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Service Coordination:Service Coordination:A Recipe for SuccessA Recipe for Success

Shared philosophy among Shared philosophy among providersproviders

Collaborative policy and funding Collaborative policy and funding infrastructureinfrastructure

Unique services and supportsUnique services and supports

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History of Service History of Service Coordination: Coordination: 1980’s – Celeste 1980’s – Celeste

AdministrationAdministration

ClustersClusters – county level cross system – county level cross system clinical/treatment teams.clinical/treatment teams.

Participants were Participants were clinical levelclinical level cross cross system personnel.system personnel.

Parents and children often not involved in Parents and children often not involved in plan development.plan development.

Focus on Focus on problems/concernsproblems/concerns.. Creation of Creation of state cluster fundstate cluster fund & application & application

process.process.

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History of Service History of Service Coordination: Coordination: 1990’s – 1990’s – Voinovich AdministrationVoinovich Administration

Family and Children First Councils createdFamily and Children First Councils created and responsible for service coordination and responsible for service coordination mechanism.mechanism.

Cross system approachCross system approach Mandates included needs assessment of Mandates included needs assessment of

child, development of individual family child, development of individual family plan, and dispute resolution process.plan, and dispute resolution process.

State Inter-systems fund State Inter-systems fund application application simplifiedsimplified..

SC requiredSC required to access funds. to access funds.

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History of Service History of Service Coordination: 2000’s - Taft Coordination: 2000’s - Taft

AdministrationAdministration

Methods to Methods to divert children from juvenile divert children from juvenile courtcourt and address at-risk unruly and and address at-risk unruly and adjudicated unruly youth.adjudicated unruly youth.

Family accessFamily access to referral and dispute to referral and dispute resolution processesresolution processes

Strengths basedStrengths based assessment of family assessment of family Required Family Team meetings with Required Family Team meetings with

specific timelines when there are specific timelines when there are emergency emergency or planned out-of-home placements.or planned out-of-home placements.

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History of Service History of Service Coordination: 2000’s - Taft Coordination: 2000’s - Taft

AdministrationAdministration

Shifted from child focus to Shifted from child focus to family family focusfocus..

Strong emphasis on Strong emphasis on family family engagementengagement and and empowermentempowerment..

Required access to Required access to Family AdvocatesFamily Advocates or support person(s).or support person(s).

Alignment of SC with many high Alignment of SC with many high fidelity fidelity WrapAround principlesWrapAround principles..

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History of Service History of Service Coordination: 2000’s - Taft Coordination: 2000’s - Taft

AdministrationAdministration

State inter-systems fund was State inter-systems fund was discontinueddiscontinued and redistributed as an and redistributed as an allocation to each mental health and allocation to each mental health and recovery services board (404 dollars).recovery services board (404 dollars).

ABC 404 dollarsABC 404 dollars allocated based on allocated based on population.population.

$5,681 non-behavioral health funds $5,681 non-behavioral health funds allocated equally to each county FCFC.allocated equally to each county FCFC.

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Service Coordination Service Coordination MechanismMechanism

ORC 121.37 (C) ORC 121.37 (C)What’s in the law?What’s in the law? Each county shall develop Each county shall develop

a county service a county service coordination mechanism. coordination mechanism. The county service The county service coordination coordination mechanism shall serve mechanism shall serve as the guiding as the guiding document for document for coordination of services coordination of services in the county. in the county.

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Service Coordination Service Coordination MechanismMechanism

The overarching requirements for coordinating The overarching requirements for coordinating services for multi-need children in a county:services for multi-need children in a county:

Referral Referral Confidentiality Confidentiality Parent Participation Parent Participation Assessment of Strengths and NeedsAssessment of Strengths and NeedsCulturally ResponsiveCulturally ResponsiveLeast Restrictive Environment Least Restrictive Environment Dispute ResolutionDispute ResolutionComprehensive Family Service Coordination Comprehensive Family Service Coordination Plan ProcessPlan ProcessJuvenile Court DiversionJuvenile Court DiversionMonitoring and Tracking OutcomesMonitoring and Tracking Outcomes

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Comprehensive Family Service Comprehensive Family Service Plan:Plan:

An Individual Family PlanAn Individual Family PlanRequirements for developing and implementing:Requirements for developing and implementing: Notification of and Invitation to CFSP Notification of and Invitation to CFSP

MeetingsMeetings Pre-Out of Home Placement Team MeetingPre-Out of Home Placement Team Meeting

Family RightsFamily Rights ConfidentialityConfidentiality Participate in Meetings and DecisionsParticipate in Meetings and Decisions Invite Informal Supports / Family AdvocateInvite Informal Supports / Family Advocate Approve Team Leader AssignmentApprove Team Leader Assignment Initiate MeetingsInitiate Meetings Dispute ResolutionDispute Resolution

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Comprehensive Family Service Comprehensive Family Service Plan: Plan:

An Individual Family PlanAn Individual Family Plan

IN THE PLANIN THE PLAN Goals and ServicesGoals and Services Designation of Service Designation of Service

ResponsibilitiesResponsibilities Timelines for GoalsTimelines for Goals Crisis and Safety PlanCrisis and Safety Plan Regular ReviewsRegular Reviews

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Service Coordination Service Coordination Process:Process:

1. Referral from family member, agency, or provider.1. Referral from family member, agency, or provider. 2. Determine level of need. 2. Determine level of need. 3. Explain SC & family rights & sign necessary 3. Explain SC & family rights & sign necessary

documentsdocuments 4. Complete Strengths & Needs Assessment & Culture 4. Complete Strengths & Needs Assessment & Culture

DiscoveryDiscovery 5. Determine Family Team/Offer Family Advocate5. Determine Family Team/Offer Family Advocate 6. Develop Family Plan including Crisis and Safety Plan6. Develop Family Plan including Crisis and Safety Plan 7. Implement Plan7. Implement Plan 8. Regular follow up team meetings held to monitor 8. Regular follow up team meetings held to monitor progressprogress 9. Final team meeting to address transition issues & 9. Final team meeting to address transition issues & celebrate success.celebrate success.

