CA-PRTF for Families
Community Alternatives to Psychiatric Residential Treatment Facilities (CA-PRTF)
*I'm going to just call it "Community Alternatives" to make it easier for us.
The Community Alternatives grant is a program that provides home and community based support
in Indiana. It is for youth who have social, emotional, behavioral and/or mental health needs. The
grant helps families stay together by providing many different services to help keep the youth at
home. To be able to be a part of this grant, the child:
Families and youth may receive:
CA-PRTF brochure.
If, at any time, you have questions...all you have to do is call 317-233-3251.
To start an application, find out who your contact person is for your county. Click here to find
your "access point". You have a RIGHT to apply. You cannot be told that you are not able to apply
or that your child does not qualify until you do the "CANS".
**You may be told that there is a waiting list. If that happens, the person will take your
information and contact you when there is space available. Make sure that you ask for and get
documentation or "proof" that your child is on the waiting list.
You will probably schedule a meeting with the person you spoke with to go over the grant and
paperwork. The contact person will need to make sure that your child has Medicaid and will ask
permission to get information from people who work with him or her.
The contact person will meet with you and anyone else that is involved in your child's life (such as
the child, therapist, school, family, or friends) to answer questions that will tell if your child is
eligible to be on the program. The questions are a part of the "CANS" or "Child and Adolescent
Needs and Strengths" and will say what 'level' of service your child needs. Your child will need to be
a Level 5 or a Level 6 to qualify.
If your child is approved to be on the grant...Congratulations!!! Now, you will need to chose a
provider for the services that he or she may get. You will be given a list of providers for different
services that says "Medicaid Waivers Provider List" at the top. Below that will have the service that
you are choosing a provider for and your county. Make sure that the list is current by checking the
date in the bottom, right corner. There isn't a way to tell how many pages there are, but you
should still check to make sure you aren't missing one. (Like having 1, 2...4, 5 with no 3) Everyone
has to have Wraparound Facilitation. The person who took your application or did the "CANS" with
you may have been a Wraparound Facilitator. That does not mean that you have to choose them.
You have "Freedom of Choice" and can pick another agency if you want.
**Description of services is at the bottom of this page
Now comes the hard part. It can be frustrating to be handed several pages of names that you
don't recognize to try and find a provider that is the right fit for your family. But, please, don't
randomly chose one or ask/let someone else do it for you. One of the most important rights you
have is the ability to "advocate" or speak for you and your family. First, ask your child who he/she
would like to "work with." They may not want someone who is a male, old or brown haired. ? It is
still good to ask them and give them a chance to say what they want. If they are able, ask them to
write down interview questions for the provider.
Next, it may make it easier if you think about what you want and narrow the choices down.
Then...call the remaining providers and ask them a few questions to narrow the list down even
more. You can just say "My child is on the Community Alternatives Grant. I am looking for a
provider and I have a few questions". You do not need to provide you or your child's name unless
you want. Then, some questions you may want to ask:
Once you have narrowed your list down, you can call whoever is left and schedule meetings to
have an "interview" with them. Write down more personal and/or important questions to ask
them. (Example: How would you respond to screaming in public? How would you react if my child
started hallucinating?) During the interview, both you and your child should ask questions. Try to
get a good feel for who feels like they would "fit" best with your family and would also be able to
meet your needs.
Now you will have your first "CFT" or "Child and Family Team Meeting". The meeting should include
everyone that is important to your child and family. The team will always include the parent
(caregiver), wraparound facilitator and all providers. It is preferred that the youth attend, as well.
Possible members could be from school, church, family or friends--just make sure that you and
your child are comfortable with them. Do not allow anyone on your team that you don't want. You
do NOT have to let anyone there that you didn't ask. And, if there isn't anyone that you can think
of who can be on the team, then that is okay too. Being on the grant can help bring in more
people to support you and your family.
It is during the CFT meeting that all of you should think of a "mission" or "vision". What do you
want to see happen? What is the end goal? Then, you will discuss the strengths of your child. I
know that it can be difficult sometimes, especially when things aren't going well. But, it's important
to try to think about the good things that happen. Did they do something without being asked?
Make a good grade? Say please or thank you? After all of you have talked about the strengths,
you will discuss the needs. What does your child need to be successful? Those needs should be
close to what was brought out in the CANS and will be turned into the goals that your child will
work on with the providers that you have chosen. Your "team" should also talk about how it will all
go together. How many hours for each service will your child get each week? Discuss the schedule
and how you will be able to contact people on the team if you need. All of you will need to write a
crisis plan so that everyone knows what to do if something happens.
