Transitional Age Youth Transitional Age Youth Program (TAYP)Program (TAYP)

Program Description and Initial Program Description and Initial OutcomesOutcomes

Stars Behavioral Health GroupStars Behavioral Health Group

Organizational ContextOrganizational Context• Part of STARS Community Services, operated by Stars

Behavioral Health Group.

• Started in 2001 as a collaborative effort with Alameda County Behavioral Healthcare (ACBHC) to address the needs of youth “aging out” of the child system.

• ACBHC runs a multidisciplinary Transitional Age Team (TAT) to conduct case review, referral, and contract management of TAYP.

• Primarily Medicaid (Medi-Cal) dollars passed through the state’s Early, Periodic, Screening, Diagnoses, and Treatment (EPSDT) program.

Service MissionService MissionFor the Young Adult To – • Become emotionally stable• Succeed in school and/or vocationally• Develop independent living skills • Have positive and satisfying relationships• Find safe and stable housing• Stay out of trouble with the law

For Their Families To –• Bring voice to their needs in both providing support

to, and “letting go” of their young adult• Discover and reinforce their young adult’s

strengths, skills, and capacity for long term self-sufficiency

Client Population Client Population

0%

10%

20%

30%

40%

50%

African American Anglo American Latino/Hispanic Asian American

350 350 Clients Clients

Ages Ages 18 to 23 18 to 23

EthnicityEthnicity

African African AmericanAmerican

Anglo Anglo AmericanAmerican

Latino / Latino / HispanicHispanic

Asian Asian AmericanAmerican

50%50%

40%40%

30%30%

20%20%

10%10%

0%0%

Clinical DiagnosesClinical Diagnoses

Externalizing Disorders

5%

Internalizing Disorders

33%

Psychotic Spectrum

62%

Additionally, 64% of clients have a co-occurring Additionally, 64% of clients have a co-occurring substance abuse problem.substance abuse problem.

Major Mental Illness:Psychotic NOS 19.3%Schizoaffective 17.5%Schizophrenia, Paranoid 15.8%Schizophrenia, Other 5.3%

Internalizing:Major Depression 10.5%Bipolar Disorder 7.0%Post Traumatic Stress 5.3%

Externalizing:Conduct Disorder 3.5%

Prior ServicesPrior Services

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Child ProtectiveServices

Out-of-HomePlacement

Non-Public SchoolPlacement

PsychiatricHospitalization

State PsychiatricHospitalization

Juvenile Probation

One or More Event,Across Types

Percent w/ Event(s) in Six Months Prior to EnrollmentPercent w/ Event(s) in Lifetime

Risk BehaviorsRisk Behaviors

11.6%

22.1%

41.9%

51.2%

59.3%

62.9%

64.0%

64.0%

72.1%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Sexual misconduct,assault, rape

Persistent defiance,oppositionalism

Impulsive, careless,reckless

Self isolation, hiding,running away

Other troublingbehaviors, varied

Suicide ideation, threat,intent, attempt

Alcohol and/orsubstance use/abuse

Bizarre acting oninternal stimuli

Fighting, assault,physical aggression

Percent of Clients with the Behavior

TAYP ServicesTAYP ServicesDirect Services:Direct Services:

• Counseling– Individual – Group– Family

• Case Management• Psychiatry Services

including Medication Support

• Crisis Intervention

Collaborations:Collaborations:

• Alcohol/Drug Treatment

• Financial Management

• Supported Housing

• Supported Education

• Vocational Training

TAYP UtilizationTAYP Utilization

All services are VOLUNTARY: Clients have a choice if they want to work with the team, when they want to work with the team, and when they want to stop. It’s up to them.

The optimal mix of services is worked out as a mutually authored (client, family and staff) plan that is periodically reviewed and updated based upon results and ongoing client need.

Average Length of Stay is 18 months Most (93%) Enroll Only Once

0

50,000

100,000

150,000

200,000

250,000

300,000

Uni

ts o

f Ser

vice

s

Counseling Case Management Medication Support Crisis Intervention

Impact: Living SituationImpact: Living Situation

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

Pe

rce

nta

ge

of

Cli

en

ts I

n S

ett

ing

Admission Discharge

Psychiatric HospitalizationsPsychiatric Hospitalizations**

0.8

2.22.0

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

4.5

5.0

Before TAYP During TAYP After TAYP

Ave

rag

e N

um

be

r o

f H

osp

italiz

atio

ns

Pe

r M

on

th P

er

Clie

nt

* Time periods are one year before compared to one year after.

Hospital Lengths of StayHospital Lengths of Stay**

1.0

5.4

15.9

0.0

5.0

10.0

15.0

20.0

Before TAYP During TAYP After TAYP

Av

era

ge

Le

ng

th o

f S

tay

in

Da

ys

* Time periods are one year before compared to one year after.

Client SatisfactionClient Satisfaction83%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Pe

rce

nt

Sa

tis

fie

d w

ith

Se

rvic

es

Clients’ ViewsClients’ Views**

What I Like About the Program –

• “I like the worker I have. I like the way they sit down and talk with you. I like that I get to choose the goals I work on.”

• “I have a place to go with my problems. I like how the program treats me with respect. I like the activities that take place.”

• “Your mentor is with you until you graduate from the program. They see you at least once a week. They help you find a job.”

* Responses to anonymous client satisfaction surveys.

Collaborators’ ViewsCollaborators’ Views**

• Regarding overall program philosophy -- “This is a program whose first motivation is the

client -- the staff are awesome!” -- Cathy Lamastrus, House Parent, Personal Support Group (PSP), Drug Rehabilitation Program, Lake Co.

• Regarding interagency collaboration -- “We are like family, a hand-in-hand partnership.

The staff is very responsive to our needs and those of the young men who reside here, who want a respectable place to live. We all make sure of that.” -- Beverly Riley, Administrator, Rene’s Place Board and Care, Alameda County.

* Quoted with permission.

Collaborators’ ViewsCollaborators’ Views**

• Regarding cultural competency – “The leadership is very astute, sensitive, and really

do set the right tone.” -- Dean Chambers, County Contract Monitor, Alameda County Behavioral Health Care Services (ACBHCS)

• Regarding supporting clients’ skill development –

“The case managers do a great job. They know how to relate to the clients and help them manage their finances so the clients become more independent. It’s a lot of work but necessary to prevent homelessness and crime.” -- Elsie Garcia, Director, Substitute Payee Program (SPP), Alameda County.

* Quoted with permission

QI ProjectsQI Projects**

Recently Completed –

• Refinements to the Medication Management Process

• Enhancement of Supported Vocational Preparation and Access

Currently Underway –• Implementation of EQUIP & ART Groups to

Reduce Client Aggression• Crosswalk of TAYP principles & practices to

Evidence-Based Practices

*Part of the SBHG Total Quality Management Program

Please direct comments or questions to:Peter Zucker, Ph.D., V.P., Clinical ServicesStars Behavioral Health GroupLong Beach Regional Office 1501 Hughes Way Suite 150Long Beach, CA., 90810310-221-6337 x108pzucker@starsinc.com