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Background. Three Committees Access to services for all children with serious emotional disordersAccess to services for children involved with juvenile justice services Involuntary Commitment. C
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1. Child and Adolescent Task Force Report Charlotte V. McNulty, Vice Chair
Presentation to House Health, Welfare and Institutions
General Assembly Building
September 6, 2007
2. Background Three Committees
Access to services for all children with serious emotional disorders
Access to services for children involved with juvenile justice services
Involuntary Commitment
3. C&A Access Issues Many of the access issues for adults are just as evident for children and adolescents
Inconsistent level of community based services for children across the state
Need a broader mandate of services to provide an adequate mental health system of care
4. Proposed Mandated Services – All
5. Core Values System of care should be
Family focused
Needs of the child and family dictate the types and mixes of services
Community based
Culturally competent
6. Comprehensive Services Act (CSA) CSA incorporates the core values
CSA raises additional access concerns
CSA should be a conduit for access but implementation has been problematic
7. C&A Access Issues (cont.) JLARC study
16,262 young people served in 2005
One quarter received residential care
Cost: $194 million
Some young people are placed in more restrictive settings due to lack of community alternatives
Costs related to residential care can be reduced by addressing the gaps in access to and availability of community based services
Effectiveness of residential care is questionable
9. Juvenile Justice Committee DJJ reports survey of young people in custody for delinquency revealed
43% are diagnosed with mental and emotional problems
70% are diagnosed with a substance use disorder
Exploration of “Sequential Intercept Model”
At each intersect between juvenile justice and behavioral health there is a need for
Prompt assessment
Access to community based behavioral health services
Juvenile justice is NOT the best place to serve children with mental health issues
10. Model of Intervention Capacity Components necessary to improve access to other private and public community based services should be the same as the it is for adults
11. Access Options 1) Fund incentives through the Office of Comprehensive Services to limit the use of residential treatment and use the money saved to create more community-based services;
2) Mandate additional services through CSB statute beyond emergency services and case management including crisis stabilization, family support, respite, in-home, day-treatment and psychiatric care. Insure funding is available
12. Access Options, Cont. 3) Recommend that the Office of Comprehensive Services develop a policy for communities that are over-reliant on residential care that requires that prior to any non-emergency residential placement, FAPT shall:
Obtain care coordinator and mental health evaluation from CSB;
Explore all possible community-based services;
Document that they are inadequate and cannot be created;
Develop discharge plan;
Report rationale and seek approval of CPMT
13. Access Options, cont. 4) CPMT shall review every residential placement within 21 days of placement to determine if crisis stabilization has occurred. Any longer care must be justified.
5) CSBs have legal authority for being “front-door” for behavioral health in community and, therefore, should conduct intake and evaluations for all CSA children needing behavioral health treatment.
14. Access Options, Cont. 6) An aggressive, clinically knowledgeable case management and utilization management system must be built in, especially in regards to use of residential care.
7) It is recognized that there is a need to build collaborative relationships between communities and universities for development of best practice models and evaluations processes.
15. Questions? Contact Info:
Charlotte V. McNulty, Executive Director
Harrison-Rockingham CSB
1241 North Main Street
Harrisonburg, Virginia 22802
cmcnul@hrcsb.org
Phone: (540) 434-1941