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System of Care in North Carolina with Story

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BHRP UNC School of Social Work

on 30 September 2015

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Transcript of System of Care in North Carolina with Story

System of Care in North Carolina
System of Care is...
Community Framework
Local Community Collaboratives
Child and Family Teams
Family and Youth Support, Education, and Voice
Effective, evidence informed services and supports
Community Collaboratives
Develop local priorities based on local data and trends.
Develop strategies to fill service gaps.
Support family and youth voice in all levels of planning.
Support care review committees.
Develop community wide training plans.
Develop memorandum of agreement to improve Child and Family Teams and system-wide collaboration.
Community Collaboratives
Local solutions to local concerns

Better coordination and a full array of quality services
and supports =better outcomes
Child and Family Teams
A Child and Family Team develops a plan that supports the family and young person' s goals; striving to keep children and young people with complex needs in their home communities with meaningful connections to people and activities. The Child and Family Team leads to the development, implementation, and monitoring of a youth centered/family focused action plan.
Who is on a Child and Family Team
Child, young person, or emerging adult
Family, friends, and supporters of the caregiver and child, young person, or emerging adult
Professional staff connected with the family: social workers, court counselors, teachers, Guardian ad Litems, mental health providers

The family has the final say on team membership though family members need information on why membership matters.
Child and Family Teams
Family Partners
Family Partner is defined as a caregiver/parent of someone who has received services and therefore has firsthand experience within the child and family system, or who has gone through the system themselves. (NC Families United)
Family Partners
For parents and caregivers: Family partners provide information, a listening ear, support in navigating services, guidance, and hope.

For system partners: Family partners provide trainings, insight into the gaps and challenges of the system, and a connecting bridge to families.
Evidenced-Informed Services
Very young children, school-aged children,young people, and emerging adults with behavioral health challenges and their families deserve quick and easy access to effective, community treatments.
Evidenced Informed Services
Supports in the Community
Communities Can Combat Stigma
SAMHSA's Key Messages:
Behavioral health is essential to health.
Prevention works.
Treatment is effective.
People recover.

Strategies: newspaper articles, art shows, trainings including
Youth and Adult Mental Health First Aid
State System of Care Framework
State Collaborative
NC Families United
NC Youth Move
System of Care Coordinators in LME/MCOs
State SOC Coordinator
SOC Expansion Planning Grant
State Collaborative
The North Carolina State Collaborative for Children and Families, through a System of Care framework, provides a forum for collaboration, advocacy and action among families, public and private child and family serving agencies and community partners to improve outcomes for all children, youth and families.
NC Families United
North Carolina Families United is the Statewide Family Network and the state chapter of the National Federation of Families.

NC Families United is a family support and advocacy organization.
Mission of NC Families United
Link families to state and community partners for the purpose of improving the lives of children, youth, and families with emotional, behavioral, or mental health needs;
focus active attention on the unique strengths and needs of these children and their families by educating and advising policy.
NC Youth Move
Supports young people 14-26 years with support and skill building including leadership training and transition mentoring. Transition mentoring is mentoring with agency staff
and a peer mentor.
A transition plan is developed with and not for the youth and family and is strength based and uses unique strengths, values, attitudes and preferences of the child, family/caregiver and the community.
Why System of Care?
Improvements for Children and Young People
Decreases in emotional and behavioral symptoms.
Increase in strengths including improved relationships with adults and peers.
Young people who have experienced trauma showed better functioning and reduced suicidal thoughts/attempts.
Improvements in school attendance and grades as well as reduction in suspensions and detentions.
Improvements for Young People

Family driven and youth guided care
Culturally and linguistically competent care
Community based services

