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Circles of Care III Bidders Meeting

Circles of Care III Bidders Meeting. Systems of Care for Native American Youth Day 1 January 2005. Welcome and Introductions. National Indian Child Welfare Association Staff members and consultants Circles of Care Evaluation and Technical Assistance Center Staff members and consultants

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Circles of Care III Bidders Meeting

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  1. Circles of Care III Bidders Meeting Systems of Care for Native American Youth Day 1 January 2005

  2. Welcome and Introductions • National Indian Child Welfare Association • Staff members and consultants • Circles of Care Evaluation and Technical Assistance Center • Staff members and consultants • Center for Mental Health Services • Project Officer • Participants/Prospective Bidders

  3. Overview of Agenda • Understanding Circles of Care • Basics of the Funding Opportunity • Working Sessions • Nuts and Bolts of the application • Logic Models and strategic planning • Developing your Project Narrative • Optional consultation sessions

  4. Meeting Goals and Process • Primary Goal: assist participants in developing a strong proposal and application for the Circles of Care grant program • Secondary Goal: increase participants awareness of the systems of care approach to community development and evaluation that can be used in a variety of future local initiatives • Process: • Facilitated working group sessions • Individual consultation • Electronic resource material

  5. Background and History of the Circles of Care Initiative Jill Erickson, MSWCMHS Project Officer

  6. CIRCLES OF CARE IIISM 05-008 • Tribal Infrastructure Grants for Transforming Behavioral Health Systems for American Indian and Alaska Native (AI/AN) Children and their Families • Standard Grant Announcement, Infrastructure Grants-INF 05 PA

  7. Americans understand that MH care is essential for all overall health MH is consumer and family driven Disparities in MH care are eliminated, cultural and rural/remote Early MH screening, assessment and referral: common practice Excellent MH care is delivered and research is accelerated Technology is used to access MH care and information. New Freedom Commission: Transforming Mental Health Care in America

  8. To develop system of care models designed by AI/AN community members, in partnership with program and evaluation staff. To engage community in assessing service system needs, gaps, potential resources, and plans . To include special emphasis on mental health/substance abuse. To increase system response and options based on values of community served To evaluate the feasibility per available resources. To support Healthy People 2010 goals: reduce suicides, increase access to treatment Goals, Circles of Care

  9. History of the Initiative • CASSP grants to States 1984, to plan a system of care, excluded Tribes • OTA Report of 1990, found only 17 child trained MH providers for total Tribal population. • 1992+ Series of meetings, SAMHSA, Indian Health Service, other federal agencies, providers, and Tribal leaders to address disparities. • Circles of Care I awarded in 1998, followed by Circles of Care II in 2001.

  10. ELIGIBILITY, Circles of Care • Tribal Governments, Federally Recognized, as defined by PL 93-638 • Urban Indian Programs, as defined by PL 94-437 • Tribal Colleges and Universities (TCU), added in 2004 • Previous Grantees not Eligible.

  11. Award Information • $2.4 Million for 7-9 awards. • Average annual award, $250k to $350k • Awards may be requested up to 3 years, depending on availability of funds • Cost sharing/match is not required. • Technical assistance provided on-site and in grantee meetings

  12. Circles of Care I Grantees(1998-2001 Projects) • Cheyenne River Sioux Tribe – SD • Feather River Tribal Health - CA • Shared Vision Project - MT • First Nations Community Healthsource – NM • Oglala Sioux Tribe – SD • Choctaw Nation of Oklahoma • Urban Indian Health Board – Oakland, CA • Fairbanks Native Association- AK • Inter-Tribal Council of Michigan

  13. Circles of Care II Grantees(2001-2004 Projects) • Tlingit and Haida Tribes - AK • Pascua Yaqui Tribe - AZ • Salt River Pima-Maricopa Indian Community - AZ • United American Indian Involvement - CA • Blackfeet Indian Tribe - MT • Ute Indian Tribe - UT • Puyallup Tribal Health Authority - WA

  14. Technical Assistance • National Indian Child Welfare Association, Program Technical Assistance, (IAA, IHS) • National Center for American Indian and Alaska Native Mental Health Research, (IAA, NIMH)

  15. Tribal Consultation • E.O. 13175, DHHS Policy on Tribal Consultation. SAMHSA participates in regional meetings with other agencies and tribes. • Circles of Care was developed over 5 year period, beginning with exploratory meeting at the National Indian Health Board. • An advisory committee of tribal leaders and providers in the field developed the concept for the grants.

