statewide strategic plan - myflorida.com€¦ · partnership for child health ... rene anderson...

2012Florida Department of Children and FamiliesSubstance Abuse/Mental Health Program&Department of Child and Family StudiesCollege of Behavioral and Community Sciences University of South Florida

Be One Florida

Statewide Strategic Plan for System of Care Expansion of Services for Children with Mental Health Needs and their Families

2012-2016

Prepared for the Department of Children and Families’ Substance Abuse and Mental Health Program Office by staff and faculty at the Louis de la Parte Florida

Mental Health Institute, College of Behavioral and Community Sciences, University of South Florida, 2012

FMHI Project Team:

Mary Armstrong, PhD

Don Policella, MA

Norín Dollard, PhD

Kathy Lazear, MA

Stephen Roggenbaum, MA

Cathy Sowell, MA

Dawn Khalil

1

Table of Contents

Acknowledgement of Stakeholders .................................................................... 2

Systems of Care .................................................................................................. 4

Florida’s Systems of Care History ...................................................................... 6

Vision, Mission and Values ................................................................................. 9

Logic Model ...................................................................................................... 10

Goals & Strategies at a Glance .......................................................................... 11

Strategic Plan ..................................................................................................... 12

Glossary of Acronyms ....................................................................................... 36

References ......................................................................................................... 37

2

Stakeholders

Representatives from the agencies listed here have participated in the strategic planning processes.

Agency for Health Care Administration

Agency for Persons with Disabilities Central Florida Behavioral Health Network

Community Based Care of Central Florida - Families and Communities Together Daniel Kids Foundation

Department of Children & Families – Office of Child Welfare Department of Children & Families – Substance Abuse & Mental Health Program Office

Department of Education Department of Health

Department of Juvenile Justice Division of Vocational Rehabilitation

Family Café Federation of Families of Florida

Federation of Families of Hillsborough Federation of Families of Northeast Florida

Florida Diagnostic & Learning Resources Center Florida Youth Council

Made By Us Mental Health America of Northeast Florida

NAMI Florida Partnership for Child Health – Jacksonville SOC Initiative

Sarasota Partnership for Children's Mental Health SEDNET

South Florida Behavioral Health Network - FACES Success 4 Kids & Families

The Florida Center for Early Childhood Top Shelf Consulting

University Area Community Development Corporation University of South Florida

Wraparound Orange Youth Advocate Programs

Youth Shine

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Special thanks to the following individuals for their contributions to the Strategic Plan.

Aida Santana Alex Brown

Alex Demola Alex DeMolina

Amy Silva Andrea Bourget Angel Rosado

Angela McCann Anne Marie Sheffield

Annette Tavera Annie Palmer

Ansley Steward Becky Pengelly Beth Piecora

Bethany Allaer Beverly Wilkinson

Blair Parker Bob Streater, III Brian Williams

Bruce Strahl Carly Fahey

Carmen Dupoint Carol Barr Platt

Carol Eloian Carol Pittman Casey Minor

Cassandra Bouchard Cathy Claud

Celeste Putnam Celocia Dobbey Charletta Clegg Charlotte Curtis Chris Duggan

Cindy Johnston Clint Rayner

Colleen Lenfestey D.D. Pickle

Dalacy Boudreaw Dalacy Joseph Daniel O’Neill David Gonzalez David Wheeler

Dee O'Neill Dell Brown

Derek Carraway Desiree Durham-

DeLeon Don Policella

Dondrell Hudson Donna Wyche Eboney Brown

Ellen Fitzgibbon Felecia Peguero

Frank Platt Frederick Andrews Gwendolyn Hinson

Jackie Beck Jaheim Hall Jane Streit

Janice Arthur Jarren McDonald

Jasmine Harris Jay Ballon

Jeannie Becker-Powell Jeannie Forthuby

Jelisa Hudson Jennifer Evans

Jennifer Marshall Jennifer Tulloch

Jeremy Countryman Jim McCready

Joe Anson John Fair

John Rodger Judith Evans Julie Etienne

Julie Radlauer-Doerfler Kate Prendiville Kathryn Shea

Katrina Bushner Kayla Crawford

Kelvin Lewis Keyonia Graham

Khush Jagus

Kimberley Brown Kimi Ramey

Kirk Hall Kristin Murray Kyle Baldwin Larry English Laurie Eckely Laurie Herring

Lee Storey Lakeesha Hines

Ligon Carrie Linda Outlaw Linda Radigan Linda Rayner Lisa Hetrick Lisa Houston Liza Leonard Lori Fahey

Lynn Laredo Marie Mosley

Martarshia Burke Mary Armstrong Mary Jane Henry Matthew Hudson Maura Bourget

Melissa Witmeier Michael Williams

Michael Lowry Michelle Lawrence

Mike Ballon Mona Kelly

Moniece Jackson Muriel Jones

Natacha Adolphe Nicki Young

Nicole Attong Norín Dollard

Otti Young Pam Jeffre Pat Kramer Pat Tuthill

Patricia Adams

Patrick Deleme Paula Thomas

Ramona Burrows Reilly O’Neill

Rene Anderson Rita Robinson

Rodger Flanders Roma Burrow

Roosevelt Badger Rosaly Guzman

Rosemarie McDonald Ruth Colon Sam Ross

Samuel Kelly Savi Marie

Sebrina Barron Senta Goudy

Seyney Dressler Shirley Outlaw Silvia Quintana Stacey Hermer

Stephanie Colston Susan Kurtin

Susan McLean Tabetha Smith Tammy Turner

Tammy Workman Tawney Harden

Tim Turner Tracy Pellegrino

Ute Gazioch Veree Jenkins

Vicki Draughon Vicki Waytowich

Ward Cox Whitney Gilbert Whitney Harris

Willie Hines Xavier Williams

Yamile Diaz

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Systems of Care

Originally articulated in 1986 in A System of Care for Children and Youth with Severe Emotional Disturbances (Stroul & Friedman, 1986), the

definition of system of care has been refined and was most recently updated

to read ‘A spectrum of effective, community-based services for children and

youth with or at risk for mental health or other challenges and their

families, that is organized into a coordinated network, builds meaningful

partnerships with families and youth, and addresses their cultural and

linguistic needs, in order to help them to function better at home, in school,

in the community and throughout life’ (p.2, Stroul & Friedman, 2011).

Systems of Care are guided by these three core values and twelve principles:

CORE VALUES

1.) Family-Driven and Youth-Guided, with the strengths and needs of the child and family

determining the types and mix of services and supports provided;

2.) Community-Based, with the locus of services as well as system management resting within a

supportive, adaptive infrastructure of structures, processes, and relationships at the

community level; and

3.) Culturally and Linguistically Competent, with agencies, programs, and services that reflect the

cultural, racial, ethnic, and linguistic differences of the populations they serve to facilitate

access to and utilization of appropriate services and supports.

