Monthly THP-Plus/THP+FC Conference Call Thursday, September 12 th : 10:00 to 11:00 a.m.

Agenda Welcome and introductions THP+FC  Update on the number of providers THP-Plus  Discussion of the THP-Plus Baseline under Realignment Other Items  Next call replaced with web seminar to discuss annual report: October 10th

THP+FC Provider Growth

What is the goal of this conversation? For the THP-Plus community to:  Understand how 2011 Realignment changed THP-Plus.  Understand the procedural requirement in state law to reduce THP-Plus capacity as part of 2011 Realignment.  Promote transparency at the county level about the baseline level of service established when 2011 Realignment was enacted.  Ensure that decisions to reduce capacity involve a range of stakeholders, including public administrators, non-profit providers and youth.

Basics of 2011 Realignment & THP-Plus General information:  Adopted by Legislature in  Directs a portion of the sales and use tax directly to counties.  Eliminates the state share of cost for almost all child welfare and foster care programs.  Gives counties new flexibility, particularly over programs that were state-only funded. Information Specific to THP-Plus  Eliminates the requirement for counties to submit a county plan to CDSS for their THP-Plus program.  Eliminates county requirements to dedicate 70 percent of its realigned THP-Plus funding to the THP+FC program.  Permits counties to use funds allocated to THP-Plus for other purposes, as long as they are child-welfare related.

Senate Bill 1020 Legislature created procedural requirement for counties that want to exercise this new flexibility to reduce THP-Plus service levels. (f) Any decision of a county or a city and county to eliminate or significantly reduce the levels or types of optional or discretionary behavioral health services, adult protective services, or child welfare services …that the county or city and county is or has previously funded…may… only be made in open session, as an action item, at a duly noticed meeting of the board of supervisors. For the purpose of this subdivision, “significant reduction” shall include a 10-percent reduction in funding in any one year or a cumulative 25-percent reduction over the previous three years.* *Government Code section (f), as adopted in Senate Bill 1020

CDSS All County Letter Page 6: “However, if a county intends to eliminate or significantly reduce the level of its THP-Plus program by 10 percent in any one year or by a cumulative 25 percent over the previous three years, the decision must be affirmed in open session by a vote of its local Board of Supervisors pursuant to Government Code section (f), as adopted in SB 1020 (Chapter 40, Statutes of 2012.)”

What THP- Plus funding was provided under Realignment?  $34,928,000 in THP-Plus funding was distributed to 58 counties (CFL 11/12-18).  The distribution was based on each county’s FY rates and allocation, with a small adjustment due to a minor budget reduction. (ACL 11-03)  Five counties received a THP-Plus distribution in FY ; their distribution was also adjusted for two bed counts per county.

What THP- Plus funding was distributed under Realignment? Alameda$2,897,614 Alpine$67,344 Amador$67,344 Butte$323,580 Calaveras$104,190 Colusa$48,622 Contra Costa$1,089,309 Del Norte$374,846 El Dorado$304,283 Fresno$522,346 Glenn$207,278 Humboldt$173,650 Imperial$99,969 Inyo$121,554 Kern$825,481 Kings$72,160 Lake$250,055 Lassen$138,919 Los Angeles$2,165,106 San Luis Obispo$421,298 San Mateo$1,476,186 Santa Barbara$331,036 Santa Clara$2,086,413 Santa Cruz$472,410 Shasta$194,488 Sierra$67,344 Siskiyou$197,036 Solano$962,670 Sonoma$376,268 Stanislaus$327,303 Sutter$260,474 Tehama$355,430 Trinity$270,656 Tulare$215,680 Tuolumne$105,316 Ventura$65,987 Yolo$162,128 Yuba$318,413 Madera$145,629 Marin$283,683 Mariposa$178,485 Mendocino$277,839 Merced$244,141 Modoc$82,859 Mono$67,344 Monterey$410,701 Napa$444,744 Nevada$144,763 Orange$1,698,256 Placer$551,102 Plumas$61,280 Riverside$866,043 Sacramento$1,984,843 San Benito$67,344 San Bernardino$1,052,386 San Diego$4,831,711 San Francisco$2,474,795 San Joaquin$539,866

