Continuum of Care Committee Meeting Notes -12/13/13

10:00am - 12:00 pm

  • Reviewed the minutes from the last meeting and approved them.
  • Judy and Ray provided a review of the last meeting from the Rule Revision work group. Talked about a potential "pre" ICG grant for those youth in crisis, depending full ICG determination. These would be for youth potentially involved in JJ or inpatient hospitalization and are in need of immediate placement (have mental health needs, i.e. lockouts). Dr. Mehlinger reported that DCFS will be providing DMH with information regarding lockouts (DCFS Dependency). Jaime Jermaine reported the information was provided to Dr. Ferguson the beginning of this week. The data regarding psychiatric lockouts may be presented by DMH in the future. Also identified that most of the time from the last meeting was spent reviewing "Eligibility Criteria", specifically education requirements. The Rule Revision is waiting to hear from this group regarding recommendations for different access points and pre ICG possibilities.
  • Continuum of Care Committee is in agreement to use the System of Care and wrap around concepts. The group decided they wanted the process to be driven by a Child and Family Team and would like the continuity to be across all areas included in a youth's life. Residential stays will be shorter. Judy put together a resource, based on Dr. Mehlinger's information that includes such things as Respite, Crisis Placement. Need to talk about Respite, Acute Crisis Rehab, Intensive Home-Based Respite. Reviewed CBHII's Service Descriptors - wrap approach (care coordination). The goal is to get the community involved in the Child and Family Team- over half of being from community. The CBHII looks at 12 domains affected by youth's life and identifies needs and strengths. The goal is to get family more reliant on natural supports. Parent and youth peer services, parent support and training, intensive home-based services are some of the services identified in the CBHII that were not in the committee's other resource. Parent support and training in this instance is related to an intensive one on one.
  • Discussed the difference between ICG services and Medicaid services. Right now all services have to be focused on the identified client. Some of these services would need to be added to the ICG service package that is currently not available. Mobile crisis response, crisis stabilization - ongoing stabilization beyond making a recommendation whether to hospitalize or not. Providing de-escalation services and supports. Families seem to want respite, which is not a Medicaid billable service. Would need to be paid via ICG or be part of a Medicaid waiver. Discussed whether we want ICG to be last resort and be available when families have exhausted all other resources. Do we change process to get youth in to ICG at an earlier point and put a system of care in place for them to help stabilize them earlier. What training would be necessary to coordinate care for youth that have an ICG.
  • Discussed purpose of ICG versus a mental health system of care. ICG is for those with a severe mental illness. Can't only look at youth's needs but need to look at family strengths and needs as well. Look at how do we identify the youth who are on trajectory to be eligible, via a screening tool. These services are for the most acute. Missouri used a screening tool to determine whether youth would be eligible for residential. Need to keep focus on the youth who have the most needs and are on the path to residential - alternative to residential, discharge from residential. Need to review what other states are using to determine needs/ screening tool scores. Potential homework assignment.
  • What is the appropriate entry point? How do we determine the appropriate level of care? These are some of the questions that need to be addressed.
  • The group determined that Care coordination should be offered throughout the ICG process.
  • The group agreed that the recommendation, for this committee's next steps include 1) identifying the levels, 2) the needs within each level, and 3) funding for the services within each level. Additionally, the group recommended identifying the service array, who is qualified to provide each service, the definition of each service and, again, financing.
  • Dr. Mehlinger reminded the committee about the number of youth that are currently receiving ICG compared to the overall population of youth in Illinois. The ICG is a small population within the overall state - highest ever was approx. 700 out of 4 million kids in Illinois.
  • Recommendations, Next Steps and Considerations were determined at the end of the meeting.
    • Judy and Mark volunteered to work on the transitioning youth
    • Develop teams that ensure safety within the community setting
    • What is the criteria for entry in to an ICG (Rule Revision group)?
    • What is the menu of services in the community that an ICG youth would get
    • What are the needs of the family while youth is in residential ( parents, caregivers, siblings)?
    • Remember the Systems of Care principles
    • Review the 5 year strategic plan and the system of care plan on DHS website
    • What is the array of services within residential - respite, transitional age services, transitioning home?
    • Community Services/Supports
    • Out-of-Home Services/Supports
    • Potential outreach/training recommendations
    • Ongoing discussion of transitions to adulthood
    • Opportunities for employment
    • Individual supports
    • At next meeting the group will divide in to two sub-groups - 1) Out-of-Home Placement and 2) Community Placement.

Next Meeting is scheduled for Friday, January 10, 2014 at 4200 N. Oak Park Ave., Annex. Members wishing to attend a specific group should notify the group in response to this email to ensure that both groups have adequate representation. Please feel free to be part of both groups.

12:00 - 2:00 - Out-of-Home Placement Group

2:00 - 4:00 - Community Placement Group