Katie A: From Compliance to Transformation CMHACY: May 14, 2015 Sylvia Deporto, MS Lynn Dolce, MFT Bonnie Friedman, LCSW Jennifer Clancy, MSW

Topics  Where Did We Start?  What Were the Critical Steps?  What Are the Lessons Learned?  What Are the Next Steps? 2

Where Did We Start? IMPORTANT ENVIRONMENTAL FACTORS  Engaged Executive Leadership  Shared Will between Child Welfare and Behavioral Health  Investment in Collective Impact- Moving from Single Agency to Multiple Agencies with Families at Center 3

Where Did We Start? IMPORTANT SYSTEM CHANGES  Key Decision- Reframe from Lawsuit to Improvement Initiative  Organizing the Interagency Services Collaborative and Creating a Structure for Shared, Cross Organizational Learning  Open Communication Between Supervisors Across Both Agencies  Cross System Training and Development of Shared Language  Use of PDSAs, Rapid Cycle Evaluation and Data  Shared Resource s 4

What Were Our Critical Steps?  IASC organized around 3 key improvement questions: 1.What are we trying to accomplish? (Aim) 2.What changes can lead to improvement? (System Changes to Achieve the Aim) 3.How do we know a change is an improvement? (Measures to Assess Are the Changes Achieving the Aim)  Improvement Questions Answered in 2 Large Stakeholder Meetings (6 months apart)  Bi-Monthly Meetings with Executive Leadership and Program Directors from Both Agencies Between Stakeholder Meetings  AFTER the ABOVE COMPLETED: Interagency Services Collaborative consisting of direct service staff, mid-management, and executive leadership from Child Welfare, Behavioral Health, and Peer Parent Advocates begins to meet 5

What Were The Critical Steps?  Shared Aim: Improve the health, safety, permanency and well-being of children, youth and families involved in or at risk of involvement in Foster Care, Probation, Special Education and are struggling with the complications of behavioral health issues by designing an attachment and trauma focused system with a shared framework that is information driven, integrated, and innovative.  Shared System Changes: 1.Hold Routine Family Centered Child and Family Team Meetings for every child at risk of entering or in the foster care system with Child Welfare, Behavioral Health, and Peer Parent Advocates to share recommendations from child welfare and behavioral health screening and assessment 2.Create Shared Family Care Plans and Engage in Ongoing Shared Family Care Planning Process between the Family and Child, Child Welfare, Behavioral Health, and the Peer Parent Advocate 3.Offer Bi-Monthly Shared Coaching to Child Welfare and Behavioral Health Workers and Peer Parent Advocates to mentor the Shared Family Care Planning 6

7  Successful Child and Family Team Meetings…..

What Is Measured?  Shared Measures (Process and Outcome): 1.Number and % of CFTs with CW, BH, PP, and Family present 2.Number of % Shared Family Care Plans 3.Number and % of children in the target population re-abused 4.Number and % of clients who were FM at case opening and have not since been placed in foster care. 5.Number and % of children in the target population who achieved permanency (i.e., reunified, adopted, legal guardianship) 6.Number and % of children in the target population who have decreased placement level of care since case opened. 8

Monthly Data Analysis*- % of children with a CFT 9 % of Children with a CFT Meeting Data Display from Nancy Callahan, IDEA Consulting

Monthly Data Analysis*-% of children with Child Welfare, Mental Health, and Parent Partner attending 10 Data display from Nancy Callahan, IDEA Consulting

Monthly Data Analysis*-Children that were re-abused 11 Data display from Nancy Callahan, IDEA Consulting

What Were the Lessons Learned?  Have humility- understand that there are two different agencies with different missions and roles  Maintain intentionality  Understand that achieving understanding is a long term process  Identify forums the agencies have to make their “marriage” work  Emphasize the role of leadership in communicating “ it is okay to fail”  Ensure coaching allows for understanding of how system change processes are mirrored with families 12

What Were Lessons Learned  Defining the questions to be answered between both agencies  Executive leadership engagement in measures selection  Using a minimal set of measures  Aligning measures with data already being collected  Establishing a routine data collection process  Making the visual display of the data more intuitive  Establishing a routine data analysis process that is linked to course corrections in the initiative 13

How Long Has It Taken & What Are Our Next Steps? Stakeholde r Kickoff March 2013 EMT& Mid- Manage- ment Engage- ment April- October 2013 Community Stakeholde r Kickoff October 2013 Finalized System Changes to Test & Measures- Nov-Jan 2014 IASC Pilot Team Testing of CFT Jan-Nov 2014 CFT Stabilized and Shared Family Care Plan Designed- Jan-Feb 2015 Shared Family Care Plan/ Shared Coaching being tested March 2015 to present 14

Questions ? 15