THE SKILL BUILDING CURRICULUM

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Building Systems of Care A Primer for Child
Welfare and
Primer Hands On-Child Welfare
THE SKILL BUILDING CURRICULUM
Developed by Sheila A. Pires Human Service
Collaborative Washington, D.C. In partnership
with Katherine J. Lazear Research and Training
Center for Childrens Mental Health University of
South Florida, Tampa, FL Lisa Conlan Federation
of Families for Childrens Mental
Health Washington, D.C.
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Primer Hands On-Child Welfare
Web-Based Training and Technical Assistance
Materials

• To Support
• Intensive 2-day capacity-building sessions, or
  shorter topical training sessions on individual
  modules, or materials for targeted technical
  assistance
• Includes
• Skill building curriculum, case scenarios,
  exercises, handouts, PPT slides, and Primer
• Creates
• Network for peer support and technical
  assistance, linked by list-serve

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Module 1 Purpose and Organization

• Purpose
• Ways to Use
• Components
• Target Audience
• Objectives
• Training Methods
• Strategic Framework
• Elements of Strategic Planning

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Primer Hands On-Child Welfare OBJECTIVES

• To strengthen the knowledge base and skills of
  system of care leaders to operate strategically
  in system building
• To give system of care leaders teaching tools to
  use in their respective communities
• Build a network of individuals grounded in a
  common strategic framework for building systems
  of care

Pires, S., Lazear, K., Conlan, L.( 2003). Primer
Hands On A skill building curriculum.
Washington, D.C. Human Service Collaborative.
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Ways to Use Primer Hands On-Child Welfare

• As a self-contained, intensive two-day training
  covering all Modules provides an overall
  strategic framework
• As separate training sessions on individual
  Modules allows in-depth focus on a given area
• As material that can be drawn on by technical
  assistance providers/consultants supports
  targeted technical assistance.

Pires, S., Lazear, K., Conlan, L. (2003). Primer
Hands On A skill building curriculum.
Washington, D.C. Human Service Collaborative.
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Module 2 - Context System Building Definitions,
History, Values, Principles and Characteristics

• System of Care (SOC) Definition
• Administration for Children and Families (ACF)
  System of Care Sites
• SOC History
• Child Welfare SOC Activities
• Avoiding Categorical Systems of Care
• -Alamance County, NC
• Organizing Framework Supported by Core Values
• Full Range of SOC Values and Principles
• Synergy with Values of Family Support and Youth
  Development Movement -Wraparound Milwaukee
• -Handout 2.1 Alabamas R.C. Goals and
  Principles
• -Nevada, Kansas, North Carolina, Oregon and
  North Dakota
• SOC Operational Characteristics
• Consistency with CFSR Systemic Factors Resonance
  between SOC and CFSR Outcomes
• SOC as a Differential Response System for
  Child Welfare
• -Oregon

continued
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Module 2 - Context System Building Definitions,
History, Values, Principles and Characteristics

• System Problems
• Fractured Accountability
• SOC Connected to Larger System Reform
• Need for Frontline Practice Change
• How Families Become Involved with SOC
• Family-Centered Practice Approach
• Shifts in Roles Expectations of Families
  Youth
• Shifts in Child Welfare Decision Making Practice
  Change at Multiple Levels - Policy, Management,
  Frontline Community
• Non-Categorical Vs. Categorical System Reform
• Population Focus
• Prevalence and Utilization
• A Population-Driven Systems Approach
• State Commitment and Local Ownership
• Definition of Evidence-Based and Promising
  Practices
• Examples of Evidence-Based and Promising
  Practices
• -Californias Evidence-Based Clearinghouse for
  Child Welfare
• Shared Characteristics of Evidence-Based
  Promising Practices
• Returning to Values,
• -Exercise 2.1 Assumptions and Values

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Module 3 - Process and Structure in System
Building

• Definition of Structure
• Example of Structures Impact
• -Wraparound Milwaukee
• Important Points about Structure
• Targeted Case Management System
• Functions Requiring Structure in Systems of Care
• Core Elements of System Building Process
• Components of Effective Leadership
• Leadership Styles
• Elements of Partnership
• Challenges to and Strategies for Collaboration
• Catalysts for Reform
• Managing Complex Change
• -Cuyahoga County, Ohio (Cleveland)
  Family-to-Family

