Transcript Systems of Care Philosophy: A Native Perspective on the

Systems of Care Philosophy:
A Native Perspective on the National
Initiative
Andy Hunt, MSW
NICWA
Director of Community Development for
Children’s Mental Health
System of Care Principles
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Family Focused
Culturally Competent
Community Based
Accessible
Individualized
Least Restrictive
Accountable
Interagency
Coordinated & Collaborative
Family Focused
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Not about only children
Not about only parenting
“Family” is defined by the community
Families are involved as key partners at every
level of the system, from direct service to policy
and evaluation
Cultural Competence
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Awareness and acceptance of difference
Awareness of own cultural values
Understanding the “dynamics of difference”
Development of cultural knowledge
Ability to adapt practice to fit the cultural
context of the client/family
Cultural Competence
• At the system level…
“A set of congruent behaviors, attitudes, [practices] and
policies that come together in a system, or
agency…and enable that system, or agency… to work
effectively in cross-cultural situations”.
(Cross, et. al)
Community-Based
• Children should be served in their own
community by people from the community
• The community should shape and drive the
design of the system
• The system should reflect the values of the local
community
• Community members should remain an integral
part of the service delivery and planning process
Accessible
• Children and families should be able to get all
necessary services with ease
• Elimination of barriers to service:
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Physical/Geographic Location
Policy, Procedures and Processes
Language and culture
Stigma and perceptions
Funding restrictions
Individualized Care
• Assessments that are based on discovering the
strengths of each child
• A “plan of care” that is truly unique to meet the
needs of each individual child
• A wraparound approach that respects
individuals
• Services are flexible and adapted to the family
Least Restrictive
• Children should remain in their own homes and
communities or in the most home-like setting
possible
• Creativity is needed to develop alternatives to
more restrictive service models and keep
children in their own communities
• Group residential treatment should be avoided
unless clinically indicated
Accountable
• Everyone in the system is answerable to each other to
meet the needs of the children being served
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The system to the community members
The system to the funding source
Service providers to the families
Service providers to their supervisors
Partners agencies to each other
Standards of practice and ethics
Interagency
• Systems of care involve multiple agencies to
meet the multiple needs of children and families
• Interagency agreements are formalized
• New partnerships are sought out
• Care is taken to build relationships between
agencies at service level, and leadership level
Coordinated and Collaborative
• Agencies and other partner organizations work
together cooperatively towards the same goals
• Each agency, partner and stakeholder has input
and offers resources to meet the community’s
goals
• Everyone is on the same page, and everyone
knows and understands their role in working
together to meet the goals
Partnership in Action:
The Indian Children’s Mental Health Initiative
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SAMHSA (CMHS & CSAT)
Indian Health Service (IHS)
Department of Justice (DOJ)
National Indian Child Welfare Association (NICWA)
Circles of Care Evaluation and Technical Assistance
Center (CoCETAC)
• American Institutes for Research (AIR)
• American Indian/Alaska Native Communities
Systems of Care
Children’s Mental Health Program
• Program funded though CMHS began in early 1990’s
for State, Counties, and Cities as 5 year grants
• First Tribe funded in 1994 (Navajo)
• Grants extended to 6 years in 2001
• US Territories are eligible to apply as of 2003 when
grants became “cooperative agreements”
• Plan, design and implement a children’s mental health
system of care
• Target population: Children with Severe Emotional
Disturbance and their families
Native CMHS Service Sites
(6 Year Implementation Grants)
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Navajo Nation – NM (Graduated 1999)
Passamaquoddy Tribe – ME (Graduated 2003)
Sacred Child Project – ND (Graduated 2003)
Saulte Ste. Marie Chippewa Tribe – MI (Graduated
2004)
Northern Arapaho Tribe – WY (Graduated 2004)
Oglala Sioux Tribe – SD (Year 6)
Yukon Kuskokwim Health Corp. – AK (Year 6)
United Indian Health Services – CA (Year 5.5)
Native CMHS Service Sites
(6 Year Cooperative Agreements)
• Fairbanks Native Association – AK (Year 3)
• Choctaw Nation – OK (Year 3)
• Urban Trails Project – CA (Year 2)
Circles of Care Grant Program
• 3 Year grant funded though CMHS
• Tribal and Urban Indian programs
• Plan, design and assess feasibility of implementing a
culturally appropriate system of care
• Target population: American Indian/Alaska Native
children with Severe Emotional Disturbance and their
families
• Goal to give grantees opportunity to compete for
System of Care implementation grants
Tribal System of Care Communities
= SoC
= CoC I
= CoC II
For more information visit some of the
following websites:
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www.nicwa.org
www.systemofcare.net
www.air.org/tapartnership/
http://mentalhealth.samhsa.gov/cmhs/Childrens
Campaign/default.asp
• http://www.uchsc.edu/ai/coc/