Transcript Document

Primer Hands On-Child Welfare
THE SKILL BUILDING CURRICULUM
Module 5
Planning, Governance and System Management
Developed by:
Sheila A. Pires
Human Service Collaborative
Washington, D.C.
In partnership with:
Katherine J. Lazear
Research and Training Center for Children’s Mental Health
University of South Florida, Tampa, FL
Lisa Conlan
Federation of Families for Children’s Mental Health
Washington, D.C.
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Factors
Influencing
Group
Process
Norms
Participation
Feelings
Influence
Membership
Group
Process
Style
of
Leadership
DecisionMaking
Procedures
Adapted from The Pheiffer Book of Successful Team-Building
Tools, Edited by Elaine Biech. 2001 by John Wiley & Sons, Inc.
Group
Atmosphere
Task
Functions
Maintenance
Functions
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Coming together is a beginning.
Keeping together is progress.
Working together is success.
H. Ford
Building Systems of Care: A Primer. Washington, D.C.: Human Service Collaborative. (2004)
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Planning Structure Issues
• Leadership
• Staffing
• Time and place of meetings
• Stakeholder involvement
• Committees or work groups
• Communication or dissemination of information
• Outreach to broader constituencies
• Outreach to and involvement of diverse and disenfranchised
constituencies
• Linkage to related reform/planning initiatives
• Resources
Pires, S. (2002). Building systems of care: A primer. Washington, D.C.: Human Service Collaborative.
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Stages of Planning For Systems of Care
STAGE 1: Form workgroup
STAGE 2: Articulate mission
STAGE 3: Identify goals and guiding principles
STAGE 4: Develop the population context
STAGE 5: Map resources and assets
STAGE 6: Assess system flow
STAGE 7: Identify outcomes and measurement parameters
STAGE 8: Define strategies
STAGE 9: Create and fine-tune the framework
STAGE 10: Elicit feedback
STAGE 11: Use framework to inform, plan evaluation, and technical assistance
STAGE 12: Use framework to track progress and revise theory of change
Hernandez, M. & Hodges, S. (2003). Crafting logic models for systems of care: Ideas into action. Tampa, FL: University of South Florida
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A Planning Process for Family and Children’s Service Reform
The
System As
It Is Now
Outcomes
For
Children
and Families
The
System As
It Should
Be
Principles
Reinvestment
Commitment
Financing
Options
Combined Fiscal Program Strategy
---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Action Plan
Multi Year
Steps
Governance
Strategy
Leadership and
Professional
Development Strategy
State
County
Community
Cross Community
Cross Agency
Political Strategy
Friedman, M. (1994). Washington, D.C.: Center for the Study of Social Policy
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Elements of Effective Planning Processes
 Are staffed
 Involve key stakeholders
 Involve families and youth early in the process and in ways that
are meaningful
 Ensure meaningful representation of racially and ethnically
diverse families and youth
 Develop and maintain a multi-agency focus
 Build on and incorporate related programmatic and planning
initiatives
 Continually seek ways to build constituencies, interest, and
investment
 Pay attention to sustainability and growth of system changes
from day one
Pires, S. (1991). State child mental health planning. Washington, DC: Georgetown University Child Development Center, National Technical
Assistance Center of Children’s Mental Health.
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Strategies for Involving Families and Youth in Planning
• Share information about planning meetings by working with family/youth
organizations and community agencies, such as Big Brothers/Big Sisters, Boys and
Girls Clubs, Family Organizations, Family Preservation services agencies, etc.
• Provide orientation/training for families/youth about current policies, plans and
workgroups (i.e., CFSR plan, PIP workgroups).
• Have involved family/youth leaders engage other families/youth to be involved.
• Provide on-going mentorship/support (i.e., Family Service Workers engage
youth/family to become involved in planning).
• Hold planning meetings in the evenings/weekends, at community centers, schools,
and recreation centers.
• Conduct focus groups/interviews/surveys to solicit views of many families/ youth.
• Pay stipends, transportation, child care; provide food.
• Conduct facilitated sessions for planning group to explore attitudes about race,
culture, families and youth.
• Publicly acknowledge the contributions of individual families and youth.
Adapted from: Emig, C., Farrow, F. & Allen, M. (1994). A guide for planning: Making strategic use of the family preservation and support services program.
Washington, D.C.: Center for the Study of Social Policy & Children’s Defense Fund.
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Cultural and Linguistic Competence
in Planning
• Conduct on-going assessments of the environment
• Build support for change
• Identify, acknowledge, engage, and partner with formal and
informal leadership
• Identify and develop needed resources and enhance leadership
capacity
• Articulate values, establish a mission, and set goals
• Plan action steps in partnership with diverse families/youth
and communities
• Develop strategies to sanction or mandate the incorporation of
cultural knowledge into policy making, infrastructure and
practice.
