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Integration of Schools and System of Care

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Title: Integration of Schools and System of Care


1
Integration of Schools and System of Care
  • IL Childrens Mental Health Partnership
    Conference
  • June 26 27, 2012

2
Brief History Systems of Care
  • 1969 Joint Commission on Mental Health of
    Children very few youth were receiving mental
    health services
  • 1982 Jane Knitzers Unclaimed Children - youth
    were receiving services in overly restrictive
    settings
  • 1984 Child and Adolescent Service System
    Program (CASSP) Model first system of care
  • 1986 System of Care approach framework put
    forth by Stroul Friedman
  • 1992 Congress passed legislation for CCMHS
    System of Care Grants

3
System of Care Communities of the Comprehensive
Community Mental Health Services for Children and
Their Families Program
Funded Communities
Date Number
19931994 22 19971998 23 19992000 22 20022004 2
9 20052006 30 2008 18 20092010 29
4
System of Care-Definition
  • Spectrum of effective, community-based services
    and supports
  • For children and youth with or at risk for
    mental health or other challenges and their
    families
  • Organized into a coordinated network
  • Builds meaningful partnerships with families and
    youth
  • Addresses cultural and linguistic needs
  • Function better at home, in school, in the
    community and throughout life. (SMHSA 2010)

5
Core Values
  • Family Driven and Youth Guided
  • The strengths and needs of the child and family
    determine the types and mix of services
  • Families have primary decision-making role in ALL
    aspects concerning the care of their children

6
  • Community Based
  • Services and supports are provided within child
    and familys community
  • Traditional as well as non-traditional
  • Informal service providers and supports are
    utilized

7
  • Culturally and Linguistically Competent
  • Organizations and programs reflect the cultural,
    racial, ethnic and linguistic differences of the
    populations they serve
  • Facilitates access to and utilization of services
    and supports
  • Eliminates disparities in care

8
Champaign County SOC
  • Juli Kartel Jill Mathews-Johnson

9
Champaign County SOC ACCESS Initiative
  • Mission
  • Build a trauma and justice informed SOC
  • Designed to create a healed community
  • Works to ensure that youth and their families are
    resilient, resourceful, responsible and restored

10
Target Population
  • Youth 10-18 with social, emotional and behavioral
    challenges
  • Who are disproportionately represented in the
    juvenile justice and child welfare systems
  • and/or by negative academic and health outcomes

11
SPARCS Structured Psychotherapy for
Adolescents Responding to Chronic Stress
  • Evidenced informed intervention
  • 16-one hour groups
  • Adolescents 12-21
  • History of trauma (broadly defined)
  • Living with ongoing stressors
  • Exhibit functional impairment
  • Structured Psychotherapy for Adolescents
    Responding to Chronic Stress (SPARCS) National
    Child Traumatic Stress Network
  • www.NCTSN.org

12
Why SPARCS?
  • Was chosen by a committee of parents, youth and
    agency stakeholders
  • Had demonstrated positive outcomes for youth in
    foster care in Illinois
  • Broad definition of trauma fit for our
    communitys experiences
  • Flexible model allowed for youth input
  • Non-Masters clinician can co-lead

13
Mental Health School Collaboration
  • Multiple Pre-planning Meetings
  • Introduce SPARCS to administrative team
  • Identification of appropriate students
  • Referral process
  • Consents/communication with parents
  • Protocols for student getting to/from group
  • Procedures for meeting w/ students individually

14
Identifying Students with Needs
  • Data-based Decision Rules for Entrance
  • At Centennial High School students were
    freshman or freshman status and
  • Through two tier two interventions and have not
    responded
  • Transitioning back from Regional Alternative
    School
  • Had multiple SASS contacts
  • Met criteria for trauma experience per TESI-SR
    (Traumatic Events Screening Inventory-Self
    Report)

15
Continued Meetings
  • Mental health provider and PBIS T.A. Coordinator
  • Strengthen integration into PBIS Framework
  • Communication between school and community
    provider
  • Identification of school and mental health
    outcomes
  • Future planning for further tiered integration
    (skills only group)

16
Outcome Measures
  • School (need to include data that we have)
  • ODRs
  • ISS/OSS
  • Grades/Credits
  • Attendance
  • Mental Health
  • YOQ parent and youth
  • Youth group survey results
  • SOC Evaluation
  • TRAC Noms
  • CANS
  • TESI

17
Organizational Structures Funding
  • SAMHSA SOC Cooperative Agreement
  • United Way of Champaign County
  • Medicaid billing (future)
  • Probation/Court Services (future)

