“Wraparound Orange”- Addressing the Children’s Mental Health System of Care December 1, 2009

““Wraparound Orange”-Wraparound Orange”-Addressing the Addressing the Children’s Mental Children’s Mental Health System of CareHealth System of CareDecember 1, 2009 December 1, 2009

Presentation OutlinePresentation Outline

• SAMHSA Grant

• Existing System

• New System -"WrapAround Orange"

• Finance Model

• Timeline

• Action Requested

Presentation OutlinePresentation Outline

• SAMHSA Grant

• Existing System

• New System -"WrapAround Orange"

• Finance Model

• Timeline

• Action Requested

SAMHSA Grant SAMHSA Grant

• Federal Grant awarded to Orange County through Health and Human Services, Substance Abuse Mental Health Services Administration (SAMHSA)

• $9M – 6 Years

• Funds the implementation of a new Children’s Mental Health services model in Orange County

• Other counties and states have been awarded similar grants

• Requires community match

• Requires hiring additional staff

Presentation OutlinePresentation Outline

• SAMHSA Grant

• Existing System

• New System -"WrapAround Orange"

• Finance Model

• Timeline

• Action Requested

Existing SystemExisting System

• Fragmented - difficult to navigate for families

• Lack of collaboration - Silo mentality

• Lack of coordination and integration

• Lack of flexibility- agencies have to “chase” the funding

• Children have to “fit” the system rather than the system fitting the child

• Florida has many different funding streams for children’s mental health

• Florida ranks 48th in the nation in mental health funding

Existing SystemExisting System

Emergency Rooms

Emergency Rooms

Foster Care/DependencyFoster Care/Dependency

SA/MHSA/MH

Juvenile Justice

JAC

Juvenile Justice

JAC

Public

Schools

Primary Care Clinics –

PCAN

Primary Care Clinics –

PCAN

ChildMental Health

Substance Abuse

Juvenile Justice

Existing SystemExisting System

• Over 6,500 children in DCF care with a diagnosis of a serious mental health issue

• Lakeside Behavioral Healthcare provides 8,300 medication clinic appointments to children with mental health issues in Central Florida

• The national juvenile justice task force indicates 75% of incarcerated juveniles have a mental health disorder.

• In Orange County last year there were over 4,000 youth in juvenile justice care.

Existing SystemExisting System

• The OC Juvenile Justice Task force recommended establishing a collaboration between all entities serving children.

• Marked improvement/outcomes in integrated/ coordinated services

– improved school attendance and performance

– reduced law enforcement contacts

– and reduction in behavioral and emotional symptoms

Existing System Existing System

• Our data shows that 38% of adult mental health consumers brought to the CRC were involved in the Juvenile Justice System

• Prevention and early intervention diverts from deep end services

• Collaborative models and positive partnering foster significant positive outcomes with monetary savings and capacity building

Presentation OutlinePresentation Outline

• SAMHSA Grant

• Existing System

• New System -"WrapAround Orange"

• Finance Model

• Timeline

• Action Requested

““WrapAround Orange”WrapAround Orange”““WrapAround Orange”WrapAround Orange”

• SAMHSA Grant $9M over a 6 year period to develop a system of care

• A “Central Receiving Center” system of care for children with mental health issues

• Central point of access (one stop shop) for integrated assessments

• Streamlined/seamless system of care

• Ends duplication and fragmentation

““WrapAround Orange”WrapAround Orange”““WrapAround Orange”WrapAround Orange”

• Offers a “Continuity of Care”

• Focuses on Prevention and Early Intervention

• Shifts costs from deep-end services

• Provides access to appropriate services based on proper assessments

• Centralizes data collection

• Leverages all funding – state, local, private, philanthropic, etc.

