Southern Region Child welfare & mental Health Learning Collaborative

May 30, 2014Setting the vision: Exploring outcome measures for the implementation of the Pathways to mental health core practice modelDawn Schoonhoven Scott, M.S.W.Mary Garrison, M.S.S.W.1 minuteIntroduce ourselves, our roles in PCWTA and in relation to Katie A.1Southern Learning collaborativeImperialLos AngelesOrangeRiverside San BernardinoSan DiegoVentura

2 minutes

There are four counties in the Southern region that are formally in the learning collaborative. Our Southern counties had been meeting to plan for implementation of the Core Practice Model prior to the start of the formal learning collaborative and we elected to continue to meet as a region and rely on Ventura, LA, Orange and San Diego to represent the Southern Region at the Statewide meetings and share feedback with the rest of the region from the state.

2Southern LC: What its all about3 meetings thus farTopics covered:Planning and preparationTeaming and Child and Family TeamsScreeningOutcome Measures and Indicators of SuccessPCWTA develops:Agenda for each meetingPowerPoint template for reports/sharingResearch and literature review

2 minutesWe have met in August 2013, December 2013 and April 2014. We are currently planning our October-2014 session.

Our sessions have covered topics including Planning and preparing for implementation of the Core Practice Model; Teaming and Child and Family Teams; Screening; and Outcome Measures and Indicators of Success.

At each session our counties use a PowerPoint template provided by PCWTA to report out on key topics. This allows each County to provide a succinct, structured update regarding their implementation process including successes, barriers/challenges, fiscal/budgetary updates, and other key updates related to the topic of the day.

3OUTCOME MEASURES & Setting the vision

2 minutes

We discussed in our initial sessions the importance of being clear about what the vision of this implementation will be as a region and as individual counties. We agreed that we wanted to be clear on the outcome measure and the indicators of success so that as we are planning the implementation process and training our work force, we would be able to set a clear vision for what it will look like when we are effectively collaborating across child welfare and mental health and what it will look like when we are effectively teaming with families, keeping the child/youth and familys voice at the center of our work through the use of Child and Family Teams, and ultimately better meeting the mental health needs of children and youth involved with Child Welfare Services.

Part of our April session was focused on this topic.

In preparation for the learning session, PCWTA researched this topic and identified several tools that have been developed to measure outcomes related to:Collaboration across child welfare and mental healthChild and Family Team meetingsWRAP meetings

At the learning collaborative session we provided an annotated bibliography and shared themes in the research. We also asked our learning collaborative participants to engage in an activity to review and think through the possible use of several tools. We provided each table group with several tools and asked them to get into pairs, select a tool to review in their pair and use a handout that asked several questions about what works about the tool, what worries them, what upgrades they would make to it to better meet the needs of their County. After completing the questions for their tool as a pair, each pair reported out on their tool to their table group and they taught one another about the tool they reviewed. The collaborative members identified some tools that they felt would support their implementation process and some that they felt would not. They identified key themes that felt helpful including some tools were succinct, the tools measured process and content, the tools measured inclusion of family voice, some tools included a way to observe concrete behaviors and actions during meetings in order to give clear feedback to a meeting facilitator and the team about strategies for improvement. 4Tools to considerTools measuring family-centered meetings:Arizona Child and Family Teams Supervision ToolAlmanac County Family Centered Meeting Survey Illinois Statewide Technical Assistance Center Wraparound Integrity ToolWraparound Fidelity Assessment System Team Observation MeasureTools measuring collaboration across systems:Collaborative Working SurveyMulti-agency Team Tool Kit Tools measuring youth voice:The Youth Participation in Planning scale (YPP)The Youth Empowerment ScaleMental Health (YES/MH)

