Collaborative Management HB 1451

Collaborative Management Program (CMP) In 2004, the Colorado General Assembly passed House Bill 04- 1451 to establish collaborative management programs. The General Assembly determined that the “development of a uniform system of management is necessary for agencies at the state and county levels to effectively and efficiently collaborate to share resources or to manage and integrate the treatment and services provided to children and families who benefit from multi-agency services.” {CRS 24-1.9-101(2)}

Collaborative Management Program Legislative Declaration 24-1.9-101 The legislative intent of HB 1451 was to address the increasing number of families served by more than one agency or system ( juvenile justice, child welfare, health/mental health, education), which has placed significant demands on agencies’ resources. The resulting CMP is designed to improve both the quality and cost-effectiveness of interventions for Colorado children, youth and families. The legislation calls for the development of local collaborative management process that bring together agencies and services for at-risk and/or high system-use children youth and families.

Overlap of Five Systems CW (N=1,881) MH (n=1,728) 92% of CW has MH DYC (n=873) 46% of CW has DYC SA (n=377) 20% of CW has SA DD (n=136) 7.2% of CW has DID December 11, 2015

System Order Progression of 1,881 High Expenditure Youth CW=833 (44.3%) MH=902 (47.9%) 1st System N=1,881 DYC=146 (7.8%) MH=632 (75.9%) CW=669 (74.2%) 2nd MH=58 (39.7%) DYC=76 (9.1 %) CW=88 (60.3%) DYC=233 (25.8%) N=1,756 (84%) : Child Welfare’s Top 20% of Expenditures Make the diameters proportionate to % of total N (1881) MH, CW, DYC for order left to right- so pull in grouped images first then change sizes Let the Ns stay, remove disappear animcation 3rd DYC= 171 (27.1%) MH=54 (71%) CW=233 (100%) CW=58 (100%) MH=74 (84.0%) DYC=247 (36.9%) N=837 (48%) *The % presented represent the percent of youth coming from the preceding system. The graphic areas represent the percent of youth out of the original sample of 1,881

Goals of Collaborative Management (CMP) Develop a more uniform system of collaboration that includes the input, expertise, and active participation of family advocacy organizations Reduce duplication and eliminate fragmentation of services Increase the quality, appropriateness, and effectiveness of services Encourage cost sharing

Mandatory Partners 24-1.9-102 Department of Human/Social Services Judicial District, including probation services Health Department (can be public health or county) School District(s) Community Mental Health Behavioral Health Organization Division of Youth Corrections Managed service organization for the provision of treatment services for alcohol & drugs 27-80-107 Domestic abuse program if representation from such a program is available 26-7.5-102

Target Population At risk children and youth ages birth through twenty-one years of age and their families who would benefit from a multi-system approach or integrated services plan

Opportunities for Improvement Colorado Logic Model MISSION: a uniform system of collaborative management for agencies to effectively and efficiently collaborate to share resources, to manage and integrate the treatment and services provided to children and families who would benefit from multi-agency services. Context Goals Strategies Outcomes Population Duplication / Fragmentation Establishment of MOU that outlines a process for collaboration Interagency Oversight Group (IOG) active participation Appropriateness Implementation of Individualized Service and Support Teams (ISST) Development of Integrated service plans Implementation of evidence based or evidence informed practices Creation of prevention programing that serves at risk children & youth Effectiveness Development of a process for continuous quality improvement Reporting of accurate and consistent data Implementation of a robust and rigorous evaluation on the effects of CMP Cost Flexible funds that promote cost sharing among systems Family Provide family involvement resources and training opportunities to build and expand family representation Family peer support Youth peer support Children & families at risk of or multisystem involved and had an ISST SOC children & youth with SED Children and families at risk of multisystem involvement and are served by a CMP Prevention programs Reduce duplication and fragmentation of services Increase quality , appropriateness and effectiveness of services Encourage cost sharing among systems Encourage active participation of family members, family advocates and family-run organization representatives Reduce flow of children into multiple systems child welfare involvement involvement in the juvenile justice system Improve educational attainment children and youth physical health children and youth mental and behavioral health Increase family and youth representation on the CMP Opportunities for Improvement System Collection of data across systems to achieve goals Consistent practice principles across CMP sites Alignment of process & performance measures across CMP practices Consistent collaboration expectations across systems Joint accountability across agencies Community Enhancing state & local partnerships to address service gaps Alignment of fiscal and programmatic resources to reach outcomes CMP # population SFY 15 = ISST (7,027) Prevention (2,599)

