Katie A. Medi-Cal Manual and Practice Guide Released

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Katie A. Medi-Cal Manual and Practice Guide Released

On Friday, March 1, 2013, the California Departments of Social Services and Health Care Services jointly released two documents relating to Katie A v. Bonta, a federal class action lawsuit intended to improve access to intensive home based mental health services for foster youth and children at risk of out-of-home placement.  The documents, Medi-Cal Manual for Intensive Care Coordination (ICC), Intensive Home Based Servicers (IHBS) & Therapeutic Foster Care (TFC) for Katie A. Subclass Members (Manual) and Core Practice Model Guide (Guide) describe services and the service delivery model that are being made available pursuant to the Katie A. Settlement Agreement .  The Manual and the Guide are intended to improve care coordination by social services and mental health agencies and workers, and help prevent out-of-home placements for children with unmet mental health needs.

Although the title of the Manual includes Therapeutic Foster Care (TFC), that service is not yet available and is not addressed in this version of the Manual.  TFC is expected to become available January 1, 2014.

The Manual describes mental health services called Intensive Care Coordination (ICC) and Intensive Home Based Services (IHBS) that are available to Katie A. class members who (1) have an open child welfare services case, (2) are eligible for Medi-Cal specialty mental health services, and (3) who are:

(a) Currently in or being considered for:

       i. wraparound;

       ii. therapeutic foster care;

       iii. specialized care rate due to behavioral health needs or other intensive EPSDT services, including but not limited to therapeutic behavioral services or crisis stabilization/intervention;

       iv. a group home (RCL 10 or above);

       v. a psychiatric hospital or 24-hour mental health treatment facility (e.g., psychiatric inpatient hospital, community residential treatment facility); or

(b) Has experienced three or more placements within 24 months due to behavioral health needs. (Manual, page 3.)

Children who meet these criteria are considered “subclass members” and will be provided formal Child and Family Teams (Id. at 5-6) and must receive ICC (Id. at 7).  ICC, according to the Manual, “is similar to the activities routinely provided as Targeted Case Management . . .” except that “. . . ICC must be used to facilitate implementation of the cross-system/multi-agency collaborative service approach described in the

[Guide]. . .” (Id.)

Subclass members may also receive IHBS, which are described as “intensive, individualized and strength-based, needs-driven intervention activities. . . .”  IHBS is different from traditional outpatient services in that IHBS “is expected to be of significant intensity to address the intensive mental health needs of the child/youth,…and will be predominantly delivered outside an office setting and in the home, school or community.” (Id. at 12.)

The Guide is intended to describe and facilitate the use of “a common strategic and practical framework that integrates service planning, delivery, coordination and management among all those involved in working with children involved in multiple service systems.”  (Guide, page 1.)  Based on wraparound and System of Care principles, the Guide presents “a set of practices and principles for children/youth served by both the child welfare and the mental health system that promotes a set of values, principles, and practices that is meant to be shared by all who seek to support children/youth and families involved in the child welfare system . . .” (Id. at 7.)

One key matter not addressed by the Manual or the Guide is timing. When will ICC and IHBS, or the Core Practice Model, be available to subclass and class members, respectively?  The answer is not straightforward.

As a practical matter, something much like ICC and IHBS has been available in Los Angeles County for several years pursuant to an earlier settlement in the case. For the rest of the state, services were intended to begin to be available on January 1, 2013, by order of the Federal District Court dated July 17, 2012.  Probably the best indicator that provision of delivery of services is imminent will be the issuance of an All County Letter (ACL) or Information Notice (ACIN) that details the “purpose, goals and timeline for implementation and describes IHBS and ICC services within CPM approach for statewide implementation.” (Katie A. timeline.) The ACL/ACIN is due out no later than March 31, 2013.

Be assured that Hear Me Out will advise its readers the moment we learn that the first county has delivered ICC or IHBS services to an eligible subclass member.  In the meantime, you may want to inquire of your County’s Mental Health Plan when these services will be available for children in your county.

By |2019-04-24T13:32:36-08:00March 6th, 2013|Featured Posts, Katie A., Litigation|0 Comments

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