Washington Integrated Services Enhancement

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Washington Integrated Services Enhancement

• (WISE)
• for Children with Special Health Care Needs

CSHCN Institute May 21, 2003
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Problem

• Multiple agencies serve CSHCN
• Service delivery system is difficult to access
• Care coordination duplicative
• Funding is categorical
• Cross agency data unavailable

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MCHB Integration of Services Grant

• Washington State Department of Health
• Four year planning grant (5/1/01-5/31/05)
• 223,000 per year

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Purpose

• To develop a plan to promote cross agency policy
  and infrastructure that will improve the access,
  availability and continuity of services for
  children with special needs and their families.

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Goals

• Care Coordination Improve care coordination
  system
• Blended Funding Develop statewide system of
  funding for CSHCN

• Common Enrollment Develop a single entry for
  families to enroll in services
• Integrated Data Link data systems to describe
  the population

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What is the structure?

• WISE Grant Team
• WISE Grant Steering Committee
• 4 WISE Grant Sub-Committees
• 5 Pilot Sites
• Washington Family to Family Network
• Family Advisory Network
• WA State Dept. of Health, Office of the
  Superintendent of Public Instruction, and Dept.
  of Social and Health Services

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WISE Grant Team at DOH
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What is the structure?

• WISE Grant Team
• WISE Grant Steering Committee
• 4 WISE Grant Sub-Committees
• 5 Pilot Sites
• Washington Family to Family Network
• Family Advisory Network
• WA State Dept. of Health, Office of the
  Superintendent of Public Instruction, and Dept.
  of Social and Health Services

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Project Administrative Structure
Executive Oversight Committee Dept. of Health
(DOH), Dept. of Social and Health Services
(DSHS), Office of Superintendent of
Public Instruction (OSPI), Dept. of Services for
the Blind (DSB), Office of Community Development
(OCD) Existing
Family Advisory Network CSHCN Family
Consultant, Washington Fathers Network, Arc of
Washington, Parent to Parent, Family Voices,
Infant Toddler Early Intervention Program
(ITEIP), Family Leadership (Existing),
Families New to health system policy
development and program planning.
WISE for CSHCN Steering Committee Family
Advisory Network Representatives, Program
Managers Staff from DOH, DSHS, OSPI, DSB, OCD
(Existing), Medical Assistance Administration
(MAA)
State Interagency Coordinating Council Advisory
to Steering Committee
WISE Grant Sub-committees Care Coordination,
Braided Funding and Integrated Technologies /
Common Enrollment
Pilot Site Representatives Designee from each of
5 Pilot Sites being Yakima Valley Memorial
Hospital Childrens Village (Yakima
County), Grant County Health Department, Island
County Health Department, Whatcom County Health
and Human Services and Progress Center (Cowlitz /
Wahkiakum County).
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Parent Involvement in Project

• Family Advisory Network
• Veterans (WA Family to Family Network)
• New Recruits

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Family Advisory Network

• Diverse group of parents who represent a variety
  of ethnic, cultural, geographic, diagnostic
  characteristics includes both fathers and
  mothers

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Parent Leadership Training

• Present the Big Picture
• Orient parents to project, issues goals
• Use interactive, visual strategies
• Model range of ways to tell family stories

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Parent Leadership Training

• Veteran New Parent Match
• Selected subcommittee of interest
• Level of participation as primary or alternate
• Give take home tools and assignments in
  preparation for subcommittees

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Parent Leadership Training

• Mentor professionals on subcommittees, too
• Involve parents in evaluation and focus groups
• Convene conferences to nurture, inspire, train,
  plan and build partnerships

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Lessons Learned

• Model and reinforce the power of storytelling
• Model equal partnership of parents and
  professionals
• Two parents on each committee
• Take time for families. Build the relationship.
  Recruit and nourish!!!

