COLLABORATIVE MANAGEMENT OF MULTIAGENCY SERVICES PROVIDED TO CHILDREN AND FAMILIES C'R'S' 241'9 Colo

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COLLABORATIVE MANAGEMENT OF MULTI-AGENCY
SERVICES PROVIDED TO CHILDREN AND FAMILIESC.R.S.
24-1.9Colorado Department of Human
ServicesHTTP//WWW.CDHS.STATE.CO.US/CHILDWELFARE/
1451CMP.HTM

• Norman Kirsch norman.kirsch_at_state.co.us Marge
  Grimsley m grimsley_at_msn.com
• Kelly Schramm kschramm_at_weldjac.org

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Collaborative Management ProgramIntegrating
Services to Multi-System Families and Children

• Provides state and local framework for system and
  service integration
• United plans and integrated course of action with
  and for multi-system families and children
• SFY 2008
• 17 participating counties
• 10,290 children served
• 3,158,00 in earned incentive funds distributed

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Growth in County Participation
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CMP Legislative Goals

• 1. Develop a more uniform system that includes
  input, expertise, and active participation of
  child serving organizations.
• 2. Reduce duplication and fragmentation of
  services.
• 3. Increase the quality, effectiveness, and
  appropriateness of services provided.
• 4. Encourage cost sharing among providers.
• 5. Lead to better outcomes and cost reduction for
  the services provided to children and families in
  the child welfare system, including foster care
  system.

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Services and Practices

• Traditional
• Family is root of problem
• Family is on the outside
• Specialized training
• Segregated delivery
• Agencies know best
• Covert process
• Compliance
• Process driven
• Categorical funding

• Collaborative Mgmt.
• Family holds the answer
• Family is central
• Cross-training
• Integrated services
• Unified commitment
• Overt process
• Collaboration
• Results driven
• Combined funding

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Interagency Oversight Group

• Local
• Authority to govern
• Capacity to govern
• Credibility to govern
• Clear about what it is governing
• Representative
• Clear protocols
• Shared liability across systems for target
  population
• Develops protocols and distributes earned
  incentive money

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Individualized Service and Support Teams

• Convenes around a neutral table, not
  pre-designated to one system, that recognizes
  that the youth and family may have complex needs
  that cut across system boundaries.
• The integrated team develops united service
  plans, with the family at the center of the
  process.
• CMP is developing state wide juvenile
  information sharing protocols based on OJJDP
  guidelines.

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CFSR CHILD WELFARE PRINCIPLES

• Family-centered practice
• Community-based services
• Strengthening the capacity of families
• Individualizing services

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Start Up

• Mobilization and advocacy
• Study and analysis
• Data collection, management, and performance
  measurement
• Inventory and assessment
• Legal and Policy Analysis and Information Sharing
• Action strategy
• Implementation
• Wiig and Tuell, CWLA, 2008

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State Steering Committee

• Program oversight by joint State/County
  Steering Committee (SSC) composed of
  participating counties, state agencies, and
  family representatives.

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Rule Waivers

• Waivers of any rules other than federal law or
  safety mandates are authorized.

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Outcomes and Incentives

• Identified Outcome Areas
• Child Welfare
• Juvenile Justice System
• Education
• Health/Mental Health/Other Health
• Incentives
• Performance-Based Collaborative Management
  Incentive Cash Fund
• proportionately distributed by size of county,
  size of population
• served, and outcomes achieved.
• SFY 2008 3,158,00 in earned incentive funds
  distributed

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Various System Incentives and Interests Serving
Children and Families

• Medicaid slowing rate of growth in inpatient,
  residential treatment, and health costs
• Child Welfare meeting AFSA and CFSR outcomes
• Juvenile Justice alternatives to incarceration
• Mental Health more effective and integrated
  delivery system
• Education reducing special education, truancy,
  and out of district placement expenditures

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CFSR and CMP Outcomes

• Continuity of family relationships/ connections
  is preserved
• Families have enhanced capacity to care for their
  families needs
• Children receive appropriate educational services
• Children receive adequate physical and mental
  health services

