SMART

SMART - State Management Advisory and Response Team:
Children and Youth: THERAPEUTIC BEHAVIORAL SERVICES FAQS
http://www.dhcs.ca.gov/services/MH/Pages/Child-Youth-FAQ.aspx

Questions Q1-Q8 are for County MHP Staff

Q1. If a Level II county did not reach the 4% benchmark for TBS, will we receive sanctions for not meeting that level of service?
A1. At the present time, there are eight Level II counties that did not reach the 4% benchmark under the Emily Q settlement. DMH/DHCS and contractors will provide technical assistance to these Level II counties to assist them in reaching the 4% benchmark and sanctions are not being considered at this time.

Q2. Are MHPs required to provide Stakeholder and Decision Maker meetings similar to last years’ requirements under the Emily Q Nine Point Plan?
A2. DMH/DHCS and TBS stakeholders have found the Stakeholder and Decision Maker meetings extremely helpful in learning about county specific information; however, these meetings are no longer required under the Emily Q Settlement.

--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Q3. Our county has programs that provide Wraparound services and Mental Health Services Act (MHSA) and we believe they are similar to TBS. Can we still request a TBS Equivalency review?
A3. Yes, DMH/DHCS will continue to provide TBS equivalency reviews until July, 2012. For all DMH/DHCS proposed TBS Activities, please see:

http://www.dhcs.ca.gov/services/mh/Pages/EPSDT.aspx

Q4. What are the qualifications for a TBS provider?
A4. TBS may be provided by a Licensed Practitioner of the Healing Arts (LPHA), or staff that is under the direction of a LPHA to provide TBS. The TBS Clinician is an LPHA and is responsible for the treatment plan establishing goals and is the Medi-Cal provider. The TBS Coach is under the direct supervision of the TBS Clinician and implements the TBS Treatment plan with the approval/supervision of the TBS Clinician.

Q5. Do Small counties or Level I counties need to meet the 4% benchmark for EPSDT clients?
A5. The Level I counties are not under the same requirements to serve TBS class members at 4%. DMH/DHCS would encourage you and your nearby counties to collaborate with other small counties in your immediate vicinity to address this service need. Small counties can contract with TBS providers from other counties, to improve capacity to serve TBS class members.

Q6. Where can the training information and manuals mentioned in be found? Who do we contact to receive these materials and the technical assistance needed to implement the new requirements?
A6. DMH/DHCS worked with the California Institute for Mental Health (CiMH) to develop the training materials mentioned in DMH Information Notice 08-38. The TBS Documentation Manual and the TBS Best Practices Manual are available on the website below. In addition, subscribe to TBS information on the DMH website for up to date details on the training materials as well as all other TBS information.

http://www.dhcs.ca.gov/services/mh/Pages/EPSDT.aspx
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Q7. If a Level II county did not reach the 4% benchmark for TBS, will we receive sanctions for not meeting that level of service?
A7. Senate Bill (SB) 785 required DMH to develop standardized procedures and documents for Foster, KinGAP and Aid to Adoptive Parents (AAP) children placed out-of-county. DMH/DHCS is implementing SB 785 which covers the above EPSDT services and TBS. An authorization document is among the standardized documents that were developed and will be required for all Foster, KinGAP and AAP children in out-of-county placements. DMH Information Notices 08-24 and 09-06 provide additional information on the DMH website at:

http://www.dhcs.ca.gov/services/mh/Pages/MH-InformationNotices.aspx

Q8. Who can provide Specialty Mental Health Services to children receiving TBS?
A8. A provider is defined in the California Code of Regulations (CCR), Title 9, Section 1810.235 as any person or entity who is licensed, certified, or otherwise recognized or authorized under state law governing the healing arts to provide specialty mental health services and who meets the standards for participation in the Medi-Cal program. Provider includes, but is not limited to, licensed mental health professionals, clinics, hospital outpatient departments, certified day treatment facilities, certified residential treatment facilities, skilled nursing facilities, psychiatric health facilities, general acute care hospitals, and acute psychiatric hospitals that are under contract with the MHP.

Questions Q9 and Q10 are for TBS Stakeholders and County MHP staff

Q9. Can TBS be a “stand alone” mental health service or does the client need to have an open mental health case with the MHP?
A9. TBS can never be a “stand alone” mental health service. TBS is considered short term and supplemental to other Specialty Mental Health Services. Specialty Mental Health Services are defined in CCR, Title 9, Section 1810.247 as rehabilitative mental health services, psychiatric inpatient hospital services, targeted case management, psychiatrist services, psychologist services, EPSDT supplemental specialty mental health services, and psychiatric nursing facility services.

Q10. Will the TBS data dashboard be updated on a regular basis?
A10. A key element of the Nine Point Plan is the development of a web-based “data dashboard” that displays the on-going progress of increasing TBS utilization of all 56 MHPs.

DMH/DHCS will update the data dashboard on an annual basis.

The data dashboard is a way to display the MHPs’ ongoing progress towards reaching a goal of 4% of TBS utilization per MHP as set by the Special Master as a part of the Emily Q Exit Plan. View the data dashboard at: TBS Data

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