Katie A. Implementation Progress & Hurdles: Child & Family Team Component Donna Ewing-Marto, Executive Family Partner, Family & Youth Roundtable Sarah Pauter, Executive Youth Partner, Family & Youth Roundtable

Family & Youth Roundtable Our Mission To advance excellence in the public child, youth and family service system through an independent network of youth and families. Our Vision All children, youth and families are healthy, safe and thriving in their communities.

The History of System Reform Efforts 1969: Congress ordered a report be conducted on the status of children’s mental health in the United States. 1974: As part of the Federal Community Mental Health Center's Act, $20 million was allocated to states as part of a seven-year effort at funding children's mental health programs : A class action lawsuit was filed in the state of North Carolina. The Willie M case set a precedent for states to create a network of case managers to coordinate care through a "system of care." 1982: Unclaimed Children: The Failure of Public Responsibility to Children and Adolescents in Need of Mental Health Services portrayed a nation that had neglected children with mental health needs. 1984: National Institute of Mental Health allocated $1.5 million to develop the Child and Adolescent Service System Program (CASSP), a federal reform effort designed to integrate services 2000: The Surgeon General created the “National Action Agenda” in response to the public crisis in mental healthcare for infants, children and adolescents. The primary concern was that many children have mental health problems that interfere with normal development and functioning. 2008: The Unclaimed Children Revisited found that 25 years later, many states are still struggling to respond to the needs of children with mental health concerns.

What is a Child Family Team? “The CFT is a team of people--- it is comprised of the youth and family and all of the ancillary individuals who are working with them toward their mental health goals and their successful transition out of the child welfare system.” Child Family Teams must: Be comprised of the child, youth and family and formal supports from both child welfare and mental health Child Family Team meetings must: Have a clear and standardized meeting process Convene a minimum of every 90 days

Child Family Team Standards Teams promote transparency and collaboration while working toward common goals. Teams have mutual respect and recognize each other’s contributions. Team members should include informal supports, such as extended family, friends, and mentors, as well as other formal supports, like teachers and other agencies providing services. The child and family guide the team composition and schedule and location of meetings based upon their needs. “Working as part of a team involves a different way of decision-making. Child welfare, mental health staff, and service providers need to become knowledgeable about and comfortable working within a team environment that engages youth and families as partners in that environment.”

Barriers Training of providers, foster care workers, and foster parents Limited collaboration between system professionals and biological parents Children with both medical and mental health needs Placement instability Stigma Lack of coordination between child welfare and mental health providers Failure to provide mental health screening and assessments Data sharing Currently Historically

Recommendations Development of an oversight commission that includes informed family & youth representatives as equal decision makers. Child Family Teams Meetings are independent of preexisting meetings. Counties develop mechanisms to provide children and families with the same information and resources provided to professionals. Educate and support children and families to evaluate the quality of services they receive. Transition from data centric outcome metrics to qualitative measures that are consistent with the CPM. Incentivize compliancy to the CPM.

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