How many THP-Plus beds does that funding translate into?** *Alameda123 Alpine2 Amador2 *Butte13 Calaveras3 Colusa2 *Contra Costa41 Del Norte9 El Dorado9 Fresno17 Glenn5 Humboldt5 Imperial3 Inyo5 Kern41 Kings3 Lake9 *Lassen4 *Los Angeles82 Madera4 San Mateo49 Santa Barbara9 *Santa Clara65 Santa Cruz17 Shasta10 Sierra2 Siskiyou5 Solano25 Sonoma13 Stanislaus17 Sutter9 Tehama10 Trinity7 Tulare9 Tuolumne5 Ventura5 Yolo5 *Yuba10 *Orange65 Placer17 *Plumas2 Riverside33 Sacramento65 San Benito2 Marin8 Mariposa5 Mendocino10 Merced9 Modoc2 Mono2 Monterey15 Napa10 Nevada5 San Bernardino30 *San Diego140 *San Francisco92 San Joaquin17 San Luis Obispo10 *indicates counties with more than one provider ** This bed count is based on ACL 11-03, adjusted down to reflect a small budget reduction from FY to 2011 Realignment.

What monthly rate amounts does that translate into? *Alameda $1,963 Alpine $2,800 Amador $2,806 *Butte $2,125 Calaveras $2,965 Colusa $2,075 *Contra Costa $2,214 Del Norte $3,555 El Dorado $2,886 Fresno $2,623 Glenn $3,538 Humboldt $2,965 Imperial $2,845 Inyo $2,075 Kern $1,677 Kings $2,054 Lake $2,372 *Lassen $2,965 *Los Angeles $2,200 Madera $3,108 San Joaquin $2,711 San Luis Obispo $3,596 San Mateo $2,520 Santa Barbara $3,140 *Santa Clara $2,658 Santa Cruz $2,372 Shasta $1,668 Sierra $2,806 Siskiyou $3,363 Solano $3,161 Sonoma $2,471 Stanislaus $1,643 Sutter $2,471 Tehama $3,034 Trinity $3,301 Tulare $2,046 Tuolumne $1,797 Ventura $1,126 Yolo $2,767 *Yuba $2,718 Marin $3,018 Mariposa $3,047 Mendocino $2,372 Merced $2,315 Modoc $3,537 Mono $2,806 Monterey $2,337 Napa $3,796 Nevada $2,471 *Orange $2,163 Placer $2,767 *Plumas $2,617 Riverside $2,174 Sacramento $2,529 San Benito $2,806 San Bernardino $2,898 *San Diego $2,884 *San Francisco $2,247 *indicates counties with more than one provider

What are symptoms of a possible reduction in service levels? Reduction in contracted bed capacity Reduction in monthly THP-Plus rate Reduction in actual beds filled

Possible symptoms of service reduction Scenario 1: Reduction in bed capacity  When we received our new contract for the coming fiscal year, the number of THP-Plus beds we are contracted for with our county was reduced by 10% or more. Example: During FY our contract was for 12 beds, but for FY it is for 10 beds (a 17% reduction).

Possible symptoms of service reduction Scenario 2: Reduction in monthly THP-Plus rate  The monthly rate per youth we are contracted to provide THP-Plus services for has dropped 10% or more Example: During FY our rate was $2,350 for our scattered site model, but for FY it is $2,115 (a 10% reduction).

Possible symptoms of service reduction Scenario 3: Reduction in actual beds filled  Although our contract did not change, our beds are not being filled. Example: During FY our contract was for 12 beds. It remained at 12 for FY , but we only maintained about 4 youth per month (a 75% reduction).

Next Steps at the Local Level 1.Make sure all providers and county representatives are clear about the amount of THP-Plus distributed to your county through 2011 Realignment (CFL 11/12- 18) 2.Understand as a group what that funding means in terms of beds and rates. 3.Make sure everyone clear about the state law requiring any decision to “significantly reduce” be made in open session, as an action item, at a duly noticed meeting of the board of supervisors. 4.Meet regularly to monitor service level and discuss the interplay between extended foster care and THP- Plus.

THP-Plus & THP+FC Annual Report FY Next month this call will be replaced with a web seminar on the Annual Report. Thursday, October 10 th from am Register for the web seminar at: er/ er/ (the link is also available on the THP-Plus website)

Other Items  Poll: what day of the week would you prefer to hold these calls? TUESDAY, WEDNESDAY OR KEEP THEM ON THURSDAY?  Date & time of November call to be determined