Overview of Systems of Care

Susan Steckel, MSSWEarly Connections Network Director

Tennessee Department of Mental Health

Tennessee Prevention Advisory Council Meeting, January 25, 2011

HISTORY of SYSTEMS of CARE…The Systems of Care framework grew out of the work of

the Child and Adolescent Service System Program (CASSP) in the field of children’s mental health.

CASSP emerged in the mid 1980’s as a result of national recognition that the needs of youth with serious emotional disabilities were not being adequately met.

In 1986, Stroul and Freidman proposed a system of care philosophy as a solution to these systemic problems.

This framework is based on a set of guiding values and principles that establishes a foundation upon which to

build systems of care.

Core Values and Principles

• Family-driven, child-centered and youth-guided

• Culturally and linguistically competent• Individualized and Community-based• Evidence Based Practice• Interagency collaboration• Continuous Quality Improvement (CQI)

A SYSTEM of CARE Is…

• Education• Families• Child welfare • Mental health and substance

abuse professionals

• Early childcare providers• Primary health care• Faith-based organizations• Other community

organizations and governmental agencies

A community partnership among families, youth, schools, and public and private organizations. Partners may represent:

Characteristics of Systems of Care as Systems Reform Initiatives

FROM

Fragmented service delivery

Categorical programs/funding

Limited services

Reactive, crisis-oriented

Focus on “deep end,” restrictive

Children out-of-home

Centralized authority

Creation of “dependency”

TO

Coordinated service delivery

Blended resources

Comprehensive service array

Focus on prevention/early intervention

Least restrictive settings

Children within families

Community-based ownership

Creation of “self-help”

Pires, S. (2002). Building systems of care: A primer. Washington, D.C.: Human Service Collaborative.

• Planning

• Decision Making & Oversight at the Policy Level

• System Management

• Benefit Design/Service Array

• Evidence-Based Practice

• Outreach and Referral

• System Entry/Access

• Screening, Assessment & Evaluation

• Decision Making & Oversight at the Service Delivery Level– Care Planning– Care Authorization– Care Monitoring and Review

• Care Management or Care Coordination

• Crisis Management at the Service Delivery & Systems

Levels

• Utilization Management

• Family Involvement, Support & Development at all Levels

• Youth Involvement, Support & Development

• Staffing Structure

• Staff Involvement, Support & Development

• Orientation and Training of Key Stakeholders

• External and Internal Communication

• Provider Network

• Protecting Privacy

• Ensuring Rights

• Transportation

• Financing

• Purchasing/Contracting

• Provider Payment Rates

• Revenue Generation and Reinvestment

• Billing and Claims Processing

• Information Management

• Quality Improvement

• Evaluation

• System Exit

• Technical Assistance and Consultation

• Cultural Competence

Pires, S. (2002).Building Systems of Care: A Primer. Washington, D.C.: Human Service Collaborative.

Potential System of Care Functions

What is the EARLY CONNECTIONS NETWORK?

A six-year federally funded early childhood System of Care initiative in Middle Tennessee to serve young children birth-5 years with social, emotional, and behavioral needs in Cheatham, Dickson, Montgomery, Robertson and Sumner Counties.

What is the EARLY CONNECTIONS NETWORK?

The ECN will be administered by the Tennessee Department of Mental Health and operated locally through a broad based public-private partnership of the Division of Special Populations, Tennessee Voices for Children, Centerstone of Tennessee, Centerstone Research Institute, families, and local and regional stakeholders.