There are an estimated 4000 foster children in Texas with a need for intensive behavioral health services. Right now, there are precious few providers across the state to offer behavioral health care on this level, which is why states are allocating funds to increase or expand Mental Health Targeted Case Management (TCM) services for youth in the foster care system.
Today, we’re proud to share a plan to get these children the support they need through a new program from Southwest Key called Together Forward.
Together Forward is a program that provides wraparound services (also known as Intensive Case Management in Medicaid) to youth in the foster care system, ages 3-19, who need a high level of care.
What exactly are wraparound services?
Wraparound services provide a unique, team-based approach to planning care that builds on the strengths of the family and community around the individual. The wraparound team consists of individuals committed to partnering with the youth and foster family to improve engagement, access to resources and commitment to support. This approach helps youth in foster care and kinship care move toward self-efficacy and empowerment. The wraparound team is made up of both formal and natural support roles: Therapists, mentors, caseworkers, religious leaders, extended family members, and other community supports.
Together Forward has been certified by the National Wraparound Implementation Center as a recognized provider of wraparound services.
Why Together Forward?
When we say, “youth in the foster care system who need a high or intensive level of care,” that’s more than just a few simple adjectives. Some states have defined this need as Level of Care 4 (LOC-4), which refers to Intensive Family Services. LOC-4 consists largely of a high degree of structure, preferably in a family, with caregivers who have specialized training to provide intense therapeutic and habilitative supports and interventions.
Right now, Texas is suffering from a lack of wraparound providers who can care for youth with needs classified as Intense, which is why Southwest Key is stepping up.
``There were not enough providers of intensive Foster and Kinship-Care with wraparound coordination. These kids were not getting the care they needed, and we knew we could help.``
– Veronica Delgado-Savage
Vice President of Youth Justice at Southwest Key
When we saw this need, not just in Texas but across the nation, we saw the potential to help thousands of children and youth who have been struggling for too long without it.
How Southwest Key is Bridging the Gap of Care
“We knew we could do the work and fill this need,” said Gladys J. Sanchez, National Director of Clinical Services at Southwest Key. “We have the capacity with counseling and Southwest Key is full of astute, skilled, licensed staff. Not to mention over 30 years of experience in youth behavioral health.”
Together Forward’s philosophy of care, inherited from Southwest Key itself, is based on preventative, community-based models. And those models are all aligned with the Family First Prevention Services Act (FFPSA). The FFPSA is a federal act that seeks to reduce entry in foster care, limit the use of congregate care, and to increase access to substance abuse and mental health services.
“The whole thing is keeping kids in the home, out of traditional foster care,” said Veronica Delgado-Savage, Vice President of Youth Justice. “Part of the work we also want to do is preventing kids from being put into placement. We want to keep kids at home. We want to serve kids in child welfare to keep them from being removed from their communities.”
“In many ways, this is a call to action. The state is seeing too few providers, so we’re stepping up and going out to bring access to mental health services to more people. We want to see these lists of providers grow alongside us.”
-Gladys J. Sanchez, National Director of Clinical Services
“There’s a lot of crossover between Foster Care and Juvenile Justice programs, going in and out of the justice system and foster care,” said Veronica. “Medicaid has been a huge part of Together Forward from its inception. We’re prepared as an organization to work in the foster care world. But the only way to do that is through Medicaid. In order to reach as many children and youth in the foster care system as we can, we wanted Together Forward to be a program that’s billable through Medicaid.”
“Thanks to a capacity-building grant from the Texas Health and Human Services Commission, we can offer Medicaid-billable wraparound services to youth with intensive needs,” said Veronica. “Wraparound services are the only service we can provide for Level 4 intensive case management, but these are services that we’re licensed to provide and that we’re comfortable with already. We happened to be perfectly positioned to meet this need and this program will hopefully open doors to even more services for youth.”
Looking to the Future Together
We’re just getting started, but Together Forward is already taking steps to become a service-array behavioral health provider. After that, it’s a matter of expanding into all behavioral health services, including substance abuse.
As we expand into other behavioral health services, we can provide more community-based solutions, including increased access to services and helping youth with Basic or Specialized needs. We’ll continue to provide services based in the home and community with a special focus on ensuring access to these services through linguistic needs.
Our focus and philosophy of care will remain the same: Keep kids in their homes as often as we can. Use trauma-informed care and techniques. Coordinate with the existing support network around individual children and youth.
We’ve certainly faced our share of challenges, though. While preparing to launch Together Forward, the team was surprised (along with the rest of the world) to find themselves in the middle of the COVID-19 pandemic. That meant canceling all in-person meetings. “The fact that we can’t do face-to-face meetings is a huge factor. Without an audience, we can’t tell you about what we do and how good we do it,” said Gladys.
Instead of meeting in-person, Southwest Key has pushed for more accessible and virtual methods of sharing Together Forward’s mission. Beyond shifting to online meetings, we’ve also conducted live webinars, implemented digital marketing and set up online fundraising tools. We’re ready to do whatever we can to help these youth get the behavioral care that they need.