Strong Minds, Strong FuturesA trauma-informed system of care initiative for adolescents with behavioral health issues and their families

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THE PROBLEMColorado's children and youth with behavioral health challenges and their families often do not receive the integrated services and supports they need, resulting in poor outcomes and high costs.

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3What we know

• 2nd only to WY in use of institutional care (2010 AFCARS data)

• 56.3% of youth in DYC have behavioral health needs requiring professional intervention. (2011 DYC Continuum of Care Report)

• Increase in teen suicides, 49 deaths in 2009. (Kids Count, 2011)

• Children of color overrepresented in corrections and underrepresented in treatment system . (2000 Minority Over-Representation Child Welfare report, 2011 DYC Continuum of Care Report, 2009 DBH Population in Need)

High levels of placement

Poor Outcomes

Health Disparities

Uncoordinated and poor quality care

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4What we know

Themes and Recommended StepsSystem Integration

Program Availability

Prevention and Early Intervention

Cultural Responsiveness

Public Engagement

Family and Youth Partnership

Professional and Workforce Development

Data Collection and Evaluation that is outcome based Flexible Funding

Meta-Analysis of30 Colorado Reports

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5The Vision

Child and Family

Behavioral Health

Child Welfare

Youth Corrections

Education

Health

Community Supports

Colorado’s children with behavioral health challenges will reach their full potential through effective and efficient

services and supports.

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6Key Strategies

• Administrative structure to coordinate care and monitor outcomes

• Improve quality of services and supports

• Implement through cohort community based model

Trauma Informed System of Care

• Families involved at all levels from services to governance

Care Management

Entities

Trauma Informed

System and Services

Communities of Excellence

Family/Youth Partnership

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Care Management Entities

FunctionsWraparound and Care Coordination

Access to Family and Peer Supports

Provider Network Development and Management

Utilization Management

Quality Improvement and Outcomes Management

Training

May be public agency, new non-profit, existing non-profit, non-profit HMOs or for-profit organization

Coordinated with Accountable Care Organizations (Medicaid)

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8Financing

Possible Funding StreamsTitle IV-E Waiver

Medicaid

Behavioral Health Block Grant

Core and AFS

State General Funds

Youth Corrections

Indigent Mental Health Funding

Funding Methods

All inclusive case rates

Fee for service

Partial case rate/bundled

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9Trauma Informed

Click icon to add picture

What happened to you instead of what’s wrong with you?

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A History of Maltreatment is the Norm among Children and Youth in Many Systems From ACF Commissioner Bryan Samuels’ Presentation to Blueprints Conference April 2012 (Miller, EA; Green, AE; Fettes ,DL & Aarons GA., 2011. Data come from a representative sample of 1,715 youths ages 6-18 in San Diego County.

0%20%40%60%80%

100%

Any MaltreatmentMultiple Types of Mal-treatment

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The Overlap of Trauma and Mental Health Symptoms From ACF Commissioner Bryan Samuels’ Presentation to Blueprints Conference April 2012 (Griffin, Kisiel, McClelland Stolback & Holzberg, 2012)

0-6 Year Olds

7-12 Year Olds

13-16 Year Olds

17+ Year Olds

0%10%20%30%40%50%60%70%80%90%

100%

68.02%

33.45%

17.03% 16.25%

11.76%

13.81%

6.93% 6.00%

7.11%

13.56%

21.92%15.75%

13.12%

39.18%

54.13%62.00%

BOTH Trauma and Mental Health Symptoms

Mental Health Symptoms Only

Trauma Symptoms Only

NO symptoms

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Communities of Excellence

Partnership ApproachWork with cohorts of communities to plan and implement

Base services/supports with local adaptation

Culturally responsive

Communities of Excellence serve in advisory role

Similar approach to child welfare practice initiative

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Family/Youth Partnership

• Important part of treatment team

• Part of paid workforce as family advocates and youth mentors

(Voice/Choice Committee- CMP)

• Voting member of Governance Bodies

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14The Plans Align

Winnable Battles

Trauma Informed System of Care

State Plan

CDHS Strategic Plan

Department Plans

Division Plans

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15Outcomes

Outcome IndicatorsChild and FamilyImproved services and supports for children, youth and families

• Youth and families are more empowered• Improved behavioral health outcomes• Improved school attendence• Decreased trauma symptoms• Less substance use

Community LevelChildren receive the right services in the right amounts at the right time

• Reduced use of institutional care/hospitalization/emergency rooms/placement reentry

• Decrease in youth suicide• Decreased truancy rates• Decreased juvenile recidivism• Decreased use of psychotropic drugs• Increased utilization of behavioral health services for

children and youth of color

System LevelDollars saved from institutional care placements are reinvested into community based prevention, early intervention and treatment services

• More use of trained wraparound facilitators• More use of peer supports i.e. family advocates, youth

mentors• More service providers and systems trained in cultural

and linguistic competence• Trauma informed practices integrated into all child and

youth serving systems• Different use of dollars in the child serving systems

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16Oversight

TISOCCommittee of BHTC

Legislative Team

CCYIS

ResearchAnd Evaluation Team

MarketingTeam

Education and Training Team

Collaborative Management Program

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17PartnershipYour Logo Here