Collaborating to Meet the Needs of Families Presented at the TCE Methamphetamine Grantee Meeting

Transcription

1 Collaborating to Meet the Needs of Families Presented at the TCE Methamphetamine Grantee Meeting October 29, 2008 Presented by Sharon Amatetti, MPH SAMHSA/CSAT

2 Topics to be Presented ACYF s Regional Partnership Grant Program The National Center on Substance Abuse and Child Welfare -- TA and Training Center CSAT s Funding Family Centered Treatment Guide

3 Regional Partnership Grants Overview

4 Regional Partnership Grants (RPGs) 53 RPGs awarded $32.46 million in Sept Represent 29 States and 6 Tribes Authorized by the Child and Family Services Improvement Act of 2006 Improve the safety, permanency, and well-being of children affected by methamphetamine and other substance abuse Address the fragmentation and lack of coordination between child welfare and substance abuse treatment services

5 RPG Cluster Groups Tribal (6) System-Wide Collaboration (9) Drug Court (10) Array of Services (11) Child-Focused (8) Treatment Focused (9)

6 Regional Partnership Grants and NCSACW In-Depth Technical Assistance Sites Regional Partnership Grants = 53 Sites Array of Services - 11 Child Focused 8 Drug Courts 9 System-Wide Collaboration 9 Treatment Focused 9 NCSACW In-Depth TA = 14 Sites 11 States 2 Tribal Communities 1 County Tribal - 6

7 Geographic Areas Served by the 53 Regional Partnership Grantees (Percentage served given geographic area) State (n=2) 3.8 Region (n=23) County (n=25) % serving a Region* or County City (n=3) *Regions being served vary from 2 to 34 counties and Tribal reservations.

8 Lead Agencies for the 53 Grantees 45% are child welfare agencies

9 Partnership Member Agencies Representing Child Welfare, Substance Abuse, Courts and Tribes (Percentage Grantees Indicating Given Member is a Primary Partner)

10 Partnership Member Agencies Representing Other Service Systems & Community Organizations (Percentage Grantees Indicating Given Member is a Primary Partner) State/County MH Agency (n=17) MH Services Provider (n=25) Health Services (n=13) Other Child/Youth Services Provider (n=18) Employment-Related Agencies/Services (n=11) Housing Services Agency/Provider (n=8) University/Evaluator* (n=19) DEC/Drug Control Task Force/Related Org (n=6) Community Stakeholder Org/Group (n=6) Schools (n=4) Faith-Based Org (n=3) Peer/Parent Mentor Groups (n=2) Other Partner(s)** (n=10) * University partners are typically the evaluators ** Other primary partners include other types of non-profit providers (e.g., legal services/client advocacy), consultant/training organizations and others

11 Five Broad Project Focus Areas Systems Collaboration and Improvements Substance Abuse Treatment Linkages and Services Services for Children and Youth Support Services for Parents and Families Expanded Capacity to Provide Treatment and Services to Families Grantees did not limit efforts to one program area: 74 percent (39 grantees) proposed approaches that include all five program areas, while another 25 percent (13 grantees) span four program areas.

12 Key Systems Collaboration and Improvements Activities 89% are emphasizing cross-systems training 59% are implementing cross-systems information sharing and data collection improvements Data sharing tools Formal structure to track and refer children Web-supported collaboration tools 40% are implementing new or expanding existing Family Drug Courts

13 Key Substance Abuse Treatment Linkage & Services and Activities 77% are providing coordinated case management or integrated case planning 74% are engaged in strategies specifically to increase access to treatment (e.g., timeliness, priority) 72% are focused on improved substance abuse screening and assessment practices 51% are implementing specialized engagement and outreach activities Approximately 62% are providing mental health/ psychiatric services 51% are providing intensive outpatient services, while 36% are concentrating on residential treatment

14 Key Child and Youth Services 68% are providing developmental screenings, assessments and services 47% are providing other types of screenings and assessments (e.g., health exams) 57% are focused on early intervention and prevention 55% are also providing children s mental health and counseling services 40% are providing additional therapeutic services and interventions Less than one-fourth (19%) are focused on services specifically for substance-exposed newborns

15 Key Support Services for Parents/Families 87% are focused on providing ancillary support services (e.g., life skills, housing, child care, transportation) parenting skills training and education 83% are providing parenting skills training and education 59% are implementing a specific family strengthening program or curriculum to improve family functioning In addition, 57% are providing family counseling 77% are implementing continuing care and recovery support services 38% are using random or periodic drug testing

