“Preferred Futures” is the title given to the array of non-Medicaid funded out of home placement settings for children and youth who require alternative placement to meet their safety and well-being needs. The settings include: family resource home, relative provider, emergency family resource home; satellite family resource home, specialized family resource home, therapeutic family resource home, youth residential care I, youth residential care II, emergency shelter, secure care, transitional living program, and community integration program.

Children/youth are placed in one of these settings dependent upon the placement assessment completed by the agency serving the child/youth: Child Welfare Community Based Service Provider, JJA Community Case Management Provider , or SRS.

Q: When will providers comprehensively know the various placement options which are part of the Preferred Futures changes?

A: SRS and JJA are finalizing standards for the Preferred Futures settings which will serve as out of home options for children who do not meet the medical necessity requirements associated with Psychiatric Residential Treatment Facilities (PRTF's). Preferred Futures standards will be mailed electronically to providers on March 27. An informational conference call on these changes is set for March 30. Providers will be asked to submit cost data enabling SRS and JJA to establish rates by early May.

Q: When do you anticipate knowing which facilities/providers will choose to become Youth Residential Care facilities (YRC's) as an alternative to PRTF's?

A: Some providers have likely already made the decision of whether they wish to become a PRTF or alternative placement facility. Having information on the standards and corresponding rates will help them to solidify their decisions. SRS and JJA will compile a comprehensive listing of providers and service offerings as these decisions are made. The listing will be made available to all providers.

Q: When will the new PRTFscreening instrument be available?

A: It is available now and posted on this web page under the PRTF documents.

Q: What screening tools will be used for Preferred Future Placements, such as Youth Residential Care (YRC's) facilities?

A: SRS and JJA recommend Child Welfare Community Based Service (CWCBS) providers and the JJA Community Case Mangers continue using current instruments to determine suitability of placement in non-PRTF types of settings. For YRC placements, a medical necessity screening may be required in certain situations. This will be more fully described in the standards document.

Q: What is the plan for transition to the new Preferred Futures model?

A: Transition planning will begin April 3, 2007. The plan will be flexible and will utilize a phased in approach so youth do not experience service disruption. SRS, JJA, and Health Care Policy (Mental Health and Substance Abuse) staff , along with provider staff, will be working together to develop the transition plan.

Q: How will youth be moved between different types or levels of facilities?

A: The step down plans will be determined for each youth on an individualized basis, dependent upon the youth’s needs.

Q: What Medicaid services are available through the medical card for kids in the Preferred Futures settings?

A: For Medicaid eligible children, Medicaid will be paying for Medicaid reimbursable physical and mental health services, on a fee for service basis, in all of the Preferred Futures settings (non PRTF settings).

Q: Will there be any gaps in service once the screens are known?

A: Once PRTF medical necessity screens have been completed with those children in existing services who will require such screen, the transition team will be better able to determine the level of need for PRTF and non-PRTF beds. Providers will be given information about the level of need for the variety of treatment and placement settings. It is anticipated the providers will, if necessary, make adjustments in the services they plan to deliver based upon the service needs identified.

Q: What alternative beds will be available for Level V and VI kids who do not screen as medically necessary for placement?

A: Once the providers have notified SRS and JJA of the service(s) they plan to deliver, a comprehensive list will be distributed to all providers to make them aware of the services planned to be delivered by all providers. It is anticipated providers may need to make some adjustments, depending upon the planned availability for each of the placement and treatment settings. We do not want to see kids warehoused either in emergency shelters or detention centers. We are confident the provider network will be able to adequately assess and re-assess the demand for the variety of placement and treatment settings, and will provide all of the settings required to meet the needs of the children served in the child welfare system.

Q: What are the expectations for Therapeutic Foster Homes and Professional Resource Homes?

A: Therapeutic Foster Homes and Professional Resource Homes are separate services, delivered by different entities, and do not serve the same population of children and youth. Therapeutic foster homes are sponsored by licensed child placing agencies and serve any child who is assessed by their referring agency as needing this level of placement. Children may remain in this level of service as long as they continue to be assessed as meeting the need for this service. Professional Resource Homes are sponsored by a CMHC which becomes a licensed Child Placing Agency. Professional Resource Homes can only provide placement service to children/youth that are on the SED waiver. The length of service is 21 days per episode, with a maximum of 90 days per calendar year. The goal of this service is to provide intense level of services to the child, birth parents, and resource parents in order to reunite the child to the home as quickly as is possible, while assuring the child’s safety and well-being. At this time, it is not anticipated that all CMHCs will choose to provide this service directly. It is anticipated the majority of CMHCs will plan to subcontract with a local child placing agency to sponsor this level of home.

Q: How will these changes affect existing CWCBS contracts and rates?

A: Additional costs to the CWCBS providers may result from these changes and could result in contract and rate adjustments.

Q: Will contract addenda be required?

A: Yes

Q: How will the alternatives be paid for without Medicaid and for those things the medical card will not cover?

A: The cost of the non-PRTF placement settings will be the responsibility of the child’s referring agency (CWCBS Provider, JJA Community Case Management Agency, SRS).