• Core value family centered
• Strengthen the resiliency of both families and
  youth and enhance natural helping networks
• Focus on all life domains, including education
• Holistic approach

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CFSR and CMP Outcomes

• Children are protected from abuse and neglect
• Children are safely maintained in their homes
  whenever possible
• Children have permanency and stability in their
  living arrangements

• Build safety plans into service/support plans
• Prevent out of home placements, keep families
  intact
• Minimize disruption in childrens lives, smooth
  transitions

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CMP Outcomes

• Counties have met 77 of projected CMP goals.
• New child welfare cases down 5
• Increase in family and youth engagement at
  governance and operational levels
• Decline of 7 in out of home placements
• Improvement in quality of collaborative process
• 5,000,000 reinvested in additional services

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How Tos Identified by Participating Counties

• Commitment from the top
• Strategic planning and goal setting
• Track outcomes
• Governance
• Inclusion Recognize/address territorialism
• Relationships/interests
• Surface issues Make the covert overt
• Tell the story
• Invest in system change
• Keep talking, it is hard work!

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Collaboration and Coordination

• Collaboration is a mutually beneficial
  relationship between two or more parties who work
  toward common goals by sharing responsibility,
  authority, and accountability for achieving
  results.
• Coordination involves directing the effort of
  multiple agents in the most efficient and
  effective manner to accomplish mutually known
  ends.
• Dr. Carl Larson

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Successful Collaboration

• A clear, elevating goal
• Results/Outcomes-driven structure
• Competent team members
• Unified commitment
• Presence of a climate of trust
• Standards of excellence
• External support and recognition
• Principled leadership
• (from Larson and LaFasto, TeamWork, Sage
  Publications, 1989.

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The world that we have made as a result of the
level of thinking we have done thus far creates
problems that we cannot solve at the same level
at which we created them. Albert Einstein
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Collaborative Management Programs Family
Involvement-Is it real?

• Margie Grimsley
• Federation of Families for Childrens Mental
  Health CO Chapter

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Goal from the family organizations perspective

• Enhance capacity to document and validate the
  merits of family involvement so that the case is
  clear, accountable and reflective of the family
  involvement movement

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Family Involvement Journey

• Families as outsiders
• Families as participants
• Families as partners
• Families as leaders
• Families as employees and contractors

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Defining Family-Driven

• 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.

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Defining Family Involvement

• Families receiving services are supported,
  prepared, and offered opportunities to
  participate in the
• Planning, Implementation and Evaluation of
  programs, services, their related policies and
  practices.

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Defining Family Involvement

C. Wells, National Center at UACF 2008
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Defining Family Involvement

C. Wells, National Center at UACF 2008
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C. Wells, National Center at UACF 2008
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Authentic Voice

• Direct representation
• Identification and facilitation
• Ensuring opportunity
• Supporting efforts
• Secondary Representation
• Mechanics for gathering information
• Reality Checks
• Development of accountability

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Involvement
C. Wells, National Center at UACF 2008
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C. Wells, National Center at UACF 2008
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CMP Steps to System Change

• Step One
• Family organization and family member serve on
  CMP State Steering Committee
• Step Two
• Retreat goal leads to forming the Family Voice
  and Choice Committee

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Family Voice and Choice Committee Structure

• Co-Chairs Systems champion and family
  representative
• Meet via conference call
• Includes family, local and state partners

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Family Voice and Choice Activities

• Data-gathering from local IOGs (Interagency
  Oversight Group)
• 2008-First Family Involvement Survey
• 2009-Second Family Involvement Survey
• Expanded to capture Youth Involvement
• Expand process to be a more collaborative process

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Family Involvement SurveysLessons Learned

• Need to define family member and family
  organization
• Need to have more than one person complete survey
• Identify family and youth representatives
• Importance of determining the surveys
• Purpose
• What they are telling us
• How best to disseminate the information gathered

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Survey Value

• Family and youth involvement became a higher
  priority
• Validated the role of the family voice in this
  leadership position
• Identified what TA local counties needed to have
  Authentic family representation

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TA opportunities

• Family/Professional Partnership training for
  counties
• Governing Board Self-Assessment
• A Tale of O video presentation and discussion
• Development of individualized plan of action
• Provided resource materials