3 minutesArizona Child and Family Teams Supervision Tool - allows supervisors to measure employee progress toward achieving proficiency in targeted skills required throughout the CFT process. It is lengthy and it describes concrete behaviors that the supervisor will see which indicate progress. Almanac County Family Centered Meeting Survey one page survey to be completed by meeting participants which includes 17 questions regarding how the meeting went including logistics regarding the meting, facilitation, group dynamics, and the plan that was developed. Illinois Statewide Technical Assistance Center Wraparound Integrity Tool is a tool that asks questions regarding engagement and team preparation, initial plan development, plan implementation and refinement and transition. The tool is intended to be used four times throughout the life of the referral to wraparound. Wraparound Fidelity Assessment System, Team Observation Measure is an observation tool that can be used during a team meeting. It covers 17domains including team process and composition, facilitation, decision making, the participation of natural supports in the team, shared responsibility, cultural and linguistic competence, youth and family voice and a focus on strengths among others.Collaborative Working Survey a brief, one page survey of 18 questions which can be used with the members of a multi-agency team to rate collaborative relationships. Multi-agency Team Tool Kit includes a survey for evaluating multi-agency collaboration as well as additional tools to measure leadership and/or stakeholder engagement, project management and includes concrete steps to overcome obstacles to collaboration. The Youth Participation in Planning scale (YPP) - whichassesses youth perceptions of whether interdisciplinary teams that create service, care, or treatment plans support meaningful youth participation in the planning process The Youth Empowerment ScaleMental Health (YES/MH) - which is designed to assess young peoples perceptions of capacity and confidence with respect to managing their own mental health conditions, and working with providers to optimize services and supports. There are reproducible versions of the measures for both the YPP and YES/MH (there is no charge to use or reproduce the measures).

5themes in selected toolsTools measuring family-centered meetings:Explanation of purpose of meetingClarity regarding roles of each person in the meeting and action plansFeeling heard/listened toParticipated in setting up ground rules/rules are followedTiming/pace of meeting is reasonableStrengths-focused Included natural supportsConcerns are clear Plans focus on concerns and strengths Facilitator is prepared/knowledgeable/upholds rules2 minutesTools measuring family-centered meetings:Explanation of purpose of meetingClarity regarding roles of each person in the meeting and action plansFeeling heard/listened toParticipated in setting up ground rules/rules are followedTiming/pace of meeting is reasonableStrengths-focused Included natural supportsConcerns are clear Plans focus on concerns and strengths Facilitator is prepared/knowledgeable/upholds rules6Tools measuring collaboration across systems Demonstrated willingness to learn from one another/respect expertise of other team membersDirect, honest and respectful communicationWillingness to compromise in order to meet goalsShared vision and missionMembers share resources/information/knowledgeAccountability to complete action stepsCommitment to collaboration and the overarching goalsMembers are recognized and appreciated for contributionsConveys respectClear roles

themes in selected tools2 minutesTools measuring collaboration across systems Demonstrated willingness to learn from one another/respect expertise of other team membersDirect, honest and respectful communicationWillingness to compromise in order to meet goalsShared vision and missionMembers share resources/information/knowledgeAccountability to complete action stepsCommitment to collaboration and the overarching goalsMembers are recognized and appreciated for contributionsConveys respectClear roles

7Themes in selected ToolsTools measuring youth voice:Youth are have a pre meeting with someone they trust to help them think through how they want to express themselves and what they want to sayPlans reflect their choices and top goalsDecisions are not held to once they are made with the youthLanguage that is understandable is used during meetingsI have ideas about how to address my mental health and emotional needs and these ideas are incorporated in my treatment plansI understand how my services are supposed to be helping me and when they are not helping, I know who to talk to

2 minutesThe two tools that we are sharing which help measure youth voice and youths perception of their mental health are succinct tools which measure very important elements of youth participation in planning with their team and in their own mental health.

Some of the key themes that emerge in these tools are the following indicators that a youth perceives that they have an equal role and voice in their team and in their mental health treatment/planning:Tools measuring youth voice:Youth have a pre meeting with someone they trust to help them think through how they want to express themselves and what they want to sayPlans reflect their choices and top goalsDecisions are not held to once they are made with the youthLanguage that is understandable is used during meetingsI have ideas about how to address my mental health and emotional needs and these ideas are incorporated in my treatment plansI understand how my services are supposed to be helping me and when they are not helping, I know who to talk to

8Successes & DriversOutcome Measures Matrix from the State offers some directionCounty workgroups are discussing this topic in their implementation teamsCounties are aligning this discussion with existing goalsRegional Learning Collaborative Sessions offer a time to share/explore this topicPCWTA has provided materials/researchSome counties have selected tools provided at the recent learning session to pilot during implementation1 minute9BarriersCounties report that they are anticipating clear direction from the State on outcome measuresIt is challenging to evaluate and link child/youth outcomes to a particular change in practiceSome counties report that building a shared vision across Child Welfare and Mental Health is difficult to operationalize and this is inhibiting the process of identifying consistent outcome measures

1 minute10ClosingQuestions?

Closing5 minutesOur next Southern session is scheduled for October-2014. We will continue to explore and define the indicators of success and outcome measures and this will shape our implementation process. 11