A Multi-System Team Approach: Engaging and Supporting Children with Extraordinary Needs Theresa Kennedy - AVP of Adoption & Youth Services, ChildNet Cassandra Evans - Chief Probation Officer, Florida Dept. of Juvenile Justice Linda Raybin – Children’s Services Administrator, Broward County Shari Thomas, LCSW - Director of Youth and Family Services, Henderson Behavioral Health

Presenters  Cassandra Evans  Linda Raybin  Shari Thomas  Theresa Kennedy Purpose & Goals Share with you how our county has improved our system of care and developed innovative programs to address:  Stabilizations of placements and supports for youth with challenging behaviors who are involved with multiple social service systems  Education of front line staff to ensure a better understanding of each others systems to include ChildNet Child Advocates, Juvenile Probation Officers, and Mental Health Professionals  Improve communication between the systems  Develop common goals for the youth and families Introduction

 Department of Juvenile Justice Specialized “Cross-over” Unit  ChildNet - Child with Extraordinary Needs (CEN) Unit  Georgetown Model  Cross System Training  Placement Partnership Program  Centralized Targeted Case Management  County funded Crossover Wraparound Case Management Pilot Project  Parent/Youth Advocates Broward County Innovation

 “Cross-over” cases are youth who are jointly served by both DJJ and DCF/ChildNet. These youth have active delinquency cases and are in the custody of DCF.  DJJ Specialized Probation Unit in Broward with Juvenile Probation Officers (JPO’s) specifically dedicated to cross-over cases.  Primary objective for cross-over unit is to effectively and efficiently deliver services to youth faced with issues within the Juvenile Justice and Child Welfare systems, while ensuring safety and well-being of the youth and citizens.  DJJ and ChildNet conduct interagency staffings to discuss pending/current issues and monthly system meeting to address the inter-related policies & to discuss pending or current issues with the youth/family being dually served. Department of Juvenile Justice Specialized “Cross-over” Unit

 In 2008 ChildNet created the Children with Extraordinary Needs Unit  The unit is staff  with one Supervisor and 6 CEN Advocates  Advocates carry a caseload of no more than 13 primary children  Advocates are to have weekly contact with the youth, a minimum of 2 face to face contacts each month  Increased contact had enabled staff to better engage youth and improve placement stability and decrease runaway episodes Children with Extraordinary Needs (CEN) Unit

 In 2010, the Center for Juvenile Justice Reform developed the Crossover Youth Practice Model to address the unique needs of youth that fluctuate between and are known to the child welfare and juvenile justice system. These youth are commonly referred to as “crossover youth”.  The Crossover Youth Practice Model focuses on reduction in the number of youth crossing over and becoming dually-involved; reduction in the number of youth placed in out of home care; reduction in the use of congregate care; and reduction in the disproportionate representation of youth of color, particularly in the crossover population.  The practice model is improving the lives of youth in 88 counties within 20 states. CJJR and Casey Family Programs have partnered since 2007 to address the issues affecting this population by first conducting the Juvenile Justice and Child Welfare Integration Breakthrough Series Collaborative with seven communities. The Crossover Youth Practice Model builds on the learning from the collaborative and creates a nexus between that information and research related to crossover youth.Casey Family Programs Juvenile Justice and Child Welfare Integration Breakthrough Series Collaborative Georgetown Model

 Data collection is an important component of the model. The model emphasizes the importance of developing cross systems data capacity and the need to use good data to make program and policy decisions.  Tailored to the needs of each participating jurisdiction, the implementation of the model ensures that practices are consistent for all youth within a system and resources are shared between the systems to maximize their impact. This will include but is not limited to the following practices: the creation of a process for identifying crossover youth at the point of crossing over, ensuring that workers are exchanging information in a timely manner, ensuring that foster care bias is not occurring at the point of detention or disposition, and maximizing the services utilized by each system to prevent crossover from occurring. Georgetown Model

 Workshops created for cross training of child advocates, juvenile probation officers, and system partners.  Presenters include:  ChildNet – Case management  ChildNet – Youth Services/Independent Living  Department of Juvenile Justice  Children Services Council –prevention/diversion programs  Juvenile Assessment Center  Thorough introduction of the child welfare and delinquency systems, with a concentration on continuity of care for cross over youth.  Conducted every 6 months Cross System Training

Henderson Placement Partnership Program (PPP)

High Fidelity Wraparound Case Management Pilot Project for Crossover Youth The goal of the program is to have a positive impact on participating youth as measured by:  A reduction in negative behaviors such as law violations and runaway behavior  An improvement in positive behaviors including participation in school, vocational training and/or employment  Stabilization of living situation  An improvement in social/emotional functioning  Youth served are ages involved with both the Child Welfare and Juvenile Justice systems with behavioral health issues that impact on their ability to function socially, academically/ vocationally, and/or emotionally.  Provides high fidelity Wraparound Case Management services by higher-level staff with smaller caseloads.

