1. Nevada Children’s Mental Health System of Care
4/15/2017 6:25 PM
Nevada Children’s Mental Health System of Care
Presented By:
Capa Casale, Subcommittee Chair
Jackie Harris, NBHC Chair
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2. Commission/NBHC Subcommittee Members
Commission on Behavioral Health and Developmental Services Subcommittee on the Mental Health of Children
Name
address
Capa Casale, Chair
Pam Johnson
Larry Nussbaum
Valerie (Viki) Kinnikin
Marcia Cohen
Paula Squitieri
Consultant
Jill Manit, UNR
School of Social Work
NCBH Consortium Members
Name
Affiliation
address
Kelly Wooldridge
Division of Child and Family Services
Joe Haas
Washoe County Juvenile/Social Services
Jennifer Coleman O’Connor
Clark County School District
Jan Marson, Chair
Rural Children’s Mental Health Consortium
Cara Paoli, Chair
Washoe County Children’s Mental Health Consortium
Jackie Harris, Chair
Nevada Children’s Behavioral Health Consortium
Karen Taycher
Nevada PEP
Carol Broersma
Parent

3. Children’s Mental Health Services in Nevada
Strengthening
Children’s Mental Health Services in Nevada
Aim: To ensure Nevada’s children and their families benefit from evidence based services and supports that are developed and delivered within a System of Care framework.

4. System of Care
A systematic network of children and families working in close collaboration with public and private providers to develop a comprehensive plan of care
“System of Care concept is a framework and a guide, not a prescription.”
“It was intended as an organizing framework and a value base.”
Pires, S. (2002). Building Systems of Care, A Primer.

5. System of Care Principles
Community Based
Family Driven and Youth Guided
Culturally and linguistically Competent
Individualized and Strength – Based
Accountability
(Baxter,2010; Foster-Fishman & Droege, 2010;Pires, 2010).

6. Services are delivered in the community, outside of institutional settings, such as a school or home.
Community Based

7. Family Driven and Youth Guided
In Systems of Care, full family participation requires mutual respect and meaningful partnership between families and professionals.
Families and youth are decision makers in their own care and in the systems, policies, and procedures that govern care at every level

8. Culturally and Linguistically Competent
Provide effective, equitable, understandable and respectful quality care and services that are responsive to diverse cultural health beliefs and practices, preferred languages, health literacy and other communication needs.

9. Individualized & Strength-Based
Every child and family enrolled in Systems of Care participates in an individualized plan of care that focuses on the needs, strengths, and challenges of the child and family.

10. Accountability
Systems of Care ensure outcome data is collected, analyzed, and reported on the individual child and family services system, performance, and financial efficiencies.

11. What Natural Helpers and Social Supports Can Provide
Emotional support; moral & spiritual guidance
System support
Concrete help & advocacy
Decrease isolation
Community navigation
Resources & education
Greater understanding of getting help or support
Keep
Lazear, K., (2003) “Primer Hands On”; A skill building curriculum. Washington, D.C.: Human Service Collaborative.

12. Role of Parent Support Providers
Technical assistance providers & consultants
Training
Evaluation
Policy Development
Research
Support
Outreach/Dissemination
Direct service providers
Family Liaisons
Care Coordinators
Family Educators
Specific Program Managers (respite, etc.)
Youth Peer Mentors
Add policy development
Wells, C. (2004). “Primer Hands On” for Family Organizations. Human Service Collaborative: Washington, D.C.

13. Systems of Care Implementation: 5 Enhancement Strategies
Implementing policy, administrative, and regulatory change
Developing or expanding services and supports based on the SOC philosophy and approach
Creating or improving financing strategies
Providing training, technical assistance, and coaching
Generating increased support for the SOC approach

14. Children’s Mental Health Leadership and Oversight
Mental Health and Developmental Services Commission NRS Chapter 433
Clark and Washoe County Mental Health Consortium NRS 433B
Rural Mental Health Consortium NRS433B
Nevada Children’s Behavioral Health Consortium (not statutorily mandated)

15. Children’s Mental Health Leadership and Oversight
Commission on Behavioral Health and Developmental Services
Establish policies to ensure adequate development and administration of services for persons with mental illness, developmental disabilities, and related conditions. The MHDS Commission has several powers related to the oversight of programs within the Department of Health and Human Services (DHHS). There are three principle DHHS divisions directly involved in this planning process: Mental Health and Developmental Services (MHDS), Child and Family Services (DCFS), and Health Care Financing and Policy (HCFAP). The MHDS Commission is also responsible for oversight of programs for co-occurring disorders since the Substance Abuse Prevention &Treatment Agency (SAPTA) is also housed within MHDS.

