Office of Mental Health

Commissioner Michael F. Hogan, PhD

Governor David A. Paterson

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Child and Family Clinic Plus
Transcripts of the October 12, 2006 Informational Sessions

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1
2
3 MEETING
4 of the
5 CHILD AND FAMILY CLINIC–PLUS
6 INFORMATIONAL SESSION
7
8
9 Long Island Field Office
10 98 Crooked Hill Road
11 Brentwood, New York
12
13 October 18, 2006
14 1:14 p.m.
15
KRISTIN RILEY, Chairperson Presiding
16
17 Also Present:
18 MICHAEL HOFFMAN, LIFO
FRANK SIEGEL, SCDCMHS
19 MARIE BALTZ, SCDCMHS
HERB RUBIN, Peninsula Counseling
20 NANCY MANIGAT, Family and Children's
SUSAN BURGER, OMH
21 RON KAPLAN, FEGS
22
23
24
25

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1
2 MS. RILEY: We would like to welcome
3 everybody. My name is Kristin Riley. I am deputy
4 director of the Office of Mental Health, Bureau of
5 Children and Families.
6 This is the first informational session
7 we are having for the Child and Family Clinic–Plus
8 RFP that we are doing in Long Island.
9 The first thing that I want to draw your
10 attention to is the handout that we provided. I
11 will place this up on the website within the next
12 day or two. This contains just a question and
13 answer we received through the procurement officer,
14 which I will let you read. Also, a clarification
15 around agencies that may be applying for multiple
16 clusters and awarded those clusters. I just wanted
17 to clarify.
18 I think you will find that this makes
19 sense, but if you are an agency that is going to
20 apply for multiple clusters with the same clinic
21 license, if you do the Clinic–Plus calculators, you
22 need to, for the RFP, separately for each of those,
23 the cost of your base clinic are going to duplicate
24 each other several times. So we need you to do
25 them separately for the sake of awarding those

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2 individual RFP awards for the cluster.
3 If you're awarded multiple clusters for
4 that clinic, what we will have you do prior to
5 going to contract is to do one Clinic–Plus
6 calculator to determine what your actual state aid
7 is going to be, so that it is not duplicate
8 counted.
9 MS. MANIGAT: For the purpose of the
10 RFP, it is separate, but if we're awarded all two
11 or three, then we will redo it to combine the ones?
12 MS. RILEY: Correct. I draw that to
13 your attention so you don't, in your own head – so
14 that in your resources, you don't double count it
15 as well. And within the handout I provided, there
16 is a more wordy explanation of that. That is what
17 the clarification is that is here.
18 If you have any questions, the first
19 time if you would give your name and spell it and
20 let us know what agency you are from?
21 MS. MANIGAT: In relation to the
22 question you just answered, if I am bidding on
23 three different clusters for one center, am I
24 making an assumption in each RFP that I am only
25 going after that one cluster.

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2 MS. RILEY: Yes.
3 MS. MANIGAT: So it is not like a
4 multicluster –
5 MS. RILEY: Right. Because the clusters
6 are – I will try and explain this to you.
7 Hopefully I won't trip on my own explanation.
8 Each of the clusters is awarded
9 separately, so you do need to approach those as if
10 theoretically in that response that was the only
11 one you were going after. So you will show your
12 existing clinic budget and you will show what you
13 would be doing for that particular site and you
14 will do likewise for the other two you are applying
15 for.
16 MS. MANIGAT: There is an assumption at
17 the end that staffing model may change based on the
18 amount of clusters awarded to that clinic.
19 I might put in a staffing model per
20 cluster, but if I am dealing with three clusters,
21 that is a totally different staffing model.
22 MS. RILEY: The reality is, RFP's,
23 unfortunately, are very rigid and circumspect in
24 the areas they are covering. You and I both will
25 need to look at some adjustments based on however

