Where Are We Going

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Advising OMHSAS Our Childrens System of Care
Who, What, Where, How
Wendy Luckenbill Mental Health Association in
PA wluckenbill_at_mhapa.org Sherry Peters, PA
Office of Mental Health and Substance Abuse
Services, Childrens Bureau shepeters_at_state.pa.us
PA 2005 Children's Interagency Training
Conference
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• New Directions in PAs
• Childrens System of Care Planning
• Mobilizing for Quality Reform

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The Stars Are Lined Up We Need to Plot Our
Course.

• 20 yrs of research supports effectiveness of
  CASSP principles the critical need for
  stakeholder voice.
• New Freedom Commission finds BH in disarray,
  supports prevention, community services, and
  collaboration.
• Political climate supportive of implementing
  research and focusing on outcomes.

4
Changing Course
PA CASSP ADVISORY COMMITTEE
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How Do We Communicate?
6
How Do We Work Together?
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Approaching the Old Barricades
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How is PA Planning for Children?

• Governors Cabinet for Children and Families
• Commission for Children and Families
• DPW DOH PDE Labor and Industry JCJC PCCD
• MHPC
• CBHTF
• ATF
• Budget, Insurance, Office of Health Care Reform,
  
• Governor's Office of Policy and Governors Chief
  of Staff

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State Planning for Childrens Behavioral Health
LOCAL REGIONAL


MHPC Other State Agency
Planning
Efforts
Mental Health Planning Council Provides Ongoing
Oversight Federal Mandates for Mental Health
Planning Councils / US Act 102-321 1. To
review plans... submit... recommendations...for
modification to the plans. 2. To serve as an
advocate for ... children with a severe emotional
disturbance... 3. To monitor,
review, and evaluate, not less than once a year,
the allocation adequacy of MH services within
the state.
PA CHILDRENS ADVISORY
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OMHSAS VisionEvery individual served by the
Mental Health and Substance Abuse Service system
will have the opportunity for growth, recovery
and inclusion in their community, have access to
culturally competent services and supports of
their choice, and enjoy a quality of life that
includes family and friends.

• OMHSAS Guiding Principles- The Mental Health and
  Substance Abuse Service System will provide
  quality services and supports that
• Facilitate recovery for adults and resiliency for
  children.
• Are responsive to individuals unique strengths
  and needs throughout their lives.
• Focus on prevention and early intervention.
• Recognize, respect and accommodate differences as
  they relate to culture/ethnicity/race, religion,
  gender identity and sexual orientation.
• Ensure individual human rights and eliminate
  discrimination and stigma.
• Are provided in a comprehensive array by unifying
  programs and funding that build on natural and
  community supports unique to each individual and
  family.
• Are developed, monitored and evaluated in
  partnership with consumers, families and
  advocates.
• Represent collaboration with other agencies and
  service systems.

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The New Landscapewww.dpw.state.pa.us/General/Abou
tDPW/SecretaryPublicWelfare/003670792.htm
Partners
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Commission on Children Families. Governors
Exec. Order www.oa.state.pa.us/oac/cwp/view.asp?
A351Q177796

• The Governor will appoint a Commission on
  Children and Families (hereinafter referred to as
  "Commission") to assist and advise the Cabinet
  to
• (1) Identify policy, program, and systemic
  barriers that prevent state and local governments
  from effectively and efficiently serving the
  needs of children and families.
• (2) Formulate remedies and solutions to
  identified problems.
• The Commission will consist of members appointed
  by the Governor.
• The Commission currently has 35 members which
  represent stakeholders from every region of the
  state. There are 6 regional chairs, and a chair
  person. Regional chairs conducted regional
  forums in 2004 to solicit local input for the
  current budget cycle.

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System of Care

• Participating Counties
• Dauphin
• Chester
• Allegheny
• Montgomery
• Bucks
• Chester
• Lehigh
• Elk
• Northumberland
• Lycoming
• Lackawanna

• Purpose of Grant To create and enhance local
  capacity to improve outcomes for children and
  adolescents with emotional and behavioral needs
  and multi-system involvement (CY/JJ) or at risk
  for out of community placement.
• OHMSAS, OCYF Family Consultant State Team
• Administration for Children and Families 3 year
  grant
• Focus- Children in CY and JJ with SED
• One county- Dauphin funded first
• 10 other counties Technical Assistance and
  possible Funding in 2005 (Mini grants)
• Promoting CASSP Principles System of Care
  models including Family Decision Making
• Local Family/Provider/Stakeholder Planning Teams

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MacArthur MH/JJ Model Systems Project ?
MacArthur County Projects Mental
Health Allegheny Chester Erie Aftercare
Allegheny Cambria Lycoming York Philadelphia
Disproportionate Minority Confinement
(DMC) Berks Allegheny Philadelphia

• 3 year grant- Goal- to develop local models of
  systems change in policy practice
• Juvenile Law Center- coordinator/lead entity
• www.jlc.org/home/juvenilejustice/mac.php
• Pa Collaboration for Youth- coordinating
  stakeholder voice at state and local levels
• www.mhapa.org/pcy/index.stm
• A state core groups will participate in a
  strategic planning process to
• 1. Identify reform goals and specific objectives
• 2. Prioritize reform areas
• 3. Outline strategies for selected outcomes.
• 4. Report to the Foundation.
• National juvenile justice experts provide
  training and technical assistance to state and
  local partners

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Childrens BH Task Force ? www.dpw.state.pa.us/G
eneral/AboutDPW/SecretaryPublicWelfare/CBHT/

• Charges
• Develop recommendations to improve the delivery,
  management, and financing of children's
  behavioral health.
• Create a comprehensive report on improving the
  current service delivery system.
• Membership- open and inclusive, seeking family
  representation of at least 50 percent
• Currently 700 members

• Committees
• Each has a family and a provider facilitator
• Adolescent
• Childhood
• Early Childhood
• Family/Community
• Funding
• Research
• Rural
• Training
• Transition

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Integrated Childrens Services Planning
www.dpw.state.pa.us/General/AboutDPW/SecretaryPu
blicWelfare/IntegratedServicesPlan05-06/DPW/DOH
Counties now engaged in a comprehensive approach
to serving children, birth to twenty-one years of
age, their families through programs that focus
on long-term prevention, early intervention,
services that support family stability, child
safety, healthy child development.

