2006 System of Care Start-up Webinar Series1 System of Care: From Vision to Infrastructure Sandy Keenan, Education Resource Specialist, Technical Assistance Partnership for Child and Family Mental Health

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3 Systems of Care A system of care is a coordinated network of community-based services and supports that are organized to meet the challenges of children and youth with serious mental health needs and their families. Families and youth work in partnership with public and private organizations so services and supports are effective, build on the strengths of individuals, and address each person’s cultural and linguistic needs. A system of care helps children, youth and families function better at home, in school, in the community and throughout life. Gary Blau, Child, Adolescent and Family Branch, CMHS, SAMHSA

2006 System of Care Start-up Webinar Series4 Creating a Vision for Your System of Care: Values and Principles  Family Driven  Youth Guided  Cultural competence  Evidence Based Practice  Interagency collaboration  Home, community, and school-based  Individualized strength-based care  Continuous Quality Improvement (CQI)

2006 System of Care Start-up Webinar Series5 Definition of Family Driven Care Family-driven means families have a primary decision making role in the care of their own children as well as the policies and procedures governing care for all children in their community, state, tribe, territory and nation. This includes: choosing supports, services, and providers; setting goals; designing and implementing programs; monitoring outcomes; managing the funding for services, treatments and supports and; determining the effectiveness of all efforts to promote the mental health and well being of children and youth. Osher, Federation of Families for Children’s Mental Health and Child, Adolescent and Family Branch, CMHS, SAMHSA

2006 System of Care Start-up Webinar Series6 Youth-Guided  Youth have rights.  Youth are utilized as resources.  Youth have an equal voice and are engaged in developing and sustaining the policies and systems that serve and support them.  Youth are active partners in creating their individual support plans.  Youth have access to information that is pertinent.  Youth are valued as experts in creating systems transformation Youth’s strengths and interests are focused on and utilized.  Adults and youth respect and value youth culture and all forms of diversity.  Youth are supported in a way that is developmentally targeted to their individual needs.

2006 System of Care Start-up Webinar Series7 Roles for Youth: Infusing Youth Voice in All Levels!  Youth Group Development  Peer Advocates  Educators/Trainers  Governing board positions  State and Local Committees  Social Marketing  Evaluation  Decision-making, directing & organizing

2006 System of Care Start-up Webinar Series8 Cultural Competence The integration of knowledge, information, and data about individuals and groups of people into  Clinical standards,  Skills,  Service approaches and supports,  Policies,  Measures, and  Benchmarks That align with the individual’s or group’s culture and increases the quality, appropriateness, and acceptability of health care and outcomes. This occurs on the individual, program and system level. This promotes effective work in cross-cultural situations. See Appendix D, Cooperative Agreement; Towards a Culturally Competent System of Care: Volume I

2006 System of Care Start-up Webinar Series9 Why Develop Cultural & Linguistic Knowledge and Skills  To respond to current and projected demographic changes in the United States.  To eliminate long-standing disparities in the health status of people of diverse racial, ethnic and cultural backgrounds.  To improve the quality of services and health outcomes.  To meet legislative, regulatory and accreditation mandates.  To gain a competitive edge in the market place.  To decrease the likelihood of liability/malpractice claims. National Center for Cultural Competence, Georgetown University Center for Child and Human Development, Washington, DC.

2006 System of Care Start-up Webinar Series10 Evidence Based Practice/ Practice Based Evidence/ Evidence Based Processes “Evidence Based Practice is the integration of best research evidence with clinical expertise and patient values.” Institute of Medicine Practice Based Evidence can be described as practices that are highly valued by families, ethnic or cultural groups because of the positive impact they have had over time, but may not have been scientifically studied. Evidence Based Processes are cross-cutting processes such as engagement strategies, relationship building, etc common to evidence based practices that make them efficacious.

2006 System of Care Start-up Webinar Series11 Family and Youth Roles in Building Evidence-Based Practice (EBP) Advocate for ethical, culturally sensitive research Participate in the development and analysis of research to support EBP Assist in data collection to support EBP Educate families, youth and leaders about EBP

2006 System of Care Start-up Webinar Series12 Building the Foundation  Voice and choice for the child, youth and family  compassion for children, youth and families  integration of services and systems  flexibility in approaches to working with families and youth, and in the funding and provision of services  safety, success, and permanency in home, school and community  care that is : unconditional, individualized, strengths-based, family-centered, culturally competent, community based, with services close to home and in natural settings  No blame, shame/use respect, empathy, listening, support, meaningful options, and self determination

2006 System of Care Start-up Webinar Series13 Sustainability Sustainability results from developing a strategic plan for maintaining the key elements that make an initiative successful and generate positive outcomes. Sustainability requires identifying and accessing adequate funding streams, and also requires an array of other resources: Political Technical Administrative Cooperative Agreement, page 12.

2006 System of Care Start-up Webinar Series14 Management Team  Project Director  Key Family Leader  Youth Engagement Coordinator  Clinical Director  Cultural Competence Coordinator  Evaluator  CQI Manager  Workforce Developer/Training Coordinator  Strategic Communications/Social Marketing  MIS

2006 System of Care Start-up Webinar Series15 Infrastructure Development  Governance Structures Interagency collaboration Policy and oversight  Administrative/Management Team  Individualized care team  Local community interagency teams  County/State/Tribal interagency team Program development committee Training committee Out-of-community gate keeping committee Management Information System committee Financing committee

2006 System of Care Start-up Webinar Series16 Defining Wraparound/Care Plan Wraparound is a philosophy of care that includes a definable planning process involving the child and family that results in a unique set of community services and natural supports, individualized for that child and family to achieve a positive set of outcomes. However, wraparound does not equal a “complete” system of care. It is only one component. Individualized care plan refers to the procedures and activities that are appropriately scheduled and used to deliver services, treatments, and supports to the child and family.

2006 System of Care Start-up Webinar Series17 Possible Service Options within a System of Care  Counseling (individual, group, and youth)  Crisis outreach teams  Crisis residential care  Day treatment  Education/special education services  Family support  Health services  Independent Living  Case management (service coordination  Community-based in-patient psychiatric care  Intensive family-based counseling  Legal services  Protection and advocacy  Psychiatric consultation  Recreation therapy  Residential treatment  Respite care  Self-help or support groups  Small therapeutic group care  Therapeutic foster care  Transportation  Tutoring  Vocational counseling

2006 System of Care Start-up Webinar Series18 Changing Relationships  Everyone needs help to: View the process differently; Act and interact in new ways; Feel comfortable with the process; and Own and believe in a new way of working together.

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