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Argosy University Evaluation TeamResearching at
4 Levels

• Level 1 IOG with a family rep
• Level 2 IOG with sporadic family rep
• Level 3 IOG with family rep challenges
• Level 4 IOG with no family rep

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Research Lessons Learned

• Funding can be challenging
• Need to identify collective county data
• Need to identify individual county data
• Learn from and revise process as challenges arise
• Determine the effectiveness of the process the
  impact that family involvement has on the CMP
  process and the impact on family, youth, system
  outcomes

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Next Steps

• Increase family representation on the family
  voice and choice committee
• Determine how data can impact funding decisions
  at the state and local levels
• Increase quality and effective services and
  supports for families at the individual, service
  and policy levels.

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The Challenge
C. Wells, National Center at UACF 2008
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Juvenile Assessment Center of Weld County

• HB04-1451 Collaborative Management Program

Kelly D. Schramm Director of Collaborative
Management Planning
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No one system can resolve the issues facing
youth, families and communities.

• We don't need to invent new services within the
  juvenile justice system
• We just have to agree on the basic community
  collaborative plan, fund better, coordinate
  better and use better the services that already
  are working, and fill in the gaps already
  identified.

(A Framework for System Improvement on Behalf of
Youth With Mental Illness and Co-occurring
Disorders in the Juvenile Justice System)
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Purpose

• The Weld County Juvenile Assessment Centers
  Collaborative Management Program works with
  partner agencies and community organizations to
  Identify community needs, encourage and support
  collaboration, and to actively engage families,
  children and youth creating solutions that lead
  to improved permanency, safety and family
  functioning.

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Outcomes

• Child Welfare Meeting the needs and services of
  child, parents and foster parents
• Juvenile Justice System Reducing Juvenile
  Recidivism
• Education Reducing Truancy
• Health/Mental Health/Other Health Improving the
  well-being and permanency outcomes for children
  and youth effected by methamphetamine and other
  drug abuse.

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Action

• Supporting collaborative management processes
  and team decision making processes within Weld
  County by providing
• Coordination and oversight of programs and
  services
• Conducting and coordinating assessments of
  community needs
• Sharing and establishing best practices and
  continuous quality improvement
• Arranging for and/or providing technical
  assistance and cross systems training
• Funding support and coordination

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Challenges The Early Period

• September 2003 VanDenBerg Community Assessment
• Lack of overall common vision for services for
  children and families
• Lack of a common approach to partnerships
• High number of children in out-of-home
  placements
• Confidentiality releases are hurting
  collaboration
• Comprehensive approach to substance abuse
  treatment needed
• Human Services cuts begin to erode the safety
  net for the poor
• Lack of transition for youth after placements
• Need for increased alternative school
  availability
• Loss of diversion efforts begin to produce the
  perception that the juvenile justice system had
  no teeth.

May 2004 HB04-1451 passed. Supports
collaboration joint planning to improve
outcomes and services, reduce duplication and
fragmentation of services, and encourage
cost-sharing among providers
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History - 2005
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Challenges Along The Way

• 2006 Collaborative Management Work Session
  Larimer County
• Kids are treated in isolation, without attention
  to families
• Families dont have sufficient input about
  treatment services
• Insufficient information about families lack of
  shared data
• A need for community staffing when multiple
  agencies are involved
• A need to focus on prevention and
• Treatment services are not provided in a timely
  way.

• 2006-07
• Development of a multi-agency client/records
  management system proved to be challenging
• State level rules and regulations limit the
  utilization of common assessment tools and single
  treatment plans
• Insuring collaborative actions lead toward
  desired outcomes
• Funding of expanding services and expenses
• Remaining focused and keeping it all on track

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History 2006-07
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Challenges As We Face the Future

• 2007-08
• First attempt at an external program evaluation
  proved challenging
• Merger of two organizations with similar target
  populations and community partners
• Partners could have a more complete
  understanding of each others roles,
  responsibilities, mandates, capabilities and
  funding
• Some services are cost prohibitive for families
  who pay on their own
• Being able to tell our stories and promote our
  successes

