Game Change! Lessons Learned to Improve Outcomes May 19, 2015 - - PowerPoint PPT Presentation

Game Change! Lessons Learned to Improve Outcomes

May 19, 2015

PRESIDENT’S “NOW IS THE TIME” PLAN

PROJECT AWARE SEA PROJECT AWARE LEA SAMHSA’S “NOW IS THE TIME” INITIATIVES HEALTHY TRANSITIONS

Closing background check loopholes to keep guns out of dangerous hands. Making schools safer. Banning military-style assault weapons and high-capacity magazines, and taking

• ther common-sense

steps to reduce gun violence. Increasing access to mental health services.

SAMHSA’S “NOW IS THE TIME” INITIATIVES

TODAY’S TEAM

FEDERAL RESPONSE

Partnerships for Youth Transition

• SAMHSA and Department of Education
• Awarded to 5 jurisdictions from 2002 - 2006
• Focus on Practice Change
• Cooperative Oversight

– Child, Adolescent and Family Branch – Community Support Programs Branch – Homeless Programs Branch

FEDERAL RESPONSE

Healthy Transitions Initiative (HTI)

• SAMHSA awarded to 7 states from 2009 - 2014
• Cooperative agreements to integrate services and

supports for youth and young adults 16 – 25 with serious mental health conditions and their families.

• State level policy change
• Local service delivery change leading to state wide

processes

7 STATES AWARDED

GEORGIA MAINE MARYLAND MISSOURI OKLAHOMA UTAH WISCONSIN

LEGACY DOCUMENTS

An issue brief series to document the impact of this initiative has been prepared by The National Technical Assistance Center for Children’s Mental Health in partnership with Pathways for Positive Futures (Portland State University), the state jurisdictions and SAMHSA. The first two briefs of the series are now available. Brief 1 describes the impact of the HTI at the local community level, with special emphasis on practice

• improvements. The impact of HTI on state level policy and system change is the focus of Brief 2. Both legacy

documents can be found at….. Look for Brief 3 focusing on impact of HTI as captured through data this winter. The briefs can be found at:

• http://gucchdtacenter.georgetown.edu/Resources/HTIIssueBrief1.pdf
• http://gucchdtacenter.georgetown.edu/Resources/HTIIssueBrief2.pdf

In collaboration with HTI state project directors, a web based tool kit that can be used to inform replication across HTI states and in other communities and states has also been produced. The primary purpose of the tool kit is to preserve and make available many of the tools that the HTI states have developed, refined and evaluated through practice. The toolkit will be available on the SAMHSA website, the Georgetown TA Center website and the Pathways to Positive Futures website. The current toolkit which will be updated regularly can be found at:

• http://www.pathwaysrtc.pdx.edu/HTItoolkit/

NOW IS THE TIME HEALTHY TRANSITIONS

To keep young adults from falling through the cracks!

GEORGIA

Melissa Robinson Graves, LMFT Department of Behavioral Health and Developmental Disabilities in the Division of Behavioral Health, Federal Grant Programs

ROLE CHANGE: BE INTENTIONAL ABOUT OVERSIGHT WITHOUT OVERKILL

ROLE OF THE “STATE”

• Unique position as oversight of the grant without

direct management of sites

– site staff serve two bosses: agency and state/grant

• Is everyone on the same page?

– Be clear on the vision from the beginning

• Whose job is it?

– Know your role and the roles of all key players – Airplane view, but know when to get “in the weeds”

• No one wants to get in trouble

– Sites may be reluctant to tell you their challenges

SYSTEM CHANGE- NOT AN EASY BUSINESS

• We are Agents of Change

– Not given federal money to do business as usual

• Tendency of sites to do what they know

– Help them think outside the box

• What’s it all for?

– Keep the vision in mind; remind yourself & others often

• It’s going to be OK

– Learn from your successes and challenges; keep a record

IT’S ALL IN THE CONTRACT- WHERE THE MONEY HITS THE ROAD

• Being a good steward of federal money

– It’s all in your hands

• Performance-based contracting

– Your new best friend

• What do you need to know?

– Meeting SAMHSA’s requirements – Getting the information you need

• If it’s not in writing…

– You can’t hold people to what’s in your head

OTHER HELPFUL TIPS

• Know your history

– Federal - PYT, HTI – State - what have others done already; what’s happening now?

• Things don’t go as

planned

– Change happens. Go with

• it. Learn from it.

UTAH

Ming Wang Principle Investigator Utah Department of Human Resources Michelle Vance Youth Coordinator NAMI Utah

HOW TO GET THE STATE AND

LOCALS ON THE SAME PAGE?

EMPHASIS ON SYSTEM PERSPECTIVES

• Make sure that the point person at the local level to

coordinate youth and family development has system perspectives and sees young people and family members as system partners, not consumers.

• Help front line staff get system perspectives on how

youth and family development can help staff succeed at their work.

MATURITY IN SYSTEM READINESS

• State system needs to develop a good sound

infrastructure in youth and family development before it can help locals grow

• Grow (both in numbers and quality) Youth and

Family Coordinators and Advocates

– Family Coordinator and Youth Coordinator can’t do it

• alone. They need an army of advocates to help them.

