CCF Family Handbook
Introduction
What families can expect
General program outline
Special needs and services
Health insurance
Medicaid (Title XIX - Medical Assistance)
CCF Coordinator
Child/Family teams
Services and providers
Parent and family support
Program values
Culture
In case of emergency
Grievances and Appeals
Leaving the program
Important Phone Numbers
(Manual para la Familia - Spanish)
Introduction

Welcome to Children Come First (CCF). CCF is a program that coordinates care for youth who have a mental health challenge and are at risk of being placed in an institutional setting. This handbook explains what CCF has to offer your child and family. Please read this over carefully. If you have questions, ask your CCF Coordinator. If you are new to CCF, your CCF Coordinator will be talking to you about this handbook. You can then decide if you want to be in our program.

CCF has coordinators to work with each family. Our goal is to help families in their communities.

When your child leaves the program, we hope they will be doing better in school, in home and in the community. Please go to the last section of this handbook “Leaving the program”, for more information.

What families can expect

1st week
• Your Coordinator will get in touch with you and have a meeting to talk about the program and sign paperwork so that your child can be enrolled.
• Your Coordinator will most likely need to call other people working with your child to find out how he/she is doing. You must sign a form for this to happen. Information about your family will be kept confidential, unless you give permission to speak to others about your child’s progress.
• You and your Coordinator will talk about teams and begin to form your child’s team.
• Your Coordinator will work with you to plan for emergencies or very stressful times. This plan, called a “crisis plan” will be updated as needed, but at least every 6 months. You should have a copy of this plan.

2nd to 4th week and later
• Your Coordinator will get in touch with you and your child at least one time each week. They will also keep in touch with other team members.
• Your team will meet during the first month and will meet at least one time each month after that.
• During the first month, your Coordinator will work with you to figure out what is going well, what your child’s strengths are and what help is needed. A plan of care will be completed during the first month and will be reviewed every 3 months and changed, as needed.
• Your child will likely be in CCF less than 18 months, but if the team believes that it needs to be longer, your coordinator can schedule a meeting with program leaders to talk about why your child needs more time in the program.
• Please contact your Coordinator or anyone else in the program if there are questions or issues that come up.

General program outline

CCF helps you find supports in your family and community. CCF puts together mental health care, alcohol and drug treatment, and other services that can help. We try to help families find their strengths so that they may reach their goals on their own. We work with you even if your child needs to be in a hospital or needs to be placed outside of the home. If your child is placed outside of your home, CCF will help you get ready for when your child can return home or to the community.

Special needs and services

Talk to your CCF Coordinator if you need special services such as:
1. You or a member of your family needs an interpreter or translator.
2. A member of your family has a disability. CCF can help make special arrangements.
3. All children who are able to receive Medicaid can also get a free HealthCheck. The HealthCheck is a complete medical exam.



Health insurance

Your child may be covered under a private insurance plan. If so, please bring your health insurance card and please give the information to your CCF Coordinator. CCF will work with the insurance company for any services they cover. Private insurance must be billed before CCF is able to pay for services.

Medicaid (Title XIX - Medical Assistance)

Your child may be able to receive Medicaid (MA). Many people who have Medicaid are enrolled in Health Maintenance Organizations (HMOs). Your child will need to leave the HMO plan while in CCF. The change from your HMO to Medicaid’s “fee-for-service” will be done when your child enters CCF and your child should be able to keep their regular medical and dental health care providers. When CCF ends your child should be able to rejoin the HMO plan, depending on openings. For questions on HMO enrollment and assistance call the local HMO Enrollment Specialist at 608-242-7432. This is an important step to help change the MA coverage from CCF back into an MA-HMO.

CCF services replace your MA coverage for MA-covered mental health services. This includes psychiatric inpatient care, but does not include prescription costs. Your child may only receive MA-covered mental health services found in your child's Plan of Care or through private insurance. The treatment team decides which services are needed and the coordinator must pre-approve these services for them to occur.

You may have to pay for mental health services that are not included in your CCF Plan of Care. Call your CCF Coordinator if you have questions about whether a service is in the Plan.

If you have any questions about MA coverage or other insurance questions, you can contact:

Andy Heidt, Ombudsman, Dane County Human Services
242-6477
heidt@co.dane.wi.us



CCF Coordinator

The CCF Coordinator is your "guide". At first, that person will help you build your child and family’s team. Then, your team will develop a Plan of Care and put the plan into action. The CCF Coordinator will make sure that the people that can help you know your strengths. The team will measure progress and will adjust the plan as needed.