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Build Family-Professional Partnerships

• Increase cultural competency
• Support families in policy work
• Mentor parents and professionals

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Outcomes

• Parents arrive as equal partners
• Parents participate in leadership and mentorship
  roles
• Diverse range of parent perspectives are
  represented in policy discussions
• Culturally competent recommendations

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Accomplishments

• Family Advisory Network February 2002
• Power of Story Telling
• Parent / Professional Sharing and Relationship
  Building
• Evaluation Plan
• Benchmarking of other state models
• Blended Funding Conference September 2002
• Unlikely / Likely Partners

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WISE Evaluation
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Short Term Evaluation Components

• Clarify existing goals of the grant
• Capture family provider
• Experiences
• Perceptions
• Receptiveness

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Short Term Evaluation Components

• Identify service system strategies key elements
  that will improve child and family outcomes

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Short Term Evaluation

• 50 Key Informant interviews
• Parent Focus group
• Results validated the goals of the grant
• Concern expressed around Blended Funding
• Greater emphasis on inform and educate both
  parents and professionals

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Existing System

• Families complete multiple applications
• Families have multiple care coordinators
• Families are dependent upon the care
  coordinators knowledge of system
• Service delivery systems not connected
• Data collection is agency specific

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What we are discovering

• Parents and professional are ready for an
  integrated system
• Multiple integration efforts happening statewide
  and nationally
• Support for linking existing systems
• Common Enrollment Families First Priority
• Current care coordination is duplicative

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Families Describe an IDEAL Integrated System
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Families Describe an IDEAL Integrated System

• Family centered
• Need and family directed
• Support for families and professionals
• Centralized data system
• A single entry point to the system
• Common enrollment
• A single care coordinator
• Supports communication

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WISE Vision Statement

• One comprehensive, integrated statewide system
  that meets the unique and evolving challenges of
  Washingtons children with special needs and
  their families.

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Preliminary Ideas for Recommendations

• Develop a web/phone enrollment mechanism
• Let parents describe childs development and
  concerns by selecting areas of concern
• Give parents the option to self-educate by
  reading about selected agencies
• Parents complete enrollment and grant permission
  for referral
• Pilot a common enrollment system
• Address integrated data warehouse options

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Strategic Plan for Year 2003

• Continue to test models at Pilot Sites
• Continue to bench mark best practices
• System assessment documenting Federal Law, WAC,
  policies and tradition that would be impacted by
  recommendations
• By May 2004, prepare final recommendations for
  each goal
• Develop a briefing or marketing document

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Strategic Plan for Year 2003

• Begin planning for final evaluation of the WISE
  Grant
• Plan for a 2004 Expanded Parent Leadership
  Conference
• Continue to build relationships

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Project Administrative Structure
Executive Oversight Committee Dept. of Health
(DOH), Dept. of Social and Health Services
(DSHS), Office of Superintendent of
Public Instruction (OSPI), Dept. of Services for
the Blind (DSB), Office of Community Development
(OCD) Existing
Family Advisory Network CSHCN Family
Consultant, Washington Fathers Network, Arc of
Washington, Parent to Parent, Family Voices,
Infant Toddler Early Intervention Program
(ITEIP), Family Leadership (Existing),
Families New to health system policy
development and program planning.
WISE for CSHCN Steering Committee Family
Advisory Network Representatives, Program
Managers Staff from DOH, DSHS, OSPI, DSB, OCD
(Existing), Medical Assistance Administration
(MAA)
State Interagency Coordinating Council Advisory
to Steering Committee
WISE Grant Sub-committees Care Coordination,
Braided Funding and Integrated Technologies /
Common Enrollment
Pilot Site Representatives Designee from each of
5 Pilot Sites being Yakima Valley Memorial
Hospital Childrens Village (Yakima
County), Grant County Health Department, Island
County Health Department, Whatcom County Health
and Human Services and Progress Center (Cowlitz /
Wahkiakum County).
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The REAL Stuff

• Over 150 people working on WISE
• A MOVEMENT for integration has begun
• Legislators are starting to propose integration
  bills
• 50 parents and providers interviewed to validate
  the WISE Grant goals and to collect service
  system strategies to improve child and family
  outcomes
• Parents and Professionals are making a
  difference!

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Contact

• Karen Kershaw
• WISE Grant Coordinator
• PO Box 47880
• Olympia WA 98504-7880
• [phone]
• Karen.Kershaw_at_doh.wa.gov