Child Welfare Council

MEETING NOTES

Date: June 25, 2013

Purpose:Collaborative oversight for cross-system child welfare improvement efforts

Attendees: Judge Holmes HehnMultnomahCounty Circuit Court

Referee Fithian-BarrettMultnomahCounty Circuit Court

Shary Mason Juvenile Court Improvement Program

Lisa HollandJuvenile Court Clerk’s Office

John Richmond Department of Human Service – Child Welfare

Alicia Hahn Department of Human Service – Child Welfare

Joe HagedornMetropolitan Public Defender Services

Lisa KayYouth, Rights and Justice

Ebony Clarke Multnomah County Mental Health Division

Jeff StilesFamily Involvement Team (FIT) – VOA

Lynn TravisCASA for Children

Mary GeelanCommission on Children, Families & Community

Topic
Direct Clinical Mental Health Services in MultnomahCounty– Presenter: Ebony Clarke
Discussion:
Ebony Clarke is the Direct Clinical Services Manager for the Multnomah County Mental Health and Addiction Services Division. She oversees Wraparound, Early Assessment and Support Alliance (EASA), School-based Mental Health, Early Childhood Mental Health and CARES NW. See the organizational structure (Attachment A) and explanation of direct clinical services (Attachment B).
Direct Clinical Services takes a system of care approach, with the goal of recovery and wellness, which they define as, children being safely:

at home,
in school,
out of trouble, and
with family.

Children’s Integrated Services Array
Ebony distributed on overview of the services available to children and adolescents through the Integrated Services Array (Attachment C).
Wraparound Multnomah
In 2005, The Children’s System Change Initiative was launched. The initiative was focused on the deinstitutionalization of mental health services for children. There was a high rate of failure for children transitioning from inpatient services into the community. It was out of this effort that Wraparound was developed locally, in order to provide a more comprehensive system of supports to keep children in their communities. Wraparound was originally run by Albertina Kerr and the Multnomah Education Service District through federal SAMHSA grants, but is now run by MultnomahCounty. Wraparound is an integrated approach to meeting the needs of high utilizers of our systems, through breaking down system barriers and being more creative, innovative and family centered. For more information refer to the brochure (Attachment D).
Health Transformation
The newly created Coordinated Care Organizations (CCO) bring together medical, mental health and addictions, and dental care providers, along with social services to ensure that people have access to the right care at the right time. The goals of transformation are referred to as the “triple aim”: better health, better care, at lower costs. The two CCOs in our region are Health Share of Oregon and Family Care.
Health Share/Multnomah Mental Health, formerly known as Verity, administers mental health benefits for members within MultnomahCounty through contracts with community providers. Over the last year, MultnomahCounty saw reduction in access to community based services due to financial constraints. With health transformation, there will be no new money added to services, but Health Share is working on new fiscal models that will allow the system to be more flexible to meet the needs of children and families.
Intersection with the Health Plan
MultnomahCounty can only provide services to children and families that is deemed “medically necessary” by the health plan. So, for instance, if a child is referred to Wraparound an the intake team determines whether the child is a member of Health Share, a Multnomah County resident, is multi-system involved, and has a score of 4,5 or 6 on the Composite Child & Adolescent Service Intensity Instrument (CASII). The intake team will then send it to the Health Plan to review medical necessity and authorize services.
In one case, a judge recommended Intensive Community-based Treatment and Support Services (ICTS) for a child, but the health plan did not deem it medically necessary, so the family was not able to receive those services.
Conclusions:
The next meeting will be in July. There will be no meeting in August.
Action Items / Person Responsible / Deadline
Type up and distribute meeting notes / Mary Geelan / Prior to next meeting

Date of Next Meeting: Tuesday, July 23, 2013, 12:10 – 1:15 p.m., Juvenile Justice Complex,

1401 NE 68th Ave. Large Conference Room