16 Progress Made by the RPGs in Year One As of March 31, 2008, services provided to more than 770 adults and approximately 1,050 children representing nearly 650 families As of September 15, 2008, all but two grantees had begun providing services In the first 6 months, 38 grantees provided 323 trainings to more than 3,500 child welfare, substance abuse treatment, court and other project staff In the first 6 months, one-third of RPGs expanded their partnerships by adding more than 120 new partners Grantees implemented various cross-systems protocols and procedures to identify, refer and serve families

17 National Center on Substance Abuse and Child Welfare

18 National Center on Substance Abuse and Child Welfare (NCSACW) A Program of the Substance Abuse and Mental Health Services Administration Center for Substance Abuse Treatment and the Administration on Children, Youth and Families Children s Bureau Office on Child Abuse and Neglect Mission: Developing knowledge and providing technical assistance to federal, state, local agencies and tribes to improve outcomes for families with substance use disorders in the child welfare and family court systems

19 Types of TA Products Collaborative practice and policy tools Information and sharing of models Expert consultation and research Development of issue-specific products Monographs, white papers, fact sheets Training resources and collaborative facilitation On-line courses, training materials Longer-term strategic planning and development of protocols and practice models

20 Collaborative Practice and Policy Tools Ten Element Framework Collaborative Values Inventory Collaborative Capacity Instrument Matrix of Progress in System Linkages Screening and Assessment for Family Engagement, Retention and Recovery SAFERR

21 Technical Assistance Level One: Information and Sharing of Models Level Two: Expert Consultation and Research Level Three: Training, Conference or Meeting Presentation Level Four: Ongoing Facilitation, Strategic Planning, 669 requests 303 requests 175 requests 77 requests 53 RPG sites 12 States 2 Tribes 1 County 9 pre-idta

22 Technical Assistance Information and Sharing of Models Materials Publications Referrals to experts Peer to peer consultation Involves identifying and using existing knowledge, materials, products, and resources Collecting and disseminating information from sites who have implemented practice and policy changes Expert Consultation and Research Background research/data analysis Conference calls with expert consultants Analyzing CCI/CVI scores Annotated bibliography and custom literature searches Compiling resources and data on specific topics (e.g. peer mentors, methamphetamine)

23 Technical Assistance Development of Issue- Specific Products Materials Publications Referrals Involves identifying and using existing knowledge, materials, products, and resources Collecting and disseminating information from sites Training Resources and Facilitation Group Facilitation Conference Presentation Legislative or commissioner hearings or meetings On-site training Web-based training courses with CEUs Training curricula and materials

24 Technical Assistance In-Depth Technical Assistance Application and acceptance process 15 month program facilitated by a Consultant Liaison Sets priorities for practice and policy changes Develops protocols and implementation plans

25 For more information on the National Center on Substance Abuse and Child Welfare (NCSACW), visit the NCSACW website at Phone: (866) or (714)

26 Funding Family-Centered Treatment for Women with Substance Use Disorders Developed for the Center for Substance Abuse Treatment under Contract with Johnson, Basin and Shaw Authored by: Kimberly Dennis, M.P.A., Nancy K. Young, M.S.W., Ph.D. & Sidney L. Gardner Children and Family Futures, Inc.

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28 Purpose To identify strategies to Increase funding flexibility Maximize revenues Optimize the efficiency of existing resources

29 Funding Family Centered Treatment By Detailing Federal and State funding sources that could support treatment services for women and their families Highlight the experiences and insights of SHIELDS for Families Provide concrete, next-step starting points

30 Prerequisite to Funding Strategies: Taking Stock of Your Program and Community

31 Understand Existing Funding Streams How they flow into their communities How they are currently allocated among different service providers How they might be better allocated to meet needs What is needed to tap into those existing resources

32 Taking Stock of Your Program and Community Who are my clients and what are their needs? Changes over time Financing for what? Understand and correctly prioritize clinical treatment and support services Use case reviews, surveys or focus groups to find out what services were most/least useful, and needed but not received

33 Taking Stock of Your Program and Community What services do we currently provide to meet parents needs, and where do we fall short? What about others in the community that serve our parents? Comparing parents priority needs with existing program services Parents are typically involved with other community service systems

34 Taking Stock of Your Program and Community What funding and other resources in the community are currently used to fund these services? Are those resources sufficient to achieve intended outcomes? How can the agency s resources be combined with others to achieve greater impact?

