1. Systems of Care and Wraparound: S upporting Success for Children and Families at the State and Local Level 2011 Fall Conference for Administrators of Special Education October 7, 2011 Presented by: Ermila Rodriguez, Oregon Family Support Network Bill Bouska, Oregon Health Authority/Addictions and Mental Health Division Terri Dickens, InterMountain ESD Matthew Pearl, Oregon Health Authority/Addictions and Mental Health Division

2. Goals today Define Systems of Care and Wraparound Learn how Systems of Care and Wraparound intersect Learn about Systems of Care and Wraparound implementation efforts at the state & local level through the Statewide Children’s Wraparound Initiative and at the local level through InterMountain ESD

4. Systems of Care (SOC) defined: The systems of care model is an organizational philosophy and framework that involves collaboration across agencies, families, and youth for the purpose of: improving services improving access to services expanding the array of coordinated, community-based services and supports …for children and youth with a serious emotional disorders and their families.

5. SOC Core Values: The systems of care philosophy is built upon core values 1. The core values of the system of care philosophy specify that the system of care: 1.Should be child centered and family focused, with the needs of the child and family dictating the types and mix of services provided. 2.Should be community based, with the locus of services as well as management and decision-making responsibility resting at the community level. 3.Should be culturally competent, with agencies, programs, and services that are responsive to the cultural, racial, and ethnic differences of the populations they serve.

6. Traditional/Categorical Care Child Welfare Juvenile Justice Education Mental Health Family

7. Coordinated/Collaborative Care Child Welfare Juvenile Justice Education Mental Health Family One Plan

8. System Reform Initiatives Pires, S. (2002). Building systems of care: A primer. Washington, D.C.: Human Service Collaborative.

9. National Results Education: Children and youth perform better academically and act-out less; families are more engaged; and educators benefit from additional resources, fewer disciplinary problems, improved academic performance, and improved coordination/collaboration with families, MH professionals, and other partners.

10. Education Results (cont.) Fewer Disciplinary Problems - expulsions fell by more than 19% - suspensions fell by about 36% - detentions fell by about 34% Improved Academic Performance - 35% participants improved academic performance after 6 months - 42% improved after 30 months

11. Education Results (cont.) Positive Impact on School Attendance - 38% said child’s school attendance improved following onset of treatment Positive Effect on Chance of Suspension or Expulsion - before treatment, 18.5% of children 6 and up had been expelled or suspended in previous 365 days; - after treatment, only 11% of same population was expelled or suspended following onset of treatment

13. Wraparound EducationChild WelfareMental Health Juvenile Justice Health Developmental Disabilities Residential Services Community Based Services Natural Supports Community Wraparound is a Systems of Care Planning Model Values & Principles Systems of Care

14. Wraparound Principles Team Based Natural Supports Collaboration Community Based Culturally Competent Individualized Strengths Based Unconditional Outcome Based Family Voice and Choice

15. Frontline Practice Shifts Orrego, M. E. & Lazear, K. J. (1998). EQUIPO: Working as Partners to Strengthen Our Community. University of South Florida: Tampa, FL

16. What Does a Wraparound Team Do? 1.Explore the family’s vision 2.Assess strengths and needs 3.Develop a team mission statement 4.Prioritize needs 5.Determine goals and outcomes 6.Select strategies to meet needs 7.Assign action steps 8.Create a crisis & safety plan 9.Implement action steps and track progress 10.Evaluate progress and revise strategies 11.Develop and implement a transition plan

17. Strengths and Needs Across Life Domains Psychological & Emotional Family & Relationships Home & A Place to live Social & Recreational Daily Living & Life Skills Substance Use & Addictions Educational & Vocational Legal Health & Medical Crisis & Safety Spiritual & Cultural Financial

18. Phases of Wraparound: What to Expect 1. Engagement & Team Preparation 2. Plan Development 3. Plan Implementation 4. Transition

19. Roles within a Wraparound Team System Partners, Providers, Other Team Members Facilitator/Care Coordinator Family /Parent Partner <> Youth Engagement Specialist Youth & Family

20. The Wraparound Team Roles and Responsibilities Family and Youth  The guiding voice in Wraparound. They inform the team of their unique strengths and needs, and insure that the planning process reflects their preferences, values and culture.

21. The Wraparound Team Roles and Responsibilities Wraparound Facilitators/ Care Coordinators  Coordinate the overall care planning, inclusive of short and long-term goals of family and youth for achieving stability and permanency in the community.

22. The Wraparound Team Roles and Responsibilities Family/Youth Support Partner  Someone who has ‘walked in the family’s/youth’s shoes’.  Ensure that the youth and family voice is heard and is central in the team process and in all aspects of Wraparound implementation.  Help youth and families understand and navigate the complex systems they are involved in.

23. Systems of Care in Oregon 2003: The Children’s Mental Health System Change Initiative (CSCI) Established state and local interagency infrastructure to support SOC Integrated the funding for high end services into the local or regional managed care environments Created a uniform process to assess level of need (Level of Service Intensity Determination) 2005: Intensive Community-Based Treatment & Support Services (ICTS) Established standards for care coordination and child & family team planning

24. Systems of Care in Oregon 2009 Statewide Wraparound Legislation House Bill 2144 passed the 2009 Legislative Session providing statutory direction for the Wraparound Initiative. DHS identified as the lead agency, among partner agencies including Department of Education, Oregon Youth Authority, Commission on Children and Families, and other appropriate agencies involved in the systems of care. Provides authority to combine resources into single funding pool, seek federal approval or waivers, and adopt rules. Phase 1 started in July 2010 to improve outcomes for children with high needs in the custody of child welfare by increasing access to care coordination and implementing wraparound to fidelity.

25. Washington County Rogue Valley Josephine County Jackson County Mid-Valley Linn County Marion County Polk County Tillamook County Yamhill County Three Project Demonstration Sites

26. Common Goals Safety Stabilization Support Improvement of symptoms and behaviors Success at school and in the community

27. Value Added with Wraparound Planning is informed by comprehensive knowledge of family and youth Brings more talent to the table Offers support and strategies not usually possible within one system Focus on creating conditions to sustain academic achievement and therapeutic progress in the community

28. Working together Greater engagement of family and natural supports Improved understanding of respective systems Increased success in the community Improved academic and family outcomes

29. Resources National Wraparound Initiative www.nwi.pdx.edu www.nwi.pdx.edu Statewide Children’s Wraparound Initiative www.oregon.gov/OHA/mentalhealth/wraparound/main.shtml