Systems of Care

1. Systems of Care Nevada PEP

2. Definition of a System of Care A System of Care is a child-centered, family-focused plan of care in which the needs of the child and family dictate the types of services provided. System of Care involves agencies, programs, and services that are working together to address individual family needs.

3. System of care is, first and foremost, a set of values and principles that provides for systems reform on behalf of children, youth and families.

4. System of Care Principles • Community-Based • Child and Family-Focused • Interagency Collaboration • Cultural Competence • Individualized & Strength Based • Accountability

5. Child & Family-Focused • In Systems of Care full family participation requires mutual respect and meaningful partnership between families and professionals. • Families are involved and their voice is valued in all levels of Systems of Care.

6. Interagency Collaboration • Interagency Collaboration within Systems of Care engages all child and family serving agencies at all levels of the public, private, and faith based sectors.

7. Cultural Competence • Systems of Care services are respectful and responsive to the child and family’s (cultural, ethnic, religious and spiritual) values and practices.

8. Community-Based • Services are delivered in the community where the child and family live, such as a school or home.

9. Individualized & Strength Based • Every child and family enrolled in Systems of Care participates in an individualized plan of care that focuses on the needs, strengths, and challenges of the child and family.

10. Accountability • Systems of Care ensure outcome data is collected, analyzed, and reported on the individual child and family services system, performance, and financial efficiencies.

11. Wraparound is a practice approach that can be applied to children and families with or at risk for service needs – not just to those with the most serious and complex problems. Unconditional Care Wraparound puts system of care values and principles into practice for service planning and provision. Pires, S. & Lazear, K. 2006. Human Service Collaborative. Washington, D.C. Adapted from the National Wraparound Initiative, Portland, OR

12. Promising Approaches or Practice-Based Evidence • Show evidence of effectiveness through experience of key stakeholders (e.g., families, youth, providers, administrators) and outcomes data. Examples include: • Family Support and Education • Wraparound Approach • Mobile Response and Stabilization Services • Family Group Conferencing • Intensive In-Home Services • Child and Youth Respite Services • Mental Health Consultation Services • Independent Living Skills and Supports • Positive Behavioral Supports Pires, S. (2002). Building systems of care: A primer. Washington, D.C.: Human Service Collaborative. Examples - Source: Burns & Hoagwood. 2002. Community treatment for youth: Evidence-based interventions for severe emotional and behavioral disorders. Oxford University Press and State of New Jersey BH Partnership (www.njkidsoc.org)

13. What Natural Helpers and Social Supports Can Provide • Emotional support; moral & spiritual guidance • System support • Concrete help & advocacy • Decrease isolation • Community navigation • Resources & education • Greater understanding of getting help or support Lazear, K., (2003) “Primer Hands On”; A skill building curriculum. Washington, D.C.: Human Service Collaborative.

14. Where Families, Youth and Family and Youth Organizations Fit Into the Service Array • As technical assistance providers & consultants • Training • Evaluation • Research • Support • Outreach/Dissemination • As direct service providers • Family Liaisons • Care Coordinators • Family Educators • Specific Program Managers (respite, etc) • Youth Peer Mentors Wells, C. (2004). “Primer Hands On” for Family Organizations. Human Service Collaborative: Washington, D.C.

15. Fundamental Challenge and Rationale for Building Systems of Care No one system controls everything. Every system controls something. “Think outside of your Silo” Pires, S. 2004. Human Service Collaborative. Washington, D.C.

16. Wraparound is “a planning process that results is an individualized set of community services and natural supports that are for a child and family to achieve a positive set of outcomes.” www.rtc.pdx.edu/nwi Bruns, B. & Hoagwood, K. (Eds.) Community-Based Interventions for Children and Families. Oxford: Oxford University Press and National Wraparound Initiative,.

17. Life Domain Areas Adapted from. Dennis, K, VanDenBerg, J., & Burchard, J. (1990). Life domain areas. Chicago: Kaleidoscope.

18. A Well Documented Service and Support Plan • Respectfully and thoughtfully documents the family’s experience. • Uses the family’s and youth’s own words to create a family and youth vision. • Is written from strengths, addresses culture and linguistics. (continued) Lazear, K. (2006) Wraparound Maryland. Human Service Collaborative: Washington, D.C. Adapted from The National Wraparound Initiative (2004).

19. A Well Documented Service and Support Plan • Identifies needs that moves the family and youth closer to their vision. • Identifies strength-based, creative and practical strategies to meet the chosen needs, not just existing categorical services. • Looks at successful formal and usual strategies from the past. (continued)

20. A Well Documented Service and Support Plan • Addresses mandates while staying family-driven and youth-guided. • Spells out a crisis/safety plan that moves from least restrictive to more restrictive. • Builds a family-based team rather than a system-based team Lazear, K. (2006) Wraparound Maryland. Human Service Collaborative: Washington, D.C. Adapted from The National Wraparound Initiative (2004).

21. A Well Documented Service and Support Plan • Includes community and natural supports • Attends to transition out of the formal wraparound process. • Includes all necessary signatures of participation and commitment. • Reflects what was said in the child and family team meeting.

22. System of Care Outcome Measures • Mental Health • Reduction in residential care • Decrease in CAFAS/CASII scores • Increase in Evidence Based Practices • Academic/Education • Improved Attendance and education performance • Reduction in discipline referrals • Juvenile Justice • Reduction in bookings • Reduction in Recidivism • Family • Increased family involvement • Increased family satisfaction Pires, S. (2006). Primer Hands On – Child Welfare. Washington, D.C.: Human Service Collaborative.

23. QUESTIONS??