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The Many Names of Service The Many Names of Service Coordination Coordination

Service Coordination Service Coordination Family Support Teams Family Support Teams Wrap Around /Hi-Fi WraparoundWrap Around /Hi-Fi Wraparound Cluster Cluster ICAT (Inter-systems Community Assessment ICAT (Inter-systems Community Assessment

Team) Team) ICAT (Inter-agency Clinical Assessment ICAT (Inter-agency Clinical Assessment

Team) Team)

FAmily Stabilty Team (FAST)

Community Wraparound

Child and Family Team Intersystem Diversion

Team (IDT) Kids in Different

Systems (KIDS) Diversion Assessment

Team (DAT) Coordinated Care

Program

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Service Coordination Service Coordination DataData

Top 7 Referral sources for 1,700 children Top 7 Referral sources for 1,700 children

receiving service coordination from 24 receiving service coordination from 24 counties: counties:

1.1. Mental HealthMental Health2.2. Juvenile CourtJuvenile Court3.3. Children’s ServicesChildren’s Services4.4. SchoolsSchools5.5. Family Member Family Member 6.6. MRDDMRDD7.7. HMGHMG

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Examples of County Examples of County ResultsResults

Columbiana CountyColumbiana County served 93 children served 93 children and 71 families in FY07 and showed a and 71 families in FY07 and showed a significant drop in risk assessment scoressignificant drop in risk assessment scores for children participating in Wraparound.for children participating in Wraparound.

Trumbull CountyTrumbull County in last year’s report in last year’s report showed that after children are referred to showed that after children are referred to the Wraparound process there tends to be the Wraparound process there tends to be a a significant drop in hospitalizationssignificant drop in hospitalizations. This . This year’s data shows a very similar pattern. year’s data shows a very similar pattern.

Erie County Results

Erie CountyErie County showed statistically showed statistically significant family improvement for 122 significant family improvement for 122 families in 13 of the 14 life domainsfamilies in 13 of the 14 life domains in in the Family Development Matrix. the Family Development Matrix.

One domain, immigration, did not One domain, immigration, did not show a change because it was not show a change because it was not indicated as a problem area for any of indicated as a problem area for any of the families in service coordination at the families in service coordination at that time.that time.

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Butler County ResultsButler County Results Butler CountyButler County found that mental health found that mental health

services were in place at the time of referral services were in place at the time of referral for 83% of the 212 children referred to for 83% of the 212 children referred to Wraparound. Wraparound.

Statistical analysis of Ohio Scales found that Statistical analysis of Ohio Scales found that most youth most youth moved from clinical to non-moved from clinical to non-clinical levels clinical levels in both Problem Behaviors and in both Problem Behaviors and Youth Functioning Youth Functioning

Most youth were able to Most youth were able to be be maintained in a maintained in a stable living stable living environmentenvironment without frequent without frequent changes in guardianship or level of care. changes in guardianship or level of care.

The majority of children who entered The majority of children who entered Wraparound while in Wraparound while in out of home placement out of home placement moved to a lower level of caremoved to a lower level of care..

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Butler County Results, Butler County Results, cont.cont.

88%88% of parents reported of parents reported improved satisfaction with supportimproved satisfaction with support

75%75% of parents reported feeling of parents reported feeling more hopeful about the futuremore hopeful about the future

86%86% of parents reported feeling of parents reported feeling more involved in their child's treatmentmore involved in their child's treatment

86%86% of parents reported of parents reported reduced safety issues in the homereduced safety issues in the home

88%88% of parents reported of parents reported improved overall family functioningimproved overall family functioning 88%88% of parents reported of parents reported improved behavior in schoolimproved behavior in school

88%88% of parents reported of parents reported improved child behavior in the homeimproved child behavior in the home

SService coordination mechanism for multi-SService coordination mechanism for multi-system involved youthsystem involved youth

EEvidence based model of National EEvidence based model of National WrapAround InitiativeWrapAround Initiative

IImplemented in 2006IImplemented in 2006

FFamily Council - Funded by SCC

3 FTE WrapAround Service Coordinators 1 FTE Clinical Reviewer/WrapAround Service Coordinator 1 FTE & 1 PT Family Advocate 1 FTE Supervisor

CChild & Adolescent Behavioral Health

CCommunity Services of Stark County

154 youth referred in SFY 0869% maleMean age of 13.7Median age 15Race

Caucasion

African American

Multi-Racial

Hispanic

FFamily Court = FFamily Court = 40%40%MMental Health and Alcohol & Drug = MMental Health and Alcohol & Drug = 15%15%FFamily self-referral = FFamily self-referral = 14%14%JJob & Family Services = JJob & Family Services = 6%6%

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Questions?Questions?