1. FIRST QUARTER STATE FISCAL YEAR 2014 JULY - SEPTEMBER 2013 Arkansas Department of Human Services Division of Behavioral Health Services 305 South Palm Street Little Rock, Arkansas 72205 Arkansas System of Care Quarterly Report First Quarter SFY '14

2. Family and Youth Activities Statewide Activities: Attending, 883 Attending, 511 First Quarter SFY '14 2 Total Attending 1394 Total Events 74 Reports are taken from information collected as of October 31, 2013 Wraparound providers are required to provide family support activities. These activities are generally held monthly or bi-monthly. The purpose is to provide a regular opportunity for caregivers to learn valuable skills to strengthen their families. These events serve as prevention level activities to offer youth and families support, education, and leadership skills. Family support activities throughout the state vary by provider, as they are based on the communities' needs. The activities allow caregivers and youth opportunities to interact with one another and to provide peer support and encouragement. These events not only provide opportunities for family socialization, but also serve as an avenue to identify stumbling blocks to recovery. A few family support activities from providers are featured below. All Incident Free Back to School Bashes: Several programs celebrated the upcoming school year with community events. Health Resources of Arkansas held a celebration at the Harrison City Pool. The event was held in partnership with the local Youth M.O.V.E. (Motivating Others through Voices of Experience) chapter and Marion County Hometown Health. The theme of the event was wear it a campaign to encourage the use of life preservers for water safety. There were 94 families from five surrounding counties attending. South Arkansas Regional Health Center, Inc., partnered with the Boys and Girls Club of El Dorado and other youth organizations to hold a back to school party/health fair with games and activities. There were approximately 1200 children and youth in attendance. All of the children received a back pack filled with school supplies. Mid-South Health Systems held a back to school bash in Hoxie with 120 family and children in attendance. Families enjoyed food and were entertained by a DJ. Division of Behavioral Health Services staff were also on hand to present information and collect feedback on the Behavioral Health Care Payment Improvement Initiative. Family Fun Day on the Farm: DaySpring Behavioral Health held a family fun day on the farm with 29 family members participating from four counties. The families were invited to Farmland Adventures in Springdale to enjoy pony rides, hay rides, feeding animals in the petting zoo, a giant corn maze, in addition to cheering on their favorite animal to the finish line during pig races. Family Cook-Out: Counseling Associates, Inc. held a family-cook out for 76 family members at Toad Suck Park in Conway. Parents were entertained with a showing of Rise Up, the movie made by ACTION for Kids, while the youth played football, basketball, horse shoes, volleyball and made crafts. Hamburgers and hot dogs was served.

3. Family Support Partner Activities Support Categories: There are seven FSPs statewide Over 300 Wraparound goals were established with families 155 families received assistance from FSPs Examples of Goals and Actions Within Each Support Category First Quarter SFY '14 3 Rates of Occurrence: Family Support Partners (FSP) are peer counselors who model recovery and resiliency in overcoming obstacles common to those who live with children or youth with behavioral health care needs. FSPs come from legacy families and use their lived experience, training, and skills to help caregivers and their families identify goals and actions that promote recovery and resiliency. These goals and actions are identified on the Wraparound plan and reported to the Division of Behavioral Health Services in order to recognize training opportunities as well as track needs of families statewide. The goals are sorted into support categories. System Navigation: Assisting in completion of DDS Waiver applications Creating a communication strategy to use with other child serving agencies Connecting with Community: Connecting families to Family Fun Day activities Increasing interaction with other parents Social/Emotional and Behavioral Health: Keeping a journal of outcomes of daily activities with child Helping family member seek outpatient therapy and engage in developing treatment plan for herself Completing safety plan with assistance of treatment team Skills Development: Enabling the family to coordinate initial wrap meeting. Using tools learned to advocate for youth's needs during teleconference with provider School/Vocation: Scheduling a meeting with school counselor before school year starts Helping family members find a job Resources/Community: Finding community resources for food, utility bills, etc. Identifying natural support person to act as a mentor Physical/Developmental Health: Preparing for next medication check with written questions and feedback for MD. Legal System: Getting Medicaid Psych Assessment needed for court ordered therapy Home and Family Relationships: Creating a behavior and chore charts Encouraging the family to engage in one leisure or recreational activity per week outside of the home with children. Keeping a written log of child's positive behaviors Reports are taken from information collected as of October 31, 2013 Goal and Action Categories

4. System of Care Community Meetings 31 community meetings were held statewide Average attendance was 16.7 per meeting State Agency Community Meetings Attendance Percent : ADHArkansas Department of Health DBHSDivision of Behavioral Health Services DCFSDivision of Children and Family Services DDDSDivision of Developmental Disability Services DYSDivision of Youth Services AOCAdministrative Office of the Courts Community Meeting Participants by Type Percent: First Quarter SFY '14 4 The Care Coordinating Council and CASSP Regional Meetings are the governance and financial structures for the System of Care in the communities. The Care Coordinating Council is a partnership of community members working together to ensure children and families have services available within their community. Some of the responsibilities include: Assuring that children, youth, and families are served by individualized Wraparound teams; Maintaining a fiscal accountability system; Facilitating the expansion of creative partnerships with community resources to create non-traditional support and services Tracking outcomes; and, Supporting the ongoing involvement and ensuring families have a primary voice in SOC.