GUIDING PRINCIPLES

1.) Ensure availability of and access to a broad, flexible array of effective, evidence-informed, community-based services and supports for children and their families that addresses their physical, emotional, social, and educational needs, including traditional and nontraditional services as well as informal and natural supports

2.) Provide individualized services in accordance with the unique potential and needs of each child and family, guided by a strengths-based, wraparound service planning process and an individualized service plan developed in true partnership with the child and family

3.) Deliver services and supports within the least restrictive, most normative environments that are clinically appropriate

4.) Ensure that families, other caregivers, and youth are full partners in all aspects of the planning and delivery of their own services and in the policies and procedures that govern care for all children and youth in their communities, states, territories, tribes, and Nation

5.) Ensure cross-system collaboration, with linkages between child-serving agencies and programs across administrative and funding boundaries and mechanisms for system-level management, coordination, and integrated care management

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6.) Provide care management or similar mechanisms to ensure that multiple services are delivered in a coordinated and therapeutic manner and that children and their families can move through the system of services in accordance with their changing needs

7.) Provide developmentally appropriate mental health services and supports that promote optimal social and emotional outcomes for young children and their families in their homes and community settings

8.) Provide developmentally appropriate services and supports to facilitate the transition of youth to adulthood and to the adult-service system as needed

9.) Incorporate or link with mental health promotion, prevention, and early identification and intervention to improve long-term outcomes, including mechanisms to identify problems at an earlier stage and mental health promotion and prevention activities directed at all children and adolescents

10.) Incorporate continuous accountability mechanisms to track, monitor, and manage the achievement of system of care goals; fidelity to the system of care philosophy; and quality, effectiveness, and outcomes at the system level, practice level, and child and family level

11.) Protect the rights of children, youth, and families and promote effective advocacy efforts 12.) Provide services and supports without regard to race, religion, national origin, gender,

gender expression, sexual orientation, physical disability, socioeconomic status, geography, language, immigration status, or other characteristics; services should be sensitive and responsive to these differences

Since 1993, the Substance Abuse and Mental Health Service Administration’s has funded

grants to more than 170 communities to promote the implementation of system of care values and

principles, including 8 in Florida. The outcomes of these grants have been positive for youth and

their caregivers, as well as in terms of costs and improvements in service system infrastructure. In

a recent review of data collected for communities funded in 2002 and 2003 (ICF Macro, 2010)

children and youth served under this grant program evidenced increased strengths and fewer

problem behaviors and symptoms, fewer justice system encounters and delinquent behaviors,

spent fewer days in psychiatric hospitals, and were doing better in school. Positive outcomes were

also seen among caregivers, who missed fewer days of work due to their child’s emotional and

behavioral issues and experienced less strain due to their care-giving responsibilities. Funded

communities were also assessed to determine the degree to which they were building or revamping

infrastructure in ways that were consistent with system of care values and principles. Positive

results have been observed in this as well, with funded communities improving in the areas of

providing care that is family-focused, culturally competent and individualized, that the service

system maximized the use of integrated, collaborative approaches, and that services were

community-based and provided in the least restrictive environments. Cost savings to the

communities due to reduced use of inpatient services was estimated at $2,377 per child and savings

from reduced justice encounters at $622 per child.

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Florida’sSystemofCareHistoryNo stranger to the philosophy and practice entailed by adherence to

System of Care principles and values, Florida has had 8 Children’s

Mental Health Initiative grants and received its first award in 1998. A

synopsis of these communities follows:

Years of Funding

Community Project Name Fiscal Agent Description

1998 -2004

Hillsborough

County

THINK - Tampa

Hillsborough Integrated

Network for Kids

Children’s Board of

Hillsborough County

“THINK” - a community-based program

providing mental health services to children under the age of 21 who have been diagnosed with

Severe Emotional Disturbances (SED) in Hillsborough County, either by the school system

according to their behavioral criteria, or by a psychologist, according to a DSM-III diagnosis. In addition, children served by this program received services by more than one agency or professional

organization (i.e., multi-system treatment).

1999 - 2005

Palm Beach

County

Family HOPE -

Helping Organize

Partnerships for Empowerment

Florida

Department of Children and Families

& Palm Beach County

Family HOPE - a community collaborative

designed to develop and implement a seamless system of care to prevent children with serious emotional disturbance, birth through 21, from moving into overly restrictive treatment services and prevent duplication of services. Building on

system of care values and principles, Family HOPE proposed to establish and grow family

empowerment services and to implement Assertive Community Treatment teams.

2002 - 2008

Broward County

One Community

Partnership - Working

Together For Our Children

Broward County Human Services

Department

One Community Partnership (OCP) - a county-

wide initiative to evaluate and redesign the existing array of children’s mental health services in

Broward County, Florida. OCP focused on building an infrastructure that supports on-going

collaboration among local stakeholders by addressing long-standing systemic issues, service

gaps, and barriers that have historically prevented this community from keeping children with SED

in the community.

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Years of Funding


2005 - 2011

Sarasota County

Sarasota County Early Childhood Mental Health

Partnership

Sarasota County

Department of Health

The Sarasota Early Childhood Mental Health Partnership - convened to improve and increase

mental health and non-mental health services and supports provided for infants and very young

children consistent with System of Care principles and best practices. The project linked the existing elements of the children's mental health system with those of the early childhood system to: 1]

create an early childhood mental health system of care; 2] expand key services needed to improve the behavioral health of these children; and 3] deliver comprehensive training and technical

assistance to ensure cross-training of system-of-care staff from the two systems.

2009 - 2015

Orange County

Wraparound

Orange

Orange County

Wraparound Orange - implements integrated community based services and supports for

children with SED and their families through development of effective and enduring systems of

care. All partners are committed to working together; to optimize outcomes; serve as a catalyst

for broad-based sustainable systematic change; facilitate policy reform; develop infrastructure;

and utilize evidenced-based practices in a culturally and linguistically competent manner.

The primary program goal is to expand community capacity by offering mental health and

support services through focused outreach, treatment, education, and prevention activities in a variety of settings and times to facilitate a family's ability to access services and to ensure there is "no

wrong door" for accessing services. 2009 - 2015

Miami-Dade

County

FACES –

Families and Communities

Empowered for Success

Department of Children and Families

FACES - a collaborative effort to enhance, expand

and strengthen the existing community-based family and youth mental health services in Miami-

Dade County, in order to better serve children who have serious emotional disturbances and

their families or caretakers. FACES is a component of the broader Miami Dade County Children's Mental Health system of care and is

intended to enable youth with multiple and changing needs to remain in the least restrictive settings in their community, in school, out of the

juvenile justice/legal system and attain and maintain a physical-mental-emotional-spiritual

recovery. The population of focus for the project is adolescents with co-occurring mental health and

substance abuse disorders.

8

Years of Funding


2010 - 2016

Seminole County

FACT – Families and Children

Together

County of Seminole

The FACT initiative - being implemented in order to refine the existing system of coordinated

juvenile justice, school, child welfare and children’s mental health services. Supports,

consisting of local public and private organizations working in teams, plan, enhance & implement an enhanced set of services tailored to each child's

physical, emotional, social, educational and family needs. FACT is intended to integrate services for children and youth involved with multiple service systems and their families at home, in school and

in the community. 2010 - 2016

Jacksonville

Jacksonville

System of Care Initiative

City of

Jacksonville

Jacksonville’s System of Care Initiative (SOCI) seeks to establish a sustainable and replicable

model system of care to provide a continuum of individualized, culturally and linguistically

competent prevention, diagnostic and treatment services to children with or at-risk for SED, from

birth through transition into adulthood, who are in or at-risk for involvement in the child welfare and juvenile justice systems, as well as homeless youth. The model establishes a public-private-academic

sector partnership to integrate systems of care principles with those of the Medical Home Model of care for children with special health care needs

and the Core and Essential Functions of public health.

In the fall of 2011, the Florida Department of Children and Families’ Substance Abuse and

Mental Health Program Office was awarded a System of Care Expansion Planning grant. This

grant was awarded to enhance the state’s ability to take the lessons learned from its graduated and

active grant sites and take the system of care philosophy and principles to scale statewide. Under

the leadership of the DCF Substance Abuse and Mental Health Program Office, families, youth,

providers, and state agency representatives joined together to develop a logic model, strategic plan

and social marketing plan.

This strategic plan was developed through a progressive, sustained collaborative process led by

the Core Planning Team and included five sub-committees that developed strategies, indicators

and responsible parties in order to move the state forward towards full realization of system of care

values and principles. These sub-committees were organized by each goal and an additional group

was convened for social marketing. The sub-committees held both in-person meetings and

conference calls to complete their tasks. Additionally, focus groups, key informant interviews, and

a two-day meeting of Florida’s family leadership were convened to provide further input from

youth and family members. The final strategic plan was approved by the statewide Stakeholder

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Planning Team at their final meeting on September 14, 2012 in Tampa. The Core Planning

Team and the Stakeholder Planning Team developed a vision, mission and value statement:

Vision

Florida's children with behavioral health challenges and their families are engaged as primary decision makers in a culturally relevant, coordinated healthcare setting that provides the highest quality services and supports and promotes their individual growth to reach their maximum potential.