• 2008-09 Beyond
• Potential reduction in funding from partner
  agencies
• Potential reduction in available local services
• Increase in countys portion of out-of-home
  placement costs
• Increased demand on limited resources
• Level of partner commitment to the collaboration
  is uncertain

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History-2008-09
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Steps down the collaborative path

• Structured planning and decision making process
• Utilization of evidence based solutions
• Continuously track and evaluate the effectiveness
  of programs
• Pursue organizational accreditation achieve
  Best Practice or evidence based standards for
  programs
• Pursue ways to positively impact partner
  identified outcomes, such as the Child and Family
  Safety Review
• Increased fund development, including a major
  gifts campaign

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Substance Abuse and Mental Health Services
Administrations Strategic Prevention Framework
Sustainability Cultural Competence
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Summary of Accomplishments

• Improved Agency Dialogue - Community agencies
  surfacing issues and planning solutions
• Reduction of Out-of-home placements
• Increase in community based services
• Improved linkages with neighboring counties
• Received Congressional support for Federal
  funding to expand JAC operations
• Judicial, School District Government leadership
  on Board
• Court Expansion/Focusing - Model Court, Drug
  Court, Family Treatment Court, and Juvenile
  Treatment Court

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Accomplishments

• 19th Judicial District Designated a Model Court
  Site
• The Juvenile Assessment Center/1451 Collaborative
  Management Board became the Oversight Committee
  for this project
• Project outcomes and goals
• Improve Visitation/Orientation
• Provide appropriate Transition and Education
  opportunities
• Reduce the time between removal and adoption

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Accomplishments

• Supported the improvement of juvenile information
  sharing
• Developed a common release of information form
  that enables cross-system information sharing
  among multiple agencies
• Participated in the Governors Colorado Child and
  Youth Information Sharing Steering Committee
• Worked with the Department of Human Services to
  form a multi-disciplinary Utilization Review Team

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Accomplishments

• Merged the Interagency Oversight Group and the
  Weld County Juvenile Assessment Center resulting
  in greater efficiencies, better interagency
  coordination, services and outcomes for Weld
  County
• Secured 2.4 million in Federal funds for the
  Regional Meth Partnership Resulting in improved
  integration of substance abuse, mental health and
  community services and expansion of Family
  Treatment Court
• Received 1,087,000 in HB04-1451 Collaborative
  Management Program incentive funds

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Accomplishments

• Provided nearly 850,000 to Weld County partners
  to support collaborative programs, services, and
  activities that provide positive alternatives to
  incarceration, reduces truancy and provides
  alternate paths to high school graduation
• Juvenile Assessment Center
• Truancy Response and Intervention Program
• Today Offers Positive Skills (TOPS) Day Report
  Center
• Greeley/Evans School District 6 Alternative
  Program (GAP)
• Valley High School Alternative Program Serving
  as an alternative school setting for at-risk
  students in Weld County

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Accomplishments

• Formed a Truancy Response Workgroup
• Partnered with the National Center for Schools
  Engagement to identify and create protocols that
  can be adopted and conformed to in Weld County
• Weld County Juvenile Assessment Center (JAC)
  received a 139,858 grant to create a new Teen
  Pregnancy Prevention and Support Program.
• This new program aims to collaboratively provide
  pregnancy prevention education to at-risk teens
  throughout Weld County and to provide support
  services to teen parents.

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Accomplishments

• Formed a Substance Abuse Response Workgroup
• Partnered with the State Meth Taskforce, Colorado
  Alliance for Drug Endangered Children, Weld
  County Prevention Partners, and Omni Institute
• Conducted a Community Resource Assessment and
  Environmental Scan of Weld County Issues
• Held a County Wide Substance Abuse Prevention
  Summit
• This Resulted in

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Accomplishments

• The development of plans to address substance
  abuse in Weld County by
• Integrating and coordinating services,
• Supporting the further development and
  utilization of the United Way 2-1-1 system,
• Expanding mentoring opportunities throughout the
  county,
• Enhancing school-based services, and
• Developing an accurate community educational
  campaign regarding prevention, early
  intervention, treatment options and recovery.

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QA