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An Integrated Approach to Working with Youth with Both Permanency and Behavioral Health Concerns Elizabeth McGovern, Area Office Director, Morris/Sussex.

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Presentation on theme: "An Integrated Approach to Working with Youth with Both Permanency and Behavioral Health Concerns Elizabeth McGovern, Area Office Director, Morris/Sussex."— Presentation transcript:

1 An Integrated Approach to Working with Youth with Both Permanency and Behavioral Health Concerns Elizabeth McGovern, Area Office Director, Morris/Sussex and Passaic Jeena Williams, DYFS Team Leader, Morris/Sussex and Passaic Elizabeth Manley, CEO Caring Partners

2 Who We Are... The New Jersey Department of Children and Families CHILD PROTECTION, WELFARE, PERMANENCY; CHILD BEHAVIORAL HEALTH; AND ABUSE PREVENTION Department of Children and Families (DCF) Division of Youth & Family Services (DYFS) Child Protective Serviced Permanency Division of Child Behavioral Health Services (DCBHS) Child Behavioral Health Services Division of Prevention & Community Partnership Prevention of Child Abuse & Neglect Area Offices Local Offices Early Childhood Services Domestic Violence Services School Linked Services Family Support Services Services to County Welfare Agencies System of Care For Children

3 DCF / DYFS Case Practice Improvement Overview Allison Blake, Ph.D., LSW, Commissioner Department of Children and Families Jean Marimon, Director DCF, Division of Youth and Family Services

4 1 st Focus on the Fundamentals Create the conditions that are pre-requisites to… 2 nd Implementing Change in the Culture of Practice Move from a case management service delivery model to a strength-based, family centered, child focused model. Then, DYFS can… 3 rd Deliver Results With improved outcomes for children and families. The federal lawsuit recognizes that reform requires a focused and staged process to achieve results:


6 Average DYFS Caseload Size Statewide as of June 2010

7 Total Resource Homes Licensed

8 Finalized Adoptions FY

9 Children in DYFS Out of Home Placement FY FY 2010

10 DCF Case Practice: Focusing on Families DCF/DYFS Case Practice model aims to see a familys whole life picture; including its natural supports (such as community organizations, family members, neighbors) and any issues effecting the familys success (such as unemployment, substance abuse, housing, education, domestic violence, physical and mental health, etc.).

11 Who is Part of a Family Team? A family team is made up of everyone important in the life of the child, including interested family members, foster/adoptive parents, neighbors, friends, clergy, as well as representatives from the childs formal support system, such as school staff, therapists, service providers, CASA, the court service and legal systems. Parents, children and youth (when age appropriate) and team members do become active participants in making decisions about what services and supports are needed, how and who should deliver the services and how to identify success.

12 Strengthening case practice, engaging families to see a child not just as he is… But as strong as his family can become. DCF CASE PRACTICE FAMILY FOCUS

13 Division of Child Behavioral Health Services (DCBHS) Contracted Systems Administrator Clinical Assessment To determine the appropriate level of care within the system and /or access to services (877) PerformCare, LLC Care Management Organization Caring Partners of Morris/Sussex (973) Helps families create Child & Family Teams that develop individual resources and give access to supportive services 1-2 year model Youth Case Management Newton Memorial Hospital (973) Face-to-face Case Management that gives access to supportive services 90 day model Mobile Response & Stabilization Family Intervention Services (877) Keeping kids at home & stable with access to short- term services 4 to 8 week model Community Providers Community Services Services through the System of Care & Direct to families Medicaid & Fee-for -service Family Support Organization Family Support Organization of Morris/Sussex Available to all families inside and outside the DCBHS System of Care For information on parent support groups call: Family Based Services Association of New Jersey Out of Home Treatment Providers Highest levels of care

14 2003 Local Systems of Care are initiated in Hudson and Middlesex counties Local Systems of Care are initiated in the remaining two areas of the state: Sussex/Morris, and Hunterdon/ Somerset/Warren Local Systems of Care are initiated in three areas: Gloucester/ Cumberland/Salem, Ocean, and Passaic counties Local Systems of Care are initiated in three additional areas: Atlantic/Cape May, Bergen, and Mercer counties Acting Governor DiFrancesco endorses the project with two caveats: 1.The name must be changed to the Partnership for Children, and 2.The project must be expedited to initiate local Systems of Care in urban areas Local Systems of Care are initiated in Camden and Essex counties The Office of Childrens Service (OCS) is created in response to the lawsuit against the Division of Youth and Family Services The Partnership for Children becomes the Division of Child Behavioral Health Services under OCS Local Systems of Care are initiated in three areas (patterned on vicinages): Burlington, Monmouth and Union counties New Jersey wins System of Care grant award from the Substance Abuse and Mental Health Services Administration (SAMHSA) of the federal Department of Health and Human Services (USDHHS) Governor Whitman endorses the project with two caveats: 1.It must be statewide, 2.It must be funded through Medicaid Rehabilitative Services. NJ Division of Child Behavioral Health Services DCBHS History


16 Childrens System of Care Info: At any given time there are: 2,562 youth enrolled in MRSS 3,558 youth enrolled in YCM 2,400 youth enrolled in CMO 2,015 youth enrolled in UCM 1,868 youth currently in out of home care 39,779 youth who are open to the CSA