Mission

Our mission, as a dedicated Florida group of youth and families, child-serving agencies, and other stakeholders is to develop a comprehensive strategic plan to guide the expansion of family driven and youth guided systems of care to improve outcomes for children and families within their cultural context. We will accomplish this through effective utilization of resources, having youth and families in all discussions, intervening early with prevention and intervention, and promoting mental health as a recognized health issue.

Values

Family-Driven; Youth-Guided; Culturally & Linguistically Competent; Community Based; Data Driven; Evidence-Based; Outcome-Oriented

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Florida’s Logic Model

A logic model (Hodges & Hernandez, 2006) was developed to provide a road map outlining how the expansion of system of care values and principles will occur and includes the population, mission and vision, the strategies to achieve the goals, and the expected outcomes (Hernandez & Hodges & 2005).

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Goals & Core Strategies at a Glance

The CMHSOC Stakeholders and Core Planning Team identified the following goals:

Goal #1: Consistent Family and Youth Voice at All Levels Goal #2: Collaboration / Integration among Community

Partners Goal #3: Link with Early Childhood Initiatives to Promote

Screening, Prevention and Early Intervention for Behavioral Issues

Goal #4: Implement Local System of Care Sites Goal #5: Implementation of Evidence-Based Practices

These goals serve as the foundation to the strategic plan. To ensure that the goals address all

aspects of system of care implementation (e.g., policy change, service implementation), five core

strategies were identified to organize the activities that will contribute to the attainment of the goals.

These core strategies, identified by Stroul and Friedman, 2011, are outlined below.

Core Strategy #1: Implementing Policy, Administrative, and Regulatory Changes Core Strategy #2: Developing Services and Supports Based on the System of Care

Philosophy and Approach Core Strategy #3: Creating Financing Mechanisms Core Strategy #4: Providing Training, Technical Assistance, and Coaching Core Strategy #5: Generating Support

In sum, the values and principles

identified herein drive all aspects of SOC

Expansion. Through the devoted effort of

stakeholders, consensus has been obtained on the

strategies necessary to achieve these goals and

provide a concrete set of tasks to move forward

with implementation. The following strategic plan

details these activities, which are organized by goal

and core strategy.

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Florida’s Statewide Children’s Mental Health System of Care Expansion Strategic Plan 2012 – 2016

13

Goal #1: Consistent Family and Youth Voice at All Levels Core Strategy: Implementing Policy, Administrative, and Regulatory Changes

Objectives Key Indicators of Success

Strategies or Action Steps Responsibility Champion

Coordinated with Timeframe/ Due Date

Objective 1.a.1 (Policy) Family organizations to meet consistently statewide PRIORITY

A statewide consortium of family leaders with aligned goals and advocacy strategies

1. Compile comprehensive list of family run organizations throughout the state serving the population of focus

‐Family Run Organization

‐Statewide SOC Core Team

10/31/12

2. Identify lead family run organization to initiate communication process

Statewide SOC Core Team

10/31/12

3. Identify family coordinator to work with Project Director to implement Goal 1.

‐Family & Youth Run Organizations


12/31/12

4. Convene meetings of family leadership group ‐Lead Family Run Org.

‐DCF SAMH Program Office

12/31/12

5. Develop forum for sharing strategic goals and resources including development of MOUs to support all SOC core values, including family‐driven and youth‐guided care

‐Lead Family Run Org.

7/31/2013

6. Outreach to diverse/underserved populations ‐Lead Family Run Org.

9/30/13

7. Provide advocacy to the legislature during the next session

‐Lead Family Run Org.

‐State MH Planning Council

9/30/13

Objective 1.a.2 (Policy) Youth organizations to meet consistently statewide PRIORITY

A statewide consortium of Youth leaders with aligned goals and advocacy strategies

1. Link with youth organizations and existing youth forums such as Youth Summit, Youth M.O.V.E and youth & family websites to compile list of youth organizations throughout the state serving the population of focus.


‐Family Run Organizations

10/31/12

2. Identify lead youth run organization to initiate communication process, convene group meeting of leadership groups, and develop forum for sharing strategic goals and resources.


‐Statewide family network/ consortium

10/31/12

3. Develop SOC website with interactive forum such as discussion boards to solicit youth input regarding needed resources and system improvements.


‐SOC Core Team 12/31/12

4. Outreach to diverse/underserved populations. ‐Lead Youth Org. ‐Local SOC Planning Teams

7/31/12

5. Convene focus groups to identify opportunities and needs of youths

‐Lead Youth Run Organization

9/30/13

6. Provide advocacy to the legislature during the next session

‐Lead Youth Run Organization

‐Youth Summit 9/30/13

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Objectives Key Indicators of

Success



Objective 1.a.2 Continued

7. Identify youth coordinators to work with Project Director to implement Goal 1.

‐Family & Youth Run Organizations


12/31/12

Objective 1.a.3.(Policy) Standards for youth and family voice/ involvement in contracts with publicly funded providers

Family & youth representation on state & local advisory boards and board of directors

1. Review Managing Entities contracts for inclusion of family and youth representatives on board of directors and provide feedback


‐Consortium of youth and family organizations

12/31/12

2. Maintain a calendar of statewide workgroup meetings on the SOC webpage

‐Statewide SOC Project Director

‐Other child serving agencies (DJJ, Health, Education, AHCA, Child Welfare, APD, etc.)

12/31/12

Objective 1.a.4.(Policy) Youth and Families are active participants in system and service evaluation processes

Family and youth voice is represented is all quality assurance, quality improvement, monitoring, evaluation and research activities

1. Identify or develop satisfaction and service effectiveness evaluations to family and youth service recipients informed by surveys, focus groups, and other methods, through in‐person and on‐line formats.

‐Providers ‐Independent evaluators


3/31/14

2. Include peer recovery specialists and/or family members in all monitoring, evaluation and research activities regarding system of care implementation as well as specific interventions.

‐Providers ‐Independent evaluators ‐MEs ‐State partner agencies


9/30/14

Objective 1.a.5.(Policy) Accessible and user‐friendly dissemination of evaluation outcomes

Youth and family members have access to service/ program outcomes

1. Link report cards for behavioral health providers to the SOC webpage


9/30/14

2. Write evaluation outcomes and processes in plain language and have them reviewed and edited by youth and family members prior to dissemination

‐Providers ‐Evaluators

‐Family run organization ‐Youth run organization ‐Office of Consumer Affairs

9/30/14

3. Identify and utilize mechanisms to bring information to families and underserved populations with limited access to technology (e.g. public health centers, guidance counselors, Exceptional Student Education Specialists, etc.)

‐DCF Regional SAMH Offices

‐Family run organization ‐SEDNET

9/30/15

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Core Strategy: Developing Services and Supports Based on the System of Care Philosophy and Approach Objectives Key Indicators

of Success Strategies or Action Steps Responsibility

Champion Coordinated with Timeframe/

Due Date

Objective 1.b.1 (Service)

Consistent statewide team planning approach driven by the family and guided by youth

PRIORITY

Availability of Wraparound/ team planning based services for youth and families with complex behavioral health needs and /or multi‐system involvement

1. Add wraparound team meetings as a mandatory Medicaid service code with ability to be billed by all qualified team members for the same time period.

‐AHCA ‐Current Wraparound Providers ‐DCF SAMH

9/30/14

2. Adopt the wraparound guidelines and principles as the foundation for person‐to‐person training for targeted case child case managers

‐AHCA ‐FMHI ‐DCF SAMH ‐Family Orgs. ‐Youth Run Orgs.

