MEETING MINUTES OF THE CHILDREN AND YOUTH COMMITTEE

ACTION/BUSINESS MEETING

June 1, 2017 at 12:30 pm to 3:30 pm

DHS, 1 West Wilson Street, Madison, Wisconsin 53707

Members of the Children Youth Committee (CYC) in Attendance: Barb Buffington, Kathryn Bush, Joanne Juhnke, Bonnie MacRitchie, Kim Eithun-Harshner, Carrie Finkbiner, Teresa Steinmetz, Rick Immler

Members of CYC in attendance by phone: Phyllis Greenberger, Kimberlee Coronado, Peggy Helm-Quest

Department of Health Services Staff/Other state staff in Attendance: Karen Bittner, Tim Connor, Chris Keenan, Ryan Stachoviak

Members of the Public in Attendance: Inshirah Farhoud

Item 1: Call to Order

·  Members were welcomed and everyone introduced themselves. Joanne summarized the meeting guidelines.

·  Kim Eithun made a motion to approve the May minutes and Bonnie seconded. The minutes were reviewed with no corrections.

Minutes were approved. All agree. No one opposed. Barb and Carrie abstained.

·  The next meeting is scheduled for July 6th and will be located at DHS, conference room 850A.

·  Announcements

o  none

·  No public comment.

Item 2: Needs Assessment Review

Tim Connor and Chris Keenan from the Division of Care and Treatment Services (DCTS) presented a background and summary of the Needs Assessment (NA).

Background

Tim noted that the NA addresses the Mental Health Block Grant (MHBG) application, which is done every 2 years. There is roughly $34 million for MHBG and the Substance Abuse Block Grant combined. The NA is used to determine where the money should go. Most of the information is from the year 2015 as 2016 data is not fully available. There are 5 domains that the NA addresses. They include:

1.  Mental Health Prevalence

2.  Access to Services

3.  Service Workforce and Capacity

4.  Quality and Appropriateness of Services

5.  Consumer Outcomes

Much of the information is from counties but DCTS does try to provide information from the private sector as well. In addition to the statewide picture, this year there will also be a second product, including county specific profiles. There will be 2-3 pages per county. This information might not be submitted as part of the formal block grant application but it is part of the process. It will be sent to CYC for review. It was also noted that stakeholder input was also included as part of the NA.

Summary

It was suggested that for the next NA, that information be added about suicide attempts that required medical attention and to use Centers for Disease Control and Prevention data.

Mental Health Prevalence

National trends show that young adults in the 18-25 age range have an increasing rate of mental illness relative to other age groups. Females and the unemployed are high, as are Native Americans and multi-racial individuals. The suicide rate in Wisconsin has traditionally been higher than the national average. Kathryn stated New Jersey is the state with the lowest suicide rate and has the highest access-to-services level. It was also noted that Minnesota also has a high youth suicide rate. Sexual minorities are more likely to attempt suicide and young adults have a higher prevalence of co-occurring diagnoses.

On Figure 6 in the NA, it was also suggested to include youth corrections data as a special population. Teresa will share data gathered for the policy academy grant. Another suggestion was to state specifically whether the information was extrapolated and to put the sources on the bottom of the graph/chart page. Prevalence rates for major depressive episode for Wisconsin youth ages 12-17 is in the top 20% among all states. In addition, Wisconsin’s rate of young adults ages 18-25 with any mental illness is slightly higher than average relative to other states, and ranks in the top 20-40% of all states.

Tim noted that just last week, DCTS obtained information and data from the Department of Public Instruction, including outcome data, attendance, and suspensions. DCTS did not receive school service data.

Access to Services

It was noted that 63% of youth use Medicaid while only 40% use commercial insurance. The overall youth treatment gap is 34%, or 67,836 youth annually. Information for those people being served by a primary care doctor is captured in the NA.

Service Workforce and Capacity

Members appreciated the NA section on Trauma Informed Care but suggested that the Department of Children and Families Trauma-Focused Cognitive Behavior Therapy program data be included. Currently, information included is what Scott Webb gathered when he was working in DCTS.

It was noted that 41% of Coordinated Services Teams (CST) experienced turnover. CST is used as an example of turnover and on page 50 of the NA, it shows the impact of this turnover. Many CSTs have only a single staff member, sometimes less than full-time, and continuity is very hard when turnover in these counties or tribes occurs. Block grant funding provides $1.8 million for CST.

Quality and Appropriateness of Services

Relative to the number of program participants in Comprehensive Community Services and Community Support Programs, few receive Evidence Based Practices. EBPs are underutilized.

Consumer Outcomes

This domain looks at adult consumer satisfaction and for youth, it is the parent/caregiver completing the survey rather than the youth themselves. Youth caregivers have been more satisfied with cultural sensitivity of service providers, participation in services, and their own social connectedness. Younger adults less satisfied. It was noted that it would be helpful to have this information compared to other states.

Tim and Chris stated that the outcomes section will include more information with the final version of the NA being completed later in June.

Item 3: Block Grant Motion: Enhanced Funding for Training

Rick provided a quick summary of the proposed motion that he presented at the May meeting but the group had to table for a future meeting. The motion was regarding returning the Federal Mental health Block Grant training dollars to $182,000 each fiscal year. In 1997, the language was reversed so the department may not spend more than $182,000 for training. The motion would return language to may not spend less than $182,000. This will provide greater flexibility with training.