35 Taking Stock of Your Program and Community What funding and other resources in the community are currently used to fund these services? Create an inventory of what other resources and services already exist in the community and the total level of public and other dollars flowing into the community to support those services Identify who controls these resources

36 Taking Stock of Your Program and Community To what extent can we tap into these existing sources? What partnerships need to be established? Identify potential collaborators Initiate discussions about which service providers have the capability and capacity to offer which services Develop an interconnected service delivery system that reflects family and community needs

37 Taking Stock of Your Program and Community Should we can we offer services ourselves? If the resource mapping identifies significant unmet service needs, providing services inhouse may best meet family needs

38 Taking Stock of Your Program and Community Should we can we offer services ourselves? Internal planning and decision-making considers: Do we have the appropriate facilities, technology, licensing, qualified staff, and prior experience How will we accommodate budget/program growth Do we use our own staff, employ additional staff, or bring in outside contractors? What are the expected savings, benefits, and outcomes

39 Strategies to Create Unified Financing Increasing Funding Flexibility Maximize Revenues Optimize the Efficiency of Existing Resources

40 Increasing Funding Flexibility Decategorization A Federal- or State-level strategy used to reduce or eliminate categorical funding stream constraints Pooled or Blended Funding Formally combine a portion of funds from several agencies or sources into a single funding stream

41 Increasing Funding Flexibility Braided Funding Used to obtain or weave together multiple funding sources to create and support comprehensive services Wraparound A process in which clients receive a full range of services to meet their needs

42 Strategies to Maximize Revenues Leveraging Maximize Federal funding by taking advantage of Federal programs that provide matching funds contingent on State/local/private spending Refinancing Maximizing use of Federal entitlement funds to pay for services financed with State/local funds Administrative Claiming Making use of available child welfare and Medicaid administrative funds

43 Strategies to Optimize Efficiency Redeployment of Existing Resources Move funding from higher cost remedial services to lower cost prevention and early intervention Reinvestment Identify cost savings generated by effective programs and reinvesting those savings Redirection Identify the least effective programs and redirect resources to more effective programs with documented results

44 Primary Federal Funding Types Entitlement Programs Open-ended, uncapped appropriations to all individual who meet eligibility criteria (Medicaid, Title IV-E) Formula or Block Grants Capped appropriations to States or localities based on established formulas (SAPTBG) Discretionary Grants Capped appropriations for specific programs under competitive awards (PPW, Regional Partnership Grants) Direct Payments Capped appropriations to individual beneficiaries (SSI, Section 8)

45 Primary Federal Sources for Adults Substance Abuse Prevention & Treatment Block Grants - SAPTBG Temporary Assistance for Needy Families - TANF Medicaid Workforce Investment Act Community-Based Child Abuse Prevention Program Child Welfare Services IV-B, Subparts I & II Developmental Disabilities Basic Support and Advocacy Grants Community Mental Health Services Block Community Services Block Grant Maternal and Child Health Block Grant- Title V Social Services Block Grant Community Prevention Incentive Grants Title V Family Violence Prevention and Services Housing Opportunities for Persons with AIDS HIV Care formula Grants Project for Assistance in Transition from Homelessness Residential Substance Abuse Treatment for State Prisoners

46 Primary Federal Sources for Children and Youth Substance Abuse Prevention & Treatment Block Grants - SAPTBG Temporary Assistance for Needy Families - TANF Community-Based Child Abuse Prevention Program Child Abuse and Neglect State Grants Child Welfare Services IV-B, Subparts I & II Promoting Safe and Stable Families IV-B, subpart 2 Child Care and Development Fund/child care and Developmental Block Grant Medicaid/Early and Periodic screening, diagnostic, and Treatment Program State children s Health Insurance Program (SCHIP) Individuals with Disabilities Education Improvement Act (IDEA) Developmental Disabilities Basic Support and Advocacy Grants Community Mental Health Services Block Community Services Block Grant Maternal and Child Health Block Grant- Title V Social Services Block Grant Chafee Foster Care independence Program Juvenile Accountability Incentive Block Grants Community Prevention Incentive Grants Title V Family Violence Prevention and Services HIV Care formula Grants

47 Details for Each Funding Source Responsible Federal Agency General Description/Overview Type of Funding How Funds are Managed Eligible Populations Use of Funds How Substance Abuse Treatment Providers can Leverage These Funds Important Restrictions Special Notes

48 Guiding Principles and Specific Steps Ensure family s needs drive the funding search Map and track funding streams Develop collaborative relationships at all levels Ensure funding is diversified Customize the approach and prioritize targets Promote the connections between funding and outcomes Work to change the rules and the priority given to substance abuse treatment funding

49 Follow-up Contact Information Sharon Amatetti, MPH, Senior Public Health Analyst, SAMHSA/CSAT, Funding Paper on the CSAT TIE Forum: NCSACW: ACYF: