Integrated Children’s Services Planning Frequently Asked Questions

July 8, 2005

Question: To whom do we submit requests for technical assistance?
Answer: Requests for technical assistance should be submitted to John Kravas, consultant to the department. His email address is jjk01@epix.net. In his role as consultant John will serve as the single point of contact for technical assistance requests.

Question: What is meant by stakeholder involvement?
Answer: The department is looking for active cross-systems teams to fulfill stakeholder involvement. The majority of stakeholders should be family members or youth. If you are unsure as to how to obtain family/youth involvement, you may request technical assistance related to this area or use other cross-systems partners to bring family members/youth to the table. You may also want to contact local parent organizations in your community as a way to get more families to the table.

Question: If a county has not made any changes to the originally submitted plan, is an update required?
Answer: Yes, the department is interested in receiving updates on county’s activities related to their original submittal of the Integrated Children’s Services Plan.

Question: Will the counties receive approval on last year’s plans?
Answer: The department developed a cross-systems management structure to review the plans. This cross-systems management team at the regional level reviewed your plans and gave feedback, so if you proposed an activity in last year’s plan feel free to proceed unless you heard to the contrary from those regional offices.

Question: We are a Systems of Care County. Can we apply this to our Integrated Children’s Services Plan?
Answer: Yes, you can apply your Systems of Care activities to your Integrated Children’s Services Plan.

Question: Our county has already integrated part of our service structure, such as a centralized intake unit. Can we use this as a priority area?
Answer: Yes, you may choose to monitor or improve on the service structure that is integrated as a priority area.

Question: Could we use Family Group Decision Making as our Integrated Children’s Services Plan?
Answer: You may use FGDM as a way of integrating children’s services provided you bring together all cross-systems partners.

Question: For total expenditures on the budget forms do you want it split out by local, state, and federal dollars?
Answer: Yes, the department would like you to split out the total expenditures by local, state, and federal dollars on the budget forms.

Question: We are an FSSR county. In the past, the funding has been non-competitive. Will the funding now be competitive?
Answer: Yes, justification and overall development of the Integrated Children’s Services Plan will determine who will receive funding.

Question: Who has to write the Integrated Children’s Services Plan?
Answer: The county is expected to write the plan and will need to determine who within the county will actually write the plan. The ICSP document when submitted to the Department is expected to be a cross-system effort.

Question: Who has to sign the Integrated Children’s Services Plan?
Answer: At a minimum the County Commissioner(s) must sign the County’s Integrated Children’s Services Plan. The ideal would be to obtain signatures of all categorical administrators in addition to the County Commissioner(s).

Question: D&A does not track the number of their clients receiving services by children, how do we handle that on budget forms?
Answer: To the extent that final expenditures are not known by the county, the anticipated costs may be estimated if there is any way to estimate the costs.

Question: If a county is not paying for services being provided to children and families by an organization/agency in their community because the organization/agency is funded some other way, should the county still list those services in the Integrated Children’s Plan on the budget forms?
Answer: No. The services that are to be included on the budget forms are those provided for either directly by the county or provided by a contract administered by the county. However, the general rule is that if the county or any of its categoricals are paying for the service in any way with county dollars then list those services according to the instructions beginning on pages 11 and 13.

Question: If counties can barely get a handle on all of the complexities related to integration, how will families be able to do so? In addition, how do we get the parent involvement that is required in the plan and will the state be flexible with counties as we attempt to involve more families?
Answer: The department is committed to ensuring that families are involved in the process of integrating children’s services and recognizes the barriers that make it difficult for getting families involved. As a start, the department has included in the Integrated Children’s Services Plan Guidelines Attachment D: Strategies for Involving Parents in Planning. Counties can request technical assistance from the department to receive additional help with coming up with ways to get families more involved at the local level. However, counties should also begin to connect with local parent organizations and parent groups in their communities as resources to promote more family involvement in their integration efforts.

Question: Does the department expect counties to have a public hearing and public review timeframe as is done with the Needs Based Budget and Plan?
Answer: It is up to the county as to how they involve the public in their integrated planning efforts. If counties have local collaborative boards, advisory boards/committees, and/or task forces then those groups should be an integral part of counties infrastructure and efforts to make systemic changes that result in how services are provided to families from an integrated approach.

Question: Is this the only training that counties are going to get related to integrating planning?
Answer: Counties can request additional training and technical assistance by emailing the state’s lead consultant, John Kravas (jjk01@epix.net).

Question: How is technical assistance going to be adequately provided across systems? For instance, the Department of Health does not seem to be connected with the Department of Public Welfare at the state level. How will that be networked/connected at the state level on the counties behalf?
Answer: The Secretary of the Department of Public Welfare has been and will continue to meet with the Secretary of the Department of Health to find ways for the two state departments to work together to support counties in whatever ways possible as we move towards a more integrated system of providing services to children and their families.

Question: When looking at expenditures for mental health services are those expenditures to include expenditures allocated to HealthChoices and those coming from mental health base dollars?
Answer: For the integrated plan do not include Medicaid HealthChoices or Fee-For-Service expenditures. However, counties should include mental health services provided to children that are funded with its mental health base dollars

Question: On budget form #2, relating to county priority integration areas, should the county include behavioral health or mental retardation expenditures funded by Medicaid?
Answer: If the county identified priority area uses services funded by Medicaid, either behavioral health or mental retardation, it should be included on these forms.