5. System of Care Clients Clients Served Per Area: 938 Active during the quarter 315 Referrals 73 In engagement phase 369 Client review meetings 208 Clients discharged First Quarter SFY '14 5 Wraparound is a family-driven, youth-guided, team-based approach that wraps services and supports around a family whose child or youth is at risk of removal from their home, school, and community due to severe to moderate behavioral health issues. The purpose of the Arkansas System of Care Wraparound sites is to facilitate the development of local systems of care and provide funding for fourteen Department of Human Services (DHS) behavioral health service areas. Reports are taken from information collected as of October 31, 2013 Area: Looking back one parent summarized Wraparound services received in one simple word: AWESOME! The client is doing very well because there have been no physical outbursts in a significant period of time and the client currently has all As in school. As for self-esteem, the client has been able to spend the night a friends house and continues to make new friends. A simple goal for most but it had been a great challenge for this client. Overall, the client and the family has grown in many positive ways. This family reported that before Wraparound they felt everyone was against them and nobody wanted to listen. The youth was being sent home from school, suspended, and had a Family in Need of Services (FINS) petition. When Wraparound was implemented, a plan of support was put in place. After Wraparound, the family feels more confident and less stressed because the legal issues have been resolved and the family is in a better situation due to being connected to needed resources. They report if the situation happens again they would be able to navigate the system and handle issues due to the skills they have acquired. Family Stories This youth was referred to Wraparound to increase independent living skills after graduation. His behavioral concerns included classroom disruptions and threatening others. As a senior, he was unsure of the direction for his future. The Wraparound team connected him and his father with Arkansas Rehabilitation Services. Paperwork was completed in order to qualify him for the Arkansas Career Training Institute (ACTI) in Hot Springs, Arkansas. During this process, he became emancipated, and the team was able to assist him by setting up the final meeting at Arkansas Rehabilitation Services, which was the first meeting without his father present. After he graduated, he was accepted to ACTI and began classes on September 8, 2013. Wraparound Activity:

6. Non-Traditional Services and Supports Provided Through Wraparound First Quarter SFY '14 6 Examples of Non-Traditional Services and Supports: Wraparound teams assisted family in purchasing school uniforms for wrap clients and siblings Family identified that client had no summer activities and would have to stay indoors all summer due to safety concerns. Funding paid for summer camp experience. Wraparound team purchased a client a bicycle to solve multiple issues: lack of exercise; transportation to after school activities; and behavioral reward Wraparound team authorized the purchase of camping and fishing equipment to facilitate positive family time outside the familys small trailer. Tae kwon do lessons were purchased to help client with self control and self discipline. Prevention/Intervention Services: Supportive Services for Children and Families: Mental Health and Substance Abuse Services: Reports are taken from information collected as of October 31, 2013 Service or Support: Percent of Expenditure: Children and youth who receive Wraparound services often are at risk of being placed out of their home, school, or community. Non- traditional services and supports such as mentoring, respite care, and subsistence, in conjunction with traditional services, help families in the Wraparound process become more resilient, independent, and accomplish their goals.

7. Arkansas Youth Information First Quarter SFY '14 7 The Arkansas Youth Information Form was developed by ACTION for Kids and Division of Behavioral Health Services employees in July 2011. The Arkansas Youth Information form measures outcomes at the beginning of Wraparound and at 90-day follow-ups. The five outcome measures were chosen to match national system of care recommended outcomes and include: 1.Hospitalization in an acute psychiatric facility, 2.Suspension or Expelled from school, 3.Custody in Division of Child and Family Services (foster care), 4.Juvenile Detention, and 5.Residential Treatment. Clients completed Arkansas Youth Information Form at the initial Wraparound plan and at review meetings every 90 days. 640 Clients completed initial and follow-up Arkansas Youth Information Forms

8. Wraparound Training September 18 - 19, 2013 Training Wraparound Training Participants: Overall Training Evaluation: 89% 11% 37 persons attended 92.4% would recommend this training to others 11 people rated every session excellent Sessions rating significantly high, include: Wraparound Tools Video, Rise Up Mock Wraparound Exercise Engagement Training First Quarter SFY '14 8