Reduced recidivism for youth involved with juvenile justice.
Young people involved with social services showed increased stability in their living situation including fewer out of home placements as well reduced emotional and behavioral symptoms and improved school functioning.
Improvements for Caregivers
Improvements in family life including reduction in caregiver stress and increased capacity to handle the child's or young person's challenges.
Increased problem solving.
Increased support from family and friends.
Increased ability to work and meet financial needs of the family.
Improvements for Caregivers
When caregivers receive support from
family partners
, they report improved:
engagement in services
skills in handling their child's behaviors
satisfaction in services
Improvements for the System
Opportunities for improved accountability
Expansion of home and community based services
Development of inter-agency agreements to improve coordination
Increases in use of evidenced -informed interventions
Decrease in use of residential care
What if System of Care isn't working
well in my community?
Work together to fix it
Reinvigorate your Community Collaborative. Enhance membership to include more family and youth voices. Include decision makers in agencies and communities.
Gather information from families and young people who are using the systems.
Use available data to understand challenges and strengths (DJJ Risk and Needs summary, DSS annual data, LME/MCO utilization and outcome data) of your community.
Use existing tools
Explore the Reclaiming Futures framework of using data to understand how young people move through the system in order to improve protocols and try new strategies to get improved outcomes.
Use learnings from counties involved in Project Broadcast and REAP. Look to the learnings of Alamance and Durham System of Care grants to consider strategies for the very young and transition age youth.

System of Care is an adaptable framework which
can be used to support other populations as communities enhance their skills in meeting the needs of young people with complex behavioral health challenges.

History of System of Care Initiatives
Since the early 1990s, NC has been involved in multiple SAMSHA grants to develop local systems of care.
In the last decade there have been 3 additional SAMSHA funded county projects in Mecklenburg, Alamance, and Durham Counties.
Alamance (0-5 years) and Durham (transition to adulthood) have focused on specific ages.

Adapt System of Care for Managed Care
Potential for use of performance and outcome based contracts with providers.
Use of savings for additional supports for families.
Increase use of evidenced informed practices.
Move beyond only considering services for children covered by Medicaid.
We can and must do better for our children and young people with mental health and substance abuse challenges and their families.

System of Care offers a solution!
Stroul,B., Goldman,S.,Pires, S.,& Manteuffel,B. (2012).
Expanding system of care: Improving the lives of children,youth, and families
. Washington,DC: Georgetown University Center for Child and Human Development, National Technical Assistance Center for Children's Mental Health

Stroul,B.,Blau,G.,& Friedman,R. (2010).
Updating the system of care concept and philosophy
. Washington,DC: Georgetown University Center for Child and Human Development, National Assistance Center for Children's Mental Health

North Carolina Families United at www.ncfamiliesunited.org
North Carolina Collaborative for Children, Youth, and Families at
Local questions can be addressed to the System of Care Coordinator at your Local Management Entity/Managed Care Organization (LME/MCO) or the Director of your LME/MCO.

State questions can be directed to the Division of Mental Health/Developmental Disabilities/Substance Abuse Services at 919-715-2774
or NC Families United at 336-395-8828.
Thank you!
Marla's Story
Marla's Story
What this Community Did Right
Universal mental health and substance abuse screening for a high risk groups.
All the professionals involved had knowledge of how trauma effects behavior and used that knowledge in their work.
All members of the Child and Family Team respected Andrea and put the family in charge of their goals.
Evidenced-informed trauma treatment was available.
The community supported juvenile justice involved young people with a meaningful rewards in its graduated rewards and sanctions plan.
Access to family partners.
The Local Management Entity/Managed Care Organization (LME/MCO) supported providers going to the psychiatric hospitals to make connections before discharge.
The community supported high quality Child and Family Teams and focused their efforts on helping young people stay in their homes and communities.
In a different community, this family's journey could have been very different with potentially devastating results.

Doesn't every child and young person with complex needs deserve to live in a community that actualizes the system of care values?
Build plans on the interests and strengths of the family and child or young person.
Create safety and crisis plans.
Change plans when they are not working.
Celebrate successes.
Behavioral Healthcare Resource Program
School of Social Work University of North Carolina at Chapel Hill
A project of the NC Division of Mental Health, Developmental Disabilities and Substance Abuse Services
A spectrum of effective, and community-based supports and services
For children and young people 0-21 years and their families
With or at-risk for mental health and substance abuse challenges
These services and supports:
are organized into a coordinated network
build meaningful partnerships with families and youth
address families' cultural and linguistic needs
All to the purpose of helping young people with behavioral health challenges function better:
at home
in school
in the community
and throughout life
Stroul, Goldman, Pires, and Manteuffel, 2012
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