Question: How do counties request categorical mental health and mental retardation dollars for children? There is no place to do this in the mental health or mental retardation plan or in the Integrated Children’s Services Plan.
Answer: For children’s mental health services, a county (at its own option) may provide narrative information on any additional mental health dollars it may need for children’s services. Counties should include requests for MR dollars for children through the county MR planning process. This planning process is person-specific and includes children as well as adults. MR does not have any specific children’s plans; children and adults are included together in the county planning process.

Question: How will the information submitted in the Integrated Children’s Services Plan be used?
Answer: The information will be used to inform the department as it develops its budget for 2006/07. In addition, the plans will be used for:

Question: Who in the county should request an extension on the submission of the plan?
Answer: It is the county’s decision as to who submits their county’s request for extension.

Question: How are the terms "family" and "client" being defined because each system identifies them differently?
Answer: It is up to the county to define these terms to meet its need to best serve children. It is important to realize that in many instances to address the needs of an individual child you need to also consider the needs of the immediate family to assure successful outcomes for the child. (Immediate family defined as any two or more people residing in the same residence and calling themselves a family).

Question: How does the implementation of ACCESS Plus and its impact on the systems factor into all this?
Answer: ACCESS Plus is a physical health care delivery system for Medical Assistance recipients who reside in counties served by the Fee-For-Service program (non-HealthChoices counties). ACCESS Plus only affects physical health care benefits. It is an enhancement to the Fee-for-Service Program and provides continuity of physical health care services for enrolled recipients. Additionally, ACCESS Plus provides a better way to manage physical diseases, such as Asthma, Diabetes, Chronic Obstructive Pulmonary Disease (COPD), Coronary Artery Disease (CAD), and Congestive Heart Failure (CHF). Counties do not provide or pay for physical health care services. These services are provided through the medical community.

Question: Who is to be considered as the "lead agency" in terms of the Integrated Children’s Services Plan since Appendix A of the guidelines asks for an Integrated Children’s Services Plan contact name?
Answer: The decision as to who is the Integrated Children’s Services Plan contact name is a decision that needs to be made by the county.

Question: What about Family Centers that are grant funded and have a county match? Are they to be included? If so, how and on which budget form?
Answer: If a county receives a special grant fund for family centers they should be included on budget form #1 and include both the state grant allocation and any local match funded by county funds. If the family center is funded via a county’s needs based budget it should be included on budget form #1. For budget form #2, the family center budget should only be included if it is part of the county’s priority integration area.

Question: What about "in-kind" match specifically related to early Head Start programs? Do counties include them and if so, where/which forms?
Answer: The county should include these costs, both local county match and state dollars, on budget form #1. For budget form #2, it should only be included if early head start is part of the county’s priority integration area.

Question: What about mental retardation waiver dollars? Do waiver dollars need to be included and broken down into state and federal dollars, if so, where/which forms?
Answer: For budget form #1, the county should include waiver dollars for mental retardation. On budget form #2, waiver dollars for mental retardation should only be included if it is a service within the county’s priority area.

Question: How is Family Services System Reform (FSSR) to be worked into the plan? The only place in the plan guidelines that mentions FSSR is the budget section, so is this the only place that FSSR needs to be discussed?
Answer: Counties may want to discuss FSSR in their priority areas section of their Integrated Children’s Services Plan as well since there needs to be a clear relationship to their request for funding for FSSR and their activity areas as they relate to their integration efforts.

Question: How does "“MA Re-alignment" fit into the ICSP?
Answer: For Integrated Children’s Services Initiatives, formally known as Medicaid Realignment, it can be considered a part of a county's integrated plan to the extent the county is emphasizing the coordination and integration of behavioral health treatment services provided to children in the child welfare/juvenile justice system.

Question: How do counties include county funded services that are not state funded, such as foundations and grant dollars?
Answer: It is at the discretion of the county to include foundation or grant funding that is not provided by state or federal dollars.

Question: On budget form #1 states "Service expenditures for mental health should only be state and local; Medicaid dollars for mental health should NOT be included on this form." Does this apply to mental retardation?
Answer: No, on budget form #1, MR expenditures should include state, local, and Medicaid dollars.

Question: The department’s rules on confidentiality raise a barrier to service integration. How is this being addressed?
Answer: To date, several counties who have integrated their services have addressed the issue of confidentiality. These county examples will be provided for other county consideration. In addition, the department will be sending out written information on how counties can address the issue of confidentiality within the programs funded by the Department of Public Welfare.

Question: Who will be responsible for delivering technical assistance to the counties?
Answer: Technical assistance will be delivered to the counties through a variety of state and local cross-systems resources.

Question: May we obtain a list of the Integrated Children’s Services Plan Advisory Committee members?
Answer: The Integrated Children’s Services Plan Advisory Committee membership list will be posted to the DPW web site which can be found at www.dpw.state.pa.us.

Question: Who will review the Integrated Children’s Services Plans submitted by the counties?
Answer: A subsection of the Integrated Children’s Services Advisory Committee will be used to review all of the counties’ plans submitted to the department.

Question: Has any other state or county integrated their human service systems?
Answer: Yes, to name just a few, Sonoma County, California, Youth and Family Services; Chautauqua County, New York, Coordinated Children’s Services Initiative; Southern Consortium for Children, Lawrence County, Ohio, Integrated Services for Youth; Milwaukee County, Wisconsin, Wraparound Milwaukee.

Question: How do we tap into best practices related to integrated children’s services planning that are occurring in other counties?
Answer: The following web sites are some of the links to resources, including best practices: www.center-school.org, www.diakon-swan.org, and www.pacwcbt.pitt.edu.

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