 Critical for a cross-systems undertaking  Establishes communication, coordination and collaboration needed among systems, agencies, and staff  System collaborative partners Involved in developing the Pilot  Broward County Human Services Department, Community Partnerships Division, Children’s Services Administration Section  Department of Juvenile Justice – Circuit 17  ChildNet  Broward County School Board  Children’s Services Council of Broward County  Behavioral Health/Wraparound Expert for the Pilot:  Henderson Behavioral Health  Peer Support Team for the Pilot:  Henderson in collaboration with Mental Health Association Crossover Wraparound Case Management Pilot - Partnerships

 Pilot started 9/23/14; Services began in November.  University of Washington’s Wraparound Evaluation & Research Team is completing an external evaluation of the Pilot  Youth receiving high fidelity Wraparound compared to youth receiving “Treatment as Usual” (TAU)  44 youth are part of the study – 21 receiving Wraparound and 23 receiving Treatment as Usual  32 youth are participating in the Crossover Wraparound Pilot (21 in the timeframe for inclusion in the evaluation). Crossover Wraparound Case Management Pilot

 A snapshot of the 21 Crossover youth at enrollment in the Wraparound Case Management Pilot  67% males, 33% females  62% African American, 27% Caucasian, 10% Hispanic  Age range:14 –19; 57% are ages 14-16; 43% are  54% living in congregate care  100% had an Axis 1 mental health diagnosis  86% also had a substance abuse diagnosis  Mean age CW Investigation = 7.6; DCF Adjudication = 11.8; First Arrest =  Committed a median of 18 offenses from Crossover Wraparound Case Management Pilot

 Philosophy of “do whatever it takes” to preserve and support the youth’s current placement.  Assessment, crisis intervention, support and linkage and referral services are provided in accordance with values of choice, individualization, family involvement and community support.  Program adheres to system of care values which include, but are not limited to: Child focused and Family centered; Strength based; Collaborative and Integrated; Persistent Commitment; Community based; Culturally Competent; and Outcome Driven.  Provides in-home therapeutic/case management crisis intervention services.  Available 24 hours a day, 7 days a week for phone and in-home support.  Facilitate Child and Family Team Meetings utilizing the Wraparound Model. Services

Henderson Crossover Pilot Team  4 Master’s level case managers who are certified in Wraparound Case Management providing high fidelity services  Supervised by a licensed therapist who is also trained in Wraparound  1 youth advocate to provide peer support  Ongoing training/support by certified Wraparound trainers Crossover Wraparound Case Management Pilot

THINK OF YOUR BIGGEST CRISIS……… EXCERSISE

 Wraparound is an unconditional commitment to create services on a “one child at a time” basis to support inclusive options for families with complex needs.  An individualized plan is developed by a Child and Family Team, consisting of 4-7 people who know the family best. The plan is needs driven rather than service driven.  The plan is strength-based and focused on normalization.  Services are based in the natural home and are culturally competent.  The plan is financially supported by a flexible funding mechanism. What is Wraparound?

Wraparound Teams/Child & Family Teams  A non-negotiable of the wraparound process: all humans need support.  Comprised of the family and the 4-7 persons who know them best (can be larger).  Team operates by consensus.  Typically not more than half professionals.  Family chooses team unless custody is involved, then representative of the government shares team selection with family

What is a Team Based Intervention?  Service provision that includes involvement of all important parties.  A team based intervention incorporates all of these people and their input into the planning process.  In order to ensure that all parties voices are heard, the team process should include all parties sitting at the same table.  The team process takes preparation and planning to ensure that all of the necessary people are included.

 Youth have a voice at the table.  Professionals may help youth through a crisis and then “discharge” the youth with no support to get them through the next crisis.  Youth and Families involved in several systems are pulled in different directions by different system mandates.  Professionals that are trying to help may become overwhelmed by trying to keep up with all of the needs of complex families. We create a single table for youth, family, formal and natural supports to come together and good things happen after we get past the pain of change…  Professionals from all systems begin to work together in unprecedented ways and truly understand each other’s systems.  Youth and families are seen as having assets not just deficits.  Natural supports begin to be organized in communities. Why should we have teams?

 Understand societal mandates of all system partners.  Relinquish the expert role to the family.  Actively support the youth and family through engagement.  Recognize child and family team meetings as an opportunity to plan as a team and attends meetings.  Actively brainstorm and prioritize at meetings.  Help the team actualize system of care values.  Be strength based.  Be open to less traditional options (karate instead of therapy). Role of all System Partners on Teams

Role of the Facilitator  Facilitate Wraparound Process (Phases).  Facilitate the positive family view.  Support family empowerment.  Develop natural support systems.  Consult the team and other agencies.  Develop resources.  Advocate.  Carry out limited tasks on plans.

Role of a Team Member  Understands societal and legal mandates of system partners.  Relinquishes the expert role.  Actively supports empowering the youth and family.  Recognizes CFT meetings are not therapy sessions.  Knows how to brainstorm.  Helps the team actualize Wraparound values.

 A coordinated plan with goals, objectives, timelines and responsible parties identified.  A sense of accomplishment that the team worked together to create this document.  A reasonable plan of action that the family is motivated to complete as their voice is clearly expressed in the document. What is the Result of a Team Meeting?

 Team based approaches can produce significantly better outcomes for children and families with significant needs than traditional approaches.  Increased permanency and stability for children.  Decreased restrictiveness of residential environments.  Improved behavior and mental health symptoms.  Improved school and early care outcomes.  Decreased child and family safety issues and risk factors.  Increased family and child protective factors.  Increased family engagement and satisfaction with services.  Increased family resources to support their own children. “What Does the Research Say?”

Youth without support looks like they may need much more treatment than the youth with support. Team based interventions typically start with supports such as respite, mentors, networking with similar families, financial supports…and then move into treatment as needed. When these go hand in hand you will see greater results for the children and families you serve. Support and Treatment

Success Stories……

Questions and Answers…. Theresa Kennedy – Cassandra Evans – Linda Raybin – Shari Thomas - As a Team, You Can Make a Difference!