Redesign and Transition Project

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Redesign and Transition Project July 2006 to
December 2006
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(No Transcript)
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Mission
The mission of Ramsey County Childrens Mental
Health Collaborative is to maintain and improve
functioning of children with mental
health/behavioral needs within the context of
their family. 
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Goals
CHILD FAMILY OUTCOME GOALS SAFETY Imminent
Danger Goal The Collaborative and its members
will promote the safety of children, family and
others who may be in imminent danger due to the
childs mental health problems. STABILIZATION St
abilization Goal The Collaborative and its
members will promote and facilitate keeping the
child in the home and school whenever
appropriate. COLLABORATIVE PROCESS
GOALS ACCESS Access Goal The Collaborative and
its members will promote and facilitate access to
community mental health information and services.
COORDINATION AND INTEGRATION OF
SERVICES Coordination and Integration of
Services Goal The Collaborative and its members
will partner and support families to promote and
facilitate coordinated services to children with
mental health needs.
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Goals (continued)
PARENT/FAMILY INVOLVEMENT Parent/Family Goal
The Collaborative and its members will support,
promote and facilitate parent involvement in the
entire continuum of care for children with mental
health needs. SENSITIVITY Cultural And Ethnic
Goal The Collaborative and its members will
promote and facilitate services that address
cultural and ethnic needs of the children we
serve and their families. SATISFACTION Satisfac
tion Goal The Collaborative and its members will
promote and facilitate satisfaction with services
provided to children with mental health needs and
their families. CONTINUUM OF CARE Continuum of
Care Goal The Collaborative and its members will
promote and facilitate the development of
services to complete a full continuum of care.
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Redesign Transition Strengths, Weaknesses,
Opportunities and Threats

• Strengths
• Provides clarity of mission and purpose to
  transition from good to great
• Provides clarity regarding population the
  collaborative serves (direct vs. general focus)
• Provides the collaborative with the ability to
  align based on expertise and funding resources
• Consistent with Ramsey Countys challenge to the
  collaborative
• Consistent with collaborative primary funding
  source
• Weaknesses
• Possible creation of potential gaps in coverage
• Alternative support systems not prepared or in
  existence to cover potential gaps in coverage
• Current providers who do not receive funding will
  no longer participate in the collaborative
• The number of children/youth identified is the
  population being served, not the children/youth
  in need
• Opportunities
• New partnerships
• Strengthen parental involvement
• Strengthen present agencies that are serving the
  future mission of the collaborative
• Improve funding for agencies serving the mission
  of the collaborative
• Improved coordination of core agencies to provide
  integrated wrap around services for
  children/youth in the need of complex services

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Redesign Transition - Priority Areas

• 5 priority areas (09/06)
• Assist troubled children/youth to become
  productive and successful individuals by
  integrating strategic programs across
  collaborative agencies.
• Establish parameters to serve the 700 to 1,000
  children/youth in need of the complex services
  offered by the collaborative.
• Connect funding to accountability, outcomes and
  RCCMHC priorities.
• Increase parental involvement for the purpose of
  generating feedback on the success and relevance
  of program offerings.
• Insure that funding is aligned with need and
  RCCMHC priorities and is regularly re-evaluated.

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Children/Youth Tiers
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System of Care
Outreach/ Formal Eligibility Short
Term Coordination Referral Determination Probl
em Solving Services
Case Management (Rule 79)

• Families
• Providers
• Communities
• Schools
• Corrections
• Law Enforcement
• Mental Health Centers
• Hospitals

Community Services --------------- Collaborative
Services ---------------- County Placement (only
if needed)
Short Term Services
Ramsey County
Assistance with Problem ID Documentation from a
Mental Health Professional. Information and
Referral for Those Not in Need of Collaborative
Level of Care
Integrated with Families, Schools
Communities (provides services where clients
live, work and play)
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Priority Area 1

• Assist troubled children/youth to become
  productive and successful individuals by
  integrating strategic programs across
  collaborative agencies.
• The collaborative will define children/youth in
  need of complex services as those eligible for
  mental health case management and/or in the
  process of being placed due to their mental
  health needs (Tier II III)
• The collaboratives goal will be to address the
  full spectrum of mental health needs for eligible
  children/youth by providing integrated wrap
  around services through its member agencies
• The collaborative will facilitate families of
  color embracing our services before, during and
  after intervention this may help children and
  families avoid child protection or the juvenile
  correction system
• The collaborative will promote the availability
  of services at the times and locations that are
  most convenient for families
• The Collaborative model will integrate culturally
  accepted intervention and traditional mental
  health services