The Wraparound Facilitator puts all of the notes from the meeting into a program called INSITE.
They also put in a request for the amount of time, services and providers that were discussed at
the CFT meeting. Once everything is entered, they send it electronically through the internet to the
Division of Mental Health and Addiction. They will look it over and either approve it or ask for more
information from the Wraparound Facilitator. It may take a few days or a lot longer to get an "ok"
that everything has been approved. Once that is done, all of the providers receive an e-mail. There
is one file that has the notes from the meeting with the crisis plan and goals. The other has the
"Notice of Action" or NOA that tells what services are approved and how much time for each month.
Example:
John Q Smith (A unit is 15 minutes so, 80 would be 20 hours per month)
09/01/10-09/30/10 Habilitation 80 units x $ per hour = $
10/01/10-10/31/10 Habilitation 80 units x $ per hour = $
Hello Agency
09/01/10-09/30/10 Respite 20 units x $ per hour = $
10/01/10-10/31/10 Respite 40 units x $ per hour = $
Once the providers have that information, everything is ready to go and services should start.
And, you have a right to ask for a copy of the NOA or Notice of Action too. The Wraparound
Facilitator should make sure that services keep going.
Notes:
Service Information:
Wraparound Facilitator (Case Manager) manages all of the paperwork and business stuff for the
grant. They are the ones who writes and sends the Plan of Care to the state that includes the
services and who will provide them. The person may also help you to find resources and monitor
the services. This service is for everyone on the grant. Participants/families/guardians may choose
a new Wraparound Facilitator at any time. It is the responsibility of both Wraparound Facilitators
to work cooperatively with the family to determine the date of transition and to assure a smooth
transition of services. Services continue as outlined in the current plan of care. New Wraparound
Facilitator contacts family within 5 working days to schedule or determine need for immediate CFT
meeting.
Wraparound Technician (Assistant Case Manager) assists with making sure your family has access
to community-based services and resources, monitors the health and welfare of your child and
may provide crisis interventions. These services may also be provided by the Wraparound
Facilitator or you can chose another provider to do them.
Habilitation (Skills teacher for your child) helps your child to be more successful and functional at
home or in the community. This may be learning how to make or keep friends, how to complete
chores, taking better care of themselves or managing their own symptoms/behaviors. The
provider will work on goals from the CFT meeting. These services are similar to, but more complex,
than a mentor and are provided one on one.
Training and Support for Unpaid Caregivers (Education for you and/or your family) Pays for
someone to work directly with you or by paying for a training, books or materials. It may help you
to learn more about how to deal with your childs behaviors, advocate for your childs education,
become better organized or learn how to access community resources. The Unpaid Caregiver is
any person (family member, neighbor, friend, co-worker, or companion) who provides care,
training, guidance, companionship, or support to your child and is NOT paid. Services can be
provided up to 2 hours per day, but cannot be more than $2,000 each year.
Respite Care (Supervision for your child) provides for supervision of your child while you get a
break. This may be provided hourly, daily or in a crisis. The service may be provided in your home
or in a licensed foster home or agency, 24 hour/daily care cannot be more than 14 days in a row
and cannot be used for you to work.
Non-Medical Transportation helps your family and child to make it to activities or community
services that are approved through the grant. The service may not be used for recreational
activities or for anything that is not included in the Plan of Care. Transportation services are limited
to a maximum of $2,000
Consultative Clinical and Therapeutic Services (Therapy/Assessments) are provided by
professionals in psychology, social work, counseling and behavior management. The service may
include assessing the youth, developing a support plan or crisis/family counseling. This is NOT
therapy.
Flex Funds (Financial Help) may be used to buy any variety of one-time or occasional
things/services up to $2,000 per year. It must be a part of success in school, living independently
or with family, having relationships, staying out of trouble or being a "stable and productive"
member of the community.
*I'm going to just call it "Community Alternatives" to make it easier for us.
The Community Alternatives grant is a program that provides home and community based support
in Indiana. It is for youth who have social, emotional, behavioral and/or mental health needs. The
grant helps families stay together by providing many different services to help keep the youth at
home. To be able to be a part of this grant, the child:
- must be on (or be able to get) Medicaid
- must be at least age 6 but less than age 21
- must have a high level of need for intense services
- and, the family must be at or below 150% of the Federal Poverty Level.