9/30/14

3. Develop or identify Wraparound guides in plain language for families and youth delineating what to expect from the provider and how to drive the team process.


‐Family Run Orgs. ‐Youth Run Orgs.

9/30/13

4. Explore train‐the‐trainer mechanisms and develop a statewide training plan.


‐Certified Wrap. Trainers ‐FMHI

9/30/13

5. Crosswalk steps of Wraparound approach with available, billable services (e.g. Arizona model)


‐DCF SAMH ‐AHCA

3/31/14


Family Care Plans instead of “treatment plan” (interpreted as a single plan of care or a master care plan)

Integrated care plan that provides consistent goals and is inclusive of or references all treatment and service plans that affect a family

1. Identify lead facilitator / agency(s) to manage process ‐Statewide SOC Core Team

9/30/16

2. Convene group meeting of stakeholders ‐Identified Lead Facilitator

Stakeholders 9/30/16

3. Review plans across systems to identify common/distinct elements

‐Identified Lead Facilitator


4. Identify ‘required’ plan elements for each system ‐Identified Lead Facilitator


5. Negotiate elements of a common plan ‐Identified Lead Facilitator


6. Secure consensus and implement ‐Identified Lead Facilitator


7. Reconvene or identify group to review and evaluate implementation

‐Identified Lead Facilitator


16



Coordinated with Timeframe/Due Date


Availability of youth and family peer support services

Annual increase in employed recovery peer specialists ‐family

1. Add Peer Support as a stand‐alone, billable service to the Medicaid Handbook

‐ Statewide SOC Core team

‐ AHCA ‐ Consortium of youth & family orgs

9/30/16

2. Increase availability and access to youth and caregiver run support group specific to the cultural and linguistic needs of the community

‐ Consortium of youth and family organizations

‐Local SOC Planning Teams

9/30/14

3. Consider youth peer certification

‐State SOC Project Coordinator

‐Florida Certification Board ‐Statewide SOC Core Team ‐ Consortium of youth & family orgs

9/30/16

Core Strategy: Creating Financing Mechanisms

Objective 1.c.1 (Financing) Funding opportunities for family and youth organizations, including funding parent and youth support services

PRIORITY

A business plan to secure and sustain family and youth support services Sustained youth and family organizations to ensure family and youth voice

1. Identify Medicaid and non‐Medicaid sources to support family and youth involvement at all levels of the system of care including independent fundraising and fund stream development including but not limited to :

a. Private sector donors, b. Grant opportunities, c. Children Services Councils, d. County Governments


9/30/13

2. Legislative advocacy for dedicated block grant funding for family run organizations to provide parent and youth support partners and support groups.


‐DCF SAMH (Chief level or higher) ‐State MH Planning Council

9/30/13

3. Develop local partnerships with providers and child serving agencies (e.g. YMCA, Boys & Girls Clubs, Faith‐based organizations, HMO’s, rotaries, schools & universities) to share resources such as space, volunteers, trainings, food, etc.


9/30/13

4. Engage university business schools to identify opportunities for help in growing non‐profit family and youth organizations


9/30/13

5. Add Family Support as a mandatory Medicaid service code.

‐AHCA ‐SOC Core Team ‐State MH Planning Council

9/30/14

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Core Strategy: Providing Training, Technical Assistance, and Coaching




Objective 1.d.1 (Training & TA) Training for youth & families in leadership, self‐advocacy & policy development

PRIORITY

A statewide training plan for youth and families

1. Conduct needs assessment and develop training initiative from evaluations conducted that have relevance to families and youth, e.g., youth in transition study

‐‐‐Consortium of family & youth orgs


9/30/13

2. Identify and review existing training curriculums and update/modify as necessary.

‐‐Consortium of family & youth orgs

‐DCF SAMH Program Office; past and currently funded SOC grantees

9/30/13

3. Identify leaders, such as Jack Levine, who can train on advocacy

‐Consortium of family & youth orgs


9/30/13

4. Identify and/or create one website in the state where all trainings are listed (See also 1.b.6)

‐Consortium of family & youth orgs


9/30/13

Objective 1.d.2 (Training & TA) Families are aware of what to expect from the behavioral health system

Availability of web‐based and written materials in plain language for families accessing services on what to expect

1. Identify or develop tip sheets / guides for various service systems written by youth and family members with TA from content experts for: a. Mental Health b. Juvenile Justice c. Schools – Individualized Education Plans

‐Youth Council ‐Consortium of family and youth organizations

‐Statewide SOC Core Team Providers ‐Child Serving Agencies

9/30/14

2. Make tip sheets available on SOC website


9/30/14

3. Ensure tools are appropriate and relevant to diverse cultural groups

‐CLC Coordinator ‐Consortium of family & youth orgs

9/30/14

4. Link with providers to distribute guides at point of first contact

‐Managing Entities ‐Statewide SOC Core Team

9/30/14

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Objective 1.d.3 (Training & TA) Parents and youth in a variety of training roles

Family & /or youth as sole or co‐trainer for SOC and Team Planning trainings as a minimum standard

1. Build community training collaborative to maximize resources

‐Local SOC Coordinator


9/30/14

2. Train, utilize and pay parents, family members and young adults to be trainers


‐Managing Entities ‐Consortium of family & youth orgs

9/30/15

3. Utilize young adults with system experience to share stories in college programs to train upcoming workforce (e.g. medical schools, psychology & social work programs, etc.)

‐Consortium of family and youth organizations

‐Youth Council ‐DCF SAMH Program Office ‐Board of Regents

9/30/15

4. Provide Wraparound training to stakeholders in addition to service providers

‐Training Collaborative

‐Local SOC Planning Teams ‐Managing Entities

9/30/15

Objective 1.d.4 (Training & TA) Service providers proficient in the areas of engagement and active listening skills

Qualitative evaluations indicate that youth and families were successfully engaged in services and felt heard

1. Develop or identify video based trainings with youth and caregivers depicting effective engagement and client/provider interactions vs. what does not work.


‐DCF SAMH Program Office ‐Statewide SOC Core Team

9/30/14

2. Teach active listening skills as well as strength‐based assessment skills (e.g. ask families what they need)


‐Certified Wraparound Trainers

9/30/14

3. Engage family and youth peer specialists in trainings


‐Certification Board 9/30/15

Core Strategy: Generating Support

Objective 1.e.1 (Support) Decrease stigma of MH/SA

PRIORITY

Implementation of Social Marketing Plan

1. Support and endorse strategies outlined in the SOC Social Marketing Plan

‐Family and Youth Organizations


9/30/13

2. Identify venues to share youth and family stories ‐Family and Youth Organizations


9/30/13

3. Promote public and professional awareness of mental health as general health issue through social media tools and websites



9/30/13

4. Identify opportunities for prevention of mental health / substance abuse disorders



9/30/13

19




Objective 1.e.2 (Support) Reach “invisible” (underserved and unconnected) populations

Increase service utilization by underserved populations

1. Analyze data at the local or regional level to determine unmet needs and determine who these underserved populations are (needs assessment on who is served, who serves them, & with what services)

‐DCF Regional SAMH Office

‐Family run organization ‐Managing Entity

9/30/14

2. Select one group to focus on (for current year) and engage them in helping to identify what the strategies are to best engage this group; identify the places to engage them (schools, faith based organizations; community leaders)


‐Family run organization ‐Managing Entity

9/30/15

3. Utilize mobile unit to access underserved areas and provide information on available resources

a. Staff with volunteers b. Utilize donated computers c. Spread SOC message d. Track # of individuals reached e. Charge community for use

‐Family run organization

9/30/15

Objective 1.e.3 (Support) Enhancing support and engagement of families and youth at all levels of the system

Business plan to support involvement at state and local levels

1. Provide outreach to where families are (e.g. libraries, faith‐based organizations, Boys & Girls Clubs, YMCA, schools (ESE), after‐school programs, etc.) a. Educate and train community on tools, resources

and SOC principles b. Utilize Great American Teach In model c. Link with existing resources such as 211 d. Link with foster and adoptive families and youth


‐Local SOC Planning Teams ‐Local Foster Parent Association

9/30/15

2. Identify family and youth leaders in schools & neighborhoods



9/30/15

3. Include input from leaders from various community

organizations – all inclusive‐for profit,‐non‐profit,

business leaders, clergy, neighborhood associations,

etc.