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Module 4 Cross-Cutting, Non-Negotiable
Characteristics Family/Youth Partnership and
Cultural/Linguistic Competence

• -Exercise 4.1 Attitudes Toward Families, Youth
  and Culture
• Non-Negotiable Characteristics of System of Care
• Defining Family Youth
• How Systems of Care are Structuring Family and
  Youth Involvement at All Levels
• Applicability of a Family-Driven Approach to
  Court-Involved Families
• -Milwaukee, Wisconsin, Wraparound Milwaukee
• Addressing Families Capacity and Willingness to
  Partner
• -Jefferson County, Colorado
• -Handout 4.1 The Rhode Island Family Coalition
  for Family Support Involvement Family-Centered
  Practice How are We Doing?
• Definition of Youth-Guided
• Roles for Youth
• Barriers to Youth Partnership
• Family Youth Networks of Support Advocacy
• The Role of Family-Directed Associations and
  Organizations
• -Missouri Youth Advisory Board Texas Regional
  Advisory Groups

continued
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Module 4 Cross-Cutting, Non-Negotiable
Characteristics Family/Youth Partnership and
Cultural/Linguistic Competence

• Cultural Competence Realities
• Theories, Disparities and Disproportionality in
  Child Welfare
• Examples of Partnerships to Address
  Disproportionality
• -Children of Color Project, Woodbury County
  (Sioux City) Iowa
• -Texas Community Advisory Committees On
  Disproportionality
• -Collaborative Circle for The Well-Being of
  South Dakotas Native Children
• Positive Outcomes from Addressing
  Disproportionality
• -Wake County, North Carolina
• Definitions of Cultural and Linguistic
  Competence
• Cultural Competence Continuum
• Organizational Cultural Competence
• Cultural Competence Core Elements

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Module 5 Planning, Governance, and System
Management

• (Organization of Remaining Training Modules
  Orientation to Team Work)
• FUNCTION Planning
• Issues for Structuring Planning
• Stages of Planning
• Elements of Effective Planning Processes
• Strategies for Involving Families and Youth in
  Planning
• Culturally Competent Planning Process
• -Cuyahoga County, Ohio (Cleveland)
• FUNCTION Governance
• Definition of Governance
• Definition of System Management
• Key Issues for Governing Entities
• Types of Governance Structures
• -Cuyahoga County, Ohio
• Example of an Evolving Governance Structure

continued
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Module 5 Planning, Governance, and System
Management

• FUNCTION System Management
• Key Issues for System Management Structures
• Types of System Management Structures
• -Sarasota County, Florida
• Locus of Management Accountability for Target
  Population
• -Sarasota County Coalition, Florida
• -Milwaukee County, Wisconsin
• -Cuyahoga County, Ohio
• Relationship between Governance and System
• System Management Structures
• -Sarasota County, Florida
• -Cuyahoga County, Ohio
• Involving Families and Youth in System
  Management
• Culturally Competent System Management
  Structures
• -Team Work (Team Meeting 1)

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Module 6 Outreach and Engagement, Organized
Pathways to Service/Supports Screening,
Assessment and Evaluation and Service/Support
Planning

• Function Outreach and Engagement
• Outreach and Engagement Issues
• Roles for Families and Youth in Outreach and
  Engagement
• Culturally Competent Community Engagement
• Examples of Culturally Competent Outreach and
  Engagement
• -Everglades Health Center, Dade County, Florida
• -Hmong Resource Center, St. Paul, Minnesota
• -Abriendo Puertas Family Center, Miami, Florida
• Caseworkers Role in Outreach and Engagement
  Home Visits
• Function Organizing a Pathway to
  Service/Supports
• An Organized Pathway to Services/Supports
• Examples of Organized Pathways
• -Cuyahoga County
• -Wraparound Milwaukee, Milwaukee County
• -Collaboration for Families and Families,
  Sarasota, Florida
• Burden on Families
• Family-Centered System Entry
• -Maryland Governors Office on Children

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Module 6 Outreach and Engagement, Organized
Pathways to Service/Supports Screening,
Assessment and Evaluation and Service/Support
Planning