  16. Special Journal Edition, U of CO • American Indian and Alaska Native Mental Health Research, V.11, #2, 2004 • Circles of Care I, outcomes • http://uchsc.edu/ai/ncaianmhr/journal/11(2).pdf

  17. Circles III, New Announcement • Announced December 16, 2004 • Due date: February 25, 2005 • Notification planned to all tribal programs, urban Indian programs, TCU’s • TA for prospective applicants, January 2005 • www.samhsa.gov

  18. SAMHSA - New Address • 1 Choke Cherry Road, Rockville MD, 20857 • Center for Mental Health Services • Center for Substance Abuse Treatment • Center for Substance Abuse Prevention • Jill.Erickson@samhsa.hhs.gov • (240) 276-1926

  19. Systems of Care Philosophy:A Native Perspective on the National Initiative Andy Hunt, MSWNICWA Director of Community Development for Children’s Mental Health

  20. System of Care Principles • Family Focused • Culturally Competent • Community Based • Accessible • Individualized • Least Restrictive • Accountable • Interagency • Coordinated & Collaborative

  21. Family Focused • Not about only children • Not about only parenting • “Family” is defined by the community • Families are involved as key partners at every level of the system, from direct service to policy and evaluation

  22. Cultural Competence • Awareness and acceptance of difference • Awareness of own cultural values • Understanding the “dynamics of difference” • Development of cultural knowledge • Ability to adapt practice to fit the cultural context of the client/family

  23. Cultural Competence • At the system level… “A set of congruent behaviors, attitudes, [practices] and policies that come together in a system, or agency…and enable that system, or agency… to work effectively in cross-cultural situations”. (Cross, et. al)

  24. Community-Based • Children should be served in their own community by people from the community • The community should shape and drive the design of the system • The system should reflect the values of the local community • Community members should remain an integral part of the service delivery and planning process

  25. Accessible • Children and families should be able to get all necessary services with ease • Elimination of barriers to service: • Physical/Geographic Location • Policy, Procedures and Processes • Language and culture • Stigma and perceptions • Funding restrictions

  26. Individualized Care • Assessments that are based on discovering the strengths of each child • A “plan of care” that is truly unique to meet the needs of each individual child • A wraparound approach that respects individuals • Services are flexible and adapted to the family

  27. Least Restrictive • Children should remain in their own homes and communities or in the most home-like setting possible • Creativity is needed to develop alternatives to more restrictive service models and keep children in their own communities • Group residential treatment should be avoided unless clinically indicated

  28. Accountable • Everyone in the system is answerable to each other to meet the needs of the children being served • The system to the community members • The system to the funding source • Service providers to the families • Service providers to their supervisors • Partners agencies to each other • Standards of practice and ethics

  29. Interagency • Systems of care involve multiple agencies to meet the multiple needs of children and families • Interagency agreements are formalized • New partnerships are sought out • Care is taken to build relationships between agencies at service level, and leadership level

  30. Coordinated and Collaborative • Agencies and other partner organizations work together cooperatively towards the same goals • Each agency, partner and stakeholder has input and offers resources to meet the community’s goals • Everyone is on the same page, and everyone knows and understands their role in working together to meet the goals

  31. Partnership in Action:The Indian Children’s Mental Health Initiative • SAMHSA (CMHS & CSAT) • Indian Health Service (IHS) • Department of Justice (DOJ) • National Indian Child Welfare Association (NICWA) • Circles of Care Evaluation and Technical Assistance Center (CoCETAC) • American Institutes for Research (AIR) • American Indian/Alaska Native Communities