Funding 24-1.9-104 & 26-5-105.5 Funding for CMP can be from 3 different sources: Incentive Funds Divorce Fees Distributed to County CW through CFMS Based on Process Measures and Performance Measures achieved General Funds – 1.5 million General Funds Child Welfare Block Funds Selection of Savings or Surplus

What is an IOG: Interagency Oversight Group 6/25/2018 What is an IOG: Interagency Oversight Group Local stakeholders participate in the CMP through membership on an IOG and by implementing local service models aligned with CMP goals. CMPs are then eligible to receive earned incentive funding in support of their work. The state requires all IOGs to meet a core set of common elements: Inclusion of all 10 mandatory partners Establishment of a collaborative process that addresses risk sharing, resource pooling, performance expectation, outcome monitoring and staff training Local stakeholder participate in the CMP through membership on an IOG and by implementing local service models aligned with CMP goals. CMPs are then eligible to receive earned incentive funding in support of their work. State requires set of common elements: 9 mandatory partners, collaborative process that address

IOG Strategies/Activities IOG oversees ISST process 1) Knows how many children and youth are served by each ISST each month 2) Knows barriers families face when going through the ISST process 3) Works as a collaborative body to address barriers at a system level 4) Determines which population are appropriate for which level of ISST process – ie: high fidelity wrap vs. CYPM IOG oversees prevention programs 1) Data driven decision making process to determine what prevention programs are needed in the community 2) Evaluation process to determine if the program is meeting the needs of the community (family engagement survey – improvement in test scores) IOG is active in making funding decisions 1) Development of a percentage based budget prior to spending any funds to determine what money will be spent based on need and data 2) Reviews and approves budget items IOG reviews and determines successes based on family surveys – sets goal on completion rate of surveys IOG develops a data collection process at the local level to ensure that they are receiving data for clients served by the CMP

What is an ISST? Individualized Service and Support Team The memorandum of understanding shall include authorization for the interagency oversight group to establish individualized service and support teams to develop a service and support plan and to provide services to children and families who would benefit from integrated multi-agency services. The goal of an ISST meeting is to develop an integrated plan to address the complex issues & safety needs of the children and family. It is recommended that information in the plan include, but is not limited to, the following: Tasks for which each individual/organization is responsible, Financial responsibilities, Timeline for completion, and Schedule for follow-up meetings

ISST’s Across the State Individualized Service and Support Team FEM - Family Engagement Meetings MDT – Multi-disciplinary Team CYPM – Cross-Over Youth Practice Model RTI – Response to Intervention Wrap Around - HFW PRT – Permanency Roundtables

Prevention Programs Evidence Based Practices encouraged Fill gaps in community as determined by a data driven process Multi-system approach or; Multiple systems were involved in development or enhancement of the program or; Multiple agencies are involved in the delivery of services Program was developed to reduce bifurcated services Shows how joint approach benefits children, youth and families

Prevention Programs Across the State School based health clinics Incredible Years Program Therapeutic Mentoring School based case management Truancy Support Programs Employment Program After school / Day Treatment programing Runaway outreach and notification Parent Partner Programs Human Trafficking

SYSTEM COLLABORATION

Local Agencies and Service providers benefit Who benefits from Collaborative Management? What is the value for families and communities? Benefits To Families Better outcomes by receiving more effective agency support Greater availability of relevant services Opportunity to receive coordinated support from local community members Streamlined communication between the family and multiple service providers Shared responsibility/accountability for service plan Local Agencies and Service providers benefit Duplication & fragmentation of services by agencies are reduced or eliminated Appropriate services are better identified Local non-profits and community members can be involved in supporting at-risk youth Family engagement in treatment plan often improves Cost sharing between service providers made possible Overall costs reduced with more effective delivery of support

CMP and Public Health Partners to help in the implementation of the local public health assessments and plans Align local public health assessments and plans with other CMP partner agencies. For example: Women’s Mental Health – Pregnancy Relation Depression strategies often requires engagement from the mental health centers which are also a mandated partner to the CMP. Bullying and Suicide Prevention often requires successful engagement from the local school districts which are mandated partners to the CMP. Mental Health and Substance Abuse are area that have to be addressed by all 10 mandated partners to the CMP. Multi-agency collaboration to achieve common goals can result in the creation of sustainable programs. These programs can be funded through the CMP incentive funds.

