8/24/ Service Coordination: A Recipe for Success Shared philosophy among providers Shared philosophy among providers Collaborative policy and funding infrastructure Collaborative policy and funding infrastructure Unique services and supports Unique services and supports

8/24/ History of Service Coordination: 1980’s – Celeste Administration Clusters – county level cross system clinical/treatment teams. Clusters – county level cross system clinical/treatment teams. Participants were clinical level cross system personnel. Participants were clinical level cross system personnel. Parents and children often not involved in plan development. Parents and children often not involved in plan development. Focus on problems/concerns. Focus on problems/concerns. Creation of state cluster fund & application process. Creation of state cluster fund & application process.

8/24/ History of Service Coordination: 1990’s – Voinovich Administration Family and Children First Councils created and responsible for service coordination mechanism. Family and Children First Councils created and responsible for service coordination mechanism. Cross system approach Cross system approach Mandates included needs assessment of child, development of individual family plan, and dispute resolution process. Mandates included needs assessment of child, development of individual family plan, and dispute resolution process. State Inter-systems fund application simplified. State Inter-systems fund application simplified. SC required to access funds. SC required to access funds.

8/24/ History of Service Coordination: 2000’s - Taft Administration Methods to divert children from juvenile court and address at-risk unruly and adjudicated unruly youth. Methods to divert children from juvenile court and address at-risk unruly and adjudicated unruly youth. Family access to referral and dispute resolution processes Family access to referral and dispute resolution processes Strengths based assessment of family Strengths based assessment of family Required Family Team meetings with specific timelines when there are emergency or planned out-of-home placements. Required Family Team meetings with specific timelines when there are emergency or planned out-of-home placements.

8/24/ History of Service Coordination: 2000’s - Taft Administration Shifted from child focus to family focus. Shifted from child focus to family focus. Strong emphasis on family engagement and empowerment. Strong emphasis on family engagement and empowerment. Required access to Family Advocates or support person(s). Required access to Family Advocates or support person(s). Alignment of SC with many high fidelity WrapAround principles. Alignment of SC with many high fidelity WrapAround principles.

8/24/ History of Service Coordination: 2000’s - Taft Administration State inter-systems fund was discontinued and redistributed as an allocation to each mental health and recovery services board (404 dollars). State inter-systems fund was discontinued and redistributed as an allocation to each mental health and recovery services board (404 dollars). ABC 404 dollars allocated based on population. ABC 404 dollars allocated based on population. $5,681 non-behavioral health funds allocated equally to each county FCFC. $5,681 non-behavioral health funds allocated equally to each county FCFC.

8/24/ Service Coordination Mechanism ORC (C) What’s in the law? Each county shall develop a county service coordination mechanism. The county service coordination mechanism shall serve as the guiding document for coordination of services in the county. Each county shall develop a county service coordination mechanism. The county service coordination mechanism shall serve as the guiding document for coordination of services in the county.

8/24/ Service Coordination Mechanism The overarching requirements for coordinating services for multi-need children in a county:  Referral  Confidentiality  Parent Participation  Assessment of Strengths and Needs  Culturally Responsive  Least Restrictive Environment  Dispute Resolution  Comprehensive Family Service Coordination Plan Process  Juvenile Court Diversion  Monitoring and Tracking Outcomes

8/24/ Comprehensive Family Service Plan: An Individual Family Plan Requirements for developing and implementing: Notification of and Invitation to CFSP Meetings Notification of and Invitation to CFSP Meetings Pre-Out of Home Placement Team Meeting Pre-Out of Home Placement Team Meeting Family Rights Confidentiality Confidentiality Participate in Meetings and Decisions Participate in Meetings and Decisions Invite Informal Supports / Family Advocate Invite Informal Supports / Family Advocate Approve Team Leader Assignment Approve Team Leader Assignment Initiate Meetings Initiate Meetings Dispute Resolution Dispute Resolution

8/24/ Comprehensive Family Service Plan: An Individual Family Plan IN THE PLAN Goals and Services Goals and Services Designation of Service Responsibilities Designation of Service Responsibilities Timelines for Goals Timelines for Goals Crisis and Safety Plan Crisis and Safety Plan Regular Reviews Regular Reviews

8/24/ Service Coordination Process: 1. Referral from family member, agency, or provider. 1. Referral from family member, agency, or provider. 2. Determine level of need. 2. Determine level of need. 3. Explain SC & family rights & sign necessary documents 3. Explain SC & family rights & sign necessary documents 4. Complete Strengths & Needs Assessment & Culture 4. Complete Strengths & Needs Assessment & Culture Discovery Discovery 5. Determine Family Team/Offer Family Advocate 5. Determine Family Team/Offer Family Advocate 6. Develop Family Plan including Crisis and Safety Plan 6. Develop Family Plan including Crisis and Safety Plan 7. Implement Plan 7. Implement Plan 8. Regular follow up team meetings held to monitor 8. Regular follow up team meetings held to monitor progress progress 9. Final team meeting to address transition issues & 9. Final team meeting to address transition issues & celebrate success. celebrate success.