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SOME COMMON QUESTIONS/STATEMENTS

• What can/do advocates do?
• They are not ready to become advocates.
• They can’t be advocates if they still drink.
• Let’s piggy back advocacy on church groups or

activities.

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WHAT CAN WE DO?

• Develop mutual understanding of what youth/family

advocacy are and what advocates can do

• Understand the good and bad of piggy backing
• Develop true understanding of recovery

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MAINE

Alice Preble State Project Director Moving Forward (NITT-HT)

YOUNG ADULT PROFESSIONALS

WITH LIVED EXPERIENCE A Best Practice that is Complex!

PEER SUPPORT IN MAINE

• It is about giving and receiving
• It is not based on diagnosis
• We encourage one another to re-evaluate how we’ve

come to know what we know

• Is about creating relationships that challenge us at

how we have learned to be in the world

• Is trauma informed
• Is intentional

THE TASKS OF PEER SUPPORT

• Building connection
• Helping each other understand how we’ve come to

know what we know

• Re-defining help as a shared learning and growing

process

• Helping each other move towards what we want

instead of away from what we don’t want

FACTORS TO CONSIDER WHEN RECRUITING FOR HIRE

• Lived experience
• Previous work experience
• What supports do you have in place for prospective

peer support

• Capacity for peer support specialist to provide own

self care

• Check references

SUPERVISION AND SUPPORT

• Consider specific situations (personal/work)
• Intentional supervision
• Clear written protocols
• Live supervision
• Strategic sharing

CONSIDERATIONS

• Enhanced peer training for Young Adult Peer Support

Specialists

• Involve Peer Support Specialists in development and

revising of policies

• Involve Peer Support Specialists in job expectations
• Peer Support Brings Value!!!

MARYLAND

John Coppola, MHS Transition Age Youth/Emerging Adult Consultant & Trainer University of Maryland School of Medicine, Department of Psychiatry, Evidence Based Practice Center

CAREER DEVELOPMENT’S PLACE IN TRANSITION

A Useful and Valuable Tool!

CAREER DEVELOPMENT’S PLACE IN TRANSITION

Self Awareness

Mental health Family Vocational Education Health & Wellness

Community

Legal Housing

Relationships

Culture Identity

• Transition is an interesting and complex

developmental process for young adults

• Successful transitions often necessitates that

the young adult address issues across multiple (interconnected) life domains

IT CAN BECOME A BIT CONFUSING

MANY QUESTIONS PRESENT ARISE

Who am I today? Who do I want to be tomorrow? Where do I fit in? Where could I fit in? What skills do I have? What do I value? What do others value in me? Where do I start???

FINDING ANSWERS COULD BE HARD WORK & REPRESENT A LARGE INVESTMENT

• Introspection
• Self-honesty
• Identity exploration
• Social skills development
• Risk taking
• Commitment of time and effort
• Perseverance

HARD WORK IS V

ALUED IN OUR SOCIETY

Just think of how helpful it could be to relationship development, engagement retention, self efficacy (& lots of other good stuff) if this effort had:

• Measurable return on investment
• Increasing opportunities for advancement
• Unlimited potential for growth
• Opportunity to pay young adult $$$

CAREER DEVELOPMENT PAYS & IS A USEFUL & V

ALUABLE TOOL

• Developmentally appropriate
• Socially accepted (even encouraged)
• Provides valuable experiential learning opportunities
• Gives real-time feedback
• Increases social connectedness
• Expands world view
• Affects and is affected by other life domains
• Self reinforcing ($$$$$$$$)

INTEGRATE CAREER DEVELOPMENT INTO SERVICE DELIVERY PROGRAMS

• Make Supported Employment/Vocational services a

formal part of transition program

• Include in all team meetings
• Coordinate and collaborate all activities with young

adult

• Carry over “lessons learned” through career

development activities to other life domains

WISCONSIN

Brian McBride Program Coordinator Milwaukee County – Wraparound Milwaukee

OWEN’S PLACE RESOURCE CENTER

One Stop Shop!

The mission of Owens Place is to provide resources skills and support that will assist young adults (16 years +) in developing positive plans for their individual futures. Owens Place will help young adults develop leadership, confidence, skills for independence and empower them to take

• wnership of their lives.