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Priority Area 1 (continued)

• Assist troubled children/youth to become
  productive and successful individuals by
  integrating strategic programs across
  collaborative agencies.
• The collaborative will work to integrate agencies
  that are currently missing 1) child protection
  services (CPS), 2) substance abuse counseling and
  3) re-establish liaison to the human services
  advisory committee (sub. childrens mental
  health)
• The collaborative will create multiple entry
  points to meet the needs of families where they
  live, play and attend school
• Ramsey County Children Mental Health program will
  integrate its resources with the collaborative
  minus its allocation for services designated for
  children/youth in Tier I
• The collaborative needs to be able to support
  crisis services
• Getting the right agencies involved at the right
  time will ensure people trust the county and
  collaborative as they enter the process and
  participate within in it

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Priority Area 2

• Establish parameters to serve the 700 to 1,000
  children/youth in need of the complex services
  offered by the collaborative.
• The collaborative believes that current resources
  are sufficient to serve 700 to 1,000
  children/youth in need of complex services
• The need is greater than the available resources.
  The Collaborative will not be able to serve all
  eligible children/youth.
• Collaborative members will serve the
  children/youth most in need.

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Priority Area 3

• Connect funding to accountability, outcomes and
  RCCMHC priorities.
• The collaborative will provide funding to ensure
  access
• The collaborative will hold itself accountable
  for good outcomes
• The collaborative will create a new measurement
  and evaluation methodology to determine its
  success serving children/youth in need of complex
  services

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Priority Area 4

• Increase parental involvement for the purpose of
  generating feedback on the success and relevance
  of program offerings.
• The collaborative will listen to and support
  families and communities of color to understand
  what children/youth need to create good outcomes
• Provide outreach as a way for families to find
  RCCMHC and its services
• RCCMHC will provide front end options for
  children/youth that are likely to meet the
  criteria for children/youth in need of complex
  services
• RCCMHC will provide a model where cultural
  communities feel they are in a true and
  meaningful partnership with mental health
  providers

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Priority Area 5

• Insure that funding is aligned with need and
  RCCMHC priorities and is regularly re-evaluated.
• Funding will be flexible enough to adequately
  provide individualized services
• Provide valuable services that a client would
  choose to pay for if they had the financial means
  versus choosing an option simply because it is
  free or very little cost
• The collaborative will eliminate funding for
  programs that no longer fit its focus
• The collaborative will fund services for
  children/youth and their families in need of
  complex services. These services will be
  targeted to alleviating the child/youth mental
  health challenges.
• The collaborative will work to ensure the
  availability of services required, including
  culturally specific services based on the needs
  of the clients

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Target Population

• Ramsey County Definition of a Child/Youth in Need
  of Complex Services
• The Child/Youth has to qualify as severely
  emotionally disturbed.
• Their emotional disturbance must have
  significantly disrupted their life for at least
  one year or is expected to disrupt their life for
  at least one year or must meet one of the other
  statutory definitions of a severe emotional
  disturbance.
• Successful intervention will require coordinated
  services from multiple providers in several
  environments (i.e. home, school, legal, etc)
• RCCMHC Parameter Indicators for a Child/Youth in
  Need of Complex Services
• SED (severely emotionally disturbed)
• Acting In (i.e. depression, suicidal, etc.)
  and/or Acting Out (i.e. violent, physical, etc.)
• The client needs intensive community based
  outpatient services
• Functionally impaired across multiple
  environments
• Evidence of community impairment (i.e. law/legal,
  public safety, school, home, behavioral, etc.)

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Eligibility Determination

• Assist families to identify need, make self
  referrals and access support services
• A diagnostic assessment will be required to
  determine eligibility for case management and
  on-going services

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Funding, Types of Services That May Be Eligible

• RCCHMC funding may be used to purchase
• Services not covered by medical assistance,
  insurance, school funding, grants or other third
  party sources of funding
• Services to uninsured or underinsured individuals
• System infrastructure that is not linked to
  specific clients (e.g. central point of access or
  assessment center)
• Time limited start-up grants for needed services
  that are expected to be at least partially
  self-sufficient in the future
• Operating subsidies for allowable expenses to
  ensure the continued availability of needed
  services that primarily rely on third party
  funding
• Offer technical assistance for training,
  certification, billing, outcome measurements and
  other additional development requirements

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Funding, Examples of Types of Services That May
Be Eligible

• Respite services
• Parental support
• Care plan funds for parental support
• Community based mental health services
• School based services as a natural point of
  intervention
• Referral services with a algorithmic flowchart
  for consistency and quality
• Etc.