• Functions Screening, Assessment, Evaluation and
  Services Planning
• Definitions of Screening, Assessment, Evaluation
  and Service Planning
• Screening, Assessment, Evaluation and Service
  Planning in Child Welfare
• Child Welfare Case Workers Role in Assessment
  and Service Planning
• Comprehensive, Strengths-Based Principles
• -Mississippi Division of Children and Family
  Services
• Comprehensive, Strengths-Based Approaches in
  Child Welfare
• -Handout 6.1 Arizona Department of Health
  Services A Comparison of Six Practice Models
• Elements of Wraparound and Family Group
  Conferencing
• Examples of Wraparound Approaches in Child
  Welfare
• -Handout 6.2 Kansas Department of Social and
  Rehabilitation Services Family-Centered Practice
• An Individualized Approach to Services/Supports
  Planning
• -EQUIPO, Abriendo Puertas Family Center, Miami,
  Florida
• Characteristics of a Well-Documented
  Services/Supports Plan
• The Team Approach

continued
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Module 6 Outreach and Engagement, Organized
Pathways to Service/Supports Screening,
Assessment and Evaluation and Service/Support
Planning

• Family Partnerships and Cultural Competence in
  Screening Assessment, Evaluation and
  Services/Supports Planning
• Accurate and Accessible Information
• Families with Repeat Involvement with Child
  Welfare
• -Pennsylvanias Allegheny County Department of
  Human Services
• Use of Common Screening and Assessment Tools
• Role of CASA Volunteers, Guardians Ad Litem and
  Judges in Service Decision Making
• Role of Supervision and Coaching
• -Team Work (Team Meeting 2)

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Module 7 Service Array and Financing

• Function Array of Service and Supports
• Overview
• Importance of Medicaid Managed Care for Child
  Welfare
• Array of Services and Supports NRCOI Framework
• Purposes of NRCOI Framework
• Examples of States/Communities Using NRCOI
  Service Array Framework
• -Nebraska and Pulaski County, Virginia
• -Handout 7.1 National Child Welfare Resource
  Center for Organizational Improvement Service
  Array Framework
• Example of a Broad Array of Services and
  Supports in a System of Care
• -Dawn Project in Marion County, Indiana
• Evidence-Based and Effective Practices
• Examples of Evidence Based Practices for
  Families and Children Involved in Child Welfare
• Examples of Non-Evidence Based Practices
• -Hawaii
• -Handout 7.2 Examples of Potentially Harmful
  Programs and Effective Alternatives
• Challenges to Implementing Evidence-Based
  Practices
• Strategies and Incentives for Implementing
  Evidence-Based Practices
• -District of Columbia
• Universal Versus Targeted Services

continued
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Module 7 Service Array and Financing

• Function Financing
• Overview of Financing Streams
• Major Child Welfare Funding Streams
• Advantages and Disadvantages of Specific Funding
  Streams
• Creating Win-Win Financing Scenarios
• Thinking of Financing across Systems
• Financing Strategies and Structures
• Examples of Financing Strategies
• -Wraparound Milwaukee
• -Central Nebraska Integrated Care Coordination
  Unit
• -El Paso County, Colorado
• -North Carolina State System of Care
  Collaborative
• -Cuyahoga County, Ohio
• -Maryland
• -Miami, Dade County, Florida- The Childrens
  Trust Fund
• -Spokane County, Washington

continued
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Module 7 Service Array and Financing

• Comprehensive Strategy
• Diversity of Federal Grant Site Funding
• Diversified Funding Sources and Approaches for
  Family Organizations
• Example Diversified Funding Sources
  Approaches at the Parent Support Network of Rhode
  Island
• Medicaid Strategies
• -New Mexico and Arizona Managed Care Waivers
• -New Jersey, Minnesota, Kansas, New York,
  Vermont, Indiana, Wisconsin, Arkansas, Florida,
  Georgia, Maryland, Mississippi, Montana, South
  Carolina, and Virginia HCBS Waivers
• -Massachusetts, Los Angeles County, and
  Pennsylvania - EPSDT Lawsuits
• -Vermont and New York - Targeted Case Management
• -New Jersey Administrative Case Management
• -Minnesota and Wisconsin TEFRA Option
• -Milwaukee Wraparound
• First Steps
• Steps in a Strategic Financing Analysis
• Tools to Support Families and Staff
• -Oregons Cost Center and Object Code Matrix
• -Handout 7.3 The Matrix from Oregons System
  of Care
• -Team Work (Team Meeting 3)

