Service Coordination: A Recipe for Success

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Service CoordinationA Recipe for Success

• Shared philosophy among providers
• Collaborative policy and funding infrastructure
• Unique services and supports

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History of Service Coordination 1980s Celeste
Administration

• Clusters county level cross system
  clinical/treatment teams.
• Participants were clinical level cross system
  personnel.
• Parents and children often not involved in plan
  development.
• Focus on problems/concerns.
• Creation of state cluster fund application
  process.

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History of Service Coordination 1990s
Voinovich Administration

• Family and Children First Councils created and
  responsible for service coordination mechanism.
• Cross system approach
• Mandates included needs assessment of child,
  development of individual family plan, and
  dispute resolution process.
• State Inter-systems fund application simplified.
• SC required to access funds.

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History of Service Coordination 2000s - Taft
Administration

• Methods to divert children from juvenile court
  and address at-risk unruly and adjudicated unruly
  youth.
• Family access to referral and dispute resolution
  processes
• Strengths based assessment of family
• Required Family Team meetings with specific
  timelines when there are emergency or planned
  out-of-home placements.

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History of Service Coordination 2000s - Taft
Administration

• Shifted from child focus to family focus.
• Strong emphasis on family engagement and
  empowerment.
• Required access to Family Advocates or support
  person(s).
• Alignment of SC with many high fidelity
  WrapAround principles.

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History of Service Coordination 2000s - Taft
Administration

• State inter-systems fund was discontinued and
  redistributed as an allocation to each mental
  health and recovery services board (404 dollars).
• ABC 404 dollars allocated based on population.
• 5,681 non-behavioral health funds allocated
  equally to each county FCFC.

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Service Coordination Mechanism ORC 121.37 (C)

• Whats in the law?
• Each county shall develop a county service
  coordination mechanism. The county service
  coordination mechanism shall serve as the guiding
  document for coordination of services in the
  county.

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Service Coordination Mechanism

• The overarching requirements for coordinating
  services for multi-need children in a county
• Referral
• Confidentiality
• Parent Participation
• Assessment of Strengths and Needs
• Culturally Responsive
• Least Restrictive Environment
• Dispute Resolution
• Comprehensive Family Service Coordination Plan
  Process
• Juvenile Court Diversion
• Monitoring and Tracking Outcomes

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Comprehensive Family Service Plan An
Individual Family Plan

• Requirements for developing and implementing
• Notification of and Invitation to CFSP Meetings
• Pre-Out of Home Placement Team Meeting
• Family Rights
• Confidentiality
• Participate in Meetings and Decisions
• Invite Informal Supports / Family Advocate
• Approve Team Leader Assignment
• Initiate Meetings
• Dispute Resolution

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Comprehensive Family Service Plan An
Individual Family Plan

• IN THE PLAN
• Goals and Services
• Designation of Service Responsibilities
• Timelines for Goals
• Crisis and Safety Plan
• Regular Reviews

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Service Coordination Process

• 1. Referral from family member, agency, or
  provider.
• 2. Determine level of need.
• 3. Explain SC family rights sign necessary
  documents
• 4. Complete Strengths Needs Assessment
  Culture
  
  
• Discovery
• 5. Determine Family Team/Offer Family Advocate
• 6. Develop Family Plan including Crisis and
  Safety Plan
• 7. Implement Plan
• 8. Regular follow up team meetings held to
  monitor
• progress
• 9. Final team meeting to address transition
  issues
• celebrate success.

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The Many Names of Service Coordination

• Service Coordination
• Family Support Teams
• Wrap Around /Hi-Fi Wraparound
• Cluster
• ICAT (Inter-systems Community Assessment Team)
• ICAT (Inter-agency Clinical Assessment Team)

• FAmily Stabilty Team (FAST)
• Community Wraparound
• Child and Family Team
• Intersystem Diversion Team (IDT)
• Kids in Different Systems (KIDS)
• Diversion Assessment Team (DAT)
• Coordinated Care Program

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Service Coordination Data

• Top 7 Referral sources for 1,700 children
  receiving service coordination from 24 counties
• Mental Health
• Juvenile Court
• Childrens Services
• Schools
• Family Member
• MRDD
• HMG

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Examples of County Results

• Columbiana County served 93 children and 71
  families in FY07 and showed a significant drop in
  risk assessment scores for children participating
  in Wraparound.
• Trumbull County in last years report showed that
  after children are referred to the Wraparound
  process there tends to be a significant drop in
  hospitalizations. This years data shows a very
  similar pattern.

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Erie County Results

• Erie County showed statistically significant
  family improvement for 122 families in 13 of the
  14 life domains in the Family Development Matrix.
  
• One domain, immigration, did not show a change
  because it was not indicated as a problem area
  for any of the families in service coordination
  at that time.

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Butler County Results

• Butler County found that mental health services
  were in place at the time of referral for 83 of
  the 212 children referred to Wraparound.
• Statistical analysis of Ohio Scales found that
  most youth moved from clinical to non-clinical
  levels in both Problem Behaviors and Youth
  Functioning
• Most youth were able to be maintained in a stable
  living environment without frequent changes in
  guardianship or level of care.
• The majority of children who entered Wraparound
  while in out of home placement moved to a lower
  level of care.

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Butler County Results, cont.

• 88 of parents reported improved
  satisfaction with support
• 75 of parents reported feeling more hopeful
  about the future
• 86 of parents reported feeling more
  involved in their child's treatment
• 86 of parents reported reduced safety
  issues in the home
• 88 of parents reported improved overall
  family functioning
• 88 of parents reported improved behavior in
  school
• 88 of parents reported improved child
  behavior in the home

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• SService coordination mechanism for multi-system
  involved youth
• EEvidence based model of National WrapAround
  Initiative
• IImplemented in 2006

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• FFamily Council - Funded by SCC
• 3 FTE WrapAround Service Coordinators
• 1 FTE Clinical Reviewer/WrapAround Service
  Coordinator
• 1 FTE 1 PT Family Advocate
• 1 FTE Supervisor
• CChild Adolescent Behavioral Health
• CCommunity Services of Stark County

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• 154 youth referred in SFY 08
• 69 male
• Mean age of 13.7
• Median age 15
• Race

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• FFamily Court 40
• MMental Health and Alcohol Drug 15
• FFamily self-referral 14
• JJob Family Services 6

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• Questions?