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The Intersection of Mental Health Families - I

• The collaborative will make support available to
  families from the point in which an SED diagnosis
  is made until the child/youth is no longer
  eligible for collaborative services or if the
  family chooses to end communication and services
  with the collaborative.
• The Resources that are needed to be supportive of
  families should include a central access person
  as the first point of contact.
• Other services needed to support families include
  but are not limited to
• Stipends for families to defray costs for
  attending classes, workshops, seminars and
  attendance at Collaborative meetings
• Development and dissemination of culturally
  diverse educational materials
• A single source contact for access to
  services/providers

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The Intersection of Mental Health Families - II

• Create and maintain current qualified respite
  providers
• Development of parent friendly application form
  for access to Care Plan Funds
• Parent representative with voting privileges on
  Care Plan Fund disbursement committee
• Creation of a Parent-Driven case management
  program to keep case management files open even
  when the child/youth is stable
• Explore possibility of developing a program to
  connect parents with each other based on
  diagnosis, school district and age of the
  child/youth (i.e. adapting models previously used
  by ARC of MN and others)

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The Intersection of Mental Health Schools - I

• Collaborative will make its services available to
  children/youth identified by schools when the
  child meets the criteria for collaborative level
  of care.
• The collaborative will understand what schools
  are mandated to provide based on federal and
  state requirements and what limitations schools
  have in meeting the needs of students identified
  as in need of complex mental health services.
• School districts, the county and community
  agencies will work together to define roles,
  rules, mandates, expectations, and strategies on
  how to better serve students with mental health
  diagnoses and needs and their families in a
  collaborative and efficient manner.
• The collaborative will review and make
  recommendations about how mental health services
  might best be addressed in the educational
  setting as well as how schools might
  partner/coordinate with public and community
  agencies.
• The collaborative will assist in identifying,
  making recommendations and addressing the issues
  related to and needs of students identified with
  persistent mental health needs and who have a
  mental health case manager and the roles schools
  will play in providing instructional and related
  services coordinating with complex mental health
  services necessary beyond the educational program.

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The Intersection of Mental Health Schools - II

• The collaborative will assist in identifying,
  making recommendations and addressing issues
  related to the needs of students in out-ofhome
  placements and the role schools should play in
  providing educational services and coordinating
  with necessary mental health services provided
  beyond the educational program.
• The collaborative will make recommendations to
  county and school agencies on strategies on how
  to meet the needs of children/youth who meet the
  criteria for county/collaborative mental health
  case management but the county does not have the
  resources to meet their needs.

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The Intersection of Mental Health Child Welfare

• Collaborative will make its services available to
  children/youth identified by Child Welfare/Child
  Protection when the child meets the criteria for
  collaborative level of care.
• Collaborative will assist in engaging parents of
  children with SED who are involved in Child
  Welfare/Child Protection.
• Collaborate will work with and participate in
  efforts to reduce racial disparities in Child
  Welfare/Child Protection.
• Child Welfare/Child Protection will actively
  participate to build relationships and improve
  partnering with the Collaborative.
• Collaborative will partner with Child
  Welfare/Child Protection in developing,
  implementing, funding and monitoring
  community-based mental health care for eligible
  children.
• Collaborative will work with Child Welfare/Child
  Protection when an out of home placement becomes
  necessary and will maintain mental health
  services whenever possible.
• Collaborative will actively participate in
  decisions about placement vs. community-based
  care for children/youth who are also served by
  Child Welfare/Child Protection. If the Court or
  Child Welfare/Child Protection places a child
  without collaborative support or involvement, the
  collaborative may choose to discontinue services.