17 PerformCare, LLC Welcome To New Jersey Childrens System of Care PerformCare is the statewide Contracted System Administrator (CSA) for the Division of Child Behavioral Health Services (DCBHS). As the CSA, PerformCare is committed to getting children, youth, young adults and their family/caregivers the services that they need at the right time, and in the right place. Hours of Operation: 24 Hours a Day 7 Days a Week For Assistance Please Contact Us at:

18 Mobil Response and Stabilization Services (MRSS) Initial Response ( within 1 hour) Initial Response can last up to 72 hours Intervention and de-escalation Assessment – Crisis Assessment Tool (CAT) Safety/Crisis Planning Individualized Crisis Plan (ICP) Discharge/Transition Planning Stabilization Services (up to 8 weeks) Provide additional resources to ensure stabilization Linkage to community resources Individual and Family In-Home Counseling/Behavioral Assistance

19 Care Management Organizations –CMO/UCM No eject no reject. Referrals are assessed for CMO level of care through the CSA and assigned to the appropriate CMO/UCM CMO has 24 hours to make contact and 72 hours for the first visit. We are generally accompanied by the Family Support Organization. Commitment to Community Resource Development. Care is coordinated through a Child Family Team Process for which all things are coordinated.

20 How Does Care Management Work ? The CFT is tasked with looking at all life domains, identifying functional strengths of the youth, family and team and prioritizing the needs and developing thoughtful strategies to meet these needs. The average length of stay is 12 to 18 months. In a CMO/UCM the youth and family have 24 hour access to Care Management Staff.

21 Family Support Organizations - FSO … Educate families on their rights and responsibilities within the NJ System of Care Advocate to assure families get what they need Enhance the service system Encourage families to recognize and appreciate their strengths Help families articulate their needs Support families in providing feedback to their service providers, their Care/Case Managers Empower families to become their childs best advocate Insure the family voice is heard

22 How do Family Support Organizations fulfill their missions? Strategic Partnerships Engender FSO/CMO/UCM Strategic Partnership Engage in Community Development Provide Peer to Peer Support for Families with Children at the highest levels of Care Management Educate Families about the System and their Childs Challenges Educate Families to Advocate in their Childs and Familys best interest Monitor the System of Care for Family Involvement, Family Friendliness and Family Focus Advocate for System Change when Necessary. ( NJ Division of Child Behavioral Health)

23 Peer to Peer Family Support Provided to Families who have Children enrolled in Care Management Organizations Give intense support services to these families when most needed Educate families to understand the NJ System of Care

24 Youth Partnership The Youth experiencing the System know it from the inside out. They bring a unique perspective to the System of Care Family Support Organizations empower Young People become advocates for themselves and their own services Youth Partnership activities are provided through the Family Support Organizations

25 Family Team and Child Family Team Similiarities Family Team Meeting - FTM Safety The family selects the team Strengths and needs focused Prioritize 3 to 4 needs Child Family Team - CFT Safety Family and youth select the team Strength and needs driven Prioritize 3 or 4 life domains

26 FTM and CFT Differences Family Team Meeting Underlying needs are quickly identified and addressed The focus is on the whole family Very quick time frames Child Family Team Underlying needs are identified and addressed over time The CFT focuses on the youth with a behavioral health concern The CFT focuses on all life domains over the Care managers involvement over12 to 18 months

27 Treatment Options Community Based Outpatient – individual, group and family Partial Care Partial Hospitalization Behavioral Assistance Intensive In Home – IIC Out of Home Treatment Treatment Home Group Home Residential Treatment Psych Community Residence Intensive Residential Treatment Services CCIS

28 Treatment Considerations Medical Necessity Safety Expectations Guardian Involvement Clinical Considerations Transition planning at admission Community Planning


30 Integrating Child Behavioral Health and Foster Care Morris and Sussex Recommendations CMO to provide crisis intervention training to all local DYFS staff. CMO to provide crisis intervention training to resource parents. CMO to develop a brochure targeted at resource parents. DYFS staff will present MRSS to resource parents as a normative transition service rather than a crisis-oriented program. Team Leader to speak directly with resource parents who have questions about or need assistance accessing DCBHS programs (especially MRSS and FSO)

31 Morris and Sussex Recommendations Continued: CMO staff can submit a timely addendum to resource home requests so that the child can be comprehensively presented from multiple perspectives. This will include strategies that are successful in comforting the youth. DYFS staff who have youth approaching discharge from out of home treatment will give early notice to the resource unit so that they can begin locating a potential step-down placement. Resource Family Workers will be invited to internal reviews to incorporate the needs of the resource parent. DYFS and CMO case/care manager will make a joint visit to resource homes requesting a youths removal to offer enhanced services to preserve the placement.

32 Permanency Project Joint venture by DYFS Team Leader, CMO Clinical Liaison, DYFS Concurrent Planner. Inspired by anecdotal evidence regarding children who require permanent living arrangements after completing treatment. 11 such cases were identified in Morris/Sussex area; sample of 5 was reviewed.

33 Permanency Project (cont.) Resulted in recommendations in the areas of family involvement; DYFS & DCBHS case management; and SOC refinement. Concrete efforts include: –Adolescent FTMs –Adolescent Life Books –Educational Sessions for Supervisors –Development of Adolescent Permanency Training

34 Next Steps Monitor the data Youth who are placed in resource homes rather than treatment facilities. Youth who are returned to the community in a resource home. Youth removed from resource homes and moved to out of home treatment.

35 Thank you for attending our workshop!

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