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Inside This Issue (click to go directly to the article):
1. DCFS Pulls Out All the Stops at Board of Supervisors' Meeting on FFA Dual Licensure and Certification Issue, But We're Not Done Yet
2. Time to Tighten the Ol’ Money Belt Again! DMH Budget Mitigation Work Group Meets
3. Asleep at the Wheel? Probation Reconvenes Steering Committee to Restructure Suitable Placement
4. A Meeting of the Minds -- ACHSA/DMH Meet to Discuss MHSA Program Implementation Issues
5. WRAP Your Mind Around This! ACHSA Comments on the Proposed Wraparound SOW
6. Making Your Voice Heard At the Service Area Level: DMH Re-Convenes Countywide PEI Steering Committee and Rolls Out First PEI Community Forum
7. Can It Get Any More Complicated? Katie A. Child and Family Team Work Group Discusses Tier Model
8. Chuggin’ Right Along: ACHSA IBHIS Work Group Meets to Discuss Data Conversion
9. MAT Steering Committee Meets Looking to the Future
10. DMH Co-Sponsors 14th Annual Asian American Mental Health Training Conference
11. Child Welfare Nuts and Bolts
12. ACHSA News
13. Conferences Events
14. In the News
15. Upcoming ACHSA Meetings
KEY ISSUES- DCFS Pulls Out All the Stops at Board of Supervisors' Meeting on FFA Dual Licensure and Certification Issue, But We're Not Done Yet
When we last left you on this critical child welfare issue, ACHSA had: 1) discussed the issue in depth at an All-FFA meeting; 2) met with DCFS Director Trish Ploehn and DCFS executive management staff to try to reach an agreement on the proposed contract language (which didn't happen); 3) proposed a compromise position accepting the dual licensure/MOU concept requirement, while continuing to strenuously object to the dual certification requirement; 4) received an August 7th letter from DCFS rejecting both ACHSA's position and proposed compromise; 5) sent an August 20th response to the DCFS letter; 6) begun to engage the Board offices to put across ACHSA's position; and 7) begun to collect additional information to help augment the arguments made in the August 20th letter.
ACHSA Receives Copy of DCFS Email from Board Office
Next in the chronology of events was ACHSA's receipt, not directly from DCFS but via information received from one of the Board offices, of a September 2nd email sent by Trish Ploehn to the Board offices attempting to respond to ACHSA's August 20th letter, which had been copied to the Board Children's Deputies. The gist of her email was that "becoming dually licensed and certified serves two main purposes": 1. to ensure that families are "studied and approved at the highest level (the adoption home study assessment and criminal background check are at a higher and more comprehensive level than what is required for a foster family)"; and 2. "to attract families that are willing to provide high quality care for our children and work with us towards timely reunification for the child with their biological family whenever safely possible AND to be willing to offer the child a timely permanent home, if safe reunification is not possible." [Emphasis added.] She also argues, as she had previously, that "this requirement for dual licensure and certification simply reduces the time it takes for the legal process to be completed - fiscally advantageous to the County but, more importantly, emotionally advantageous to the child."
ACHSA's final written reply on this issue, sent on September 11th, went to DCFS, the Board Deputies, and the CEO, both responding to some of the misleading and inaccurate comments made by the DCFS Director in her September 2nd email, and summarizing ACHSA's position on the issue. Not only did ACHSA, on behalf of all of the FFAs of Los Angeles County, reject DCFS arguments in support of mandatory dual certification, it also provided reasons why mandatory dual certification was harmful and bad public policy. Significantly, ACHSA pointed out, based on its research, that contrary to DCFS' assertion, the adoption home study assessment and criminal background check are NOT at a higher level than that required for a foster family. ACHSA had learned from Community Care Licensing that both foster and adoptive parents experience the exact same background checks. In addition, the adoption home study does not determine a higher standard of care, but rather a different standard of care -- to determine the long-term compatibility of the foster youth with his/her prospective adoptive family.
At the same time, ACHSA objected strenuously to the negative impact of the mandatory dual certification requirement. As noted, foster families who are attracted to becoming dually certified already have that option available to them today, and would continue to have that option available in the future without mandatory dual certification. In addition, prospective foster families who do not want to become dually certified, and simply wish to foster youth and assist with reunification or emancipation, would be repelled by mandatory dual certification. Not only that, and its impact on the recruitment of foster parents that are already in short supply, but what kind of message is the Department sending to those prospective foster parents that simply want to foster, and are not "willing [or able] to offer the child a timely permanent home, if safe reunification is not possible"? As reinforced by the DCFS Director at a later meeting with ACHSA, the message is, sadly, loud and clear: "We don't want you!"
ACHSA Meets with DCFS, CEO, and Board Office
But lets' not get ahead of ourselves in the chronology of events. ACHSA's final written reply on this issue was followed by more discussion with several of the Board offices, leading to a meeting at the end of September with DCFS and Deputy CEO Miguel Santana, the head of the Child and Families' Well-Being Cluster of County Departments. At least four of the Board offices were hoping to attend the meeting, but in the end only Wendy Tait from Supervisor Burke's office was able to make it. The meeting itself was cordial enough, with most of it spent having each side articulating its point of view. At the meeting's conclusion, Deputy CEO Santana suggested a follow up meeting to discuss possible resolutions to the disagreement, including a discussion about possible solutions to the cost implications for the FFAs.
ACHSA Proposes Additional Compromise
Prior to this second meeting, ACHSA floated an additional compromise proposal (approved by the ACHSA Board) on top of the prior concession on the dual licensure/MOU issue. In an email to the Department and the CEO, the following additional proposed contract language was presented, to take the place of the mandatory dual certification language:
"Prior to the administration of a home study to a prospective FFA family, the FFA shall have a fair, balanced, and honest discussion with that family regarding consideration of possible adoption should reunification efforts not be successful, and shall administer an adoption home study of that family unless the family expresses an objection."
