1. 1 Youth and Family Training Institute Overview

2. 2 Recovery and Resilience People who are involved in supportive social relationships experience benefits in terms of health, morale, and coping; Strengthening interpersonal and community ties is a resilience and development promoting strategy; Research shows that engaging and empowering Youth and Families results in enduring improvement for youth with behavioral health challenges. Introduction

3. 3 Transformation Objective Transform the children’s behavioral health system in Pennsylvania to a system that is family driven and youth guided. Introduction (cont.)

4. 4 Establishment of Child-Family Teams Establish an Institute to provide training, support and monitoring of Youth and Family Teams Develop mechanism for Medicaid payment of Youth and Family Team process Begin process of implementing Youth and Family Teams throughout the Commonwealth Introduction (cont.)

5. 5 The Process Request for Applications Three proposals Review Team composed of youth, family, and other stakeholders Team met with the three applicants Selection of the University of Pittsburgh Introduction (cont.)

6. 6 A partnership of the University of Pittsburgh, family organizations, youth organizations, providers, community organizations and managed care organizations. University of Pittsburgh Office of Education and Regional Programming (OERP), Department of Psychiatry, Office of Child Development, Department of Social Work Pennsylvania Families, Inc. (PFI) National Alliance for the Mentally Ill (NAMI-PA) Western Pennsylvania Partnership for Family Support Allegheny Family Network (AFN), chapter of the Fed. of Families Youth Outreach Union (YOU) Is it really the University of Pittsburgh?

7. 7 Pennsylvania Community Providers Association (PCPA) CASSP Coordinators County Administrators Western Psychiatric Institute and Clinic of UPMC Adelphoi Village (Westmoreland County), provider of MST Allegheny County System of Care Initiative Beaver County System of Care Initiative Community Care Behavioral Health Organization (MCO for 35 counties) …………..More to Come! Is it really the University of Pittsburgh (cont.)?

8. 8 Family/family member: A person or persons who are directly responsible for raising a child or children with behavioral health challenges. Usually a mother, father, legal guardian or grandparent. Youth/child/young adult: An individual between the ages of 0-25 with behavioral health issues. Key Definitions

9. 9 “Do you actually know what you are going to do or are you making this up as you go?” Father of an adolescent in an inpatient family session “I’m glad you’re happy that my rating scales have improved, but my life sucks.” A 23 year old said to her psychologist “Train me so I can do without you.” Mother of a 10 year old with severe ADHD to their case manager So what is the problem?

10. 10 Current System

11. 11 CASSP Coordinators will be part of the solution! Currently advocate for youth and families and often include other child serving systems as evidenced by one doctor’s experience: What is the Solution? “Dr. Nash, why wasn’t the family at the meeting?” “Dr. Nash, why hasn’t the family signed off on the treatment plan?” “Dr. Nash, are you sure that the child needs to be on all of these medicines?” “Dr. Nash, shouldn’t the school be involved in this discussion?”

12. 12 High Fidelity Wraparound Not current version of PA wraparound! Builds on CASSP principles and the work of the CASSP Coordinators A process for supporting youth and families with complex behavioral health needs Defined by National Wraparound Initiative 10 principles Four phases (engagement, plan development, implementation and transition) Theory of Change: Needs, self efficacy, natural supports and an integrated plan What is the Solution?

13. 13 What is the Solution (cont.)?

14. 14 Teach facilitators how to help youth and families decide for themselves what pieces belong in their puzzle, how to organize and coordinate the pieces, and how to bring all of the child’s and family’s unique puzzle pieces together so that it belongs to them. Equip youth and families with the skills needed to design, assess and monitor their own puzzle. Assure that facilitators have the ongoing knowledge and insight to address all puzzle pieces while assuring fidelity to the model. The Youth and Family Training Institute will…

15. 15 Create an evaluation and monitoring function to continually assess the quality of each child’s puzzle and the impact it is having on improving the lives of the youth and family. Share relevant information about fidelity, outcomes, services and costs with the counties and with OMHSAS to effect change. The Youth and Family Training Institute will…(cont.)

16. 16 Start-Up Activities (November 2007- June 2008) Bureaucracy related things (contract, public announcements etc.) Hired Vroon VanDenBerg; train the trainer model. Providing High Fidelity Wraparound orientation and initial “big picture” training for Pitt/WPIC and partners, OMHSAS staff, OMHSAS Advisory Council, County Administrators, CASSP Coordinators, child serving system partners, youth and family leaders, PCPA and others. Implementation

17. 17 Start-Up Activities (cont.) (November 2007- June 2008) Hire Director - Job posted on www. UPMC.com (Dec. 1- Dec. 21) - Advanced degree and ten years management experience - Prefer family member - Offices in Harrisburg and Pittsburgh; extensive statewide travel Hiring Process - Selection committee - Decision by February; start March 1 Implementation (cont.)

18. 18 Start-Up Activities (cont.) (November 2007- June 2008) Recruit, train and prepare Advisory Board - 24 total members - Application kits for youth, family members and “others” to be distributed Dec/Jan - Selection committee; defined criteria representing the diversity of Pennsylvania - Selection by March Implementation (cont.)

19. 19 Start-Up Activities (cont.) (November 2007- June 2008) Develop RFP process and county readiness assessment; select first demonstration counties. - RFP to be issued in January 2008 Implement High Fidelity Wraparound in demonstration counties. - June 2008 Implementation (cont.)

20. 20 On-Going Activities (July 2008-2012) Actively partner with Youth and Family Organizations and individuals to develop partnerships and training opportunities. Train, coach and credential wraparound facilitators. Develop and implement a system that assures that services are continually evaluated to support fidelity to the model, areas are identified for improvement and outcomes are assessed. Implementation (cont.)

21. 21 On-Going Activities (cont.) (July 2008-2012) Roll-out High Fidelity Wraparound model to all 67 counties. Engage and support System Partners in the transformation process. Work hand in hand with OMHSAS to create policy and funding recommendations. Implementation (cont.)

22. 22 Build a national model Access to best practice research from University of Pittsburgh Department of Psychiatry, other Pennsylvania university researchers and nationally recognized experts. Create the first true wraparound model that incorporates relevant aspects of the medical model. Other Opportunities: Future

23. 23 Redefine hiring criteria for key positions (50% of staff will be youth or family members). Time Sensitive and other NIMH grants (for evaluation and best practice). Technology based training (video conferencing etc.). Other grant/funding opportunities. Other Opportunities (cont.): Future

24. 24 Introducing Jim Rast of Vroon VanDenBerg… Today