Making RBS Happen in the Bay Area

Establishing a Regional Child and Family Reconnection Resource

Our Challenge

• This consortium has accepted AB 1453’s challenge to transform the nature of group care

• A primary focus on reconnecting children and youth with their families and communities

• By integrating parallel community services, short term intensive residential interventions and continuing aftercare

Our Mission

• To work together to help the children and families in our target populations build and sustain whole lives.

Our Vision

• Foster the creation of Regional RBS Resources with local impact that provide centralized intensive and research-based stabilization, assessment, treatment, and care coordination in concert with locally provided outreach, services, support and aftercare through a hub and satellites model.

What’s the Transformation

• A shift from a facility-centered approach• With a readiness mental model• To a community-centered approach• With a recovery mental model

A Shift in Perspective

Performance and ImpactPerformance Elements

To what extent does the RBS System:

• Have a data driven process for resource utilization and management?

• Provide for comprehensive, continuing and coordinated strength-based service planning and implementation?

• Insure active, effective, and sustained youth and family involvement?

• Deliver an integrated combination of therapeutically focused residential care options and parallel community-based services?

• Offer ongoing after care services and support for transition to any needed ongoing formal and informal services following enrollment?

Outcome TargetsTo what extent does the RBS system help:

• Children, youth and families express a sense of satisfaction with the assistance they have received and acquire hope for a positive future?

• Children and youth form positive, safe and sustained connections with family members or other adults who are making a lifelong commitment to them?

• Children and youth live in positive, safe, and stable community settings with either their families or other adults who are committed to provide ongoing care, nurture and support?

• Children and youth demonstrate a significant reduction in the behaviors that resulted in their being identified as needing a high level of care?

• Children and youth make reasonable progress in advancing grade to grade and acquiring skills for long term life success given their gifts, talents and preferences?

What’s Different

On the County Side• From sending children to a

place …• To enrolling them in a

process• From monitoring services

and compliance …• To tracking performance

and outcomes

On the Provider Side• From counting heads in the

beds …• To managing progress along

a pathway• From selling services as

commodities…• To delivering

responsiveness and results

Achieving This Transformation• To move from the system we have now to the

system we want to achieve• We need to know how things currently work and

the drivers that make them work that way• This provides a clear picture of the base state we

are starting from• Then we need an equally clear picture of the

shape and operation of the future state we are designing

• So we can build effective transition pathways from the base state to the future state

Balancing Three Change Pathways

To create an effective change pathway from group care to RBS, we need to understand how things are now, and what we want them to become in three inter-related areas: •Defining and delivering the resource (What are the differences between group care and RBS?)•Funding and regulating the resource (How do we restructure existing funding to support our chosen innovations?)•Using and managing the resource (How do we decide when to use it, and keep track of what happens while we’re using it?)

Who Manages the Pathways?

• Each pathway is under the purview of different system partners in different types of dialog

• Define and Deliver: Providers in dialog with county agencies and administrative personnel

• Fund and Regulate: State CDSS offices in dialog with the county agencies

• Use and Manage: county agencies and administrative personnel in dialog with providers

The RBS Spiral of Inquiry

The iterative movement from one phase of development in the spiral to the next is accomplished by asking questions that open up space for new ideas.

The Four Deliverables• Program Description: An overview of where we are

starting from, where we want to go, and how we are going to get there

• The Voluntary Agreement: A document that describes the shared understanding of roles and responsibilities of all of the participants

• The Funding Model: A description of how we will use the same money we have now to do something completely new and different

• The Waiver Request: How we want to restructure the regulatory environment to support our effort while insuring accountability