October 2005

Our system of care community is in the process of hiring our key family contact. We are looking for information on how other system of care communities have approached the hiring of the key family contact, sample job descriptions, and the success and challenges of implementing the key family contact position and family involvement.

The Comprehensive Community Mental Health Service for Children and Their Families Program recognizes this position as essential to the success of your system of care initiative. The position is especially crucial in light of the President’s New Freedom Commission goal that mental health treatment should be family and consumer driven. Applicant guidelines define the lead family contact as the individual responsible for setting up or working with an existing family organization, who represents the cultural and linguistic backgrounds of the target population. This position should be filled by a parent or other family member of a child or adolescent with a serious emotional disturbance who has received or currently is receiving services from the mental health system. Responsibilities include, but are not limited to working in partnership with core administrative management staff in all aspects of developing, implementing and evaluating systems of care and providing support services for families receiving services through the cooperative agreement. This key position should be staffed by one individual in a full-time equivalent position.

New system of care communities are responsible for working toward becoming family driven. The Federation of Families for Children’s Mental Health and the Child and Adolescent, Family Branch at SAMHSA are sharing the following definition of family driven:

Family driven means families have a primary decision making role in the care of their own children, as well as in the policies and procedures governing care for all children in their community, state, tribe, territory and nation. This includes :

• choosing supports, services, and providers;
• setting goals;
• designing and implementing programs;
• monitoring outcomes;
• managing the funding for services, treatments, and supports and;
• Determining the effectiveness of all efforts to promote the mental health and well-being of children and youth.

Some system of care communities decide to contract with existing local or state family organizations to hire and employ the key family contact position and coordinate other key deliverables. Other system of care communities feel the need to develop their own local family organization. The 2003 SAMSHA Guidance for Applicants defines that a family run organization is a private, nonprofit entity that meets the following criteria:

• Its explicit purpose is to serve families who have a child, youth or adolescent with a serious emotional disorder (children, youth, and adolescents who have an emotional, behavioral, or mental disorder, age 0-18; or age 21, if served by an Individualized Education Plan (IEP).
• It is governed by a board of directors comprised of a majority (at least 51 percent) of individuals who are family members.
• It gives preference to family members in hiring practices.
• It is incorporated as a private, nonprofit entity (i.e., 501C)

The following are examples of system of care community approaches to hiring a key family contact and implementing family involvement.

Family Organization Example

A Statewide Family Organization was included in planning meetings with the lead agency for development of a cooperative agreement application, and the two groups worked in partnership to ensure additional family participation that represented the community and target population. Once the system of care received its award, the lead agency established a contract with the Statewide Family Organization to hire the key family contact position and additional family partners. It was important that the key family contact who was hired represented the population and community. Deliverables in the system of care contract included establishing a local family organization chapter; ongoing focus group meetings with families; raising public awareness and decreasing stigma; participant supports for participating in system of care governance meetings; family partners providing direct one to one support and advocacy with enrolled families; and establishing partnerships across the child serving agencies to become family driven. This model’s successes are:

• a key family contact representing the community and target population who receives ongoing support and supervision from the statewide family organization
• the development of a local family organization chapter representing the diverse cultural and linguistic backgrounds of the community
• an increase in the number of diverse family representatives participating on governance boards and public awareness activities
• the presence of skilled family partners working in collaboration with care coordinators by providing intensive one-to-one support, resources, and advocacy to enrolled families
• partnerships between families and professionals in evaluation and social marketing

Some of the challenges in working towards this model have included:

• understanding the need for the key family contact to attend all governance and core management team meetings
• establishing realistic deliverables and funding capacity for the family organization contract
• engaging professionals to attend family and professional partnership trainings and model new relationships
• coordinating meetings for times that are convenient for working families

County Government Agency Example

The county mental health government is the lead agency for one system of care and has worked with a number of local and statewide family organization representatives in their strategic planning. Once county mental health received the award, they chose to hire a key family contact internally that would partner with families and the existing family organizations to ensure their system of care initiative would become family driven. In this model, the key family contact was employed as a county government employee. The key family contact worked directly with families and as a contract liaison with other family organizations and direct provider agencies delivering family involvement components. This model’s successes are:

• a key family contact representing the community and the target population who has nonprofit and community organizing experience
• the establishment of a family driven coalition of family members and diverse family organizations that support the target population
• a number of contracts to local family organizations providing direct support and advocacy, with enrolled families representing the target population
• ongoing training and technical assistance opportunities for system of care community agencies, families, and family organizations on system of care transformation and partnership.

Some of the challenges in this model include:

• key family contact gaining trust and collaboration with existing family organizations
• infighting and competition between family groups and organizations
• families feeling that they are meaningful, respected partners in governance and decision-making

It is impossible to provide one job description for hiring of key family contact positions across the country because of the uniqueness of each community’s existing family involvement structures and/or family organization relationships. It is important for the community to complete a community assessment on family involvement before determining job descriptions, roles, and responsibilities. Below are some sample job descriptions and resources that may help as your community defines the key family contact position and other family leader positions.

• Family Involvement Coordinator (Key Family Contact) Sample Statewide Family Organization Job Description
• Family Involvement Coordinator (Key Family Contact) Sample County Government Job Description
• Family Support Specialist Job Description
• Working Definition of Family-Driven Care
• Family Involvement in the Child Mental Health Initiative