8/24/ The Many Names of Service Coordination Service Coordination Service Coordination Family Support Teams Family Support Teams Wrap Around /Hi-Fi Wraparound Wrap Around /Hi-Fi Wraparound Cluster Cluster ICAT (Inter-systems Community Assessment Team) ICAT (Inter-systems Community Assessment Team) ICAT (Inter-agency Clinical Assessment Team) ICAT (Inter-agency Clinical Assessment Team) FAmily Stabilty Team (FAST) Community Wraparound Child and Family Team Intersystem Diversion Team (IDT) Kids in Different Systems (KIDS) Diversion Assessment Team (DAT) Coordinated Care Program

8/24/ Service Coordination Data Top 7 Referral sources for 1,700 children receiving service coordination from 24 counties: 1. Mental Health 2. Juvenile Court 3. Children’s Services 4. Schools 5. Family Member 6. MRDD 7. HMG

8/24/ Examples of County Results Columbiana County served 93 children and 71 families in FY07 and showed a significant drop in risk assessment scores for children participating in Wraparound. Columbiana County served 93 children and 71 families in FY07 and showed a significant drop in risk assessment scores for children participating in Wraparound. Trumbull County in last year’s report showed that after children are referred to the Wraparound process there tends to be a significant drop in hospitalizations. This year’s data shows a very similar pattern. Trumbull County in last year’s report showed that after children are referred to the Wraparound process there tends to be a significant drop in hospitalizations. This year’s data shows a very similar pattern.

Erie County Results Erie County showed statistically significant family improvement for 122 families in 13 of the 14 life domains in the Family Development Matrix. Erie County showed statistically significant family improvement for 122 families in 13 of the 14 life domains in the Family Development Matrix. One domain, immigration, did not show a change because it was not indicated as a problem area for any of the families in service coordination at that time. One domain, immigration, did not show a change because it was not indicated as a problem area for any of the families in service coordination at that time.

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8/24/ Butler County Results Butler County found that mental health services were in place at the time of referral for 83% of the 212 children referred to Wraparound. Butler County found that mental health services were in place at the time of referral for 83% of the 212 children referred to Wraparound. Statistical analysis of Ohio Scales found that most youth moved from clinical to non-clinical levels in both Problem Behaviors and Youth Functioning Statistical analysis of Ohio Scales found that most youth moved from clinical to non-clinical levels in both Problem Behaviors and Youth Functioning Most youth were able to be maintained in a stable living environment without frequent changes in guardianship or level of care. Most youth were able to be maintained in a stable living environment without frequent changes in guardianship or level of care. The majority of children who entered Wraparound while in out of home placement moved to a lower level of care. The majority of children who entered Wraparound while in out of home placement moved to a lower level of care.

8/24/ Butler County Results, cont. 88% of parents reported improved satisfaction with support 88% of parents reported improved satisfaction with support 75% of parents reported feeling more hopeful about the future 75% of parents reported feeling more hopeful about the future 86% of parents reported feeling more involved in their child's treatment 86% of parents reported feeling more involved in their child's treatment 86% of parents reported reduced safety issues in the home 86% of parents reported reduced safety issues in the home 88% of parents reported improved overall family functioning 88% of parents reported improved overall family functioning 88% of parents reported improved behavior in school 88% of parents reported improved behavior in school 88% of parents reported improved child behavior in the home 88% of parents reported improved child behavior in the home

SService coordination mechanism for multi- system involved youth EEvidence based model of National WrapAround Initiative IImplemented in 2006

FFamily Council - Funded by SCC 3 FTE WrapAround Service Coordinators 1 FTE Clinical Reviewer/WrapAround Service Coordinator 1 FTE & 1 PT Family Advocate 1 FTE Supervisor CChild & Adolescent Behavioral Health CCommunity Services of Stark County

154 youth referred in SFY 08 69% male Mean age of 13.7 Median age 15 Race

FFamily Court = 40% MMental Health and Alcohol & Drug = 15% FFamily self-referral = 14% JJob & Family Services = 6%

8/24/ Questions?