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2 many are awarded. You are right. If it is one,
3 that is simple because then it would just be what
4 you had put on the net proposal for that one
5 particular cluster. If it is two, it will be
6 different. So, that is the process where if it was
7 two or three, you would do the overall Clinic–Plus
8 calculator work sheet for us and would have the
9 opportunity at that point to adjust your staffing
10 within that budget.
11 Is that clear?
12 MS. MANIGAT: Yes.
13 MR. RUBIN: Kristin –
14 MS. RILEY: Did you have a follow–up on
15 that?
16 MS. MANIGAT: Yes. Let me get mine out
17 of the way.
18 For the same program, we are looking at
19 targeting a cluster outside of that program's
20 immediate catchment area for a multitude of
21 reasons. They have school–based clinics that area,
22 one of the districts is very difficult, if not
23 impossible, to get into, so we would like to set up
24 a satellite in another area.
25 Is that okay?

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2 MS. RILEY: Is it roughly geographically
3 proximate?
4 MS. MANIGAT: It is the next cluster
5 over.
6 MS. RILEY: Mike, you may want to jump
7 in here. As long as it is within a reasonable
8 distance. You have some very long and distant
9 areas in Long Island. If one was on one end of the
10 Island and one on the other, that would be an issue
11 because you wouldn't be able to really say that was
12 a satellite, given the geographic distance. As
13 long as it is a reasonable geographic distance,
14 that is fine.
15 MR. HOFFMAN: I assume you are talking
16 about another cluster within the same county?
17 MS. MANIGAT: Yes.
18 MR. HOFFMAN: That wouldn't be a
19 problem.
20 MS. MANIGAT: The other question, last
21 question for Family and Children at this moment in
22 time. Last time you talked about your definition
23 of fee–for–service Medicaid and I wanted some
24 clarification. Are we counting the Medicaid
25 dollars associated with managed Medicaid visits and

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2 crossover Medicare/Medicaid visits? Because we
3 bill Medicaid – we bill Medicaid on those visits.
4 Are you excluding those in the calculations?
5 MS. RILEY: We have tried to make this
6 as simple as possible. It is not actually the
7 funding that you are counting; it is the kids.
8 Because the difference here in the spread is on
9 your historical admissions. So, you are going to
10 find out how many historical admissions you had.
11 Then you need to break them down into Medicaid, as
12 you correctly stated, Medicaid fee–for–service and
13 everything else.
14 Medicaid fee–for–service would be those
15 kids who you bill primarily Medicaid
16 fee–for–service. That is what they come in with as
17 their insurance. Or if you have kids that you are
18 billing, if you are a designated clinic and you
19 have kids you are billing Medicaid fee–for–service
20 on but because they are SED you are able to bill
21 for them, those are the only count of kids
22 admissions you would put within that breakout.
23 MS. MANIGAT: So, yes?
24 MS. RILEY: Yes.
25 MS. MANIGAT: Management –

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2 MS. RILEY: Understand that when you
3 talk about kids that have multiple levels, where
4 Medicaid may be a third payer, those aren't kids
5 that you are going to put in that historical
6 admissions of Medicaid fee–for–service. It is only
7 kids that are absolutely one hundred percent pure
8 Medicaid fee–for–service or the kids that you are
9 billing Medicaid fee–for–service because of the
10 Serious Emotional Disturbance designation of
11 Medicaid managed care.
12 MS. MANIGAT: Last question. From the
13 last session that we had in building 102, are those
14 questions and answers publicized yet on the web?
15 MS. RILEY: I just had an update today.
16 I would expect those to be on the web either later
17 today or tomorrow.
18 MS. MANIGAT: Thank you.
19 MR. RUBIN: Herb Rubin, Peninsula
20 Counseling Center.
21 The first question, Kristin, is about
22 meeting the deadline of December 6th, I think,
23 for –
24 MS. RILEY: December 8th. I misspoke.
25 Everybody should have gotten correction letters.