20




Objective 1.e.4 (Service) Develop multiple methods of connecting families and youth to resources, information and other families and youth

Youth and families are connected via website, resource guides, web chat capacity, and hotlines

1. Utilize social media tools a. Blogging/ Facebook / Apps b. Discussion board for both parents and for youth



9/30/13

2. Mobile unit to reach populations without transportation a. Community‐supported with donations b. Identify infrastructure supports financially for

bus/vehicle liabilities


9/30/15

3. Develop hotline staffed by certified recovery peer specialists for families and youth statewide to gain access to information, resources and support. Costs to be shared by family and youth organizations statewide.


9/15/16

21

Goal #2: Collaboration / Integration among Community Partners Core Strategy: Implementing Policy, Administrative, and Regulatory Changes




Objective 2.a.1 (Policy) Establish common practices and policies across agencies that reflect SOC and Trauma Informed Care (TIC) values and principles PRIORITY

MOU’s between governmental entities that incorporate SOC and TIC language, values and principles and required data elements SOC and TIC language spelled out in provider contracts and included in monitoring protocols Multiagency workgroup created to work on standardized assessment framework and produce plan for Years 2‐4

1. Link with workgroups where this is being addressed, operationalize SOC and TI Care, as needed, and review MOUs currently being edited to include TI Care language, SOC language and physical health care.


‐TI Care Interagency workgroup

9/30/13

2. Coordinate and engage agency representatives to identify minimum common assessment elements, processes for each agency to review and approve assessment changes, and generate recommended steps to achieve in Years 2‐4. a. Workgroup will consider linking with Georgetown

Crossover Youth Practice Model Initiative for communication guidelines related to child welfare – justice involved youth

b. Identify resources outside of child welfare that would fund CBHA assessments and expand Medicaid eligibility / definition that would allow for billing under this code outside of child welfare

c. Revise or develop assessment procedures for use outside of the child welfare context

d. Identify training and support for sharing comprehensive behavioral health assessments (CBHA) across systems, train agency staff in using CBHAs in family support / care planning.


‐Georgetown Crossover Youth Practice Model Initiative workgroup ‐AHCA ‐DCF SAMH Program Office ‐DJJ ‐Child Welfare ‐Managing Entities

9/30/13

3. Utilize common language understandable to all a. Develop a cross‐agency glossary b. Publish the glossary on the SOC webpage


‐Statewide SOC Core Team ‐Consortium of family & youth orgs

9/30/15

4. Review age requirements across systems and revise to make them consistent



9/30/16

5. Standardize release/request for information forms within regions


‐Local SOC Planning Teams ‐Managing Entities – Providers

9/30/16

22




Objective 2.a.2 (Policy) Common

outcomes across

child serving

systems

including:

Child/family

functioning,

school drop‐

outs, out‐of‐

home

placements,

caregiver stress,

suspensions /

expulsions,

employment,

school

attendance &

arrests

PRIORITY

Cross‐system report card, common monitoring and evaluation tools (Years 2‐4)

1. Identify lead facilitator / agency


9/30/13

2. Convene stakeholders (possibly an existing group like the state Children’s Cabinet) to review outcomes for each system identify common domains.

‐Lead Facilitator ‐Agency CQI and IT staff ‐Consortium of family & youth orgs ‐Child Serving Agencies

3/31/14

3. Identify evaluation tools for core data set across systems

‐Stakeholder Workgroup

‐Agency CQI and IT staff ‐Consortium of family & youth orgs

3/31/15

4. Review measures for each domain, identify strengths of measures.



3/31/15

5. Propose core data set for child and family service agencies



9/30/15

6. Review evaluation, QA/QI and data monitoring resources in each agency and develop funding for impartial evaluation of systems & services.



9/30/15

7. Develop a common data base to be to be shared across systems, accessible to stakeholders including youth and families


‐Agency CQI and IT staff ‐Consortium of family & youth orgs ‐Child Serving Agencies

9/30/16

23

Core Strategy: Developing Services and Supports Based on the System of Care Philosophy and Approach Objectives Key Indicators



Due Date

Objective 2.b.1 (Service) Single point of care coordination

PRIORITY

An identified individual or entity responsible for cross‐system communication, practice, and QA/QI

1. Identify EBPs that support team‐based single point of care approach (e.g., wraparound, medical home)

‐DCF CW‐CBC pilot on single point of care


3/31/13

2. Implement individualized family‐specific team planning process for children, youth and family with complex needs

‐Managing Entities ‐DCF CW‐CBC pilot on single point of care

‐Providers ‐AHCA ‐Regional SAMH Office

9/30/14

3. Implement team based discharge/ transition planning process for youth in residential care and youth transitioning to adult services

‐Managing Entities ‐DCF CW‐CBC pilot on single point of care

‐Providers ‐AHCA ‐Regional SAMH Office

9/30/14

4. Use Managing Entity (ME) contracts to reinforce single point of care


9/30/14

5. Monitoring tools will be developed and used to identify that single points of contacts are being used appropriately in each region


‐Consortium of Youth & Family Orgs

9/30/14

6. ME and Regional SAMH Directors provide TA to circuits / local service areas on team planning and single point of care



9/30/14

7. Review current guidelines for the use of 100800 funds (CBCs use children’s MH general revenue funds to provide non‐Medicaid compensable community MH services and natural supports to children in out of home care and those at risk of removal. The purpose of the funds is to build resiliency through a wraparound approach to service provision and amend as needed to support team planning).


‐DCF CW‐CBC pilot on single point of care

9/30/14

8. Utilize curricula from team planning approaches, such as Wraparound, to develop consistent and comprehensive targeted case management training as required by AHCA.

‐AHCA ‐FMHI ‐Statewide SOC Core Team

9/30/14

24




Objective 2.b.2 Early intervention, screening and assessment based on SOC values and principles

‐Reduced time from problem identification to screening ‐Increased number of BH screenings

1. Identify mechanisms and supports to help parents obtain screenings, assessments and early intervention as soon as a problem is identified and remain engaged through the process.

‐ DCF SAMH Program Office

‐Local community ECC & SOC Teams ‐ Providers ‐ Family Orgs. ‐ DOE

9/30/15

2. Provide screenings and services in the community that are easily accessible to families (e.g., pediatrician offices, childcare centers, schools, home‐based, etc.).

‐ Providers ‐ Local community ECC & SOC Teams ‐ Providers

9/30/16

3. Conduct school‐based screenings earlier and include parents in each step of screening, assessment and referral process.

‐ SEDNET ‐ Local SOC Planning Team ‐ DOE

9/30/16

4. Provide outreach, education and supports to underserved populations regarding the importance of early screening and assessment (e.g., single parents, relative caregivers, foster/adoptive families, etc.).

‐ Family Orgs ‐ Local SOC Planning Team

9/30/16


Objective 2.c.1 (Financing)

Maximize service accessibility and usage of funding streams

PRIORITY

All children will be served through the age of 21 for more than just basic clinical services; case management and intensive levels of care will be provided to all children through age 21.

1. Ensure that the SOC Expansion Toolkit includes strategies and incentives to leverage resources for outreach, prevention and intervention.


Statewide SOC Core Team

12/31/12

2. Create forums to discuss leveraging resources at the community level (e.g. providing training on SOC opens up conversation on “how can you help us?”)