OWEN’S PLACE SUPPORTS

• Gathering place to socialize
• Resource center

– Employment resources – Housing resources – Practice daily living skills

• Food & meals available, washing clothes, etc.
• Hosts classes

– Health – Banking – Cooking – Employment preparation – Learning about Medicaid, SSI, social security

OWEN’S PLACE SUPPORTS

• Connect with peer specialists, mentors
• Work on “portfolio” toward things needing to get

done to move toward independence

• Connect youth/young adults who need & desire more

help with a transitional specialist

SUPPORTS OFFERED

Computer Lab Kitchen Washer and Dryer Recreational Activities Resources Library Peer Specialist Transitional Support Groups Relaxation Hygiene Supplies Clothing and Food Pantry Portfolio Building

OWEN’S PLACE HAS INFORMED OUR PRACTICE

• Engagement is easy to talk about, but true

engagement takes time and dedication

• Network of community supports and services is

crucial – Housing first

• Terminology matters
• Peer driven services is necessary

OWEN’S PLACE HAS INFORMED OUR PRACTICE

• Simple data helped inform what groups are needed by

young adults

• Planned at own pace – utilizing portfolio allows for

young adults to pick back up and see what they need to do each visit

• Embraced our growing pains

– 3 different locations – Started as more social environment – Had included younger youth – Slow process

FUTURE

Our lessons learned and flexibility has allowed us to expand our services at Owen’s Place once again by adding an additional 4,500 sq. feet.

• 2 larger conference rooms
• Full kitchen
• Transitional Coordinators office
• Community Independent Living Agency to share

space with us

Moving us to closer to a ONE STOP SHOP FOR YOUNG ADULTS

OKLAHOMA

Marqus Butler OHTI Project Director Program Administrator of Cross System Collaboration Oklahoma Department of Mental Health and Substance Abuse Services

OKLAHOMA’S HEALTHY TRANSITION INITIATIVE LESSONS LEARNED

Data, CQI, and Evaluation 101!

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LEVERAGE PARTNERSHIPS AND COLLABORATIVE EFFECTORS WITH DATA/EVALUATION

Partnerships, Collaboration, and Integration

PARTNERSHIPS AND COLLABORATION

Partnerships and collaboration require thinking outside the box, challenging assumptions and the status-quo:

• Recognizing opportunities for

change by using data;

• Developing a vision of long-term

change by using data;

• Seeking support and involvement

from diverse and non-traditional partners by using data; and

• Developing learning opportunities

for partners by using data.

INFORM PRACTICE AND POLICY WITH DATA/EVALUATION

PRACTICE AND POLICY CHANGE

• Self-assessment/

Self-study

• Match the self-

assessment/self-study with target population(s)

• Use data and evaluation

to frame key areas of required change

• Start broad, and narrow

your focus

CQI/OUTCOMES

CQI

Analyze Refine Improve

CQI/OUTCOMES

• Data collection

should be priority #1

• Use outcomes to

leverage support, build partnerships, and address systemic issues

Be Flexible!

COLLEAGUE DRIVEN COMPETITION

WITH DATA/EVALUATION

COLLEAGUE DRIVEN COMPETITION

WITH DATA/EVALUATION

Look in the Mirror…. That’s Your Competition!

MISSOURI

Lu Ann Reese Statewide Family Support Coordinator Missouri Department of Mental Health, Division of Behavioral Health

ADJUSTING POLICIES TO MEET

THE NEEDS OF YOUTH, YOUNG

ADULTS AND THEIR FAMILIES DURING

THE TRANSITION TO ADULTHOOD?

MISSOURI CHILDREN’S SERVICES SYSTEM

• VS. ADULT SERVICES SYSTEM

Prior to the Healthy Transitions Initiative (HTI)

• Children’s mental health services ended at age 18
• Youth had to be assessed under a different eligibility criteria
• Family Support Provider services (peer support) ended

when youth turned 18

• A high number of youth did not continue to receive services
• Youth re-entered the system in later years

PREPARING FOR THE TRANSITION “YOUTH”

Questions

• Who is working with the youth to prepare for continued

mental health or substance use services after 18?

• What approach are they using to engage the youth in

discussions about ongoing services and supports?

• When do you start talking about the approaching

transition?

PREPARING FOR THE TRANSITION “PARENT, CAREGIVER”

Questions

• Who is working with the parent/caregiver to prepare

for the changes that take place during the transition to adulthood for their youth?

• What approach are they using to engage the parent in

discussions about ongoing services, supports, and their concerns as a parent?

• When do you start talking about the approaching

transition with families?

Employment/education – Housing – Transportation – Parent’s concerns/fears

MISSOURI POLICY CHANGES AS A RESULT

OF THE LESSONS LEARNED DURING THE HTI

Youth and Young adults can access services from the children’s system AND/OR the adult system between the ages of 16 to 25.

• Youth who qualify for children’s CPR services

automatically qualify for adult services (no additional assessments, evaluations)

• Youth can receive services from either the children’s

system, adult system or both (developmentally appropriate)

Parents and Caregivers can continue to receive Family Support provider services until the youth/young adult reaches age 25.

Lessons learned:

• Parent/caregiver need for continued support does not

stop when youth reaches 18.

• If parent/caregiver are still involved with youth after

age 18 they need continued support during this often difficult time.

• Parents/caregivers need someone to help them make

the shift from being the primary decision maker to the support behind the youth.

PREPARING FOR THE TRANSITION “PARENT, CAREGIVER”

The Importance

• f Peer Support

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Questions? Comments? Insight?

Contact the NITT-TA Center: Toll-Free: (844) 856-1749 Email: NITT-TA@cars-rp.org

Need additional assistance?

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