While you are a part of CCF, your CCF Coordinator will find ways to help you be in control. Your Coordinator will help you meet your needs. CCF believes most families can care for their own children and meet their needs. Also, CCF is a time-limited service. This is why it is important to be in control and meet your needs as soon as possible. The CCF Coordinator helps you to make sure you have support, even after your child is no longer in CCF.

You will be assigned a CCF Coordinator through:

Dane County Department of Human Services — ARTT Unit or Community Partnerships, Inc. (CP)



Child/Family teams

You will be part of a team and your child can be part of the team if he/she wants to. This team will include different people who will work with you to help your family. We hope that you will pick people who are important to you and your child. These people may be relatives, friends, neighbors, or others. It is very important that there are people on your team who will still be in your life after the "professionals" are gone. Your team will also be made up of a CCF Coordinator and Dane County Department of Human Services Social Worker and may contain teachers, therapists, etc. You and the team will create a Plan of Care that will cover the strengths and needs of your family. A Plan of Care explains how your team will meet your needs and will include the supports and services used to help. The team updates Plans once every three month.

Team meetings are held every month and sometimes more often. Your CCF Coordinator will try to schedule meetings at times and places that work best for you. It is important that you take part in team meetings and talk with your coordinator about what you would like to see happen at those meetings. It is our general policy to only go to the meetings that parents are also invited to go attend. Please tell your CCF Coordinator if you have any questions about your team.

Services and providers

CCF Coordinators will try to help you keep your child at home or in the community. CCF will try to do that with family and community supports. CCF also purchases services when needed. We use providers who work closely with families. Our money to purchase services comes from many places so that we can provide a flexible Plan of Care. We are not limited to services covered by only health insurance, Medicaid, or Dane County Department of Human Services. Services are pre-authorized by CCF Coordinators either immediately if a service is necessary right away or prior to the start of the next month for planned services. The team can request that the Coordinator “expedite” or speed up the review of a request for approving a service if the team feels that a service needs to be in place right away. When an authorization for service is completed will depend on the immediacy of the needs of the child and family.

Parents always have the right to obtain a second opinion related to mental health care concerns from a qualified mental health care professional. If you would like a second opinion from a different Psychiatrist, therapist, etc., your coordinator can help arrange for this to occur.

Out of Network Providers

All services for your child must be provided by someone covered by your private insurance or the Children Come First (CCF) network. CCF will consider funding Providers who are not in our network, for up to 6 months, in the following situations:

    1. Your child needs urgent or immediate care;

    2. Your child lives outside of Dane County and CCF has no Providers in the area;

    3. Your child needs a service and CCF doesn’t have anyone in their network that provides that service; or

    4. A court-ordered assessment is assigned to someone outside of the CCF network.

All providers need to meet basic standards set to work with CCF youth.

Please talk with your CCF Coordinator to request to use a provider who is not in the CCF network.

Sometimes, because of different reasons, children need to be placed outside of their homes for short periods of time. Examples of these placements are:
• foster or group home care
• respite or shelter care
• juvenile detention, residential treatment or hospitals

CCF will continue to work with your family to try to return your child to your home. Dane County may need you to pay part of the cost of the placement. These expenses are the parent's responsibility. Dane County will review and collect a fee from parents for all of these placements. This fee is on a sliding fee scale. The Dane County Parent Support Collection Unit sets the fee and this office is not part of the Children Come First program. These fees are not covered by Children Come First, but your coordinator may help arrange for these services. You can call the Dane County Parent Support Collection Unit for more information at 608-242-6200.

Parent and family support

Every family can be a part of our parent and family program. This program includes:

1. Helping you help yourself: We invite parents to share anything they would like to about their children. What you know about your child’s needs and what they are good at is very important and useful.

2. Parent meetings: We offer parent meetings on the last Wednesday of the month at Community Partnerships, from 5:30-7:00 p.m. Your CCF Coordinator can help provide transportation if you need it. Child care is always available at the office for children during these meetings. Meetings have been on special education, the juvenile courts and other areas important to CCF families. A meal is provided at 6:30 p.m., where parents and children can eat together with staff members attending the meeting. The topics for monthly parent meetings are from parent’s ideas.

3. Help from the Family Advocate: The family advocate is available to work with individuals and families. Some of the types of help that can be provided are: attending school meetings, placements, court, team meetings, mentoring either a parent or child, providing transportation for the parent or child, helping the parent with budgeting issues and providing information.

