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Implementation Evaluation Report

Phase One Implementation: Katie A. Strategic Plan. Implementation Evaluation Report. CEO, DCFS, and DMH committed to evaluate the first year of the Katie A. Strategic Plan implementation: A total of 27 focus groups across 3 SPAs (7,6, and 1) were conducted in November and December of 2009.

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Implementation Evaluation Report

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  1. Phase One Implementation: Katie A. Strategic Plan Implementation Evaluation Report

  2. CEO, DCFS, and DMH committed to evaluate the first year of the Katie A. Strategic Plan implementation: • A total of 27 focus groups across 3 SPAs (7,6, and 1) were conducted in November and December of 2009. • The data collection process included 23 individual interviews with DCFS Regional Administrators/Assistant Regional Administrators and DMH District Chiefs/Program Heads. Evaluation

  3. The evaluation explored four specific components: • Mental Health Screenings • Referrals to Assessments for Children with Positive Mental Health Screenings • Assessments for Children with Positive Mental Health Screenings and Linkage to Mental Health Services • Mental Health Service Provision Evaluation

  4. Mental Health Screening Process • Seven elements: • Easy-to-use screening • How-to training • Ongoing support • Protocols and roles specifying responsibility • Checkpoints ensuring completed screening on all children • Data-tracking system • Cross-system ownership Key Strengths

  5. Mental Health Screening Process • Ensuring that all children with existing cases are screened for mental health needs. • Administering the mental health screening tool consistently across different and complex, time-limited situations, including the Medical Hubs. Key Challenges

  6. Referrals to Assessments • Formal procedures • Clear roles and responsibilities • Referral packet checklist • Data-tracking system • Coordinators of the Multidisciplinary Assessment Teams and Service Linkage Specialists Key Strengths

  7. Referrals to Assessments • Obtaining the necessary consent for services in a timely fashion. • Determining, obtaining and maintaining benefits for certain children in the child welfare system that are Medi-Cal eligible. Key Challenges

  8. Assessment and Linkage Activities • Coordinated Service Action Team (CSAT) Key Strength CSAT is viewed as a structure that has brought greater order, efficiency, and accountability to assessment and linkage services for newly detained cases, non-detained and existing cases.

  9. Assessment and Linkage Activities • Track 1 (Newly Detained Cases): Availability of Assessment Slots and Assessment Capacity • Track 1 (Newly Detained Cases): Difficult Deadlines, Expectations, and Additional Costs • Track 2 and 3 (Non-Detained and Existing Cases): Distancing, Roles, and Partnerships Key Challenges

  10. Mental Health Service Provision • Confidence that Wraparound services provided mental health services. Key Strength CSWs and Intensive Social Workers reported that they regularly check in with Wraparound service providers regarding case files.

  11. Mental Health Service Provision • Children Social Workers (CSWs) lack of clarity concerning their roles. • CSWs lack of strong mechanisms for cross-agency collaboration. • Structural constraints: • Inability to bill fully; • Costs of training; and, • Department managers lack clear buy-in and a set of expectations about the practice principles. Key Challenges

  12. Screening Process • Further formalize the roles of staff that are responsible for ensuring that in existing cases, children are screened for mental health needs. • Improve the process of filling out the mental health screening tool in specific context, namely for children 0-5 years of age, for crisis situations and in the Medical Hubs. Recommendations

  13. Referrals to Assessments • Improve the ways in which release of information and consent for mental health treatment are obtained. • Minimize the problems of Medi-Cal enrollment and disenrollment, particularly for children with private insurance, HMO Medi-Cal, or placements outside Los Angeles County. recommendations

  14. Assessment and Service Linkage • Align the various deadlines for completing assessments. • Reduce delays of reports from the Medical Hubs. recommendations

  15. Assessment and Service Linkage • For Newly Detained Cases: • Consider establishing a system to redistribute MAT slots across SPAs. • Increase MAT provider capacity for conducting assessments in specific SPAs. • Strengthen the protocols (roles, expectations, processes) for completing the Summary of Findings Report. • Address the billing issues reported by MAT providers regarding covering the full costs of assessments and service linkage. Recommendations

  16. Assessment and Service Linkage • For Non-Detained and Existing Cases: • Clarify the role of DMH Co-located staff and mental health providers. • Address partnership issues between DCFS and DMH staff. Recommendations

  17. Assessment and Service Linkage • Increase the understanding of CSWs regarding their role in Child/Family Teams. • Strengthen the relationship between CSWs and mental health providers. • Address the structural constraints reported by mental health providers. recommendations

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