Strong Minds, Strong Futures A trauma-informed system of care initiative for adolescents with behavioral health issues and their families

THE PROBLEM Colorado's children and youth with behavioral health challenges and their families often do not receive the integrated services and supports they need, resulting in poor outcomes and high costs. 2 Draft Plan 6/20/12

What we know 2 nd only to WY in use of institutional care (2010 AFCARS data) 56.3% of youth in DYC have behavioral health needs requiring professional intervention. ( 2011 DYC Continuum of Care Report) Increase in teen suicides, 49 deaths in (Kids Count, 2011) Children of color overrepresented in corrections and underrepresented in treatment system. ( 2000 Minority Over-Representation Child Welfare report, 2011 DYC Continuum of Care Report, 2009 DBH Population in Need) High levels of placement Poor Outcomes Health Disparities Uncoordinated and poor quality care 3 Draft Plan 6/20/12

What we know Themes and Recommended Steps System Integration Program Availability Prevention and Early Intervention Cultural Responsiveness Public Engagement Family and Youth Partnership Professional and Workforce Development Data Collection and Evaluation that is outcome based Flexible Funding Meta-Analysis of 30 Colorado Reports 4 Draft Plan 6/20/12

The Vision Child and Family Behavioral Health Child Welfare Youth Corrections EducationHealth Community Supports Colorado’s children with behavioral health challenges will reach their full potential through effective and efficient services and supports. 5 Draft Plan 6/20/12

Key Strategies Draft Plan 6/20/12 6 Administrative structure to coordinate care and monitor outcomes Improve quality of services and supports Implement through cohort community based model Trauma Informed System of Care Families involved at all levels from services to governance Care Management Entities Trauma Informed System and Services Communities of Excellence Family/Youth Partnership

Care Management Entities Functions Wraparound and Care Coordination Access to Family and Peer Supports Provider Network Development and Management Utilization Management Quality Improvement and Outcomes Management Training May be public agency, new non-profit, existing non-profit, non-profit HMOs or for-profit organization 7 Draft Plan 6/20/12 Coordinated with Accountable Care Organizations (Medicaid)

Financing Possible Funding Streams Title IV-E Waiver Medicaid Behavioral Health Block Grant Core and AFS State General Funds Youth Corrections Indigent Mental Health Funding Funding Methods All inclusive case rates Fee for service Partial case rate/bundled 8 Draft Plan 6/20/12

Trauma Informed What happened to you instead of what’s wrong with you? 9 Draft Plan 6/20/12

A History of Maltreatment is the Norm among Children and Youth in Many Systems From ACF Commissioner Bryan Samuels’ Presentation to Blueprints Conference April 2012 (Miller, EA; Green, AE; Fettes,DL & Aarons GA., Data come from a representative sample of 1,715 youths ages 6-18 in San Diego County. 10 Draft Plan 6/20/12

The Overlap of Trauma and Mental Health Symptoms From ACF Commissioner Bryan Samuels’ Presentation to Blueprints Conference April 2012 (Griffin, Kisiel, McClelland Stolback & Holzberg, 2012) 11 Draft Plan 6/20/12

Communities of Excellence Partnership Approach Work with cohorts of communities to plan and implement Base services/supports with local adaptation Culturally responsive Communities of Excellence serve in advisory role Similar approach to child welfare practice initiative 12 Draft Plan 6/20/12

Family/Youth Partnership Important part of treatment team Part of paid workforce as family advocates and youth mentors (Voice/Choice Committee- CMP) Voting member of Governance Bodies Draft Plan 6/20/12 13

The Plans Align Winnable Battles Child Welfare Master Plan, DBH Block Grant Plan Trauma Informed System of Care CDHS Strategic Plan 14 Draft Plan 6/20/12

Outcomes OutcomeIndicators Child and Family Improved services and supports for children, youth and families Youth and families are more empowered Improved behavioral health outcomes Improved school attendence Decreased trauma symptoms Less substance use Community Level Children receive the right services in the right amounts at the right time Reduced use of institutional care/hospitalization/emergency rooms/placement reentry Decrease in youth suicide Decreased truancy rates Decreased juvenile recidivism Decreased use of psychotropic drugs Increased utilization of behavioral health services for children and youth of color System Level Dollars saved from institutional care placements are reinvested into community based prevention, early intervention and treatment services More use of trained wraparound facilitators More use of peer supports i.e. family advocates, youth mentors More service providers and systems trained in cultural and linguistic competence Trauma informed practices integrated into all child and youth serving systems Different use of dollars in the child serving systems 15 Draft Plan 6/20/12

Oversight TISOC Committee of BHTC Legislative Team CCYIS Research And Evaluation Team Marketing Team Education and Training Team Collaborative Management Program 16 Draft Plan 6/20/12

Partnership Your Logo Here 17 Draft Plan 6/20/12