Families and youth may receive:
- Wraparound Facilitation (Service Coordination/Case management)
- Respite (Time away/a break for the caregiver)
- Non-medical Transportation (Help getting places other than the doctor, dentist or therapist)
- Training and Support for Unpaid Caregivers (Pays for stuff like trainings, books, classes,
materials for people who help with the youth, but aren't paid for it) - Habilitation (One on one intensive mentoring to support and meet goals)
- Flex Funding (Financial assistance for things that may be needed every now and then)
CA-PRTF brochure.
If, at any time, you have questions...all you have to do is call 317-233-3251.
To start an application, find out who your contact person is for your county. Click here to find
your "access point". You have a RIGHT to apply. You cannot be told that you are not able to apply
or that your child does not qualify until you do the "CANS".
**You may be told that there is a waiting list. If that happens, the person will take your
information and contact you when there is space available. Make sure that you ask for and get
documentation or "proof" that your child is on the waiting list.
You will probably schedule a meeting with the person you spoke with to go over the grant and
paperwork. The contact person will need to make sure that your child has Medicaid and will ask
permission to get information from people who work with him or her.
The contact person will meet with you and anyone else that is involved in your child's life (such as
the child, therapist, school, family, or friends) to answer questions that will tell if your child is
eligible to be on the program. The questions are a part of the "CANS" or "Child and Adolescent
Needs and Strengths" and will say what 'level' of service your child needs. Your child will need to be
a Level 5 or a Level 6 to qualify.
If your child is approved to be on the grant...Congratulations!!! Now, you will need to chose a
provider for the services that he or she may get. You will be given a list of providers for different
services that says "Medicaid Waivers Provider List" at the top. Below that will have the service that
you are choosing a provider for and your county. Make sure that the list is current by checking the
date in the bottom, right corner. There isn't a way to tell how many pages there are, but you
should still check to make sure you aren't missing one. (Like having 1, 2...4, 5 with no 3) Everyone
has to have Wraparound Facilitation. The person who took your application or did the "CANS" with
you may have been a Wraparound Facilitator. That does not mean that you have to choose them.
You have "Freedom of Choice" and can pick another agency if you want.
**Description of services is at the bottom of this page
Now comes the hard part. It can be frustrating to be handed several pages of names that you
don't recognize to try and find a provider that is the right fit for your family. But, please, don't
randomly chose one or ask/let someone else do it for you. One of the most important rights you
have is the ability to "advocate" or speak for you and your family. First, ask your child who he/she
would like to "work with." They may not want someone who is a male, old or brown haired. ? It is
still good to ask them and give them a chance to say what they want. If they are able, ask them to
write down interview questions for the provider.
Next, it may make it easier if you think about what you want and narrow the choices down.
- Does it matter if it is an agency or an individual person who provides the service? (Think of
good and bad things for each. Example: An agency could be bigger, better known and do
more services. An individual could be more personal, attentive and flexible.) - Do you want them to be located in the same city or county that you live in?
- Are you wanting one person/agency to do all of the services or is it okay to have more than
one provider? (If so, compare the lists and mark out the ones that don't provide both/all
services. Don't include Wraparound Facilitation in that because only community mental health
centers are able to do that service.)
Then...call the remaining providers and ask them a few questions to narrow the list down even
more. You can just say "My child is on the Community Alternatives Grant. I am looking for a
provider and I have a few questions". You do not need to provide you or your child's name unless
you want. Then, some questions you may want to ask:
- Are you taking any new clients?
- What is your availability? or Will you have the time to meet the needs of my family?
- Would you be able to come if there is a crisis?
- Are there any times that you would not be able to come?
- What is your experience working with my child's diagnosis? (You may also want to ask about
gender, race/ethnicity, age group or any other specific concerns such as seizures)
Once you have narrowed your list down, you can call whoever is left and schedule meetings to
have an "interview" with them. Write down more personal and/or important questions to ask
them. (Example: How would you respond to screaming in public? How would you react if my child
started hallucinating?) During the interview, both you and your child should ask questions. Try to
get a good feel for who feels like they would "fit" best with your family and would also be able to
meet your needs.
Now you will have your first "CFT" or "Child and Family Team Meeting". The meeting should include
everyone that is important to your child and family. The team will always include the parent
(caregiver), wraparound facilitator and all providers. It is preferred that the youth attend, as well.