Adapted from Cross, T., Bazron, B., Dennis, K., & Issacs, M. (1989). Towards a Culturally Competent System of Care Vol. 1. & NCCC
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Cuyahoga County Planning Process Structure
System of Care Oversight Committee
Chaired by Deputy County Administrator for Human Services
Includes a Broad Representative Stakeholder Group, e.g., major child serving
systems, families and youth, Neighborhood Collaboratives, providers,
researchers
Cultural &
Linguistic
Competence
Social
Marketing
Family &
Youth
Involvement
Sustainability
Evaluation &
Research
Training &
Coaching
Staffed by
System of Care Office
Pires, S. (2006). Primer Hands On – Child Welfare. Washington, D.C.: Human Service Collaborative.
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Definition of Governance
Decision making at a policy level that has legitimacy,
authority, and accountability.
Pires, S. (1995). Definition of governance. Washington, DC: Human Service Collaborative.
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Definition of System Management
Day-to-day operational
decision making
Pires, S. (2002). Building systems of care: A primer. Washington, D.C.: Human Service Collaborative.
12
Key Issues for Governing Bodies






Has authority to govern
Is clear about what it is governing
Is representative
Has the capacity to govern
Has the credibility to govern
Assumes shared liability across systems for target
population
Pires, S. (2000). Key issues for governing bodies. Washington, DC: Human Service Collaborative.
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Examples of
Types of Governance Structures
State and/or local interagency body
Non profit board of directors
Quasi governmental entity
Tribal government
Hybrids
Pires, S. (2002). Building systems of care: A primer. Washington, D.C.: Human Service Collaborative.
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Evolving Governance Structure
Illustration 1.2A
Policy Level
Local Governing Board
Operational Level
Agency Directors
Family Advocacy
Organizational Representative
DSS Director
“Bring the Children Home”
SOC Supervisor and Staff
“Bring the Children Home”
Service Managers
Illustration 1.2B
Families Served
Other Agency Workers
BRING THE CHILDREN HOME STATE LEGISLATION
COUNTY EXECUTIVE
Local Governing Board
SOC Team Leader
Agency Directors
Family/Youth Reps.
DSS Director
Providers Forum
“Bring the Children Home”
Interagency Service Management Team
“Bring the Children Home”
Service Managers
Families/Youth Served
Other Agency Workers
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Pires, S. ( 2006). Evolving governance structure. Washington, DC: Human Service Collaborative.
System Management: Day-to-Day
Operational Decision Making
Key Issues
• Is the reporting relationship clear?
• Are expectations clear regarding what is to be
managed and what outcomes are expected?
• Does the system management structure have the
capacity to manage?
• Does the system management structure have the
credibility to manage?
Pires, S. (2002). Building systems of care: A primer. Washington, D.C.: Human Service Collaborative.
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Examples of Types of System
Management Structures
• State and/or local interagency body
• Quasi-governmental entity
• Non profit lead agency
• Public sector lead agency
• For profit commercial managed care entity
• Coalition management
Pires, S. (2002). Building systems of care: A primer. Washington, D.C.: Human Service Collaborative.
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Examples of Management Accountability
Cuyahoga County Management
Structure
Sarasota Co. and Milwaukee Co.
Management Structures
Deputy County Administrator for Human Services
Sarasota County
Coalition for
Families & Children
System of Care Office
Subsets of Children & Families
Involved in Child Welfare
Children in or at
risk for residential
Children with serious
placement
behavioral health
challenges
Youth who are
status
offenders
Milwaukee Co.
Division of Child
Mental Health
All children involved
in child welfare
Subset of cw population
0-3 population Early
Intervention
engagement
challenges
Children in/at risk for
RTCs
Pires, S. (2006). Primer Hands On – Child Welfare. Washington, D.C.: Human
Service Collaborative.
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Examples of Relationships Between Governance and
Management Structures
Sarasota County, FL
Cuyahoga County, OH
Locally-Based, Representative Governance Board
& State/District Office
Interagency
Governing Body
Contract
Lead Public Agency:
SOC Office
Coalition Management Entity
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Pires, S. (2006). Primer Hands On – Child Welfare. Washington, D.C.: Human Service Collaborative.
Example of Governance/Management Structure
State Funding Pool
Local Allocation
County Alliance
Case Rate for each
enrolled child
Provider
Financer/
Payers
Purchaser
Care Management Entity
• Organize and manage provider network
• Staff and manage child and family team process
• Care management, including case management
and utilization management/utilization review
• Quality assurance
• Outcomes management /monitoring
• Management Information System (tracks
children, services, dollars)
Provider
Pires, S. (1996). Contracted system management structure. Washington, DC: Human Service Collaborative.
Provider
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Examples of Types of Family/Youth Partnership
in System Governance and Management
• Input/evaluation of key management
• Input/evaluation of quality of services and programs
• Local system of care input
• Resource allocation
• Service planning and implementation
• Policies and procedures
• Grievance and resolution procedures
Conlan, L. (2003). Implementing family involvement. Burlington, VT: Vermont Federation of Families for Children’s Mental Health.
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Culturally Competent Management Structures
 Hire from diverse communities
 Incorporate quality improvement that addresses
issues important to racial and ethnic communities
(e.g., disparity and disproportionality)
 Outreach to and engage racially/ethnically diverse
stakeholders, other “minority populations”
 Conduct cultural “self assessments”
Pires, S. (2006). Primer Hands On – Child Welfare. Washington, D.C.: Human Service Collaborative.
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