““WrapAround Orange”WrapAround Orange”““WrapAround Orange”WrapAround Orange”

• Comprehensive and Coordinated System of Care

• Cultural and Linguistic Competence

• Child Focused and Family Driven

• Based on Evidence-Based Practice (Georgia, Oregon, Milwaukee)

• Community Funding for Project

“Wraparound Orange” Governance Model“Wraparound Orange” Governance Model

PolicyPolicyFinance & SustainabilityFinance &

SustainabilityEvaluation Outcomes

Evaluation Outcomes

CulturalCompetency

CulturalCompetency

Clinical ServicesClinical Services

Family & ConsumerFamily & Consumer

Implementation TeamImplementation Team

Management TeamOrange County Staff, Provider/Child Serving Agency Leadership

Management TeamOrange County Staff, Provider/Child Serving Agency Leadership

Steering Committee or Governing BoardElected officials, Community Leaders

Steering Committee or Governing BoardElected officials, Community Leaders

“WrapAround Orange”“WrapAround Orange”

• Department of Children and Families• Department of Juvenile Justice• Family Services Metro Orlando• Florida Hospital and Orlando Health• Heart of Florida United Way• Orange County Public Schools• University of Central Florida• Various Child Serving Providers:

(CHS, Lakeside, Devereux, UBC etc.)

Possible Partnerships:

“WrapAround Orange”“WrapAround Orange”

Service Intensity Matches Needs

Natural Supports

Community Based

Early PreventionIntervention

Individualized Services

Team Based

Culturally Competent

Presentation OutlinePresentation Outline

• SAMHSA Grant

• Existing System

• New System -"WrapAround Orange"

• Finance Model

• Timeline

• Action Requested

Finance Model - ExistingFinance Model - Existing

• $700,000 Orange County GR in Children’s Services

• $1.19 M DCF children’s mental health funding - Crisis Beds in Lakeside Behavioral Healthcare

• $2.6M DCF funding for children’s substance abuse at the Center for Drug Free Living

• $500,000 for mental health programs Juvenile Justice funding – (part of the $8M in predisposition costs to DJJ)

Finance Model - FutureFinance Model - Future

• In-Kind contributions

• Partner match

• Systemic shifts of money to mental health services

• Social Marketing plan

• Corporate Sponsorship

Finance ModelFinance Model

Grant Year Federal

Orange County Match

Community Match

1 (Actual)

$958,664 $336,093 0

2 $1,500,000

$336,093 $163,907

3 $2,000,000

$336,093 $330,574

4 $2,000,000

$336,093 $1,663,907

5 $1,500,000

$336,093 $2,663,907

6 $1,000,000

$336,093 $1,663,907

7 0 $336,093 $1,500,000

Presentation OutlinePresentation Outline

• SAMHSA Grant

• Existing System

• New System -"WrapAround Orange"

• Finance Model

• Timeline

• Action Requested

TimelineTimelineTimelineTimeline

• December ’09 BCC grant approval

• 2010

– Form Management Team and Implementation Team and develop implementation plan

– Select Steering Committee Members

– Review Plan and timelines with Steering Committee

TimelineTimeline

Year One Activities

• Completion of community-wide assessment, strategic plan and logic model

• Development and implementation of cultural and linguistic competence model

• Identify service gaps and barriers

• Recruit and hire project staff

TimelineTimeline

• Orange County staff lead the project – Syd McCallister, Donna Wyche, and Anne Marie Sheffield

• Hire additional positions Year 1 and 2 –

– Business/Finance Advisor

– Lead Family Advocate

– Family Advocates (5)

– Youth Coordinator

– Technical Assistance Coordinator/Program Manager

– Social Marketing- Communications Manager

Presentation OutlinePresentation Outline

• SAMHSA Grant

• Existing System

• New System -"WrapAround Orange"

• Finance Model

• Timeline

• Action Requested

Action RequestedAction Requested

Approval of Substance Abuse Mental Health Services

Administration (SAMHSA) Grant and

Approval to add ten positions to themanning table for grant funded positionsto carry out the provisions of the grant

““Wraparound Orange”-Wraparound Orange”-Addressing the Addressing the Children’s Mental Children’s Mental Health System of CareHealth System of CareDecember 1, 2009 December 1, 2009