California Institute for mental health FSP Advisory Committee meeting February 14 th , 2011

1. California Institute for mental healthFSP Advisory Committee meetingFebruary 14th, 2011 Jennifer Clancy,

2. Topics For the Day • Training Plan for FSP Tool Kits • FSP Tool Kit Demonstrations: PRE-FINAL Version of Child and Family & Adult Tool Kits • Subcommittee Meetings: Ensuring the Cultural Relevance of FSP Programs • Plan for Implementation of the Practices • Introduction to Small Group Discussion: Supervision to Support Best Practice in FSP Programs • Small Group Discussion • Large Group Discussion: Identification of Next Steps CIMH FSP Advisory Committee Meeting, 2-14-11

3. Training Plan- FSP Tool Kit: Philosophy & practices Webinars • 4 Webinars, 1 for each age group • Time: 10:00-11:30am • Dates: • March 29: Adult FSP Tool Kit • April 12: Older Adult FSP Tool Kit • April 26: Transition Age Youth • May 5: Child and Family Tool Kit CIMH FSP Advisory Committee Meeting, 2-14-11

4. Training Plan- FSP Tool Kit: Philosophy & practices Webinars • Learning Objectives: • Increase awareness of the content of the FSP Tool Kits: Philosophy and Practices • Identify the role of FSP Networks in assisting line staff and supervisors to implement FSP best practices • Demonstrate how FSP Tool Kits can support continuous quality improvement of FSP Programs CIMH FSP Advisory Committee Meeting, 2-14-11

5. Training plan-Best practice implementation training in fsp network meetings • 5 Trainings in Combined FSP Network Meetings • Time: 9am-1pm • FSP Network Meeting will follow the Trainings • Trainer: Lynne Marsenich, PhD • Dates: • Northern Region, All Ages: May 25 , Sacramento • Bay Area Region, All Ages: June 1, San Jose • Southern Region, Child and Family: June 9, Los Angeles • Southern Region, Older Adults: June 15, Pasadena • Los Angeles, Adults: June 22, Los Angeles CIMH FSP Advisory Committee Meeting, 2-14-11

6. Training plan-Best practice implementation training in fsp network meetings • Learning Objectives • Identify Administrative Requisites for Practice Implementation • Identify Clinical Requisites for Practice Implementation • Increase Knowledge on Choosing Practices that Meet Organizational and Program Needs and Stages of Development • Stages of Program Implementation CIMH FSP Advisory Committee Meeting, 2-14-11

7. FSP Tool Kits: Philosophy & practice • Demonstration of Child and Family FSP Tool Kit (Pre-Final, not yet approved by DMH for distribution) • Demonstration of Adult FSP Tool Kit (Pre-Final, not yet approved by DMH for distribution) CIMH FSP Advisory Committee Meeting, 2-14-11

8. Shaping the plan to support supervision of best practices at the local level • Current training plan does not yet identify a congruent approach to supporting clinical and program supervisors as they guide FSP Teams on best practice implementation • Purpose of Afternoon Small Group Discussion-Committee members provide CIMH with feedback on 2 questions: • Is there a need for a congruent approach to support clinical supervisors at the local level? • Can a congruent approach accommodate the wide range of FSP program structures, team membership, practice approaches, etc? • If not a congruent approach, what are other proposals for the adoption and ongoing supervision to support the direct service team members/staff in best practice implementation? CIMH FSP Advisory Committee Meeting, 2-14-11

9. Age group subCommittee Breakouts • Editing and ongoing development of the FSP Tool Kit: Ensuring the Cultural Relevance of FSP Programs • 4 Subcommittee Breakouts: • Children and Families (Jeanie Sleigh) • Transition Age Youth (Wayne Munchel) • Adults (Debbie Innes Gomberg) • Older Adults (Janet Yang) CIMH FSP Advisory Committee Meeting, 2-14-11

10. Introduction to Small Group Discussion: Supervision to Support Best Practice in FSP Programs Setting the Context: • What do we know about Full Service Partnership Programs? • What do we assume about Full Service Partnership Programs? • What does the FSP Tool Kit Do and Not Do Support Using Best Practices in FSP Programs? • What are the Critical Next Steps to Support Best Practice Implementation at the Local Level? CIMH FSP Advisory Committee Meeting, 2-14-11

11. What Do We Know About FSP Programs? • Program Outcomes Are Measured in the Following Domains: Residential Status/Living Arrangements (includes hospitalization and incarceration) Education Employment Sources of financial support Legal issues/designations (parole/probation, conservatorship) Emergency Interventions Health Status Substance Use CIMH FSP Advisory Committee Meeting, 2-14-11

12. WHAT DO WE KNOW ABOUT FSP PROGRAMS? • Key Event Tracking as events occur and resolve: Residential Status/Living Arrangements Education Employment Legal issues/designations Emergency Interventions • 3 Month (3M) Updates: Sources of financial support Legal issues/designations Health Status Substance Use

13. What Do We know about fsp programs • Client Level Outcomes: • Client level outcomes are identified by the individual’s being served in FSP Programs • These are identified in the ISSP (treatment plan) • FSP Programs are responsible for designing services & supports and implementing practices that help achieve not only program level outcomes but also the client level outcomes CIMH FSP Advisory Committee Meeting, 2-14-11