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The Intersection of Mental Health Community
Agencies

• Collaborative will make its services available to
  children/youth identified by community agencies
  when the child meets the criteria for
  collaborative level of care.
• Collaborative partners will work jointly with any
  and all systems (schools, out-of-home placement,
  corrections, etc) our clients interact with to
  ensure their mental health needs are met.
• Collaborative partners will work with any and all
  systems to maintain the continuity of care.
• Collaborative partners will assist in engaging
  parents of children/youth in need of complex
  services to create a world class process to meet
  their mental health needs.
• Collaborate partners will work with and
  participate in efforts to reduce racial
  disparities by continuously being culturally
  conscious of the community it serves.
• Collaborative partners will work to build
  relationships with all of the stakeholders
  regarding children/youth in need of complex
  services.
• Collaborative partners will interactively make
  recommendations to improve the process by which
  children/youth enter the process, interact within
  the process and exit the process.

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The Intersection of Mental Health Corrections

• Collaborative will make its services available to
  children/youth identified by corrections when the
  child meets the criteria for collaborative level
  of care.
• Collaborative will assist in engaging parents to
  help resolve instances where the child/youth has
  become involved with the correctional system
• Collaborative will work with Corrections, when an
  out of home placement becomes necessary, to mainta
  in mental health services whenever possible 
• Collaborate will work with and participate in
  Juvenile Detention Alternatives Initiative
• If the courts and corrections place a child, then
  corrections is accountable for serving the needs
  of the child/youth versus the collaborative
• The county has the mandate that it does not have
  to serve children/youth that it can not afford to
  serve
• The collaborative must jointly make the decision
  as a cooperative and collaborative partner with
  the county to place a child/youth

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Next Steps in the Process - Overview
Phase I Assessment Figure Out What To Do 07/06 to
12/06 Phase II Strategy Figure Out How To Do
It 01/07 to 03/07 Phase III Implementation Begin
Doing It 04/07 Phase IV Measurement
Evaluation How Well We Did It 12/07 to 12/08
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Next Steps in the Process - Strategy

• Phase II - Strategy
• Maintain Momentum from the Previous Six Months
  (July to December 2006)
• Clearly Understand This Phase Will Be a Challenge
• Two Vehicles to Provide Future Input
• New Opportunity to Participate in the Planning
  Group
• Provide Feedback via the Large Collaborative
• Communication Will Continue to Show Weekly and
  Monthly Progress
• Utilize World Class Best Practices
• Create the Process by Which a Strategy Will Be
  Formulated
• Create a Integrated System of Care Model
• Create a Service Delivery Model
• Create a Financial Model to the Support the
  System of Care and Service Delivery Model
• Finalize Personnel, Detailed Steps and Providers
  to Execute the Strategy

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Potential Marketing Activities

• Create marketing plans to suit the need for
  multiple audiences
• Create a marketing plan for families and clients
• Increase the visibility and awareness of the
  collaborative
• Understand the benefits of the collaborative
• As a means of support for families
• Understand the process to gain trust and
  confidence in the mental health system
• Create a marketing plan for funding sources to
  ensure they are aware of the value of the
  collaborative
• Create a marketing plan that highlights
  successful collaborative partners who have
  created successful outcomes for its clients
• Insure that current and future collaborative
  partners understand and work within the
  Collaborative model. This will allow effective
  marketing for future funding.

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Redesign and Transition The Team

• RCCMHC Redesign Transition Team
• American Indian Family Center Angie Stratig
• Face To Face Health Counseling Center Betsy
  Clipper
• Family Improvement Network, Inc. Janet
  Nelson-Schaner, RN
• La Familia Guidance Center, Inc. Jose Santos,
  Jr.
• La Familia Guidance Center, Inc. Roberto Avina,
  LICSW, LMFT
• Life Long Mentoring Services, Inc. Corey Byrd,
  Sr.
• LifeSpan of Minnesota Traci Hackmann, M.A.,
• L.P. Metro Social Services, Inc. Sunday
  Olayinka
• Mounds View Public Schools 621 Ann Bettenburg
• Northeast Metro ISD 916 Bonnie Bray
• Parent Suburban June McCarthy
• Parent Urban Shellie Rowe
• Parent Urban, Alternate Sharon Moore
• Progressive Individual Resources, Inc. Richard
  Oni
• Ramsey County Board of Commissioners Toni Carter
• Ramsey County Community Corrections Frank Hosch
• Ramsey County Community Human Services Joel
  Hetler, Ph. D.
• Ramsey County Juvenile Family Justice
  Center Carol Geraghty

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