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2 MR. RUBIN: I don't think we did.
3 MR. HOFFMAN: It is probably in the
4 mail.
5 MR. RUBIN: We are going to, hopefully,
6 apply for two clusters. They involve eleven school
7 districts. The process, because we have gone
8 through this in the past – the process of getting
9 the approval of each superintendent, who in turn
10 has to get the approval of the school board, who in
11 turn has to get the approval of – not the approval
12 but the support of the psychological and social
13 work and guidance staff that they are not being
14 replaced by something like this is long and
15 cumbersome.
16 We can initiate that process and we
17 will. I am not sure we are going to have the
18 approvals of the superintendents by the time we
19 need to submit this. That is one concern.
20 MS. RILEY: What you are going to need
21 to do on that, what we have put forth as our
22 expectation in the RFP is that you do have some
23 kind of letter of agreement, letter of
24 understanding. If that is not achievable,
25 obviously, what you are going to have to do is

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2 report within the RFP what steps you have taken,
3 where you are at with that and what your future
4 plans are with that and how far you have gotten.
5 MR. RUBIN: The second area of concern
6 has to do with the selection and screening devices.
7 I am a little surprised that the Office of Mental
8 Health has not designated – you provided a
9 directory, I think, of where we can go.
10 MS. RILEY: We actually provided
11 information within the guidance document about
12 various tools, what ages they run with, which ones
13 that we were able to ascertain were valid and
14 reliable.
15 MR. RUBIN: Is there a reason why you
16 have not selected one, though, to say that this
17 would be the device that we would use?
18 MS. RILEY: Two reasons. There isn't a
19 definitive screening tool sort of above all else
20 that people should use. The level of screening
21 that we are implementing in New York State is so
22 unique that there isn't another state to say –
23 that has done it this broadly, that here is the
24 tool you want to use.
25 Lastly, the whole Clinic–Plus process is

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2 really built around trying to leave some options
3 for local decision–making about what they feel
4 works best for their clinic or works best for the
5 particular population they are working with. Again,
6 we are trying to give people choice within that.
7 MR. RUBIN: I looked up the cost of
8 ordering a screening tool, and for 1,500 students
9 the cost would be about $7,000. The particular
10 grant, I think, for each cluster for screening is a
11 little over 16,000. That doesn't – and that also
12 assumes that one has to have somebody responsible
13 for doing the screening. I am just wondering, when
14 you count the cost of the screening tool plus the
15 hiring of someone –
16 MS. RILEY: A couple things. We put
17 in – there are several tools available within
18 that. Some have costs and some don't. That may be
19 a decision–making factor for some programs,
20 depending on the size of the populations they are
21 working with.
22 The other thing I would caution, and I
23 don't know which specific one you are looking at,
24 but some of the tools have – if you were to ask –
25 I am looking at the Acme Screening Tool. The Acme

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2 Screening Tool may have 112 pages in it. It may
3 have a student/teacher/parent component, so when
4 you get the quote of $7,000, you may get that if
5 you are doing all the elements and the only piece
6 you would be required to do for Child and Family
7 Clinic–Plus, depending on the age of the child,
8 would be one of those – the students, if they are
9 old enough to fill it out, or the parent if they
10 are not at an age to do that.
11 So, you have to also be very careful in
12 terms of what it is you are asking them to cost
13 out.
14 MR. RUBIN: This was for students.
15 MS. RILEY: Student only? That is a
16 call. If, within the total budget of not just
17 screening but comprehensive assessment and clinic
18 explanation and in–house services and the state aid
19 you have for start–up, you decide you want to use
20 one of the tools that has a cost associated, you
21 can. There are others that don't have cost
22 associated.
23 MR. RUBIN: The other question, the
24 comprehensive assessment refers to psychiatric
25 evaluation. I don't think it is required.