‐Local SOC Coordinators

‐Local SOC Teams ‐Providers ‐State and local business comm.

9/30/13

3. Dedicated DCF managed care person ‐Chief of SAMH Program Office

‐AHCA 12/31/12

4. Increase awareness of existing funding sources so that staff and families have comprehensive list of available resources


‐Local SOC Planning Teams ‐Providers

9/30/14

5. Expand Medicaid coverage through age 21 for children with eligible mental health diagnoses

‐AHCA Statewide SOC Core Team

9/30/15

6. Train ACCESS staff on Medicaid eligibility for youth in foster care through age 21

‐Child Welfare ‐AHCA 9/30/15

7. Maximize use of private insurance for eligible youth and families by assisting providers in entering private insurance networks so they are eligible to bill

‐Managing entities ‐AHCA ‐Local SOC Planning Teams

9/30/15

25

Core Strategy: Providing Training, Technical Assistance, and Coaching Objectives Key Indicators



Due Date

Objective 2.d.1 (Training & TA) Universities and community colleges as partners in SOC implementation

YEARS 2‐4

Florida universities and community colleges incorporate SOC in their curricula

1. Identify programs that produce workforce (i.e. social work, psychology, mental health counseling, early childhood, child care, etc.)



9/30/14

2. Identify any curricula already available inclusive of SOC philosophy and practices



9/30/14

3. Identify SOC champion within the university system ‐FMHI ‐Statewide SOC Core Team

9/30/14

4. Undergraduate and graduate programs – provide guest speakers / experts in the field to speak with classes about SOC and reality of current practices

‐ Statewide SOC Project Director

‐Statewide SOC Core Team ‐FMHI

10/1/13‐9/30/16

5. Link with community college child care programs and leadership groups to introduce EBP’s such as mental health consultation and SOC principles


‐Statewide SOC Core Team ‐FMHI

10/1/13‐9/30/16

26

Goal #3: Link with Early Childhood Initiatives to Promote Screening, Prevention and Early Intervention for Behavioral Issues Core Strategy: Developing Services and Supports Based on the System of Care Philosophy and Approach




Objective 3.b.1 (Service) Strengthening family involvement in EC SOC

PRIORITY

Work plan developed, meeting agendas and sign in sheets to document family involvement

1. Connect and coordinate existing early childhood groups (e.g., Infant Mental Health) and families to serve as workgroup to develop a plan to fully implement this objective

‐Project Director ‐Statewide Infant Mental Health Council

9/30/13

2. Explore the possibility of providing thebump.com website with Florida specific resources on parenting

‐Project Director ‐Local community ECC and parenting providers

3/31/13


EBPs are utilized in early childhood settings

PRIORITY

Work plan developed Select EBP’s are implemented

1. Identify lead facilitator / agency to convene and staff process


9/30/13

2. Engage local early childhood coalitions (ECC) & groups to inventory system capacity & gaps

‐Local Project Directors

‐Local Early Childhood community

9/30/13

3. Identify Early Childhood EBPs and administer EBP survey to early childhood community


‐Florida Center 9/30/13

4. Provide TA in response to the survey including training the child care workforce to notice signs and symptoms early and how to deal with specific challenges prior to diagnosis.


‐Local community Local community ECC and parenting providers & FSU

9/30/13

5. Ensure child care contracts and licensure includes EBPs in their Continuing Education credits and training plans


‐FSU, Local ECC & parenting providers

9/30/13


Trauma Services are available, especially for child welfare youth

Joint workgroup for TIC and SOC

1. Focus on Trauma Informed Care Trainings for Child Welfare staff, foster parents related to children 0‐5 as this is the largest percentage of children removed from homes.

‐Statewide TIC Workgroup

‐Child serving agencies ‐Providers ‐CBC’s

9/30/14

2. Ensure that members of the SOC planning workgroup are also on the Trauma Informed Care workgroup.



10/31/12

3. Coordinate the goals and objectives in the SOC Strategic Plan and the goals and objectives in the trauma informed care workgroup strategic plan.


‐Statewide SOC Core Team ‐TI Care Workgroup

9/30/16

4. Coordinate regional trauma informed workgroups in the local system of care.


‐TI Care Workgroup 9/30/14

27

Core Strategy: Creating Financing Mechanisms Objectives Key Indicators



Due Date

Objective 3.c.1 (Financing) Funding opportunities for prevention services & universal promotion

Educational materials developed for dissemination

1. Creating training and education for HMO’s about cost effectiveness of prevention and outreach.

‐‐Statewide SOC Core Team

‐AHCA 9/30/15

2. Link with AHCA to have these services covered under Medicaid.


‐AHCA 9/30/16


Objective 3.d.1 (Training & TA) Educating primary care providers regarding availability of behavioral health screenings and how and where to refer young children

PRIORITY

Training Plans and materials for developed for dissemination Trainings and outreach to medical professionals

1. Bright Futures Initiative‐American Pediatric Society provides on their website holistic screenings to be used by pediatricians during well visits. Possible linkage with this already provided resources to include referrals for local SOC. Educating pediatrician offices regarding this free resource and benefit to patients and their families.

‐DCF SAMH Program Office Circuit 2

‐Florida Chapter of APA Association ‐CMS ‐Florida Center for Early Childhood ‐Florida Association for Infant Mental Health

9/30/13

2. Reach out to local pediatric society to provide awareness material and presentations to local pediatric doctors and nurses concerning early childhood mental health issues and training on use of the medical home model in providing holistic care to infants and young children and their families.


‐Florida Chapter of American Pediatric Association ‐CMS

9/30/13

3. Work with higher education on developing strategies to reach out to medical and nursing schools to provide exposure to early childhood mental health issues and providing holistic care to infants and young children and their families.


‐USF, FSU, UM and other Florida institutions of higher education

9/30/13

4. Utilize existing early childhood mental health collaboratives (e.g., Miami/Dade Children’s Trust, Hillsborough Early Childhood Council) as demonstration sites.



9/30/13

28

Goal #4: Implement Local System of Care Sites

Core Strategy: Implementing Policy, Administrative, and Regulatory Changes Objectives Key Indicators



Due Date

Objective 4.a.1 (Policy) Assess each Florida region for readiness, opportunities and needs to implement local SOC’s

PRIORITY

All regions complete a readiness/needs assessment in the areas of family involvement, partner collaboration, quality of communication, cultural and linguistic competence, and EBP utilization

1. Reevaluate current SOC readiness assessment and inventory other readiness and needs assessments, modify as necessary for dissemination throughout the state.


‐Managing Entities ‐DCF SAMH Regional Offices

3/31/13

2. Ensure the readiness assessment is in plain language and family and youth friendly.


‐Consortium of family & youth orgs ‐CLC Coordinator

3/31/13

3. Ensure the assessment is available in other languages, including Spanish and Creole.

‐CLC Coordinator


3/31/13

4. Find multiple ways to engage families and youth in completion of the readiness/needs assessment.



9/30/13

5. Disseminate assessment to community stakeholders. ‐Managing Entities ‐DCF SAMH Regional Offices


9/30/13

6. Develop mechanisms that allow information gathered through the readiness/needs assessment process to be disseminated broadly and quickly through multiple media



9/30/13

Objective 4.a.2.(Policy) Infrastructure for local SOC planning and implementation

PRIORITY

Completion of local strategic plans

1. Identify community leader / champion for SOC implementation


‐DCF SAMH Program Office ‐Consortium of family & youth orgs

3/31/13

2. Identify and engage community partners in the planning and implementation process – create local planning team. Ensure that families and youth are included in all implementation councils and groups.


