A Successful Approach to Family Care and Collaboration Patricia “Shannen” Davis, MSW, CAP (SPI) Silvia Quintana, LMHC (DCF) Islem Pardinas, MSW (Our Kids) Larry Allen, LCSW, MBA(SFBHN) To prevent and divert children from entering the Dependency System. To assess family needs in an effort to promote wellness. To engage families in accepting community services. Referral Sources • • • Child Protective Services Family Intervention Specialist Our Kids Intake Providers • • • • • • • Substance Abuse Treatment Providers Mental Health Treatment Providers Co-occurring Treatment providers Dependency Full case management agencies Domestic Violence providers Infant Mental Health Provider Safe at Home/Parents as Partners/ Family Empowerment Program The following services are co-located at the DCF Service Centers: 100 Opa Locka Blvd. Miami, FL 401 NW 2nd Ave. Miami, FL 12195 Quail Roost Drive, Miami, FL Child Protective Investigation (CPI) Family Intervention Specialist (FIS) Our Kids Intake (OK) • • On August 1, 2008, The Family Intervention (FIS) Program operated by Spectrum was embedded within each of the CPI locations North, Central and South as was intended by the legislators when the positions were authorized. The FIS program also adopted the best practice model approved by SAMHSA called Screening Brief Intervention Referral and Treatment (SBIRT) that incorporates Motivational Interviewing as part of the engagement techniques. Call comes into the Hot Line where CPI suspects Substance Abuse and/or Mental Health need for services CPI will contact FIS if suspected substance abuse or mental health are identified in the family. FIS will make contact with family within 72 hours for assessment. FIS makes referrals to the community and SAMH system of care as appropriate. Total individuals assessed: 5,525 Parents: 3126 Kids: 2399 Families Assessed: 1,512 24% of Parents assessed received a positive drug screen 24% of Parents referred needed Services 100.0% 90.0% 80.0% 70.0% 60.0% 50.0% 40.0% 30.0% 20.0% 10.0% 0.0% n=748 Average LOS: 38 days Needed Services Referred to Who have Provider and had treatment service appointment in SFBHN** **Note: This data reflects only those individuals who received services through SFBHN funding. If other services were received through any other funding source, this data is not reflected here. • • If based on GAIN, drug/alcohol test, and client interview no services are needed FIS reports findings to CPI. If Services are needed: • • • FIS continues to assess, engage, and link the family to services FIS reports weekly to CPI on status of family and referrals FIS provides results on ongoing engagement to CPI at the end of 21 days including recommended services and linkage status to providers. FIS, Child Protective Investigator, Child Protective Investigator Supervisor, Our Kids, Children Legal Services will staff case as needed. FIS and Our Kids full case management agency if warranted will continue to engage and transition family into case management and other SAMH provider services. • Spectrum Program is the FIS provider. They have been trained and use: • • • • • Screening, Brief Intervention Referral and Treatment Model (SBIRT) Motivational Interviewing Solution Focused Case Management Global Assessment of Individual Needs (GAIN) Quick Family Centered Practices being used by CPI, FIS and OK are: Structured Decision Making and Trauma Informed Care • • • • • • • • Mental Health Services Substance Abuse Services Domestic Violence- Victim or Perpetrator Children’s Mental Health Full Case Management Crisis Intervention Intensive in-home services Other Community Services Quarterly staffing focuses on persons who have dropped out of treatment, appropriate levels of care, appropriateness of referral and is really an in depth qualitative review from hotline to termination of supervision. Quarterly meetings at the hubs focus on system issues as well as provide updated educational information. South Florida Behavioral Health Network, SAMH, Our Kids, DCF/CPI units, will be responsible for Data tracking. Data collected includes: Referral, linking, treatment completion, drop out from treatment, recidivism rate, referrals to dependency court. The Southern Region’s Substance Abuse and Mental Health (SAMH) Program Office entered into a contract with South Florida Behavioral Health Network on October 1, 2010 to oversee the Substance Abuse and Mental Health System of Care. System of Care development and management Utilization Management Network Management and sub contractual relations Continuous Quality Improvement Technical Assistance and Training