16. Mental Health Consortiums
Children’s Mental Health Leadership and Oversight
Mental Health Consortiums
Pursuant to NRS A mental health consortium may: Participate in activities within the jurisdiction of the consortium to:
      Implement the provisions of the long-term strategic plan established by the consortium pursuant to NRS 433B.335;  Each mental health consortium established pursuant to NRS 433B.333 shall prepare and submit to the Director of the Department a long-term strategic plan for the provision of mental health services to children with emotional disturbance in the jurisdiction of the consortium. A plan submitted pursuant to this section is valid for 10 years after the date of submission, and each consortium shall submit a new plan upon its expiration.
    Improve the provision of mental health services to children with emotional disturbance and their families, including, without limitation, advertising the availability of mental health services and carrying out a demonstration project relating to mental health services.
     To the extent practicable, a mental health consortium shall coordinate with the Department to avoid duplicating or contradicting the efforts of the Department to provide mental health services to children with emotional disturbance and their families

17. Current Efforts in Nevada
Key stakeholders include families, service providers, administrators, and researchers.
Commission on Behavioral Health and Developmental Services
Nevada Behavioral Health Consortium
Commission/NBHC Subcommittee
Nevada PEP Statewide Family Network Partnership
Clark County Children’s Mental Health Consortium
Washoe County Children’s Mental Health Consortium
Rural Children’s Mental Health Consortium

18. Current Efforts in Nevada
In the past year, the Commission/NBHC Subcommittee has:
Conducted a comprehensive review of Nevada’s previous system of care implementation efforts and an analysis of gaps in the implementation process
Conducted an analysis of how existing efforts align with the Systems of Care guiding framework
Developed strategies to implement an enhanced Nevada System of Care approach to the provision of children’s mental health services.

19. Overarching Strategy
The enhancement strategy (draft as of April 2014) has been adapted to the current Nevada approach and prioritized into 3 phases
Each phase is comprised of development and planning activities that will be followed by implementation strategies
A comprehensive evaluation plan will be developed and implemented for each phase of the strategy

20. Developmental Strategies Implementation Strategies
Overarching Strategy
Phase One: Generate increased support and rebuild capacity for the Nevada System of Care
Developmental Strategies
Implementation Strategies
Phase Two: Develop or expand service and supports based on the Nevada System of Care philosophy and approach.
Phase Three: system of accountability, management, and standards of care at the State and local level that focus on the implementation of the Nevada System of Care for Children’s Mental and Behavioral Health

21. Phase One: Generate increased support and rebuild capacity for the Nevada System of Care
Develop a public awareness/social marketing plan to support Nevada system of care efforts and inform consumers about how to access services
Utilize Current resources such as the local Consortia, DCFS, and Nevada Partnership for Training to create a workforce development plan
DCFS will provide a “Nevada System of Care Chief” working in partnership with a Family Support specialist to oversee all System of Care Activities
Build on current training efforts in evidence based practices to include Trauma Informed Care, Wraparound Training, System of Care Training, Motivational Interviewing, Family Check-up, Aggression Replacement Training, and Brief Strategic Family Therapy

22. Phase Two: Develop or expand service and supports based on the Nevada System of Care philosophy and approach.
Develop and support a plan with local school districts to provide school based mental health services and Signs of Suicide (SOS) training across the State
Develop a plan to fund wraparound services that include all aspects of high fidelity wraparound to “high end, multiple system youth and families” no matter what their insurance or custody status.
Develop a plan to increase prevention activities across the State
Expand the current model of mobile crisis services across the State that includes a “no wrong door” philosophy, practice, and procedure. Mobile crisis will include Family to Family Support Services.
Continue support of Wraparound in Nevada (WIN) for “high need, multiple service youth and families.” DCFS will ensure WIN is practicing high fidelity wraparound services.

23. Phase Three: system of accountability, management, and standards of care at the State and local level that focus on the implementation of the Nevada System of Care for Children’s Mental and Behavioral Health
Develop a plan and support to propose legislation supporting the Nevada System of Care approach and establish DCFS as the Children’s Mental Health Authority. This includes accountability at the local levels through the regional consortia for approval of local policy and procedure, as well as the development of protocols for quality assurance and accountability.
Develop a memorandum of understanding with the Division of Health Care Financing and Policy to work toward a “Nevada System of Care” certification process for provider agencies, and unlicensed providers of publicly funded Children’s Mental Health Services. This will include technical assistance and quality assurance provided by DCFS to community providers.

24. Next Steps
The Nevada System of Care enhancement system will need appropriate funding in order to adequately implement this evidence-based approach.