It was noted that in the past 7 years or so, the variation in block grant funding was $6-8 million and that currently the federal government is looking to cut block grant funds. There was also a discussion about whether or not this is a children and youth issue. Kathryn believes that it does affect children especially in regards to EBPs. As there is an increase in EBP trainings, it could increase services due to lack of mental health providers.

Rick amended his original motion and now moves that Wisconsin statute be updated regarding the Mental Health Treatment Provider Training appropriation defined under s. 20.435 (5) (md) from the Federal Mental Health Block Grant, such that the Department shall distribute $182,000 in each fiscal year to provide training for mental health treatment professionals.

Members agree to update the motion.
Vote: 5 members agree. Joanne opposed. Phyllis, Bonnie, Kim, Teresa, and Peggy abstain. The motion carries.

Item 4: Mental Health Council Update

Rick provided the Council update. The Council reviewed and discussed the Needs Assessment. There was an election of officers, which is effective July 1st. Mishelle O’Shasky will be the Chair, with Julie-Anne Braun as Vice-Chair, and Karen Iverson Riggers as the 2nd Vice-Chair. The Council reviewed and approved a motion to accept the updated Charter Guiding Principles.

The Council reviewed motions approved by CYC. The Council supported the CYC’s motion to oppose the CHOICE Act. The Council approved the Mental Health Gaps Analysis motion with friendly amendments. The Council also approved to Support Technical Assistance to Counties from Counties, again with friendly amendments. There was also a Medicaid waiver motion in support of concerns that passed.

DCTS provided updates during the Council meeting. For Comprehensive Community Services, there are 2 tribes providing services and all but 8 counties have CCS. The State Targeted Response to Opioid grant for $7.6 million was received.

Barb volunteered to provide the August Council update.

Item 5: Policy Updates, including School Mental Health (LRB 0063/1)

Joanne provided a Joint Finance Committee (JFC) update. The Youth Crisis Stabilization funds were approved with an amendment requiring DHS to present the plan to JFC. JFC approved to increase funding for the Children’s Long-Term Support Waiver Program in order to serve those children currently on the waiting list. This committee also approved the Governor’s recommendation to increase funding to the Child Psychiatry Consultation Program by $500,000 annually. The committee approved that DHS provide reimbursement for clinical consultations under the medical assistance program, subject to federal approval. Kathryn stated that school personnel would not be recipients of consultation funding.

In a previous meeting, CYC weighed in on AB87 and AB90, bills regarding the serious juvenile offender. CYC opposed these 2 bills. Joanne stated that both bills have been passed out of committee in both the Senate and Assembly and will be scheduled for full legislative vote.

Item 6: Office of Children’s Mental Health Update

Kim Eithun-Harshner stated that Elizabeth Hudson, Director of the Office of Children’s Mental Health went to Washington DC to visit with heads of various departments to talk about Fostering Futures and Trauma Informed Care (TIC), along with First Lady Walker. Joann Stephens, the Family Relations Coordinator, has been doing TIC trainings for Fostering Futures. Kim also stated that the Collective Impact Parent Partners do trainings every other month. They have not yet decided on the topics for their September and November meetings and Kim asked the group for ideas. Suggestions included Sue McKenzie who can discuss stigma reduction and Honest Open Proud (HOP) that focus’ on helping parents to tell their story rather than their child’s story.

Item 7: Children Youth and Families Section Update

Teresa noted that there are 2 new hires in the section. Kaitlin Tolliver was hired for Project YES! and Jason Cram is the new Adolescent Treatment Coordinator.

Wisconsin received the Youth Treatment Initiative Grant which will begin on September 30th of this year. This is a 4 year grant focused on improving evidence based practices for adolescents with substance use and/or co-occurring needs. A Request For Proposal process will be conducted to choose 4 sites to be trained in Multi-Dimensional Family Therapy (MDFT) and serve youth in their area with this approach. In year 2 of the grant, there will be a train the trainer. The grant amount is $760,000 per year.

There will be a conference in early September, the date yet to be determined, that will focus on best practice and work with young adults, aged 16-25 years, with behavioral health challenges, as part of the Project YES! carryover money. The project is working on planting seeds of Evidence Based Practices in how to work with young adults. Teresa also noted that they are supporting Hopeline with some of the carry over funds as well.

The September Coordinated Services Teams (CST) Statewide Meeting will be combined with Comprehensive Community Services (CCS) children’s providers in an effort to move the system towards the vision of a seamless, collaborative system of care (SOC) for children with the first step of infusing wraparound into the CCS benefit for children. This is continued work to develop Wisconsin’s system of care which is overseen by the Children Come First Advisory Board. There is a focus on SOC development and laying the ground work for best practice with children and families for CST and CCS providers. The June CST Regional meetings are focused on youth engagement and supportive relationships.

Item 8: Summary of Action Items + July 6th meeting Agenda

Joanne will forward the approved motion to the Council.

Carrie, Phil, and Peggy will take the lead for the July action meeting working on workforce development for strategic planning.

Teresa will share data from the policy academy grant.


This was Kathryn’s last meeting with CYC, due to her retirement. The committee thanked her for her service.

Item 9: Adjourn

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