New Service Planning and Design
The Tiered Care Coordination (TCC) and NC High Fidelity Wraparound Training Program originated in July 2017 in response to concerns about a lack of coordination across child-serving systems which resulted in an insufficient assessment of behavioral health needs, slow delivery of services, and an impenetrable public behavioral health system.
The TCC approach connects two at-risk populations to behavioral health services: youth and families involved in Child Welfare and Juvenile Justice. Both populations have high rates of exposure to trauma and complex behavioral health needs. Assessing, treating, and coordinating their behavioral health and life domain needs can assist social services in maintaining or reunifying youth with their families and can assist juvenile justice in keeping youth from moving deeper into the justice system.
The TCC approach focuses on youth ages 6-21 years of age across judicial districts and in Years 1 and 2, this consisted of Durham and District 27. Currently, moving into Year 6 (i.e., FY 2023), there are now 16 active High Fidelity Wraparound teams across North Carolina as of March 15, 2022, with a goal of expanding to 30 teams by the end of Year 6 (Fiscal Year 2023).
Tiers
Tier 1: Local Management Entity-Managed Care Organization (LME-MCO) Liaisons and Family Navigator co-located at juvenile justice and child welfare offices and this provides access to these positions for youth in outpatient services. This also includes access to an assessor.
Tier 2: Addressing youth with moderate service level needs. This includes access to the Family Navigator and Liaisons. These are also youth in outpatient with low or moderate level needs as well as youth who are in enhanced services with case management built in. This Tier also includes an assessor.
Tier 3: Intensive Care Coordination (High Fidelity Wraparound; HFW) with evidence-based family/youth peer support for youth exiting out-of-home placements as well as those who are at risk for out-of-home placement. This Tier is the primary focus for the pilot and the ROI evaluation.
Components for Success
Additional critical components for success of the TCC/HFW approach are:
1) access to trauma-informed comprehensive clinical assessments;
2) tracking outcomes;
3) connecting youth with dual developmental disabilities and mental health concerns to specialized consultations; and
4) utilizing existing local and state cross-system partnerships to maximize resources and service access to achieve positive outcomes for pilot participants.
Additional information is available at https://nchfwtp.uncg.edu/
Project AWARE (Advancing Wellness & Resiliency in Education) supports collaboration between the Department of Public Instruction (DPI) and NCDHHS. DCFW employs a full-time Project Co-Director to work in partnership with a Project Co-Director at DPI. It provides a new opportunity to address systemic challenges to promote student mental health and wellness and prevent/mediate behavioral health risks. Project Aware requires the selected counties (Beaufort, Cleveland, and Rockingham) to develop services and strategies for connecting youth and families to mental health services.
Project AWARE offers an opportunity to test innovations in these areas, learn how to scale them across the state, and prepare for the changes and opportunities to come within the Standard, Tailored, and Specialty Plans.
The goal of the Standardized Assessment Program is to ensure that every youth, 4 years old and older who enters foster care, receives a standardized, trauma and evidence-informed screening and assessment to ensure an appropriate diagnosis leading to proper service provisions with the goal of improving child and family outcomes.
Through standardized screening and assessment, more children will receive the appropriate services at the appropriate time while decreasing the utilization of high-level services, lowering the overall cost to the Medicaid system, and minimizing the traumatic impact on the child resulting from multiple failed or inappropriate placements.
For additional information, visit: https://www.benchmarksnc.org/center-for-quality/partnering-for-excellence/.