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2 MS. RILEY: Do you want me to go through
3 that?
4 MR. RUBIN: Go ahead. I appreciate it.
5 MS. RILEY: The biggest issue with
6 comprehensive assessment in the program model is
7 really having all clinics look at trying to raise
8 the bar on the assessment they are providing so
9 people understand the value behind that. The
10 guidelines we put out from the American Academy of
11 Child and Adolescent Psychiatry, which, as you
12 might guess, coming from the American Academy of
13 Child and Adolescent Psychiatry, they recommended
14 that a child psychologist be involved in every
15 assessment.
16 In New York State, with the current
17 resources and with the shortage of child
18 psychiatrists, that isn't practical in all aspects,
19 certainly. What we would be looking for, though, is
20 how have you set up your assessment process to be
21 consistent with those guidelines. And that would
22 include things like how do you use psychometric
23 tools? How do you use more of those regular scales
24 to help you make diagnostic determinations versus
25 sort of clinician opinion, which has been shown to

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2 have some bias with it, depending on what people
3 are comfortable with or familiar with.
4 So, how do you use those tools? How do
5 you as a clinic set up your clinic assessment
6 process? Who do you have doing the intakes? What
7 do you have them doing? How do you have staff have
8 consultations with the psychiatrist around? That
9 is how many are addressing that, having some case
10 consultation to say "I met my second assessment
11 visit with this Child and Family and this is what I
12 am seeing; what do you think?"
13 The psychiatrist may say, "Continue on,
14 I think you are doing fine," or may say, "I am
15 picking up a need to do this test or go in this
16 direction." So, there can be some dialogue yet in
17 a more cost–efficient way, and that that may happen
18 in a one–hour meeting around a range of things the
19 psychiatrist is interacting with the staff on.
20 And that is just one example of how to
21 get some of that input. How does the clinic make
22 determinations about which youngsters in the
23 assessment process really do need to get in front
24 of the child psychiatrist? What is the threshold
25 for that within the process? Those are things that

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2 would be included within your response to that.
3 MR. RUBIN: At Peninsula Counseling
4 Center we see about 750 children a year. We have,
5 among our psychiatric staff, we have a child
6 psychiatrist 28 hours a week. There is no way that
7 he would be able to take on the additional
8 responsibilities of helping us on the assessment,
9 on the comprehensive assessment of new children who
10 may be identified.
11 MS. RILEY: What you may do is you may
12 take a look at – every clinic is going to be
13 different. You may take a look at how you
14 currently have that doctor's time structured and
15 look at that – look at priorities differently or
16 look at how you have that broken out differently.
17 If you're applying for Child and Family
18 Clinic–Plus, you are going to see a significant
19 expansion of clinic treatment services, so one of
20 the things you will need to do is add time anyway.
21 It may be, if you are adding time and if
22 you are adding a psychiatrist or child
23 psychiatrist, how are you going to look at those
24 roles and responsibilities, again, across that new
25 level of volume and what it is that you do.

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2 MR. RUBIN: My concern is whether you
3 have taken that into account in the reimbursement,
4 to hire psychiatric – first of all, they are very
5 scarce and hard to find and also very expensive.
6 MS. RILEY: Upstate we saw a lot of
7 expansion in child psychiatry contained within the
8 Clinic–Plus proposals. I feel we put that into the
9 model in terms of the state aid and the Medicaid
10 rate. And we did see a fair amount of that upstate
11 as well, actually coming into people's proposals.
12 MS. BALTZ: As I recall, wasn't there
13 some provision as to an assessment could be done by
14 a nurse practitioner if they were supervised by a
15 psychiatrist?
16 MS. RILEY: The psychiatrist or child
17 psychiatrist per the regulations has to sign off on
18 the treatment plan. The nurse practitioner can't
19 do that. Again, looking at ways of having nurse
20 practitioners be involved in that are another of
21 the tools in taking a look at comprehensive
22 assessment and how you do that.
23 MS. MANIGAT: OMH already has
24 regulations and guidelines as to how we need to
25 incorporate our psychiatric staff into our

