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Because Minds Matter: Collaborating to Strengthen Management of Psychotropic Medication for Children and Youth in Foster Care Washington, D.C. August 27-28, 2012. Maximizing Opportunities to Improve Child and Family Well-Being through Innovative Funding: - PowerPoint PPT Presentation

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  • Because Minds Matter: Collaborating to Strengthen Management of Psychotropic Medication for Children and Youth in Foster CareWashington, D.C. August 27-28, 2012

    Maximizing Opportunities to Improve Child and Family Well-Being through Innovative Funding: Transforming Rhode Island System of Care for Children, Youth and Families

    Dr. Janice DeFrances, Ed.D.Director, RI Department of Children, Youth and Families

  • Rhode Islands Commitment to System of Care Transformation 1989, CASSP Child and Adolescent Service System Program (Infrastructure) Grant , SAMHSA

    1991-Present, Statewide Family Network Grant Parent Support Network of RI

    1992, Project REACH grant Center for Mental Health Services (youth with serious emotional disorders and their families) SAMHSA

    1997, Project HOPE grant Center for Mental Health Services (youth adjudicated) SAMHSA

    2003, Report of RI System of Care Task Force: Toward An Organized System of Care for RIs Children, Youth and Families

    2005, RI Positive Educational Partnership Center for Mental Health Services (early childhood and positive behavior supports and interventions- infrastructure) SAMHSA

    2009, RI Family Care Community Partnership Implemented

    2011, Expansion Grant Planning Year, Center for Mental Health Services, SAMHSA

    2012, RI Networks of Care Implemented July 1st

  • System of Care Planning in RI: Overview1992 through 2003-Statewide Childrens Mental Health Advisory Board/ CASSP Board/ and 8 Local Coordinating Councils

    2001-2003 Governors Task Force meets to produce report to guide planning

    State Redesign planning: Focus groups and Public meetings to gain community, family and youth input with concept papers and then final RFPs

    Ongoing bi-annual retreats with state agencies, current and potential providers, community, family, and youth involvement

    Present: Statewide Family Community Advisory Board and four regional Boards

    Rhode Island State Expansion Team: Strategic Plan and National Consultation

  • System of Care Planning in RI: The Foundation2001, the RI System of Care Task Force was established with joint Leadership

    Key leadership from House, Senate and the Department of Administration

    Stakeholders met over the course of 2 years to develop the final report

  • System of Care Planning in RI: The FoundationResult:

    The Report of the RI System of Care Task Force, Toward an Organized System of Care for RIs Children, Youth and Families, January 2003 was submitted to the incoming governor and legislative leadership which included these key statements:

    With this letter, we send to you the report of the Rhode Island System of Care Task Force and ask for your full support and your strong leadership in moving us closer to an organized system of care for Rhode Islands children, youth and families.

    The members of the System of Care Task Force unanimously endorsed the vision and principles of this report and acknowledged that considerable work needs to yet be accomplished.(page 7, The Report of the Rhode Island System of Care Task Force, January 2, 2003)

  • The Report became a blueprint for the statewide development toward an organized system of care for Rhode Island

    The work of this Task Force became the springboard for our current system of care transformation in RI

    System of Care Planning in RI: The Foundation

  • Until 2005, innovative programs remained separate and a statewide integrated system had not been achieved

    The outcomes for children, youth and their families had not changed significantly.

    In 2005, RI DCYF Senior Leadership committed to full system transformation based on system of care (SOC) principlesTransforming RIs System of Care: Transition

  • Transforming RIs System of Care: ImplementationPhase I - Family Care Community Partnerships (FCCP)- Implemented January of 2009

    -Designed for families not involved with the Department: Prevention and early intervention through family preservation and community-based behavioral health programs and family supportsPhase II - Networks of Care- to implemented July of 2012- For families and youth active with the Department

  • System of Care - Phase II Implementation Date: July 1, 2012

    RI Family Care Networks: Ocean State Network and RI Care Management Network

    Phase II is serving families who are open to the department and actively receiving services. The department established two Statewide Networks of Care that partner with the department and families to consolidate the management of services and supports for each child and family according to their unique strengths and needs.

    Each Network of Care has a Network Lead that is responsible for building a collaborative, comprehensive array of accessible formal and informal services and supports, including residential and home-based services and support that will strengthen and support the home setting during and following out-of-home placement.

