Partnering for Excellence: Moving on Up (stream that is)

1. Partnering for Excellence:Moving on Up(stream that is) Jenny Cooper Project Director Benchmarks

2. The Problem… one of many • Youth in DSS custody experience higher rates of physical and mental health problems than their peers not in DSS custody • High levels of emotional or behavioral problems • More likely to be suspended • More likely to have skipped school • Often have experienced trauma in their lives, which can be compounded by the system through: • Investigation • Removal from home • Changing schools • Multiple placements

3. 10 Most Common Causes of Death in North Carolina Cancer Heart Disease All other unintentional injuries Motor vehicle injuries Intentional self- harm (suicide) Diabetes Chronic liver disease and cirrhosis Chronic lower respiratory diseases Cerebrovascular diseases Assault (homicide)

4. Risk Attributable to ACEs

5. Bringing the ACEs Research Home3

6. Building Resilience in the Community Help children feel safe in their community Help children to become more engaged in school Ensure that kids are attached to a Medical Home Improve the system of care for kids who have chronic conditions Cultivate positive traits3 Positive, warm responses and interactions with child Modelling controlled thoughts, feelings, and behaviors5

9. Success will look like: Improved child well-being outcomes Decreased number of children entering custody Decreased CPS re-assessments Decreased need for high-intensity behavioral health services Containment of Medicaid, state, and county costs for children in the child welfare system

10. Lessons Learned by Private Providers Fee for service operations trying to do managed care work Cultural shift is hard with narrow profit margins Additional collateral contacts as relationships are built Coaching is essential, but use coaching to create an internal champion Agency capacity and learning curve Timeliness relates to capacity and facilitative administration

11. Steps to Creating Trauma Informed Partnerships • Find other evidence-based practices to support • Determine capacity of community • Find out what other EBPs round out the service continuum • Parent-Child Interaction Therapy • Triple P • Seeking Safety • Celebrating Families! • Invite clinicians to CFTs- may not be able to attend, but find other creative ways to share information • Challenging population to engage – work in partnership • Create communication expectations with leadership

12. Reflections of 2012 “Early intervention and prevention systems have been gutted, so it is hard to get services children need to keep them out of more intensive placements” “Sometimes, clinicians simply don’t want to work with the parents- either the biological parents because they are seen as the bad guys or the foster parents because they are temporary.” “There is not much sharing of information among providers, which makes services less efficient and effective and allows families to fall through the cracks.” “Caseworkers feel that they conduct screening or assessment because of their lack of expertise.”

13. Reflections of 2015 “From a systematic view, you can’t do child welfare without mental health partnering” “Partnering for Excellence has really done an amazing job of bringing a lot of organizations together to work in collaboration.” “It has really shown us that when you truly invest in collaboration and partnership….it just works better, not just for the child, but for the entire community.” Others care….

14. Early Preliminary Trends Increase in diagnoses indicating trauma histories (versus behavioral diagnoses) Higher percentage of youth being assessed

15. Hey, PFE! I sure am excited for us to move services upstream to create healthier communities. Thanks for being a model of the value of front end services! 1115 PFE