4. Parent involvement after leaving the CCF program: When the child leaves the CCF program, parents can still stay involved with the parent meetings and other groups. The parent advocate welcomes questions and updates on how you are doing anytime.

Program values

CCF focuses on the family and on your strengths and needs. Your family and child are an important part of the team. CCF also believes children with mental health issues get the most out of services from their own communities that will be there after your child is doing better. We work very hard to find and put together anything that is needed to keep your child at home, or close to it.

These statements explain our thoughts to helping you and your family:
1. Each child and family is unique. All families have strengths as well as needs.
2. Families are responsible for their children.
3. Children have better success while living at home and in their own communities.
4. Families can set their own goals for the future.
5. A team effort helps a family reach their goals.
6. Children and families are successful when CCF uses a balanced approach. Treatment plans must protect the community. Plans also must help families build new living skills.
7. To achieve the family's vision for the future, it is important to respect a family's culture.

Culture

The program believes that cultural awareness is a major part of our values.

We believe that cultural awareness is a long-term process that encourages an understanding of our own beliefs and values and how they affect our relationships with others.

We believe that it is our duty to gain the needed cultural information about families that will help us work together. We believe that cultural diversity includes more than language, food, the way we dress and cultural events. It is the way a person thinks, acts and understands the world around them.

In case of emergency

A Crisis Plan will be created for children enrolled in Children Come First. The Crisis Plan will figure out who to call during a crisis. If needed, for CP clients, an on-call CCF Coordinator or Manager can be reached 24 hours per day by calling the on-call pager at 608-657-0964. For ARTT clients, the Youth Crisis unit can be contacted at 280-2610.

Contact your CCF Coordinator if you think your child needs to be in a psychiatric hospital. For ARTT clients, the Youth Crisis Unit at the Mental Health Center of Dane County decides on the psychiatric hospital needs for those children enrolled in CCF who do not have primary health insurance.

Grievances and Appeals

GRIEVANCES & APPEALS Children Come First wants your family to get the best care possible. If you are not happy with the care you are getting, we would like you to let us know. You will not get in trouble for telling us your concerns. Knowing your concerns can help us give you better care.

Informal Grievances If you are unhappy with your care, you can let the person you are working with know you are not happy. He or she can try to help work it out. If you don’t want to tell this person, you can call his/her Supervisor.

Formal Grievance If you are not happy with the response from the person you are working with, or their supervisor you can file a formal Grievance. You can also do this right away if you want. To do this, contact the following people:

For Community Partnerships:
Quality Improvement Manager
1334 Dewey Court
Madison, WI 53703
608) 250-6634, ext. 110

For ARTT:
CYF Mental Health Manager
1202 Northport Dr.
Madison, WI 53704
(608) 242-6404


If you would like, you may use this form to file your grievance Click here for a Grievance Initiation form

If you need help to file or write your Grievance you can call Wisconsin Family Ties at (608) 267-6888.

If your formal Grievance is about a decision to decrease or deny a covered service, you must file within 45 days of that decision. This also applies:

    a. If you were not getting the service before the decision CCF does not need to provide the service during this process.

    b. If you weregetting the service before the decision CCF will provide the same level of service during this process. If the decision does not change you may have to pay for these services.

This is how Children Come First will respond to your formal grievance:

    1. The Quality Improvement Manager (for Community Partnerships) or the CYF Mental Health Manager (for ARTT) will send you a letter within 10 business days. This is to let you know we received your grievance. We will look into your concerns. The Manager will mail you a decision letter within 30 calendar days from the day you filed your grievance. You will also get information on what to do if you do not like this decision.

    2. If the Quality Improvement Manager (for Community Partnerships) or the CYF Mental Health Manager (for ARTT) needs more time to make a decision, their time period may be increased by 14 calendar days. If this happens, we will notify you in writing. We will explain why we need more time. We will also tell you when we will have a decision for you. The total time for Children Come First to make a decision will not be more than 45 calendar days from when you filed.

    3. If you do not like the CCF Manager’s decision, you can ask for it to be reviewed by the CCF Grievance Committee. You have 14 days from the day you receive the Manager’s decision letter to ask for this review. You can ask for this review by contacting the following person:

CYF Mental Health Manager
1202 Northport Dr.
Madison, WI 53704
(608) 242-6404

    You will get a letter telling you when and where the Grievance Committee will meet. You will get this letter at least 7 days before the meeting. You have a right to be at the meeting. You have a right to present your information in writing or orally. You can bring whoever you want to the meeting. This can be a family member, a friend, or a provider.