    The Networks must integrate wraparound principles, trauma and evidenced-based practice into service delivery and include strong partnerships with education and other entities in order to improve educational stability and success.

  • Governance in Rhode IslandEOHHS / DCYFMedicaid/RIte Care, Behavioral Health and Child Welfare dollarsGlobal Consumer Choice Medicaid WavierStatewide Protocol & Implementation TeamState Expansion TeamCommunity Networks4 FCCPs2 Networks of CareStatewide Family Community Advisory BoardContracted Care Management NetworksAnderson, J., Conlan-Lewis, L., (2012. Primer Hands On, Orlando, FL: RI Department of Children Youth and Families)

  • RI Outcomes:Over the past five years, the Department of Children, Youth and Families has:

    Reduced the number of youth placed out of state by over 77% from 2008 -2012

    Lowered the number of children entering out of home care by 39%from 2007 2012

    Developed and implemented Phase I of the System of Care (FCCP) as a front end diversionary program that has successfully reduced the number of families becoming open to the department and reduced the number of children in our care

    Launched Phase II of System of Care (Networks of Care)

  • RI Outcomes: Reduction in Residential Placements

    Chart1

    1202

    965

    809

    503

    Residential Census

    Sheet1

    FY2007FY2009FY2011FY2012

    Residential Census1,202965809503

  • RI Outcomes: Reduction in Out-of-State Residential PlacementsAs of June 2012 Reduced to 44 Out-of StateMost are nearby

    Chart1

    190

    128

    91

    71

    44

    # Youth

    Placement Solutions Out of State Residential Placements Quarter 1 by Fiscal Year

    OOSFY

    OOS #'s

    200720082009201020112012

    Number of Youth

    2332191591129458

    OOSFY

    Number of Youth

    Fiscal Year

    Number of Youth

    Out of State Placements

    OOS Q1FY08-12

    FYQ1 #OOS

    FY 08190

    FY 09128

    FY 1091

    FY 1171

    FY 1244

    OOS Q1FY08-12

    # Youth

    Placement Solutions Out of State Residential Placements Quarter 1 by Fiscal Year

  • Current RI System of Care Management Structure and Funding for Promoting Safety, Permanency, and Well-beingState AppropriationsTitle IVB & EMedicaid/RiteCareChildrens Trust FundDepartment of Children, Youth, and Families- behavioral health, child welfare, and juvenile justiceFamily Care Community Partnerships4 Lead Provider Agencies andRegional NetworksAt risk child welfare Service NavigationPartnershipsCommunity Providers, Family Support Organizations, and Natural Helping NetworksAnderson, J. , Conlan-Lewis, L., (2012. Primer Hands On . Orlando, FL.: RI Department of Children, Youth, and Families)CMHS , SAMHSA System of Care GrantsExecutive Office of Health and Human ServicesNetworks of Care 2 Lead Provider Agencies and Statewide NetworksFormal involvement with child welfareIntensive Care CoordinationPartnershipsWraparoundChild & Family Teams

  • Structuring the Array of Servicesand Supports in Rhode Island: FundingDCYF utilized prevention and earliest intervention, community-based dollars to support the preservation of families, early childhood and school-based programs:

    The state established the foundations of an evolving infra-structure to support:- The strengths of families;- Develop and connect families to effective, evidence based practices;- Identify kinship and protective factors, ensuring that families are connected to natural helping networks.

  • Community agencies are working together in partnerships to reduce duplication and identify the appropriate resources for families

    Prevention dollars are being utilized across the state for mental health awareness and prevent child abuse events to support families in healthy, fun and normalized activities

    State inter-agency collaborative work is demonstrating fruitful results:

    1.RI DCYF and RI Medicaid are working to ensure the best use of State and Federal Funds

    2.The Activities of the Wraparound process are now billable through the Global Consumer Waiver, (1115 Demonstration), Cost Not Otherwise Matchable (CNOM)

    Structuring the Array of Servicesand Supports in Rhode Island: Funding

  • Evidence-Based and EffectivePractices in Rhode Island Building the Base

    Established a Continuous Recruitment Request for Qualifications (CR-9) in 2002 for Evidence-based And Promising Practices: Child And Family Intervention.

    Result: current array of practices including Multi-Systemic Therapy, Strengthening Families, Functional Family Therapy, Parents as Teachers, Cognitive Behavioral Therapy (CBT) and Alternatives

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