18
Feedback from Staff
  • MH Staff
  • Positives
  • Being part of Tier II team helpful
  • Having school staff facilitate arrival/departures
    from group very helpful
  • Having one dedicated administrator is essential
    to coordination

19
Improvements
  • Improvements
  • Protocols for communicating with mental health
    staff when crisis or disciplinary events occur
  • More time prior to group to get to know student
    and parent
  • Establish formal Collaborative Agreement

20
Feedback - Students
  • Student Survey Results
  • 1strongly agree 2disagree 3 dont know
    4agree 5strongly agree
  • Skills were helpful to me
  • Mindfulness 3.8
  • Self-sooth/distract 4.4
  • LET M GO 4.0
  • MAKE A LINK 4.2
  • Have used skills outside
  • of group 4.4

21
Best Part of Group
  • It helped me to make better choices and not get
    into trouble
  • That you can talk about stress level and
    feelings
  • It allowed me to share
  • It helped me to identify my sources of anger
  • I liked that it had structure, that we had a
    lesson plan that we followed and I liked the
    handbook
  • Food

22
(No Transcript)
23
Outcomes School Data Office Discipline Referrals
24
Outcomes School Data In-School and
Out-of-School Suspension
25
Outcomes School Data Tardiness and Absences
26
Outcomes School Data - Grades
27
Future Goals
  • Identify incoming freshman service Summer 2012
  • Potential for multiple groups next year at
    Centennial feeder middle school is also
    beginning 2012-2012SY
  • Refine data decisions for appropriate ID of
    students
  • Provide further teacher/staff training in SPARCS
    skills and develop plan for further integration
    of skills
  • Utilize students to co-lead group
  • Build stronger parent engagement
  • Build sustainability plan
  • Professional development plan for all staff

28
Systems Work
  • Stakeholders

29
Collaborative Efforts
  • Schedule meetings with stakeholders
  • Bi-monthly Secondary Systems meetings
  • Monthly/Quarterly administrative meetings
  • Allows all stakeholders to have voice
  • Keeps communication lines open
  • Establish procedures and protocols
  • Create true partnerships
  • Stakeholders need to be seen as viable members in
    both settings (team membership, professional
    development)
  • Make interventions sustainable
  • Funding
  • Part of system of support

30
System of Care Framework, Philosophy and Outcomes
  • Presented by Angie Hampton, CEO

31
System of Care
  • In 2009, EHD received the SAMHSA Childrens
    Mental Health Initiative grant for 6 years to
    transform our local childrens mental health
    system of care.
  • Project Connect

32
PROJECT CONNECT
33
SOC Guiding Principles
  • Comprehensive services
  • Broad array of services
  • Individualized to each child and family
  • Provided in the least restrictive environment
  • Coordinated at both the system and service
    delivery levels
  • Organized to include families and youth as full
    partners
  • Designed to emphasize early identification and
    intervention

34
(No Transcript)
35
SYSTEM OF CARE
  • The System of Care approach can provide both a
    conceptual framework and specific strategies for
    implementation of the ACA in ways that ensure
    that the behavioral health needs of children,
    adolescents, young adults, and their families
    will be effectively.
  • The System of Care approach has been the major
    framework for improving delivery systems,
    services, and outcomes for children with mental
    health needs for the past 25 years, shaping
    system reforms in many states.

36
SYSTEM OF CARE
  • Extensive research and evaluation have documented
    the effectiveness of this approach for improving
    the organization and delivery of childrens
    mental health services, and for improving
    clinical and functional outcomes for children and
    their families.

37
Integrated Care
  • EHD is integrating services with a local FQHC.
  • A Care Coordinator is being hired by EHD but
    located in the FQHC. (co-location)
  • Illinois DocAssist contract (behavioral health
    consultation to primary care providers in Region
    V)
  • A Family Nurse Practitioner is on staff to
    provide Medical Home services to complex cases as
    well as provide behavioral health consultation
    services to primary care providers

38
Health Homes
  • The health home concept is closely aligned with
    the system of care approach, sharing many of the
    same values and operational principles.
  • The major goal of the health home model is to
    provide more comprehensive, coordinated, and
    cost-effective care for individuals with
    disabilities than is generally provided when
    services are fragmented across multiple health
    providers and organizations. Designed to operate
    under a whole-person approach

39
Health Homes
  • System of Care approach can serve as a model for
    implementation of health homes- not only for
    children with behavioral health disorders, but
    for other health care populations as well.

40
System of CareHealth Reform
  • Systems of care and health reform are both
    designed to
  • Increase access to health care services
  • Increase the array of available services and
    supports
  • Improve the coordination of care
  • Improve the quality and outcomes of care
  • Improve the cost-effectiveness of services, and
  • Better invest resources.