CMP and CTC Communities Sedgwick Logan Larimer Moffat Weld Jackson Phillips Routt Morgan Grand Boulder Yuma Rio Blanco Broomfield Gilpin Adams Washington Clear Denver Creek Arapahoe Eagle Garfield Summit Jefferson Elbert Douglas Kit Carson Pitkin Lake Park Mesa Teller Delta El Paso Lincoln Cheyenne Gunnison Chaffee Fremont Kiowa Montrose Crowley Ouray Pueblo San Miguel Hinsdale Saguache Custer Prowers Otero Bent Dolores San Juan Huerfano Mineral Alamosa Rio Grande Montezuma La Plata Las Animas Baca Costilla Ute Mountain Ute Tribe Southern Ute Tribe Archuleta Conejos CTC Site with CMP Program CTC Site in non-CMP County CMP Sites *

Crosswalk Description CMP SOC ACF Ed. Stability DANSR TGYS CTC SB94 SYSTEM COMPONENTS   Oversight groups X Multi-disciplinary staffing’s/Service integration (SI)/Multi-agency plans X (SI) Family involvement Identification/selection of evidence-based & promising practices Trauma-informed system MEASUREMENTS / INSTRUMENTS Screening/Assessment (including Trauma) Documenting service delivery process (agencies/individuals involved; services received; use of evidence-based/informed practices; cost of services) Family Feedback/Satisfaction TARGETED OUTCOMES Child Welfare (permanency; placement stability) Juvenile Justice (recidivism; successful completion of probation) x Education (attendance; academic performance; disciplinary issues; school stability; graduation) Health/Mental Health (overall functioning; substance use; use of inpatient mental health; access to care) RESOURCES / TOOLS Common consents/release of information/data interoperability Data sharing agreements Statutory Mandates Guidance re: legal issues (e.g., HIPAA, FERPA) TECHNOLOGY / DATA SYSTEMS Trails Judicial ICON / JPOD Other Statewide database SHARED SERVICE DELIVERY MODELS (High Fidelity) Wraparound Team Decision-Making / FEM / FFM Multi-systemic Therapy other EBPP Crossover Youth Practice Model Differential Response / PA3

Judicial District CMP Counties/Regions SB94 sit on the IOG(s) CMP sit on their JSPC annual plans together System of Care  1st Judicial District Jefferson County No Yes 2nd Judicial District Denver County 3rd Judicial District Huerfano County   Las Animas County 4th Judicial District El Paso County Teller County  5th Judicial District Eagle County Lake County 6th Judicial District Archuleta County La Plata County  7th Judicial District Gunnison County Montrose County Yes  Ouray County No   No San Miguel County  8th Judicial District Larimer County 9th Judicial District Garfield County Pitkin County 10th Judicial District Pueblo County  11th Judicial District Fremont County Park County 12th Judicial District Alamosa , Rio Grande Saguache County 13th Judicial District Kit Carson County Logan County Morgan County 14th Judicial District Grand County Moffat County Routt County 15th Judicial District Baca ,Cheyenne, Kiowa Prowers 16th Judicial District Bent, Crowley, Otero 17th Judicial District Adams County  18th Judicial District Douglas County Elbert, Lincoln 19th Judicial District Weld County 20th Judicial District Boulder County 21st Judicial District Mesa County  Yes 22nd Judicial District Dolores, Montezuma

Colorado’s Continuum Primary Prevention Prevention Services Intervention Treatment CTC TGYS CMP SOC SB94

RESOURCES Tiffany Sewell Collaborative Management Administrator 303 866-3930 Tiffany.sewell@state.co.us

QUESTIONS