ACHSA felt strongly that not only was this fair and reasonable in general, but is should fairly meet the County's interest, while at the same time allowing freedom of choice and protecting the child welfare system's ability to maintain its supply of foster families.
Interestingly, going into the second meeting, which was held on the afternoon of the ACHSA Luncheon, ACHSA had obtained support from four of the five Board offices for this compromise language, two of them putting their support in writing. Unfortunately, this mattered little, as after a very short period of time DCFS refused to budge at all, and Deputy CEO Santana noted that we had reached an impasse, despite what we noted as support from four of the Board offices for the compromise language. What was even more disconcerting about the meeting, however, was once again the clear message from the DCFS Director that the Department did not want new foster families brought into the foster care system who were unwilling to consider adoption if reunification efforts failed.
ACHSA Prepares for Board of Supervisors' Meeting
What next? ACHSA worked feverishly to attempt to get Board support to move the Department to agree to the compromise language, and even drafted a Board motion at the request of one of the Deputies that would have "directed County Counsel and the CEO to report back within 30 days as to how the new language being proposed might be integrated into the FFA contract prior to October 31, 2009." And yet, in spite of the prior support that had been received from the four Board offices, all five offices ultimately decided to stand behind the County's Deputy CEO and DCFS Director, and ACHSA could not get any of them to ultimately agree to sponsor the drafted Board motion at the Board of Supervisors' meeting where the FFA contract was to be approved.
Board of Supervisors Hear Limited Testimony on FFA Dual Licensure and Certification Issue
At that October 21st BOS meeting, prior to the Board's decision on the contract, ACHSA's Executive Director, Board President Sil Orlando, and Board Member Craig Woods all testified in support of ACHSA's position, along with a foster parent from both agencies. [Please click here for a copy of ACHSA's Board of Supervisors' testimony.] It was clear that the Board, missing Supervisor Knabe, was in no mood to buck their Director publicly on this issue, and severely limited the testimony from ACHSA's presenters after DCFS had brought in a number of adoptive families, as well as Judge Michael Nash, to testify in support of its position. Accordingly, after really no debate, the Board unanimously approved the FFA contract.
While certainly extremely disappointed after the Board of Supervisors' meeting, ACHSA's Executive Director and President both strongly agree that this issue is far too important, with far too many implications for foster youth and the future of the foster care system, to simply go away now. Accordingly, in the immortal words of Revolutionary War hero John Paul Jones, "We have only just begun to fight."
If you have any questions or need additional information, please contact Bruce.
- Time to Tighten the Ol’ Money Belt Again! DMH Budget Mitigation Work Group Meets
DMH has established a budget mitigation work group, comprised of different stakeholders, in response to State and County budgetary impacts that have occurred in three different “waves.” According to DMH, the first wave of impacts occurred prior to the Department's submission of its proposed budget for FY 2008-09, where the Department absorbed internally $27 million in budget curtailments to cover increases in medication costs, COLAs and employee benefits, along with other miscellaneous cost increases and a $1.6 million managed care decrease from the State. The second wave of budget impacts, from the beginning of FY 2008-09, consists of: $7 million for decreased State Vehicle License Fee (VLF)/Sales Tax funds; $4 million for COLAs for DMH physicians and nurses; $2.1 million for FFS hospital rate increases; and $2.5 million for DMH unavoidable costs. The third wave of budget impacts is attributed to the adoption of the State budget and accompanying legislation. These impacts include: $2.2 million for increased managed care costs; $6.3 million for the elimination of the State’s share of ancillary services for IMD clients; $5.2 million for increased State hospital bed costs (assuming L. A. County maintains 220 beds); and the elimination of MIOCR programs.
Prior to any discussion on curtailments or transformation, DMH Acting Chief Deputy Robin Kay wanted the budget mitigation work group to agree on a set of principles. The work group adopted the following seven principles, five of which were the same as those used in last year’s budget curtailment process:
1. Proportional Share: A value endorsed throughout our recent stakeholder process is the importance of maintaining a balanced system, including DMH directly operated and contracted programs. DMH administrative and non-clinic based services are not exempt. However,
· Costs incurred by directly operated programs will be absorbed solely by DMH (e.g., Cost of Living Adjustments for clinic staff), and
· Decrease in programs supported through County General Funds (CGF) should be apportioned according to the proportion of dollars in each part of the system of care.
Historically, the burden of the County's cost of living adjustment (COLA) increases were shouldered by both DMH and contract providers. This was not the case in last year’s budget curtailment process and ACHSA plans to continue advocating for equity between directly operated and contract providers in this year’s budget mitigation process. In addition, it should be noted that at ACHSA's request, the following sentence was removed, as it was felt that it was premature to agree to contract agency curtailments: "…Reductions must be made across the entire system, including DMH directly operated and contracted programs."
2. Cost Sharing: Certain cost increases incurred by DMH in its role as the Mental Health Plan and as fiscal intermediary for contractors should be apportioned equitably throughout the system.
While ACHSA did not debate this theory in principle, it reserved the right to revisit this during the implementation phase. During the discussion, DMH argued that unavoidable costs such as the addition of County Counsel staff to review MHSA contracts for legal entities should not be shouldered entirely by the Department. ACHSA pointed out that County Counsel’s time for MHSA contracts should be absorbed as part of the Department’s MHSA administrative costs. Another potential cost sharing example provided by Administrative Deputy Lyn Wallensak was the increased Auditor Controller Office’s administrative costs for processing checks.