California’s Short-Term Residential Therapeutic Programs or STRTP mental health integration progresses with positive results. Since 2016, when California’s Continuum of Care Reform law went into effect, STRTP’s as former group homes became mental health providers. No longer did STRTP’s need to refer out mental health services to other agencies. Now an STRTP could be a one-stop-shop, providing STRTP and mental health together at one site.
While California’s 58 counties all conduct services in different ways, the state’s STRTP Mental Health standards provide the structure for all services. Though counties are very supportive of the STRTP’s and their provision of mental health services, many problems exist statewide. Here are some examples of these issues and possible solutions:
1. High staff turnover – due to COVID-19, the Great Resignation, and the higher acuity of youths, agencies struggle to retain mental health staff. Especially with the Master’s level Head of Service, where employees at one agency for example last no longer than three months. STRTP’s must first be selective of their staff (not hiring out of desperation), then offer small rewards and recognition. When mental health staff feels part of the STRTP team, the STRTP mental health integration process moves smoothly.
2. Certification delays and inconsistency. STRTP’s must be certified by either the state Department of Health Care Services or their county for billing Medi-Cal (similar to Medicaid) services. Having programs approved can take months or years. Often, two clinical reviewers of programs will look at the same information and critique it differently. This process delays the STRTP’s ability to provide services. Also, some counties over critique the program service documents requesting infinite details. Thus, the end product seems more like a lesson in grammar than in STRTP mental health integration. The whole process should benefit the youths, not penalize STRTP’s. Consistent guidelines and a procedure-based focus will reduce these delays.
3. Lack of psychiatry resources. According to Active Medical Partners, reasons for a shortage of psychiatrists includes the aging out of professionals, burnout, and lower reimbursement rates. While STRTP mental health integration offers higher rates of compensation, few agencies can find psychiatrists willing to work with STRTP youths. Moreover, many telepsychiatry services won't contract with STRTPs because they lack the volume of youths needing services. To combat this problem, telepsychiatry companies can be more flexible in their pricing programs or bundle several agencies together to provide them with the services necessary.
4. Finally, Families First Prevention and Services Act (FFPSA) compliance. As a national law, STRTP’s, as well as Qualified Residential Treatment Programs or QRTP’s must meet the FFPSA standards. For programs over 16 beds, they lose funding because they are considered an Institute for Mental Diseases (IMD). Nursing services are required, along with CARF or COA accreditation. Also, a youth must receive an independent assessment from a Qualified Individual (QI) within 30 calendar days from the date of the referral or from the date the youth is placed in an STRTP or QRTP. While the FFPSA had good intentions to reduce out-of-home care for youths, it interferes with STRTP mental health integration. Further state and federal communication is required to find solutions that benefit the youth and their family, not politicians.
While STRTP mental health services are improving, many obstacles remain and will take time to be solved.
Praxes provides consulting services to STRTP and QTRP facilities in mental health integration. For more information, please contact us.
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PRAXES is a nationwide behavioral health software, consulting, and training company. No one in the behavioral health industry has a better reputation, and if you give us the chance, we’ll show you why! At PRAXES, our services improve the efficiency and structure of behavioral health agencies serving children and families nationwide. PRAXES brings over 45 years of administrative and clinical expertise. With more than 100 client companies nationwide, we offer the expertise to advance the quality of behavioral health services. We accomplish these goals through our new clinical decision software, our training of best practices, and helping companies meet regulatory standards. At PRAXES, we believe in being creative and fostering new ways to serve children and their families. Our vision is to empower the families our agencies serve with skills that not only improve their functioning, but help them to thrive in their everyday lives. When you give us the chance, you’ll be connected directly to our friendly staff, so you can expect immediate attention to your inquiry. So, don’t wait, call now!
Dan Thorne has unique perspectives on the field of mental health. As a clinician, he has had over 40 years of experience working with clients in the Southern California area. After obtaining his Bachelor’s degree from the University of California at Irvine, he worked with children in the Orange County Juvenile Hall. Here he honed his earliest techniques on at-risk children. After that, he obtained his Master’s degree in Counseling from California State University, Fullerton.
In the 1990’s, Dan turned his attention to the clinical and administrative side of behavioral health organizations. For three years, he was the Assistant Administrator of Starting Point, a chemical dependency facility in Costa Mesa, CA. In 2001, he took an opportunity to be the Director of Harbor View Community Services Center in Long Beach. When he arrived, the Center had only 80 clients and 13 staff. When he left, there were over 400 clients and 75 staff. Dan created several programs through their contract with the Los Angeles County Departments of Mental Health and Child and Family Services. Under his guidance, Harbor View became one of the leading providers of children’s services in Los Angeles County.
While improving the results of the client’s parents at the Center, Dan reflected on his experiences as a parent. His children themselves had special needs such as mental and intellectual challenges, and Dan knew the toll it takes on the parent. In order to help the child, the parent has to be healthy. From this concept, he created his parenting program. After years of refining it, teaching it to his staff at the Center, and then taking the results and comments from these efforts, he became the developer of the current PRAXES program. It is a culmination of Dan’s personal trials and tribulations as a parent along with empirical results and research of over 40 parenting programs.
Our vision at PRAXES is to advance the strength of parents and caregivers of children with special needs (mental health, intellectual, or physical) through education, support, and empowerment. Thus, they can live healthy and functional lives while caring for the child.
Apogee is a clinical decision software designed to help behavioral health practitioners with their treatment and patient engagement. It provides evidence-based and research-based components. Not only do they consist of elements from such practices as Cognitive Behavior Therapy, Seeking Safety, Dialectical Behavior Therapy, Motivational Interviewing, Functional Behavior Analysis, but also the Intensive Models for Parents, Youth, and Children.
PRAXES has over 30 years of accreditation experience. We know what it takes to get your organization accredited. Whether it’s Joint Commission, CARF, or COA, our team can provide an evaluation of your current status and review the standards which need improvements. We will assist you with the policies, documentation, and training required to be accredited.
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