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2 treatment planning and things of that nature. Are
3 you asking us to go above and beyond that, or just
4 meet those expectations?
5 MS. RILEY: There will be new items
6 within the regulations that speak to comprehensive
7 assessment, that speak to screening, that speak to
8 in–house services. So, in terms of meeting the
9 enhancement for comprehensive assessment, you will
10 have to take a look at your assessment process and
11 make sure it is consistent with those guidelines.
12 When you start getting into treatment planning and
13 those time frames and those components, that is not
14 changing.
15 MR. RUBIN: Kristin, if – I think you
16 indicated at the last meeting that, for example, if
17 there are a group of 3,000 children that were
18 screened, that the projection from experience would
19 be about 12 percent of them would be in need of
20 further assessment.
21 MS. RILEY: Depending on if they were
22 school kids coming from schools, yes.
23 MR. RUBIN: That would be about 400.
24 MS. RILEY: 500. 499.
25 MR. RUBIN: And from –

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2 MS. RILEY: I have done this
3 presentation a lot.
4 MR. RUBIN: Have you also then figured
5 out the number of additional staff that would be
6 needed to see those children? Because they can't
7 all be seen – the screening is done at one time.
8 It is impossible to follow up all those children
9 within the immediate period following the
10 screening.
11 MS. RILEY: Let's talk about that a
12 little bit. Within Child and Family Clinic–Plus,
13 every clinic is bit different and the state Office
14 of Mental Health doesn't have – we have guidelines
15 around how much staffing you need to have, how much
16 percentage of time is professional time or
17 psychiatry time, but we don't come out with a
18 specific staffing model saying if you are going to
19 see 500 kids, this is the staffing you specifically
20 need.
21 As it relates to those coming in from
22 screening to comprehensive assessment, you have to
23 take a look at that number and do a couple of
24 things with it. First, to make some assumptions
25 based on where you are, what you know about the

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2 settings that you are going into, about how many of
3 those kids are actually going to come in for
4 comprehensive assessment. You may have some of
5 those kids that move forward that say, "I want to
6 go to my pediatrician to follow up on the
7 screening."
8 You may have others that decide to come
9 once and don't come back. There is going to be a
10 range of options of kids that sort of happens with
11 that 500. That is part of looking at that.
12 The other consideration for that would
13 be how do you want to structure that intake and
14 that comprehensive assessment process? Coming back
15 to that, you now have a significant influx of money
16 coming into the agency around comprehensive
17 assessment. How do you do that now? Do you have
18 one person doing intakes or a couple people doing
19 intakes, or does every therapist who is potentially
20 going to be working with a child do the intake
21 piece? How do you want to see that structured?
22 That may be one piece that you want to
23 look at. What some agencies have done upstate, to
24 give you a flavor for that, is to have one person
25 who is going to do that initial contact visit with

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2 the parents around the comprehensive assessment, to
3 sort of see – so they can do more. They are
4 shorter visits the first one, to see is this a
5 place where you want to receive care? Can we get
6 you to engage? Do you want to go someplace else?
7 Am I going to do the referral out for that?
8 Really, that first comprehensive visit
9 is more focused on engagement. Is this the right
10 place for you? Did your kid have a bad day when
11 they did the screening and they don't really need
12 services? Do you want to go someplace closer to
13 your home? Working on it that way versus, in a
14 sense, tying up a primary therapist or a
15 particularly long visit on that first one.
16 Again, that is one option.
17 MR. RUBIN: I want to understand
18 something. That covers the first assessment. Then
19 the person would see someone differently for the
20 second and third appointments?
21 MS. RILEY: They may, yes, in that
22 option. Hudson River County is actually doing –
23 they can only bill the comprehensive assessment
24 visit. I don't want this to confuse you, but they
25 are going to do a lot of assessment visits in the

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2 home, actually out in the community, and they found
3 that works for them.
4 MS. MANIGAT: How do you get paid on
5 that? I remember you said early on –
6 MS. RILEY: They are not getting billed
7 for both. But they are doing the comprehensive
8 assessment visit in the home because they found
9 that doing visits in the home for them has helped
10 to improve their engagement rates and has really
11 reduced no–shows to a level where they feel that
12 for them it is financially viable.
13 The variability, when you ask the
14 question around staffing model, I have seen other
15 clinics that are totally anxious about doing any
16 in–home visits. That gives you a sense that part
17 is looking at your own clinic, seeing what your
18 strengths and weaknesses are, seeing what it is you
19 are trying to achieve and how you are going to meet
20 those guidelines.
21 MR. RUBIN: Could you provide the names
22 of those clinics that are operational under
23 Clinic–Plus?
24 MS. RILEY: That is a good question. I
25 don't know why not, but I will take that back.