  32. Systems of CareChildren’s Mental Health Program • Program funded though CMHS began in early 1990’s for State, Counties, and Cities as 5 year grants • First Tribe funded in 1994 (Navajo) • Grants extended to 6 years in 2001 • US Territories are eligible to apply as of 2003 when grants became “cooperative agreements” • Plan, design and implement a children’s mental health system of care • Target population: Children with Severe Emotional Disturbance and their families

  33. Native CMHS Service Sites(6 Year Implementation Grants) • Navajo Nation – NM (Graduated 1999) • Passamaquoddy Tribe – ME (Graduated 2003) • Sacred Child Project – ND (Graduated 2003) • Saulte Ste. Marie Chippewa Tribe – MI (Graduated 2004) • Northern Arapaho Tribe – WY (Graduated 2004) • Oglala Sioux Tribe – SD (Year 6) • Yukon Kuskokwim Health Corp. – AK (Year 6) • United Indian Health Services – CA (Year 5.5)

  34. Native CMHS Service Sites(6 Year Cooperative Agreements) • Fairbanks Native Association – AK (Year 3) • Choctaw Nation – OK (Year 3) • Urban Trails Project – CA (Year 2)

  35. Circles of Care Grant Program • 3 Year grant funded though CMHS • Tribal and Urban Indian programs • Plan, design and assess feasibility of implementing a culturally appropriate system of care • Target population: American Indian/Alaska Native children with Severe Emotional Disturbance and their families • Goal to give grantees opportunity to compete for System of Care implementation grants

  36. Tribal System of Care Communities = SoC = CoC I = CoC II

  37. For more information visit some of the following websites: • www.nicwa.org • www.systemofcare.net • www.air.org/tapartnership/ • http://mentalhealth.samhsa.gov/cmhs/ChildrensCampaign/default.asp • http://www.uchsc.edu/ai/coc/

  38. Tribal Perspectives on Wraparound and Community-Based Strategic Planning Ethleen Iron Cloud Two Dogs Oglala Lakota Nation Annette Squetimkin-Anquoe Puyallup Tribal Health Authority

  39. Participatory Evaluation Mary Phillips, BME Former Circles of Care Program Coordinator, Oakland and an Evaluator, Los Angeles, CA

  40. It’s Not Just an Evaluation Methodology • “We all have a lot in common. We all care very deeply about the communities that we come from and about American Indian and Alaska Native communities across the country. We all share deep concern about the well-being and future of Indian children and families. We are all very self-sacrificing. We are in this business because of our personal beliefs and our desire to make a difference. Our personal backgrounds, our training, our education, and our professional experience all contribute to our desire to make a difference.” • Holly-Echo Hawk, M.S., Echo Hawk and Associates

  41. It’s Not Just an Evaluation Methodology • Participation Evaluation is a key component of the systems of care evaluation process that informs the mission, vision and authority of the Tribe/community throughout the Circles of Care program. • Participation evaluation allows the community to voice its cultural values and promote cultural appropriateness in systems changes development at all levels.

  42. It’s Not Just an Evaluation Methodology • The Circles of Care initiative represented one of the first opportunities for American Indian/Alaska Native AI/AN families and their communities have substantial input into the design of services to address the needs of their children, from their own understanding of these needs. • The Standard Infrastructure Program Announcement, INF 05 PA and the Circles of Care III NOFA have included community involvement and participation measures that you MUST address throughout the application and are considered in the review process.

  43. How it Works • blends evaluation process components to actively involve members of the community to collect qualitative data that better informs the system. • Having members who are knowledgeable about cultural norms of the community bared an unobtrusive context to present systems change.

  44. The Process of Participatory Evaluation • Planning the assessment will require a working process between the project staff and evaluation staff and the key informants of each community. Taking into consideration the current status of delivery systems for Native youth and mental health, developing the assessment tool(s) was pivotal in getting necessary information on contextual issues of the system. • Example: Community Readiness Model was developed at the Tri-Ethnic Center for Prevention Research at Colorado State University to measure systems change in Native American and other communities.

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