‐DCF SAMH Program Office ‐Consortium of family & youth orgs

6/30/13

3. Develop strategic plan including a financing and service array plan.


9/30/13

4. Set clear expectations, protocols and standards of core performance for SOC implementation


‐SOC Core Team ‐CLC Coordinator

9/30/13

5. Provide training and technical assistance to local implementation sites, including a web‐based toolkit


‐Mentors from past & current SOC sites

9/30/13 ‐ongoing

29


Strategies or Action Steps Responsibility Coordinated with Timeframe/Due Date

Objective 4.a.3.(Policy) Continuous Quality Improvement processes for SOC service and infrastructure implementation

Expansion regions have evaluation plan with specific data requirements inclusive of process and clinical measures

1. Develop indicators based on SOC values and principles using the grant required outcome measures


‐Evaluation Team ‐Local SOC Planning Teams

6/30/13

2. Ongoing surveys of participants in the SOC on quality of process. Surveys should have room for comments either in writing, or audio/video feedback if on‐line.


‐Evaluation Team

10/1/12‐9/30/16

3. Any performance measures, surveys and reports (quantitative and qualitative) are to be written in common language to be reviewed by youth and parents with an ongoing feedback loop.


‐Evaluation Team ‐Consortium of youth & family orgs ‐CLC Coordinator

10/1/12‐9/30/16

4. Make all assessments and data available on SOC webpage.

‐State SOC Project Director


10/1/12‐9/30/16

5. Identify ways for families to access computers to access (i.e. link with local libraries, ACCESS kiosks).


‐Evaluation Team ‐Consortium of youth & family orgs

9/30/13

Core Strategy: Developing Services and Supports Based on the System of Care Philosophy and Approach

Objective 4.b.1. (Service) An array of needed services and supports are available

PRIORITY

All regions complete a readiness/needs assessment

1. Use multiple sources of information to conduct local needs assessments to determine:

a. What services are provided / available b. Who receives these services c. What the ideal array of services and supports

are (e.g., mobile crisis, team planning, respite)



9/30/13

2. Educate communities on array of services that have been successful for the population of focus in areas similar to their community (i.e. rural vs. urban, ethnic make‐up, poverty prevalence, etc.)

‐Managing Entities ‐DCF SAMH Regional Offices ‐Family & Youth Run Orgs

‐DCF SAMH Program Office ‐CLC Coordinator

9/30/13

3. Advocate with funders and providers to change / expand array based on need.

‐Managing Entities ‐DCF SAMH Regional Offices ‐Family & Youth Run Orgs


9/30/13

4. Create a mechanism for ongoing gap analysis ‐Managing Entities ‐DCF SAMH Regional Offices

‐DCF SAMH Program Office ‐Family & Youth Orgs

9/30/13

30



Objective 4.b.2 (Service) Youth & families have equal access to services across systems & locations that are: 1.) Community‐based, 2.) Strengths‐based, 3.) Culturally & linguistically responsive, 4.) Holistic and 5.) Individualized

Increase in utilization of community based services

1. Educate communities on the array of services provided in a comprehensive SOC


‐Local SOC Planning Teams ‐Family Org

3/31/14

2. Implement team planning approaches such as Wraparound for case management

‐Managing Entity ‐Local Providers ‐Local SOC Planning Teams

9/30/14

3. Identify a champion for Wraparound at the state level ‐Statewide SOC Core Team

9/30/13

4. Hire staff who are representative of the cultures prevalent in the community that they serve

‐Providers ‐CLC Coordinator 9/30/16

5. Include being multi‐lingual as a preferred qualification for service providers

‐Providers ‐CLC Coordinator 9/30/16


Objective 4.c.1 (Financing) Financing mechanisms sustain services consistent with SOC values & principles

PRIORITY

Financing grids that identify funding sources on the state level and local levels.

1. Convene Financing Workgroups on state & local levels to identify all potential sources & opportunities such as county government, independent tax districts, etc.

‐SOC Core Team ‐DCF SAMH Regional Offices

‐State Mental Health Planning Council

9/30/13

2. Develop financing plans in conjunction with the Strategic Implementation Plan

a. Statewide plan b. Local plans

‐SOC Core Team ‐DCF SAMH Regional Offices

‐State Mental Health Planning Council

9/30/13

31



Objective 4.c.2 (Financing) Financial structures promote flexibility, reduce duplication, and support SOC values

Funding follows the child as opposed to the service

1. Review and revise policies that promote multiple assessments and discourage assessment updates



10/1/12‐9/30/16

2. Assessments follow the child and family across providers and agencies



10/1/12‐9/30/16

3. Identify and develop a crosswalk for flex funding opportunities in local communities



10/1/12‐9/30/16

4. Identify / create / clarify mechanisms that allow maximal flexibility and support SOC values and principles, e.g., Care Management Entities, Administrative Service Organizations.


‐Local SOC Planning Teams ‐AHCA ‐Managing Entities ‐MCO’s

10/1/12‐9/30/16

5. Clarify similarities and differences between managed care organizations and managing entities


‐AHCA ‐DCF SAMH Program Office

10/1/12‐9/30/16

6. Standardize structures of MCO ‐AHCA 10/1/12‐9/30/16


Objective 4.d.1 (Training & TA)

Provide a SOC blueprint to local communities outlining strategies for successful implementation.

PRIORITY

Web‐based, Florida specific SOC Implementation Toolkit

1. Develop a SOC orientation training that can be easily tailored for multiple audiences, including families and youth.


‐Core Planning Team

12/31/12

2. Develop a Florida SOC Implementation toolkit utilizing existing resources such as the Oklahoma Model.

3. Identify and update a system navigation guide written in plain language (no acronyms) by parents for other parents such as the Florida Parent Navigator


‐Core Planning Team ‐Consortium of Youth & Family Orgs

3/31/13

4. Market test all written materials prior to distribution


‐Core Planning Team ‐Consortium of Youth & Family Orgs

3/31/13

5. Make toolkit available in multiple media, including web‐based


3/31/13

32



Objective 4.d.1 (Training & TA) Continued

6. Utilize existing Florida SOC communities as demonstration sites


‐Local SOC Planning Teams‐Current and graduated SOC sites

10/1/12‐9/30/16

Objective 4.d.2 (Training & TA)

A well trained and qualified workforce

Local training plans

1. Develop train the trainer mechanisms for ongoing training and coaching in wraparound.


‐Certified Wraparound Trainers

10/1/13‐9/30/16

2. Provider staff have training and support to treat families in a strength‐based, individualized, family centered approach

‐CLC Coordinator


10/1/13‐9/30/16

3. Identify champions in all areas of the state to promote SOC values and principles

‐CLC Coordinator


10/1/13‐9/30/16

4. Create partnerships with universities and community colleges (refer to 2.d.1)

‐Local and State SOC Coordinators

‐FMHI 10/1/13‐9/30/16

Objective 4.d.3 (Training & TA) A culturally / linguistic relevant SOC

Satisfaction surveys reflect a CLC SOC

1. Identify a state level CLC champion / expert ‐CLC Coordinator


9/30/12

2. Develop or identify provider education about requirement to have trained interpreters.

‐CLC Coordinator


9/30/13

3. Evaluate SOC’s to ascertain if decision makers and front line staff reflect the cultural and ethnic make‐up of the community they serve

‐CLC Coordinator


10/1/12‐9/30/16

Core Strategy: Generating Support Objective 4.e.1 (Support) Strategic engagement of community members who need to be in the planning & implementation process PRIORITY

Presence of

local planning

and

implementation

councils and

workgroups

1. At a minimum, engage and set meeting with: a. Managing entities b. Community based care agencies c. Local family and youth support

mechanisms d. Culturally specific organizations e. Local Providers

‐DCF SAMH Program Office ‐Regional DCF offices ‐Local SOC Coordinator

‐Statewide SOC Core Team ‐Consortium of youth & family orgs

3/31/13

2. Engage county government and MCOs (e.g. Magellan) ‐Local SOC Coordinator

‐Regional DCF offices 9/30/13

3. Identify leadership and convene local planning process ‐Local SOC Coordinator

‐Regional DCF offices 9/30/13

33

Goal #5: Implementation of Evidence Based Practices Core Strategy: Implementing Policy, Administrative, and Regulatory Changes




