Early Childhood System of Care Communities Networking Meeting at the Georgetown Training Institutes
July, 2006

The Early Childhood Community of Practice met twice during the 2006 Georgetown Training Institutes. A planning group developed the agenda that consisted of topics from past calls and listserv discussions. All of the early childhood system of care communities, as well as other system of care communities, were present for one or both meetings. In the second larger meeting, a general discussion took place initially and then the group broke into sub-groups to discuss topics chosen by the planning committee and the outcome of the general discussion.

The following are comments/discussion items from various system of care communities.

Colorado
Partnerships are key

• Define roles, eligibility criteria of each agency
• Explore lessons learned from older sites on handling children pre-diagnosis
• BLOOM part of Quality CC Coalition that developed a training assessment, use wraparound to build on existing relationships with families

Vermont

• Know the context; scan all EC providers; by pooling resources one can go beyond MH System
• Gather EC people right away to gather input on outcomes
• Billing using V codes helps
• SOC for all young kids vs. a SOC for kids with MH
• Use DC-03-R
• Communicate/market mental health as health
• Focus on how joining in ECMH can reduce the number of special education children
  • Be strategic & tailor SOC to interests of different stakeholder groups

General Resources on effective marketing tools including Project Bloom website, Michigan Developmental Wheel, Bright Futures, DC 0-3-R

Florida
Convened a task force to develop a strategic plan→ policy for children 0-5;
Rates were increased;
Developed cross-walk between DC 0-3-R and DSM IV to bill;
Partnered with Children’s MH Director.
Cultural issues related to diagnosis
How to serve kids in the interim before providers/stakeholders are on board?

• At. risk of or beginning to display symptoms
• Link MH-->IEP qualifying criteria
• Upper level buy-in from education and other systems

Oregon
Include focus on other areas of delay (speech/language) that impact Social Emotional Development to access special education

Rhode Island
Connected to advocacy organizations and look for common interests, including www.NCTSN.org for trauma;
Hire family service workers from same cultures as in community;
Hire “cultural brokers”;
Connect with ‘already trusted’ supports;
ASQ-translated into many languages

Child Welfare Linkages

Los Angeles
Child welfare is a key player in their work but service guidelines and funding mechanisms can present challenges;

Vermont
CW may also subsidize CC slots to use money to provide ECMH consultations
Expulsion prevention-role of consultation → for CW placement stability
As a graduated site we are in position to lobby;
Focus on EPSDT “outreach administration” can fund outreach including ECMH consultation.

Oregon
Investigators do ASQ
Colorado
CW representative on all committees which leads to better collaboration;
Facilitate connections using the “Family Guide to Child Welfare System” by Jan McCarthy, et al on the GUCCHD website;

Allegheny County
Family Group Decision making process;
Link back to EPSDT

Rhode Island
Need to educate pediatricians

General Comments
Missing cultural competence coordinator as a key position;
Need to link with adult system to focus on parents/families’ mental health & substance abuse issues.

The following are sub-group notes:

Prevention, Early Intervention & At Risk

• Who makes eligibility decisions?
• What is the intake structure that works best
• Hub model?
• Team decision?
• What are effective tools?
• Confidentiality issues
• The diagnosis or "label" of SED in an infant - 3 yr old is difficult
• Special Ed has intake system/possibly build on that

 

• Use imminent risk-look at definitions from Part C & B & Psych & research criteria
  • Find viable tool(s) to quantify “at-risk”
• CAPTA- EPSDT, TANF provide opportunities for serving children at high risk- who is maximizing these opportunities?
• Family dyad is “population” – issues of billing and grant requirements;
• Look at cost benefit as a sustainability strategy;
• Use list serve to share strategies/concerns;

Speak with Gary Blau and CCC to get SAMHSA buy in around imminent risk and family dyad needs.

Service Delivery

• Explore different models and evidence-based practices;
• Facilitating smooth transitions to next level of care;
• Connection with primary care;
• Find common language- health, MH, ED, CW, etc.;
• Broaden system to address promotion and prevention;
• Use a Service Coordination/wraparound model
  Fragmentation

Training

• Definition- what training is needed & to whom
  • Who provides
  • What this entails
    • Make this connect w/ SOC marketing
    • Families both as recipients and providers
• Use of TA Coordinator
  • Work across regions
  • Bring in and share good resources
• Focus on treating families
• Certification- CA- standards
  • VT- competencies
  • MI- standards
• Look at EC expertise across systems
• Address need for competencies
• Link with ECCS
• Talk w/SAMHSA/TAP about EC track at future meetings
• Share resources-email
• Post resources on TAP & Georgetown websites

Family/Youth

Sub-Topics:
Family Involvement-Provide skills development for fathers and mothers;
Explore family engagement strategies;
Business skills development needed for family organization administration;
Youth Involvement-Role of the Youth Coordinator.

Challenges:
What does youth involvement look like in an EC site?;
Funding for Youth Coordinator and youth related activities;
How to provide a meaningful voice for children birth to eight;
Hiring full time Youth Coordinator who may still be in school;
How to engage diverse families and youth from communities that will be receiving services, in SOC planning and decision-making;
Expanding opportunities to engage fathers;
How to deploy human resources in a culturally competent manner when connecting with communities of color?

Strategies:
Hire full time youth coordinator, or no less than half time youth coordinator;
Have a dedicated budget for youth work/activities with the youth coordinator having responsibility and authority for budget and obtaining input from youth in making budget decisions;
Potential recruits to serve in role of Youth Coordinator:

• Sibling of young children in care;
• Someone who had been in the system when young (between birth to eight) and able to represent the needs of young children from that experiential perspective;
• A teen or young parent representing themselves as a family member and their child who is the recipient of services and supports in the system currently;
• An advocate, spokesperson, mentor, teacher, leader for and of young children;
• Recruitment of youth to represent young children and their needs/challenges as a strategy for workforce development, to develop youth leadership through mentoring for future leadership role in the system of care;
• Youth role in grant-writing and fundraising and social marketing activities.

Also seek other ways to expand youth involvement by including representative youth voice and hearing from older youth who are still in the system (i.e. foster care, juvenile justice, mental health, etc)

• Ask them what could have been different.
• They bring a different voice and perspective than families.

In reaching to our communities of color, suggestions were:

• Go to the communities and connect with leaders
• "Ask them” about needs/challenges/ideas/etc. via focus groups
• Convene community gatherings; socials, provide food

Resources for Family and Youth Involvement:
Rhode Island Program, “Youth Speaking Out” started in 1996; and “Nothing About Us Without Us” youth leadership training;
Allegheny County “PYT” and “CCF” Programs for youth;
Statewide Family Network membership.

Next Steps for Family and Youth Involvement:
Family and Youth Involvement Sub-Group conference calls;
Establishment of email group to share resources;
Use of TA Partnership Early Childhood webpage to post resources;
Use of TA Partnership Early Childhood listserv.

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Overall Next Steps

Regular monthly conference calls will be resuming soon. The topics and schedule will be posted on this webpage. Other suggested next steps are:

• Broader Listserve
• Use TA Partnership website
• EC Webpage
  • Discussion Room
  • Listserve
  • Conference Calls
• Include other sites/programs/initiatives