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Module 8 Provider Network, Natural Supports
Purchasing and Contracting

• FUNCTION Provider Network
• Provider Network Options
• Characteristics of Effective Provider Networks
• Examples of Incentives to Providers to Change
  Practice
• Importance of Natural Helpers
• Roles for Natural Helpers
• -Cuyahoga County (Cleveland) F2F
• -Cedar Rapids, Jacksonville, Louisville and St.
  Louis CPPC Strategies
• -Family Finding Washington State and Santa
  Clara County, CA
• Mecklenburg County, North Carolina
• Pinellas County, Florida
• -San Antonio, Texas Community Partnerships in
  Child Welfare
• -East Little Havana, Miami, Florida Abriendo
  Puertas Center EQUIPO
• Families and Youth as Providers
• Infrastructure to Support Families and Youth as
  Providers

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Module 8 Provider Network, Natural Supports
Purchasing and Contracting

• FUNCTION Purchasing/Contracting
• Purchasing/Contracting Structures
• -Southern State
• Capitation and Case Rates
• Example of System Using Capitation and Case Rate
• Progression of Risk
• Purchasing Quality Care
• Examples of Purchasing Strategy Tied to Reform
  Goals
• -Massachusetts- Continuous Quality Improvement
• -Connecticut
• -Team Work (Team Meeting 4)

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Module 9 Care Management, Utilization and
Quality Management

• Function Care Management
• Service Coordination versus Care Management
• -Nebraska Integrated Care Coordination Units
• Care Management Principles
• Importance of Structuring Care Management
• A Continuum of Service Coordination/Care
  Management
• Types of Care Managers
• Pros and Cons of Different Structures
• Function Utilization Management (UM)
• Utilization Management (UM)
• Principles for Utilization Management
• Aligning UM Interests and Responsibilities
• -Pennsylvania Early Warning System

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Module 9 Care Management, Utilization and
Quality Management

• Function Quality Management (Continuous Quality
  Improvement)
• Quality Management
• -Handout 9.1 Massachusetts Department of
  Social Services Continuous Quality Improvement
  Program (Discussion Guide for Learning Forums)
  and CQI Process Scenario
• -Contra Costa County, California
• -Missouri Quality Assurance Practice
  Development Reviews
• Purposes of UM and Evaluation Data
• Types of Data Reports and Their Use
• Example of Use of Data for Continuous Quality
  Improvement
• -Michigan Child and Adolescent Functional
  Assessment Scale
• Examples of Outcomes Measures Related to CFSR
• -Integrated Care Coordination Unit
• -Early Integrated Care Coordination Unit
• -Wraparound Milwaukee
• -Large Group Discussion

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Module 10 Brief Introduction to and Discussion
of Other Functions (e.g., Human Resource
Development, External and Internal Communication,
Training and Technical Assistance)

• Other Important SOC Functions
• FUNCTION Human Resource Development
• Human Resource Development Overview
• Culturally Competent, Family/Youth-Driven HRD
  Strategies
• Staffing Systems of Care
• -District of Columbia student loan repayment
• A Cross-System Training Focus
• -Clark County, Nevada and St. Marys County,
  Maryland
• -North Carolina- System of Care Child and Family
  Team Curriculum and Training Workgroup
• FUNCTION Communication
• External and Internal Communication
• -North Carolina Local Collaborative
  Communication Committee
• Social Marketing, Media and Public Relations
• -Kansas Family Centered System of Care
• -Oregons System of Care Goals and Performance
  Measures
• -Illinois Dont Write Me Off Foster Kids Are
  Our Kids
• FUNCTION Protecting Confidentiality
• Confidentiality and Rights Protection
• FUNCTION Information Management

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Additional Materials

• Case Scenarios Urban, Rural, Suburban
• Exercises
• Handouts
• Trainers Addendum
• Acronyms
• Glossary
• Web Links
• LISTSERV Instructions
• Evaluation
• Complete Primer Hands On Child Welfare Slides

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Primer Hands On-Child Welfare
Available on the Web at www.nrcoi.org