Mark Washington, DHS Assistant Commissioner “Preparing for Tomorrow Today” Part II April 23, 2010 FY, FT The Transforming of a Culture and the Potential of Partnerships

Where did we begin?  Listening and Accessibility  C P R  Transparency  Vision and Goal Setting  Agreement of Accountability in the Relationship 2

Where are we headed?  Setting Goals Together  Managing Performance  Both public and private agencies seeking similar and improved outcomes in safety, permanency and well- being for each child and family we serve.  Identifying the linkages between practice, performance and payment  Buying Outcomes  Community-based Services Growth 3

Lifelong Connections for Children and Youth 4 QUALITY AND ACCOUNTABILITY Scorecard Evidence-Informed Decisions Performance Focused Program Evaluation Fiscal incentives COMMUNITY AND LOCAL CAPACITY Transparency with Stakeholders Community Partnerships Interagency Relationships Clear Communications Unmet need PRACTICE MODEL DEVELOPMENT Values-driven Family-strengths based Permanency for Children and Youth Casey Family Programs partnership CARE MANAGEMENT: SERVICE PROVIDERS Public/Private Partnership Shared Risk and Responsibility Targeted Outcomes and Incentives Buy Outcomes, Not Beds Coordinated Prevention/Early Intervention Strategies CASE MANAGEMENT: DFCS Staff Development and Training Competency-based Learning Supervisory Management Development Central Office Support/Technical Assistance Communications TRANSFORMATION

Redefining How We Work Together  Values mean everything.  DFCS has rolled-out several initiatives in the past year to enhance the collaboration between our agency and the private providers community and other external stakeholders.  Our goal is to increase accountability on all fronts and build a framework wherein all parties understand the collective goals and understand how best to manage them. 5

Building the Infrastructure  Office of Provider Utilization and Outcomes Management was established in the fall of This was the remaking of Provider Relations Unit.  With leadership staff in place DFCS continues to enhance the work of this office through the addition of more staff to assist providers and streamlining the traditional activities of monitoring and review.  Monitoring and technical assistance will be the primary focus of this office in the coming year.  Customer service is paramount. OPUOM will be the foundation to ensure that our provider partners have a voice with DFCS. 6

Managing for Performance  Provider G meetings have been occurring regularly since November, 2009 and are the cornerstone of our mutual accountability.  They give us an opportunity to review performance and delve deeper into critical issues impacting outcomes while creating a safe environment to discuss the manner in which we measure success and learn from the success of others.  Developing common protocols for defining and measuring success will be a critical goal for us all in the coming year. 7

Performance-Based Permanency Initiative  Why?  Provide supports and resources for credentialed CCIs and CPAs to move older youth towards permanency,  Develop a broader array of community-based, in-home services and provide necessary after-care support to families post-permanency.  Because DFCS cannot do this work alone.  Every child deserves permanency. Period.  Who?  Through April 15 th there have been 28 youth enrolled and 44 providers engaged in the work with more being added going forward. 8

Performance-Based Contracting  New RBWO contracts will be centered on the principle that we must work together to produce quality outcomes for children and families.  By focusing on key outcome measures and sharing ideas for improvement we will provide better service to children and families.  The over-riding purpose of the performance-based system is to recognize high performance in serving children and families and provide assistance to those who struggle in one or more areas. 9

Focus Groups  Why?  Transparency and collaborative development  Common glossary  Focus groups made up of DFCS staff and private providers were instrumental in the design of the performance-based contracting measures.  Gathering feedback from our provider partners in this way helps redesign our tools and are foundational for our success moving forward.  Continued opportunities to participate in focus groups throughout the upcoming fiscal year (both with PBC review and other initiatives). 10

Other Work Ahead  Decisions need to be made regarding how the rescinding of the CMS rule on unbundling will impact service provision of Medicaid-funded mental health services for children moving forward.  While returning to our “old system” will not move us forward there are certainly opportunities that must be explored.  A Public/Private focus group will be established to explore our historical model and examine new ideas to find parts of both that will enhance our work. 11

Solving the Puzzle – Behavioral Health and Improved Care Management  Children and youth in foster care require access to quality, family-centered behavioral health assessments, services and treatment  DFCS is working in partnership with DBHDD to develop a framework and foundation to better manage child- specific and provider-specific services delivery  Pharmacy Utilization  Appropriateness and effectiveness of services delivered  Improved network management and development 12

Family-Centered Work Leads to Better Outcomes for Youth  Our ability to align with and engage a child’s family and community supports is central to achieving success with all of our performance indicators.  We need to explore new and innovative ways to make our family-centered case practice model the foundation on which all services are built.  As these philosophical and structural shifts are made within your service model OPUOM will be readily available for technical assistance.  Peer-to-peer learning is also encouraged. 13

Future Provider Summits Two Key Strategies  DFCS can provide learning opportunities and workshops that focus on technical assistance and emerging trends and initiatives.  July Stay tuned for more details.  Provider-led workshops that showcase strategies being utilized to achieve outcomes that are yielding positive results, i.e. keeping children in care safe, moving towards permanency, engaging with birth families, etc. 14

PBC – And Beyond  Continuous outcome evaluation  “How did we do?” surveys from families served for providers  Case rate program development based on experiences in Year 1 and results in other states  Targeted build-out of community-based services  Early Intervention Services – The Unmet Need  Youth  Stronger partnerships between the DFCS, DJJ, DCH and DBHDD agencies at the local and state levels to support 15

Are You Ready? 16