City of Alexandria, Virginia
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MEMORANDUM
DATE: SEPTEMBER 4, 2013
TO: THE HONORABLE MAYOR AND MEMBERS OF CITY COUNCIL
FROM: RASHAD M. YOUNG, CITY MANAGER /s/
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Consideration of a Grant Application to the Virginia Department of Behavioral Health and Developmental Services to Expand the Department of Community and Human Services System of Care Funding.
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ISSUE: Consideration of a three year grant application to the Virginia Department of Behavioral Health and Developmental Services (DBHDS) to expand the Department Of Community and Human Services (DCHS) system of care services in support of keeping youth ages 5 - 21 with serious behavioral health problems in the community.
RECOMMENDATION: That City Council:
(1) Authorize the submission of the three-year grant application to BDHDS for funding in the amount of $305,771 per year;
(2) Approve a 3.5 FTE increase fully supported by grant revenues, to include:
· A 1.0 FTE Caseworker to provide peer parent partner services as part of the intensive care coordination process,
· Three 0.5 FTE Direct Support Technicians to provide intensive in-home parent coaching services, and
· A 1.0 FTE Health and Community Education Specialist to coordinate a local chapter of Youth MOVE (Motivating Others through Voices of Experience) for youth with experience in the mental health, child welfare and juvenile justice systems, and to provide peer youth partner services as part of the intensive care coordination process.
These grant-funded positions will terminate upon the expiration of the grant. The individuals who fill these positions will be notified of this condition of employment at the time they are hired and will be required to sign an agreement of understanding with regard to this condition. There are no funds available in the City budget to continue these activities once the grant funds expire.
BACKGROUND: In October of 2012, DBHDS in partnership with other children's services stakeholders was awarded a System of Care Expansion Implementation Cooperative Agreement through the Substance Abuse and Mental Health Services Administration (SAMHSA). A provision of the four year federal grant is the establishment of a Wraparound Center of Excellence at the Office of Comprehensive Services that oversees the development of a public-private provider network statewide that requires High Fidelity Wraparound (HFW) intensive care coordination through a System of Care Framework. HFW is an ecologically based process that brings parents, youth, family allies and service providers together to mobilize resources and talents to successfully support families with children with serious mental health challenges.
Another of the provisions of the DBHDS System of Care Expansion SAMHSA grant is to provide mini grants to local government providers to develop community based services that support intensive care coordination and the wraparound philosophy at the individual service planning level, and Systems of Care values and principles at the larger community level system. Applications for the mini grant must be submitted to DBHDS with approval from local Community Policy and Management Teams and include a description of how family partners will be incorporated into intensive care coordination services.
DCHS Center for Children and Families developed the application in consultation with parents, youth, and representatives from the Court Services Unit, Alexandria City Public Schools, Health Department, SCAN, and DCHS divisions of Child Welfare, JobLink and Children's Behavioral Health. The Alexandria Community Policy and Management Team (ACPMT) approved the application. The application was submitted to the City Manager's Office for consideration on August 27, 2013. The application was submitted to DBHDS on September 5, 2013, pending City Council approval. The grant award will be announced by November 1, 2013.
DISCUSSION: Advances in Alexandria's system of care significantly reduced the number of children publicly funded (through the Comprehensive Services Act) for placement in congregate care facilities over the past five years. Nonetheless, in FY 13 we had 54 youth through age 21 who were hospitalized, 97 students in special education whose eligibility is emotional disability, 141 Children in Need of Supervision (CHINS, youth with truancy and/or serious behavior issues at home) within Court Services, 143 young people detained at Northern Virginia Juvenile Detention Center. If awarded, this grant will allow us to fill gaps and reach more at-risk youth more efficiently and effectively.
The proposal includes the following three components that will expand our system of care:
1. As a means to strengthen Intensive Care Coordination services, DCHS will offer High Fidelity Wraparound (HFW) with Peer Parent and Youth Partners. DCHS child behavioral health staff is currently being trained through OCS in HFW. This funding will allow us to provide the Peer Parent and/or Peer Youth Support component that is required for fidelity.
2. Funded staff will develop a local chapter of Youth MOVE, a diverse collective that unites the voices and causes of youth with experience in the mental health, child welfare and juvenile justice systems while raising awareness around youth issues. "Youth Guided" is one of the five core System of Care values, as defined by SAMHSA, and Alexandria is weak in this area. Nationally, successful systems are those that have active Youth MOVE chapters.
3. A community-based peer Parent Coaching service will be launched. A recent informal needs assessment that included representatives from multiple sectors, including parents, emphasized the need for in-home intensive individualized parenting support as a necessary component to keeping kids in the community. Currently there is nothing in our system that provides this type of service.
Target population is youth ages 5 - 21 with serious behavioral health problems involved in at least one system. When the program is at full capacity we will serve 100 children annually with the High Fidelity Wraparound process, 42 parents with Parent Coaching and 30 youth with Youth MOVE. There may be duplication among the services, Parent Coaching may impact more than one child, and Youth MOVE will have a broader reach beyond core members.
Managers within the DCHS Division of Child Behavioral Health and Youth Development will administer the project with an eye toward sustainability. ACT for Alexandria has agreed to provide consultation in this area. A possible goal for Youth MOVE is to create the structure for it to become an independent organization. CSA will fund HFW, Parent Partner, Youth Partner and Parent Coaching services. While HFW and peer support services are not currently covered through Virginia Medicaid, this could change. The Centers for Medicare and Medicaid Services, along with the SAMHSA, issued a Medicaid bulletin to states which highlights the critical importance of wraparound and parent and youth peer support services, along with financing strategies.
This grant application is consistent with both the City Council Strategic Plan (Goal Four) and the ACPS School Board Strategic Plan (Objectives One and Three), that focus on enhancing the well-being, success and achievement of children, youth and families in Alexandria.
FISCAL IMPACT: The federal fiscal year 2014 budget for this grant is $305,771. The funding consists of the following: City Personnel ($205,587) and City Non-Personnel ($100,184). The grant period is November 1, 2013 to October 31, 2016, with no required matching funds.
The City is responsible for the normal administrative costs associated with this grant. These costs include financial and reporting oversight provided by DCHS, the administering agency. Existing administrative staffing will provide these functions.
It should be noted that there are no monies available in the City budget to continue these activities once the grant funds are expended. The grant-funded positions will terminate upon the expiration of the grant and the individuals who fill the positions will be notified of this condition of employment.
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