Expedited Review If you think your grievance is urgent you can ask for an Expedited Review. This means we will decide very quickly. This is for when you need a response right away to prevent serious harm. We will look over your concerns and decide within 2 business days. You can ask for an Expedited Review from the person you are working with, or their Supervisor. You will not be penalized for asking for this. Also, your providers will not be penalized for asking for this.

If we do not think this is urgent, we may not speed up your decision. If that happens, we will tell you right away. We will also mail you a letter within 2 calendar days. We will then respond to your grievance in our regular timeframes.

Grievance Rights
You have the right to:

    • Get help to write and file your grievance. You can get help from any CCF employee. Or you can call Wisconsin Family Ties at (608) 267-6888. You can also call the Medicaid Managed Care Ombudsman at 1-800-760-0001.

    • Look at the information Children Come First used to make its decision.

    • Attend meetings about your grievance. You can bring whoever you want to these meetings. This could be a family member, a friend, or a provider.

    • Present new information during the grievance process.

    • Ask that your grievance be handled in an urgent manner (see Expedited Review above).

    • Have an interpreter. This will be free to you. You can ask for an interpreter by calling the Quality Improvement Manager (for Community Partnerships) or the CYF Mental Health Manager (for ARTT).

    • Move to any part of this grievance process at any time.

Appealing a Decision

Please note: You can go to any part of this grievance process at any time. You can file directly with the State if you want to.

You have 14 days from the date you get the CCF Grievance Committee decision to ask for a State level review.

Appealing to the Department of Health and Family Services
You can appeal a grievance decision to the State of Wisconsin, Department of Health and Family Services. You can do this by contacting:

Medicaid Managed Care Ombuds
P.O. Box 6470
Madison, WI 53716
Phone: 1-800-760-0001

The Department will review your grievance. They will provide a final response within 30 days from the date the Department has all the information they need to make a decision.

State Fair Hearing Request
You can appeal a grievance decision by asking for a hearing with the State’s Department of Hearings and Appeals (DHA). You can do this by writing to:

Division of Hearings and Appeals
P.O. Box 7875
Madison, WI 53703-7875

In your letter you will need to include the enrollee’s name and social security number, your mailing address, a brief description of the problem, and your signature. The hearing request date will be the date they receive your letter.

If your Appeal is about a decrease or denial of a covered service this applies:

    a. If you were not getting the service before the decision CCF does not need to provide the service during this process.

    b. If you were getting the service before the decision CCF will provide the same level of service during this process. If the decision does not change you may have to pay for these services.

If you need help asking for a State Fair Hearing, you can call the Medicaid Managed Care Ombudsman at 1-800-760-0001.



Leaving the program

It is important for the team to talk about your child moving out of CCF as soon as possible during enrollment. It is our goal to help your family be independent as soon as possible. A “transition” plan must be in place by the 16th month of enrollment, if not, a review of the CCF plan will occur by the Transition committee who will help with the planning. It is very important for the team to develop a plan for leaving the program that includes who will be continuing to work with you and your child, goals and information about what to do if things aren’t going well.

CCF services will end if:
1. The child is no longer at great risk of an institutional placement in a psychiatric hospital, residential treatment center or corrections.
2. The parent or guardian asks that the child be removed from the program.
3. The child is no longer eligible for Dane County services, including if court supervision ends.
4. The child or family is not benefiting from services, including an extended runaway by the child.

You are always encouraged to attend the parent groups and stay in contact after your child leaves the program. It is also possible for your child to re-enroll into the program if needed in the future. Ask your Coordinator for more information.

Important Phone Numbers
After hours ARTT-CCF crisis line of the Youth Crisis program
608-280-2610
After hours CP-CCF crisis line
Pager
608-657-0964
Alcohol and drug assessments
608-263-8173
Briarpatch Teen Helpline
608-251-6221
CCF Family Advocate
608-250-6634 ex. 124
Dane County Department of Human Services
CYF Mental Health Manager
608-242-6404
Dane County Parent Support Collection Unit
(Alternate care payment questions)
608-242-6226
Domestic Abuse Intervention Services
608-251-4445
First Call for Help
2-1-1
Parental Stress Center Helpline
608-241-4888/608-241-2221
Suicide prevention helpline
608-280-2600
Wisconsin Department of Health and Family Services
Division of Managed Health Care Programs
CCF Contract Monitor
1 W. Wilson Room 265
Madison, WI 53703
608-264-7724
Wisconsin Family Ties
608-267-6888