Los Angeles County Proposed RBS Demonstration Project RBS Forum Sacramento, CA September 4/5, 2008

Mission, Vision, Collaboration Sept., 4/5, 2008Los Angeles County RBS Demonstration2 Mission The Los Angeles RBS Demonstration will transform intensive mental health services within the child welfare system to empower families and achieve permanency for youth. Vision The creation of a strength-based, family-centered, needs-driven system of care that transforms group homes from long-term placements to short-term interventions, which are not place-based, which provide for seamless transitions to continuing care, and which support the safety and permanency needs of youth and their families LA RBS Collaborative In November of 2007, the RBS Collaborative design group was formed and is composed of county, provider and community stakeholders.

LAC Group Home Trend Data

Target Population Children in or approved for RCL 12 or 14 placements –CANS will be the assessment tool Approximately 200 DCFS children will be served –Over 24 mos –Using up to 64 RCL 12 or 14 beds and 192 Wrap slots Average age – 15.8 years Sept., 4/5, 2008 Los Angeles County RBS Demonstration 4

Page - 5 Baseline Data: RCL-12 Children 50% 90% 80% All RCL 12 FY Exit Cohort Data

Baseline Data Continued (collaborative profile applied)

Page - 7 LOS Data Analysis Notes: 1.For RCL 12, 24 mo. analysis captures ~90% of population 2.For ‘Collaborative Profile’ - 24 mo. analysis captures ~80% of population

Proposed Outcomes Sept., 4/5, 2008 Los Angeles County RBS Demonstration 8 SAFETY Safety in placement Safety in home-based settings PERMANENCY Shortened timelines to permanency for youth Limited, shortened length of stay in RCL 12 and 14 placements Stability in home-based settings WELL BEING Family and youth satisfaction with RBS services Family identification and connection for disconnected youth Culturally and linguistically sensitive family involvement (visitation, participation in and ratification of planning process, agency contact, connectedness) Educational improvement (attendance, stability, GPA) Socio-behavioral improvement (evidenced by CANS) COST Cost neutrality

Wraparound and Group Home Enrollment (FY 2003 – 2007)

Cornerstone Innovations Wraparound-based Child and Family Teams during residential tx. Family finding, engagement, preparation and support during residential tx. Residential therapeutic milieu influenced by Wraparound principles Shared risk/benefit between County and providers Sept., 4/5, 2008 Los Angeles County RBS Demonstration 10

System Design Sept., 4/5, 2008Los Angeles County RBS Demonstration11

Proposed Funding Model Augmented residential rate for facility based services –RCL-12 = $5,891+ $2,300 RBS rate –RCL-14 = $6,694 + $2,300 RBS rate –Modeled at 9 months RBS Rate covers –Family finding, engagement, preparation and support –Child and Family Team –Flex funds LAC Wrap rate for community based services ($4,184 excluding placement costs) Risk pool –Could possibly be used for Extended LOS Respite Unanticipated costs Placement costs during Wraparound –$1,000 set aside per month per child for 1 st 12 months of care Cost reconciliation –Either annually or semi-annually –Share risk and benefit Sept., 4/5, 2008 Los Angeles County RBS Demonstration 12

Potential Waiver Requests RCL and related point systems No new placement agreement for respite Sept., 4/5, 2008 Los Angeles County RBS Demonstration 13

Current Status Request for interest letter to be issued mid-Sept. Provider selection by end of Sept. Contract negotiations to follow Sept., 4/5, 2008 Los Angeles County RBS Demonstration 14

Concerns/Issues/Requests for Help Cost neutrality calculation Interaction with Title IV-E Waiver Administration and claiming processes CCL implications Sept., 4/5, 2008 Los Angeles County RBS Demonstration 15