, the family receives 8 weeks of intensive in-home services, free of charge. Five regions are aligned with local health authorities statewide. Local care management and high-fidelity wraparound practice with children and youth with unique, intensive needs touched by multiple systems. Goals are very short-term and measurable. Natural supports are very important.
Questions:
- From Jan Bowker thinks she has a family in the SoC, but doesn’t know, as Mom isn’t a good communicator. How to partner/communicate? Lana will provide contact info for regional coordinators. The family decides who to include in the SoC team, which could include the medical provider.
- From Eric C— HIPAA/FERPA and 42 CFR (federal confidentiality law) have been barriers. Don’t want to duplicate efforts. How do we create a single plan of care among UDOH, DSPD, MDs office? Lana: If you are a part of a SoC care team, there is a release in place to share information with all members, with family’s consent to release of information.
- From Karine Romero: a dangerously violent older sibling is repeatedly removed, then returns the next day. Lana: DCFS is not always part of System of Care; SoC must be a separate referral. Juvenile Justice is also doing some wraparound services. Juvenile Receiving Center, Salt Lake County Youth Services has 24/7 drop-off. A second center in West Jordan. Use Stabilization and Mobile Response.
- From Chuck: who determines the members of the SoC care team? Lana - it’s a negotiation, the family ultimately decides; juvenile court may be a required participant.
- Chuck: what is the percentage of medical clinicians on care teams? Lana: Higher in rural areas. She has those numbers, but not with her. There is a medical advisory committee for System of Care; with time involvement.
- Chuck: how is the info shared? Lana: there is an online platform and people have access. She doesn’t know exactly how it works. Can find out.
- Eric: are families prompted to think about who from a medical team could be involved? Lana: great question, doesn’t know; will ask.
Regional Coordinators for System of Care
System of Care
System of Care is a customized mental health service approach to keep families safely together while effectively helping children with emotional and/or behavioral health needs thrive in their homes, schools and communities, a wraparound approach.
MHP 10609
Stabilization and Mobile Response
Mobile Response Services; provided to you in your home to ease an immediate crisis and provide support. Minimize the impact of the crisis on you and your family. Create safety plans. Connect you and your family to other helpful resources. Stabilization Services: short-term services may be provided in addition to mobile response for six to eight weeks to help ensure your family’s long-term success. Teach skills to improve family functioning. Create plans that prepare you for and prevent future crisis. Prevent the need for out-of-home services. Arm you with ongoing resources and support.
MHP 35073
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Other:
Our next meeting will be August 21st at the
SLC (Taylorsville) USU Campus
and upon request, at additional USU extension campuses. Our topic:
School services - MPSS/Behavioral supports for all populations (not just those with IEPs or 504s).
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Mindy Tueller, MS
Manager, Medical Home Portal
Facilitator, Utah Children’s Care Coordination Network
Department of Pediatrics
University of Utah
801-213-3920
Tay Haines
Portal Services and Resources Coordinator
Medical Home Portal
Department of Pediatrics
University of Utah
801-587-1464
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