Possible members could be from school, church, family or friends--just make sure that you and
your child are comfortable with them. Do not allow anyone on your team that you don't want. You
do NOT have to let anyone there that you didn't ask. And, if there isn't anyone that you can think
of who can be on the team, then that is okay too. Being on the grant can help bring in more
people to support you and your family.
It is during the CFT meeting that all of you should think of a "mission" or "vision". What do you
want to see happen? What is the end goal? Then, you will discuss the strengths of your child. I
know that it can be difficult sometimes, especially when things aren't going well. But, it's important
to try to think about the good things that happen. Did they do something without being asked?
Make a good grade? Say please or thank you? After all of you have talked about the strengths,
you will discuss the needs. What does your child need to be successful? Those needs should be
close to what was brought out in the CANS and will be turned into the goals that your child will
work on with the providers that you have chosen. Your "team" should also talk about how it will all
go together. How many hours for each service will your child get each week? Discuss the schedule
and how you will be able to contact people on the team if you need. All of you will need to write a
crisis plan so that everyone knows what to do if something happens.
The Wraparound Facilitator puts all of the notes from the meeting into a program called INSITE.
They also put in a request for the amount of time, services and providers that were discussed at
the CFT meeting. Once everything is entered, they send it electronically through the internet to the
Division of Mental Health and Addiction. They will look it over and either approve it or ask for more
information from the Wraparound Facilitator. It may take a few days or a lot longer to get an "ok"
that everything has been approved. Once that is done, all of the providers receive an e-mail. There
is one file that has the notes from the meeting with the crisis plan and goals. The other has the
"Notice of Action" or NOA that tells what services are approved and how much time for each month.
Example:
John Q Smith (A unit is 15 minutes so, 80 would be 20 hours per month)
09/01/10-09/30/10 Habilitation 80 units x $ per hour = $
10/01/10-10/31/10 Habilitation 80 units x $ per hour = $
Hello Agency
09/01/10-09/30/10 Respite 20 units x $ per hour = $
10/01/10-10/31/10 Respite 40 units x $ per hour = $
Once the providers have that information, everything is ready to go and services should start.
And, you have a right to ask for a copy of the NOA or Notice of Action too. The Wraparound
Facilitator should make sure that services keep going.
Notes:
- No provider is allowed to work with your child or family without a current NOA for the month.
This may happen if the Wraparound Facilitator did not request it. Even if they are going to or
start to fix it, the provider cannot start again until it is approved and they have the e-mail
with the NOA approved. - If your child loses Medicaid, for whatever reason, all services are put on hold for a little while.
It will give you time to talk to the Medicaid caseworker to have it fixed. If your child is no
longer able to get Medicaid, they are not able to be on the Community Alternatives grant. - Your child can be admitted into an "acute" hospital while on the grant, but not a residential
facility. The Community Alternatives grant is an alternative to residential out of home care. - Reminder: you have a right to choose your provider. Do NOT allow or accept anyone else to
make that choice for you. If you use a community mental health center for therapy and
medications...it does NOT mean that you have to use them for your Community Alternatives
services. - Providers are NOT allowed to take your child to their home. They also cannot take your child
on their family outings. - If you chose an individual provider for services, THEY are the ones that need to provide
services. They cannot send anyone else in their place at anytime. - Training and support for unpaid caregiver can be used for a lot of different things. Anything
that helps to teach you or another caregiver about how to meet the child's needs can be
bought. If your team knows someone who can help you learn, then you can choose a
providing agency from the list to pay that person for services. - The CA-PRTF Sharepoint site is open to anyone. Information is posted there for all
Wraparound Facilitators and providers throughout the state. There is also a folder for
families. - And, no matter what, if you have any questions or concerns....call 317-233-3251
Service Information:
Wraparound Facilitator (Case Manager) manages all of the paperwork and business stuff for the
grant. They are the ones who writes and sends the Plan of Care to the state that includes the
services and who will provide them. The person may also help you to find resources and monitor
the services. This service is for everyone on the grant. Participants/families/guardians may choose
a new Wraparound Facilitator at any time. It is the responsibility of both Wraparound Facilitators
to work cooperatively with the family to determine the date of transition and to assure a smooth
transition of services. Services continue as outlined in the current plan of care. New Wraparound
Facilitator contacts family within 5 working days to schedule or determine need for immediate CFT
meeting.
Wraparound Technician (Assistant Case Manager) assists with making sure your family has access
to community-based services and resources, monitors the health and welfare of your child and
may provide crisis interventions. These services may also be provided by the Wraparound
Facilitator or you can chose another provider to do them.