Data Collection Reporting and Analysis Planning Acute Treatment Support Services • Detoxification • Crisis Stabilization • Addiction Receiving Facilities • Outpatient • Intensive Outpatient • In Home-On Site • Residential • Comprehensive Community Service Teams (CCST) • Wraparound (Flexible Funds) • Clubhouses • Drop-In Centers Lead CBC for Miami Dade and Monroe County System of Care development and management Utilization Management and Continuous Quality Improvement Network Management and sub contractual relations Technical Assistance and Training Planning Dependency Full Case Management service for all case through 6 Community Providers Intake Foster Care Placement and Licensing Shelter and Residential Group Care Level of care assessments Nurse Case management Adoptions Independent Living services Intensive in-home family preservation services through two program Safe at Home and Parents as Partners for High Risk Families where there are safety threats Case Management through Family Empowerment Program for moderate to low risk families Since 2009 Our Kids is using Children’s Research Center’s Evidence Based structured Decision Making Tool to guide all service decision. 3500 3000 Number of Children 2500 2000 Family Empowerment Program 1,446 1500 1000 Court-InParents As Partners 537 1,389 Relative/Non392 Safe At Home 473 Licensed 596 Family Preservation (n=3,308) Court (n=1,525) 500 0 For purposes of this analysis, cases from other states and counties (ICPC and OTI) were excluded. 7/27/2011 Prevention Diversion Services Services Dependency If a family is at risk of becoming involved with the Dependency System and could benefit from services based on assessment and recommendations, referrals will be made to SAMH providers and other community providers as needed. If a family is found to need SAMH/CW services and CPI finds that there are some risk factors, staffing will be held between Our Kids intake, CPI, CPIS, CLS and FIS. Service recommendations will be made in an effort to divert the family from the Dependency System. If a family is found to be at risk and diversion is not an option the CPI,CPIS, FIS, Our Kids Intake, CLS will staff the case and make appropriate treatment and services recommendation based on assessment as the case is moved to the Dependency System. Reporter Family Intervention Specialists / SAMH Process Map (DRAFT- REVISED as of 11/10/2009) Call to the Hotline Hotline See Prevention Referral Procedures Receive and Process the call Assess the call Assign to Respective Region Accept Substance Abuse and Mental Health Providers Our Kids Inc. Family Intervention Specialist (FIS) Child Protective Investigations Serv. Centers Southern Region Reject Accept the report CPI will continue with the investigation. Assign to the Service Center NO NO Receive and determine if SAMH/ FIS services are needed If SAMH/FIS services are need YES See CPI Process Map Complete referral and submit to FIS CPI & FIS go out on the investigation. FIS complete assessment (GAIN Q) & drug screen NO Is FIS available Receive the referral YES assessment (GAIN Q) & drug screen within 72 hrs Engage & link family to service for 21 days from the day of referral If services are not needed based on assessment (GAIN Q) Receive status report from FIS Receive assessment and recommendation report from FIS at the end of 21 days YES For prevention, diversion and dependency cases a staffing will be held between CPI, CPIS, FIS, and OK for appropriate services as needed OK will receive referral to provide prevention or diversion services Provide CPI with weekly report on status of case Complete assessment with treatment recommendations & status of Family. Submit to CPI & O.K. (if applicable) at the end of 21 days Receive assessment and recommendation report from FIS at the end of 21 days, if applicable See CPI Process Map CPI and OK staffing to determine services recommendations and if family is engaged in developing a service plan. Case is closed within 60 days by CPI and FIS FIS & OK will continue to engage & transition family to In-Home case management services CPI, FIS, and OK staffing to determine services recommendations and if family is engaged in developing a service plan Continue providing services to family (mental health, substance abuse, domestic violence, and other services as needed) If family YES drops out of treatment and refuse additional care NO OK and SAMH provider will notify CPI Treatment and services are completed Narrowing front door Revision of protocol Developing a plan to mine data from FSFN, Medicaid, SFBHN, and Our Kids databases for Adults and Children