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Recommendations 7

• R1
  The recommendation is implemented. (Explain how this was accomplished.)
• R2
  The recommendation is not implemented. It will be implemented in the near future. (Present the plan, including the time-line, for implementation).
• R4
  2 from the January 2006 audit included a provision that Wraparound program managers should prepare written procedures regarding eligibility and services offered to children receiving services with Wraparound funding but not assigned to service allocation slots. Eligibility criteria and services for these participants is now included in the Wraparound program plan document since there is no distinction made between the two groups according to representatives of the Department of Human Services. What is still needed for participants, whether revenue generating or not, and their family teams is a documented list of services, or examples of services, and service providers available to families participating in the program. As discussed in the previous section, most services now provided to participants, whether in service allocation slots or not, are provided by the Department of Mental Health and its contractors. While these are undoubtedly very valuable services and should be continued as a key part of the program, one of the tenets of the Wraparound program is that the participants and their family teams should be determining the services that will best meet their needs and help them achieve their goals. The Wraparound program tenets should be codified and communicated to participating families in official written program documents such as the County’s new “Family Guide to Wraparound Care in El Dorado County” and examples should be provided of services that could potentially be made available to make it clear that the participants do not have to rely entirely on services provided by the Department of Mental Health or other County departments only. The document currently describes how family needs should be identified in the Wraparound planning process. What could be more clear is that those services or needs can be addressed by County service providers or others and that the decision about how the services are provided is up to the family teams.
• R5
  Number of psychiatric hospital admissions by Wraparound program participants.
• R6
  Number of participating families reporting satisfaction with program and services received.
• R7
  Measures of performance at school such as attendance. These measures would allow the Interagency Advisory Council to better assess the Wraparound program’s overall effectiveness and to assess whether interventions or program changes are needed in terms of staff training, new procedures or other measures to achieve other outcomes. As noted in the discussion of Recommendations 2.3 and 2.4 in the Status of Recommendations table above, state law calls for counties to assess their Wraparound program participating families’ satisfaction with the program as well as the program’s overall accessibility to its target population. The Department of Human Services (DHS) has recently developed a Wraparound program family satisfaction questionnaire that, starting in November 2006, it has been distributing to participant families upon exiting the program asking them to assess program services and staff. As of the writing of this report, only nine families have exited the program and returned a completed questionnaire so it is too early to draw any conclusions about overall family satisfaction with the program and services provided. DHS staff report that it is not always easy to get family members to respond to the questionnaires and to provide honest answers or criticisms to the County when they are in the middle of receiving services. The Department will need to continue to request families’ responses to these questionnaires Harvey M. Rose Associates, LLC 11
• R14
  Funding is provided for these six slots by the State and County on a formula basis at the same level as would be provided for group home payments for these youth. To the extent the funding provided for these six youths exceeds the actual cost of services provided to them, which so far has always been the case, the remaining funds are used to provide services to other youth at risk of group home placement but whose risk is determined by the County to be not as imminent as those assigned to the six County “slots”. This arrangement, allowed by the State, enables the County to provide Wraparound services to more than the six youth in the County’s designated slots. In fact, there are more youths participating in the program in non-revenue generating slots than in revenue generating slots. In FY 2006-07 through mid-January 2007, there were a total of eight youths assigned to the six service allocation slots and 29 youths had been assigned to non-revenue generating slots. While inclusion of youths other than those eligible for the service allocation slots in the Wraparound program is a good example of the County’s ability to leverage program funding, it raises the question of the adequacy of the number of County service allocation slots since some of non-revenue generating children actually meet the slot criteria but can’t fill a slot until there is a vacancy. Though their situations may be less severe than those of the youth assigned to the service allocation slots, this indicates that there are more at-risk youth in the County than those filling the six slots. By increasing the number of program slots, the County would be eligible for additional funding to use for these and other at-risk youth. It should be noted that any increase in the number of slots would also increase County costs as the County is responsible for 60 percent of the revenue per slot generated by the program; the State pays the other 40 percent. California Welfare & Institutions Code §18252(a) Harvey M. Rose Associates, LLC 12