41
Systems of CareHealth Reform
  • Systems of care have demonstrated that the
    availability of a broad range of treatment and
    support services for childrens behavioral health
    is effective in preventing more serious problems
    and mitigating overall health care system costs.
  • An individualized, wraparound approach to service
    planning and delivery has proven effective and
    ensures that children and their families receive
    optimal, appropriate, and cost-effective care.

42
Systems of CareHealth Reform
  1. Care coordination and management at the
    individual and system levels have reduced
    fragmentation and resulted in better use of
    resources.
  2. Systems of care have demonstrated that there are
    cost-reducing and cost-effective alternatives to
    serving children in hospitals, residential
    treatment centers, and other institutional
    settings.

43
Youth in Transition to Adulthood
  • Presented by
  • Liz Doyle, Clinical Director and Sharon Slover,
    Director of Education Careers,
  • McHenry County Family CARE System of Care Grant
    2006 - 2012

44
Statement of the Problem
  • U. S. 3,000,000 transition youth have serious
    emotional disorders - APA Fact Sheet (2000)
  • Prevalence is greatest among 18 25 year olds
    (12) of population
  • 60 of TY with SED do not complete high school, 3
    Xs greater risk for JJ involvement, higher risk
    for substance abuse

45
Transitional Youth in State of IL
  • 1,617,703 (age 16 24) (2010 census)
  • 12 with serious emotional dx 194,124
  • ISBE Stats (2010) 58,544 with IEPs (age 16)
  • 101, 079 with IEPs
    (age 14)

46
Identification of Transitional Youth in McHenry
County through Family CARE
  • 10/2005 Received SAMHSA System of Care
    cooperative agreement for 6 years
  • TY - one of 4 populations of focus
  • McHenry County (2010) 33,779 TY (age 16 24)
    estimated 4,053 (12) with SED
  • Youth in Special Ed 3,621 (age 12 21)
  • Youth receiving MH services 1,200 (age 16 24)

47
Using System Of Care Principles to Identify and
Meet Needs of TY
  • TYWG and Youth Council
  • Development of Youth Voice
  • Choosing an EBP Identification of Transition
    to Independence Process (TIP) Model by Youth and
    Parents

48
TIP Process
  • Engage young people
  • Tailor services and supports
  • Develop personal choice
  • Ensure a safety net of support
  • Enhance young persons competencies  
  • Maintain an outcome focus
  • Involve young people, parents, and other
    community partners

49
Needs of Transitional Youth
  • Youth Needs Life Skills and Education
  • Training Needs in EBP
  • Adolescent Adult School and MH
  • Shared training use of same language
  • Lack of Coordination
  • Lack of Specialized Programming

50
Transition to Adulthood Program (TAP)
  • Youth-Guided Process
  • Home-Based Case Management Program
  • Strengths-based and futures planning
  • Fidelity to the TIP Process
  • Specialized Programming for TY
  • Development of Formal and Informal Supports

51
Family Care Transitions to TAP
  • Implemented 1/2012
  • First provider SEDOM (Special Education
    District of McHenry County) via school contract
    with MHB
  • TAP Clinical Panel meets every 2 weeks to review
    referrals, provide case consultation, and ensure
    data collection for CQI
  • Referral Process

52
TAP Program
  • Current Census 11 clients
  • 4 females 7 males
  • Age range 1 (16-17) 10 (18 and older)
  • Ethnicity 9 White, 1 African American, 1
    Bi-racial
  • Referred by 5 - Schools 4 - Mental Health
  • 1 - JJ 1 Self Referrals
  • Living Arrangement 2 - Independent Youth
  • 6 - Two Parent
    Family
  • 3 - Single
    Parent Family

53
Questions
  • Concerns
  • Clarifications

54
Contact Information
  • Angie Hampton CEO Egyptian Public and Mental
    Health Department - ahampton_at_egyptian.org
  • Jill Mathews-Johnson MSW, Technical Assistance
    Coordinator PBIS Network
  • Juli Kartel LCPC, Director of Youth and Family
    Services - Community Elements -
    jkartel_at_communityelemnts.org
  • Liz Doyle LCPC, Clinical Director -McHenry
    County Mental Health Board, ldoyle_at_mc708.org
  • Sharon Slover, Director of Education Careers,
    Special Education District of McHenry County
    (SEDOM), sslover_at_sedom.org
  • McHenry County Family CARE 815-788-4360
  • Liz Doyle, Clinical Director, ldoyle_at_mc708.org
  • Sharon Slover, Director of Education Careers,
    Special Education District of McHenry County
    (SEDOM
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