14. What Do We Know About FSP Programs? • Todd Gilmer’s FSP Practices Tool identifies characteristics of FSP Programs that should lead to positive client outcomes • FSP Programs employ a team based approach • All FSP Clients have personal services coordinators (single point of responsibility) • There is a strategy in place for 24/7 crisis response. CIMH FSP Advisory Committee Meeting, 2-14-11

15. What Do We Assume about FSP Programs? • FSP Clients all have recovery oriented treatment plans • The plan specifies the goals, objectives and interventions planned in partnership with the client and FSP Team • The plan specifies if an evidence-based practice is part of the ISSP (primarily in child and family FSPs) CIMH FSP Advisory Committee Meeting, 2-14-11

16. How Does the Tool Kit Support Local level FSP Programs? • Offers a comprehensive overview of best practices in FSP programs • Offers information on implementation strategies • The Tool Kit does not offer direction or ongoing support to local level clinical supervisors responsible for guiding their teams in the adoption and implementation of best practices • Without this support, sustaining best practices is very difficult CIMH FSP Advisory Committee Meeting, 2-14-11

17. An Approach to Supporting clinical supervisors in counties implementing recovery oriented treatment planNing • CIMH has an approach to supporting clinical supervisors in other projects that are attempting to influence local level practice • The Transformational Care Planning (TCP) Supervision Curriculum is a good example of an approach to Clinical Supervision that is flexible, yet definitively focused on helping supervisors develop distinct skills designed to support staff becoming more competent in designing and implementing Person-Centered Treatment Plans. CIMH FSP Advisory Committee Meeting, 2-14-11

18. CiMH Supervisory Support EXAMPLE • The TCP Training for Supervisors focuses on the following learning objectives: • Identifying the skill sets needed to implement TCP • Defining the relationship between person-centered planning and strengths –based practice within the TCP context • Utilizing strengths-based and person-centered approaches as a TCP supervisor • Practicing skills development in TCP/strengths-based supervision CIMH FSP Advisory Committee Meeting, 2-14-11

19. CiMH Supervisory Support EXAMPLE • The Training focuses on techniques that supervisors can use to facilitate best practice, and is organized in such a way that different team dynamics, configurations, and cultures can benefit from the Supervisor’s interventions and skill. CIMH FSP Advisory Committee Meeting, 2-14-11

20. CiMH Supervisory Support EXAMPLE • In order for the supervisory approach to be flexible, the following competencies must be mastered by the supervisor: • Person-Centered and Individualized supervision style (parallel process to practice) • Effective Utilization of Data • Strengths-Based Supervision • Cultural Competence and Humility • Assessing TCP skills CIMH FSP Advisory Committee Meeting, 2-14-11

21. Maximizing The Supervisory RELATIONSHIP • The supervisor and supervisee have an opportunity to create an exceptional learning environment. In order for this to happen: • Supervisors need to utilize a combination of supervisory styles depending on the needs of the situation. • In order to be effective in the aforementioned, they must understand the dynamics of different styles of supervision. • Supervisors also need to be able to assess employee’s learning styles. CIMH FSP Advisory Committee Meeting, 2-14-11

22. Supervising to outcomes The TCP supervisor must be effective in supervising, monitoring and coaching towards program outcomes, as well as to the range of outcomes that are decided by the person’s we serve. Some key dictums concerning supervising to Client/Family-centered outcomes are: • Clients are the focus of all our activities. • The ultimate criterion of organizational performance is improving client outcomes. • Managerial performance is identical to organizational performance. • Primary role of supervisor is to help staff do their job more effectively and efficiently. University of Kansas, Supervising to Outcomes CIMH FSP Advisory Committee Meeting, 2-14-11

23. Strengths-Based Supervision Competencies • Provides proactive strengths-based supervision. • Models person-centered values. • Encourages and supports staff to improve outcomes for people receiving services. • Encourages and supports staff to complete work assignments. • Sets goals with staff and monitors progress. • Gives consistent feedback on quality of work. • Celebrates successes with staff on a consistent basis. • Identifies and builds on the strengths of the employee. CIMH FSP Advisory Committee Meeting, 2-14-11

24. Progress Notes Interventions Objectives Goal Narrative Summary Assessment with Strengths The TCP Logic Model CIMH FSP Advisory Committee Meeting, 2-14-11

25. Introducing the TCP Skills Assessment • A tool for supervisors and staff. • Provides an easy checklist of criteria for each part of the Transformational Care Plan. • Skills are identified as Met, Partially Met, Unmet or Don’t Know. • Comments section allows for specific feedback, both strengths and areas for growth. CIMH FSP Advisory Committee Meeting, 2-14-11

26. Small Group Discussion GUIDING QUESTIONS: • Do you see the need for a congruent approach to support of clinical supervisors at the local level? • If not, what are other proposals for supporting clinical supervisors as they guide direct service team members/staff to implement and sustain FSP Tool Kit best practices? CIMH FSP Advisory Committee Meeting, 2-14-11