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2 Just this week we are doing the first round of
3 proposals we have from upstate counties and upstate
4 providers are receiving their conditional approval.
5 I will check in and see if we can share that list.
6 MR. KAPLAN: I was looking to see if
7 there were any questions after the updates.
8 Two questions. One, in Suffolk County,
9 I know the areas are divided by location rather
10 than school district. If you are only interested
11 in specific school districts within more than one
12 area, is there a way to split up or do you have
13 to –
14 MS. RILEY: The clusters are what the
15 clusters are. If you are going to apply for one of
16 those clusters, you need to apply to cover the
17 whole component. The one option you would have is
18 if you can find another agency that would be
19 interested in partnering with you for that cluster.
20 You can share that cluster in a collaborative way
21 as long as both of you bid on a whole number of
22 screening units.
23 MR. KAPLAN: Then, within those areas,
24 are you responsible for all of the school districts
25 within those areas or just the ones you choose to

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2 work with?
3 MS. RILEY: Just the ones you choose to
4 work with that provide between the minimum and
5 maximum number of kids screened.
6 MR. KAPLAN: The other question I had
7 was in terms of the health centers and how that is
8 set up. I was speaking briefly with Frank
9 yesterday and he told me that there is a way to
10 arrange that the health centers themselves would do
11 the screening and then refer; is that correct?
12 MS. RILEY: One of the things that you
13 could look at as you are looking at this, you have
14 to make sure that the clinic maintains the
15 accountability around doing the screening, that you
16 maintain confidentiality on the parts of the
17 families involved, particularly, though we saw an
18 opportunity with the health clinics where people
19 may have less of a sense of stigma about looking at
20 assessment with a primary health provider; that if
21 the Clinic–Plus program were to train that program
22 in how to present the screening, train them in how
23 to obtain the consents, provide the parents with
24 the Clinic–Plus provider who can answer questions
25 about what does this mean if the parent has

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2 questions or wants to wait before they consent,
3 before they talk to somebody, they can fill it out
4 or the student can fill it out.
5 They are provided that by the health
6 clinic and then the results would be put in an
7 envelope, sealed and the Clinic–Plus provider would
8 come in, get the results, score them and contact
9 the parent for follow–up.
10 MR. KAPLAN: How would payment work in
11 terms of those screenings?
12 MS. RILEY: The payment still goes to
13 the Clinic–Plus provider and that Clinic–Plus
14 provider is held accountable for that. If you can
15 talk to the health clinic and they feel they are
16 getting enough in return in terms of the reciprocal
17 capacity for referrals, that they can just attach
18 that and absorb it, fine. If they need some
19 compensation, that is something that would be
20 between the provider and that particular site.
21 Again, the biggest thing would be making sure that
22 the Clinic–Plus provider is maintaining
23 responsibility, accountability and oversight of
24 that.
25 But I think there are – there are

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2 natural opportunities to look at partnership and
3 look at actually benefiting kids by having somebody
4 who they may have a more long–standing relationship
5 with talking to them about screening.
6 MR. SIEGEL: Our own health clinics have
7 expressed they want to do this project.
8 MS. BALTZ: I met with them. Really met
9 with enthusiasm for the process. The feeling was
10 the children would have a better chance of
11 obtaining services.
12 MS. RILEY: Correct.
13 MS. MANIGAT: One more question.
14 Getting back to the clinic that is trying to set up
15 a satellite in another cluster. If we can look at
16 the cluster in which the clinic is located in and
17 we can break that out and we can still meet the
18 minimum screening units, then we can target that
19 cluster?
20 Our concern was that there were several
21 school–based clinics in that cluster, so if we took
22 one town and that town had sufficient –
23 MS. RILEY: Numbers to meet the
24 screening?
25 MS. MANIGAT: We don't have to hit every

