World Café Summary Report

1. World Café Summary Report Department of Children and Families, Circuit 4 Substance Abuse and Mental Health Office Prepared by the Health Planning Council of Northeast Florida June 30, 2009

2. Table of Contents Who is the Health Planning Council of Northeast Florida 3 World Café Assessment Introduction and Background 8 Assessment Methodology 10 Summary of Findings by County 12 Circuit Wide Comparisons 25 Debrief Summaries by County 30

3. Who is the Health Planning Council? • One of 11 Local Health Councils created by state statute 408.033 in 1982 • Manage the Certificate of Need process for hospitals and nursing homes located in Baker, Clay, Duval, Flagler, Nassau, St. Johns and Volusia counties • The only health planning organization to collect, analyze, and warehouse real-time health care utilization data submitted by hospitals and nursing homes in the 7 county northeast Florida region • The only non-partisan / non-profit planning organization mandated to dedicate resources and expertise to regional health planning and community organizing on health disparities and healthcare issues (State Statute 408.033) • Trained to execute cultural competent health planning models such as the World Cafe’, Community Based Participatory Research (CBPR), Community Based Participatory Marketing (CBPM), Social Marketing, Empowerment Evaluation, Strategic Framework Prevention (SPF), Mobilizing for Action through Planning and Partnerships (MAPP), Planned Approach to Community Health (PATCH) * Competency within these models are highly recommended by all major federal and state funding agencies • Conducts SPSS data analysis for reliable health planning analysis • HPCNEF reviews and provides input on Development of Regional Impact pre-applications via the Northeast Florida Planning Council

4. What We Do Health Planning Collects monthly hospital utilization statistics, monthly emergency department statistics, and quarterly nursing home utilization statistics from the providers in the seven counties of northeast Florida (over 100 providers) for Agency of Health Care Administration (AHCA) Provides subscription-driven hospital data clearinghouse Develops annual county profiles and regional health plans on hospital utilization rates, health disparities, health care work force capacity, regional development impact studies, health care funding equity Performs theory-based community health needs assessments Facilitates community organizing and convening activities to discuss health disparities and healthcare issues

5. What We Do Advocacy Facilitates community forums on Medicaid Reform and Florida KidCare Provides leadership and advocacy for the uninsured and underinsured Contributes to the development of the Jacksonville and Northeast Florida Healthcare Guide (the green pages) Develops the Guide to Assisted Living Facilities in Northeast Florida Develops influencing plans for the health advocates and coalitions Serve on many regional Boards and Advisory council to advocate for cultural competent health planning and health care advocacy Health Planning and Community Organizing: It’s what we do every day

6. What We Do Health Promotion and Evaluation Provides flu, pneumonia and hepatitis vaccinations to high risk, minority populations thru churches, community centers, and homeless shelters in Duval County Conducts social marketing training to regional community based organizations Administers and serves as an AIDS Insurance Continuation Program enrollment site Supports the St. Johns River Rural Health Network’s diabetes disease management program for Baker, Clay, Nassau, Bradford and Union counties Conducts program evaluation for small community based organizations

7. What We Do • Non-Profit and Coalition Support • Provides fiscal and administrative support to the local non-profits and coalitions including the St. Johns River Rural Health Network and the Healthy Start Coalition of Northeast Florida. • Provides fiscal and administrative support for Ryan White Title II, general revenue funded HIV/AIDS Network in for Volusia and Flagler counties, • Provides fiscal and administrative support for Housing Opportunities for People with AIDS (HOPWA) for Volusia and Flagler counties • Provides staff support and technical assistance to the Duval County Immunization Task Force

8. Assessment Introduction and Background The Department of Children and Families (DCF), Circuit 4 (Clay, Duval, and Nassau counties) is reviewing its strategic plan for the long term future and success of the Circuit. As part of the process, leaders from Circuit 4 contracted with the Health Planning Council of Northeast Florida (HPC) to plan, coordinate, facilitate four World Café dialog meetings in each county located within the Circuit: Clay County- 31 people in attendance Hilltop Country Club- Orange Park Thursday May 21, 2009 2:00 PM - 5:00 PM Duval County- 34 people in attendance Three Layers Cake- Downtown Jacksonville Friday May 22, 2009 9:00 AM -12:00 PM Nassau County- 9 people in attendance Hampton Inn and Suites- Fernandina Beach Friday May 22, 2009 2:00 PM - 5:00 PM Nassau County- 3 RSVP’s – meeting cancelled County Inn and Suites- Yulee Thursday, June 18, 2009 2:00 PM – 5:00 PM

9. Assessment Introduction and Background The purpose of the World Café was to engage community stakeholders and provide them an opportunity to share their thoughts on the effectiveness of the system of care (infrastructure and service delivery) within the substance abuse and mental health services, offer ideas for integrating our services, and to help the Circuit prioritize substance abuse and mental health services. *Over 70 individuals attended one of the three World Cafés meetings where they were asked to discuss the following five questions: • How do we blend our substance abuse and mental health services into services for clients with co-occurring disorders? • Prioritize our Circuits services. • Assess the effectiveness and quality of our system of care. • If additional dollars come into Circuit 4, what substance abuse and mental health services would you like to see expanded or created? In other words, where would you like the money to go? • How do we integrate our substance abuse and mental health services into our child welfare system? At the end of each meeting, all participants were asked to debrief about their experience in a “Town Hall” setting

10. Assessment Methodology Three weeks prior to the scheduled World Café meeting dates, the HPC sent electronic invitations to community leaders, advocates, providers, the judicial system, law enforcement, school board members, academic institutions, and elected officials. Recipients of the electronic invitation were encouraged to forward their electronic invitation to other constituents who would see value in attending. Each of the four World Café meetings were held in Circuit 4’s respective counties eliminating the participants from having to drive more than 15-20 miles from their service area to attend a meeting. By request, a forth World Café meeting in Nassau County was added to provide west Nassau County stakeholders a closer venue. This venue was cancelled due to the low number of RSVPs (3). World Café locations (Hilltop Country Club, Three Layers, Hampton Inn and Suites, and Country Inn and Suites) were selected because of their café style environments. This relaxing and inviting environment is one of the pillars of the World Café dialog model. RSVP lists for each of the four meetings were managed by using a computer based polling program called doodle.com.