• Year One
• establish a local vision for children family
  services and supports
• identify planning partners, including families
  adolescents in the system
• highlight current strengths of the local system
  identify local, state, or federal regulatory or
  fiscal barriers that limit the ability to
  operationalize the vision
• move to a process of targeting and tracking
  desired outcomes appropriate performance
  measures for counties that are also consistent
  with federal and state outcomes measures.
• In the first year of integrated childrens
  service planning, counties
• submitted plans that address the components
  presented in this document based on their current
  level of coordinated service delivery.

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Integrated Childrens Services Planning Year 2

• Bulletin distributed on April 29, 2005
• Guidelines being developed by DPW/stakeholder
  workgroup
• Counties will submit 2006-2007 plans by August
  15, 2005
• Half day trainings will be held in the month of
  June to provide technical assistance for counties

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Cross System and OMHSAS Workgroups

• SAP- Trained School District teams identify
  students with BH needs and refer with family
  partnership.
• Stigma ?- Funded campaign expands existing adult
  project- Open Minds Open Doors.
• Pilots ?- Transition-Federal Block Grant funds
• Partial Hospital/ED ?- Improve education in
  Partials
• Resilience/Recovery ?- Expand and Promote
• Suicide Prevention- Promote PAs Suicide
  Prevention Plan
• Quality Improvement- Outcome Measurement for
  OHMSAS
• Seclusion and Restraint- Develop specific
  standards for children based on success of PAs
  Adult State Hospital Model.

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Opportunities for Input- Where Are You?
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County CASSP Coordinators

• Local and Regional Stakeholder Groups
• Your county CASSP coordinator connects you to
  local planning activities including
• County MH/MR board
• County CASSP Advisory Board
• County Integrated Planning
• SAP in local schools (including County
  Coordination Teams and District Councils)
• Transition Coordinating Councils (Communities of
  Practice)
• Local Interagency Coordinating Councils (Early
  Intervention)
• In HealthChoices Counties- Childrens
  HealthChoices Advisory Groups
• Any special planning activities- i.e. MacArthur
  JJ, System of Care
• Current List of coordinators by county at
• http//pacassp.psych.psu.edu/
• Go togt Publicationsgt CASSP Coordinators

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Partnering Checklist

• Everyone on equal footing- same information, same
  language
• ? Does everyone speak in everyday language- or
  explain terms
• ? Are there interpreters/translators
• ?Are there opportunities for all members to get
  background info
• ?Are there clear minutes
• ?Are there multiple ways to connect, inform,
  participate
• ? Are there frequent reality checks- Any
  concerns, questions?
• Everyone equally welcomed- geographic,
  socio-economic, cultural, ethnic diversity
  affirmed
• ? Are there ongoing cultural competency
  activities
• Everyone equally able to access- place,
  information, meetings, networking, training
• ?Are meetings well attended and if not is there a
  variety of outreach to determine how to get
  authentic and robust participation by the broad
  diversity of stakeholders
• TA- Esp. for Building Family Partnerships-http//f
  fcmh.org/pub_facts.htm

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OMHSAS Guiding Principles

• The Mental Health and Substance Abuse Service
  system will provide quality services that
• Facilitate recovery for adults and resiliency for
  children
• Are responsive to individuals unique strengths
  and needs throughout their lives
• Focus on prevention and early intervention
• Recognize, respect, and accommodate differences
  as they relate to culture/ethnicity/race,
  religion, gender identify and sexual orientation
• Ensure individual human rights and eliminate
  discrimination and stigma
• Are provided in a comprehensive array by unifying
  programs and funding building on natural and
  community supports unique to each individual and
  family
• Are developed, monitored and evaluated in
  partnership with consumers, families and
  advocates.
• Represent true collaboration with other agencies
  service systems

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OMHSAS Unified Systems Strategy 2004-05

• To assure that individuals receiving treatment in
  our state hospitals have the opportunity to live
  and thrive in open integrated community settings,
  by continuing to examine OMHSAS ability to close
  or consolidate state hospitals while building
  community partnerships and integrating funding to
  support a model that promotes recovery.
• To redesign the childrens behavioral health
  system to better meet the needs of children and
  their families.
• To expand behavioral health managed care
  statewide.
• To commit to a quality management system which is
  built on sound data systems.

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OMHSAS/Stakeholder Planning Drives Quality
Management of Outcomes

• OBJECTIVE 2
• To redesign the childrens behavioral health
  system to better meet the needs of children and
  their families
• Target (expected change/time period)
• Goals Supported
• Treatment, services and supports are provided
  where, how and when needed
• Funding will support the OMHSAS vision
• Supporting Projects/Initiatives-aforementioned
  plus,
• Education services to youth in Partial Hospital
  programs
• Options for residential and out of home
  placements
• Seclusion and Restraint