Technical Assistance Partnership for Child and Family Mental Health |
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Transformation Equation ~ T = (V+B+A) x (CQI) 2 | |
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DATE: August 26, 2004 TO: Interested Parties FROM: Gary M. Blau, Ph.D. Chief, Child, Adolescent and Family Branch SUBJECT: Transformation Equation ~ T = (V+B+A) x (CQI) 2 Branch initiatives aligned with SAMHSA directives to focus on transforming children's mental health As we move through the summer months I would like to share with you my thoughts about the direction the Child, Adolescent and Family Branch is taking to support the transformation of children's mental health called for in the Final Report of the President's New Freedom Commission “ Achieving the Promise: Transforming Mental Health Care in America, ” and being championed at the federal level by SAMHSA and CMHS. At our System of Care Community meeting in June, I described the key components necessary to move us in the direction of this transformation. Starting with a set of values and immutable principles, transformation is the combination of vision, a strong belief in the work we do and tangible action at the federal, state and local level. Driving these important elements is a commitment to continuous quality improvement. Put simply in the form of an equation ~ T = (V+B+A) x (CQI) 2 ~ As Branch Chief I have a fairly straightforward goal – ensuring as much as possible that these elements are a part of everything we do. In order to do this I am asking for your support, your help, and your active modeling of this transformation at the local and state level. So much of transformation is about developing the partnerships and collaborations that are needed to ensure that strong systems of care endure long after federal funding comes to an end. As I said in San Francisco , the true outcome of the System of Care program is not about what happens during the six years of federal funding, but rather it is about what happens during the six years after federal funding. Vision + Beliefs + Action (V + B + A) Here at the Branch we have been working to update our vision and mission to more accurately reflect the federal direction of transforming mental health in America . I want to share our vision with you and encourage you to share it with your colleagues. The clearer we can all be about our direction the more likely we are to achieve success.
Continuous Quality Improvement (CQI) 2 As you can see, we have an ambitious, yet I think ultimately achievable, vision and mission. If we are to truly embrace collaboration, family involvement and cultural and linguistic competence, we must be fundamentally committed to taking a continuous quality improvement approach to ensure that our actions reflect our beliefs and values. In the Transformation Equation (CQI) is squared for a reason – we must continually ask ourselves if the resources and technical assistance we provide are meeting the mark. Quite simply, we must continually ask ourselves if we are most effectively meeting the needs of those who have accepted the challenge of working to make systems of care a reality in local communities. Youth and Family Involvement One of the key ways we can better ensure continuous quality improvement is by incorporating the voice of youth and families into everything we do. Not only must we listen to the voices of families and youth about their experiences with transforming mental health services, we must involve them in the design of the transformation. We must ensure that we have a vibrant feedback loop that incorporates their experiences, good or bad. We need to make sure our efforts are practical, meaningful and family driven, which means that we must continue to refocus our evaluation questions on those factors that families are telling us are the most meaningful. Branch Initiatives “There are two ways of constructing a system of care; one way is to make it so simple that there are obviously no deficiencies, and the other way is to make it so complicated that there are no obvious deficiencies. The first method is far more difficult.” —Adaptation of a quote by Sir Anthony Richard Hoare of Oxford University In this memo I would like to identify some of the ways we are working to actualize the elements of the transformation equation. My commitment to you is to ensure that the work of the Branch and those who work for and with the Branch is meaningful, easy to understand and based on our vision and beliefs. Strategic Approach The knowledge you are gaining from the day to day, front line work you are doing to help transform mental health through the development of systems of care is truly awe inspiring. More important, it is the type of knowledge that collectively will help give us the wisdom necessary to effectively shape the future of the service delivery system for youth and families across America . We need to listen, and listen well, to the knowledge you are gaining. As part of the vision and focus for the Branch, we have incorporated several strategies to help ensure that we are indeed listening to the knowledge you are gaining at the tribal, state and local level. Our strategies are focused on six areas. They are:
Council on Coordination and Collaboration (CCC) Charged with Developing Strategies The mission of the CCC is to help the Branch and the funded communities envision and implement comprehensive systems of care for children and their families, through a team process of collaboration which puts the communities at the center of a coordinated approach to technical assistance and support. The CCC is comprised of the leaders from all contracted technical assistance centers and includes 10 additional representatives from the field. For each strategic area as described above, we must be relentless in our customer focus. It is not enough for us to say we want to improve the way we do business. We must lead by example. As such, I have charged the CCC with the important task of identifying specific strategies for addressing each area in ways that incorporate our vision, beliefs and actions in a strategic planning and implementation process that is family driven and is focused on continuous quality improvement. The following identifies the specific work group and the identified chair/co-chair:
Each Work Group is staffed by a member of the Branch, and is developing a specific action plan that will guide efforts for the next year. This action plan will then be used to evaluate the progress being made in the program. Copies of the action plans will be available soon on the TA Partnership website (www.tapartnership.org). Federal Site Visits The Branch is committed to improving the site visit process to ensure that the most relevant information is obtained in ways that are productive and meaningful for both the federal government and your grant or cooperative agreement. Toward that end, a detailed Site Visit Protocol has been established, as well as Report Guidelines. It is my hope that the funded communities see a site visit as valuable, and that the recommendations and lessons learned become blueprints for continued system reform efforts. Twenty Years of Growth In the past twenty years we have come a long way in strengthening systems of care. We are seeing more and more examples of families who have been involved in the service delivery system participating on governing boards, legislative committees and providing services. We are beginning to see the meaningful involvement of youth. Most telling, we have seen the federal budget for systems of care grow from 4.9 million in 1993 when the Comprehensive Community Mental Health Services for Children and their Families program was initiated to 102 million in 2004. And yet, so much more needs to be done. Work to be Done The success we have seen is due to the hard work of those of you involved with system of care development efforts and those who preceded you in this important work. However, there is still much to be done to make systems of care truly responsive to families. Too many families are not getting the services they need or are being forced to relinquish custody or agree to juvenile justice involvement to get what meager services they can. Too many youth are being served in more restrictive placements out of their community, tearing at any sense of family and connectedness - factors that are key to overall mental health. Too many communities are missing out on innovative service delivery because of silo thinking among human services agencies. The list is long, and I am sure if I were to ask, you could provide a passionate list of your own examples. Creating a Mutual Partnership Those of us involved in developing and strengthening systems of care are a vital component to the national effort to transform mental health. The steps I have outlined in this memo will give you an idea of how the Child, Adolescent and Family Branch is strategically positioning itself to help lead this critical part of the transformation. None of us can be successful without each other. What we do and learn together will help shape the direction for the future. Please feel free to share your thoughts, ideas and suggestions at any time with your Project Officer and myself. I look forward to working in partnership with you as we combine our vision, beliefs and actions, with a relentless pursuit and focus on continuous quality improvement. T = (V+B+A) x (CQI) 2
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