11. Assessment Methodology Attendees participating in each World Café meeting were presented with the same *five questions in order to capture consistent data from each of the three World Café meetings. It is important to recognize that each person had the opportunity to give multiple responses to each question. Notes recorded on table-top paper were also included in the analysis. The HPC collected all of the data from each World Café meeting and synthesized the data according to each county. Major themes emerged in the responses to each question, and they, along with un-coded responses are reported in the summary of findings by county and then by Circuit. Themes are presented in the order of magnitude. Rounding is used in the display of percentages, so totals may fall within +/- 1% of 100. * Due to World Café requirements, the attendees participating in the Nassau County World Café’ in Fernandina Beach were presented with three questions rather than five questions. Low attendance (20 RSVPs; 9 people in attendance) restricted the HPC from introducing additional meaningful questions.An additional meeting was scheduled in Nassau county (Yulee) however, due to low RSVP numbers, this meeting was cancelled.

12. Summary of Findings By County- Clay Question 1 : How do we blend our substance abuse and mental health services into services for clients with co-occurring disorders? 4 major themes emerged from a total of 29 responses.

13. Summary of Findings By County- Duval Question 1 : How do we blend our substance abuse and mental health services into services for clients with co-occurring disorders? 6 major themes emerged from a total of 21 responses.

14. Summary of Findings by County- Nassau Question 1 : How do we blend our substance abuse and mental health services into services for clients with co-occurring disorders? 6 major themes emerged from a total of 40 responses.

15. Summary of Findings By County- Clay Question 2: Prioritize the Circuit’s services 7 major themes emerged from a total of 22 responses

16. Summary of Findings By County- Duval Question 2: Prioritize the Circuit’s services 9 major themes emerged from a total of 35 responses

17. Summary of Findings by County- Nassau Question 2: Prioritize the Circuit’s services 9 major themes emerged from a total of 35 responses

18. Summary of Findings By County- Clay Question 3: Assess the effectiveness and quality of our systems of care 3 major themes emerged from a total of 21 responses

19. Summary of Findings By County- Duval Question 3: Assess the effectiveness and quality of our systems of care 5 major themes emerged from a total of 44 responses

20. Summary of Findings by County- Nassau Question 3: Assess the effectiveness and quality of our systems of care 8 major themes emerged from a total of 30 responses

21. Summary of Findings By County- Clay Question 4: If additional dollars came into Circuit 4, what substance abuse and mental health services would you like to see expanded or created? 7 major themes emerged from a total of 23 responses

22. Summary of Findings By County- Duval Question 4: If additional dollars came into Circuit 4, what substance abuse and mental health services would you like to see expanded or created? 8 major themes emerged from a total of 52 responses

23. Summary of Findings By County- Clay Question 5: How do we integrate our substance abuse and mental health services into our child welfare system? 2 major themes emerged from a total of 13 responses

24. Summary of Findings By County- Duval Question 5: How do we integrate our substance abuse and mental health services into our child welfare system? 4 major themes emerged from a total of 34 responses

25. Circuit Wide Comparison Question 1 : How do we blend our substance abuse and mental health services into services for clients with co-occurring disorders?

26. Circuit Wide Comparison Question 2 : Prioritize the Circuit’s services

27. Circuit Wide Comparison Question 3 : Assess the effectiveness and quality of our systems of care

28. Circuit Wide Comparison Question 4 : If additional dollars came into Circuit 4, what substance abuse and mental health services would you like to see expanded or created?

29. Circuit Wide Comparison Question 5 : How do we integrate our substance abuse and mental health services into our child welfare system?

30. Debriefing- Clay • More specific training is needed for staff, CBC’s, teachers etc… • Align Baker Act and Marchman Act with each other better • Lack of continuity of care • Silo’s in funding • Fragmentation of system • Transportation- rural communities have unique needs • Education the community on services available • There is a lot of duplicated people • Prevention education is needed • Gaps in services • Develop the concept of “no wrong door” • Work better with the criminal justice system • Staff retention is awful • Share! Share! Share!

31. Debriefing- Duval • A lot of work to be done • Need more community engagement • There is no community ownership • Consistent training and standards are needed • Streamline processes • Centralized assessments are necessary • Need a quality work force • There is a willingness and desire to work together • 24/7 services • Combine physical heath and behavior health • Self directed care works

32. Debriefing- Nassau • Transportation is a big issue • Services do not match the treatment needed • Very positive results in providing intervention and prevention in Nassau county schools • Surprised to hear about the great work being done in the schools • Surprised to hear about how the female gangs are outnumbering the male gangs • Substance Abuse Prevention Coalition is working

33. World Café Findings • This report is intended to provide an executive level overview of the findings from the three World Café meetings. Copies of the hand written synthesis and illustrations of the collapsing process of the data is available by written request. All information contained in this report is owned by the Health Planning Council of Northeast and can not be reproduced without their permission. Furthermore, any of the findings listed in this report must be cited and or referenced in all public documents including web site postings. • For further information, please contact Dawn Emerick, Executive Director of the Health Planning Council of Northeast Florida. 904-723-2162