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2 town in that cluster?
3 MS. RILEY: No.
4 MS. MANIGAT: Okay.
5 MR. RUBIN: It was a strange combination
6 of clusters, by the way. Carle Place in Nassau
7 County was placed in our cluster. Carle Place is
8 in central Nassau County. We are in southwest
9 Nassau County. We have never had any dealings at
10 all with Carle Place. It would be much more
11 appropriate that it belongs to Nancy's agency than
12 ours.
13 MS. RILEY: I will defer to my county
14 counterparts.
15 MR. HOFFMAN: The determinations were
16 made by the county in terms of how they wanted it
17 broken down.
18 MR. RUBIN: Carle Place is where the
19 Roosevelt Mall is, and we have nothing to do – we
20 are not within ten miles of the area.
21 MR. HOFFMAN: Again, you are not
22 required to serve every single district.
23 MR. RUBIN: It is unfair to the
24 district. It might have a better opportunity of
25 being served by a facility it was used to working

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2 with.
3 MS. RILEY: If you want, I will ask.
4 What is the name?
5 MR. RUBIN: Carle Place, in cluster ten
6 or eleven.
7 MS. RILEY: I will ask them for some
8 clarification and get that.
9 MR. KAPLAN: Can I clarify the issue
10 around private schools? In the city, apparently,
11 they are allowing this to be done in the private
12 schools. I was under the impression at the last
13 meeting in Nassau and Suffolk you can't do private
14 schools.
15 MS. RILEY: What we did for both New
16 York City, and Long Island, Nassau and Suffolk, we
17 partnered with the counties in looking at what the
18 target populations were and really very heavily
19 deferred to them in terms of what the target
20 populations would be.
21 In the city, one of the things they
22 identified as being an important area they wanted
23 to cover were schools that had kids that had unique
24 cultural characteristics. It was in some ways less
25 about private schools and more about there would be

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2 certain children that, based on cultural needs,
3 would not receive services from just any particular
4 provider. They made an accommodation within their
5 RFP to cover that, and that wasn't done for Nassau
6 and Suffolk.
7 MR. KAPLAN: So if a child, let's say,
8 is attending a parochial school and receiving
9 special services from the local school district as
10 part of their educational services, is that someone
11 who would or wouldn't qualify?
12 MS. RILEY: Somebody who is in –
13 MR. KAPLAN: You could have somebody –
14 MS. RILEY: You would not be screened in
15 that school. If that child needed mental health
16 services and was going to be referred to one of the
17 Clinic–Plus programs, they absolutely could be
18 served. But the parochial school would not be
19 screened.
20 MR. KAPLAN: The parochial school would
21 have to ask the public school to make the referral?
22 MS. RILEY: No. They would make the
23 referral.
24 MR. HOFFMAN: To the clinic. I see.
25 Directly –

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2 MR. HOFFMAN: There just wouldn't be a
3 site where screening would occur.
4 MR. KAPLAN: We could inform private
5 schools of that option?
6 MS. RILEY: It exists right now as well.
7 MR. KAPLAN: They may not be aware of
8 what is going on.
9 MS. RILEY: Their capacity to refer to a
10 clinic now would exist.
11 MR. KAPLAN: I am saying they may not be
12 aware of this particular program, though, that is
13 now in existence. We could go directly to the
14 clinic from private school.
15 MS. RILEY: Yes.
16 MR. SIEGEL: I did want to comment that
17 the other alternative is that we are anticipating
18 using the health clinics, who serve a broadbased
19 population. So there are children who are
20 attending parochial schools who could go that
21 route. But you don't have to go actually through
22 being screened by this in order to have the
23 advantages of this Clinic–Plus.
24 MS. RILEY: Good point.
25 MR. SIEGEL: We also felt that making