Habilitation (Skills teacher for your child) helps your child to be more successful and functional at
home or in the community. This may be learning how to make or keep friends, how to complete
chores, taking better care of themselves or managing their own symptoms/behaviors. The
provider will work on goals from the CFT meeting. These services are similar to, but more complex,
than a mentor and are provided one on one.
Training and Support for Unpaid Caregivers (Education for you and/or your family) Pays for
someone to work directly with you or by paying for a training, books or materials. It may help you
to learn more about how to deal with your childs behaviors, advocate for your childs education,
become better organized or learn how to access community resources. The Unpaid Caregiver is
any person (family member, neighbor, friend, co-worker, or companion) who provides care,
training, guidance, companionship, or support to your child and is NOT paid. Services can be
provided up to 2 hours per day, but cannot be more than $2,000 each year.
Respite Care (Supervision for your child) provides for supervision of your child while you get a
break. This may be provided hourly, daily or in a crisis. The service may be provided in your home
or in a licensed foster home or agency, 24 hour/daily care cannot be more than 14 days in a row
and cannot be used for you to work.
Non-Medical Transportation helps your family and child to make it to activities or community
services that are approved through the grant. The service may not be used for recreational
activities or for anything that is not included in the Plan of Care. Transportation services are limited
to a maximum of $2,000
Consultative Clinical and Therapeutic Services (Therapy/Assessments) are provided by
professionals in psychology, social work, counseling and behavior management. The service may
include assessing the youth, developing a support plan or crisis/family counseling. This is NOT
therapy.
Flex Funds (Financial Help) may be used to buy any variety of one-time or occasional
things/services up to $2,000 per year. It must be a part of success in school, living independently
or with family, having relationships, staying out of trouble or being a "stable and productive"
member of the community.
The process of the grant works kind of like what is known as "Wraparound". A good way to learn what that means is by reading
the Wraparound Process Users Guide: A Handbook for Families.
Wraparound is an intensive, holistic method of engaging with individuals with complex needs (most typically children, youth, and
their families) so that they can live in their homes and communities and realize their hopes and dreams. In recent years,
wraparound has been most commonly conceived of as an intensive, individualized care planning and management process.
Ten Principles of the Wraparound Process
The design is modeled like a System of Care. The Family Guide to Systems of Care for Children with Mental Health Needs is a good
place to find out what that means.
A system of care is a coordinated network of community-based services and supports that are organized to meet the challenges
of children and youth with serious mental health needs and their families. Families and youth work in partnership with public and
private organizations to design mental health services and supports that are effective, that build on the strengths of individuals,
and that address each person's cultural and linguistic needs. A system of care helps children, youth and families function better at
home, in school, in the community and throughout life.
Systems of care is not a program. It is a philosophy of how care should be delivered. Systems of Care is an approach to services
that recognizes the importance of family, school and community, and seeks to promote the full potential of every child and youth
by addressing their physical, emotional, intellectual, cultural and social needs.
the Wraparound Process Users Guide: A Handbook for Families.
Wraparound is an intensive, holistic method of engaging with individuals with complex needs (most typically children, youth, and
their families) so that they can live in their homes and communities and realize their hopes and dreams. In recent years,
wraparound has been most commonly conceived of as an intensive, individualized care planning and management process.
Ten Principles of the Wraparound Process
- Family Voice and Choice
- Team Based
- Natural Supports
- Collaboration
- Community-based
- Culturally-Competent
- Individualized
- Strengths-Based
- Persistence
- Outcomes-Based
The design is modeled like a System of Care. The Family Guide to Systems of Care for Children with Mental Health Needs is a good
place to find out what that means.
A system of care is a coordinated network of community-based services and supports that are organized to meet the challenges
of children and youth with serious mental health needs and their families. Families and youth work in partnership with public and
private organizations to design mental health services and supports that are effective, that build on the strengths of individuals,
and that address each person's cultural and linguistic needs. A system of care helps children, youth and families function better at
home, in school, in the community and throughout life.
Systems of care is not a program. It is a philosophy of how care should be delivered. Systems of Care is an approach to services
that recognizes the importance of family, school and community, and seeks to promote the full potential of every child and youth
by addressing their physical, emotional, intellectual, cultural and social needs.
If the Community Alternatives Grant were a car…
- You and your child would be the drivers
(steering and leading the way)
- Family and friends would be the car
(protecting and making sure your family has
a way to get where you are trying to go)
- Providers would be the tires (holding your
child and family up to keep on going)
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