Statewide Children’s Wraparound Initiative COSA Conference Presenters: Erinn Kelley-Siel Mary Lou Johnson Larry Sullivan.

Statewide Children’s Statewide Children’s Wraparound InitiativeWraparound Initiative

COSA Conference Presenters:COSA Conference Presenters:Erinn Kelley-SielErinn Kelley-Siel

Mary Lou JohnsonMary Lou JohnsonLarry SullivanLarry Sullivan

BackgroundBackground

Fragmented and duplicative systems.Fragmented and duplicative systems. Children served in most restrictive Children served in most restrictive

environments.environments. Cost and outcome data not linked.Cost and outcome data not linked. Public policy making not well Public policy making not well

informed.informed. Service delivery inefficient.Service delivery inefficient. Outcomes not what we would like to Outcomes not what we would like to

see.see.

Governor’s Governor’s Executive OrderExecutive Order

Created a Steering Committee.Created a Steering Committee. Called for a plan to:Called for a plan to:

1.1. Provide supports as early as possible.Provide supports as early as possible.

2.2. Base plans on individual needs.Base plans on individual needs.

3.3. Maximize resources.Maximize resources.

4.4. Hold systems accountable for Hold systems accountable for outcomes.outcomes.

MissionMission

To build capacity to effectively To build capacity to effectively serve children, youth and their serve children, youth and their families through a governance families through a governance structure that oversees structure that oversees coordinated policy development, coordinated policy development, comprehensive planning, and comprehensive planning, and collaborative budgeting for collaborative budgeting for children’s services.children’s services.

System of CareSystem of Care

A comprehensive spectrum of A comprehensive spectrum of mental health and other necessary mental health and other necessary services which are organized into a services which are organized into a coordinated network to meet the coordinated network to meet the multiple and changing needs of multiple and changing needs of children, youth and their families.children, youth and their families.

WraparoundWraparound

Wraparound is an approach to Wraparound is an approach to implementing individualized, implementing individualized, comprehensive services within a comprehensive services within a system of care for children and system of care for children and youth with emotional and youth with emotional and behavioral problems. behavioral problems.

Target PopulationTarget Population

Children and youth birth to 18.Children and youth birth to 18. Emotional, behavioral, substance Emotional, behavioral, substance

abuse related needs.abuse related needs. Involved in at least two systems.Involved in at least two systems. At risk and those who already have At risk and those who already have

a diagnosed problem.a diagnosed problem.

OrganizationOrganization

16-member Steering Committee.16-member Steering Committee. Four subcommittees – finance, Four subcommittees – finance,

local implementation, cultural local implementation, cultural competency, data & evaluation.competency, data & evaluation.

Project team.Project team. National experts.National experts.

FrameworkFramework

System of Care Values and System of Care Values and Principles.Principles.

Cultural Competency Standards.Cultural Competency Standards. Family and youth voice.Family and youth voice.

Shared Shared RecommendationsRecommendations

Serve all children.Serve all children. Generate family-driven and youth-Generate family-driven and youth-

guided individual plans.guided individual plans. Include culturally competent, non-Include culturally competent, non-

traditional services.traditional services. Blend funds.Blend funds. Monitor outcomes.Monitor outcomes.

Finance Finance RecommendationsRecommendations

Purchasing collaborative.Purchasing collaborative. Market assessment.Market assessment. Strategic finance plan establishing Strategic finance plan establishing

infrastructure that supports system infrastructure that supports system design.design.

Blended funding pool (education, Blended funding pool (education, child welfare, juvenile justice, child welfare, juvenile justice, mental health).mental health).

Local Implementation Local Implementation RecommendationsRecommendations

Electronic record for service Electronic record for service information.information.

Adopt Values and Principles Adopt Values and Principles statewide.statewide.

Connect service across a child’s Connect service across a child’s developmental stages.developmental stages.

Build local governance structure to Build local governance structure to implement system of care.implement system of care.

Local Implementation Local Implementation RecommendationsRecommendations

Manage care through care Manage care through care coordination – one facilitator for coordination – one facilitator for each child and family team.each child and family team.

Establish a basic benefit package.Establish a basic benefit package. Put resources into a Family and Put resources into a Family and

Youth Organization.Youth Organization. Create accountability mechanisms.Create accountability mechanisms.

Cultural Competency Cultural Competency RecommendationsRecommendations

Adopt culturally appropriate Adopt culturally appropriate services statement.services statement.

Adopt culturally competent Adopt culturally competent standards.standards.

Develop process to review Develop process to review traditional practices.traditional practices.

Identify ways to improve culturally Identify ways to improve culturally appropriate care.appropriate care.

Data & Evaluation Data & Evaluation RecommendationsRecommendations

Create standard data sharing Create standard data sharing agreements.agreements.

Create one or more entities at Create one or more entities at state level to review and select state level to review and select outcomes.outcomes.

Evaluate and adjust state Evaluate and adjust state workforce strategies.workforce strategies.

Develop and maintain two-tiered Develop and maintain two-tiered data system.data system.

Key indicatorsKey indicators

Educational/vocational progress.Educational/vocational progress. Stable, homelike environment.Stable, homelike environment. Safety.Safety. Out of trouble.Out of trouble. Social/interpersonal support.Social/interpersonal support. Mental/behavioral health.Mental/behavioral health. Individual needs met.Individual needs met.

Role of EducationRole of Education

Key partner in the collaborative.Key partner in the collaborative. Schools at the “center” of the child-Schools at the “center” of the child-

serving system.serving system. Shared accountability with other Shared accountability with other

child-serving systems.child-serving systems. Investment of local dollars to Investment of local dollars to

leverage additional funding.leverage additional funding. Schools are where children and Schools are where children and

youth need to be in order to youth need to be in order to succeed.succeed.

Critical issuesCritical issues

Development or enhancement of Development or enhancement of management information system.management information system.

Identification of state and local Identification of state and local leaders.leaders.

Creation of blended funding structure.Creation of blended funding structure. Adoption of culturally competent Adoption of culturally competent

standards.standards. Establish community readiness Establish community readiness

criteria.criteria.

Path to ImplementationPath to Implementation

Establish/fund implementation team.Establish/fund implementation team.– Complete market assessmentComplete market assessment– ID management information systemID management information system– Calculate size of system contributions Calculate size of system contributions

for blended fundfor blended fund– Develop protocol for moving funds into Develop protocol for moving funds into

the poolthe pool– Analyze administrative rules and Analyze administrative rules and

statutesstatutes

Oregon will haveOregon will have

Single point of contactSingle point of contact Family and youth voice and choiceFamily and youth voice and choice Least restrictive placementsLeast restrictive placements Coordinated servicesCoordinated services Blended resourcesBlended resources Infrastructure in placeInfrastructure in place Agencies and organizations that Agencies and organizations that

are accountable for outcomesare accountable for outcomes

Questions?Questions?

http://www.oregon.gov/dhs/mentalhealth/wraparound/main.shtml