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2 arrangements with 72 separate school districts, and
3 then if you start adding every private school,
4 would become...
5 MR. HOFFMAN: Overwhelming?
6 MR. SIEGEL: Well, more overwhelming.
7 MS. BALTZ: Half the 72 is overwhelming.
8 MR. RUBIN: Kristin, did you indicate
9 last time that once the Clinic–Plus program starts,
10 that all kids in the existing clinic program, all
11 new kids would be eligible for the comprehensive –
12 would be expected to have the comprehensive
13 assessments and would be eligible for that add on?
14 MS. RILEY: Yes, as well as all existing
15 kids that are already admitted. They wouldn't need
16 comprehensive assessment, but they could have
17 in–home services. If all the existing kids within
18 your clinic that are currently served within your
19 first day of operation, those kids would be
20 eligible for in–home services at the enhanced rate
21 as well.
22 MR. RUBIN: If they are a Medicaid
23 child, they have the Medicaid rate, they would have
24 the enhanced rate?
25 MS. RILEY: Correct.

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2 MR. RUBIN: Would they also have the
3 COPS rate on top of that?
4 MS. RILEY: The COPS rate would be on
5 top of that as long as you were within your
6 threshold. We sort of go back to the COPS piece
7 again. Your base calculation in terms of the state
8 aid that you would get would include those kids
9 that are currently being served in terms of the
10 in–home services and the state aid cost offset for
11 that.
12 MS. RILEY: Just to give you a sense of
13 the other dates that we do have for informational
14 sessions, our next one would be October 27th.
15 These are all available on the web and were all
16 handed out to people at the bidders conference. It
17 would be the 27th and then another one on November
18 8th as well. Both of those are 10 a.m. to 1 p.m.
19 MR. HOFFMAN: Just to confuse you a
20 little bit more, the next information session, the
21 one on October 27th will be at building 102 on the
22 grounds here. Then the November 8th will be back
23 in this room. It is just that this room was not
24 available on the 27th.
25 MS. RILEY: I would also just remind the

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2 providers that at any point in time you can send
3 your questions that you have to the procurement
4 officer and we will respond to them. Given that we
5 have a little bit of time here in between sessions,
6 you know, we may be able to put some up on the web
7 before that, or we will bring them to the next
8 informational session and be able to respond to
9 those.
10 Anybody have any other questions?
11 Thank you for coming.
12 MR. RUBIN: If we did not get full
13 approval of the school districts by the time we
14 have to submit the application and we included the
15 letters and correspondence that were part of trying
16 to get that, can we still submit it understanding
17 that you can't act until we have the final
18 approval?
19 MS. RILEY: Yes. What we will need is
20 to know what steps you have taken to be able to do
21 that. If it was out of your control – you know,
22 they weren't having a school board meeting, there
23 were other things you ran into, we will have to
24 take those into consideration. You are really
25 providing either the letter of agreement or your

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2 documentation of what you have done and where you
3 ran into an issue.
4 MR. HOFFMAN: If you prepared a draft
5 letter of agreement and forwarded that to the
6 school but you are waiting for a school board
7 meeting two weeks from the due date, include that
8 draft letter as well as what is expected.
9 MS. RILEY: Thank you.
10 (Time noted: 2:00 p.m.)
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3 C E R T I F I C A T E
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5 I, DEBRA STEVENS, a Registered
6 Professional Reporter and notary public within and
7 for the State of New York, do hereby certify that I
8 reported the proceedings in the within–entitled
9 matter on October 18, 2006, and that this is an
10 accurate transcription of what transpired at that
11 time and place.
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14 DEBRA STEVENS, RPR–CRR
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Child and Family Clinic Plus Transcripts of the October 12, 2006 Informational Sessions

Child and Family Clinic Plus
Transcripts of the October 12, 2006 Informational Sessions