Objective 5.a.1 (Policy) Accountability standards for providers to implement EBP’s that highlight individualized, family‐centered care PRIORITY

Contracts and monitoring protocols outlining expectations for EBP implementation

1. Managing Entities contracts require 80% of DCF publicly funded services must be EBP’s


‐Managing Entity ‐Family and Youth Organizations

9/30/13

2. Monitoring entities check for evidence that SOC values and EBP’s are implemented to fidelity.

‐DCF SAMH Program Office ‐AHCA ‐DJJ


9/30/13

3. Monitor the participation of youth and families in the identification of EBP’s for their community.



9/30/13

4. Implement a mechanism to collect ongoing feedback from the community on the effectiveness of implemented EBP’s (i.e. Angie’s list for EBP)



9/30/13

5. Convene workgroup with AHCA to explore how Medicaid can increase use of EBP’s



9/30/13

Objective 5.a.2 (Policy) Incentives for providers to implement EBP’s

EBP workgroup that includes all parties Statewide toolkit for implementing and sustaining and EBP

1. Identify and convene workgroup with multiple levels of expertise. Local workgroups could be established to leverage resources

‐Statewide and local SOC Coordinators

‐State and local SOC planning teams

10/1/13‐9/30/14

2. Educate providers on EBPs and how to sustain fidelity ‐EBP workgroup ‐State and local SOC planning teams

10/1/13‐9/30/16

3. Require % of workers within providers have certain certification.

‐Managing Entities ‐DCF SAMH Program Office ‐AHCA ‐Florida Council on Comm. Behavioral Health

10/1/15‐9/30/16

34




Objective 5.a.2 (Policy) Incentives for providers to implement EBP’s

CONTINUED

4. Obtain buy‐in from funders through education on improved outcomes and cost‐effectiveness

‐EBP workgroup ‐State and local SOC planning teams ‐Florida Council on Comm. Behavioral Health

10/1/13‐9/30/16

5. Quarterly calls with EBP workgroup that gives providers and opportunity to talk about successes and barriers

‐EBP workgroup 10/1/13‐9/30/16

6. Information from workgroup informs training and TA content

‐EBP workgroup ‐State and local SOC planning teams

10/1/13‐9/30/16

Core Strategy: Developing Services and Supports Based on the System of Care Philosophy and Approach

Objective 5.b.1. (Service) Broad statewide implementation of EBPs

PRIORITY

Increase to baseline on use of EBPs to fidelity

1. Annual provider self‐assessment


‐Providers, families & youth

9/30/13

2. Use NIATX models (quick change process improvement strategy) for implementing and assessing fidelity to an EBP

DCF SAMH Program Office

‐Providers 9/30/13

3. Provide incentives for providers for EBP implementation to fidelity (e.g. free training)

‐Managing Entities, ‐AHCA ‐DJJ

9/30/13

4. Develop review and monitoring process to assess implementation and fidelity checks, including cost to providers



5. Develop and sustain a competent workforce able to implement EBP’s to fidelity


6. Educate families and youth what EBPs are


‐Consortium of youth & family orgs

9/30/13

7. Ensure that EBPs identified include trauma‐informed and trauma‐specific interventions

DCF SAMH Program Office ‐AHCA

‐Maureen Honan, DJJ, Chair Statewide Trauma‐informed Care Interagency Workgroup

3/31/13

35

Core Strategy: Creating Financing Mechanisms Objectives Key Indicators



Due Date

Objective 5.c.1 (Financing) Maximize funding for EBPs

PRIORITY

Develop matrix of funding sources and how they can be used to fund EBPs

1. Crosswalk all funding sources with EBPs to identify funding gaps (e.g., funding for supervision to ensure fidelity)

‐EBP Workgroup ‐Providers ‐AHCA ‐Managed Care Organizations ‐DJJ, DCF, DOH, DOE, ‐family and youth advocates ‐CSCs and county government

9/30/13

2. Create local / regional training collaborative to coordinate and share resources for trainings (e.g. Broward County)



10/1/13‐9/30/15

3. MOU’s to address leveraging resources for shared ‘train the trainer’ trainings.



10/1/13‐9/30/15


Objective 5.d.2. (Training & TA) Trauma Informed Care

YEARS 2‐4

TI and trauma‐specific curricula are developed or identified for varied audiences including families, youth, and for populations and in settings for children, youth and youth adults 0‐25

1. Develop or identify curricula on TI Care, e.g., through National Child Traumatic Stress Network (NCTSN), for use with families and youth

‐DCF SAMH Program Office ‐AHCA

‐Statewide and Circuit Trauma‐informed Care Interagency Workgroups ‐Seminole Families and Communities Together (FACT) ‐Florida’s NCTSN sites

3/31/13

2. Develop statewide Trauma Informed Care training plan that includes EBPs and leverages state and local expertise and experience

‐DCF SAMH Program Office ‐AHCA

‐Statewide and Circuit Trauma‐informed Care Interagency Workgroups ‐Seminole (FACT) ‐Florida’s NCTSN sites

9/30/13

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Glossary of Acronyms

211 - Telephone and web-based information and referral ACCESS - Automated Community Connection to Economic Self Sufficiency (food/temporary cash/medical assistance program) AHCA – Agency for Health Care Administration APA – American Pediatric Association APD - Agency for Persons with Disabilities CBHA - Comprehensive Behavioral Health Assessment CLC - Cultural and Linguistic Competence CMS - Children’s Medical Services CQI - Continuous Quality Improvement CW-CBC Child Welfare – Community-Based Care DCF SAMH - Department of Children and Families Substance Abuse and Mental Health Program Office DJJ - Department of Juvenile Justice DOE – Department of Education DOH – Department of Health EBP - Evidence-Based Practice(s) ECC - Early Childhood Coalition(s) ESE – Exceptional Student Education FMHI - Louis de la Parte Florida Mental Health Institute FSU - Florida State University HMO – Health Maintenance Organization IT – Information Technology MCO - Managed Care Organization ME - Managing Entity MH – Mental Health MOUs – Memoranda of Understanding NCTSN - National Child Traumatic Stress Network QA/QI – Quality Assurance / Quality Improvement SED – Serious Emotional Disturbance SEDNET - Network for Students with Emotional/Behavioral Disabilities SOC – System of Care TA – Technical Assistance TI – Trauma-Informed TIC Trauma - Informed Care UM - University of Miami USF – University of South Florida

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References

Stroul, B., & Friedman, R. (1986). A system of care for children and youth with severe emotional

disturbances (rev. ed.). Washington, DC: Georgetown University Child Development

Center, National Technical Assistance Center for Children’s Mental Health.

Hernandez, M. & Hodges, S. (2006). Applying a theory of change approach to interagency

planning in child mental health. American Journal of Community Psychology, 38(3/4),

165-73.

Hernandez, M. & Hodges, S. (2005) Crafting logic models for systems of care: Ideas into action. [Making children’s mental health services successful series; no. 216-1-rev]. Tampa, FL: University of South Florida, The Louis de la Parte Florida Mental Health Institute, Department of Child & Family Studies. Available at http://rtckids.fmhi.usf.edu/rtcpubs/CMHseries/IdeasintoAction.html

Stroul, B., & Friedman, R.M. (2011). Effective strategies for expanding the system of care

approach. A report on the study of strategies for expanding systems of care. Atlanta, GA: ICF Macro.

Stroul, B., Blau, G., & Friedman, R. (2010). Updating the system of care concept and philosophy.

Washington, DC: Georgetown University Center for Child and Human Development, National Technical Assistance Center for Children’s Mental Health.

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