Maine Children’s Behavioral Health Services Recommendations Implementation Support 7/29/19

Agenda 3 | Prior Work 4 | Current Work 7 | Next Steps

PCG Prior Children’s Behavioral Health Services (CBHS) Work Project Goal: Obtain an independent assessment of the CBHS system of care, including its strengths and weaknesses, quality of outcomes, service array, capacity, funding structure, and program operations. In December 2018, PCG completed two (2) reports: CBHS Assessment (External) Identified short- and long-term recommendations to improve the availability, accessibility, and quality of children’s behavioral health services Resulted in 24 recommendations CBHS Assessment (Internal) Examined internal operations, including staff roles, responsibilities, and business processes Resulted in 3 recommendations Publicly available on the Office of Child & Family Services (OCFS) website: https://www.maine.gov/dhhs/ocfs/cbhs/index.shtml www.pcghumanservices.com | ME OCFS CBHS Recommendations Implementation Kick-off

PCG Current Scope of Work Project Goal: Assist the Office of Child & Family Services (OCFS) with the successful implementation of selected recommendations identified in the CBHS internal and external assessment reports. Task Status Establish an executive team, change team, staff and stakeholder advisory groups, and internal and external workgroups to support collaborative systems change. Complete Clearly define vision, guiding principles, desired future state, and desired outcomes for OCFS’ Children’s Behavioral Health Services. In Progress Clarify job roles and responsibilities for CBHS staff and develop and validate desk level procedures (DLPs) for key CBHS team tasks. Next Up Create an implementation roadmap, including key steps, timeframes, responsibilities for the selected strategies in the CBHS Vision. Develop and validate logic models and performance measures for CBHS services. Update contracts to reflect validated and approved performance-based contracting measures.

Children’s Behavioral Health | Vision All Maine children and their families receive the services and supports they need to live safe, healthy, and productive lives in their home, school and community. Guiding Principles Strategies Outcomes Broad and Equitable Access Family engagement, empowerment, and well-being Early Intervention Individualized Services Culturally-Sensitive, Trauma-Informed Engagement The right service at the right time for the right duration Coordinated and Integrated Services Effective Evidence-Informed Practices Least Restrictive Service & Setting Engaged and Empowered Families Families and children safely stay together in their homes and communities Quality Assurance and Accountability Working Draft

Children’s Behavioral Health Services Array

Next Steps Next Up Select top 10-12 recommendations Staff and Stakeholder Advisory Groups provided input and feedback on 7/25 CBHS leadership to make final selections Identify Strategies CBHS leadership to identify strategies to implement final recommendations Finalize Vision Finalize Vision Statement Add strategies to Vision Share updated Vision, Strategies, and Recommendations with Staff and Stakeholders (by end of August) Next Up Clarify CBHS Job Roles & Responsibilities Develop Desk Level Procedures (DLPs) for key CBHS tasks Create Implementation Roadmap Establish workgroups to develop implementation plan for each strategy Include key steps, timeframes, responsibilities, and risks for the strategies in the CBHS Vision

Linkages to Juvenile Justice System Studies confirm that a large proportion of youths in the juvenile justice system have a diagnosable mental health disorder Studies have suggested that about two thirds of youth in detention or correctional settings have at least one diagnosable mental health problem, compared with an estimated 9 to 22 percent of the general youth population. Schubert and Mulvey 2014; Schubert, Mulvey, and Glasheen 2011 Similarly, a systematic review found that youths in detention and correctional facilities were almost 10 times more likely to suffer from psychosis than youths in the general population. Fazel and Langstrom (2008) A robust children’s behavioral health system can prevent entry into formalized systems of care (child welfare, juvenile justice, etc.) and reduce recidivism. Implementing and supporting effective evidence-informed practices is a key guiding principle for strong behavioral health systems. Key among these practices are those involving cognitive–behavioral therapy (CBT), such as Functional Family Therapy (FFT), Multisystem Therapy (MST), and Trauma-Focused Cognitive Behavioral Therapy (TF-CBT).